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Philippine hospital recommends penalties for medical staff in videotaped surgery

MANILA, Philippines _ A Philippine hospital recommended penalties Friday, including possible dismissal, for three doctors and a nurse who conducted a rowdy operation on a patient that was videotaped and posted on YouTube. The unidentified doctors and nurses from the central Philippine city of Cebu have been condemned by medical associations. Health Secretary Francisco Duque III has ordered an investigation.

The Vicente Sotto Memorial Medical Center in Cebu, where the operation to remove an object from the patient's rectum took place Jan. 3, recommended filing administrative cases against the four personnel, with penalties ranging from reprimands to dismissals for violating a code of conduct and ethical standards.

Medical center spokesman Dr. Emmanuel Gines said the government-run hospital can only recommend penalties to the Health Department and cannot take action on its own.

The nearly 3-minute video of a noisy operating room shows doctors and nurses laughing, giggling and cheering. At one point, a hand appears with a cell phone camera taking a close-up picture of the surgery.
As a doctor gingerly pulls out a 15-centimeter (6-inch) -long spray canister from the male patient's rectum, someone shouts, "Baby out!" amid loud cheers.

The doctor then removes the canister cap and sprays the contents toward a crowd of nurses and doctors viewing the procedure.

The 39-year-old patient, who remains unidentified, plans next week to file a complaint seeking the revocation of the licenses of those responsible and a civil suit for damages, his lawyer, Guiller Ceniza, said.

A hospital committee that investigated the incident reported that the successful operation may have prompted the cheers, but added they were "excessive and inappropriate and some acts were already in violation of some hospital policies," the hospital said in a statement.

Gines said a fourth doctor and three other nurses were "sternly warned," and a clinical instructor who supervised a group of nursing students from a local school who observed the operation was banned from the hospital.
He said a nursing student suspected of uploading the video to YouTube would be dealt with by the school.

Ceniza said his client was dismayed that the hospital did not impose penalties itself after its investigation.

"We are not satisfied with the proceedings conducted by the hospital," Ceniza said. "All the while we thought that they were conducting an administrative proceeding ... to impose sanctions but what turned out was merely a fact-finding inquiry."

The Cebu Medical Society condemned the incident "in the strongest possible terms." It said the medical staff were insensitive to the patient and violated his rights to privacy. "The actions are indefensible," it said.

The patient received surgery three days after a New Year's drinking spree and a "one-night stand" with a male partner, Ceniza told The Associated Press.
He said his client was too drunk to remember how the body spray canister ended up in his body. OLIVER TEVES, Associated Press Writer

Vicente Sotto Memorial Medical Center names out

THE Department of Health (DOH) finally named yesterday three doctors, a nurse, and a nursing attendant involved in the Jan. 3 surgery of a florist at the Vicente Sotto Memorial Medical Center (VSMMC).

The procedure to remove a body spray canister from the 39-year-old patient’s rectum was captured on camera and uploaded to YouTube, a video-sharing site.
DOH Secretary Francisco Duque identified the doctors and nurses as Dr. Philips Leo Arias, head surgeon; Dr. Angelo Alinawagan, assistant surgeon; Dr. Max Joseph Montecillo, who is assigned to an adjacent operating room; nursing attendant Rosemarie Villareal; and circulating nurse Carmina Sapio.

In a press conference yesterday morning in Manila, Duque clarified that formal charges have not yet been filed against the doctors and nurses.
He said his office still has to send a show-cause letter, asking them to explain why they should not be charged.

In four to five days, a DOH central office lawyer will personally hand the letter to the five personnel through the VSMMC administration. Their answers to the letter will be evaluated, while a formal investigation will be done jointly by the hospital and the DOH.

The investigation will include assessment of the gravity of offenses committed and the corresponding sanctions, before formal administrative charges can be filed.
Duque, however, said they still have to identify the person who posted the video clip on YouTube. The video shows more than 10 people in an operating room shouting, giggling, and jeering, especially after the canister was removed.

One of the medical staff even opened the canister and sprayed it around. The video also captured several individuals taking footage of the operation using cellular phones. The patient, who wanted to be identified only as Jan-Jan, was unconscious all that time. The controversy started when the video was uploaded to YouTube, reportedly by a nursing student, and shared through mobile phones, prompting the VSMMC to investigate.

The hospital’s fact-finding committee found just three doctors and a nurse as the ones involved. It recommended that an administrative complaint be filed against them for possible violation of provisions of Republic Act (RA) 6713 or the Code of Conduct and Ethical Standards for Public Officials and Employees.

The hospital also issued a “stern warning” to one doctor and three nurses and advised them to be more cautious in performing their duties as supervisors. The DOH 7, which conducted its own inquiry, likewise pointed at the three doctors and the nurse as the ones who should be investigated. It sent a copy of its own report to Duque last Monday.

But in an ANC report, Duque told a press conference that another nurse was involved. He said more than 10 people were actually in the operating room, including students, consultants and trainees. He said the names of the others might be added to the list of who should be charged after the preliminary investigation, which may take a month to complete.

While he considered the case as isolated and commended the medical team for a successful and well-performed operation, he said the DOH will not tolerate their behavior. He pointed out the violations: not confining the room to the medical team involved; not prohibiting the use of cellular phones while an operation was ongoing; taking footage without the patient’s consent; and lack of respect for the patient, as manifested by the jeering, laughing, and cheering captured by the video.

Duque added that the head surgeon, being the “captain of the ship,” should have ensured that protocol was followed. He said the DOH can only file administrative complaints and impose sanctions ranging from suspension to dismissal from government service.

