The decision to operate

The possibility of Gary growing out of his heart condition depended on his increasing in weight and size. His low weight, small size, and poor breathing were associated with his poor heart function. Therefore, it is noteworthy that Gary's condition did not improve significantly during the intervening period. He suffered two episodes at the hospital where he had a high fever, although tests did not show that he had developed an infection. He was, however, treated with antibiotics during this period. (In fact, he was receiving antibiotics when he was admitted to the Children's Hospital for surgery.) Gary's increased expiratory wheezing also disturbed the doctors in Thompson. They were not able to determine if his apparent asthma originated from his heart or from a problem in his lungs (Exhibit 5, page CAR 58).

Gary was transferred to the HSC in Winnipeg for assessment on February 28, 1994. On admission to the HSC, his weight was up approximately one kilogram from his December 1993 weight of 5.5 kilograms, but he was still far below the normal weight for a child of his age. On admission the doctors could hear a great deal of wheezing throughout both lungs, although Gary had fairly good air entry into both lungs.

Gary's case was presented at the March 7 pediatric cardiac surgery conference. A heart catheterization done that day confirmed the earlier findings. However, the catheterization study also demonstrated significant muscle bundles in the right ventricular outflow tract. Odim concluded that surgery was necessary to correct the VSD, which he did not believe would close on its own. He believed Gary was showing signs of congestive heart failure. Odim predicted a stormy course for Gary's recovery because of his frail condition. This would be the first time that Odim would undertake such an operation on his own. It would also be the most difficult case the team had undertaken under Odim's direction to that point.

None of the medical consultants retained by the Inquest disagreed with Giddins's and Odim's diagnosis. Dr. Gary Cornel testified that he believed that by March 7, surgery was the only reasonable choice. He did suggest that Gary was in better condition for surgery earlier than he was on March 14, when surgery was actually performed. Since the delay was to see if Gary could be strengthened for surgery, it would not have been wise to wait any further. However, the question remains as to whether or not the operation should have been carried out in Winnipeg.