THE DEATH OF JOHN McGUIRE.

New Zealand Herald, Volume XXXVIII, Issue 11642, 2 May 1901, Page 3

THE DEATH OF JOHN McGUIRE.

CORONER'S INQUIRY. / EVIDENCE ON THE ADMINISTRATION OF CHLOROFORM. The adjourned inquiry into the circumstances surrounding the death of the young, man, John McGuire, who died at the District Hospital on Saturday last, while under chloroform, was resumed yesterday morning, before the district coroner, Mr. T. Gresham, and a jury of sis; Mr. J. M. Jefferson as foreman. Mr. W. J. Napier represented the family of deceased,' and Sergeant Gordon appeared on behalf of the police. On the application of Mr. Napier, all witnesses to the facts were ordered out of Court, with the exception of Dr. Adams. STATEMENT OF DECEASED'S FATHER. Patrick McGuire, father of deceased, who commenced to give evidence on the opening day, continued. He said deceased entered the hospital on April 10, about 10 days after he had been injured. Deceased was not in any way inconvenienced by the condition of his nose; of this witness felt certain. The first mention as to the condition of deceased's nose was made on Tuesday, 25rd, when deceased told witness that the doctor said there was a bone broken or something, and that he would have to undergo an operation. Deceased took bold of his ii'jat: and pulled it, stating that it did not hurt him, but that when lying on his back his breathing was interfered with ; there was difficulty in drawing his breath. Witness thereupon advised hi.-' son not to undergo the operation, saying that he thought the breathing trouble would wear off ail right. Deceased, in reply, said that the doctor had said he (deceased) must undergo the operation. Witness had nevtr known deceased to have a day's illness in his life ; he was a big, strong young fellow, and not what witness would call a nervous man. He was always temperate in Ids habits, and always had been ; but was fond of a cigarette or pipe, though by no means an excessive smoker. He had never gone in for excessive athletic training, and bad always kept himself to himself, living quietly. When witness visited hisn at the ! hospital, deceased said his knee was getting, on fine, and that he expected to be out by the following Monday or Tuesday, April 29 or 30. Witness understood that if deceased underwent the operation he would need to take chloroform. He last saw deceased alive on Thursday, 25th, in the afternoon, I when he remained with him for about an ! hour. Deceased was then quite jolly, and apparently did not have any apprehension of the results of chloroform being administered to him. To the Foreman: Deceased had not said that the nose pained him, but that it caused inconvenience. THE MEDICAL EVIDENCE. Dr. T. Hope Lewis, who conducted the post-mortem examination on the body of deceased, at the direction of the coroner, was the next witness called. The doctor, in his evidence, said there were no external marks of violence on the body, except an incised wound over the left external jugular vein. Both the kidneys, the liver, and the spleen were abnormally developed, but he did not think that the organs were enlarged by disease. The man was a big man, and there was not necessarily anything extraordinary in these conditions. The stomach was empty, the lungs normal, and the heart weighed 1503. the normal weight being lOoz to 12oz. The heart was fatty, and its muscular tissue appeared pale. The right ventricular walls were very fatty and attenuated, this being very marked. The organ was soft and flabby, and in a diseased condition. The brain was normal. Witness was sure that the brain had not been in any way injured by the operation. The nose showed an almost complete closure of the right channel, and the left channel was abnormally large. There was evidence of a section of the central cartilage having been cut. There was no evidence of disease sufficient to cause death. The condition of the heart of deceased could not, in witness' opinion, be accurately diagnosed while he was alive. He thought that it was impossible to diagnose the dilatation of the heart in question. He should say there would not have been any appreciable irregularity of the heart-beat disclosed during life, also that it would have been impossible to have discovered the existing fatty degeneration of the right side. To. Mr. Napier: There would have been some bleeding from the cut in the nose, and as far as witness could see there had been no plugging for the purpose of preventing the down How of blood to the larynx. It was the usual practice in Auckland to examine the iieart of a patient before administering chloroform, but the practice was by no means a. universal one. After discovering the existence of heart disease, it is the general practice to administer chloroform notwithstanding the disease. In certain cases it would not be administered. Experts were not employed solely for the giving of anaesthetics except in the large centres of England. Chloroform might cause death either by suffocation or by direct action on (lie heart. His opinion was that death was caused by the absorption of chloroform into the nerve centres supplying the heart, thus causing paralysis. In administering chloroform properly a sufficient amount of fresh air should be allowed for the patient. The open method of administering chloroform was usually adopted by the profession in Auckland. There was always a certain amount of danger to life in the use of chloroform, even though properly administered. The very few deaths of patients under chloroform in Auckland spoke well for the administration