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More Contributions by Carl Goosen: Inventor of the Aortic Valve Prosthesis

Author and Curator: Carl Goosen

 

 

1. Flow in the Prostheric Heart Valve: state-of-the-art and Future Directions

Yoganthan pdf

2. Miracle after Death

MIRACLE AFTER “DEATH”, by Carl Goosen.

I joined the Florida Hospital in 1968 to start the open heart surgery program since there had never been a survivor in the state of Florida. I was attached to the Respiratory Department for pay purposes and , while I was waiting to set up, I studied their manual. It said that acidosis opened the pre-capillary sphincters and improved oxygen supply to the cells so that CO2 increased and O2 decreased, providing increased gradients for gas exchange in the lungs.

What is the opening shout in emergency room movies. “Bicarbonate and Oxygen” Both will ensure that the pre-capillary sphincters , i.e. the doors to the cells remain closed so that vital metabolism is cut off. Blood reaching the lungs will, therefore have a less advantageous gradient for gas exchange. You might find 6 doctors in the USA who will know or agree with this. I will forward publications which explain this. Doctors will refute serious results because they think otherwise.Remember Louis Pasteur?

My eldest son J.G. was a patient at Tampa General Hospital and had been diagnosed with lung cancer. At no time during our visits (80 miles away) could we find him coherent on the respirator. One day I noticed on his chart that his pH was 7.65. I asked the tech if he could adjust the respirator to produce an acid value and explained what I had read in the manual. He told me he could not over-ride the respirator which was factory set. “ He asked if I would like an HCl drip to be set up! My son died 3 days later and no-one had been able to speak with him for many days.I mentioned these facts to all the doctors attending me and, without exception they said it was not their field of expertise! I recall a case of a woman who was unconscious on a respirator having her husband ask to take her off after 3 months. She woke up and went home with full knowledge of everybody 2 weeks later!

The recent recovery of a life-long friend (a heart patient with 7 stents) after his emergency visit had such a poor result that he was transferred to a bed without special treatment and they were told that no more could be done but wait for the end.

This was on April 3^rd. We were waiting for news of when to send the wreath, when n April 13^th we had news of his “miracle recovery”. The physician said it was a miracle and he could not understand how he made a complete recovery from renal failure and diminished lung capacity! He is ready to start rehabilitation with the physio and go to a “step-down” facility for further rehab and then off home in a week or two. “Praise the Lord and thank Him for answering our prayers”

Nevertheless the physiological cause is proven by the pictures his daughter took, showing complete absence of any equipment, except a nasal oxygen tube.I was sure that his life was restored because he did not have a mechanical respirator and it was confirmed by the e-mail response from the physician because” he did not need it”?

I could not help but send him an e-mail discussing the benefit of NOT having an alkalotic pH , which is computer programmed! His daughter asked the doctor to re-test his kidney and lung functions because there was an enormous improvement over the next 2 days.Test results came in and she “skelmpies” ( on the sly ) read the results. “ Can’t believe what I see., everything is back to normal’ and then comes the ampath nurse again to draw some more blood. This morning Dr. M comes to Dad’s bedside and touches him very softly on his arm, looks at me and says”I’ve never seen what I see here—Your Dad has made a complete recovery from renal failure and diminished lung capacity” He is ready to start rehabilitation and physio and go to a stepdown facility for further rehab and the off home in a week or two, Praise the Lord and thank Him for answering our prayers.

I asked the doctor if he had the patient on a respirator at any time. He said: No, he did not need it. A patient with diminished lung capacity did not need it?

I spoke to AM on the day he woke up and he talked about events we had shared in our childhood. He was reading a magazine, laughing and joking!

I had been corresponding with a heart surgeon in that area for some time until he laughed at the concept of the ill effect of respirators. A week later he sent a post-bypass patient to the mortuary where a day later she woke up and was completely normal!

Carl Goosen

3. Effect of Carbon dioxide on Systemic Oxygenation

CO2 Effect

CO2 Effect 3

CO2 Effect 4

CO2 Effect 5

4. Oxygen Consumption and Respiratory Mass

CO2 Effect1

5. Expert Witness

EXPERT WITNESS

On two occasions I was used as an independent expert witness involving death or brain damage following cardio-pulmonary bypass operations, both involving errors by perfusionists.

 

The first was brain damage on a child who at the time of the trial was 15 years old and had a mental age of 5 years. His parents were a doctor and a lawyer. The trial had been been suspended for 10 years because the pump sheet ( log of the bypass procedure ) had been lost and then found behind a filling cabinet when it was moved for cleaning.

