The Application of Article 359 of the Criminal Code in the Investigation of the Death of Post-Operative Patients (Juridical Analysis: Case of the Death of Three Patients in the MHP Hospital, Lampung)

The incident of the death of three post-operative patients in a line at the MHP hospital, Lampung on April 5, 2016 had emerged the decline of public confidence toward hospitals, both public and private hospitals. The symptoms in the patients' body before they died were convulsed and decreased consciousness. Based on dr. AA, Sp.An., if post-operative impact occurs, then a person who takes responsibility is an anesthesiologist. This means that responsible for the death of these patients was the doctor who performed anesthesia before the operation. All three patients, who died after operation in MHP Hospital, respectively, were Mr. RM suffered from varicose; Mr. S the patient with a tumor in the left leg calf; and Mrs. DP who performed a caesarean section. These patients underwent a convulsion and decreased consciousness after operation, although the anesthesiologist had tried to save their life. Yet, these patients died. During the operation, the doctor had operated with the use of Standard Operating Procedures. Based on the information from the Chairman of IDI and the Chairman of MKEK, they said that dr. EP, Sp. An. As the anesthesiologist had done the right procedures in doing anesthetic injection to these patients. During the investigation process conducted by the Regional Police of Lampung, toward dr. EP, Sp. An., he was presupposed in violation of Article 359 of the KUHP which stated "whoever due to his negligence has caused another person's death, will be sentenced with a maximum imprisonment of five years." In a juridical study over Article 359 of the Criminal Code committed by the writer in the cases described above, it can be concluded that the element of "negligence" as the main requirements of this article “is not fulfilled”. Thus, this article applied in this case does not meet the main requirement of criminal elements which is presupposed, and the investigation process is terminated.


