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Million-Dollar Debt Between Amapá Government and São Camilo Hospital Interrupts High-Complexity Surgeries, Causes Death of 37-Year-Old Patient, Cancels Heart Surgery Scheduled for October 20, and Continues to Disregard Court Order Mandating Resumption of Service with Daily Fine of R$ 10 Thousand at the Only Hospital.
A debt for services accrued since 2023 that, according to São Camilo hospital, amounts to R$ 98 million led the only high-complexity hospital in Amapá to suspend surgeries under SUS, temporarily close its doors to new patients last week, and cancel already scheduled procedures, such as a heart surgery planned for October 20. According to Domingo Espetacular published in October 2025 but still in current effect, the stoppage directly affects those who depend on the Unified Health System and exposes the fragility of the public network when a single hospital concentrates essential services.
In the midst of this impasse, Edilene Batista Siqueira, 37, died awaiting an emergency surgery to treat a tumor in her intestine, even after her family contacted the Public Prosecutor’s Office and obtained a court order for the hospital to perform the procedure. The case highlights a serious flaw in the SUS service in the state, where court decisions have not been sufficient to guarantee real access to health services.
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The patient had discovered a tumor in her intestine and needed an urgent operation at São Camilo hospital, which receives funding from the Amapá government to treat SUS patients.
With no available slots because the capacity of the emergency contract between SUS and the unit was exhausted, the family turned to the Public Prosecutor’s Office and the courts to secure the surgery.
Even with a favorable court decision, the government did not provide the service, and Edilene died at 37 without undergoing surgery.
Shaken, the father summarizes the situation by stating that “health in the state is abandoned”, an expression that conveys the feeling of helplessness in the face of a hospital that did not conduct the procedure even after intervention by oversight bodies.
Only High-Complexity Hospital Closes Doors to SUS Due to Million-Dollar Debt
Last week, São Camilo hospital closed its doors to new patients from the Unified Health System.
The administration of the unit claims that the Amapá government has ceased to transfer funds for services rendered, resulting in a debt of R$ 98 million.
The hospital is the only one in the state authorized for heart surgeries, neonatal ICU care, and other high-complexity services, with nearly 500 monthly admissions under SUS.
According to a lawyer specializing in health law, the responsibility for the continuity of care lies with the state, which must determine the fate of the patients, whether in the hospital itself or in other units.
He recalls that the government could be held liable if there is a worsening condition or death due to a lack of contracts or measures to ensure assistance.
Court Orders Resumption of Service, but Decision Is Not Fully Followed
After the suspension of services due to the debt, the Amapá Court ordered the immediate resumption of services at São Camilo hospital and imposed a fine of R$ 10 thousand per day for non-compliance.
Staff interviewed report that there is no overcrowding in the unit, which reinforces the perception that the problem is financial and contractual, not physical capacity.
Nonetheless, the services have not returned to normal, and part of the high-complexity services remains compromised, affecting patients in delicate situations.
According to internal reports, more complex procedures, such as heart surgeries, remained suspended, prolonging the wait for those who already had a medical indication for urgency.
Heart Surgery Scheduled for October 20 Is Canceled at the Last Minute
Among the affected patients is Nilva, who had a heart surgery scheduled at the hospital for October 20.
The physician had requested urgency for the procedure, but, with the suspension of services under SUS, the family received the message that the surgery was canceled.
She reports that she felt despair upon learning of the cancellation and fears suffering a heart attack while awaiting a solution.
Nilva’s case illustrates how the conflict between the government and the hospital, fought over contract values, translates into insecurity and direct risk to the lives of those who depend exclusively on SUS.
Amapá Government Challenges Amount and Talks About Redirecting Patients
In a statement, São Camilo hospital reported that it would not comment on the matter and that it awaits a conciliation hearing set by the Amapá Court for the end of the month.
The state Health Secretariat presents another version: the secretary disputes the amount of debt pointed out by the hospital and claims that the population did not go without care, as patients were redirected to other units.
According to the manager, the government has been tracking the debts since 2023 and has to date identified around R$ 30 million in open amounts, which are being analyzed to determine whether there is a larger sum.
She also argues that the service could not be abruptly interrupted, as negotiations were underway between the state and the hospital.
Expert Calls for Oversight and Transparency in Health Accounts
For the lawyer specializing in health law, the case reveals a serious oversight failure in public contracts.
He argues that it is necessary to investigate why the debt has not been paid over the years and whether funds designated for health have not been redirected to other areas.
The expert emphasizes that these are not small amounts. According to him, “we are not talking about R$ 1 million or R$ 2 million, but possibly R$ 100 million”, which makes even graver the absence of active monitoring of the flow of resources and the execution of contracts.
In the lawyer’s view, the lack of transparency and continuous oversight allows financial problems to accumulate until they explode in the form of a collapse in care.
While the government and the hospital argue over the exact amount of the debt and who should pay it, patients like Edilene and Nilva find themselves caught in the middle of the conflict, forced to turn to the Public Prosecutor’s Office and the courts to try to secure what the Constitution already guarantees as a basic right: quick and safe access to hospital care through SUS.
And what about you, do you think a hospital can suspend SUS services due to a debt with the government, or should the state ensure the service no matter what? Leave your opinion in the comments.
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