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MANILA, Philippines - The successful operation to remove a perfume can from a Cebuano patient’s rectum could have brought honor to the Philippine medical profession if not for the “shameful conduct” of some hospital staff who took videos and laughed at the patient, said Health Secretary Francisco Duque III yesterday.
Duque, who finally identified three doctors and two nurses involved, said the rare operation in the Black Suede scandal was a missed opportunity for glory.
“If the protocol had been observed, it (surgery) would have been praise-worthy. What happened is we tend to shoot ourselves in the foot,” Duque said in a news conference in Manila. “That’s the problem here instead of highlighting the fact that it can be done by our doctors, excellent and world-class doctors that we keep telling everyone.”
A day after he received the initial investigation report of the Vicente Sotto Memorial Medical Memorial Center (VSMMC) from the Department of Health (DOH), Duque made public the names of the key staff involved.
They are head surgeon Dr. Phillips Leo Arias; assistant surgeons Dr. Angelo Linawagan and Dr. Max Joseph Montecillo; nursing attendant Rosemarie Villareal; and circulating nurse Carmina Sapio,
Duque said more persons may be named respondents, depending on the outcome of the preliminary investigation.
“I would like to clarify and stress, no charges have been filed as of yet because we need to follow certain procedures. It behooves upon us to make sure that the processes, the procedures are being followed. Ayaw nating ma-teknikal tayo (We don’t want to be caught in a technicality),” he said.
Dr. Arias, 29, said he is preparing to defend himself in the proper forum.
“Thank you for being impartial. We'll let you know when I'm ready. My lawyer will speak in my behalf,” he said in a text message.
The other doctors and nurses involved in the scandal were not available for comment.
Duque said that what prompted the canister scandal was “a lapse in judgment” brought about by “the ecstatic feeling that they were able to retrieve this canister without resorting to an invasive operative procedure.”
“There was an inordinate overreaction. And then there was the crowd because there were a lot of people inside (the operating room),” Duque said.
According to Duque, among the breaches in protocol observed were: the use of cellular phones in the operating room, the use of a video camera, as well as the behavior of those involved in the surgery.
“There must be respect for the patient's rights. In the case of a patient under general anesthesia, that is sacrosanct. Other doctors pray before they conduct a surgery. This is a far cry from what the medical staff did — they laughed, talked, did everything else wrong. It is shameful,” he said.
Copies of the video were uploaded on YouTube and spread through mobile phones.
Duque said the three doctors and two nurses of the government-run hospital may face administrative charges ranging from simple neglect to grave misconduct.
During a call to the VSMMC, the person who answered said Villareal was on leave and would be back on Friday while Sapio was on day off.
But in a call to Sapio's residence, her father-in-law said the nurse was on duty at the hospital.
A staffer at the VSMMC surgeon's hall said that Dr. Linawagan and Dr. Montecillo were at the hospital Tuesday morning but were not around in the afternoon when called.
The patient, Danilo, whose real name is being withheld by media organizations, heaved a sigh of relief after the DOH identified the team who operated on him.
He earlier filed a complaint with the Visayas Ombudsman’s Office but didn’t provide specific names.
He was hoping to get a preventive suspension of the doctors and nurses pending investigation, according to Basak Pardo barangay (village) Captain Dave Tumulak who is helping the patient.
Secretary Duque, however, said the five would first undergo a preliminary investigation.
He said that while the VSMMC and the DOH in Central Visayas have conducted their own fact-finding investigations, the hospital still has to issue show-cause letters to the respondents and allow them to explain why they should not be charged.
It is only after they have responded that the DOH can conduct a preliminary investigation into the possible filing of administrative charges, during which the levels of participation and corresponding sanctions will be determined.
The DOH-7 upheld the findings of the VSMMC probe team that recommended the filing of administrative charges against the three doctors and nurses.
Dr. Susana Madarieta, DOH-7 director, said that some of the respondents expressed remorse when they were interviewed by the VSMMC fact-finding committee.
“Based on the report that I received, they were ecstatic because they were able to successfully extract the object. They were not aware of what was happening around them, that people were even taking videos,” she said. “However, the reaction was also excessive.”
She said it was such a waste because the surgeons are very good.
“If only they did not have this behavior,” she lamented.
“Everything would have been all right, the operation was very successful. It's such a waste that this thing happened to them because these are very young professionals with budding careers. They don't know what will happen to them because of this incident,” Madarieta said.
Secretary Duque said that as captain of the ship, head surgeon Arias should have made sure that proper decorum was observed inside the operating room.
Dr. Arias and the other doctors and nurses continue to report for duty at the VSMMC although they are not allowed to work in the operating room and have been transferred to different wards and stations in the hospital.
In a phone interview with Arias’ mother, she said the surgeon was not demoralized by the controversy “because he believed he had not committed any error.”
The mother said the results of the VSMMC investigation were unfair because there were other consultants present during the operation.
She said that while her son was the head surgeon during the operation, he has been under training at the hospital as a resident doctor.
Dr. Arias is the youngest of four siblings who are all professionals. He got married last year and has been working at the VSMMC for three years after he passed the physician's board in 2005.
The mother said her son is a good doctor who helped his poor patients.
Several times, he had used his own money to help indigent patients, the mother said.
At one time, her son went out of the house about midnight to give money to a poor patient from Samar.
“Could this be the repayment for all his generosity?” she asked.
The mother said she had told her son that this was not the end of the world.
“I also told him, if you are guilty admit it but if you are innocent, there is nothing to be afraid of,” she said.
She said the family was hurt especially by unfavorable radio commentators who she said condemned the doctor without knowing the full story.
“No family would be happy because we tried to raise our children in a very proper way,” she said.
A House bill was filed seeking a joint inquiry into the surgery scandal at VSMMC.
Akbayan Representative Riza Hontiveros-Baraquel filed House Resolution 524, directing an investigation by the committees on civil service and professional regulation and civil, political and human rights on the rectal operation performed on a patient by doctors and nursing staff.
The resolution described the incident as “discriminatory, degrading, abusive and humiliating” as the medical attendants involved “displayed a blatant disregard for human dignity and human rights.”
It also noted that the patient was “not only a victim of discrimination and stigma but of sexual abuse and hate crime as well.”
Hate crimes are defined as those committed against persons on the basis of race or gender./Correspondents Jhunnex Napallacan and Carine Asutilla and Inquirer
