The medical student, Larissa Moraes de Carvalho, aged 31, is still in a vegetative state one year after having surgery to correct her mandible and jaw, in Juiz de Fora (MG).
Larissa, who also has a degree in Pharmacy from the Federal University of Juiz de Fora (UFJF), entered the Santa Casa de Misericórdia de Juiz de Fora, in Minas Gerais, on March 16, 2023, to perform orthognathic surgery, aimed at to correct changes in the growth of the jaws and mandibles. After undergoing surgery, the student became seriously ill.
According to Ricardo Carvalho, Larissa’s father, the young woman had a cardiorespiratory arrest while being transported from the surgical center to the infirmary, which led her to the vegetative state in which she finds herself today.
Carvalho was admitted to the unit until March 15 of this year. Afterwards, the young woman’s family obtained authorization for her to continue her recovery due to the complications she had in the surgery while undergoing home treatment.
According to the young woman’s father, it is not known at what exact moment the respiratory arrest occurred or at least what caused it.
The father claims that the free and informed consent form (TCLE) signed by the patient on 03/08/2023 did not detail any of the risks associated with general anesthesia, nor did it directly mention the possibility of cardiorespiratory arrest, with associated sequelae.
The family also emphasizes that they were not contacted by anyone at the hospital to clarify what happened. Therefore, they requested a meeting with the board, which only occurred on 04/05/23.
For the father, the anesthetist had completely incorrect attitudes that were not consistent with correct medical practice. As reported by surgeon Dr. Gustavo Saggioro, who performed the procedure on Larissa, the anesthetist responsible for promptly monitoring the young woman’s vital signs, Dr. Isis da Rocha Costa Bille, was absent from the room at various times during the surgery.
What the doctors say
Doctor Dr. Saggioro stated that Dr. Isis was in a hurry to discharge Larissa, as she had to participate in another surgery. Dr. Marcileia Cristiane, a dental surgeon who followed the procedure, also confirmed the information.
In a report requested by Larissa’s own family, Dr. Marcileia highlights the details of the anesthetist’s absence in the operating room:
“During the surgery, anesthetist Isis was outside at times, as according to her, the room was very cold. A few times Dr. Gustavo even called her to check the process, and was worried about that, as she was outside”, said the dentist.
Marcileia stated that she always witnesses that Dr. Saggioro is attentive to any changes in his patients’ parameters during his surgeries, demanding that the anesthetist does not leave the room at any time.
“However, an important observation: I remember that the patient had an excessive drop in blood pressure, in which the anesthetist was called by Dr. Gustavo with more vehemence, even changing the tone of voice asking where the anesthetist was”, as she was not there. in the room. This was witnessed by those present.”, Dr. Marcileia told the family.
For Larissa’s father, the anesthetist’s lack of professionalism, when she was absent from the operating room, did not allow her to make the necessary notes in the anesthetist’s file, such as the failure to detail the anesthetics applied at each moment, as stated in two reports experts.
According to the Regional Council of Medicine (CRM), the anesthetist must remain inside the procedure room, maintaining permanent surveillance, assisting the patient until the end of the anesthetic procedure. Furthermore, he must know, in advance, the patient’s clinical conditions, from admission to discharge. Also throughout the process, patients must remain monitored and clinically evaluated.
Dynamics of surgery
The surgery began at approximately 12pm in the surgical center of Santa Casa de Misericórdia de Juiz de Fora, with Surgeon Dr. Gustavo Saggioro, and anesthesiologist Dr. Isis da Rocha Costa Bille on the 14th floor on 03/16/23, according to Larissa’s father, Ricardo Carvalho.
The medical student was admitted to the post-anesthesia recovery room (PACU) while awake and maintaining contact at 5:25 pm, according to Ricardo. She was discharged from the PACU at 5:45 pm after spending only 20 minutes in the PACU.
“The recommended time would be at least one hour, according to the resolution of the Federal Council of Medicine (CFM 2,174/2017)”, stated Carvalho. Larissa was then taken to the 9th floor, where she was greeted by the nurse and a cardiorespiratory arrest (CRA) was confirmed.
Images from the hospital’s security cameras recorded the moment the young woman was transported from the surgical center to the ward. The student’s family even requested access to the images to try to clarify what happened during the patient’s transfer, but was not answered.
“They did not hand over the images to us and stated that they would only do so following a court order. Afterwards, we made a legal request and to our surprise, they responded to the court that the images had been prescribed”, alleges the father.
The procedure aimed to make a correction to her jaw, which did not bother her, but could cause future problems, explained Carvalho. The student prepared calmly for three years to undergo this surgery.
According to the father, it would be a simple but long surgery. He reported that the expert reports indicate that Larissa was not alerted to the risk of anesthetic complications.
What the Santa Casa de Misericórdia says
Sought by the Public Ministry of Minas Gerais (MPMG), the President of Santa Casa de Misericórdia de Juiz de Fora, Dr. Renato Vilela Loures, informed the body that:
“The medical records and the respective reports of the exams carried out by the patient Larissa Moraes de Carvalho were delivered to her parent, now representative, on April 25, 2023, within the institutional deadline for making records available.
As for the footage from the Hospital’s security cameras, unfortunately it is not possible to make them available, since the recordings expire in 30 days and the facts narrated by the representative occurred on 03/16/2023.”, said the hospital’s presidency to MPMG .
Contacted by CNN, Santa Casa de Misericórdia de Juiz de Fora reported that it will not comment on the case:
“Santa Casa de Misericórdia de Juiz de Fora informs that, once action has been taken in court, in respect of due legal process, the Hospital will not make any comments on the matter outside of the court records. We reiterate our commitment to transparency and quality in the care provided to the entire community throughout our history, which spans almost two centuries,” stated the hospital.
What the Regional Council of Medicine of the State of Minas Gerais (CRM-MG) says
The Regional Council of Medicine of the State of Minas Gerais (CRM-MG) informed that all complaints received, formal and ex officio, are investigated, with full defense and contradictory rights being respected. All procedures are carried out under confidentiality, as provided for in the Code of Ethical-Professional Process.
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