Image: Sanook

 

A grieving Thai wife has gone to the media for help after her husband - a policeman in the north east - died after surgery on a broken leg he sustained in a football match.

 

Sanook reporters found a sad scene at a house in Ban Sing sub-district of Buriram where the body of Sen Sgt Maj Sirawut Lotthong, 44, of the Chamni police station was laid out. 

 

His wife Suwannee, 43, and distraught police friends wanted answers how a healthy man could die after breaking his leg.

 

Suwanee explained that her husband was in goal playing with police friends on Thursday 18th March when there was an accidental collision and he broke his left leg.

 

He was immediately taken to Nang Rong Hospital where he seemed to be fine and was scheduled for surgery the following day.

 

This was then delayed as a more serious case came in but after the break area began swelling up continually doctors further delayed surgery. 

 

Suwanee said she had no reason to disbelieve the doctors.

 

Surgery then went ahead on 24th March with Sirawut opting for a general anasthetic. 

 

Moments after he went into surgery his wife was told to "Prepare yourself". He was set to be transferred to Soon Buriram Hospital but died. 

 

Doctors told the wife that he had suffered a blood clot limiting blood to heart and lungs.

 

Now she wants an investigation into why he had to wait so long for surgery and how a healthy man can die after getting a broken leg.

 

Nang Rong Hospital would not give a cause of death and were waiting on the results of an autopsy, reported Sanook who published a video of the aftermath of the original footballing accident. 

 

-- © Copyright Thai Visa News 2021-03-27

 

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30 minutes ago, rooster59 said:

Doctors told the wife that he had suffered a blood clot limiting blood to heart and lungs.

Caused by the 6 day delay in operating on his broken leg which to my mind should have been done first day but TIT .

2 minutes ago, keith101 said:

Caused by the 6 day delay in operating on his broken leg which to my mind should have been done first day but TIT .

Agreed, bone breaks need to be set immediately.

43 minutes ago, rooster59 said:

This was then delayed as a more serious case

I Would like to know what more serious case than this one. ????

1 hour ago, keith101 said:

Caused by the 6 day delay in operating on his broken leg which to my mind should have been done first day but TIT .

 

Without having much medical knowledge, I believe this is not the approach they follow in Asia.

 

When I messed up my right hand (4th and 5th metacarpal badly fractured), upon taking an X-Ray it was obvious I would be needing a surgery. Just I wanted it right away, and my doctor back in China said operating on something as swollen as my hand was back then would cause very poor cosmetic results (and increase the risk for complications too), so I waited 6-7 days for the swelling to go down and everything was fine, with very good results. 

 

I guess it may have been a similar case here?

1 hour ago, Tarteso said:

I Would like to know what more serious case than this one. ????

Someone rich with an ingrowing toe nail would be my guess

1 hour ago, ctxa said:

 

Without having much medical knowledge, I believe this is not the approach they follow in Asia.

 

When I messed up my right hand (4th and 5th metacarpal badly fractured), upon taking an X-Ray it was obvious I would be needing a surgery. Just I wanted it right away, and my doctor back in China said operating on something as swollen as my hand was back then would cause very poor cosmetic results (and increase the risk for complications too), so I waited 6-7 days for the swelling to go down and everything was fine, with very good results. 

 

I guess it may have been a similar case here?

 

I guess you're making a big assumption.

good thing he didn't have a covid vaccine yet or that would be the news.

4 hours ago, Tarteso said:

I Would like to know what more serious case than this one. ????

Anything that’s an immediate danger to one’s life, like a skull fracture, slit artery, stroke, heart attack...

2 hours ago, scorecard said:

 

I guess you're making a big assumption.

He’s right! Operating on a broken limb while there is massive swelling can cause big problems during and after the procedure, like excessive bleeding for example and it can become extremely difficult to sew up the wound afterwards and if they get it done the scar will most definitely look a lot worse then if they had sewn it up after the swelling had receded. 

5 hours ago, keith101 said:

Caused by the 6 day delay in operating on his broken leg which to my mind should have been done first day but TIT .

Blood clots are always a danger when it comes to broken limbs, even if they had operated on him immediately. Even the surgery itself can cause blood clots, which it seems pretty much to be the case here. As they said, a more serious case came along and that’s just how it goes in hospitals, if they don’t have enough staff/operating theaters at hand. The question is whether they gave him prophylactic blood thinners after the surgery.

1 hour ago, pacovl46 said:

Blood clots are always a danger when it comes to broken limbs, even if they had operated on him immediately. Even the surgery itself can cause blood clots, which it seems pretty much to be the case here. As they said, a more serious case came along and that’s just how it goes in hospitals, if they don’t have enough staff/operating theaters at hand. The question is whether they gave him prophylactic blood thinners after the surgery.

That is why Warfarin was invented!

2 hours ago, pacovl46 said:

Blood clots are always a danger when it comes to broken limbs, even if they had operated on him immediately. Even the surgery itself can cause blood clots, which it seems pretty much to be the case here. As they said, a more serious case came along and that’s just how it goes in hospitals, if they don’t have enough staff/operating theaters at hand. The question is whether they gave him prophylactic blood thinners after the surgery.

 

"He was immediately taken to Nang Rong Hospital where he seemed to be fine and was scheduled for surgery the following day"

 

No indication of swelling on the day of the injury.

