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Violations of Art. 6 par 1 - Page 7
Alleged violation of Article 6, par. 1
The second ultrasound examination was performed at 1:00 p.m. that is also proved by the testimony of witnesses. Exactly, as a result of this exam the liquid, allegedly blood, was detected in the patient's abdomen that was duly recorded (see the attached Annex A.. - case history). The expert in ultrasound examination Gia N. testifies: "the second ultrasound examination was over at 12:50". "I recorded the examination results at 13:00 o'clock on a separate sheet". "I told Tina Sv. that there was some liquid, allegedly blood, in the abdomen and that the patient needed to be operated. I could not determine the bleeding source by ultrasound examination".
Gia N.'s behavior was logical, when he informed Tina Sv. about the examination results, because exactly Tina Sv. was responsible for the patient and her treatment, including providing surgical intervention.
Only paragraph 7 of the bill of indictment demonstrates really the patient's medical condition and necessity of surgical intervention, because only after the second ultrasound examination, i.e., from 13:00 p.m. it became evident that the patient needed an operation, failure of which would absolutely cause the patient's death.
Pursuant to the investigation materials and uncontradicted evidence the investigation could easily ascertain, who was responsible for the patient within that period, who was supposed to conduct an immediate operation and who was responsible for delay of such surgical intervention for 2 hours after the second ultrasound examination results became available.
If one summarizes the merits and evidence of the case, it will become clear that the prosecutors' office should answer these questions very easily. But as it seems, if they did so, from one hand, they would prevent a minister of healthcare and social welfare in passing so-called "reforms", and from the other hand, they would have to emphasize their protégé Dr. Tina Sv.'s guilt and really punish her instead of the applicants.
For this reason, the prosecutors' office makes absolutely baseless, illogical and, lightly said, biased conclusion in paragraph 8 of the bill of indictment:
"N. Lobzhanidze together with the gynecologists Z. Oboladze and Tina Sv. has neglected Article 38 of the law of Georgia on healthcare, according to which she was responsible for providing an emergency medical care to the patient Guliko M being in a life-threatening condition, i.e., for making a precise diagnosis and conducting an adequate treatment. N. Lobzhanidze could not make again a precise diagnosis (the bleeding developed as a result of the burst of the right ovarian tube provoked by the abdominal pregnancy) without a reasonable excuse, did not determine the type of the liquid detected in the patient's abdomen, did not perform an immediate operation that caused the patient Guliko M's death at 15:50 o'clock". (See the attached Annex A.. - bill of indictment).
The applicants would like to state again that the reason of such a detailed analysis of the bill of indictment was that all these arguments and statements of the prosecutors' office were absolutely shared by the courts, which declared the applicants guilty by neglecting all the case materials and uncontradicted evidence.
It is very interesting if one can find such a masterpiece somewhere else in the world jurisprudence. It is also interesting, which is the logic that the investigation, the prosecutors' office and the court followed, when having proved the first applicant's guilt, nothing said about the second applicant, whose connection to this tragedy is still ambiguous.
Therefore, the applicants would like to analyze the case materials and summarize their obligations and relevant actions undertaken by them on 22 September 2005.
The first applicant:
- He was called for consultation to patient Guliko M. at 04:15
- Based on taken anamnesis and blood test results ordered by him, he made a preliminary diagnosis: "postabortal acute endometritis? pelvioperitonitis?" (accompanied by question marks) that proves that this was a preliminary diagnosis and not a final one
- In order to exclude the preliminary diagnosis and according to the treatment strategy he made a decision about curettage, because as the patient reported she had an abortion ten days ago at home and she could have some residuals
- He performed curettage assisted by the second applicant, who entered into the manipulation room after a nurse told her that the first applicant needed some strong antibiotic for her neighbor
- After having performed curettage, the first applicant prescribed antibiotic infusion therapy and conducted the patient's clinical observation during the whole period of his duty
- At 07:00 he made a second blood test to the patient, which was almost identical to the first one, where only those blood components were increased, which indicated inflammation process. Hemoglobin, which is the first and main indicator of anemia, was normal
- At 09:30 a.m., i.e., after the first applicant's duty was over, he examined the patient again and evaluated her state as of a mean gravity
- At 09:45 a.m. he handed the patient over to manager of gynecology department Dr. Tina Sv., who was then responsible for the patient
- At 10:00 a.m. the first applicant joined the morning conference, where he reported shortly about Guliko M's state of health and stated that he had already handed the patient over to Tina Sv. by observing the hospital's internal order. Tina Sv. did not attend the morning conference
- Despite the fact that the first applicant's working hours were over, he still remained with the patient in order to provide her with assistance and stayed at the hospital all the time, until she died
- Because the first applicant saw that the patient's operation was delayed, he told Dr. Tina Sv. several times that he was ready to perform operation and take over all responsibility for its success. Though, Dr. Tina Sv. categorically refused him for the reason that he had no right to perform any operation
- Even when Guliko M died in the operating-room and the surgeons left this place in order not to meet with the patient's relatives, the first applicant showed his conscientiousness and informed the patient's family members about her death
Now, the first applicant puts a question: Which of the above actions does fall within the prosecutor's conclusion made in paragraph 8 of the bill of indictment? Where can his inaction be observed and, especially, when did he leave the patient in danger and refused her treatment?
First of all, patient Guliko M was in a life-threatening state not at the moment of her admission to the hospital, neither before the first applicant terminated his working hours at 10:00 a.m., which is proved by testimony of witnesses (see the attached Annex A.. - testimony of B., M. and Ch.). The patient's medical condition became grave afterwards, from 10:25 a.m. on and especially after the second ultrasound examination, which has detected much free liquid in her abdomen. Exactly starting from this moment it became evident that the patient needed immediate surgical intervention.
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