Victor Costache

Victor Sebastian Costache (born 18 March 1974 in Iași) is a Romanian cardiovascular, thoracic and pulmonary surgeon who served as minister of health from 4 November 2019 to 26 March 2020. He held the post in the first cabinet of Prime Minister Ludovic Orban, of the National Liberal Party, and left it early in the COVID-19 pandemic in Romania.

He attended the Grigore T. Popa University of Medicine and Pharmacy in Iași from 1992 to 1998 and then spent a year as a thoracic-surgery resident in Romania before leaving for France. Admitted in 2002 to the national residency competition in Paris, he trained in thoracic and general surgery in Toulouse and in digestive surgery, trauma and cardiovascular surgery in Grenoble, and in 2004 completed a master's degree in anatomy at the Joseph Fourier Faculty of Medicine in Grenoble. He received a Romanian specialist diploma in thoracic surgery in 2006, defended a 2009 doctoral thesis on the diagnosis and treatment of mediastinitis, and worked in Grenoble until 2010 and as a senior cardiovascular and thoracic surgeon at the Annecy regional hospital from 2010 to 2013.

In 2014 he suspended his practice in France and settled with his family in Sibiu, becoming head of cardiovascular and thoracic surgery at the private Polisano clinic and later its medical director. From October 2014 he was an associate professor at the Lucian Blaga University faculty of medicine in Sibiu, and from October 2015 president of the health ministry's commission on cardiovascular surgery. By the time Orban nominated him, on 24 October 2019, he was a National Liberal member and the prime minister-designate's adviser on health.

Three days after taking the oath he signed a part-time employment contract with Polisano, an arrangement the newspaper Libertatea reported in January 2020 as being in tension with his ministerial duties; Costache and Orban said the work was lawful. On the evening of 25 March 2020 he announced a plan to test the population of Bucharest for the coronavirus, which government sources described as logistically unsupported. Orban said the next morning that he would forward the resignation to President Klaus Iohannis and would propose state secretary Nelu Tătaru, then in Suceava, as the next minister. Within a week Costache had been appointed an honorary adviser in Tătaru's office.

Early life and education

Family and schooling in Iași

Victor Sebastian Costache was born on 18 March 1974 in Iași, in Iași County, Romania, according to an AGERPRES biographical note of 24 October 2019, published when he was proposed as minister of health.

In a July 2017 interview with Revista Cariere he said that a large part of his childhood was spent very near a hospital, in a family working in medicine, and that his earliest memories were mixed with visits, consultations and night-time telephone calls. Choosing medicine, he said, felt like the continuation of something already familiar. His maternal grandparents, Dumitru and Ludmila, were both surgeons; he described his grandfather as one of the respected doctors of Iași and said that Dumitru had taken part in the Second World War and in the Battle of Stalingrad, so that sitting the examination for the medical faculty surprised no one. He added that the grandparents had been much more present in his upbringing than his parents, as often happened in other families, but that they had died too soon, and he named among his memories the first bicycle lessons, primary-school homework, and anatomy and physiology while he prepared for university. A message of his published on 12 May 2022 by Mesagerul de Sibiu says that he grew up, in the first part of his life, inside a hospital, because his grandparents, who were doctors, had service housing there.

AGERPRES does not name a secondary school. A curriculum vitae posted by Titu Maiorescu University records a 1992 baccalaureate from Liceul „Mihai Eminescu” in Iași, and the same school and year appear on a Europass curriculum hosted by the Romanian Academy of Scientists.

Medical studies

He studied at the Grigore T. Popa University of Medicine and Pharmacy in Iași. AGERPRES gives the course as 1992–1998. A curriculum supplied by Polisano Hospital and reprinted on 10 September 2014 by Turnul Sfatului uses the same span and lists a 1998 medical thesis, “Diagnostic și efectuarea disecțiilor aortice la Spitalul John Radcliffe – Oxford; experiența noastră în zece ani” (“Diagnosis and performance of aortic dissections at John Radcliffe Hospital, Oxford; our experience over ten years”), coordinated by Stephen Westaby, named there as Prof. Steve Westaby, and by S. Mihalache in Iași. The subject is aortic dissection at the John Radcliffe Hospital. A curriculum later posted by Titu Maiorescu University dates the medical degree to 1999, and both the 2017 interview and the 2022 Sibiu note say that he began the faculty in 1992 and finished it in 1999.

