SUPREME COURT.—CIVIL SITTINGS.

Daily Telegraph (Napier), Issue 3858, 28 November 1883, Page 3

SUPREME COURT.—CIVIL SITTINGS.

Tuesday, Novicmbkr 27,

(Beforo His Honor the Chief Justice.) FKLLOAVKS V. HAMILTON".

Mr McLean for plaintiff; Mr Lascelles br defendant.

This caso Avas continued after avo Avent to press yesterday. Eii/a Followes, sister of the plaintiff, gave confirmatory evidence as to the breaking of the limb; the atteudance of Dr Hamilton, and the general condition of her sister after the accident occurred.

W. I. Spencer, surgeon, deposed that ho had performed an operation upon plaintiff in the Napier Hospital, after having examined her at the request of her mistress, Mrs Nelson. When tho operation Avas performed Avitnoss found the ends of the small bono of the leg overlapping each other. AVitnoss cut off a portion of the bono and brought the ends of it together. The bone did not bear the appearance of having been set. When witness examined plaintiff before the operation he found a lump, but did not think it Avas an abscess. Ho thought it AA-as the ends of the small bono of tho leg, and the operation proved it to be so. Thero Avas no evidence of an abscess at all, The operation had had the effect ivituess expected Avhen ho performed it. Beforo the operation plaintiff could not put her leg to the ground, but she could Avalk on it now. Witness did not find traces of hip disease in plaintiff Avhen lie examined her. Plaintiffs left leg was shorter than the other. E. Mcnzics, Surgeon-Superintendent of the Napier Hospital, deposed that lie had examined the plaintiff, and found that sho had sustained a fracture of the bones of tlie log. The fractured ends of tho small bono Avcrc projecting, forming a lump and interfering Avith the action of the muscles. Plaintiff could not put her foot to the ground. Tho entry in the hospital books Avas to the effect that plaintiff had had both bones of her left leg fractured twelve months before, and that only one had united. Witness Avas told that tho fracture had taken place tAvclvc months before, aud the condition of the bone Avas in conformity with Avhat Avitnoss Avould expect if the statement Avere true. The large bono of tho leg had evidently also been fractured, but Avas joined, and in witness's opinion both bones Avero fractured at tho samo time. Witness found no traces of an abscess. There Avas a curve in the large bono of plaintiff's leg, AA'hich in Avitncss's opinion had been caused by the ends of the bono sinking during the progress of the case.

Dr. Matthews aud Dr. Caro gave similar evidence, Avhen the plaintiffs case closed.

Mr Lascelles said the defence would be a denial that any injury to plaintiff Avas caused by unskilful or negligent treatment. A. P. Hamilton, surgeon, and licentiate of Apothecaries Society, London, the defendant in the caso, deposed to being called in to attend the plaintiff for a fractured log on March 25th, 1882. Tho leg was straight and free from twist when examined, and no crepitus, or grating sound, could be detected. There Avas no swelling, nor any discoloration. Witness set the bones, bandaged the limb, and saAV it enclosed in a properly-constructed fracture box. The box Avas made Avith a foot piece, and Avas so constructed that plaintiff Avould not be able to shift the limb by involuntary iiioa-o-ments. Suitable diet Avas prescribed, and a lotion to keep down inflammation ordered. Saw plaintiff frequently afterwards, and tbe case progressed favorably. 'X'liere were no appearances suggesting any danger to plaintiff, and no complaints Avero made. During tho third Avcek after the accident plaintiff manifested signs of serious constitutional derangement, which subsequently Avitnoss discovered by tests and examination to be incipient Bright's disease Tho principal outward symptoms avctc dropsical swellings, from tlic thigh downwards. Tho symptoms continued Avith slight variations for about a fortnight, or three Aveeks. The bandages avoi-c altered and re-arranged several times during the progress of the case, and were removed on tho 30th day after tho accident. They Avould havo boon retained in position longer but for the dropsical symptoms. The bono union Avas perfect when tho bandages Avero removed. There was no sign of anything dangerous during the progress of the caso except the constitutional derangement. Witness continued his treatment for about three months. No complaints Avere made during that time by plaintiff. Upon ceasing to attend Avitness was careful to inform plaintiff that sho must not expect to regain the full uso of her leg all at once, and that it could only be recovered by proper care and attention on plaintiffs own part. Plaintiffs statement that Avitnoss pulled her log, and that something snapped, must bo pure imagination. Plaintiff professed herself very thankful for tho attendance she had received, and personally thanked witness Avhen he ceased to attend. There was no sign of any fracture of tho small bone, nor any sign of a projecting lump on the injured leg Avhilc Avitness had charge of the case. Six months after Avitness ceased to attend plaintiff she consulted him at his residence at Hastings, and complained of not being able to Avalk avcll. Witness then found a lump on the leg, and Avas very much surprised, as there had never been any sign of it previously. The lump Avas near the scat of tho fracture, and suggested to Avitness inllammation. Witness had no idea of any fracture of the small bone till plaintiff saAV him at Hastings. At a subsequent visit of plaintiff, some twelve months after the accident, she took offence at witness's manner, and consulted another surgeon. By Mr McLean : Witness did not knoAV, until that day, that tho plaintiff was not

