A doctor who lives with a religious cult in northern NSW is to be examined by health authorities after he failed to report that his mother had died and was buried on the sect's private grounds while she was on holiday from the US.
In March 2010, Irene Maendel collapsed of a suspected stroke while staying with her son Chris Maendel, who is a senior figure and the resident doctor of a restrictive Christian-based religious order called the Bruderhof.
The Amish-style community of 170 people live on a compound called Danthonia, 25 kilometres east of Inverell. Instead of contacting the outside world for help or transporting Irene to a hospital for appropriate treatment, she was kept within the community, prayed for around the clock and given repeated doses of morphine. She died six days later. Dr Maendel then completed her death certificate and she was buried on the compound. Neither the police nor the coroner were informed.
When conflicting and alarming reports filtered back to Irene's US-based family, it contacted the NSW Police which launched an investigation. At a subsequent inquest into her death in October 2011, coroner Michael Holmes refused to be drawn on evidence that suggested Irene's demise had been turned into a "church event".
He labelled it "unfortunate" that her death was not reported and that, by treating an immediate family member and signing her death certificate, Dr Maendel had breached NSW Medical Board policy.
An "inter-cranial haemorrhage with hypertension" was listed as the official cause of death.
Concerned that the religious group's collective "connection with Jesus" had been placed before Irene's "basic right to the best treatment a modern medical system can offer".
A Fairfax Media investigation can now reveal that, after a separate probe, the Health Care Complaints Commission is bringing Dr Maendel before a medical tribunal on March 4, alleging he is guilty of unsatisfactory professional conduct and/or professional misconduct under the Health Practitioner Regulation Law.
Irene's daughter-in-law Nicole said she hoped to receive "honest answers" about the unexpected death of a "wonderful woman my husband called mother... and our three sons called grandmother".
In her submission tendered as evidence in the coronial inquest, Nicole noted that Irene's "situation" had occurred shortly before Palm Sunday and that the tenor and language used by some present drew direct comparisons to both Jesus and his death on the cross.
"Rather than Irene being taken in for emergency care and an appropriate, dignified and definable diagnosis, she was uplifted in an almost sacrificial way towards the cause of the community as they approached Easter," she said.
Irene and her husband, Jake, were US citizens who raised 10 children in a Bruderhof community. They were eight months into a year-long stay with Dr Maendel who, since arriving in Australia in 2005, had served as Danthonia's licensed medical practitioner. He also serves non-Bruderhof residents from Inverell and Glen Innes in an outpatients clinic.
But on March 1, 2010, he was confronted with a crisis when his mother collapsed in a toilet cubicle.
A series of documents, submitted as part of the evidence at the later coronial inquest, raised questions about whether Irene was denied treatment that could have saved her life.
In a report of death tendered to the State Coroner in October 2011, Detective Senior Constable Dave Ryan confirmed no ambulance or help from the outside world was sought.
He also said that, when Nicole asked Dr Maendel why she had not yet received a CT scan and expert diagnosis, he allegedly replied that Danthonia was located "deep in the Australian outback" and the journey to a "small country hospital" would be hours "over rough terrain". According to the statement, Dr Maendel reasoned that she would be better cared for by the brothers and sisters, "surrounded by the love of Jesus".
When Irene's US-based family looked up Danthonia on the internet, it was alarmed to discover that the compound was, in fact, less than 30 minutes' drive to Inverell Hospital and just off the Gwydir Highway, a two-lane sealed road.
The family was further shocked when, after Irene's death, a handwritten letter arrived providing a detailed, first-hand account of her final six days at Danthonia.
The correspondence was sent by a young Bruderhof sister called Dorrie Rhodes, who cared for Irene during her final week.
"It is just so hard to put into words what we were allowed to experience together. But I feel I must try... there was such a holy atmosphere surrounding Irene... I am sure there were angels standing unseen around her bed at all times," Ms Rhodes wrote. She described Irene as awake, alert and full of life in the days before her death. Senior Detective Ryan noted in his report to the coroner that it was "unclear if the deceased was ever informed of her condition or consulted as to her treatment".
Ms Rhodes wrote: "I was so touched how several times when I entered the room or came over to her, she waved at me and smiled... it was also very hard to witness her puzzlement over why she was in bed and what had happened. She asked several times, 'What happened to me?' or, 'Am I sick?' She wanted to get up to take a shower. I didn't know what to say to her... we were at a loss at what to tell Irene about her situation. It was just so new for all of us."
The letter went onto state that, after Irene's death, members kept watch over her body for four days. "To see her lying there was so unbelievable... I feel this experience was a gift from God to Danthonia to melt our hearts of stone."
Senior Detective Ryan said it would appear "to a non-medical person" that the correct diagnostic procedure for brain bleeds was either CT or MRI scans, adding none of these methods were used.
After seeking legal advice, Dr Maendel declined to be interviewed by police. But based on Senior Detective Ryan's investigation and evidence, an exhumation order was issued with toxicology results confirming the presence of morphine in Irene's body.
When the coronial inquest was set down for four days in 2010, it seemed likely a spotlight would shine on the Bruderhof, its policies and practices which, in Irene's medical case, at least, seemed at loggerheads with those adopted in the outside world.
But Mr Holmes steered clear of the religious aspects surrounding the case. He also declined to make any recommendations due to the HCCC investigation that was running parallel to the hearing.
The court, however, did receive advice from medical experts, including Margaret Ellen Gibbons, who believed Irene would have had a 50 to 60 per cent chance of a full recovery had she seen a specialist neurologist.
Irene's son James said: "My mom was a vibrant 70-year-old who loved life. I believe she would have wanted everything possible done to save her life, including being airlifted to one of several cutting-edge teaching hospitals within an hour from her location."
Her Michigan-based family members said they would make no comment until after they had given evidence to the HCCC. Dr Maendel could not be reached. His lawyer said he had moved to New York but would return for the tribunal.
The timeline
March 2010 US tourist Irene Maendel collapses of a suspected stroke while visiting her son who lives with the Bruderhof in northern NSW. The son, Christopher Maendel, the commune’s doctor, decides not to take Irene to nearby Inverell, where specialist hospital care was available. Six days later she dies.
June 2010 NSW Police investigate after a complaint is received from family members in the US.
July 2010 The Health Care Complaints Commission receives a complaint about Dr Maendel, alleging breaches of professional conduct.
May 2011 An exhumation and post-mortem show morphine was administered to Ms Maendel.
March 4, 2013 An HCCC tribunal will begin in Sydney, focusing on Dr Maendel’s alleged misconduct.
The Bruderhof at a glance
The Bruderhof formed in Germany after World War I, when Dr Eberhard Arnold created a community in which love and justice replaced violence, isolation and greed. Beyond a few minor possessions, members have no assets. They receive no pay. Income is pooled for the care of all.
In 1937, Nazi persecution forced the Bruderhof to flee Germany and establish a new base in rural England. Today they have communities in the US, Britain, Germany, South America and Australia.
Founded in 1999, Danthonia is a Bruderhof community near the NSW town of Inverell. The commune now has 170 members who survive through livestock rearing, sign-making and gardening
