December 18th 2013. Doctor Burnei summons the TV networks: he’s performing a surgical procedure that has never before been attempted in Romania on a little girl suffering from scoliosis. The eight-year-old girl dies on the table. The news report is canceled.
The implant that he used wasn’t recommended on the scoliosis associated with Andreea’s affliction. The procedure was bound to leave her pelvis just as crooked, claim doctors who had access to the medical records. Due to the surgery, particles of fat from the bone marrow migrated into the bloodstream and the little girl died. Moreover, Burnei accidentally introduced a screw into her spinal marrow.
“She was a goner anyway”, the doctor said to the mother. Despite her severe neuromuscular disease, the girl could have gone on to live for years or even decades, doctors claim.
“Such is life,” Burnei told her. “You’re young, you can have another baby.”
The little girl’s body was taken to the Institute of Medical Forensics for autopsy. The report that stemmed from it describes a risky and fruitless procedure: „the pros/cons ratio was significantly disadvantageous for the patient.”.
One doctor from Marie Curie with knowledge of the case told us bluntly: „Andreea is a child who was killed out of negligence”.
One coroner from the forensics institute was even more assertive: „The procedure is, from all stand points, extreme, aggressive, and posing a very high degree of risk. The benefits for the patient were nil from the get-go”. The coroner also noted that the surgery was not only “absolutely pointless”, but also plain wrong. Burnei stuck a screw in the spinal marrow, which would have led to the demise of her spinal nerves and, ultimately, to paralysis.
Andreea was suffering from . The procedure “is not recommended in cases of spinal amyotrophy, ” Mr. Alexandru Thiery further confirmed for us; Mr. Thiery is a medic specialized in spinal surgery and a member in the pediatric orthopaedics committee with the Ministry of Public Health.
Doctor Burnei was placed under house arrest a few days ago. The arrest warrant stated that he “performs surgical procedures even when the child’s medical status or age disavow the need for such procedures; also, he implants systems and prostheses which are unnecessary or performs the implant in an incorrect manner”.
Orthopaedist Roman Marchitan, who used to be under Burnei’s supervision during his medical residency, and currently working in France, claims that „Burnei had reinvented a parallel medicine of sorts, contrary to any stream of modern logic, stepping on the victims without the slightest hint of remorse”. Marchitan dubs these procedures as „outrageous experiments on humans”.
Andreea’s death spawned a criminal record that keeps on suffering delays. The case will go to court on the basis of Mr. Burnei’s colleagues’ expertise. Mr. Burnei headed the malpractice committee on pediatric orthopaedics at the Medical Board. The Board’s chairman, Gheorghe Borcean, already stepped up in his defense and called him „a pioneer in medicine”.
One month after her death, Ana Maria Găman, Andreea’s mother, made the trip from Brașov to Bucharest to retrieve her child’s discharge papers. She was summoned to the doctor’s office. The woman recalls Burnei adding, after having the anesthaetist for the girl’s death:
Did you see how straightened-up she was?
“He was considerate enough to tell me that, how he straightened up her spine. Yeah, she was straight as an arrow in her coffin, good thing for that, otherwise they’d have rejected her in heaven.”
Hundreds of comments describe scenes similar to those recalled by parents and patients who interacted with Burnei
Rewind back to December 2013. Andreea is a second grader in a school just across the street from her house. She knows eins, zwei, drei as well as other words in German, she’s ludicrously funny, laughs a lot and makes the others laugh as well. Her grandmother tells:
“We were sitting here, in the kitchen, we had just finished homework. I was at the sink, preparing dinner, and she was watching TV. And she was so talkative… I told her Let’s do a contest: Who can abstain from talking for five minutes?
Granny, but why are we having this contest? Granny, but why me? She was so rattled! She sat there watching cartoons while I waited for her to make a comment. At a given moment I can make out that there’s a silence. That’s all I did from that sink, because, that very second, Andreea said, facing the TV:
Granny, I don’t wanna die.
