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Slight pain leads to quick death at Metropolitan Hospital of Miami

Julio Lorenzo brain-dead at Metropolitan Hospital.
Photo courtesy of the Lorenzo family

A ventilator tube funnels oxygen into Julio Lorenzo's lungs. The 51-year-old air-conditioning repairman lies on a gurney inside the intensive care unit at Metropolitan Hospital of Miami, just south of Miami International Airport. It's mid-afternoon on April 30, three weeks after the lively, joke-cracking Cuban immigrant arrived complaining about a mild pain in his right testicle. The machine hisses and every four seconds, it belts out a loud sucking sound.

To his left, a boxy machine on a pole with five wheels at the bottom indicates his blood pressure is a very low 67/30. His olive-color eyelids are shut tight, and his stubbly face is impassive. His hands and feet are swollen from fluid retention.

Lorenzo's girlfriend, Mileidys Cordero, a petite, long-haired brunette with a few freckles on her cheeks, grips his unresponsive left hand. Her soft brown eyes well up with tears. Cordero is flanked by Lorenzo's 60-year-old brother Rafael, who doesn't say a word, and the repairman's 49-year-old close friend, Raul Urquiaga.

Then, suddenly, Lorenzo's 26-year-old son, Andy, who's sitting in a chair nearby, buries his ruddy face in a white pillow. His father, he sobs, used it as a head support.

At 2:04 p.m., Lorenzo's lanky body spasms and his arms reach up for a few seconds. Then he goes limp. An auburn-haired nurse monitoring the machines rushes out and returns less than a minute later with the charge nurse, who breaks the news. "I'm sorry," she tells the family. "He's gone."

Lorenzo's life was abruptly and unexpectedly cut short, but the fight over his death is just beginning. His trip to the hospital is a surreal revelation of how patients are treated in one of Miami's oldest and most respected community hospitals. Physician Maray Rocher Gomez — who treated Lorenzo on April 8, according to his medical records — did not respond to two messages left on her cell phone. The number was provided by the hospital, which has no other number for her. Jaime Roncancio, another doctor listed on the Metropolitan documents, declined to comment, citing pending litigation.

"What happened to Mr. Lorenzo is a tragic situation," says Metropolitan's chief compliance officer, Carlos Garcia. "This matter is under investigation." He declined further comment.

Metropolitan has established roots in Miami-Dade County. It was founded in 1963 as Pan American Hospital by 13 Cuban exile doctors who planned to serve newly arrived immigrants from the island. It was the place where iconic exile leader Jorge Mas Canosa spent the last moments of his life in 1997.

But during the past decade, the hospital has been sued 33 times. Most complaints were dismissed, but nine plaintiffs received settlements. There have been three wrongful death lawsuits. One was dismissed, but on October 12, 2001, Pan American paid the family of patient Solange Delatour $2.8 million. (Court records of that case have disappeared.)

Before that, there was the well-publicized scandal in 2000, when then-Chief Executive Carolina Calderin and two Pan American doctors sued hospital founder Modesto Mora, his wife, then-Chief Financial Officer Roberto Tejidor, and other board members for defamation. Calderin claimed she had been removed in an attempt "to cover up... misdeeds." She asserted the defendants had been "looting" Pan American. Among other things, she said Mora's wife had a $60,000-per-year no-show job and that his sister lived rent-free in a home owned by the hospital. She also claimed Tejidor had falsified a $26,000 check request.

Pan American officials countered that Calderin had been fired after buying stock in a company negotiating a contract with the hospital. Tejidor was later criminally charged for harassing her, but those charges were dropped.

In 2001, the former chief executive's lawsuit was settled for an undisclosed amount.

The company suffered financial problems in the years that followed, abruptly closing 12 clinics, and then — in 2004 — filed for bankruptcy. Two years later, a Puerto Rican company bought the hospital for $34 million and renamed it.