The placements abroad during those studies are known from curricula he prepared. Cotidianul, reprinting one in 2020, stated that he had written the entries himself; the same sequence appears in the 2014 Polisano curriculum. They list a November 1994 course, described as basic research, on myography of the structure and function of small arteries with Professor Mulvany at the medical school of Aarhus University in Denmark. For 1995 they list clinical attachments at Edinburgh School of Medicine, part of the University of Edinburgh—from 17 July to 8 September in the vascular service with Professor Ruckley, and from 8 August to 8 September in cardiothoracic surgery with Professor Walker—and at Sheffield Medical School, of the University of Sheffield, from 11 September to 21 October, in cardiology and cardiothoracic surgery with Professor Locke. From 3 June to 24 October 1997 they list a clinical attachment in cardiac surgery at the University of Oxford, again with Westaby. An English curriculum later posted by Titu Maiorescu University places that attachment at “Oxford University, USA”; the 2014 text and the thesis title place the hospital in Oxford, England.

AGERPRES, citing a file on the doctoral site of Lucian Blaga University of Sibiu, states that after the Iași course he spent one year as a resident in Bucharest. The 2014 curriculum instead dates admission, in 1999, at the national residency competition held in Bucharest, on the general and thoracic surgery track.

Doctorate

On 20 May 2009 he defended the doctoral thesis “Optimizarea metodelor de diagnostic și tratament în mediastinite” (“Optimization of diagnostic and treatment methods in mediastinitis”) at the Grigore T. Popa University of Medicine and Pharmacy in Iași. AGERPRES attributes the date, the title and the university to the Sibiu doctoral site; the 2014 Polisano curriculum records the same defence and title and does not name a supervisor. The defence came years after the medical degree, while published biographies already place him in specialist training in France.

Training and practice in France

Residency at Toulouse and Grenoble

Victor Sebastian Costache’s first postgraduate post was in Romania. From August 2000 to November 2001 he was a thoracic-surgery resident and a junior university demonstrator at the Iași University of Medicine and Pharmacy, and he then left for France. In October 2002 he passed the national competition in Paris for the diplôme d’études spécialisées (DES), the French specialist-training pathway, on the surgical track.

A curriculum vitae he prepared, reproduced in 2020 by Cotidianul, places him in Toulouse before that examination. From November 2001 to May 2003 he was a resident in general and thoracic surgery under Professor Dahan at CHU Purpan, listed as an FFI, a doctor filling an intern’s post outside the national DES intake. The same document then lists him at Grenoble University Hospital as a DES intern: digestive surgery with Professor Letoublon until November 2003, traumatology with Professor Merloz from November 2003 to May 2004, cardiovascular surgery with Professor Blin from May to November 2004, vascular surgery with Professor Magne from November 2004 to April 2005, and cardiac surgery with Blin from May 2005 to November 2006.

Papers carry the hospital’s affiliation rather than only his curricula. A 2005 report and a 2007 series on acute type A aortic dissection are from its cardiac-surgery department, and a 2009 paper on lung-transplant survival names him from cardiovascular and thoracic surgery at the university hospital and the medical school of Joseph Fourier University; a manuscript received in April 2009 uses the address vcostache@chu-grenoble.fr. A curriculum posted by Titu Maiorescu University dates that residency to 2001–2008, with an anatomy tutorship at Grenoble in 2003–2008. After November 2006 the CV reproduced by Cotidianul continues intern semesters in vascular surgery to May 2007, cardiovascular surgery to November 2007, and vascular surgery again until February 2008.

Qualifications and the Laval fellowship

In 2004 he obtained a master’s degree in anatomy at the Joseph Fourier faculty in Grenoble, and in November 2006 the faculty of medicine in Bucharest issued a Romanian specialist diploma in thoracic surgery. The Titu Maiorescu curriculum dates a DES in general surgery to 2008, through the southern French college and the Joseph Fourier faculty, and a qualifying diplôme d’études spécialisées complémentaires (DESC) in cardiovascular and thoracic surgery to 2009. The CV reproduced by Cotidianul dates the DESC examination to 2 October 2009 and records a 2007 inter-university diploma in endovascular surgery at Lyon, Marseille, Grenoble and Saint-Étienne. It also states that on 2 May 2007 he was entered on the French medical register as number 8766, with ADELI identifier 381087667; AGERPRES records membership of the French medical college from 2007.

For February to November 2008 that CV records a fellowship diploma in cardiovascular and thoracic surgery at Université Laval in Quebec, Canada. A Europass file hosted by the Romanian Academy of Scientists describes it as a fellowship at Laval’s cardiology institute, and both that file and the Titu Maiorescu curriculum list his nationalities as Romanian and French.

Consultant posts at Grenoble and Annecy

From 2008 to 2010 the same curricula list him as chef de clinique, a specialist with teaching duties, in cardiovascular and thoracic surgery at CHU Grenoble; AGERPRES renders the post șef de lucrări and groups 2006–2010 as residency, specialist practice and that appointment. Those Grenoble dates overlap the Quebec fellowship as the CV places it, from February to November 2008.

