Hospital cleared in probe of Anna Lindh's care

Sweden's National Board of Health and Welfare ruled on Monday that it found no grounds to criticise the care administered to former foreign minister Anna Lindh, who died in 2003 after a knife attack, following a review of her case.

"I can say that the board's overall assessment of medical records and the experts' review indicates that all the medical care was based on the science and reliable experience that existed in 2003," said agency director general Lars-Erik Holm in a statement on Monday.

Karolinska University Hospital, which treated Lindh after the attack, turned to the agency last autumn and requested a review of the care given to the former foreign minister.

The hospital made the request after a television programme questioned the care that Lindh had received when she arrived at the hospital on the afternoon of Septemeber 10th, 2003.

After a number of operations, Lindh eventually died on the operating table on the morning of September 11th.

In general, Sweden's health board does not investigate cases that are more than two years old.

However, due to the fact that the case dealt with a matter of great public interest - how the health care system functioned in a situation in which the country's foreign minister was involved in a knife attack - a special investigation was commissioned.

An expert team of three specialists proposed by supervisory authorities in Denmark, Finland and Norway have reviewed patient records and also interviewed staff who worked on the day in question.

According to the agency, there is no reason to criticise either the operations or the health care professionals who participated in the treatment of Lindh.

The report showed that Lindh was treated quickly by a trauma team when she arrived at the hospital. Head surgeons were changed several times in connection with the operations, ensuring that Lindh had doctors with the best possible training the various procedures which were carried out.

In addition, a large number of medical experts were called in to assist in the operations.

Lindh's stab wounds made the work to save her very complex, the agency found.

Initially, the staff concentrated on damage control. This included trying to stop the abdominal bleeding. At first, the bleeding was under relatively good control, but more surgeries were needed later.

Separately, the blood transfusion that Lindh received and the handling of problems with coagulation followed scientific practices and tested experiences.

In addition, it was inappropriate to provide care to Lindh with an artificial lung, known as an ECMO machine, because she was always well oxygenated. Any decision to provide her with ECMO treatment during her last minutes of life was not because she was beyond saving.

Lindh was stabbed repeatedly in the arms, chest and abdomen by a man with a history of psychiatric problems as she shopped at the upmarket NK department store in Stockholm without a bodyguard on September 10th, 2003.

She was fully conscious at the time of the incident and was subsequently taken to Karolinska for surgery, but died of massive internal bleeding some 13 hours later at 5.29am the next morning following massive blood loss due to internal bleeding.

The knife had damaged major arteries in her abdomen, including the aorta. Lindh's liver was also damaged.

Sweden's TV4's "Cold Facts" programme on Lindh's treatment featured two experts who testified her death could have been prevented, including US trauma surgeon Donald Trunkey, who said he "would have classified her as a preventable death."

Lindh's killer Mijailo Mijailovic, now 32, is serving a life sentence for the murder. The killing of the 46-year-old mother of two young boys sent a shockwave around Sweden, bringing back painful memories of the still-unsolved 1986 assassination of prime minister Olof Palme.

Lindh's widower Bo Holmberg died in February 2010, leaving behind their two now-teenage sons.