A wrong diagnosis, a series of clinical evaluation errors; oversights, omissions, negligence: everything revolves around these words, unfortunately common in cases of suspicious death on which an investigation is carried out, the disappearance – on 19 July 2023 – of the journalist Andrea Purgatorisuffering from lung cancer but died due toendocarditis (an inflammation of the heart valves) not promptly identified and treated.
These are the conclusions of the experts, Luigi Marsella and Alessandro Mauriello, put down in black and white following the request of the prosecutor of the Rome Prosecutor’s Office, Giorgio Orano (the Purgatori family presented a complaint). Four doctors are currently under investigation: Guido Laudani, the cardiologist who followed Purgatori; Gianfranco Gualdi, professor of the Villa Margherita Clinic – where the journalist spent his last period of illness; and the latter’s collaborators, Claudio Di Biasi and Maria Chiara Colaiacomo.
The central point on which the experts’ report is based, therefore, says that none of the doctors who treated Purgatori really understood the serious pathology he was suffering from, endocarditis in fact, in addition to the lung cancer for which he had been treated for the longest time. Consequently, one would have been enough simple antibiotic therapy to prevent the clinical picture, already quite compromised, from inexorably worsening.
The chain of errors, according to experts, even began a month before the journalist’s death: therefore, already in mid-June last year, his condition began to worsen due to inflammation of the heart valves, the symptoms of which ( high fever) would have already been quite evident but which led to confusion among the doctors under investigation. Which, write Marsella and Mauriello, with the right diligence and appropriate antibiotic therapy, could have saved the patient.
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Andrea Purgatori’s funeral in Piazza del Popolo, Rome
Specifically, the prosecutor’s experts write: Laudani “omitted the prescription of clinical, laboratory and instrumental tests aimed at the diagnosis of infective endocarditis. In our opinion, these omissions are attributable to incompetence and do not comply with the good clinical practices identified by us in the literature”. And they add: “On the basis of the clinical, radiological data and the established therapy, it was appropriate to evaluate other diagnostic hypotheses in addition to that proposed by Dr. Giallonardo of an embolism resulting from atrial fibrillation.” A urinary infection was also thought but the tests came back negative.
Marsella and Mauriello also indicate the procedures that should have been implemented to effectively treat Purgatori: “It would certainly have been appropriate to carry out a set of blood cultures and request an infectious disease consultation. The indicated tests could have intercepted the pathogen responsible for the febrile events and infective endocarditis, with a subsequent request for transfer to another facility”. A transfer which, in fact, took place, since the journalist was also taken to the Policlinico Umberto I even if it was too late: “At Umberto I, with essentially the same elements, the health workers immediately hypothesized a bacterial endocarditis and promptly carried out the necessary tests to confirm the diagnosis.”
In short, this is the conclusion of the experts, the doctors who worked on the patient’s medical records hypothesized, incorrectly, other causes: metastases to the brain, never found in retrospect, for which Professor Gualdi requested radiotherapy and anticoagulant treatments. Actions which, however, would not have (and have not) been useful for endocarditis.
In fact, the family, through the lawyer Alessandro Gentiloni Silveri, comments: “Andrea was diagnosed and urgently treated for brain metastases which at the time of death were discovered not to exist. And this has led to a deviation from the correct diagnosis and therapy.”