FORCEPS IN BODY.

New Zealand Herald, Volume LXVII, Issue 20560, 10 May 1930, Page 2 (Supplement)

FORCEPS IN BODY.

SUIT BY A WOMAN.

SURGEON WINS THE CASE.

STORY OF TWO OPERATIONS.!

"Tho risk of forceps being left in tha body, after an operation is one of the bugbears of the profession," said counsel i n a London Court a. few weeks ago. Ho was appearing in an action brought before the Lord Chief Justice and a special jury by a woman in whose body a pajj • s of forceps was found afteir she had under- 'H. gone two operations. * Miss Martha Harriot Gordon Crotch, of Vence/ near Nice, sued Mr; Ernest Mil es an operating Londori surgeon, for alleged negligence. Mr. Miles denied that he had left forceps in the body of his patient or that ho had been in any way negli. gent. Miss Crotch was operated on<\by Mr. Miles in 1920. She had another operation in. Franco in 1926 and the forceps were discovered and removed in ' 1920. Dr. Louis Prat, who conducted the operation upon Miss Crotch in June, 1926, said that the forceps which ho used werq of a different type from those subsequently found in the body. In cross-examination ho said that during operations no discounted tho forceps or swabs used. Dr. Dominic Maestracci said that ho examined Miss Crotch in September, 1928, and 'ordered tho X-ray photograph which rovealed tho presence of forceps in the body. Ho had seen Dr. Prat operate several times and the. typo of forceps which ho used differed from thoso found in tho body. . • ,s Dr. Henri Fay, who conducted the operation at Nice in September, 1928, when the forceps were removed from tile body, agreed that it was impossible for a surgooh operating in a difficult case to keep count of all tbo swabs and forceps used. It would be possible for an instru* ment to be left inside the patient's Without negligence on the part of the surgeon. _ ' Eight. Years Afterwards. , Mr. Rayner Goddard,, K.C., who ap< peared for Mr. Miles, submitted that under the- Statute of Limitations the action, did not lie, Admittedly, discovery of the alleged negligence had not arisen until'eight years later, but he contended that the time limitation dated from the date of the alleged negligence and not from the date of discovery. It would bo unfai? to Mr. Miles to ask him to account for an operation conducted ten years ago, particularly as there lhad been intervening operations. ,It was agreed that the point raised should remain optm till a later stage, Mr; Goddard stating that Mr. Miles was anxious to be given an opportunity of making '.his explanation. Mr. Goddard, addressing the jury, said . that there were colossal difficulties in the way of Mr. Miles answering this case. Memories were fallible, documents were destroyed and witnesses died in the course of tpn years. The vital witness for Mr, ! Miles, the theatre sister, was among thosa who had died. Since the operation in 1920 another operation had been conducted by Dr. i' ci ' Prat, who, on his own admission, never counted his instruments. They had bean told that after Mr. Miles' operation Miijis Crotch had gone to surgeon after surgeon, expert after expert, let none of these discovered the forceps and it was left to Dr. Maestracci, a small general practitioner, -to detect the source of the trouble, after the operation bv Dr. Prat. Was it not an irresistible inference, therefore,-^' — that the forceps were left inside the body after the second operation in 1926 ? Other!-, • wise the expert surgeons mentioned would have made the discovery years before. Mr. Miles Gives. Evidence. .v' j Mr. Miles, in evidence, said that he was emeritus surgeon at the Brompton Cancer Hospital and the author of a 'number of standard works on tlie abdominal region. Ho had performed hundreds of operations since that which he conducted uponfMisa Crotch in 1926, but he recalled that to- : ward the end of that operation the anaesthetist warned liira to finish as quickly as possible as there was clanger of collapse. 00( .i For abdominal operations, said witness, : ho always had with him. the same number of instruments? These were divided into's|#| groups of three or mult iples of three. He ) sjv devised this system so that missing instruments could be checked speedily by tho theatre sister before the patient? was ' sewn up. Never in the 30 years of his J';"' experience had he used forceps of the type found in Miss Crotch's body for work on • iu ai the abdominal cavity. . baffl At the end ol an operation he could . Y usually tell at a glance whether his in- ■ \j, struments -were all present. Hv relied upon the theatre sister, however, to see that the instruments were all correct.-,.,«« That was the accepted method in modern _ ||| hospitals, and theatre sisters , were very jggjj carefully trained for that task. " It would be absolutely impossible for a •. surgeon to hunt around for missing' in- 1* struments or swabs. To do" so would be A® l ? to expose - tho patient to very great risk s by delaying the operation. If, however, au instrument were reported missing, the doctor's duty was to satisfy himself that it was not in the abdomen. -''jawi Counting the Instruments. After an operation was completed and Sjj.fa the patient put to bed, it was h's custom • $ tv .to pack his instruments away :'uto their aijafc case, counting them as ho did s i.. Nevej;..{; in the whole of his career had ',Ve missed * ou' a pair of forceps. - ' •. •' "I can say absolutely definitely that -.lt? after the operation on Miss Crotch I.was . not short of a pair of forceps,' - .Mr. Miles v ,j p added. • ' 1 /. risM Mr. J. W. Morris, counsel for Miss e; j$ Crotch: If tho forceps found in Miss Crotch's body are yours your system must have broken down for once ?—-Yes, b'ut I t deny they are mjno. "An operation is a delicate matter, • j said Mr. ]\liles. "It is not like dealing with a motor-car, where you can smoke your pipe and think about things. gory is a ritual which is closely and. ;-ja strictly observed." . . Sir Hugh Rigby, the King's and consulting surgeon to the London Hos**, w pilal, said it was not tho common practice, for surgeons to count their instrumentsi after an operation. A trained nurse tended to that task. Judgment for Mr. Miles. Lord Hewart, sunnning-up, said: 1 Th®, \ task for tho jury is noli an emotional one, ,\'£| but a highly scientific one, and it is ® : to say that the reputation and skill 0. Mr. Miles are not involved in this case. "Everybody must havo tho greatest sympathy with Miss Crotch, who walked about for a long time with forceps in h® r . • body, but the real question was the ooW» |jp|& | plain ono: Who left the forceps there. j Lord Hewart drew attention to I .j 11 marked difference in tho practice adopt# by the French doctor who operated 0 , v Miss Crotch in 1926 and that of i> lu Miles. ,ii,« «0i "Tho French doctot- admitted that •?. ,^ ! . did not count his instruments; no ,V>' counted them," said Lord Hewart. V... tho other hand, Mr. Miles has tho elaborate and effective system pi? ? tised Ly him to ensure that no instrunie . is lost sight of.''' v Mr. Miles bad declared, with that he had never missed a pair of ceps in the whole of his surgical ca T ' The jury found thar, it had not established that the forceps weye Ie« * ■; Miss Crotch's body in the course 0 operation by "Mr. Miles. • ,r; lnf , Judgment wa3 entered for Mr* with costs. - \ t £