Naples – The hearing before Naples investigating judge Sorrentino is scheduled for next Tuesday to award the assignments to the technical consultants in the preliminary investigation into the death of Domenico Caliendo, the child who died on February 21 after an unsuccessful heart transplant performed at Monaldi Hospital.
The Naples Public Prosecutor's Office, VI Labor and Professional Misconduct Section, has placed seven doctors under investigation, suspected of conspiracy to commit manslaughter. Each suspect will be able to appoint expert witnesses to assist the judge's experts in determining the cause of death.
The Region's report: three critical issues
The 295-page report submitted by the Campania Region to the Ministry of Health, containing documentation produced by the hospital, also sheds light on the possible causes of the fatal outcome.
According to the document, three main factors contributed to the transplant failure: ice, transport container, and intraoperative communication.
The first element concerns a procedural flaw during the collection and transportation phase: the departure from Monaldi with an insufficient amount of ice would have made it necessary to obtain more at the explant site. Subsequent insertion into the transport container would have altered the heart's preservation conditions during the transfer to Naples.
The second factor concerns the failure of the removal team to perform a final check of the container: at the time of sealing, an effective check of the organ's condition was not carried out, resulting in a validation deemed insufficient.
The communication issue in the operating room
The third critical aspect, indicated as decisive, concerns a communication and procedural deficit within the surgical team, especially in the most delicate phase between the removal of the recipient's heart and the implantation of the donor's.
Internal audits revealed that, during the rush of operations, there was no clear communication between the personnel responsible for extracting the organ from the container and the surgeon responsible for the implant.
The latter, the director of cardiac surgery at Oppido, reportedly reported in a January 21 meeting that, before the patient's cardiectomy, he had asked whether the donor heart was already in the operating room and whether "bench" cardioplegia had been started. The surgeon stated that he perceived the staff present as having agreed.
However, during the audit, none of the team members—cardiac surgeons, nursing coordinator, perfusionist, and operating room nurses—confirmed having provided an explicit affirmative response. This, according to the report, reveals a discrepancy between the perception of the manager and the statements of the staff, which occurred in the moments immediately preceding the removal of the recipient's heart.
Towards the technical assessment
The preliminary investigation will now crystallize the technical details regarding the causes of death and any professional liability. The investigation, ordered during the preliminary investigation, will allow for cross-examination of the parties to obtain medico-legal assessments of the entire transplant process: organ procurement, preservation, transport, and implantation.
Source EDITORIAL TEAM
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