From 2010 to 2013 he was a senior hospital practitioner in cardiovascular and thoracic surgery at the regional hospital in Annecy, called praticien hospitalier in the English curriculum and medic primar at CHRA Annecy by AGERPRES. A 2013 paper with Nicolas Chavanis, Jean-Philippe Frieh and David Bougon gives the Department of Cardiac Surgery, Annecy Regional Hospital, Metz-Tessy, and a later multicentre report lists the Centre hospitalier de la région d’Annecy. On 27 September 2010 the public Annecy hospital and Lyon’s private Clinique du Tonkin opened the GCS “Chirurgie cardiaque 74”, Haute-Savoie having had no authorized cardiac-surgery centre. A later Europass CV also calls his Annecy job a head-of-department post, which the 2019 AGERPRES file does not.

The detailed CV and the Europass date the national competition for praticiens hospitaliers in cardiovascular and thoracic surgery to 11 April 2011, at the Centre national de gestion in Paris; one summary line in the English curriculum dates a consultant examination only to 2010. Both the CV and AGERPRES state that from 2011 he was a titular member of the French College of Cardiovascular and Thoracic Surgery, identified in the CV with the Société française de chirurgie thoracique et cardio-vasculaire. In February 2020 Cotidianul reported that he was absent from the society’s public list and that its secretariat said he was not a titular member. In 2014 he suspended his French practice and settled with his family in Romania, and HotNews, citing a CV then on the Lucian Blaga University site, reported the return to Sibiu that year after a further residency in France.

Return to Romanian cardiovascular surgery

Polisano European Hospital in Sibiu

Costache resumed practice in Romania in 2013 after a long period of work in Canada and France. A curriculum supplied by the hospital and printed by Turnul Sfatului dated his post as head of cardiovascular and thoracic surgery at Clinica Polisano in Sibiu from 10 June 2013. By April 2014 the same paper was also calling him medical director of Spitalul European Polisano. In June 2020 it wrote that from 2013 he had created the first cardiovascular-surgery centre in the Sibiu region.

He later told DC Medical that the cardiovascular and thoracic centre opened in August 2013, with Mugurel Bosânceanu. In April 2018 MedLife became the sole shareholder of Polisano's medical-services division, including the Sibiu hospital, after the Romanian competition authority approved the transaction, Turnul Sfatului reported. Costache was still described as department head and medical director in October 2017. He left day-to-day work in Sibiu on becoming health minister in November 2019. In June 2020 he said he had wanted to return to Polisano, but that the local manager, Celestin Constantin, did not wish to continue the collaboration for the time being, and that most of the cardiovascular-surgery and cardiology team had been placed on technical unemployment.

Reported procedural firsts

Sibiu newspapers repeatedly described operations at Polisano as firsts for Romania, Eastern Europe or the world. Those labels came from the hospital and the surgeons; they were not rulings by a surgical society.

Mesagerul de Sibiu wrote in October 2014 that Costache had performed what it called a national first — an aortic-valve replacement with a sutureless Perceval S prosthesis, in December 2013 — and what it called a world first, an aortic endograft with an MFM Streamliner, in April 2014. Reporting the April cases at the time, Turnul Sfatului said the Irish surgeon Sherif Sultan, with Costache and Nicolae Florescu, had implanted a new Belgian Cardiatis multilayer prosthesis in five patients aged 28 to 83, some of whom other centres had turned away. Sultan told the paper that both the device and the method of implanting it were being used in patients for the first time, and that an earlier Cardiatis version had already been used in France. A September 2014 account of the same work named the device a Phantom graft made by Cardiatis.

On 2 October 2015 the paper reported a transcatheter aortic valve implantation which it presented as the first in Eastern Europe: an Edwards Sapien 3 valve placed by a transaortic route through a 4 cm incision, without opening the sternum and without stopping the heart. The patient was Dan Popa, a 67-year-old paediatrician from Iași with severe aortic stenosis and several other serious conditions. The operation lasted about two hours. Costache said the prosthesis brought the cost to about 26,000 euro and that reimbursement would be needed if it were to be widely available. The paper named collaborators including Charles Lutz and Amad Nazem, whom it placed at St. Joseph Hospital, and P. Rainer of the University of Kiel.

In October 2017 Turnul Sfatului reported what it called another national first: emergency video-assisted implantation of a Perceval S sutureless valve, again without sternotomy, in a 58-year-old man with acute aortic regurgitation after the valve ruptured. It lasted two and a half hours and, the paper said, fell within the national cardiovascular-disease programme.

DC Medical reported that on 11 September 2018 the Academy of World Records had awarded Costache for what that body treated as the first complex aortic dissection treated entirely by an endovascular route, at Polisano. In the same interview he referred to a confirmation in the World Book of Records. Both are private record-listing organisations. The press account relays their recognition and his description of the case, not a finding by a professional surgical society.

