Unusual Death Rate Reported at Sheba

The administration at Sheba Medical Center, Tel Hashomer, has restricted the work of three senior surgeons in the cardiac department "to give the patients a real chance," after discovering a "catastrophic" death rate there.

In June 2000, the management at Sheba found that the mortality rate for surgery on heart valves conducted at the department, was two-and-a-half times greater than the average in Britain. About half the patients of one of the three doctors had died during surgery.

In a letter sent in May 1997 by Sheba director, Prof. Mordechai Shani, to the head of the cardiac department, Prof. Aram Smolinsky, Shani notes that "the national statistics point to a catastrophic mortality rate here."

However, Shani told Ha'aretz that "the average mortality rate in the department is in the range of international standards."

According to an investigation completed in March 2000, the mortality rate during operations for repair or replacement of heart valves in the department, in the years between 1994 and 1999, was higher than in most other leading medical centers in the West.

Interim restrictions were imposed on Dr. Yaron Moscowitz and Dr. Zvi Ziskind in 1998. Ziskind, the chief valve surgeon at the hospital, was ordered in May to stop surgery because the death rate among his patients was unusually high.

However, the hospital management was forced to lift the restrictions on Ziskind, as a result of opposition led by the doctor's union, with the backing of the Israel Medical Association.

In July, Dr. Yaakov Lavi, deputy head of the cardiac department, was restricted in carrying out heart valve surgery until a probe on "a drastic raise" in the mortality rate of patients in recent months. According to the data, about half the patients of one surgeon in the department died during surgery.

However, earlier this week, Shani told Ha'aretz that "there is no restriction on Dr. Lavi in terms of the operations that he is authorized to carry out."

Earlier this month, a committee was set up at the Health Ministry to examine the mortality rate during operations carried out by Dr. Ziskind.

The Health Ministry does not normally carry out routine mortality rate checks at Sheba or at any of the other publicly-owned hospitals, despite repeated criticism of the ministry in recent years, both in official and unofficial forums.

The attorney representing Dr. Ziskind, Asher Haled, said that most of the claims of the Sheba administration are not known to his client and they are merely "a collection of lies."

"If what is written is true, Dr. Ziskind should have been kept out of surgery a long time ago and should have been prevented from coming near patients ... but the fact is that Ziskind saves the patients in the department. The trend at Sheba is to avoid operating on seriously ill patients but Ziskind operates on these patients who would be dead if they were not immediately put on the operating table. Two-thirds of them returned home, after long and expensive hospitalization, instead of winding up at the cemetery."