Jose Cotto, living a seemingly solitary life on Decatur Avenue for the last several years, replays the circumstances leading to his mother’s death, Santa Torres, at a hospital in the Commonwealth of Puerto Rico.

She died June 6, 2014, a day after undergoing simple surgery on a fractured hip from a fall while seeing her daughter in Puerto Rico. But after receiving several multiple doses of morphine Torres, 89, passed away from a heart attack.

Torres’ main residence was in the Bronx. Living with her son for several years, the two were inseparable. These days, the apartment she lived in that Cotto occupies is quieter. Cotto, who lives alone, can’t stop thinking about his mother, a symptom of nagging survivor’s guilt.

“I left you alone, I’m sorry,” Cotto recalled saying to his mother the day she died.

Burying his mother would not be Cotto’s only step to remember her. He’s now launched a malpractice lawsuit against the hospital, citing contradictory statements the hospital made about Torres’ death as evidence. His goal has been singular, if not obsessive—his mother died and he wants someone held responsible.

Cotto, who is Puerto Rican, has spent the last two years taking on the Hospital Universitario del Centro Médico de Adultos (University Hospital Medical Center for Adults), the island’s large state-run hospital where his mother died. In the five trips he’s taken, Cotto has been met with closed doors, endless phone calls, a bureaucratic runaround, and a dwindling bank account.

Seeking justice from 1600 miles away has also proven costly for Cotto, who relies on disability payments to get by.

He’s since created a page on the crowd-funding website Go Fund Me, cobbling donations for his case against Puerto Rico’s health care sector. Cotto has already earmarked any future funds on an independent health care expert in Colorado state to offer expert testimony on why the hospital should be held responsible for his mother’s death.

“Any donation is accepted; the important thing is to help me fight,” wrote Cotto on the Go Fund Me Page. “I’m tired of asking, but believe me I am not tired of fighting.”

Driven to seek justice for his mother, Cotto’s desire to sue isn’t monetary (he’s not seeking compensatory damages), but merely punitive, hoping medical staffers that worked on his mother never treat anyone again.

He’s outlined his dilemma via photographs, notes of every contact made with hospital officials and government agencies in the hopes of proving negligence. Cotto detailed his account to the Norwood News, finding the following:

• When Torres arrived to the ER on June 3, 2014, she was injected with a dose of morphine, a painkiller known to cause heart failure when taken in high doses, to numb the pain from her fractured hip. She was taken to surgery June 4, 2014.
• Following his mother’s successful surgery on June 5, 2014, everything seemed normal. She was told she would leave the next day.
• After leaving for the night, Cotto returned the next morning to find his mother in deep sleep, appearing pale and white.
• Medical personnel concluded his mother would be discharged that day, June 6, 2014. They gave him a prescription. Cotto asked what was wrong with his mother, and explained it was anesthesia that put her to sleep.
• Cotto learned via hospital records that a nurse injected Torres with 4mg of morphine 7:30 p.m. and 9 p.m. on June 5, 2014 separately.
• On June 6, 2014, Torres received another 4mg dose of morphine at 12 a.m. and 5 a.m. each time, prompting the doctor to conclude Torres had overdosed on morphine, according to Cotto.
• The doctor administered to Torres a dose of naloxone, reversing the side effects of the opioid drug. She was immediately revived.
• Known to nurses and doctors was a clogged catheter tube that did not discharge the naloxone and morphine fluids, remaining in Torres’ system, according to Cotto.
• The revival was short-lived. Another doctor was brought in, who said another dose of naloxone would be used should she undergo deep sleep. The naloxone was only available at a nearby pharmacy.
• Because of a nurses’ strike that triggered a backup of prescription services, the naloxone never came in time, according to Cotto.
• His mother later died at 8:15 p.m. from a heart attack. CPR attempts were unsuccessful.

Cotto admits his next steps were a miscalculation. An autopsy performed by the hospital, not an independent body, concluded Torres’ official cause of death to be an underlying head fracture, which Cotto says conflicts with original statements made by the hospital.

“I have proof that when my mother was in a hospital, they did a CT scan,” recalled Cotto. “If she had a fracture on her head it would show on the CT scan. And I have proof it was negative.”

Cotto took his complaints to patient relations in San Juan, which denied to hear his case since he and his mother were not residents of Puerto Rico. He then took it to Puerto Rico’s federal and state courts, which bounced the case around because of his and his mother’s status as New York residents.

“I feel that there’s discrimination for people who live here in New York,” said Cotto. “They closed all the doors because I’m not a citizen of Puerto Rico, even though I’m Puerto Rican and my mother is Puerto Rican.”

Lawyers on the island haven’t been helpful. Having sifted through several attorneys, Cotto managed to find one he could trust. The lawyer, though not officially hired, found the Colorado doctor to offer expert testimony on where the hospital deviated from its standard of care.

Cotto has been working on this case for two years and although it was discontinued, he was given a year to find the doctor and refile his case.

“In Puerto Rico, it’s hard to find one to testify against the hospital because the [Hospital Universitario del Centro Médico] belongs to the state,” said Cotto, referring specifically to Puerto Rico’s Department of Health, adding that his lawyer cautioned his malpractice case is “infected.”

The agency also oversees Hospital Universitario Dr. Ramon Ruiz Arnau. Through its Board of Medical Licensure and Discipline and Medical Services Administration of Puerto Rico, the state effectively controls the careers of doctors, making Cotto’s search for an independent doctor impossible. And with these entities part of Puerto Rico’s government, it enjoys an Eleventh Amendment protection that bars individuals from suing the government without permission, forcing Cotto to go through the Tribunal Supremo de Puerto Rico.

For Cotto to prevail in his case, he must establish that the hospital’s standard of medical care fell below expectations. He intends to have the world know, for the sake of his mom.

“I want them to know that I’m not going to stop doing justice for my mother,” said Cotto. “It’s not going to end like this.”

Representatives from Puerto Rico’s Department of Health did not return calls or emails to the Norwood News. A spokesperson for Puerto Rico Governor Alejandro Garciá Padilla also declined to comment over questions on what would happen to medical personnel involved in the case should negligence be proven.

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Welcome to the Norwood News, a bi-weekly community newspaper that primarily serves the northwest Bronx communities of Norwood, Bedford Park, Fordham and University Heights. Through our Breaking Bronx blog, we focus on news and information for those neighborhoods, but aim to cover as much Bronx-related news as possible. Founded in 1988 by Mosholu Preservation Corporation, a not-for-profit affiliate of Montefiore Medical Center, the Norwood News began as a monthly and grew to a bi-weekly in 1994. In September 2003 the paper expanded to cover University Heights and now covers all the neighborhoods of Community District 7. The Norwood News exists to foster communication among citizens and organizations and to be a tool for neighborhood development efforts. The Norwood News runs the Bronx Youth Journalism Heard, a journalism training program for Bronx high school students. As you navigate this website, please let us know if you discover any glitches or if you have any suggestions. We’d love to hear from you. You can send e-mails to norwoodnews@norwoodnews.org or call us anytime (718) 324-4998.