The family of Maria Elena Casasola is demanding Panamanian authorities reopen a medical negligence investigation they believe caused her death. Their legal battle centers on a nearly three week delay in performing emergency surgery for appendicitis at a public hospital in Bocas del Toro. Despite two court rulings that absolved the involved medical staff, the family insists the case must not be closed.
Maria Elena Casasola was admitted to the Raul Davila Mena Hospital on October 18, 2017, where she received a diagnosis of unspecified appendicitis. Her surgery, however, was not performed until November 5, a full twenty days after her initial diagnosis. During that critical delay, the infection spread throughout her body, severely complicating her condition. Her health deteriorated following the operation, leading to a transfer to the Dr. Rafael Hernandez L. Hospital in Chiriqui, where she ultimately died on March 16, 2018.
A Legal Battle for Accountability
The case has moved through two separate court proceedings. The first trial, held on August 15, 2024, ended with the acquittal of the attending surgeon. The family immediately filed an Appeal (law), which resulted in a judge ordering a second trial. That new hearing took place on October 6 of this year, but the outcome was the same. The court again determined the medical personnel bore no criminal responsibility for the patient’s death.
Casasola’s daughter has publicly questioned the court’s handling of evidence. She asserts the judge admitted a defense exhibit that lacked the proper controls and protocols mandated by Panama’s Law 68 of 2003. The family also contends that the court failed to properly consider a medico-legal report which, in their view, clearly establishes that Medical malpractice occurred between October 22 and November 11, 2017.
The appendicitis requires an immediate surgical intervention. In my mother’s case, the surgery was performed late and that deteriorated her health until it caused her death. [Translated from Spanish]
Her daughter stated they possess supporting forensic expert reports that corroborate their complaint. She expressed a profound desire for justice, emphasizing she does not want the case to go unpunished or for other families to endure a similar ordeal.
A Call for Transparency and a Final Appeal
The family is now fighting to prevent the case from being permanently archived. They perceive significant inconsistencies in the management of the medical file and have voiced deep concerns about a lack of transparency during the judicial process. Their next legal step involves filing a criminal complaint directly against the involved doctors. They have also initiated a cassation appeal, a legal mechanism that represents their final opportunity to challenge the verdict in the Supreme Court.
When consulted on the matter, the Social Security Fund (Caja de Seguro Social or CSS) provided a brief statement. The agency noted these events occurred under previous administrations, effectively distancing the current leadership from the 2017 incident. The family remains undeterred by this institutional response.
Appendicitis is a medical condition characterized by the inflammation of the appendix, a small pouch attached to the large intestine. Standard medical protocol worldwide treats it as a medical emergency, almost always requiring prompt surgical removal to prevent a rupture. A ruptured appendix can spill infectious materials into the abdominal cavity, leading to a life-threatening infection called peritonitis. Timely diagnosis and intervention are considered critical in managing Appendicitis and preventing fatal outcomes.
The Casasola family’s prolonged struggle highlights ongoing challenges within healthcare and judicial systems. Their case continues to draw attention to the difficult path families face when seeking accountability for alleged medical errors in Panama.