Despite the “urgent” nature of the judicial order of the federal judge Sandra Arroyo Salgado, the measure did not materialize on Friday 17. The officials of the Ministry of Health of the province of Buenos Aires, the Municipality of Vicente López and PAMI who were present at the request of the judge They agreed not to refer the 29 patients who were hospitalized for the social work of the retirees that same day, despite being all older adults and constituting a risk group. According to the inspection report, the clinic was complying with the COVID-19 protocol and no “irregularities” would have been observed. It was agreed that new patients would not be admitted and that they would seek to refer those who had a negative swab.
However, due to the lack of adequate preventive measures, To the date there are two deceased patients with coronavirus and there are more than 20 members of the infected medical and non-medical staff of the clinic, of which three are hospitalized and the rest isolated in their homes. Justice confirmed that six of them – two nurses, a maid, a maintenance worker and two from the pharmacy – went to work between April 19 and 21, being infected. Four relatives of one of the victims, and three people from the M.Menini shack who intervened in his funeral are also infected with coronavirus. The rest of the interned retirees have tested negative so far, although the Justice has doubts about some analysis of samples carried out in two private laboratories.
Prior to the preventive closure order, the magistrate had asked the Buenos Aires Ministry of Health on April 11 -in its capacity as the highest health authority- to carry out “an epidemiological inspection, audit and investigation”, After the post-mortem analysis of the patient who died on April 6 had given a positive result.
The request was reiterated two days later, on the 13th of this month, before the report submitted to Justice by the medical director of the clinic, Jorge Pinzetta, regarding the activation of the COVID-19 protocol. As you could know Infobae, he would have failed to specify what he had arranged regarding the hospitalized patients. Arroyo Salgado reiterated another office on Monday 20 to the minister Daniel Gollán, ratifying the preventive closure order and ordering “immediate intervention in the medical order.”
Finally, the next day, the judge warned the owner of the Buenos Aires health portfolio that had not yet received any report on “the audits carried out, nor the result of the inspection, audit and epidemiological investigation ordered“, and that had not yet appointed a medical director – to replace Pinzetta, who is serving home isolation – as he had requested last Monday. “In its capacity as the highest health authority in the Province, it is responsible for arbitrating the necessary and urgent preventive measures to prevent the spread of the pandemic. In all, 21 patients continue to be hospitalized, all from the risk group.“Arroyo Salgado maintained in his office.
The judge also required the head of the PAMI, Luana Volnovich, to articulate with the Municipality of Vicente López the necessary measures for the “immediate referral” of patients to the nearest provincial or municipal hospitals to treat their pathologies, and to evaluate which were in conditions to be discharged, if they did not present symptoms of coronavirus.
The intervention of Justice in this provider clinic of PAMI where the coronavirus spread was generated from the complaint of Carlos Cellini, who had doubts about the causes of death of his sister. Despite the fact that the retired woman had been admitted for a urinary infection on March 8, during her hospitalization -and after having improved from her initial pathology-, she developed symptoms compatible with coronavirus. However, in the clinic they did not perform the test to detect it, nor did they treat her for that disease.. In his death certificate, “cardiac arrest, refractory shock and respiratory failure” was recorded. The post mortem analysis was recently carried out on the 65-year-old woman by order of Arroyo Salgada and she tested positive.
Bodies in the morgue not informed
In the inspection that staff from the Buenos Aires Ministry of Health carried out last Friday afternoon when the judge ordered the closure, in which an epidemiologist participated, the morgue of the clinic was not reviewed, however. It was recently inspected this past Tuesday, after a Federal Police cash stationed at the door alerted the Juzagdo of the existence of bodies in the morgue. It was so five bodies were found that had not been reported by the clinic authorities when was the operation of the health authorities by order of Justice, nor after the Court. Three of those patients had died on the same Friday morning and noon inspection, one the day before, and one on April 11. They were only found on Tuesday the 21st, after Arroyo Salgado sent the new letter to Minister Gollán.
