DEATH UNDER ANAESTHETIC

Evening Star, Issue 20592, 18 September 1930, Page 16

DEATH UNDER ANAESTHETIC

CARDIAC FAILURE THE CAUSE The inquest Lunching tho death of Walter Tyrrell, who died in the hospital on Tuesday night while under an amcsthctic, was held at the hospital yesterday afternoon, Mr J. R. Bartholomew, S.M., sitting as coroner. Sergeant Hall represented the police. Edward Stanley Cross Tyrrell identified the body as that of his father, who had been'ill for the last six years and unable to work during that time. He suffered from tubercular affection of the glands. About 6 p.m. on Monday ho took ft bad turn, and Ur London was sent for and ordered his removal to the hospital. Witness did not see his father after he left the house. The deceased was fifty-nino years of age. Dr Lindon said be had been attending the deceased for about folir years for general glandular tuberculosis. Witness had not seen him for six or seven months till Tuesday night, when deceased had been ill for twenty-four hours. Deceased then was Buffering from what was known as acute abdomen, necessitating his removal to the hospital with a view to operation or not as it was thought fit in the hospital. Witness said he had sent the deceased to the hospital on a former occasion, when he told the authorities lie thought the deceased might have a perforating ulcer. On this occasion lie thought it pointed more To appendix trouble. The deceased bad told witness that Dr Batchelor had told him ic had appendicular trouble. In a note to the hospital authorities, witness mentioned the former trouble. Witness did not see him in the hospital, but from his knowledge of the case the deceased should have beeu a suitable subject for an ansesthetic. He had not, however, made any particular examination for that purpose, but left it for the hospital authorities. The case was one which might need an urgent operation at any time. Witness knew that the deceased had not been operated on on the previous occasion. The deceased’s heart would be affected by his trouble. Dr R. A. H. Fulton said that on Tuesday night ho received a telephone message from the hospital stating that a man had been sent in by Dr Lindon with acute abdominal pain of twentyfour hours’ duration. Witness visited 'the hospital at 9.15 and discussed the history of tho case with the house surgeon, Dr Ashcraft. Witness later examined the patient in the operating theatre, paying special attention to the chest and abdomen. He was of opinion that there was a murmur present in the heart, indicating some previous disease there, but not such as to render tho administration of an anaesthetic in any way dangerous. Witness examined Ins lungs carefully, and could find no evidence of bronchitis or pneumonia. The examination of tho abdomen suggested to him that the patient was suffering from inflammation of the appendix or gall bladder with local peritonitis. Witness decided that an immediate operation was necessary. Dr Stevenson administered the anaesthetic. While witness was washing his hands, his hack being to the operating table, bo board sounds indicating that the patient was struggling. After a few moments that ceased, and tho deceased was breathing deeply. The theatre sister was fastening witness’s gown and mask over his face when ho noticed that Dr Stevenson had .removed tho ansesthetic from tho patient’s face and was commencing artificial respiration. That would bo about five minutes from the commencement of the administration of tho amesthe.tic. Witness stood by for a moment and then assisted with restorative measures, which were artificial restoration, oxygen inhalation, and injections of strychnine and adrenolin to tho heart. He also made a rapid incision and performed massage of the heart with his hand. There was no response, and, half an hour having elapsed from tho commencement of resuscitation, it was considered that those measures had failed. In witness’s opinion, death was duo to acute cardiac failure coming on with great rapidity during the induction of anesthesia. The contributing cause to that cardiac failure was tho pre-exist-ing long-standing tuberculosis. Witness believed the deceased would not have recovered without au operation. The previous records were consulted before the operation, but they did 7iot help in the present diagnosis. The choice of nniesthetic .was left to tho ansosthetiat.

Dr Stevenson, house surgeon at the hospital, said that at 9.30 p.rn. ho first saw the deceased in the operating theatre. He examined him prior to administering tho amesthetie, and found that the heart was somewhat enlarged. He heard a double murmur accompanying the heart sounds, but considered ho was a fit subject to have an anaesthetic administered. He had been already examined by Dr Strang, who bad discovered from questioning that the heart muscles were sound. Tho anaesthetic used was a mixture of chloroform and ether. Witness had been administering tho anaesthetic about seven minutes when tho patient suddenly collapsed. Prior to that there was nothing unusual in his struggling. Witness at once took the usual restorative steps and corroborated Dr Fulton’s evidence in that respect. Ho agreed that tho cause of death was cardiac failure due to tho induction of anesthesia. From a record of tho deceased’s heart, extending over a number of years, it would be impossible to foretell that he would collapse under an anesthetic. After reviewing the evidence, the coroner said his verdict would be that death was duo to cardiac failure while under an anesthetic for a necessary operation. “It is only proper to add,'"’ ho said, “that all proper steps were taken by the medical officers concerned prior to the administration of the anesthetic, and also that all proper remedial measures were taken when the deceased collapsed under the anesthetic.”