Monday, August 16, 2010


by Rowena Thursby

According to a recent report in the Independent, a frog-like jump across the lilly pad has transmuted the cause of Dr David Kelly's death from "haemorrhage" (Hutton Inquiry) to "heart attack" (Independent): "Kelly had heart attack, says pathologist" blares the headline.

Dr Jennifer Dyson, a retired pathologist, tells an Independent reporter, "there seem to have been a lot of pills in his stomach". I am not sure she has paid close attention to the forensic reports given to the Hutton Inquiry. Possibly her words reflect a common assumption: that Dr Kelly ingested all 29 of the tablets missing from the three blister packs beside his body - but did he?

Other than the existence of three blister packs with 29 pills missing found at the death scene, there is no real indication that Dr Kelly took all 29 pills, voluntarily or otherwise. There is more evidence that he did not.

  • At the Hutton Inquiry, forensic toxicologist Dr Richard Allan, clearly stated that he found only a fifth of one tablet in Dr Kelly's stomach. He did not find the residue of anything approaching 29 pills.

  • Dried regurgatative material was found in a line from both corners of Dr Kelly's mouth to his ears - more was distrbuted on the ground beside his body. This suggests that a substantial amount of any drug ingested would have been ejected.

  • Although Dr Allan found the amounts of the two components of co-proxamol in Dr Kelly's blood to be possibly consistent with an ingestion of 29 pills, he seemed puzzled that this quantity represented significantly less - more than half - than the amount that would normally cause a fatality.

  • Dr Robert Forrest, Home Office forensic toxicologist at the University of Sheffield, points out in a BMJ article that after death, concentrations of a drug increase - sometimes up to tenfold. If that is the case, Dr Kelly may need only have ingested two or three pills for Dr Allan's findings to make sense.

  • US army interpreter Mai Pederson, a close friend and colleague of Dr Kelly's towards the end of his life, maintains that he had a medical condition: "unexplained dysphagia" - a condition that makes it very difficult to swallow pills, while food is taken without any problem.

The Independent further records Dr Dyson as saying: "my suspicion would be that he had a coronary attack, brought on by the circumstances he found himself in and the stress that that entailed".

So is that to say, Dr Kelly was found dead in the woods, with wounds to his wrist, pill packets and a knife beside him, but that was just coincidental - he died of a heart attack, nothing to do with poisoning or blood loss? Or does Dr Dyson mean the combination of blood loss and poisoning probably caused a heart attack? Only the latter is plausible - but is it so?

In recent days The Times has published a letter (reproduced below) from nine eminent medical specialists - one of them, Sir Barry Jackson, ex-president of the Academy of Forensic Sciences and past surgeon to the queen. They aver that, absent a clotting abnormality, it is 'extremely unlikely' that anyone would bleed to death from a single severed ulnar artery. In recent television interviews two of them have maintained there is a strong consensus on this point across the medical profession.

Venturing opinions, especially medical ones, without reference to the facts of a case seeds false ideas which take root in the public mind. In fairness to Dr Dyson, she did not baldly state, as the headline claims, that Dr Kelly had a heart attack. The reporter turned her opinion into an assertion.

Lord Hutton's conclusions on how Dr Kelly met his death are unsafe. Even the forensic pathologist to the Hutton Inquiry, Dr Nicholas Hunt, told the news-team at Channel 4 News that he would be 'more comfortable' with an inquest.
Today's Daily Mail reports that only one person in five believes Dr Kelly committed suicide. This was no ordinary death - Dr Kelly was at the centre of a political furore which threatened to bring down the British government.

The medical details surrounding Dr Kelly's death and the circumstantial details are complex. The many facets of the case need to be gathered and forensically analysed with care by independent experts in a public forum. Witnesses must be supoenaed, give evidence under oath and be cross-examined. That didn't happen at the Hutton Inquiry; a full inquest is essential.


brian in the tamar valley said...

I'm very pleased that you have drawn attention to the mystery of the co-proxamol tablets. Understandably media attention has been more focussed on the severance of the ulnar artery following the letter to 'The Times' by the medical and legal experts; consequently the absurd notion that Kelly swallowed 29 tablets has slipped into the background I feel.

There are a couple of points I want to mention: the first one concerns the size of the co-proxamol tablets. Norman Baker makes the point that the oval shaped tablets were about half an inch long. Of course different tablets vary enormously in size and I imagine many people won't have experienced swallowing tablets this big. This summer for instance I have taken tablets to keep the misery of hayfever at bay and although the dosage is just one tablet a day they are so small that it would be feasible I think to swallow several at once.

Compare these with the co-proxamol. I can't really imagine anyone being able to swallow more than one at a time, let alone Kelly who, Mai Pederson asserts, found it virtually impossible to swallow pills.

The alleged swallowing of the 29 tablets leads me on to the water bottle. We are told that a half litre water bottle was found by the body with an unspecified amount of water still in it. It would be totally logical for anyone intent on swallowing tablets, whether or not they had a medical condition, to use the water they had with them to assist in the swallowing action.

I was interested to find out how much water would be available to Kelly to swallow each tablet using this one bottle. Taking a straight sided glass tumbler of 55mm diameter I have ascertained that the amount of water available for each of the 29 tablets would give a depth of about 6 to 7 mm or approximately one quarter of an inch in the glass - an almost insignificant quantity. This of course assumes equivalent amounts for each tablet which wouldn't happen in practice, therefore for some tablets less water would be available.

I think that if an inquest jury was shown both the size of one tablet and the minute amount of water available for swallowing and took that in conjunction with any corroborated evidence from Mai Petersen they would realise the total idiocy of the "suicide" theory.

J. Hartford said...

Rowena, a very interesting and thorough blog. Congratulations on your continuing efforts to make sense of this dark episode in our recent history.

I wanted to bring this image to your attention, it struck me quite forcefully in relation to Dr Kelly. It's clearly based on Caravaggio's 'The Deposition of Christ' and has been re-titled, "The Re-position of Dr Kelly."

It suggests that increasingly, people are unwilling to let the matter lie, and are finding inventive and surprising ways of speaking their mind.

Anonymous said...

@ brian You are quite right to push this matter of the co-proxamol (incidentally who prescribed them? was that ever found out?)
It is inconceiveable that one would take 29 of these as you say without immense difficulty
Obviously the size of bottle and amount of water remaining in it would have been recorded and locked away for 75 years - have any FoI requests been made in this nexus? (witnesses at Hutton give varied answers, all having been pushed by Hutton towards this convenient bottle) Were there fingerprints on the bottle?

Can anyone make sense of the residual amounts of dextropropoxyphene and paracetamol in Dr Kelly's stomach/ blood as Hunt told Hutton? (of course we have no idea at all when Dr Kelly died owing to the taking of the rectal temperature at the end of the day (7.15pm) rather than the beginning (12.15pm) when Hunt arrived at the scene, giving such a broad estimated time of death}. Can anybody shed more light here?

John said...

I have placed an illustration of the bloodstain at David Kelly: New Evidence. I have also reproduced the evidence from the Hutton enquiry about the amount of blood at the scene. On the subject of heart failure, Hunt noted that there had not been a heart attack.