Death of Domenico, obsolete protocols and systemic deficiencies in the hospital from the Region's inspection

"The investigation initiated in the past weeks has revealed an extremely concerning situation." This is how the President of the Region, Roberto Fico, announced a first package of measures following the death of little Domenico. First of all, "an extraordinary inspection" at the Colli hospital company, which oversees the Monaldi hospital, will also involve external professionals and will need to verify the organization and operations of the company, to ascertain, as stated in a note, "whether the conditions that made the tragic event possible were known or knowable and whether the most appropriate necessary measures were then adopted."

"I want to reiterate my deepest condolences to the family of little Domenico. This very painful situation has upended their lives and has marked an entire community. It compels us to intervene with the utmost determination, seriousness, and sense of responsibility so that such events do not happen again. Finally, I also thank the medical and paramedical staff who continue to provide the necessary care to the citizens of Campania with a spirit of service," Fico emphasizes.

The investigation conducted in the past weeks by the General Directorate for Health Protection of the Region "has established a more serious critical situation than initially emerged: transport and organ preservation protocols not updated, failure to use available preservation devices in the Company, inadequate staff training, a severely deteriorated internal relational climate pre-existing to the event of December 23, 2025, significant delays in communications to regional and national health authorities. The combination of these elements constitutes a pre-existing systemic organizational issue," the Region notes.

The President of the Region, Roberto Fico, in light of the critical issues that have emerged, has therefore taken a position on the pediatric heart transplant program at Monaldi, stating: "it should not resume until the necessary safety conditions are fully restored". The program had been suspended by the management of the health company in recent weeks.

"Continuity of care for patients on the waiting list is currently guaranteed through the agreement with the Bambino Gesù Pediatric Hospital in Rome. The resumption of pediatric heart transplant activity at Monaldi will be subject to the implementation of structural interventions that the investigation has highlighted as essential: activation of a ward and an operating room specifically dedicated to pediatric cardiac surgery, recruitment of cardiac surgeons with documented pediatric experience, adoption and formalization of updated protocols for the transport and preservation of organs in accordance with the latest scientific evidence, adjustment of the training programs for staff, and strengthening of operational integration among the units involved in the care pathway. The actual implementation of each of these interventions will be verified by the regional inspection body before any authorization for resumption".

The Regional Transplant Center, the coordinating body for transplant activities, currently located in the Azienda Ospedaliera dei Colli, will be transferred to the Offices of the Region, in order to ensure closer and more effective coordination with the regional structures responsible for the planning and control of transplant activities. The relocation will allow the Region to exercise a more precise monitoring of the transplant network.

Finally, a "comprehensive review of the organization of the transplant network in Campania will be conducted, verifying the adequacy of protocols, professional resources, information flows, and security systems in each center".

"With these measures, the Region - in institutional coordination with the Ministry of Health, respecting mutual competencies - initiates a first series of organizational measures", Fico emphasizes.