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Gulf Air pilot killed by wrong treatment in Dhaka

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Tala Elhendy Josephano, sister of Gulf Air pilot Mohannad Yousef Hassan Al Hindi, at a press conference on Monday claimed that her brother was murdered due to wrong treatment and negligence of a hospital in Dhaka.

The pilot, Mohannad Yousef Al Hindi, fell ill after arriving in Bangladesh and was admitted to the United Hospital on 14 December 2022, where he died.

In a press conference at Dhaka Reporters Unity, Tala Elhendy said when she came to Bangladesh and asked for the necessary documents from the hospital, the hospital authorities did not cooperate with her. She claimed that they provided her with fraudulent documents.

A Jordanian-American pilot has died due to the negligence of a reputed private hospital in Dhaka, his sister has alleged. Tala Elhendy Josephano yesterday said her late brother Gulf Air pilot Mohammad Youssef Hassan Al Hendi was not given timely and proper treatment at the United Hospital after he had a heart attack.

Here is the full statement of Tala Elhendy Josephano –

Press conference

I am Tala Elhendy Josephano an American citizen working for the British government. I came all the way to Bangladesh to ensure that my brother gets justice for his wrongful and negligent killing.

My brother, Mohannad Yousef Hassan Al Hindi, was a happy, positive and presumed to be healthy 63 years old pilot. He loved his family. He would get routine and regular health checks for the purposes of his work as a pilot. He was a veteran pilot who carried out his job with great care and skill to ensure the safety of his passengers and colleagues. It breaks my heart to say that my brother was a victim of medical negligence and manslaughter here in Bangladesh as he thought so highly of this country and the kindness of the people.

The tragic and fatal incident took place on 14 December 2022. Here is the exact timeline of the day of the incident:

  1. He was staying at Meridian Hotel in Dhaka, Bangladesh before his early morning Gulf Air flight where he would be the pilot. He woke up at 2:45am to get ready for the flight and left for Hazrat Shahjalal airport.
  2. He arrived at Hazrat Shahjalal airport at around 3:30am.
  3. While he was going through immigration at around 4:10am, he collapsed and was found to be unresponsive.
  4. At around 4:20am in Hazrat Shahjalal airport, my brother had his FIRST CARDIAC ARREST. At this point, my brother received five minutes of cardiopulmonary resuscitation (CPR) at the airport. His blood pressure was going down. Thereafter he was transported to United Hospital.
  5. Between 4:30am to 5:30am, he was still in the transport carrying him to the hospital from the airport.
  6. He arrived at the Emergency Room of United Hospital at around 5:30am. He did not receive any treatment at the ER.
  7. At around 5:45am, he was transported to CCM of United Hospital.
  8. At around 6:25am, he had his SECOND CARDIAC ARREST and again CPR was given for 10 mins.
  9. After carrying out return of spontaneous circulation (ROSC) and Electrocardiogram (ECG), reports showed ST segment elevation.
  10. At around 6:45am, he had his THIRD CARDIAC ARREST and CPR was given for 15 mins with ROSC.
  11. At around 7am, immediate echocardiogram (ECHO) was carried out on my brother, and cardiology opinions were taken.
  12. At around 9am, the cardiologist consultation was for the first time taken and my brother’s friend/first officer, Khalil became privy to the information that a percutaneous coronary intervention (PCI) was necessary due to the then critical state of my brother. He consented and a second consent was required but the Gulf Air personnel who was present there at that time knew that the procedure was very risky. Since the process was risky, the hospital was required to get Gulf Air’s consent which they failed to do and instead obtained the consent of another brother of mine. The hospital contacted my suffering brother’s wife and my other brother to gain consent for the medical process. During the call where they sought for consent for PCI surgery to check for heart blocks, they said it’s a normal, standard procedure, downplaying the risks involved as my brother was on ventilator and suffered three cardiac arrests already.
  13.  At around 10:30am, my brother was transferred to catheterization laboratory (Cath Lab) for PCI intervention. Upon Coronary Angiogram (CAG) inspection, they claim they found the left main artery was 99% blocked.
  14. At around 11:15am, my brother had his FOURTH AND FINAL CARDIAC ARREST during the procedure. He was given 45 mins of CPR and temporary pacemaker (TPM) was inserted and my brother took his final breath at 12:08pm. He was sedated during the procedure. Upon making an inquiry at the said hospital, I was informed that Dr Kaiser Nasir did the procedure but his name is not found in the patient file provided to my brother’s family. The report stated that my brother had asthma when in fact he never had asthma. When inquired about this, they said it was mistakenly left out. I also suspect that a cardiologist was consulted via phone only was never present in person to see my brother.
  15. My brother was buried within 48 hours of his death.
  16. I believe that between 4:08am to 12:08pm which is 8 hours, the hospital could have saved my brother which they failed to do.

