Saturday, 30 June 2012

The mobile phone was switched off

ACC Page is asked at the Inquiry about whether the mobile phone was switched on or off when it was discovered in the pocket of the Barbour jacket.  His reply:

My recollection is that when found it was off.

The first of the five people who tried to ring Dr Kelly was John Clark.  He is clear that he had an electronic response that was proof of the phone being turned off.  Similarly the last of the five, Olivia Bosch also got an electronic response but the detail is hazy as to the nature of this message.  James Harrison and Bryan Wells it seems each rang with no response as if perhaps the phone was on but not being answered; their attempts to call Dr Kelly were only ten minutes apart.  Rachel Kelly simply says 'I could not reach him on his mobile phone'  

Are these variations in response indicative of some quirk with mobile phones ... that sometimes the electronic response cuts in quickly and on other occasions you have to wait for a considerable number of rings.  In the latter circumstance the caller might ring off too early.  I don't know enough about this subject to know whether this can happen but otherwise it appears possible that the phone was turned off, then turned on by Dr Kelly (or a third party) but with incoming calls ignored and finally turned off. 

Paragraphs 2, 3 and 4 from Annex TVP-5 supply a little more illumination: 

2. At a meeting held at 5.00am on Thursday 17th July 2003 cell site data was ordered on the mobile telephone of Dr Kelly in an attempt to pin point its location.  Unfortunately the phone was switched off so cell site data could not be retrieved.  Following the discovery of Dr Kelly's body his mobile phone was found, turned off, in his coat pocket.

3. At that time cell site techniques were not as advanced as they are now and technicians were unable to trace when the mobile last accessed the network (or where) as there had not been live cell site tracing on the phone at the time. 

4. Technicians were able to say that mobile communications were operating correctly in the Longworth area on the 17th and 18th July although one sector was showing slight congestion on the afternoon of the 18th. 

The date quoted in paragraph 2 is meant to be "Friday 18th July" I imagine.  Perhaps the "congestion" mentioned in paragraph 4 resulted from intense media use of the airwaves that afternoon.

Normally Dr Kelly was well known as a person always contactable because he kept his mobile phone on.  Therefore goes one argument he set off to commit suicide by keeping his phone off so that he couldn't be contacted or his location known.  My counter argument to this is why take his phone at all.  We know that the phone wouldn't have already been in the jacket because the last outgoing call was at 12.58 that day, a time according to Mrs Kelly's testimony when he was at their home.

Perhaps Dr Kelly took his phone as he normally would on his walks but decided to leave it turned off.  From his perspective he might have thought that his last conversation with John Clark shortly before 3 o'clock had finally wrapped up all the points he had had to deal with and that he needed a walk uninterrupted by telephone calls to try and wind down from what had been a tumultuous and stressful week.  Speculation on my part?  Certainly.  I don't think it's possible to come to any definitive explanation as to why, unusually, the mobile phone was switched off.

Friday, 29 June 2012

The mobile phone and James Harrison

At this point I need to make a correction, thinking that I had mentioned all those known to have rung the mobile.  In the late afternoon of 17 July John Clark had to go to an appointment with the optician.  A colleague, James Harrison, made one further attempt to ring Dr Kelly's mobile and this is Mr Harrison answering Mr Knox's questions on 27 August:

Q. Did you try to call Dr Kelly on his mobile?  
A. Yes. John had left at, as I say, around 5 o'clock and he had tried to ring -- he had spoken to Mrs Kelly shortly before that. I was very conscious of the need  to get the balance right. On the one hand, we had to try to answer these questions and the letter fully and accurately on that day if we could. At the same time, I did not want to be bothering Mrs Kelly on the phone or David indeed unnecessarily soon, when there were already messages for David to ring back.  
Q. When you rang Dr Kelly's mobile phone -- 
A. Yes.
Q. -- what was the response? Was it dead, completely dead or was there any electronic voicemail?
A. My recollection is it rang and was not answered and I rang at about 10 to 6 or thereabouts.
Q. I think we heard from Wing Commander Clark that when he tried calling there was an automated response.
A. Yes.

Q. You say when you tried it was simply ringing and there was no automated response?
A. Yes. We discussed this issue the following day, the Friday.   Bryan Wells was in the office and that was after it had been announced by the police that David Kelly was missing. We compared noting on our telephone conversations. I think Bryan Wells had tried shortly after I had and at that time on the Friday morning my clear recollection was that I had rung his
mobile number and that the phone had rung but not been answered.
Q. And you may already have said, what was the precise time as far as you can tell that you first tried to get hold of the mobile?
A. At around 10 to 6. That was the only time. 

From the above it seems as if Bryan Wells had also tried to contact Dr Kelly but to no avail.

The "questions" referred to in the testimony will be the subject of a later post.

The mobile phone - Freedom of Information request

I note this Freedom of Information request and response on the Thames Valley Police website:

This request, reference RFI2010000133, was received on Monday 08 November 2010, 10:48am.
1) At what time was Dr Kelly’s mobile phone last operating and did it cease operating because it was switched off or because it was damaged? 2) Was it damaged or undamaged when found by police officers? 3) At what time was it last operating? 4) Can you confirm at what time the last call from the mobile was made, and at what time the last call to the mobile was made, and what the location of Dr Kelly was on the occasion of those two calls, giving the grid reference or similar.
1) We do not hold information as to when Dr Kelly’s mobile telephone was last operating.
2) There were no signs of damage to the phone.
3) See response to point 1.
4) Last outgoing call was at 12.58hrs on 17/7/2003.
Last incoming call was at 19.18hrs on 16/7/2003.
We do not hold information about the location of Dr Kelly at the time the calls were made.

