The death of Enrique Morente

The day before Enrique Morente died on December 12, 2010, his family brought a lawsuit for negligence against the medical team that had been treating him.

Morente, 67, the best-known flamenco singer of his generation, had been admitted to Madrid’s Clínica La Luz for an ulcer operation on December 4, and slipped into a coma after a second, emergency operation on December 6. Less than a week later he passed away, after being brain-dead for several hours.

At the time the media simply said that Morente had died of complications following an ulcer operation. But reports soon appeared saying he had been suffering from cancer of the esophagus.

Morente will be remembered as one of the greatest of Spain’s flamenco singers, or cantaors, as they are known in Spanish. Less well known, but equally renowned in his field is Enrique Moreno, the surgeon who operated on Morente — also known as “the hand of God.” Moreno has carried out more than 1,600 liver and pancreas transplants over his more than 40-year career, and he continues to combine his well-paid private work with treating patients within the state healthcare system at Madrid’s 12 de Octubre hospital.

The two men met for the first time at Moreno’s private consultancy, in Madrid’s up-market Salamanca district on December 2, 2010.

That same day, Morente, accompanied by his wife Aurora Carbonell, was admitted to the private La Luz clinic on Moreno’s recommendation.

Morente’s surgeon, Enrique Moreno, is known as “the hand of God”

With the couple was another doctor, Julio García Paredes, a lifelong friend of Morente. He had treated the singer for throat problems for several years. Two weeks previously, on November 18, Morente had been diagnosed with cancer of the esophagus. Morente and his wife asked García Paredes for his advice — he recommended they talk to Enrique Moreno.

Moreno, 72, looked at the results of the tests, and, according to Aurora Morente, without even bothering to look up, told the couple that the singer required an operation immediately, without further treatment.

Moreno is used to dealing with life-and-death cases, and tends not to beat around the bush.

“You need to make a decision now, don’t waste my time,” he told them, silencing Morente’s attempts to explain that he had numerous professional commitments: he was in the middle of a tour, was finishing a film, and was due to be awarded the French Legion of Honor.

I don’t think we were informed about just how serious the illness was”

But just 11 days later, Morente was dead. “I don’t think that we were properly informed about how serious the illness was. Obviously, had he survived, my husband would never have sung again,” adds his widow. Nevertheless, they decided to put themselves in Moreno’s hands, and left immediately for the hospital. The next day Morente would undergo full tests, X-rays, and a heart examination.

On the morning of Saturday December 4, 2010, Morente was taken into the operating theater to have his esophagus removed. After seven hours, at 6.30pm, he was taken to the intensive care unit.

The next morning, Moreno examined Morente, who was awake. The operation had been a success, and there seemed to be no signs of post-surgery complications. His condition remained stable through to the afternoon. Carbonell, who had been at his side all night, had not been able to go home to change. “The whole thing was so sudden that I was still wearing the same clothes I had on the day before. The duty doctor told me that he was in safe hands, and that I should go home. It was a terrible mistake,” she says now, talking from the office of Enrique Gordillo, a former High Court prosecutor and the Morente family’s new lawyer.

On April 13, Carbonell and Gordillo, along with her son-in-law Javier Conde, met investigating magistrate Fermín Javier Echarri.

It is now up to the courts to decide what exactly happened that night

It is now up to the courts to decide what exactly happened between midnight and 5am, after Carbonell left the hospital and when Morente went into a coma.

During that time period, Morente’s condition suddenly deteriorated, and he underwent a second operation. But at this point, the hospital’s version of events and that of Morente’s family differ radically. Conde says that his father-in-law was “left to fend for himself.” He says that Morente was admitted during a holiday weekend, when many people leave the city. “This was not the best time to be dealing with an emergency. I suspect that they delayed operating on him. We know that he called out for his wife, and that when he was admitted to the operating room his abdomen was swollen from internal bleeding.” At this point Carbonell and Conde are unable to continue talking, overcome with emotion.

“When I called the hospital at 1am to see how he was, the hospital staff told me he was fine,” she says. The next call she received was around 5am, when one of the team tasked with looking after Morente told her to hurry to the hospital.

