“That kind of order, like the one that came from former mayor Milan Bandić last Friday, when he asked me to call a meeting of the Executive Council with only one point on the agenda: to confirm the return of Dr. Asim Kurjak to Head of the Gynecology and Obstetrics Clinic, is one I don’t want to hear. I tried to explain to Bandić that at the last session of the Council, a tender was issued for 6 new clinic heads, that Kurjak’s mandate had ended before the court cleared him of any wrongdoing in the tragic deaths of Dragica Ivankić and her child, and that I see no reason why he should receive any special status and be appointed in place of current clinic head, Dr. Ante Klobučar. This is a short time period, the tender deadline is 8 January, and we must soon appoint a new clinic hear. I would prefer to not comment on the affair surrounding Dr. Kurjak, I am not a legal expert, and I would rather permit the judiciary to do its job. However, I would also like to do my job correctly and to treat each candidate for clinic head equally, and to select them based on professional references. However, Bandić did not have any understanding for my arguments, he spoke to me from the position of an owner, and told me that I had to implement the city’s policies. I hung up on him, and I am prepared to hand in my resignation is I am expected to implement political decisions.”

Lobbying Battle

Pavelić on the threats ‘Bandić called me and asked me to call a meeting of the Executive Council with only one item on the agenda: to return Kurjak to his former position’This excerpt of the telephone conversation with Milan Bandić was given to Nacional by Dr. Ljubo Pavelić. In and of itself, it is interesting as an example of a direct political dictatorship. However, after some investigation by Nacional’s reporters, it was shown that forcing the return of Dr. Asim Kurjak to the position of Head of the Gynecology Clinic in Zagreb is not only connected to his amnesty in the tragic deaths of Dragica Ivankić and her child about one year ago, but also to the fate of the entire Sveti Duh Hospital.

Nacional’s investigation into the news of a possible return of Kurjak as Clinic Head showed that behind the return of Kurjak, at Bandić’s insistence is the battle for the doctor’s and political lobby of the so-called Israel project. This is the name given in physician’s circles to the project of constructing a large new medical center at Sveti Duh: which is to include centers for dialysis, human genetics, woman’s health, osteoporosis and day surgery. The construction is to be financed by the investment fund Danel, under majority ownership by a powerful Israeli company, which is prepared to offer EUR 8 million up front. The hospital, together with Chief of Staff Dalibor Krpan, as he himself confirmed for Nacional, has already signed a contract of strategic partnership with Danel, and a new joint company has already been registered with the Commercial Court and is called “Polyclinic Sveti Duh II”.

This news was met with resistance in part of the physicians and political circles, due to fears that such an arrangement could actually be an attempt to put the entire hospital into private hands, and turn it into a massive source for profit. Krpan, however, believes that such a project and this financial assistance could result in a small but true revolution in patient care and in improving the chronically poor Croatian health care standards.

Krpan explained the idea of the project briefly. “The founders of Danel are strong companies, which are primarily Israeli owned, including Kardan, well known for its purchase of the Rostock Harbour, Hapoling Bank, Israel’s largest bank, Elbit, a computer company, Deutsche Bank and several smaller companies. This is an investment fund which creates feasibility studies in the fields of infrastructure and health case in transition countries. We have signed a contract which, with the help of the Hadassa Medical Center, the world’s leading genetics institute, will secure professional development, technology transfer and an entry onto the world market and top rate standards. Drago Primorac, a physician with international experience, will run the Human Genetics Center, and has already been to Israel several times for consultations. One of the first and most important steps will be to transform our dialysis clinic, such that our 180 patients can begin treatment under the highest standards within two months… This project could significantly alter the image of today’s hospitals and health care services.”