From reading the official narrative it seems quite likely to me that the 19.18 time was a call to her husband from Mrs Kelly who had come up to Oxford by train that day from Cornwall and arrived in the evening.

The 12.58 time for the last outgoing call from the mobile is interesting.  Mrs Kelly's testimony has her husband sitting in the sitting room at about 12.30.  At some stage they have some sandwiches and after that Mrs Kelly developed a huge headache ... she went upstairs to lie down, something she said she quite often would do because of her arthritis.  The timing she gave for this was 'about half past 1, quarter to two perhaps' .  Mrs Kelly also says in relation to her headache that she was physically sick several times so it's not inconceivable that, unknown to her, her husband used his mobile while he was in the sitting room and she had gone to the toilet.

I have no idea as to the recipient of the 12.58 call.

The mobile phone - Rachel Kelly and Olivia Bosch

Apart from John Clark, whose relevant testimony is in my last post, at least two other people tried to contact Dr Kelly on his mobile after he left home: daughter Rachel Kelly and colleague Olivia Bosch.

In her evidence we have this from Rachel:

Q. I think you came and helped look for your father?
A. I did, yes. I came over -- Mum told me that Dad had gone for a walk; and we are actually quite a private family and I assumed that after all he had been through he would want to find some solitude, which I quite understood. I thought he had perhaps gone for a walk down to the river. I could quite understand that need in him. So initially I did not worry. But When he then -- I could not reach him on his mobile phone, which did make me worry because I could always reach him.  I then dashed home and was talking to my sisters. Mum actually was not very well and I was torn between leaving Mum and going to look for Dad.

This is part of Olivia Bosch's testimony for 17 July:
Q. Did you have any other conversation with him?
A. No. That evening I tried to call him because I had called him -- we called -- we spoke with each other every day and after the Channel 4 News I tried to telephone him. His land line did not have the answer machine on so I thought maybe there was a problem in the village as before. I tried his mobile phone and some message came up to the effect that the line was not working or you could not get through, or something to that effect.
Q. Just pausing there for a moment. This may be significant. You are sure that the phone just did not keep ringing but there was actually a message that came up on the mobile phone?
A. Yes, yes.
Q. Can you recall roughly what time it would have been that
you tried to call him on his mobile phone?
A. It was after the Channel 4 News, so about 7.45 or so that night. So I would have talked about the news coverage of the day with respect to what was going on.
Q. Did you try again later that evening or just that one time?
A. I just tried that one time. I assumed from our conversation that morning he was finding time to himself.

I don't know whether Mrs Kelly had tried phoning her husband, I've not found anything on the Hutton website to say one way or the other.

The mobile phone - John Clark evidence

After Dr Kelly left his home on the afternoon of 17 July his colleague Wing Commander John Clark repeatedly tried to contact him on his mobile phone:

Q. At what time did you attempt to ring Dr Kelly?  
A. It was -- I have since been told by the police -- I thought it was close to 3 o'clock but it was about 3.20, and I was told by his wife who answered the telephone that Dr Kelly had gone for a walk at 3 o'clock.  
Q. Can you recall what the last telephone conversation you actually had with Dr Kelly was before that attempt to get hold of him? 
A. Yes, I had a call with him which was just before 3 o'clock. Again I thought it was earlier but we have been able to track that down from investigating my log of e-mails and the telephone log that the police were able to provide. So about 6 or 7 minutes before 3 o'clock was the last conversation. That was the one where we discussed Susan Watts and the business cards.
Q. When you say Susan Watts, i.e. appearing in the body of the text?  

A. Absolutely right. So that had been agreed. 
Q. And after you had not been able to get hold of Dr Kelly, what did you do?  
A. I was surprised that I could not get two-way with him because he was always very proud of his ability to be contacted. He took his mobile phone everywhere. I do not mean to be light-hearted but an example of that was that one day I rang him up and I could hardly hear what  he was saying because he was on his lawnmower cutting his grass. But that is the sort of man he was; he was always contactable. So on this occasion when I rang him I asked his wife in the first instance when she said he went for a walk, did he have his mobile, and she did not  know. I rang and it was switched off and I was very surprised that it had been switched off.  
Q. When you say it was switched off, did you get any message?
A. Yes, I got an electronic voice saying: the number you have rung is not reacting. Which is the normal one that one would associate if the telephone itself had been switched off.
Q. After you had not been able to get hold of Dr Kelly on the mobile then, did you try again?
A. I rang his wife because clearly I needed to get the staff work taken forward and I needed to speak to Dr Kelly. I spoke to her and said I had not been able to contact Dr Kelly on his mobile and I thought she might say something but she was quite matter of fact and said, you know -- did not really record the fact. 
I then said: could you ask Dr Kelly when he returns, could he give me a ring. That is how the message was left with his wife.  
Q. Did you try to get hold of Dr Kelly again? 
A. Yes, I did. I hoped that he would perhaps switch on his mobile so I probably tried about every 15 minutes for the remainder of the time. I left the Ministry of Defence at about 10 to 5 because I had an optician's appointment and then handed over responsibility to my  colleague, James Harrison.  
Q. Did you get the same message every time you rang the mobile? 
A. Yes. It was never switched on. 

Journalist Tom Mangold argues that the repeated attempts by John Clark to contact Dr Kelly is evidence of Kelly's intention to commit suicide.  Discussion of this will have to wait though.

