Doc: I did give formalin

2016-06-20 10:37

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Pietermaritzburg - An anaethetist who was in training at Grey’s Hospital in 2010 has admitted in the high court that she mistakenly gave 84-year-old surgical patient Isabella Smith formalin, instead of water, to drink following a knee operation.

Asked on Friday by Smith’s advocate, Rocky Ramdass (instructed by Siva Chetty Attorneys), to confirm if she was the doctor who gave Smith formalin to drink, Dr Christella Alphonsus replied: “Unfortunately, yes”.

“Formalin is a toxic substance that should not be given orally. There is evidence before this court that 30 millilitres can kill a patient,” Ramdass said, to which Alphonsus replied: “I don’t disagree with you.”

Alphonsus testified, however, that Smith only took a “sip” of the formalin, and then told her that the liquid tasted “funny”. Alphonsus then took it away.

Alphonsus said she did not remember Smith taking a “big gulp” and immediately screaming that the liquid was burning her and “killing her”, and a nurse telling her to keep quiet.

The anaethetist referred to notes she made after the incident, in which she recorded that Smith had swallowed “about 10ml” of formalin. She said while she cannot be certain exactly how much Smith drank, it was a “small” amount.

She testified that when she accompanied Smith out of the theatre into the recovery room, Smith said she was feeling nauseous. She also mentioned she had a hiatus hernia which made her nauseous and that water helped her.

Alphonsus said she ordered an intravenous drug for the nausea, which was administered. Initially a nurse also brought water, but this was discarded as Smith’s nausea had subsided.

Smith again asked her for water and this time Alphonsus went to an adjacent room where there was a tap and sink. She picked up a container with what she thought was water, but turned out to be formalin, and gave it to Smith.

She said she did not know why the Health Department initially filed papers in reply to Smith’s law suit, saying they knew nothing about the matter.

“In the light of your evidence in this court [their reply] was frankly quite astonishing,” Judge Graham Lopes commented.

The department is currently still defending Smith’s claim for damages she alleges she suffered as a result of swallowing the formalin.

Since summons was issued in the case in 2013, the claim has risen from R425 000 to just over R1 million.

Alphonsus said at the time of the incident she was a “specialist-in-training” and had been responsible for administering an epidural anaesthetic to Smith during her knee replacement operation.

She agreed it was her duty to make detailed notes about the formalin incident, termed an “adverse event”.

She said the matter had been discussed at a meeting in her department the same week, but no minutes were kept as far as she knew.

Alphonsus said Dr David Bishop, the consultant on duty that day, took over Smith’s treatment when she had to return to theatre. She later recorded that Smith had been given active charcoal to drink. Alphonsus said she had ordered that a blood test be done on Smith, and she had also gone to check on her condition and to get the test results the following day.

A number of other witnesses testified on Smith’s behalf last week, including clinical psychologist Nirvernie Elder, who said that she suffers from chronic post traumatic stress disorder as a result of the formalin incident.

“She can be described as a damaged individual living in hopeless misery. What started off as a potentially health enhancing event turned out to be a continuing tremendous nightmare,” said Elder in her report to court.

She said Smith is not expected to overcome her PTSD given the length of time and “downward spiralling of her existence”.

Smith is now distrustful of hospitals, clinics and health professionals, and suffers from anxiety.

Dietician Jean Ernest said Smith needs a proper dietary treatment plan, including supplements which will cost around R8 000 per month.

Read more on:    pietermaritzburg  |  health  |  court

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