DEATH AFTER OPERATION

Grey River Argus, 18 September 1937, Page 8

DEATH AFTER OPERATION

Late William McDougall INQUEST PROCEEDINGS. Al the inquest proceeduigs into the death of William McDougall; contractor, the Coroner; Mr. Raymond Fenier S.M. yesterday returned a verdict that deceased died on September 14 at the Grey Hospital, the cause of death being shock; associated with an essential operation, necessitated through injuries received on constructional works at Kamaka on September 8, when he was crushed by a falling concrete pile. Sergeant F. R. Ebbett conducted the proceedings on behalf of the police, and Mr. W. Montgomery appeared for the Inspector of Scaffolding and Excavations. Dr. H. C. Barrett, Medical Superintendant of the Grey River Hospital stated that McDougall was admitted to the hospital on September 8 about 4.30 p.m. He said that he was employed building a bridge, and the pile drive struck him ill the back. He was not unconscious. On admission he was suffering from shock and complaining of pains in the back and the left chest. Examination showed (1) a fracture of the third lumbarvertebrae; (2) fractures of the ribs on the left side, together with internal injuries of the left chest. There was a small cut over the left eye. The heart was displaced very much to the right. This was at first thought to be due to accumulation of fluid in the chest. Subsequent examination, however, showed that this was due to a rupture of the left half of the diaphragm, with displacing of abdominal organs into the thorax. His condition improved after admission, and he remained in a satisfactory condition until September 13. On that date witness consulted Dr. Ray, and on September 14, Dr. Moore saw McDougall in consultation with witness in the morning, and it was decided; that an operation should be performed. At this time McDougall was showing signs of obstruction of the bowels. On September 14 about 3 p.m. an operation was commenced. Dr. MacPherson gave the anaesthetic and Dr. Moore assisted witness to perform the operation. It was found that there was a large rent >n the diaphragm and there was present in lift side of the chest, th? stomach, about half the small intestine and a large portion of the large intestine, together with the spleen. The •stomach was greatly dilated. The patient took the anaesthetic well, and his condition remained satisfacuntil about 4 p.m. when his pulse and respiration deteriorated. This falling off of his condiiton coincided with the return of the abdominal organs. He improved and the operation was proceeded with., as it was impossible to discontinue the opera? ion at this stage. The essential part of the operation was completed, at 4.15 p.m., but the heart ceased belting at 4.20 p.m. Intracardiacs were given, to-

gether with artificial respiration and cardiac massage. These measures were continued until 4.45 p.m. when

it was considered that no further treatment was of use. Oxygen was administered continuously from the beginning of the anaesthetic, on account of the collapse of the left lung. In witnesss opinion, the patient died as a result of shock during the course of an operation. The operation was made necessary as a result of the injuries received on September 8. Without the operation the injuries would have proved fatal. The decision to operate was arrived at after consultation with Dr. Moore. There was also a consultation with Dr. Ray. Death was not occasioned by the administration of the anaesthetic, nor in connection with the administration of the anaesthetic. The shock of the operation was the immediate cause of death. Dr. J. F. C. Moore said that lie saw deceased in consultation with Dr. Barrett on the morning of September 14. He inspected the X-Rays of the case, and tne essential feature was the displacement of the heart to the right side and a massive shadow almost obliterating the lung on the lift .side. Examination established that this shadow, could be caused only by the presence of the stomach in the chest, and as pressure symptoms in the chest were severe, and would be fatal if not relieved, it became necessary to replace the abdominal organs, in the abdomen by operation, which offered the patient the most chance of recovery the sooner it was done. Accordingly at 3 p.m. on that day, witness assisted Dr. Barrett to perform this operation, which disclosed a large rent in the left side of the diaphragm, and the presence in the chest of the abdominal organs, as detailed by Dr. Barrett. The operation proceeded most satisfactorily until the first weakening of the patient’s condition about 4 p.m., but improvement occurring, the diaphragm was satisfactorily closed and the abdominal organs placed in their correct positions about 4.15 p.m. At this point, however, the heart was rapidly weakening, and breathing ceased shortly after. Remedial measures were immediately instituted but did not produce the desired effect, and were not further perservered with after 4.45 p.m. Oxygen had been administered continuously throughout the operation through a tube, duo

to the collapse of the left lung. In witness’s opinion, the cause of death was shock associated with the- performing of an essential operation. The published records show that the operative mortality of this condition, which is a rare condition, are very high. The operation was very extensive.

