SHAH ALAM: A senior cardiothoracic consultant surgeon today told the inquest into the death of Muhammad Adib Mohd Kassim that the fireman might not have understood when asked if he was beaten up.
Dr Mohamed Ezani Md Taib of the National Heart Institute (IJN), the 14th witness in the inquest into Adib’s death last November, said he asked Adib if he knew what had happened.
He said Adib shook his head sideways, indicating he was unaware of what happened.
Ezani also told coroner Rafiah Mohamad an IJN medical assistant had told him that Adib nodded when asked if he recalled whether he was beaten up.
To a question by Ahmad Lufti Awang, one of the five lawyers holding a watching brief for Adib’s family, Ezani said Adib most likely did not know what was going on because of the shock he received from his injuries, said to be blunt force trauma.
Ezani, who is also the clinical director of IJN’s Heart and Lung Transplant Department, repeated his earlier statement when pressed by the lawyer: “He shook his head when I asked him how he was.”
The lawyer then remarked that this was all speculation, before moving on.
Earlier today, Ezani said Adib’s cause of death was “acute lung failure secondary to lung injuries associated with blunt force trauma”.
He said the blunt force trauma was the result of a hard object hitting Adib in the chest.
To a question by Yahaya Othman, another lawyer representing Adib’s family, on whether a punch or a kick could be considered as hard enough to cause the impact Adib received on his right side, Ezani said this was difficult to say.
Asked again by the lawyer if “one or two big punches” could cause such an impact – Adib had some of his rib bones fractured and his lungs were also injured – Ezani replied: “Maybe, if it had a lot of pressure.”
Ezani said he received a call on the night of Nov 27 from Deputy National Unity and Social Well-being Minister Mohamed Farid Md Rafik, a trained anesthesiologist, who asked if IJN had an ECMO (extracorporeal membrane oxygenation) machine.
Asked why the deputy minister took a “sudden interest” in the case, Ezani said he did not know.
“He only asked if the hospital had the ECMO system and whether the IJN could accommodate Adib,” he said.
Ezani said he helped facilitate Adib’s transfer to the IJN from the intensive care unit at the Subang Jaya Medical Centre after receiving the green light from his superiors.
Adib was connected to the ECMO on Nov 28 to aid his heart and lungs with oxygenation.
To a question by lawyer Syazlin Mansor, who appeared for the housing and local government ministry and the Fire Services Department, on how Adib’s left lung had contusions when only his right side was injured, Ezani said injuries in the thoracic cavity could spread.
He also disagreed that it could be inferred that Adib was unconscious if he was asleep.
“It’s your ability to comprehend,” he said, adding that Adib was also heavily sedated on the first day he arrived at IJN with the dosage decreasing gradually.
Asked how a particular internal fracture was not seen in a CT scan when Adib was admitted at SJMC and why this showed up later on, Ezani said he doubted someone had “dropped” Adib’s body, which was the only way he could have suffered the injury.
He also clarified his earlier remark that Adib used dumbbells during his physiotherapy sessions, saying these were special weights used in what he branded as “passive physio”.
He said Adib’s muscles needed to be “challenged” but that this was done according to his condition.
Ezani also said any bone displacement as indicated in the CT scan could not have been caused during the physio exercises as Adib would have responded and complained of back pain, “non-verbally at least”.
“He never complained of any back pain,” he said.
The inquest entered its ninth day today.
Adib, 24, was part of the Emergency Medical Rescue Services (EMRS) sent from the Subang Jaya fire and rescue station to the Sri Maha Mariamman temple on Nov 27
He died at the IJN on Dec 17.