Italy arrests doctor suspected of killing Covid patients to free beds – 01/29/2021 – World

Italy was at the height of the first wave of the coronavirus pandemic when, in March, nurses at Montichiari hospital in the northern province of Brescia noticed that the doctor responsible for emergencies was adopting a practice totally outside protocols: the application of lethal doses of inappropriate drugs in hospitalized patients with severe symptoms of Covid-19.

The case became public last Monday (25), after Carlo Angelo Mosca, 47, was placed under house arrest on suspicion of intentionally killing patients with the anesthetic propofol and succinylcholine, a neuromuscular blocker. These potent substances are indicated for situations of intubation through the trachea, a procedure to which victims were not subjected.

This Friday (29), Mosca was questioned for two and a half hours in front of the court in Brescia. He denied the charges and, according to his lawyers, provided clarification. Just before 10 a.m., the doctor came for a walk alone and was surrounded by journalists and cameras, to which he simply said, in a low voice: “I am innocent”.

However, Judge Angela Corvi, who accepted the prosecutor’s house arrest request, justified her decision by acknowledging “serious evidence” that Mosca had committed capital intentional murder in at least two patients.

The investigation, which began in May, proved that the deaths of Natale Bassi, 61, and Angelo Paletti, 79, were caused by the lethal doses applied by the doctor between the 20th and 22nd. March.

At that time, northern Italy was experiencing the peak of the first wave of the pandemic, with a growing number of new contaminants and a record number of daily deaths – on March 22, 651 deaths from Covid-19 were recorded . The province of Brescia was then the second most affected in the whole country, behind that of Bergamo, both in Lombardy.

It was the most acute moment of the health emergency in Italy, the first country in the West to identify cases of internal contamination and put in place a strict mandatory national lockdown, as a measure to reduce the circulation of the virus . Italy is still among the hardest hit today, with 87,000 dead, sixth in absolute numbers.

Apart from the lack of knowledge about the behavior of the virus and the disease, the first wave was marked by the scarcity of beds, equipment, surgical masks and tests.

According to Mosca himself, in June, in an interview with the newspaper Corriere della Sera, the hospital in Montichiari, a city of just over 25,000 inhabitants, had 570 Covid-19 patients hospitalized in phase 1, which required occupancy of a cafeteria with 30 beds.

During the same time, nurses and health workers began to notice that the doctor was behaving inappropriately. Faced with severe cases that entered the emergency room, Mosca asked someone to get one or both of the drugs and applied them when he was alone. In Bassi’s case, he asked the team to leave the emergency room.

“A few minutes later, the employee returned, realizing the death of Bassi, at that time unaccompanied by the team members. The death was declared by the doctor. [nome omitido], which indicated in the table “sudden cardio-circulatory arrest” “, specifies the document signed by the judge, based on the investigation.

In Paletti’s case, authorities found and photographed empty drug packets the morning after the patient died, which occurred during the doctor’s suspicious shift.

The investigation began with an anonymous complaint from one of the nurses at the end of April. In principle, four victims were recruited. Three bodies were exhumed – the fourth patient was cremated.

The toxicological analysis of Paletti’s remains is one of the most convincing evidence, since the presence of propofol in organs and tissues, “in sufficient quantity to cause death”, has been proven.

Propofol is an anesthetic used for sedation and one effect is ‘severe respiratory depression’. It was the drug found in the body of singer Michael Jackson, who died in 2009. Succinylcholine, on the other hand, is a neuromuscular relaxant applied under anesthesia to facilitate tracheal intubation. According to the technical opinion, “its paralyzing effect depends on the dose”.

The investigation carried out by the public prosecutor’s office reveals that there was an “abnormal” consumption of the two drugs between January and April of last year. Between November 2019 and April 2020, five tracheal intubation operations were performed on the PS Montichiari. However, orders for propofol and succinylcholine at the central pharmacy increased by 100% and 70%, respectively, between January and April.

None of the medical records of the patients to whom the doctor allegedly administered the remedies contain communication of these therapies, making him a suspect in another crime – an ideological lie committed by a public official.

In her order, the judge says that it is not possible to assume that Mosca acted at the request or with the consent of the two patients. “He administered the substances not out of intolerable frivolity, recklessness or the effect of inexcusable inexperience, but in full awareness of the assumptions of his conduct and of his intention to kill.”

Further on, the magistrate says it is “credible” that the investigation was “determined to kill out of a desire to” free “not only the beds, but also the instrumental resources and the human, physical and emotional energies of fellow doctors. , nurses and other operators. the emergency room ”.

In the same June interview, in which he commented on the worst moments of the first phase of the pandemic, Mosca said that as soon as the circulation of the virus was identified in Italy at the end of February, he decided to settle in a sort of hostel, so as not to run the risk of infecting his wife and daughter, then aged 7.

He remained like this until the beginning of May, for more than two months without seeing his family, who live in the town of Mântova. About that distance he said: “It was a mistake, now I realize”.

After the interrogation this Friday, the prosecution must carry out additional investigations depending on the answers given by the doctor. He is still not considered an accused, as the investigation is still in the preliminary stages.

As soon as preventive detention was ordered, Mosca was suspended from his duties. In a statement, hospital management called the charges serious and said they were working with authorities. The Order of Physicians of the Province of Brescia emphasizes that “it is an investigation, not a conviction” and that, although very serious, it is still a “hypothesis of a crime”.

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