A WIDOW’S DEATH.

Star (Christchurch), Issue 17039, 12 May 1923, Page 1

A WIDOW’S DEATH.

AN UNUSUAL CASE. OPERATION CONTINUED AFTER DEATH. An inquest concerning the death of Mrs Anita Gundersen, a widow, aged sixty-four, which occurred at the Lewisham Hospital last Friday under an amesthetic was hold on Thursday by Mr Wyvern Wilson, S.M. Dr A. B. Pearson, pathologist at the Christchurch Hospital, gave evidence that he had made a post-mortem examination of the body of tho deceased on May 5. The appearance of the lungs led him to the conclusion that death was due to asphyxia. The immediate cause of death was asphyxia. Toxaemia would precipitate Mrs Gunderaen’s death, the whole system being very much weakened. Dr J. D. Marks said that he had attended deceased who was suffering from gallstones. He attended her in November. 1922, and advised an operation at the time, but Mrs Gundersen had deferred it. On April 26 he saw her and she was moderately well. From then till April 30 her condition fluctuated. Ho recommended her removal to a private hospital and with Dr Acland he saw her next morning at Lewisham. On May 4 her condition became more grave and at about 1 p.m. on that day The operation was commenced and

shortly after the patient collapsed. All efforts at resuscitation failed. Dr Acland was operating and witness was assisting. The amesthetic was being given by Dr Lester. Tt appeared to him that a stone had passed from the gall bladder into the intestine and had become impacted. The presence of the Bfone in the intestine might easily have been ascertained if there had been an X-ray plant at the private hospital, but the patient was too ill to be removed to an X-ray plant. Dr H. T. D. Acland deposed that with Dr Marks he had seen deceased at Lewisham Hospital on Slay 1. She gave a history of having been seriously ill with symptoms of gall stones. Vomiting had ceased and she was apparently improving. On Thursday, May 3, the patient was again seen, and her condition had improved. Her condition was altogether puzzling. When he saw deceased on Friday morning she was not so well and was vomiting slightly. Ar operation was decided on then. Her ccndition was serious. Dr Lester administered the amesthetic, which was taken satisfactorily. The operation was begun and he found that there was mischief in the gall bladder region. L)r Acland said that he thought that he detected a stone there. At that time, breathing was shallow and an effort at vomiting occurred. The anesthetic was stopped and attention was given to the clearing of the throat. A large quantity of fluid had come from the stomach and it was impossible to clear the air passages. Respiration was not restored. Artificial respiration was carried out but the heart had failed. When it was obvious chat no more could be done for the patient he investigated the abdomen further. He found a large gall stone about two inches in length and one inch in diameter occupying ttic small bowel. The stone was not impacted and could lie moved Ho removed the segment of bowel in which the stone lay, and this was handfcd to the patho\ogist. The stone had ulcerated from the gall bladder through to the intestine and had caused a partial stoppage. With reference to the doctor making further investigations of the abdomen the Coroner inquired if he thought it ■was a right thing to do. The witness: I do not.

The Coroner said he thought it was improper in the circumstances. The witness: I realise that. The Coroner : The proper way was to satisfy yourself, from a surgeon’s point of view, that life was extinct. Any interference with a dead patient’s body was wrong, and was to be strongly deprecated. Dr Acland : T know that. Continuing he said that obstruction had caused an accumulation of fluid. Before the operation there was no evidence of a large quantity of fluid in the stomach. Tn reply to the Coroner, the witness said that the shadow' of the stone might have been given on an X-ray photograph, although the back position would have been difficult to show. In reply to a question as to the soundness of deceased’ heart, the witness said that Drs Marks and Lester had sounded it. He had examined the heart previously on the Tuesday or Thursday. Dr G. M. L. Lester said that he administered an anaesthetic (ether) at the operation. The patient took tho anaesthetic fairly well. He had pre viously sounded her heart, and for her age and condition there was nothing alarming. Shortly after the operation commenced, the patient vomited. All efforts were made to clear the respiratory passages, but the flow of the liquid was so continuous and so large in volume that the efforts were un availing, and she was “drowned.” It could not have been anticipated. Vomiting on the operation table under the present anaesthetics was very rare. It occurred, perhaps, onefe in every 4000 or 5000 cases, and could be met by keeping the air passages clear. The Coroner said he thought it was •desirable in every case where patients died under anaesthetics to have a full investigation of the circumstances as had been done in this instance. It was desirable in the interests of the medical profession and of the public. Mrs Gundersen had put off the operation till her condition had become serious An enormous gallstone had apparently ulcerated right through into the intestines, and had caused a stoppage. A large collection of fluid was caused bv the partial stoppage, and the fluid was vomited when Mrs Gundersen was under an anaesthetic. and she had choked herself. The surgeon and doctor were unable to ascertain the collection of fluid, and could not reasonably anticipate the unusual form of vomiting. He returned a verdict in accordance with the medical evidence.