A FATAL FALL

Otago Witness, Issue 3610, 22 May 1923, Page 7

A FATAL FALL

PNEUMONIC PATIENT’S DEATH. ACCIDENTALLY KILLED. The adjourned inquest into the circumstances surrounding the death of Alexander Webster, who fell from a window of Dominion Ward, Dunedin Hospital, on Thursday night, May 10, and died, was held in the Hospital on Thursday morning, Mr H. W. Bundle, S.M., acting as coroner. Senior-sergeant Mathieson represented the police, and Air J. M. Paterson the relatives of the deceased. Dr G. R. Kingston said that the deceased had been admitted to the Dominion Ward, of which he was in charge, about 1.30 p.m. on- Wednesday, May 9. Witness had examined him, and had found him to be suffering from pneumonia of the upper lobe of the left lung. Patient had received treatment and had done very well on the Wednesday. On Thursday afternoon he was examined by Dr Fitchett, and his condition then was excellent. Witness saw deceased at 6.45 p.m. on Thursday night, and found him to be slightly hysterical. He was quite rational and responded to witness’s questions. At 7.45 p.m. witness saw deceased again, and his condition then was very much improved. He left the ward and returned at 9.30, when he made a complete examination of the patient and left him 10 minutes later in good condition. Witness was summoned .about 15 minutes after the accident, but did not see deceased that time. To tho Senior-sergeant : When witness saw the patient at 6.45 he showed signs of hysteria, but there had been no such signs on either of the other two occasions. He had not instructed the nurses to take any extra precautions when he had seen that the patient was slightly delirious, as he considered it unnecessary. The senior probationer nurse was quite capable of dealing with such cases. If the senior probationer said that the patient was delirious from 7 till 9.39 p.m. he would certainly contradict her. If she were satisfied that it was an abnormal case, she would report it to him. In this case the casualty officer (Dr C. S. Williams) had sent deceased to the Dominion W arcl without referring to anybody. To Mr Paterson: There had been two other pneumonic patients in the ward at the time. Pneumonic cases were put near windows covered with wire screenings so that they could get plenty of fresh air. He concluded that the patient had been hysterical, because he had been crying. The patient would be unable to look after himself at the time. To Dr Falconer: If the patient had become violently delirious, a special nurse would have been provided and some form of restraining apparatus applied, and if that were not sufficient he would have been moved to another ward and been placed under the control of a- male attendant. To the Senior-sergeant: In the case of a pneumonic patient signs of delirium would be present all the time rather than intermittently. Dr .Fitchett, honorary physician Dunedin Hospital, gave evidence that he examined the patient on Thursday afternoon in Dominion Ward. He found him to be suffering from pneumonia, but there was nothing about him to attract special attention. It was just a case of acute pneumonia, and he was a proper patient to have in that ward. There was nothing to indicate despondency, and, in his opinion, there was no necessity for a special nurse. Caroline Binnie, sister in charge of Dominion Ward, stated that on Wednesday, May 9, she was on duty from 7 a.m. till 4 p.m., in charge of the Dominion Ward. She was present when deceased was admitted at 1.30 p.m., and helped to put him into bed. In answer to the Senicrsergßant’s question she stated that the patient appeared quite normal mentally and answered her questions sensibly. On Thursday, May 10, atout 6.30 p.m.. Nurse. Tansley, who was in charge of the patient, came and told her that he was crying. She made investigations and concluded that the patient was hysterical. A quarter of an hour later Nurse Tanslcy said that he had been complaining about not getting anything to drink, and this confirmed her belief that he was hysterical, as he had been getting drinks at regular intervals. She gave him another lemon drink and went off duty at 7 p.m. That was the last she saw of deceased. When she went off duty Nurse Tansley was left in charge till 10.30 p.m. The patient was not weeping when she saw him a little after 6.30, but his attitude suggested that be was simulating it. She attached no importance to this, however. Iva Tanslev. senior probationer nurse,

