Doc ‘violated’ DOH order on ambulance use

CEBU, Philippines - The suspended head of the Minglanilla District Hospital has violated the Department of Health’s administrative order on the use of ambulances in government-run hospitals.

This was the initial finding of the Provincial Health Office (PHO) after a week of investigation into the hospital’s alleged failure to rescue a hit-and-run patient on early dawn of May 24.

PHO Chief Dr. Rene Catan, who appeared before the Cebu Provincial Board yesterday to shed light on the controversy involving the management of the district hospital, said Dr. Bella Villaganas issued a separate memorandum order on ambulance policy without prior approval from his office.

The order was issued on March 22 this year, two days before the incident.

Villaganas’ order, Catan said also ran contrary to what was indicated in the DOH’s order dated January 7, 2010, which states “ambulance services is one of the vital health services for the delivery of pre and post hospital care to a sick patient or to an injured patient resulting from an emergency or a disaster.”

Under the department order, the ambulance service includes transporting patient from the incident site to the emergency room of the receiving hospital for definitive care; transferring the patient to another hospital for further diagnostic and treatment purposes; and rendering emergency medical care and life support to sustain the stability of the patient in transit to and from the hospital, as a special health service.

Catan said the PHO and other district and provincial hospitals have been following the DOH policy.

“Hospitals should not think twice about transporting patients who are critically ill and seriously injured,” he said.

Villaganas’ order, on other hand, provides that the “priority” functions of the ambulance are only limited to referrals of patients to tertiary hospitals within Cebu City; to transport hospital personnel with business transactions at the Capitol and banks; to purchase hospital materials; to transport patients needing laboratory and diagnostic procedures not available in the hospital, such as X-ray and chemistry tests, but within Minglanilla and Naga City.

“The provisions of Villaganas’ order are clear violations of the department order. There’s a clear discordance between the hospital order and DOH policy on the use of ambulance,” Catan said.

In a letter to PHO dated May 25, Villaganas admitted that she does not allow the use of ambulance to rescue patients outside the hospital compound, assuming that there might be more “serious” emergencies than the incident outside.

“…much more that she (Villaganas) is not allowing her personnel to go out of the facility especially when on duty as hospital post will be abandoned,” Catan said.

A day after the May 24 incident, Governor Hilario Davide III had placed Villaganas and a nurse under preventive suspension while Catan’s office investigates on the incident.

Catan said the investigation will be elevated to the Provincial Committee on Discipline and Investigation (CODI).

The provincial government will take appropriate action, depending on the result of the investigation.

The governor said he will wait for the recommendation from CODI as to the fate of the suspended hospital official and staff.

The management last month allegedly refused to ferry a hit-and-run patient on the hospital-owned ambulance that allegedly led to the latter’s death.

A certain Marvey Bastida Cano posted on his Facebook account what he said happened on May 24.

Cano wrote that he found an unidentified man lying on the ground near Bethany Christian School in Barangay Tunghaan, Minglanilla at around 1:10 a.m. that day. The man was bathed in his own blood, barely breathing but apparently still alive.

He said he went to the police station to ask for help, while his friends went to the district hospital.

But the hospital nurse reportedly did not grant their request to use the ambulance because “the ambulance is only for patient transfers and not for rescue operations.”

Cano said he personally went to the hospital for the second time to seek help. However, he said a male nurse also refused to help them.

The victim was only brought to the hospital in Minglanilla by a police patrol car at 2 a.m. or about an hour after Cano and his companions found the victim. However, by the time the patient arrived in the hospital, he was already dead.

But Catan said the victim was already dead even before he was found by Cano and his friends.

Based on the report given by the doctor on duty, Catan said the victim had already undergone “Rigor mortis,” which is a stiffening of the joints and muscles of a body a few hours after death, usually lasting from one to four days.

He said the victim, who remains unidentified, suffered fatal injuries to the head and multiple injuries in other parts of his body which resulted to his immediate death.

Board Member Christopher Barcuatro, who was tasked by the governor to coordinate with the victim’s family for the release of the financial assistance, said the victim’s remains are still in the hospital.

“At present, no one is claiming the remains of the victim,” he said. (FREEMAN)