The lack of preventive maintenance caused the collapse of the tomograph of the General San Juan de Dios Hospital in early April, so patients who need that study should be transferred to other public and private services, although there are complex cases that cannot leave the health center to submit to the exam. The repair of the device, which spent five months without technical service, has a cost of Q696 thousand, according to the price that came to the hospital administration yesterday.
In the emergency of surgery there is a patient with a tumor that, for four days, needs a tomography, which functions as a map for the doctor to know the advance of the disease and determine how and where to intervene.
“Severe cases risk when they move outside the hospital protection. In addition, that it has been and requires human resource that we do not have,” says doctor Napoleón Méndez, head of the surgery section of the adult emergency department.
Therefore, he insists that Tomographies should be done inside the hospital; However, several months will spend for the service to be restored.
The tomograph that was found was donated in 2020 by the government of Japan. The machine was put into operation two years later, with the inauguration of the image diagnostic room. With the delivery of the team Preventive maintenance was guaranteed until November 2024.
According to the authorities of the General Hospital, on February 15 of this year an event was published in Guatecompras to continue maintenance, but there was only one offeror and the amount exceeded the estimated spending.
Subsequently, another contest was created, which is identified with the number 25977121 on the Guatecompras portal, which was awarded on April 1 for Q90 thousand in favor of the company that offered the service in February, since it is the only one with representation in Guatemala to maintain the team donated by Japan. This is the Guatemalan Distributor Corporation (Disgua) that, through a statement, indicated that, after the guarantee of the team, it “warned” that preventive maintenance should continue, and that for more than five months the device did not receive technical attention, which caused damage to its operation.
María Alejandra Mejía Estrada, financial administrative manager of the General Hospital, indicates that last week they received an initial diagnosis of the state of the tomograph. It was this Monday, April 21 when they arrived quotation to repair it and ascends to Q696 thousand 640.
The estimated time for the purchase of spare parts and reparation could be extended between three and four months, Mejía Estrada mentions.
While the tomograph repair is carried out, the San Juan de Dios General Hospital relies on the Roosevelt and Villa Nueva hospitals, where 15 patients have been transferred to carry out image studiesReported the doctor and director Erika Pérez, at a press conference.
Mejía Estrada points out that for transfers there are six ambulances. However, Méndez says that any transport cannot be used, since in severe cases monitors, sufficient oxygen are required and the ideal is that in each unit a doctor, a nurse and a technician travel. However, transfers are being made with the same medical staff that attends within the hospital.
On the other hand, a private tomographic service was hired. According to information available in Guatecompras, the London Clinic will provide the assistance by Q89 thousand 880 to serve 214 patients referredwith a cost of Q420 for each study. Until Monday, 34 patients had moved.
The most specialized 3D studies are not covered by the hospital, and the people who need them to receive medical care must pay them in private clinics.
According to Mejía Estrada, while the tomograph donated by the Government of Japan is repaired, the support of the other hospitals and with the External Service contract will continue, for which they have a budget.
In parallel, an event will be held Equipment lease with option to purchasewhich will guarantee the service to the population; However, it will depend on the delivery time of the supplier.
“We know that an approximate time to be able to deliver the team could be five to eight weeks, depending on the location from where it is brought. Here it is not so much the agility we have to generate the processes, but also of the agility that the entrepreneur has to bring the team,” adds Mejía Estrada.
This Tuesday they will meet with companies that have a tomograph availability, so that they can submit their proposals. With that base information, A contest will be published to start the process and have clarity about the technical specifications of the equipment and its market price.
The financial administrative manager indicates that the hospital has a budget to lease the equipment with the option to buy and pay the contracted services. The intention is to acquire a third tomograph for the high demand of patients who require these studies; For this purchase they may require financial support.
Images for diagnosis
A tomograph is a device that allows you to obtain images from the interior of the body by sections or cuts, through the use of X -rays. It facilitates a more complete visualization than an radiography. The team donated by the Government of Japan is computerized and 64 cuts, which allows to obtain a greater detail from the studied area. It has a cost of US $ 2.8 million, As reported on the day when it began to operate, and it was indicated that each year in the hospital approximately 2 thousand tomographies are held.
Not all patients require studies of this type, but many of the polytraumatized do, especially those who have alteration of the state of consciousness, since they are at risk of hemorrhagic lesions in the brain, whose solution is surgical.
“You cannot open a skull if you do not have an image, and the only mapping that exists, without any substitution for that study, is tomography,” says Méndez.
Tomographies are useful for diagnoses such as:
- cancer
- Intrabdominal infections
- Airway tumors, thorax and abdomen
- spine injuries, pelvis and peripheral vessels
- brain aneurysms
- skull trauma
- Hydrocephaly
- Postoperative controls, among other cases.
It is not the first time
In the hospitals of the public network the lack of maintenance in the teams is recurrent. In July last year, the tomograph broke down at the Hospital for not giving preventive service, and internal and emergency patients were affected.
On that occasion, the team reached more than one million studies, but due to the high price of these devices, another had not been acquired.
On that occasion, it was also coordinated with the General and Villa Nueva hospitals to study patients who depended on these tests to receive treatment.