LDS Hospital called two press conference sessions Monday to clarify controversial reports about a woman who removed an orthopedic rod from her daughter's leg.
Josefina Gonzales, a native of Mexico, used a double-edged razor at home in Wendover to remove the rod from the leg of Maria Castro, 24. Both live in Wendover and have been provided with housing in Salt Lake City while Castro receives further medical attention at LDS Hospital.Born with spina bifida, Castro had an operation in Mexico to remove a tumor near her spine, and a Mexican doctor inserted the rod to stabilize her leg. The rod also helped to anchor Castro's broken hip.
In September, a nurse-midwife at a Wendover clinic brought Castro to LDS Hospital after seeing a large ulcer that Castro had.
During the first of two press sessions Monday, Hospital Administrator Dr. Greg Schwitzer disputed a report that the ulcer was caused by the rod poking through the skin.
"The rod was not causing the ulcer," he said. The ulcer, at the site of the tumor operation, "was in the right buttock . . . The rod was in the left femur (upper leg bone)," he said.
"The rod itself had been loose approximately a year and a half," he said. However, the rod was providing "a vital function" in stabilizing the leg, and doctors decided not to remove it.
At no time was the rod protruding from Castro's skin, and while it was loose, there was no infection there, he said.
"The ulcer was cared for optimally," he said. "In the intervening two months, a complication developed in the femur."
It was after this complication developed that Gonzales removed the rod. He said the incision was only an inch long and it was not difficult to slide the rod out.
The hospital did not refuse to care for Castro, Schwitzer added. "LDS Hospital has been committed for some time to the charitable care" for those who need it.
Asked why so much confusion surrounded the case, he said, "I suspect there may have been a language barrier." Mother and daughter speak only Spanish.
Asked why an orthopedic surgeon saw Castro during her September visit, he said that was to see if the area of the rod was infected. It was not, but as with any metal object in a body, there was a chance it could become infected later.
"LDS Hospital sent the patient back home because the optimal care had been given," Schwitzer said.
At the time of Castro's visit in September, the hospital authorized a follow-up visit with the orthopedic surgeon to see if the shaft should be replaced eventually and said the family should call within two weeks to set up the appointment. But the family did not call, Schwitzer said.
At the time, he said, the rod area "was not infected."
Asked if he meant to say that in September there was no sore with the rod sticking out, Schwitzer replied, "That's correct . . . It was not through the skin."
Later, after the leg with the rod became infected, Gonzales operated at home.
When reports were published this week about the home surgery, LDS Hospital sent an ambulance to Wendover to fetch the mother and daughter.
Asked how much of the costs would be covered by the hospital, he said, "I would think that with Marie's (financial) condition, it would be 100 percent."
The second meeting with the press was in Marie Castro's hospital room. As reporters crowded in and bombarded Gonzales with questions, Castro lay in bed, her eyes closed, not speaking.
Gonzales was asked if LDS Hospital had turned her daughter away. Speaking through interpreter Omar Canals, she replied, "The only thing that they said at the time was they were not able to take care of the case at that time."
Apparently that referred to Gonzales' request in September that the hospital do something about the 12-inch rod.
An infection eventually developed at the site of the rod, before the operation. Speaking of her daughter's condition just before the home operation, Gonzales said, "She was unable to rest. Her leg was completely swollen at that place where the bar was coming out. There was a protuberance and she was in severe pain."
Castro told her mother that if she couldn't cut the rod out, she'd do it herself.
"She didn't want to do it," Canals continued translating. "Many times she held the blade in her hands," and her hands were shaking. She had to have Castro's brother hold her, she said.
The mother said that when the family came to LDS Hospital in September, "The bar was moving . . . There was no infection or sign of infection" around the bar, and the pain was not as severe.
Asked why she did not call the hospital in November instead of operating, the interpreter said, "She was unable to speak the language" and had a transportation problem.
Gonzales confirmed that the sore was on the other side from the rod in the young woman's leg. The sore apparently was caused by an earlier surgery in Mexico. "It wasn't the bar," she said.
"When she removed the bar, it was already completely out of place, dislocated, according to her own interpretation," Canals said.
At one point, Canals translated, "She complained at the time, and the arrangements were made for her to be readmitted, and she was told a second time a room would not be available."
The comment may have referred to an attempt that Gonzales said the family made to have Castro admitted to University Hospital after the home operation. Gonzales said someone at University Hospital asked for $5,500 to cover costs before she could be admitted, and the family did not have the money.
John Dwan, spokesman for University Hospital, said that Castro was in the hospital's emergency room for more than two hours on Dec. 4, which was after the home operation. "They drained some fluid off of her hip, and they ran laboratory tests on the fluid to see if it was infected," he said.
It was not infected, he said. An appointment was made for her to see a specialist on Dec. 7, but "that appointment was not kept," he said. Dwan talked with a physician to whom Castro had been referred and said the doctor told him he did not ask for any money. Dwan says he does not know where the $5,500 figure comes from.