The 1st of October is marked in the lives of two mothers, residents of Iguatu, a municipality located 440 kilometers from Fortaleza, in the South Center of Ceará. While Maria was admitted to the Regional Hospital of Iguatu (HRI), with her 14-year-old son Álvaro, Francisca cried the pain of losing little Gael, who was not yet four months old. Three days later, on October 4, Álvaro also died. The two believe they lost their children to medical negligence.
According to Francisca, Gael was born healthy, in a peaceful delivery, in June last year and everything was fine until August 16th, when the baby was admitted to the hospital for the first time, presenting with vomiting and colic. Francisca says that after clinical exams in the pediatrics, the doctor diagnosed Gael with reflux and lactose intolerance, prescribed the medication and indicated to the mother products that she could eat, because Gael only breastfed.
Francisca had a peaceful pregnancy waiting for her son Gael. / Personal archive
As the cramps persisted for ten days, Francisca asked for an appointment with the pediatrician at the Family Health Primary Care Unit and the same doctor who attended her at the Regional Hospital of Iguatu attended her at the medical center. There she was instructed to continue with the medication and to do an ultrasound on the child. The exam showed no changes and Francisca continued the medication for gases.
On September 18, Gael vomited three times and Francisca returned to the Regional Hospital in Iguatu. According to the doctor who treated the family, Gael was dehydrated and started taking saline solution, until shortly afterwards he was discharged with medication prescribed and stamped by another doctor who had not seen the child that day. The worried mother paid for a private consultation and discovered that Gael had Milk Protein Allergy (CMPA), a condition different from the one diagnosed at the HRI. The family started treatment in the hope that everything would end well, but on September 29, Gael started vomiting again, feeling tired, and they returned to the hospital.
“I arrived at the hospital with my cousin and Gael and after telling the doctor the history, he said that my baby had nothing. I asked him to listen to his lungs to find out why he was tired and he didn’t like it, he listened and repeated that he had nothing”, reports Francisca Silvino, Gael’s mother. She decided to wait for the same doctor who attended her first appointment and at the medical center. “I asked for a referral to the pediatrician and the first doctor even told me to pay for a consultation if I wanted something more detailed. There was a moment when he signaled for me to shut up”, denounces the mother.
Gael died at the Iguatu Regional Hospital on October 1st. The family believes in medical malpractice. / Personal archive
When the doctor arrived and was examining Gael, the child choked and had to go on oxygen because of low saturation (76%) and the doctor admitted Gael to perform some tests. That same night, the child developed a fever and became very agitated. The family reports that during nebulization, they noticed that the child was getting cold and with purple extremities. The nurses called the doctors and the child was taken away. We stayed there in the room not knowing where they took my son and we didn’t know what was actually happening. My sister insisted that the nurse tell the truth, tell her what was going on, and she said that the doctor would come by later to talk, says Francisca.
Later that night, the doctor spoke to the family and said that Gael’s health was serious. He had had two cardiorespiratory arrests and was intubated. The health professional said that he was trying to get a place in the system, but it was being denied, a situation that continued into the next morning. On the 30th, my husband and I went to social assistance to ask them to transfer Gael because his case was very serious and no hospital would send him back, but the request was denied by the social worker who was on duty that day, says Francisca.
The family got a place at the São Francisco de Assis Hospital and Maternity, in Crato, two hours from Iguatu. Gael was admitted shortly after 6 pm and his father was allowed to sleep in the hospital. Francisca returned home to rest and at five o’clock in the morning of October 1st, she received the news that she had feared so much. I just want to know what happened to my little angel. I don’t see any sense in anything anymore, I’m destroyed. What I want most from the bottom of my heart is to know what happened to my little angel and live my grief in peace.
Álvaro case
It is this same pain that takes over the life of Maria Lima, mother of Álvaro, a 14-year-old teenager. In March of last year, the family discovered that he had an air bubble in his left lung.After many consultations and examinations, he was referred to the specialist doctor, a thoracic surgeon, at the Hospital do Coração in Messejana. There were long months of treatment until the surgery took place on August 17th.
