On 4/9/1991 a cochleovestibular nerve resection was done on Dr A Braude.

He had had a Labrinthectomy done by Plester in Germany over 10 years before for intractable Meniere’s Disease. This was done via a cortical Mastoidectomy.

He was seen early in 1991 with a history of total hearing loss on the affected side, a disabling tinnitus and an almost constant vertigo that made it almost impossible to work. He was desperate!

He was cautiously offered a vestibular neurectomy as the only option left after all other options had failed. He was warned he may still not get suitable relief. He was counselled about this for more than two hours with 6 to 7 members of the department present. The risks were stressed especially that of a facial palsy which can happen even with dissection next to the nerve and an intact nerve which could take 6 to 12 months to recover.

He telephoned with more questions 2-3 times a week for almost 6 months before surgery.

The procedure was quick because of the previous Mastoidectomy in a well pneumatized cavity and most of the ENT department watched through observation tubes on the microscope and a video monitor.

In the morning in post op his facial nerve function was still intact.

By the evening ward round an early facial weakness set in which became complete. He was monitored on ENoG (electroneuronography) as the function deteriorated. His son committed suicide while he was in hospital post operatively.

He developed a CSF Leak down his eustachian tube about 10 days later. He had spongistan film over hisinternal canal with a fat graft filling the mastoid.

His leak stopped about two weeks later.

He disappeared from follow up.

His vertigo and tinnitus were dramatically better.

At trial he said he was not counselled properly and didn’t understand the procedure iehe did not have informed consent) as a doctor living with the condition for almost 20 years and having had previous surgery by a world expert. See separate publication by SA Strauss. 

He had at least two separate ENG’S which showed reinervation of his facial Nerve ( S Levy and le ROUX)

Dr H Hammersma took him to U. Fisch in Zurich where Hammersma provided all the test results. No new nerve function tests were done in Zurich. He also provided the history without ever contacting me or the department for information.

On seeing Hammersma they decided to bring a case against Mcintosh and the Johannesburg Hospital. See enclosed Letter from Hammersma to Fisch where he tries to persuade him to make statements to affect the case. (The letter was in Dr Ble Roux file)

At trial, Hammersma regularly avoided making statements on his own tests as he had “lost” his file which only came into being once this was a medicolegal case.

His evidence against Mclntosh lasted almost 6 weeks. See the appeal court judgement enclosed where judgment with all costs was found against the plaintiff.