Dubai's health regulator has launched an urgent investigation after a young Emirati woman fell into a coma during a routine nose surgery.
The patient, 24, is understood to have suffered significant brain damage after medics at First Med Day Surgery Centre Dubai failed to spot a rapid and sustained drop in blood pressure.
Officials from Dubai Health Authority said an initial investigation had revealed malpractice by both the surgeon, identified by the initials SH, and anaesthetist, SE.
In a statement on Thursday, it said the centre in Muraqqabat in Deira has been ordered to stop conducting any surgeries until the investigation was complete.
The two doctors were also ordered to stop practising medicine, with authorities saying legal action would be taken against anyone who risks the lives of patients.
Oxygen also stopped reaching her brain, which caused her heart to stop for several minutes and put her into a deep coma - which she is yet to wake up from
One of the doctors involved in the botched operation was detained by authorities trying to leave the UAE, according to Arabic language media.
Dr Marwan Al Mulla, chief executive of the DHA’s regulation department, said the organisation had begun legal proceedings against the medics.
The authority’s preliminary investigation revealed that the Emirati woman attended elected nose surgery the centre to correct a deviated septum - a routine surgery that typically lasts two hours.
“The patient suffered from a severe drop in blood circulation and blood pressure. Oxygen also stopped reaching her brain, which caused her heart to stop for several minutes and put her into a deep coma - which she is yet to wake up from,” the statement read.
DHA said the woman’s medical files and history showed she did not suffer from cardiovascular or vascular diseases prior to her surgery.
Its investigation revealed medical negligence in the management of the case by both physicians. It said the doctors did not follow correct medical procedures for surgical intervention prior to the surgery, such as conducting a thorough medical examination before the surgery by a sufficient period.
It also found that the patient’s clinical case was not accurately documented by the anaesthesiologist in her records of the surgery. The files did not include records of the patient’s vital signs while the patient’s oxygen levels dropped and her heart stopped.
The anaesthesiologist also did not record the time he gave the patient the anaesthesia or what her vital signs were prior to administering the drug.
DHA said this created problems for doctors once the patient began to deteriorate during surgery.
The patient’s aunt told the Arabic news outlet Barq that the family became concerned when medics provided no word on how the operation had gone after five hours.
The patient's medical records were also not available when she was transferred from the centre to Cleveland Clinic Abu Dhabi, where she has remained in a coma for 16 days.
Staff at First Med Day Surgery Centre said they could not discuss the case and are awaiting further notice from the authorities.
General anaesthetic complications rare
Although safe in most cases, some patients with existing medical conditions are at risk of suffering complications during general anaesthetic in surgery.
Patients placed under GA are done so in a closely controlled medical environment to allow surgeons to operate on a patient without pain.
Risk increases if a patient suffers from seizures, has existing heart, kidney or lung conditions, high blood pressure or a history of adverse reactions to anaesthetic.
Smokers and heavy drinkers can be more likely to suffer complications.
Common side effects can be dizziness or nausea, difficulty passing urine, shivering or feeling cold, temporary confusion and memory loss.
In extreme cases where anaesthetic is administered incorrectly, the patient may experience awareness during surgery.
The surgery itself typically carries more risk than general anaesthetic, which is considered an aspect of everyday hospital procedure.
LA LIGA FIXTURES
Friday (UAE kick-off times)
Real Sociedad v Leganes (midnight)
Saturday
Alaves v Real Valladolid (4pm)
Valencia v Granada (7pm)
Eibar v Real Madrid (9.30pm)
Barcelona v Celta Vigo (midnight)
Sunday
Real Mallorca v Villarreal (3pm)
Athletic Bilbao v Levante (5pm)
Atletico Madrid v Espanyol (7pm)
Getafe v Osasuna (9.30pm)
Real Betis v Sevilla (midnight)
Classification of skills
A worker is categorised as skilled by the MOHRE based on nine levels given in the International Standard Classification of Occupations (ISCO) issued by the International Labour Organisation.
A skilled worker would be someone at a professional level (levels 1 – 5) which includes managers, professionals, technicians and associate professionals, clerical support workers, and service and sales workers.
The worker must also have an attested educational certificate higher than secondary or an equivalent certification, and earn a monthly salary of at least Dh4,000.
Key findings of Jenkins report
- Founder of the Muslim Brotherhood, Hassan al Banna, "accepted the political utility of violence"
- Views of key Muslim Brotherhood ideologue, Sayyid Qutb, have “consistently been understood” as permitting “the use of extreme violence in the pursuit of the perfect Islamic society” and “never been institutionally disowned” by the movement.
- Muslim Brotherhood at all levels has repeatedly defended Hamas attacks against Israel, including the use of suicide bombers and the killing of civilians.
- Laying out the report in the House of Commons, David Cameron told MPs: "The main findings of the review support the conclusion that membership of, association with, or influence by the Muslim Brotherhood should be considered as a possible indicator of extremism."
Abu Dhabi traffic facts
Drivers in Abu Dhabi spend 10 per cent longer in congested conditions than they would on a free-flowing road
The highest volume of traffic on the roads is found between 7am and 8am on a Sunday.
Travelling before 7am on a Sunday could save up to four hours per year on a 30-minute commute.
The day was the least congestion in Abu Dhabi in 2019 was Tuesday, August 13.
The highest levels of traffic were found on Sunday, November 10.
Drivers in Abu Dhabi lost 41 hours spent in traffic jams in rush hour during 2019
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
