The Woolley and Roe case. A reassessment

@article{Hutter1990TheWA,
  title={The Woolley and Roe case. A reassessment},
  author={C. D. D. Hutter},
  journal={Anaesthesia},
  year={1990},
  volume={45}
}
  • C. Hutter
  • Published 1 October 1990
  • Medicine
  • Anaesthesia
In 1953, two patients, Cecil Roe and Albert Woolley, sued their anaesthetist for alleged negligence because they had developed painful spastic paraparesis after spinal anaesthesia. The court found that phenol, which was used to sterilise the outside of the ampoules of local anaesthetic, had percolated the glass through invisible cracks, contaminating the solution, but that the anaesthetist could not have been aware of this risk. The case was important, despite the fact that judgement was in… 

HISTORY The Woolley and Roe case

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 are reviewed.

The Woolley and Roe case.

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 are reviewed.

The Woolley and Roe case

The case has been critically re-evaluated by Dr C. D. Hutter and his findings certainly seem to provide a more logical explanation for the events that occurred in 1947 and may also explain other episodes of neurological damage following spinal anaesthesia.

Cope RW. The Woolley and Roe Case. Woolley and Roe versus Ministry of Health and others. Anaesthesia 1954; 9: 249-70

It seems almost unbelievable that general anaesthesia was the norm for all obstetric procedures pretty much up until the late 1970s – all as a result of this legal case, which turned spinal anaesthesia on its head and almost instantaneously, the technique virtually disappeared from clinical practice.

Negligence litigation and medicine: force for good or root of all evil?

The judge, having heard the experts’ views, concluded that 60 mmHg was widely regarded as the lowest acceptable level to which blood systolic blood pressure should be lowered as part of a deliberate hypotensive technique, and further found that Kerr had not followed up or evaluated his patients in any meaningful way.

Continuous regional analgesia: can we afford not to use it?

A recently published meta-analysis of the results of 141 trials of neuraxial blockade concluded that these techniques, when compared with general anaesthesia, were associated with a one-third reduction in mortality, along with larger reductions in pulmonary embolism, blood transfusion requirements, pneumonia and respiratory depression.

Neurological complications in association with spinal and epidural analgesia — again

  • H. Breivik
  • Medicine
    Acta anaesthesiologica Scandinavica
  • 1998
A serious concern is that the index of suspicion is generally much too low, causing serious delays in verification of the diagnosis and effective treatment, and an increasing number of reported intraspinal haematomas associated with epidural analgesia is the topic in two recent publications.

Severe adhesive arachnoiditis resulting in progressive paraplegia following obstetric spinal anaesthesia: a case report and review

In the absence of more conclusive data, practitioners of central neuraxial anaesthesia can only continue to ensure meticulous, aseptic, atraumatic technique and avoid all potential sources of contamination.

A Critical Look at the Evidence for and against Elective Epinephrine Use in the Finger

There is considerable valid evidence in the literature that supports the tenet that properly used adrenaline in the fingers is safe, and that it removes the need for a tourniquet and therefore removes theneed for sedation and general anesthesia for many hand operations.

References

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Congenital Atresia of the Oesophagus

In conclusion, it is emphasized that nitrogen mustard is a dangerous substance; there is reason to believe that the human eye is some five times more sensitive to its effects than the rabbit's eye, so that just a fraction of a milligram of nitrogen mustard in the conjunctival sac may be enough to cause symptoms as acute as those described here.

NERVOUS COMPLICATIONS FOLLOWING SPINAL ANESTHESIA: A CLINICAL STUDY OF SEVEN CASES, WITH TISSUE STUDY IN ONE INSTANCE

The subarachnoid injection of cocaine derivatives for surgical analgesia has become an accepted and frequent procedure except in cases of severe myocardial degeneration, hypertension or

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The safety of this procedure as compared to the older intrathecal alcohol injections was emphasized in their series of cases by the relative lack of disabling complications such as paresis of the leg or bladder.

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The second part of this book considers diseases of organ systems, taking eight main systems, and describes the diseases which occur in these systems, but with considerable reference to the previous parts which relate to retlologlcal factors.

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Aitkin, M.D., G.O.G., D.C.S., J.R.Sc.

The role of pH in the development of tachyphylaxis to local anesthetic agents.

It is suggested that tachyphylaxis to local anesthetic agents may be associated with changes in pH and shifts in the amounts of ionized and nonionized forms, and the limited buffer reserve available in the cerebrospinal fluid makes these areas especially vulnerable.