Of course, Lorenzo had no idea about Metropolitan's troubled past when he went to the emergency room this past April 8. His buddy Urquiaga, who was in the hospital room during his death, says Lorenzo was an easygoing, charismatic man. Born the same year Fidel Castro took over, he was twice divorced. He had a son, Andy, with his first wife and a daughter, Arelys, with his second spouse. "He deeply loved his children," Urquiaga says. "They miss him terribly."

Lorenzo and Urquiaga fled Cuba together in 1994. They were intercepted at sea by the U.S. Coast Guard and transported to the Guantánamo naval base, where they stayed for close to a year.

In 1995, the pair made it to Miami, where Lorenzo studied and earned a license as an air-conditioning repairman. He lived in Hialeah with his older brother, Rafael. "We would have barbecues every weekend," Urquiaga recalls. "He was a regular guy who was always on call because of the nature of his job. He was always working."

In early 2008, Lorenzo's son, Andy, fled Cuba and joined his father in Hialeah. (His daughter remains on the island.) Later that year, Lorenzo ran into Cordero, who was an old flame from Cuba. They rekindled a romance and moved in together last year. Andy stayed in Hialeah while the couple found an efficiency off Flagler Street and 57th Avenue, about a five-minute drive from Metropolitan.

The night before he experienced the testicular discomfort that led to his death, Lorenzo and Cordero celebrated her birthday with friends inside their tiny apartment. Photos show Lorenzo with a beaming smile and his arms wrapped around his people.

On the morning of April 8, Lorenzo — who was rarely ill — called his son to say he was going to Metropolitan to have his testicle examined because it was causing some pain. He rode to the hospital with his brother, Rafael, around 10:30 a.m. He had no insurance, but doctors agreed to treat him anyway. An emergency department nursing assessment form filed around 11:30 notes he rated his pain level at a 3 on a scale from 1 to 10. At 12:30 p.m., an ultrasound showed no significant issues with the testicle. Soon a doctor prescribed five pain-killing medications, including .5 milligrams of a powerful morphine-like narcotic called Dilaudid. It's impossible to read the signature on the hospital record, which was shown to New Times by attorney Stephen Kandell, whom the family has hired.

"When they injected him with that medicine, my father told us he felt like a hot vapor was traveling up his body," Andy says. "He felt a little woozy and laid down on a bed. He vomited and then passed out."

Urquiaga adds, "Since he didn't have insurance, the emergency room staff just wanted to discharge him as quickly as possible. They let him sleep on a gurney, but they really weren't attending to him."

At 3:45 p.m., Andy says Lorenzo, who was still unconscious, began having convulsions. The son alerted Dr. Jaime Roncancio, who was near the nurse's station, of his dad's distress. "The doctor told me my dad was acting crazy," Andy claims. "He said my dad was faking it as a cry for attention so that he could stay at the hospital." (Public records show no lawsuits or disciplinary records alleging wrongdoing by Roncancio, who has been licensed in Florida since 1998).

Lorenzo was left alone until 6 p.m., when Dr. Rocher Gomez (who was licensed in Florida in 2007 and also has a clean record) checked on him. "That's when they realized something was wrong," Urquiaga says. Indeed, the hospital's ongoing assessment sheet for Lorenzo shows Gomez began giving him Dilantin, Benadryl, and Narcan — medications that can be used to treat seizures and reverse the effects of opiates such as Dilaudid, according to WebMD.com.

It was too late, records show. Lorenzo had suffered a brain edema. He slipped into a coma and was declared brain-dead before midnight. Dr. James Gorelick, a neurologist, was then called in. He initially suspected herpes meningitis had caused Lorenzo's edema. But a spinal tap quickly ruled that out. A separate report indicated Lorenzo's body showed no traces of bacteria.

He survived for 22 days on a ventilator. At the end of April, the family signed documents to pull him off life support. He died on his own as a New Times reporter watched.

Says family lawyer Kandell: "It's a tragedy."

Andy Lorenzo says he is lost without his father, whose body was cremated May 10. The ashes are in an urn on a nightstand next to his bed. "I feel terrible," he says. "I don't have anyone else here. I came to Miami because of him. Now I am all alone."

His dad's first hospital bill came in the mail, Andy says. Amount due: $15,000.


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