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Pantaleón Is Gone: Deporting the Very Ill

La Raza, News Report, Fabiola Pomareda Posted: Sep 05, 2008

Editor's Note: A hospital’s effort to repatriate a patient who is an undocumented immigrant has been suspended. But for the patient, Francisco Pantaleón, the decision came too late. Pantaleón died in the hospital last week.

CHICAGO, Ill - Francisco Pantaleón came from Olinalá, Guerrero, a tiny mountainous village, its people known for making beautiful hand-made wooden boxes and for its San Francisco de Asís temple. During Pantaleón’s always remembered his birthplace with longing and affection.

On July 17, Pantaleón, who was 30, was working at a local car wash when he suffered the onset of a brain hemorrhage. It began with a headache, followed by vomiting and dizziness, his sister Socorro Pantaleón told La Raza.

He was rushed to Alexian Brothers Hospital in Elk Grove Village, a northwest Chicago suburb, and was translated the same day to the University of Illinois at Chicago (UIC) Medical Center, where he remained in a coma.

One month later, still in a coma, hospital workers informed his family of they intended to repatriate him to Mexico. They were told Pantaleón would be transferred by air ambulance to a hospital in Acapulco.

Soon a small protest formed outside the hospital. Meanwhile, hospital officials denied accusations they were going to deport a patient in a coma. They promised to work with the family and ensure that Pantaleón was well-cared for.

On Aug. 26, hospital officials announced that Pantaleón had passed away.

Hope shattered

Before he died, family members were hopeful he would recover. His sister Socorro recounts their interactions with Pantaleón at the time: “When I ask him questions, he moves his eyes and his fingers. When I say to him, ‘If you see me, close your eyes’, he does.”

“The doctor says that he is in a vegetative state, but because he’s so young, we have faith that he’s struggling to recover,” she said last week.

She was also grateful to the doctors and nurses that attended her brother, thanking them while at the same time pleading that they prevent his return to Mexico.

“What I desperately want for my brother is to receive medical attention here in the U.S. because in Mexico, hospitals are small and they lack the necessary equipment,” she said.

Back in Mexico, Pantaleón’s closest relative is his 82-year-old father, Genaro, who is in poor health and lives in Olinalá. An aunt had recently sent Francisco a small wooden box known as “cajita de Olinalá.” She had hoped the aroma from the lacquered box would remind her nephew of home.

The circumstances

Julie Santos of the League of United Latin American Citizens (LULAC), who helped the Pantaleón family throughout their ordeal, said they would ask the Cook County Medical Examiner for an independent autopsy. But the family held a funeral service for Francisco last September 1st and sent his remains to Mexico.

Meanwhile, LULAC has begun collecting funds to help pay for the cost of a funeral and support Francisco’s two children, aged two and six-months.

Sherri McGinnis Gonzalez, spokesperson for UIC Medical Center provided a statement saying the hospital “provided and exemplary care to a patient with a devastating and debilitating condition. We are side by side our doctors, nurses and medical personnel who provided him with an extraordinary care,” she said.

The preliminary autopsy by the hospital cited by local media said the cause of death would be an uncommon and difficult neurological condition, that implied internal damages, with a big trend towards bleeding.

Controversy

Pantaleón’s tragic case highlights an increasing trend in U.S. hospitals regarding the repatriation of critically ill undocumented immigrants to their countries of origin. The decision is financial; hospital officials often find it cheaper to pay the total cost of transferring the patient than continue their care. But, argue lawyers and activists, hospitals can’t do this without notifying family members or local consulates.

Ioana Navarrete, chief of protection at the Mexican Consulate in Chicago, says that there is a formal procedure for hospitals to follow in these cases. “The hospital sends us a signed consent form from the family. We then receive the patient’s medical file, we forward it to the Health Secretary in Mexico, and they look for a hospital close to where a patient’s family members live. There must always be a family member in Mexico that can take legal responsibility of the patient,” she said.

Bypassing procedure

Evidence suggests that hospitals are not following proper procedures when repatriating patients. “In Pantaleón’s case, a hospital was located in Acapulco, but the family lives in Chilpancingo, which is a few hours by car away,” Navarrete said.

“Equally troubling, in this case the hospital sent us nothing. The (hospital’s) social worker in charge of (Pantaleón’s) case said there was no reason to collaborate with the consulate,” she said.

Worse, according to attorneys John De León, consultant for the Mexican Consulate in Miami, and James Geraghty of Chicago, hospital officials in Acapulco – where Pantaleón was to be sent – did not agree to accept the patient, because to do so would expose an already critical patient to even greater risk.

For UIC Medical Center, the problem in many cases for undocumented immigrants, is that after hospital treatment, patients often require further care, nursing homes or rehabilitation centers. But these care centers do not treat patients that have no medical insurance, said McGinnis

Direct flights

From January 2007 to August 2008, 13 patients were repatriated to Mexico from Chicago-area hospitals. Most came from Cook County, according to Navarrete.

“There are likely cases that we don’t have records for because the consulate wasn’t contacted,” Navarrete said.

An investigation by The New York Times cites 10 Hondurans repatriated by Chicago hospitals in 2007. A social worker at Mount Sinai Hospital who was cited by the paper said the hospital has repatriated Mexicans, Hondurans, Guatemalans and Poles, with an average of two patients annually.

Honduran Consul General in Chicago Erasmo Montalván said he has no information of any Honduran patients being repatriated from Chicago, although he added that, “This doesn’t mean there are no cases.”

He urged families of Honduran patients facing repatriation to call (773) 342-8573.

Legal precedent

For De León, the law regarding patient deportation is clear. “A hospital has no legal right to deport a patient from Chicago to Mexico,” he said. Florida lawyers filed a civil lawsuit on behalf of a Guatemalan patient deported by a hospital under similar circumstances (Montijo versus Martin Memorial Hospital case).

“Legal precedence has already been established, and the courts have said that the hospital cannot act as a private deportation agency, nor do they have the legal right to make decisions regarding the future of the patient without the permission of the families and the (foreign) governments involved,” De Leon said. The court ruled in May 2004.

“Every patient at UIC has the right to life and I think the hospital must maintain its goal of providing for the well-being of its patients, whether they are (US) citizens, undocumented, Mexican, poor, rich, from Illinois or wherever,” he said.

Before Pantaleón died, lawyers had asked Chicago courts to intervene in the case to ensure that UIC provide him with potential life-saving care.

Similar case

Three months ago, a similar case was reported at the Holy Cross Hospital in Chicago, according to Horacio Esparza, director of the Progress Center for Independent Living and an advocate for the rights of people with disabilities.

In 2004, Benito Mendía was left paralyzed after being struck by vehicle. He was taken to the public Cook County Hospital, where he was treated for six months before being released. In December, Mendía fractured his leg and was taken to the private hospital Holy Cross.

Faced with the high cost of treating him, hospital officials considered repatriating Mendía to his home state of Durango, in Mexico.

Esparza negotiated a compromise that avoided the transfer, arranging instead for Mendía’s sister to care for her brother at home. But Mendía’s need for rehabilitative care is intense and caring for him has become unmanageable for his sister, who has a full-time job and children.

Esparza hopes the Hispanic community will organize a fund to help build a rehabilitation center for undocumented patients with disabilities in the U.S. In 2007, he helped block a move by Oak Forest Hospital and then-Cook County chief of Health Services Robert Simon to deport 30 undocumented patients from that facility when it closed its long-term rehabilitative care center.

A settlement brokered by county commissioner Roberto Maldonado helped relocate the patients under a three-year, $3 million contract. That contract expires in December 2010.

Translated by David Boddiger


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