Dr Kelly's Death: We're After The Truth
Dr Kelly's Death: We're After The Truth
Submission From Rowena Thursby
Professor Chris Milroy had this letter - "Fantasists and Dr Kelly" - published in the Guardian (see below, top) hot on the heels of a letter - "Medical Evidence Does Not Support Suicide by Kelly" - by medical specialists from the Kelly Investigation Group. (See below, bottom). Vikram Dodd, a journalist from the Guardian, had previously responded with an article countering our message, and quoting Milroy. We might be forgiven for wondering if the Vikram Dodd article, and this Milroy letter were linked.
Milroy failed to declare here that he is more than a university professor, and is in fact a Home Office pathologist, employed by the British government. The forensic pathologist at the Hutton Inquiry, Dr Nicholas Hunt, was also a Home Office pathologist. I'll leave you to read between the lines. - Rowena Thursby
Five Letters To The Editor From The Guardian Follow:
Fantasists and Dr Kelly
Saturday February 14, 2004
Andrew Rouse and colleagues (Letters, February 12) say Hutton was wrong to conclude Dr Kelly took his own life. They do this by ignoring the clear autopsy evidence and yet present no evidence that another party was involved in Dr Kelly's death. They challenge the very idea that slitting the wrists can cause death, ignore the toxic dose of coproxamol present and dismiss Dr Hunt's finding of ischaemic heart disease. A reading of the evidence shows Dr Kelly had tentative marks to the wrists, typical of self-infliction. He had evidence of ischaemic heart disease, which Dr Hunt said may have played a part and put it in his cause of death. He also said the dextropropoxyphene may have killed him, if he had not haemorrhaged from his wrists. Dextropropoxyphene is a dangerous drug in overdosage. It also has direct effects on the heart, a fact pointed out by Dr Allan in his evidence and important in the context of Dr Kelly's heart disease. The concentration recorded in Dr Kelly was in the toxic range, according to several different textbooks (such as Clarke's Analysis of Drugs and Poisons).
I would not recommend Rouse and his colleagues taking 29 tablets of coproxamol. They will end up in my colleague's mortuaries. There is more than enough objective evidence to account for the unfortunate Dr Kelly's self-destruction. The evidence for his murder lies only in the minds of fantasists.
Prof Christopher Milroy
Professor of forensic pathology, University of Sheffield
Medical evidence does not support suicide by Kelly
Thursday February 12, 2004
Since three of us wrote our letter to the Guardian on January 27, questioning whether Dr Kelly's death was suicide, we have received professional support for our view from vascular surgeon Martin Birnstingl, pathologist Dr Peter Fletcher, and consultant in public health Dr Andrew Rouse. We all agree that it is highly improbable that the primary cause of Dr Kelly's death was haemorrhage from transection of a single ulnar artery, as stated by Brian Hutton in his report.
On February 10, Dr Rouse wrote to the BMJ explaining that he and his colleague, Yaser Adi, had spent 100 hours preparing a report, Hutton, Kelly and the Missing Epidemiology. They concluded that "the identified evidence does not support the view that wrist-slash deaths are common (or indeed possible)". While Professor Chris Milroy, in a letter to the BMJ, responded, "unlikely does not make it impossible", Dr Rouse replied: "Before most of us will be prepared to accept wristslashing ... as a satisfactory and credible explanation for a death, we will also require evidence that such aetiologies are likely; not merely 'possible'. "
Our criticism of the Hutton report is that its verdict of "suicide" is an inappropriate finding. To bleed to death from a transected artery goes against classical medical teaching, which is that a transected artery retracts, narrows, clots and stops bleeding within minutes. Even if a person continues to bleed, the body compensates for the loss of blood through vasoconstriction (closing down of non-essential arteries). This allows a partially exsanguinated individual to live for many hours, even days.
Professor Milroy expands on the finding of Dr Nicholas Hunt, the forensic pathologist at the Hutton inquiry - that haemorrhage was the main cause of death (possibly finding it inadequate) - and falls back on the toxicology: "The toxicology showed a significant overdose of co-proxamol. The standard text, Baselt, records deaths with concentrations at 1 mg/l, the concentration found in Kelly." But Dr Allan, the toxicogist in the case, considered this nowhere near toxic. Each of the two components was a third of what is normally considered a fatal level. Professor Milroy then talks of "ischaemic heart disease". But Dr Hunt is explicit that Dr Kelly did not suffer a heart attack. Thus, one must assume that no changes attributable to myocardial ischaemia were actually found at autopsy.
We believe the verdict given is in contradiction to medical teaching; is at variance with documented cases of wrist-slash suicides; and does not align itself with the evidence presented at the inquiry. We call for the reopening of the inquest by the coroner, where a jury may be called and evidence taken on oath.
Public health consultant
Specialist in anaesthesiology
Specialist in trauma
Specialist in radiology
Dr Peter Fletcher
Specialist in pathology
Specialist in vascular surgery
TODAY, IN THE GUARDIAN:
Questions still unanswered over Dr Kelly's death
Thursday February 19, 2004
Professor Christopher Milroy refers three times (Letters, February 14) to "wrists". While slitting all four wrist arteries (two in each wrist) and then sitting in a warm bath may allow a person to commit suicide, Dr Kelly had only one completely severed artery and no warm bath. The dose of Coproxamol was an overdose over therapeutic levels but not, by a factor of three, a lethal dose. If Dr Kelly did take 29 tablets, why were the contents of his stomach consistent with only one-fifth of a tablet? If the suggestion is that Dr Kelly vomited, then where is the vomit analysis that shows this? No analysis was presented to Hutton. Clearly, also, if the stomach contents were vomited up, this would reduce the amount of the drug in Dr Kelly's body.
The arguments discussed by Professor Milroy are only a small part of the picture. There is considerable circumstantial evidence surrounding the disappearance, death, and discovery of Dr Kelly that also raise suspicions. I have written a detailed letter to Nicholas Gardiner (the Oxfordshire coroner) outlining my concerns over this.
The fact that Dr Kelly's ulnar artery was completely severed makes it even less likely that bleeding would have been sufficient to cause his death, as a small, completely severed, wrist artery quickly retracts and narrows, promoting blood-clotting. The scratches to the wrist Professor Milroy refers to neither support suicide nor refute the possibility of murder made to look like suicide.
We did not ignore "the toxic dose" of Coproxamol (Letters, February 12): we referred to the toxicologist's statement that the amount of each drug component found in the blood was a third of what is normally considered fatal. As for "ischaemic heart disease", while Dr Hunt, in his report to the Hutton inquiry, noted some hardening of the arteries - common in men of Dr Kelly's age - he stated he could not find evidence of a heart attack.
At the Hutton inquiry, crucial pieces of forensic evidence were missing: it is not clear whether or not a full battery of tests was done on the lungs, the blood, the heart and the soil. Dr Hunt's report, for instance, did not provide information on an estimated residual blood volume. If Dr Kelly lost significantly less than five pints of blood, then haemorrhage could not have been the cause of death.
If people are to be convinced beyond reasonable doubt that Dr Kelly did die in the manner described to Hutton, a full set of test results should be produced - preferably at a full inquest where a jury is called, witnesses subpoenaed and evidence given on oath.
Dr Andrew Rouse
And five other medical specialists
Wrist-slashing suicide is so rare that the Office of National Statistics does not report it as a specific cause of death; it is subsumed into "suicide and self-inflicted injury by cutting and piercing instruments"; there are about five male cases a year. All Professor Milroy has to do is to produce a single actual example, to show that even the very unusual does happen from time to time.