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Last update - 19:40 25/01/2008 Surgeons convicted in woman's death during stomach-stapling operation By Ran Reznick, Haaretz Correspondent Tags: Israel, malpractice  Two surgeons were convicted of malpractice over the death of a woman who had undergone gastric stapling surgery in Petah Tikva's Hasharon Hospital. Judge (ret.) Vardi Zeiler, whom the health minister appointed to head disciplinary hearings against doctors, found Doctors Dan Zror and Edward Ram culpable two weeks ago, even though a Health Ministry committee had previously decided to acquit them. Isabella Svirsky, 31, of Netanya, suffered from morbid obesity and related diseases when Zror performed the gastroplasty, a surgical procedure to reduce the stomach size, in 2003. The surgery was performed laparoscopically by doctors Zror and Arye Arish and described as "difficult, complicated and exhausting." Advertisement After the operation, the surgeons carried out a special examination to make sure her stomach had not been perforated. However, Svirsky died of a stomach perforation about a week after the operation. Two committees were appointed, by the hospital and the Health Ministry, to examine the case. Both found numerous grave failures and shortcomings in the treatment of the patient and in the lack of communication between the doctors. The panels ruled that the lack of contact between Ram, the doctor on duty, and Zror, the doctor who performed the operation and was on call the following day, was the main cause for the delay in the patient's diagnosis and treatment. Professor Zeev Dreznik, the hospital's surgery director, testified that the main problem was "belated diagnosis." "Had the diagnosis been earlier, the patient's chances of recovery would probably have been higher," he said. The Health Ministry charged the doctors with inappropriate conduct in its disciplinary tribunal in 2004. More than three years later, at the beginning of December 2007, the tribunal acquitted them. However, some two weeks ago Zeiler decided that the two surgeons were guilty of inappropriate conduct. He ruled, on the basis of testimonies presented to the tribunal, that on Friday, the day after the surgery, the doctor on duty had known nothing about the procedure. Ram could not read the surgery report, which was unintelligible, while Zror went home after receiving the impression that the patient was "alright," and told Ram nothing. Due to these two doctors' conduct, the patient was left in the care of people who knew nothing about her condition, Zeiler concluded. The doctor on duty in the ward the following day, on Saturday, realized immediately that the patient had been given the wrong treatment, based on the wrong diagnosis. He suggested she was suffering from stomach perforation. Zeiler said that it was obvious that had the perforation been detected earlier, the chances of saving Svirsky's life would have been greater. It was the surgeons' duty to make all the doctors handling the case aware of the possibility of this complication, he said. "When Zror left the hospital on Friday, the patient was left in the care of people who did not know exactly what her condition was ... It was his duty to make sure that all the surgical aspects, which only he was familiar with, were covered, as this was a patient who had undergone a problematic operation," Zeiler concluded. "No doctor could plead innocence after failing to treat a patient properly," said Zeiler, even if this failure was wholly or partially because of his lack of knowledge of the patient's condition. The doctor was all the more culpable if he was uninformed simply because he hadn't bothered to read the surgeon's report because he claimed the writing was illegible, he ruled. Attorney Doron Caspi, who represents the Svirsky family, said, "The family takes a grim view of the tribunal's recommendation to acquit the surgeons despite all the evidence ... Even graver is the Health Ministry's decision ... to make do with disciplinary measures against the doctors and with charges of 'inappropriate conduct' instead of grave negligence that led to the patient's death." Caspi said that the Health Ministry's decision was especially outrageous given the harsh findings of two examination committees that reviewed the case, as well as Professor Dreznik's testimony. The management of the Rabin Medical Center, which includes Hasharon Hospital, said it extended its condolences to the family. "Following the examination committee's findings, the lessons were learned to prevent the recurrence of such cases," it stated. "Since the disciplinary process has not ended yet, we cannot comment in detail on further questions," the center said. Bookmark to del.icio.us   Photoshopped launch Did Iran doctor an image of its provocative missile test launch? 'Hitler was a good boss' Nazi bodyguard describes the fuhrer's last moments in a Berlin bunker.   1.   A sequence of dangerous and unnecessary procedures 08:47  |  TEA 25/01/08   2.   surgery 14:06  |  Realistic 25/01/08   3.   Stapled Strategy 18:52  |  Ori 25/01/08   4.   Tea 19:01  |  leon 25/01/08   5.   To #4 Obesity and treatment 21:06  |  TEA 25/01/08   6.   stomach stapling 05:08  |  M. Hahn md 27/01/08   7.   Stomach stapling 11:08  |  Raphaela 27/01/08   8.   To #6 Stomach stapling as `treatment of choice` 12:19  |  TEA 27/01/08   9.   How much do you really know? 15:43  |  Jody 11/07/08

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