I will explain why as follows:

Issues

Issue 1: Negligence of ER staff and absence of cardiologist

My brother suffered the first cardiac arrest at the airport at 4:20am and arrived in the Emergency Room of United Hospital over an hour later, i.e., at 5:30am.

ERs are known to be the special area in a hospital that is staffed and equipped for the reception and treatment of persons requiring immediate medical care. As the name suggests, emergency room’s function and expertise are in the area of responding to emergencies and involves taking immediate steps. It was known to the ER that my brother had suffered a cardiac arrest well over an hour ago and that he was in a critical state with his blood pressure dropping lower. It was necessary and reasonably expected that the staff at the ER would exercise their professional skills and knowledge and alert at least one cardiologist so that they could give this critical patient the medical care/immediate surgery he needed. However, the staff at the ER failed to inform any cardiologist. At no point was any heart specialist present at the ER. The ER staff did not take any steps to treat my brother. At this point, there was more than enough time for the hospital to provide my brother with the treatment that could have saved his life but they failed to do so. Without any cardiologist’s input on the matter, within 15 mins, i.e. 5:45am, my brother was transferred to the CCM Unit by the ER staff.

Thus, even though 1 hour 25 mins passed by since my brother suffered his first cardiac arrest, the ER failed to (1) take any proper medical measures to revive my brother and (2) alert any cardiologist of this hospital to advise on the case.

Issue 2: Negligence of CCM staff and absence of cardiologist

My brother was shifted to the CCM Unit at 5:45am. One would expect that at the very least, one cardiologist would be available to oversee my brother’s case since he was a heart patient at the hospital. However, there was not a single cardiologist present. I suspect it may have been the case that since it was nighttime, the cardiologists took off and entrusted the junior and inexperienced doctors/staff to cater to cases. This in itself is sheer negligence. Because there was no competent medical profession/cardiologist present to advise on my brother’s case, 40 mins after being shifted to the specialized heart care unit, CCM, i.e. at around 6:25am, my brother had his second heart attack. The inexperienced doctors present at that time gave my brother a 10 min long CPR. In less than an hour of arriving at the hospital, my brother suffered yet another heart attack, rendering him a vulnerable patient requiring urgent and immediate specialist care. The negligent and incompetent medical staff who witnessed my brother suffer a second heart attack should have but failed to contact a heart specialist/surgeon then for the purposes of preparing for stent or artery clearing procedure.

20 mins after his second heart attack, i.e. at 6:45am, my brother suffered a third heart attack. A little over two hours and my brother suffered three cardiac arrests already. The unit specializes in cardiac issues and is part of one of the most popular hospitals in Dhaka but again, there were no steps taken to inform a cardiologist. This amounts to sheer and gross negligence on the part of CCM staff. The only step taken by them was to give CPR for 15 mins with ROSC. After that, my brother who suffered three heart attacks by then was left without any medical care 2 hr 15 mins i.e. till 9am when presumably a cardiologist started their duty at the hospital for that day. Days after my brother’s death, when I made an inquiry at the hospital as to why no steps were taken during this long period of over 2 hours, they stated that their protocol is to start with CPR and thereafter opt for other measures such as angiogram. They stated that since he was not in a stable condition and required high doses of some particular medication (he was given three as opposed to one) to keep his condition under control at that time, they could not perform angiogram. There were two staff members present at the time of the inquiry and when asked who were attending my brother during those two hours, the female staff member nonchalantly said a ‘junior consultant’ was present and the male staff member quickly and suspiciously corrected her that an associate consultant was present. It is clear from this discrepancy and contradiction in their versions of the story that no cardiologist was present and rather inexperienced junior consultant was attending to a patient that they were not qualified to handle and that there are conscious and deliberate efforts being made to manipulate the records and that is why they are not giving me any access to it. They only provided me with a ‘medical test report’. No part of the ‘medical test report’ provided to me contained the name of any cardiologist on duty and I am being refused access to the main patient file. When I first requested for it, they said that I will be provided with it and simply asked me to wait or come by later; this went on for days. When I became agitated and angry and threatened to take legal action or involve members of the embassy, they agreed to provide it to me initially but later they claimed that my niece signed for his release of body, and since I am not the same person, I could not gain access to it. This had no logic. At no point did they ask me to present my identification documents and only used this as an excuse to prevent me from gaining access. Thus, the hospital never gave me access to my brother’s medical record labeling it confidential. It cannot be confidential hospital property as the patient’s family has a right to this information.