I was benumbed. Andreea, oh my, you, Granny’s joy, but you’re such a little hero, a brave soul, oh you… but do you think there’s anyone on this Earth that wants you dead? They’ll put you under anaesthetic, Andreea, and you’ll be asleep, and when you wake up, the operation will be done and dusted.”
In the morning, just before the surgery, the TV crews came in. They asked Andreea whether she’s afraid, and her answer was I’m not scared, mommy is scared, ‘cause she’s the kind that shits her pants..
The reporters laughed. So did mommy.
The Professor leads the surgery. A conductor who asks for screws, rods, little hammers. He’s the only one, out of all the doctors in the operating theatre, who can feel the body’s reaction to the delicate maneuvers. His hands go inside the sedated patient’s body, measure the curvature of the spine, straighten it up and thread in the screws into the vertebrae. All in all, thirteen screws are to be mounted with maximum precision, so that they’ll support the rods.
„Science, art, prediction, ”that’s Mr. Burnei’s take on orthopaedics, the field he’s been in since the ‘80s. Merging science with art, the screws are inserted , one by one, into Andreea’s vertebrae.
The extreme intervention chosen by the doctor makes the fatty particles, from the area that’s operated on, break loose and enter the bloodstream. Nearing the procedure’s end, the Professor makes a botched attempt at the vertebra bone and sticks a screw into the spinal marrow. The surgery carries on to the last screw.
It’s the first time that the Shilla implant is mounted in Romania.
Meanwhile, the fat reaches Andreea’s lungs and blocks the blood vessels that feed them. She goes into pulmonary embolism. Shortly after, her heart stops. CPR commences.
Almost an hour later, they call the time of death. The anaesthetist comes out crying.
The discharge papers state: „Exitus 15.10 o’clock”.
Andreea is dead.
„Now that this little girl is gone, so is everything else.”
Granny and Ana Maria, Andreea’s mother, are sitting at the table in the kitchen and look back: this is where Andreea used to sit on her little stool; this is where she’d do her homework; that’s where we both used to sleep. She had a killer humor. She would slap a joke sometimes that our bellies hurt from laughter; that’s how we all were once…
„Mommy, I love you, she used to tell me, and I did too, twenty thousand times a day, regardless of where we were, on the street or in a store. We had a very special relationship; perhaps her illness contributed to that. If she had been a healthy child and our lives had been normal, maybe I wouldn’t have developed such an addiction to her.”
Andreea was born with spinal amyotrophy, a muscular disease which prohibits the normal growth of muscles. You can’t walk, you can’t turn on the other side in bed, and you need a backrest or a cushion to stand upright. As a sufferer, you always rely on those around you.
Ana Maria learned of the diagnosis in Bucharest, at the Obregia Hospital, when her little girl was one and a half years old. “All you can do is physical therapy,” the doctors said to her.
Desperate to get her well, mother and grandmother sold their apartment, moved into a rented flat and took her to China for a stem cell treatment, but to no avail. Andreea developed scoliosis, a frequent side effect of amyotrophy.
Amyotrophy is untreatable, but scoliosis can be corrected.
Ana Maria had an uncle who was an assistant orthopaedist, who knew someone from the “Queen Mary” hospital in Cluj-Napoca. He told her: A very well-known doctor comes in here and offers consultations, I wonder how come you’ve never heard of him, Professor Burnei.
In the gray landscape of Romanian medicine, Gheorghe Burnei is the unlikely saint. The media introduced him as “the magician orthopaedist”, “the life saver”, “the miracle inventor”, one who has a special connection with God, world-renowned, who “uses the scalpel as a magic wand” and turned down offers for tens of thousands of euros abroad “to come to the aid of Romanian children who need him”.
He claims to be the author of more than ninety medical firsts in the span of a thirty-year career. Andreea was one of those.
In the middle of August of 2013, Ana Maria and Andreea made it to Bucharest toThe Professor, at “Ninety euros for two minutes of his time. I brought her in on her little stool, he lifted her shirt, yes, he saw her scoliosis, it requires surgery, you’ll have to go to Marie Curie on said date, bon voyage,” Ana recalls.
