The transformation of Imran Hussein from company executive to a bed-ridden hospital patient with the mental age of a toddler is both heartbreaking and tragic.
Equally frustrating for his family is that his current state - confined to a hospital bed, thousands of miles from his family in Canada - might have been avoidable.
Damages worth US$58 million (Dh213m) are now being sought from the doctor who treated Mr Hussein and the hospital where he was located when his condition turned. The damages are being sought on behalf of Mr Hussein, a 50-year-old father of four, to help pay for his 24-hour lifetime care.
Every hour, nurses enter his small, private room to vacuum mucus from his throat to stop him choking, as he is unable to swallow.
The only person he recognises is his brother, Amjad, who was there when he opened his eyes for the first time. When his mother visited him from America, there was no recollection of who she was.
While his legal case is yet to be resolved in Dubai’s civil courts, Amjad is facing medical bills of more than Dh1.7 million to pay for Mr Hussein’s ongoing care at Mediclinic’s City Hospital in Dubai Healthcare City.
His insurance company has refused to pay out, due to the ongoing court proceedings.
“When we heard about Imran needing surgery, we advised him to go to the US, Canada or even Pakistan, but he stayed in Dubai,” said Amjad, who has moved to Dubai from Bahrain to support his brother.
“The whole family was in America, as our mother just had a major heart surgery. We thought Dubai offered good medical treatment and promotes medical tourism so it should be OK for him.”
Routine angioplasty surgery, which opens blocked arteries and restores normal blood flow to the heart, was successfully performed in Garhoud, before Mr Hussein was transferred to City Hospital for another procedure on August 3 last year.
A week later and recovering well, his condition took a catastrophic turn.
While in recovery, it is claimed that cardiac surgeon Dr Uwe Klima removed Mr Hussein’s epicardial pacing wires and left him, without leaving instructions for the team of nurses and doctors charged with his care. The wires act as a failsafe during surgery and provide quick access to a temporary pulse generator that helps notify doctors if there is a problem.
According to the subsequent review of the case by an independent panel of experts, a “cardiac tamponade” occurred, where fluid collects and compresses the heart, starving his brain of oxygen and causing irreparable damage.
The condition was not picked up by his carers, and it is claimed that there is no record of nurses checking on his vital signs for 80 minutes after the wires were removed.
His family are alleging that a breach of the basic standard of care occurred. Because of the delay in recognising Mr Hussein's dangerous condition, the urgent care he needed was not offered until it was too late.
Amjad Hussein is claiming a discrepancy in the timings of interventions by the medical team, and that the following investigation was insufficient.
Although City Hospital was at first deemed at fault for mismanagement by Dubai Healthcare City Authority, its appeal was accepted and the decision revoked. The only sanction handed out by a Fitness to Practice Panel was a three-month ban on Dr Klima. He has since returned to practice after serving that suspension.
DHCCA was asked by The National and Mr Hussein’s family for details of the committee that oversaw the investigation, but their names and qualifications have not been revealed.
"DHCCA would not allow us to appoint our own independent doctors to interact with the committee," Amjad said.
“They didn’t respond to my emails properly, which was hugely frustrating.
“Anywhere else in the world when there is a case like this you look at the evidence and discuss and debate what went wrong. It was a clear case of cardiac tamponade.”
A spokesman later added that the family's requests "were responded to in a timely manner and were addressed to ensure a clear understanding of the regulatory processes and procedures that are being followed in Dubai Healthcare City with the aim of obtaining a fair decision".
The family said it sought opinions from doctors in America, Egypt and the UK, all of whom, they say, have examined case notes and agreed it was a simple case of cardiac tamponade.
A case submitted to Dubai civil courts is claiming the $58m in compensation to cover the cost of Mr Hussein’s ongoing care, and the loss of earnings from his Dh50,000 salary as an executive at Dow Chemicals, an American multinational.
In its original ruling, DHCA found there was no professional misconduct or negligence but said there was mismanagement in dealing with and recognising cardiac tamponade. The hospital was warned for failing to provide a replacement cardiac surgeon to monitor Mr Hussain in Dr Klima’s absence, though in a subsequent email to the family DHCA’s director of clinical affairs said an appeal by the hospital had been accepted and only the mismanagement charge against the doctor stood.
“Patient safety is our top priority," said Dr Ramadan Al Blooshi, the chief executive of DHCCA – Regulatory.
“We make every effort to ensure a fair, transparent and equitable complaints process.
“In this particular case, the appeals board revoked the decision made against the hospital and upheld the decision of the Fitness to Practice Panel against the concerned doctor.
“Any case that is criminal in nature or related to monetary compensation is outside of the jurisdiction of the DHCC free zone, and is handled by the relevant authorities.”
In a brief statement, Mediclinic said it had been cleared of any wrongdoing by DHCCA but could not comment further because of the ongoing civil court case.
“Mediclinic can confirm that a legal claim has been made against Mediclinic City Hospital in relation to the case of Imran Hussain, however the hospital has been cleared of any wrongdoing by Dubai Healthcare City Authority,” it read. “As the legal process is ongoing, Mediclinic has no further comment at this time.”