Later posts in Brașov and Bucharest

After the ministry he moved the practice to Brașov. BizBrașov reported on 22 April 2020 that Mihai Miron, owner of the private Spitalul Sfântul Constantin, had said Costache would hold an employment contract there from May. On 14 May the paper reported the opening of a cardiovascular-surgery centre coordinated by Costache, at the invitation of the hospital's general director, Camelia Șamotă. Operations it listed as new for medicine in Brașov were an endoscopic mitral-valve repair and minimally invasive aortic and mitral replacements, without opening the sternum. Costache told Turnul Sfatului that about 25 doctors, nurses and other staff from the Sibiu team had moved with him to found the new department.

The Brașov relationship later came before the courts over pay. In September 2022 Transilvania365 reported that Costache and the cardiologist Tatiana Melnic had asked a court to open insolvency against the company running the hospital, citing unpaid salaries, and that early information put Costache's claim at about 500,000 lei. On 5 December 2022 the Brașov tribunal rejected insolvency petitions brought by Endovasc SRL, with Costache as its legal representative, and by Melnic against Theo Health SA, the company that administers the hospital, and ordered each creditor to pay 5,950 lei in costs.

By the summer of 2022 he was also operating in Bucharest. Gândul reported that on 9 June 2022 a team he led at Spitalul Clinic Sanador carried out, in a single transcatheter procedure, a TAVI and an endovascular repair of an infrarenal aortic aneurysm in a 76-year-old patient; the hospital described the combination as a national first. DC News in November 2022 identified him as director of Sanador's cardiovascular-surgery clinic. A 2023 Digi24 report identified him as head of the hospital's cardiovascular surgery department. Clinical complaints about his practice are covered elsewhere.

Academic work and professional organizations

University posts

On 10 September 2014 Victor Costache passed a public competition for an associate professorship (conferențiar universitar) at the Faculty of Medicine of Lucian Blaga University in Sibiu. Turnul Sfatului, reporting the same day, already called him the faculty’s new associate professor; rector Ioan Bondrea said the university would back his plans for cardiovascular and thoracic surgery there. A curriculum vitae posted by Titu Maiorescu University dates that appointment from 2014 to 2021, in the department of surgery, and dates doctoral supervision at Lucian Blaga from 2017, after his 2009 doctorate at the Grigore T. Popa University of Medicine and Pharmacy in Iași. By 16 October 2015 a Ministry of Health order was already styling him conferențiar.

He resigned that associate professorship on 26 August 2021. In the letter, Turnul Sfatului reported, he accused rector Sorin Radu of cancelling a full professorship in cardiovascular surgery in 2020, blocking residency training, and dismantling the NextCardio research centre. Radu replied that the step was unilateral and a surprise, that Costache had asked to remain an affiliated doctoral supervisor, and that the university regretted the manner of the departure while respecting it.

The same curriculum vitae dates a professorship at Titu Maiorescu University’s Faculty of Medicine in Bucharest from 2021. The faculty’s teaching-staff page lists him as tenured professor of cardiovascular surgery. Its November 2022 conference programme named him professor and vice-rector for medical education. The executive-bureau page lists him as prorector for residency and postgraduate programmes.

Commissions and societies

Order no. 1.297 of 16 October 2015 amended the named membership of the consultative commissions created under Order 398/2013. It made Conf. dr. Victor Costache of Sibiu president of the cardiovascular surgery commission of the Ministry of Health of Romania, with Dr. Sorin Baloș of Târgu Mureș as vice-president. The university curriculum vitae states that this presidency ran from September 2015 to January 2017, and that he was president of the Romanian Society of Endovascular Surgery from 2015 to 2019.

A curriculum vitae printed with the September 2014 Turnul Sfatului profile states that on 21 October 2011 he became a titular member of the French College of Cardiovascular and Thoracic Surgery, listed there with the French Society of Cardiovascular and Thoracic Surgery. On 21 October 2020 Tribuna, quoting Costache, reported that he had been received that month as a member of the French National Academy of Surgery (Académie nationale de chirurgie) in France, after addressing its general assembly; he thanked Claude Vaislic and secretary-general Hubert Johanet. The East Meets West congress page also calls him a member of the French Academy of Surgery. Those accounts do not give a rank above member.

The Romanian Society of Vascular Surgery lists him among its past presidents for 2022–2024. East Meets West, organized with the International Society for Endovascular Specialists and in partnership with the Romanian Society of Endovascular Surgery, names him president of the 2026 congress and, on the same page, president of the vascular-surgery society.

Publications

Indexed work under his name centres on endovascular treatment of aortic dissection, multilayer stents, and heart-valve surgery. A 2026 PubMed query for the author name Costache V.S. returned 23 records.