“So we went to Marie Curie, and I stayed there for a week, during which time I slept in one of those baby cradles with bars, me and her in the same bed. I felt like in a zoo. Inhumane conditions. All this, only for them to realize a week later that Andreea needed an MRI scan.” They gave her the contact of a private facility and told her to make an appointment. The earliest free slot was in November.
Andreea and Ana Maria remained hospitalized at Marie Curie from November 18th to December 18th. Ana recalls the Professor entering the ward one week after they had been admitted, taking a glance at Andreea and saying: We’re going to use Shilla. We have to make a call and make an order.
Shilla?, one of the other doctors reportedly asked in dismay. Yes, yes, the Professor replied. And that was the last of that.
Shilla implant mounted by Doctor Burnei
The Shilla implant is made up of two rods that are fastened into the spine with screws. It was patented by a medic from Arkansas and, at the time of Andreea’s surgery, only a handful of doctors from the UK and Poland had used it. It hadn’t been approved yet in the US. The advantage over pre-existing implants is that it doesn’t require subsequent surgeries, with the device growing along with the spine.
However, several medical sources confirmed for us that the implant isn’t recommended for patients with spinal amyotrophy. Shilla would have addressed only the issue of the girl’s spine, while her pelvis was to remain tilted, unable to straighten itself up due to the neuromuscular condition. Incapable of fixing the pelvis, the implant was useless.
I showed Andreea’s X-ray to Mr. Alexandru Thiery, the pediatric orthopaedist specialized in spinal surgery, and asked him what the preferable approach in her case was. “I would have waited until Andreea was ten years old, when she’d have been suitable for a standard spinal fusion,” says Mr. Thiery. There would have been other options in the event of the girl’s scoliosis escalating: “Dual Growing Rod is the standardized, go-to technique, and it’s the international gold standard at this time for spinal amyotrophy, among others.
Burnei asked Ana Maria to support a part of the cost of the Shilla implant. “Somewhere around 10.000–11.000 euros was my share of the cost, not to mention the fact that I had to pay him as well… The father of one of Andreea’s colleagues from school helped me raise the money. When he found out that she had died, the man fell to his knees in the middle of the street. He said it was his fault, that if he hadn’t given us the money, maybe there would’ve been no surgery and Andreea wouldn’t have died.”
Sources within the hospital say that, after her death, the implant was reimbursed by the National Health Insurance Agency. In fact, the mother shouldn’t have put up a single dime.
Ana Maria repeatedly tried to learn more details from the surgeon, but only managed to speak with the anaesthetist, who explained the risks to her, as far as the anaesthesia was concerned. It was he who gave her a waiver to sign, stating that she acknowledged the risks and the projected positive outcome.
“I kept on trying to approach him [Mr. Burnei], ask him what this is about. He was always short on time. This one time he summons me to their quarters over there, where the residents hang out. All he explained to me was: The spine needs straightening up.”
“Any risks? I asked. It’s a fairly complicated procedure, but there shouldn’t be any.”
Ana Maria returned home on a Friday, completely clueless as to what had happened.
In the beginning you don’t realize it… They had to sedate me those few days, during the funeral and the vigil. I’d look at her and not realize it was her.
For a long time I felt guilty, I was having panic attacks, I couldn’t sleep alone. I was wetting the bed, and I was suffocating.
A month or so after Andreea died, the serious depression took over me. I’d feel that loss for a day, two, three… I’d open the closet and bam!, there were her clothes. Then I’d recall – that time I got that little blouse for her, how she reacted when I bought her that little dress; then I’d bump into the small cart she used to sit in, her copybooks, her school bag…
It’s the little things, man, that really get to you. She couldn’t turn from one side to the other or tuck herself in. And at night she used to ask me: Mommy, turn me over, Mommy, tuck me in, untuck me, my foot is numb, straighten it up for me, that’s about an accurate a description of a night’s sleep for me as there can be. I’d be awake most of the time, but I got used to it. I’d also dream of her saying: Mommy, wake me up, and I instinctively woke up to… And I’d look and I was actually alone in bed. Naturally, what followed was that pain and I would start crying. And I ran off quickly to mother’s room and curl up next to her in bed. She already knew, You dreamt of her again? Yes.
