Oswald Operative Record
Dr. Tom Shires’s operative record dated 11/24/63 for Lee Harvey Oswald (Unit # 25260, age 24) documents surgery for gunshot wound of upper abdomen and chest with massive bleeding, with post-operative diagnosis of major vascular injury in abdomen and chest. The operation (exploratory laparotomy, thoracotomy, efforts to repair aorta) ran from 1142 to 1307 under general anesthesia. Anesthesiologists were Drs. M. T. Jenkins, Gene Akin, and Curtis Spier; assistants were Drs. Perry, McClelland, and Ron Jones. Preoperative inspection revealed an entrance wound over the left lower lateral chest cage and an exit identified by subcutaneous palpation of the bullet over the right lower lateral chest cage. Preoperatively, the patient was without blood pressure, with heart beat heard infrequently at 130 beats per minute; an endotracheal tube was placed and oxygen administered via anesthesia before transfer to the operating room. Two counted sponges were noted missing when the body was closed, though the square pack count was correct. Massive pharmacological intervention included calcium chloride (3 vials), Cedilanid (12), one molar lactate (6), Isuprel (24), and Adrenalin 1:1000 (3). IV fluids included 3,000 cc of lactated Ringer’s solution, 16 units of 500 cc whole blood, and 6,000 cc of 5% dextrose in lactated Ringer’s solution. The patient expired at 1307 with a measured blood loss of 8,376 cc.
CHAPITRE II. With the assistance of Agent in Charge Sorrels of the
Chapter II combines a detailed surgical narrative of the emergency operation performed on President John F. Kennedy at Parkland Memorial Hospital on 22 November 1963 with the official autopsy protocol conducted later that day at the Naval Medical School, National Naval Medical Center, Bethesda, Maryland. The chapter documents the operating-room intervention by Dr. Tom Shires, who worked alongside Drs. Malcolm O. Perry, Robert N. McClelland, Ronald Jones, and cardiologist Dr. Fouad Bashour, followed by the full autopsy report (A63-272) prepared by CDR J.J. Humes, MC, USN, with assistance from CDR “J” Thornton Boswell, MC, USN, and Lt. Col. Pierre A. Finck, MC, USA. Together, these records provide the complete clinical and pathological account of the wounds sustained by the President, the surgical attempts at resuscitation, and the postmortem determination that gunshot wounds of the head caused his death.
Description of Operation
The Description of Operation, signed by Dr. Tom Shires, recounts the emergency exploratory laparotomy performed under endotracheal oxygen anesthesia. A long mid-line abdominal incision exposed approximately 2 to 3 liters of liquid and clotted blood in the peritoneal cavity. The bullet pathway was traced as it shattered the upper medial surface of the spleen and entered the retroperitoneum, producing a large hematoma near the pancreas. The missile then exited through the inferior vena cava, traversed the superior pole of the right kidney and the lower right lobe of the liver, and lodged in the right lateral body wall. The right kidney was dissected free and the caval hole clamped with a Satinsky partial-occlusion clamp; packing controlled renal bleeding. On the left side, the spleen and left colon were mobilized to access a massive mid-line retroperitoneal hematoma, revealing a shattered mid-portion of the pancreas and aortic bleeding, which was controlled with finger pressure by Dr. Malcolm O. Perry. The superior mesenteric artery had been sheared off the aorta and was cross-clamped with a curved DeBakey clamp, after which the aorta was occluded above and below with straight DeBakey and Potts clamps. With major hemorrhage controlled, blood pressure reached approximately 100 systolic, but the pulse dropped from 80–90 to 40 and then to zero, with no aortic pulse. The left chest was opened through the fourth intercostal interspace using a Finochietto retractor; the heart was flabby and motionless, with no hemopericardium, no hemothorax, and a pre-existing left closed chest tube. The pericardium was opened, cardiac massage restored a pulse, and calcium chloride followed by epinephrine-Xylocaine were injected into the left ventricle. Standstill converted to fibrillation, and defibrillation was accomplished at progressively higher voltages (240, 360, 500, 750 volts), but no effective heartbeat could be established. A pacemaker inserted into the right ventricular wall produced only a feeble localized muscular response. Dr. Jenkins then confirmed absence of life: fixed and dilated pupils, no retinal blood flow, no respiratory effort, and no effective pulse even with massage. The President was pronounced dead at 1:07 P.M. Anesthesia was limited to oxygen; the patient was never conscious. The subcutaneous bullet was extracted from the right side during rotated defibrillation attempts, with cardiac massage and defibrillation carried out by Drs. McClelland, Perry, and Jones, and cardiologist Dr. Bashour providing assistance.
The original text of this work is in the public domain. This page focuses on a guided summary article, reading notes, selected quotes, and visual learning materials for educational purposes.