johnwood1946

New Brunswick History and Other Stuff

Saint John General Public Hospital, Part 2/2

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From the blog at https://johnwood1946.wordpress.com

This is the second of two excerpts from the History of the General Public Hospital in the City of Saint John, New Brunswick, by William Bayard, published in 1896.

Last week’s blog dealt with the history of the hospital from 1865 to 1894, while this week’s blog details law-suits and controversies surrounding the hospital during the same period.

This is an unusual record. At first it seems to be an imperious resistance against any investigation of or meddling in hospital management. It then seemed to me to become a sad defence of Bayard’s honour in the face of controversy. I was considering editing it to delete some of this section when it changed again, and became a commentary on the role of general public hospitals. Bayard believed that the job of the hospital was to serve the ‘mechanic and the labourer’ who could not afford to pay for medical attention. Those who wanted the services of the hospital even though they were able to pay for private services were malingerers.

 St J Hospital 2 

The Saint John General Public Hospital, c 1912

New Brunswick Museum

Following are Bayard’s comments:

[][][][][][][][][][][][][][][][][][][][][][][][][]

The Saint John General Public Hospital, Part 2 of 2

The history of an institution is worthless if not full and true in every particular. I now approach the unpleasant part of my subject, and have to record the first scandal against the hospital since its establishment.

On the 27th February, 1889, a man with a diseased eye was sent in, after the visiting hour of the oculist, by a member of the staff, who had been in attendance upon him for eight or ten days, assisted by an oculist. The disease was ulceration of the cornea, with pus in the anterior chamber (hypopyon). The day after admission the ulcer penetrated the abscess, and the matter was discharged. The next day he left the Hospital, having been there about fifty hours, when he again went under the treatment of those who placed him there, and ultimately lost his eye. About a year after this he prosecuted the Commissioners, claiming that he lost his eye in consequence of neglect.

When the case came into court, the chief witnesses against the Commissioners were their paid employé, Dr. Daniel, and a disappointed aspirant to the situation of oculist, Dr. Crawford. The trial resulted in a verdict for the plaintiff—damages, $500; costs, $500. While it is the duty of the oculist to visit his patients every other day, or oftener if necessary, he did not see this man as he should have done. The house surgeon was away on leave, and a friend acting in his place, which may have accounted for, though not excused, the neglect. But had Dr. Daniel displayed the same zeal for his patient that he did at the trial, or the ordinary zeal that a medical man attached to a hospital should display towards it, he would have seen the oculist, and secured his attendance upon his patient. Had ho done so, his patient certainly would have received the benefit of the treatment he urged at the trial. He would have prevented the slander upon an institution of which he was a paid member, and he would have saved the pocket of the tax-payer to the extent of $1,000. And it may he asked why he, or the oculist with him, did not perform the simple operation of opening; the abscess before they sent the man to the Hospital?

The Commissioners claim that the disease in the man’s eye was so far advanced when he came to the Hospital that an operation would have been of no avail; that to afford a prospect of success it should have been done days before. They claim that it is unprecedented to hold the governing body of a hospital liable for the malpractice or laehes of a member of the medical staff. They can find no such case on record.

They claim that the result of this trial has done irreparable injury to the institution, inasmuch as it has paved the way to litigation and prosecution, which no amount of vigilance and care on their part can prevent. They employ the best men they can obtain, and make rigid rules and regulations governing their conduct, but cannot always be at hand to see them enforced. Indeed it has already yielded fruit, for an action is now pending in the Supreme Court against the Commissioners at the instance of a woman who claims that she was discharged before she was well. A pauper comes to our door; we admit him, feed and care fur him, and when recovered we tell him to go. He likes his quarters, and says no. We discharge him, and as a return for what we have done he prosecutes us. This is small encouragement for the philanthropist. But it will continue ad infinitum unless such claimants are compelled by legislative enactment to furnish security for the costs. They have nothing to lose, and consequently embark into a speculative action. It will be claimed that the interest of the poor man should be guarded. True; so should that of the giver.

We have to record scandal No. 2. In July, 1893 a statement appeared in one of the newspapers, that Commissioner Clark had taken samples of various kinds, and medicines from the Hospital. The statement was of such a character as to demand immediate investigation, which was made before a full Board.

