Public Defender says it found insufficient medical staff after inspection at Children's Hospital

Public Defender carries out inspection at Hospital da Criança in São Luís A team from the Public Defender's Office of the State of Maranhão (DPE-MA) carried out, on the afternoon of this Wednesday (15), an inspection at Hospital da Criança Dr. Odorico Amaral de Matos, in São Luís, to verify the operating conditions of the unit amid reports of failures investigated in pediatric ICUs. ?Download the g1 app to see MA news in real time and for free During the inspection, which lasted just over three hours, public defender Davi Veras stated that he had identified signs of irregularities, including the presence of a doctor without specialization in pediatrics and a number of professionals below that considered adequate by technical standards. "Some issues were clear. First, part of the team is not a specialist. We identified a doctor who was not a pediatrician. The number of doctors, by regulatory standards, is insufficient, does not meet demand and this, of course, will somehow compromise assistance", said the defender. The inspection was motivated by reports of failures investigated in pediatric Intensive Care Units (ICUs). The case is investigated by the Public Ministry of Maranhão (MP-MA) and the National Audit Department of the SUS (Denasus), of the Ministry of Health. The Public Defender's Office says it found an insufficient team of doctors after inspection at the Children's Hospital Reproduction/TV Mirante During the inspection, the defenders evaluated the care provided to children, the availability of medicines and supplies, in addition to the shift schedules of doctors who work in pediatric ICUs. The inspection included the participation of defenders from the Health and Child and Adolescent centers, who will prepare a report with the observations made during the visit "We will prepare a very detailed inspection report, listing everything that was observed. We also spoke with many family members, with parents of children who were accompanying their children. They reported to us situations related to delays in care and problems with lack of medication. We will put everything in the report and contact the Department of Health, in addition to the hospital management, to try to resolve the problems as quickly as possible. possible", said public defender Vinicius Goullar. Body has been monitoring the case since last year The Public Defender's Office has been monitoring the situation at Children's Hospital since last year, when the City of São Luís issued the notice to hire a company responsible for managing the unit's ICUs. The Brazilian Institute of Medical Services (IBMED) won the bid which, according to the Public Defender's Office, had several flaws. At the time, the body recommended to the Public Ministry of Maranhão (MP-MA) the adoption of measures to prevent the company from being hired, on the grounds that irregularities could compromise care in pediatric ICUs. The Public Defender's Office also notified São Luís City Hall about the risks identified. "On August 4, 2025, Semus was notified of the irregularities. The company only started operating on October 13, 2025. In other words, two months before we notified the secretariat, we notified the Society of Childcare and Pediatrics and the Public Prosecutor's Office. Afterwards we had meetings with the teams and we were assured that the problems would be resolved", stated Davi Veras. Under-reporting is investigated Public defender says he alerted City Hall about contract failures for pediatric ICUs In an interview with TV Mirante, public defender Davi Veras said that he is investigating signs of possible under-reporting of occurrences at the Children's Hospital. According to Davi Veras, the analysis of medical records and documents from the unit will be necessary to verify whether all cases were registered correctly. The defender also investigates possible failures in care, such as errors in medication administration and care by professionals without specialization in pediatrics. The cases still need to be confirmed through technical analyzes and statements from families. If irregularities are proven, an intervention in the unit is not ruled out. note from the City of São Luís on children's deaths at Hospital da Criança Company did not have a ready team, says defender According to Davi Veras, during the meetings held before the contract was signed, the company responsible for managing the ICUs admitted that it did not have enough staff to take over the service and tried to absorb the doctors who already worked at Hospital da Criança. underwent audit Audit by the Ministry of Health at the Hospital da Criança in São Luís lasts three hours and the final report should be released in the next few days Reproduction/TV Mirante Technicians from the Ministry of Health carried out, on Tuesday (14), an audit at the Hospital da Criança Odorico Amaral de Matos, in São Luís, to investigate complaints related to the operation of the unit's pediatric Intensive Care Units (ICUs). The end of the inspection should be announced in the next few days. According to Rafael Bruxellas, director of the National Audit Department of the Unified Health System (DenaSUS), the audit is not a routine visit, but an urgent action in light of complaints sent by parents of patients to the Unified Health System (SUS) Ombudsman's Office. DenaSUS is not