A 2010 paper with Grenoble colleagues reported postoperative mediastinitis after coronary bypass, treated with negative-pressure dressings, titanium sternal plates and pectoral flaps. A 2018 case in the Journal of Endovascular Therapy described two multilayer flow modulator stents from the sinotubular junction to the infrarenal aorta, followed with computed tomography and flow modelling for three years. A 2020 paper in Materials applied that kind of analysis to 16 type B dissections and reported a larger true lumen, a smaller false lumen, and lower velocity and pressure. A 2021 single-centre series in the same journal covered 23 patients, 16 of them chronic: technical success was 91.3%, and at 12 months the estimates were 100% free of rupture or aortic-related death and 91.3% free of reintervention, with 144 overstented branches reported patent. He is also a co-author of a 2017 Journal of Vascular Surgery registry report on the Streamliner multilayer device in chronic symptomatic dissection.

A 2018 review in Minerva Cardioangiologica compared sutureless surgical aortic valve replacement with transcatheter aortic valve implantation. A 2025 review in the Journal of Clinical Medicine, with Costache as senior author, pooled studies the authors put at more than 10,000 patients and reported higher short-term quality-of-life scores after minimally invasive valve surgery than after sternotomy, with the difference narrowing after a year.

Minister of Health

Nomination to the Orban cabinet

Victor Sebastian Costache became minister of health in the first cabinet of Ludovic Orban, president of the National Liberal Party. On 26 February 2019 the party’s Sibiu organization announced that Costache, who had joined the liberals some months earlier, would advise Orban on health. In October 2019, after Orban was designated prime minister, Costache was proposed for the portfolio held by Sorina Pintea.

The joint health committees of the Parliament of Romania heard him on 29 October and, by the national news agency’s count, gave a favourable opinion by 13 votes to one, with four abstentions; a live account recorded 14 in favour. Orban attended. A 2017 criminal complaint over a patient’s death was already public: the Alba Iulia Court of Appeal prosecution told Libertatea that no one had been indicted, and Costache said he would resign if he ceased to be merely a suspect.

On 4 November the chambers adopted Parliament Decision no. 22/2019, granting confidence to the government in the annex — Victor Sebastian Costache as minister of health — for the published programme. Mediafax reported 240 votes in favour. That evening the ministers took the oath before President Klaus Iohannis at Cotroceni Palace in Bucharest. Presidential Decree no. 783 of 4 November 2019, in Official Gazette no. 889, named Costache minister of health under Articles 85(1) and 100(1) of the Constitution and Decision no. 22/2019.

Programme and early measures

At the hearing he listed near-term problems rather than a finished bill. Residency came first: several thousand graduates had been “taken hostage” in a political dispute, he said, and Romania had lost more than 30,000 doctors in ten years. The December sitting would follow the rules candidates had prepared for; with the education minister he would unblock it, and he said Orban had guaranteed that no graduate of a Romanian medical university would be left out. The examination was held on 8 December 2019. The pass mark stayed at 60 percent of the maximum score in each field, and Costache said the ministry would seek to admit everyone who reached it.

On 11 December the government adopted an emergency ordinance, requested by the Health Ministry, amending Government Ordinance no. 18/2009 on residency. Training could also run in military hospitals and, where ministerial criteria were met, in private units and accredited private universities. Costache put the intake at about 7,159 residents and said more than 900 general-medicine graduates above the pass mark could not have been placed in the 3,960 places first allocated to that field.

He told the committees there were 367 public hospitals and that none would close. Reports of closures were, he said, “fake news”: linking smaller hospitals to county and emergency hospitals was a way to share on-call staff, not a shutdown, and in some hospitals wages already took more than 90 percent of the budget. On a vaccination law in the governing programme, he opposed radical solutions, argued for persuading parents, and showed a French vaccination booklet as a model; for family doctors he mentioned complementary private insurance and less bureaucracy.

On 13 November he told the cabinet that the regional emergency hospitals for Iași, Cluj-Napoca and Craiova had construction and environmental permits and were not in litigation. Iași was furthest along; he expected financing contracts from mid-December through early February, then a design phase and a construction phase, as the European Commission had recommended. Orban told him to coordinate with the minister for European funds so the EU money would not be lost.

In late January 2020 the ministry drafted an amendment to Law no. 95/2006 so national curative programmes for insured patients — including cancer, HIV/AIDS, tuberculosis and cardiovascular disease — could also run in private hospitals. Costache said copayment was already forbidden there, that private providers had been eligible since 2013 or 2014 only when public capacity was deemed exceeded, and that talk of privatization was a “utopia” raised whenever the rules changed. He accepted that tariffs were below cost and would have to be rebuilt in stages. HotNews reported in the early hours of 5 February that the government had adopted the ordinance with a ban on extra charges; state secretary Nelu Tătaru stood in for Costache, who was in France. On 2 June 2020 the Constitutional Court of Romania held Emergency Ordinance no. 25/2020 unconstitutional as a whole, for lack of a Legislative Council opinion, on a referral by the Ombudsman.

