No abnormal findings to Cornelius John’s head, neck, abdomen and lungs

ALTHOUGH CORNELIUS JOHN testified that in addition to being shot, he was also “stamped” repeatedly in the stomach and chest, the notes by the doctors who attended to him reflected that the wound to his leg was his only complaint.

Consultant Orthopaedic Surgeon at the Milton Cato Memorial Hospital(MCMH), Dr Charles Woods, was one of the doctors who attended to John at the hospital following his being shot on April 13.

A report was prepared by the surgeon as evidence during the trial that ended on November 18 with the acquittal of Senator Ashelle Morgan and Assistant Director of Public Prosecutions( DPP) who had been charged with various offences alleged committed against John that evening.

John, a businessman of Diamond had told the court during his evidence that a tall man accompanied by a shorter man and the Senator had visited him on his property. During an exchange he said that he was kicked off a concrete block on which he was sitting and also stamped repeatedly in his chest and stomach with a force that caused him to defecate on himself. Shortly after this the tall man supposedly cranked a gun and shot him in his stretched out leg.

Woods took the stand on November 15 and told the court that John had been admitted to the male surgical ward with a gunshot wound to the left leg. He had decreased range of motion, but no loss of consciousness, and no nausea or any other complications.

On physical examination his vital signs were stable, and he had no abnormal findings to head, neck, abdomen and lungs.

“On examination of his extremity, a 1.5cm diameter wound was noted to the anterior proximal(in the front of the leg where the bone widens closer to the knee joint) aspect of his left leg with active bleeding,” the doctor said, reading the report. Swelling to the leg was noted.

They said that the patient was oriented of person, place and time and his blood work was normal.

An x-ray revealed a comminuted fracture(a fracture that has multiple fracture lines) to the tibia, secondary to a gunshot wound. A cast was placed on the leg on April 14 after the swelling had reduced.

John remained stable and was said to have been discharged on April 16 with instructions to follow up. He visited a doctor on April 30 and May 28, when he had his cast removed. On June 3 he underwent surgery to remove bullet fragments from his leg.

The prosecution, led by S.Stephen Brette, Deputy Director of Public Prosecutions(DPP) in St Lucia, attempted to ask how close a gun may have been to John to have caused such a fracture. However, the defence objected inquiring whether this was a question in his medical expertise or a normal opinion, noting that Woods was not a forensic specialist. It was also submitted that the question would be unfair to the doctor because he did not know what kind of gun was used. The prosecution pointed out that he had asked the doctor if he would be able to say.

The doctor noted that he would not be able to say.

The prosecution next asked whether someone who received such a gunshot wound, as seen on John, would be able to walk around normally afterwards.

“Well the fracture was not a displaced fracture. In other words the integrity of the bone was still intact so it is possible that he may have been able to bear some weight on the affected leg, but with considerable pain,” the orthopaedic surgeon replied.

The prosecution then attempted to ask more specifically concerning distance, but was halted by the defence who said that this would be calling for the doctor to speculate as he was not there, and that the doctor had already said John would be able to move but with considerable pain.

Brette said that it was a different question and only a doctor would be able to tell him the effect of an injury and what is possible with such an injury. He said he was asking a specific question.

The defence maintained that the doctor’s answer had been clear.

Magistrate Bertie Pompey ruled that it wasn’t a fair question.

The prosecution responded that he was guided by the court.

He asked Woods whether he was the first doctor to attend to John when he reached the Accident and Emergency Department of the MCMH, and Woods replied that he was not. The first time he saw him was the subsequent day. The first lawyer to ask questions was Duane Daniel, who represented Morgan. He asked the doctor if the procedure is that when a patient presents at the hospital there are case notes, and Woods said yes.

Woods was asked and he confirmed that he did use those case notes in the preparation of his report before the court.

The report did not refer to any abdominal complaints Daniel noted, and it included an examination of the abdomen. Daniel commented that the report says that the abdomen was soft, non-distended, and non-tender. Therefore, counsel sought clarification on whether this meant there was no abnormality.

However the prosecution was against this line of questioning, stating that the doctor was not there when that examination took place.

Daniel stated that he would ask him about the case notes. He asked if the case notes reflect that there was abnormality in the abdomen, and Woods replied that it did not.

The lawyer was going to move on to ask about the lungs when he was again stopped by the prosecution who made the point that the report would be in evidence, the doctor had only transcribed that examination and he wasn’t there when it was done.

Daniel said that he is entitled to ask, emphasise and draw what he wants to the attention of the court.

The magistrate indicated that the defence could continue, also noting that the question was concerning the case notes.

“Other than the injury to the leg, the case notes record that Mr Cornelius John made no other complaints other than the injury to the leg?” Daniel asked, and the doctor said that was correct.

Woods said that the management of John’s injuries did not include any treatment for abdominal pain or discomfort; nor did it include for chest or thoracic discomfort.

Daniel concluded by asking if it would be a fair statement that the only complaint that John presented with, based on the report/case notes, was a gunshot wound to the leg. Woods stated that this would be a fair statement.

Counsel Ronald Marks asked for clarification on non-distended, and he was told that a common term would be bloating, so that it wasn’t bloated.

Non-tender on palpations means that on feeling the abdomen there was no pain, the doctor also explained.

The surgeon also said that the bone was still together but cracked.