TCE orders audit of pediatric ICUs at Hospital da Criança, in São Luís Reproduction/TV Mirante The Court of Auditors of the State of Maranhão (TCE-MA) ordered a special audit to be carried out at Hospital da Criança Dr. Odorico Amaral de Matos, in São Luís. The hospital unit is the target of several reports of failures in pediatric Intensive Care Units (ICUs). The case is investigated by several bodies such as the Public Ministry of Maranhão (MP-MA), the National Audit Department of the SUS (Denasus) and the State Public Defender's Office (DPE-MA). The TCE-MA inspection will investigate the execution of the contract signed between the City of São Luís and the Brazilian Institute of Medical Services (IBMED), responsible for managing the hospital's three pediatric Intensive Care Units (ICUs), which total 29 beds. The precautionary measure was granted by counselor Marcelo Tavares Silva after a representation presented by the Maranhão Public Ministry of Accounts (MPC-MA). ?Download the g1 app to see MA news in real time and for free The decision provides for an in-person inspection of the hospital and analysis of the application of public resources, contractual execution and the structural and care conditions of the ICUs. According to the rapporteur, it is not yet possible to establish a relationship between the management of the contract and the deaths recorded in the unit. However, the elements presented justify preventive action by the Court. Contacted by Grupo Mirante, the Municipal Health Department (Semus) reported that, to date, it has not been formally notified of the TCE-MA's decision, but stated that it is committed to the assistance provided to children treated at the Children's Hospital Find out more about the crisis at the Children's Hospital in São Luís After a report from DenaSUS, the Public Defender's Office asks the Court for urgent measures to regularize ICUs at the Children's Hospital MPC calls for an audit of the ICUs at the Children's Hospital after reports of a reduction in doctors After DenaSUS report, Ombudsman's Office asks Justice for urgent measures to regularize ICUs at the Children's Hospital Public Defender says it found insufficient medical staff after inspection at the Children's Hospital Audit by the Ministry of Health at the Children's Hospital in São Luís lasts three hours and final report should be released in the next few days MP-MA investigates allegation of increase in deaths in ICUs at the Children's Hospital, in São Luís Representation points out possible irregularities In the representation, the Public Ministry of Accounts claims there are signs of failures in execution of the contract with IBMED. Among the points that should be analyzed are: possible increase in mortality after changing the management model; suspected irregularities in the bidding process; differences between the structure foreseen in the Preliminary Technical Study and the one actually implemented; possible lack of professionals specialized in pediatric intensive care. The MPC also questions the model provided for in the notice, which brought together the three ICUs in a single care center and established only one technical coordinator for the 29 beds. The audit must verify whether this organization meets the technical requirements necessary for the operation of the service. Decision mentions problems identified by the Public Defender's Office When determining the audit, the counselor cited an inspection carried out by the Public Defender's Office of the State of Maranhão at the Children's Hospital. According to the decision, the inspection found signs of a lack of professionals, the absence of day doctors in the ICUs and the possible work of workers without specific specialization in pediatric intensive care. Failures in the supply of medicines and other operational weaknesses were also reported. The situations must still be confirmed during the TCE audit. The rapporteur also highlighted differences between the death numbers presented by the Mortality Information System, Datasus, the hospital's internal records and the municipal administration. For the Court, the difference between the data reinforces the need for an independent technical analysis. Audit will be carried out at the hospital The TCE understood that the requirements for granting the precautionary measure are present: the existence of signs of irregularities and the risk of loss or alteration of evidence while the contract continues to be executed. The audit must verify: the number and qualifications of ICU professionals; hospital mortality indicators; the regularity of bidding and contract execution; the relationship between the amounts paid by the municipality and the services provided. According to the counselor, the measure does not interrupt service or suspend the contract. The decision is limited to monitoring the service and the use of public resources. Department of Health will have to present an emergency plan The municipal secretary of Health, Ana Carolina Marques Mitri da Costa, must present, within 48 hours, an Emergency Plan for Contingency, Continuity, Safety and Humanization of Assistance. The document must include an assessment of the risks to patients, team sizing and measures to ensure coverage for any absences of professionals. The plan must also provide for: guarantee of medicines and supplies; actions to address overcrowding; patient transfer flows; schedule for implementing the measures; indicators for monitoring results. Actions must follow the guidelines of the National Policy for Comprehensive Child Health Care. Those responsible will have ten days to send documents Those responsible for the unit and the contract will have ten days to send documents to the Court. Among the materials requested are the complete bidding process, professional rosters, proof of technical qualifications, bed occupancy data and death records. Reports from the Death Review Committee, inventories of