here for a routine audit, but to investigate an urgent situation, in the face of a serious complaint about the risk to the lives of children in vulnerable health situations", said the director. According to Rafael Bruxellas, if irregularities are found, the report may contain alerts and recommendations for the City of São Luís to present a contingency plan to correct the problems identified. In addition to in-person inspections, auditors must examine medical records, professional rosters, contracts, mortality indicators, hospitalization records and notifications posted in the SUS systems. Case is investigated by the Public Ministry The complaints investigated by the Ministry of Health are also investigated by the Public Ministry of Maranhão (MP-MA). According to the report, the Children's Hospital recorded 113 deaths in 2025 and of these, 101 would have occurred within the Health Unit's three ICUs. That would be 62 more deaths than in 2024. The City of São Luís disputes the numbers presented. According to the Municipality, in 2024, 112 deaths were recorded. However, 39 deaths are reported on the Ministry of Health website. The complaint points out that the increase in the number of deaths coincides with the change in management of the hospital's ICUs. According to documents cited in the investigation, more than half of the 31 deaths registered in the SUS system in 2025 could have been avoided. The classification and criteria used must be detailed by the responsible bodies during the investigations. Public Ministry of Maranhão investigates the increase in deaths in the children's ICUs at Hospital da Criança Reproduction/TV Mirante In October 2025, the City of São Luís placed a tender to hire the company Instituto Brasileiro de Serviços Médicos (IBMED) to manage the hospital's ICUs. The contract, according to the Public Ministry, would have drastically reduced resources to pay for the ICUs, as well as the number of doctors on the team. Professionals who previously worked at the unit say that some team members were invited to stay, but declined the proposal because they considered that the expected number of doctors would be insufficient to guarantee safe care. Company denies irregularities The Brazilian Institute of Medical Services (IBMED), a company contracted to manage the pediatric ICUs at Hospital da Criança, denies that it has reduced the number of professionals and states that there are no irregularities in the execution of the contract. According to the company's clinical director, Paulo Bayma, currently more than 20 doctors are part of the team responsible for care at the unit. "Today we have approximately 20 doctors. We brought professionals from various regions of Brazil who were willing to come here. Doctors came from Amazonas, Piauí, Ceará, São Paulo, and several states, so that pediatric medical care in our capital would not be interrupted", says the director. Families report delay in care and deterioration of children Note from the City of São Luís angers families of victims Among the cases investigated is that of Kerliane, aged 7, who died after being treated and admitted to the Children's Hospital. According to her mother, civil firefighter Jainara Sousa dos Santos, the girl was taken to the unit on April 23 with pain in her leg. Two days earlier, she had fallen in her backyard and injured her buttocks. Jainara states that her daughter underwent blood tests and a CT scan. After identifying a clot, the child would have been discharged without undergoing drainage. "My daughter wasn't that bad, but she did some blood tests and showed a little anemia. If there was a slight infection, they didn't say anything right away and discharged my daughter", reported Jainara. Kerliane, aged 7, died after being treated and admitted to the Children's Hospital in São Luís. Reproduction/TV Mirante Two days later, the mother returned to the hospital because the pain had increased and the girl began to vomit. New tests would have indicated an infection, in addition to changes in the lungs, liver and kidneys. Kerliane was intubated in an area known as the “large room”, where she remained for two days before being transferred to an ICU. The girl died on April 29th. The case is investigated by the Public Ministry of Maranhão. "My daughter's leg was just swelling and she (the doctor) said it was normal, that it was a reduction in fluid. When they thought about draining it, it was on the 29th, my daughter passed away", lamented the mother. Professionals denounce reduction in medical staff MP investigates increase in deaths at Hospital da Criança, in São Luís Doctors, nurses and technicians who work or have worked at Hospital da Criança claim that there was a significant reduction in staff after a change in ICU management. The professionals agreed to speak without being identified for fear of retaliation. According to a pediatrician, until October 12, 2025, the three ICUs had 53 doctors. The shifts would have eight professionals in the morning, six in the afternoon and six at night. From October 13th, according to reports, the number of doctors would have been reduced. On certain shifts, there would only be three professionals to serve the three ICUs — one doctor in each unit. The complainants also claim that some of the people on duty do not have specialization or experience in pediatrics. "With this number of professionals, even a trained, very experienced and qualified