redux-orm: Selector is not running while orm state has changed

Currently using the following selector to get the data of a patient from the orm database:

export const patientSelector = createSelector(orm, ormSelector, hashSelector, (session, hash) => {
	const patient = session.Patient.withId(hash);
	const consultations = patient.consultations.count();
	const therapies = patient.therapies.count();

	return session.Patient.hasId(hash) ? {
		...patient.ref,
		totalConsultations: consultations,
		totalTherapies: therapies
	} : null;
});

But after I update a deeper property (patient.resources.medicalFiles) it does not recognize the change and the selector does not update to the new state, so the component does not re-render. Looking at the redux devtools you can see the state has changed.

Reducer

case ActionTypes.ADD_PATIENT_MEDICAL_FILE:
	const resources = Patient.withId(payload.patient).ref.resources;
	const medicalFiles = resources.medicalFiles || [];
	medicalFiles.push({name: payload.name, url: payload.url})

	Patient.withId(payload.patient).update({
		resources: {
			...resources,
			medicalFiles: medicalFiles
		}
	});
break;

Any ideas about this?