Family says Israeli man died after hospital staff ignored doctor's note

A 54-year-old man who died after stomach surgery at Ichilov Hospital could have been saved if proper procedures had been followed, his family said in a lawsuit filed Tuesday in the Tel Aviv Magistrate's Court.

The patient, Michael Roisman, of Rishon Letzion, had been suffering from chronic stomach pain, heartburn and respiratory difficulties. The father of two also weighed 135 kilograms, which placed him at a body mass index of 45, well within the obesity range.

In December 2007, Roisman was diagnosed with a hiatal hernia, a tear in his diaphragm that resulted in his stomach protruding into his chest. He was scheduled for a surgery to pull his stomach down to his abdomen and a stomach stapling to treat the obesity problem.

According to the lawsuit filed by lawyer Doron Caspi on behalf of Roisman's widow Sophia, the patient was not explained the risks and potential complications of the surgery.

In the summer of 2008, Roisman was admitted to Ichilov Hospital for an operation described by the hospital as a stomach stapling. The operation was concluded without treating the hernia, despite it being the primary reason for the procedure and despite the tear being noticed and noted by the operating surgeons.

Consequently, parts of Roisman's stomach remained within his chest cavity, the lawsuit said, and the physicians told the family the attempts to close the hernia were unsuccessful.

After two days of being fed through intravenous tubes, Roisman was told he could drink on his own again. However, as soon as he began doing so, he began complaining of chest pains.

The pains, along with heartburn, continued through the second day, but the family was told this was not unusual after such operations.

Roisman was released on the fifth day after the operation, despite still suffering from chest pains.

The next day, on August 29, 2008, Roisman was taken to the emergency room in Ichilov, after not being able to sleep lying down, and after every attempt to drink provoked vomiting. He was diagnosed with acute respiratory difficulties, and was sent for a CAT scan.

Dr. Freddie Aviv, an internal medicine specialist at Ichilov, who examined Roisman in the emergency room, noted in the patient's file that he had to be put on artificial respiration before undergoing the scan, since lying down put his life in danger. However, the recommendation was ignored by the rest of the staff.

"Despite the dramatic situation, even at this stage the medical staff failed to comprehend the dire state of the deceased and to treat him appropriately," the lawsuit said.

Roisman was taken to the CAT scan room, where he was made to lie down on the bed. During the scan, he suffered a respiratory arrest and a dramatic drop in his heart rate, secreting stomach content from his mouth, prompting the physicians to stop the scan and begin immediate resuscitation. He was taken to the intensive care unit, where he was diagnosed with respiratory problems and sepsis. He died a week later.

The post-mortem, carried out at the hospital, revealed a massively enlarged stomach, residing mostly within the chest. A professional opinion cited in the lawsuit in support of a diagnosis made by a senior surgeon of the hospital, said that when Roisman was laid down for the CAT scan, the stomach contents were ejected upwards. Some of the stomach content entered the trachea, leading to pulmonary aspiration and an extensive lung infection.

"It's highly likely that if the medical crew followed Dr. Aviv's advice, the pulmonary aspiration would have been averted and the life of the deceased would be spared," the opinion said.

Roisman immigrated to Israel from Romania in 1964. Ichilov hospital told Haaretz it hadn't yet received the lawsuit, and would respond to it at court.