Coroners Act In the matter of Coronial Findings and Recommendation into the Death of Ms Souzana Afianos pursuant to section 46B dated 1 January 2004
Tabled paper 1394
Tabled Papers for 9th Assembly 2001 - 2005; Tabled Papers; ParliamentNT
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Report - the fact that the application of the band is bound to cause necrosis; is it not? Not so much the band itself but the - the operative process. Fat is a pool of (inaudible) tissue. It doesnt like being operated on, fat tissue. And nearly always with trauma from just the surgery itself, you know, bruising of the fat tissue when y o u re manipulating and operating can cause saccharomyces which is (inaudible) fat cells that have had very poor blood supply and that really is the focus for infection particularly with a foreign body. But (inaudible) operate on a patient and re-operate that there is some saccharomyces. T h e re s basically a small amount of saccharomyces is often a common scenario, that is to say operating a patient. I t s not necessarily related to the band per se. Although if the band was too tight one could' assume that would happen, but I dont see any evidence of that in the autopsy report, histology, or in the pa t ien ts clinical presentation. She seemed to have no problem in swallowing and if it was too tight, she would have had problems in swallowing. So I believe that that necrosis is a consequence of surgery per se rather than the band. 4 8 . Dr Gilhome is independent and I thought a most impressive witness with part icular expertise with the subject surgery. The explanation given as set out in the preceding paragraph is the only possible cause which has not discounted. Moreover his explanation is plausible and persuasive. By a process of elimination of all other possible causes I find, in accordance with Dr G ilhom es view, that the process leading up to the secondary haemorrhage resulted from the operative process without fault on the part of any person. 4 9 . Dr Christopher Baggoley, a specialist emergency physician since 1996 and currently the head of the Emergency Department at Ashford Hospital in South Australia, was called to give evidence essentially as an independent expert in emergency medicine. His evidence was particularly relevant to the issue of the adequacy of the protocol for contacting treating surgeons in the case of operative patients attending at Accident & Emergency. He also provided two reports, the first dated 12 June 2002 and the second dated 8 October 2002. Those reports were tendered as a bundle and marked Exhibit 3.
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