'Pope's hospital' put children at risk as it chased profits
ROME (AP) — Doctors and nurses at the Vatican's showcase pediatric hospital were angry: Corners were being cut. Safety protocols were being ignored. And sick children were suffering.
The Vatican's response was swift. A secret three-month Vatican authorized investigation in early 2014 gathered testimony and documentation from dozens of current and former staff members and confirmed that the mission of "the pope's hospital" had been lost and was "today more aimed at profit than on caring for children."
What happened next surprised many involved: The report was never made public. While some of the recommendations were implemented, others were not. And the Vatican commissioned a second inquiry in 2015 that — after a three-day hospital visit — concluded nothing was amiss after all.
An Associated Press investigation has found that Bambino Gesu (Baby Jesus) Pediatric Hospital, a cornerstone of Italy's health care system, did indeed shift its focus in ways big and small under its past administration. Under leadership that governed from 2008 to 2015, the hospital expanded services and tried to make a money-losing Vatican enterprise turn a profit — and children sometimes paid the price.
Among the AP's findings: — Overcrowding and poor hygiene contributed to deadly infection, including one 21-month superbug outbreak in the cancer ward that killed eight children.
— To save money, disposable equipment and other materials were at times used improperly, with a onetime order of cheap needles breaking when injected into tiny veins.
— Doctors were so pressured to maximize operating-room turnover that patients were sometimes brought out of anesthesia too quickly.
Some of the issues — such as early awakening and the focus on profits — had been identified in 2014 by the Vatican-authorized task force of current and former hospital doctors, nurses, administrators and outsiders. The AP corroborated those findings through interviews with more than a dozen current and former Bambino Gesu employees, as well as patients, their families and health officials. The AP reviewed medical records, civil court rulings, hospital and Vatican emails, and five years of union complaints.
On Monday, the hospital denied the AP's findings and threatened legal action. It called the AP report a "hoax" that "contained false, dated and gravely defamatory accusations and conjectures that had been denied by an independent report of the Holy See." It cited its reputation as a center of excellence. It draws top-notch surgeons to work there and celebrity visits, including one by U.S. First Lady Melania Trump in May.
Vatican spokesman Greg Burke acknowledged the Vatican had investigated staff complaints and said it welcomes efforts to improve care, "including reports of practices that might be below standard."
"No hospital is perfect, but it is false and unjust to suggest that there are serious threats to the health of children at Bambino Gesu," he said.
Both the Vatican and Bambino Gesu pointed to the Vatican's second investigation, led by American Catholic health care expert Sister Carol Keehan, as evidence that all of the allegations — except one involving space constraints — were false.
"While there are many things we could have missed or been misled about, we came away from this evaluation with a real sense that on the major charges and the major issues alleged, we have been able to disprove them," Keehan's report said.
The Vatican's first investigator, though, fully stood by the findings he delivered to the Vatican in 2014.
"What we wrote in that report was the exact truth," Dr. Steven Masotti said in a June 2 telephone interview. He said the hospital has its problems but that overall it has "very good standards."
Facts are hard to come by in the secretive halls of Bambino Gesu, which does not make public financial details or publish its mortality and infection rates. Perched on a Roman hillside just up the road from Vatican City, the private hospital sits on Holy See territory and enjoys the same extraterritorial status as a foreign embassy — making the Italian taxpayer-funded institution immune to the surprise inspections other Italian hospitals undergo. It is financed by Italy's public health system, but its main campus isn't even technically in Italy.
There is no indication that the Vatican ever shared the results of either in-house investigation with the Italian health ministry, which in its 2015 recertification of its research activities reported that the hospital offered quality care "in such a way that assumes characteristics of excellence." Provided with AP's findings in December, the health ministry promised to investigate.
"If this is true, a myth has fallen," the ministry's then-spokesman Fabio Mazzeo said. "We have to verify." Mazzeo's successor, reached in June, said he had no further information, saying the hospital belongs to the Vatican.
All of the hospital employees who talked to the AP spoke on condition of anonymity, fearing they would lose their jobs if their names were used. Out of concern for the children, they said, they broke what the hospital's union has called the "omerta," the Italian code of silence.
Staff members told AP that some of the conditions they first reported in early 2014 have improved since the surprise resignation of Bambino Gesu's president in 2015. The new administration, they said, focuses less on volume and shows more respect for protocols.
But some of the task force's most important recommendations have not been implemented, including the replacement of the medical director. And in its July 2016 newsletter, the hospital's main union said problems remain.
"Ten years ago, the ERs were jammed and they still are. Ten years ago, patients waited on stretchers and they still do. Ten years ago you entered with one illness and left with two hospital infections, and still do," it wrote. "What has changed in 10 years? The machines are better, the pharmaceuticals are better, but the level of care is not."
Pope Francis himself used the occasion of a 2016 Christmas audience with thousands of hospital staff members and patients to exhort Bambino Gesu not to fall prey to corruption, which he called the "greatest cancer" that can strike a hospital.
"Bambino Gesu has had a history that hasn't always been good," the pope said, jettisoning his prepared remarks to decry the temptation to "transform a good thing like a children's hospital into a business, and make a business where doctors become businessmen and nurses become businessmen, everyone's a businessman!"
"Look at the children," Francis said in Italian, pointing to the young patients gathered at his feet in the Vatican auditorium. "And let each one of us think: 'Can I make corrupt business off these children? No!'"