The Madrid Prosecutor's Office has filed for the first time a complaint against a doctor and a manager of a private nursing home for the death of an elderly woman by Covid-19.
The letter of the Public Ministry considers that the breach of the protocols that the Community of Madrid had marked could suppose, in the case of the doctor, a crime of reckless homicide and denial of health care;
and in the case of the manager, omission of the duty of relief.
The representative of the Public Ministry affirms that the two women denounced ignored the protocol of action in cases provided for patients with coronavirus, which caused the death of an 85-year-old woman a few days after entering the center.
The action of the Prosecutor's Office comes after the Madrid Court has revoked the file of a complaint of relatives of nine deceased and two infected in several residences in Leganés, and after a court in the capital has charged a director of another center for the death of an old woman.
The residence denounced by the Prosecutor's Office, which at the beginning of March had 44 of its 46 occupied places, had a health team made up of a doctor and a therapist.
During the health crisis, health care continued to be provided by the same doctor, AMG, who attended from Monday to Friday from 9:00 a.m. to 1:00 p.m., "being available the rest of the time on her mobile phone."
It had the collaboration, within its availability, of the Isla de Oza Health Center.
Since March 13, "by order of the competent regional authorities", there was also the support of a reference geriatrician, available daily on her mobile or through the social and health portal.
Protocol
On March 19, the residence hall received a draft protocol to be taken as a reference document for the management of Covid-19 cases.
The so-called "Coordination Protocol for the care of institutionalized patients in residential centers of the Community of Madrid during the epidemic period caused by COVID-19" established some recommended referral criteria and others where management in residence should be assessed.
A communication system was established with the referral hospital, so that the geriatrician liaison would be the one to decide the transfer or permanence in the residential center.
The Prosecutor's Office maintains in its complaint that, "disregarding all these provisions that were - and should be - known", the doctor did not contact the geriatric service of the Jiménez Díaz Foundation until eight days later in relation to the situation of a resident who had started with respiratory problems on March 22.
Despite the rapid transfer to the hospital arranged by the reference geriatrician, her death could not be prevented the following day, as a result of a cardiorespiratory arrest.
According to the Prosecutor's Office, the deceased woman presented on March 23 a nonspecific picture that included oxygen saturation in the blood, for which the denounced doctor prescribed nasal glasses, achieving an increase in saturation.
However, instead of contacting the geriatrician of reference, "as he should have done according to the current protocol," he called another doctor from the Isla de Oza Health Center to process the hospital referral.
When the residence doctor found out the next day that the transfer had not been carried out, she consulted the health center, where they told her that it had not been possible because 061 was applying patient prioritization protocols in the transfers it carried out.
"Far from calling the Jiménez Díaz Foundation to activate the referral protocol that corresponded to him, he proceeded to treat the user in the residence, where they did not have a nursing service and despite the fact that his own assistance shift ended at 1:00 p.m. 00 hours, "explains the complaint.
No consultation
The writing continues with the detailed account of what was happening.
Two days after admission to the residence, the patient maintained stable blood oxygen saturation, although she had a temperature of 37.1 and slight bibasal crackles in the lungs, in addition to presenting vomiting.
"However, neither that day nor the next, of which there are no medical records, was there any consultation with the geriatrician of reference, and this despite the fact that on March 26 e-consultations began to be made, including the relative to the husband of (the patient), to whom the doctor (the geriatrician of reference) prescribed oxygen therapy on that date, and who finally survived the disease ".
On March 27, the denounced doctor decided to increase the oxygen, thereby achieving better saturation.
On the 28th and 29th, "since it was the weekend," no exam was performed, since he had no service, "and he did not leave a requested visit from the emergency doctors at the health center, so, although the The deceased's children repeatedly tried to get them to come to examine their mother, they indicated that it was not appropriate, since they had evaluated her during the week. "
The manager of the residence was also not in the facilities "leaving the user in the care of the geroculturists, who lacked sanitary qualifications."
Family
Finally, on March 30, the relatives of the patient managed to find out through 112 staff that referrals of institutionalized users in residences were possible: Hence, they contacted the patient care service of the Hospital Universitario Fundación Jiménez Díaz, where they made the urgent consultation to the geriatrician of reference, "who knew nothing about the situation of this user", who arranged everything necessary for the transfer of the woman.
At the same time, a medical team from the public health system, together with the denounced doctor, assessed the patient who noted her "notable" deterioration during the weekend when she had not received medical assistance.
"Once again unaware of the protocol, the doctor tried a referral through 061, being the personnel of this emergency service who told her that she should make the request through the reference geriatrician. Based on this, she made an e -consultation at 11:56 am, which was immediately answered, at 1:12 pm, by the (geriatrician of reference), who personally managed the urgent transfer, sending an email message to the head of the SUMMA guard ", concludes the Prosecutor's Office.
Finally, the complaint refers to the fact that the manager of the residence was aware of the clinical situation of the patient and of the real possibilities of medical treatment that she had in her center.
Despite this, "nothing was arranged to ensure the health coverage of the user during the periods in which the contracted doctor was absent from the residence -especially during the weekend before the death- nor to alert the authorities, with whom kept in communication to require material and personal means for the management of the pandemic, the need for urgent treatment of the user ".
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