Bandić excluded

However, before this can come to life, the project is being ton apart by political interests and conflicts. As is well known, the Sveti Duh Hospital is owned by the City of Zagreb. Milan Bandić, who had no participation in the negotiations, is directly opposed to the new joint venture, which is supported by both the Health Ministry and the Health Insurance Bureau (HZZO), his party rivals. Bandić, however, knows the new investors, as he has been involved in various negotiations with the company, from bridge building to construction of golf courses and tennis courts in Zagreb. He was left out in the Sveti Duh negotiations, which obviously did not suit him as one of the “owners” of the hospital. Considering that Kurjak’s name was also nowhere to be seen in any segment of the new project, these two men became natural allies against the hospital director Krpan, president of HZZO Nikica Gabrić and Andro Vlahušić, Health Minister. Up until she was made Defense Minister, Željka Antunović also showed her support for the project.

As a result, last Friday, Bandić attempted to put some pressure on the administration of the Sveti Duh Hospital, hoping to return Kurjak to his former position as Head of Gynecology at any cost. Bandić allegedly left no stone unturned to secure a formal return by Kurjak, even though only days remain in the current tender. With Bandić’s help, Kurjak has succeeded in obtaining the necessary form stating that there is no ongoing legal cases against him, even though press reports say that he has been the subject of a police investigation for some time. On Bandić’s orders, Zvonimir Šoštar, Head of the Zagreb office for Health, Labour and Social Affair, also forwarded a letter to Krpan, suggesting that Kurjak be returned to his position, though there is no support for such a move in the legal regulations.

As he explained to Nacional, Krpan did not do what he was asked as according to the Statute, the clinic heads are appointed by the Executive Council and not the director, as Šoštar has so freely interpreted. “Such a situation is not explained anywhere explicitly, and considering that the clinic is now run by an acting head, I see no reason to call a session of the Council while the tender is still ongoing,” explained Krpan, adding, “Kurjak’s mandate ended on 23 November, while he sought a return to his position on 2 December, as the reasons and circumstances for which he had turned in his resignation had been resolved. He referred to the ruling by the Croatian Chamber of Physicians, which concluded that he was not responsible for the deaths which occurred.”

The point of Bandić’s involvement to reinstall Kurjak is quite unquestionable: returning Kurjak in the midst of a tender would act to discourage the remaining candidates. The message to the potential candidates would be as follows: if they are prepared to return him without regard for the rules and deadlines, then you can be sure of his reappointment.

Such a move by Bandić also aroused a critical reaction from Snježana Biga Friganović, head of the parliamentary board for health care. She declined to comment on the Kurjak affair, saying only that “things would unfold in their own time, a tender has been issued and the most qualified candidate should be appointed.” She feels that it is irrelevant who will be acting head for the next few days. Though she is not inclined to giving an assessment of Kurjak’s responsibility in the affair, she admitted that it was somewhat puzzling how the opinions on the cause of death of Dragica Ivankić was different between domestic and foreign experts. “I would rather not interpret those assessments, I would leave them to those who gave them, and to the General Attorney’s office to determine whether there is grounds to take further steps.”

The reason why Asim Kurjak is not in the plans for the new hospital center at Sveti Duh is because the hospital administration and the HZZO and Health Ministry feel that he has become too compromised over the past year in a series of affairs. He tried to cover up the circumstances surrounding the deaths of Ivankić and her baby, which suggested that the death of this mother of two was the result of a poorly lead birth.

Is Kurjak responsible?

General Attorney Mladen Bajić has called a meeting of the prosecutors this week in which to discuss whether the case against Kurjak will move ahead, and concerning possible criminal prosecution. Bajić has allegedly sought that this case be put on the agenda without any hesitation or cover-ups. Official reports have been collected by the authorized medical institutions and hospital commissions has shown that within the profession, there a split in the opinion concerning Kurjak’s responsibility. The possible outcome of the entire case could also be hindered by the fact that the patients which raised the allegations against Kurjak are no longer prepared to cooperate with police investigators out of private reasons. If the prosecutor’s office decides to raise charges against Kurjak, then that will imply further expert opinions as well as the essential cooperation of other damaged patients.

