About 10 leading diagnoses make imprisonment incompatible - "Empathy" conclusion on Mikheil Saakashvili

The Center "Empathy" publishes a statement on the state of health of Mikheil Saakashvili, the third President of Georgia, citizen of Ukraine, Chairman of the Council of Reforms of Ukraine, who is imprisoned.

The forensic medical examination commission of the Center "Empathy" with the participation of 10 Georgian and 6 international experts conducted in accordance with the principles of "Istanbul Protocol", international and national legislation in the field of health care. According to the organization, the examination took place from June 1, 2022 to November 28, 2022.

The report consists of 194 pages and is accompanied by 22 appendices totaling 2,980 pages.

According to Empathy, Mikheil Saakashvili has more than 20 diagnoses or symptom complexes, of which about 10 are leading diagnoses, making incarceration incompatible. The major diagnoses mentioned are not made public at this stage.

"The Center "Empathy" and the expert commission of international experts as a result of analysis of clinical and paraclinical studies, submitted medical documentation, came to the conclusion that:

1) Before detention (10.01.2021) the patient was practically healthy, had arterial hypertension, was taking symptomatic medicines; also with anxiety - due to the depressive condition which developed in the post-coventric period (2020-2021), he was taking some medicines in small doses, with occasional interruptions; Against the mentioned treatment he felt good, there was a disturbance of social functioning. He was well fed. There were no neurological disorders.

2) Currently, the subject had symptoms and diagnoses (neuro-psychiatric, gastroenterological, as well as musculoskeletal, vision), fever of unclear etiology, anorexia, rapid weight loss, pain in muscles, joints, bones, irritations - scratches on the body - Traces of hair, muscle atrophy, which may be the result of an unspecified infectious process and/or possible intoxication, as the toxicological examination of the hair sample detected more Ba, Bi, Mercury (Hg) than the limit of documentation. These poisonous substances are dangerous in that they can cause not only physical, but sometimes mental disorders as well.

3) Thus we consider that Mikheil Saakashvili can not be in the current institution, as well as in conditions of imprisonment, as we consider impossible to conduct a full toxicological examination in these institutions; The timely diagnosis of poisonous substances, including chemical compounds and radioactive substances is necessary, otherwise, given the probability of intoxication, coma and lethal outcome should be expected.

4) The detainee was subjected to possible torture and improper treatment, as well as inadequate medical care in the Georgian penitentiary system. The conclusions of the experts include facts of physical and psychological inhuman treatment and stories of the detainee; among them the lies, forced hospitalization, humiliation of the detainee by the inmates of the criminal subculture and death threats, on November 8, 2021 when he was transferred from the colony N12 to the institution N18, there was noise - screaming, the prisoner was forcibly pulled out of the ambulance. In the institution N18 he had not been able to sleep for 11 days, when the light was turned off and the TV was turned off, the terrible things began - cursing and swearing from the prisoners - there was sleep deprivation; On the background of starvation, as well as the encephalopathy developed in the result of hunger, he was alone in the intensive care unit created for him, prisoners were yelling at him and threatening with death, in this state the subject risks death. (19.11.2021).

5) As a result of said torture and inhuman treatment (as a result of physical trauma), he most likely suffered a craniocerebral injury to his spine, and developed a severe form of traumatic stress disorder, with starvation and organic lesions and brain dysfunction. The mentioned trauma, unfortunately, according to the current rule of forensic medical examination of the degree of severity of bodily injuries of the USSR times is assessed as a trauma of medium severity, but taking into account the bodily and mental injuries and consequences in the aggregate it is assessed as severe.

6) Thus, the entire traumatic stressful experience in the penitentiary system, with its physical and psychological components, inadequate medical care, taking into account the severe consequences, is assessed as inflicting severe physical and mental suffering and, therefore, as torture.

7) According to the presented diagnoses (psychoneurological direction), Mikheil Saakashvili's current state of health is assessed as severe and incompatible with incarceration; Individual diagnoses, both individually and together, will lead to irreversible damage to health, reduction of life expectancy and even death if he is not given the opportunity to receive adequate diagnosis and treatment, Order N 01-6/N of Minister of Labor, Health and Social Protection of Georgia (15. 02.2013) according to the Change Order N01 - 55/N (30.08.2017) is the basis for release, and in the gastroenterological and nutritional direction is assessed as having a risk of severe cachexia.

The subject requires invasive/aggressive therapeutic diagnostic and rehabilitative procedures:

According to Professor Cobb: His condition is severe: musculoskeletal-wise, "He needs an accurate diagnosis and possibly a total replacement of the left shoulder joint and hip joint. After these procedures, he will need a C5-C6-male fusion. Subsequent decompression of the L4-5 spinal stenosis. "The severe weakness in his left arm and leg may be related to spinal atrophy and pain caused by immobility."

9) Dr. S.I. According to Finkel: aggressive diagnostic procedures will be required, i.e., regular follow-up EGDS and multiple gastric biopsies. These procedures are widely available in Western Europe and the United States. where they are performed by competent gastrointestinal endoscopists;

In consultations with psychiatrists, neurologists, and medical examiners:

10) Psychiatric and neurological diagnosis/diagnosis, requires additional aggressive/invasive techniques (e.g., liquor study, repeat CT, MRI, EEG - 24 hours, etc.) to direct neuro-cognitive impairment and adequate treatment - rehabilitation course, Otherwise, it will progress rapidly and end in malaise, cachexia and death.

11) The subject/patient needs high-tech investigations to clarify or exclude an infectious/intoxicating genesis and/or neurodegenerative process/disease, dysmetabolic process - Z13.8: Special screening for other clarified diseases and disorders for specific diseases and disorders (including studies of toxic agents).

12) Accordingly, Mikheil Saakashvili should be immediately released from prison and urgently transferred to a US and/or EU third-class multidisciplinary university hospital for diagnosis and treatment.

13) At the same time it should be noted that in case of diagnosed post-traumatic stress disorder - PTSD - F 43.1, which is associated with improper treatment conducted in the Georgian penitentiary system, the fear of deprivation of life significantly worsens the neuro-psychological and general state and makes it impossible even to achieve stabilization of the condition.

14) Any additional stress factor, including imprisonment alone, causes deterioration of the said state of health.

15) With such a mental and neurological status and condition, the imprisonment of Mikheil Saakashvili is unacceptable and incompatible with international standards of incarceration. His mental health condition, along with neurological, psychiatric or other disorders of the musculoskeletal system or digestive system, is in itself incompatible with incarceration," the statement said.