Issue 3: Incompetent and inadequate consultation by cardiologist (if at all)

Firstly, at around 7am, it is alleged by the hospital that ECHO was done and that cardiology opinions were taken. It is unclear whether the cardiologist was present at the CCM, how he gave his opinions and what his exact prognosis was. This alleged cardiologist, whose identity was not disclosed by the hospital anywhere, opted for conservative management treatment “for the time being” (as stated in the report) when it is clear to even a non medical professional that surgery would be needed as a matter of urgency after a patient suffers from three cardiac arrests in a little over 2 hours. The doctor gave my brother a Heparin Sodium 5000IU Injection (used to prevent blood clots) after making the decision regarding conservative management treatment. This demonstrates that there probably was no cardiologist opining on the matter and that the staff advising was grossly negligent.  

Secondly, when there was a change of shift of the medical professionals at 8am, they wasted time carrying out CT Scan and other irrelevant medical tests on my brother when in fact all they had to do is the PCI procedure and these tests were not necessary for a patient who experienced cardiac arrest. They were simply piling up costs for their personal gain.

Thirdly, at around 9am, they say they were discussing my brother’s case for 30-45 minute at 9am and then they wasted time calling us in a medical emergency that required urgent attention. Allegedly a cardiologist consultation was again taken, and my brother’s friend, Khalil, was informed about the necessity of a PCI procedure due to the then critical state of my brother. Gulf Air personnel came when they needed another consent. Because Gulf Air knew that risk was so high, they needed my other brother to give it so that they will not be blamed. My other brother is now not doing well from this as he thinks it is his fault allowing them but he was put in a situation which he should not have been in.

My brother was on ventilator owing to which PCI entailed major risks for my brother. It is unclear as to what changed from 6:45am (when it was deemed that my brother’s condition was not stable for a PCI) to 9am (when my brother, despite being on being ventilator and unconscious and in critical condition due to prolonged delay in treatment, is deemed to be in a condition for PCI). While on being ventilator, he got cardiac arrest two times; this rendered performing angiogram very risky as opposed to immediately after the first cardiac arrest.

After yet another delay since the time the hospital recklessly decided to opt for PCI, the hospital staff, who did not introduce himself as the cardiologist but as a chief counsel, contacted my other brother and my brother’s wife to gain consent for the medical process. Not only did the ‘medical test report’ not have any cardiologist’s name but also the staff members at no point claimed to be a cardiologist. During the call from the staff seeking permission for surgery, they said it’s a normal, standard procedure and since he had “a big heart attack”, he needed a PCI. When my brother’s wife inquired about the percentage of risk involved, the prognosis and name of the surgery, the staff evaded the questions. It is evident that the staff was not fully aware of the details of my brother’s case himself. The nature and gravity of the risk was not fully disclosed to my brother intentionally. I know it was deliberately withheld as my investigation revealed that a tall bald person from Gulf Air wanted to make sure my brother signed the consent form as they knew the procedure was risky.

No cardiologist was present until 9am and if any cardiologist was so contacted, they were consulted over the phone. By the time the cardiologist came (if at all) who I believe is not Dr Nasir Ullah; most likely Dr Faruq and Dr Nasreen, a gynecologist, were present. The doctor that performed procedure was in my opinion Faruq not Nasrallah. Prof Dr Mohammad Omar Faruq, chief consultant of Critical Care medicine and emergency medicine, is the one that killed him and now I’ve been informed that suddenly he’s out of the country.

The CAG procedure and then the PCI procedure should have been done before 7am and he should not have been moved from ER on the outset. I am being refused access to my brother’s patient file and so it is hard to tell what actually happened to my brother.

Issue 4: Negligence of ICU staff

After almost three/four hours of being admitted at the United Hospital, decision was taken (albeit it is unclear whether it was a decision by a cardiologist), to transfer my brother to the intensive care unit (ICU). This delay is unjustified and illustrates the gross negligence on the part of all the medical professionals involved in my brother’s case at the hospital.

There was further unjustified delay as at around 10:30am (which is one and a half hours since the decision to opt for PCI was taken and five hours since the time he arrived at the hospital and by now suffering from three cardiac arrests), my brother was transferred to Cath Lab for the PCI intervention. They alleged that upon conducting CAG inspection, they found the left main artery was 99% blocked. It is unclear as to why the at every step along the way the medical professionals have been slow to take action in this emergency case. They themselves have acknowledged that the patient’s condition was not stable. There was a 99% block found at the last minute; they could have found this out earlier.

