Man impaled on industrial crowbar saved by hospital trauma team

Thanks to highest standards of trauma care, he walked out of hospital 19 days after major accident

Monday, July 27 2015

 "I was talking the whole time, trying to keep the other guys calm," engineering supervisor Daniel de Wet says, describing his experience of being impaled on a two-metre metal industrial crowbar, commonly known as a "gwala", in a mine 3.5km underground.

The accident occurred while Mr De Wet was assisting with a breakdown at the gold mine where he works, near Carletonville, Gauteng.

"I was using the gwala to stir up the mud, because we were washing out an underground dam. I wanted to stand up on the suction pipe, which stands about a metre high, and somehow I slipped."

Mr De Wet looked down and, to his utter disbelief, saw that the gwala had penetrated his body, going in between his legs and coming out his back, just below his shoulder blade.

"Because of the adrenaline rush, I had absolutely no pain at first. There was only one guy with me, he became very scared and didn't know what to do. I told him to calm down and call for help on the two-way radio."

Within minutes, a rigger crew with a first-aid pack and stretcher arrived. "They didn't know how to put me on the stretcher because of the way the gwala was sticking out of my back. I told the guys: 'Calm down, let's think what to do'."

Mr De Wet is accustomed to keeping a cool head in dangerous situations as he himself is a member of the mine's rescue team and has been trained to deal with emergencies. In this case, the best the team could do was to perch Mr De Wet on the stretcher in a sitting position.

They carried him like this through the knee-high muddy water for about 40 meters in order to reach a station area, where a cage lift was waiting to hoist them to the surface. This was no mean feat as the bottom of the gwala was almost level with Mr De Wet's feet.

"On 34 level sub-shaft, paramedics of the mine met me and gave me morphine for the pain. I remember nothing further, until I woke up two weeks later in Netcare Milpark Hospital."

Fortunately, Mr De Wet was in good hands. Having been brought up to surface level at a pace that would ensure that he did not suffer any adverse decompression effects, commonly known as 'the bends', he was airlifted to hospital an hour after the accident occurred.

Trauma Director of Netcare Milpark Hospital's emergency department, which is one of only two Level I accredited trauma units in South Africa, Professor Kenneth Boffard, received a call to tell him about the unusual case that was en route to the hospital for treatment and he began assembling an appropriate operating team and making the necessary preparations to receive the patient.

Asked about his initial reaction when confronted by the sight of a person with a metal pole stuck right through his body, the unflappable Prof Boffard says: "I had to think of it in terms of a technical problem to which I had to apply my mind in order to decide on the best course of treatment for the patient."

"When Mr De Wet arrived at the hospital, we put him under anaesthetic, lying on his side. We needed to get him in a position that would enable us to operate but with the gwala sticking through his back, it was rather awkward."

Prof Boffard explains: "We got some strong paramedics to pull out the gwala by about half a metre so that it was flush with his body. This allowed us to lie the patient on his back."

"Fortunately, the gwala had been pressing on the blood vessels and this pressure prevented too much blood loss." Two surgical teams were ready to operate: one team concentrating on the abdomen and one on the chest area.

"We operated twice on Mr De Wet. In order to safeguard the patient, given the traumatic nature of his injury, our first operation could not last any longer than 60 minutes. During this procedure we did massive damage control in order to stem the bleeding and to contain any form of contamination caused by his injury."

"This is an technical exercise in that one has to know when to stop so that the patient can live to fight another day," explains Prof Boffard. "During the next, more major procedure, extensive repair work was undertaken. In cases of extreme trauma this can generally happen only 24 to 48 hours later, when the patient is more stable and can withstand the trauma of a longer, more extensive procedure. This is the methodology was followed with Mr De Wet and it was crucial to his full recovery.

Mr De Wet says his wife had been distraught when she heard that he had been involved in an accident and one of his colleagues had immediately driven her to the hospital to be with him. "At the hospital, Prof Boffard met my wife, and she described his manner as very calm and reassuring. He reassured her that if I arrived at the hospital alive, I would go home alive."

Mrs De Wet waited anxiously as the two surgical teams, led by Prof Boffard and Professor Elias Degiannis, another renowned trauma surgeon at the hospital, worked to save her husband's life. Once the gwala was pulled completely free of Mr De Wet's body, the doctors saw that the impalement had caused significant damage, destroying one kidney and damaging the small bowel and numerous blood vessels.

After the initial surgery, Prof Boffard came out of the theatre to speak to Mrs De Wet. "When Prof Boffard came out with the gwala in his hand, my wife says she didn't know how to thank him," Mr De Wet says.

"Everyone at Netcare Milpark Hospital who looked after me was absolutely caring. Prof Boffard and his wife also gave my wife a lot of support. We are so very grateful."

"My team from the mine came to the hospital to support my wife. They told the nurses they wanted to pray for me outside the intensive care unit (ICU). The sisters allowed them to come into the ICU for five minutes and they prayed around me. Even though I was unconscious, they told me later that the tears were rolling down my cheeks when they prayed."

Once Mr De Wet regained consciousness, he had trouble sleeping and felt anxious. "One of the nurses was so kind to me, she would talk to me until I fell asleep. Netcare Milpark Hospital's doctors and nurses went above and beyond the call of duty, not just treating my physical injuries but also showing great compassion for my state of mind and my wife's emotional wellbeing."

Although Mr De Wet lost a kidney, he made rapid progress and was able to walk after being transferred to the high care unit of Netcare Milpark Hospital. Only 19 days after his dramatic accident, Mr De Wet was discharged from hospital.

Mr De Wet has since returned to active duty at the mine and continues to serve on the mine's rescue team. "Everyone thought I would resign from mine rescue but I won't. I have already attended to three fires underground since the accident," he says.

"My employers had the gwala chromed and mounted on a stone with a bible verse on it. I'm planning to donate it to Netcare Milpark Hospital as a token of my appreciation for all they have done for me. What I have learnt from this whole experience is: 'You must believe in miracles every day'."

Prof Boffard says that there were a number of factors that contributed to Mr De Wet's having survived the impalement and making such a full and rapid recovery. "Everything happened according to the textbook. We were well prepared to deal with the incoming patient and Mr De Wet had the benefit of being treated at a world class, level-one trauma unit," Prof Boffard concludes.


Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Milpark Hospital
Contact : Martina Nicholson, Graeme Swinney, Sarah Wilson or Meggan Saville
Telephone: (011) 469 3016
Email: [email protected], [email protected], [email protected] or [email protected]