The family of 14-year-old Álvaro also believes that the teenager died as a result of medical negligence by the HRI. / Personal archive
The procedure was a success and Álvaro was monitored by the team until he was discharged to perform simple activities, maintaining day-to-day care. Everything seemed to have gone well until, on October 1st, Álvaro felt a strong pain in his stomach. I ran to the Regional Hospital of Iguatu and told the doctor who attended us. He said it had nothing to do with the surgery, he gave us the medication and sent us home, but he didn’t get well and we went back to the hospital, says Maria.
The medication was repeated by another health professional who assisted Álvaro at the doctor’s office, but the teenager’s pain did not go away. He prescribed a stronger medicine and we had to wait until the next day to do the x-ray, but in the morning he was still in the same pain, points out the teenager’s mother.
Maria says that, as the hospitalization took place on election day, they had to wait for the professional responsible for taking the x-ray to vote because there was no other employee to replace him. The exam was performed around 11 am and Álvaro also had a CT scan. While waiting for the results, Álvaro continued to feel severe pain and was unable to eat.
When the report arrived, at the end of the afternoon, the doctor gave the diagnosis: diaphragmatic hernia. The doctor said that his stomach had occupied the same space as the operated lung. That he was going to pass a tube in aspiration to see if the stomach returned to its place, if not, it was a case of surgery. I asked if the surgery was done there and he said yes, says Maria.
Also according to Álvaro’s mother, the probe was placed at the beginning of the night and the procedure was very painful for the teenager. Álvaro had a fever and red spots on his body, with persistent hiccups. My son was throwing up dark liquid all the time. The doctor saw that the probe was not working and still left the room.
Álvaro’s family and friends demonstrate against the HRI administration. / Personal archive
The night was one of terror for Maria, who saw her son writhing in pain and the medication having no effect. Desperate, she kept going to get the attention of health professionals, until Álvaro got too tired. The doctor came to me and said that although the hospital did not have support for the surgery, he was going to operate on the hernia because his condition was extremely serious and he would not be able to handle the transfer. But he was supposed to be transferred as soon as we arrived. The doctor at Hospital do Coração said that we should send him there at vacancy zero, that I shouldn’t wait. I tried this transfer, but they operated on my son and killed him.
Justice
Maria and Francisca united in pain and found other families who also denounce the Regional Hospital of Iguatu for lack of supplies and health professionals. Another mother, who declined to be identified, also believes her son was killed by negligence at the hospital. Together, they are creating an association as a way of putting pressure on the government about the situation at the hospital, which has dragged on for years. Between January and March 2017, ten babies died at the HRI.
Francisca went to the Public Ministry of Ceará (MPCE) and denounced the lack of pediatricians in the hospital. Last week she was heard by the 2nd Public Prosecutor’s Office of Iguatu. She also filed a police report at the city police station and requested an investigation by the MPCE to find out the causes of Gael’s death. In a note, the Public Prosecutor’s Office, through the 8th Public Prosecutor’s Office of Iguatu, informed that it is following the case and requested that the Regional Police Station of Iguatu initiate a Police Inquiry. Now, the MPCE awaits the outcome of the investigations to later formally comment on the case.
Families are creating an Association to strengthen the search for justice. / Personal archive
Still on Gael’s case, the Civil Police also manifested itself. He said he served a search and seizure warrant with the aim of elucidating the circumstances of the baby’s death. The Iguatu Regional Police Station, which investigates the case, seized documents referring to the understanding and medical interventions carried out and which continues to carry out diligences and hearings in order to elucidate the case.
Political instability
State deputy Renato Roseno, president of the Human Rights Commission of the Legislative Assembly, was in Iguatu and spoke with the families about the various complaints related to the hospital.In an interview with Brasil de Fato, the parliamentarian said that the mandate is following the case and that he spoke with the health secretary of Iguatu, Marleuda Gonçalves. To the parliamentarian, she said that the Regional Hospital of Iguatu was undergoing an internal audit. We also contacted the Public Prosecutor’s Office to follow up on this case because there are many reports of poor management at the hospital and it must be remembered that the municipality of Iguatu is experiencing instability in public management, with three mayors in the last three years and this is affecting public policies , stressed the deputy.