The mobile phone - finding and testing

When Dr Hunt checked the pockets of Dr Kelly's Barbour jacket at the scene he finds, among other things in the front bellows pocket, a nokia mobile phone.  In his first visit to the Inquiry on 3 September ACC Page refers to items found by Dr Hunt and says:

A. Again when the body had been moved he found Dr Kelly's mobile phone.
Q. Do you know whether that was on or not?
A. My recollection is that when found it was off.

A pouch for a mobile phone was also found on the body; this will be discussed in a later post. 

Mr Green states that he received swabs from the mobile phone in his laboratory on 28 July and reports as follows:

Mobile telephone: Swabs from the ear area (SART.1) and the mouth area (SART.2) of the mobile telephone, which was recovered from the jacket pocket, were examined for the presence of bloodstaining but none was found.  Attempts to obtain an STR profile from these swabs were unsuccessful.

On 29 July the mobile phone (and other items) were tested by Fingerprint Development Technician Rennee Gilliland but no marks were recovered from it.

Further testing is described in Annex TVP 5 on the Attorney General's website

The mobile phone was tested by police officers on the 17th September 2003 to check it was functioning correctly.  To achieve this officers took the phone back to Harrowdown Hill and performed several functions to ensure the phone was operating correctly.  The phone was undamaged and in working order.  

It's an interesting time gap between fingerprint checking and seeing if the phone was operational ... almost as if this last mentioned procedure was a late afterthought.

Wednesday, 27 June 2012

A contact email address

I had stipulated very early in this blog that comments on posts should relate to the particular subject matter within the post.  However I appreciate that someone might wish to discuss some other point regarding this mysterious death or just might feel inhibited about making a public comment.  If this is the case then there is the option of contacting me via this email address:  Please feel free to use it.

The co-proxamol (7)

A comment on my last post asked if it was believable that Dr Kelly never took a tablet.  I think that this question deserves a totally new post from me.

The medical term for difficulty with swallowing is "dysphagia" and more can be read about it here  I believe in Dr Kelly's case it has been suggested that he didn't have any apparent difficulty in swallowing food, his dysphagia was confined to swallowing tablets.  This sounds like a very unusual condition but I have had the odd occasion when I have found it extremely difficult to swallow a tablet, almost to the extent of giving up.  Personally I'm not particularly keen on taking tablets but there are occasions when one just needs to do so.

If Dr Kelly did have an aversion to taking tablets the question to be asked is whether he just didn't like the idea of taking a medicine or was there a physical difficulty that stopped him so doing.  This is part of a report by Sharon Churcher in the Mail on Sunday relating how Dr Kelly's confidante Mai Pederson was surprised to hear that he had taken an overdose of co-proxamol:

Ms Pederson’s Washington DC lawyer, Mark Zaid, has made available to The Mail on Sunday parts of her final statement to Thames Valley Police, given on September 1, 2003.

Its ten pages would appear critical, since they describe Iraqi death threats and the incident with the laser. She also stated that she was bewildered about how Dr Kelly could have taken an overdose, as he suffered from a disorder that made it difficult for him to swallow pills.
‘I was so confused when I heard he had swallowed a load of painkillers,’ she told the officers.

It sounds to me then that it was difficult rather than totally impossible for him to swallow pillsRegarding the anti-malarial drug "Paludrine" commented on following my last post that seems to be supplied in tablet form usually from a quick look at internet entries about it.  If Dr Kelly was suffering from a limited form of dysphagia it might be something that he didn't discuss with the family.  Dr Warner's testimony suggests that it was in 1994 that he last prescribed medication for Dr Kelly: this may not have been tablets necessarily, it could have been a skin ointment for example.  We just don't know.

In summary, we really aren't informed enough about possible dysphagia in the case of Dr Kelly.  If Ms Pederson had informed detectives about Dr Kelly having problems with swallowing tablets then Hutton was remiss in not investigating further in open court.
It was Hutton incidentally who asked the police to go to America to talk to Mai Pederson.


Monday, 25 June 2012

The co-proxamol (6)

Now I want to highlight a few miscellaneous points not covered in the previous five posts.
  • Why was one tablet left?  If Dr Kelly had managed to swallow 29 tablets with 78% of the water (assuming a full bottle to start with) then I'm sure that there was enough water left for the final tablet.
  • Why didn't Dr Kelly buy a half bottle of whisky say in the village instead of taking water with him.  Alcohol is much much more lethal in combination with co-proxamol than water.
  • The fingerprint technician (Renee Gilliland) has to record ANY marks even if they don't appear to be usable If Dr Kelly swallowed 29 tablets then one is looking at 29 thumb/finger movements to extract the tablets.  The blister packs were found in the Barbour jacket so protected from the elements.  I really can't believe that Dr Kelly would have left no marks whatsoever.  This comment needs some qualification in fact because one of the blister packs was kept for DNA testing so only two were checked for fingerprints.  In that respect 29 should be replaced by 19 ... still an unbelievable scenario.
  • Regarding the DNA testing of one blister pack Mr Green says in his report  A full STR profile matching that of Dr Kelly was obtained.  It's not inconceivable in my opinion that the pack aquired Dr Kelly's DNA through being in the pocket of his Barbour jacket.
  • Schedule of responses to issues raised number 33 concerns post mortem changes in drug levels  This is part of the response:  The number of pills ingested is only of relevance to cause of death if there were evidence to suggest that the drug was introduced into his body in some other way.  There is no such evidence.  It could also be argued that there is no evidence that the drug wasn't introduced into his body in some other way.  As previously pointed out it's possible that the damage to Dr Kelly's lip happened as a result of the insertion in his mouth of a gastric tube.  Perhaps the injury complex on the left wrist masked an injection site.  I'm not saying I have proof on any of this but it's wrong for the official response to be so dismissive.
  • In the response to issue 18 we read: Mrs Kelly stated that her husband would never take any sort of tablet, not even for a headache but that he was aware that she was prescribed co-proxamol as a painkillerSimilarly in 44 there is reference to Mai Pederson giving details to Thames Valley Police of Dr Kelly's avoidance of taking pills.  From a press article we learn that Ms Pederson has also said that Dr Kelly had in fact a physical problem in swallowing pills.  If TVP were aware of this then they are clearly guilty of covering up the fact.  Hutton should have investigated why Dr Kelly had an aversion to taking pills.  Yet again he failed to perform his task with due diligence.

