24th August: Florentina Cartsea stands alone

(Photo: News 24 de Ore) Florentina Carstea, detained yesterday for 24h, has now been formally placed under preventive arrest for 29 days without bail on suspicion of involuntary manslaughter and grievous bodily harm, says the Romanian Times. According to her lawyer, Simona Luciana Parvu, Carstea accepts her guilt to a certain degree and profoundly regrets the dreadful tragedy. She says that she wasn't EVER at the St Mary's celebration (even says that there wasn't one - see Hotnews). At the onset of those 12 controversial minutes, Florentina intended to go to the bathroom, she says in her statement. On the way, she stopped at the c-section ward to ask a collegue to stand in for her whilst she was gone. The colleague, instead, asked Florentina to cover for her because she had to go and assist at a birth. Therefore, Florentina decided not to go to the bathroom but stay and cover her colleague in the c-section ward while the other went to assist.

Florentina Cartea's job description declares that she should have had two student nurses working with her or one or two childrens' nurses. She should not have been the sole responsible being on the ITU. But that, we already knew.

The process took an hour behind closed doors, says Romania Libera, and her lawyer made it clear that it wasn't the first time Florentina Carstea had left the babies because she was often called by doctors from other wards. She added in her client's defence that Florentina Carstea had been proposed the position of Chief of Section, but that she had refused for love of the children - she wanted to be with the children and hated the bureaucracy that the job would entail. Florentina's colleagues have spoken up for her, some in front of the judge, stating they have lost a very good colleague. They added that when medical assistants are asked to help doctors, it's always very difficult. Simona Parvu also stated that Florentina Carstea still doesn't know where the other members of staff with card swipe keys were that evening. She is said to be extremely emotional, weeping that the babies were like her own as she spent more time with them than the parents who could not be present due to infection risk... (see Gândul)

Bucharest Herald printed the following press release yesterday issued by the Prosecutor's Office:"The evidence collected during the criminal investigation so far lead to the conclusion that the suspect – an employee of the Prof. Dr. Panait Sarbu Obstetrics and Gynecology Hospital – failed to do her duty and did not continuously monitor the newborns under treatment in the 'intensive care' ward. By leaving the ward without justification, she could not notice the moment when the fire started and made the evacuation of newborns impossible.” The article further says that Florentina Carstea risks spending the next 2-7 years of her life behind bars while The Romanian Times adds that "the penalty may be even higher, as there were several deaths in the fire that broke out on Monday last week, chief prosecutor Marius Iacob said."

The President of the Order of Nurses, Mircea Timofte, told Realitatea in the same article, “I am surprised to see that the arrested nurse of the Giulesti Maternity Hospital bears the blame for the whole tragedy. The responsibility belongs to several people. Certainly, the nurse has her share of guilt, but I also believe that another nurse is making the same mistake as we speak.”

Mircea Timofte is absolutely right and has hit the nail on the head. Florentina Carstea has been left entirely alone to carry the can, just as we suspected. I believe it was even a comment left at the end of Tuesday's post. Cseke, Marinescu, Savu, Ranga...they have all found the perfect scapegoat. Florentina Carstea clearly doesn't have great connections with anyone at any useful level and her lawyer expresses herself badly at best - I wonder how she ended up with Simona Parvu. Was she provided by the Nursing Union? Marius Iacob says, though, that others are being questioned and may also be charged.

Florentina Carstea must indeed pay for her neglectful lack of insight, erroneous decision and unprofessionalism, but she is by no means the only one who should. If those even more guilty than she for the criminal state of the a/c system, the scheduling of the ward, the budget cuts, the lack of staff, the absence of fire detection equipment, the wooden cupboard in the babies room that was a fire hazard and those stupid damn doors noone could open without a swipe card which had no emergency opening device...well, Florentina Carstea is not alone in her incompetence - not by a long chalk. A very long chalk.

Comments from TVR.ro are spot on: What kills the system is the doctors. The assistant is indeed to blame but noone else is?? 8 other people had cards but noone else opened the door that night. Where were they? Even Florentina doesn't know - and if she is being loyal to her colleagues, now is not a good time for a cover up.

The system is rotten to the core and as they say in Roumanian, 'a fish rots from the head'. Never a truer word. Florentina Carstea is indeed a victim of a lousy, useless, necrotic system which has been allowed to decline to such a state that babies burn to death in incubators and the assistant chief of ITU is the only one on duty for 11 babies when there should have been 4 members of staff present.

The whole health care service has passed the verge of collapse. What of the medical assistants themselves? They are few and far between, badly trained and indifferent. They are, says another comment, incapable of giving advice or being nice because they do not have the knowledge. They do not KNOW the answers to how to hold a baby, how to breastfeed. If a young mother asks, she is rebuked. The medical assistant will not be kind if she is not renumerated for it.

