Despite the patient's complaints of severe pain in his leg as a result of an injury from a nail, the doctors at Wolfson Hospital mistakenly insisted that he was suffering from diabetes, and did not investigate his condition in depth, according to a huge lawsuit recently filed against the hospital.
According to attorney Ran Shapira from the Almog-Shapira law firm, who filed the lawsuit on behalf of the patient, the long delay in diagnosing and treating his client, during which he was discharged home twice, ultimately caused the loss of his foot.
According to the lawsuit, a resident of Holon (51) who owns an aluminum business, arrived at Wolfson Hospital at the end of August 2017, complaining of severe pain and decreased sensation in his right foot. According to him, he suffered for several months from excruciating pain in his right foot, after being stabbed by a nail that penetrated through the sole of his shoe, pains that became severe and unbearable in the last days before he was hospitalized (8 out of 10 on the pain index). In addition, the plaintiff complained of hot flashes, weakness, diarrhea and vomiting.
In the examination conducted, the doctors found that he was suffering, in addition to the pain and symptoms in his foot, from symptoms of inflammation and a sharp decline in kidney function.
According to the lawsuit, the hospital staff ignored the plaintiff's complaints about the condition of his leg, while the doctors claim that he suffers from diabetes and kidney failure, while he knows that he does not suffer from diabetes at all.
The claimant had to be hospitalized, and he was given a dose of intravenous antibiotics. But after several hours, when he was told that a catheter had to be inserted into his bladder, he panicked, felt that his treatment was wrong, and agreed to sign a form refusing hospitalization.
Upon his release, he was advised to undergo antibiotic treatment in the community, and to conduct, at a private institute, a Doppler ultrasound test (a diagnostic test to assess blood flow and measure the direction and rate of blood flow). According to him, after his release, the plaintiff tried to make an appointment for the aforementioned examination, but the closest date he was given was for another three months.
According to Attorney Shapira, despite taking the antibiotic treatment, the pains in his leg did not go away, and even increased, and were joined by waves of heat and weakness, diarrhea and vomiting. Unfortunately for him, the plaintiff returned to Wolfson Hospital, but even then, it was claimed, the doctors continued to neglect his treatment.
In addition to the findings in his previous examination, the doctors diagnosed that he suffers from a rapid pulse without fever, and he was also diagnosed with ischemia of the leg (damage to blood vessels or decreased blood supply to an organ or tissue). According to Attorney Shapira, despite this, the plaintiff was released to his home this time as well with a recommendation for antibiotic treatment and orthopedic follow-up.
And so, about 13 days after his first visit to the Wolfson Hospital, the plaintiff on his own initiative sought the help of his best friend who works at the Ichilov Hospital. In this context, the plaintiff sent her a picture of his foot, and she allowed him to come urgently to Ichilov Hospital.
According to the claim, when the plaintiff arrived in Ichilov, a US Doppler test was immediately performed on him, and a blockage of the distal segments of the right calf arteries was diagnosed. Based on his examination, the doctors in Ichilov informed him that he is suffering from severe necrosis in the foot, and because of this, there is no escape from amputation.
The hospital staff explained to the plaintiff that an amputation should be performed below the knee of the right leg, but before doing so, and since he is not diabetic, they can try and fight for the fate of the leg, to avoid a significant amputation.
According to the claim, this war proved to be successful, and effectively prevented the amputation of the leg below the knee, but it was still necessary to perform an amputation of the foot itself.
Two opinions were attached to the indictment, one by Dr. Yonatan Lehmann, an expert in vascular surgery and the other by Dr. Sergio Marchevsky, an expert psychiatrist.
Dr. Lehmann states in his opinion that when examining a patient with sudden pains, it is necessary to take into account, among other things, the possibility of the results of trauma, inflammatory factors and disruption of the arterial flow.
According to him, despite the plaintiff's complaints, which mainly concerned pain and numbness in the right foot, no mandatory tests related to the evaluation of the arterial flow to the foot were performed at the Wolfson Hospital, no record was made of the color or temperature of the foot, and no pulse test was performed in the ankle (testing for the regularity of the pulse).
In his opinion, Dr. Lehman explains why the claimant signed a form refusing hospitalization at his first visit: “According to the claimant, he was told that he was diabetic and suffering from kidney failure and they asked him to be hospitalized and have a urinary catheter inserted.
The plaintiff did not understand why there was no reference to his complaints of pain in his right foot and why he was told that he was diabetic, when he was not… He was very frightened and asked to leave the hospital. There is no doubt that the medical team had an obligation already in this visit to address the condition of the leg since it was the plaintiff's complaints.”
According to Dr. Lehmann, the medical team should have evaluated the severity of the arterial blockage by using the means found in every emergency room – a Doppler device, an oxygen meter and an automatic blood pressure monitor. Also, there was no urgent consultation with a vascular surgeon, even though the condition of The patient owed it and early treatment would have significantly improved his chances of successful treatment, in a way that could have prevented the amputation of the foot.
The expert states in his opinion that if in the first visit we did not examine the issue at all and he left the hospital, then in the second visit the orthopedist's examination revealed changes suitable for ischemia of the leg, including the absence of a pulse.
“Under these circumstances, of ischemic signs in the patient's leg with complaints of sudden worsening and pain and decreased sensation in the leg, not expanding the investigation in an urgent setting, as well as releasing the patient to his home, is medical conduct that blatantly goes beyond what is required. That is, beyond improper conduct at his first visit, after all Even in his second application, proper treatment would have led to the saving of the leg through correct treatment” states Dr. Lehman in his opinion.
The claimant currently suffers from pain in his right foot, takes painkillers at night and sometimes during the day and has started smoking licensed cannabis. He walks without a brace but is able to walk a distance of 100 meters with a slow limp and then his leg needs rest.
In the opinion, Dr. Lehmann states that for the amputation the plaintiff suffered a disability of 30%, for the damage to his mobility he suffered an adjusted disability of 20% and for the phantom pains (feeling of pain in the amputated limb) he suffered a disability of 20%. All these disabilities are permanently.
In the opinion of Dr. Sergio Marchevsky, an expert psychiatrist, which was attached to the lawsuit, he was asked to examine the mental state of the plaintiff, as well as the relationship between his mental state and the medical events that occurred at the Wolfson Hospital and their results.
In the opinion, he states that his current mental state is suitable for a diagnosis of untreated chronic depression, sleep disorders, post-traumatic stress disorder and adjustment disorders that do not allow him to access treatment for his mental problem.
According to the opinion, the plaintiff feels powerless, hopeless, he is pessimistic and full of guilt for choosing to go to the Wolfson Hospital, due to this diagnosis he states that the appropriate disability for his situation is at a rate of 50%, with a loss of work capacity of 100%, and in light of The continuation of the case must be determined permanently.
According to Attorney Shapira, until the case the plaintiff was an independent man full of joy in life, a father of three children who lived with his partner for 20 years and owned a business. Following the case he left home because he felt a burden and sank into depression, he stopped working and he lives alone.
In the lawsuit, attorney Shapira requests from Wolfson Hospital to compensate the plaintiff with the maximum amount within the court's authority (up to NIS 2.5 million) for medical negligence.
The lawsuit is currently being discussed in the Herzliya Magistrate's Court, a statement of defense has not yet been filed.
The Wolfson Hospital responded: “The statement of claim was filed recently. We will study the case and address it in the legal courts.”
