Radiologist and 2 nurses referred to court for death of patient

General Prosecutor Hesham Barakat referred a physician and two nurses accused of manslaughter and negligence leading to the death of 26-year-old patient Heba al-Ayouty to the Criminal Court, state-owned news portal EgyNews reported on Tuesday.

Ayouty’s case was brought to media attention early in June when her family and friends shared her story on social media.

According to a Facebook page, “bringing back her rights,” Ayouty’s private gynecologist referred her to the Nile Badrawi Hospital in Maadi for a contrast X-ray procedure known as a hysterosalpengiograph. On 11 May, the procedure, which involves the injection of a certain contrast dye into the uterine cavity, was conducted by a radiologist called Mohamed Salah.

“The radiologist injected Heba with a caustic fluid instead of the dye required for the procedure. The fluid, horrifically, perforated and damaged her internal organs,” the page added.

Ayouty reportedly suffered from severe pain following the injection, which the radiologist claimed was “psychological.”

“He denied injecting Heba with any substance and refused to resume the contrast x-ray procedure. The radiologist finally, and arrogantly, asked both Heba and her mother to conduct the procedure at another hospital,” the page asserted.

The prosecution’s investigations revealed that the victim went to the Nile Badrawi hospital on May 11, where Dr. Mohamed Salah injected her with a chemical substance handed to him by nurse Doaa Nabil Abdel Magued.

“When the desired effects of the injection didn’t appear, the radiologist inspected the canister containing the injected substance, when he discovered that it had a strong odor, different from the supposed contrast dye,” the prosecution’s report added.

The prosecution also said that, while the contrast dye is supposed to be preserved inside special containers with a distinct red lid to avoid mixing it with other chemicals, nurse Nahed Hussein stored “Formalin” inside one of the dye containers six days prior to the incident. She neglected to report the switch, leading nurse Doaa Nabil Abdel Magued to use Formalin for the procedure without verifying the canister’s contents.

The victim’s family said they received a refund of the fees they had paid, and that medical records at the hospital were deleted “to cover up and remove all paper trails pertaining to her case.”

Ayouty’s state deteriorated overnight and she was rushed to Al-Nakheel Hospital’s emergency room, where two surgeries were performed on her. However, both were unsuccessful and caused no substantial improvement.

Tests conducted by the Egyptian Forensic Medical Authority on samples obtained during the autopsy, including intestinal samples retained at Al-Nakheel hospital, confirmed that the injected Formalin lead to a severe drop in the victim’s blood pressure, abdominal distension, severe non-bacterial inflammation, as well as the failure of multiple organ functions including the kidneys, lungs, and heart, leading to her death.

The forensic report also proved that the Formalin resulted in a severe inflammatory reaction in the small intestine and peritoneum, consequently perforating them and leaking into the abdominal cavity, the erosion of the stomach wall and gangrene in the bowels, which confirms negligence on the part of the radiologist and nurses. 

The victim’s family flew her to Germany on June 7, where “physicians confirmed that the deterioration of her health could have been avoided and her life could have been saved if an immediate lavage was conducted by the Nile Badrawi physicians,” the family’s testimony added.

Ayouty passed away on June 9 in Germany. Investigations confirmed that the victim’s life could’ve been saved had the radiologist performed emergency peritoneal dialysis once he discovered the mistake, to avoid the lethal effects of the Formalin. Instead, the radiologist reportedly left the hospital, declined to answer distress calls on his mobile phone and instructed the nurse not to mention the incident to anyone.

Ayouty’s case is not the only example where alleged medical negligence led to the death of a patient in Egypt. In March, scriptwriter Nadine Shams died following an operation to remove a uterine tumor.

While the hospital reported that her death was caused by a sudden drop in blood pressure, her family and close friends said that her death was the result of a fatal error by the doctor who performed the operation, which allegedly perforated her colon and resulted in fatal blood poisoning.

An initial autopsy showed that Shams died of colon gangrene. However, the Forensic Authority’s report, released on Tuesday, said that Shams’ death was the result of common complications rather than medical negligence. 

Shams’ husband, Dr. Nabil al-Kott, told Mada Masr that he is yet to examine the latest forensic report. However, he believes that the published information “doesn’t make sense, since previous official reports released by the Health Ministry prove otherwise, confirming that her death was the result of malpractice and not expected complications.”

Kott said that he filed a request with the prosecution to form an independent tripartite committee to perform further examination. He asserted that he’s willing to allow further autopsy of the deceased’s body to reach the truth.

He added, “After what we witnessed during this tragedy, we won’t stop fighting until there’s no more negligence in Egypt’s hospitals.”