Report on the State of Human Rights in Institutions for Persons with Disabilities Acute respiratory insufficiency; Acute bronchitis, bronchospasm; Acute swelling of lungs; Pediatric cerebral palsy.” The child’s condition was assessed as extremely severe. The child died on May 26, at 2:15 A.M. The preventive group conducted an inquiry into the condition of Sh.K. in the framework of the current monitoring and, in order to find out what had caused the sharp deterioration of the child’s health two months after s/he was admitted to the institution and whether medical assistance had been provided in a timely manner, the monitors interviewed the local medical staff and other involved persons. When asked about the development of pneumonia and swelling of the lungs, the director of the institution answered: “S/he had phlegm, the phlegm was accumulated, and it’s impossible to take out phlegm here.” According to the local pediatrician, the medical staff of the institution prescribed Sk. K. anti-convulsion treatment (against epileptic cramps) (Finlepsin, Diazetex) only on the basis of the words of the child’s mother who had said that the child had epileptic cramps. The medical staff of the institution had not seen the episode of cramps; the child had been admitted without a neurologist’s consultation sheet or documents confirming diagnosing or examination for EPI syndrome. The medical staff also prescribed Sh.K. Normokid (to remove vomiting), though the child had not had a single episode of vomiting during his/her stay in the institution. No examination had been conducted on the child to establish the cause of vomiting (if such had taken place) before the aforementioned medicine was prescribed. According to the pediatrician, on May 6, 2012, the child’s temperature rose to 390, and s/he was transported first to the Senaki inpatient unit and then, on the same day, to the Kutaisi hospital. According to the pediatrician, despite the fact, that the immediate cause of the child’s death was connected with acute bronchospasm and swelling of the lungs, Sh.K. had not had any types of respiratory (connected with breathing) problems during his/her entire stay in the children’s house. It should be noted that he child’s medical history also includes a sheet of paper with the results of the general blood test of Sh.K., on which the data were entered by hand; it is an ordinary sheet of paper without a stamp or official requisites of any establishment. A person called L. Kharbedia on April 27, 2012 did the test. A member of the preventive group talked independently to the nurse who had ac- companied Sh.K. when the blood test was taken; She confirmed that, due to the lack of insurance policy, they, indeed, had to take the blood test in the car and, with this aim, L. Kharbedia had actually violated a regulation established by law and taken the child’s blood covertly, without registration. The laboratory examination of the blood was also conducted unofficially. ANNUAL REPORT OF THE PUBLIC DEFENDER OF GEORGIA NPM Report 2012 It is these data that exposed the hidden details of the case. A person from the institution who had been present when Sh.K.’s condition deteriorated told a different version of the story to the monitoring group. According to him/her, Sh.K. did not have a medical insurance policy, and, for this reason, s/he was not hospitalized for 20 days, despite the fact that s/he needed to be transferred to hospital. When the child’s condition became extremely severe, the administration took the child to a hospital in the car of the Senaki children’s house, though, as s/he had no insurance policy, the blood test was taken in the institution’s car, under non-medical conditions (see the aforementioned document with the results of the blood test on a piece of paper without the requisites of the medical establishment which was obtained by the monitoring group). According to the person, the process of taking the blood test in the car was attended by N.L. – the music teacher, S.K. – the nurse, N.Ts. – the caregiver, Z.K. – the driver, and him/her himself/herself.