The death of eight patients due to open-heart surgery at one of Egypt's main cardiac centres caused a panic, Reem Leila investigates Prosecutor-General Abdel-Meguid Mahmoud initiated an urgent investigation on 1 April into the mysterious death of eight heart patients in a hospital at the Delta city of Mahala Al-Kubra. The patients, whose ages were between 50 and 65 years, died in the Intensive Care Unit (ICU) of the Cardiac Centre located in Mahala between 12 and 21 March following severe brain haemorrhaging and renal failure, after undergoing open-heart surgeries at the centre. Four of the eight died on one day. Minister of Health and Population Hatem El-Gabali convened a high-ranking committee headed by Dr Adel El-Banna, chief cardiology surgeon at the Cairo Cardiac Institute. Dr El-Banna, who refused to comment on the incidents, is empowered to investigate the entire issue and look into violations that may have led to the death of the eight victims within 10 days of each other. Abdel-Rahman Shahin, official spokesman to the health minister, stated that head of Mahala Cardiac Centre Dr Mahmoud Hamza and his deputy Dr Mohamed Qinawi were suspended from work, the centre's blood bank was shut down. Hamza was replaced by Dr Ahmed Badran. Shahin confirmed that as soon as the Health Ministry received reports on the deaths, all open-heart surgeries at the centre were banned between 17-23 March. Despite the fact that the issue is still under investigation, Shahin assumed that the heparin (anti-clotting medicine) Protamine Sulphate or blood platelets might be the reason behind the deaths. Five of the eight were operated on again the next day after the operation due to severe bleeding. Open-heart surgeries resumed at the centre on 24 March and by the end of the month, 10 open-heart surgeries were conducted using Protamine Sulphate from different batches while blood platelets were brought from Cairo's blood bank. "All 10 patients survived the operation and their condition is stable," Shahin revealed. "The incident is still under investigation; the ministry has nothing now except assumptions." Mahala Cardiac Centre opened in 2000 and has undergone 2,400 open-heart surgeries. Some 320 operations took place there during the past year with 10 fatalities, and 142 procedures since the beginning of 2008 until the end of March. According to Shahin, the percentage of successful operations is between 90 and 95 per cent, which is "fully compliant with international standards". The centre serves all 27 governorates, and "despite the eight recent deaths, has proven a great success," he asserted. But several members of parliament have brought up the issue in parliamentary discussions, demanding that El-Gabali specify the exact reasons behind the deaths and punish those responsible. MP Saad El-Husseini asserted that families of the deceased were threatened not to report the issue to the authorities or the hospital will not hand over their relatives' corpses. "Out of fear, people reported the deaths after the funerals," revealed El-Husseini. He added that several administrative and medical violations have been committed at this hospital, since surgeons had asked the families of the deceased to buy medicine and blood bags out of their own pockets, which is a clear breach of the state-funded health system. Adel Muawad Azzam, whose father died at 65 after surgery, stated that the surgeon who did the open-heart operation asked him to buy two anti-coagulant bottles at LE450 each and blood platelets worth LE250 to save his father's life. "But my father died on 20 March anyway, despite the expensive medicine I bought," stated Azzam. In the meantime, lawyer Afifi Abu Zeid has pressed charges against the centre's director Dr Hamza and his deputy Dr Qinawi, to stand on the overall circumstances of the deaths in order to identify whether there was administrative or medical negligence. According to Dr Qinawi, there are three types of healthcare at the centre -- state-funded, medical insurance or economic. Insurance and economic healthcare cover all costs, while state-funded does not include blood bags, platelets and certain anti-coagulant medicine. "In such cases, the hospital asks the patient or his family to buy the required medication," he explained. "There is no other option."
