SunStar.com CEBU CITY, Philippines - Unethical and scandalous.

April 16, 2008

That’s how several doctors described the behavior of Vicente Sotto Memorial Medical Center (VSMMC) doctors and nurses during the operation to remove a perfume canister from the anus of a male patient. Doctors involved in the operation were seen laughing boisterously during the operation, which was recorded on video. A video clip was later uploaded to the video sharing website YouTube. Dr. Emmanuel Gines, VSMMC media liaison officer and emergency room department head, said in a radio interview that they will apologize to the 39-year-old patient identified only as Jan-Jan because of the embarrassment he suffered. Gines said at least six doctors, including Dr. Ariel Arias, are being investigated. He could not say how many nurses were placed under investigation. A five-member body tasked to look into the controversy is expected to release its findings this Friday. Gines, a surgeon, said that taking a video and laughing at a patient while he is being operated on is inappropriate. “On the question of the behavior of the doctors and nurses, it was really improper,” he said. He said their investigation began even before the scandal came out in the media because the hospital leadership is concerned about the incident. He urged the media to just wait for the committee’s report. While admitting that the incident placed VSMMC in a bad light, Gines assured the public that what happened to “Jan-Jan” was an isolated case that will not occur again. “We have enforced and strengthened our (privacy) policy as far as the operating room and anywhere of the sections in the hospitals after this incident, especially the banning of cellular phones with or without cameras,” he said. In a separate interview, Basak Pardo Barangay Captain Dave Tumulak said Jan-Jan is bent on filing a complaint and has already executed an affidavit against the doctors and nurses, some of whom were shown in the video. Jan-Jan will also complain before the Department of Health (DOH), the Professional Regulations Commission, and the Office of the Ombudsman Visayas. Dr. Wyben Briones, a neuro-surgeon for 30 years connected with VSMMC and hospitals like Chong Hua and Velez, said doctors are bound by their profession to respect the patient’s privacy. In a TV Patrol World report, he said medical practitioners must respect the privacy of the patient at all times. “For us, that (privacy) is sacred. No doctor or nurse shall announce that somebody is suffering from an illness or that somebody is positive of Aids (Acquired Immune Deficiency Syndrome),” Briones said. Briones, who is also an Emergency Rescue Unit Foundation (Eruf) member, said it is really objectionable for somebody to take videos of an operation and upload it to YouTube for all the world to see. What is acceptable, he said, is for a doctor operating on a patient to allow young doctors and nurses to witness, as long as the aim is to educate them further. “Di ta ma-doctor kon wa pa ta tudlo-i or wa pa ta mo-agig (we could not be doctors if we do not go through) training. And the Sotto hospital (VSMMC) is a teaching hospital. But what happened here is a violation of ethical standards,” he added.

Briones said non-resident doctors and nurses who are not on field duty are not even allowed to witness an operation. In his case, he said, he only allows neuro-surgeons to witness him treating his patients if it concerns their profession. As of press time last night (Tuesday night), Tumulak, Jan-Jan and his lawyer were still having a conference to come up with an airtight complaint. Tumulak said they will also include Dr. Gerardo Aquino Jr, VSMMC chief medical officer, who was in Manila attending to an official business when the operation happened. Tumulak said Jan-Jan is demanding for the hospital to furnish him the official records of the January 3 operation for easy identification of all doctors and nurses involved. Dr. Susana Madarieta, DOH Central Visayas director, said they will review the result of the VSMMC investigation to ensure that there is no whitewash.

