THE MANAGEMENT OF THE HOSPITAL.

Otago Daily Times, Issue 9563, 20 October 1892, Page 3

THE MANAGEMENT OF THE HOSPITAL.

At yesterday's meeting of the Hospital Tiustees a couple of, matters arisiug out of the proceedings at rcceutly held inquests, and affecting, the management of the institution, were brought up for consideration. The first matter arose out of an inquest held at MiltDn on the body of a child that had died from atropine poisoning. \ Mr A. A. Raphael, the dispenser, wrote drawing the attention of the trustees to the repoits ■in the newspapers of last week of a child dying of atropine poisoning, where in evidence it was sHted: "It is not customary in hospitals to label poisonous drugs ' poison.'" He informed the trustees that if any medical man ordered any highly poisonous drug it was never sent mside or out3ide the hospital to a patient without the precautionary label, with directions plainly written, and " poison" marked on the botMe. To outsiders it was the writ .t's custom to draw attention to such on the label. Several of the trustees expressed themselves surprised that the medical gentleman who was present at the inquest, and who was acquainted with the custom of the hospital, did not rectify the error the jury had fallen into hi respect of the dispensirig^of prisons. - Mr BKpw#said':;.,l.a.m glad that.Mr Raphael, our dispenser, ,nas,. brought this matter under our notice, and-I am further-glad to hear that the statements made at the coroner's inquest are withont foundation and that the rider was quite uucalled for. Such a reprehensible practice I felt sure was not in voguo in this hospital and that it would not be tolerated by the trustees for one moment. When reading the newspapers I felt that I could not give credence to the statements made, and that they were unjust and had not a scintilla of truth in them The Chairman said that the trustees no doubt had noticed in the newspapers a report of an mquest which was held at the hospital on tne body of- a young man who died'in the institution from' injuries sustained through being kicked by a horse at Cav'ersham. The jury added to their verdict a rider to the effect that there had been too much delay between the time the man was admitted to the hospital and bsmg operated upon. The House Committee took the matter in hand and wrot3to the coroner for any evidence that was given in respect of the rider. The coroner( Mr Carew) had replied to the letter of the House Committee, and Dr Brown, who was the hon surgeon that day, also wrote on the mattar' Dr Brown's letter was as follows •—

r,,, ( ~ . ~, Dunedin, 4th October 1892 Ihe Chairman of the Hospital Trustees. _ Dear Sir-I beg to call yom- attention to the Ota™ Diiily Innes report of the inquest held at the hospital last week on Alexander Dickey You will see that the jury added a rider to their verdict virtually imputin- culpable delay and to myself tO- the: assistant-house surgeon or Bad the rider affected myself only, I should °«^tjwusat it necessary to trouble you with tins letter, considering that the verdict with it* rider was brought m without my having baen called to give evidence upon the serious charge affecting inc. Ihe management of tho hospital ge-ierally is, however, impugned by the rider to the verdict and almost every detail of the management of the hospital has been, as you are aware, and still is so frequently and recklessly attacked out of motives not always the purest and by persons not always of the greatest wisdom that I consider it my duty to a&k that the trustees will, with as little delay as possible, investigate tins last charge against the assistant house surgeon and myself. I am reluctant to give any additional trouble to the trustees, but it seems to me that the only effectual way now to reduce tho number of capricious charges that are so constantly being trumped up against the hospital in a manner that misleads the public creates mistrust of the trustees, and Kreatlv lessons the usefulness of the hospital, is for the trustees themselves to meet each accusation with instant and minute inquiry, and to demand that whoever maiccs any charge should be required to prove his statement to the letter, and if he fail to do so, then to compel him to acknowledge the fact as readily and effectively as he has made his charge. .

Referring again to the present charge, I would suggest that the trustees should take, in addition to my own evidence, the evidence that can be given by the nurses and patients in Ward 2, and by the cabman whom I employed to drive me from my house to the hospital immediately upon my receiving the* telephone message to attend there.—l am, dear sir, yours obediently, "William Brown.

