ROME, ITALY - When doctors and nurses at the Vatican's showcase children's hospital complained in 2014 that corners were being cut and medical protocols ignored, the Vatican responded by ordering up a secret in-house investigation. The diagnosis: The original mission of “the pope's hospital” had been lost and was “today more aimed at profit than on caring for children.”
Three years later, an Associated Press investigation found that Bambino Gesu (Baby Jesus) Pediatric Hospital did indeed shift its focus in ways big and small under its past administration, which governed from 2008 to 2015. As the hospital expanded services and tried to make a money-losing Vatican enterprise turn a profit, children sometimes paid the price.
Among the AP's findings:
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, who spent three months gathering information and interviewing staff off-campus.
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.
Vincenzo Di Ciommo Laurora, a retired Bambino Gesu epidemiologist, described the hospital's past culture this way: “The more you do to a patient, the more money you bring in. You have to produce, produce, produce.”
Bambino Gesu disputed the AP's findings and threatened legal action. It said the AP's investigation was based on information that was “in some ways false, in other ways seriously unfounded and out of date by two years but above all clinically implausible and defamatory on a moral and ethical level.”
It cited its own reputation as a center of excellence. The hospital draws top-notch surgeons to work there and celebrities to visit, including U.S. First Lady Melania Trump in May.
Founded in 1869 to treat poor children, Bambino Gesu (Baby Jesus) was donated to the Vatican in 1924 and is now the main pediatric hospital serving southern Italy. In 2015, the 607-bed facility performed over 26,000 surgical procedures - more than a third of all children's operations nationwide.
Perched on a hillside just up the road from Vatican City, the hospital's main campus enjoys extraterritorial status, making the Italian tax-payer funded institution immune to the surprise inspections that other Italian hospitals undergo.
The Italian health ministry certifies Bambino Gesu for its research activities and in 2015 reported it had “characteristics of excellence.” Provided with AP's findings, the health ministry promised to investigate.
The employees who spoke to the AP requested anonymity, fearing they would lose their jobs. 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 the AP that some of the conditions they first reported in early 2014 have improved since the administration changed in early 2015. The new leadership, they said, focuses less on volume and has more respect for following protocols.
But some of the task force's most important recommendations have not been implemented, including the replacement of the medical director. And 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 in July 2016. “What has changed in 10 years? The machines are better, the pharmaceuticals are better, but the level of care is not.”
Federica Bianchi brought her 17-month-old son Edoardo to Bambino Gesu in October 2015 because he had breathing problems. He was treated in an ER room where other children were receiving rehydration treatments. Two days later, he suffered bouts of severe diarrhea and vomiting.
After Edoardo's twin also fell ill, she took both boys back to the overcrowded ER, where twice over the following days, staff sent her home. The twins were eventually diagnosed at another hospital with rotavirus, an infectious disease that can cause dehydration. They were admitted, isolated and put on rehydration drips.