Panel: ER Treatment at Ichilov Is Flawed

A commission of inquiry has uncovered numerous, and at times serious, flaws in the treatment received by seriously ill patients requiring urgent attention at Ichilov Hospital's emergency room.

An investigation into complaints about the treatment received by journalist Yoram Bronowski, who died of a brain hemorrhage at the hospital in April, has also discovered that important information about the patient's condition is often kept from relatives.

As reported by Ma'ariv yesterday, the commission of inquiry, headed by Professor Eran Dolev, was appointed after Bronowski's relatives complained about the treatment he received from and the attitude of the medical and nursing staff at Ichilov's emergency room. Bronowski, a member of the Ha'aretz editorial board, was admitted to the hospital on April 4 after experiencing difficulty in talking and becoming seriously confused.

After an internal medicine specialist, neurologist, neuro-surgeon and hematologist conducted a series of tests in the ER, Bronowski was admitted to the neuro-surgery ward in serious condition after suffering a brain hemorrhage. He was operated on, but died a few days later.

Bronowski was first examined by Dr. Yossef Reskin, the internal medicine specialist and by neurologist Dr. Yossef Sheinder two hours later. He then underwent a CT scan and an EEG. The commission found that the doctors did not treat Bronowski as an urgent case in need of special supervision, as was required by his condition. Moreover, in contrast to hospital guidelines, an orderly, not a doctor, accompanied the patient to the tests.

The panel also discovered that neither the doctors nor nurses "bothered" to update Bronowski's condition to friends and family who brought him to the hospital, and dismissed one doctor's claim that a member of the accompanying group did not understand Hebrew as "fabricated." The commission of inquiry found that during Bronowski's entire stay in the ER, even when it was clear that it was a case of an emergency, the staff showed a lack of "professional handling of those who accompanied the patient and remained with him."

Though the panel did not say that Bronowski could have been saved had he been classified as an urgent case, it found that "the case warranted a more aggressive attitude," and that, "the patient was only 53-years-old, and the means for improving [his] clotting mechanism quickly were in the hematology department. It is possible that had the case been classified as urgent ... the outcome would have been different, but this cannot be definitely declared, even with hindsight."

Based on the testimony of the head of the internal medicine department, Dr. Jackie Sarov, and the ER's chief nurse, Ayalah Lior, the commission found that when a medical team member is not present, there is a basic problem in the treatment of critical patients in the ER. The panel did not draw conclusions over the doctors who treated Bronowski.

In response to the incident, Ichilov's administration issued new guidelines in August for treating patients in serious condition and at high risk in the ER. Under the guidelines, a nurse is appointed to each serious patient and is charged with organizing the treatment, expediting medical examinations and maintaining constant contact with relatives.

Ichilov Hospital said that its managing director, Gabi Barabash, met with Bronowski's family, presenting them with the report's findings. He also explained that the patient's coagulation system was so serious, that "even if Bronowski had lived, the damage caused to his brain would have been irreversible."