Issue 5: Negligence during PCI procedure

At around 11:15am, my brother had his fourth and final heart attack during the procedure. He was given 45 mins of CPR and TPM was inserted whereupon he died. It was alleged by the hospital that Dr Kaiser Nasir did the procedure. It is unclear whether he was a cardiologist as his name is not there in the ‘medical test report’ and they claimed it’s a ‘mistake’. Angiogram was performed by senior consultant (Dr Kaiser Ullah and another consultant). His name was not in the report. And when asked why it’s not on the summary report, they said it is their internal and confidential document. Cardiologist apparently consulted my brother’s case but at no point was he present at the hospital.

The ‘medical test report’ stated that my brother had a previous history of asthma and hypertension which he in fact did not have (which may have exacerbated his condition and hindered his treatment). The hospital baselessly assumed that my brother had asthma and hypertension based on their allegations that Khalil provided them with a bag of medication and hypertension medication and inhaler; this is absolutely contrary to the facts as Khalil did not provide the hospital staff with any such inhaler. It may have been possible that one pill of hypertension medication was given but not inhaler and not a bag of medicine as they claimed. They did not know his medical history and did not make any reasonable effort to find it out from Gulf Air or the family. They negligently relied on circumstantial medication to decide a critical patient’s medical history. My brother was a healthy person who only took B12 medication. Nowhere in the ‘medical examination report’ was it mentioned that he arrived at the hospital with the inhaler and hypertension medication. They did not once contact Gulf Air to provide them with the medical history of their pilot who was hospitalized. If my brother received proper treatment, he could have been saved after the first cardiac arrest instead of prolonging treatment and allowing his condition to become critical. 

He was sedated during the procedure which ultimately caused his death. It is unclear who decided to sedate him despite knowing about his heart condition and in what dose. It is abnormal for a heart patient like him to have been sedated.

A patient who arrived at the hospital after experiencing a cardiac arrest should have been treated with PCI on the outset at the ER instead of being moved to three different parts of the hospital. It is inhumane treatment and torture in the hands of medical experts.

Issue 6: my investigation (post death)

I investigated the matter by visiting the hospital and I suspect that there has been manipulation of cctv footage and medical documents by the hospital. Furthermore, I was intimidated by the staff while I was investigating. 

On 26 January 2023, I sought for the medical reports/records at United Hospital and wanted to see the cctv footage from the hospital but they had been stalling for time to manipulate the evidence. Till date, I have not had any access to the patient file.

Initially, they provided me with what they called a ‘medical test report’ which comprise of some medical examination history and is not comprehensive and lacks details; they said that their internal patient record consisted of the details which was confidential and a hospital property and could not be handed out to me. They would make fun of me, be rude to me, try to intimidate me when I asked for them.

After a threat of legal action and of getting the embassy involved, they provided me with more ‘medical test report’ after three days of delaying. They are intentionally refusing me access so that they have enough time to successfully manipulate the medical records or hide them or add to them fabricated documents. Even though they claim that it is hospital’s property, they were delaying in providing me with it with the excuse that it was in the possession and control of the doctor and that it would be made available to me once the doctor was free. In this way, I had to wait for days before I was able to gain access to only 20 pages of heart beats examination rather than any proper cardiology reports or treatment details.  

When I went to the hospital and carried out my investigation, I found out that that there was no cardiologist in the CCU where my brother was kept for the majority of the time at the hospital.

I contacted doctors in the USA for expert opinion on the treatment of my brother that led to his death. USA doctors stated that my brother ideally should have had the emergency procedure within an hour which in reality he got after 6 hours.

The staff at the United Hospital informed me that doppler echocardiography exam was carried out for 3-4 mins which they claimed is a simple procedure done with the ultrasound machine (and takes a maximum of 15 mins) and that throughout this process, my brother was incubated on his bed. This again portrays medical negligence on the part of the hospital as the experts I contacted say it takes 30 to 45 mins by very experienced professionals. I was also informed by the medical expert that no doctor/medical professional in their right mind carries out this procedure after the patient suffers from cardiac arrest. Thus, my brother did not receive any proper treatment.  

The hospital authorities informed me that after arriving he got several consultation from cardiologists but there is no documentary proof of the phenomena and no duty time was recorded in the ‘medical test report’.

