Tribunal clears doctor in surgery death case

By ROSALEEN MacBRAYNE

A Rotorua anaesthetist has been cleared of professional misconduct in the case of a Matata woman who died soon after surgery to repair bones broken in a motor accident 5 1/2 years ago.

The Medical Practitioners Disciplinary Tribunal held a two-day hearing in Rotorua early in April into allegations that Dr Thirunavukarasu Rajasingham did not adequately monitor the condition of 43-year-old Patricia Ross.

In a written judgment due out today, the tribunal says Mrs Ross' injuries and trauma appeared to have been underestimated.

She was trapped in a car for about 40 minutes after an accident near Edgecumbe late in the afternoon of December 11, 1996.

She was cut out of the vehicle and flown by rescue helicopter to Rotorua Hospital, where at least 13 fractures to her legs and hands were repaired after a six-hour wait.

Mrs Ross died 12 hours after the intensive overnight surgery from a severe internal haemorrhage.

An artery had been punctured during insertion of a central venous line.

Dr Rajasingham had become concerned around 4.30am and was suspicious that the line might have been in the wrong place.

He was told that an x-ray of Mrs Ross' chest could not be done in the theatre.

When the x-ray was taken, after she was moved to intensive care, it showed bleeding into the chest cavity.

"The tribunal found during the course of the evidence that management of a severe trauma patient such as Mrs Ross was below what would be an acceptable standard from a level-four hospital," the judgment says.

Serious questions had been raised about the standard of care Mrs Ross received on arrival at Rotorua Hospital's emergency department.

"To single out Dr Rajasingham as playing a major role in the tragic outcome for Mrs Ross and her family is not, in the tribunal's view, borne out by the circumstances at the time or the opinions of the medical witness who reviewed Dr Rajasingham's actions," says the tribunal.

Members accepted that Dr Rajasingham did not argue fatigue was a factor in his management of Mrs Ross.

The anaesthetist, then aged 61, had worked for 16 hours before the start of her 6 1/2 hour operation.

In an earlier investigation, Health and Disability Commissioner Ron Paterson called for a review of the long hours worked by anaesthetists in public hospitals.

The Australian and New Zealand College of Anaesthetists has drawn up policy guidelines on fatigue which say its members should not work "excessive hours".

Mrs Ross' husband, Ken Ross, said yesterday that he was disappointed by the tribunal's finding after waiting five years for some accountability.

He said he was considering appealing.