‘Lung failure cause of death’
SHAH ALAM: Firefighter Muhammad Adib Mohd Kassim’s death was due to acute respiratory distress syndrome (ARDS) and multiple organ failure, the coroner’s court was told yesterday.
National Heart Institute cardiothoracic surgeon senior consultant Datuk Dr Mohamed Ezani Md Taib said ARDS, or lung failure, occurred due to major blunt force trauma suffered by Adib.
“The multiple organ failure occurred as Adib’s oxygen level decreased, which led to heart failure. His kidney never recovered until he died on Dec 17.
“We included sepsis as one of the causes as Adib had stayed in the intensive care unit (ICU) for a long period of time.
“Sepsis is a serious condition caused by the presence of harmful microorganisms in blood or other tissues and the body’s response to it. This condition can lead to the malfunctioning of organs,” Dr Ezani told deputy public prosecutor Fatin Hadni Khairuddin.
He said Adib’s injuries were caused by blunt force trauma from a hard object, which hit his chest.
“However, I cannot speculate what was the object. I also cannot determine the damage (to his lungs) as we did not perform the operation.”
Earlier, he said once Adib arrived at IJN, his team tried to stabilise the patient’s blood pressure and oxygen level, which were decreasing rapidly due to his injuries.
“We reviewed the computerised tomography (CT) scan and concluded that Adib had chest injuries. Air was leaking from his lungs, which was why doctors had difficulty maintaining Adib’s oxygenation.”
He said Adib’s condition was critical and this was agreed by his colleague, IJN’s ICU director, Datuk Dr Suneta Sulaiman, who was one of the doctors who had accompanied Adib in the ambulance which transferred him from Subang Jaya Medical Centre to IJN.
He said the IJN team had attached Adib to an extracorporeal membrane oxygenation (ECMO) machine as soon as Adib arrived at IJN to stabilise his oxygenation and blood pressure.
Fatin: What is the function of ECMO?
Dr Ezani: It will help the patient’s blood flow by bypassing the heart and lungs’ functions.
Fatin: What was Adib’s condition after the ECMO?
Dr Ezani: Improving. His hemodynamic (blood pressure and pulse rate) were improving and oxygenation was at 100 per cent. He was more stable compared with when he was in the ambulance.
He said on Dec 2, Adib’s assessment revealed that his heart function had recovered.
He said this led to a decision for the ECMO procedure to be converted from a veno-arterial method to a veno-venous one.
(Veno-arterial ECMO method supports the heart or just the heart and lungs. The veno-venous ECMO is done only to support the lungs).
Dr Ezani said doctors decided to remove the ECMO treatment on Dec 11 as a temporary measure as his condition permitted it.
“Once we stopped ECMO, we continued to monitor his oxygen level and it was adequate throughout the entire process, including during physiotherapy sessions.”