• Before posting an article from a specific source, check this list here to see how much the Orange Room trust it. You can also vote/change your vote based on the source track record.

The Ella Tannous vs Dr. Issam Maalouf case

eLad

Legendary Member
Orange Room Supporter
The Ella Tannous Case: When Every Lebanese Suddenly Becomes A Doctor




I just wasted 7 years of my life in medical school.

Naturally, when you live in the country with the likes of professor Marcel Ghanem, Dr. Joe Maalouf, Tony Khalifeh and their friends, is there a point for you to remotely try to get an education? They will tell you what you need to know, give you medicine crash courses and guide public opinion on the matter.

Clearly, they’re the ones who know everything and those doctors are just backward-minded folks who only care about money.

Ella Tannous is a young 9 months old whose pediatrician is now in jail. Why is he in jail? Because we live in a corrupt country where security forces get carried away by the sensational reporting of Kalam Ennas and other similar shows to ruin the life of a man simply because of the science of Marcel Ghanem’s report and that dramatic Lord of the Rings music in the background and the tears of the child’s mother as she whispers: why can’t my little girl play with barbies?

Again, what would I know. I’m sure that policeman in between his Malek el Tawou2 sandwiches was busy reading medical textbooks. Give me the differential of a crying baby, kind sir. Oh, you have cramps from all the garlic consumption? Excuse me.

According to her parents, Ella had a high grade fever for which they contacted her pediatrician, Dr. Issam Maalouf, who ran some tests that revealed Ella most likely had a viral illness and prescribed medications to lower her fever.

However, Ella’s fever did not subside and upon contacting the doctor again, he told them not to worry and to use cold towels to try and drop her temperature.

When the parents saw that their child’s situation did not improve they took her to the hospital. It was a Sunday. The pediatrician did not see Ella that day and instead saw her the following day when she had already deteriorated.

He got her transferred to AUBMC where further treatment was done. Ella, however, was in shock and in a state called DIC (Disseminated Intravascular Coagulation) and had gangrene in her limbs, which had to be amputated to save her life.

This is what happened with Ella Tannous according to her parents:



*cue in dramatic music.*

What happened to their child is surely devastating to them and Ella’s parents have every right to be sad and heartbroken over what happened to their daughter.

But just because someone’s daughter had complications does not make that person a doctor who can go on air and pretend they know what makes sense scientifically and what doesn’t. It also does not give Marcel Ghanem or any Lebanese media, who were quick to jump on this very delicious scoop, the right to become full blown medical professionals who spent their times doing night duties in pediatrics.

So let’s go with what we know one by one:

1) Ella’s blood tests revealed a viral illness. Viruses are not treated with antibiotics as Ella’s father was alluding should have happened. In fact, the side effects of those antibiotics and possible increasing resistance to them make their use in viral illness not recommended. How do you treat a viral illness, scientifically? You provide symptomatic relief. A patient has fever? You give anti fever medication. A patient has a sore throat? You provide pain relief, etc.

2) Ella’s fever persisted. Viral illnesses can have fevers that persist. You still give anti-fever medications and monitor. This is what you do, unless LBC or Annahar have new guidelines that we need to be aware of, in which case enlight us please.

3) Ella deteriorated and they contacted her physician as they took her to the hospital. He didn’t recognize them at first. Well, bring the guillotines. A pediatrician could not recognize over the phone a patient out of the hundreds that he has. He must be incompetent. Issam Maalouf’s mistake? He did not go see Ella that day at the hospital. However, that hospital is a university hospital and they should have been reporting back to him every single that happened with Ella as she would’ve been admitted under his care.

4) Ella’s fever continues and she starts experiencing decreasing urine output and becomes lethargic. These are signs of dehydration and deterioration. Dehydration can lead to kidney damage because blood flow to the kidney is decreased which causes something that is called acute kidney injury. This is not what probably happened to Ella, however.

5) Because of her decreasing immunity fighting the virus, Ella contracted another bacteria called Group A Strep (GAS). This bacteria is virulent and has been known to cause a wide array of complications when not recognized and treated early. To recognize and treat it early, you need to maintain a very high level of suspicion which in the setting of a clear viral illness, such as Ella’s case, was not the case.

