Ahola v. Sincock

• Decision Date: 03 February 1959
• Citation: 94 N.W.2d 566,6 Wis.2d 332
• Parties: Janie Lee AHOLA, by her gdn. ad litem, Daniel I. D'Amico, et al., Appellants, v. H. A. SINCOCK, Respondent.
• Court: Wisconsin Supreme Court

Page 566

94 N.W.2d 566

6 Wis.2d 332

Janie Lee AHOLA, by her gdn. ad litem, Daniel I. D'Amico, et al., Appellants, v. H. A. SINCOCK, Respondent.

Supreme Court of Wisconsin.

Feb. 3, 1959.

Rehearing Denied April 7, 1959.

Daniel I. D'Amico, Cumberland, Harry T. Lathrop, Duluth, Minn., for appellants.

R. Charles Banker, Superior, Johnson, Fritschler, Barstow & Witkin, Superior, for respondent.

DIETERICH, Justice.

The plaintiff was taken to St. Mary's hospital in Superior, Wisconsin, and placed under the care of Dr. H. A. Sincock, a specialist in diseases of children, gynecology and obstetrics, on August 26, 1953. X-rays were taken and the doctor found from physical examination 'that she had a fracture, a portion of which was just protruding just beneath the skin about five inches below the hip joint itself, plus multiple slit superficial abrasions of the thigh. Mostly on the top surface of the thigh.' Dr. Sincock testified as follows:

'Q. Where would you say this fracture occurred? A. I would say this fracture occurred, dividing the femur into thirds, that it was at the lower part of the upper third and the beginning part of the middle third.'

The doctor stated that the child's leg was placed in Bryant's vertical traction which consists of a type of adhesive tape. The tape is sticky on one side and the other side is a plain ordinary surface. A sheet wadding of cottony material is used as padding. One strip of tape is used on both sides and a small wooden block or spreader is placed inside the tape in position on the bottom of the foot. The spreader is used so that the tape does not stick to the ankle. The tape is placed so that the two sticky sides come together from the edge of the block down to where the cotton wadding is, so there would be no part of the tape that would stick to the ankle. Gauze was used over the tape so that it will adhere to the calf of the leg. From the ankle to the knee, on the top surface there is a space left at least one inch wide. On the back of the leg from the ankle to the knee a space of one inch wide is left so that in no place is the tape overlapping. That is where the bandage touches the skin. A rope is put through the end of the spreader and put over a pulley and weights are attached to the pulley to apply traction. This creates a direct pull to the leg. The leg is pulled straight up at a right angle to the bed rather than lengthwise to the body. Care must be given to the foot and the leg because it is necessary for the blood to be pumped high up into the air. Splints were applied above the knee. On August 30, 1953, the splints were adjusted. The hospital records indicate in Dr. Sincock's handwriting that he readjusted the splints because of pain and slight cyanosis of the foot (a bluish tinge in the color of skin) due to the presence of excessive amounts of reduced hemoglobin (reduced oxygen) in capillaries. Hospital records in Dr. Sincock's handwriting show that in a notation on August 27, indicated that 16 pounds were used on the leg, and further reads: 'Removed five pounds, so now there is 11 pound pull.' On August 30, the record indicates a decrease to nine pound pull and that the doctor readjusted the splint on account of pain and slight cyanosis of the foot. On September 1, 1953, there is a notation that toes were somewhat cyanotic and the splint was again readjusted. Dr. Sincock's own records for September 2, show 'Splint removed on 9/2/53 at 6 p. m., on account of circulatory disturbance. Upon removing tape, found the hematoma involving about 10 inches of calf and pressure area over the patella [knee].' On September 2, Dr. Picard looked at the leg and on September 3, Dr. Finn was called in for consultation. On September 4, 1953, Dr. Houkom was called from Duluth. His findings were: Fracture just above the knee with moderate overriding, in addition there was necrosis of the skin, particularly between the knee and the ankle joint and considerable swelling and bleb formation present. The diagnosis indicated: 'Fracture of the shaft of the left femur with circulatory disturbance to the skin. Treatment recommended: That a Kirschner wire be inserted into the distal end of the left tibia using a Kirschner bow traction on this leg from an overhead frame. This would facilitate the change in applications of dressings to the rest of the leg. Signed S. S. Houkom.'