INTRODUCTION
On April 5, 2016, medical world in Indonesia was shocked by the death cases of three patients in surgery performed in MHP Hospital, Lampung. All three patients were RM suffered from varicose; Mr. S patients with a tumor in the left leg calf; and Mrs. DP who did the operation sesco ciceasria. These malpractice cases, [ 143 ] carried out by a team of doctors who conducted the operation at MHP Hospital, had spread widely, because there was a short message using Whatsapp: ³7HPSRUDULO\ JHQHULF EXSLYDFDLQH spinal from Bernofarm brand should not be used, because there was a case in Pringsewu that three patients died convulsively after spinal yesterday, this case would be followed to the IDI-DINKES (Indonesian Doctors Association -Public Health Department) Lampung and PERDATIN Center (Specialist Doctors Association of Anesthesiology and Intensive 7KHUDS\ ,QGRQHVLD ´ The death case of three postoperative patients in a line at MHP Hospital, Lampung had emerged in the decline of public confidence toward hospitals, both public and private hospitals. The V\PSWRPV LQ WKH SDWLHQWV ¶ ERG\ EHIRUH they died were convulsed and decreased consciousness. Based on dr. AA, Sp.An (an anesthesiologist), if post-operative impact occurs, then a person who takes responsibility is an anesthesiologist. This means that responsible for the death of these patients was the doctor who performed anesthesia before the operation. Related to this case, the person who was responsible in surgery was dr. EP, Sp.An. as the anesthesiologist.
Third, the chronology of Mrs. '3 ¶V death was on Monday, April 4, 2016 at 17:00. The preparations of Mrs. '3 ¶V operation for caesarean section was in a good condition and healthy. To prepare for caesarean section, the patient was given anti-biotic of cepotaxim and gentamicin drugs which had function to prevent infection due to the surgical wound. At 22.00, dr. UMB, Sp.OG met dr. EP, Sp.An as an anesthesiologist in OK room and he saw that the patient was ready for operation. Then, anesthesia injection was administered by dr. EP. At 22:15, with the permission from anesthesiologist, dr UMB performed caesarean section and [ 145 ] success to deliver the baby. The operation was held approximately an hour and after that the patient's condition was good and normal. Yet, this condition did not last long LW VKRXOG EH WREH ³ZDV´ , before being taken to inpatient room (still in OK room), the patient had convulsions. At 23:40, the patient was transferred from OK room to ICU room with convulsions, then at 23:42, operations officer handed WKH SDWLHQW WR ,&8 ¶V RIILFHUV $W WKDW WLPH WKH SDWLHQW ¶V FRQGLWLRQ LQ a state of halfcoma, convulsions constantly and equipped with ETT (Endotracheal Tube) WR WKH SDWLHQW ¶V PRXWK (re-read and make sure the sentence). At 23:50, the anesthesiologist provide (it should be V2) infusion therapy of NaCl 500 drip propofol 1 amp, tramus 1 amp bolus intravenous, infusion with NaCl 500 ml drip efedri 2 amps with the installation of a new infusion (all drugs obtained from MHP Hospital). At 24.30, the BP of patient decreased up to 40 times per minute, subsequent the patient was given two lanes infusion to the patient with 500ml NaCl and efedri 2 amps. On Tuesday, April 5, 2016 DW WKH SDWLHQW ¶V FRQGLWLRQ ZDV JHtting worse and cardiac arrest, then dr. T gave an instruction to do CPR (Cardiac Pulmonary Resuscitation) +30 minutes with negative response, then dr. T instructed to perform ECG (Electrocardio-JUDP EXW WKH SDWLHQW ¶V IDPLO\ UHIXVHG and requested that doctor continued to perform defibrillation, but it was not performed by dr. T. Although the patient experienced cardiac arrest and had also performed CPR movement, but the family requested that performed CPR again. At 1:45, there was a response from the patient with pulse ±70, but at 02:00, the pa-WLHQW ¶V FRQGLWLRQ ZDV GURSSHG WKHQ &35 was performed again with 5 cycles. Yet, at 2:10, dr. T stated that the patient, DP, had died.
In the investigation process of the reported, dr. EP, Sp.An was presupposed by Article 359 of the Criminal Code which stated: "Whoever due to his negligence has caused another person's death, will be sentenced with a maximum imprisonment of five years." To explore the facts on the fields which will be used as evidence on alleged criminal acts committed by the reported, then the writer will conduct a normative juridical study toward Article 359 of the Criminal Code that has been applied in this case to prove whether this Article can be appliedor not related to the death of three post-operative patients in MHP Hospital, Lampung.
In addition to the reason above, this juridical analysis also will contribute to the reported in terms of legal certainty on the presupposition toward Article 359 of the Criminal Code in the investigation of the death of three post-operative patients MHP Hospital, three patients were named; RM suffered from varicocele; S patients with tumor in the left leg calf; and DP who performed caesarean section. Theoretically, the requirements of the punishment that must be met: a.) Formal requirement is the first step for investigators in determining the criminal laws based on the chronology of the event allegedly has been done by the reported, whether it meets the elements of crime contained in that Article or not; b.) Material requirement is the facts in the form of testimonies explored by investigator from some persons who have correlation [ 146 ] Sriwijaya Law Review " Vol. 1 Issue 2, July (2017) with the reported event, and some evidences which are founded by investigators in that event. Material requirement will be the justification on suspicion on an Article specified in formal requirement. If both of these conditions are fulfilled, then the investigators are declared as successful in making light of a case. Based on the facts described above, the writer deems that it necessary to conduct a juridical study in the investigation process which is performed by investigators by applying Article 359 of the Criminal Code on the actions of doctors that can cause a death in medical practice. This juridical study will be valuable information in medicine, and also for police investigators who conducts the investigation process of medical practice. The result of juridical study will be written in the form of International Journal entitled "The Application of Article 359 of The Criminal Code in The Investigation of The Death of Post-operative Patients (The Juridical Analysis: The Case of The Death of Three Patients at MHP Hospital, Lampung)."

METHODS
According to Bambang Waluyo 1 , research method is one of the ways that research should be conducted by the certain procedures, which can be seen from the procedures for data collection, data analysis, and writing research report.

Type of Study and Approaches
This article uses literature review supported by empirical data derived from the investigation results for malpractice case that occurred in MHP Hospital conducted by criminal Directorate of Special Regional Police of Lampung, by using two approaches, namely; normative juridical approach used to analyze the application of Article 359 of the Criminal Code toward the reported person, dr. EP, Sp.An., and empirical juridical approach used to explore the data fields in the investigation process conducted by Special Criminal Investigation Directorate (Ditreskrimsus) of the Regional Police of Lampung, related to the death case of three postoperative patients in MHP Hospital. These two approaches are expected to be able to answer the legal issue that have been identified by the writer related with the view of the pros and cons toward the application of Article 359 of the Criminal Code in the investigation process of malpractice case that occurred in MHP Hospital, Lampung.