 

That was a result of the 2 delays.

 

Why wasn't the bone set on the day of the fracture instead of scheduling it for next day?

 

It was the scheduling for the day following the injury (when he was then bumped forward....again) that, ultimately, did for him.

 

"Carpe Diem" indeed.

 

 

 

 

 

7 hours ago, BritManToo said:

Agreed, bone breaks need to be set immediately.

Not always possible to operate immediately . Often it is required to allow swelling to reduce before surgery .

17 minutes ago, itsari said:

Not always possible to operate immediately . Often it is required to allow swelling to reduce before surgery .

that's right.

He likely got a deep vein thrombosis and subsequent pulmonary embolism. Can not be avoided sometimes. The question is : did he get Heparin injections from day 1 for thrombosis prophylaxis ? If he did  I would consider his death just fate. I got the impressions that they don't take thrombosis prophylaxis serious enough in Asia.  

1 hour ago, Seismic said:

That is why Warfarin was invented!

Warfarin first came into commercial use in 1948 as a rat poison. 

7 hours ago, ctxa said:

 

Without having much medical knowledge, I believe this is not the approach they follow in Asia.

 

When I messed up my right hand (4th and 5th metacarpal badly fractured), upon taking an X-Ray it was obvious I would be needing a surgery. Just I wanted it right away, and my doctor back in China said operating on something as swollen as my hand was back then would cause very poor cosmetic results (and increase the risk for complications too), so I waited 6-7 days for the swelling to go down and everything was fine, with very good results. 

 

I guess it may have been a similar case here?

Maybe it was but as his leg was getting more and more swollen they should have had a look at it because the swelling might have occured because of a blood clot (as the story says thats what he died of ) i geuss in your case it was swollen already the same moment and didn't swell more and more . 

Perhaps in the interest of sensationalism some relevant facts have been omitted?

I do not  see any question as to why the surgical  capacity delayed  his surgery in favour of one other  more urgent case for 6 days?

 

44 minutes ago, itsari said:

Not always possible to operate immediately . Often it is required to allow swelling to reduce before surgery .

There was no swelling the first 2 days.

The swelling happened because they kept putting the surgery off.

26 minutes ago, sweatalot said:

I got the impressions that they don't take thrombosis prophylaxis serious enough in Asia.  

Second that.  My Thai doctor didn't put me on blood thinners, but my American doctor did.  Blood thinners reduced my risk of stroke by half.  The risk of blood thinners (excessive bleeding) can be more easy to treat than strokes.

 

Strokes can be deadly. ????

This headline will certainly instill confidence in Thai medicine and boost medical tourism.

7 hours ago, Nanaplaza666 said:

Maybe it was but as his leg was getting more and more swollen they should have had a look at it because the swelling might have occured because of a blood clot (as the story says thats what he died of ) i geuss in your case it was swollen already the same moment and didn't swell more and more . 

Yes, it’s true that in my case, when the doctor decided not to operate right away, it was already extremely swollen, later on they gave me daily IV drugs which with every passed day made it less and less swollen til they finally decided it was safe to operate. 
 

It never happened that the swelling increased, so as you said that

might very well have been the case here. 

17 hours ago, rooster59 said:

This was then delayed as a more serious case came in but after the break area began swelling up continually doctors further delayed surgery. 

Why??

A 6 day delay is crazy.

22 hours ago, Tarteso said:

I Would like to know what more serious case than this one. ????

By serious they meant either:

A) Someone more important 

B) Someone with more money 

C) A friend or relative 

 

Blood clots from broken bones leading to death are not uncommon.  A first year medical student knows this. 

2 hours ago, Cereal said:

By serious they meant either:

A) Someone more important 

B) Someone with more money 

C) A friend or relative 

 

Blood clots from broken bones leading to death are not uncommon.  A first year medical student knows this. 

I know the matter;  30 years ago I broke my tibia and fibula, the leg was hanging????, with great inflammation and high risk. I was operated 2 times in 1 year.  At the end, everything turned out fine.  ????

21 hours ago, Enoon said:

 

"He was immediately taken to Nang Rong Hospital where he seemed to be fine and was scheduled for surgery the following day"

 

No indication of swelling on the day of the injury.

 

That was a result of the 2 delays.

 

Why wasn't the bone set on the day of the fracture instead of scheduling it for next day?

 

It was the scheduling for the day following the injury (when he was then bumped forward....again) that, ultimately, did for him.

 

"Carpe Diem" indeed.

 

 

 

 

 

Probably because the surgeon wasn’t there? Maybe they’re understaffed and at some point everyone needs to sleep? Maybe the break wasn’t that bad? Also, the clot happened after the surgery which means the swelling and not setting the leg right away had nothing to with the clot. 
 

I got run off my bike in Thailand once and broke my collarbone, by the time I got to the hospital the surgeon had gone home already because he had finished his shift. So, the nurse put a figure 8 on me and told me to come back the next day, which I did. Luckily for me there was no bone sticking out, so the figure 8 was all I needed. I’m sure they had their legitimate reason why they didn’t do it right away. If you really want to know you should ask a surgeon or someone who works taxi hospital and I don’t mean that sarcastically. I’d really like to know, too! 

One of the comments in the news article suggests fat embolism syndrome could be the cause. It usually takes 24 -36 hrs to develop after the initial trauma, but can take up to 7 days.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700578/