By Order No. 21 of the Public Defender of Georgia of February 6, 2025, a group of specialists/experts was created to assess the adequacy and timeliness of the medical services provided to defendant Mzia Amaglobeli.

Journalist Mzia Amaglobeli explains that she has not received food since January 12, 2025 (after her arrest).[1] She has not received food since the moment of her admission to the penitentiary institution (January 14).[2] She has officially declared a complete hunger strike since January 21, 2025.[3] Initially, she was placed in penitentiary institution No. 5, and on February 4, 2025, for the purpose of treatment - in the VivaMedi clinic.

Two members of the medical team, namely Giorgi Gvilia (gastroenterologist, cardiologist, internal medicine) and Elene Giorgadze (endocrinologist, nutritionist, pediatric endocrinologist, public health and healthcare organization) visited Mzia Amaglobeli at the VivaMedi clinic on February 7, 2025, while doctor Giorgi Javrishvili (ophthalmologist) visited the patient on February 12.

The doctors spoke with Mzia Amaglobeli, the medical staff of the clinic and the penitentiary service, and checked the patient’s medical documentation.

Results of the monitoring conducted by Giorgi Gvilia and Elene Giorgadze:

During the period of her stay at the clinic, including February 7, the patient was provided with all basic medical examinations and, depending on her condition and the results of the examinations, complete medical intervention was performed. In this regard, we, the members of the medical council, have no complaints or serious remarks about the medical staff of the clinic.

It can be said that on the 27^th day of the hunger strike, the patient's general condition was not as extremely severe from a medical point of view as it could have been during this period of hunger strike. By February 7, 2025, the loss of body weight did not exceed 10% of the initial weight. There was no so-called ketosis stage of hunger. The analyzes did not show severe anemia or severe iron deficiency. There were no laboratory data of acidosis. There was no decrease in glomerular filtration, the level of creatinine and uric acid was normal. Serum protein and albumin were at the lower limit of the norm, and the glycemic profile was not significantly abnormal, and there were no changes in liver function indicators. Echocardiographic data were within the normal range (no reduction in heart size, characteristic of severe starvation, was observed). A tendency to bradycardia was observed, heart was in sinus rhythm, borderline bradycardia, 60 beats per minute. The patient had no hypothermia, did not complain of shortness of breath during light physical activity or speech (only general weakness and slowed, but completely adequate speech were observed). She did not report impaired vision, hearing, or smell. She was taking fluids (water) adequately, orally. When swallowing water, she did not report pain along the esophagus characteristic of severe esophagitis, despite the fact that esophagogastroduodenoscopy had established the diagnosis of reflux-esophagitis variant LA-C (large, deep erosions prone to fusion in the distal part of the esophagus).

By February 7, 2025, the patient's energy balance was maintained by glucose solution infusion, electrolyte balance was maintained by systematic electrolyte infusion. Anemia was treated with iron and B group vitamin infusion (B1; B2; B6 and B12). There was no severe iron or B12 deficiency, severe anemia. Vitamin B1 was given to prevent possible Wernicke's encephalopathy (by February 7, 2025, the patient did not have symptoms of this syndrome).

Limb movement was free, she moved around the ward on her own, without assistance, however, she moved slowly. She did not complain of abdominal pain, she did not have pronounced symptoms of gastroesophageal reflux (for this, she was prescribed PPI and antacid).

By February 7, 2025, the patient's condition was assessed as satisfactory, although worth attention. In a similar condition, there is a high risk of rapid deterioration of the patient's condition, in particular, the second phase of starvation - ketosis and the third - irreversible protein catabolism - may occur rapidly. At this time, polyorgan failure and a real threat to life may develop very soon. We explained all this in detail to the patient, advised her to stop hunger strike and start eating according to special guidelines, or in case of refusal (which was her decision), to continue treatment and remain under observation at the clinic.

Results of the monitoring conducted by Giorgi Javrishvili:

The patient underwent ophthalmological diagnostics at the VivaMedi clinic. Diagnosis: keratoconus of the III degree of both eyes.

Several years ago, the left eye was operated on due to keratoconus - arc implantation was performed.

Currently, the patient reports visual discomfort and dry eyes, which is consistent with the general condition of the body against the background of starvation.

Conservative treatment of dry eye syndrome is underway.

I completely agree with my colleagues in the diagnosis and drug treatment tactics.

Members of the group of specialists/experts:

Giorgi Gvilia

Elene Giorgadze

Giorgi Javrishvili

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[1] Report IV-200-5/a of January 31, 2025 on the examination of the patient in penitentiary institution No. 5.

[2] Document on the results of the consultation of doctors held in penitentiary institution No. 5 on February 1, 2025.

[3] Letter No. 26177/01 of the Medical Department of the Special Penitentiary Service of January 30, 2025.