Medico-legal officer tears up death papers, faces complaint

DAVAO CIY -- A couple whose baby died hours after receiving immunization shots sought the help of Mayor Sara Duterte-Carpio after a medico-legal officer allegedly tore up their son’s death certificate.

The baby was identified as Khean Mark M. Boco, one month and 15 days old, a resident of Purok 9-B of Lower Madapo in Barangay 8-A, Davao City.

His mother, Maridelma S. Madanlo-Boco, told Sun.Star Davao that Dr. Danilo P. Ledesma, of the City Health Office (CHO) Medico Legal Service Division, tore the death certificate after she and her husband Almacio sought for the doctor’s signature.

The couple needed the medico-legal officer’s signature as a requirement for the burial of their son at Madapo cemetery on September 10.

Mayor Duterte advised the baby's parents to file a written complaint letter against Ledesma so that she can address their concerns.

Madanlo-Boco said Ledesma refused to sign the death certificate because it was not him who conducted the autopsy, but a certain Dr. Britania. The parents also approached Britania but failed to get his signature.

"He (Ledesma) was really angry. He ranted and before we left his office, he tore the death certificate of our son in front of us. I do not understand why he needs to do that, when he could have referred us to another if he doesn't want to sign the paper," Madanlo-Boco said in the vernacular.

Sun.Star SuperBalita tried to contact Ledesma but failed. When contacted by Radyo Patrol, the doctor refused to be interviewed on air, but he said he tore up the document because the parents of the child did not even show him respect when they entered his office.

Healthy boy

Madanlo-Boco said her baby was in good health before he was given the BCG (anti-tuberculosis) vaccine and Oral Polio Vaccine by a certain Pinky of the health center in Barangay 8-A.

"We really don't want trouble with those city health personnel. Pero dili namo maiwasan magduda sa kamatayon sa among anak tungod healthy among anak before pa man na siya gi-inject with immunization (but we cannot help but doubt these city health personnel because our baby was healthy before he was immunized)," Madanlo-Boco said.

She added that her son was given a BCG shot, an intra-derma immunization, around 11 a.m. of September 5. She said she woke up around 3 a.m. of September 6 and was shocked to see that her son was no longer breathing.

"Una nilang turok sa dagum, ni balik ug gawas ang tambal; human giturukan na pud sya'g balik kay ingon atong babae wala daw na sulod tong unang tambal kay nausik daw. Didto nagsugod na kalintura among anak, kinaugmaan patay na ang bata (They first injected him with the vaccine but the liquid spilled out. The procedure was repeated by the lady there who said the content of the first syringe was accidentally spilled. My son had a fever after that, and he died the following morning)," Madanlo-Boco said.

The mother also said that because she and her husband suspect that the immunization may have caused their son's death, they decided to bring the body for autopsy at the St. Peter Funeral homes.

Funeral personnel contacted Ledesma to conduct the autopsy but the latter refused to do so.

She said they even tried to seek the San Pedro Police’s assistance but some of its personnel advised them to ask the assistance of the Department of Health instead.

Roundabout

SPO1 Sherwin Arbania, investigator of the San Pedro police station, said the station can only put in record the couple’s complaint but the couple's concern to have their baby autopsied is not their responsibility.

"We tried to contact the Scene of the Crime Operative (Soco) but they refused to do the autopsy kay bata man gud na unya namatay siya after immunization, mao to gipasa namo siya sa DOH. Gihatod pa gani namo na sila didto (because it involved a baby who died after immunization and so we had to refer them to the DOH. We even brought them there)," Arbania said.

Madanlo-Boco said they were again referred to Dr. Ledesma, thus they instead contacted those at the Tomas Claudio Helath Center because the one who administered the vaccine on the baby was said to have come from that center.

The mother also appealed to the City Government to conduct investigation so that justice will be served to their son.

According to Barangay 8-A councilwoman Annabelle Abayan, Boco's son perhaps died because he did not undergo newborn screening. She said the child was born only in the couple’s house.

"Pero impossible mana kay ako uban anak gipanganak man sila diri ra pud sa balay pero ngano wala mana sila na unsa. Ako pa nuon pakasad-un ani (Many children were born at home but nothing bad happened to them. Now they are blaming me for this)," Madanlo-Boco said.

Based on the death certificate of the child, Khean Mark died because of a "cardio respiratory arrest probably secondary to Vitamin K deficiency versus adverse event following immunization, and Pentavalent vaccine."

No link yet

Meanwhile, the Department of Health (DOH) in Davao Region said Wednesday that the case involving the one-month-old boy is "isolated" and that the relationship between the boy's death with the vaccine is yet to be established.

Dr. Abdullah B. Dumama Jr., DOH regional chief, said the pentavalent vaccine (five in one vaccine) that was administered to the boy was first used by DOH across the country last July. This is administered intra-muscularly or directly into the muscle.

Aside from the pentavalent vaccine injected on the boy on September 5, the midwife also injected BCG, a vaccine against tuberculosis (TB) that was administered intra-dermally, and an Oral Polio Vaccine (OPV) that was taken orally.

Dumama assured that the pentavalent vaccine, which is being used globally, is a product of thorough medical research and evaluation from internationally recognized organizations, including the World Health Organization (WHO), before it was released worldwide.

Delisted?

But in an article published at the official website of WHO last August 17, 2011, the pentavalent vaccine has been delisted from WHO's list of prequalified vaccines.

Pentavalent vaccine, which is manufactured by Panacea Biotec, contains the vaccines against diphtheria, tetanus, whole cell pertussis, hepatitis B and h-influenzae type b components, and two other vaccines -- a DTwP-hepatitis B vaccine and a monovalent hepatitis B vaccine.

This after WHO, along with other groups and laboratories, conducted a routine audit in June last year, particularly on pentavalent vaccine, and found out "deficiencies in quality systems found at the company's Lalru manufacturing site."

"The decision to delist was made because of the risk, unless corrective action is taken by the manufacturer, that the quality and safety of future batches of these vaccines will be compromised," WHO said in the article.

WHO ruled, however, that batches of pentavalent vaccines already distributed to other countries should not be recalled and should still be used.

"This is because there is no evidence of quality or safety defects with batches already distributed whereas there is a real risk, if immunization is withheld, of death or morbidity from the diseases against which the vaccines protect," WHO said.

Dumama admitted they have been administering pentavalent not only in Davao City but also in other cities and municipalities in Davao Region to save thousands if not millions of kids against preventable diseases.

"We will not compromise others' health against one case which is not yet been proven," Dumama said.

But even then, Dumama said other first world countries like the United States of America (USA) and other countries have been using pentavalent for several years already.

He said the same case was the very first case across the country directly questioning the efficacy of the pentavalent, which has already saved millions of children globally.

At present, DOH is coordinating with the Southern Philippines Medical Center for the prompt release of the autopsy report to assess what really had happened to the kid and what caused his instantaneous death. (Sun.Star Davao/Sunnex)