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Napoles medical condition 'urgent,' says expert witness

MANILA, Philippines – Contrary to testimonies of previous witnesses and the assertions of Janet Lim-Napoles' defense team, the opinion expressed by a veteran ob-gyn surgeon is that her medical condition needs "immediate attention."

Dr. Santiago del Rosario, a former president of the Philippine Medical Association and the chairman of the Makati Medical Center ob-gyn department, was called upon by the defense team to testify on Tuesday, March 18, on the need for Napoles to undergo surgery and confinement. (READ: Napoles condition 'nothing alarming' – PNP doctors)

Napoles is currently detained at a police camp in Laguna for serious illegal detention charges. In detention for almost 7 months, Napoles is now asking a Makati court to allow her to undergo surgery to remove a myoma in her uterus that was discovered during a medical examination at the Camp Crame General Hospital.

The alleged mastermind of the multi-billion-peso pork barrel scam had previously complained of "hypoglycemia, drastic weight loss, chest pains, severe abdominal pains, and profuse menstrual bleeding."

After examining Napoles earlier, PNP ob-gyn Michelle Daguno said exam results did not indicate anything "life threatening so far."

Del Rosario told the Makati Regional Trial Court Branch 150, however, Napoles' age makes the situation "urgent."

"Myoma with bleeding commands immediate attention, particularly women at middle age. Women in middle age with abnormal bleeding introduces the risk of cancer," Del Rosario said.

Because cancer is a possibility, Del Rosario said, "a delay could spell the difference between a cure and no cure."

Previously, Napoles' team said medical examinations indicated elevated levels of CA 125, a biomarker used to detect ovarian cancer. Her special counsel Fay Isaguirre Singson said that Napoles' condition is "not alarming," but the menstrual bleeding was still a cause for concern.

Tests first, not surgery

The prosecution argued that the medical examination in Crame did not indicate bleeding at the time of the exam. But Del Rosario said: "Only one examination does not tell the story."

"We should do more so we can build the story: what is happening [to Napoles]?" he added. "One of the possibilities we would like to eliminate as soon as possible is cancer."

Based on documents presented by the defense to Del Rosario, he said Napoles lost around 2 liters of blood in a period of 2-3 months. Del Rosario, who has not met Napoles in person, said he based his conclusion on an examination that showed Napoles' hemoglobin droppped from 12 grams per deciliter to 10 grams per deciliter.

Confusion arose in the court, however, since the December 2013 medical examination results on which Del Rosario based his opinion were that of a "Jenny Tan." Judge Elmo Alameda said the court would resolve Napoles' possible use of an alias during the medical examination.

The defense will be bringing in witnesses to prove that in the case of the blood examination results, "Jenny Tan" is also "Janet Lim Napoles." Del Rosario, meanwhile, said it wasn't odd for a patient to use aliases in medical exams for security reasons.

Patient's rights

Del Rosario, during his testimony, said any patient – free or under detention – had the "absolute right" to choose her doctor, as well as the time and place of possible procedures, based on the World Medical Association's Declaration of Lisbon.

"It is our code of ethics, we don't classify a patient. Whether he is young or old, male or female, gay or lesbian, or free or detained.... Basta pasyente, she has every right to seek medical attention with a doctor she trusts, at a place where she feels she will get adequate treatment for her condition," said Del Rosario.

Her choice, of course, would be limited by the court's decision.

Napoles previously asked to undergo medical examinations at the St. Luke's Medical Center, but the court allowed the medical examination at the Camp Crame General Hospital instead.

This time, however, her camp is asking that she be allowed surgery and confinement in St. Luke's "and not at any government facility." Napoles' lawyers said she is averse to confinement in a government hospital because of her "bad experience" at Crame. (READ: Why it's St. Luke's or bust for Napoles)

Alameda set another date for the hearing on Napoles motion, during which the defense will present the doctors who were present when Napoles allegedly underwent blood tests under the name "Jenny Tan." – Rappler.com