Medical supervision: We don’t have computers, we don’t make protocols, we hand out organs over the phone

The Executive Agency Medical Supervision (EAMS) does not have a computer system for determining organ recipients for transplantation. In addition, no protocols shall be kept for the determination of the most suitable applicant to obtain an organ for grafting. Decisions are made unknown how and by whom, and everything happens over the phone. This is understood by answers to questions asked under the Access to Public Information Act (APIA) after it became clear that the Secretary General of the Council of Ministers Veselin Dakov had pre-arranged three people in the queue for liver transplantation and was operated on at Lozenets Hospital.

The priority service of the highest patient was first reported by the BRRD, and then Minister Stoycho Katsarov checked and officially confirmed that a senior official was fourth with 14 points on the waiting list for liver, but predicted the first one, who had 54 points and received an organ from a cadaveric donor. This happened after a phone call from an authorized person.

So far, it is unclear who called whom and how the pre-targeting happened. In order to clarify this, the BRRD asked questions twice to EAMS under the APIA, but the answers entangled the situation even more and systemic defects in the regulatory framework came to light, allowing telephone law to swirl in this sensitive area, instead of clear procedures subject to inspection and audit.

The fact that there is no automated computer system for the organization of the selection of recipients is strange, since there has been a special ordinance for 17 years: Ordinance 17 of 24 May 2004 on the terms and conditions for the inclusion of persons in need of grafting. It describes in detail the selection algorithm, which contains many criteria that make it difficult to calculate by hand. After all, this is a complex matter in which every human error puts someone’s life at risk.

But even more shocking is the fact that EAMS’s patient selection activities leave no written trace and this is evidenced by the answer to additional APIA questions. From them we understand that a protocol-decision on the provision of the specific body is missing, as there is no “legally defined document”. And this is because in the relevant Article 10 of Regulation 17 it is written only that “the selection of a specific recipient of an organ provided by a human corpse for transplantation is carried out by the Executive Agency “Medical Supervision”, but nowhere is it indicated that protocols must be drawn up and there must be documents on how exactly this selection was carried out.

The ordinance exempts EAMS from unnecessary bureaucracy also with regard to the notification procedure. According to Article 11 of that Ordinance 17 ‘withThe Executive Agency “Medical Supervision” shall notify the medical institution under art. 5, para. 1 for the availability of a suitable organ for transplantation.” The answer under the APIA shows that the notification is made by phone and again there is no written trace.

Earlier, the BRRD asked the question “Who made the decision to pre-order the senior state official” and received an answer that “The selection of a specific recipient is carried out according to a normative algorithm for each specific grafting body. After the application of the algorithm according to the data in the Official Register of EA Medical Supervision, three potential recipients have been identified, which are arranged in accordance with the received complex assessment for each of them. Subsequently, on the basis of a notification received from the University Hospital Lozenets EAD for updating the data in the official register, a fourth patient with emergency status was included in the order.

To the questions who and whom has called to make the pre-heating happen, as well as when exactly this call was received, EAMS answer that they have no information.

BRRD contacted the former head of EAMS Georgi Deyanov by phone. He denied receiving a call about Dakov’s transplant. According to him, the transplant team from Lozenets Hospital took the decision on who to give the organ.

Minister Stoycho Katsarov said that he handed over the case to the Ministry of Interior, but in the absence of any documents and the possibility of an audit, only two methods remain at the disposal of Boyko Rashkov’s office – interrogations of all officials from EAMS, University Hospital “Lozenets” and MMA and a requirement by mobile operators of all printouts of their conversations in the days from 21 to 23 April.

From the documents that the BSDP still received under the APIA, it is clear exactly which time interval should be examined in order to find out who has called and to whom. The donor patient was brain dead on April 20, 2021 at 6:45 p.m. The seizure of the organ happened on 21.04.2021 at 12:50 in the University Hospital “Lozenets”. The graft occurred on the same day at 16:50 of a patient with identification number BGRSOF1721.

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Разследващата журналистика е разузнаването на гражданите. BIRD се финансира от дарения. Ние не публикуваме реклами. Не получаваме държавни субсидии. Не разчитаме на грантове. Финансирането чрез малки дарения от читатели е гаранция за нашата независимост. Включете се, за да продължим да разкриваме злоупотреби и да държим отговорни властимащите. Използваме Вашите пари за хонорари на журналистите, командировки, изграждане и поддръжка на нашите информационни системи, такси за фирмени и имотни регистри у нас и по света, придобиване на техника и специално оборудване, осигуряване на нашата безопасност и други важни работни мисии. Важно: Ако дарявате всеки месец това ще ни даде възможност да планираме и организираме нашата работа. Благодарим Ви! Нас ни има, защото Вас Ви има!

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