35

P. KELLER

H.—Blb.

Tie Mrs. Porch. — Complaint No. 1. Florence Keller, sworn, saith. I do not consider a labour of 63 hours 25 minutes a normal labour. 1 have heard that MrsChamberlain died in the isolation ward on the 9th September about midnight, of puerperal septicaemia > that her body was removed on the 10th September, about 8.30 a.m.; that on the 10th September, in the evening, Mrs. Porch was placed in the same ward ; that she was there attended by the same nurse —Nurse Adams —who had attended Mrs. Chamberlain ; and that the patient was removed thence to the General Hospital suffering from pelvic abscess. I do not think, under those circumstances, it was proper to put Mrs. Porch in that ward. I would condemn that practice. I would condemn the practice, though the place was thoroughly fumigated. If they used formaline there would be enough fumes left in a few hours to set up irritation of the mucous membranes of the incoming patient. I think it was equally grave that Mrs. Porch should have been nursed by a nurse who had nursed Mrs. Chamberlain, who had died of puerperal septicaemia. In a case of puerperal septicaemia at the Army Home the nurse was isolated for a month. In this case the patient did not die. Cross-examined by Mr. Mays.] I did not know that Mrs. Porch was septic for five days before she was put in the isolation ward. If the ward had been disinfected thoroughly, and I knew the patient had been septic.for five days, I would not want her put in there if she had been a patient of mine. It would only add to the infection. The fact that the woman's septic condition improved rather than got worse would tend to show that the infection had been destroyed by the fumigation. I have had experience of the naidwives that have been trained at St. Helens, and think very highly of them. I am glad to get them when in need of their services. Re-examined.] It was not justice to the two other women who were occupying the room to allow Mrs. Porch to remain in the room with them for five days when she was known to be suffering from puerperal fever. Such patients should be isolated till it is ascertained what is the matter. Herbert Myer Goldstein, on his oath, saith. lam a duly-qualified and registered medical practitioner practising in Auckland. At various times I have acted with Dr. Inglis, and sometimes for him at St. Helens Hospital. Amongst others, I attended Mrs. Martha Porch, at St. Helens. I was sent for by the Matron as it was a case of difficult labour. To effect delivery I had to administer chloroform and use forceps. I decidedly think the Matron sent for me at the right stage. I had been at the Hospital earlier in the day and had the case explained to me, and I take all responsibility from that time onwards. After delivery, the patient did not recover normally. Her temperature was unsatisfactory from the next day. Her demeanour became strange from the evening of the second day, until she became practically insane—a case of puerperal insanity. She refused to take food, and had to be forcibly fed. On the fourth day Dr. Inglis and I saw the patient together. Dr. Inglis then took charge of the case. I know of Mrs. Chamberlain's case, and that she died at midnight on the 9th, and that Mrs. Porch was put in the same ward on the evening of the 10th. If the ward were thoroughly fumigated, I think that, under the circumstances, to put Mrs. Porch in the same ward was the only thing to do. Mrs. Porch's condition so far as her septic condition was concerned got no worse, and her recovery would seem to indicate that the means taken to disinfect the isolation ward were complete. I have seen the Matron at work in the Hospital. I consider her absolutely qualified for her position, and that she can be trusted to exercise her judgment and discretion soundly. Cross-examined.] I was told when at the Hospital at 11 a.m. of Mrs. Porch's case and of her condition at the time, and I gave instructions to send for me when the case had reached a certain stage. It would have been harmful for me to have interfered sooner. I knew of the long stage of labour she had gone through. It is very hard to say what is a normal labour. This one was an abnormal labour to a certain extent. Anything done sooner that I did it would have absolutely risked injuring the patient. It was not abnormal to that extent. I do not know that the woman was without sleep during those three days of labour. A protracted labour brings on sleeplessness. [Mrs. Nicol states that she will formulate no more complaints, except to enlarge that of Mrs. Porch.] Tracy Russell Inglis, recalled by Mr. Mays, saith. I first saw Mrs. Porch on the Ist September. I was ill when she was admitted, and Dr. Goldstein attended her on my behalf. I think I took the case over from him on the 4th September. On the Ist September, when I saw her, she was strange in her manner, showing early signs of puerperal mania, and she had a temperature. I produce the chart. [Exhibit No. 5.] I conferred with Dr. Goldstein as to her condition. We came to the conclusion that she was developing puerperal mania. Dr. Goldstein continued to attend her till the 2nd September. I took over the case on the 3rd September. I attended the patient daily after that. One day I had Dr. Goldstein with me. The patient was then in a room by herself in the main building. That day I gave her a interuterine douche. That was to make sure that nothing was left behind. She was removed to the isolation ward on the night of the 10th September. That was because the isolation ward was free. I attended her there till she was removed to the General Hospital. I attended her there, too. She recovered. I ordered the removal to the isolation ward. I knew of Mrs. Chamberlain's death there from septicaemia. I gave instructions as to what was to be done before Mrs. Porch was removed there. I instructed the nurse to have the place thoroughly disinfected and to see that the nurse disinfected herself. I consider that under the circumstances the removal to the isolation ward was the best and proper thing to do. I tried to get other accommodation. From the time I first saw her there was nothing done or left undone to which I could take exception. Patient had not fully recovered her mental condition when she left the General Hospital. The Matron telephoned me what she was doing in the case. I considered the means taken sufficient. I was frightened of the woman getting out of the window. She