The Conselleria de Salut will sanction several healthcare centers for not detecting signs of physical and sexual violence in an infant treated in Barcelona. The Hospital de Sant Pau will be fined, while it is being analyzed if the Hospital Sant Joan de Déu and the CAP Roger de Flor will also be admonished. The Hospital del Mar, however, would be exempt from the sanctions.
Salut appreciates failures in the detection of the case
The review opened by the department concludes that there were deficiencies in the clinical assessment of the minor before the child violence protocol was activated. The general director of Health Planning and Regulation, Clara Pareja, has admitted that the system failed at different levels and that the response was not adequate despite the existence of signs that should have alerted the professionals.
"The system has failed in different aspects. To begin with, there was positive discrimination because the mother was a healthcare professional" - Clara Pareja, Director General of Health Planning and Regulation
The baby was born on February 3 at Hospital Vall d"Hebron. The mother worked there as a Traumatology nurse. Weeks later, on March 1, the parents took the child to Hospital del Mar due to cough, reflux, and vomiting. At that center, a urine catheter was placed on him.
The next relevant care was on March 7 at Sant Joan de Déu. The infant presented with a low-grade fever, genital hematomas, tachycardia, and broken ribs, although an X-ray was not performed on that visit. For Salut, that was a key point at which the suspicion of child abuse should have been activated.
"The child violence protocol should have been activated in Sant Joan de Déu" - Clara Pareja, general director of Health Planning and Regulation
The fractures were detected days later in Vall d"Hebron
The alarms were activated on March 16 in Vall d"Hebron, when long-standing lesions were detected. It was then when X-rays were performed and rib fractures were confirmed.
"That he/she had broken ribs was evidenced on March 16 in Vall d"Hebron. There X-rays were taken and the fractures were seen" - Clara Pareja, General Director of Health Planning and Regulation
Two days later, on March 18, Vall d"Hebron activated the child violence protocol and the Mossos d"Esquadra arrested the parents. The police and judicial investigation remains open, so both maintain the status of alleged perpetrators until there is a firm resolution.
Salut will review the protocol and the training of professionals
The Conselleria maintains that in this case prejudices intervened that conditioned the clinical reading of the symptoms. It also points out that the parents would have introduced distracting elements that made it difficult to clearly identify a possible episode of child violence.
"The clinic is the clinic and the clinic rules. But there were prejudices, a positive discrimination because the mother was a healthcare professional and apparently they seemed like a structured family" - Clara Pareja, general director of Ordenación y Regulación Sanitaria
Salut will now review the action protocol and will incorporate corrective elements to reinforce the training of doctors and nurses in child violence. The objective is to prevent signs compatible with abuse, especially in patients as vulnerable as infants, from going unnoticed again in the Catalan healthcare network.