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Trafficking in organs alleged
Medical tourism's dark side revealed

By the Medical Vacations in Costa Rica staff

Six arrests and a continuing investigation have illuminated a dark side of medical tourism.

The allegation is that physicians and recruiters targeted low-income residents of the country and caused them to sell their internal organs, mainly kidneys.

Detained June 18 was Francisco Mora Palma, chief of nephrology at the public Hospital Calderón Guardia. He is believed to have done up to 550 kidney transplants at private hospitals outside his government job. He was detained at the respected Hospital Hotel La Católica in Guadalupe.

Mora provided kidney transplants as part of packages with prices ranging up to $150,000. Some of the patients, including one 80-plus-year-old U.S. medical tourist, had been turned down for surgery in their home countries. Others found that the procedure was must less expensive here.

The judiciary here is treating those who gave up an internal organ as victims.

Investigators detained two urologists and a vascular specialist Oct. 10. The urologists were identified by the last names of Mauro Stamati and Fonseca Guzmán. The vascular expert was identified with the last names of Monge Monge. Also detained was a local businessman, Dimosthenis  Katsigiannis, who was accused of being a recruiter among would-be organ donors. When Mora was detained, a woman who worked in the security ministry's communications center was arrested. She has the last names of Cordero Solano and was identified as another recruiter.

The individuals are being held under a last passed in 2012 that makes illegal the possession, transport, sale or purchase of organs in an illicit way. Local prosecutors acted after a Mexican newspaper characterized Costa Rica as a center of illegal transplant activity.

At least one of Mora's operations did not turn out well. The overweight and elderly U.S. citizen who underwent a kidney transplant last November at his hands, died after he returned home to the United States.. The procedure took place at La Católica. The man at the time told friends here that he could not get a transplant in the United States because physicians there rejected him because of his weight and age, more than 80 years. He received the kidney of a younger friend, he reported.

The wealthy U.S. citizen has a long association with
 
More arrest
Judicial Investigating Organization photo
Investigators confront and arrest Francisco Mora Palma at Hospital Hotel La Católica.

Costa Rica, but he said he found out about a package deal offered by the hospital via an Internet search. He said at the time he spent upwards of $150,000.

After the surgery, the U.S. citizen returned to his home there and immediately was put in intensive care by his own physicians, who expressed shock that he had undergone such an operation. He died several weeks later.

There was no secret about the transplant business. Mora even did an interview with a local promoter on YouTube. Mora is reported to have done nearly all his private practice transplants at La Católica. The other physicians who were detained in October have associations with the other major private hospitals, Hospital Clinica Biblica in San José and Hospital CIMA in Escazú

When he was detained, Mora was handcuffed with his hands behind his back and led to detention with a garment thrown over his head in much the same way that robbers and other street crooks are treated. The same thing happened to the other suspects later.

Investigators said they confiscated the files of the physicians. These files would contain the names of those who obtained the various transplant surgeries in Costa Rica, and they might end up being implicated in future court cases. Those who donated organs are likely to see large money judgments.

The suspects who were detained were placed in a local prison for preventative detention.

  — Oct. 13, 2013


Expats and medical tourists should do their homework

Never does the phrase "you get what you pay for" apply more strongly than in seeking medical care in Costa Rica. A medical tourist who looks only to price is bound to have troubles. Some of them can be very serious.

See our story HERE!


Here are some factors to bear in mind
Special to Medical Vacations in Costa Rica

So, you are considering medical tourism as an option. Here are five issues you should consider before booking that flight:

1.    Insurance: Most U.S. health insurance companies only cover procedures done in the patient’s home network coverage area. They generally do not cover procedures performed in foreign countries, which means that the trip and the procedure are out-of-pocket expenses.  The continual increase in medical tourism, however, is forcing some insurance companies to change their stance. One U.S. insurer is offering to waive a $3,000 deductible for very expensive hip surgeries, if the surgery is done overseas. In fact, insurance companies will probably jump on the medical tourism bus within the next decade or so, if they can see a way to save their money on your care.

2.    Malpractice Laws: Be advised that the main reason medical procedures are so inexpensive overseas is partially due to the lack of medical malpractice insurance. Doctors and hospitals pass those savings on to you. The lack of coverage does not mean they are necessarily doing anything wrong. Quite the contrary. It just means that the laws governing malpractice in foreign countries are very different than those in America. Translation: You have little recourse to sue.

3.    Recovery Issues: Medical professionals in the United States have expressed concern that patients will be rushed through recovery and forced back onto a plane. This is unlikely, but make sure you schedule
enough vacation time to be able to recovery completely. It is also important to note that doctors always recommend keeping scars out of direct sunlight for the first 12 months after surgery. It helps the healing  process and to minimize the discoloration. So, do not plan on spending your recovery in a lawn chair at the pool. 

4.    Traveling Home: When you are fully recovered, another concern arises with long, international flights and the risk of blood clots. Discuss any concerns you have with your doctor but it is always a good idea, post-op or otherwise, to get up and walk around every hour on long flights to maintain proper blood flow. You could also spend some of the money you saved on upgrading to pricey first-class seats. Airline seats are notoriously cramped but first-class can offer considerable more legroom.

5.    Follow Up Care: Under normal circumstances, a patient schedules several check-ups with their doctor after surgery, sometimes as far out as 12 months post-operative. This can be difficult when the surgeon is in Pavas and you are in Punxsutawney. Be sure to ask your primary care physician if they can perform follow-up care or inquire with your medial travel agency on their standard protocol.

The advantages to medical tourism are very real but so are the risks. Be sure you weigh out the pros and cons before making your decision to go ahead with surgery. If you feel the advantages are greater than the risks then it's time to pick your location and book your flight.
— Oct. 13, 2013

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