 

It was the first time that I was involved in a field that involved the methods used by defence attorneys. Fortunately the attorney for the prosecution proved to be a valuable teacher and was equally responsible for my success in the verdict for the procecution. The heart surgeon that was my lifelong friend recommended me to the attorney who visited me along with an assistant in Florida. The case was in New York.They decided I could help because I “was able to think on my feet”.

 

I was transported by limosine to a New York hotel.I spent a miserable night which had a window air conditioner and it had some sort of loose metal sheet outside that was clanging all night. In the morning I found the wash basin plug missing making shaving miserable. Next, breakfast was late by 20 minutes because the waiter overslept. The bacon was burnt on eggs overcooked. IS THIS THE WAY TO TREAT A MAN TRANSPORTED BY LIMO? Everybody handed the doorman $10 to open the cab door but I was not shy to avoid this.

 

We were late for the 60 minute trip to Queens, site of the trial. On the way The attorney tried and gave up teaching me tricks but ended by saying: YOU DON’T HAVE TO AGREE WITH ANYTHUING THEY SAY EVEN IT IS OBVIOUSLY TRUE.This proved to be the reason we won! On the way he said the legal firm we had to beat had 2 dozen research workers who had been working on thru case for 10 years. Their research library occupied the entire floor of a building in downtown New York. I was to find that during the two days of the trial they were desperately calling everybody in Florida and the University of Cape Town to fid if I had any dirt they could use against me .

 

Their attorney arrived with a handcart laden with heavy tomes, with slips marking certain pages. They sometimes had dug up information about my profession that I had never heard of but this did not faze me since I had no hesitation insaying I doubted if they had any relevance.                   For 2 days I stood in front of the judge and faced the court. My advisor told me that I would win over the Jury by looking each juror in the eye for 5 minates at a tjme.

 

I studied the pump sheet which had been given me. They had seen it 6 months earlier.IO could immediately see where the perfusionist had commited a gross error which accounted for the brain damage to the child. I was not permitted to address the court but could only answer questions.Each time a question required education of the jury they would remove copy sheets from thir spread and supply the jury, judge etc and me with a copy. Just before lunch in answer to a question I suggested that the brain damage was caused by the error of the perfusionist. Their attorney looked triumphant and said I was not a brain specialist and not qualified to make this decision. All perfusionists know that low oxygen can cause brain damage!

 

I will now explain where she went wrong. For some time it had been postulated and presented at meetings tha elderly patients sometimes had symptoms of brain disorders following bypass surgery.       It was suggested that oygen levels should be reduced so that higher pH levels are avoided. A good judgment is shown by NEVER TURNING OFF ANYTHING BUT RATHER TO REDUCE. She had turned off the ogygen but failed to turn it on again for more than 20 minutes until the lab report from the laboratory showed the result. The blood in the bypass is visible to the perfusionist and long before this it would be black showing unsafe levels of oxygen

 

We went out for a two hour lunch break during which I was ready to drown myself following the triumphant look of their attorney.I was surprised that they had alcohol during lunch (beer). I did not drink. Suddenly they started to laugh and said I was priceless!. As you might know, all court decisions are made by precedent, i.e. past decisions They quoted a 1929 precedent that lay people have the right to an opinion. Nevertheless, their man succeeded in tying me into knots all afternoon. The only bright moments were when the retired to the judge’s chamber and the seargent confided to me that the jury liked me, especially my South African accent. I also found that the judge was not a lawyer but an elected layman. The next day we were getting buddy-buddy and he confessed he had a daughter who might want to become a perfusionist.

 

Towards the end of day two I had been pulled about by their attorney when he finally set a trap which almost caught me. He produced a chart showing changes of values and asked if I would agree the extrapolating the line outside the box (i.e.wher the facts are not proven by past information I SAID NO1 That was the end of the story and the $10,000,000 lawsuit was over. When I asked the judge if I would be able to go home to-night. He said: My son and grandchildren are coming to dinner to-night and I won’t be late

 

The second case where I was called did not involve a court case but we went to Oklahoma City where a perfusionist fell victim to a lack of knowledge which caused the death of a patient after suffering for 12 months. We used oxygen cylinders where it was not supplied through the wall. It was necessary to filter the oxygen and these should be renewed after each. The main reason for the problem, however, was not realizing that the standard guages DO NOT REPRESENT FLOW , BUT PRESSURE. This means that when a filter gets clogged to any degree it causes the pressure to rise while decreasing flow. The lack of oxygen produces the usual brain damage .I BELIEVE A PERFUSIOIST SHOULB BE ABLE TO SEE THE COLOR OF THE BLOOD.

Rachel, I wish you to e-mail this letter, if possible with margins corrrcted and numbered paragraphs is if submitted for publication

6. Autoregulation and Capillary Dynamics

capillary sphincters

capillary sphincters1