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Health Ministry, hospital sued for negligence after patient's suicide
By Ran Reznick, Haaretz Correspondent
Tags: mental health, Israel 

A woman whose husband committed suicide near the Abarbanel Mental Health Center in Bat Yam sued the Health Ministry and the hospital for compensation last week.

The widow, who filed a civil suit at the Petah Tikva District Court, is accusing the state-owned psychiatric hospital of negligence in caring for her husband, a doctor, who set himself on fire in February 2006. The widow says that with proper supervision her husband's suicide could have been prevented, and accuses the hospital of attempting to whitewash the irregular incident, which is reported here for the first time.

At the widow's request, a gag order was slapped on details of the doctor and his family, represented by attorney Doron Caspi of the Caspi & Srur law firm. No defense has been submitted yet.
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The doctor, 50, from the central region, suffered from acute anxiety. On the day he self-emolated he told the the nursing staff that he "couldn't take it any more," and asked to see the duty doctor. He then left the hospital and set himself on fire in a nearby field. He was so badly scalded that he had to be identified by his dental records.

During his hospitalization he told his psychiatrists that he had "thoughts that he deserved to die," and blamed himself for causing his patients severe medical damage.

The suit cites the opinion of a senior psychiatrist who has managed several state psychiatric hospitals, who wrote that the gap between the Abarbanel doctors' diagnostic and clinical impression of the patient's condition and their failure to draw the self-evident conclusion was intolerable. Any reasonable psychiatrist would have prescribed supervision, more massive tranquilizing treatment and adequate vigilance to the risk of suicide, he wrote.

"I have no doubt, in view of the doctor's normal mental history and swift development of the depression state, that with appropriate treatment he would have had a high chance of making a complete recovery... and resuming his previous position," he wrote.

The doctor had been the longtime director of a private clinic in the central region, and suffered no apparent psychiatric problems. However, in January 2006 he began to experience severe guilt and anxiety. On January 31 he was examined by Dr. Hagai Oren, director of Abarbanel's closed ward, who diagnosed severe depression. Oren recommended medical treatment, but the following day the patient's condition deteriorated and Oren advised his wife to hospitalize him.

On the afternoon of February 1 2006, on arrival at Abarbanel, the doctor was diagnosed with "extreme restlessness, severe anxiety and flawed perception of reality." He was hospitalized voluntarily and received medication, but was permitted to move freely inside and outside the hospital.

The following day he was examined by Dr. Marganit Carmon, who testified that he denied having suicidal intentions. But she added that he said that in the past week he had "thoughts of death, that he deserved to die, as part of unrealistic guilt feelings that were characteristic of this depression state."

On his second day in the hospital he awoke early and complained of feeling extremely poor and restless. He asked the nurse on duty to see a doctor, but was told to wait until the morning shift nurse had time for him. When the nurse came to his room she discovered that he had vanished. Two hours later, he torched himself outside the hospital.

The senior psychiatrist cited in the family's suit says that despite the acute depression symptoms that the patient reported and displayed, the medical staff gave him minimal (medical) treatment and did not suspect him to be suicidal. "This is a strange, inexplicable contradiction," the psychiatrist wrote.

Three days after the suicide, the hospital's deputy director, Dr. Moti Mashiach, set up an internal inquiry committee to probe the incident. The committee's report did not include conclusions, recommendations or judgmental statements on the hospital's medical and nursing staff. The report was handed to the family only after attorney Caspi threatened to obtain a court order compelling the hospital to submit it to the family, as required by law.

"The report looks like a letter summarizing the hospitalization rather than an inquiry committee's report... The failure of the committee and hospital's deputy director to demand the completion of the report's most important section speaks for itself... constituting a blatant attempt to whitewash the grave incident," Caspi wrote in the suit.

Haaretz presented the Health Ministry with numerous questions about the allegations of negligence leading to the suicide, and the alleged whitewash of the internal probe. The questions were addressed to the ministry's head of mental health services and Abarbanel's director and his deputy. The hospital did not comment directly on the issue.

A Health Ministry spokesperson responded that, "the ministry's legal office has not received the suit yet, and when it does it will be treated as customary. The ministry's defense will be presented in court."
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