A CT scan conducted as part of fireman’s Muhammad Adib Mohd Kassim’s post-mortem report had revealed fractures on his left ribs which were not visible during an initial scan.
The inquest to determine Adib’s cause of death focussed on scanned images taken at Sime Darby Ramsay Medical Centre on Nov 27 and later as a part of the post-mortem conducted at HKL on Dec 17.
When presented with the two images, the National Heart Institute’s (IJN) consultant anaesthesiologist Dr Suneta Sulaiman said the initial scan from SJMC only revealed fractures to Adib’s right anterior (front) and posterior (back) ribs, but the scan from HKL also showed a linear fracture on his left posterior ribs.
“It (fractures on the left) was not visible. Whether it existed or not (from the beginning) we don’t know.
“Displacement of bones could be more visible when there was more movement in that area,” said Suneta to questions from inquest conducting officer Zhafran Rahim Hamzah.
“Whilst the patient was with us from SJMC and his whole stay, there was no trauma. Nothing fell on him. We didn’t do procedures in that area.
“It’s unlikely that these injuries happened in that time,” she said.
Suneta said there must be significant impact applied to a particular area in order to fracture multiple bones, although not all fractures would be visible unless the bones were displaced through movement.
“It’s possible due to a movement that the fracture can be displaced. A fracture can be undisplaced when the bones are aligned.
“When the bones are no longer aligned, the fractures are clear and visible to see,” she further explained on possible reasons that more fractures were visible in the post-mortem scan.
She said when the firefighter was recovering in the ICU from December 4 to 11, he underwent physiotherapy, making it possible that movements during the sessions led the fractures on the left side of his ribcage to show.
To questions from Adib’s family lawyer Mohd Kamaruzaman A Wahab, Suneta, however, said she was unable to ascertain the amount of force that had caused the fractures, as it was beyond her area of expertise.
To a suggestion from Kamaruzaman that less force had caused the fractures on Adib’s left posterior, as they were only visible after the second CT scan, Suneta said it was possible, but a pathologist would be able to provide more clarifications.
“For a doctor all multiple rib fractures are severe. I cannot say which (based on scans) is more severe.
“To say whether the fractures on back or front is more severe, to me both are severe,” she said.
No CT scan was conducted on Adib throughout his treatment at IJN as the team of experts led by Suneta had deemed his condition unstable to be moved from the ICU to their radiology unit on a different floor.
Previous witnesses in the inquest had testified how there were visible signs of bruising on the right side of Adib’s body from near his armpits down to his ribcage.
Earlier reports:
Feb 25, Adib Inquest: Question of Whether Adib was Beaten
Feb 25, Adib Inquest: Why Life Support Machine Could Not Save Fireman
Feb 22, Adi Inquest: Injuries Likely Not from Assault
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