DEATH IN SURGERY.

Hauraki Plains Gazette, Volume XXXVIII, Issue 5184, 28 September 1927, Page 2

DEATH IN SURGERY.

LATE MR. ALEXANDER R, AITKEN. NOBODY BLAMEWORTHY. An inquiry touching the death on Friday last at Waihi of Alexander Robert Aitken while under an anaesthetic was held in the Waihi Police Court on Saturday before Mr W. M. Wallnutt, district coroner. SeniorSergeant Maclean represented the police. Adam William Maclaren, engineer, residing at Karangahake, said he had known the late Mr Aitken since childhood. Deceased was an engineer by occupation, a married man with two children, and a marine engineer during the war. He was a man of wonderfully good health, but had expressed a dislike: to having teeth extracted. MEDICAL EVIDENCE. Dr. J. M. Cole deposed to having known the deceased by sight. On Friday last he gave Aitken an anaesthetic for the extraction of teeth. He carefully examined the patient before administering the anaesthetic, and considered that he was perfectly fit to have an anaesthetic. Two minor facts he had noticed were that the man’s heart was unusually rapid, probably due to nervousness, and that his neck was rather short. In regard to the anaesthetic itself, Aitken was given a small quantity of chloroform on a thin towel and took the anaesthetic perfectly. As, soon as he was slightly unconscious the anaesthetic was changed to ether, and another small aerolated towel was later laid across the mask and over deceased’s hand to keep it from being too close to the patient’s face. The anaesthetic proceeded quite normally, and at no time did the patient struggle, hold hisbre,ath, or otherwise give him (witness) any other anxiety. JTis pulse was quite good during the giving of the anaesthetic. The patient was now in a proper stage of .anaesthesia, and witness asked the dept Ist to begin the work of extraction/ The latter extracted a stump from the light lower jaw, and during this operation the patient held his breath for a. few seconds. The gag was accordingly released, and the patient immediately began to breathe in a normal manner. The gag was then reinserted and another tooth extracted from the same side of the jaw. The patieint again held his breath for a few seconds during the extraction, and again the gag was released and normal breathing was resumed. Witness noticed a few seconds later that Aitken’s, pulse had become practically imperceptible. Restorative methods were immediately applied, including artificial respiration for threesquarters of an hour, also injections] of stimulating drugs, oxygen inhalations, and finally cardiac massage-. Respiration continued for about a quarter of an hour at irregular intervals, and was of a sighing nature, but the heart did not improve and the organ, which had already ceased beating, did not beat again. Everything possible was done to restore life.

EVERY CARE EXERCISED. The operating dentist (Mr E. A. Wlison) s-aid he had known the deceased for some years. Hei had examined Aitke-n’s mouth the previous day (Thursday), when he found it necessary for him to have all his remaining teeth extracted, and an appointment was, made for the following morning. He could corroborate Dr. Cole’s evidence in regard to the details up to the commencement of the extractions. After the patient was under the; anaesthetic he extracted one root, a difficult task as the crown of the tooth was level with the gum. After extracting the root the gag was released and breathing gradually became normal. He then extracted a tooth posterior to the root. Breathing again became difficult and ceased. No further teeth were extracted, and restorative methods were at once applied. He had been in practice as a qualified dentist for 19 years, except for three years during the war. It seemed a most favourable case; from an anaesthetic point of view. Exceptional care was taken in such cases by both doctor and dentist, and every cara was taken in this case. Chloroform and ether in such operations were safe and satisfactory. DEATH FROM HEART FAILURE. Dr. T. Gordon Short deposed to having made, a post-mortem examination of the body. There was some fatty infiltration of the heart, and one valve, the mitral, was diseased. Witness made a careful examination of the throat, the air passage, and the lungs. The.re was no sign of a tooth or any other foreign body obstructing these organs-. AH the other organs of the body were normal. Deceased appeared to be well nourished and well developed. Death was due to 'heart failure caused by the effects of an anaesthetic on a weak and diseased heart.

To Sergt. Maclean : It was usual in most operations to start with a little chloroform and then follow with other. Ether was an unpleasant drug to give to a conscious person, hence the practice of first giving a little chloroform. The defects that he found in the deceased’s heart would not be noticeable by the usual methods of external examination owing to the excitement of the patient about to go under an operation. In response to an urgent call he was in attendance at the dental rooms at 11 o’clock and found Dr. Cole engaged in -the usual methods of restoring life. He bqlieved the patient was then dead, but he advised massage of the heart as a last resort. This was carried out, but failed to restore the beat of the heart. He was satisfied everything possible was done to restore life. DIFFICULTY OF DETECTION. To deceased’s father (Mr Robert M. Aitken) : Had he known of the condition of deceased’s heart prior to the post-mortem he would have considered it risky to administer a general anaesthetic. It would have been possible to detect the condition of the, heart had deceased been resting for some time before the examination' which preceded the administration of the anaesthetic, and not been in a somewhat nervous and excited condi-1 tion. An examination of the heart j

when a person was in an excited condition would not be- absolutely certain. It must be remembered that no anaesthetic was without some risk. There was a risk in every case, but only one in 5000 cases was accompanied by serious consequences. After the witness had replied to further questions by Mr R. M. Aitken the latter said he had not asked these questions, because of any doubt in his mind as to the exercise of skill and attention on the part of the doctor or the dentist, but because he wanted for his own satisfaction all information possible. He knew that both had done thojr best to save his boy’s life.

This concluded the evidence, and the coroner returned a verdict in accordance with the medical testimony, which had also shown that the usual and correct methods, in such circumstances, had been adopted to restore life. He would extend to Mr Aitken and members of the family the sincere sympathy and condolence of the Court in their very sad bereavement. The deceased was well known throughout the district, and esteemed and respected by all who had come in contact with him.