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Contradictions between gov’t, doctors emerge in Senate hearing over Hurricane Maria deaths

By on January 24, 2018

SAN JUAN – A second public hearing by the Public Safety Committee on Senate Resolution 713, authored by committee Chairman Henry Neumann, was held Wednesday to adopt a protocol to determine the cause of death in cases in which environmental factors related to a weather event or disaster contributed to the death of a person.

Contradictions arose between what the government, or the Demographic Registry office and the Forensic Sciences Bureau, maintains and the Physicians & Surgeons Association’s version regarding who should complete the certificate of death and in which situations.

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While, in a previous hearing, the Demographic Registry was categorical in that the responsibility falls on the doctors, who are required by law to fill in the boxes that correspond to them, including box No. 25, which says in bold that “other significant conditions that contributed to the death” must be detailed, “the doctors do not fill it,” the Demographic Registry maintained.

This was backed Wednesday by the Funeral Association, Public Safety Secretary Héctor Pesquera and the Forensic Sciences Bureau.

Meanwhile, the president of the Physicians & Surgeons Association, Dr. Víctor Ramos, assured it was not the doctors’ responsibility to fill out the form, but of the Forensic Sciences pathologists.

Ramos said the death certificate is filled by a doctor only “when having a patient who is already under established medical treatment, has been in the hospital for a month, a week and is hospitalized and you are giving medical attention for ‘x’ condition and the patient dies from that condition or something sudden. It’s a patient who is under your service and it is your responsibility to fill out the death certificate unless you suspect there is something criminal–anything that is criminal cannot be filled out by the doctor, it must be completed by a forensic doctor. All those who were in the hospital and died in the hospital correspond to the doctor, while if a person arrives at the hospital and dies it is not for the doctor but for the coroner.”

The doctor said he was “uncomfortable” with the Demographic Registry and Forensic Sciences blaming the doctors. “We feel quite uncomfortable that the Demographic Registry and the Bureau blamed the doctors when those of us who were out on the streets were the doctors and that the [Physicians & Surgeons] Association has done at least 500 voluntary missions serving the living, who are the priority, and we feel quite uncomfortable that they blame us for their responsibility,” he said.

Also in the hearing, Public Safety Secretary Pesquera confirmed that the number of deaths due to Hurricane Maria are 64, and that eight certifications await toxicology test results. He indicated that many other direct or indirect deaths may have occurred as a result of the storm but cannot be accounted for, since they were not certified by the Forensic Science Bureau.

To Sen. Neumann’s questions about whether he was satisfied with the process carried out to determine the deaths, Pesquera replied, “I feel comfortable.”

“The process to quantify the deaths of the hurricane…. Only in the Forensic Sciences phase is where we can quantify the deaths; some are those corpses that go to the bureau and the other are the bodies that do not go to the bureau. For example, a person who died in the hospital and that body did not arrive in the bureau, therefore neither that death certificate nor that corpse [are counted] by the bureau. When I stand in front of a microphone and say a number, it’s because I’m sure it’s the right number.”

“The chain of events depends on a doctor who has to fill out or answer a question,” Pesquera added regarding the death certificate physicians must fill out under the law.

The committee chairman asked the secretary if he should penalize doctors who did not complete the form. “I don’t think I should be in a position to request that it be compulsory; what I’m saying is that the question exists and that it would help the bureau a lot if it were answered,” Pesquera replied.

“When we saw the difference in the figures on the deaths caused by Hurricane Maria, we began to question the protocol used to make an exact determination of death and numbers. This has legal repercussions that citizens can make in terms of preventing deaths in the future. It does not look good for a government that gives one figure and another gives another. So what we want is to establish an exact protocol. We want that everyone in government knows what their role is and the role they have to carry out,” Neumann stressed.

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