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<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR>DEATH AFTER KIDNEY DONATION
</TR><!-- headline one : start --><TR>Just 1-2 minutes to save life: Surgeon
</TR><!-- headline one : end --><!-- Author --><TR><TD class="padlrt8 georgia11 darkgrey bold" colSpan=2>By Selina Lum
</TD></TR><!-- show image if available --></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->AN AUSTRALIAN transplant surgeon said a woman who died hours after surgery to donate a kidney, collapsed so rapidly and so unexpectedly that it would not have made any difference if she had been monitored more frequently.
Dr Howard Lau, from Westmead Hospital in New South Wales, told the High Court yesterday that blood loss from the renal artery would be 'ferocious' and 'catastrophic' and there would be a window of opportunity of just one to two minutes, or even less, to save her life.
<TABLE width=200 align=left valign="top"><TBODY><TR><TD class=padr8><!-- Vodcast --><!-- Background Story --><STYLE type=text/css> #related .quote {background-color:#E7F7FF; padding:8px;margin:0px 0px 5px 0px;} #related .quote .headline {font-family: Verdana, Arial, Helvetica, sans-serif; font-size:10px;font-weight:bold; border-bottom:3px double #007BFF; color:#036; text-transform:uppercase; padding-bottom:5px;} #related .quote .text {font-size:11px;color:#036;padding:5px 0px;} </STYLE>About this case
MADAM Narindar Kaur died on Feb 16, 2005, hours after an operation to donate her left kidney to her husband.
She was stable for the first two hours after surgery but became breathless and pale 1-1/2 hours after she was moved to a general ward.
</TD></TR></TBODY></TABLE>He said the way in which the surgery was carried out and the post-operative care for Madam Narindar Kaur was of high standard and acceptable worldwide.
Dr Lau is the expert witness for the two surgeons who operated on Madam Kaur and for the National University Hospital, who are defending a medical negligence suit brought by her family.
He disputes the opinion of the expert witness for the family, Professor Michael Nicholson, who said doctors should have concluded that Madam Kaur was bleeding when she went into shock at about 4pm, 3-1/2 hours after surgery, and should have sent her back to the operating theatre.
Dr Lau said there was no reason to suspect she was bleeding as she had been stable for so many hours and the clips used to clamp her renal artery were the 'gold standard' at the time. He said it was 'exceedingly rare' for bleeding that had already been controlled for the first few hours to suddenly start again.
Lawyer S. Palaniappan, acting for Madam Kaur's family, noted that even though she was supposed to be monitored hourly, the records showed that her vital signs were not taken between 2.30pm and 4pm.
But Dr Lau said it was an 'entirely acceptable' practice in hospitals worldwide that monitoring is not done on the dot; a margin of 30 minutes is acceptable.
'This, unfortunately, is reality.'
He noted that a nurse in a general ward has to look after eight patients. It would take five minutes to take each patient's vital signs, a total of 40 minutes.
The nurse would also have other duties, such as paperwork, dispensing medication and cleaning up after patients. As such, it was 'impossible' for nurses to be able to monitor patients on the dot. 'I've never seen it done before,' said Dr Lau.
He pointed out that, for instance, while Madam Kaur was being resuscitated, the other patients in her ward would not have been monitored. In any event, said Dr Lau, even if monitoring was done on the dot for Madam Kaur, the nurse might not have seen any earlier signs because the bleeding would have been 'fast and furious'.
</TR><!-- headline one : start --><TR>Just 1-2 minutes to save life: Surgeon
</TR><!-- headline one : end --><!-- Author --><TR><TD class="padlrt8 georgia11 darkgrey bold" colSpan=2>By Selina Lum
</TD></TR><!-- show image if available --></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->AN AUSTRALIAN transplant surgeon said a woman who died hours after surgery to donate a kidney, collapsed so rapidly and so unexpectedly that it would not have made any difference if she had been monitored more frequently.
Dr Howard Lau, from Westmead Hospital in New South Wales, told the High Court yesterday that blood loss from the renal artery would be 'ferocious' and 'catastrophic' and there would be a window of opportunity of just one to two minutes, or even less, to save her life.
<TABLE width=200 align=left valign="top"><TBODY><TR><TD class=padr8><!-- Vodcast --><!-- Background Story --><STYLE type=text/css> #related .quote {background-color:#E7F7FF; padding:8px;margin:0px 0px 5px 0px;} #related .quote .headline {font-family: Verdana, Arial, Helvetica, sans-serif; font-size:10px;font-weight:bold; border-bottom:3px double #007BFF; color:#036; text-transform:uppercase; padding-bottom:5px;} #related .quote .text {font-size:11px;color:#036;padding:5px 0px;} </STYLE>About this case
MADAM Narindar Kaur died on Feb 16, 2005, hours after an operation to donate her left kidney to her husband.
She was stable for the first two hours after surgery but became breathless and pale 1-1/2 hours after she was moved to a general ward.
</TD></TR></TBODY></TABLE>He said the way in which the surgery was carried out and the post-operative care for Madam Narindar Kaur was of high standard and acceptable worldwide.
Dr Lau is the expert witness for the two surgeons who operated on Madam Kaur and for the National University Hospital, who are defending a medical negligence suit brought by her family.
He disputes the opinion of the expert witness for the family, Professor Michael Nicholson, who said doctors should have concluded that Madam Kaur was bleeding when she went into shock at about 4pm, 3-1/2 hours after surgery, and should have sent her back to the operating theatre.
Dr Lau said there was no reason to suspect she was bleeding as she had been stable for so many hours and the clips used to clamp her renal artery were the 'gold standard' at the time. He said it was 'exceedingly rare' for bleeding that had already been controlled for the first few hours to suddenly start again.
Lawyer S. Palaniappan, acting for Madam Kaur's family, noted that even though she was supposed to be monitored hourly, the records showed that her vital signs were not taken between 2.30pm and 4pm.
But Dr Lau said it was an 'entirely acceptable' practice in hospitals worldwide that monitoring is not done on the dot; a margin of 30 minutes is acceptable.
'This, unfortunately, is reality.'
He noted that a nurse in a general ward has to look after eight patients. It would take five minutes to take each patient's vital signs, a total of 40 minutes.
The nurse would also have other duties, such as paperwork, dispensing medication and cleaning up after patients. As such, it was 'impossible' for nurses to be able to monitor patients on the dot. 'I've never seen it done before,' said Dr Lau.
He pointed out that, for instance, while Madam Kaur was being resuscitated, the other patients in her ward would not have been monitored. In any event, said Dr Lau, even if monitoring was done on the dot for Madam Kaur, the nurse might not have seen any earlier signs because the bleeding would have been 'fast and furious'.
