Court orders Napoles's return to Fort Sto. Domingo

MANILA, Philippines - The Makati City Regional Trial Court Branch 150 ordered on Thursday the return of businesswoman Janet Lim Napoles to her place of detention at Fort Sto. Domingo in Sta. Rosa, Laguna.

In a four-page order, Judge Elmo Alameda said Napoles has no more reason to challenge the earlier court order returning her to the police camp.

"Her zeal to avail continued health care in the hospital even after her discharge should not exceed the bounds of the law for she remains to be an accused for an unbailable offense, burdened to placed in a detention facility pending trial," the order read.

Alameda also ordered Police Chief Inspector Magnolia Ruth Priscilla Bermudez, a medical officer assigned at the Regional Police Office 4-A which has jurisdiction over Fort Sto. Domingo to carry out the post operative care on Napoles as recommended by her doctors.

"Whefore, premises considered, the motion to recall and reconsider the order dated May 20, 2014 is denied," the court order added.

Alameda ordered the director of the Police Regional Office 4-A to escort Napoles back to Fort Sto. Domingo from the Ospital ng Makati.

Earlier, Osmak gynecologist Dr. Florentina Villanueva testified that Napoles has been responding well to medication, particularly tranexamic acid and that her vaginal bleeding has already stopped last May 22. 

Tranexamic acid is used to stop heavy bleeding.

Villanueva said Napoles could be discharged seven days from May 22, or on May 29.

"She has responded to tranexamic acid. In a few days time, we could discharge the patient. I suggest a discharge seven days from May 22," she said.

The court last Friday deferred the return of Napoles to her place of detention at the Fort Sto. Domingo in Sta. Rosa, Laguna after one of her doctors testified that she suffered from "significant" vaginal bleeding.

Napoles was supposed to be returned to the police camp for detention by midnight last Friday.

Napoles' gynecologist Efren Domingo told the court last Friday that Napoles started bleeding last May 17 and was referred to him by the Osmak on May 19.

"The vaginal bleeding is significant in amount. It began last May 17 and was referred to me on May 19. It was a direct referral," Domingo told the court.

Domingo told the court that Napoles had stopped bleeding last May 21. He said he is willing to have Napoles discharged from the Osmak after a "bleeding-free" period of seven to 10 days.

"I could order her discharge on May 28," he said.

Villanueva also told the court that stress- particularly from entertaining so many visitors at her hospital room-could have triggered Napoles's vaginal bleeding. Villanueva told the court that Napoles receives so many visitors even at night.

Osmak Medical Director Perry Peralta said the hospital visiting hours are only from 9-12 p.m. and from 3-6 p.m. Peralta added that the hospital only allows two visitors per patient.

"You put a patient in a situation na maraming bisita. Pag nag rounds ako sa gabi, may mga tao pa sa kwarto nya. I would be stressed if marami akong bisita," said Villanueva.

Peralta meanwhile clarified that Osmak has no control over the number of Napoles's visitors saying that the job of permitting visitors to see Napoles at the hospital falls on the Philippine National Police (PNP).

"Reports have reached my office that the (rules on) visiting hours and the number of visitors have been violated. The PNP showed us a list of visitors. We saw a long list of authorized visitors. We told them that we could only allow two visitors during visiting hours. We left it to the PNP to control the number of visitors," said Peralta.

Peralta added that he has also received reports that even people not on the PNP's list of authorized visitors were able to see Napoles inside her room at the hospital's seventh floor.

"There were people not on the list who were able to visit Mrs. Napoles. We have no control. These people were getting their permission from someone else," said Peralta.

Prosecutor Christopher Garvida also presented in Thursday's hearing Inspector Garry Abregunda- the leader of the police team tasked to secure Napoles inside the hospital- who testified that there were no clear instructions to limit the number of Napoles's visitors.

"I was not informed on how many visitors are allowed inside. We have a list on our table to include (Napoles's) relatives, doctors and lawyers. There was no instruction on how many could enter the room at one time," said Abregunda.

The prosecution panel also presented Osmak nurse Lourice Grace Bien who testified that Napoles had informed her at 5 a.m. Thursday that she was still bleeding. Bien told the court that Napoles got angry and asked why she had been taken off intravenous tranexamic acid when she claims she was still bleeding.

Bien said Napoles had stopped receiving intravenous tranexamic acid at 11 p.m. on Sunday on the orders of her doctors. 

Bien told the court that Napoles told her that she still have "streaks" of bleeding and even changed pads and underwear twice.

However, Napoles could not produce the soiled panties and pads when it was requested by the nurses, Bien said.

"Everytime magpapalit siya, dapat ipakita nya sa amin ang pads niya. Kailangang i-report sa nurses na nagpalit siya ng pads or panties," Bien said.

Peralta later told reporters that "spotting" was expected following a surgery like what Napoles had underwent. Peralta added that Osmak doctors were also not informed by Napoles's doctors that she had been taken off intravenous tranexamic acid.

"If she was bleeding or not, we have to validate. We expect vaginal spotting. Expected 'yun after that kind of surgery. Normal ang vaginal spotting. Hindi normal kapag soaked na soaked na," he said.

After hearing the testimonies of the witnesses, Alameda said he would be issuing his decision on Napoles's motion for an extended stay at the Osmak on Thursday (May 29).

Napoles lawyers last May 21 filed an urgent motion with the court asking that she be allowed to stay longer at the Osmak following her vaginal bleeding episode. Her lawyers also asked that all her post-surgery check-ups be done at the Osmak.

In her seven-page motion, lawyer Fay Isaguirre Singson informed the court that on Tuesday at 8:30 p.m., Napoles was checked by her gynecologists Pascua and Domingo, both from St. Luke's Medical Center.

Singson said that after the check-up, Napoles' doctors recommended the continuation of her hospital stay due to vaginal bleeding.

According to the progress report prepared by Pascua and Domingo, Napoles started complaining of vaginal spotting on May 17 and she was referred to them on May 19 for vaginal bleeding.

Singson said that because of Napoles' new condition, the doctors ordered her complete bed rest and that she avoid straining, lifting objects and stress.

"Due to this supervening event of the patient experiencing vaginal bleeding, the attending physicians were alerted and hence recommended that the patient should continue her confinement at the hospital due to the said bleeding and for her regular pelvic examination," the motion read.

Singson asked the court to reconsider its earlier decision ordering the return of Napoles to Fort Sto. Domingo not later than May 23.

"She be allowed further confinement until such time that the series of her regular and routinary medical check-ups are completed to detect and avoid early and late complications," Singson said in her motion. 

Alameda on Tuesday denied the very urgent motion of Napoles asking for an extension of her stay at the Osmak.

Alameda ordered the Philippine National Police (PNP) to transfer Napoles on or before midnight Thursday back to Fort Sto. Domingo for detention.

In his order, Alameda noted that after a month has passed since Napoles underwent surgery, "her attending physicians may have already completed the once a week post-operative checkup for the first month including psychological examination."

Napoles underwent a total hysterectomy on April 23 during which a uterine cyst was removed along with her uterus and two ovaries.