Naples – "Further, progressive, and rapid deterioration." This is the picture contained in the latest clinical update from Monaldi Hospital on the condition of Domenico Caliendo, two and a half years old, who has been hospitalized in the pediatric intensive care unit for weeks.
The parents, mother Patrizia and father Antonio, were summoned shortly before dawn due to a new deterioration in their child's condition. During these hours, the child's sedation level was increased, and the "shared care" programs, which were no longer effective in addressing his clinical condition, were reportedly suspended.
The ward is filled with painful waiting: the mother remains at the bedside, while the family faces what are described as the most difficult moments since the beginning of the story.
The transition to palliative care: an end to overtreatment.
After nearly two months of battling, the mother yesterday agreed with doctors to transition to palliative care, with the stated goal of avoiding aggressive therapy and ensuring the child a dignified and pain-free end of life.
In yesterday's meeting—as part of shared care planning—the hospital proposed targeted interventions to discontinue therapies deemed "no longer helpful" to the patient's condition and to initiate a gradual de-escalation of other treatments. In agreement with the family and the medical examiner indicated by the parents, the child will be maintained on only therapies considered strictly lifesaving.
ECMO and organ damage: "Removing it now would be tantamount to interrupting life."
Domenico remains connected to the ECMO, the breathing and extracorporeal circulation machine used after the failed transplant on December 23rd. Prolonged use of this machine would have caused serious damage to his internal organs. According to the text, interrupting the support now would be tantamount to "pulling a plug."
The doctors ruled out both euthanasia and obstinacy: the child was described as sedated, with critical parameters. Monaldi cardiologist Antonio Corcione, quoted in the text, assures that he is "in no pain whatsoever," while reiterating the seriousness of the situation.
The chain of alleged errors: the "unusable" organ and the transport from Bolzano
At the heart of the story—and the investigation—is the dramatic sequence of steps that led to the transplant of a heart described as "unusable." According to reports, the irreversible damage to the organ occurred during the journey to Naples: the use of dry ice instead of regular ice and the use of an older-generation insulated container, lacking temperature sensors and alarms, are cited.
The container was apparently chosen by the team departing from Naples despite the hospital having more modern technological boxes; the reason given is the lack of staff training in their use. The Naples Public Prosecutor's Office is working to clarify responsibilities and the circumstances surrounding the case: currently, six doctors and nurses at Monaldi are under investigation, with the possibility—mentioned in the text—of additional suspects, including those from Bolzano, where the organ was allegedly prepared for shipment.
The final consultation and the renunciation of further opinions: no remaining possibilities
A consultation of experts "from across Italy" ruled out further options for Domenico. The heart identified on Tuesday as a possible alternative was instead transplanted into another child at the Giovanni XXIII Hospital in Bergamo.
At that point, the mother and the forensic consultant reportedly gave up on seeking further opinions from European specialists: once the search for solutions was over, the story began to move into a period of reflection.
Source EDITORIAL TEAM
Comments (3)
Domenico's situation seems tragic and complex. We hope the relevant authorities can shed light on what happened, because ensuring the safety of hospital patients is essential.
Reading about this story, I wonder if the doctors and the team involved were actually responsible. It's important to clarify the situation to prevent similar mistakes from happening again in the future.
Domenico's situation is extremely difficult and complicated. His parents are facing terrible times, and the decision to transition to palliative care is undoubtedly a painful one, but one necessary to avoid further suffering.