LETTER REGARDING CO-PROXAMOL

This letter, from a retired anaesthetist - published in the Daily Telegraph on 24th August -speaks of the inconclusive nature of one of the secondary averred causes of Dr Kelly's death: co-proxamol poisoning.


'the fact that the blood level of Dp was so low as to be below that necessary for cardio-respiratory dpression suggests that not many tablets ever arrived in the stomach.'

Sir

If David Kelly (Letters, August 23) did not die from ulnar artery blood loss, then can we be sure that death was even due to cardio-respiratory depression after ingesting co-proxamol?

The drug contains dextropropoxyphene (Dp) and paracetemol. Paracetemol overdose can cause death but only in excess of three days after ingestion. Dp can cause death within one hour but usually within a mean of five hours.

As a retired anaesthetist with training in pharmacology, I noted that the stomach was empty of capsules, which indicates the Dp was totally absorbed. But the fact that the blood level of Dp was so low as to be below that necessary for cardio-respiratory depression suggests that not many tablets ever arrived in the stomach. An empty blister pack is not proof of ingestion.

Wrting as a citizen of this country, I feel that there are enough untidy ends in this sad saga to justify a coroner's inquest in which scene-of-crime officers and specialists in pharmacokinetics, forensic pathology, toxicology and vascular surgery can explain inconsistencies.

Dr David Rutter
Romsey, Hampshire