The death of two-year-old Domenico Caliendo, who died last Saturday at the Monaldi Hospital in Naples after a heart transplant performed on December 23, 2025, with an organ damaged during transport from Bolzano, may not be an isolated event.
This is the thesis contained in the complaint filed by Federconsumatori Campania with the Naples Public Prosecutor's Office, which points to alleged systemic criticalities in the facility's pediatric transplant department.
According to the association, represented by attorney Carlo Spirito, other pediatric patient deaths have occurred over the years while enrolled in the same transplant program. This circumstance, if confirmed, would constitute a structural rather than episodic problem.
“Obvious non-conformities ignored by the institutions”
"The documents today confirm that we were right. We did our duty as a protection association, but it wasn't enough: Domenico tells us we still failed," Spirito declared, presenting the contents of the complaint to the press.
According to Federconsumatori, the responsibility also falls on the health institutions responsible for inspections, starting with the Regional Directorate General for Health. The association cites serious shortcomings in oversight and renewals of authorizations despite persistent operational, structural, and organizational noncompliance at the transplant center.
Inspection after another pediatric death
The legal action stems from an inspection of the National Transplant Center, initiated after the death in 2024 of Pamela Dimitrova, Domenico's peer. According to Federconsumatori, the inspection report—notified to the association only in February 2026—had long been in the possession of both the regional health directorate and the hospital.
The document also included a timeline agreed upon with the National Transplant Center to establish a department dedicated to pediatric transplants by March 2025. According to the complaint, this deadline was never met.
Non-existent department and activities in adult areas
Among the critical issues highlighted by the association's lawyers was the lack of a true pediatric transplant department, with young patients housed in adult surgery spaces not designed for child care. There was also no sub-intensive care unit dedicated to the post-operative phase, while transplant activity would have continued even during the renovation of the pediatric cardiac surgery unit.
Federconsumatori then raises concerns about regional controls: between 2019 and 2024, the operating unit responsible for pediatric transplantation performed only one operation, a fact that—according to the association—should have highlighted anomalies in the assessment of activity volumes.
Authorizations and accreditation under review
The complaint also reconstructs critical administrative issues: the facility's request for health authorization, submitted to the City of Naples in 2002, was never formally approved but was instead extended without the required checks. In this context, the association argues that the center could not have been designated as a transplant facility without proper and up-to-date accreditation with the National Health Service.
“Not a fatality but a systemic problem”
"Domenico's death cannot be dismissed as a fatality, given what has been reconstructed over the years," said Giovanni Berritto, president of Federconsumatori Campania. The association describes a compromised healthcare system and widespread responsibility at multiple institutional levels, albeit with varying degrees of severity.
The request to the judiciary is to determine any causal links between the center's organizational conditions and the fatal events, verify the implementation of clinical protocols, and verify the facilities' compliance with regulatory requirements. "Seeking justice," Berritto concludes, "means repairing this distortion and restoring the right to healthcare to the most vulnerable patients."
It seems like a serious case, but we need to be cautious and clarify. The documents show anomalies in the pediatric ward, with patients in adult spaces, and checks not performed, with authorizations extended without verification. Responsibility would lie at multiple levels; the judiciary will need to carefully examine the causes and procedures.