I was afraid to sleep.
Nearly a month after the funeral, Ana realized she had left the hospital with no document of any sort. They hadn’t given her any discharge note, not even the check-ups she’d paid for at the private facility. It was as though her child had never set foot inside Marie Curie, and the medical premiere had never happened.
So she had to go back there.
“I entered the hospital, tracing back my steps, and with every step I took I would remember the time I’ve spent there with Andreea…
When he saw me, he kinda turned white, kinda lost his grasp, because he didn’t know what I was doing there. He called me up in his office; just me, the father and the goddaughter were not allowed in.”
Ana Maria recalls how Burnei told her, in the presence of the hospital’s psychologist, that „he did everything that was surgically possible, but the anaesthetist is to blame, because my little girl had a problem with her blood and he failed to do extra blood tests, and the blood they put into her was rejected by her body and that’s why she died.”
Upon leaving, on the hallway, he reiterated to her, “in the presence of Alexandra, my mother’s goddaughter, to go to the prosecutor’s office [the prosecutors had already opened an inquest at their own initiative – e.n.], and tell them that I knew how it was, that he had explained it to me, and he told me not to go ahead with the case. You must go right now. He’d teach me what to do, and I’d say: Yes, doctor, of course, but in my head I was saying:
«You just sit tight over there, ‘cause things are far from how you think they are. Goddamnit, this is my child we’re talking about, not a car!»”
The anaesthetist was also pointed at in the statement for ProTV, a major Romanian TV network: “the anaesthesia crew probably couldn’t replace [her blood]”. For two years, that’s what Ana Maria thought, that the anaesthetist was to blame, right up until she read the coroner’s report, which was at the police station where her file eventually ended up. It showed that the little girl never needed the procedure anyway, and that surgical technique errors were made, chief among which was the introduction of a screw in her spinal marrow.
In the statement he provided for the criminal record that was opened after the girl’s death, Burnei claims that he explained all the risks involved to the mother, and that the surgery he would undertake was to prolong Andreea’s life „to the top limit of survivability, given the disease”. The coroner’s report shows that it wouldn’t have made a difference.
In an interview that we got from him in September, Mr. Burnei told us that, “This little girl’s death occurred following a complication that can spring up during any other procedure, because the use of an implant that has nothing in common with surgical technique can constitute itself into a first-of-its-kind when it can be used for the first time.”
“But that’s not the most important side of things: the fact that an incident happened, one that could happen anywhere else. I mean, there isn’t an issue which states that because of this thing, that issue occurred.”
“During your entire career, have you had any cases of malpractice?”
Afew months after Andreea’s death, there was a new medical premiere on the news: the Shilla was implanted for the first time in Romania.
Ana went nuts after seeing the news report. She rang all the TV networks to tell them that the death of her little girl was the result of the same premiere. Almost nobody gave a damn.
After the girl’s death, Burnei went on with two more Shilla implants. Medical sources claim that, on the third patient, screws were found scattered throughout the body.
Ana graduated from the nursing course she had started in order to understand Andreea’s affliction. It came in handy, eventually, because the night shifts in the ambulance service helped her take her mind off her little girl.
I immersed myself in the ambulance work; I would sleep in the work clothes. If one of my colleagues wanted to take the day off, they knew Ana Maria would pick up all the shifts. I no longer felt good at home. ‘Cause that’s where I had her little stool, a little wooden stool custom-made with a little table.”
Let’s get one thing straight: I don’t live. I stopped living. I crawl. I died with her.
She looks back on her decision to take Andreea to Bucharest from every angle and wonders if, somehow, she could’ve avoided doing that, if only she could read some tell-tale signs warning them of impending disaster.
There were some dreams… To this day, one of them floats above the bed where Andreea and Ana Maria used to fall asleep every night:
“Granny, I dreamt last night that a crocodile plucked out my left hand and it hurt so badly and I cried and God came and put it back into place and made it healthy for me.”
The first episode: “It Was an Experiment“