Sunday, 24 June 2012

The co-proxamol (5)

The interview by Antony Barnett of the two ambulance team for the Observer of 12 December 2004 has plenty of interesting information

At one point Dave Bartlett says: I remember saying to one of the policemen it didn't look like he died from that [the wrist wound] and suggesting he must have taken an overdose or something else.

I have already mentioned number 18 in the schedule of responses to issues raised  This is part of it:

Following the discovery of Dr Kelly's body a search was made of his house.  Mrs Janice Kelly was present and was asked to show officers any medicines in the house.

Whether at that time Mrs Kelly felt there were any of her medicines missing I don't know; the only slight hint is her reply to Dingemans that she 'assumed' that the blister packs found on the body had come from her supply.

At the Inquiry there is this interesting commentary by PC Franklin responding to Mr Dingemans:

Q. When the forensic kit arrives and you start doing the fingertip search, do you start on the common approach path?
A. I actually, as police search adviser, do not do the search; that was run by PC Sawyer.
Q. You watched them all doing it for you?
A. Some of the time. As police search adviser I have to
liaise with the senior officers about the policies for the search and what we hope to get out of it, so I was backwards and forwards.
Q. What were you hoping to get out of this search?
A. We have to speak to the DCI initially and he wanted us to look for -- if again I may refer to my notes -- medicine or pill bottles, pills, pill foils or any receptacle or bag that may contain medicines.
Q. You are doing a search for that. Are you also looking for anything else?
A. Yes. The police search teams I work with would pick up anything that would be dropped by a human or out of the ordinary. Those are the items that were just specified to us, but as a search team we tend to look for anything that should not be there.

It is strange isn't it that DCI Young makes that specific point that I have highlighted.  Did DCI Young go to Harrowdown Hill via the Kelly home at Southmoor?  Assuming that he was appointed the Chief Investigating Officer by ACC Page shortly after the body discovery then it seems that it was another two and a half hours approximately before he arrived at the scene.

The co-proxamol (4)

In 2003 Mrs Kelly was taking prescription co-proxamol to relieve the pain of her arthritis.  When Dr Kelly's GP, Dr Warner, was examined by Mr Knox at the Inquiry there is this exchange:

Q. Did you ever have to prescribe Coproxamol to Dr Kelly?
A. No.

If Dr Kelly had ingested co-proxamol tablets then his wife's supply would be the most obvious source, particularly, as I understand things, co-proxamol was available prescription only.

Mr Dingemans questioned Mrs Kelly about the co-proxamol:

Q. Do you take any medicine?
A. I do. I take co-proxamol for my arthritis.
Q. I think we are also going to hear that appears to be the source of the co-proxamol that was used.
A. I had assumed that. I keep a small store in a kitchen drawer and the rest in my bedside table.

That highlighted question was one of the most disgraceful in the whole of the Hutton Inquiry!  It seems to me that Dingemans was trying to nudge Mrs Kelly towards a favourable answer, he must have known that nobody would know for sure about the source of the co-proxamol or would give evidence about that.  He should have asked Mrs Kelly whether she had noticed any missing from her supply.  She was making an assumption, not certain how much she had perhaps.

We aren't told at the Inquiry how much co-proxamol Mrs Kelly had in her home.  However the responses to issues raised schedule does have an answer at number 18

Subsequent to the body being found there were 4x10 packs in her bedroom drawer and, in the kitchen drawer, a full box of 10x10.  One would think, assuming the removal of 3 packs in one go, that she might have noticed that amount of depletion from her stock.  Although the full pack had come from the "White Horse Medical Practice" I'm aware of the fact that she had been getting supplies of the drug from a high street chemist.  My guess is that the Medical Practice had recently set up their own dispensary, a not unusual circumstance. 

As can be seen from this witness statement dated 11 November 2003 from DC Eldridge the manufacturers of the co-proxamol were approached regarding the batch numbers of the tablets.  It looks as if DC Eldridge might well have been posing the wrong question, certainly he is quoting the "product licence" number in his statement rather than a batch number.  The subject is covered in this blog post by Dr Andrew Watt

The co-proxamol (3)

The two substances that make up co-proxamol, paracetamol and dextropropoxyphene, were found in Dr Kelly's body.  Three blister packs of co-proxamol, originally ten in each pack but with just one tablet remaining were found in a pocket of the Barbour jacket Dr Kelly was wearing when the forensic specialists were at the scene.  So originally 30 tablets available, one left, that means Dr Kelly swallowed 29 tablets.  Yes?  No, not necessarily.

