WILL THE HUTTON REPORT TELL US HOW DR DAVID KELLY DIED?
By Rowena Thursby
On the eve of publication of the Hutton Report, medical specialists are making public their doubts over how Dr David Kelly died. Items found with his body suggested suicide, but a UK surgeon and a specialist anaesthesiologist from South Africa believe the case may not be so clear-cut.
BACKGROUND
In July 2003 the coroner’s inquest into the sudden death of Dr Kelly, the microbiologist who claimed the British government had “sexed-up” intelligence in support of war with Iraq, was perfunctorily dismissed and subsumed into a public inquiry. The Hutton Inquiry concerned itself largely with identifying who was responsible for pushing the scientist towards suicide. Scant attention was paid to the question of whether or not Dr Kelly did, in fact, take his own life.
Dr Nicholas Hunt, the forensic pathologist in the case, concluded that the scientist died primarily of a self-inflicted wound causing haemorrhage, with co-proxamol ingestion as a secondary cause. Given the absence of rigorous probing of Hunt’s testimony by barristers at the hearing, Lord Hutton’s report is likely to confirm that verdict. But recently there have been murmurings of dissent amongst the medical fraternity.
MEDICAL SPECIALISTS DISPUTE DEATH CAUSED BY HAEMORRHAGE
A debate has arisen over whether haemorrhage emanating from a wrist incision could have been the primary cause of Dr Kelly’s death. David Halpin, FRCS, a retired British orthopaedic and trauma surgeon with professional experience of dealing with incised wounds, thinks it “highly unlikely” Dr Kelly could have died as a result of transversely slashing one wrist. Mr Halpin wrote, in a letter to the “Morning Star”, 15 December 2003:
“As a …trauma and orthopaedic surgeon, I cannot easily accept that even the deepest cut into one wrist would cause such exsanguination that death resulted. The two arteries [in the wrist] are of matchstick size and would have quickly shut down and clotted.”
According to Dr Hunt, of the two main arteries in the wrist, only one – the ulnar artery - was severed, and from this wound Dr Kelly bled to death. Mr Halpin points out however, that complete transection (as opposed to partial transection) would have led to the artery quickly retracting and closing off the lumen. The chances of death from haemorrhage would thus have markedly decreased.
Notched and crushed edges to the wound, noted by Dr Hunt in his forensic examination, indicate the knife Dr Kelly used may have been blunt. Bluntness in the knife, in Mr Halpin’s view, would have induced an even swifter clotting response:
“If the Sandvik knife was blunt… that would have tended to produce greater spasm of the severed ulnar artery, and that severance, being more traumatic, would have been a greater stimulus to clotting within the lumen of the vessel and in the wound itself.”
Vanessa Hunt and David Bartlett, the ambulance crew who worked at the scene of Dr Kelly’s death, made a point of telling the Hutton Inquiry that they were surprised there was not more blood present; they did not see how Dr Kelly could have died from such a small blood loss. For Dr Kelly to have died from haemorrhage he would have had to have lost at least 3 litres of blood.
Dr Sennett, a specialist anaesthesiologist from Johannesburg, doubts that Dr Kelly could have lost more than 500ml (one pint) of blood:
…“to bleed to death from a cut blood vessel is not as simple as it sounds, because as the blood is lost the blood pressure falls, and this in turn, slows the blood loss…. It is extremely difficult to lose significant amounts of blood at a pressure below 50 – 60 systolic in a subject who is compensating by vaso-constricting (contracting the blood vessels)… although the subject may lose consciousness at this blood pressure, he may not necessarily die.”
“In fact, I suggest that it would be impossible to lose a “lethal” amount of blood from an ulnar artery which had been cut in the manner described for Dr Kelly.”
OVERDOSE NOT DEMONSTRATED
If Dr Kelly did not die from haemorrhage, might he have died from co-proxamol overdose? Mr Allan, toxicologist at the Hutton Inquiry found this improbable. Three packets of co-proxamol were found in the pockets of Dr Kelly’s jacket. Each contained a blister pack of 10 tablets. Twenty-nine were said to be missing. Mr Allan, was not able to show however, that Dr Kelly had ingested all 29 tablets. Only a fifth of one tablet was found in the stomach. Although levels of the co-proxamol found in the blood were higher than therapeutic levels, Mr Allan conceded that the blood level of each of the drug’s two components was less than a third of what would normally be found in a fatal overdose.
