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Dr Nurul Ainna Khirul Annur, who facilitated K Roopan’s transfer from the emergency department of Kajang Hospital to the medical ward in June 2021, said the request for the test would normally be made when the patient is at the medical ward.
“We only request for the test to be done at the emergency department if it is a critical case,” she told the coroner’s court here today.
“But even then, the doctor from the medical department would be called in to do that,” she added.
Ainna said it was the prerogative of specialists and medical officers to order a D-Dimer test.
She said she had “no clue” as to who ordered the test to be administered.
A D-Dimer test is administered to check if a patient has a blood-clotting disorder. The court previously heard that a normal D-Dimer reading would be 0.5, whereas Roopan’s was 17.97.
During the inquest’s Feb 14 hearing, Roopan’s family lawyer, T Shashi Devan, said that the abnormal D-Dimer reading alone should have prompted the doctor to perform a CT scan to rule out possible pulmonary embolism (PE).
However, that was not done.
A pathologist had testified that Roopan died due to PE at Kajang prison a day after he was discharged by the hospital.
A PE occurs when a blood clot travels from the leg to the lung and blocks the flow of blood, which may lead to death.
Another witness, Dr Shamira Shahar, who also treated Roopan when he was warded, testified today that she, too, did not know who ordered the D-Dimer test.
She stressed that the D-Dimer test must be interpreted together with clinical symptoms and the risk of thrombosis to the patient. “Thrombosis” refers to blood clots occurring in the blood vessels.
“If that particular doctor had a high suspicion of PE or thrombosis, either a CT pulmonary angiogram or a deep vein ultrasound should have been conducted,” she said.
The seven-day inquest before coroner, Rasyihah Ghazali, which ended today, heard testimony from 25 witnesses.
The coroner has set Aug 25 to deliver her verdict.
Roopan was serving time in prison after being convicted in 2017 of a triple murder at his neighbour’s house in Dengkil in 2013, when he was 17.
He died eight days before his appeal, which was set to be heard on June 29, 2021.
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