Accepting a hospital change to avoid waiting lists had tragic consequences for Margarita Espallardo. This woman of 52 years, Neighbor of Cartagena (Murcia), married, mother of two children and employed as a cleaner, has been in a vegetative state for almost a decade because of the brain damage suffered in a surgical procedure. The origin of the lesions were the complications arising from being intubated, which left her almost without oxygen for more than 15 minutes.
A sentence now responsible for what happened to the two anesthetists who attended her at the Hospital de Molina de Segura, a mixed center of public ownership and private management to which Espallardo had been diverted to advance her entrance in the operating room. The specialists ignored the warning of the preoperative report, which indicated that Espallardo had already suffered problems with intubation in a previous surgery. The ruling grants the woman and her family a compensation of 1.62 million euros (between principal and interest) after the legal support received from the Association of Victims of Medical Negligence (Avinesa) with the lawyer Rafael Martín Bueno.
"It was the doctor who treated her in the Santa María del Rosell Hospital the one that proposed the change, "recalls José Andrés Torres, brother-in-law of Espallardo. "He told her that she would be operated long before. Margarita was not feeling well and had been waiting for more than four months, so she accepted. We have regretted it every day, especially the children, who were left without a mother with only 10 and 12 years, "he adds.
The doctors of the Santa María del Rosell had found some nodules -which finally turned out to be benign- in the thyroid gland of Espallardo and in January 2010 they indicated its extirpation, according to the medical reports consulted. After being referred, the woman was visited by the anesthesiology service, in whose report there are "anesthetic complications: intubation difficulty". The informed consent includes a similar message: "possible difficult intubation-emergency tracheotomy".
Martín Bueno explains that "the danger in these cases is that, after anesthesia, doctors can not intubate the patient, because he is no longer able to breathe on his own." "Therefore, medicine provides several alternative precautionary measures, none of which were adopted in this case," adds the lawyer.
The clinical history shows that at 5:45 pm on April 26, when he entered the operating room, Espallardo, he had normal blood oxygen saturation (98%). At 5:50 pm, the anesthetists slept her, after which they tried unsuccessfully to intubate her repeatedly for an agonizing 25 minutes. At 18.05, the saturation had subsided to 70% (below 90% the organism no longer receives all the oxygen it needs). And at 18.15, up to 50%.
The anesthetists were able to normalize moments later the oxygenation with a tracheotomy, a perforation in the front part of the neck by which the air is brought to the lungs. Finally, at 18.30 thyroid was removed.
Espallardo was transferred the next day, even sedated, to the ICU of her home hospital, the Santa María de Rosell. When the drugs were removed, the doctors saw him open his eyes, but "without looking or responding to external stimuli." Since then, the woman has not recovered any of her vital functions and lives prostrate in a bed of a residence in Cartagena.
The management of waiting lists and referrals to reduce them has been a recurring theme in the Region of Murcia in recent years. A debate that intensified last March with the death of a 29-year-old man operated on in a private clinic for a cyst on his foot.
"It is necessary to strengthen the teams in public hospitals," explains the health spokesperson for the PSOE in the regional Assembly, Consuelo Cano. "The goal is to achieve 75% occupancy of the operating rooms. The PP government has made promises to reach even 80%, but the truth is that many hospitals do not even reach 60%, "he laments. For María Ángeles García spokesperson for Podemos, "the big problem in the management of waiting lists in Murcia is opacity: there is no single public record". "The derivations still have a lot of discretion. You do not know when you are going to operate or the alternatives you have. It all depends on the medical equipment you have and what you want to do. Thus, the patient loses all the autonomy to make a decision ", denounces García.
The Ministry of Health defends that "only the least complex procedures are derived, always according to medical criteria". "74% of the interventions are made in public hospitals, 17% in private but by public doctors and only 9% is done in private clinics with their staff," adds Sanidad, who declines to report on the case of Espallardo "Judicialized". The Hospital de Molina, for its part, has limited itself to specifying that "the claim was filed against the anesthetists, not against the hospital." The insurer of the doctors, who has appealed the sentence, has not wanted to talk to this newspaper.
The Hospital de Molina is a center unparalleled in the Murciano Health Service. Unlike the large hospitals in the region (entirely public) and the concerted clinics (private), the one in Molina is integrated into the public network for all purposes. It is municipal property, although its management is in the hands of the private company Terapias Médicas Domiciliarias, S.L. According to a spokesperson, 75% of the activity is public and the rest private.