Ministério Público Closes All Six DIAP Inquiries Into Deaths During the November 2024 INEM Strike — Pombal Court Reads 'No Robust Indications' Linking the Response Delay to a 53-Year-Old's Heart Attack in Ansião

The Procuradoria-Geral da República (PGR) confirmed today that the Ministério Público has archived all six DIAP inquiries that were opened into deaths during the November 2024 strike by INEM's pre-hospital emergency technicians, closing the criminal channel of an accountability file that began with twelve fatalities flagged for review and ended with three of those deaths formally linked by IGAS to delays in the emergency response. The six closed inquiries spanned Bragança (two files), Pombal/Ansião, Tondela, Almada and Vendas Novas. The PGR's confirmation, sent in response to a Lusa inquiry and reported across RTP, ECO and Expresso, did not specify on which dates the archive decisions were signed, which prosecutors took them, or what reasoning the magistrates committed to paper — the only file in which a court reasoning has surfaced is Pombal, which told the family of a 53-year-old man who died of a heart attack in Ansião that there were no 'robust indications' connecting the INEM dispatch delay to the cause of death.

What the Six Inquiries Were

The six DIAP inquiries were opened in late 2024 and through the first half of 2025 after Lusa, Público and SIC reported a chain of cases in which patients died waiting for an ambulance during the strike that paralysed parts of the INEM CODU dispatch network in November 2024. The strike, called by the Sindicato dos Técnicos de Emergência Pré-Hospitalar (STEPH), was the most disruptive labour action in INEM's history and triggered the political fallout that put Health Minister Ana Paula Martins under direct pressure and eventually produced the parliamentary commission of inquiry that has been hearing testimony since early 2026.

The geographical spread of the archived files reads as a map of the country's pre-hospital response gaps:

• Bragança — two inquiries, both opened in the Trás-os-Montes Norte DIAP. One concerned an 86-year-old man who died of a myocardial infarction in the Bragança district. The second was the file linked by IGAS to the death of an 84-year-old man who choked in Mogadouro, in the same comarca.
• Pombal/Ansião — the file on the 53-year-old man whose family received the only published court explanation. The Tribunal de Pombal told the family that the inquiry was archived because investigators had not found 'indícios robustos' that the INEM response delay had caused the cardiac arrest.
• Tondela — opened in the Viseu DIAP after a death during the strike window in the Beira Alta district.
• Almada — the only file from the Setúbal margin and Greater Lisbon catchment.
• Vendas Novas — the Évora DIAP file, in the Alentejo Central district.

What IGAS Said and the Prosecutorial Standard the Closure Crosses

The criminal channel that the Ministério Público has now closed ran in parallel with an administrative inspection by the Inspeção-Geral das Atividades em Saúde (IGAS), the SNS' internal regulator. IGAS reviewed twelve deaths reported during the November 2024 strike and concluded that three of them were linked to delays in the INEM response: the 84-year-old who choked in Mogadouro, the 86-year-old who suffered the myocardial infarction in the Bragança district, and the 53-year-old in Ansião. The other nine cases reviewed by IGAS produced findings that the regulator did not associate with response delays.

That asymmetry — IGAS finding a link in three cases while the Ministério Público archives all six inquiries — is the legal hinge of today's news. The IGAS finding is administrative: it can ground disciplinary proceedings against managers or technicians, recommendations to the Health Ministry, and contributions to the inquiry commission. Criminal homicide-by-negligence requires a tighter chain — in particular, evidence that the conduct of an identifiable person caused the death and that the standard of care expected from that person was breached. The Pombal court's published rationale, that there were no 'robust indications' linking the delay to the heart attack, is the prosecutorial language for that gap. The other five inquiries, the PGR confirms, were closed under the same logic, even if the PGR has not published the case-by-case reasoning.

Where This Lands This Week

The closure arrives on the same day the Council of Ministers approved the new lei orgânica for INEM, the legislative cornerstone of the institute's refundação after the late-2024 strikes. The diploma converts INEM into an Instituto Público de Regime Especial, restructures the top cadre with a Clinical Director and a Nursing Director locked into the leadership group, and removes the requirement that the president be a doctor. The Council of Ministers also re-approved a separate diploma for the work-time regime of médicos tarefeiros, the freelance hospital doctors whose contracting framework had been on the inter-ministerial conveyor for five months.

For the families of the three deaths IGAS linked to delays, the criminal channel has now closed without trial. Civil claims against INEM and the State remain a separate route and do not run on the same standard of proof — and the parliamentary inquiry into INEM, which has been tracking accountability since 2019 and heard from bereaved families on 22 April, retains the political and administrative levers that prosecutors have just declined to use.

The Open Questions

Three things the PGR's terse statement does not answer:

1. When were the archives signed. The PGR confirmed only that all six are closed, not the dates of the despachos. The order in which the magistrates ruled would tell readers whether Pombal's reasoning influenced the other comarcas, or whether five DIAPs reached the same conclusion independently.
2. Whether the IGAS reports were on the case file. Magistrates can request administrative reports as part of an inquiry. If the IGAS findings linking three deaths to response delays were lodged in the criminal files, the closure says the threshold for negligent homicide is harder to clear than the administrative threshold IGAS applies. If they were not, the inquiries closed on a thinner record than the parallel administrative track.
3. Whether disciplinary follow-up at INEM is now on the line. IGAS conclusions can ground disciplinary proceedings against the chain of command in the CODU dispatch network and in the regional sub-units. With the criminal channel closed, the disciplinary lever is the only remaining accountability route inside the executive — and the new INEM lei orgânica resets the chain of command from the top.

The Ministério Público's communication office confirmed the archives but declined further detail. The PGR's silence on the reasoning is unusual for a politically salient file and is likely to draw a request from the parliamentary inquiry commission for the magistrates' despachos.