Helsinki Citizens’ Assembly-Vanadzor

Hrayr Manukyan applied to Helsinki Citizens’ Assembly Vanadzor and informed that Davit Sahakyan, endovascular surgeon of Erebuni MC, refused to perform aneurysm brain surgery on his father Ashot Manukyan, as a result of which the latter had a hemmorhagic stroke occur for the third time. As a result, Ashot Manukyan’s health state deteriorated even more and limb immobilization was recorded. 

On September 13, 2019, taking into account the prima facie crime features in the incident, Artur Sakunts, HCA Vanadzor Chairman, submitted a report to the RA Prosecutor General claiming to take measures to conduct relevant examination of the facts presented in the application submitted to the Organization by Hrayr Manukyan, Ashot Manukyan’s son, to institute a criminal case in case of disclose alleged crime features, to find those responsible and to restore Ashot Manukyan’s violated rights.  

Hrayr Manukyan applied to the office on September 6, 2019, with the matter of his father’s health rights protection and informed that on June 19, 2019, his father Ashot Manukyan applied to “Vanadzor” medical center with acute headache. Not conducting any proper medical examination in Vanadzor MC, they stated that the headache was a result of pressure fluctuation and that there was nothing dangerous. 2 days later, feeling unwell, Manukyan again applied to Vanadzor MC. He underwent a CT examination of the brain and subarachnoid hemorrhage (hemorrhagic stroke) was discovered. Manukyan was accepted for inpatient treatment and received a conservative treatment. On July 3, his health state deteriorated. Re-examination was conducted and it showed that the stroke had reoccured and it was necessary to transfer him to Yerevan for an urgent examination and if necessary, also for operation. 

On July 4, Ashot Manukyan was transferred, by an ambulance car, to Erebuni MC in Yerevan, where brain CT examination revealed aneurysm (blood vessel hernia). After the examination, he was immediately transferred to intensive care unit. The next day, however, he was transferred to a hospital ward for unknown reasons. One day later, Erebuni MC endovascular surgeon Davit Sahakyan told Ashot Manukyan’s son Hrayr Manukyan that  aneurysm complexity level was quite high, an operation was necessary and he recommended that Hrayr Manukyan prepare all the documents required for the compensation of the operation. Concerned about his father’s serious health state, Hrayr Manukyan asked doctor Davit Sahakyan to get the agreement from the hospital management to perform his father’s operation urgently, to tell them that he was willing to present operation compensation documents or the amount of money to be paid as soon as possible. Davit Sahakyan contacted the management of the MC, presented the situation but received a refusal with regard to the operation until the required money was paid. 

On July 5, Ashot Manukyan’s state sharply deteriorated, the relevant examination revealed that hemorrhagic stroke occured for the third time and as a result, Manukyan’s left limbs were immobilized and his consciousness  sharply deteriorated. After the third stroke, Manukyan was transferred to the intensive care unit in an unconscious state. 

Based on the sharp deterioration of his father’s health state, his son again asked Davit Sahakyan to perform the operation immediately and was again refused by “Erebuni” MC management. As a result, having CT examination results, being well-aware of the serious threat to Ashot Manukyan’s life and health, the MC manifested an unconscientious attitude and refused to perform brain aneurysm operation by “considering a person’s health subordinate to money”.

On July 6, Ashot Manukyan’s son paid the medical center around AMD  4,650,000 and only after that “Erebuni” MC management allowed operating on him.  

On September 12, 2019, we applied to the head of Health and Labor Inspection Body to clarify a number of important conditions: 

-Does the medical aid provided to Ashot Manukyan by Erebuni MC meet the requirements of the standards defining the procedure of medical aid and medical service provision?; was it complete, proper and adequate or not?

-Were all the examinations performed in time?

- How legal were Erebuni MC medical staff actions of transferring Ashot Manukyan from the intensive care unit to a hospital ward on 05.07.2019 and their inaction with regard to not performing an operation until the occurrence of the third hemorrhagic stroke? 

-Was the management of Ashot Manukyan’s medical documents in Erebuni MC proper and timely or not?

On September 30, 2019, in response to our letter, Head of the RA Health and Labor Inspection Body informed that on September 19 administrative proceedings had been initiated to find out the compliance of Ashot Manukyan’s medical documents’ filling, storing and circulation with the requirements of the RA Law “On medical care and services for the population” Article 19.3 § 1 point 6 / Medical workers should fill in, manage and circulate medical documents, as well as record medical interventions in the manner prescribed by the RA legislation /, the RA Health Minister N 02-N order “On approving a number of medical document forms used in hospital medical organizations” dated February 14, 2014, and the RA Health Minister N 76-N order “On approving the medical forms made as a result of laboratory diagnostic tests” dated November 25, 2013. The Inspection Body also informed that a number of points in our letter were out of the frame of their competence, hence they were redirected to the RA Ministry of Health. 

Taking into account the condition that the prepared materials contain prima facie crime features envisaged under Article 130§1 of the RA Criminal Code /Failure to implement or improper implementation of professional duties by medical and support personnel, as a result of careless or not diligent treatment which through negligence caused grave or medium-gravity damage to the patient, is punished with a fine in the amount of 100 to 200 minimal salaries, or with arrest for the term of up to 3 months/ on October 3, 2019,  a criminal case was initiated in Erebuni Police division.