INQUEST, IF RESUMED, MAY RE-EXAMINE FINDINGS
If Dr Kelly died neither from haemorrhage nor overdose, how did he die? Did his heart condition play a part? Or were the items found at the scene of death – the knife, the packets of pills, the bottle of Evian water – not evidence of suicide as is widely assumed, but a false trail left in an attempt to cover up the scientist’s murder? Nicholas Gardiner, coroner at the original inquest, has spoken of resuming the inquest after studying the Hutton Report. If the inquest does re-open, let us hope it scrutinises much more closely Dr Hunt’s conclusions as to the cause of Dr Kelly’s death.
Contact Rowena Thursby at:
RowenaThursby@onetel.net.uk
Comment from medical specialists especially welcome.
The following letter was requested by Seumas Milne of The Guardian.
Three highly qualified medical professionals dispute that Dr Kelly could have bled to death from a slashed wrist, as claimed at the Hutton Inquiry. This should be a BIG STORY - but media silence is utterly deafening.
Will he, won't he, will he, won't he.... will Mr Blair be affected by the Hutton Report - might he lose his job? The question of whether Dr Kelly's death was suicide or murder continues to be ignored in favour of political tittle tattle.
Rowena Thursby
27 January 2004
Dear Letters Editor,
THREE DOCTORS DISPUTE HOW DR DAVID KELLY DIED
As medical professionals, a trauma & orthopaedic surgeon, a specialist anaesthesiologist, and a diagnostic radiologist, we do not think evidence given at the Hutton Inquiry has demonstrated that Dr David Kelly committed suicide.
Dr Nicholas Hunt, the forensic pathologist who appeared at the Hutton Inquiry, concluded that Dr Kelly bled to death from a self-inflicted wound in his left wrist. We consider this highly improbable. Arteries in the wrist are of matchstick thickness and severing them does not lead to drastic blood loss. Dr Hunt stated that the only artery that had been cut - the ulnar artery - was completely transected. Complete transection means the artery quickly retracts, promoting clotting of the blood:
"When an artery is completely divided, the highly elastic quality of its wall causes it to retract into the tissues, thereby diminishing the calibre of the vessel and promoting clotting."
(A Textbook of Surgery by Christopher, Fourth Edition, 1945, p210)
It was reported by the ambulance team that blood at the scene was minimal. It is extremely difficult to lose significant amounts of blood at pressure below 50-60 systolic in a subject who is compensating by vaso-constricting. To have died from haemorrhage, Dr Kelly would have had to lose 3 litres of blood; in our view it is unlikely that Dr Kelly would have lost more than a pint from the wound described.
Mr Alexander Allan, the toxicologist testifying at the Inquiry, considered the ingestion of co-proxamol insufficient to cause death. Mr Allan could not show that Dr Kelly had ingested the 29 tablets said to be missing from the packets found. Only a fifth of one tablet was found in his stomach. Although levels of co-proxamol in the blood were higher than therapeutic levels, Mr Allan conceded that the blood level of each of the drug’s two components was less than a third of what would normally be found in a fatal overdose.
In summary, we dispute that Dr Kelly could have died either from haemorrhage or from co-proxamol ingestion. The coroner, Nicholas Gardiner, has spoken in recent days of resuming the inquest into Dr Kelly’s death. If it does re-open, a clear need exists for further scrutiny into Dr Hunt’s conclusions regarding the cause of death.
Yours sincerely
David Halpin, MB BS FRCS
Trauma & Orthopaedic Surgeon
Dr C Stephen Frost, BSc, MB ChB
Specialist in Diagnostic Radiology (Stockholm, Sweden)
Dr Searle Sennett, BSc, MBChB, FFARCS
Specialist Anaesthesiologist
Please also see:
THE HUTTON REPORT – A COVER-UP?
An Open Letter to the U.K. Public (and media)
http://debateusa.com/featured/jrarey.htm
Dr Kelly 'did not kill himself'
http://www.femail.co.uk/pages/standard/article.html?in_article_id=206680&in_page_id=2
Experts question Kelly 'suicide'
http://www.itv.com/news/429586.html
Coming Storm, by Gordon Thomas
http://www.guerrillanews.com/intelligence/doc3813.html
The Alternative Hutton Report
http://www.stopwar.org.uk/release.asp?id=200104
By Rowena Thursby
On the eve of publication of the Hutton Report, medical specialists are making public their doubts over how Dr David Kelly died. Items found with his body suggested suicide, but a UK surgeon and a specialist anaesthesiologist from South Africa believe the case may not be so clear-cut.