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SunStar News: Doctors May Lose Their Licenses Over Surgery Scandal
April 17, 2008

CEBU CITY -- A video posted on YouTube showing doctors laughing while removing an object from a patient's rectum may lead to charges against the surgeons and cost them their medical licenses, officials said Wednesday. And even after the apology by Vicente Sotto Memorial Medical Center (VSMMC) officials, the patient is still considering filing a civil suit for damages against the medical team. He said he will file the case unless VSMMC imposes sanctions on the doctors and nurses and he is satisfied with the penalties. If he is not satisfied with VSMMC's action on the medical team, there will be a "legal battle," said his lawyer Guiller Ceniza. In other developments of the case: * The president of the Philippine Medical Association (PMA) said if doctors are found violating medical ethics, they could be expelled from the association. * The Office of the Ombudsman-Visayas has launched a fact-finding investigation on the incident to determine the liability of VSMMC officials, doctors, and nurses. * VSMMC has scheduled a press conference on Friday to announce the result of their investigation. The hospital is also set to discuss recommendations on how to prevent a similar incident as well as reveal the list of doctors and nurses involved in the operation. * A nursing student suspected to have posted the video on YouTube was not able to graduate because of a pending investigation on the incident by the school.

The unauthorized 2:54-minute video of a noisy operating room shows VSMMC doctors and nurses laughing, giggling and cheering. At one point, a hand appears with a cell phone camera taking a close-up picture of the surgery. As a doctor gingerly pulls out the six-inch long canister from the male patient's rectum, someone shouts, "Baby out!" amid loud cheers. The doctor then removes the canister cap and sprays the contents toward the crowd of nurses and doctors viewing the procedure. It remains unclear who shot the video and who posted it on YouTube, but the person who posted it removed it from the website Wednesday. Sun.Star Cebu was told by an informant that the video was uploaded by a nursing student. Basak-Pardo Barangay Captain Dave Tumulak, who helped the patient raise the complaint, said he also got the same information from his sources. Tumulak said the student was not able to graduate because of a pending investigation by the school on the incident. Commission on Higher Education (Ched) 7 Director Enrique Grecia will look into the matter when he comes back to Cebu on Monday from an official trip to Bohol. "The behavior shown in the video is not acceptable. It is not within the realm of human reason. I will check the school once it is identified, get its side and the student's side before we give sanctions," he said. Tumulak said several VSMMC doctors called him up for help in requesting hospital management to name the persons involved in the case so that those not involved will not be dragged into the case. Dr. Jose Sabili, president of the PMA, on Wednesday said the group will conduct an investigation if a formal complaint is filed and doctors found violating medical ethics could be suspended or expelled from the association, which would result in the suspension or termination of their state health insurance accreditation. The results of the investigation could also be used by the Professional Regulation Commission (PRC) to suspend or revoke their licenses, Sabili said. "I believe what they did was very blatant," he said. Health Undersecretary Alexander Padilla said the Health Department will conduct a separate investigation. The president of the Integrated Bar of the Philippines (IBP) Cebu City chapter has also condemned the incident. Lawyer Briccio Boholst wants the incident investigated and those responsible sanctioned. Assistant Ombudsman Virginia Santiago said their fact-finding investigation will not be bound by the hospital investigation report. Nevertheless, she wants a copy of their findings. She did not comment when asked if the apology by hospital management constituted an admission of fault.

Santiago said they want to find out the identity of the doctors and support staff involved in the operation. Santiago said she wants the complainant to drop by the anti-graft office and issue an official statement. The fact-finding investigation, however, will push though without it. In a dyLA radio interview, Ceniza said there was no question on the medical procedure. "Most likely, what we can file is a civil action for damages. We are still studying the criminal aspect, as there was no negligence on the medical procedure of the doctors. But for taking video footages and making fun of the whole thing is a violation of the patient's right to privacy," Ceniza said. He described the doctor-patient confidentiality as "privileged communication" similar to the privacy of matters between a lawyer and his or her client as or a priest and a penitent. Ceniza also questioned why, based on the video, people without gloves were allowed to enter the operating room, which is supposed to be a sterile area. The Commission on Human Rights agreed that there was a violation of medical ethics and in the confidentiality between the doctor and the patient while the Archdiocese of Cebu reminded the Catholic flock to respect the human dignity. (AP/NRC/KNR of Sun.Star Cebu)
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