stated that 1 was on duty in the Dominion War< the Wednesday when the deceased was admitted. He appeared untie normal then. She was on duty the following day from 2.30 till 10.30 p.m. in the

same ward. The patient appeared very ill, but quite normal. About 2.30, though, he appeared a little restless, but no more so than a pneumonic patient usually is. Deceased’s wife came into the ward about 7, when patient’s mind seemed to be wandering a little at intervals. Indications pointed to delirium. At 9.30 p.m., acting under instructions from Dr Kingston, she gave him a drug to make him sleep. He objected at first, but she afterwards .persuaded him to drink. About 10.20 she was joined by. Nurse Westwood, also a probationer, and she assisted witness to make cieceased comfortable. Nurse Westwood was on duty the same hours as witness and in the same ward. At 10.20 tho patient was again delirious. When she left h.m, however, he had settled down and gave no indication that he would try to get out of the window. She left to go to the kitchen to finish her report preparatory to going off duty at 10.30. * About five minutes later she heard a noise and remarked: “I suppose that pneumonia patient will be out of bed,” and hastened back. On entering the ward she found deceased’s bed empty and the guard moved back from the window. She at once gave the alarm to the night hall porter. She stated that there wore three thumb-screws on the screen over the window, two on the left and one on the right bottom corner, this being the one unfastened and furthest from him. Deceased had only to lean over to undo tho bottom thumbscrew and thus leave the window open About 10.20 deceased sat up near the window and looked out. She did net attach any significance to this. Nurse Westwood assisted her to replace the patient. His mind was wandering then, and he probably did not know what he was doing. The window was up about, two feet, so he had merely to open the screen and get out. To the Coroner: The sedative administered by her had no effect op the patient. T 0 Dr Falconer: He was not as restless as the usual pneumonic patient, and she did not think there was any likelihood of his getting out of bed. To Dr Falconer: A pneumonic patient usually gives some indication that he wants to get out of bed, and deceasedMiad not shown any inclination to do so. To Mr Paterson: She did not at any time think it likely that the patient would get out of the window. To tlie Senior-sergeant: She did not think deceased was on the danger list at any time. She had marked the chart of ■the patient at 5 p.m. and 9 p.m. on that day. At 9 p.m. his temperature was 100.6, his pulse 124, and his respiration 48. The porter’s report book showed that deceased had been put on the dangerously ill list, but Dr Kingston said that he believed that the entry was a mistake. He had no recollection of having put deceased on the dangerously ill list,. It was probable, however, that deceased was on the seriouly ill list. Elizabeth Mair Westwood, junior probationer nurse, corroborated Nurse Tansley’s evidence as to the patient’s condition. D r A. Perry, senior house surgeon, stated that at 10.30. on May 10 he had been informed that there had been an accident, and he rushed out to the asphalt below Dominion V/ard. He found deceased lying there bleeding from the nose and mouth! No sign of life was present. There was a severe depressed fracture at the base of the skull, and there was no other sign of external injuries. The injuries were quite consistent with a fall from the window. The body was about two feet from the edg-e of the wall. He thought that deceased had landed on his head. The Coroner said that there was no doubt, from tho evidence, that the patient was hysterical rather than delirious. Nurse Tansley had stated that deceased was restless, and it was apparent that he had got an idea into his head that he wanted to leave the Hospital, and consequently he went to the window. The question was whether deceased was sufficiently ill to be dangerous Dr Kingston had examined him three times, and there was no doubt that the patient was wandering in hi s mind He could not see, however, that the deceased was sufficiently delirious to require the additional precautions. The screen was not one that would be readily opened by a patient, certainly not a pneumonic. here was no reasonable ground for thinking that the patient would go to the window to open it. He did not throw himself out, but went there to escape, therefore the verdict would be that deceased died on May 10 from cerebral injuries caused by an accidental fall.