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Israel's largest health maintenance organization must defend in court its decision to deny a patient expensive medical treatment, after the patient filed a lawsuit this week.

Eliezer Grievski, 60, from Kfar Sava, told the Tel Aviv Magistrate's Court that a senior manager at the Clalit HMO made "an unreasonable decision" not to cover a costly medical procedure for Grievski, who suffers from a heart condition. A few weeks later, Grievski had a heart attack.

Spokesmen for Clalit said the organization will study the lawsuit and respond in court.

Grievski claims that by denying treatment recommended by other specialists, Dr. Nicky Lieberman, head of Clalit's medical division, caused him serious physical and mental damage. "Lieberman's decision stemmed from foreign and improper considerations," the lawsuit says.

Last March, Grievski was rushed to hospital after going into cardiac arrest. His neighbors saved his life by performing cardiopulmonary resuscitation on him. Grievski says he has not fully recovered, and still suffers from severe memory loss, concentration problems and acute fears and phobias. One month after his cardiac arrest, he underwent an operation to implant a pacemaker in his chest.

But only weeks before his heart attack, Clalit refused to cover the procedure, despite an expert opinion that Grievski needed a pacemaker. Last January, Dr. Israel Shetboun, a senior cardiologist, recommended implanting a pacemaker in Grievski's chest. Grievski has suffered from chronic cardiac problems for many years.

Shetboun submitted his recommendation to Lieberman in February, but Lieberman - who is not a cardiologist - determined Grievski did not meet the criteria for a pacemaker.