A 22-year-old lawyer, Letícia Paul, died after suffering anaphylactic shock during a tomography with contrast at the Regional Alto Vale Hospital in Rio do Sul, Santa Catarina, on Tuesday, August 19, 2025. The death, confirmed less than 24 hours later on Wednesday, August 20, shocked family and friends seeking answers about the tragedy. Letícia, who was treating a urinary infection and kidney stones, became ill during the procedure, was intubated, but did not survive. The family questions the handling of the emergency, while the hospital claims to follow protocols. The case reignites debate about the rare but severe risks of contrast in imaging exams.
Letícia, recently graduated in Law and pursuing a postgraduate degree in Real Estate Business, underwent tomography regularly for kidney issues, according to her aunt, Sandra Paul. There was no known history of allergies, but the family is unsure if previous exams used contrast. The Civil Police are investigating, requesting medical records to clarify the circumstances.
- Routine exam: Letícia regularly underwent tomography for kidney stone monitoring.
- Rapid reaction: Anaphylactic shock occurred during contrast administration.
- Ongoing investigation: Authorities are examining possible failures in care.
The tragedy, which shook the city of Lontras where Letícia lived, raises questions about the safety of contrast exams and hospital emergency protocols.
Risks of contrast in imaging exams
The use of contrast in tomography, such as iodine-based agents, is common to highlight blood vessels and organs, aiding diagnoses. Though safe in most cases, it can trigger severe allergic reactions like anaphylactic shock in less than 0.04% of patients, according to radiologist Augusto Villela Polonia. These rare reactions require immediate response. In Letícia’s case, the family questions why the care provided failed to reverse the situation, given it occurred in an equipped hospital.
Hospitals must follow strict protocols before administering contrast, such as assessing allergy history and keeping medications like epinephrine on hand. Surgeon Vanessa Prado emphasizes that pre-exam screening is critical to identify risks.
- Medical history: Detailed evaluation of allergies and chronic conditions.
- Emergency preparedness: Teams must have epinephrine and ventilatory support ready.
- Alternatives: Non-contrast exams, like ultrasound, may be indicated.
The absence of known allergies in Letícia’s case makes the tragedy even more unsettling, reinforcing the need for greater awareness of risks.
What is anaphylactic shock
Anaphylactic shock, as explained by allergist Jane da Silva from UFSC, is a severe allergic reaction where the immune system overreacts to a substance, such as medications, foods, or radiological contrasts. Symptoms appear within seconds or up to an hour after exposure and may include breathing difficulties, swelling, hives, and low blood pressure.
In Letícia’s case, the reaction was fulminant. After the contrast, she suffered cardiac arrest inside the tomography machine, was resuscitated and intubated, but passed away the following night. The family notes she was lucid and well before the exam, intensifying their quest for answers.
- Respiratory symptoms: Wheezing, coughing, and throat tightness.
- Cardiovascular signs: Rapid pulse, dizziness, and fainting.
- Skin reactions: Hives and swelling in lips, tongue, or face.
- Fatal risk: Cardiac arrest can occur without immediate intervention.
The speed of the reaction requires hospitals to act within minutes, which is not always enough, as rare cases like this show.
Hospital safety protocols
Hospitals and clinics must adopt strict measures to minimize risks in contrast exams. Before the procedure, thorough screening is essential, checking for allergies, asthma, or conditions like kidney failure that increase vulnerability. The Brazilian Radiology Society recommends teams have epinephrine, corticosteroids, and antihistamines available for emergencies.
At the Regional Alto Vale Hospital, the administration stated all procedures followed recommended protocols. Still, the Civil Police requested records and statements to clarify potential failures. Letícia’s family, devastated, demands transparency.
- Pre-exam screening: Questions about allergies and current medications.
- Emergency medications: Epinephrine and corticosteroids for severe reactions.
- Monitoring: Observation during and after the exam.
- Safer alternatives: Use of non-contrast exams when possible.
The investigation may shed light on the adequacy of care and procedures followed.
Community impact and search for answers
Letícia Paul’s death caused widespread grief in Lontras and Rio do Sul. Friends and colleagues, many lawyers, vowed to seek answers. Her cousin Yuri Kaue said the family only wants to understand what happened, without rushing to assign blame. The wake, held on Thursday, August 21, drew dozens to the Memorial Jardim Primavera Cemetery before cremation in Balneário Camboriú.
Cases like this reignite debate about the safety of routine medical procedures. Though the risk of anaphylactic shock is low, its severity demands heightened attention. Experts recommend patients with allergy histories carry epinephrine injections and wear identification bracelets.
- Family support: Community rallies to support Letícia’s relatives.
- Awareness: Debate on contrast exam risks gains traction.
- Investigation: Civil Police analyze records and statements.
The tragedy underscores the importance of rigorous protocols and emergency preparedness in healthcare facilities.
Prevention and post-exam care
Avoiding known allergens is the main way to prevent anaphylactic shock. For patients without allergy histories, like Letícia, the risk is unpredictable but can be minimized with proper screening. After contrast exams, hydration is recommended to eliminate the substance through the kidneys, especially in patients with renal issues.
Doctors may prescribe pre-medication with corticosteroids or antihistamines for high-risk cases. Patients with prior severe reactions should consult allergists for tests to identify triggers.
- Hydration: Helps eliminate contrast from the body.
- Pre-medication: Reduces risks in patients with allergy history.
- Allergy testing: Identifies triggering substances.
- Medical guidance: Essential for patients with chronic conditions.
Raising awareness about these precautions can save lives in critical situations.
