For almost four months, doctors and
at Advocate Christ Medical Center cared for the young Mexican laborer who had fallen from a roof and lost the ability to speak, breathe or move most parts of his body.
But Quelino Ojeda Jimenez was in the U.S. illegally, and just before Christmas he was taken from the Oak Lawn hospital, loaded on an air ambulance and flown to Oaxaca, capital of the Mexican state where he was born.
His abrupt departure, which Ojeda says was undertaken without his consent, outraged a group of Mexicans living in
who had rallied to his aid, tending to him in the hospital and encouraging him not to give up.
Florinda Marcial, one of his frequent caregivers, said she pleaded with authorities to stop as Ojeda was rolled away on a gurney, dressed in a hospital gown, crying. Authorities at the Mexican Consulate in Chicago also said they tried to intervene.
"They threw him out like he was a piece of garbage," said Horacio Esparza, a disability rights advocate who runs the Progress Center for Independent Living in Forest Park.
Now, the 20-year-old man is in a Mexican hospital that is so resource-poor that it is reusing filters for the breathing machine needed to keep him alive. After an investigation completed late last week, Advocate Health Care — the largest hospital network in
— acknowledged it never obtained Ojeda's permission to transfer him to
"We really do regret the way this process flowed and the steps that were taken," said Kelly Jo Golson, an Advocate senior vice president.
Advocate Christ spent about $650,000 on Ojeda's medical care and another $60,000 to transport him to Mexico after several private long-term care facilities refused to take the young man as a patient, Golson said.
"We saved his life and brought him to a stable condition," but when it became clear that Ojeda needed a lifetime of care, it seemed best to return him close to family, she said.
That move sparked fierce criticism from Chicago's Mexican community, and Advocate has decided to draw up comprehensive new policies to address medical "repatriations" at its 12 hospitals, Golson said.
Such policies are important because there are potentially "hundreds and thousands of Quelinos," illegal immigrants building American homes or working in American factories who risk serious illness or injury, said Julie Contreras, national immigrant affairs commissioner for the League of United Latin American Citizens, a Latino rights organization working with Advocate on the policies.
In Illinois, more than 272,000 undocumented Latino immigrants are uninsured, according to the
's 2008 Current Population Survey. Only emergency medical services are guaranteed to these patients, as they are to anyone in a medical crisis; once their condition has stabilized, they have no rights to any other type of treatment.
There is no consensus about what should happen to undocumented patients who become severely disabled and need long-term care. By law, hospitals are required to discharge all patients to "appropriate facilities" where they can receive adequate follow-up care. This is also an ethical obligation for physicians, according to a recent report from the
's Council on Ethical and Judicial Affairs.
But rehabilitation centers and nursing homes won't accept illegal immigrants with no insurance, no government support, and no means to pay their bills.
That leaves hospitals such as Advocate Christ Medical Center responsible for handling tragedies like Ojeda's, while coping with the fallout of a depressed economy and trying to remain financially viable.
Whether Advocate had legal authority to send Ojeda back to Mexico is unclear. Although hospitals say they are serving patients' interests by sending them to their countries of origin, advocates argue they are potentially violating U.S. immigration laws. So far, legal repercussions remain largely unexplored.
is the province not of hospitals, but of the federal government," according to a
in the Northwestern University Law Review.
In Advocate Christ's case, the hospital made what it thought was a justified medical decision, not a deportation decision, said Howard Peters, executive vice president at the Illinois Hospital Association.
Cases such as Ojeda's are relatively rare. Each year, the Mexican Consulate in Chicago gets involved with medical repatriations of 10 to 15 seriously ill or disabled illegal immigrants, according to Ioana Navarrete Pellicer, a consular official.
What makes Ojeda's story "completely unorthodox," she said, is the allegation that the young man was returned to Mexico against his will and the wishes of his family. The Mexican Consulate was not consulted, but there is no legal requirement that hospitals take this step, she said.
