I may’ve spoken prematurely in my last post about Ariel Sharon in saying now may be the right time to let him go. The most recent medical reports in Haaretz say that he’s now breathing on his own and has shown “slight movement” in his arm and leg in response to pain stimulus. But this is a far cry from cognition and Sharon has not yet awoken from his coma. We can only hope that he will recover…certainly not fully, but to the greatest extent possible.
In that previous post, I raised several pertinent questions about the standard of care provided Sharon. Today’s Haaretz ratchets up the debate by indicating that Sharon has a genetic disease that affects blood vessels in the brain, making them more liable to rupture from excessive fluctuations of blood pressure or from the use of blood thinners:
…Sharon received anticoagulant drugs despite suffering from a disease of the blood vessels in the brain which, if diagnosed, would almost certainly have prevented doctors from prescribing these drugs – which are known to increase the risk of strokes and brain hemorrhage. One doctor close to the situation told Haaretz Monday that the disease was diagnosed by doctors treating Sharon at Hadassah University Hospital during his current hospitalization.
The disease, cerebral amyloid angiopathy (CAA) could have greatly increased the risk of a brain hemorrhage, following the administration of the medication that he received after his first stroke Dec. 19, Haaretz has learned.
The diagnosis occurred after examining CT scans Sharon has undergone, according to testimony presented Monday to Haaretz by a medical source involved in the treatment of the prime minister…
The doctor who provided the testimony defined the administering of the blood-thinning medication after the first stroke as a “screw up.”
In the event of such a rupture, the blood thinning medication would make it much harder for the blood to coagulate and stop internal bleeding–precisely what happened to Sharon during his stroke last week.
Everyone agrees that the anti-coagulants contributed or caused his stroke. But now we learn that taking such medication in the the presence of this illness is counter-indicated since such blood vessels are more likely to rupture than normal ones. Further, MRIs of Sharon’s brain taken after his first stroke might have indicated to physicians that he had this condition. Now, doctors will have to go through those images with a fine tooth comb to see if they missed this critical indication. I certainly hope that doctors and Hadassah Hospital will be candid about the outcome of this investigation. Sharon’s family, the nation, and the medical profession deserve no less.
Haaretz also points out that many questions have been raised in Israel about the standard of care prescribed for Sharon:
The medical testimony given to Haaretz on Monday reinforces the questions raised regarding the quality of the treatment and supervision Sharon received in recent weeks, following his hospitalization after the first stroke he suffered.
As reported in Haaretz, senior doctors – including two hospital directors and a senior physician at Hadassah itself – have raised numerous questions since Sharon’s hospitalization regarding his medical supervision over the past two weeks; the administering of the blood-thinning medication; the dosage administered; the medical and laboratory supervision in the wake of administering the blood-thinning medication; and the decision to perform the cardiac catheterization as well as its timing.
Haaretz also quotes a “senior doctor” (whatever the hell that’s supposed to mean) acknowledging there might’ve been a major screwup:
“If the image facilitates identifying the illness and this wasn’t done, then it appears that we are dealing with a significant failure on the part of Hadassah,” the doctor said. “However, it is important to note that it is difficult to diagnose this illness by means of computer imaging only.”
I don’t know if there is medical malpractice in Israel. But if there is, Sharon’s two sons should consult attorneys about this matter. With the caveat that I am not a doctor, I have a strong suspicion that the standard of Sharon’s care was negligent.