Tbilisi: The Ombudsman of Georgia, on February 19, invited a group of specialists/experts for a regular visit to the clinic “Vivamed” to assess condition of Mikheil Saakashvili.  Given the mandate of the Ombudsman, the purpose of the visits of the expert group from the day of its establishment is to monitor the medical services provided to the patient. The group did not/does not join in the immediate process of treatment of a patient.
 On February 19, the members of the expert group planned to examine the patient and introduce his medical documentation. Mikheil Saakashvili’s physical examination was possible, and medical materials were provided on-site. Unfortunately, the clinic could not provide it due to a non-working day.Â
However, the Public Ombudsman has requested all medical materials from December 4, 2022 (the last visit of the experts to Mikheil Saakashvili), and the introduction of the materials will be carried out by the expert group.
 The Public Ombudsman’s Apparatus and a group of experts will continue intensively monitoring the health management of Mikheil Saakashvili .
 The February 19 visit was attended by experts: Tengiz Tsuladze (neurologist), Grigoli Khurtsidze (therapist, internal diseases/hospital medicine), Giorgi Kacharava (cardiologist) and Nino Zavrashvili (endocrinologist). Giorgi Papiashvili (cardiologist / arithmyologist) and Giorgi Grigolia (anesthesiologist-reanimatologist) also participated in the online discussions held after the visit.
As per the conclusion of the doctors-experts, the patient’s condition is as:
Sensible aggravation since December 4 (last visit with patient).
 With an objective survey:
Expressing severe sarcopenia.
The patient lost another 5.7 kilograms at the expense of a significant muscle analysis. Movement is significantly limited due to weakness.
The fall marked a strong drop in pressure from 125/75 to 60/40, accompanied by a loss of balance and sense of coordination.Â
Remarkable further decline of mental functions
 Impressions:
1. Sarcopenia, muscle dislocation, severe 4th stage of cachexia.
2. Critical drop in orthostatic pressure due to loss of coordination.
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Forecast and risks:
1. Patient enters the active catabolism phase.
After losing 5-7 kgs, he will be chained to a bed because his lower limbs are completely dislocated and unable to move due to weakness.
If you lose weight at this rate, it is expected to reach this point in 1-2 months.
The critical weight for him is 52-53 kg, after which the inevitable changes in the body will begin.
2. Peripheral and autonomic neuropathy is deepened, which causes a critical drop in blood pressure during fall.
Currently, unsupervised patient movement is dangerous as the risk of falls, bodily injury/fractures are very high. In the case of the latter development, the resource of the coxial body to heal the wound or fracture is very low, leading to other critical complications (haemorrhoids, infection, deep vein thrombosis, etc. B). Cascade development with a high probability of a lethal outcome.
 Members of the specialists/expert group: Giorgi Grigolia, Grigoli Khurtsidze, Giorgi Kacharava, Giorgi Papiashvili, Tengiz Tsuladze and Nino Zavrashvili.
