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Last update - 04:38 27/07/2008 Court awards NIS 8M to parents of brain dead child over hospital negligence By Ran Reznick Tags: Hadassah Negligence and complacency at Hadassah University Hospital permitted a child to be born with serious brain damage and irreversible disability in 1993, ruled the Jerusalem District Court. It named the hospital's d Advertisement irector-general, Shlomo Mor-Yosef, a gynecologist, as the person responsible and awarded the child's parents some NIS 8 million in compensation, including lawyers' fees and trial expenses. Mor Yosef acted with negligence and complacence, the court said, and violated his professional duty in the follow-up of a pregnant woman. Hadassah commented that "everyone involved was of the opinion that the fetus' birth defect could not have been prevented or treated." The verdict, published here for the first time, was given in May by Judge Moshe Drori after seven years of hearings on a suit filed in 2001. Dozens of experts testified, with the hearings yielding 3,000 protocol pages. Drori ruled that a more serious medical follow-up would have detected spinal bifida, which caused the brain defect and severe disability. "Mor Yosef's treated the ultrasound examination with complacence and not in keeping with the conduct of an obstetrician in general and of an expert for pregnancies-at-risk in particular," Drori wrote in the verdict. After the suspicion of fetal defect was raised, Mor Yosef was obliged to advise the parents of the option of abortion, despite the woman's being 27 weeks pregnant and the family's being ultra-Orthodox, he said. Mor Yosef conducted the pregnancy follow-up at Hadassah as a gynecologist before he was appointed its director general in 2001. The woman "made a special effort, she didn't trust the free public service provided by the Well Baby stations and went to a famous expert professor who ran a pregnancy-at-risk clinic in the hospital considered the best in Israel," the verdict says. The court also ruled that the Clalit health maintenance organization and the Jerusalem Municipality (responsible for the Well Baby stations), which performed part of the pregnancy follow-up, were also negligent. The municipality will pay the child's parents NIS 2.2 million of the NIS 8 million in compensation, and the Clalit HMO and Hadassah will each pay NIS 2.6 million, the verdict says. However, it also says the family will make do with the NIS 1.9 million that Hadassah paid it in 2004 as part of a compromise agreement. Finally the verdict allocates part of the guilt (estimated at 15 percent of the compensation) to the mother, who failed to do the vital tests instructed by the Well Baby station. The family, represented by attorney Jonathan Davis, has been living in the U.S. since 2001 with the disabled child, now 15. He suffers from low intellectual functioning and complete loss of sphincter control. He has needed and still needs numerous operations, including bladder reconstruction surgery. The mother was 19 in 1992, when she first became pregnant by her husband, 23, who was studying in an ultra-Orthodox yeshiva after immigrating from the U.S. The mother went to the Well Baby station in Jerusalem's Romema neighborhood for pregnancy check ups, which sent her to do to a fetal protein-level test, which detects spina bifida (Latin for "split spine"), a developmental defect resulting in an incompletely closed spinal cord. This can cause paralysis and retardation. However, the woman did not undergo the test. The verdict says that the Well Baby staff was negligent in failing to make sure the woman did her tests and did not give her explicit explanations of their critical importance. This was all the more important as the woman was a newlywed who had spent most of her life in a protected ultraOrthodox environment that limited her exposure to information. During the pregnancy the woman underwent three ultrasound tests at Jerusalem's Clalit HMO institute to detect fetal defects, including spina bifida. The tests were performed by Dr. Ernest Tauber, who was found negligent in reading the test results and failing to detect the defect. In January 1993, Mor Yosef examined the woman, 27 weeks pregnant, in Hadassah. After four ultrasound examinations the fetus' spinal chord defect was detected and two weeks later the baby was delivered by caesarean section. The verdict says that after detecting that fetal growth was lagging after the third examination, Mor Yosef should have ordered an intensive follow-up to find the reason for this, and had he done so, the defect would probably have been detected. The woman testified that Mor Yosef said of the fetus' small head "he'll catch up after the birth" and "at the most he'll wear a smaller hat." The judge wrote that "it's all right for a doctor to encourage a patient. But today, in retrospect, Mor Yosef's words sound like mockery, and some may say they demonstrate excess confidence." Hadassah said: "All those involved said the defect could not have been prevented or treated. The only way to "treat" it was by terminating the pregnancy and since the woman was ultra-Orthodox it was not suggested.... Reading the entire verdict indicates that Mor Yosef treated the case seriously and tried to calm the woman down." 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