Charles Norman Page, contractor in partnership with McDougall said that deceased and himself were engaged constructing a bridge over the No Town Creek at Kamaka. About 3'p.m. on September 8, McDougall met with an accident when lifting a 25 feet 14 inch concrete pile. Mr. Fairhall was operating the winch, and was acting on instruction from Mr. McDougall. Witness did not see the accident, but was attracted by the screams, of McDougall. He went over and assisted to carry McDougall to safety.. Deceased was extricated from under the pile by members of the gang who were working on the bridge. McDougall was attended by Dr. Fitzerald of Wallsend and within an hour of the accident was conveyed to the Grey Hospital by ambulance. The pile was lying full length, one end on the ground, and the other on an Sin x Sin beam, thus saving the full weight from being on McDougall’s body. Deceased was 43 years of age, married, with three children, and resided at Kilgour Road, Greymouth. Witness had been in partnership with deceased for 12 months on August 31 last. They had driven 24 piles of a heavier nature

in a previous job, and had driven 12 piles on this job. To the Coroner: Witness would say that it was ill advised and dangerous of deceased to have ventured upon moving the rope in Hie way he did. Deceased was in complete charge of the pile driving. Witness was not aware of any statutory regulations dealing with situations such as that in which deceased found himself. William McKendrick Fairhall, Labourer, of Marsden Road said tnat for about 12 months past he had been employed by Page and McDougall contrators of Greymouth, who had a

contract irom tne niouc vvorns department to build a concrete bridge at No Town Creek Kamaka. Witness ihad been employed on this as a labourer for some time. McDougall superintended the building of the bridge on which 8 hands were employed. On September 8 between 2 and 3 p.m. deceased and witness were engaged in lifting a concrete pile preparatory to laying it in the bed of the creek for the purpose of building a staging on top of the pile to carry the derrick to drive other piles. The pile they were lifting was 20ft. by 14in. and weighed about 2 tons. They were lifting the pile with a derrick; using a petrol engine for power. The gear, so far as witness knew, was all in first class order. The persons engaged in lifting this pile wei'e deceased (who was in charge), two youths, Stanley Morrison and John Morrison, and witness. They had already lifted the pile and put it down when they found that it was not far enough upstream. They then put the 1 crab winch on it to pull it upstream, and lifted one end of it about four feet with a derrick. They then found that the crab winch rope was not properly on, and deceased walked over to fix it properly, going underneath to do so. As he took hold of the rope with his hand to shift it into the proper place, the rope around the pile gave way and the pile fell, coming to rest on an Sin x Sin timber log. Deceased was also underneath the pile but the log prevented the full weight of the pile from resting on his body. He was quite conscious, but was groaning a lot. They were able to get him out at once' without shifting the pile. If the log had not been there he must have b«en killed instantly. Deceased complained of pains in his back, but never mentioned the accident or its cause. He did not blame any person for it. They carried him to the other side of the creek and made him as comfortable as possible. Dr. Fitzgerald and the ambulance were sent for and Me- 1 Dougall was taken to the hospital. It was the knot of the rope round the pile which became unfastened, and allowed the pile to fall. The rope did not break. Deceased himself fastened the knot which gave way. Witness did not examine the knot, and did not know whether it was properly fastened.

' To the Sergeant: The rope on the crab winch remained fast. The rope that slipped was the one which was carrying the whole of the strain. That strain would not be increased by using the crab winch. To Mr. Montgomery: The sling that carried away was hemp. There was a wire sling handy that could have been used. It was about half a chain away. In reply to the Coroner. Mr. Montgomery said that it was one of the unforseen things the regulations did not cover. In his opinion it was a pure accident. Robert Stanley Morrison, labourer of Stillwater, who was working on the bridge said that after the pile had been lifted about four feet it was seen that it was not in the correct position, and deceased called out to Fairhall to stop the winch. McDou gall then went down beneath the pile for the purpose of shifting the rope which was around the pile. The next thing witness knew was that the pile had fallen, and deceased was underneath it. Witness did not actually see (he accident. They had shifted othe* piles in a similar manner previously'

on the same job, without accident. The hauling gear was all in good order. Deceased tied the rope round the pile himself prior to the accident. He did not blame anyone for the accident, or mention how it happened after they got him out.

ALL SURGICAL CARE GIVEN

In giving his verdict the Coroner said. “I think it is prpoer to observe,” that the operation was necessary, and without it deceased would have died. Deceased had every medical and surgical care and skill, but unfortunately lie was unable to survive the shock of so extensive an operation. As to the accident itself, it appears from the evidence that no ' blame was attachable to any other person.”