Criminal complaints can be filed before the Office of the Ombudsman, he added, while the Professional Regulation Commission can look into the matter once the agency receives the complaint. The PRC can reprimand those involved or even suspend or revoke their licenses. “There is no whitewash (in our fact-finding). There is no such thing in our vocabulary. The patient should not worry. We will make sure that necessary penalties or sanctions are meted (out). But we have to understand that (the five medical staff) are presumed innocent until proven guilty, and not the other way around,” Duque said in a radio dyLA interview.

He also requested that the competence and credibility of the attending medical team should not be confused with the “insensitive” behavior committed during the operation.

Dr. Jucel Ann Jumao-as, Philippine Nurses Association (PNA) Cebu chapter public relations officer, agreed with Duque and urged the public to look at both sides of the story.

“The doctors and nurses did good in the operation and in past operations. The call for revocation of their licenses is too much, as their licenses are what feed their families. While an operation should not be treated as a circus, we should also look at the circumstances on how and why the patient got into that situation,” she said.
Apart from the DOH’s preliminary investigation, the House of Representatives’ committees on professional regulation and civil, political, and human rights were also asked to conduct a joint inquiry, in aid of legislation.

Akbayan party-list Rep. Risa Baraquel, deputy minority floor leader, submitted a resolution asking for an inquiry yesterday afternoon, and it was approved. “The condemnable conduct of the doctors, nurses, interns, and medical attendants involved in the incident displayed a blatant disregard for human dignity and human rights,” she said.

Baraquel also asked that Congress exercises its oversight and legislative powers “to contribute to the efforts to stop the burden of oppression and stigma carried by the lesbian, gay, bisexual, and transgender community.” She believes that the incident required legislative intervention “to imbibe and deepen the principles of human rights and human dignity among medical professionals, nurses, and nursing students.”

Sun.Star Cebu tried but failed to get a reaction from Dr. Gerardo Aquino, VSMMC chief, who was reportedly attending to a family emergency. A lawyer, who said he represented the nurses and doctors, said his clients will call for a press conference anytime soon to answer the issues raised against them.

A woman, who identified herself as mother of Dr. Arias, also called Sun.Star Cebu and said her 29-year-old son is willing to answer the charges when the case is brought to court. She said they have three lawyers handling the matter. She also told radio dyLA that Arias was innocent and not “demoralized” by the incident. She admitted, though, that the family is hurt and worried why the son she raised well is accused of misconduct. She called it unfair for her son to be included since there were consultants supervising the operation.

The woman also appealed to members of the media, especially radio commentators, not to make conclusions about her son’s capacity as a doctor just because of the incident. Dr. Arias, she said, is generous, attending to calls even at night and giving out free medicines. Dr. Arias, who got married just last year, spent three years as a VSMMC resident doctor after graduating from a reputable Cebu City university.
Meanwhile, Jan-Jan, a Basak Pardo, Cebu City resident, is “happy” that the identities of the doctors and nurses are now made public as it would not just strengthen his complaint but also hasten its resolution.

“Jan-Jan is grateful for the way the doctors and nurses saved his life by taking the canister out. But he is not appreciative of the way they behaved,” said Barangay Captain Dave Tumulak, who is helping him.

Jan-Jan’s camp is pursuing civil action for damages against the doctors and nurses this week, and will file a separate complaint with the PRC. By Nancy R. Cudis
Sun.Star Staff Reporter (With CYR)



The health news headlines shown above are provided courtesy of
Medical News Today

Doctors, nurse in Cebu surgery scandal face raps

Three doctors and a nurse face administrative charges but other medical staff and students got off with relatively light penalties over a controversial surgery scandal in Cebu last January 3.

Radio dzBB's affiliate in Cebu reported that the Vicente Sotto Memorial Medical Center made the recommendations following an internal investigation into the incident.

However, Dr. Roque Anthony Paradela, the officer-in-charge who read the recommendations at a press conference, did not name names but said other legal actions will be referred to the Health Department which supervises the Vicente Sotto Memorial Medical Center.

The hospital released its findings and recommendations even as its head Dr. Gerardo Aquino Jr was summoned to Manila for the health department's parallel investigation into the case.
Among the findings of the hospital were:

  • Three doctors and one nurse in the medical team involved in the operation will face administrative case for possible violation of conduct and ethical standards;

    • One doctor and three nurse supervisors were sternly warned and advised to be more cautious in performance of duty as supervisors;

    • A clinical instructor alluded to by the staff who misbehaved was banned from the hospital;

    • The student allegedly responsible for uploading the video to video-sharing site YouTube should be endorsed to his or her school for disciplinary action; and

    • SOPs of the operating room should be reviewed, revised and updated.

Last January's surgery sparked controversy when a video clip showing doctors and nurses laughing and giggling while conducting the operation was posted on YouTube. The video has since been taken off the audio and video platform.
In the video, loud cheering and shouting can be heard during the operation. Someone then shouted "Baby out!" when the canister was removed from the patient's rectum.

One of the medical staff even opened the perfumed canister and then started spraying its contents.

The incident also sparked condemnation from many medical groups. The Philippine Medical Association (PMA) had said that if found violating their code of ethics, the doctors could be expelled from the association.
Aside from losing membership from the PMA, the doctors and nurses may either get suspended or have their licenses revoked, according to the Professional Regulation Commission.

Other organizations who voiced their condemnation of the act included the Commission on Human Rights, the Integrated Bar of the Philippines Cebu City chapter. - GMANews.TV