By Troy Torres
Christine Quichocho, 29, went to Guam Memorial Hospital in August, nearly seven months pregnant, with pneumonia symptoms. She was admitted and tested negative for the coronavirus. As doctors loaded her with antibiotics to fight whatever infection was afflicting her, they tested her again and again for COVID-19. She was tested nine times in three days, testing negative throughout. Finally, the Monday after she was admitted, she tested positive.
Her family believes she acquired the coronavirus sickness while at GMH, according to her older sister, Tanya Barcinas.
Ms. Quichocho's condition worsened over time. Days turned into weeks as she remained in isolation fighting for her life; her only human connection being the doctors and nurses who took turns through their shifts to help her. And her baby.
Then the child died. Whether Ms. Quichocho ever realized the life growing within her had been vanquished by the disease killing her as well is unknown. She was in a coma, when the miscarriage happened, and remained in that coma until she died February 19. The baby was nearly at full term.
Court documents related to her end-of-life care, and her burial, reveal that Ms. Quichocho did indeed die from the coronavirus. Yet, the government of Guam never revealed this fact. She should have been publicly numbered as the 131st death related to COVID-19.
So when a 36-year-old woman died last week and the government announced her death was the 131st COVID-19 related death, her sister wondered why GovGuam was keeping quiet about Christine's death. And what about the death of her child?
"The doctors said the baby died with COVID, too," Ms. Barcinas said.
The family tried to get answers, but has run into several legal hurdles. According to court documents, GMH attendants to Ms. Quichocho wrote notes in her medical chart between September and October 2020 that the patient did not wish to communicate her worsening condition with her family.
"[The Patient] got emotional while talking about her family and cried. She does not want us to talk to her family." - note by Dr. Anu Taylor, October 12, 2020 at 1 p.m.
Brain dead and incapacitated
The woman's health declined quickly; while hospitalized she suffered a stroke and was "essentially brain dead" and a quadriplegic on December 7. In mid-December Judge Elyze Iriarte declared her medically incapacitated and incompetent to make decisions. A series of orders from December 18, 2020 to February 11, 2021 (just days before she died) tell the heart wrenching tale of a woman who lost everything, a family in grief and shock at the government's refusal to let them have anything to do with their sister, and a government lawyer trying to decide whether to end Quichocho's life, and then what to do with her body after.
That attorney is Marcelline Santos, who is the Public Guardian, or the person a court entrusts to deal with life decisions of persons under her care. People can be ordered under her care for a number of reasons involving their incapacity to make decisions for themselves.
What to do with the baby's body?
Among her first duties as Ms. Quichocho's guardian was to "make contact with the presumed father of the ward's deceased child to determine the disposition of the child's remains. If the father is not willing to take responsibility for the child's remains, the Public Guardian is authorized to communicate with the ward's family members to obtain their direction for the disposition of the child's remains." - Judge Elyze Iriarte, December 18, 2020
Four days later, Ms. Iriarte ordered the Public Guardian to interview people in Ms. Quichocho's life to determine whether she had expressed any wish for anyone to make end-of-life decisions for her. Her previous order appointing the Public Guardian revealed that no one had been authorized by Ms. Quichocho to make the decision to end her life if she reached a continuing vegetative state. The judge heard the results of the investigation on January 22, 2021; then on February 11, she empowered Ms. Santos to make the decision for her ward.
Iriarte gave the Public Guardian 14 days from February 11 to prepare a report on whether Ms. Quichocho should continue to remain on life-sustaining treatment. The report wasn't necessary; she died eight days later.
Family tries to bury their sister
Ms. Quichocho's family, whom the judge recognized in court documents as having their sister's best interests at heart, were grief-stricken by their loss, according to her sister, Tanya Barcinas. Assuming their sister's death ended the Public Guardian's role, they began to prepare for her funeral.
A sibling, who is serving in the military off island needed documentation of her death in order to be granted leave. That's when the family first found out the Public Guardian was still involved and still responsible for decisions involving their sister, including her funeral.
The matter has been a bureaucratic nightmare for the siblings.
"Myself and my family would like to know if we would be involved in laying our sister to rest," wrote Ignacio Quichocho, Jr., Christine's youngest brother, in an email to Ms. Santos.
"Christine passed away before 4 p.m. on Friday Guam time. It is now just about 2 p.m. on Monday. I have quotes from the funeral home and waiting of the death certificate to see if her funeral can be paid for by the government since her death is COVID related. Unless the family is willing to pay for the funeral, I am proceeding as expeditiously as possible. Further, I ahve just assisted another family in obtaining the right of sepulcher to bury their father who died on February 16th and the tentative funeral date is not until March 10th. THEREFORE, i would appreciate your patience."
The tone of Ms. Santos's communications with the Quichocho family is not the only matter that has upset them.
Why weren't deaths reported?
"Why didn't the government announce that my sister died of reasons related to COVID-19?" Ms. Barcinas asked. "And what about her baby? Why is this being swept under the rug?"
The family suspects their sister contracted the coronavirus from GMH, and that hospital management are trying to escape liability for any medical negligence or malpractice.
"Please understand that per the Health Insurance Portability and Accountability Act (HIPAA), I/we have a legal responsibility not to disclose or provide any specific information regarding patients’ cases/hospitalizations without their authorized consent," GMH administrator Lillian Perez Posadas said.
Death count may be higher than reported
Governor's spokeswoman Krystal Paco-San Agustin was surprised to hear there was a COVID-related death on February 19. The Joint Information Center, which she leads, was not made aware of any such death on that date. So, she referred Kandit's inquiry to the territorial epidemiologist, Dr. Ann Pobutsky, Dr. Felix Cabrera, and the COVID-19 surveillance team at the Department of Public Health and Social Services.
"I can confirm that the DPHSS Chief Medical Officer, Territorial Epidemiologist, and the Acting Chief Medical Examiner are conducting a review of possible COVID-19 related deaths," Ms. Paco-San Agustin said.