"I didn't want to come back … because here there's no medicine … I need therapy, I need a lot of things and they don't have," said Ojeda, who spoke to the Tribune from a bed at Maria Lombardo de Caso General Hospital, a one-story concrete institution in a small town in the state of Oaxaca. He has gradually regained an ability to talk, albeit with difficulty, and move fingers and toes on his left side.
"I wanted to stay (in the U.S.) until I recuperated," he said.
Ojeda's stay in the U.S. began four years ago, when he journeyed to
to find work and to help support his Mexican family — a common law wife, his nearly 3-year-old daughter, six sisters and his impoverished parents, who live in a town of 18 small wood and straw-roof homes in the mountains.
Within a few months, he moved to Atlanta, where family members lived, and where he worked as a roofer. Ojeda came to Chicago in August to work on a building near
, according to James Geraghty, a local lawyer who at one point represented the young man.
There, Ojeda said, he was trying to remove a sheet of metal from a roof when he pulled hard, thinking the sheet was secured by nails. It wasn't and he fell backward over 20 feet to the ground. Three days later he awoke, a near quadriplegic connected to a ventilator, at Advocate Christ.
Imperial Roofing Group owner Anthony Ritter said Ojeda was working for a subcontractor who handled workplace issues on the Chicago job.
"I did not know Quelino," said Ritter, adding that he thought what happened to the young man was "horrible."
Ritter said he wasn't sure if the subcontractor carried active workers compensation insurance. Imperial Roofing, he said, has since closed operations in Chicago, Atlanta and Houston because of the poor economy.
Ojeda knew no one here, but his aunt in Atlanta, hearing of his accident, contacted Ana Maria Cruz, a Chicagoan she had met through work.
Soon, Cruz and a circle of Mexican friends in Chicago began visiting Ojeda in the hospital, talking to him, feeding him and helping him move his limbs.
Cruz's husband, Reynaldo, was appointed Ojeda's temporary guardian by the Circuit Court of Cook County's probate division. Reynaldo Cruz said he sought legal help to successfully halt the hospital's first plan to send Ojeda back to Mexico in October.
Gradually, the young man improved. It was clear he understood what was going on, and on Dec. 10 a judge removed Cruz as guardian and ruled that Ojeda could make his own decisions.
But Ojeda said he had no idea what Advocate Christ was planning.
"They did not tell me anything about leaving," he told the Tribune, describing what happened the morning of Dec. 22, when hospital staff quickly disconnected him from equipment and ushered him out the door.
"They told me, 'Today you are going to your home,'" Ojeda said, recalling being struck with terror and unable to get words out. "I wanted to say something, but I couldn't talk. I wanted to ask why."
AeroCare Air Ambulance Service Inc. of Sugar Grove took over, conveying Ojeda to Mexico. Joseph Cece, AeroCare's CEO, said doctors in that country as well as Chicago approved the patient's transfer. "The actual responsible parties in a situation like this are the discharging physician and the receiving physician," he said. "The way I see it, this was a successful mission."
The hospital in the city of Oaxaca, where he was first taken, didn't have a bed for him, family members say, and specializes in emergency care only, according to Pellicer, of the Mexican Consulate. That institution transferred Ojeda in early January to a smaller hospital that doesn't provide rehabilitation and that cannot afford new filters for his ventilator. Instead, hospital staff cleans the filters daily and reuses them.
Almost every day, Ojeda's uncle tries to help the young man and keep his spirits up. An aunt says Ojeda is sometimes "desperate" because "he isn't getting better." Ojeda's parents and his wife live about four hours away in a rural village with a population of 140. They have spent little time with their son because they cannot afford transportation or hotels, they told the Tribune.
This is what Ojeda expected after his move to Mexico.
"I felt sad because I know how my state is. It's poor … there's nothing," he said.
Without rehabilitation, he knows progress is unlikely. But still, he imagines a better future, saying, "I want to get up from here … and back at work."
Tribune photographer Abel Uribe reported from Mexico for this report.