DOCTOR PROSECUTED.

New Zealand Herald, Volume LXI, Issue 18897, 20 December 1924, Page 13

DOCTOR PROSECUTED.

DISEASE NOT NOTIFIED. ALLEGATION OF FLOUTING. CHARGE STRENUOUSLY DENIED. SYMPTOMS NOT DEFINITE. [BV TELEGRAPH,— CORRESPONDENT.] HAMILTON. Friday. A pica of not guilty was entered by Dr. W. Fulton, of Waihi (Mr. J. F. Strang) to a charge at Hamilton of failing to notify the District Officer of Health that a patient he attended, Mrs. Catherine Kelly, was suffering from septicaemia, a notifiable disease. The case was heard before Mr. H. A. Young, S.M. Mr. H. X. Gillies, who appeared for ths informant, the Medical Officer of Health, said there was no suggestion against Dr. Fulton regarding his professional conduct. The case, however, had become an important one, in view of the fact that Dr. Fulton had decided to defend it. If he succeeded the medical profession would be in the position of defying the Health Department and its regulations. Relating the circumstances of the case, Mr. Gillies said that Mrs, Kelly, a resident of Waikino, who had been confined had developed symptoms indicating septicaemia, Hor temperature rose to a dangerous point and her condition became so serious that Dr. Fulton ordered her removal from a private nursing home to the public hospital at Waihi. He sent swabs to Auckland for bacteriological examination, and there was no doubt lie had grave suspicions that sepNcaemia was present. Mr. Gillies reiterated that Dr. Fulton's action in defending the case was an indication that the doctor and the medical profession as a whole intended to flout the instructions of the Health Department. Mr. Strang objected to Mr. Gillies' remarks. He said the suggestion was a most improper one to make. The defence concerned the' facts of the case before the Court and that case only. Mr. Gillies read correspondence written by Dr. Fulton to the District Health Office, Auckland, describing the patient's condition in detail and the precautions taken by the doctor with a view to ensuring complete disinfection. This correspondence, said Mr. Gillies, pointed to the fact that Dr. Fulton was suspicious that the patient was suffering from a notifiable disease. The doctor in one letter said that he was under the impression that so long as he took the necessary precautions he did not regard himself obliged to notify. Mr. Gillies commented that the attitude of the doctor appeared to be that it was his duty *o look after the interests of his individual patient, whereas the department was concerned with the health of the multitude. The Patient's Condition. Evidence was given by Sylvia Mary Burke, registered maternity nurse. She said the patient's temperature rose to 104.8. To Mr. Strang: There were no symptoms usually associated with puerperal septicaemia. * The only complaint tho patient made was of a feeling similar to that experienced when she had had gastric attacks following enteric fever, from which she had suffered some two years before. On admission to witness' home the patient had a slight epileptic fit. The child was born within two hours of the patient's admission. Dr. Hughes, medical officer in charge of the Auckland district, said that the charts supplied by the Waihi Hospital showed that the temperature of Mrs. Kelly upon admission to tho institution was 104, rising to 105 later in the day. Asked whether the circumstances of the case were 'such as to justify a suspicion of the existence of puerperal septicaemia, witness said that when after confinement the patient's temperature and pulse increased to any great, extent, one would naturally think, in the absence of any other explanatory cause,' that some septic trouble was existent. The whole facts of the present case certainly pointed to puerperal . sepsis. It was not absolutely necessary in puerperal septicaemia that a patient should exhibit the symptoms the absence of which were commented o.i by the nurse, but their presence was usual. There was not the slightest suggestion of any professional misconduct or mistreatment on tho part of defendant. He had simply failed to notify the department that he suspected the existence of a notifiable disease. Dr. A. G. Waddell, Hamilton, said that something more than a temperature and a pulse was looked for in a case of septicaemia. There might be shivering, in flanimation, distension of the abdomen and interference with the milk flow. Difficulty of Diagnosis. Defendant said he had been practising for 32£ years. Ho had been in New Zealand for three years. When Mrs. Kelly engaged him three months before her confinement, she complained of vomiting. Witness prescribed for her, and asked her to see him again if she experienced further trouble. Witness did not hear from her until the confinement. Mrs. Kelly said sho had been vomiting for several weeks just prior to her admission to the home. Witness described Mrs. Kelly's condition during the days following her confinement. He did not feel any uneasiness until three days after the confinement, when the patient's temperature became abnormal. The patient did not show any of the symptoms of septicaemia. He was puzzled over her condition, and spent hours trying to account for the abnormal temperature. Dr. Cole, {lie superintendent of tho Waihi Hospital, twice examined the patient, and he could not assist witness in accounting for her condition. Dr. Brown, now of Gisborno, also made an examination. Tho patient was admitted to the Waihi Hospital on the fourth day following her confinement. Witness' obligation conj corning tho patient ended when she was admitted to the hospital, but he still took a keen interest in the case. He disinfected the nursing homo because he always did (hat in cases where he could not account for a patient having a high temperature and pulse. Witness corld draw up an extensive list of diseases which might have accounted for the temperature and pulse of the patient, many of which were not 'notifiable. Witness" excluded puerperal septicaemia because of the total absence of symptoms, lie had attended 4000 confinement cases all over the world, and had never met a case of puerperal septicaemia until he came to New Zealand, where ho found it mens prevalent than anywhere else, and there was no mean: of accounting for it. Witness said he regarded the prosecution as an insult, and a reflection on his honour a- a medical man, especially in view of tho precautions he had taken. He took strong exception to the Crown Solicitor's suggestion that he desired to [lout the Health Department. He knew of no medical men who did not wish to I co-operate with the Minister for Health. To Mr. Gillies: Dr. Cole sent the swab to Auckland to establish a diagnosis. The thought that the patient's temperature of 104 and pulse of 123 were due to septicaemia passed through his mind, but lie bad no reasonable suspicion lie twecn the date of the woman's confine- j ment and the date she was sent to the j public hospital, four days later, that she ' was suffering from septicaemia, When | the swab taken by Dr. Colo was returned and the indications .-bowed the presence of septicaemia witness notified the case. The magistrate questioned defendant in connection with several letters written to the Health Department, in which he j cussed the case and referred to a sus- I picion that septicaemia existed. The witness stated he was endeavouring to help the department, and that the suspicion referred to did not come within the meaning of the Act. Ho admitted that he had expressed himself badly in tho letters. IT.? case was adjourned until January 25 to enable other "oa idence to bo taken.