The Pantelimon scandal, probably the biggest in the field of Health, is increasingly detaching from the core issue and turning into an emotional broth where everyone unloads their frustrations, angers, and disappointments, justified or not, related to their interaction with the healthcare system.
And this broth is thrown by generalization onto all doctors. This is not only unfair but also very dangerous because the effect will be the emptying of hospitals, both of doctors, who will leave wherever they see fit, and of patients, who will die in droves refusing hospitalization to avoid being killed by doctors.
Therefore, clarifying every detail, at least when the emotional temperature decreases, of what happened at Pantelimon Hospital is of systemic importance, beyond the necessity of correctly applying the law in a specific case.
What should be clarified precisely is the frontline, so to speak, between the official accusations, including from the judicial reasoning for the arrest of the two female doctors accused of premeditated murder, and the unanimous version of the ICU doctors primarily, but also from other specialties.
Frontline
Namely: the death was caused by the reduction of noradrenaline, so it would not have occurred if the reduction had not taken place, as the prosecutors and forensic doctors claim, or, the version of the doctors - noradrenaline had no effect on the exhausted body, and death would have occurred anyway, with or without the substance that is by no means an elixir of eternal life, as many believe.
The prosecutors and forensic experts invoke the timeline and the obvious disagreement between what the infusion pump memory indicates and the medical record.
In the view of the doctors, even from France, when an organism receives the maximum dose of noradrenaline for a long time and its effect does not raise blood pressure to the normal range, it means that noradrenaline has no actual effect. Therefore, the body is no longer viable.
In the specific case, if under the maximum dose of noradrenaline the blood pressure does not stabilize above 60 mm Hg at least, it means that it did not help at all.
Why? Because, as explained by the head of the ICU, Dr. Radu Țincu, the main effect of noradrenaline is vasoconstriction to raise blood pressure. If despite this major vasoconstriction, the pressure does not increase, it means the problem lies elsewhere, namely at the pump.
It's useless to act on the pipes if the pump that should push the water through them no longer works. And indeed, the patient in question had the most severe form of heart failure, so severe that it had caused liver cirrhosis due to the liver's circulation deprivation.
Who is right?
The question does not distinguish between impeccable and malpractice, which became a fait accompli the moment the medical records were no longer in line with the actual medical act, but between malpractice and premeditated murder, the truly terrible accusation that must be clarified down to the last detail.
How can clarification be obtained? Legally, the forensic medical report would be sufficient. But realistically, I believe two aspects should be taken into account.
On the one hand, I find it extremely hard to believe that all ICU doctors who have spoken publicly or whom I have spoken with, all doctors from related specialties, such as Professor of Cardiology Andrei Gh. Dan, would be willing to make professional mistakes in the public space, to shatter their professional condition and reputation to defend two criminals whom 90% of them don't even know personally.
On the other hand, we have a case where therapeutic conduct is discussed, not a necropsy exam, not an autopsy with organs on the table, so to speak.
Given these circumstances, it is still difficult to admit that there is any doctor specialized in all fields, from head to toe, as Dr. Radu Țincu pointed out.
ICU doctors are still people who, in addition to their 6 years of medical school, undergo another 5 years of specialization, at the end of which they take a common European exam simultaneously across the continent.
The judge writes in the reasoning for the arrest of the two female doctors that they could have saved the patient's life by raising the level of noradrenaline, while the ICU doctors claim that the patient's life could not have been saved and noradrenaline was already useless, if not harmful.
In these circumstances, in my opinion, an analysis by an independent ICU expert is necessary in this case.
Not Romanian, not of Romanian origin, to avoid speaking of solidarity and fraternity. INML, the prosecutor's office, the court should choose a high-caliber ICU doctor from any country, from Europe or the US, to clarify the specific case to understand whether premeditated murder took place in an ICU unit in the capital of Romania or a series of negligence and administrative deficiencies, akin to malpractice.