HEART FAILURE

Gisborne Herald, Volume LXXIV, Issue 22241, 29 January 1947, Page 6

HEART FAILURE

MR. BOOT'S DEATH SUDDEN COLLAPSE EVIDENCE AT INQUEST At the resumed inquest into the death of Mr. Vernon Patrick Boot, aged before the coroner, Mr. E. L. Walton, S.M., yesterday a finding was returned that death was due to syncope. Mr. Boot died in a private hospital in Gisborne on the morning of January 15. Senior-Sergeant G. S. Norris represented the police, and Mr.K. A. woodward the deceased’s relatives.

Dr. Stanley Burnham Lake Bowker said he had examined Mr Boot clinically prior to the operation. Mr Boot had told him that some years previously he was told by Dr. Hazel Allison, Christchurch, that she had experienced considerable difficulty in anaesthetising him for the removal of his tonsils as he was very resistant to chloroform. Examination of his heart and lungs showed no abnormality. The patient entered a private hospital on the night of January 14 and the following morning, after pre-medi-cation with morphine, a quarter grain, and atrophine. 100th of a grain the witness started the induction of anaesthesia, using a mixture of one part, ol chloroform and two parts of ether. Approximately GO c.cs. of the mixture was used.

Just after the induction stage had been completed and the witness had changed to pure ether, the patient showed very sudden signs of collapse, with weak pulse and shallow respiration. The anaesthetic was immediately stopped and artificial respiration started Cardiac and respiratory stimulants were given, and also oxygen. As there was no improvement after a few minutes he injected adrenalin into the heart and then carried out cardiac massage. Efforts at Resuscitation All efforts at resuscitation were unavailing, continued Dr. Bowker. On his instructions Dr. F. Kahlenberg was sent for. After consultation with him it was decided that further efforts were useless. The time anaesthesia was started was approximately 9.50 a.m. and 15 minutes had elapsed before the deceased showed signs of distress. At approximately 11.15 a.m. it was decided that the patient was dead. Approximately 10 months ago, the deceased first consulted the witness with regard to treatment for hay fever and urticaria of seasonal occurence. Dr Bowker said he had given Mr Boot a course of injections. On December 29 the deceased was not feeling well and he was found to be suffering from Vincent's stomatitis, for which he was treated with penicillin lozenges and sulphadiazine tablets. His condition improved, though he telt rather debilitated. Mr Boot was referred to Mr \\ llton Irwin for advice in regard to dental treatment. It had been agreed by the dentist that all the teeth should be extracted.

“When I decided to use oxygen on the patient the two oxygen cylinders in the theatre were found to be defective owing to the key not fitting the tap which was worn.’’ said Dr. Bowker. "Nothing else could be found which would turn the tap. The Cook Hospital was phoned and requested to send an oxygen cylinder to the hospital immediately. The cylinder arrived very soon alter and was utilised.” He said he had since learned that the deceased had suffered from mfective hepatitis when in the army and he appeared to be considerably debilit.tted for a lengthy period after that. Wilton. Lawry Irwin, dental surgeon, said the deceased’s mouth was anything but normal, when he started work on nis teeth about two years ago. The condition of his mouth would vary from a reasonably healthy condition to a mild inflammatory condition. When he saw the deceased at the hospital just, prior to the anaesthetic being administered he said Mr Boot appeared to be' in a cheerful frame of mind and reasonably normal. In his opinion every possible effort was made by Dr. Bowker and the theatre staff to restore life.

Called to Hospital

Dr. Fritz Kohlenberg said he had received a message from the hospital at 10 a.m. on January 15 asking him to take them some oxygen. He went to get his bottles o£ oxygen, but found them empty. He went to the hospital where Dr. Bowker was massaging the heart of the deceased. In the witness’ opinion the patient was dead. "I then inspected the oxygen cylinders in the theatre and found one of them sealed and the other one, the lock ot which 1 was able to tree was lull of oxygen and ready for use,’ continued the witness. "These two cylinders are the ones that are always in the hospital theatre. They belong to me, but would be used in any case of emergency. “The cylinder which came from the Cook Hospital was the one used on the patient.” The sister in charge of the hospital, Sister Lorna Stuart Ballantyne, said the collapse of the patient was sudden. Before the anaesthetic had taken full effect the deceased said: “I am still awake,” or words to that effect. “The collapse took place at this sta«e.” She corroborated the evidence of Dr. Bowker about the artificial respiration and stimulant given.

Dr. Cedric Walter Isaac gave evidence concerning a post-mortem examination. All the organs of the body .were healthy, but the heart muscle showed that death had been caused by syncope. That condition, in his opinion, was caused by the toxic effect ot the brain and probably to a slight degree, by an infection of the gums. As a result of his examination, the witness continued, he would have had no hesitation in giving anaesthetic to the deceased on lanuary 15. 1047.