Surgeons took an hour to find source of bleeding in patient

PUBLISHED : Saturday, 19 April, 2008, 12:00am
UPDATED : Saturday, 19 April, 2008, 12:00am

It took nearly an hour to find the source of profuse bleeding suffered by a former Swire Beverages general manager during keyhole surgery at Hong Kong Adventist Hospital to remove non-cancerous growths, a nurse told the inquest yesterday.

The patient, Ng Keong-ching, 55, lost 10 litres of blood and died from heart failure on June 9, 2005, two days after the surgery to remove lumps on an adrenal gland, the coroner's court had heard.

Phoebe Lai Kit-ying, one of the nurses who assisted in the surgery, said she noticed massive bleeding right after the surgeon, John Boey, made an incision in the adrenal gland at 5pm.

Within five minutes a machine monitoring Ng's blood-oxygen level could not detect anything, she said. A colleague drew this to the attention of another nurse, Hilary Hui Mei-ling.

After a further five minutes Dr Boey decided to perform open surgery at the suggestion of the attending anaesthetist, Ms Lai said.

While preparing instruments for the new operation, the anaesthetist asked Ms Hui to summon another surgeon to assist in the operation.

Ms Lai said surgeon Darren Mann and another anaesthetist, Vivian Cheung, reached the operating theatre to assist in surgery 45 minutes after the bleeding began.

While operating theatre staff waited for Dr Mann to arrive, Ng was transfused one pack of blood containing between 350cc and 400cc, Ms Lai said.

While the two anaesthetists worked on resuscitating Ng, Drs Boey and Mann spent five to 10 minutes discussing the operation and deciding who would be in charge of it.

Dr Mann was able to identify the source of the bleeding within five minutes of placing a vascular clamp in Ng's abdomen, she testified.

He eventually managed to stop the bleeding by putting packs of gauze in Ng's body. The patient was sent to the Happy Valley hospital's intensive unit care at 9pm.

Ms Lai told the court she had only learned several days ago from reading reports prepared for the inquest that the cause of the massive bleeding was a cut in the inferior vena cava - a large vein that carries blood from the lower half of the body to the heart.

Another nurse, Tam Kim-ping, told the coroner's court that a tube had been inserted in Ng's abdomen at 3.15pm on the day of his surgery to allow doctors to use a camera to look into his interior cavity.

Ms Tam said she went off duty at 3.30pm and Ms Lai had taken her place in the operating theatre.

Between 5pm and 6pm she was ordered back to the operating theatre to assist in an operation to remove a patient's appendix. The operation was scheduled to be carried out in the same theatre as Ng's operation.

Upon arriving in the theatre, she was told to help resuscitate Ng.

She told the court she did not have much recollection of what happened during the resuscitation efforts since she had been running in and out of the theatre fetching surgical instruments and performing other pre-operative tasks.

The hearing continues on Monday before coroner William Ng Sing-wai.