Why I comment on the doctor's competency? My wife's friend is a doctor by profession. When they emigrated to Canada, his qualification was not recognized in Canada and he was disallowed to practice there. Eventually, they shifted to New Zealand and now he's back to being a full-time doctor in New Zealand. So, it seems that that the qualification requirement is not as stringent in New Zealand.
When your wife friend migrated to Canada? SG qualifications are not recognized here as equivalent. Have to take exams then apply to train in residency.
Anyway I worked with Dr Teo Li Tserng at SGH GS back in 2003. SARS period. We were fellow MOs. He is a good chap.
Crush injuries can be difficult because you cant really tell how badly the organ or tissue is damaged till later. Especially if they are internally organs. They might not be bleeding and dont have like obvious cuts or tears to repair.
It could be why things played out that way. Aloysius could have seemed stable. But as time went on there was more necrosis that declared itself.
Fracture ribs are usually not fixed with hardware. It is possible there were no other fractures if the crush injury was to his chest and upper abdomen.
Pulmonary contusion is another notorious trauma injury. Eg patient is hit by a car. Initial chest x Ray's look normal. Then later on you see a whiteout picture. Pulmonary edema is widespread an failure ensues.
There is also the element of shock. Medical definition of shock. With more necrosis there may also have sepsis. Operations subsequently might have been to excise neurotic bowel and other tissue to reduce the necrotizing burden for the patient. It could have become too extensive by the 2nd or 3rd day so they knew it was a lost cause. Multi organ failure.
It is also why they send Li Tserng a trauma surgeon. Cos there wasn't anything specific to repair or fix per se. It also wasn't a case of ballistic or shrapnel that needed removing. Multiple organs. All crushed. It isn't something surgery can fix.
Surgeons mostly do wok like cutting out tumors respecting segments of bowel. Patching perforated ulcers. Removing gallbladders. Connecting artery to artery vein to vein eg in transplants.
You cannot cut or burn your way to repair a crushed organ.
Aloysius could hav ben saved if they could have stabilized him and then get him heart lungs liver kidneys transplant. It would still be a massive heroic effort.