“You can see this type of injury... in car accidents”
Injuries isolated and there were no defensive wounds, says Dr Anand
ACARDIOTHORACIC surgeon who treated Muhammad Adib Mohd Kassim cast major doubt on the theory that the fireman was assaulted due to the nature of the injuries he suffered.
Dr Anand Sachitanandan of Subang Jaya Medical Centre (SJMC) said the blunt force trauma suffered by the Emergency Medical Response Services (EMRS) team member was usually caused by being crushed, falling from a certain height, acceleration impact or assault.
However, he said it would be considered unusual that such injuries could have been caused by assault in Adib’s case as they were isolated and due to the absence of defensive wounds.
Questioned by deputy public prosecutor Zhafran Rahim Hamzah, Dr Anand added, though, that it was difficult to be accurate on what exactly had caused the injuries.
Zhafran: What were the nature of his injuries and its causes?
Dr Anand: Basically, the injuries the deceased received were major blunt force chest trauma. When you talk about that, there are two types — one penetrating the chest either due to a gun shot or stab, which is usually localised.
A blunt force chest trauma occurs in a wider area. You can see more of this type of injury in Malaysia in car accidents… usually in blunt chest trauma, possible mechanisms of injuries would, for example, be a crush injury, a fall from a height, acceleration injury or assault. Zhafran: Can you distinguish between the two? Was assault more likely than being crushed?
Dr Anand: It is impossible to be accurate. I find it unusual if you have a blunt force trauma which is isolated. Normally, we expect defensive wounds (in an assault), which were not present, and (his) injuries were confined to the thorax or chest. It is somewhat unusual for the trauma to be isolated to one area of the body if it was assault.
Zhafran: It is unusual to see such a thing? Generally, there should have been defensive wounds?
Dr Anand: Yes. Not possible. Zhafran: What kind of trauma or impact could be the cause, from your experience?
Dr Anand: I classify this as blunt force trauma. I’m not in a position to say its causes.
Dr Anand, 46, was the 13th witness in the inquest into the cause of Adib’s death.
He was part of a team of nine specialists from SJMC who treated Adib after he was sent to the facility.
He also said his professional role ceased when Adib was transferred from SJMC to the National Heart Institute (IJN) for further treatment.
Dr Anand said Adib was intubated when doctors treated him at SJMC, and that a transoesophageal echocardiogram, or ultrasound of the heart, was conducted which revealed that Adib’s heart was functioning well even though he was still experiencing low blood pressure.
He said despite the (chest) drains conducted on Adib, there was air sitting behind the sternum (breast bone), putting pressure on his heart.
He said, subsequently, the doctors at SJMC sought help from two specialists from IJN whom they met the same night and based on discussions, they decided that extracorporeal membrane oxygenation, a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream, at IJN was the best option.
Dr Anand said the process to transfer Adib to IJN was done with great difficulty as taking him down from the sixth floor intensive care unit of SJMC to the ambulance had taken the medical team 30 to 45 minutes.
Adib was taken to SJMC on Nov 27 after being injured during a riot at the Seafield Sri Maha Mariamman temple in USJ 25, Subang Jaya.