The acknowledgments of Mr. Clark, coupled with the evidence, made it apparent that he had taken samples. While the amount taken was trivial, and not in the nature of stealing, still the members of the Board reluctantly came to the unanimous conclusion, that his usefulness as a commissioner was destroyed, inasmuch as he could not prevent the employees of the Institution from doing the same thing, having been guilty himself. Consequently a resolution was passed, urgently requesting him to resign. He declined to do so, leaving no alternative but to place the resolution and evidence into the hands of the Municipal Council, as the appointing body. This was done, and the following is the answer received:

Saint John, October 5th, 1893.

Dear Sir,—With reference to your letter to the Warden, of date 29th August last, enclosing evidence taken before the Commissioners of the General Public Hospital, in an investigation held by them, and their resolution thereon, requesting Mr. G.H. Clark, a commissioner of the Hospital, to resign. I beg to inform you that the same was laid before the October meeting of the Council of the Municipality, when a resolution was passed to refer the matter to a committee of the Council, “to investigate the same, and all matters connected with the Hospital and its management, and report to the Council.”

The committee consists of the Mayor, and Councilors Law, J.A. Chesley, O’Brien, Baxter, McLeod and Irvine.

I am, dear sir, your obedient servant,

W. Bayard, M.D., H.W. Frith, Secretary.

President Hospital Board of Commissioners

The resolution in an extraordinary one to say the least of it. A Board, after an impartial investigation, finds one of its members guilty of committing a wrong, he its requested to resign, he declines, the resolution and evidence forwarded to the parties appointing him; the answer the Board receives, is the appointment of a committee with a roving commission, “to investigate all matters connected with the Hospital and its management.” No charge was made against the Board, none could be formulated. Had the Council declared that we had dealt harshly with Mr. Clark, or that the evidence did not justify the resolution, we must have bowed to that decision. Or had they decided the Clark matter, and then demanded the investigation, we should have had no cause of complaint, for we have always courted the fullest publicity for our acts. But when they based the resolution upon the Clark matter, they did not treat the Commissioners with the confidence that men in their position deserved. The members of the committee claimed that a want of confidence was not intended—that may be so—but acts speak stronger than words, and no other construction can be put upon the act. And it may be asked, does not this act of the Council create an inducement for a Board to condone or cover the act of an erring member, rather than subject themselves to the treatment we have received?

Several meetings of the investigating committee were held at the Hospital. Every possible facility was afforded. Nothing could be found for the hidden hand to disapprove of, except that some of the Commissioners had suspected Mr. Clark, and did not place their suspicions before the Board. It did not enter their minds that it is an invidious act to make a charge against a brother member, the ground should be sure before it is made; and recent experience would not encourage a man in that procedure, even with the best proof at hand.

We cannot help feeling that the hidden hand placed the investigating committee in an unenviable position when it induced that body to call for the opinions of the medical men in the city regarding the management of the Hospital, none of whom were present at the investigation. It was apparent that the large majority did not approve of the call, for but three out of the forty appeared at the meeting. The three ventilated their opinions; two did not display their usual judgment. The vaporings of the other can be accounted for from the fact that he had been on the staff, and was left off for cause. That but three out of the forty could be found to speak disparagingly of the institution is largely in its favor.

At this stage of the proceeding, Dr. Bayard placed his resignation as Commissioner in the hands of Warden McLauchlan. That gentleman wrote him a kind letter requesting its withdrawal. Below is the Doctor’s answer, declining to do so:

St. John, January 1, 1894

Dear Mr. McLauchlan—Nothing would give me greater pleasure than to grant a request coming from you, particularly when it is couched in such kind and flattering terms as those conveyed in your note.

When I placed my resignation as Hospital Commissioner in your hands, I felt it prudent to do so without note or comment. Your kind request makes it incumbent upon me to give you my reasons for so doing.

When the resolution passed the County Council appointing a committee with a roving commission “to inquire into all matters regarding the management of the Hospital,” I determined to resign my position, but delayed doing so in order that I might assist my fellow commissioners in affording every possible facility for investigation to the committee. That investigation, I believe, has been concluded, and I am now in a position to carry out my original intention.

