The Woolley and Roe case

Abstract

Albert Woolley and Cecil Roe were healthy, middle-aged men who became paraplegic after spinal anaesthesia for minor surgery at the Chesterfield Royal Hospital in 1947. The spinal anaesthetics were given by the same anaesthetist, Dr Malcolm Graham, using the same drug on the same day at the same hospital. The outcome for the patients and their families was devastating, as it was for the use of spinal anaesthesia in the UK. At the trial 6 yr later, and against the opinion of leading neurologists, the judge accepted Professor Macintosh's suggestion that phenol, in which the ampoules of local anaesthetic had been immersed, had contaminated the local anaesthetic through invisible cracks. In an interview 30 yr after the verdict, Dr Graham believed tha the tragedy was caused by contamination of the spinal needles or syringes during the sterilization process. The subsequent explanation that, on the day in question, descaling liquid in the sterilizing pan had not been replaced by water, supported his belief and finally offered a credible explanation. We review the Woolley and Roe case, the status of spinal anaesthesia before and after 1947, and the relevant medico-legal judgments in claims for negligence in the early days of the National Health Service.

Obstetric epidurals and chronic adhesive arachnoiditis

“…Their paralysis has been attributed to contamination by chemicals used in the descaling of spinal needles and syringes. 9 We realize that, by their chemical structure, these are acids, not detergents. We referred to them as detergents, as they were used in the cleaning process.…”

“…8 At Cecil Roe's post mortem, the pathologist found classical signs of CAA, 7 and the most likely and now generally accepted explanation is acid contamination of the syringes and needles. 9 Failure by Rice and colleagues to identify this has led to their omission of acidity as another cause of CAA.…”

A legal theory with a memory Roe v Ministry of Health & Others: Woolley v Same

“…Not every point has however been cleared up. 11 Attacked by the medical establishment, Denning seems to have conducted somewhat of a retreat as he explained in his later book The Discipline of Law: 12 As a result of that case [Cassidy], the medical profession became alarmed. It seemed to have opened the door to many groundless charges of negligence.…”

National audits in the UK: fancy acronyms or real patient benefit?

“…The anaesthesia and perioperative medicine community has long been interested in outcomes. 1 In a world where anecdotal reports of poor outcome 2 or expert opinion can still dramatically and adversely influence patient expectation and clinical behaviour, there is a real and ongoing need for high-quality evidence to support and improve our clinical practice.…”