"A large part of the heart was in danger": Doctors performed catheterization in the wrong order — the patient was left with severe brain damage
In a lawsuit filed against the Galilee Medical Center in Nahariya, it is claimed that during a catheterization, the team of cardiologists acted in an order different from that described in medical practice, which caused severe physical and brain damage to the patient. His condition continued to deteriorate until he suffered cardiac arrest and required resuscitation. The expert opinion states that "he became nursing-dependent, bedridden, and completely dependent on others for routine activities."
A., 72, from the Galilee, arrived at the Galilee Medical Center in Nahariya after suffering from chest pains for two days. Tests revealed an acute myocardial infarction, and he was hospitalized in the intensive cardiac care unit for an urgent catheterization. In a medical malpractice lawsuit filed by attorney Ran Shapira on his behalf against the medical center, a chain of errors is described that, apparently, led to his severe injury.
According to attorney Shapira, the catheterization performed the following day showed that A.'s right coronary artery was completely blocked by a chronic obstruction, while the left anterior descending artery — a central artery in the blood supply to the heart — had narrowed by about 90 percent.
Dr. Yoel Obil, a specialist in cardiothoracic surgery, whose expert opinion was attached to the lawsuit, determined that in such a situation, about 70 percent of the muscle mass of the left ventricle is in danger. According to him, medical literature requires opening the left anterior descending artery first, a procedure that would have improved blood supply to both the front area of the heart and, through collateral flow, would have provided oxygen to the lower area that was already damaged.
The catheterizers acted in reverse order
However, according to the lawsuit, the medical team chose to act in the opposite direction and tried repeatedly to open the right coronary artery, even though it was a chronic obstruction with significantly lower chances of success. These attempts failed, and the left anterior descending artery was neglected and remained blocked.
It is also claimed that after the catheterization failed, A.'s condition deteriorated rapidly: he developed pulmonary edema and life-threatening arrhythmias, required ventilation, and due to impaired kidney function, he later also required dialysis.
According to Dr. Obil, the situation required urgent action. The heart muscle continued to suffer from a lack of blood supply, the blood circulation was unstable, and a large part of the heart was in danger. In the expert opinion, the expert argued that according to the American Heart Association guidelines, in such a situation, there is little room for physician discretion. An urgent bypass surgery must be performed, and an intra-aortic balloon pump should be used — a device inserted into the artery that temporarily helps the heart pump blood and reduces the load until the surgery is performed.
However, the surgery was not performed. Moreover, when A.'s transfer for surgery to another hospital was planned, it was recorded that the transfer was delayed due to a fever. Dr. Obil added that a fever does not justify delaying a life-saving surgery and that such a decision does not correspond to reasonable medical care.
According to him, if A. had been connected to an intra-aortic balloon pump and transferred for surgery within two to three hours, it would have been highly likely to prevent his further deterioration.
Irreversible damage
According to attorney Shapira, A.'s condition continued to deteriorate until he suffered cardiac arrest and required resuscitation. After the anesthesia was stopped, he did not regain full consciousness, and tests found that he had suffered severe brain damage due to a lack of oxygen, along with severe weakness in the left side of his body and cognitive impairment.
A few days later, A. was transferred to Sheba Medical Center. There, according to the lawsuit, the procedure that the expert claimed should have been performed from the beginning was carried out: the left anterior descending artery was opened using a stent with full success.
But according to the claims, the correct treatment performed at Sheba was provided with a delay of about three weeks, after the brain damage had already become irreversible.
A neurological expert opinion by Dr. Sergio Reuven Eichenbaum was also attached to the lawsuit, stating that A. suffers from severe weakness in the left side of his body, severe cognitive impairment, and significant memory impairment. He became nursing-dependent, bedridden, and completely dependent on others for routine activities. His weighted medical disability was estimated at about 89 percent.
"The best proof of negligence is in the medical file itself," says attorney Ran Shapira. "The same procedure that the expert determined had to be performed in Nahariya was performed at Sheba about three weeks later — and with full success. But in the meantime, my client suffered cardiac arrest, resuscitation, and irreversible brain damage. From a completely independent person, he became nursing-dependent and dependent on others."
In the lawsuit, attorney Shapira asks to compel the Galilee Medical Center in Nahariya and the Ministry of Health to compensate A. in an amount of no less than 2.5 million shekels. A statement of defense has not yet been filed.
Galilee Medical Center stated: "Upon receipt of the statement of claim, the hospital will study it and respond to the lawsuit using the accepted legal tools and not through the media."
