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Recorder of Chester Judge Elgin Edwards ruled that Slav Mitev, 50, was unfit to plead due to his mental state.
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Some victims of the McDermott brothers have expressed disappointment that James and Owen Roe were deemed unfit to plead in 2010 for mental health reasons.
BBC: Donagh child abuse: McDermotts 'may have further victims'
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But Dr Jan Vermeulen, one of the medical experts appointed by Mr McKinnon's advisers, asserted for the first time that he was unfit to plead and stand trial.
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But because Owen Roe and James McDermott had been deemed unfit to plead, under the terms of the Mental Health (NI) Order 1986, they could not be sent to prison.
BBC: Northern Ireland
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But the survivors and many others living in the Donagh area were angry that two of the brothers, Owen Roe and James McDermott, escaped being sent to prison because they were found unfit to plead.
BBC: Northern Ireland
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Two other brothers, James and Owen Roe McDermott, were deemed unfit to plead in 2010 and returned to their home in the village, living in the same community as some of their victims and their families.
BBC: Donagh child abuse: McDermotts 'may have further victims'