The Chairman then instructed the secretary to read a letter from the assistant house surgeon on the same subject. It was as follows :—

Dimedin Hospital, „, ~ m . Dunedin, October 19,1532. lo the Chairman, Hospital Trustees bir—ln reference to the admission of Alexander Dickie, I beg to report as follows :-The patient was brought to the hospital on the evening of the 27th September In my evidence at the inquest I said I thought between 6 and 6.30 p.m , but nurse Drabble says that she saw him brought in lat TJ.V™ TO °ff duty- That wouW h* 6.30. T r e S;^\ findl"sthat they woe very serious, d^s soTtt c MS* <ffi- .fe operation proceeded with, Dr CouTtrev beinl bein "Tirfth^V^- So & fZ 'there ditious&tment. * "^ reCeivCcl Vc^ cx *>e+l m t ?'f° t!le rider ad(led by the jury I gather that they were of opinion that it was my duty is house surgeon, to have immediately done allthat was necessary in the way of operation?and there fore insinuating that it was through vnnfhfni incompetence that I did not doso Vvidentlv they are unaware of by-law 113-"In all cases of severe accident, and in cases which may require an immediate operation, he (the hove Sl S, shall immediate y send for the honorary S of the day, and if he cannot be found, or fabie to attend, shall summon some other member of the honorary medical staff ."—I am & c "emDel 01

The following is the text of the communication received from the coroner:

Resident Magistrate's Office mr <-< * (i ir • Dunec»n» October 10,1892 The Secretary the Hospital, Duuedin Sir, r l have the honour to inform you that the following rider was added to the verdict at tht inquest on the body of Alexander Dickie •-" Wn are rather inclined to think that rather too long a time elapsed between the time of the man being Drought here and the operation being performed

In reply to your note of the 7th inst., I cannot do more than gl ve you the names of witnesses whose evidence seemed to affect the question apparently dealt with by the jury in the rider. These are Mr Samuel M'Orackcn, Mr R. 1. Calder, and Dr Griffin. I thin];: Constable lower who accompanied the deceased to the hospital, could also Rive evidence on the point It is proper that 1 should state that from remarks of some of the jurymen, I understand the rider is not intended to censure any medical gentleman concerned in the case, but to represent au opinion that there should be a medical man experienced by long practice ready at the hospital to take

charge of an accident case as soon as it is brought to the hospital. As this was a matter outside ut the inquiry, I express no opinion upon it.—l have, &c,

IS. H. Caiiew, Coroner The following report was also read ;—

Iho House Committee's attention having been drawn to the ropoi ts of tho inquests recently lieiii on tho late Alexander Dickie and the atropine poisoning case at Milton, and the respective riders or tho juries thereon, beg to report that house surgeons, whether old ai\X experienced or young audinexperieuced, are not allowed in any hospital having an honorary medical staff to oporatc on accident or urgent cases, the rule invariably being to call in the honorary surgeon of the day. IU-oiu the evidence of Drs Brown and Griffin it' will be found that no unavoidable delay occurred in opjratins on the patient Dickie, anil we have lurthor to repoifc that there was not only no undue delay, but that prompt measures for the comfort and safety of the patient were taken. In reference to the rider of the juiy on the atropine poisoning case at Milton, apparently ba=ea on the evidence of Dr Newell, your committee positively affirm, on the evidence of Mr Iv-aphaiil, the dispenser to the hospital, that no poisonous drags are dispensed either to out or inpatients without being properly labelled iVith a printed ved label marked" Poison." Even allowing that the atropine was as alleged dispensed from the hospital to a patient and Riven by him to another person, after a lapse of seven years, tiie probabilities are that whatever labels may have been affixed would not have remained on ttie bottle. We cannot, therefore, consider the ruler m either case justifiable.

The Chairman said that after making full inquiries the House Committee had come to the conclusion that the jury were not justified in adding tho rider they did to their verdict. Mr Wills said that he had been informed by the sergeant of the police that one of the jury, named Mr Lloyd, had volunteered his services as a juiymau that day. Mr Lloyd had a grievance against the hospital for a long time, lhat was the whole secret of the affair. Mr Lloyd had led the jury, and he (the speaker) had no doubt was the author of the ride"r. He got himself put on the jury in order that he might have an opportunity of " getting at" the hospital in some way without rhyme or reason. It was eventually resolved—"That the trustees approve of the- action taken by the House Committee in holding an inquiiy into the circumstances, and with a view to obtaining correct information as to the evidence on which the juries based their riders to tho verdicts on the death of Alexander Dickey and I the atropine poisoning case at Milton, reseive the committae's repavfc, .and adopt the same." It was also resolved to forward a copy of the dispenser's letter to the coroner at Milton.