When the baby Rodrigo was born in the Hospital of São Bernardo de Setúbal (Portugal) on October 7, doctors predicted that he would die within a few hours. The creature had no eyes or nose, and part of the skull was missing . With such malformations, one could hardly expect his brief stay in this world to be as painful as possible.
Against all odds, however, two weeks after his birth, the little one resists . His mother, Marlene Simão, refuses to leave his side and spends hours encouraging him to keep fighting. Maternal affection seems to have given the baby the strength to defy death and exceed all expectations of doctors; According to family sources, the child no longer requires assisted breathing, and this weekend he removed the tube that had provided him with nutrients because he is already able to feed through the bottle .
Stabilized the child's life, the focus is now on the conditions that made it possible for Rodrigo to be born with such malformations, and the apparent medical negligence committed by Artur Carvalho, the obstetrician who attended to the baby's family. Over the past nine months, the child's parents performed various routine tests at the private Ecosado clinic, where Carvalho was in charge of pregnancy control. The doctor performed three ultrasound exams during that period, and after each one he affirmed that everything was developing with absolute normality .
Upon learning that another private clinic in Setúbal offered 5-D ultrasound -a type of ultrasound that allows three-dimensional images to be captured-, Rodrigo's mother chose to have one, wishing she had a better portrait of her future baby. His confusion was absolute when the technician who performed the ultrasound informed him that the fetus seemed to suffer a serious malformation .
Alarmed, the woman went to Carvalho, but the obstetrician told her there was no reason to worry because the 5-D ultrasound was not reliable. The doctor assured him that there was no problem with the pregnancy, and that in a short time he would have a perfectly healthy son in his arms.
Four investigations of the Portuguese Prosecutor
Carvalho's claims are now at the center of an investigation by the Portuguese Prosecutor's Office, which got involved in the case after receiving the formal complaint filed by the baby's family shortly after birth. Although the obstetrician evidently did not cause, nor could have avoided, Rodrigo's malformations, the apparently failed interpretation he made of the ultrasound he performed was not justified.
It is not the first time that Carvalho has been investigated by the Portuguese Prosecutor's Office: at least four proceedings against him have been initiated in the past, although all have ended up being filed. In 2011 a formal complaint was filed against him for a very similar case, in which a mother whose pregnancy had been followed by the obstetrician gave birth to a girl without a chin, with her legs inverted, her toes fused and severe brain injuries And as happened with the baby Rodrigo, throughout the pregnancy the mother of the creature was attended by the doctor, who performed all the routine exams and at no time indicated that the fetus was developing abnormally. At the request of the mother, the Public Ministry opened a process, but it was filed when the Institute of Legal Medicine concluded that the anomalies were difficult to detect through routine tests.
In addition to the Prosecutor's investigations, the Portuguese Medical Order (OMP) currently has six active disciplinary proceedings against Carvalho. In spite of them, the obstetrician continues exercising, and during the last weeks he has continued attending patients in Setúbal. At the request of Rodrigo's family, the OMP Disciplinary Council plans to meet on Monday afternoon to determine whether the doctor's preventive suspension should be decreed until pending proceedings are resolved.
Absence of rules on ultrasound
The General Directorate of Health of Portugal establishes that pregnant women must undergo three ultrasound exams throughout pregnancy: one between 11 and 13 weeks of gestation, in which the cranio-caudal area and the neck are measured; another between 20 and 22 weeks, in which a morphological study is carried out and a thorough examination of the entire fetal anatomy is done in search of possible anomalies; and one last between 32 and 34 weeks, to assess the development and well-being of the fetus.
The problem is that in Portugal there are no rules that define who can perform obstetric ultrasounds : any doctor can perform and interpret them without needing to have any training in the procedure. This reality is a matter of concern for the Portuguese Obstetrics Society, which recognizes that many doctors performed ultrasounds without having any idea what they are doing. This ignorance and lack of ability to interpret the images contributes to errors in the diagnosis of fetal malformations.
Although some doctors choose to specialize in the subject, and a few even dedicate themselves to it exclusively, the number of Portuguese obstetricians who continue to perform ultrasound exams without having sufficient knowledge is such that several Portuguese collegiate bodies have been studying how to resolve the matter for years. . So far, no consensus has been reached that establishes criteria that are acceptable for both obstetricians and gynecologists, as well as for radiologists, whose collegial body protects the ultrasound area in the neighboring country.
Although the Rodrigo baby scandal is expected to serve to promote the resolution of the issue, at the moment there are no requirements that serve to guarantee the competence of the Portuguese obstetricians at the time of performing ultrasound examinations, nor method to supervise the execution of these tests in the clinics of Portugal.
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