The Court of Justice of São Paulo (TJ-SP) ordered the City of Ribeirão Preto (SP) to compensate and pay for the psychological treatment of a 15-year-old teenager due to neglect of care at the Institutional Reception Service for Children and Adolescents (Saica) after she underwent surgery.
The young woman, who was under protective measure at the municipal shelter, had a severe infection that resulted in the presence of larvae in her head and the need to undergo a second emergency surgery, according to the Public Defender's Office of the State of São Paulo.
"One of these inappropriate behaviors was exactly the care given to this girl and that led to the filing of this compensation action. They were very simple things, such as, for example, cleaning the girl's head, washing the girl's hair and stitches with a neutral shampoo. (...) The municipality did not provide the neutral shampoo, they told her to use the shampoo they had there, they did not accompany and did not help the girl to clean them", says public defender Bruno César da Silva, one of the authors of the action.
Now 16 years old, the teenager is doing well and returned to Saica, where she continues to be cared for. The Public Defender's Office reported that it will not disclose the exact amount of compensation to preserve the victim's identity and privacy.
The municipal administration informed g1 that it had not been officially notified about the decision, but reiterated that it has adopted measures to improve the provision of services in Saica.
Structural problems at Saica
Saica is a municipal service provided for by the Child and Adolescent Statute (ECA) intended to shelter young people up to 18 years of age removed from family life by court decision, due to situations of domestic violence, abandonment or neglect.
The unit where the young woman was housed, in the Planalto Verde neighborhood, had already been the target of complaints for structural irregularities, lack of staff and episodes of physical violence and abuse among inmates.
Due to irregularities highlighted by the Public Defender's Office and the Public Prosecutor's Office, Saica was banned by the courts. The City Hall, however, delivered the renovation of the unit's "House 1" in August, as part of a structural improvement plan.
At the end of August, in another civil action that is being processed independently of the compensation process, the TJ-SP suspended orders for the immediate compulsory transfer of inmates and the prohibition of new emergency shelters to avoid social assistance.
The court, however, gave 90 days for City Hall to present a detailed schedule for readjusting all social assistance services.
Negligence in the postoperative period
The teenager underwent neurological surgery called cranioplasty, in February 2025, at the Hospital das Clínicas de Ribeirão Preto, to place a titanium plate in the skull.
The procedure was necessary due to complications from polyarteritis nodosa, a blood vessel problem resulting from a stroke she had in 2019.
After being discharged, she was referred to Saica, but, according to the Public Defender's Office, she did not receive support in post-operative care, carrying out her own asepsis without the help of professionals and without adequate hygiene material.
"There were no employees at the service to help her clean it, she was the one having to clean her own spots. (...) She tells the reception staff that she is uncomfortable, that she is hurting, that she has a bad smell. It takes a week for the staff to take her to the doctor, after she was already talking about this problem", says Bruno César da Silva.
Due to poor hygiene, there was a serious infection in the surgery wound. Medical reports recorded that the girl felt the larvae moving in her skull, according to the Public Defender's Office.
When she was admitted to the HC again, she had to undergo a new emergency surgery to remove the titanium plate, clean the infected area and reimplant the prosthesis.
After the second surgery, the young woman was temporarily housed in a volunteer's home to ensure adequate recovery, before returning to institutional care at Saica.
The Public Defender's Office began investigating the case and proposed a lawsuit for moral damages after having access to the HC's detailed medical records.
Compensation and treatment coverage
In the first decision, in May this year, Ribeirão Preto City Hall was ordered to pay moral damages and cover the full costs of the young woman's medical and psychological treatments.
The Public Defender's Office appealed to increase the compensation because it considered that the original amount did not correspond to the severity of the suffering imposed on the victim.
The municipal administration also appealed, trying to overturn the obligation to pay for psychological treatment on the grounds that the care should be provided directly by the Unified Health System (SUS).
In the ruling of August 26, the Special Chamber of the TJ-SP rejected the municipality's appeal and accepted the Public Defender's request. The decision maintained the city hall's duty to fully pay for necessary future treatments and increased the value of the compensation established in the first instance by 200%.
The amount must remain in a judicial account linked to the process until the teenager turns 18.
According to the public defender, treatment should be made possible in the private network if the SUS is unable to meet the young woman's immediate demands:
"The SUS does not have psychotherapy [in appropriate conditions for the case], so this psychotherapy will be carried out privately, with payment by the municipality. The whole situation that happened to her was a huge trauma."
What the City Hall says
In a statement, the Municipal Department of Social Assistance reported that it had not been officially notified about the court decision. "The process is being processed in secret and, for this reason, the municipality does not comment on details related to the case."
He also announced that, since the beginning of 2025, City Hall has prioritized improving services, paying attention to social protection policies and guaranteeing rights.
"The municipality has been adopting continuous measures to improve the Institutional Reception Service for Children and Adolescents (SAICA), including renovations and improvements to units, reinforcement of technical teams and actions aimed at improving the service and assistance offered to children and adolescents in care", he informed.
The ministry also announced that the City Hall is monitoring Saica's situation, which has been complying with court orders and taking all appropriate and necessary measures.