The woman, Fatima, I interviewed claimed that she is a cardiologist who was present in ER; this is false as I asked other staff who gave contrary information and her profile states the time of her shift in the hospital which does not coincide with the time my brother arrived in ER.

Since they were making excuses and unnecessarily delaying in providing me with the medical records only to later outright deny me access to the medical records of my brother and the CCTV footage of the day of the incident, I am suspecting that the hospital is trying to manipulate the reports to hide their negligence that killed my brother.

Thus, I investigated the matter and strongly suspect that there has been manipulation of cctv footage and medical documents by the hospital. Furthermore, I was intimidated by the staff while I was investigating. They did not give me cctv footage even though they promised they would. They continued to delay in providing me with the patient’s filed stating that it was with the doctor. Deceased’s files should be in hospital archive and not with the doctor. Later they outright refused to share them with me.

Issue 7: Negligence of Gulf Air

My brother suffered from his first cardiac arrest and fell unconscious and remained in that state until he died. This happened while my brother was about to board a Gulf Air flight as the pilot. During the course of his duty, he fell unconscious and it was the duty of Gulf Air authorities to ensure and oversee (in the absence of his family) that he was getting proper treatment and that his medical history (which they had in their possession) was provided to United Hospital as soon as he arrived at the ER. Gulf Air authorities owed my brother a duty of care which they did not fulfil. They did not provide any of their personnel to remain with my brother as his guardian during his improper treatment at the hospital At no point did the Gulf Air take any step to ensure that their pilot on duty, who was 10 mins away from flying an aircraft with 300 passengers and had the potential of crashing in any area of the crowded city, was getting the treatment that was needed. At 9am, Gulf Air’s consent was needed which they evaded providing and so the consent was being obtained from my brother’s immediate family for the risky surgery. The only contact person/guardian of my brother for the hospital at the time he arrived at the hospital was Gulf Air. Gulf Air should have exercised reasonable care when they shifted their pilot from the airport to the hospital which they failed to do.

When my brother’s brother was contacted by the hospital, they asked about his allergies to the brother who was in a state of shock after suddenly learning about the hospitalization of his brother who was about to undergo a risky process. He was in the right mental space to assist the hospital with my brother’s history at that time. The right entity to provide them with the history would have been Gulf Air authority who has in their database the medical history of my brother, esp when a critical surgery was to take place. The hospital assumed my brother had asthma based on circumstantial evidence, as they claimed. Gulf Air did not send a report or make sure a cardiologist was present and nor did the hospital try to get the report or the information from them. If Gulf Air accepted at the hospital that my brother had asthma, then it means that they have that on their record. Thus, considering this medical history and age, they should have not allowed him to fly in the first place. In 2008, my brother had blood pressure problem and he was in the hospital and he was off his job for 6 months. During corona, Gulf Air laid off many of their pilots but because my brother was a good pilot, they kept him. In March 2021, I have a voice note from him that they are overworking him at Gulf Air.

My demands
  • Documents, evidence from the hospital
  • I want full and free access to the unadulterated medical and autopsy records/reports and CCTV footage of my brother. I have a right, as the patient’s/victim’s sister, to know what medical procedures were actually carried out on my poor brother and by who. The hospital marked my brother’s file confidential, and I am suspecting that they hid records, added records and tampered with video footage. Withholding my access to my brother’s file is not only unethical but also illegal. I also want to know the communication and agreement between the hospital and Gulf Air, documented or otherwise. I have a right to know.
  • Criminal proceedings against the ICU doctor and those involved
  • It is very clear that from the time that my brother had his first cardiac arrest and arrived at the hospital at 5:30am to the time he was undergoing PCI procedure at around 12pm which is six and a half hours, the hospital could have saved my brother. Instead they demonstrated negligence every step along the way, allowing my poor brother to go untreated for prolonged hours and suffer from multiple cardiac arrests. They failed to call a cardiologist during those 6 and a half hours for cardiac patient. They have in effect killed my brother. I want justice for my brother by taking appropriate criminal action against United Hospital.
  • Exemplary compensation or fine to ensure this is not repeated
  • I do not want anyone else’s brother, sister, father or mother to go through what my brother did. I do not want anyone to suffer wrong medical treatment in the hands of professionals we vest our trust in. I want United Hospital to be deterred from treating their patients with this level of negligence.
  • Revocation of United Hospital’s license
  • United Hospital has in the past faced lawsuits urging for the revocation of their licence after they burned their patients in the ICU during the covid outbreak. It is clear that they are routinely incompetent and negligent in carrying out their activities and my brother’s case was not a one-off incident.

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