Type of Data and Data Collection
The type of data presented in this study are primary data obtained from some informants, such as; police investigators, the Chairman of IDI Lampung, the Health Law Expert from University of Lampung (UNILA), the Chairman of PERDATIN Lampung and the Chairman of MKEK Lampung; while the secondary data will be obtained from documents, literature or reference books, and the judge's decisions that have been final and binding to explore and expose the facts of law to match the requirements of the Article 359 of the Criminal Code that are applied by police investigators in the investigation process. To explore the empirical data, this writer conducts interviews, observation, and dialogue with informants related to the stu- [ 147 ] died problem 2 . What is meant by the informants in this study are: Police investigators, medical experts from IDI, MKEK, PERDATIN, and health law expert from UNILA, who are considered to have the competence to analyze that the use of Article 359 of the Criminal Code can be applied or not in the death cases of three post-operative patients at MHP Hospital, Lampung.
The important essence of this juridical analysis is "the verification of the elements of Article 359 of the Criminal Code that are applied in the investigation process". There are two important things that will be in the analysis of the application of Article 359 of the Criminal Code, those are: first, if in the investigation process conducted by Ditreskrimsus, Regional Police of Lampung, investigators are success to meet the material requirements that will be the evidence in this malpractice case. Thus, the case status of the anesthesiologist, who is responsible for the death of three post-operative patients in MHP Hospital, can be upgraded to be the suspect and the investigation process can be proceeded to the Public Prosecutor; Second, if in the investigation process, the legal facts are ineligible to be used as evidence in this case, then, the investigation process in MHP Hospital "must be stopped (Letter of Suspension of Investigation or SP3)".

Theoretical Framework
The theory used as a tool for analysis in WKLV DUWLFOH LV 0RHOMDQWR ¶V YLHZ DERXW WKH error theory", he states that there are two error theories in the theory of Criminal Law in Indonesia, first, Deliberateness (opzet); second, Negligence (culva). The theory which will be used to analyze the deed of reported person related to the application of Article 359 of the Criminal Code is the Culva theory that states Culva in the science of law has a technical meaning, that is a kind of mistake of the offender which is not as heavy as in the deliberate act, such as less cautious, so an unintentional result happens. 3 Related to administration of the investigation process, the writer refers to a theory from Frank Remington who has introduced the Criminal Justice System as a judicial system that is known in Indonesia. This theory emphasizes on the quality of coordination, synchronization of criminal justice components, supervision, and restraint toward the use of power by the components from this justice system; the effectiveness of crime prevention system is more important than the effectiveness of settling disputes; the use of law as an instrument in order to strengthen the administration of justice 4 . Related to this theory, the writer will use Remington's view as the administrative guidelines in the investigation process. Only through the provision of written law administratively, justice can be applied.

The Case Investigation Process
To clearly expose the case of the death of three patients in MHP Hospital in order to find the suspect in this case, Sub Directo- (2017) rate IV Ditkrimsus of Regional Police of Lampung had conducted the investigation process and forceful efforts to call the witnesses involved in this case, then the results can be described as follows: The information from dr. Z, Sp.OG The informant is a doctor who has performed a caesarean section toward the victim, namely Mrs. DP. This section was performed in consideration of "there was an abnormal condition with fetus in Mrs. DP's womb or OBLIG (fetus's head was in oblique position over pelvis)," so it was needed medical action to perform caesarean section. He stated that the required conditions in performing a caesarean section was (should be were) the doctors who perform this action had (should be have) to have a midwifery competence. In the sequences of medical steps in the implementation of the operation were laundering operation area (laundering pests); putting fabric on operation area; incision (or dissection on operation area); making sure the position of the womb, then cutting the uterus to take the fetus; after that the fetus was treated as it should be; cutting the umbilical cord and it was given to pediatrician; gave birth to the placenta; suturing (sewing up) the surgical wound; ensuring that the womb was in a good condition, then close the abdominal wall by suturing. After the caesarean section completed, the patient was given xepotaxine and gentamicin drugs in accordance with the procedure in caesarean section. He also stated that the operation of Mrs. DP was performed by obstetrician which consisted of an operator (doctor), operation assistant, instrument assistant, while the anesthesia con-sisted of an anesthesiologist and an anesthesiologist assistant.

