UNDER ANAESTHETIC

Evening Post, Volume CVIII, Issue 81, 2 October 1924, Page 11

UNDER ANAESTHETIC

DEATH IN HOSPITAL

MOUTH AND THROAT OBSTRUCTED

During an operation at the Wellington Hospital on 27th Sept-ember for the extraction of some teeth to enable him to radium treatment for a cancerous growth of the throat, an Ohakune stock inspector named William Charles King died. The circumstances were investigated by'the Coroner (Mr. B. Page, S.M.) yesterday afternoon. Sergeant Butler represented the police, and Mr. T. iP. deary appeared for deceased's widow.

Dr. Donald M 'Donald WOson, medical superintendent, said that determined by a specialist deceased's only chance of relief from the disease was radium treatment. Before the treatment could, be carried out it was necessary to remove some teeth, and for that purpose deceased was admitted to the Hospital. Dr. C. M. Hector gave evidence that the cause of death was asphyxia, combined with shock. A post-mortem, examination made by the witness disclosed a large cancerous growth involving the soft palate, the left side of the throat, and the left side of the tongue at the back "I should say," said witness, "that with this growth of bis throat the position of the mouth parts required by tho -dentist to carry out his operation would tend to cause obstruction of the air passages. Knowing what I do now I think it would have been a wise precaution to havo done an operation of tracheotomy before giving an anaesthetic, -but, possibly, the extent of the growth was not realised before tho operation commenced." Witness added that on removing the cancerous growth he found a large piece of cotton wool saturated with blood-stained fluid lying over the upper part of the wind pipe. He could not say whether it was put in before or after death.

Dr. Norman M'Kay, who administered tho_ anaesthetic, said he examined the patient's heart oefore the operation. He did not examine the throat, and when' he began administering the ether he was not aware of the fact that the patient had a cancerous growth. He had been administering the anaesthetic for about 15 minutes when he noticed that the patient's breathing became shallow, and he suggested that a stop should be made to enable him to pick up. The patient took only two more breaths, and then stopped breathing. Artificial respiration was tried without success, and when he exa>n|ned the heart 20 seconds after the patient had stopped breathing, he found that 'it had stopped beating. He was of the opinion that death was due to heart failure. From an anaesthetist's point of view it was not an aspliyxial death. To Mr. Cleary, witness said that ho Vvas told five minutes after commencing the administering of the ether that the patient had a cancerous growth. < Mr. Cleary: "In cases such as thesa is there no previous examination by anyone to see if there is any such condition as in the present case?"—" Not unless it appears to be a particularly dangerous case._ As a rule the anaesthetist, unless it is a dangerous case, does not know the nature of the disease."

"Would it have been useful if before tho operation some report or other details of the nature of the disease could have been supplied to you?"— "This was purely a dental case." "Don't you think it would have been helpful if you had known something about it? Would it have influenced you at all?"—"I don't think if I had known of'tho growth it would havo influenced mo whatsoever."

Witness added that on looking back on it now he did not think it a sufficiently bad case to mako an operation for tracheotomy necessary.

To tho Coroner: Ho was administering the anaesthetic mainly through two tubos down tho nose. Asphyxia in any marked degree sufficient to cause deatli was not obvious before death. From witness's observation of the patient he did not think it was an asphyxia death. It may have contributed to a slight degree, but tho main cause of death was heart failure, due to toxaemia from the growth accentuated by tho anaesthetic. Tho fact of the heart not containing blood pointed to death by heart failure! Erno3t Gordon Bender, senior dental surgoon, who extracted the teeth, said that owing to deceased's condition the use of local anaesthesia was prohibited. He did not uso packs or swabs. The piece of cotton wool was probably placed in tho throat after death. It was not there prior to death, otherwise he would have seen it. As soon as he entered the theatre ho advised Dr. M'Kay of the condition of the man's mouth # and throat. The patient was then partly "off."

The verdict was: "Tho deceased, who was suffering from an extensive cancerous growth in tho mouth and throat, died at the Wellington Hospital during the course of an operation, and while under an anaesthetic, the cause of death being asphyxia, combined with shock. It is not clear how the asphyxial condition arose, but it was probably due to, and accentuated by,, the cancorous growth in the throat."