I came to this conclusion because I considered the act of the County Council a declaration of “want of confidence in the Board over which I have the honor to preside.” It has been claimed that it was not so intended by the Council. It may not have been intended, but the fact remains: the investigation was ordered; such an order necessarily carries suspicion with it. What was the suspicion? No charge was made; none could be formulated by the committee. Then it may be asked, was it right or just that a body of gentlemen, performing a gratuitous work for the benefit of suffering humanity, should, without any apparent reason, be subject to hostile criticism by the press—one writer going so far as to class them as freebooters and thieves—or that they should be compelled to defend their acts against irresponsible and disappointed medical men?

It is hard to trace the hidden hand moving in this matter. I am unwilling to believe that the action of the Hospital Board in the Clark matter is the cause. Yet, when looking for one, I cannot find another. If such. is the case, a dangerous principle has been established, inasmuch as it holds out an inducement for a Board to condone or cover the act of an erring member. Had the Council passed a resolution that we had dealt harshly with Mr. Clark, or that the evidence did not justify our conclusion, we should have bowed to that decision. The acts of Mr. Clark were right, or they were wrong. After due consideration we came to the painful conclusion that they were wrong, and we feel that our decision has received scant consideration at the hands of the Council. I have personally requested my brother Commissioners not to follow my example, for by so doing I believe the institution will be seriously injured. I do not say that honest men could not be obtained to fill their places; but I do say that none could be obtained who know the various duties so well, or who have the welfare of the institution more at heart.

It may be claimed that if the committee report favorably of the Commissioners, no harm is done. Not so; we have been in the pillory, and must necessarily come out soiled; not in the eyes of those who know us, but in the eyes of those abroad who do not know us.

I wish it to be understood that I have no fault to find with the investigating committee, the members of which treated us with the utmost courtesy.

I have seen the Hospital rise from nothing to its present state of usefulness. I have taken more than common interest in it. I leave it with regret, not in auger. I leave it as a matter of self respect. And, sir, after the perusal of my reasons, I believe you will agree with me that I have just cause for so doing.

I have the honor to remain, Yours very sincerely,

W. Bayard.

C. McLauchlan, Esq.,

Warden County Council.

The following is the report of the Committee:

To the Warden and Council of the Municipality of the City and County of St, John

The special committee of Council, appointed in October last under the following resolution, viz.:

That the communication and evidence sent up to this Council, by the Commissioners of the General Public Hospital, respecting certain charges made against Commissioner George H. Clark, “be referred to a committee of seven for investigation, together with all matters connected with the Hospital and its management,” such committee to report thereon, beg now to report as follows:

The committee have held several meetings, at three of which the President and other members of the Hospital Board of Commissioners were present, and at two of which Mr. Clark was present. They have heard all the evidence produced before them, and the statements of Mr. Clark himself; several of the Commissioners, including the President, have been heard, and at the last meeting of the committee opportunity was given for the attendance of medical men not on the staff of the Hospital or connected therewith, when they were favored with the views of several physicians as to the general Management of the Hospital, and the committee having also had full consideration of all matters referred to them, arrived at the following conclusions:

First. They agree with the resolution of the Commissioners that while Mr. Clark, in the matters charged against him, acted with no idea or intention of wrong-doing, his usefulness as a commissioner is destroyed. The committee regret that Mr. Clark did not, as requested by the Board of Commissioners, tender his resignation, but he has not seen fit to do so, the committee feel compelled to recommend that the Council remove him from office.

Second, It appeared in evidence during the investigation of the committee, that certain of the commissioners had for several years been acquainted with some of the acts now charged against Mr. Clark, and the committee cannot but regret that these acts were not at the time brought before the Commissioners of the Hospital for action.

[Third. This section has not been adopted, having been ordered to lie on the table.]

Fourth. In view of the large number of non-paying patients treated in the Hospital who come from all parts of the Province outside of this city and county, the committee are strongly of opinion that the annual grunt from the Government should be increased, and they recommend that the Council should join with the Commissioners in a renewed application to the Government to increase the same.

Fifth. The committee submit herewith a record of their proceedings, and of the evidence taken before them, as published in the columns of The Sun.

Sixth. In conclusion the committee beg to say that, during this investigation, and the visits of the committee to the Hospital in connection therewith, they have had the hearty co-operation of the President and all the Commissioners; have been readily and frankly afforded full information upon all matters of inquiry, and given every opportunity to examine for themselves the Hospital buildings, the officials employed, and the patients under treatment.