aware that a part of the defence Avas that sho had Bright's disease ; ho mentioned it to her Avhen ho Avas visiting her. He had had forty years' experience as a surgeon, and ho found that the duration of pain after such an injury as that the plaintiff received A-aricd according to the temperament of the patient, and in patients of low vitality a bone fracture might cause serious disturbance of the system. Tlic tibia might bo fractured without fracture of the fibula. Witness examined the plaintiff carefully, and had the fibula been fractured he Avould have discovered it ; ho examined both bones. He did not sco any dark spot; ho did think there had been time for that. [By his Honor: The time depended upon the nature of the enquiry: Avith a severe concussion it would show much sooner.] He should not expect a dark spot from tho fracture of the fibula, unless there had been direct external violence; just at that point the fibula was thickly covered with-uiusclcs. When 'he removed the bandages six Aveeks after-

Avards there was a dark spot. In March this year, when the plaintiff culled upon him, sho did not say that something moved in the leg ; but ho was suprisod to see a swelling in the neighborhood of the fracture. He believed ho did mention the probability of an abscess, but he was more inclined to believe that a bony growth had been sot up, and he told her to call again. He prescribed iodine and broth, and ordered her to wear an elastic stocking. Ho did not tell her to keep to a low diet; ho prescribed nourishing food. I After ho set tlie leg he examined it I periodically. When ho said he did not manipulate it he meant that ho did not manipulate tho nuked leg. He Avas afraid of inflammation; the binding of broken bones and muscles together AA'ould bo likely io cause inflammation. Inflammation consequent on tho fracture of the tibia might remain for a very long time ; in this ease he attributed the inflammation he saw twelve months after the leg wa.s set to the result of the injury ; he had met similar cases previously. When he left the patient the injured log was a little shorter than the other, but the difference was hardly perceptible, and ho attributed it to the want of exercise of tho iujured limb. He did not anticipate any shortening from the fracture of the tibia, but no doubt it might result from a fracture of the fibula, if it were overlooked, aud the ends did not unite truly. Plaintiff never complained to him that the leg Avas not straight. It was perfectly straight when he when lie ceased visiting her, though he admitted there was a slight curve now. He had heard from the evidence that tho fibula had been broken, but he was still of opinion that it was not broken when lie set the plaintiff's log. [Piece of bono shown.] That might be a diseased growth of bone, or a piece of the fibula ; he could not say which it Avas ; ho thought it was too large for tho fibula of a girl like plaintiff. He suggested to the plaintiff that the shortening was due to hip disease, but none of the ordinary symptoms were found. He did not think he suggested an affection of the lungs, but botli lungs and heart Avero tested Avhen the plaintiff Avas examined by the doctors; spinal disease wa.s also mentioned ; witness suggested kidney disease ; and sho Avas examined for swollen neck.

James Reed, surgeon, said he had examined plaintiff in company Avith Drs Todd and Faulkner, and the defendant. Ho found thero Avas a slight curve. Tho curve might have been caused by tho muscles in the calf of the leg ; he had found difficulty from this source. From Avhat Dr Hamilton said of the way in Avhich he treated the injury witness thought it had boon well treated ; Avitnoss usually adopted very similar treatment. It ivas very difficult to discover fracture of the fibula at tho place Avhere the plaintiffs injury Avas received, because the fibula Avas thickly covered Avith muscles. Witness agreed that some of the symptoms mentioned by Dr Hamilton Avere indicative of Blight's disease. The Court thou adjourned.

THIS DAY.