BACKGROUND
In July 2003 the coroner’s inquest into the sudden death of Dr Kelly, the microbiologist who claimed the British government had “sexed-up” intelligence in support of war with Iraq, was perfunctorily dismissed and subsumed into a public inquiry. The Hutton Inquiry concerned itself largely with identifying who was responsible for pushing the scientist towards suicide. Scant attention was paid to the question of whether or not Dr Kelly did, in fact, take his own life.
Dr Nicholas Hunt, the forensic pathologist in the case, concluded that the scientist died primarily of a self-inflicted wound causing haemorrhage, with co-proxamol ingestion as a secondary cause. Given the absence of rigorous probing of Hunt’s testimony by barristers at the hearing, Lord Hutton’s report is likely to confirm that verdict. But recently there have been murmurings of dissent amongst the medical fraternity.
MEDICAL SPECIALISTS DISPUTE DEATH CAUSED BY HAEMORRHAGE
A debate has arisen over whether haemorrhage emanating from a wrist incision could have been the primary cause of Dr Kelly’s death. David Halpin, FRCS, a retired British orthopaedic and trauma surgeon with professional experience of dealing with incised wounds, thinks it “highly unlikely” Dr Kelly could have died as a result of transversely slashing one wrist. Mr Halpin wrote, in a letter to the “Morning Star”, 15 December 2003:
“As a …trauma and orthopaedic surgeon, I cannot easily accept that even the deepest cut into one wrist would cause such exsanguination that death resulted. The two arteries [in the wrist] are of matchstick size and would have quickly shut down and clotted.”
According to Dr Hunt, of the two main arteries in the wrist, only one – the ulnar artery - was severed, and from this wound Dr Kelly bled to death. Mr Halpin points out however, that complete transection (as opposed to partial transection) would have led to the artery quickly retracting and closing off the lumen. The chances of death from haemorrhage would thus have markedly decreased.
Notched and crushed edges to the wound, noted by Dr Hunt in his forensic examination, indicate the knife Dr Kelly used may have been blunt. Bluntness in the knife, in Mr Halpin’s view, would have induced an even swifter clotting response:
“If the Sandvik knife was blunt… that would have tended to produce greater spasm of the severed ulnar artery, and that severance, being more traumatic, would have been a greater stimulus to clotting within the lumen of the vessel and in the wound itself.”
Vanessa Hunt and David Bartlett, the ambulance crew who worked at the scene of Dr Kelly’s death, made a point of telling the Hutton Inquiry that they were surprised there was not more blood present; they did not see how Dr Kelly could have died from such a small blood loss. For Dr Kelly to have died from haemorrhage he would have had to have lost at least 3 litres of blood.
Dr Sennett, a specialist anaesthesiologist from Johannesburg, doubts that Dr Kelly could have lost more than 500ml (one pint) of blood:
…“to bleed to death from a cut blood vessel is not as simple as it sounds, because as the blood is lost the blood pressure falls, and this in turn, slows the blood loss…. It is extremely difficult to lose significant amounts of blood at a pressure below 50 – 60 systolic in a subject who is compensating by vaso-constricting (contracting the blood vessels)… although the subject may lose consciousness at this blood pressure, he may not necessarily die.”
“In fact, I suggest that it would be impossible to lose a “lethal” amount of blood from an ulnar artery which had been cut in the manner described for Dr Kelly.”
OVERDOSE NOT DEMONSTRATED
If Dr Kelly did not die from haemorrhage, might he have died from co-proxamol overdose? Mr Allan, toxicologist at the Hutton Inquiry found this improbable. Three packets of co-proxamol were found in the pockets of Dr Kelly’s jacket. Each contained a blister pack of 10 tablets. Twenty-nine were said to be missing. Mr Allan, was not able to show however, that Dr Kelly had ingested all 29 tablets. Only a fifth of one tablet was found in the stomach. Although levels of the co-proxamol found in the blood were higher than therapeutic levels, Mr Allan conceded that the blood level of each of the drug’s two components was less than a third of what would normally be found in a fatal overdose.
