Cuban MDs and Public Health Officials Penalized for Malpractice

By CaféFuerte

HAVANA TIMES — A total of 10 medical doctors and Public Health officials practicing in Cuba’s provinces of La Habana and Mayabeque have been subjected to disciplinary actions for irregularities in the treatment of an accident victim in need of urgent medical attention.

The measures taken included the penalization of the Provincial Head of Public Health, Dr. Juan Carlos Andux, and encompass disciplinary actions that range from public reprimands and demotions to dismissals from different institutions.

This information appears in a letter written by Public Health Minister Roberto Morales Ojeda, published this Friday in Cuba’s Granma newspaper. The names of those implicated in this case of malpractice were not divulged, only their positions and duties.

The disciplinary measures respond to a series of negligent practices discovered in the treatment of 19-year-old patient Leordanis Torres Pedros, who suffered a bicycle accident on May 5 this year.

Organizational Problems

The young patient was admitted at the Humberto Castello Polyclinic, in the locality of Los Palos, municipality of Nueva Paz, at around 9:30 at night. There, he received immediate medical attention from Dr. Grisell Rodriguez Borges, who was on call at the polyclinic at the time.

According to the initial medical examination, upon admittance, the young man was about to go into hypovolemic shock. His arm was severely mutilated and showed dangerous tearing of the tissues. The case needed to be remitted to a care facility in Havana, but a lack of coordination and organizational problems resulted in the patient’s mistreatment and inadequate medical attention.

Ten different hospitals flatly refused or chose not to admit the patient. Finally, he was taken to the Salvador Allende Hospital, in Havana’s Cerro Municipality.

On May 10, angered by the situation surrounding her patient that day, Dr. Rodriguez Borges sent a letter of complaint to Granma’s editorial board, titled “Do we live in an island made up of 15 provinces, or in 15 different countries that make up one island?”

“These situations make the process of finding a course of treatment that will save a patient’s life extremely stressful.”

Following the official complaint, health authorities put together a commission chaired by First Vice-Minister of the Ministry of Public Health (MINSAP) Dr. Jose Angel Portal Miranda and made up of other high ministry officials.

A Chain of Errors

With a view to clarifying the incident, the commission interviewed 27 public health workers, which included administrators and employees, and paid a visit to the Leopoldito Martinez Hospital in the town of San Jose de las Lajas, the Nueva Paz Municipal Public Health Office and the patient’s home, in the province of Mayabeque.

The official communiqué issued by the Ministry also reported that the commission examined the minutes of administrative meetings at hospitals, medical consultation sheets, clinical histories, call registries and reports on the remittance of patients, conducted before proper medical conclusions had been arrived at.

According to the letter, MINSAP’s investigation uncovered serious administrative deficiencies in the Mayabeque Provincial Public Health Office and detected organizational problems in the treatment of patients who require transfer to another institution.

The letter also refers to the “inadequate organization” of the institution’s Orthopedics ward and holds the head of the emergency ward at Havana’s Medical Coordination Center responsible for the irregularities in the transfer of the patient to an institution in the capital.

The Minister of Public Health stated that the case should have been remitted to the Salvador Allende Hospital without the need to secure previous authorization, as per the regional procedures scheme established.

The commission confirmed that the official at the Julio Trigo Hospital Coordinating Office, located in the municipality of Arroyo Naranjo, did not report the incident and failed to inform the emergency ward of Mayabeque’s request.

Warnings and Dismissals

The commission appointed by MINSAP admitted the complaint as reasonable and applied the following measures:

1- Mayabeque Provincial Head of Public Health. Public reprimand before the Provincial Public Health Council and Provincial Administrative Council.

2- Vice-Director for Medical Assistance of the Mayabeque Provincial Public Health Office. Demotion to a lower position.

3- Head of the Hospitals Department of the Mayabeque Provincial Public Health Office. Public reprimand before the Provincial Public Health Council.

4- Head of the Emergencies Department of the Mayabeque Pronvincial Public Health Office. Demotion to a lower position.

5- Head of the Emergency Ward of the Mayabeque Provincial Coordinating Center. Demotion to a position with lower wages.

6- Mayabeque Coordinating Center Official. Demotion to a position with lower wages.

7- Head of the Basic Response Team of the Humberto Castello Polyclinic (Nueva Paz). Public reprimand before the hospital staff.

8- Head of the Emergency Ward of the Havana Coordinating Center. Public reprimand before the staff.

9- Julio Trigo Hospital Coordinating Office Official. Dismissal from the institution.

10- General Surgery Specialist at the Miguel Enriquez Hospital (La Benefica), located in the municipality of Diez de Octubre, Havana. Public reprimand before the hospital staff.

The letter adds that “a series of administrative measures have been taken in response to the problems identified. These will be followed up on by the Ministry of Public Health, in conjunction with the Mayabeque Administrative Council.”

The disciplinary measures applied have been made public as part of the campaign launched by President Raul Castro during a speech before parliament this past Sunday, which called for initiatives against social indiscipline and negligence at State institutions.

Complaints about structural deterioration, irregular medical services and poor hygienic conditions in hospitals around Havana, such as the Julio Trigo and Miguel Enriquez, have been brought to light in recent days by the general public and reports published by the independent press.