Two senior physicians at Rambam Medical Center in Haifa who admitted to negligence in the unnecessary and improper removal of the uterus and ovaries of a patient are to have their medical licenses suspended for two months, a Health Ministry disciplinary committee recommended last month. This would put an end to one of the worst cases of medical malpractice in Israel.
The family of the patient, Tamar Barnea, who has since died of cancer, accused the ministry of nine years of inexcusable footdragging.
Retired judge Vardi Zeiler has not yet issued a verdict on behalf of the Health Ministry in the case.
Tamar Barnea was 27 when her uterus and ovaries were removed in a wrongful, mistaken and negligent manner by then-head of Rambam's Surgery B ward, Prof. Moshe Hashmonai.
A Health Ministry investigative committee concluded that the physicians who conducted the surgery, Hashmonai and gynecologist Prof. Zeev Blumenfeld, mistakenly assumed that Barnea had a metastasized cancerous growth in her uterus that required removal. It was only after the operation, and after the pathological examination that should have been conducted beforehand, that they discovered that she did not have cancer.
As a result of the surgery, Barnea required intensive, regular hormone treatments. She died of breast cancer in July 2004.
Barnea's family was very critical of the committee that recommended the disciplinary action against the doctors as well as how the Health Ministry prosecuted the case.
Hashmonai is now retired. Blumenfled is a senior member of Rambam's Obstetrics and Gynecology Department.
In January, the Barneas took the unusual step of appealing to the committee to ask for a stiffer punishment for Hashmonai and Blumenfeld, to no avail. In their appeal, they wrote that Tamar had died "with the absolute sense that it was the doctors who shortened her life," and that in this case "there is no room for forgiveness." They said the members of the committee must not "turn away from their basic obligation to protect the health of the public from all those doctors who are supposed to understand the gravity of the case and in so doing, prevent the next act of medical negligence."
Prof. Avi Rivkind, the head of the trauma unit at Hadassah University Hospital Ein Kerem in Jerusalem, was appointed to head a committee established to investigate the events at Ramban on the night of May 17, 1999. The committee handed in its findings in January 2000.
They stated that that night, Barnea initially underwent operation for an intestinal obstruction of an unknown nature. Hashmonai was summoned to the operating room. During the operation, Hashmonai spoke with Barnea's husband and told him the obstruction was caused by a cancerous tumor that also affected her uterus, which would therefore have to be removed. Blumenfeld, the senior gynecologist on call, was called in to perform the hysterectomy.
The committee determined that the doctors did not conduct a critical pathological exam, which should have been carried out during the course of the surgery, and as a result needlessly removed Barnea's uterus and ovaries. The post-surgery pathology exam revealed no cancer.
Regarding Hashmonai, the committee said, "His unequivocal conclusion regarding the presence of cancer, based solely on visual appearance, is illogical and inappropriate." The committee recommended harsh disciplinary measures against both Hashmonai and Blumenfeld.
In November 2000 the Health Ministry submitted a disciplinary complaint against the physicians to the disciplinary committee. By law, this committee must include two physicians and a lawyer from the attorney general's office. A Health Ministry attorney, acting as prosecutor, and the physicians' attorneys, appear before the committee. The panel can recommend punishments ranging from a warning or reprimand to a temporary or permanent suspension of the medical licenses of the doctors brought before it.