Due to her low immunity, Ella had a dissemination of GAS. This led her to go into septic shock and full blown DIC. Septic shock is an extremely lethal condition whereby the body cannot adequately find the overwhelming infection. DIC is a complication of septic shock that leads to the depletion of the body’s ability to coagulate the blood through the formation of little clots that block blood vessels across many organs and vessels. The condition is extremely lethal.

In fact, the combination of septic shock and DIC is usually unescapable. Ella is lucky to be alive. Do you know why she’s lucky to be alive? Because her pediatrician saw the signs early enough to transfer her to a hospital that can manage her well.



Bring The Pitchforks, Why Don’t You:
After all that they’ve done, I can’t believe the Lebanese populace still trusts Lebanese media blindly when it comes to medical issues just because they’re sensationalized enough for their liking.

This is the same media that wanted to convince you wehad a Guillain-Barré virus.

This is the same media that, a few years ago, ruined an OBGYN’s life by pretending they know medicine and accused him of killing one of his patients who was giving birth. That patient had an amniotic fluid embolism that is a lethal and extremely rare complication of giving birth. That doctor’s future was ruined anyway. He was also thrown in jail for something out of his hands before the courts realized that he was thrown in jail simply because of Tony Khalifeh’s report at the time.

Issam Maalouf joins the growing list of doctors whose entire career rests upon the whims of a reporter who understands nothing and who goes by what the parents or family of a patient are saying as if they know what’s happening, as if they know the medicine behind diseases. A devastated parent is not a doctor.

This is the same media that now has you convinced a competent doctor is now where he belongs, behind bars, and has you changing your display pictures to “Justice for Ella” snapshots.

When faced with a report from the Lebanese Order of Physicians about what actually happened, that same media downplays the report as inaccurate. Because clearly, the Order of Physicians does not know the medicine behind what’s going on. Those physicians did not go to med school for years and then did residency and fellowship programs for more years only to be ridiculed on air for being imbeciles.

Complications in medical scenarios happen. Not every single complication, despite how deliciously journalistic it looks, is a headline story.

With all due respect to a patient’s family, the esteemed reporters across the Lebanese republic and the people holding the pitchforks in Ella’s defense: You really have no freaking clue what you’re saying. Stop suggesting treatment modalities. Stop suggesting scientific explanations. Stop ruining people’s lives just because it makes for fancy headlines.

And then you get the Ministry of Health pretending they suddenly understand medicine to bring their pitchforks too. You know, that same ministry who turned Lebanon’s food safety issue into a Star Academy-like nominee-every-week report fashion.

There is a reason we go to medical school for endless years. There is a reason we do residency for another batch of endless years. Only doctors can know when medical errors occur. Only doctors can judge another doctor who does a medical error. Only doctors know how to treat patients and diagnose them. Only doctors know how to manage complications.

This is not elitism. This is common sense. This extends to other professions as well. I can’t judge the work of an architect, but an architect can. I can’t judge the work of an electrical engineer, but another electrical engineer can, etc.

The bottom line is: I just wasted 7 years of my life in medical school, that much is clear. Because clearly, Marcel Ghanem and his friends know better than me and all my colleagues.

A Separate State of Mind | A Lebanese Blog


your thoughts?
 

HannaTheCrusader

Legendary Member
Orange Room Supporter
Maybe the doctor is innocent , maybe not

The issue is in Lebanon , many doctors atrocities have gone unpunished , so the public is fed up and sometimes overreact and innocent doctors might end up paying the price ...

My own father was a victim to such a quack....be had an emergency operation and told the doctor he is on blood thinning medicine due to his heart condition

The doctor forgot to prescribe thinning blood after the operation, which led to my dad having a blood clot. Thsi is a given to give post operation blood thinning ....

All we for was a sorry from the doctor and a visit and he said , he was sorry wa wa wa

We didn't press charges , as we know we won't get anywhere . And we won't get justice

I wanted to kill the doctor , but my dad stooped me .... That's how bad and angry and powerless we felt. We wanted to get justice at any price , My dad was 51 when that doctor messed his life .

