Hospital Inquiry

Hawke's Bay Herald-Tribune, Issue 132, 21 June 1937, Page 8

Hospital Inquiry

COMMISSION SEEKS VITAL DETAILS "Is It Amnesia?" Asks Sir James Elliott WARD SISTER'S POS1TION The first week of the investiga-^ Uon being made into the affairs of the Napier Public Hospital by the Royal Commission concluded on Saturday with prohahly the most dramatic episode in the proceedings to date. The greater part of the morning sitting had heen devoted to the examination of Dr. J. Allan Berry hy his own counsel, Mr A. E. Lawry, regarding the anthorities he had forl giving the heat treatment; then fot over an hour Sir James Elliott, the medical expert on the commission, made a searching and ezhanstive examination of the witness along the lines of a questionnaire he had prepared. This concluded Dr. Berry 's evidence on the happenings in the Shrimpton Ward. To Sir James Elliott, witness sa'd that he was aware that vulvo-vaginitis had been treated along several diiferent lines and that these methods had gained the upproval of a lar-je body of medical men. He considered the bath treatment a simple one and one free from xisk, but admitted that- he did not consult ,with the ofher Jxonorary pbysicians regarding the giving of the treatment, ae he did not consider that the degree of xislt warranted so doing. He did not t.lnnTr that there was sufficient xisk to make it advisable that the children ehonld have his personal superwision throughout the treatment. and was not aware that there was an unqualified nurse in. attendance. The sister was in charge. Sir James: .Was there a bell in the hathroomf Witney: I do not know. You have heard that a nurse called •ut twice and then had to go for mssistancef — "Yea.H Might that not have happened beforet — "Yes." ^ Data EasentiaL Ia it not one of the essential things Brhen conducting experdmental treatment that you should have full data? — "Yes." Have you got the full data regarding the hot-bath treatment! — "I consider J have sufficienf data." Where is it! — "In the literature." Were you aware that some of the nurses found they could not control tho temperature of the water correctly? — "I appreciated that, and eaid the temperature could be 110 to 112 degrees when 110 degrees was the temperature I wantecL" Do you think a young child, or even an infant, could stand the same treatment as an adultf — "Yes. They are more resistant to heat than adults." Ara they not more likely to suffer from shock than adults! — "Yes." And more likely to collapse! — "Yes." Witness added that it was not until recently that he wa8 aware that the collapse of the child had any resemblance of an epileptic fit. He did not associate the facts that, after the child had undergone a bath at a temperature of 120 degrees, it had been sick and the baths had been discontinued for jorne 16 days. Sir James; Did it not occur to you that the risk was a chillf Witness: No. I thought that the wave of colds had gone through tho hospital to the children. Regarding the .taking of temperatures, witness admitted that he gave no Instructione for these to be takeii with diiferent and separate instruments for each child. He agreed tliat it would have been possible for the instruments used to form a means of contact and thus cause a spread of the disease. Quesfcioned regarding the views of Dr. A. D. g. Whyte on each treatment, witness said he did not know anything about Dr. Whyte 'e opinions on the matter. Sir James: Dr. Whyte has told us that he did not favour hot-baths treatments for this disease. How is it, then, that when he became a hot-bath advoeate, as you would assume he had when yo.u assumed that he had always allowed his patients to have the treatment, you did not collaborate with hirfi in giving the treatment? ? Witness: I hardly saw Dr. Whyte. The Sister 's Responsibilities. Now, regarding tlie nurses's respon■bilities. Is it not part of, shall we •ay, their religion to refrain from ordering medical treatment for patients? —"Yes." Do you think it credible, then, that Ihe ward sister would make sueh a rajiical cliange? — "Yes." In spite of traditions? — "Well. yes." Would it not bo more likely that she did that under some pressure, or d'irection! — "The pressure, I think, was an urgent desire to have the children eured," Was it because of your iniluence over her, and her subconscious idea that you would support her in what she was doing? — "I don't know.." . Can you quote any authority for ireating children for vulvo-vaginitis with baths of,a temperature of over 110 degrees? — "No, not at tho moment." Seexng that you are a xnember of the board, does it seem right to you that you should apply to another member of the board in hie capaeity as actingcoroner in so serious a matter? — "Now, it does not seem so." Did you mislead the coroner 9— ^No." Did you give him all the particulars? n-f'Yes." You did not tell him about the ebild's temperature, or the poesibility of hyperpyrexia, or about having a post-mortem? — "I did say something about. .the child having collapse 4 affcei;

