Adib had lung contusion, multiple rib fractures, says emergency doctor
KUALA LUMPUR: Firefighter Muhammad Adib Mohd Kassim was suffering from serious lung injuries caused by blunt force trauma when he arrived at the Subang Jaya Medical Centre (SJMC), the Coroner’s Court was told.
Dr M. Nanta Kumeran, the emergency doctor who treated Adib at SJMC, said the medical team suspected that the 24-yearold had a punctured lung as well as fractures to bones on the right side of his ribcage when he was first brought to the hospital.
“Based on our X-ray results, however, we found he was suffering from a lung contusion (bruising of, and not puncture to, the lung), and fractures to his second, third, fourth and fifth ribs.
“Under X-ray, the lung usually will appear pitch black. However, in Adib’s case, there were white patches all over the lung, which meant there were abrasions in that area,” he said.
Questioned by deputy public prosecutor Zhafran Rahim Hamzah, Dr Nanta Kumeran, the 12th witness in the inquest, said the injuries could have been caused by blunt force trauma.
He also said he had to perform resuscitation on Adib when the fireman arrived at the hospital as the latter’s blood pressure and vital signs were low.
“When he arrived, I saw him gasping for air while making incomprehensible sounds. His pulse was 145 beats per second (bps), blood pressure 85/46, and he only had 48 per cent of oxygen level in his blood,” he said, adding that the normal oxygen level was more than 95 per cent.
Zhafran: What did you do?
Dr Nanta Kumeran: I called cardiologist Dr Anand (Sachitanandan), anaesthetist Dr Zurina, and asked to send the patient to be Xrayed as I heard a cracking sound on the right side of his ribs (when he was moved). I suspect he suffered from pneumothorax.
What is pneumothorax?
presence of air or gas in the cavity between the lungs and the chest wall (pleural space), causing collapse of the lung. Zhafran: What did Dr Zurina do? Dr Nanta Kumeran: She examined the patient and decided to intubate (inserting a tube into the trachea) to help him breathe manually.
Zhafran: What did Dr Anand do? Dr Nanta Kumeran: He also assessed the patient and decided to put in a chest tube to increase oxygen levels and remove excess air in Adib’s pleural space. He also ordered a computerised tomography (CT) scan on Adib’s abdomen, head and chest.
Dr Nanta Kumeran said Adib’s abdomen, neck, face and scrotum were swollen due to subcutaneous emphysema (leaking of air below the skin), caused by air leaking from the lung.
Asked about bruising to Adib’s right arm and whether this was due to him being gripped, the doctor said the injury was more likely caused by blunt force trauma.
Asked if there were any imprints or marks on Adib’s body, he said there were only bruises.
Dr Nanta Kumeran said his objective was to increase Adib’s level of oxygen and blood pressure which he did after the chest tubing.
He said after treating Adib for more than an hour, he went outside the emergency room to approach three Indian men who had brought Adib to hospital, to get a clearer picture of the situation.
“They told me they found Adib lying on the ground and did not know what actually happened to the fireman. They said they did not know whether Adib had fallen from the fire engine or had been beaten,” he said.