So l do understand the family feelings and the anger .....

In Lebanon many doctors act as gods .....
 

nonsense

Legendary Member
I don't know the case, and its hard to judge.

In most decent countries yes a medical committee would judge whether malpractice occurred or not, and how bad the fault of the doctor is. And to have a general idea, probably 2000 or more people die every year in Lebanon due to medical errors. At least. That is in line with what it is in other countries. Unfortunately medicine is not perfect. But we should weed out what is clearly preventable and repeatable.

Not commenting on this case in particular, but in general, the transparency and trust in such bodies in Lebanon is close to zero. Part of it is the rampant corruption, part of it is culture, part of it is the closing off and yes elitism of the medical community. It is enough to see how doctors bully nurses who bully students in hospitals left and right. Its not only in Lebanon, but we definitely have a big load.

So I do not have much confidence in the bodies that should rule on this case. But I wouldn't consider the doctor guilty until proven innocent, that's just wrong. So yes, the media is just as rotten as any sector. Then get the politics and security in it...perfect storm. Feel sorry for the innocent caught up in this.

But we should each work on our own ends and make some change, even its inch by inch.
 

DLT

Well-Known Member
Orange Room Supporter
Maybe the doctor is innocent , maybe not

The issue is in Lebanon , many doctors atrocities have gone unpunished , so the public is fed up and sometimes overreact and innocent doctors might end up paying the price ...

My own father was a victim to such a quack....be had an emergency operation and told the doctor he is on blood thinning medicine due to his heart condition

The doctor forgot to prescribe thinning blood after the operation, which led to my dad having a blood clot. Thsi is a given to give post operation blood thinning ....

All we for was a sorry from the doctor and a visit and he said , he was sorry wa wa wa

We didn't press charges , as we know we won't get anywhere . And we won't get justice

I wanted to kill the doctor , but my dad stooped me .... That's how bad and angry and powerless we felt. We wanted to get justice at any price , My dad was 51 when that doctor messed his life .

So l do understand the family feelings and the anger .....

In Lebanon many doctors act as gods .....

Sorry to hear that :( , but yes many Lebanese doctors act as gods, it's like they need a good slap on the face to bring them down to earth. They are annoying!
 

My Moria Moon

Legendary Member
Orange Room Supporter
Sorry to hear that :( , but yes many Lebanese doctors act as gods, it's like they need a good slap on the face to bring them down to earth. They are annoying!

From own experience with a lot many of those types under different circumstances, becoming a doctor seems to come to many, not all, with a superiority complex that borders psychic malfunction.

I think it's a combo of our own social projections that levitate the candidates to the clouds and the deeper insight about the transience of the physical body which they acquire while on their way to that social stratosphere.
 

DLT

Well-Known Member
Orange Room Supporter
From own experience with a lot many of those types under different circumstances, becoming a doctor seems to come to many, not all, with a superiority complex that borders psychic malfunction.

I think it's a combo of our own social projections that levitate the candidates to the clouds and the deeper insight about the transience of the physical body which they acquire while on their way to that social stratosphere.

you are right, it might be the mix of both of these factors. I find them moody too.
 

My Moria Moon

Legendary Member
Orange Room Supporter
you are right, it might be the mix of both of these factors. I find them moody too.

True. I forgot to mention that this is irrespective of nationality, it seems "doctorship" is own nationality, emirate/ caliphate / kingdom :D
 

DLT

Well-Known Member
Orange Room Supporter
True. I forgot to mention that this is irrespective of nationality, it seems "doctorship" is own nationality, emirate/ caliphate / kingdom :D
hehehehe right, but you know a lebanese doctor is still more special :D
 

Nayla

Legendary Member
Orange Room Supporter
I made some researches about the Gas Gangrene Disease to know what they're talking about:

"Symptoms progress at a very rapid rate. Treatment may include antibiotics and surgery to remove the dead tissue.

Gas gangrene is a medical emergency. If not treated quickly, it can lead to death in as little as 48 hours."

