HOSPITAL INQUIRY.

Globe, Volume XXII, Issue 2082, 26 October 1880, Page 3

HOSPITAL INQUIRY.

Monday, Octobbb 25

The following evidence was taken yesterday after we went to press ; Dr. Davies deposed that he had bee house surgeon to the Christchurch Hospital since February last. The dispenser entered the names of patients in the books, and witness sines June last bad diagnosed ;the oases. If a patient brought a letter from a medical man witness would nevertheless make a diagnosis for himself. This was in accordance with instructions received from the Hospital Board.

Dr. Nedwill proceeded to put a question with a vioW of eliciting that there were other cases of typhoid fever in the Hospital whilst Mrs Keetley was an inmate, but this was objected to by Dr. Campbell as being ultra vires, and Dr. Skae held that the question alluded to matter other than the subject within the scope of inquiry. Ultimately the questions were allowed. Dr. Nadwill mentioned a number of oases, and asked if they were enteric fever. Witness said he was not prepared to state, as they were not entered by himself, but by Mr Hawkes, the dispenser. Before the 220 d of March last most of the cases reported to the Board of Health were enteric j there were nine cases entered iu the book us enteric which were not enteric. Ho was not responsible for those entries. There were, between the 22nd of March and the 26th of April, ten cases entered in the dispenser’s book as enteric, but they were not reported to the Board of Health except one. On May 15th and 16th there were three oases entered by witness as gaatro-enteritis, and he would swear that they were not typhoid fever. On the 24th of March a case outside the district was reported, but on another date a case was not reported because it was outside the district. Mrs Keetley was admitted into the Hospital on the 24th of April. Witnesstook her temperature regularly, and in his opinion she had gastro-enteritis. In her case Mr Hawkes was responsible for the entry “typhoid.” To the best of his belief she had not “fever” marked on the bed card. The symptoms indicated gastro-enteritis, and witness was prepared to say she had not typhoid fever. Hhe was under the care, of Dr. Townend. Witness described the symptoms which attended his diagnosis of the patient. By Dr. Campbell—Witness had no object in not reporting any cases of typhoid fever there might be in the Hospital ; and it was his custom to do so. Mrs Keetley did not show, when admitted, symptoms of typhoid. She had diarrhoea, exhibited a hiyh temperature, and delirium, but those symptoms were often patent in other diseases. The disease she was suffering from was not stated on the bed card, because it was not customary to indicate the diagnosis on the card at that period. As a medical man it was his experience that disease was often diagnosed wrongly. By Dr. Skae—Witness was not aware that instructions had been given to the House Surgeon to report infectious diseases to the Board of Health. He believed some cases of dysentery had been reported as typhoid. Dr. Skae—lt is an extraordinary thing that the only book in the Hospital should be full of errors, and no one be deemed responsible for the same.

Witness continued that in the case of Mrs Keetley, whilst she was in the Hospital, both Dr. Townend and himself agreed that her complaint was gastro-entoritis. She was eleven days in ' the Hospital, and it was not deemed necessary to hold an inqaest upon her.

Dr. Townend, before giving evidence, asked whether the inquiry was upon a public institution or regarding his private practice. On being assured it was not concerning himself individually, he stated he had no recollection of Mary Keetley, or attending her case outside. He reported a case of typhoid in one Williams. He would swear to the best of his recollection that he did not say to Keetley or Barnes that Mary Keetley was suffering from typhoid. By a record it appeared he had sent Mr Grimes to attend her. Mr Grimes was not a qualified or registered practitioner. Mr Grimes might have said her complaint was typhoid, but he was not surprised at anything that gentleman said. Witness attended her in the Hospital. She had typhoid symptoms, but certainly was not suffering from typhoid. He was aware that Mary Keetley lived in a locality where typhoid fever was prevalent at the time, but he would swear that that was not her disease. Whenever he found a case of typhoid fever outside, he reported it to the Board of Health, This Day. The Hospital enquiry was resumed this morning before Dr. Skae at ten o’clock, there being present—Dr. Skae (Commissioner), Drs. Nedwell, Frankish, Prins, Townend, Camp • bell, Davies, Herman, Messrs lok, Tancred, and Parker.

The examination of witnesses was proceeded with.

