AMPUTATED LEG

New Zealand Herald, Volume 82, Issue 25180, 18 April 1945, Page 9

AMPUTATED LEG

HOSPITAL BOABD CASE denial of negligence A SURGEON'S EVIDENCE Evidence for the defence was heard yesterday against the claim, of a Huntly miner, Andrew Merelich, aged 56 CMr Haigh and Mr A. K. Turner), i for £4OOO general and £IO6O special damages from the' Auckland Hospital Board (Mr V. R. Meredith and Mr Goldstine) ifor alleged negligent treatment. The 'case is h e in K heard by Mr Justice Callan and a special jury. The plaintiff, who was employed by the Renown Collieries, Ltd., tore the igemilunar cartilage of his right knee in the mine on January 5, 1943. He was operated on for this in the Auckland Hospital by Dr D. W. Guthrie on May J, 1943. but the leg subsequently became affected, and had to be amputated jabove the knee on May 13. The plaintiff Alleged that the amputation was made ijiecessary by the negligent and unskilful treatment he had received in hosJital, and in particular that the log ad been too tightly bandaged and not sufficiently examined. The board denied that there had been any negligence in the treatment of the plaintiff. "No Prool of Allegations" "Proof of all these allegations is entirely lacking even upon the plaintiff's own showing," said Mr Goldstine, opening the case for the defence. "It is very difficult to find any proof whatever of these wholesale allegations which have been levelled against the doctors and nurses involved in this case." The plaintiff, counsel continued, had endeavoured to cast a widespread net in which to catch the doctors and nurses, making as many and as varied allegations as possible without knowing in fact whether they were really true, but in the hope that some doctor or nurse might be Caught up. The plaintiff in an amended statement of claim put in as recently as April 10 had shifted his ground, said Mr Goldstine. Evidence would be given by Dr D. W. Guthrie, acting-medical superintendent of the Green Lane Hospital. that the plaintiff agreed to be operated on by him and nursed in the general surgical ward. In that ward there were nurses with considerable orthopaedic experience. Causes Beyond Control It was conceded that this was an operation that did not usually create 8 great deal of difficulty r.nd that complications were unusual, counsel continued. but unfortunately what happened in this case was due to causes entirely beyond the control of any doctor or nurse and for which no one could be held responsible. The gangrene that set in was the result of a rare occurrence, known to medical science only recently, due to the obstruction of an artery. Tight bandaging would not cause it, but it was due to some inherent defect in the arterial system of the particular patient. This caused an arterial spasm, a condition that had only recently been discovered 'and described. There was no doubt whatever that that was what had occurred in this case.

Dr D. W. Guthrie, superintendent of the Green Lane Hospital, said he had had special experience in orthopaedic 6urgerv in England, and. for two years had had charge of all the orthopaedic outpatient work at the Auckland Hospital. Routine orthopaedic bookings extended for si.x or nine months ahead at the Auckland Hospital, but a special request came from plaintiff's insurers that he should be got back to work as soon as possible. Marelich agreed to be operated on by witness. Ordinary Technique Used The ordinary technique was applied, ■witness continued. The cartilage disfilacement was of some years' standing, t was quite impossible to have bandaged the aluminium boot produced on to the leg as described by Marelich, and uo such splint was used. When he first saw the patient again two days after the operation the leg was discoloured and gangrene was in process, said Dr Guthrie. This was the first sign that arterial present. The bandage was not tight. The leg was treated by exposure to cold for ninfe days, and then it was found, after consultation, necessary to amputate it. Recent Surgical Discovery Witness believed that late on the Sunday night or early on the Monday morning an arterio spasm set up which completely occluded the arterial circulation and produced the result as seen on Monday morning. Subsequent examination established that there bad been an arterial obstruction. This arterio spasm, now known as raso spasm, had only recently been given recognition in surgical text books, witness said. So many of these cases had happened recently as a result of the war that investigation had been able to establish the cause. The spasm in this case was initiated by a damaged segm?nt of the artery in the thigh consequent on the normal and proper use of the tourniquet. Statement by an Authority

To .Mr Haigh, wiHiess said lie conicl not say why vaso spasm should come about in this case and not in another. Vaso gpasm could occur as the result of a too tight tourniquet or of. a too loose one. The statement of a leading authority, Watson Jones, that "more limbs have been lost -by" the use of tourniquets than have been saved by them, witness described as a deliberate exaggeration to impress a point, characteristic of the author. Witness said he did not know beforehand that the plaintiff had come to the hospital with a note from Mr Axford. It would not have made any difference if he had known that plaintiff had been recommended by Mr Axford. Witness could have arranged for Mr Axford t-o do this operation if he had wished. The hearing was adjourned until this morning. LEBANESE SOCIETY A branch of the Lebanese Society of New Zealand has been formed in Auckland. The society, which was established in the interests of liebane.se living in New Zealand, ha<s been functioning for about two years and tranches alreadv exist in Wellington and Dunedm. Property has been purchased in Wellington as a site for the future headquarters and a substantial *um has been collected from the three centres toward the cost. The grand president, Mr S. Mattar, and the grand secretary, Mr J. Marsh, visited land last week in connection with the formation of the branch, and Mr K. A. Corban was elected branch president and Mr P. Zanilmcka secretary.. A committee of nine was also elected. There will be a conference of branch delegates in Wellington in the near future.