of chloroform in this centre. It was quite possible that deceased might have been placed sufficiently under the influence of chloroform in ten minutes to allow of the operation being proceeded with. If there had been any interference with the breathing the administration of chloroform would be unsafe. The free breathing of a- patient, under the influence of chloroform was necessary for safety. He was quite aware that the Hyderabad Commission held that death was not due to direct action on the. heart, but to suffocation. It was always necessary that the closest attention should be paid to breathing. In the administration of chloroform to a. patient it was almost immaterial,'as far as risk to life was concerned, whether the heart was diseased or not. provided that the respiration was carefully watched. He did not know whether the principles of the late Professor Syme in administering chloroform were carried out in Auckland. He did not know anything about the statement that during forty-two years nob a single death had occurred under chloroform where Professor Symes' principles had been carried out. He agreed with the opinions of Lord Lister and Df. Waller, physiologist, two eminent authorities on medical subjects, that in the administration of chloroform, death was nearly always due to unskilful administration— was to say. to overdosing. Witness did nob consider it desirable that young and comparatively inexperienced medical men a* house surgeons and physicians, should be left in sole charge of a hospital ; there should be a permanent resident experienced medical man. Mr. Napier: You know what the present conditions are with regard to the Auckland Hospital ? Witness: I think the present system most unsatisfactory. To the Coroner: He considered the matter of the nasal septum an operation of a minor character, yet- one that he would have advised. To Mr. Napier: With the knowledge he had of the deceased, derived from the post mortem, he would not have hesitated in administering an anaesthetic. The operation to the nose of deceased was quite a common one, and one not considered dangerous. To Dr. Adams: He could not suggest any cause for the enlargement of the organs referred to as abnormal. He did not think alcohol would cause the enlargements with the exception, possibly, of the liver. He would consider the fatty degeneration of the heart a pathological condition. The abnormal adherence of the capsule of the kidneys in the case under notice was such as was frequently caused by alcoholism. He would, however, have expected that a different condition of the kidneys would have existed had it been the result of alcoholism in this case. THE MOTHER OF DECEASED EXAMINED. Hannah McGuire, mother of deceased, being sworn, said deceased had always enjoyed good heaith. When he came to town,

about April 8 or 9, he made the remark to witness that lie thought there was something wrong with his nose. He had spoken to her about the proposed operation to his nose on the Thursday prior to his death, when she saw him at the hospital, and she had advised him to let well alone. In. the event of the operation being decided upon deceased told witness he would get* the hospital authorities to ring up and tell her in order that she might be present. Witness left the institution with the understanding (between herself and deceased) that she was to be informed of the operation, should it be the intention to carry it out. Deceased was robust and of temperate habits, and though not a teetotaller,. Avas not a man addicted bo drink. She understood that chloroform was to have been used in connection with the operation. To Mr. Napier: Witness heard of the death of deceased about half-past eleven on Saturday forenoon. She visited the hospital, arriving shortly after eleren o'clock, but it was not until nearly half-past that she heard of the death. During the interim two of her daughters and Mrs. McLeod came up to the hospital. Witness met Dr. Adams, who, on being asked, said that her brothertaking the son for a brotherwas very bad. and then that he was dead. Witness asked if a priest had been in attendance, and was informed that they (the doctors) had no time. She next asked if deceased died, from the chloroform, and the doctor said, No, he did not; he died through an unforeseen accident, through the instrument." Witness exclaimed, "Oh. doctor, you've killed him." The doctor, in reply, said, "I was one of five," whereupon witness said, " Excuse me, doctor, I did not know what I was saying." This was for what she thought might have been con--sidered a. somewhat offensive remark. .The doctor said he was sorry for her. Nothing was said about deceased's heart, but Dr. Adams volunteered the statement that he did not know how such a mistake could have occurred; it had never happened before. Shortly afterwards, in the hospital grounds, there was a further conversation between Dr. Adams, witness, her daughters. and Mrs. McLeod. Either Mrs. McLeod or witness asked the doctor what was the real cause of death, and Dr. Adams, in reply, said it was an unforeseen mistake through the wrong instrument, and then correcting himself, said "through an instrument," leaving out the word "wrong." Asked by one of witness' daughters if deceased's heart was sound, the doctor replied, " Yes, perfectly sound." Mention was made by someone present of chloroform, and the doctor said deceased was dead five minutes after lie was put under chloroform. Deceased had never complained to her, or in her presence, of anything being wrong with his heart. To Dr. Adams : Witness