INQUEST, IF RESUMED, MAY RE-EXAMINE FINDINGS
If Dr Kelly died neither from haemorrhage nor overdose, how did he die? Did his heart condition play a part? Or were the items found at the scene of death – the knife, the packets of pills, the bottle of Evian water – not evidence of suicide as is widely assumed, but a false trail left in an attempt to cover up the scientist’s murder? Nicholas Gardiner, coroner at the original inquest, has spoken of resuming the inquest after studying the Hutton Report. If the inquest does re-open, let us hope it scrutinises much more closely Dr Hunt’s conclusions as to the cause of Dr Kelly’s death.
Contact Rowena Thursby at:
RowenaThursby@onetel.net.uk
Comment from medical specialists especially welcome.
The following letter was requested by Seumas Milne of The Guardian.
Three highly qualified medical professionals dispute that Dr Kelly could have bled to death from a slashed wrist, as claimed at the Hutton Inquiry. This should be a BIG STORY - but media silence is utterly deafening.
Will he, won't he, will he, won't he.... will Mr Blair be affected by the Hutton Report - might he lose his job? The question of whether Dr Kelly's death was suicide or murder continues to be ignored in favour of political tittle tattle.
Rowena Thursby
27 January 2004
Dear Letters Editor,
THREE DOCTORS DISPUTE HOW DR DAVID KELLY DIED
As medical professionals, a trauma & orthopaedic surgeon, a specialist anaesthesiologist, and a diagnostic radiologist, we do not think evidence given at the Hutton Inquiry has demonstrated that Dr David Kelly committed suicide.
Dr Nicholas Hunt, the forensic pathologist who appeared at the Hutton Inquiry, concluded that Dr Kelly bled to death from a self-inflicted wound in his left wrist. We consider this highly improbable. Arteries in the wrist are of matchstick thickness and severing them does not lead to drastic blood loss. Dr Hunt stated that the only artery that had been cut - the ulnar artery - was completely transected. Complete transection means the artery quickly retracts, promoting clotting of the blood:
"When an artery is completely divided, the highly elastic quality of its wall causes it to retract into the tissues, thereby diminishing the calibre of the vessel and promoting clotting."
(A Textbook of Surgery by Christopher, Fourth Edition, 1945, p210)
It was reported by the ambulance team that blood at the scene was minimal. It is extremely difficult to lose significant amounts of blood at pressure below 50-60 systolic in a subject who is compensating by vaso-constricting. To have died from haemorrhage, Dr Kelly would have had to lose 3 litres of blood; in our view it is unlikely that Dr Kelly would have lost more than a pint from the wound described.
Mr Alexander Allan, the toxicologist testifying at the Inquiry, considered the ingestion of co-proxamol insufficient to cause death. Mr Allan could not show that Dr Kelly had ingested the 29 tablets said to be missing from the packets found. Only a fifth of one tablet was found in his stomach. Although levels of co-proxamol in the blood were higher than therapeutic levels, Mr Allan conceded that the blood level of each of the drug’s two components was less than a third of what would normally be found in a fatal overdose.
In summary, we dispute that Dr Kelly could have died either from haemorrhage or from co-proxamol ingestion. The coroner, Nicholas Gardiner, has spoken in recent days of resuming the inquest into Dr Kelly’s death. If it does re-open, a clear need exists for further scrutiny into Dr Hunt’s conclusions regarding the cause of death.
Yours sincerely
David Halpin, MB BS FRCS
Trauma & Orthopaedic Surgeon
Dr C Stephen Frost, BSc, MB ChB
Specialist in Diagnostic Radiology (Stockholm, Sweden)
Dr Searle Sennett, BSc, MBChB, FFARCS
Specialist Anaesthesiologist
Please also see:
THE HUTTON REPORT – A COVER-UP?
An Open Letter to the U.K. Public (and media)
http://debateusa.com/featured/jrarey.htm
Dr Kelly 'did not kill himself'
http://www.femail.co.uk/pages/standard/article.html?in_article_id=206680&in_page_id=2
Experts question Kelly 'suicide'
http://www.itv.com/news/429586.html
Coming Storm, by Gordon Thomas
http://www.guerrillanews.com/intelligence/doc3813.html
The Alternative Hutton Report
http://www.stopwar.org.uk/release.asp?id=200104