The committee recommend that a copy of this report be forwarded to the Commissioners.

Respectfully submitted.

Signed by Thomas W. Peters, J. McLeod, A.L. Law, John Irvine, John A. Chesley, John B. M. Baxter, K. O’Brien.

H.W. Frith, Secretary.

St. John, January 16, 1894.

On the 16th of January, 1894, G.R. Vincent, Esq., offered the following resolution regarding Dr. Bayard’s resignation:

Whereas, Wm. Bayard, Esq., M.D., was in July, 1860, appointed a Commissioner of the General Public Hospital, and was immediately thereafter elected chairman of the commission of the said Hospital, the onerous duties of which he has faithfully and honestly discharged, to the entire satisfaction of this Council, and the public at large;

And whereas. This Council recognizes and fully appreciates the successful efforts of Dr. Bayard on behalf of the institution, and his deep devotion to its interests, for which he has labored for more than a third of a century, and which, under his management, has been gradually enlarged and fully equipped, until it has attained its present magnificent proportions and usefulness, standing as it does today, a monument to the indomitable energy of Dr. Bayard, and a credit to the City and County of St. John;

And whereas, During all these years of faithful and successful management, and the accomplishment of so much under most trying circumstances, this Council has learned to look upon Dr. Bayard as the father of the institution;

And whereas. This Council desires to express regret, that any misunderstanding resulted from the passage of a resolution, at the last meeting of the Board, relating to Hospital matters, and to assure Dr. Bayard that no reflection was intended to be cast on him; but on the contrary, the Council always had and still has, the utmost confidence in his honesty, integrity and ability, to discharge the duties of commissioner and chairman, which he has so long discharged at great personal sacrifice, and without fee or reward.

Therefore resolved, That this Council do not now accept Dr. Bayard’s resignation as such Commissioner, but earnestly request him to withdraw the same, and that a copy of this resolution be forwarded by the secretary to him under the corporate seal.

This resolution did not please the hidden hand, consequently Dr. Bayard received the following:

At a meeting of the Council of the Municipality of the City and County of Saint John, held at the Court House, in the City of Saint John, on Tuesday, 16th January, A.D. 1894—

Read a letter from Dr. William Bayard to the Warden, requesting him to place Dr. Bayard’s resignation as member of the Board of Hospital Commissioners before the County Council;

Whereupon resolved, That this Council do not now accept Dr. Bayard’s resignation as such Commissioner, but earnestly request him to withdraw the same, and that a copy of this resolution be forwarded to him by the secretary under the corporate seal.”

True extract from the minutes. In testimony whereof I have hereunto set the seal of the said Municipality this 17th day of January, A. D. 1894.

[Seal] (Signed) H. W. Frith, Secretary.

This resolution is in keeping with many that have preceded it from the municipal authorities of the day since the commencement of Dr. Bayard’s efforts to establish a hospital in this city. The members of the Hospital Board have occasionally found themselves compelled to differ from the civic authorities upon points connected with the management of the institution. This was done under the firm conviction that they were acting for the best interest of all concerned, not with the wish or intention of ignoring public opinion. Dr. Bayard asks neither praise nor thanks for anything he has done; but when kind words are offered, and refused, it displays the existing feeling towards him by the majority of the Council. To Mr. Vincent, and those who supported him in the kind expressions offered, he owes a debt of gratitude; to those who refused them, he leaves to the enjoyment of their triumph.

As appears by the following letter to Warden McLauchlan from Dr. Bayard, that he has withdrawn his resignation, thereby subjecting himself to be made use of a little longer. But it is evident from its wording, that the withdrawal was in consequence of the expressed wish—by resolutions—of his brother commissioners and the members of the medical staff:

Charles McLauchlan, Esq.,

Warden of the County Council.

Dear Sir—I have the honor to acknowledge the receipt of a resolution passed by the County Council declining to accept my resignation as a member of the Hospital Board of Commissioners, and “urgently requesting me to withdraw the same.”

In answer, I have to say that unanimous resolutions having been passed by the Board of Commissioners and the members of the medical staff of the institution, strongly urging me to retain my position at the Board, induce me to obey the expressed wish of the Municipal Council, I consequently withdraw the same.