I'-ELLOAVES V. HAMILTON. This case was continued at 10 o'clock this morning. Mr McLean said, with His Honor's permission, ho should like to ask the defendant, Dr Hamilton, another question as to Avhat fee had been paid him in this case. Dr Hamilton said the fee he charged wa.s £25. Ho rendered the bill to Mr Nelson, and it ivas paid by him. Frederick IrA-ing do Lisle, surgeon, deposed he had a very fair experience in ■surgery, having been surgeon to a hospital in Jersey for four years. He assisted at the operation performed on the plaintiff at the hospital. Dr Caro also actively assisted. He had no opportunity of forming a diagnosis oi the case previous to the operation, but Dr Mcnzics stated beforo tho operation that tho case avhs one of ununited fracture of the fibula. That diagnosis was not confirmed by the result. Tlic appearance at the time of the operation led him to the belief that tho fibula had at some lime been fractured, and had united iii an overlapping condition. At tho time of the fracture the bones from somo cause had either slipped or not been brought into their position. Tho fracture was in the upper third of the fibula, which would increase the difficulty of ascertaining the fracture, supposing the tibia Avas also broken. The fracture Avas a A'ory oblique one, supposing it was a fracture. Deformity is much more common in an oblique fracture than a transverse ono. That Avas a Avellknown fact in surgeiy. An oblique fracture Avas also much more difficult to keep in position. Ho believed the pieces of bono exhibited in Court Avcrenot the pieces taken out by Dr. Spencer, although thoy resembled them.

Mr McLean bore protested against this style of examination-in-chief as being decidedly improper, and was an uncalledfor reflection on Dr Spencer, Avhich ho had no means of refuting. Besides, DrMenzics had sworn in Court that the pieces Avero tho same.

His Honor said Lr Spencer should be recalled, to Avhich Mr Lascelles agreed.

Dr de Lisle continued: Ho had no fault to find Avith Dr Hamilton's treatment of tho avze at the time of the accident. It seemed to be treated in proper form. Ho could suggest nothing better for the conduct of the case than had been done by Dr Hamilton. Ho (witness) should have put the bones in their position. If ho had no splints he Avould have contrived to make some. He considered tho plaintiff Avould bo an emotional patient, and one that Avould bear pain very badly. Witness thought the diet ordered by Dr Hamilton for the plaintiff Avas a light nutritious diet. By His Honor: lie believed the caso to have been a fracture, but should not like to swear it Avas.

By Mr JX'liOan: It would be absolute proof of the fracture of both bones if the leg shook about. The fibula Avas almost invariably fractured in an oblique direction. If lie had been attending tho case ho Avould havo taken bandages or splints Avith him. Witness admitted that doctors might not always bo successful with their cases ; thoy could not command success.

Dr Spencer re-called : The pieces of bone produced in Court yesterday appeared to be tho same as those taken out during the operation. He could not swear that they Avere. They appeared to be of the same size and shape. Dr Mcnzics re-called : The fragments of bones (produced) were the projections of the fibula cut on the 14th of May, and thoy Avere then put in a bottle of spirits.

By Mr M'Lean : He had no doubt Avhatcver that the pieces of bone produced were the same as those taken from the fracture. He would swear it if ho Avere going to his grave to-morrow. Alexander Todd, surgeon, of Waipawa, Avas tho next Avitness called. He positively denied that at the timo of the examination of the patient by himself, Drs. Reed, Faulkner, and Hamilton, Dr. Hamilton stipulated for tho examination respectively of her rib, spine, lungs, and neck, but that Dr. Faulkner only suggested an examination of the lungs and spine. He Avas aware Avhorc the fracture of the fibula had been. It Avas the junction of tho middle and upper third. If he Avere attending the case ho should have put splints on as Dr. Hamilton had done. He could suggest no improvement in Dr. Hamilton's treatment except that he might havo used different splints. There Avas generally very little pain after the splints Avere put in position. He considered that Dr. Hamilton paid every attention to the case that he could have done. The Avitness had a good deal of country practice, and had not always all tho appliances he required for treating cases. Fracture of the fibula Avas generally oblique. _ Those fractures Avere moro difficult to bring into position, and Avero also more difficult to treat than transverse ones. Ho had no objection to make to tho diet prescribed by Dr. Hamilton for the plaintiff. By Mr McLean: He Avas certain the fracture Avas at the junction of the upper third Avith the middle. One of tho results of a patient getting very Aveak Avas dropsy, which may or may not bo connected with | Bright's disease. By His Honor : Dropsical swelling might bo connected with Bright's disease. Joseph Faulknor, physician and surgeon, of Hastings, stated that various suggestions were made at the examination of plaintiff by himself, Drs Todd, Reed, aud Hamilton, lie was not aware Dr Hamilton made any statements as to the examinations of plaintiff's rib or lungs. Dr Hamilton did not make any such suggestions as stated by plaintiff in her evidence. He had no suggestion to make in connection with Dr Hamilton's treatment of the fracture.

(Left sitting)