'Healthy' swine flu victim hospitalized nearly a week before death

Swine flu claimed its 13th Israeli victim yesterday, a 27-year-old woman who was otherwise healthy. In all but one of the other 12 deaths, the patient has had other illnesses that may have contributed to or even been the primary cause of death.

Vered Geiron-Basson of Rishon Letzion developed symptoms of the disease about a week ago. Last Tuesday, she went to the emergency room at Assaf Harofeh Hospital in Tzrifin with a cough and fever. But after conducting various tests, including a chest x-ray, doctors found no sign of any damage to her lungs, so they sent her home.

By Friday, she was worse, so she went back to Assaf Harofeh. This time, a chest x-ray found irregularities in her lungs, so she was hospitalized in the internal medicine ward as a suspected swine flu case. She was given Tamiflu and antibiotics, and as of 6 A.M. yesterday, she was conscious, in stable condition and breathing easily.

But two hours later, when she was checked again, she was dead. Doctors tried to resuscitate her, but without success.

Later that day, the results of a blood test she had done at a local clinic confirmed she had swine flu. An autopsy concluded that she died of pneumonia as a complication of swine flu.

Geiron-Basson had none of the factors that would have made her a high-risk patient, such as chronic illness. According to the Health Ministry, however, she smoked and was overweight, though not obese, and this put her at higher risk than a thin nonsmoker.

Nevertheless, "it is not common for a young person who is not chronically ill to die of this complication [pneumonia]," said Dr. Ofra Havkin, acting head of the ministry's public health services department.

"For most people, swine flu is a minor illness," added Prof. Dan Engelhard, head of the ministry's epidemiology department. "Data from the United States and Canada show that between 10 and 15 percent of those who die of swine flu are not patients with known risk factors. But one must remember that it is very rare for completely healthy people to die of this disease."

In contrast, he added, it is vital for high-risk patients to receive proper treatment quickly.

Family claims hospital at fault

Geiron-Basson's family blamed the hospital for her death.

Miriam Geiron, interviewed from her Carmiel home, said that after her daughter returned from Assaf Harofeh the first time, she told her mother that doctors had told her, "you don't have anything; go home and take liquid Optalgin [an analgesic]."

Only when she returned to the hospital on Friday, Geiron said, was her daughter diagnosed with pneumonia and swine flu and hospitalized.

Her family stayed with Geiron-Basson in the hospital over the weekend, and on Saturday, they said, the on-call doctor in the internal medicine ward decided that her situation had worsened enough to warrant consulting a doctor from intensive care.

But the latter decided that there was no need to transfer her to intensive care - and the next morning, she died.

"This isn't the time to go into it, but there appears to have been medical negligence here," Miriam Geiron said.

In response, the hospital's deputy director, Dr. Yitshak Sharf, noted that the first chest x-ray, last Tuesday, found no injury to Geiron-Basson's lungs, nor did she meet any of the Health Ministry's other criteria for hospitalization.

On Friday, when another chest x-ray did show signs of pneumonia, she was promptly hospitalized and given all the standard medications.

Moreover, he said, she was checked periodically by the ward's medical staff, and each time, her condition was stable, so there was no need to move her to intensive care.