"Gas gangrene is caused by bacteria called Clostridium perfringens (C. perfringens). In some cases, it can be caused by Group A Streptococcus.

Gas gangrene generally occurs at a recent surgical or injury site. Rarely, it happens spontaneously, without apparent cause. In either case, it comes on suddenly and spreads quickly.

Certain injuries have a higher risk of causing gas gangrene, including:

  • wounds that are very deep
  • injury to muscles
  • crushed tissues
  • wounds that are contaminated with stool or dirt"
"Treatment must begin immediately. For advanced cases, it may be necessary to begin treatment before test results are in. Dead or infected tissue must be surgically removed (debridement), and high doses of antibiotics will be administered.

In severe cases, amputation of a limb must be performed to prevent the infection from spreading to the rest of your body.

Some physicians and hospitals use high-pressure oxygen (hyperbaric oxygen) to increase the amount of oxygen in your blood. This f therapy is used to help wounds—especially infected wounds—heal faster."

"Preventing Gas Gangrene
If you have an injury, make sure to clean the skin thoroughly. Contact your doctor at the first signs of infection. Signs of infection include redness, swelling, pain, and discharge. Your doctor will remove any foreign objects and dead tissue from the wound.

Healthcare providers routinely give antibiotics before and after surgery to help lower your risk of developing an infection. Be sure to take all medications as directed by your doctor."

Gas Gangrene: Causes, Symptoms & Diagnosis
 

Dark Angel

Legendary Member
I made some researches about the Gas Gangrene Disease to know what they're talking about:

"Symptoms progress at a very rapid rate. Treatment may include antibiotics and surgery to remove the dead tissue.

Gas gangrene is a medical emergency. If not treated quickly, it can lead to death in as little as 48 hours."

"Gas gangrene is caused by bacteria called Clostridium perfringens (C. perfringens). In some cases, it can be caused by Group A Streptococcus.

Gas gangrene generally occurs at a recent surgical or injury site. Rarely, it happens spontaneously, without apparent cause. In either case, it comes on suddenly and spreads quickly.

Certain injuries have a higher risk of causing gas gangrene, including:

  • wounds that are very deep
  • injury to muscles
  • crushed tissues
  • wounds that are contaminated with stool or dirt"
"Treatment must begin immediately. For advanced cases, it may be necessary to begin treatment before test results are in. Dead or infected tissue must be surgically removed (debridement), and high doses of antibiotics will be administered.

In severe cases, amputation of a limb must be performed to prevent the infection from spreading to the rest of your body.

Some physicians and hospitals use high-pressure oxygen (hyperbaric oxygen) to increase the amount of oxygen in your blood. This f therapy is used to help wounds—especially infected wounds—heal faster."

"Preventing Gas Gangrene
If you have an injury, make sure to clean the skin thoroughly. Contact your doctor at the first signs of infection. Signs of infection include redness, swelling, pain, and discharge. Your doctor will remove any foreign objects and dead tissue from the wound.

Healthcare providers routinely give antibiotics before and after surgery to help lower your risk of developing an infection. Be sure to take all medications as directed by your doctor."

Gas Gangrene: Causes, Symptoms & Diagnosis
it seems the key factor here is that GAS gangrene rarely occurs spontaneously without an apparent cause, not many doctors would have been able to make the call, additionally she was suffering forma and being treated for another condition altogether, so the symptoms of the original condition would have made much more difficult to make the correct diagnosis.
quite a heartbreaking tragedy for everybody involved.
i think many states (if not all) in the US requires a doctor to have a malpractice insurance in case he makes the wrong call, else his license risks being suspended. humans make errors at times, there is no escaping this truth.

however, i think i know plenty of doctors who should go to jail for intentionally abusing and endangering their patients to make a few dollars more..
 
Last edited:

vegojimbo

Legendary Member
Regardless of how you may feel about doctors and Medicine in general in Lebanon, the security forces and the health minister have no right whatsoever to imprison the doctor without getting a professional opinion from either the Lebanese Order of Physicians or a panel/committee of renowned doctors of the fields in question (surgery, infectious diseases, pediatrics, hematology). Just like the regular Joe knows jack about fixing electronic equipment or repairing a broken car, only ppl with knowledge about medicine can judge the doctor in question and point whether there was malpractice or not.