That the constituents of co-proxamol were found in the body is clear I believe.  At the end of his testimony at the Inquiry there is this exchange between Dr Allan and Lord Hutton:

LORD HUTTON: Mr Allan, if a third party had wanted paracetamol and dextropropoxyphene to be found in Dr Kelly's blood is there any way that the third party could have brought that about by either persuading or forcing Dr Kelly to take tablets containing those two substances?
A. It is possible, but I think it would be --
LORD HUTTON: That is the only way that those substances could be found in the blood, by taking tablets
containing them?
A. Yes, he has to ingest those tablets.
LORD HUTTON: Yes. Thank you very much indeed.

Why did Hutton stop Dr Allan answering his first question?  Then Dr Allan finishes up by telling an untruth:  The components of co-proxamol could have been injected into the body.  Alternatively the tablets could have been crushed and fed by a tube.  Dr Hunt reporting on the mouth writes:  There was a small abrasion consistent with contact against the teeth or biting of the lips on the lower lip on the lipline.  This was approximately 0.6 x 0.3 cms.  There was no significant vital reaction.  Later, at conclusion 16, is this:  The minor injury to the inner aspect of the lip is not associated with bruising nor damage to teeth and does not appear to have any well-developed vital reaction.  This sort of injury may be caused if the tissues of the mouth are bitten.  His deduction may be correct but would this injury to the lip also match the insertion of a tube in his mouth, particularly if Dr Kelly had been incapacitated.

If Dr Allan's last answer in the quoted extract above really had been correct that would have strongly enhanced the suicide hypothesis in my opinion.  Was the "suicide" faked?  If so a lot of trouble was taken over it.  

The co-proxamol (2)

In my last post I reproduced those parts of Dr Hunt's final report relating to the co-proxamol.  I also flagged up the fact that in his initial report of 19 July Dr Hunt hadn't seemingly included co-proxamol ingestion as a factor in the cause of deathWe know from a statement of forensic toxicologist Dr Allan dated 21 July 2003 that certain items from Dr Kelly's body were received at his laboratory on Saturday 19 July

With the post mortem being completed at 00.15 on the 19th the fact that various items were sent to the laboratory on the same day at least shows a commendable desire to get things done.  Looking at what Dr Allan had to say at the Inquiry he did his testing that Saturday morning.   However the test results given in the 21 July report together with the testimony given by Dr Allan at the Hutton Inquiry gave cause for concern in as much that it seemed that the amount of testing was inadequate.  It wasn't until eight years later, on 9 June 2011, that it was discovered that Dr Allan produced two further reports on 18 August 2003 and 17 September 2003  and respectively.  The last mentioned concerned a blood sample NCH/47 sent to the Royal Hallamshire Hospital in Sheffield and I don't know that that document is particularly relevant to possible co-proxamol ingestion.

Dr Allan's report of 18 August (the same day as the Registrar recorded the cause of death of Dr Kelly) details the examination for any contaminants in the liquid in the Evian bottle.  Dr Allan also says: The stomach contents (item NCH/49) was further analysed for dextropropoxyphene, and the vitreous humour (plain - item NCH/53) for this and for paracetamol.  The "missing" results in the 18 August report weren't discussed at the Hutton Inquiry.  There is no evidence that either Hutton or the coroner Nicholas Gardiner saw Dr Allan's second or third reports, certainly they weren't listed in the evidence tab on the Inquiry website.  This may be cock up rather than conspiracy ... perhaps it demonstrates the lack of medical background, or just a lack of concern, on the part of both Lord Hutton and Mr Gardiner.

The apparent failure to test the stomach contents for dextropropoxyphene was an issue raised with the Attorney General.  See number 25 here for the response to this:  If the 18 August statement was before the Inquiry why wasn't it listed and discussed?

Dr Allan states that he had to estimate the amount of dextrpropoxyphene in the stomach contents.  Why couldn't that have been done for his 21 July report?  Similarly the vitreous humour was among the items received on the 19th July for testing.  The lab didn't receive the decanted liquid from the Evian bottle until 25 July so some delay in that result was inevitable.  It seems ridiculous to me that the stops were pulled out to carry out some initial testing but then there was a delay of almost a month before the second report was produced.  

The question that has to be asked is whether this seemingly haphazard approach to testing and reporting in the forensic industry is widespread.

The co-proxamol (1)

Before examining the evidence relating to the co-proxamol I think it's worth reminding ourselves first of all about Dr Hunt's conclusions on the subject.

  • A green 'Barbour' waxed jacket, which was undone at the zip and buttons at the front.  A mobile telephone, pair of bi-focal spectacles, a key-fob and a total of 3 blister packs of co-proxamol (10 packs) were found in the bellows pocket on the front right panel of the jacket.  Only one co-proxamol tablet remained in its blister pack.
At the time of completing this report, I have been provided with the following verbal information by Dr Alexander Allan, a forensic toxicologist from Forensic Alliance Limited.
  • The blood sample contains the drug dextrpropoxyphene at a concentration of 1.0 micrograms per millilitre.
  • The blood sample contains the drug paracetamol at a concentration of 97 micrograms per millilitre.
  • Paracetamol is present in the stomach contents.
  • No alcohol has been detected.
In addition, I have been provided with a copy of the formal statement of Dr Allan dated 21 July 2003 (21/07/2003) and given the laboratory reference FAL-05969-03.

The levels of dextropropoxyphene and paracetamol in the blood were confirmed as above.


12. Given the finding of blister packs of co-proxamol tablets within the coat pocket and the vomitus around the mouth and floor, it is an entirely reasonable supposition that he may have consumed a quantity of these tablets either on the way to or at the scene itself.