I have the honor to be Yours truly,

W. Bayard.

St. John, March 26, 1894.

It appears that there is no rest for the Hospital Commissioners, for, on the 25th of May, 1894, the following communication was received from the County Secretary:

[Memorandum.]

The following is a true copy of Section 3 of the Report of the Special Committee of the Council of the Municipality appointed in October last under the following resolution:

“That the communication and evidence sent up to this Council, by the Commissioners of the General Public Hospital, respecting certain charges made against Commissioner George H. Clark, be referred to a committee of seven for investigation, together with all matters connected with the Hospital and its management, such committee to report thereon.”

Section 3. While as the result of inquiry into the general management of the Hospital, the committee are satisfied that the affairs of the Hospital are carefully conducted, and that a vast deal of unremunerated time and labor are bestowed upon them by the President and all the Commissioners, the committee would recommend the following changes as improvements on the present system, that is to say:

That paying patients shall be allowed to have the attendance in the Hospital of their own physicians; and

That the purchasing of supplies, the duty of which is now thrown on a single commissioner during the month which he takes in rotation with his fellow commissioners, should be made the business of some responsible official paid by the institution.

The report containing the above section was submitted to the Council at a meeting held on the 16th day of January last past, and the whole of said report was adopted except the third section, which was by resolution laid on the table.

That at a meeting of the said Council, held on the 8th day of May instant, the said section was taken off the table and considered, and the following resolution passed:

Resolved, That so much of the report as relates to the attendance of physicians on their private patients be adopted, and that the Commissioners be recommended to entrust the purchased supplies to an official, if it can be done without increasing the expenses of the institution.

G.R. Vincent, [Seal] County Secretary.

St. John, N. B., May 25th, A.D. 1894.

Governed by the by-laws of the Hospital, a large majority of the articles required for the institution are obtained by tender; others cannot be so obtained—the Commissioner of the month, with the sanction of the Board, purchases them, but he cannot individually spend more than $20 during his month, without such sanction given before or at the next board meeting. The members of the Municipal Council are well aware of these facts. Then it may he asked, why the above resolution was passed? with its extraordinary proviso: “If it can be done without increasing the expenses of the institution.” Is it done to cast suspicion upon the integrity of the Commissioners? For I am unwilling to believe that any member expects that a man can be found who will do this work for nothing; or if found, will not pay himself. Personally I have no interest in the matter, never having purchased ten cents worth of provisions for the institution, but I assume equal responsibility. The Commissioners do not covet the work, but as they are responsible, they prefer to trust those they know, rather than one they do not know, hence the following answer:

At a meeting of the Commissioners, January 11, 1895—

Resolved, That the Commissioners cannot recommend any change in the purchase of supplies for the Hospital, as they do not consider it would be in the interest of the Hospital, and could not be done without a very considerable extra expense.

At the same meeting, the question of allowing paying patients to have the attendance in the Hospital of their own physicians was discussed, when the following resolution was passed:

That the Commissioners of the General Public Hospital cannot recommend that any change be made in the present medical management of the Hospital, as we do not believe it would be conducive to the best interest of the institution, and would, we believe, add very largely to the cost of management.

This did not please the hidden hand, as appears by the following resolution:

At a meeting of the Council of the City and County of St. John, held at the Court House, in the City of St. John, on Tuesday, the 15th day of January, A.D. 1895, the following resolution was passed:

Whereas, This Municipal Council having heard read the communication from the Commissioners of the Public Hospital, in which they decline to accede to the request of this Council that private paying patients should have the privilege of being attended by their own physicians whether on the staff of the Hospital or not;

Therefore resolved, That the Commissioners of the General Public Hospital be requested to try the experiment, and that a committee of this Council be appointed to confer with the Commissioners on the subject.”

The Warden appoints the following councillors on such committee: McRobbie, Catherwood, Daniel, Christie, Baxter, Lee and Dunn.

I hereby certify that the foregoing is a true and correct extract from the minutes of the Council of the Municipality of the City and County of St. John, embodying the resolution in regard to Hospital matters, passed at the meeting of said Council on the fifteenth day of January, 1895.

(Signed) Geo. R. Vincent, Secretary.

Acceding to the request, the Commissioners met the committee named, at the office of the Municipality, on the 2lst of March instant, and, after a prolonged discussion, the matter was left as it stood before.

