Last update - 00:00 21/09/2006
Rambam hospital sued for causing child's death by negligence
By Ran Reznick, Haaretz Correspondent
Negligence and maltreatment killed a six year-old girl who was being fitted with a catheter at Rambam Medical Center in Haifa, her parents claimed on Wednesday in the Be'er Sheva District Court.
The surgery underwent by Jenin resident Marwat Abu-Mawis, who suffered from a congenital heart defect, was arranged and financed by the Peres Peace Center in June 2005. The Health Ministry is also investigating the case following the family's charges of negligence.
Abu-Mawis was diagnosed as having Patent Ductus Arteriosus (PDA), a congenital heart defect caused when the ductus arteriosus remains open after birth. After her hospitalization in June 2005, doctors decided on catheterization to block the open blood vessel.
The surgery, conducted by Dr. Avraham Lorber, director of pediatric cardiology at Rambam, was supposed to enable the patient to live "a normal, healthy life." However, the indictment alleges, the device inserted into her heart was larger than necessary. Also, Lorber allegedly did not verify that it was in the right place.
After the surgery, Abu-Mawis was transferred to the children's intensive care unit and at first recovered as expected. But the following day, her condition worsened rapidly because the device in her heart slipped down the aorta, blocking it and the arteries supplying blood to the kidneys, the charge says. The child's condition deteriorated for many hours until the doctors found the cause. But despite the deterioration the doctors did not advise Lorber and did not consult with senior doctors, the charges say.
After Lorber was advised of the girl's condition, valuable time was lost in vain attempts to take the device out of her heart, the charges say. Finally the device got lodged again, in the artery supplying blood to the lungs. Only some 24 hours later was the child taken to the operating theater; she died, however, before reaching it.
The charges also say that vital documents pertaining to the critical hours during which her condition deteriorated were missing from the girl's medical file.
An opinion from heart surgeon Ron Amar that is attached to the indictment says that when the child's condition deteriorated, the ICU doctors should have expected one of the complications that occurred and should have examined whether it had. "Instead, the doctors only made recurring attempts to stabilize her and the vital hours from the beginning of the deterioration were not used properly for treatment," Amar wrote.
He further said that "the operation was postponed repeatedly due to erroneous medical evaluation, the doctors came to their senses and decided to operate too late, when the deceased had no chance... Her fate was sealed by failures in medical understanding and treatment from the moment of deterioration, leaving her no chance of survival."
Medical literature was full of successful cases of mending the defect in this simple and quite safe method, Amar wrote.
Rambam has not submitted a defense yet. The hospital issued a statement that "the girl arrived in very serious condition with almost irrevocable damage. Lorber assessed that had the defect been discovered in infancy, her recovery chances would have been high.
"Lorber explained to the parents that they could choose between waiving treatment, with a reasonable chance the girl would die shortly, and a complicated high-risk catheterization to try to mend the defect. Following the decision to operate, the child received the most professional and excellent treatment possible in her condition.
"Since the Health Ministry's committee is still examining the case, we cannot comment on the family's complaints about the treatment after catheterization at this stage until the committee completes its probe," the statement said.