Sima Biton-Yehuda from Nitiv was only 30 years old when she bled to death in her home, just one day after she was released in a "negligent, hasty, imprudent, unreasonable, premature and without a doctor's examination" from the Otolaryngology Department at Barzilai Government Hospital in Ashkelon, after who underwent tonsillectomy surgery. Until the surgery, Sima was completely healthy except for recurrent tonsillitis which brought her to surgery, and she and her husband Shlomo raised their daughter Shili, now two years old. From now on Shlomo will raise his daughter with his parents in Ofakim.
The case of Sima's tragic death in December 2021, revealed here for the first time, arises in the medical negligence lawsuit that was filed about a week ago against the Ministry of Health and Barzilai Hospital to the Central District Court in Lod.
The lawsuit demanding financial compensation was filed by Shlomo Yehuda and his daughter Shali Yochaved Yehuda.
In addition, back in March of this year, the family appealed to the Ministry of Health with the demand to establish a committee to investigate the affair.
The family is represented by attorney Shay Feuering, one of the most prominent lawyers in Israel in representing victims of medical malpractice.
The late Sima, Shlomo and Shi-Lee. In the days if the family was alive,
In the statement of claim, Attorney Feuering made very serious allegations about the functioning of the medical staff at the Otolaryngology Department in Barzilai under the direction of Dr. Yehoshua Ben Zion and the conduct of the medical staff, from the surgery to the quick release of Sima to her home.
"The writing was on the wall," the lawsuit claims, "the unnecessary death of the deceased could easily have been prevented if the hospital had acted in a careful, reasonable and reasonable manner and if they had identified the source of the bleeding immediately after the operation, taken steps to minimize the cough she was suffering from and certainly if they had They leave her under observation at the hospital."
She complained in real time
Sima was admitted on Thursday, December 23, 2021 for planned (elective) tonsillectomy surgery in the otolaryngology department at Barzilai Hospital.
According to the statement of claim and according to the record in the medical file, the operation was performed as the responsible surgeon by the senior doctor Dr. Vladimir Trushin and she was operated on using a heating device (diathermy) in order to make the incision and stop the bleeding. With this method of surgery there is a higher level of risk of bleeding and it requires increased caution and attention Heart of the medical and nursing staff for any bleeding that is discovered in the patient after the operation.
According to the lawsuit, immediately after Sima was transferred from the operating room to the recovery room, she had a significant burst of blood of 50 cc and she herself told in real time to her sister Efrat Biton who accompanied her throughout the hospitalization: "I coughed in recovery and it came out full of blood and they probably realized that it was out of control." However, despite this, she was not then examined by the surgeon or by an otolaryngologist.
According to the lawsuit, instead of returning Sima to the operating room and calling senior doctors to check and treat the potentially dangerous bleeding, she was only treated once with a drug that prevents the dissolution of blood clots and was transferred to the hospital ward with an order that she should stop coughing.
Even worse: even though she was prone to repeated bleeding, and even though she continued to cough, thereby endangering the stability of the blood clot around the surgical area.
Already that evening at 19:35, the specialist doctor in the ward, who was completely unaware of the bleeding that happened to Sima, rushed to write her the discharge letter to her home.
In the letter itself it is explicitly stated that she did not bleed at all!
However, not only did Sima bleed after the operation, but according to the lawsuit, during the night she continued to cough and she feared that the bleeding would return.
Sima asked her sister to help her ask the medical staff for treatment that would prevent the coughs, but "unfortunately, her repeated pleas for cough treatment were completely ignored and she was discharged on Friday morning hastily and carelessly, about 18 hours after the operation, with the discharge letter written the night before and without being checked on by some doctor before her release."
About this, Sima told her sister Efrat the day after her release from the hospital that "she is in pain and she doesn't stop coughing, and that when I was released from the ward, no doctors came to me at all, only a nurse came and released me."
Vague answers
On Saturday night, the day after her release from the hospital, the worst thing happened: she started bleeding massively from an arterial blood vessel in her throat.
She was rushed by ambulance to Soroka Hospital in Be'er Sheva, where she was admitted to the intensive care unit with a severe brain injury. She was pronounced dead 4 days later.
The statement of claim relies on the opinion of Dr. Yoram Gurevich, a senior doctor in the otolaryngology department at Shaare Zedek Hospital in Jerusalem. According to the opinion, "there was room to keep Sima under observation at the hospital for a few more days to minimize the chances of the delayed bleeding if She lied and this is also because of the use of the surgical technique which carries more bleeding risks than any other method, in light of her older age which carries bleeding risks and in a more massive way and in view of the early bleeding she had near the end of the surgery which was not treated surgically but with medication.
Unfortunately, the necessary precautions were not taken in this case, and it can be said that if the bleeding had occurred while she was hospitalized, her chances of being saved would have been almost certain."
Prof. Hezi Levy, director of Barzilai Hospital, photo: Yehuda Peretz
Sima's family not only filed the lawsuit, they also demand to finally receive answers about what happened from the management of Barzilai Hospital, the senior doctors in the department and the Ministry of Health.
According to them, so far they have only received evasive and vague answers, some of which even contradict the documentation in the medical file and Sima's words in real time.
For example, it is claimed that the surgeon, Dr. Trushin, told Sima's husband after her death that "she did not bleed in the ward after the operation, that is what I know.
Maybe there's something I don't know and I'm sure she left Barzilai in good general condition, if there's a complication they don't release her and if she wasn't fine she wouldn't have gone home the next morning, right?"
Prof. Hezi Levy, the director of Barzilai Hospital, responded: "Sima Biton was operated on at Barzilai Hospital on 12/23/21 and underwent a tonsillectomy. She was operated on as usual and remained for observation in recovery for several hours and was also given a preparation that encourages blood clotting. The next day she was examined again and released to her home as usual , with no evidence of bleeding. She was referred to the Soroka Hospital on 12/25/22 with a low hemoglobin count and in a repeat examination no blood was found from the tonsil bed, and later unfortunately she died.
The risk of bleeding due to tonsillectomy is up to 5% and the risk of mortality is 1:20,000.
Unfortunately, the patient passed away.
There are several accepted methods of tonsillectomy.
We performed a professional internal inspection of the entire process, including the recommended methods for performing the surgery and the adjustment of the appropriate method to the operated patient.
"Of course, the incident was reported to the Ministry of Health as soon as Soroka Hospital reported it to us. The incident is in the process of a lawsuit, and therefore because of this, and due to its confidentiality, we cannot now add more than that. We express our sorrow and offer our condolences to the Beaton family."
The Ministry of Health responded: "The complaint is being thoroughly examined. We are in direct contact with the family and will update them on the procedure, as usual."
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