At a meeting of the Hospital Commissioners, on the 3rd of May, 1895, the following resolution was passed:

“The Commissioners having, on the 21st of March, met with a committee of the Municipal Council for the purpose of further considering a request of the said Council, that pay patients at the Hospital be allowed, if required, to have the service of their own physicians outside of the Hospital staff, and having heard the arguments of the committee of the Council regarding the matter, are still of the opinion that it would not be in the general interest of the Hospital to make any change in this department, and that the secretary write to the secretary of the municipality to this effect.”

The idea of making the Hospital a hoarding-house for the patients of every doctor in the city has been pursued with a determination worthy of a better cause.

In April last, at the instance of Dr. Berryman, a petition urging this measure—signed by half of the medical men in the city—was placed before the Board of Commissioners, but the arguments in support of it were not such as to induce them to rescind their former decision.

Our answer is, that room does not exist in the institution for such patients without excluding the poor, for whom alone the Hospital was established. It is incidental to all hospitals to have a few rooms for accident or emergency, but it never was contemplated that they should be open to all. It is idle to contend that the wealthy should be admitted because they contribute to its support. They contribute to the support of many institutions, but I have not heard of their demanding admission to any. No! this movement is for the benefit of the petitioners, who, having failed to establish a private hospital for their patients, come forward and ask the rate-payer to furnish one for them. Appreciating their wish to obtain rooms, skilled nursing, continued medical and surgical supervision, medical and surgical instruments, appliances, etc., I feel, as a Commissioner disbursing public money, I have not the right to grant such privileges at the expense of the rate-payer.

We have been asked to try the experiment; we answer, we have no right to try experiments with the public funds. The word experiment implies a risk. If we lose—of which we have little doubt—what then?

Again, it may be asked, have the petitioners taken: into consideration the risk of placing their patients—when it can be avoided—in the atmosphere of a hospital that has been in constant occupation for thirty years. They should know, that with all the care possible, the air of such hospital cannot be made so pure as a private house with proper sanitary surroundings that has not been made a receptacle for the sick; the safety of their patients should be their first consideration. It is more than probable that the other half of the profession who refused to sign the petition, had this risk in their minds.

It has been claimed, that by granting this petition, it would prevent persons from going abroad to seek surgical aid; daily experience proves such a claim to be fallacious.

—————–

Hospitals are institutions that should commend themselves to the sympathy of all classes. To the poor, for whom alone they are established, and to the rich, who see the result of their good work—a form of charity, to which, every individual should be proud and glad to contribute his mite. For I hold, that no man—whatever his prejudices may be—can pass through the wards of one, without being impressed with the care and comfort extended towards each and every sufferer who receives the daily, and I may say the hourly attention of the experienced physician, with the kind and gentle aid of the skilled nurse. And as the road to the heart is oftener through the eye than the ear, we solicit the visits of all to this one.

While the large majority accept these gifts with gratitude, there is another class who demand this charity as a right, and would not be satisfied if “Angel Gabriel” appeared and ministered to their wants. This class is largely composed of persons who, having deceived the commissioners regarding their poverty, occupy the beds of the poor at the expense of the rate-payer.

Again, the “out-door departments” of all hospitals are widely abused. It is claimed that in London nearly 2,000,000 visits are paid yearly to the various hospitals by applicants for advice and medicine, one-half of whom are not fit subjects for such charity, being well able to pay for that which they obtain. This abuse has so alarmingly reduced the voluntary contributions to those institutions that the authorities are making strong efforts to remedy the evil.

This evil does not exist in the same proportion in St. John, but we are approaching it. The Commissioners find it difficult to discriminate, and the waiting room at the Hospital is often occupied by persons who would feel insulted if classed as paupers, and who would not dare to ask such charity from any other source. I do not wish to convey the impression that such charity should not be afforded. Better to give to two undeserving, than to withhold from one who really deserves it.

It would fill pages to name each individual who has contributed valuable articles for the comfort of the sick and afflicted in this institution; also, the lady visitors who, by their presence and kind sympathy, have done so much towards relieving the misery of the sick bed. To one and all we here tender our sincere thanks.

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Written by johnwood1946

February 12, 2014 at 3:16 PM

Posted in Uncategorized

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