The information from dr. A, Sp.An
The informant is an anesthesiologist from PERDATIN of Lampung Province. He said that he knew about the incident of the death of three patients in MHP Hospital, Lampung from dr. EP, Sp.An via telephone on Tuesday, April 5, 2016 approximately at 07.00. Edi told him that three patient died after the operation of spinal anesthesia in MHP Hospital, Lampung. Dr

Information from dr. U, Sp.OG
The informant is anobstetrician in MHP Hospital, Lampung who handles the pa-WLHQW ¶V SUHJQDQF\ QDPHG Mrs. DP ¶V +LV patient routinely consulted with him for±2.5 years and succeed to get pregnant, then after approaching her childbirth, the condition of the fetus was oblig (baby oblique position) and it was difficult to be born normally. Thus, he suggested to the patient to do a caesarean section in childbirth which was scheduled on April 4, 2016. It was the last consultation which was given to the patient on March 24, 2016. On April 4, 2016 at 17:00, according to a set schedule by doctor, a nurse had informed that the patient, Mrs. DP, was ready to undergo a caesarean section and her condition was good and healthy, and was informed that a caesarean section would be held at 23.00. When he was in VK room, he received a report that the patient was ready for operation and had been given antibiotics of cepotaxim and gentamicin to prevent infection from the surgical wound. At 22.00, he went to OK room to meet an anesthesiologist, dr.EP, Sp.An, and he sawthat the patient was ready for surgery, then dr. EP performed anesthesia. At 22:15, he stated that the patient was performed surgery with a medical procedures that were: splitting the patient's stomach with transverse position, then splitting the uterus, subsequently giving birth to a baby and was lifted to be purged at resuscitation room, then he sew the incision wearing vicryl, chromic, and catgot yarns. This sewing took approximately ±1 hour, and during operation, he VDZ WKDW WKH SDWLHQW ¶V FRQGLWLRQ ZDV LQ D good condition and normal. He explained that when in the operation, there were some people in OK room at that time; himself, DP (patient), dr. EP, Sp.An, P (operation assistant), Genti and two other nurses (who were not known their name by the informant). Then, when the patient, Mrs. DP, underwent convulsion after surgery, he did not help anything, because the condition was not on his domain, but an anesthesiologist.

The Information from Mr. W
The informant is a duty nurse in ICU room of MHP Hospital in the examination by investigators. He got the information from OK room on April 4, 2016 at 23:30, that there was a patient who would enter to ICU room with convulsion after caesarean section and he was asked to prepare a respirator. At 23:40, he and his coworker, named T, fetched the patient in operation room with carrying gurney and oxygen tube. At 23:42, the operating officers handed the patient in half coma condition, convulsions continuously, and equipped with ETT (Endotracheal Tube) and he took to ICU room to get handling and further treatment. At 23:50, he received instructions from anesthesiologist to give injection of infusion therapy with NaCl 500ml drip propofol 1amp, tramus with 1 amp bolus intravenous, infusion with NaCl 500ml drip efedri 2amps with the installation of a new infusion. At 24.30, BP of patient decreased up to 40 times per minute, then dr. EP, Sp.An gave an instruction to provide two lanes infusion to the patient with fluid therapy of NaCl 500ml and efedri 2 amps. On April DW WKH SDWLHQW ¶V FRQGLWLRQ was getting worse and cardiac arrest, then dr. T gave an instruction to the informant [ 150 ] Sriwijaya Law Review " Vol. 1 Issue 2, July (2017) to do CPR around 30 minutes with negative response, then CPR was performed again with 5cycles. Yet, at 2:10, dr. T stated that the patient, Mrs. DP, had died.

The information from PM
The information is a duty nurse in operation room of MHP, Lampung, when he entered operation room to see the patient, RM, the patient had been given anesthesia by dr. EP 6S $Q 7KH SDWLHQW ¶V FRQGition was still normal and could talk to, and he gave an information to dr. G, Sp.B that the patient was ready for operation. P VDZ WKH SDWLHQW ¶V FRQGLWLRQ DIWHU RSHUDWLRQ was in convulsions, and then given help by dr. EP, Sp.An by installing the hose, taking injection, and other tools, and dr.A helped dr. EP to pump oxygen and to prepare the hose.

