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A month after the wedding, in search of a cure for pain caused by endometriosis, nursing technician Bruna Conceição dos Santos, 25 years old, underwent treatment with phenol at a private clinic in the Federal District, in May 2024. After the procedure, instead of relief, and dreams.
“I lost the dream of having the dream of making greater progress in my professional life. The dream of being even more independent than I was. The dream of perhaps being able to have children. That dream was left behind. It is not known whether or not I will be able to be the mother of my own children”, lamented Bruna.
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Bruna lost the movement of her legs shortly after treatment at a private clinic in DF
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Bruna got married a month before she lost movement in her legs
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The nursing technician lived an active life and played sports
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Bruna started singing to face the pain
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The patient went to court seeking compensation for alleged medical malpractice
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The dream of motherhood is practically impossible. “Because of both situations, and the real situation I find myself in, with the loss of movement in my legs. And also because of endometriosis. At the last appointment, the doctor asked if I wanted to have children. I said yes. And he remained silent. At the moment, it’s not possible”, he said.
According to Bruna, the loss of movement in the legs is irreversible. The nursing technician began to undergo physiotherapy to prevent limb atrophy.
The DF Public Defender’s Office () filed a lawsuit against the private clinic L’Essence and the doctor Lucas Franca, responsible for the procedure. According to the agency, there was alleged medical malpractice. Both deny failure to provide service (read more below). The case is investigated by the Regional Council of Medicine ().
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Before losing movement in her lower limbs, Bruna liked to sing. After the procedure he isolated himself, but now he has decided to return to music in the church. In the melodies, he finds the strength to face the challenges.
“I feel like I’m in a hole. My life has changed completely. Sometimes I think I’m in a nightmare, at some point I’m going to wake up and everything will go away. There are a lot of therapies with a psychologist. It’s very difficult to accept, seeing myself in a wheelchair and having a totally dependent life. I can’t go to the bathroom”, he commented.
Before, even with the pain caused by endometriosis, Bruna lived intensely. I took pleasure in tidying the house. I loved going to work. And in moments of relaxation, I ran, rode a scooter and cycled. For nursing technicians, staying in bed or in a wheelchair is extremely depressing.
“I had just returned from a wonderful honeymoon. I was starting a life. The blow was huge,” he said. Bruna’s husband, Maxwell Gonçalves Dourado, 30, started working at home to take care of his wife. With love and dedication, he provides all of his partner’s needs, from bathing to food.
Neurostimulator
Bruna started to feel pain in 2022 in her abdomen and pelvic region, especially when sitting. He sought treatment and a doctor recommended the implantation of a sacral neurostimulator. But the professional costs for the procedure were not covered by the nursing technician’s health plan.
Bruna looked for a clinic that would perform the implant according to the plan and, thus, arrived at the L’Essence clinic. At the scene, the doctor said that she would have to undergo procedures that would be required for the implant.
The patient underwent 10 sessions of sympathetic venous block to alleviate the pain, but there was no improvement. The doctor suggested blocking the hypogastric nerve with anesthetic in the operating room. Without success, the professional then recommended a nerve block with phenol.
“The phenol would destroy the nerve that radiated pain to my brain. It would burn that nerve. When I left the procedure, I was in a wheelchair. I lost the motor strength in my legs”, he reported.
Unable to stand, Bruna sought explanations from the doctor and the clinic. “We did tests. And he said I had a herniated disc. I had an MRI, but it didn’t show a herniated disc. From then on I had no further assistance from the doctor”, he said. According to Bruna, tests confirmed the destruction of the nerves, so the condition would be irreversible. The family sought CRM-DF, DPDF and a new treatment.
“I don’t want other people to go through what I went through. I want them to evaluate the doctor well in consultations and for procedures. That they ask for the risks of the surgery. They don’t go just for trust”, he pointed out.
Phenol risk
From the point of view of the public defender and head of the Consumer Protection Legal Assistance Center (Nudecon), Antônio Carlos Cintra, the case is an example of the risks of phenol. According to the defender, the accused doctor’s choice to use the substance or instead of carrying out the previously recommended implant is noteworthy.
“The information given to Bruna was insufficient, especially regarding the risks of phenol. It is clear negligence in not informing the patient of the risk. Studies show that 3% to 5% of cases end up with an injury. In this case, the pain was close to a very sensitive nerve and this risk needed to have been informed”, he warned.
For Cintra, there was also alleged negligence when the professional opted for such a risky treatment, when there was a less risky option. “And finally there is malpractice in the treatment. It left a healthy patient without the ability to walk”, he concluded.
One month after Bruna’s phenolization, the National Health Surveillance Agency (Anvisa) issued resolution no. 2,384/24, prohibiting the use of phenol in procedures, due to its high danger. The DPDF’s action seeks compensation for moral and aesthetic damage, a lifetime pension, health plan payment and the cost of health treatment.
Other side
O Metropolises contacted the clinic and doctor involved in the complaint. Both denied any failure in the treatment. According to Lucas Franca’s defense, the treatment was indicated for refractory chronic pelvic pain, resistant to multiple drug and physiotherapeutic approaches.
According to the doctor, chemical neurolysis of the superior hypogastric plexus with phenol is a procedure included in international interventional pain protocols, described in widely recognized medical publications and adopted in specialized centers in Brazil and abroad.
In a note sent to the report, he assured that he had informed Bruna of the risks of the treatment. “The patient was informed about risks, benefits and therapeutic alternatives, and a Free and Informed Consent Form was collected, validated by the nursing team and filed with the hospital records”, he declared.
According to the doctor, the procedure was carried out in a hospital environment, under strict safety and radiological control protocols, with adequate contrast dispersion and without immediate complications. He highlighted that any invasive procedure involves risks, even if carried out with correct technique and within ethical parameters.
“The neurological complications reported in the literature for this type of treatment are rare (1% to 2% of cases) and do not constitute malpractice, imprudence or negligence when all technical precautions are observed, as occurred in this case”, he explained.
Clinic
L’Essence argued that the procedures took place in two hospitals with their own infrastructure, care team and direct responsibility for the medical acts carried out on their premises. He also claimed that he provides specialized medical care and low-complexity, minimally invasive procedures.
“In cases of neurolysis and more complex procedures, it is the team’s routine to refer and carry out such interventions exclusively in a hospital environment, precisely to ensure the highest standards of patient safety. The clinic has no direct involvement with the clinical event in question, limiting itself to outpatient monitoring of the patient before hospital referral”, he declared.