Carbonell says that when she arrived, Moreno was waiting for her.

As soon as the operation began, Morente suffered a heart attack

“He was standing there, with his arms crossed, with his white coat on, and he was very calm. He told us that my husband had undergone a second operation and that he had gone into a coma. To stimulate him, he suggested we sing to him, and talk into his ear.”

The hospital records say nothing more than that around 1am, Morente’s blood pressure suddenly shot up, and that he had sharp pains in his abdomen, brought on by internal bleeding, which often happens after major surgery. At around 3am, a Doctor Alonso, who was in charge of the intensive care unit that evening, called Moreno, who immediately set off for the hospital. Around 3.30am, Morente was taken into the operating theater. But as soon as the operation began, Morente suffered a heart attack, and the doctors attempted to resuscitate him. His family estimates that this went on for about 10 minutes; the hospital says that only one attempt at resuscitation was needed. After the operation, a brain scan revealed a number of problems. A subsequent analysis revealed hypoxic-ischemic encephalopathy, or severe blood deprivation to the brain. Morente had suffered several heart attacks.

It was not an easy morning for Moreno and his team. According to the hospital records, that same day he had carried out a liver transplant that began at midnight, and finished at 8.10pm on December 6, the same day he had operated on Morente at 5.20am. In lengthy and complicated operations such as transplants, surgeons and their team will take a number of short breaks. “Moreno is a slave to his profession, and would never abandon a patient, but once the operation is over, a surgeon cannot be expected to remain by the patient’s side for 24 hours. A doctor cannot interrupt their professional duties for a patient. What normally happens in these cases is that the doctor has their team, who can stand in should there be an emergency, or if the surgeon is resting, or if they are attending a conference,” says a colleague of Moreno’s. “Nobody can be in two places at the same time. Regardless of whether he carried out the operation, or one of his team did, I don’t think that he can be accused of a lack of ethics.”

Meanwhile, at La Luz clinic, Morente’s daughter Estrella was following the instructions she had been given by the resuscitation team, and was singing gently into her father’s ear. Her husband had blindfolded her, to keep her from seeing her father in such a serious condition. Morente’s grandchildren talked to him via telephone to see whether it would help wake him. Conde says that while Morente was in a coma, he began to suspect negligence, and recorded a number of conversations with the medical staff. He has since handed these conversations to the courts.

Enrique Moreno is a pioneer in liver and other organ transplant techniques. He has carried out more than 1,600 operations and was the surgeon responsible for saving the life of Pope John Paul II after he was shot by Ali Agca in Saint Peter’s Square in Rome in 1981. He has a reputation for total dedication to his profession.

Through Estrella Morente’s contacts in the powerful SGAE performing rights society, the family contacted a lawyer named José Ramón García García. A brief, handwritten letter was written and presented to a night court on the evening of December 11, outlining their suspicions regarding possible negligence by the medical team tasked with his care. While the singer was still lying in a coma, the police became involved in the matter.

The family asked the hospital not to disconnect Morente from his life-support machine. The next day, he was dead. Morente’s widow then contacted Gonzalo Martínez-Fresneda, a lawyer recommended by Judge Baltasar Garzón, who was also a friend of the singer. Once the complaint had been lodged with the court, another lawyer took over. Fermín Javier Echarri will now decide whether there is a case to answer.

Almost 18 months after the singer passed away, the controversy over the circumstances of his death continues. Countless articles have been written about the matter; four lawyers have represented the family, several hearings have taken place, and all seven members of Moreno’s medical team have given testimony regarding their alleged negligence. The most recent event was the giving of evidence last week by Morente’s widow and his son-in-law.

The case has divided opinions, with some assuming the worst and accusing the hospital and the medical team of negligence even before the investigation is completed, and others talking of a lynching by the media.

The family has used its media connections to discuss the matter far and wide, while the surgeon at the center of the affair, Enrique Moreno, is deeply pessimistic, saying that his reputation has been ruined, and that he has been the target of a sustained campaign to discredit him.