The Information from KSG
The informant is a duty nurse who served as nurse practitioner in ICU room of MHP Hospital, Lampung. He explained that he had received an information from OK room to pick up the patient, RM, in the operation room to do the handling and treatment, because the patient was in unconscious condition, the patient was in convulsions after varicocele surgery. At 18:30, he was together with Mr. I, dr. A, and dr. EP, Sp.An as the anesthesiologist to transfer the patient, RM, from operation room to ICU room. At 19:00, dr. EP, Sp.An received a telephone from OK room, then dr. Edi told him to pick up another patient, S, in OK room, and then he prepared the bed for the patient, oxygen, bagging, and then at 19:30, he was helped with OK room's functionary to transfer the patient to ICU room and ac-FRPSDQLHG E\ WKH SDWLHQW ¶V IDPLO\ 7KH equipment had been already installed in the patient's body. The patient was in convulsions condition after surgical tumor removal on the patient's left leg calf.
At 24.45, dr.EP, Sp.An gave a prescription for RM, then the informant took injection drug (tiophental 1 vial) in pharmacy room, and was given it to dr. EP, Sp.An in ICU room. Both patients were still in convulsions. Then, K, his coworker, and the reported one, dr. EP, Sp.An, still monitored both patients until 21.00, then, K took over shift. The next day, he received information from the hospital that both patients whom he left (due to over shift) in a state of unconsciousness and convulsions in ICU room, then they died.
Under the provisions of Article 359 of the Criminal Code, which was written by R. Soesilo, said that "Whoever due to his/her mistake caused someone's death, sentenced to a maximum imprisonment of five years or a maximum confinement of one year" (Susilo, 1991:248). The elements contained in this article are as follows:

The Element of Whoever:
This element is "fulfilled", because there is one who will be held accountable in the death case of three post-operative patients in MHP, Lampung, namely dr. Edi Pramiono, Sp.An. (an anesthesiologist).

The element for his mistake:
This element is "not fulfilled", based on the examination results of some witnesses, namely: the Health Law Expert, expert witnesses from IDI, PERDATIN, [ 151 ] and the testimonies of some doctors and investigators who conduct the interrogation toward dr.EP, Sp.An allegedly infringes Article 359 of the Criminal Code, it can be explained as follows: a. The definition of "wrong" in Article 359 of the Criminal Code according to R.Soesilo described in his book entitled Kitab Undang-Undang Hukum Pidana (KUHP), serta Komentar-Komentarnya Pasal demi Pasal is "inadvertent or negligent of the defendant (culpa offense)". In analogy of a driver who drives his car too fast, then bumping a person to death. The death of the person is not intended by the defendant. This analogy is in line with the actions of a doctor in the operation, who is trying to help the patient in or-GHU WR VXUYLYH DQG WKH SDWLHQW ¶V GHDWK LV not intended by a doctor. Yet, when WKH SDWLHQW ¶V GHDWK LV LQWHQGHG E\ WKH reported person, he can be subjected to murder Articles (Article 338 or 340 of the Criminal Code). In the explanation of Article 360 of the Criminal Code, further stated that which may be subjected to this Article for example; doctors, midwives, drug experts, driver, coachman gig, machinist, who as an expert in their job. If they ignore (neglect) the rules or imperatives in their work until they cause death (Article 359 of the Criminal Code) or serious injury (Article 360 of the Criminal Code), then they will be punished more severely 5 . In the theory of criminal law outlines that negligence, mis-take, carelessness, or omission are called as culpa. Wirjono Prodjodikoro in his book, Asas-Asas Hukum Pidana di Indonesia states that the meaning of culpa is "a general mistake", but in science, the law has a technical meaning thaW LV D NLQG RI WKH RIIHQGHU ¶V PLstake which is not as heavy as in a willful mistake that is less cautious, so an unintended incident happens 6 . Jan Remmelink in his book entitled Hukum Pidana states that in essence, culpa is less careful thinking, lack of knowledge, or act less directional. According to Jan Remmelink, culpa here obviously refers to a person's psychic ability, therefore it can be said that culpa means no or significantly less suspect (the first possibility emerges) toward the fatal consequence of the person's action, whereas it is easy to do, because it should be done7.
It is similar with Wirjono Prodjodikoro's argument that according to the Dutch writers, the meaning of culpa in Articles of the Criminal Code is a rather heavy mistake. The term which they use are a 'big mistake' (groveschuld). Although the measurement of this 'big mistake' is not yet assertive as same as deliberate, but in the term of groveschuld has owned the estimation that someone is not include as culpa if the offender does not need to be very careful to be free from punishment 8 .
%DVHG RQ 5 6RHVLOR ¶V H[SODQDWLRQ above, the main requirement in the appli- Sriwijaya Law Review " Vol. 1 Issue 2, July (2017) cation of Article 359 of the Criminal Code is "there is an unintentional mistake" in the form of "inadvertent or negligent act" that the consequence of "some-RQH ¶V GHDWK LV XQLQWHQGHG E\ WKH GHIHndant." The words of "an unintentional mistake and the consequence which is unintended by the defendant" become the keywords in Article 359 of the Criminal Code. If the act committed by the defendant is "the opposite of that keywords", then this act will be the crime act of murder as provided for in Article 338 or 340 of the Criminal Code.
b. The meaning of negligent in general meaning is an unintentional mistake, while in narrow meaning is a mistake in the form of negligence, a conditions in such a way that endangers the safety of persons or goods, or brings disadvantage against someone in such a large loss and irreparable, so the Law regulates the prohibition that makes people cautious, reckless or careless act or in short as schuld (negligence which causes that condition). Negligence in one hand completely opposites with deliberateness and on the other hand, with accident (toevel or caous). Negligence is milder mistake than deliberateness, but it is not light deliberateness. Based on this explanation, it can be concluded that the mistakes in theory of criminal law, there are two types, namely: first, deliberateness (dolus, opzet, vorsatz, intention); and second, negligence (culpa, onacht zaamheid, nelatigheid).