doctor would not be able to handle this scenario. And we are talking about people who have no experience in pediatrics. In the vast majority of cases, it is not a pediatrician who is on duty, and this has a direct impact on care." What do the authorities say? City Hall states that assistance followed technical protocols The Municipal Health Department of São Luís reported that the audit conducted by the SUS National Audit Department (Denasus) is still in progress and that all requested information is being provided to the body. The secretariat stated that it sympathizes with the pain of the families and reiterated that the data presented previously were extracted from medical records and reports. The body also informed that, with the authorization of family members, it may make official documents available and highlighted that the assistance provided to patients followed current technical and care protocols, with conduct adopted according to the clinical evolution recorded of each child. City Hall says that the Public Defender's Office's inspection took place without prior notice Regarding the inspection carried out by the State Public Defender's Office at the Children's Hospital, the Department of Health stated that the visit took place without prior communication to the body, unlike institutional inspections carried out by the Ministry of Health. Even so, according to the secretariat, the unit's team received the representatives of the Public Defender's Office and provided the requested information. The ministry highlighted that the Children's Hospital is a highly complex unit and that, therefore, access to care areas must follow technical criteria related to patient safety, infection control and continuity of care. The Secretariat also informed that it awaits the presentation of the Defender's Office's notes, since, according to the body, there was no prior communication about the specific object of the inspection and, to date, no information has been made available about any irregularities identified during the visit. City Hall denies omission of data The City of São Luís denied that there is a widespread shortage of supplies and medicines at the Children's Hospital. Municipal management admitted, however, that occasional reductions in stocks may occur during periods of high demand. In these situations, according to the municipality, internal relocation of materials or replacement of medicines with equivalent products is carried out. Regarding safety and quality of care, the city hall stated that it monitors pediatric ICUs to avoid interrupting services or closing beds. The municipal administration also highlighted the regional role of the Children's Hospital. According to the city hall, the unit provides around 10,000 consultations per month and 71% of patients admitted in the first half of this year came from municipalities in the interior of Maranhão. The City of São Luís also denied that it omits information from the Unified Health System and stated that all deaths registered in the hospital are officially reported to the Mortality Information System. According to municipal management, possible differences between local data and information available in federal public systems are caused by delays in processing and updating the national database. Contrary to what the complaint investigated by the Public Ministry points out, the city hall reported that there was no significant increase in the number of deaths at the Children's Hospital. According to the municipality, there was a variation of 4.5% between 2024 and 2025. The number of deaths increased from 112 to 117 in the period. The municipal management also stated that the ICU professional staff fully meets the requirements of the National Health Surveillance Agency, Anvisa. The city hall also reinforced that there are no official records of widespread shortages and that the supply of hospital materials follows continuous planning. Contract with IBMED Regarding the contracting of the Brazilian Institute of Medical Services, IBMED, the City of São Luís stated that the tender and the contract strictly comply with the legislation. The municipality also declared that the State Court of Auditors denied the requests for suspension of the contract and archived the representations presented against the municipal administration. Regional Council of Medicine The Regional Council of Medicine reported that it monitors the situation of the pediatric ICUs at Hospital da Criança. According to the agency, the objective is to guarantee the safety of care provided to patients and the working conditions of doctors. The council stated that it acts in accordance with the legislation and that it will take appropriate measures if irregularities are identified. Federal Public Ministry The Federal Public Ministry informed that it received the complaint about the situation at the Children's Hospital. The case will be analyzed by a public prosecutor, who will evaluate the adoption of the necessary measures to investigate the facts. Ministry of Health The Ministry of Health reported that it is already investigating the complaints sent to the SUS Ombudsman's Office about the deaths registered at the Hospital da Criança, in São Luís. A team from the National Audit Department of the Unified Health System, DenaSUS, was sent to the unit to analyze the situation in the pediatric ICUs and verify the information presented in the complaints.