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Rambam doctors charged with negligence in child's dehydration death By Ran Reznick Tags: Medical negligence  A protracted investigation into the death of a dehydrated four-year-old boy in June 2005 recently resulted in a number of disciplinary indictments against doctors from Rambam Medical Center in Haifa, who stand accused of negligently sending the parents on a medical ping-pong which allegedly resulted in the boy's death. The hospital said it could not relate to the specifics of the case while they are still being determined, but added it has already taken steps "to improve the way in which the pediatrics department operates with the auxiliary departments." The most severe allegations in the case of Tarabia Murrad from Sakhnin involve a senior surgical pediatrician, Dr. Lili Haya'ari, pediatrician Igor Nutenko, Dr. Leonid Kapitulski and Dr. Sammer Khatib. Health Ministry deputy director Dr. Boaz Lev filed indictments to the ministry's disciplinary tribunal, whose magistrates are scheduled to review the cases in the coming weeks. Advertisement As Haaretz reported in September, the probe committee which investigated the child's death established that the four doctors demonstrated indifference and opted to stick to the letter of their job description rather than save the boy's life. As a result, the committee said, the boy fell between the cracks and died a preventable death. Haya'ari, according to the disciplinary indictment, never bothered to come to the hospital's pediatrics department, where she holds the position of deputy department head, even though the doctor on call told her that the patient was in a critical condition. Haya'ari was the doctor responsible for the case, and the on-call doctor who called was prevented by protocol from independently administering treatment. Rambam's on-call pediatrician, Dr. Nutenko, stands accused of failing to perform basic tests on the child such as measuring his blood pressure after admitting him into the department at 7 P.M. on June 17. He also allegedly failed to administer salts even though tests showed the saline level of the boy's blood was dangerously low as a result of dehydration. The child was examined next by Leonid Kapitulski, an on-call doctor from the surgical pediatrics department. Kapitulski does not belong to Haya'ari's department and was therefore not authorized to treat the boy independently. Despite this, the indictment reads, "Haya'ari did not see fit to arrive and administer treatment herself." The parents, Ali and Dina Murrad, brought their son to the Kupat Holim clinic in Sakhnin, and told the doctors the boy suffered from stomach pains, vomiting and diarrhea. The clinic's pediatrician, Adel Shala'ata, diagnosed the boy as suffering from dehydration and referred him to Rambam. Khatib, who served as an anesthetist in Rambam, allegedly put the boy under sedation for tests without analyzing his blood test result or measuring his blood pressure. Khatib is said to have measured the level of oxygen saturation in the boy's blood, which turned out to be dangerously low. But he allegedly failed to conduct further tests to find out why that was. While under sedation, the boy vomited and his physical condition began to rapidly deteriorate. The staff reported the developments back to Haya'ari. "Despite the boy's critical condition, she did not see any reason to come over to the hospital, and did no more than order over the phone that the examination be cut short," the disciplinary indictment read. Another hitch occurred, according to the indictment, when Dr. Khatib allegedly removed a breathing tube from the boy's windpipe. "This was done prematurely, before the boy reached the recuperation room," the indictment reads. The boy stopped breathing 90 minutes later. Had senior physicians arrived that night at the hospital, the committee determined, "then the grave situation that the boy was in might have been helped." Rambam reacted to the indictment by saying that "any patient's death is unfortunate, and doubly so in the case of the death of a child. This is a very complex case which is being reviewed now in the Health Ministry and we are therefore not at liberty to comment on it." The hospital will respond to the allegations and issue a public statement on this case when the judicial system is concluded. The hospital declined to respond to Haaretz's query, which was addressed specifically to Rambam's pediatrics department and the four named doctors. Bookmark to del.icio.us   Wimbledon shocker Shahar Peer knocks out 9th-seed Safina to slide into the fourth round. Time to hit Iran Israel must destroy Iran's nuclear program within one year or risk being attacked.

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