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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



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

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Tabled paper 1394


Tabled Papers for 9th Assembly 2001 - 2005; Tabled Papers; ParliamentNT






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11. Whether the emergency treatment given at the Accident & Emergency Department of the Royal Darwin Hospital on 21 February 2002 was appropriate. 14. Dr Alistair McNair was the doctor who attended the Deceased at Accident & Emergency on 18 February 2002. His extensive notes were available to the Inquest. Favourable comments were later made by Dr Gilhome of the excellent quality of these notes which enabled a thorough consideration to be given of all the relevant history and the various steps taken. Dr NcNair is to be commended for the quality of his notes. He also provided a written statement (Exhibit 1 Folio 13) and he gave evidence by video conference link. 15. Dr McNair qualified in England and had been working at Royal Darwin Hospital for some seven months at the relevant time. He said that he took a comprehensive history from the Deceased, made detailed notes as aforesaid and conducted an examination. He conducted an abdominal examination on two occasions during the course of the admission. He conceded that his examination was not ideal although he considered that it was sufficient for his purposes. The difficulty was that the Deceased claimed to not be able to lie down due to pain. As a result, the examination was conducted with the Deceased sitting and partly reclining. There is medical opinion to the effect that this would not have resulted in a satisfactory abdominal examination although there was variance on this issue. Dr McNair was confident that he could exclude internal bleeding as a result of his examinations and particularly because he was able to exclude rebound, guarding and tenderness. This does not appear to be disputed by the medical experts. There was no major disagreement about this despite much of the medical opinion commenting that the optimal position for a proper abdominal examination was the fully supine position. Moreover there seems to be agreement that even if the examination was inadequate, nothing else of any significance would have then been discovered if an examination in a fully 6

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