Esther Cohen (pictured with her husband, Rabbi Cohen, and four of their children), 33, died five weeks after having her sixth child. She suffered a perforated stomach ulcer which led to septicaemia and organ failure
The young wife of a Jewish rabbi died in hospital from an
undiagnosed stomach ulcer - just weeks after giving birth to their sixth child.
Esther Cohen, 33, had complained of sickness in the weeks
before and after the delivery of baby Avraham Tzvi.
After being sent home from hospital following the birth, she
was readmitted only to be discharged again despite her husband Rabbi Mendel
Cohen fearing his wife, ‘wasn’t the complaining type’ and was still very
poorly.
Mrs Cohen, whose grandparents helped found Jewish outreach
activities in America and Canada, was sent back to North Manchester General
Hospital after her sickness continued and she lost weight. She died a month
later.
Tests showed Mrs Cohen had a perforated ulcer which had not
been detected by doctors but which caused septicaemia and led to multiple organ
failure.
At an inquest in Manchester, Rabbi Cohen wept as the hearing
was told there is an ‘inherent’ difficulty in detecting diseases in the stomach
or intestine when a patient has recently given birth - as symptoms can be
attributed to the after-effects of delivering a baby. Doctors could not have detected
the symptoms any sooner.
Mrs Cohen - known as Esty and described as ‘very well liked
and very well respected’ - was originally from Albany in New York State but
moved to the UK in 2005 with her Manchester born husband.
He headed a synagogue in Broughton Park, Salford, and ran
the 60 pupil Lubavitch Jewish Boys’ School.
During her lifetime Mrs Cohen was said to be dedicated to
promoting Jewish life and the mission of Chabad-Lubavitch – an organisation
which helps promote Judaism and provides Torah lectures.
After marrying her husband she had given birth to her first
five children Moishe, now 13, Mushka, 12, Rivka, 10, Chana, seven, and Yechiel,
two. But problems arose after the delivery of Avraham Tzvi in August 2010.
Following the birth tests performed on Mrs Cohen at the
hospital’s emergency unit on August 29 showed everything appeared normal and
despite her vomiting, she was discharged on August 31.
Dr Tamer Al-Sayed said: ‘She spent the weekend in the
emergency unit and according to nurses notes she was stable throughout. There
was intermittent vomiting through the night and day but it stalled.
‘On August 31, I was asked to review the patient to see what
the plan was. Her blood pressure was normal and she had been able to eat.
‘I thought maybe the best the best place for her was home
given that there had been no changes throughout the weekend. She was stable and
ambient.’
During the hearing Rabbi Cohen’s lawyer Ian Cohen said he
was concerned that his wife had no energy and was very listless.
But Dr Al-Sayed added: ‘The sheer effect of reduction in
nutrition would have accounted for her lack of energy. If a patient was
presented in the same circumstances today I would follow exactly the same
procedures.
‘Over and above being a doctor, I am a human being, and I
would like to offer my sincere condolences.’
Dr Martin Patrick, a consultant physician in acute
medication said it was not necessary to carry out an abdominal examination.
‘Because vomiting had stalled and she was eating she should
go home,’ he said. ‘I saw Mr Cohen and explained this. She seemed well when I
saw her and she was mobile.
‘If she wasn’t keeping down food I would have kept her in,
but the notes I have are that she was eating. I know she wasn’t an “in your
face” type person but that’s why I arranged to see Mr Cohen. If there had been
no improvement I wouldn’t have sent her home.’
Mrs Cohen was discharged at around midday on August 31 but
readmitted on September 3 where she was described as suffering ‘profound septic
shock’.
Her condition again deteriorated on September 9 and by this
time, surgeon Professor Derek Alderson said there was evidence of organ damage
where the septic state had begun to impact on the function of her organs.
Professor Alderson said: ‘The examination of the abdomen in
women who have recently given birth is one of the old chestnuts in surgery as
you can miss small diagnoses like acute appendicitis when they have not long
given birth.
‘We don’t understand why that is but most expert doctors
have seen something like that.
‘Even if there had been something subtle there, the chances
of you identifying something with a single abdominal examination are really
small. You would have passed it as being normal and there is a risk you would
have missed perforation.’
Rabbi Cohen’s lawyer Ian Cohen said: ‘There has been
significant concern from the family that she wasn’t eating and wasn’t holding
down food.
‘You have a lady who was quite passive and didn’t complain.
We think that may have been interpreted as she was OK and improving.’
But recording a verdict of death by natural causes, Manchester
Coroner Nigel Meadows said: ‘It is obviously a complete tragedy that you have a
woman of 33 years old who is a mother of six and it deserved the fullest
investigation and that is why I have gone to the trouble of consulting medical
experts at public expense.
‘At the end of the day, I would hope you understand you have
had a full enquiry and matters have been looked at carefully. My deepest
sympathies are passed on and I know this brings back terrible memories.’
Speaking after the inquest, Rabbi Cohen said: ‘I did think
that the medical care was not perhaps up to par at the time but everything has
been followed up and today has clarified the care was up to the correct
standard. I want to thank the coroner and the medical staff for their
incredible work.’
A collection of memories of Mrs Cohen by family and friends,
as well as her own childhood journal entries, have been posted on a blog
RememberingEsty.blogspot.com
Family friend Rabbi Yossi Chazan, of Prestwich’s Holy Law
Synagogue, said: ‘Esther was reserved, gracious and very God-fearing and built
a beautiful family.
‘She was an aristocrat of the spirit, but at the same time
very devoted and always behind her husband in the running of the shul and the
school. She sacrificed a tremendous amount for these communal organisations.’
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