The Information from Investigators and Some Experts
To expose the criminal act in the phenomenon of the death of three patients in MHP, Lampung, the elements of Article 359 of the Criminal Code that are applied by investigators in this case need to be studied and analyzed juridically, to find the facts of the Law whether Article 359 of the Criminal Code can be applied or not in the case of the death of three postoperative patients in MHP Hospital, Lampung. It depends on the investigations result conducted by Ditreskrimsus, Regional Police of Lampung. The information from the medical experts and the health law experts and the judges' decisions that have been established as the jurisprudence in the application of Article 359 of the Criminal Code toward the case of medical practice, then its results are described as follows:

The Information from the Chairman of PERDATI Lampung
Based on the investigation result conducted by Police investigator toward dr. AA, Sp.An who currently serves as Chairman of Lampung PERDATIN, he said about the job description of anesthesiologist that "if there is an impact occurred after the operation, such as convulsion, pain, and a doctor still be in that place, then the one who must to take action is anesthesiologist; if this patient has been given anti-seizure injection and consulted to neurologist and the patient itself, then it does not need to be consulted to another doctor." In the interview with dr. AA, Sp.An (as the Chairman of PERDATIN Lampung) obtained information that he had reconstructed the chronology of operation performed toward three patients who died [ 153 ] after operation at MHP, Lampung and he had concluded that dr. EP, Sp.An as anesthesiologist, did not violate of the SOPs of operation toward these patients, who later died after operation. All procedures had been arranged in the SOPs of operation, and the steps had been done properly by dr. EP, Sp.An 9 .

The Information from the Health Law Expert
The information from Dr. MF, SH, M.H. as Health Law Expert, stated that "principally, when an anesthesiologist is performing medical actions, he must refer to Article 2 of the Minister of Health No.519/MEN KES/PER/III/2011, which contains the Guidelines for Implementation of Anesthesiology Services and Intensive Therapy at Hospital, which listed in that Article." Furthermore, in the Chapter IV, letter A, No. 2 on the services of the Intra-Anesthesia, the Minister of Health No. 519 /MENKES/PER/III/ 2011, mentioned that an anesthesiologist and the team should remain in the operation room during general and regional anesthesia actions, and procedures that need sedation action; b) During the injection of anesthesia, this should be continuous monitoring and evaluating toward oxygenation, ventilation, circulation, temperature, tissue perfusion and documented in the anesthesia notes; c) The last action of anesthesia must pay attention to oxygenation, ventilation, circulation, temperature, and tissue perfusion, all in a stable condition.
In the literature of Medical Law 10 "an anesthesiologist is not allowed to perform two operating tables at once, except in exceptional circumstances". This exception is like the jurisprudence of the Netherlands, which states that: Medische Tuchtcollege Amsterdam, June 18, 1979, which states that in general, it is unintended (ongewenst) that an anesthesiologist serves more than one operation at once, except in exceptionalcircumstances (zeer buitengewone omstandigheden).
The conclusion from Dr. MF, SH, M.H. as health law expert is "all actions of surgeon principally have met the procedures that have been implemented in the provisions of Article 35 paragraph (1) of the Law No. 29 of 2004 about Medical Practices that "doctors or dentists, who have had a letter of registration, have the authority to perform medical practice in accordance with the education and competencies, such as: to do an interview with patient (anamnesis), to examine physical and mental of patient, to determine the additional investigation, to do diagnosis, to determine the management and treatment for patients, to perform medical action or dentistry action" 11 .

