The executive director of the insurance company Prevent Senior, Pedro Benedito Batista Júnior. Jefferson Rudy / Jefferson Rudy / Ag ncia Senado
The medical insurer Prevent Senior was at the center of attention at the beginning of the pandemic in Brazil, when it accumulated 30% of deaths from covid-19. Owner of some thirty hospitals, the company, which was born in 1997, specialized in serving people over 60, just the public most impacted by the coronavirus. Now, it is back in the news with complaints from doctors who denounce that the insurer tested the popularly called
covid kit
on their patients
—Compound of hydroxychloroquine and ivermectin, among other ineffective drugs against covid-19— in infected patients without their consent or that of the National Research Ethics Commission.
In addition, the insurer would also have hidden deaths from covid-19 to improve its statistics, as found by the Parliamentary Investigation Commission of the Pandemic of the Brazilian Senate.
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The file also indicates the existence of a link between the company and the Government of Jair Bolsonaro through a parallel cabinet of denial doctors that operated within the Ministry of Health - the president himself relied on the data released by Prevent Senior to substantiate his defense of chloroquine as a method to cure covid-19—. The director of the insurance company, Pedro Benedito Batista Júnior, who was summoned last Wednesday to testify before the Senate, denied all the accusations and avoided talking about the dead patients.
However, he did not fully deny one of the accusations. In one of the moments of greatest tension in the commission, the senators showed him a message that was in the file, in which Batista Júnior ordered that the CIE (world code that describes the patient's disease) be changed for people with suspicion of covid-19 or that they had tested positive. The code had to be changed to another disease code after the patient had been hospitalized for 14 days or 21 days in the ICU, the time that the COVID-19 cycle lasts in the human body. Batista Júnior did not deny it and justified himself: "If these patients had already passed that period, the ICD could be changed, because they no longer represented a risk for the hospital population."
The problem is that, when changing the patient's ICD, Prevent Senior considered only the diseases or conditions derived from covid-19, and not the disease itself, according to the file. Thus, many patients remained in the hospital with sequelae and ended up dying as a result of these, but without the covid-19 appearing on the death certificate. According to the senators, it would be a way of masking the statistics, making the deaths from COVID-19 low and, thus, the treatment with chloroquine and other ineffective drugs could be presented as a success. “They consider that after 14 days the patient no longer has covid. This is fraud, ”Senator Humberto Costa said irritably.
This seems to have been the case of doctor Anthony Wong, a well-known denier close to the Bolsonaro government and who propagandized the ineffective covid kit.
Pediatrician and toxicologist, he died on January 15, 2021 with a diagnosis of gastric ulcer and digestive bleeding.
But he came to Prevent Senior with symptoms of covid-19 and was treated with hydroxychloroquine, azithromycin, and ivermectin for four days.
They then gave him other drugs without proven efficacy against COVID-19, such as inhaled heparin and intravenous methotrexate.
He also received twenty rectal ozone therapy sessions.
But neither his medical history nor his death certificate mention that he died of covid-19.
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It is also suspected that this procedure was used with Regina Hang, mother of Bolsonarista businessman Luciano Hang, who even recorded an emotional video recommending early treatment against covid-19. “When my mother arrived at the hospital, she already had almost 95% of her lungs damaged. As long as the vaccine does not reach all Brazilians, we have to fight for life with all the possibilities we have. Until he was diagnosed with covid-19, he had never given my mother any preventive medicine, "said the businessman on his social network.
But the insurer's doctors gave another version. Regina Hang reportedly received early treatment with hydroxychloroquine, azithromycin and colchicine before entering Prevent Senior on December 31. At the hospital, he was also given ivermectin and rectal ozone therapy, a controversial alternative medicine method to treat everything from joint pain to skin wounds. The mother of the owner of the Havan chain of stores died on February 3 of this year and, according to the file of the parliamentary investigation commission, her death certificate was “falsified”, because covid-19 was not listed as the cause of the death. death.
The document, to which EL PAÍS has had access, also states that Dr. Maria Emília Gadelha Serra treated both Regina Hang and Wong with ozone therapy.
Serra belongs to the Brazilian Society of Medical Ozone Therapy and is also linked to the Brazilian Association of Vaccine Victims, an entity that promotes misinformation about vaccines.
During his statement before the investigation commission, Batista Júnior avoided answering questions about these two patients, alleging ethical issues, such as the need to maintain medical secrecy and family privacy.
