スペインのLeon市の49歳の男性が、手術の9ヶ月待ちで、大動脈破損で死亡。
Muere al rompérsele la aorta tras nueve meses en lista de espera
Un hombre de León tenía una dilatación arterial que, según su médico, debía operarse
En urgencias le trataron durante cuatro horas de una indigestión
Emilio de Benito Madrid 17 ABR 2013 - 19:11 CET
He died of a broken aorta after nine months on the waiting list
A man of Leon had arterial dilation, according to her doctor, was operated
In the emergency department treated him for four hours of indigestion
Emilio de Benito Madrid 17 ABR 2013 - 19:11 CET
"My brother drowned in his own blood after waiting nine months to operate it." Laura Canabal crudely sums of the death of his brother Luis, who meet 49 years on 5 May. According to roles giving Laura, her brother went on the waiting list for surgery for an aneurysm (widening) of aorta on May 10, 2012. He died, as recorded by the medical certificate for a "break dissecting aortic aneurysm" at 00.30 the February 21, 2013. That is, what is supposed to treat. He was about to be operated on in January, but got sicker patients, said a spokesman for the Junta de Castilla y León. Lawyers for the family have prepared a claim against assets autonomic Health Service.
The data confirms counseling offered Laura. In an email sent to this newspaper, a spokesman describes that it is a "patient diagnosed ascending aortic aneurysm with aortic insufficiency," and that was "included in the surgical waiting list on 10/05/2012".
The problem is that it was considered Priority 3, "not urgent", which, according to the website of the ministry, indicating that they are "patients whose conditions can delay treatment, since that does not produce significant consequences." "Patients waiting are valued based on that priority," the spokesman counseling.
Laura Canabal and his lawyer, Javier de la Pena, Lex Law, believe that, obviously, "see what happened", that score was not good.
The intervention was planned, but other cases took precedence
This raises one of the problems of the case. According to history they did to Luis, his aorta had a maximum expansion of 58 mm. But in the upper report Hemodynamics service that issued the Lion Care Complex when it was on 9 May to make him preoperative reflects that has a "dilated ascending thoracic aortic aneurysm" with a "diameter of 46 millimeters" .
The difference between these 58 mm maximum and 46 of the last report is irrelevant. Gonzalo Esquivias Baron, president of the Section of Cardiology and Outpatient Clinic of the Spanish Society of Cardiology, said by email: "An aortic aneurysm rupture risk always has, but the decision of when to surgery is based on the size of the dilation. The indication is established in patients with aortic aneurysm greater than 45 mm only if they also suffer from Marfan syndrome, and those with 50 years or more if you also have a bicuspid aortic valve. In the remaining patients, only indicated if the aortic root is 55 millimeters. " If it "is not intended to operate".
Laura does not understand much technicality. "My brother spent nine months waiting to be called. He was a good man who leaves a wife and child. I was very worried. He'd had other health problems, because it was mine and had to stop working ".
Board spokesman clarifies this. Patients "have available a telephone number that was used on 19/10/2012 and 11/02/2013, confirming that continued in asymptomatic situation". "The type of disorder that had (without symptoms of cardiac nature without pulmonary hypertension and associated coronary disease) is less risky than other valvular, hence, was considered clinically lower priority than others."
The family will take legal action against the Board
In addition, there was bad luck. "The intervention came to be scheduled in January 2013 and was suspended as a result of surgical emergencies in patients already admitted to the coronary care unit," the spokesman said.
Laura is outraged when he learns that his brother was about to be operated. "If they had such waiting list, is that no other hospitals in Spain to do so?".
But apart from the delay in the operation, Canabal family was also believed to failures clamorous day of his death. "When my brother started to feel sick, went to the doctor and was diagnosed header indigestion. He was sent for home. Eight hours emergency again. "
Laura will be difficult to conclude the story. Two months after the death of his brother, has depression and mourn breaks easily. "In emergencies spent four hours until they realized what was happening. They called the hospital in Leon Bierzo because no cardiology, and took an hour to send the ambulance. Just mount it on it died. "
Medical reports confirm this version. "Patient admitted on 20/02/2013 about 20:00 in the ER" writes the head of El Bierzo hospital guard. "A diagnosis of dissecting aortic aneurysm. He was taken by mobile ICU from the ED to Hospital de León. A few miles out, started with hemodynamic problems that do not respond to treatment, turning around and returning to our hospital, where he entered already dead. "
This is the summary, because the important thing, says Laura, is the time you spend. "First he was diagnosed with indigestion, and he was already dying," he says. The report of the emergency box 28 makes clear. "Table of eight hours of pain in the upper abdomen after eating continued, accompanied by vomiting, watery diarrhea with traces of blood abundant" he says. This is at 20.00 when it arrives.
But at 23.00, another ER doctor says and "thoracic aortic dissection." The entries are: "We talk by phone with H. Leon (Cardiology) and decided transfer. " At 00.00, "mobile ICU arrival. Hemodynamically stable patient. He moves ". The end of the story is already told.
"I do not know if my brother could have been saved, but not given the opportunity. First, with waiting in operarle, and then eventually had him in the ER despite knowing its history. I do not know if they charged the health care system, but to me, of course, I could have done more damage, "says Laura.
A growing problem
Location. Budget cuts in health of the autonomous communities forced to abandon plans to reduce waiting lists.
Background. The Catalans cardiologists complaint earlier this century that several patients had died while awaiting a heart operation was the first decision: to tell the time and people waiting for surgery. The data of the Ministry of Health together, to get communities to the den, agreed with them not to give a breakdown. This prevented the citizens make comparisons.
Official data. The latest data are offered Health June 2012. By his count, the number of people waiting to be operated throughout Spain (except Madrid, which does not count because it gives no comparable data) exceeded half a million, 28.6% more than the same month a year earlier.
All other indicators related to delays have worsened recently. For example, the Ministry of Health indicates that in the whole of Spain, the average time a patient waits for surgery was in June 2012, 76 days, 12 plus (up 18.75%) than a year earlier.
Castile and León. In the community of Luis Canabal Ramon, the number of people waiting for an operation had increased by 55% between 2010 and 2012, according to data provided by the Board to this newspaper.
Also the average delay for surgery has increased. The Board indicated that their community was waiting 73 days, up 52.1% from a year earlier. This delay was largely overcome in the case of Luis Canabal: entered the surgical waiting list in May of that year and was waiting when he died nine months later.
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