Family Alleges Profit Motives Played Role in 3-Year-Old’s Death

Three-year-old Ivanna Saucedo was a miracle child, according to her father David.

Ivanna was diagnosed with hydrocephalus, an abnormal buildup of fluid in the brain, while David Saucedo’s wife Mariana was still pregnant. But the Texas couple’s little girl exceeded every expectation after her birth, Saucedo told MedPage Today.

Not only did Ivanna walk, she danced, he said. And not only did she talk, she was bilingual.

However, on Sept. 2, 2019, Ivanna passed away days after being admitted to El Paso Children’s Hospital.

A year after Ivanna’s death, David and Mariana Saucedo filed a lawsuit against El Paso Children’s Hospital and two local doctors. Represented by high profile attorney Tony Buzbee, they allege in their complaint that their daughter’s demise was the direct result of grossly negligent care by the hospital, its staff, and a well-known physician recruited to boost revenues after years of financial strife.

“We miss Ivanna dearly,” David Saucedo said in a statement provided to MedPage Today about the ongoing litigation. Saucedo, a local businessman, former El Paso mayoral candidate, and appointee to the Texas Board of Nursing, added that his family’s pain is “a grief that’ll never heal.”

“We are doing this for our community because we don’t want any more children to die,” Saucedo said, “and we certainly don’t want any more parents to live through what we have experienced.”

Seeking Care

On Aug. 29, 2019, Ivanna Saucedo began throwing up at home. Concerned, her parents sought the care of Roberto Canales, MD, a well-known El Paso physician, at his local medical clinic.

Canales concluded that Ivanna needed emergency medical care and instructed the Saucedos to take their daughter to the emergency room at El Paso Children’s Hospital, according to the Saucedo’s complaint. He promised he would follow them there and treat Ivanna personally.

At the hospital, staff abruptly moved the Saucedos from the emergency department to a room on the hospital’s ninth floor, according to the complaint.

The Saucedos claim that hospital staff explained that Canales would arrive shortly, and that only he could treat Ivanna. Overnight, the Saucedos claim they pleaded for help as they watched their daughter’s condition deteriorate, only to continue to be told that Canales would arrive soon. But almost 12 hours later, Ivanna went limp and turned blue, and began to foam from the mouth.

The hospital’s emergency trauma team finally agreed to treat Ivanna, sedating her and transporting her to the pediatric intensive care unit, according to the complaint. Canales didn’t arrive until after 9 a.m., and he and another doctor named in the complaint, Rodolfo Fierro-Stevens, MD, assured the Saucedos that Ivanna would soon wake up, the Saucedos stated in court documents.

Ivanna’s previously inserted shunt — a drainage device commonly used to treat hydrocephalus — had malfunctioned, according to the complaint. However, the Saucedos claim that Canales and other hospital personnel failed to recognize a common complication of shunt placement and hydrocephalus, and misdiagnosed Ivanna’s condition as hypoxic stroke.

Ivanna never woke up, and she was ultimately declared brain dead.

In the U.S., hydrocephalus occurs in two of 1,000 births, and patients often have a full lifespan if hydrocephalus is caught early and treated. Typically, children need two to five surgeries throughout their life to maintain their shunts.

Recruiting Revenue

The Saucedos allege in their complaint that Canales is unqualified and untrained in the area of pediatric intensive care medicine. They allege that Ivanna’s death was also caused by policies and procedures at El Paso Children’s Hospital put in place to “accommodate and entice” Canales to do business with the hospital “in exchange for millions of dollars of revenue and massive amounts of patients” promised to it by the doctor.

The Saucedos note in their complaint that from the time El Paso Children’s Hospital began operations in 2012 until it hired Canales in early 2019, it had lost millions of dollars in revenue each year, declared bankruptcy, and continued to struggle financially.

When bringing the well-known physician on board, the hospital sought an exemption to allow him to practice pediatric intensive care medicine, according to the complaint. Though several medical directors and physician managers refused to provide the exemption, the hospital allegedly threatened those doctors with termination, bypassing them and obtaining the exemption anyways.

The hospital also refused to allow its doctors to peer review Canales’ work, according to the complaint. Hospital administration told its doctors they weren’t allowed to treat Canales’ patients, giving him the exclusive right to treat and bill his patients and their insurers, the complaint states.

The latter practice resulted in physicians, at times, being forced to respond to staff calls for assistance by saying “this is not our patient,” and “we can’t help them,” according to the complaint.

Bypassing Bylaws

The Saucedos state in their complaint that El Paso Children’s Hospital bylaws require all doctors to be board-certified in their field.

Though Canales says he is a specialist in general pediatric medicine, pediatric intensive care medicine, hematology, and oncology, he has no formal board certifications, credentialing and/or training in the latter three areas, the Saucedos allege in their complaint.

Information available through the Texas Medical Board states that Canales’ physician license was issued in 1980, and that he obtained specialty certification from the American Board of Pediatrics in 1985. It also lists a fellowship in pediatric hematology and oncology at Tufts New England Medical Center from 1978 to 1980, and a postdoctoral fellowship in the same area at Baylor College of Medicine from 1980 to 1981.

The Saucedos note in their complaint that practicing in numerous areas of medicine results in higher profits.

They allege that Canales regularly sees between 100 and 200 patients a day at his medical clinic — a “virtually impossible feat,” according to their complaint — and that the “practice of placing profits over patient care directly caused the worsening and delay in treatment” for Ivanna.

The Saucedos further allege that El Paso’s Children’s Hospital attempted to withhold medical records after Ivanna’s death, including radiology and CT scans that showed she died from intracranial pressure and not the hospital’s incorrect diagnosis.

The Saucedos are seeking damages in an amount to be determined by a jury, according to their complaint.

Conflicting Claims

A spokesperson for El Paso Children’s Hospital said in a statement provided to MedPage Today that it cannot comment on any legal case, but that patient care is its top priority.

“El Paso Children’s Hospital is focused on providing high quality outcomes for the most vulnerable patients in El Paso and the surrounding community,” the spokesperson said. “Our number one goal is to provide safe, quality care to all our patients.”

Paul Bracken of the El Paso law firm Robles, Bracken & Hughes is representing Canales in the case. Bracken told MedPage Today that, “We look forward to disproving the allegations in the complaint.”

Legal counsel for Fierro-Stevens did not immediately return a request for comment; neither did attorneys for the Saucedos.

“El Paso deserves a world-class children’s hospital,” David Saucedo told MedPage Today. “That is what we want. We want competent administrators and doctors who care about healthcare and not just making a profit.”