had seen her son the worse of drink a few times. She was quite clear that lie (the doctor) had stated that the death had been caused through the use of a wrong instrument, and not that be merely said that deceased died while under chloroform from an accident; without making reference to an instrument at all. She would not swear that he (the doctor) had used the words that he was "one of five" when she made the reference to her son having been killed. He might have said that there were five doctors present. To the- Foreman : Witness was not informed by anyone on the Saturday morning that the operation was pending. STATEMENTS OP OTHER RELATIVES. Rose Mary McGuire, examined, said she was a sister of deceased. She heard of his death about a-quarter to ten on Saturday morning by telephone ; she being at the time at the United Service .Hotel. Between eleven and twelve o'clock witness, accompanied by her sister Mary and Mrs. McLeod. went to the hospital. Her mother was there, and she and her mother were the first to meet Dr. Adams in the grounds. Her mother asked the cause of deceased's death, and the doctor, in reply, said "the wrong instrument," and then correcting himself, said it was " an unforeseen mistake through the instrument." Mrs. McLeod and deceased's sister Mary then joined the party, and Mrs. McLeod asknd the doctor if deceased's heart was bad, and rim reply was, " No ; it was perfectly sound." She did not remember any reference to chloroform. She was quite clear that what she had said in evidence had been spoken in the grounds. Mary G. McGuire, also a sister of deceased, gave evidence as to meeting Dr. Adams in the grounds. Mrs. McLeod asked the doctor if he thought chloroform was the cause of death, and on being, replied to in the negative, then asked if .he deceased's heart was the cause. The doctor said, "No, his heart was perfectly sound." Witness' mother then asked the doctor what was the cause, and he said at first, "It, was an unforeseen accident, through the wrong instrument," and then, correcting himself, said "an instrument," leaving out the word "wrong." Mary Agnes McLeod deposed to visiting the hospital, in company with Mrs. and the Misses McGuire. In the hospital grounds, in the presence of the other members of the party, witness asked Dr. Adams if deceased had died through the effects of the chloroform. The doctor said, "No," and then, being further asked by witness if the heart was weak, he said, " No, it was perfectly sound." The doctor hue! also said that death was caused "through an unforeseen accident with the wrong instrument," and then correcting himself, said " through the instrument." To the Foreman : Dr. Adams seemed very excited and nervous during the course of the conversation. EXAMINATION OF THE OPERATING DOCTOR. Dr. W. G. Scott, honorary visiting surgeon to the Auckland Hospital, sworn, said that his attention had been drawn to the fact that deceased was suffering from a deviation of the nasal septum, preventing air having free access to the right nostril. He suggested an operation to deceased, and on Saturday morning last, deceased presented himself in the. operating theatre for the operation. Dr. Adams, resident house physician, administered chloroform in the ordinary manner by means of an Esmarch mask. Dr. Peter Moir, acting as house surgeon. was also present, being there to assist" witness in the operation. Two or three nurses were also present, but witness could not say who they were. After Dr. Adams had put the man fairly under chloroform this lasting, some 10 sufficiently for the purposes of the operation, but not deeply under, the Esmarch mask was removed by Dr. Adams, who then introduced a mouth tube of Yanker's Inhaler, improved by Krohine. Witness thereupon placed an Asch's scissors in the nose, with the object of making the first incision. Before the incision was completed, or immediately on completion. Dr. Adams called out, "Is he breathing?" Witness immediately withdrew the instrument from the nostril, and, with the assistance of Drs. Adams and Moir, pursued a course oi treatment, with a view to endeavour to resuscitate the patient. About a-quarter of an hour or twenty minutes later Dr. Williams came in, and gave those present the benefit of his advice. After working for from threequarters of an hour to an hour, they ceased their endeavours to resuscitate. In the opinion of witness, it was about, ten to fifteen minutes after the chloroform had been administered that respiration finally ceased, but he could not say positively as to time, as he did not look at his watch. To the Coroner: There was no reason whatever for the suggestion that a wrong instrument was used, or that the correct instrument (the scissors) was wrongly used. The operation for the deviation of the nasal septum was quite a minor operation. He considered ether a. safer anaesthetic than chloroform, and stated that its use would have answered the purpose as well as chloroform. At this stage Mr. Napier asked for an adjournment, which was granted, the Court rising at half-past four p.m. Mr. Napier will proceed with his cross-examination of Dr. Scott on Friday morning at ten o'clock. "Three children sliding on the ice all on a. summer's day." Then there will he no difficulty in standing (be jolly in ice; it will set quicker. Twelve flavours, all excellent. Tucker's, overywheie, 6d packets. Wade's Teething Powders for babies are soothing, reduce fever and. prevent blotches. Price, Is. DON'T TOOK OLD. With advancing years groyness increases. 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