A medical assistant makes 600 RON a month. That's nothing at all. About 150 euros. This is why the vicious circle of spaga (bribes) is so necessary within this very gangrenous system of Roumanian healthcare. The patients end up supplementing the nurse, not the government and why should the government bother when the patient does such a good job having to pay to have sheets changed, a glass of water, a smile, a little kindness, the right to see one's own baby, the right to hold her. As long as they do that, salaries will not increase for the government sees no reason to do so. A medical assistant knows that she is hired for 600 RON before she starts. Perhaps she will begin wanting to break the mould, wanting to help. But (says the comment), she will soon see the gossiping, the rebuking of patients, the smoking in hospital corridors...and end up doing exactly the same. Doctors do not discipline the medical assistants and neither do the managers.

Those quoted above are either medical assistants themselves or patients and are very aware, painfully so, of how the system works (or doesn't).

A school for medical assistants gives possibility for a care-free and responsibility-free existence, since revenue (tax-free) comes from bribing patients. If I accept, for example, that being grumpy and rude will assure 'sweeteners' from my patients of, let's say, the equivalent of 5 euros a day and I have a good few, then it's definitely in my best interest to have a face like a smacked bum. It's a money-spinner. A medical assistant can thus double her salary and does. The evil begins at the very top. The system doesn't only allow this practice of disrespect and lack of compassion but management actively encourages it.

Florentina Carstea should NOT be paying for this alone. This situation is hardly unique in Roumania where, in hospitals (and excuse me for generalising, because I know there are exceptions to the rule), there is no sense of duty and no differentiation between the right and wrong way to treat a patient. Who is to blame, then? The medical assistant who has no sense of discipline or the management who won't discipline her? Look at it another way - a spoilt brat in a supermarket yelling and screaming for sweets as the parent looks the other way and does nothing. I know who I'd blame, I know who I'd slap - and it wouldn't be the spoilt child (I'd yell at him, though and take his sweets away once and for all).

Medical staff in Roumanian hospitals are grossly overworked due to a pitiful lack of personnel which also leads of course to mistakes and negligence. Everyone gets tired, everyone has a bad day. But there, every day is a bad day and mistakes have taken on the most astronomical proportions. Almost every day, the TV or newspapers report yet another case of malpractice, yet another victim to the system. It has become so much a part of life than one hardly blinks anymore...one lives with it every day. Here we go again...ce pot se fac?

Mirela Ranga should be up there in handcuffs alongside Florentina Carstea as Medical Director. The overworked staff, the lack of personnel and the nepotism within the hospital are the responsibility of Mirela Ranga. There are discussion groups available for all to see on-line where 80% say how aloof she is, how rude, how rebuking and how she "makes you wait." How she makes you wait...you want a bedpan, a glass of water, a painkiller, your waters have broken...but she makes you wait.

There SHOULD be a difference made and a line drawn between private and public sector positions and Cseke is right to deal with that (even if its not top of his list right now). Ranga says, "yes, I'm coming" to her public sector patients but goes off to her private ones - and who, in the meantime, is monitoring these comings and goings? As they say in Roumanian, "este greu sa tii doi pepeni în bratze" - it's hard to hold two watermelons in your arms.... No-one can work an 8h shift in a public hospital and then go and do another four or five in a private clinic...therefore, the public hospital gets ripped off since it certainly isn't the one that provides the bread and butter, is it. Here is an example of another botched job of malpractice because the physician left to work at a private clinic.

Florentina, you are an idiot, you made a very great error of judgement and have no right to be an assistant chief of ITU...but you are not the only idiot. I am sorry you are so alone there in front of the judge, sorry there has been a bail out and you are left holding the whole can of worms and I only hope that Marius Iacob is a good and honest man with an excellent nose for sniffing out the nasty odour of rot and slime...for there's a great deal to be found.

Prof. Ioan Lascar, the President of the College of Doctors in Bucharest won't support her, either. "She shouldn't have been allowed to leave," he said. In his opinion, she is the only one to blame. In my opinion, it has become a witch-hunt which profits solely those who should really be in handcuffs - once again, I repeat: Marinescu, Ranga and Savu.

(ProTV) Meanwhile, the top news stories in Roumania today are 1) Miss Universe is Mexican 2) Do you think priests should not be paid from the state budget 3) 23rd August Then and Now and 4) Baby Zebra Killed by its Mother. Only at number 17 do we find a story called 'Who's satisfied by the Medical System' and even further still, a report on how the 6 surviving babies are doing...

As Florentina Carstea lives with images of burnt babies in incubators on her conscience and carries the weight of the only one responsible for five dead babies, six in critical condition with one of those six still intubated, life goes on... merge si asa...