Relations inside the government

Orban called his presence at the hearing a signal that legislation would be done in Parliament, and described the programme as that of a cabinet expected to last about a year. Costache used the sitting to press the budget. Because the health-insurance fund was already spent to the calendar and “we will be uncovered” in December, he said, a positive revision was urgent; an audit of investments would start at once. He would be “a difficult colleague” for Florin Cîțu, the finance minister-designate, and would fight for health “at the risk of Orban getting angry with me.”

At the end of January 2020 a conflict-of-interest controversy over Costache’s work for a private clinic became public. Orban defended him the same day: the minister operated at weekends because patients asked for him by name, a contract had been legally required, and the prime minister said he saw no conflict between that practice and the office of minister.

COVID-19 response and resignation

Preparedness and the first cases

Romania confirmed its first case of the COVID-19 pandemic on the evening of 26 February 2020. At a press conference at the Ministry of Internal Affairs, Health Minister Victor Costache said testing in Gorj County of people who had met an Italian citizen from Rimini, in the county from 18 to 22 February, had produced the first infection. The man was in good health and had no symptoms; 33 further local tests were pending, and an inquiry would trace his contacts.

Clinicians at the National Institute for Infectious Diseases “Prof. Dr. Matei Balș” later described the patient as a 25-year-old man from Gorj. Tracing began on 25 February after the visitor was diagnosed in Rimini; he later said he had been feverish throughout his stay in Romania and sought care only after returning to Italy. Contacts in Gorj and Dolj were isolated at home, swabs were tested by RT-PCR at Matei Balș, and the positive result was reported that evening. Raed Arafat, state secretary and head of the Department for Emergency Situations, said the man would be taken that night to Matei Balș in Bucharest in an isolation vehicle, and that seven relatives who had tested negative would be quarantined at home for 14 days. He called it a single case, not an epidemic.

The World Health Organization named the outbreak a pandemic on 11 March. On 16 March President Klaus Iohannis signed Decree No. 195, a 30-day state of emergency over the whole country. It restricted freedom of movement and of assembly, citing the international spread and an expected surge of infections in Romania. Hospitals were already short of protective equipment. By the week of Costache’s resignation, Bloomberg reported that hundreds of doctors and nurses had tested positive amid a lack of equipment, while cases rose among Romanians returning from Italy and Spain. Europa Liberă wrote that, once the emergency was in force, Arafat rather than the health minister gave the official health briefings, and that government sources described disagreements over strategy. It said shortages of masks, coveralls and visors on ordinary wards were held against Costache, while his team argued that supplies had gone first to the ambulances, emergency rooms and firefighters coordinated by Arafat.

The Suceava outbreak

An early cluster formed at the “Sfântul Ioan cel Nou” county emergency hospital in Suceava. On 26 March Europa Liberă reported more than 100 infections among about 1,300 staff, a hospital that was no longer functioning, and eight of the 17 deaths then counted in Romania recorded there. County council president Gheorghe Flutur had removed manager Vasile Râmbu the day before. State secretary Nelu Tătaru was in Suceava and was called back to Bucharest that morning.

That afternoon Prime Minister Ludovic Orban said testing capacity should grow so that medical staff could be tested even without symptoms, “so that the experience of Suceava is not repeated.” Military management came after Costache left office. The Ministry of National Defence later said a team led by Colonel Daniel Derioiu took over the hospital on 2 April, when only 10 to 15 percent of the medical staff were fit for duty and the rest were diagnosed with COVID-19 or in quarantine. The team returned the hospital on 30 April to a civilian management chosen by the medical council.

The Bucharest testing plan and departure from office

On the evening of 25 March, Costache told several television programmes, including Adevărul Live, that he and Professor Adrian Streinu-Cercel had signed a protocol, still to be validated, for a programme he compared with South Korea’s. “We want to test all the citizens of Bucharest with mobile door-to-door testing teams,” he said, putting the need at between two and five million tests.

Prime Minister Ludovic Orban and Health Minister Victor Costache at a March 2020 press appearance.

Digi24, citing official sources, reported that the government had taken no such decision and did not have the tests, and that the announcement angered the emergency committee, the cabinet, the National Liberal Party and the presidency; those sources said Iohannis was displeased. Mayor Gabriela Firea said the city would back a wide campaign and offered 13 municipal cars to Matei Balș for older people, patients with chronic disease and infected patients treated at home. Government sources told Europa Liberă that the plan was the last straw: at about 3,000 tests a day, a city of more than three million would take years to cover, use up scarce kits and favour the capital over the rest of the country.

Costache resigned on the morning of 26 March. Orban said he had taken note, regretted the resignation and also understood it, thanked Costache for almost five months in government, and would propose Tătaru to Iohannis. Buying equipment to protect hospital staff, he said, was “priority zero.” Party sources told Digi24 that Orban had demanded the resignation after a heated argument about missing equipment and disorganisation, and that the testing announcement, made without logistical cover, had angered him most. They said he had been asked to apologise in public. In the cabinet meeting Orban said that stories of going “from door to door to do tests are not serious,” and that Romania would follow procedures set by the National Institute of Public Health—symptomatic patients with a history of international travel, contacts who became symptomatic, and medical staff—which he described as also a recommendation of the European Commission.