The diagnosis and findings of Dr. Finn indicated: 'Fracture of the left mid one-third femur. Maceration of skin from knee to ankle with sloughing following crush injury from car wheel * * * fracture of the femur. 2nd, maceration of the skin and underlying tissue left lower leg. Recommended treatment: Observation, hot packs, traction to the leg.' Dr. Sincock made a summary of the history that is included as part of the hospital records dated October 26, 1953, which read: 'Transvers and slightly oblique to the end of the proximal third of the left femur with abrasion to the thigh and a deep contusion to the patella and inner condylar of the femur. Complications: Sloughing of the skin and fatty structure of almost the entire left calf. Muscle structure and sloughing about the inner condyle and over the * * * patella.'

An operative record made by Dr. Houkom indicated 'Case No. 3162, Date September 5, 1953. Room, Pediatrics. Name Miss Janie Ahola. Address, Poplar, Wisconsin. Service of Dr. Sincock. Preoperative diagnosis: Fracture of the mid third shaft of the left femur. Postoperative diagnosis: Fracture of the mid third shaft of the left femur. Doctor Houkom is surgeon. Sister Alitaria as the anesthetist, Doctor Finn as the assistant and Sister Roseanne as the instrument nurse.' The type of anesthetic used was ethel chloride. The operation was a Kirscher wire in the left tibia. The operation began at 8 a. m., in the morning. Was closed at 8:45 in the morning. What was done: Under general anesthesia a Kirschner wire was passed through the distal portion of the tibia above the epiphyseal plate. A Kirschner bow was then fastened to the wire. The leg suspended by vertical traction with enough weight to keep the left buttock off the bed. Signed, S. D. Houkom, and it says post-operative condition, hemorrhage, shock, etc. was satisfactory.'

Dr. Sincock on cross examination was asked:

'Q. Will you describe to the court and jury just the process that you used in applying that method? A. The Bryant Extension, as you know it now, is an up-right holding the leg at right angles with a block of wood separating the tape that comes on either side. The tape is held with the bandage so as to conserve the heat of the body so that the adhesive will adhere to the skin. There is a rope that goes through this cross bar, up into a pulley. The pulley goes to the foot of the bed, down the side and where a weight is placed upon it. The amount of weight that is placed at the ends of it, of course, is judged entirely by one factor. You want to get the child--you want to get, or want to know that those muscles are under tension, but not too much. We have only one rule to follow there. Chatterton told you that this afternoon. When your child's buttocks are above the bed so that you can slip your hands under the buttocks, that is the criterion of the amount of weight you should use on a child, and that is what I did, and then following that, the child's leg was properly padded * * * so that we could apply splints.

'Q. Now, Doctor, on the 27th of August, did you adjust any of the weights on the leg, or on the traction? A. Yes.

'Q. And what adjustments did you make? A. I took off one of those five pounds weight you saw.

'Q. And, by five pound weights, what do you mean? A. It would reduce that pull by three-quarters of a pound.

'Q. And again are those weights the weights that we have shown to be exhibit A? A. They are.

'Q. Doctor, * * * I would like again to show you defendant's exhibit A and ask you if there is any explanation for the word, five pounds on there? A. Yes. This is a weight from a Beam scale. That is * * * when this weight is placed on the end of a beam, it will take five pounds to balance it over here, but the actual weight in itself is only three-quarters of a pound. * * *

'Q. Doctor Sincock, did you make any diagnosis after the condition developed that you found on Janie Ahola's leg on September 3rd of the cause of the trouble? A. I did * * * I found an area of demarcation involving the calf of the leg. That was the diagnosis * * * September 3rd, the area of demarcation that Doctor Picard and I noticed the night before had broken open and had begun to slough. The cause of this sloughing was primarily * * * from an automobile weighing 2700 pounds running over the leg of a child four years old, * * * the tire crushing the muscles and impairing the circulation at the time of the accident. * * *

'Q. Now on August 26, 1953, there were 16 pounds of weight pull applied to this traction, is that right? * * * A. * * * No, that is not right * * * that wasn't actually 16 pounds.

'Q. The record is wrong? A. No, the record isn't wrong, because I fully realized when that was put on that the numbers on the weights tallied up to 16 pounds, but those weights were weights that had been gathered here and there. They did not have enough weights at that particular time. It was kind of a gathering in of many weights. The total amounted to 16 pounds. No, the numbers on them totaled 16 and so that we might have some knowledge of the numbers we put down pounds. It could have been 11 pounds the same as it could have been 16 pounds.

'Q. What weight was applied? A. I don't know what weight was applied, but it is not done by weight, it is done by what you want to accomplish.

'Q. You answered the question. So you apply certain weight to accomplish certain things, don't you? A. No, No, not in pounds, no. You put on enough weight so you will get the result that you like to attain.

'Q. Well the records shows that on that date 16 pounds? A. But not...