“Spectre of Tragedy”

Sun (Auckland), Volume I, Issue 287, 24 February 1928, Page 9

“Spectre of Tragedy”

DEATH OF WOMAN PATIENT Famous Surgeon’s Skill Unavailing • (From Our Oven Correspondent) HAMILTON, To-day. WHILE Mr. Victor Bonney, the famous visiting surgeon. was performing an operation at the Waikato Hospital yesterday, his patient collapsed and died under the anaesthetic. Fifty doctors attending the British Medical Association’s conference were present. The patient was Mrs. Rhoda Rawlings, of Te Kuiti, aged 42, and the operation was a serious abdominal one. In returning a formal verdict the coroner said that the spectre of tragedy must always be present at grave operations until the perfect anaesthetic has been discovered.

An inquest was held to-day by Mr. Wyvern Wilson, S.M., into the circumstances in connection with the patient’s death. Dr. G. W. Gower, surgeon-superin-tendent of the Waikato Hospital, said Mrs. Rawlings was admitted on January 24, and he found her suffering from a fib tumour of the womb, with adhesions of the intestines. An operation was essential, but a difficult one, and it was decided that they should wait for Mr. Bonney. the London specialist, to operate. Witness said Dr. McMiken made the examination to ascertain whether the patient was fit to undergo the operation. Witness was present at the operation, which Mr. Bonney was performing in the large theatre before 50 surgeons gathered for the medical conference. They were seated on a stand of tiers against the wall and the operation was not impeded by their presence. Dr. Gower said he assisted Mr. Bonney, and Dr. McMiken administered the anaesthetic. Before the patient was brought in, she was in a state of anaesthesia. The Coroner: Is it the custom of the operating surgeon to make any exminaion as to the condition of anaesthesia? Witness- He usually asks if the patient is ready. If the anaesthetist saw the operation starting before the patient was ready, he would stop him. The Coroner: Nothing of that kind occurred in this case? —No. Witness said the tumour and womb had been removed. The operation was very difficult owing to adhesions, and it was very ably performed. The trouble was exactly as diagnosed. The operation lasted an hour, when the patient collapsed. THE FIRST COLLAPSE The first indication of anything wrong was when the ajiaesthetist reported the patient was not breathing well and the operation was discontinued and restorative measures taken, and assistance rendered by two additional doctors. No improvement occurred after the first collapse. Efforts were continued for over half an hour, but life was found to be extinct. The anaesthetist -was very careful. He was specially deputed for the purpose on this occasion. The patient was very adipose in condition. Mr. Victor Bonney, the surgeon who operated, said he was the gynaecological surgeon to the ‘Middlesex Hospital, surgeon to Chelsea Hospital of Women to the Freemasons’ Hospital, to Putney Hospital and gynaecological surgeon to Queen Alexano-T Hospital. He was visiting New Zealand as a representative of the British Medical Association to the N.Z. Conference. The first indication of anything wrong was the patient’s sudden collapse. This was reported by the anaesthetist, and when he looked at her face he did not think she was then dead. The operation was

discontinued and resuscitation methods applied. The heart was masaged through the abdomen and andrenolin injected into the heart. Strychnine and oxygen were given and various forms of artificial respiration adopted. All steps known to medical science were taken. The operation was nearly finished when the collapse occurred. While resuscitation was being applied he finished sewing up the abdominal wall. He attributed death to sudden cardiac failure, probably due to the degenerate condition of the heart. DIFFICULT AND NECESSARY “The operation was very difficult,” said Mr. Bonney, “and a most necessary one. Every safeguard known to modern surgery was taken as far as he was aware, and there was no undue haste. “I am quick, from having performed so many operations, but there was no undue haste. I had the assistance of Dr. Gower and a beautifully-trained theatre staff. I have never had an anaesthetic given for me better than it was yesterday. Extra pains were taken to make the operation as perfect as possible. The whole object was to make the operation an example of what an operation should be.” Dr. Waddell said that at the coroner’s request he had made a post-mortem examination. He attributed death to cardiac failure due to the shock of the operation on a patient with a fatty heart. Dr. McMiken said he found no definite sign of heart disease in the patient. Drs. Hockin and Gower also made an examination and the general opinion was that she was fit to undergo the operation. Witness did not, however, consider she was a very good patient for an operation owing to her general condition. CORONER’S VERDICT The coroner stated the case was one of those regrettable circumstances which medical and surgical science were unable to prevent. “I suppose the spectre of tragedy will stand by the surgeon until a perfect anaesthetic is discovered, because the shock of an operation will still be felt by the patient despite the anaesthetic.” He said everything possible seemed to have been done, and the condition of the patient’s heart appeared to be the real cause of death. It was gratifying that an expert of high standing should speak so well of the local hospital appointment. A verdict was returned that: “Mrs. Rawlings died on February 23 at the Waikato Hospital while in a state of anaesthesia by an application of ether and chloroform, for the purpose of undergoing a necessary surgical operation and that she died from shock, accelerated by fatty degeneration of the heart and pleural and hydatid adhesion.”