The Information from Police Investigators
The interview result with Rohim as an investigator of Ditreskrimsus of Regional Police of Lampung, who handled the case of reported person, dr. EP, Sp.An, he stated that "the result of this case, which was attended by Health Law Expert, the Chairman of PERDATIN Lampung, the Chairman of IDI Lampung, and internal oversight functions of Regional Police of Lampung, namely: Itwasda, Propam, Intelkam, and Bidkum had recommended that the criminal investigation process of the death of three patients in MHP, Lam-SXQJ ŠDOOHJHGO\ ZDV GRQH E\ GU EP, Sp.An as anesthesiologist on suspicion of $UWLFOH RI WKH &ULPLQDO &RGHŠ GLG not meet the elements of Article that was presupposed", because the element of "negligent" contained in Article 359 of the Criminal Code "was not fulfilled" 12 .

Jurisprudence
In the application of Article 359 of the Criminal Code, there are some cases alike that have been judged by the District Court Judge, the High Court Judge, and the Supreme Court Judge on the Cassation level and judicial review (PK) toward some cases of medical practice that eventually always give acquittal verdict against the defendant with consideration of "non-fulfillment of negligence in Article 359 of the Criminal Code." These cases are: First, judicial review (PK) Decision No. 79.PK/PID/2013, which granted an appeal for PK from dr. DASP, dr. HS, and HS and annulled the decision of judex facti and this decision as same as the decision at the first instance court. Then, dr. DASP and her friends were given verdict by the Supreme Court Judge that they violated Article 359 of the Criminal 12 Interview with Aiptu Rohim (an investigators maid at Special Criminal Investigation Directorate (Ditreskrimsus) of Regional Police of Lampung), May27, 2016. Code. Due to this verdict, dr. DASP and friends purposed PK. In the next verdict, the judicial review judges finally granted an appeal from dr. DASP and friends. The composition of the panel of judges, who prosecuted dr. DASP and friends, consisted of MS (the chairman), SJ, MS, M, and MDP. Besides to acquit the defendant, the judges also ordered to vindi-FDWH WKH GHIHQGDQWV ¶ QDPH Second, the decision of High Court of Semarang No: 203/1981/Pid/PT. Semarang on May 19, 1982 that streng-WKHQHG WKH 'LVWULFW &RXUW ¶V GHFLVLRQ RI Pati No.8/1980/Pid.B/PN.PT on September 2, 1981 and simultaneously accepted WKH 3URVHFXWLRQ ¶V DSSHDO %DVHG RQ WKH science of criminal law, especially the theory of negligence, it could not elimi-QDWH WKH GHIHQGDQW ¶V PLVWDNH ,W ZDV EDVHG on the recognition of the defendant, the ZLWQHVVHV ¶ WHVWLPRQ\ the evidences, and it was viewed from the aspects of rela-WLRQVKLS DQG FRPSOLDQFH 7KH GHIHQGDQW ¶V mistake had been proved legally and convincingly by the Law, because his negligence caused others died. Then, in the decision of Cassation, the Supreme Court Judge "cancelled the High Court of Semarang on May 19, 1982No. 203 of 1981and No. 8/1980

CONCLUSION
Based on empirical facts obtained from the investigation process conducted by [ 155 ] Special Criminal Investigation Directorate (Ditreskrimsus) of Regional Police of Lampung and the testimonies from the medical experts and health law experts, the writer can conclude that: a. The application of Article 359 of the Criminal Code toward the impact of operation conducted by a doctor cannot be applied, throughout the operation that has been conducted using SOPs in accordance with Article 2 of The Minister of Health Regulation (Permenkes) No: 519/Menkes/Per/III/2011, which contains the Guidelines for Implementation of Anesthesiology Services and Intensive Therapy at the Hospital.
b. Juridically, the incident of death of three post-operative patients in MHP hospital, Lampung, leads to the Special Act (lex specialist), then the application of Article 359 of the Criminal Code in this case has violated the principle of "lex specialist derogat legi generalist".

RECOMMENDATION
In the provisions stipulated in the Law