14ymedio, Luz Escobar, Havana, 22 March 2019 — “Mamita, if something happens to me, you get me justice.” Those words, pronounced by her daughter shortly before she died, in 2015, due to complications during delivery, resonate in the head of Isabel Cristina Cabello López. Besides being a mother, she is a doctor and for her it was a case of medical malpractice.
The last four years have been years of complaints in the courts and lawsuits before the Attorney General of the Republic to establish responsibilities. Also of great loneliness and professional reprisals.
Cabello shows 14ymedio a bulky folder with documents, letters sent to the official press and institutional responses that she has received since she began demanding responsibility for the death of her daughter Beatriz. The doctor claims that the doctors involved in the death of her daughter and her granddaughter “receive criminal sanctions,” and not only administrative, as has happened with some.
Her daughter died at the age of 18 at the Arnaldo Milián Hospital in Santa Clara after multiple medical complications after a cesarean section in which the baby did not survive.
The closest thing to a medical malpractice charge included in the Cuban Penal Code is Article 8.1 where it states that “any socially dangerous act or omission is considered a crime.” To take a doctor before the courts it is not enough to demonstrate that the doctor has “produced an injurious result, but that said result has been due to their reckless, negligent, imperious or unobservant conduct of the regulations,” says the lawyer Nora Cedeño Guerra.
Rarely are doctors who are involved in this type of negligence prosecuted legally and hospital centers traditionally protect their doctors from any criminal complaint. The official press never publishes cases in which Public Health professionals are responsible for errors in diagnosis or treatment, and few lawyers want to take cases of this type.
So far, Cabello has only managed to get the Ministry of Public Health to respond to her complaints through a letter signed by Dr. Roberto Álvarez Fumero, head of the Maternal and Child Department at the time of the incident. The letter acknowledges that there was a “non-compliance with the obstetric emergency care protocol” of a “high risk” patient by the specialists who attended her at the maternal hospital.
The day that the pregnant woman’s labor pains began, Cabello was away on a medical mission in Venezuela. The doctor who treated her daughter, a fourth-year student, ignored the report of “strange pains, different from those of my first birth,” which the young woman commented on and also dismissed the altered result of the first tests. Instead of doing a thorough examination, the doctor said that it was a reaction for not having eaten food.
“They did not place the monitor to measure the heart rate of the baby and that’s why they did not realize that they needed to perform an urgent caesarean,” says the mother, who received frequent calls from her daughter and other relatives in the hospital throughout the process. “She had a retroplacental hematoma and her hemoglobin collapsed.” The baby died during the caesarean section and the young mother had to undergo a hysterectomy, a removal of the uterus.
But the worst was yet to come. From that surgery, Beatriz was not transferred to an intensive care room as her mother thought she should have been, but to a recovery room where she was discharged 60 hours later. After arriving home she continued to feel badly and the mother returned urgently from Venezuela to Cuba on February 18 to be with her. “She was sweating, she said it hurt and she was very weak,”s he recalls.
“We went back to the maternal hospital, I talked to the director and I asked him for help, but he told me to take her home, that there was nothing else to do for my daughter,” she tells this newspaper. They went directly to the police station to make a report but the mother has never been able to retrieve a copy of that initial complaint because the police authorities have not delivered it.
“On March 5, she got up to go to the bathroom, when she went back to bed she fell down. She went into respiratory arrest at home and I took her to the Arnaldo Milián hospital, where she died at three in the morning,” she says sadly. The cause of death in the death certificate speaks of a “retroplacental hematoma that produces a clot, a thrombus in the inferior cava that went up to the left lung.”
The doctors involved were administratively penalized with one month of salary reduction, the removal of their position as a director, and with revocation of the young physician who attended the pregnant woman opportunity to graduate inthe specialty of gynecology and obstetrics. Measures that the doctor considers insufficient because she thinks that the case should reach the courts.
Still sad for the double loss, Cabello returned to Venezuela to conclude her medical mission in that country, but her continued demands to the Cuban Ministry of Public Health to initiate an investigation into what happened ended with her being terminated from her mission and returned to Cuba, with no warning. “They put me on the plane and I still have not been able to recover anything that I left there.”
Her older granddaughter is now the focus of her worries. “I am claiming the belongings that I left in Venezuela to be able to fulfill, in part, what I promised my daughter, to take care of her little girl,” she adds. But neither the resources she saved for her family nor legal justice arrive.
After a four-year stalemate of legal procedures in which she reported what happened to the police, the Provincial Prosecutor’s Office, the Attorney General’s Office, the Provincial and National Public Health Departments, as well as the State Ombudsman, Cabello continues to fail to receive an answer that brings her relief. She has filed new appeals and says she will not stop until justice is done and thus fulfill the promise she made to her daughter before she died.
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