SHIP OPERATION.

Auckland Star, Volume LXIV, Issue 145, 21 June 1934, Page 10

SHIP OPERATION.

SWAB LEFT IN BODY.

"NOT THE CAUSE OF DEATH."

STORY TOI/D AT INQUEST,

Sympathy with ships' doctors who arc called upon to perform operations under adverse conditions was expressed by the coroner, Sir. F. Iv. Hunt, S.SI., at the

inquest yesterday afternoon concerning the death of John Gillies (20), a steward on R.SI.s. Monowai. who died in the Auckland Hospital on Friday last. Evidence was given that a post-mortem examination of the body resulted in the discovery of a swab, but the coroner said that, after hearing the evidence, he was satisfied that the leaving of the swab in the body, had in 110 way been responsible for the patient's dea^li.

The inquest was conducted by Senior Sergeant Flannagan, and Sir. Gray appeared for the Union Steam Ship Company and the doctor who performed the operation. 111 asking that the inquiry should be held in camera Sir. Gray said that 110 possible good coukl come from giving publicity to it, but the coroner declined to grant the application.

The surgeon 011 the Slonowai, Robert James Boyd, said that he operated 011 deceased 011 board the ship 011 June 9, when the liner was one day out from Sydney 011 her way to Auckland. The patient was suffering from an acute general peritonitis, arising from a chronic appendicitis. The operation was performed under an anaesthetic administered by the chief officer, under witness' supervision, and another steward was present to assist. Giving a detailed description of the condition of deceased's abdomen, witness said there was paralysis of the small intestine, due to peritonitis. During the operation the patient appca. d to be sinking, and witness had to leave him to get a hypodermic charged with adrenalin. The patient then seemed to recover, and the operation was proceeded with. When the ship reached Auckland the patient, on witness' advice, was sent to hospital immediately.

Swabs Not Counted. Continuing, witness said that he had since heard that a swab had been found in the body. If that was so it might have slipped in while witness was getting the hypodermic, as he had laid a swab over the wound. The swab might have been 3£in by 2£in and was made of lint. The steward who was assisting witness had been present at two previous operations and had been instructed by the previous ship's surgeon. Witness had •merely instructed the steward to prepare the swabs and to sterilise the instruments. Witness did not know how many swabs had been prepared. He had asked the steward how many there were, but ha did not know. As the patient was in such bad condition 110 delay could be made and the operation liad been completed in the ordinary way. No count liad been kept of the swabs used.

AVitness said that lie did not expect the patient to recover owing to the widespread inflammatory condition of the peritoneum, under which condition fthere was always a great danger of death. The fact.that the swab was left in-would do no immediate harm, and later it would have been discovered and removed. The swab would have -had 110 effect because it would be closed' off from the abdominal cavity by adhesion. "Onfy a Chance." Evidence of conducting a post-mortem examination on the body "was given by Edgard. Francis Fowler, assistant pathologist at the hospital. He found a swab, he said, between two coils of the ileum. The cause of death, in his opinion, was acute generalised peritonitis and paralytic ileus. The post-mortem examination showed that there Was still present acute peritonitis and well-marked paralysis of the bowel. The inflammation was such that the removal of the appendix might have given the patient a;chance, but that was all. The swab might have retarded that chance of recovery, but would have nothing to do with the cause of death. In witness' _ opinion the .patient would have died in any case. Mr. Gray: Even in the best regulated hospitals and under the best conditions sw-abs are sometimes left in? Witness: I have heard so. Arthur Hallam Howie, senior resident house surgeon at the hospital, said, that deceased was "a very sick man" when he was admitted. He was. considered to be suffering from acute peritonitis and witness expected him to die. In reply to a question by Mr. Hunt, witness said that Dr. Macky had asked for a postmortem in order to see if an operation for drainage would, have been of any value, although he did not think that it would have been.'

The chief officer of the Monowai; Thomas William White, said that the operation 011 the last trip of the ship had been much the worst of any of the four similar operations at which he had ,been present. The doctor had not only the operation to perform, but also had to watch liis assistants.

No Qualified Assistants. In answer to Mr. Gray, Dr. Boyd said that he had been practicing for a considerable number of years and had performed many operations for appendicitis. He had been three years at -sea, but had previously performed only trivial operations 011 the ship. There was no quali-fied-person 011 the ship at the time except himself. Witness said-that about eight weeks before the operation he had told deceased that an operation was advisable and deceased -had said that lie' would have it done during his holidays. "The medical evidence shows clearly that this misadventure in no way hastened or caused death," remarked the coroner. "Deceased seems to have been in a parlous condition when the operation was performed. I find that the cause of death was acute generalised peritonitis." The coroner said that he sympathised with ships' doctors who had to perform operations at a moment's notice and without qualified assistants. It was wonderful that they were able to do as well as they did. He added that he thought the sugestion of Dr. Fowler that known numbers of swabs should be kept, in readiness 011 ships was an excellent one.