BARI – Leonardo Milella, former head of the Anesthesia and Resuscitation department of the Giovanni XXIII pediatric hospital in Bari, where 12-year-old Zaray Tatiana Coratella Gadaleta died on 19 September 2017 from malignant hyperthermia after reduction surgery, risks a 2-year prison sentence of a fractured femur, caused by a simple fall while playing in a park. Milella is on trial on charges of manslaughter and in recent days the Prosecutor’s Office has requested a 2-year sentence against him. In the same hearing, the victim’s family, acting as a civil party with the lawyer Michele Laforgia, asked for damages of one million euros.
The former head doctor is accused of not having diagnosed the congenital pathology from which the little girl was suffering in time, administering a life-saving drug to her late, which was also missing in the operating room, when the 12-year-old had already been transferred to intensive care with a fever of 43 ,6 degrees.
The long debate – according to the reconstruction of the prosecution and the civil party – would have demonstrated that the surgery to reduce the fracture of the femur to which Zaray was subjected could and should have been deferred in order to verify the type of anesthetics to be injected into the patient, in consideration of the altered CPK value and the absence of anamnestic information regarding malignant hyperthermia. Upon Dr. Milella’s arrival (around 10.50 am), once the surgical operation was completed, these elements should have led to the diagnosis of malignant hyperthermia, with consequent administration of Dantrium; the accused, however, would have investigated other diagnostic hypotheses until 12.15 pm (when the echocardiogram was carried out), failing to proceed promptly with the administration of the life-saving drug. In any case, the Dantrium was not available either in the operating room or in the intensive care unit and was urgently requested from the pediatric hospital pharmacy, to be administered only starting around 1pm. If it had been available and administered within thirty/forty minutes of Milella’s arrival in the operating room, the drug could have saved the little patient’s life.
On the question of the drug, the former head physician is currently under investigation in a separate file also for the crime of forgery for having noted in the medical record that the medicine had already been administered at 11.30 am, when in fact the patient would only have received it at 1 pm. rest, the delay in administering the drug is one of the aspects that are considered the cause of death and therefore complained to the doctor. The provision of 48 bottles of that particular antidote is mandatory both in the operating room and in intensive care. In this case not only was the Dantrium not available, but, at least in the operating room, the last supply dated back to June 2015 and therefore would have expired in June 2017 anyway.
In the same case, for the crime of manslaughter, the anesthetist who during the orthopedic operation administered a drug for general anesthesia which is contraindicated in the case of congenital pathologies such as from which the teenager suffered.
