Mine

                g_error := 'UPDATE VISIT -> ' || to_char(i.id_visit);
                UPDATE visit v
                   SET id_institution = g_instit_lixo, id_patient = g_patient_lixo
                 WHERE id_visit NOT IN (SELECT MAX(id_visit)
                                          FROM visit v2, episode e
                                         WHERE v2.id_patient = i.id_patient
                                           AND v2.id_visit = e.id_visit
                                           AND e.id_epis_type = 4
                                           AND v.id_institution != g_instit_lixo)
                   AND id_institution != g_instit_lixo;
            
                --actualiza a instituição no agendamento
                g_error := 'UPDATE SCHEDULE_SR -> ' || to_char(i.id_schedule_sr);
                UPDATE schedule_sr
                   SET id_institution = g_instit_lixo, id_patient = g_patient_lixo
                 WHERE id_schedule_sr NOT IN (SELECT MAX(id_schedule_sr)
                                                FROM schedule_sr v2
                                               WHERE v2.id_patient = i.id_patient
                                                 AND v2.id_institution != g_instit_lixo)
                   AND id_institution != g_instit_lixo;