"I will leave the pediatric emergency scene": Specialists resign one after another… Search and seizure fallout becomes reality

Concerns that "pediatric emergency specialists are leaving" have become a reality, following the fallout from police search and seizure operations at a Pediatric Specialized Emergency Medical Center (Pediatric Emergency Center) where an infant under treatment died. Some predict that the aftershocks will be even greater than those of the "Ewha Mokdong Hospital Neonatal Mass Death Incident," which left a precedent of a sharp decline in the application rate for pediatric and adolescent medicine residents.

According to medical industry sources on the 18th, one specialist who had been working at the Pediatric Specialized Emergency Medical Center at Ajou University Hospital, which police searched and seized last month on the 30th, recently submitted a resignation letter. It is also known that two specialists at another Pediatric Specialized Emergency Medical Center have recently submitted resignation letters.

Lee Ji-suk, Director of the Pediatric Specialized Emergency Medical Center at Ajou University Hospital, vented his frustration, stating, "This is not the first time that emergency center treatment has been halted by police and medical professionals have been treated as criminals," and adding, "Despite doing our best to treat patients, the nurses and doctors on site were treated as criminals."

Previously, the Gyeonggi Southern National Police Agency searched and seized the Pediatric Emergency Center at Ajou University Hospital on the 30th of last month. This was to investigate whether there was medical negligence in connection with the death of a four-month-old infant who had been receiving treatment for cyanosis at the hospital in July. At the time of the search, medical staff were in the middle of emergency procedures, but police reportedly requested that they vacate their positions so that "we could check the treatment computer." In response, doctors strongly protested, labeling this as an "excessive investigation."

The Center Director expressed concern that this search and seizure might not be a one-off incident. The Center Director argued, "Doctors and nurses feel humiliation and pressure, and do not want to provide treatment," adding, "If medical staff have to halt treatment or respond to investigations every time an investigation is conducted regarding patient deaths in the emergency medical field, it will inevitably affect the treatment of other emergency patients."

As of last May, there were 14 Pediatric Emergency Centers nationwide designated by the Ministry of Health and Welfare. Among them, the Pediatric Emergency Center at Ajou University Hospital, where this search was conducted, is the first pediatric emergency center to open in the country. As of the first half of this year, its proportion of severe patients (Korean Triage and Acuity Scale, KTAS, Levels 1 and 2) was 30.4%, boasting the highest level nationwide.

However, according to the Korean Society of Pediatric Emergency Medicine, it is reported that each hospital is discussing "returning their Pediatric Emergency Center designation" following this search. This is because anxiety has spread that handling severe and emergency patients who are difficult to treat will inevitably lead to an influx of infants with poor prognoses, and that this incident could result in them becoming targets of police investigation.

Ryu Jung-min, President of the Korean Society of Pediatric Emergency Medicine, protested, "As a result of police wielding warrants as if treating emergency rooms like criminal dens, specialists at pediatric emergency treatment sites are submitting resignation letters," adding, "This incident will further accelerate the existing avoidance phenomenon in pediatric emergency medical care."

In fact, when aggregating "Emergency Room Treatment Restriction" messages from nationwide emergency medical institutional investors in the first half of this year by department, Pediatrics and Adolescent Medicine had the highest number.

According to documents submitted by the National Medical Center to So Byeong-hun (Rep.) (Democratic Party of Korea) of the National Assembly Health and Welfare Committee, a total of 24,256 emergency room messages by department were registered on the integrated emergency medical information intranet by Regional Emergency Medical Centers, Local Emergency Medical Centers, and Local Emergency Medical institutional investors from January to June this year. Among these, Pediatrics and Adolescent Medicine accounted for 2,985 cases, the highest among all departments, which was 1.7 times more than Surgery (1,766 cases), which ranked second.

Previously, following the death of four neonates in the neonatal intensive care unit at Ewha Mokdong Hospital in 2017, Pediatrics and Adolescent Medicine became a department avoided by residents after the responsible professor was detained on charges of negligent homicide. Although the Supreme Court ruled that the medical staff were not guilty, the application rate for Pediatrics and Adolescent Medicine residents hit rock bottom, dropping from 112.1% in 2017 to 25.5% in 2023.

As the avoidance phenomenon of Pediatrics and Adolescent Medicine residents has continued for several years, it was tallied at the end of last month that there were only 113 Pediatrics and Adolescent Medicine residents nationwide. Even among these, 78.8% (89 people) were concentrated in training hospitals in the Seoul region, while Gyeonggi Province had only two remaining, accounting for 1.8% of the total proportion. There are not a single Pediatrics and Adolescent Medicine resident in six metropolitan cities and provinces nationwide. According to the recruitment results for first-year Pediatrics and Adolescent Medicine residents at training hospitals for next year, 85.2% (52 locations) of the 61st training hospitals nationwide failed to secure even one resident.

The "Gathering of Young Pediatricians (NGP)" issued an official statement saying, "In an environment where the results of treating severe patients can lead to investigation and punishment at any time, and where treatment for other patients right in front of us may be halted, we cannot demand that young doctors remain on the front lines of essential medical care."

Ryu (Chairman) also stated firmly, "The act of presenting warrants first, as if on-site medical staff were shameless criminals forging records, over unavoidable deaths that occur despite doing their best in treatment is an abuse of public power," adding, "In such an atmosphere of distrust and insult, no medical staff will be able to guard the emergency room."