Dear Editor,

I read the CMO's account in regard to the death at the N. A. Hospital. I was a bit perplexed at the sequence of events as stated by him. There are many things that just don't add up or make any sense medically speaking.

The doctor said that 'When the patient arrived in the Emergency Room he was triaged was found to have 'only a penetrating wound to the right buttock two inches in diameter with no exit wound.'

There is no reason why anyone should die of a wound to the buttox in a fully equipped medical facility, having arrived there alive and survived for almost three hours!

The action of giving blood was correct since it was apparent that the great loss of blood from the wound contributed to his state of shock. Something went wrong from there. What should have been done is that the patient should have been given enough blood to replace loss volume. His vital signs should have been carefully monitored and airway maintained. Should there have been any signs of fatal cardiac rhythms, steps should have been taken to correct this by means of Advanced Cardiac Pulmonary Resuscitation. Once this patient was stabilized the next step should have been to the operating room.

From what the CMO said, this Patient needed an Exploratory Laparatomy. (making a surgical incision into the abdomen to see if there is any problem and fixing it surgically) He did not indicate why.

Anyway, if there was a need for that type of surgery, that should have been the next priority for this patient( not an orthopaedic consult) Furthermore, the blood transfusion could have been going simultaneously during this Exploratory Laparatomy, providing the patient was stable (from a cardiac standpoint).After this the patient should have been allowed to further stabilize in the Intensive Care Unit until he was medically stable to undergo any orthopaedic evaluation.

I totally disagree with the CMO's conclusion. There was some gap in the medical response. I do not think this is the type of medical care one should expect to receive from any such medical facility in Guyana.