On a side note, please get off your high horses. Some doctors are arrogant and full of themselves, but many are not. In fact, in Lebanon, doctors are underrated, unappreciated, unprotected, and many times abused by their patients. Medicine is the field that requires the most years of study by far, and doctors need to be continuously up-to-date with latest innovations. So if you may, some humility when u accuse doctors left and right.
 

vegojimbo

Legendary Member
Joe El Khoury
10 hrs · Beirut · Edited ·
While I'm on strike, Dr Kalam Ennas - Marcel Ghanem will be replacing me in the E.R. department next Monday and Tuesday, while Dr. Joe Maalouf and Dr Tony Khalife 1544 will be on duty for the rest of the week. Please do not hesitate to show up anytime between 1:00 AM and 5:00 AM, they will be glad to address your compaints as they have the knowledge and experience that I unfortunately lack. I realize that I have wasted 7 years of my life in medical school while I could have achieved much more with 3 years of journalism, a few clicks on google and invaluable medical articles on the few trustworthy websites that have taught them everything they need to know (Check au-feminin.com, sante-dune-femme-excitee.xxx and doctissimo.com)
Note that they are experts in infectiology, like many of their collegues (Some have participated to the discovery of the Guillain-Barré Virus, and they have even discovered the 100 000 cases of H1N1 that are running free in the wild while doctors are doing their best to hide this terrorizing fact), psychiatry specialists (Dr Khalife can explain in a few words the Homosexuality Paraphilia and tell you how to get rid of it, and they all always do their best to catch every schizophrenic patient leaving the hospital for his annual holiday in order to expose them to the public and prove the monstruosity of these people), but unfortunately, they still do not acknowledge the existence of some futile medical inventions like the "amniotic emboli" or the "Hemolytic Uremic Syndrome"- too boring, so please try to give another explanation to your symptoms if you feel that they are not convinced by your chief complaint.
Please rest assured that the continuum of care will be provided in the best way possible while we doctors are absent.
Have a good day.

 
  • Like
Reactions: DLT

DLT

Well-Known Member
Orange Room Supporter
Regardless of how you may feel about doctors and Medicine in general in Lebanon, the security forces and the health minister have no right whatsoever to imprison the doctor without getting a professional opinion from either the Lebanese Order of Physicians or a panel/committee of renowned doctors of the fields in question (surgery, infectious diseases, pediatrics, hematology). Just like the regular Joe knows jack about fixing electronic equipment or repairing a broken car, only ppl with knowledge about medicine can judge the doctor in question and point whether there was malpractice or not.

On a side note, please get off your high horses. Some doctors are arrogant and full of themselves, but many are not. In fact, in Lebanon, doctors are underrated, unappreciated, unprotected, and many times abused by their patients. Medicine is the field that requires the most years of study by far, and doctors need to be continuously up-to-date with latest innovations. So if you may, some humility when u accuse doctors left and right.

Of course not all doctors are like that, in my opinion the Lebanese doctors are the best in the world with other doctors from different nationalities too :) They take time to explain to the patients and they are very easy to reach.
And then you have doctors that are full of themselves, especially the one outside of Lebanon :)
 

Pablo Honey

Member
Elad , as part of the medical community , this is my opinion :

1. Jail before trial in lebanon for doctors in the case of a medical error is wrong and probably illegal ( someone correct me )
2. That said , without knowing the full details of the case , the doctor in question was greatly mistaken . University hospital or not , he is responsible for the care of his patient . Sunday or not , he and his team have clearly missed red flags in the baby's clinical course . One does not go from an acute febrille illness to fulminant DIC suddenly . There were grave error in diagnosis and management for her to reach that endpoint .
 

eLad

Legendary Member
Orange Room Supporter
Elad , as part of the medical community , this is my opinion :

