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Ariel sharon second stroke caused doctors

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Last update - 11:42 06/01/2006
Hospital director: Letting Sharon go to Negev farm was negligent

By Ran Reznick, Amos Harel and Aluf Benn, Haaretz Correspondents

Several senior doctors raised a host of questions Thursday about the standard of treatment Ariel Sharon has received over the last two weeks, with the director of a large hospital telling Haaretz that according to the media reports on Sharon's medical treatment, he fears "there was indescribable negligence."

The questions cover the period from Sharon's first stroke two weeks ago to his arrival Wednesday night at Jerusalem's Hadassah University Hospital, Ein Karem, where he is being treated for a severe stroke and cerebral hemorrhage. They pertain to the supervision over Sharon's physical state, following the blood-thinning medicine he received after his first hospitalization.

Such supervision is essential, as these medicines could cause a cerebral hemorrhage, like the one Sharon suffered. Questions were also raised about the dosage he received.

"Yitzhak Rabin was not wearing a bulletproof vest that could have protected him from the murderers' bullets, and now, 10 years later, Sharon was not given the required medical treatment that could have saved him," the hospital director said. "Israel has not learned the lesson from Rabin's murder, and thus lost two prime ministers because of inadequate protection - one from weapons, the other from illness. I cannot understand how the prime minister could have been sent to stay in an isolated farm, more than an hour away from the hospital he was supposed to be treated in, two weeks after a stroke and one night before a heart procedure he was afraid of."

Sharon was slated to undergo a cardiac catheterization procedure Thursday to fix a small hole between the chambers of his heart that doctors said contributed to his initial stroke.

"A night before the catheterization he should have been hospitalized in Hadassah or at least made to stay in Jerusalem," the director said. "I also have questions about the dosage of blood-thinning medication he received. My feeling is that Sharon did not get the best medical treatment he deserved."

A senior doctor told Haaretz that "Sharon's medical condition was iatrogenic - that is, induced by treatment of physicians, as it was likely that the blood-thinning medicine Sharon was receiving had caused the severe brain bleeding."

According to the doctor, "Clearly, Sharon needed complete rest at least until the catheterization, as anyone who had undergone a stroke would. But it is hard to say that Sharon's refusal to rest caused the hemorrhaging."

Another senior doctor said he suspected "Sharon's treatment was partly faulty because he fell victim to the political-media spin intended to show the public he was back to work as usual."

"He paid a high price for this spin," the doctor said. "My concern is that non-professional considerations dictated the chain of medical events. The doctors took a dangerous but calculated risk when they gave him blood-thinning drugs at home instead of in the hospital under full supervision. But he should have been kept under constant supervision and certainly not allowed to return to work as usual."

However, several other senior doctors told Haaretz on Thursday that the treatment Sharon received in the last two weeks was correct and adequate under the circumstances.

Several questions have been asked this week regarding the standard of treatment Sharon has received: How much time elapsed from the moment Sharon told his son, Gilad, he wasn't feeling well to the arrival of his personal doctor at Sycamore Ranch? Why wasn't there a doctor at his side since the first stroke, especially on the eve of the catheterization? Why wasn't Sharon taken to the hospital by helicopter? Why was he taken to the distant hospital in Jerusalem, rather than to Be'er Sheva's Soroka Medical Center? To what extent did the treatment Sharon received after the first episode account for the hemorrhaging?

Sharon's aides said nobody thought he was in danger when he left his office for Sycamore Ranch on Wednesday afternoon. The paramedic of the Shin Bet security service's VIP protection unit, who was always at his side, accompanied him.

According to the initial plan, a doctor was to be with him after the catheterization, when he returned to convalesce at the ranch.

Since his release from Hadassah on December 20, after the first incident, Sharon was frequently examined by his personal physician, Dr. Shlomo Segev, who also administered his blood tests. Sharon did not complain of pain or feeling bad.

The chief cardiologist at Hadassah, Professor Haim Lotan, who was supposed to perform the catheterization, visited his office on Tuesday. Sharon received two Claxon shots a day intended to thin his blood and prevent blood clots and a recurrent stroke. He received the last shot on Wednesday morning, so that its effect would wear off before the heart procedure.

When Sharon felt unwell on Wednesday, his personal physician was called in from the center of the country. According to one version, he arrived at the ranch just as Sharon was being put into an ambulance, and joined him on the trip. According to another version, he met the convoy at the Masmia junction on the way to Jerusalem.

Sharon's aides, who pieced the event together, said Sharon did not want to be taken to hospital. He said he was due at Hadassah for the procedure the next morning anyway. Apparently, his son, Gilad, and the Shin Bet paramedic convinced him to go anyway. Even when in the ambulance, he told Segev he wanted to turn around and go the following morning.

Segev, who refused to comment Thursday, was under the impression that Sharon had suffered another stroke, which was worse than the first one. He decided to proceed to the hospital in the ambulance rather than scramble a helicopter. He feared that the movement of the helicopter would harm Sharon more than a few more minutes in the car.

Apparently, Segev was the one who decided to take Sharon to Hadassah rather than to the closer Soroka center. The trip to the hospital took 55 minutes, during which Sharon's condition deteriorated.

Doctors asked why Sharon wasn't required to stay in his Jerusalem residence instead of the ranch, at least while he was being treated with Claxon and until the procedure to mend the hole in his heart had been performed. Why wasn't a senior doctor at his side at all times, one who could have administered immediate treatment when the deterioration began?

Some of the questions suggest that Sharon and his aides' desire to show that the prime minister had returned swiftly to his daily routine resulted in inadequate treatment and supervision.

The senior doctors asked why Sharon's physicians had not insisted that he take a significant rest after the first stroke, as they would have done with any other patient. They asked to what extent political and media considerations were involved. They also asked why the catheterization was not performed earlier.

Other questions refer to why it took about two hours from the time Sharon felt unwell at his ranch to the time he arrived at the hospital emergency room at about 11 P.M., and why he wasn't taken to Soroka for preliminary treatment at least.

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