Medical student remains in a vegetative state after jaw surgery in MG: ‘Nightmare’

Just over a year ago, the life of Larissa Moraes de Carvalho and his family has changed drastically. She came in well to make a jaw surgeryin a hospital in Juiz de Fora (MG), but had a cardiorespiratory arrest after the procedure and is in a vegetative state. Family members still try to understand what happened.

Larissa is 31 years old, is a pharmacist and was studying her 3rd period of Medicine at the State University of Rio de Janeiro (UERJ) when the case occurred. In an interview with Earththe young woman’s father, Ricardo Carvalho, says that she prepared for three years to undergo orthognathic surgery, carried out to correct changes in the growth of the mandible and jaw.

The procedure was scheduled for March 16, 2023, to be carried out by the health plan at Santa Casa de Misericórdia in Juiz de Fora, where his family lives. According to her father’s report, she did not have any health problems and exercised regularly.

Shortly after the procedure was completed, the young woman went into cardiorespiratory arrest, but it is not known at what exact moment. Her father says he saw her get out of the elevator, which takes from the post-surgery room to the room where she would stay in the infirmary. The daughter had her ‘eyes half open’ and appeared to be still unconscious.

“They entered the room, put her on the bed. The nurse asked what surgery she had done and asked me to leave the room. I thought it was some procedure she was going to do, like changing clothes, something along those lines,” she explains. She then saw an employee from the unit enter the room and, through the door, realized that they were giving her cardiac massage.

Post-surgery release

The family explains that the medical record indicates that she was taken to the Post-Anesthetic Recovery Room (PACU) at 5:25 pm and, at 5:45 pm, directed to the 9th floor of the unit. Larissa arrived on the infirmary floor at around 6:02 pm. During this 17-minute interval, according to Ricardo, no one identified that anything was wrong with the patient.

“A journey that wouldn’t take a minute to do and there is no record in the medical records of what happened during that journey. So, it was during that journey that she had to stop”, concludes the father. He also points out that the determination to stay in the Post-Anesthetic Recovery Room it is 60 minutes.

Larissa was resuscitated and was intubated in the unit’s Intensive Care Center (CTI) for about a month and ended up having some complications, such as pneumonia and urinary infections. The student was between life and death and never became conscious again. She spent almost a year under hospital care, and for the past month, she has been undergoing home treatment and has 24-hour care.

“No one came to us [do hospital] to provide satisfaction with what happened. The doctor claimed that the surgery was a success. He delivered her conscious”, says the father. Given the lack of answers, the case was taken to the Public Ministry of Minas Gerais and, on September 11, 2023, prosecutor Jorge Tobias de Souza ordered the Civil Police to investigate the case.

Signs of irregularities

A police investigation was opened to find out what happened, and both Santa Casa de Misericórdia and the doctors responsible for the surgery and anesthesia are being investigated. To initiate the process, two experts, from São Paulo and the Federal District, were hired to investigate all the documentation obtained by the family from the hospital.

The medical record was only made available to family members after the request was made to the MP, as reported by Ricardo. Furthermore, the prosecutor requests that a copy of the procedure be presented to the Regional Council of Medicine for information and the adoption of possible measures.

According to the order from prosecutor Jorge Tobias, the expert reports conclude that irregularities exist according to the analysis of the documents:

“Flaws are evident at different points in the medical and hospital care provided, from anesthetic monitoring to post-CRA care [pós parada cardiorrespiratória]which contributed to the observed neurological outcome”.

“There is evidence of non-compliance with medical conduct recommended in medical literature and good health care practice in the care of Mrs Larissa Moraes de Carvalho, during health care in the hospital environment”.

In the document that the Earth had access, one of the experts, doctor Hugo Ricardo Valim de Castro, highlights the following points:

• Surgical description without detailing the steps performed in each stage of the procedure;
• Incomplete anesthetic report and incomplete post-anesthesia recovery form;
• Incomplete and discordant records regarding PCR assistance [parada cardiorrespiratória] suffered by the patient – ​​the professionals who participated in the assistance, the duration of the arrest and the reason why the patient’s rhythm was not identified were not informed, and there is disagreement regarding the number of resuscitation cycles performed in different records.

Furthermore, the expert and professional Janice Rodriguez de Almeida also emphasize that a 20-minute stay in the anesthetic recovery room (PACU) is considered premature.

“These two different examinations show medical misconduct that led Larissa to this point. They were made in different places just so we could see what matched or converged”, explain the family’s lawyers, Fabio Guimaraes Timponi and Patrícia Quinane Coelho Timponi.

The young woman’s father says he tried to take images of the procedures carried out while his daughter was in the unit, but did not receive them. According to him, the director of the unit had said that the images were preserved and separated, but when the Prosecutor’s Office asked for them, the response was different. “When the hospital’s response came to the Prosecutor’s Office, they informed us that they no longer had any images,” she recalls.

‘Nightmare’

The family’s routine changed completely after Larissa’s surgery. Today, she has 24-hour medical care. Her mother is on medical leave due to her daughter’s condition, and her father balances working as a freelancer with the support that everyone needs.

“We are living a nightmare. It destroyed our life, her life. We fight for her recovery. She had the dream of studying Medicine, she tried hard. Our life is over. They tried to destroy it, and we are fighting to prevent that from happening”, concludes Ricardo emotionally.

What the authorities and the health unit say

When contacted, the Civil Police reported that they had opened a police investigation to investigate the circumstances of the incident. The responsible police station has already collected statements and is taking steps to fully investigate the case.

The Regional Council of Medicine of Minas Gerais clarified 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.

The Santa Casa de Misericórdia of Juiz de Fora was also contacted, but, so far, has not commented on the case. The space remains open for demonstrations.

Source: Redação Terra