Doctor performs surgery on woman’s heart in endometriosis surgery – 09/26/2024 – Balance and Health

Renata tries not to be too emotional. She also avoids physical activities. If it exceeds a hundred beats per minute, she could get sick and even die. According to her, it is the result of a heart operation performed on her, without her consent, by gynecologist Ricardo Mendes Alves Pereira.

The Civil Police opened an investigation in April to investigate the case. An article signed by Delegate Ana Lucia de Souza, of the 78th Police District (Jardin), repeatedly accuses the patient of having “underwent surgery to correct endometriosis in the pelvic area”. However, without her consent or that of any family member, Pereira would also have performed “thoracic surgery on the victim, operating on the diaphragm and pericardium”.

According to the document, she ended up with a “terminal disease” that left her, at age 34, dependent on constant medication and living a life of restrictions, such as not being able to exercise or get pregnant.

Her desire to be a mother of four children was what first brought her to Pereira’s office, in Jardim Paulista, west of São Paulo, for a consultation that cost R$1,500. To reconstruct the case, which had been kept secret since May, Binder I looked up Renata’s relatives – a pseudonym, as the patient prefers to remain anonymous and not speak publicly about the complaint.

There are three sources of investigation: the Civil Police, the Ethics Committee of the Albert Einstein Hospital in Israel, and Kremisp (the Regional Council of Medicine of the State of São Paulo).

According to the Public Security Secretariat, “details will be preserved to ensure independence in the conduct of police work.”

The Albert Einstein Israelita Hospital, where the operation was performed, says it is “still in contact with the patient and her family, and is providing all necessary support,” and that “the reported facts about the doctor’s behavior are being investigated by the relevant authorities.” Cremesp reports that it has opened an investigation into the complaint.

the Binder He contacted the defense and prosecution lawyers. No one wanted to talk. Louisa Oliver, a partner at Turon Advogados, said she was “advocating for the patient’s interests,” but “cannot provide further information due to the confidentiality of the files.”

“Since the case is confidential, and in the interests of the patient herself, we understand that we are forbidden to provide any information or details about the accusations,” says Daniel Gerstler, the doctor’s lawyer. “We also understand that publishing information about the case in the press also conflicts with this prohibition.”

Renata and her husband decided to get pregnant in mid-2022. They tried for months, but nothing. Then they sought medical help. Tests showed endometriosis, when the endometrium, the tissue that lines the uterus, grows in other parts of the body.

The disease affects one in ten women worldwide and can cause excruciating pain. This was not the case for Renata, who had no unusual cramps. But one of the symptoms was infertility. Because she wanted to become a mother but couldn’t, she thought it would be best to have surgery.

He arrived in Pereira on the recommendation of his gynecologist. The surgery was scheduled for October 19, 2023. Four months earlier, the couple had frozen embryos, with an eye toward the possibility of in vitro fertilization at a later date.

But the original plan was to conceive naturally, hence the surgery to remove pockets of endometriosis that could get in the way. Renata’s family says the gynecologist expected up to five hours in the operating room. The operation took more than twice that time and was performed without a heart surgeon present, they claim.

She believed she was going to have surgery on her uterus, ovaries, fallopian tubes and colon. According to the complaint, Pereira expanded the surgery to treat endometriosis, which would also have affected her diaphragm and pericardium, the membrane that surrounds the heart. All without asking permission and without any emergency nature to justify the procedure.

A family member of Renata’s showed in the report the exchange of messages between the doctor, the patient and relatives, as well as a recorded conversation between Pereira and her husband – all related to the indictment. When asked about the intervention in the pericardium and diaphragm, areas not identified in the tests, the gynecologist said in the audio recording that perhaps “Renata is warming up a little bit, getting more nervous when she knows she’s going to be moved here.”

Months later, the patient was diagnosed with pericarditis, an inflammatory process that occurs in the area. From being a healthy, athletic woman who loved soccer, tennis, hiking and beach tennis, she developed a chronic condition.

Today, he stretches as much as possible and uses his Apple Watch to monitor his heart rate, which must stay below 100. It’s not always possible. Even walking the dog has pushed him past that threshold. At the Paris Olympics, he stopped watching some matches to avoid too much stress — in some matches, the excitement reached 115, 120 beats per minute.

Renata can no longer get pregnant either. The heavy medications she is on, including corticosteroids, don’t allow it.

Other side effects reported include insomnia, sudden hair loss, and swelling. He tried to reduce the dose of corticosteroids, but the pain came back with a vengeance.

For the relatives, if the adversity had been caught earlier, the pericarditis could have been reversed. However, the doctor assured her for weeks that everything was fine, going so far as to say that there was no chance this was the correct diagnosis, even allowing Renata to return to her normal routine. Physical exercise, for example.

Meanwhile, she was complaining of severe pain, which she later discovered was a classic symptom of pericarditis. One of the crises occurred after he played beach tennis on New Year’s Eve, thinking it would do him no harm, as the doctor allowed it, his relatives say.

The report obtained an email Pereira sent to the patient in February, three and a half months after her surgery. He writes that the trust between doctor and patient was “unwillingly lost.” After the surgery, “his and his family’s insecurities became apparent” about the procedure, which treated “an endometriosis lesion that had invaded the pericardium,” he says there.

He also says that he was “fully transparent” on several occasions and explained the reasons for his local endometrial ablation. He also states that he sought to “thoroughly” understand “the symptoms resulting from complications that arose after the surgery” and that he takes “full responsibility for the decision to undergo surgery”.

He has been appointed director of the Endometriosis Center at the Hospital da Mulher Santa Joana, one of the most traditional private maternity hospitals in São Paulo. On its website, the hospital highlights Pereira’s CV as a “gynecological surgeon, with a specialization from the University of Barcelona”, who has “extensive experience in the treatment of endometriosis” and specializes in “minimally invasive gynecological surgery (laparoscopy and vaginal surgery) and neuropelvic surgery (study of changes involving the pelvic nerves)”.

The family reported another version: that Pereira, on at least one occasion, was upset when she learned that Renata had asked another doctor for a second opinion for the pain she was feeling.

Currently, Renata is taking care of her pericarditis with other doctors and looking for treatments abroad, with no guarantee of a cure. Meanwhile, she and her husband see that almost all their friends are having children. They don’t know if their turn will come. It all started because being a mother and father was what they wanted most.

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