Alfred Sharland, colled by Dr. Nodwell, deposed that he had searched the Ohristchuroh Hospital admission books from 1875 up to the 23rd inst., and only found recorded four cases of gastroenteritis. Dr. Townend, recalled and examined by Dr. Nedwill, said it did not strike him as odd that there were no entries for gastroenteritis until after Mrs Keetley’s death, although throe cases were recorded after that period. He was of opinion that gastroenteritis was common in Ohristchuroh and surroundings, and was probably attributable to a dangerous miasma and climatic influences. As a fact many cases of gastroenteritis were diagnosed by the doctors as typhoid fever. He had been in practice in the centre of a large population in England, and his experience had led him to conclude that the symptoms of certain diseases were very different here to what there were in Groat Britain. There were diseases here which were not understood by medical practitioners. The only two cases of cholera he had ever seen occurred in Christchurch within a short time of each other. His experience showed that diseases of a certain type occurred in large numbers after long intervals. Mary Hayton, formerly night nurse in the Hospital for a period of eleven years, had seen a large number of cases of typhoid fever during that time. She remembered Mary Keetley being an inmate. She was suffering from fever, and was unconscious the whole time witness saw her. There was no special ward for fever at that time, patients with all classes of diseases being in one ward. Witness could not say that Mrs Keetley was suffering from typhoid fever. She had frequently seen on the bed cards the word “ fever," but not the kind of fever specified.

After consultation the Hospital staff deemed it necessary to the purposes of the enquiry that Dr. Nedwill should be examined, and Dr. Prins asked that his evidence should be taken.

Dr. Nedwill said he was there as representing the Board of Heath, and it would place him in a very awkward position it ho was subpocaoed to give evidence as an expert. In fact, before giving evidence, he would require to know the points upon which it was proposed to examine him. Dr. Skae said such a privilege could not be granted to him any more than to other witnesses.

Dr. Campbell said the inquiry had been brought about thr iugh allegations made by Dr. Ned will to his Board of wilful neglect. He (Dr. Campbell) wanted lo prove it was not wilful neglect, and if it was not brought out the proper ends of the inquiry would not be obtained. Ho would undertake that there would be no personal names or matters introduced, but facta made public. Dr. Skae did not agree with him. The word “ wilful ” did not ocour in his commission. It was alleged that cases of typhoid fever had been admitted into the Hospital which were not notified to the Board of Health, and when the patients died they were registered as dying from some other disease.

Jane Carmichael, late night nurse at the Hospital, had seen numerous oases of typhoid fever. She remembered the admission of Mary Keetley into the institution, but could not of her own knowledge state whether she was suffering from typhoid fever. By Dr. Campbell—Dr. Nedwill called on witness at her house and questioned her concerning Mary Keetley and what she was suffering from. He did not tell her she would be called as a witness. This was the case for the Board of Health, and the Hospital staff resolved to enter upon their defence the following morning. The next case taken was that of George Kirkhouse. Dr. Irvine, visiting physician to the Hospital, attended Kirkhouse. He did not think the diagnosis of his disease was entered on tho bed-head card. From the apparent symptom* he judged it to be gastroenteritis.

Witness described the symptoms, and admitted that they were also observable in typhoid fever. Gastroenteritis was common in children, hut exceptional in adults, although ho did not agree with Taylor that it was exclusively confined to infanta. Witness did not instruct the house surgeon to sign gastroenteritis on the death certificate of Kirkhouse, hut he_ himeelf would have so made out the certificate. Witness had at times remarked to the house surgeon that some oases were put down as typhoid which had not reached that stage. He did not note any remarkable absence of that disease from March 22nd until the beginning of May. By Dr. Prins—Witness had been in practice twenty-three years, and found diseases here varied considerably than those in England. By Dr. Campbell—lt was his opinion that if the old custom of placing the diagnosis of each case on the bed cards had been continued this complication of matters would not have occurred. The reason of doing away with the former custom of stating the disease on the cord was because it was not always advisable to let the patients know what was their complaint. It was not unusual for typhoid to break out in epidemic, such having been the case last summer through the breaking up of .certain drains. He saw no reason why he should not call gastroenteritis, which was rare England, common in Hew Zealand. Ho might diagnose a disease he bad never seen before and call it by n new name. Michael Young remembered George Kirkhouse, a nephew of his, who was taken ill at Weka Pass and brought to the Christchurch Hospital. Witness enquired of one of the nurses what his disease was, and she said “ typhoid fever.” He saw the bed head card, but did not read what was written upon it. Witness would swear he had not told Dr. Ned will a different story to this. He would swear he had not told Dr. Ned will that he saw “ typhoid fever” written on the card, or on the card of the next bed. He did not tell him that he applied to the Hospital for Kirkhouse’s clothes, but he applied for his boots. He did not tell Dr. Ned will that the Hospital authorities refused to give up the clothes because they had burnt them, as he died from typhoid fever, and they wore in the habit of destroying clothes of persons who died from typhoid fever. [Loft sitting.]