X-ray showed Adib with collapsed lung, four fractured ribs.
The injuries sustained by Muhammad Adib Mohd Kassim were most likely not caused by assault, one of the doctors who treated him told the inquest into the fireman’s death.
Dr S Anand, a cardiothoracic surgeon with Subang Jaya Medical Centre (SJMC), said CT scans on the upper parts of Adib’s body showed that they were normal but not his chest area.
Under questioning by Zhafran Rahim Hamzah, who is on the three-member team from the Attorney General’s Chambers (AGC), Anand revealed that the major injuries were confined to only the chest area.
According to the doctor, Adib’s injuries to the chest area were caused by blunt trauma.
Dr Anand: There are various mechanisms that could lead to this injury – a crush, fall from a height, rapid acceleration and deceleration, or assault.
Zhafran: Is it possible to distinguish between assault and other causes?
Dr Anand: It’s hard to say. But I find them (Adib’s injuries) somewhat unusual (to be from an assault).
In an assault, one would expect other injuries such as self-defence wounds.
It is somewhat unusual to have major trauma that is confined to one section. It’s not impossible (for it to be from being assaulted) but less likely.
Dr Anand, who was the 13th witness called to the inquest, treated Adib at SJMC until he was transferred to the National Heart Institute (IJN).
Adib, he said, suffered from intensive lung damage and fractured ribs when he was brought to SJMC in the early morning of Nov 27.
Dr Anand said the patient had lung contusion – which meant that his lung was bruised – pneumothorax, where the space between his chest wall and lung was filled with air, and multiple rib fractures.
He also said that while Adib’s condition stabilised, the team of specialists at SJMC felt that the fireman needed to be put on an extracorporeal membrane oxygenation machine that was not available at the hospital.
“The machine takes over the function of the lungs to allow a patient’s lungs to have less work to do and recover.
“IJN has more experience with it,” he added.
Asked by Faten Hadini Khairuddin, who is also from the AGC team, on what he noticed when he first came into the emergency room to treat Muhammad Adib, Dr Anand said the fireman’s chest was “very swollen” due to subcutaneous emphysema, which is air being trapped under the skin.
Faten: Did you see any bruising on his chest?
Dr Anand: I can’t recall seeing bruises or marks, but my focus was on his life-threatening injuries.
Emergency physician Dr MK Nantha Kumeran, who was the first doctor to treat Adib, also testified to the bruises on the upper right side of his chest wall and four fractured ribs.
Dr Nantha, the 12th witness, told the coroner’s court that Adib was gasping for air, unable to talk and making incomprehensible sounds when he was brought in.
He ordered an X-ray scan on the fireman after seeing a large bruise on his upper right chest.
The X-ray reports showed fractured second, third, fourth and fifth ribs on the right side.
“And when I touched his chest, I could hear cracking sounds.
“At that time, I was looking towards (him having) pneumothorax (collapsed lung),” he said.
Dr Nantha noted that Adib’s body and face became swollen after doctors inserted a tube into his trachea.
“The lungs were already injured, and we were forcing air into him. The oxygen we gave him had escaped under his skin,” he added.
He said after one hour of treating Adib, he approached three Indian men who had brought Adib to SJMC to ask what happened to him.
All of them stated that Adib could have fallen from a (fire) truck or could have been beaten up, he said.
Judge Rofiah Mohamad sits as coroner for the inquest held at the Shah Alam Sessions Court.
Adib was critically injured when he and his teammates from the Subang Jaya fire station responded to an emergency at Seafield Sri Maha Mariamman Temple where riots were happening last November.
He passed away at IJN on Dec 17.
Earlier reports:
Feb 19, Adib Inquest: Cabbie Recalls Feeling ‘Dazed’ After Struck by Fire Truck
Feb 18, Adib Inquest: Partial “Shoe” Print on Fireman’s Ribcage
Feb 15, Adib Inquest: Fireman Unconscious by the Road
Feb 15, Adib Inquest: Group Helped Injured Fireman
Feb 12, Chaos, Danger When Mob Attacked Fire Truck, EMRS Van