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The Canberra Times
The Canberra Times
National
Blake Foden

'Everybody's eyes got very big': Needle snaps in 'petrified' patient's spine

A public servant has lost a medical negligence case against Canberra Hospital, despite a judge finding her quality of life has suffered since half a needle snapped off in her spine.

Details of the incident were revealed on Friday, when the ACT Supreme Court published a judgment that showed patient Bronwyn Fuller was left "absolutely petrified".

Mrs Fuller, who works for the Australian Maritime Safety Authority, sued the hospital on the basis of vicarious liability for the alleged negligence of a registrar and an anaesthetist.

Acting Justice David Robinson, who presided over a four-day civil trial, said Mrs Fuller had attended the hospital in February 2020 to give birth by caesarean section.

A spinal anaesthetic was to be administered by the registrar, Manil Abeygunasekara, who gave evidence he had done this "more than 10 times".

Dr Abeygunasekara, described as being "a junior trainee" at the time in question, said he had problems on this occasion and hit bone whenever he "redirected" the spinal needle.

He said he eventually asked a more experienced colleague, anaesthetist Lanie Stephens, to take over.

Dr Stephens had "scrubbed up" in case help was needed, having anticipated there might be difficulties because of Mrs Fuller's obesity.

She told the court she started "getting deeper than Dr Abeygunasekara had gone" and "felt like things were going well" until she pulled the 80mm needle out of Mrs Fuller's spine.

"I immediately realised that half wasn't there and I was surprised," she said.

Dr Stephens described how she held the needle up "and everybody's eyes got very big".

"And I said to Bronwyn, 'Look, I'm really sorry but half of the needle has broken off and it's still in your back'," Dr Stephens told the court.

"'We are going to fix this. We're going to make it better. I need you to hold really still.'"

Acting Justice Robinson said Mrs Fuller was understandably "in a very high state of anxiety, if not terror", so her husband was brought into the hospital theatre to give her moral support while Dr Stephens went to find neurosurgeon David McDowell.

An "absolutely petrified" Mrs Fuller, who gave evidence "it felt like I was there a lifetime", told her husband while waiting for Dr McDowell that she did not want to be in a wheelchair.

Dr McDowell was ultimately able to remove the broken part of the needle and Mrs Fuller, who went on to have a general anaesthetic, gave birth to a healthy daughter later the same day.

Under cross-examination, Dr Stephens was challenged about why she had not changed the spinal needle in light of it having possibly being weakened by Dr Abeygunasekara.

"Dr Stephens informed the cross-examiner that she had never seen or heard of a spinal needle breaking," Acting Justice Robinson said.

However, Dr Abeygunasekara gave evidence he was aware this had happened in the past, and Acting Justice Robinson found the risk of it in this case had been foreseeable.

The judge concluded the most likely reason the needle broke was that Dr Stephens had hit bone or "hard ligamentous material" while trying to insert it into Mrs Fuller's spine.

While he said Dr Stephens ought to have been aware that might happen, Acting Justice Robinson placed emphasis on the fact the risk to be avoided was "rare or very rare".

The judge also said Dr Stephens had "acted in the manner accepted as competent professional practice at the time", adding that there was "no evidence that either doctor withdrew the spinal needle ... in other than a proper manner".

"In my view, [Mrs Fuller] has failed to prove that the duty owed to her in the circumstances of this case has been breached," Acting Justice Robinson said.

He also noted medical evidence that suggested Mrs Fuller was likely to "make a good recovery" from physical and psychological injuries suffered in the "traumatic" incident.

"Her quality of life has been diminished and her plans to have a child by caesarean section, which were important to her, were frustrated," the judge said.

Canberra Hospital, where the incident occurred.
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