Medical records were forged and evidence falsified in a medical file by at least one of three pediatricians at the Bnei Zion Medical Center in Haifa, northern district prosecutors said on Sunday. The three stand accused by the state of medical malpractice.

In an urgent communique to Judge Mordechai Argaman of the Krayot Magistrate's Court in Kiryat Ata, the prosecution said the falsified evidence created the impression that proper care had been given to Ziv Shriki, now 8 years old.

Shriki became brain-damaged allegedly after being
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administered an overdose of medication and then not being properly treated.

The prosecution said at least some of the doctors knowingly submitted this evidence to the court. The police were informed of these suspicions on Sunday, and began questioning staff at Bnei Zion's records department.

Ziv Shriki was treated in Bnei Zion's cancer ward. She recovered from cancer, but in June 2001 she was diagnosed with irreversible brain damage due to alleged failures in the medical and nursing care she received.

According to the indictment, a nurse gave Shriki 100 times the dosage she was supposed to have received. After this incident, the three doctors involved behaved in a seriously negligent manner.

The indictment was issued by attorney Bassem Kundelfat, the northern district deputy prosecutor, against Professor Michael Yaffe, then-head of the Bnei Zion pediatrics department (now retired); Dr. Dina Atias, head of the pediatric hematology and hematology-oncology
department; Dr. Yulia Nobikov, then-pediatric resident at Bnei Zion, who now works for a health maintenance organization; and nurse Lilia Oskatz, who admitted to the infractions and was sentenced to six months in prison commuted to community service, and a monetary fine.

The doctors are charged with ignoring signs of deterioration in Shriki's condition. Yaffe is also charged with "showing indifference" to Shriki's worsening condition, and with not examining Shriki thoroughly, even though he passed through her ward on rounds.

In March, Yaffe's attorney Nimrod Lipsker asked Gila Inbar, a pediatric nurse at Bnei Zion who witnessed Shriki's treatment, about Yaffe's examination of Shriki on June 25, 2001. Inbar was also shown a document from the child's medical file allegedly written that night by the duty physician, Nobikov.

According to the document, Shriki's condition was normal; Yaffe examined the child and reported by phone to Atias.

The defense submitted the document as supporting evidence to show Shriki received proper medical follow-up and Yaffe had personally checked her.

Then, in April, at the request of the defense, the court ordered Shriki's original medical file from the hospital, which the prosecution received on Thursday. The file contains Nobikov's notes as they were presented to the court.

However, the prosecution discovered in Bnei Zion's records department another photocopy of Shriki's file, apparently made the day after the incident. This file contains the same page, but lacks Nobikov's alleged real-time notation on Shriki's normal condition and her examination by Yaffe.

"In comparing the documents, it appears the medical notation was allegedly forged by the accused (or some of them), who added details ... to make it appear that the notation was made in real time ... of examinations ostensibly carried out on the girl and instructions for
treatment ... this interpretation is being sent for police investigation on suspicion of forgery by a public servant, falsifying evidence and knowingly making use of false evidence to mislead the judicial authority," the judge's report reads.

Attorney Doron Caspi, representing Ziv's parents, Ilan and Ayala Shriki, said the family had rejected Yaffe's claims all along. "Having been present at their child's hospital bedside the whole time, they said all along that Prof. Yaffe's claim that he examined her in real time is not true. The suspicions now revealed support their claims and show how far the medical staff is willing to go to cover up its negligence," he said.

The doctors denied the allegations on Sunday. "Instead of properly conducting the trial," Lipsker said, "the prosecution prefers to spread baseless accusations." Lipsker also said the allegation that the records were falsified is illogical since it was the defense that had requested the original records.

Attorney Ofer Doron, representing Nobikov, said, "The medical record as it was presented in court accurately reflects the girl's treatment, and when a note was added after the events, this was specifically stated."

Attorney Erna Lin, representing Atias, declined to comment, saying the issue was under police investigation.