Delayed diagnosis and surgical intervention culpably performed two hours after the maximum time limit of "six hours from the onset of the pathological phenomenon." These erroneous actions by healthcare workers are at the root of "irreversible ischemic necrosis due to double torsion of the spermatic cord," which on September 22, 2017, necessitated the removal of the left testicle (left orchiectomy) of a three-year-old boy. These actions were deemed erroneous by the civil judge of the Tempio Tribunal, Alessandro Di Giacomo, who ordered the ATS (Health Protection Agency) to compensate the child's parents with €265,000, plus interest and legal fees.

The story

The incident occurred in the emergency room of Olbia Hospital. The judge upheld the argument of the child's parents' lawyer, Gianmario Pilatu. The handling of the case in the emergency room of the Giovanni Paolo II Hospital, according to the findings of the panel of experts appointed by the judge, was characterized by a series of errors that caused serious harm to the child. Essentially, no timely action was taken from the child's arrival at 3:00 PM on September 22, 2017, failing to perform tests and consultations that would have revealed the severity of the testicular torsion. The ruling refers to a failure to modify the "original (erroneous) nursing assignment of the yellow severity code, which does not appear to have been duly modified by the attending pediatrician and duly communicated to the radiologists."

«He had a snack»

According to the documents, the child was admitted to the hospital in Olbia at 3:00 PM on September 22, 2017. Doctors noted "symptoms consisting of pain, edema, and swelling of the left testicle." Only at 5:51 PM was left testicular torsion diagnosed, "followed by the indication of the need for surgical treatment." The child was transferred to Sassari at 8:30 PM and operated on "only at 10:30 PM." Too late; the only thing the surgeons could do was perform an orchiectomy. The judge wrote that the first error was "the Radiology Service was not alerted to the urgent nature of the clinical case." Therefore, the radiological examinations followed the standard schedule. The second misconduct was that of the anesthetists, who established a "clear contraindication to surgery, given the presumed anesthetic risk identified in the minor's ingestion of water and a snack." The experts confirmed that food ingestion no longer constitutes an absolute contraindication to administering anesthesia. The final error, according to the ruling, was not ordering immediate surgery, adding another two hours to the delayed diagnosis. The ATS (Healthcare Authority) provided the judge with a reconstruction of the facts that ruled out errors by the Olbia medical staff.

Andrea Busia

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