ALLEGED MEDICAL MALPRACTICE.

Evening Star, Issue 3427, 14 February 1874, Page 2

ALLEGED MEDICAL MALPRACTICE.

We give an extended report of the case of FTuut v. Sorley, heard at the Resident Magistrate’s Court yesterday, to which we made slight reference in our last issue : Edward Hunt : I am book-keeper for Heymauson, Low, qud Company, Dunedin, 'n the night of tbe 22nd of January, 1873. [ was coming down a street at the top of Break Neck Hill, when I fell over a bank. I could not walk, and I was carried to town I hurt my right leg and was carried to the Occidental Hotel. When I got up on my left, leg after the fall I felt that I had no power over my right leg. A doctor was sent for, and Dr S’orley came. My leg was swollen at this time, an hour after the accident. The doctor carefully examined my leg for over ten minutes. He tbeu applied lotions, to ray leg with loose rags, and said the injury was only a sprain, and that he would have me on my legs in about a week. He attended me until tbe 17th of May, continuously and solely, and from the first to the last ho told me the injury was a sprain. He always said that it was neither a dislocation nor a fracture. My leg was never ban dagcd for support, hut only loosely bound. On more than one occasion I suggested that he should call in another medical man, once in the presence of Mr Isaacs, the merchant, He said that there was no necessity for another doctor ; that it was merely a question of time, and that there could be no two opinions about it. My foot has never got well, and I am a cripple. It has been examined by four doctors. Drs Bakewell, Hocken, Alexander, and Pulme examined me before the case was brought on. Drs Young and Cole saw me after. To Mr Smith : i am under Dr Rakewell’s treatment. The other doctors examined me in May, 1873, after Dr Scrley left me. It. might have been June when Dr Bakewell took me in hand. In the interval between the time Dr Sorley left me o,nd Dr Bakewell attended me. I sometimes applied Dr Sorley’s lotions and sometimes not. When Dr Bakewell attended me for about two months and a half he left me and said he could do no more for me. I could get a boot on then. The first thing Dr Bakewell did was to bandage my leg and order rest. He told me I had a broken leg, after he had examined it twice. When first he saw it it was very much inflamed. He also told me that I should be lame for life. Dr Bakewell never appeared to me. to change his opinion as to ray leg being broken. All the time Dr Sorley attended me’my leg was in a swollen and inflamed state. This did not continue after Dr Bakewell treated me. I never told Mr Barnard Isaacs or Mr Lazarus that I was all right. Re-examined : I think it was on the 12th of March Dr Sorlev ordered me to try to wa k, and strain my foot into position. I did so, until I had to desist from intense suffering. Dr Bakewell told me that if I put my foot to the ground he could not tell me what the consequences might be.

Robert H. Bakewell: I was called on the 18th of May last to examine Mr Hunt’s leg. t found considerable deformity of the ancle joint, great swelling, pain on movement* inability to bear the weight of the body on the foot, the foot turned outwards somewhat, the end of the tibia pushed forward, and the distance between the ball of the left toe and the internal malerus was increased, and the distance between the heel and the internal malerus decreased by three-quarters of an inch. There was a good deal of involuntary motion of the ancle joint. The swelling was too great to allow me to see if the fibula wa« broken ; but on a subsequent examination, when the swelling had subsided, after special precautions had been taken to reduce it, i arrived at the conclusion that the fibula had been broken near the end, a little above the malerus. I advised Mr Hunt to have the fracture reduced by pressure, unde* chloroform, but he objected to this. I then tried to make the foot as useful to him as possible. In my opinion Mr Hunt will never be able to use his foot properly. 1 do not think it was proper treatment of the foot to treat it for a sprain.—To Mr Smith : The fibula was fractured, for I found from examination that the bane is not in a line. The internal malerus is in its right position, showing that it was not carried forward. The tibia was dislocated. When Dr Hocken says that tibia and fibula are both fractured, I say he was wrong, f think that a competent medical man might not detect the fracture of the fibula alone. In a case like that there might be no displacement or shortening of the limb, and therefore it might not take from the credit of the medical man not to discover it. If the bone were impacted there would be other means of detecting the injury. There would be the shortening, but when there was great swelling it might tend to prevent the discovery of a fracture. If dislocation of the tibia took place, the heel could not be put to the ground until after a time—then it could for a false joint would be formed. Re-examined : if there wes displacement of the tibia, the fracture of the fibula ought to be discovered.

Thomas Milner Hock on : I wag called in by Mr Hunt about four or five months ago, I do not know what month. I examined the plaintiff's right leg, and found it much distorted and enlarged about the ankle joint, and the foot turning outwards. He told me how’it was injured, and it appeared to be that tfye small'bone of the leg, called the fibula, had bepu fractured ; also, the top of the large bone, called the’ tibia, and that there was displacement of the foot. The fractures were of some months’ standing. At the end of eight weeks, the fractures would have set, and no special good could accrue from further rest. Toe fractures were not easily discoverable, bub it appeared to me that.such fractures should have been discovered at the time of the accident. The fracture should have been immediately set, and the parts kept in that position. Mr Hunt will never have a sound leg again, though he will have valuable use from it. To Mr Smith : I mean to say, from the appearance presented by the leg when 1 examined it, four months after f _ accident, that I can pronounce positively that a medical man of competent skill ought to have detected at the first that it was fractured. What brings you to the conclusion that the leg was fractured ? -There was a great deal of enlargement round the ankle joint ; eversion of the foot; and a hollow at the back of the ankle, which showed that the foot had been displaced. He would swear that (there had not been scrofulous enlargement of the ankle joints, and no skilled medical man would be deceived aboj.it such enlargement. In th;s case the enlargement was not abnormal. The turning outward of the foot was confirmation to his mind of the fracture, and there was a hollow at the back 'of the ankle caused by the broken parts of the bones gofog forward. When 1 saw the plaintiff he could put his foot to the eround. but this was ipany months after the accident If the limb was examined shortly after the accident, and was greatly swollen, it wopld be difficult to discover the fracture. A competent surgeon should be able to detect the injuries, especially a few hours after If there was impaction, that is if the fractured bones were driven into one another, the difficulties would be very much increased. Im paction will prevent the medical man detecting the rubbing of the bones together. At the time L made the examination it was impossible to say whether there had been 1 impaction. If erysipilas set in two or three days after the injury, it would

increase the difficulty of the medical man in determining the nature of the injuries. It is difficult to dedele it a fracture of the fibula, hut under proper medical observation it oiuht to be detected. It might escape detection if it was very low down. I should say that the displacement I no iced took place on the receipt of the injury. In this case I do not pronounce the large bone displaced, except the end which I consider was fractured. If Dr •Sorley swore that when first he saw the leg there was no displacement of the bones, and no indentation or hollow at the back of the heel, I adhere to my opinion that the fracture should have been discovered if there was no impaction. When -I spoke of the difficulty of discovering fracture of the fibula, it was when that bone was broken singly, lo Mr Stout: If there was displacement there could be no impaction. The case was adjourned till Monday.