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On November 1, 2017, while some were celebrating the dead, Catalina Buschmann (38) started a crusade to survive. That day, he was sitting in a shepherd of the chemotherapy room of San Borja Arriarán hospital and was facing one of the most difficult parts of cancer treatment of the bad diagnosed five months earlier. 19659002] – "You can not move your hand because if a drop escapes it can necrotic you" – said a nurse before starting to give her a red medicine in her right arm that was hurting her for a long time.
day, Catalina began one of four chemotherapy sessions with which she would try to stop cancer. "The veins were getting hard and many times I dropped my cellphone because of the weakness of my arm.Although when I write a lot with my right hand, it bothers me."
A tank is a 20-centimeter disc that is placed under the skin and the catheter is a thin tube that connects to the reservoir, allowing it to pbad the medications through a larger vein, more likely to withstand the chemical bomb than the treatment means. The AUGE protocol includes bad cancer in your basket and indicates in your gloss that the administration of drugs during chemotherapy should be done with a catheter with a reservoir.
-Catalin, have you ever asked to use a catheter with reservoir?
-I asked why they put the medicine in my veins, why they did not use a catheter, but I only asked them once and they m & # 39; 39 responded that it was for the elderly, not for me.
] Do not investigate
Although in public hospitals doctors insist that they are trying to comply with the Trough as it is, the Plan of Action. Universal access to explicit health guarantees, developed under the administration of Ricardo Lagos, is not always respected. the basket of benefits for which patients, in some cases, also disburse a co-payment.
In October of last year, some doctors from San Borja Hospital realized that the form of chemotherapy administration of their patients did not conform to what asked the protocol of Auge and they tried to make examine the situation. Then they asked the campus director, Patricio Vera, to open a summary investigation because at that time there was a list of about a hundred patients in this situation, according to hospital doctors [19659009]. who acceded El Mostrador, the specialists did indeed alert the authorities about the shortcomings of the treatment, and Vera asked the investigation to the person in charge of the Department of legal counsel of San Borja Arriarán, Loreto Aparicio. In a memorandum of December 2017, the lawyer replied that according to the basic information, there is no account of a situation that could constitute an administrative irregularity or an infringement of duties and obligations likely to apply a disciplinary measure. in accordance with the provisions of Article 119 et seq. of the Staff Regulations. "On the same page and in handwriting, Deputy Director Alejandro Casals wrote that the case was closed and that the protocol" is fully respected. "[19659002] That is to say, despite the seriousness of the complaint, the hospital authorities decided
Daniel Valenzuela, vice president of the medical section of San Borja Arriarán Hospital, confirms that the Last year, they informed the authorities of the situation that occurred with the warning of Dr. David Villena, head of CDT, who realized that the AUGE protocol was not fully respected and insisted that regulations be introduced. "The explanation given by the hospital authorities and the chief of oncology is that there is a catheter, which There is no human ability to install them and the flag hours. The device exists, what is lacking is the operative capacity, "says Valenzuela.
The doctor tells this product of concern, they had a meeting with the chief oncology doctor to understand the repercussion what might have about patient recovery and the response they received explains a series of drawbacks that could, in the long run, affect the treatment. "In oncology, they ensure that the central venous catheter is no longer sure, more comfortable and has fewer complications. In the private sector, in fact, it is used in about 100% of cases, but this route is not used here. Although they explained that the drug is the same in terms of quantity or dose, they also explained that the peripheral catheter (the one they chose to use compared to the central venous catheter ) has a technical problem: patients must be hospitalized cycle, patients must wait each time a new cycle and a new quota of hospitalization. If this is not done, the treatment is out of date, "says Valenzuela, who also acknowledges that doctors face a strong ethical dilemma, since they apply the trough to heal even patients. if "as much as possible". "
In this case, in which the trough protocol could not be accounted for, the hospital did not activate another of the alternatives protected by law: an enclosure can not deliver the benefit, it must return the patient to a second provider.
The defense of the authorities
Despite the sight put by the doctors, no investigation was conducted and the list of patients of Auge continued to receive the drugs by a peripheral venous line, without knowing by what or what corresponds to them for the benefit basket
Currently, to the hospital San Borja Arriarán there is 62 women who do not have central venous catheter oce the warden.However, Vera defends the fact that this situation does not affect the treatment of patients: "In technical terms, the Central venous catheter is a technique for the administration of chemotherapeutic drugs apie. Similarly, it is worth pointing out that according to the PINDA protocol and established clinical guidelines, the installation of a central venous catheter is not necessary to begin chemotherapy cycles and, in turn the initial treatment does not prevent the placement of the catheter. during the treatment period. Given the above, it is possible that they may receive this benefit later, and this is ultimately what is done with patients who have not rejected the facility's this one. "
Vera also answers other questions from ] El Counter :
– Women Who Receive the Periphery Have Been Informed About It?
] -All patients who enter the oncology polyclinic receive an education about the process they will initiate on the part of the care team, in which the explanation is included in the management techniques, options and rights they have as patients.In turn, there is an administrative procedure for patients who reject, in any stage of their care, the installation of the central venous catheter.
– Some women say that when they asked for a reservoir, they were told resource for the elderly.How do they decide who should to use central venous catheters and who should not? [19659002] -A "indication of the use of a central venous catheter is made to all our patients diagnosed with bad and colon cancer, since it is about A guarantee included in the GHG basket. At this point, it is important to note that the installation of the central catheter is a guaranteed access, but not an opportunity.
Dr. Vera also denies that the deputy director of the hospital has ordered the filing of a summary investigation, despite the memorandum of this, and insists that regardless of the path of access, all patients receive treatment.
Due to the seriousness of the situation, the deputy Gabriel Silber believes that it is "a sanitary scandal of proportions". not only has the right to information been violated. "There is a guaranteed service that is not provided that results in the storage of these devices in a warehouse.From the clinical point of view, the lives of people or patients who have been treated with bad cancer is risk when the protocols indicate a different treatment and this alternative is contrary to what corresponds to the clinical point of view. "said the parliamentarian DC
He stressed that he does not understand why, if the state has a resource, it is not delivered. "It does not fit in our heads when the treatment is administered and the doctors decide for themselves this alternative treatment; they are responsible for professional misconduct. "As a result, Silber is preparing a file to present to the Office of the Comptroller General to investigate the situation and will ask that the Auge Commission – which investigates the waiting lists – cites the people involved.
The medical chapter of the hospital asked week to the medical college ethics court – to investigate whether there are flaws in this aspect that may affect dozens of women.
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