Castellammare, a woman dies in hospital after an endless wait: doctor convicted for misdiagnosis

Castellammare di Stabia - A misdiagnosis and a late surgical procedure cost a woman from Castellammare di Stabia her life. expectation to the emergency room of San Leonardo Hospital, where she had presented on August 9, 2021, with severe abdominal pain. The patient would later die on August 28, after weeks in intensive care and a dramatic race against time.

The Torre Annunziata Court sentenced Dr. Grazia Maria Iovine, a physician working at San Leonardo Hospital, to ten months in prison. She was held responsible for the patient's death due to diagnostic negligence and delayed treatment. In addition to the sentence, the judge ordered the payment of civil costs and a provisional payment to the family.

Daughter's testimony: "Hours of waiting and no ultrasound"

In court, the victim's daughter, Rita Rosaria Langellotti, assisted by lawyer Massimo Autieri, reconstructed her mother's last hours of life.

"I called 118 on the night between August 8th and 9th," he said, "my mother was complaining of unbearable abdominal pain. We arrived at the emergency room between 3:30 and 4:00."

The woman described an interminable wait in which her mother, lying on a stretcher, remained for hours without the nature of the pain being clarified.

"They were talking about possible pancreatitis," she recalled. Only around 9:30–10:00 a.m., after a CT scan, was the ruptured spleen discovered and the emergency surgical protocol activated. The operation was scheduled for around noon, but the patient never woke up, ending up in intensive care, where she remained until her death on August 28th from septic shock and serious complications.

The surgeon's report: "An emergency ignored for hours."

Professor Adelmo Gubitosi, surgeon and technical consultant for the civil party, explained the chain of errors, defining the case as a classic abdominal emergency.
According to the expert report, a complete blood count performed at 5:25 a.m. showed hemoglobin at 9 g/dL and marked anemia, a finding that should have triggered immediate further investigations.

Gubitosi emphasized that a simple fast ultrasound exam—an emergency ultrasound that can be performed in five minutes—could have revealed blood in the abdomen without waiting for the CT scan.

The CT scan, requested at 4:30 am, was only viewed around 10:30 am, by which time the patient was in hemorrhagic shock.

In the operating room, over two liters of blood were found, a sign of prolonged bleeding that had already compromised vital organs.

For the consultant, the surgery came "late", and the post-operative conditions led to nosocomial sepsis and multi-organ dysfunction, culminating in the fatal septic shock on 28 August.

Technical disputes: between "urgency" and "emergency"

In court, the debate also focused on operating protocols. Professor Gubitosi distinguished between urgency and emergency, specifying that in the case in question, the surgical team would have been required to be activated immediately, even without waiting for the official radiological report.

According to the consultant, intervening between 5:00 and 7:30 in the morning could have radically changed the outcome, while the delay allowed the splenic rupture to evolve into diffuse hemorrhage.

The cause of the splenic rupture is thought to be traumatic or contusive, with left rib fractures subsequently detected. In the operating room, the diaphragm was found to be intact, ruling out perforating lesions; the triggering event remains unclear.

The case has brought the structural issues of the San Leonardo emergency room back into the spotlight, which have been repeatedly highlighted during and after the Covid emergency. A story of waiting, mistakes, and pain, which today finds its first answer in court, but still leaves many unanswered questions about the hospital's emergency management.
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