Reuters reported 906 confirmed infections and 13 deaths that day, wrote that Orban gave personal and professional considerations as the reason, and said Tătaru would succeed Costache. On 2 April Digi24 reported that Costache had been named an honorary adviser in Tătaru’s cabinet. Two days after resigning he told the station he had not “abandoned the ship in the middle of the storm” and would stay with the ministry team, without discussing his reasons. In an interview on Antena 3’s Sinteza Zilei, reported by News.ro on 31 August 2021, he said Orban had asked for the resignation. One reason, he said, was mass testing: by taking up Streinu-Cercel’s initiative he had been accused of “fraternizing with the opposition, with the PSD.” In medicine, he added, there was neither government nor opposition, only the interest of patients.

Conflicts of interest

The Polisano employment contract

On 7 November 2019, three days after taking the oath as minister of health, Victor Costache signed individual employment contract no. 1589 with SC Clinica Polisano SRL, the private clinic in Sibiu where he had been medical director and which Libertatea described as part of the MedLife group. Published with additional act no. 1590 of the same day, it engaged him as a primary physician for 10 hours a week, outside ministry hours, at a gross monthly base salary of 20,512 lei, and required fidelity to the employer while allowing the clinic to give binding instructions, subject to the law. Non-compete clauses barred him from diverting the clinic’s “clients” or staff, or from working for others in the same field, and a confidentiality term required written notice within 24 hours if a judicial or administrative body asked him to disclose confidential information.

On B1 TV on 29 January 2020 he said that he “operated for free.” He later wrote that the operations were pro bono, that a private hospital could not use a volunteer contract, and that the salary was the grid minimum for a primary physician with his qualifications. Prime Minister Ludovic Orban said he knew of the weekend surgery, called the pay the minimum sum without which Costache could not operate, saw no conflict with the ministerial post, and would not remove him unless the National Integrity Agency found one.

Changes to funded programmes

Libertatea also published internal drafts, edited on 18 November 2019, of orders on “priority actions,” budget funding for costs not covered by health-insurance contracts. In a draft of the 2015 order on critical patients in intensive care, Costache was reported to have added Sanador and Monza in Bucharest and Clinica Polisano Sibiu, then to have deleted the names after staff said favouring his own hospital was blatant, leaving the list open to later change. A draft of the acute myocardial infarction order, the same day, replaced “access to at least two angiographs,” the text of Order 449/2015, with “one angiograph,” and added Sanador, Polisano Sibiu, Monza and the Bacău county hospital; the reporters wrote that Polisano had only one angiograph.

The ministry told HotNews that the signed orders, as printed in the Official Gazette, named no private hospital for those purchases, only state hospitals. Lavinia Coțofană, a former judge hired as an adviser, told Libertatea the emails were authentic and that she had warned him, “It is obviously a conflict of interest; you cannot issue orders that throw you straight into a conflict.” She said the private names had left the body of the order, but that annexes still referred to units outside the ministry and local authorities, which she took to include private hospitals. Order no. 6/2020, published on 10 January 2020 in place of Order 449/2015, did set eligibility at access to at least one angiograph; its named list did not include Polisano, Sanador or Monza.

The integrity agency's view

Costache published an opinion of the National Integrity Agency, which he said he had requested before taking office. On the facts as he had presented them, the agency wrote that government office together with medical work under an individual employment contract “is not such as to generate a situation of incompatibility” under Law 161/2003. Libertatea noted that the view did not show the agency had received the contract or the additional act. Coțofană said the letter was limited in the same way: incompatibility is for the agency, which she said could not rule without the file, whereas a conflict of interest would be for prosecutors, and she added that the stated salary could have been nominal.

Laura Ștefan, an anti-corruption specialist who had worked on the law establishing the agency, argued that the orders were not a legal conflict of interest. Article 301 of the Criminal Code, as she set it out, does not apply to normative acts, an earlier clause covering a benefit for an employer had been removed, and Romanian law did not forbid being minister and a primary physician together; a conflict, on her reading, could arise from an individual act for himself or a close person. Adevărul reported that prosecutors said they had no reason to open a file of their own. That letter was an opinion on incompatibility, not a ruling on the drafts or the published angiograph rule.

Clinical complaints and litigation

The 2017 patient death

In February 2017 Elisabeta Tudorică, then about 64, died at the Polisano clinic in Sibiu about a week after Victor Costache operated on her for aortic-valve stenosis. Her husband, the priest Tudorică Mihalache, from Craiova, complained of ucidere din culpă (negligent homicide). He alleged an unnecessary operation, a new arrhythmia, death in her room in the early morning without timely resuscitation, and records that misstated how the arrest was found and when she died.

