Report: Bnei Brak Hospital Operating Rooms Are Dangerous

A shortage of anesthetists and registered nurses in the operating room and deficiencies in basic infrastructure at Maayanei Hayeshua Medical Center in Bnei Brak (MYMC) endanger women undergoing Caesarian sections and other patients, a Health Ministry review found.

The results of the review, reported here for the first time, were submitted to the Health Ministry and hospital's administration in July 2006. The hospital claims that every single problem has been corrected, but a senior ministry official told Haaretz yesterday that some of the major deficiencies remain.

The review found a long series of failings in the hospital's functioning, some unnecessarily endangering patients' lives and some entailing deficient treatment, in violation of Health Ministry directives. Among other things, the review found "increased and unnecessary risk to patients in need of anesthetizing and recovery at the hospital during the afternoon and night, due to failure to comply with Health Ministry orders and procedures concerning personnel."

MYMC has 223 hospital beds, and caters to the religious and ultra-Orthodox residents of Bnei Brak. According to hospital data, some 7,000 births and 3,000 operations and surgical procedures take place there annually, including some 1,000 Caesarian deliveries. The medical director is Professor Mordechai Ravid; professor Mordechai Shani, a former Health Ministry director general and director of the government-owned Sheba Medical Center, Tel Hashomer, is designated "Hospital rector."

The review findings contradict Ravid's statement to ministry officials at the time of the review that "all the doctors employed at the hospital, including those on call, are experts."

The oversight report on the hospital sums up four routine inspections (one of them a surprise inspection) that the Health Ministry conducted in 2005 and 2006. Statements made by the ministry official in charge of inspections, Dr. Michael Dor, at a medical conference last May in Ramat Gan indicate that the ministry conceals the findings of its reviews from the public, in keeping with a promise made to the hospitals and health management organizations.

The review found that the anesthetists on call for the operating room have "at best" completed the first stage of their specialization and "sometimes have not even taken those exams." The duty resident, a senior anesthetist, "is usually not called." The review states that "anesthesia administered by an anesthetist who is not an expert, especially if he has not taken the first-stage exams, without an expert anesthetist being present, endangers the patient. This is particularly the case during Caesarian sections, where general anesthesia is among the most dangerous sort. Therefore the presence of at least one expert anesthetist is paramount."

An anesthetist, who is not the doctor in the operating room, must also be present in the recovery unit, and "an experienced doctor" must be the one to release patients to the wards, the report states.

The report also warned that the hospital does not have an active blood bank, making it potentially difficult to meet emergency needs at peek times.

The number of nurses on staff "has decreased to a minimum," the review found: there is a shortage of nurses in the hospitalization wards, especially in delivery and operating rooms. Furthermore, nurses do not undergo refresher courses on CPR, and "an atmosphere of frustration" is rife among them.

The review also discovered that staff needs for operating rooms "do not meet safety requirements." Beginning at 3 P.M., there is no nurse in the recovery room attached to the operating rooms, despite the many surgeries performed in the afternoon and night. Instead, nurses are brought in as needed, some of them "practical nurses," "not one of which has the appropriate skills."

In addition, the review cited a long list of safety violations involving "rusty equipment" and a "low level of cleanliness" in the pediatrics ward, including a kitchenette used to prepare baby food, and carts containing dirty laundry situated near the kitchen.