He also argued that death certificates are the responsibility of each physician.
Parallel cabinet
The file explains that the parallel cabinet intervened in Prevent Senior through doctors Nise Yamaguchi and Paolo Zanotto, two great defenders of early treatment, who have already testified before the pandemic investigation commission for being accused of giving informal guidance to President Bolsonaro about the disease. “Communication and alignment with the federal government were constant. The President of the Republic even published, on his social networks, the numbers of the Prevent Senior investigation even before it was officially published ”, says the document. This can be seen in a Facebook post of April 18, 2020, when Bolsonaro wrote that “according to CEO Fernando Parrillo, Prevent Senior has reduced the time of use of respirators from 14 to 7 days and has announced today, to the 1:40 o'clock in the morning, the complement of a clinical study that he has carried out ”, announcing that the complete study would be“ published soon ”.
As proof of the doctors' actions, the file presents a copy of a therapeutic protocol to treat COVID-19, which provides for the use of hydroxychloroquine and azithromycin early and which is signed by the two professionals.
According to the commission, Dr. Nise Yamaguchi went to Prevent Senior to align early treatments and also counseled patients considered "special", such as Dr. Anthony Wong, who died in a network hospital.
Through her social network, the doctor reported "that she did not participate in Wong's early treatments, but that she" visited him promptly after he was intubated, although she was not the doctor responsible for his admission to Prevent Senior. "
Details about the file
The 54-page file that fed the discussions of the investigation commission on Wednesday was prepared by Senator Humberto Costa's team, and is based on the documents received by the commission and on the complaint of 12 doctors who worked at the insurer. The professionals, whose identities have been kept secret, said that the federal government made an agreement with Prevent Senior to test the effectiveness of the combination of chloroquine or hydroxychloroquine with azithromycin to treat COVID-19. Doctors Rodrigo Esper and Fernando Oikawa would have been responsible for the investigation.
The file states that the investigation commission received a copy of a WhatsApp message, dated March 25, 2020, in which the company's management informed the doctors about the treatment protocol with hydroxychloroquine and azithromycin. "Please do not inform the patient or family member about the medication or the program," the message said.
That same month, the insurer occupied the pages of the newspapers after the then Minister of Health, Luiz Henrique Mandetta, harshly criticized the company's procedures when treating the first victims of covid-19, which caused a large number of infections. and deaths in one of the insurer's own hospitals - the first official death from covid-19 in Brazil was registered in a hospital managed by Prevent Senior. At that time, there was already speculation about the informal collaboration between the company and the so-called parallel cabinet of the Bolsonaro government. According to the file, the purpose of the collaboration would be "to facilitate the manipulation of the results of the investigation to 'prove' the efficacy of the treatment and deliver what had been agreed with the 'advisers' of the President of the Republic."
However, the company did not request authorization to carry out the investigation from the National Research Ethics Commission until April 6, 2020. The study was authorized on April 14, but was suspended six days later, since the commission of Ethics detected several irregularities, such as the “non-existence of a control group”, a “difference between the declared number of participants (700) in the clinical trial and the number defined in the research project (200)” and the “omission of the obligation to notify the cases of covid-19 ″, which were lower than the real number.
The file also informs that the new clients of the company, since the middle of last year, received the covid kit at home without even going through medical attention. The drugs were sent with a "standard prescription, all identical, and always signed by the same doctor, Rafael Souza da Silva." The material was also distributed in consultations for patients with influenza syndromes. "Doctors who did not deliver it were sanctioned," the complaint reports.
In July this year, Prevent Senior had 542,471 clients, the majority in São Paulo, almost 12% more than in August last year, according to data available on the National Health Agency website. Some 4,000 patients admitted with covid-19 in the hospital network of the insurer died throughout the pandemic. This represents almost 22% of the 18,000 users who were hospitalized for covid-19 in the units managed by the company, according to data released by Batista Júnior during the investigation commission.
Batista Júnior, when he found himself on the ropes, questioned the file and pointed out the professionals who got into the medical records of patients that were not his, extracted data and disclosed them to the press and the investigation commission.
According to the executive, an attempt is being made to "usurp" the name of the company and the doctors who accuse Prevent Senior had been fired for "serious ethical and moral failures, such as the invasion of medical records or the application of inadequate treatments."
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