13. The toxicology result indicates that prior to his death he had consumed a significant quantity of these tablets.  The active ingredients of co-proxamol are paracetamol and dextropropoxyphene.  The absolute levels of paracetamol and dextropropoxyphene in the blood are not particularly high and may not ordinarily have caused death in their own right.  In this particular case however, even these levels may be relevant as one must consider that dextropropoxyphene may cause death by its actions upon the heart leading to abnormalities of heart rhythm.  Such abnormalities of heart rhythm are made all the more easy to induce if there is hypotension (low blood pressure) as the result of bleeding and underlying narrowing of the coronary arteries.  In this case, both the latter factors would be operant.

14. Dextropropoxyphene is an opioid drug which is relatively rapidly absorbed into the blood following ingestion.  It has an analgesic effect and hence would be expected to deaden the perception of pain due to injury, particularly when taken in the sort of amount seen here which is above the normal therapeutic range.

25. In summary, it is my opinion that the main factor involved in bringing about the death of David Kelly is the bleeding from the incised wounds to his left wrist.  Had this not occurred he may well have not died at this time.  Furthermore, on the balance of probabilities, it is likely that the ingestion of an excess number of co-proxamol tablets coupled with apparently clinically silent coronary artery disease would both have played a part in bringing about death more certainly and more rapidly than would otherwise have been the case.  Therefore I give as the cause of death:

          1a.    Haemorrhage
          1b.    Incised wounds to the left wrist

          2.     Co-proxamol ingestion and coronary artery atherosclerosis  

The extract above is from Dr Hunt's final report of 25 July 2003.  He had made a preliminary report six days earlier on the 19th, in other words two days before Dr Allan's (first) formal statement.  In his opening statement on 1 August Hutton states:

37. A post-mortem examination was carried out by Dr Nicholas Hunt, a Home Office accredited forensic pathologist and his post-mortem report dated 19th July has been sent to me by the coroner. A toxicology report has also been sent to me by the coroner. The post-mortem report will be referred to in greater detail at a later stage in this Inquiry. However, it is relevant to state at this stage that it is the opinion of Dr Hunt that the main factor involved in bringing about the death of Dr Kelly was the bleeding from incised wounds to his left wrist. 
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Dr Hunt also states:  "It is noted that [Dr Kelly] has a significant degree of coronary artery disease and this may have played some small part in the rapidity of death but not the major part in the cause of death."   

Because he removed the three blister packs from the jacket pocket Dr Hunt ought to have considered at that time that co-proxamol might have been a contributor to the death.  Perhaps he did but on the 19th the toxicology results from Dr Allan wouldn't be to hand.  Therefore he, perhaps knowingly, produced a post mortem report that would likely have to be amended.  The subject of the production of more than one post mortem report by a pathologist is one that will have to keep for another day; here though we have the situation of Dr Hunt initially providing a report for the coroner in which he doesn't refer to co-proxamol ingestion in the "cause of death".  

Friday, 22 June 2012

Nicholas Rufford and Dr Kelly's heart disease

A few days ago I had written a couple of posts about Dr Kelly's heart disease  and

Since then I have read an interesting article in the Sunday Times of 25 January 2004 by journalist Nicholas Rufford.  A remark he makes somewhat contradicts what I wrote in the penultimate paragraph in the second link above.  This was my perspective:

A little over a week before his death Dr Kelly evidently got a clean bill of health from the MOD doctorFurthermore Dr Warner, Mrs Kelly and Rachel Kelly have nothing to say at the Inquiry about Dr Kelly having complained about any heart problem. There is no obvious evidence of Dr Kelly being aware of a problem of hardening of the arteries. 

Mr Rufford makes a short reference to Dr Kelly's heart condition.  To give it some sort of context I've included the text immediately preceding it:

Kelly's role diminished further after 1998, when UN inspectors were ordered out of Iraq because Saddam's officials were refusing to co-operate. As the months slipped by he was consulted less. The intelligence services were now the lead agencies on Iraq. Phone intercepts and satellite surveillance replaced the UN inspectors as the new sources of information.

With a gap in his life, Kelly spent some time in Monterey, California, with Mai Pederson, an Arab American linguist he had met in Iraq. Pederson introduced Kelly to the Bahai faith, an offshoot of Islam that preaches universal peace.

There was speculation after Kelly's death about their relationship but there was no evidence of anything deeper than friendship. Nevertheless, Kelly's marriage was complicated. He rarely mentioned to his wife his conversion to Bahai and he did not discuss his work with her.

Problems he had kept at arm's length came to the fore. He had high blood pressure and signs of heart disease.

He told me that it was partly to keep his doctor happy that he gave up drinking and became a Bahai

I won't go into the detail of how well Rufford knew Kelly at this juncture.  Suffice to say that it was clear from the Hutton Inquiry that they had met a significant number of times and conversed on a range of matters.  What has thrown me is the sentence that I have highlighted.

From the tenor of this and other articles he has written I get the sense that Dr Kelly might well have confided a health problem with Mr Rufford.  However in this instance I have a problem with what Rufford is saying.

So far as signs of heart disease is concerned Mr Rufford might merely be repeating what Dr Hunt had said four months previously at the Inquiry, in other words we still have no evidence of Dr Kelly being aware of a problem here.  But what of the 'high blood pressure'?  I hadn't been aware of any reference to this. 