a hot bath, and I think I did say something about the post-mortem." You gave him all the eesential &etails! — "I think bo." . Did you mislead Dr. Foley! — "No." Has Dr. Foley had "Fair Go." He says he di.dn't know about tho hot-baths treatment, and that you did not give him all the information he wanted to know' in making out tho death certificate; and further that he did not know you had not got authority for the post-mortem; and that you had started the post-mortem before he caiue on the scene'. What do you say about all that? — "I certainly did not mention the post-mortem, for I 'thought he would know all about it. I assumed he would know about the hot baths too." To put it quite bluntly, has he ever had a fair go? — "In what way?" In relataon to you and the other members of the board? — " Well, no." There has been a split into factione on the board? — "Yes." His position has been a difficult one? —"Yes." Did you mislead the parents! — "No." What about conducting the postinortem then?— "I assumed that Dr. Foley had obtained the necessary permission." Were you frank with the matron? — "I never saw her very mucTL, as far as I know." She said that ehe knew nothing about itf — ."I certainly never discussed tne treatment with her." Had she not a right to know what was going on, especially with the n>urses under her charge! — "I suppose so, but I don't consider the onus was on me to tell the matron." "Did you mislead the sister? — "Not intentionally. " You know that through your . treatment she came in for censure from the matron, loet her position, and actually was ruined professionally? — "Yes." It is a very serious thing! — "A very grave thing. ' ' X agree, with you. Was the child'? death the xesult of heat therapyl— "That was a contributory factor." Was it not the primary factor!— "No. there was some other cause." What, then, was the primary factor? — "Heart failure." •«Who Is Besponsible?" Have the proceedings and all these inatters had any effeci on the reputation of the Napier Hospital!-—" Yes." That is a serious thing, is it not? — "Yes." As far as I can gather you put the responsibility for these irregularities on the sister! — "I don't do so." Who is responeible then? — "Well, the sister ..." You are a chivalrous man, truthful and honourable; surely you are not going to say that you are in the main correct and that the sister is to blame! — "Throughout this business I have been trying to protect her." You are not ahielding her nowf— "I am here tp tell the truth." What responsibility do you take m all this sequence Of- events! — "The whole responsibility. All the sister did was to ,cure in remarkably good time four other patients." You give her credit, then, for becoming a doctor instead of a nurse, and doing it secretly? — "It would be impossible to keep it a secret." Why is your memory so defective at critical points! — "What critical points?" When Dr. Foley taxed the sister for some fault you were so impressed that you said you would take the blame for it, and yet you forgot it the same day?— "Yes." You -can't say whether you applied to Mr. Bedford regarding inquests of hospital patients? — "Well *. . . ." You forgot to tell the coroner certain particulars that he no doubt would have liked to know; you couldn't remember whether you obtained the permission of parents for the post-mortem; you forgot to apply for permission to hold the post-mortem; you don't remember details of the post-mortem. It is unfortunate, is it not! — "Yes." Is it not a form of amnesia? — "Well, a long period has elapsed since them." * 'I would like to say that this examination, which I consider it my duty to have done, is as painfnl for me as it is for you," said Sir James, in concluding. "I do not like questioning another brother medical gentleman.' ' In dismissing Dr. Berry from the witness-box, the chairman said that for tho present the witness would not bn required, but he would later be re* quired again to give evidence in some of the other points in the order of reference^ Did Not Know of Post-Mortem. A brother of tho mother of the dead child was called by Mr Foden in regard to the post-mortem. Mr Foden: Did you, previous to the session of the commission, know that a post-mortem had been held? Witness: No. Have you ever asked Dr. Berry what was the child 's heart condition as revealed in the post-mortem? — "I asked Dr. Berry whether he had examined the child, but there was no mention of a post-mortem." Did he mention a post-mqrtem?— "I don't remember it." Did Dr. Berry suggest to you iri your conversation that the parents had consented to post-mortein? — "No." Mr Foden intimated at the conclusion of the session that Dr. Foley would be recalled as the first witness and would be followod by Dr. Harold Borry-