It later became known that one of those five bodies, that of a 70-year-old woman who died that morning on April 17, turned out to have COVID 19. The test was known post mortem. Although when it was found in the red mortuary bag corresponding to an infectious contagious disease, that would not have been the way the body was preserved on the day of the health audit. Justice suspects that the way it was preserved was altered after the inspection on Friday afternoon 17, and that originally biosecurity and prophylaxis measures had not been taken to prevent possible contagion.
From mid-March to date, 9 patients died at the North Health Center, of which two had been infected with coronavirus: the woman whose death gave rise to the court case, and the latter. There are three other cases in which the test was negative, and a room about which there are doubts about the time elapsed until the sample is taken. Of the rest of the deceased patients, despite having been admitted for pathologies such as femur fracture or kidney failure, died of “in-hospital pneumonia”, according to the clinic.
To the date, there are still 15 patients in the clinic. Since the health inspection last Friday, 7 patients were discharged and many others were referred to other medical or geriatric institutions. As they are all PAMI patients, this body had the responsibility of relocating them according to the available capita.
Based on this situation table, the prosecutor intervening in the case, Fernando Domínguez, asked the magistrate to “order the Ministerial Health Authority (Municipal, Provincial and National) to under warning of initiating actions for disobedience (art.239 of the CP) and / or by breach of public official duties (Art. 248 and 249 of the CP), evaluate the situation of the North Health Center as a possible source of infection for the patients treated there and for the morgue, medical and administrative personnel with functions in place “, in order to” ensure that the Ministerial Health authority carries out the inspections that are necessary (applying administrative sanctions if applicable), so that the heads of the investigated Center apply all the protocols issued in the face of the COVID-19 pandemic. ” The clinic is managed by ROPHE SA, one of whose owners is Benjamin Teitelbaum, also owner of the Mariano Pelliza Sanatorium, in Olivos.
For Domínguez, “the mismanagement of the medical center translated into negligence that made possible the spread of the pandemic to levels that are still difficult to establish, behaviors that took place in the midst of the health emergency situation that is widely known, merit the adoption of the compulsory measures that are required below. ”
From the Province Ministry of Health they said to Infobae that the portfolio “has no influence” on the medical management of the clinic. “We open an epidemiological investigation at the request of the Justice and we establish the procedures to follow and the operating rules. We have a leading role, but not an audit role. We have no authority over the medical practice of the private effector”, They pointed out.
“We went and did the inspection together with PAMI and we evaluated that the clinic was in a position to continue operating, to the extent that protocols are followed. As far as we saw, they were being fulfilled. We prepared a technical report that was submitted to the judge and it was decided that it should remain open for the time being, with a rearrangement of equipment, since a large part of its staff is in isolation. Then the follow-up of the patients is from PAMI, since the clinic is a provider of this organism ”, they reported.
In a statement released last week, the North Health Center maintained that “the institution has working protocols for handling suspected cases of COVID-19 implemented since February of this year, with Triage sectors at the entrance to the clinic and areas of isolation of suspected patients managed by properly trained personnel, using all the personal protection elements standardized by the Ministry of Health of the Nation and the Ministry of Health of the Province of Buenos Aires ”.
According to half a dozen testimonies collected by Infobae clinic workers, there were no basic preventive measures -as chinstraps, gloves and disposable camisoles, nor temperature taking when entering the establishment- before the intervention of Justice that revealed that the deceased woman had a coronavirus. They only began to be implemented once the case had public significance.
The North Health Center also He ruled out the possibility of cross-infection between patients and suggested that the contagion of the deceased woman that gave rise to a legal complaint came from the family that visited her at the clinic.. Her brother Carlos tested negative and her niece, who had cared for the woman for a few days, her husband and two children tested positive for the test ordered by Justice. Also infected were the owners of the M. Menini shack that had the body of the deceased woman in the funeral home and were in contact with their documentation.