1. Jail before trial in lebanon for doctors in the case of a medical error is wrong and probably illegal ( someone correct me )
2. That said , without knowing the full details of the case , the doctor in question was greatly mistaken . University hospital or not , he is responsible for the care of his patient . Sunday or not , he and his team have clearly missed red flags in the baby's clinical course . One does not go from an acute febrille illness to fulminant DIC suddenly . There were grave error in diagnosis and management for her to reach that endpoint .
thank you for your input, the opinion of a member from the medical community is highly valuable.

can you explain to us what are the red flags that the doctor missed? the way i understood is that a very common high temperature with babies at her age ended with a tragedy in a very short time.

what could have been done? a lot of us have kids here and many times they suffer from high fever. the first thing we do is reduce it with antipyretics drugs. i don't think any doctor recommends hospitalization and full examination for every case of high fever, especially that there are no other symptoms and knowing that at this baby's age even a tooth moving could cause a persisting high fever
 

nonsense

Legendary Member
Regardless of how you may feel about doctors and Medicine in general in Lebanon, the security forces and the health minister have no right whatsoever to imprison the doctor without getting a professional opinion from either the Lebanese Order of Physicians or a panel/committee of renowned doctors of the fields in question (surgery, infectious diseases, pediatrics, hematology). Just like the regular Joe knows jack about fixing electronic equipment or repairing a broken car, only ppl with knowledge about medicine can judge the doctor in question and point whether there was malpractice or not.

On a side note, please get off your high horses. Some doctors are arrogant and full of themselves, but many are not. In fact, in Lebanon, doctors are underrated, unappreciated, unprotected, and many times abused by their patients. Medicine is the field that requires the most years of study by far, and doctors need to be continuously up-to-date with latest innovations. So if you may, some humility when u accuse doctors left and right.

It is true that most doctors in Lebanon are overworked, underpaid, underappreciated. The order of physicians also has a lot to do with this as well, as do the insurances and hospitals. A minority of doctors who make it big and charge crazy rates take most of the attention so people think docs have it better off.

But that is true of probably ever profession in the country.

As to years of study, doctors are not special. And most are probably not up to date either. If the system is abusive to its own workers, it does not mean they have any special privileges over other members of society. So I think humility should be shared and equal by all. And doctors could best prove this by example. Some do, but they are not many.
 

nonsense

Legendary Member
Yes indeed this public lynching by the media is a circus. He should not be jailed until the case is examined by an independent medical committee, and then in court if need be.

But this is a symptom of the broader disease of lack of transparency and accountability that is in many sectors in Lebanon. Which is why we'll keep having these circuses.
 

Pablo Honey

Member
thank you for your input, the opinion of a member from the medical community is highly valuable.

can you explain to us what are the red flags that the doctor missed? the way i understood is that a very common high temperature with babies at her age ended with a tragedy in a very short time.

what could have been done? a lot of us have kids here and many times they suffer from high fever. the first thing we do is reduce it with antipyretics drugs. i don't think any doctor recommends hospitalization and full examination for every case of high fever, especially that there are no other symptoms and knowing that at this baby's age even a tooth moving could cause a persisting high fever[/QUOTEHere we are un
thank you for your input, the opinion of a member from the medical community is highly valuable.

can you explain to us what are the red flags that the doctor missed? the way i understood is that a very common high temperature with babies at her age ended with a tragedy in a very short time.

what could have been done? a lot of us have kids here and many times they suffer from high fever. the first thing we do is reduce it with antipyretics drugs. i don't think any doctor recommends hospitalization and full examination for every case of high fever, especially that there are no other symptoms and knowing that at this baby's age even a tooth moving could cause a persisting high fever
From here on it is all speculation . Did the doctor on the call know that she was oliguric .....was her urine output measured ...was her blood pressure checked frequently ....was she given enough iv fluids...is there a pediatric icu unit in the hospital and why wasn't she transferred to the icu ...where the appropriate lab tests taken ....did anybody inform her parents of her deteriorating case ....or as in many cases in Lebanon , families are reassured when all is not good.....a septic baby and the managing doctor is no where to be seen......the syndicate needs to answer these questions in a transperent way..... the doctor most likely needs to be tried but this public lynching is no way of dealing with the matter .
 
Top