Surgeon Flown to California Crash to Amputate Leg

An Enloe surgeon was flown by helicopter to a crash site to amputate the driver's leg while he was still inside the vehicle, Thursday.

The driver, Bryant Rix, 28, of Oroville, suffered major injuries and his brother, Daniel Rix, 21, who was a passenger, sustained moderate injuries. Both were flown in the FlightCare helicopter to the Enloe Medical Center.

It was about 6 a.m. when a 1996 Chrysler Seabring convertible driven by Bryant Rix was traveling westbound on Grubbs Road approaching Rabbit Road.

According to CHP Investigating Officer Don W. Pederson, Jr., Rix was passing a vehicle and crossed a double yellow line before he lost control and smashed into an oak tree on the right side of the road.

Emergency response units from CAL Fire/Butte County Fire arrived on scene within eight minutes of the call to dispatch, and CHP arrived in about 15-20 minutes.

When emergency personnel arrived on scene they found the Chrysler Seabring was wrapped around an oak tree and the driver, Bryant Rix, was trapped inside. His passenger, Daniel Rix, had already managed to exit the vehicle.

The engine compartment and front end of the vehicle were torn away from the rest of the vehicle. Major extrication was required, and Battalion Chief Russ Fowler commanded the rescue effort.

First Responder paramedics arrived and gave the trapped driver an IV line. "His vitals were stable and blood pressure was good and he was given oxygen and fluids. We knew the extrication was going to be extensive," said Battalion Chief Fowler.

"We had to cut through the bottom of the vehicle. The strength of these vehicles is in the bottom. We tried to cut the vehicle open to get to the patient and he was in extreme pain. We decided it was best not to move the vehicle too much until the surgeon arrived," Fowler said.

The driver's right leg was crushed and wedged inside the vehicle and the oak tree. "This created pressure and helped the blood coagulate. There was very minimal bleeding. The pressure functioned like a tourniquet. We had a concern if we did free the driver from the vehicle before the surgeon arrived, he might have more blood flow from arteries. We knew he was a viable patient, and we knew he could be saved," Fowler said.

Fowler called for an emergency surgeon to come to the crash scene. Oroville Hospital was contacted first, but no surgeons were available. Rideout and UC Davis were contacted also, but then Enloe Medical Center responded and said they had a surgeon available to be flown to the crash site.

The Enloe FlightCare helicopter, which had been called out on initial dispatch, first flew the passenger, Daniel Rix, out at 6:51 a.m. and then later returned with the surgeon, Dr. Kevin Mitchell, from the Enloe Medical Center. It was about 8 a.m. when the surgeon arrived with two nurses and with all of their tools to conduct the surgery.

Dr. Mitchell had to amputate just below the driver's right knee while the driver was still trapped inside the vehicle. The driver was conscious and in extreme pain before going under the general anesthesia.

Two Enloe FlightCare nurses, who routinely responded to traffic collisions, assisted the surgeon by providing the patient with anesthesia.

The surgeon laid out his tools like a surgical unit and used medication to prevent infection. Only about 20 minutes lapsed from the time the surgeon landed in the helicopter at the crash site to the time the driver was packaged and transported to the helicopter. The surgery itself only lasted about a minute, Fowler said.

"The driver's right leg was already about 90 percent severed due to the crash, and it took less than a minute to complete the amputation," Fowler said.

"This is highly unusual to need to have a surgeon flown out to perform an amputation while the patient is still inside the vehicle," Fowler added.

Both Fowler and CHP Officer Pederson said it is the first "field amputation" in their careers they had ever witnessed.