The Sibiu prosecutor's office opened a file in 2017 and on 21 May 2018 sent it to the office at the Alba Iulia Court of Appeal. Comisarul.ro quoted an address to the family's lawyer giving the number 703/P/2018 and saying Costache had been summoned as a suspect. In October 2019, as he was proposed health minister, that office told Libertatea and Gândul, the latter through prosecutor general Ilie Narița, that evidence was still being taken and that no one had been charged. At the hearing he said a doctor had been on duty, the diagnosis was correct, and he would resign if held culpable rather than left a suspect; he later said the expert reports had been favourable. No conviction is reported. Context.ro wrote that prosecutors closed the file in 2022 and that a challenge was finally rejected in August 2023.

The Brașov disciplinary case

Costache later worked at Spitalul Sfântul Constantin in Brașov, run by Theo Health SA. The patient-advocacy site AbuzÎnSănătate, citing what it presented as the court record, reported a 2022 disciplinary dismissal. On that account, in file 335/85/2022, the Sibiu Tribunal annulled the sanction and the dismissal on 23 June 2022 (judgment 382) and ordered reinstatement with back pay, and the Alba Iulia Court of Appeal rejected the company's appeal on 20 June 2023 (judgment 2032). Brașov press did not repeat those numbers. As described, it was an employment dispute, not a finding of negligence.

Separately, Transilvania365 reported that Costache, through Endovasc SRL, and the cardiologist Tatiana Melnic asked a court to put Theo Health into insolvency over unpaid pay, with Costache reported to be owed about 500,000 lei. On 5 December 2022 the Brașov Tribunal rejected both applications (judgment 1036/2022) and ordered each creditor to pay 5,950 lei in costs.

Complaints at Sanador

As head of cardiovascular surgery at the private Sanador hospital in Bucharest, Costache was named in family complaints over operations in 2024 and 2025. Context.ro, which said it had read the medical papers and received no answer from him or the hospital, reported long admissions, bills far above the first quotes, and organisms often linked to hospital care, which relatives said they learned of late. No conviction has been reported.

Elena Cufner, 56, admitted in March 2025 after a consultation in Iași, had hypertrophic cardiomyopathy and severe mitral regurgitation. Her family said the plan changed, without consent, to a sternotomy and a mechanical valve, and that she stayed nearly nine months. Context.ro cited Klebsiella, Pseudomonas, Morganella and Candida after a negative pre-operative screen, and a bill rising from about 12,000 euro to more than 212,000. A February 2026 complaint went to the Sector 1 prosecutor's office; the outlet did not then know its status. Adina Luca, 75, died more than six weeks after mitral and tricuspid surgery in June 2025. Relatives said they had been offered about a 99 percent chance of success. The outlet cited resistant Klebsiella, MRSA, Candida and, on 14 July, Magnusiomyces clavatus, and a bill above 100,000 euro, from about 13,000. Police opened a file in March 2026 on possible forgery, use of forgery and negligent homicide.

Marin, 72, had coronary bypass surgery in late July 2024 on papers describing a one-day admission. Further operations, including reopening of the sternum, raised the bill from 10,000 euro to about 39,000. In September the family moved him to Floreasca Hospital, where he died about three months later; his daughter said she learned of a resistant organism only afterwards. Sector 1 prosecutors told Context.ro they were investigating possible negligent homicide. Constantin Zbanț, 81, received four coronary stents on 3 November 2025 and later died of cardiac arrest and toxic-septic shock. His wife said a rehabilitation centre linked an organism to Sanador; screening there grew resistant Klebsiella. In March 2026 police opened a file for possible negligent homicide and forgery offences.

The National Institute of Public Health told Context.ro that from 2019 to March 2026 it held no healthcare-associated-infection form for Sanador, and that Magnusiomyces clavatus was not reported for Luca between 22 June and 10 August 2025. The Bucharest public-health directorate said the hospital reported five such infections in 2022–2026, none of these cases, classed many isolates as colonisation, and from 2020 to 2026 logged seven complaints and six fines totalling 37,400 lei. Sfin.ro, summarizing Anchetatorii.ro, added civil malpractice actions and complaints said to cover negligent injury, fraud and failure to report disease, and found no indictment or final judgment.

Three days after the investigation, Costache's lawyers demanded that Context.ro delete it within a day and threatened suit; the newsroom refused. Separately, represented by the former justice minister Tudorel Toader, he sued a lawyer over the Facebook page "Nemulțumiți de doctorul Costache Victor chirurg cardio (Sanador)." Știripesurse reported that in January 2026 the Bucharest Court of Appeal kept a ban on new posts about him until the main case ended, and that on 3 July 2026 the Bucharest Tribunal, at first instance, ordered the page closed, posts removed, later publication of the judgment, and 10,000 euro in moral damages. The order was not described as final and did not decide the clinical complaints.