The death of mother Dragica Ivankić has still not received its epilogue, as Kurjak has tried to present to both the public and to Nacional’s reporters. For him, the case is over, as a court has acquitted him of and responsibility in the case. However, medical circles claim that this ruling came at an extremely tense time, stressing that the case was resolved by Ante Dražančić, former Chief of Staff of Petrova Hospital and one of the first perinatologists in Croatia. Today, he is retired. Some are inclined to doubt his objectivity, as his son Filip Dražančić is employed in the company HKO, which is owned by Kurjak’s son Alan. Talk in the grapevine is that as a sign of gratitude, Kurjak proposed that Perinatal Days be renamed Perinatal Days, Ante Dražančić.

It is also interesting that the acquittal was made despite the opinions sought from independent German, Slovenian and Norwegian medical chambers, which unanimously stated that errors existed and the deaths resulted from unprofessional conduct. A short report on these findings was even printed in the Medical news. However, in a conversation with Nacional’s reporters, Kurjak denied their findings. He claimed that these findings were thought up and that an apology would be published in the next issue of the publication. He also believes that the Executive Board has decided to return him to his old position. Of course, in that decision of 23 December, he only stated that the case of determining responsibility for the deaths had been closed. However, there is not a chance that he will be returned to this position before the tender deadline is up.

Political meddling

Kurjak also denies that there is a police investigation ongoing into his role. He has referred to the reports by the Internal Control Committee of the Sveti Duh Hospital which conducted an investigation into the media stories of egg cell abuses and fictitious operations. With the exception of three benign cases, in which insignificant administrative problems were uncovered, the committee confirmed that the procedures were all in accordance with the medical documentation, and that sufficient documentation existed.

Just why Kurjak is so keen on returning to his old position at any cost, when he was forced to resign in May, three full months after the deaths of Dragica Ivankić and her child. At that time, he suggested that he was returning his mandate out of an act of morality. The fact, however, was in the discussion on how Kurjak should be suspended. Over the past 20 years, he has enjoyed the reputation of a leading authority in the field of gynecology, however, that reputation has been seriously damaged over the past year. In December, he was re-elected as the Head of the Gynecology Department at the Faculty of Medicine, which helped somewhat to soften some of the blows delivered over recent months. Today he is fighting a serious battle to regain his reputation and status, as he knows that the new laws which will permit hospitals to be in state, private and combined ownership will bring with it radical change, and he has already been forced out of the Israel project.

The drama surrounding the election of six new clinic heads at Sveti Duh, as well as the long-term strategy of the hospital’s administration is likely best illustrated by one mistake which slipped out in a conversation between Kurjak and a reporter. When asked how he interpreted the discrepancy in opinions between the domestic and foreign experts, adding that Snježana Biga Friganović, president of the parliamentary health board had assessed it to be odd, Kurjak said, “What does politics have to do meddling in that? I’ll have to tell Račan about that!”

Kurjak’s case before the General Attorney

Over the past year, the press has expressed suspicions in Kurjak’s authority. Old notes have been brought out of the archives and wiped free of dust, and the assessment by the late Dr. Pero Bagović, president of the Department of Gynecology of the Faculty of Medicine, stating that Kurjak’s doctoral thesis was wreathing with falsehoods, scientific inaccuracies and plagiarisms. In the end, he completed his Ph.D. in Belgrade.

The public was also shocked by the scandal surrounding egg cells and ‘air operations’, what the press called his allegedly fictitious operations of the uterus septum, as a possible cause of infertility. As a result, the crime police have launched an extensive investigation into Asim Kurjak, and two and a half months ago, they handed over a thick file to Krunoslav Canjuga, on suspicions of illegal obtaining of material benefits and professional errors connected to the donated egg cells. It is expected that the Prosecutor’s Office will decide this week on the fate of those charges, the alleged abuses with egg cells and the professional errors which resulted in two deaths.