From my own limited experience it seems that any visit to a doctor, particularly if the patient is of relatively mature years, will likely include a check on blood pressure.  Dr Kelly's MOD medical, carried out just a few days prior to his death, must surely have included a blood pressure check ... it seems unthinkable that such a check would be omitted.  I had highlighted this from the report by forensic pathologist Dr Richard Shepherd:

I note that in October 1983, 24 years before his death, David Kelly complained of angina (chest pain). (TVP/10/0122 - RJ 1/222).  This was self-diagnosed and his GP did not consider the pains to represent angina.  There are no further complaints of angina or any other evidence of cardiac disease in the medical notes.

Shepherd was given access to Dr Kelly's medical notes (did Dr Hunt look at them I wonder).  No mention of high blood pressure there.  Did Dr Kelly self-diagnose the high blood pressure and perhaps get it wrong?  Even if there was high blood pressure but Dr Kelly's problem with swallowing tablets left the problem unchecked wouldn't there be a remark in the medical notes?

My own feeling is that Mr Rufford might mistakenly have thought that Dr Kelly had a blood pressure problem ... there just doesn't seem to be other evidence to back up his belief.

Thursday, 21 June 2012

Campbell, Mrs Blair and the signed Hutton Report

I hadn't envisaged writing about Tony Blair's former spin doctor Alastair Campbell today.  However a well penned piece by journalist Miles Goslett has changed that.

Mr Goslett has written a number of thoughtful articles about the death of Dr David Kelly before.  The publication this week of the latest volume of Alastair Campbell's Diaries has led to the linked article ... and a reminder of one of the most tasteless episodes in modern politics that I can recall.

In his article Miles relates the fact that Campbell and Cherie Blair signed a copy of the Hutton Report and that it was auctioned at a labour party fund raising event for £400.  But it wasn't simply that that Miles found utterly appalling, it was the fact I think that Campbell says in his introduction to the book: 'I never met David Kelly, but I think about him often ...' whilst using the death as a promotional tool for his book.  It's Campbell's obvious hypocrisy allied with that signing of a copy of the Hutton Report that is so stomach churning.

As for Cherie Blair I have long wondered whether she has any real concept of good taste.

Were there factual errors in Dr Hunt's report?

Any post mortem report must be factually accurate ... I hope that is accepted.  In the case of Dr Kelly's death there are grave doubts about whether Dr Hunt's report is 100% accurate as to the facts.  I'm not talking about his interpretation of what he saw, it's the facts pure and simple that I want to discuss in this post.

In normal circumstances of course we wouldn't know whether the pathologist has recorded everything correctly, we just assume that is the case.  Occasionally there is a death where the report of the pathologist is so obviously wrong that it finds its way into the public domain.  A classic instance of this concerned the repatriated body of SAC Bridge wherein Dr Hunt evidently was reporting on the wrong body.  This could be seen as an exceptional case but does call into question whether Dr Hunt tended to be habitually careless - or was this a "one off"?

On 22 October 2010 Dr Hunt's final report, dated 25 July 2003, was published on the internet.  Some of the facts he lists are of questionable accuracy as I shall now explain. 
  • Some very minor errors, not crucial perhaps but indicative of a somewhat casual approach:  his statement consisted of 14 pages not 144; Dr Kelly's date of birth 14.5.44 immediately transposed to (15/05/1944); Dr Eileen Hickey was described as Eileen Hetty; logged in at the inner cordon by PC1971 Hayes, logged out by DC1971 Hayes.
  • The only witness to record the right fist clenched over the right chest area.  Others just refer to the right hand.
  • Under "Bloodstaining and contamination on clothing" he writes 'There was bloodstaining visible over front of the right side of the shirt beneath the left hand, the palm of which was bloodstained'.  I have to believe he meant the right hand. 
  • His left fist wasn't clenched, 'his left hand pointing down towards his feet'.  Compare this with Mr Green's testimony at the Hutton Inquiry: 'He was on his back with his left wrist curled back in this sort of matter (Indicates)'  Later I shall explain why the evidence points towards the left arm being repositioned relative to the body after the departure of the ambulance personnel.
  • He writes 'He was of medium build.  He weighed 59 kgs, and was approximately 170 cms tall'.  It has been pointed out that this a surprisingly low weight for a person of that height, particularly when Dr Hunt says in his first conclusion 'The deceased was an apparently adequately nourished man'.  Dr Shepherd states that his weight on his medical record checked 9 days before his death was 74 kg but Shepherd tries to close the gap by saying that the discrepancy was mainly due to the difference between clothed and unclothed weights together with the weight of the blood that was lost.  Fifteen kg does seem too much of a difference to me!  The weight of the body has a particular relevance in estimating time of death.
  • Dr Hunt records the weight of Dr Kelly's liver as 136 gm, less than the weight of either kidney.  That of course is ridiculous..
In summary there appears to be enough doubt about Dr Hunt's factual reporting to give cause for concern. Can we really be confident about the overall accuracy of his report?

Update (8 Oct 2012)
It's been pointed out to me that it's very likely that Dr Hunt transposed the weights of the lungs.  With the heart being on the left side of a human body the expectation I'm told is that the left lung would be somewhat smaller than the right.  Dr Hunt appends these weights in his report: R Lung 368 gms, L Lung 475 gms. 

Wednesday, 20 June 2012

Dr Hunt - what he did before 14.10 (3)

Mentioned in my last post was the fact that Dr Hunt confirmed the death at the scene at 12.35.  His detailed examination with Mr Green commenced at 14.10.  He withdrew from the scene and was away from it for just over one and a half hours. Did he use this time to advantage?

