Doctors: Saakashvili Needs Immediate Transfer to Multi-profile Clinic ICU

A group of medical doctors created by the Public Defender has concluded that Mikheil Saakashvili’s health condition is “critical”, and recommended that the patient should immediately be transferred into the intensive care unit in a functional and well-experienced multi-profile hospital. These conditions are not satisfied by the Gldani prison hospital, physicians noted.

The medical experts said the prison hospital is currently being formed: only a part of medical equipment is functional, while the remaining are going through the testing mode. The doctors noted, that there is currently an internal medicine doctor and a resuscitation brigade present round-the-clock in the prison hospital, but warned that while 24/7 availability of a resuscitator is a positive development, it creates a false sense of security. Since the multi-profile experts can not be constantly present in prison, in case of a sudden aggravation of the condition the resuscitation measures are likely to be ineffective. 

In case of a possible aggravation of Saakashvili’s condition, the management of the patient by the team currently present on-site will not be sufficient, the doctors said, noting for instance that 1) the Wernicke encephalopathy — an acute neurological condition — was not diagnosed due to the lack of consultation with a neurologist; 2) Despite necessity, the examination of possible gastrointestinal bleeding was not raised by prison doctors; 3) The need for continuous cardiac telemetry in light of Saakashvili’s hypokalemia (lower than normal potassium level) was not considered as cardiologist did not examine the ex-President.

The report also listed expected complications in the nearest future, including 1) the exacerbation of Wernicke’s encephalopathy – coma, with status epilepticus; 2) Lethal arrhythmia caused by hypokalemia, rhabdomyolysis (muscle breakdown and death), renal failure; 3) Gastrointestinal bleeding; 4) Hemolysis – thalassemia plus hypophosphatemia; 5) Pulmonary embolism (blood clots in the lung); 6) Heart failure 7) In case of calling off hunger strike, food recovery syndrome. The doctors also said Saakashvili suffers from hypokalemia since November 8.

Public Defender Nino Lomjaria said her office has already addressed the European Court of Human Rights to be included as a third party in the discussions for the interim measure over Saakashvili’s case. She said this would allow the Public Defender’s Office to present the experts’ findings to the ECHR. But if the Court would choose otherwise, Lomjaria argued the group’s conclusion would still factor into the judges’ assessment of the adequacy of the medical services provided to the ex-President.

The physicians and Public Defender visited the Gldani penitentiary hospital and met Saakashvili on November 16, on the same day as Lomjaria set up the group.

The ex-President was transferred to the prison hospital on November 8, against his will. Saakashvili, his family, doctor, and lawyers had repeatedly rejected the option, and the council of doctors monitoring the inmate’s health in the Rustavi #12 prison had also recommended transferring the ex-President to a multi-profile civilian hospital. The council of doctors was not enabled to visit Saakashvili following his transfer to the penitentiary clinic.

Saakashvili has been on hunger strike since his arrest on October 1.

On November 17, before the group of physicians gathered by the Public Defender published their conclusion, a doctor of the Gldani prison clinic, Sandro Mateshvili had argued that Saakashvili’s heart rate, blood pressure, oxygen saturation and glucose levels in blood all within the normal range. He said Saakashvili was under constant monitoring and his life was not in danger.

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