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Politician died from ‘over tight’ bandage

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A FATHER died from a “crush injury” caused by a bandage which was applied too tightly after surgery, an inquest heard.

Former Lewes district councillor Paul Gander, 59, of Ringmer, suffered multiple organ failure after the bandage on his leg acted like a tourniquet.

It was applied following a heart bypass at Brighton’s Royal Sussex County Hospital, an inquest into his death heard yesterday.

Brighton Coroner’s Court heard the hospital’s own preliminary records identified several areas of “poor” care that “probably” led to a deterioration of his condition following his operation on June 2 this year.

A pathologist found his death had been caused by a condition called compartment syndrome caused by a tight compression bandage on his left leg.

The coroner was told the condition was also known as a “crush injury”.

A vein had been taken from Mr Gander’s leg for the surgery, as is the procedure with a heart bypass. However, the thigh wound, from where the vein was taken, started bleeding. The bandage was applied but the pressure put on his leg cut off his circulation, causing kidney failure.

The inquest heard that plans were made to amputate his leg. However at 2.55pm on June 7, he suffered cardiac arrest and died.

Gnanmurthy Kugan, the cardiac registrar on duty during the night of June 2, applied the pressure bandage.

He told the court he added two extra bandages over three others at about 8.30pm. But at 10.45pm Mr Gander’s foot looked mottled, was cold and had no pulse.

He said: “I checked at what rate he was bleeding.

“I had a discussion with the nurses about the rate he was bleeding and how we couldn’t let it go on all night and decided to put on a pressure bandage.

“I applied the pressure bandage in the way I normally do.

“I don’t think I have ever had to take a patient back to theatre for bleeding in the leg.”

Dr Kugan wrapped Mr Gander’s thigh in two extra layers of bandage. When he removed the outer layer he said the colour and temperature returned to normal and pulse returned.

“I have never seen that before,” he said. “I did not use brutal force to tie the bandage.”

The surgeon said he had not checked how much Mr Gander was bleeding after removing the bandage and accepted he should have.

When Mr Gander woke at 7am he was complaining of extreme pain in his thigh and being unable to move his leg, the inquest heard.

However, the specialist registrar Khalid Mujamid, who took over in the morning and was the only doctor in the department to have seen the condition before, said he was unaware that Mr Gander was suffering severe pain, loss of sensation and unable to move his leg, the coroner was told.

Consultant cardiac surgeon Uday Trevedi told the court Mr Gander’s case was the first seen in the 18 years the cardiac department had been operating.

But said he no longer used bandages on patients who had veins removed from their legs.

Mr Trevedi said: “I have never come across this complication before.

“Since Mr Gander’s case I have actually stopped bandaging legs. My other colleagues may well still do it but I have taken the view not to.”

Coroner Veronica Hamilton Deeley said that as well as looking at whether the hospital acted correctly she was concerned about how Mr Gander’s wife Susan was kept informed of his deteriorating condition.

Addressing his widow, she said: “I’m going to look at how you Mrs Gander were informed.

“For a patient in a life threatening situation I understand that they have to do everything they can to rescue him but nothing is going to bring back those precious hours for you.”

The inquest continues.


Source: The Argus