PATIENT'S CLAIM

New Zealand Herald, Volume LXXV, Issue 23060, 10 June 1938, Page 15

PATIENT'S CLAIM

HOSPITAL BOARD SUED MEDICAL WITNESSES DEFENCE CASE CLOSED ADDRESSES TO JURY TO-DAY After five days' hearing, evidence for the defence was concluded in the Supreme Court yesterday in the case in which Mrs. Mary Margaret Barry, of St. Heliers, claims £1.8113 damages from tho Auckland Hospital Board on the ground of alleged negligent and unskilful treatment. She was a patient in the Auckland Hospital for a considerable part of last year, and was operated on on January 11 and April 7. She alleged that after one of these operations a swab had been left in her abdomen, and that this was recovered dhring an operation in a private hospital on November 27 last. Mr. Justice Callan is presiding. Mr. Sullivan and Mr. Winter appear for the plaintiff, and Mr. V. R. Meredith and Mr. McCarthy for the defence. When the evidence was completed it occupied 109 typed pages of foolscap, representing more than 40,000 words.

A Lump Discovered

Continuing from the previous day his evidence-in-chief, Dr. Trevor G. de C. Lowe said that on examining Mrs.

Barry during August he felt a lump and diagnosed it to bo a thickening of inflammatory tissue in the abdomen. This was what one would expect in the circumstances. The reason for not operating was that the infection was localised, and an operation would involve grave danger of general peritonitis. He therefore sent Mrs. Barry home for six weeks, but she did not come back to hospital. To Mr. Sullivan, witness said Mrs. Barry was under his observation from May 20 to July 30. Ho had heard Dr. Bridgman speak of removing something the size of a lemon. Referring to witness' examination of Mrs. Barry on August 14, Mr. Sullivan asked: "What words did you use in your report about si tennis ball?" Witness: The words are not mine. They arc my house surgeon's. I think he was erring on the large side. Remark in Report Witness agreed that the report on this examination said that it "revealed a mass the size of a tennis ball." • Mr. Sullivan: You are trying to repudiato that now? —I am not trying to repudiate it. Do you accept it?— With reserva-

tions. What reservations?— The words used by my house surgeon in describing the

operation procedure do not necessarily

meet with my approval. I accept the precis produced as substantially correct.

Who made it?—l myself made tho precis.

Witness said he could not be definite about the size of the lump, but it was hardly likely to be the size of a tennis ball. He had never come to the conclusion that there was a foreign body in this woman. Mr. Sullivan: Did you make a request to Dr. Main to look for a foreign body ?

Witness: I-did.The possibility cer-f~ tainly crossed my mind. Witness said he did not consider the use of opaque oil would have been the correct method of detecting a swab by X-ray. The swab would not show up with the oil, but it might show up without it. It was not unusual for sinuses to heal spontaneously, said witness, when asked to account for Mrs. Barry's speedy recovery after the operation in the Mater Misericordiae Hospital. X-ray Plates Witness would not admit that there was anything in the nature of a foreign body shown in Dr. Gwynne's X-ray plate. He did not attach any importance to the evidence of a thread having come away from the patient's wound. The case had symptoms which suggested a foreign body, but a foreign body was not the only cause of such symptoms. Dr. W. W. Main, radiologist, produced an X-ray plate he had taken of Mrs. Barry, and said he had reported on it: "No evidence of opaque foreign body in the abdomen or pelvis." The Elate disclosed nothing. If a swab had een there it would not have been shown on that film. Dr. Gwynne's plates showed a large spherical shadow, but the likelihood of the presence or a swab being disclosed on them was very remote. In his opinion the appearance pointed out by Dr. Bridgman did not represent a swab in an abscessed cavity. In cross-examination, witness said if he had been asked to look for a gauze or a swab he would not have used opaque oil. Ho could not recall ever having used it for the purpose of finding a foreign body. A Surgeon's Conclusions

Dr. K. MacCormick, honorax-y surgeon at tho Auckland Hospital for 16 vears, said that when ho saw Mrs. Barry in August her general condition was comparatively good. He folt that considerable surgical procedure might be required to relieve her condition, and that she should leave hospitnl for n time to prepare for this. Sinuses often persisted through some diseased tissue or foreign body. The former was the very much more common cause.

"I do not feel," said witness, "that it is iny business to state whether or not a swab was found, but I am quite confident the course of the case and subsequent relief are explicable on otfy?r grounds." The statement by Dr. Bridgman that he cut out a mass the size of a lemon from this part would represent an extraordinarily unusual feat or surgical performance. Witness did not agree with Mr. Sullivan that it was extraordinary that no record of Mrs. Barry's weight was taken when she was going in and out of hospital. He had in other cases had experience of a swab being left in, but lie had never found one. Dr. F. J. Gwynne, specialist in radiology, recalled, denied that Dr. Bridgman had told him that he had recovered some layers of gauze from Mrs. Barry.

■ The Last Witness Dr. Frank Macky, surgeon, said this case, as described by Dr. Dreadon, was just the type of case in which chronic sinuses would be expected. Mr. Meredith: What do you think was brought out at Dr. Bridgnian's operation ? Witness: I think it most likely that what was removed was the fragmentary remains of a wall or contents of an abscess cavity hitherto inadequately drained. 1 believe it is quite impossible to remove from the human abdomen intact an abscess cavity with walls three-quarters of an inch thick containing hidden within it a gauze swab. To remove Buch a mass from Buch a position would be a most unusual performance, and witness knew of only one case in which anything similar had been done. It could not possibly have escaped the notice of a trained observer like Mother Mary Agnes. In answer to Mr. Sullivan, witness said he had not seen Mrs. Barry until a day or two-- ago. This completed the evidence for the defence, and His Honor adjourned the Court until this morning, when counsel's addresses and His Honor's summing up will be heard.