Frustratingly we don't know what he did in this time gap and he was never asked.  This post is concerned with some things, in my opinion, he should have been doing and thinking about.
  • He should have asked the police to find out about Dr Kelly's handedness in view of the injury to the left wrist.  In a statement WPC Roberts (Family liaison officer) said that she asked this question of Sian Kelly on 19 July but it's not known if Dr Hunt was told
  • In view of Dr Kelly's job it was quite likely that there would be a history of medical tests by a government doctor.  Any such reports and any similar from his GP should have been requested.
  • If there was a possibility of suicide then the fact that the body wasn't leaning against a tree when he first saw it should have been something to think about.  As DC Coe said to journalist Matt Sandy:  'As I got closer, I could see Dr Kelly's body sideways on, with his head and shoulders against a large tree.  He wasn't dead flat along the ground.  If you wanted to die, you'd never lie flat out.  But neither was he sat upright.'  
  • The fact that there was blood on the Barbour cap off the body was another anomaly.
  • Dr Hunt showed remarkably little interest in the open bottle of water.  The fact is that it was very close to the left shoulder where, as the ambulance crew later remarked, it was surprising that it wasn't knocked over.  To all intents and purposes it was impossible to reach from the body's position too.
This is not intended to be an exhaustive list, rather it flags up a few things that Dr Hunt might have thought about or done.  Surely he must have used some of that time in considering the case, shouldn't he?

Dr Hunt - what he did before 14.10 (2)

Dr Hunt starts his post mortem report as follows:

At approximately mid-day on 18th July 2003 (18/07/2003), at the request of Thames Valley Police, I attended the scene of a suspicious death near Longworth, Oxfordshire.

I was logged into the outer cordon of the scene at 12.00 (1200) hrs.

I approached the inner cordon via a farm track and field.  I was logged into this cordon at 12.04 (1204) hrs by PC1971 Hayes.

On arrival I was met by DI Ashleigh Smith, Acting Principal SOCO, Mark Schollar and Senior SOCO John Sharpley.

DCI Young (the Senior Investigating Officer) was logged in at the outer cordon just minutes later at 12.06.

Dr Hunt goes on to describe being given brief background information by Mr Schollar

He is then shown a "scene video" by SOCO Andrew Hodgson.  I seem to remember being critical of this in my earlier Dr Kelly blog.  This still seems to me to be very wrong.  It is essential in my opinion for the pathologist to first view the scene through his own eyes, he is the one who will write his report and make his judgements.  He is a short distance from the scene, why not just get on with the job?   Rant over.

Dr Hunt now confirms the fact of death:

Having met with the Senior Investigating Officer, DCI Young, I then proceeded to examine the body itself for the purposes of verifying the fact of his death.
The fact of death was confirmed at 12.35 hrs (1235).
There then followed a period of time during which a fingertip search was conducted of the common approach pathway and the arrival of the forensic biologist was awaited. 

Moving on to "Scene Examination" Dr Hunt writes:

At 14.10 (1410) hrs I was logged back into the inner cordon by DC928 Riley in the company of Roy Green, Eileen Hetty and John Sharpley.
By the time I returned to the immediate scene a scene tent had been erected over the deceased. 

The "Eileen Hetty" he refers to is evidently Dr Eileen Hickey, Mr Green's assistant.

Regarding the time of his being called out and his arrival at the scene Mr Green responds to Mr Dingemans as follows:

Q. And when was your first involvement?
A. May I refer to my notes, if that is all right?
Q. Yes, of course.
A. I received a phone call on 18th July.
Q. At what time, morning, evening?
A. It was around about dinner time.
Q. Around about?
A. Dinner time.
Q. What did you do as a result of that?
A. I attended Harrowdown Hill accompanied by one of my colleagues.
Q. What was the name of your colleague?
A. Dr Eileen Hickey.

One has to assume I think that the call to Mr Green was made as a result of the discussion between Hunt and Young.  Never mind public perceptions: death from incised wrist wounds is exceptionally rare and there is no evidence from Dr Hunt to say that he had come across such a case before.  I don't know whether it was he or DCI Young who suggested that a forensic expert (with a special knowledge of bloodstaining for instance) should attend.  What it did mean was a delay of about an hour and a half before the forensic examination of the body and its very immediate surroundings really began.  It would be understandable that Dr Hunt would want to await Mr Green's arrival.  I suspect that some of Dr Hunt's observations in his report had originally come from Mr Green.  

Dr Hunt - what he did before 14.10 (1)

Dr Kelly's body was discovered at about 9.15 on the morning of Friday 18 July 2003.  It was though nearly three hours before the forensic pathologist Dr Hunt arrived at Harrowdown Hill and then two more hours before the examination of the scene started in earnest.  It is self evidently a matter of commonsense that the pathologist should start his investigation as soon as possible.  

On page 27 of his book Norman Baker makes some criticism about the time it took for Dr Hunt to arrive.  However I feel he is being a little unfair on Hunt ... unless Mr Baker is party to some information that I haven't yet seen.  Critically, I don't know when on that morning Dr Hunt was contacted and asked to attend the scene. 

We have a little information from the coroner, Nicholas Gardiner, who, in a letter to Kevin McGinty at the Attorney General's Office dated 6 May 2011 included this:

To turn to this particular case the discovery of Dr Kelly's body was reported to me by the police on the morning of 18th July.  From the outset it was clear that this was going to be a high profile case.  Amongst matters I would have discussed with the police at that point would have been the identity of the pathologist who would be carrying out the post mortem examination.  We were both clear in our minds that this would have to be what is commonly called a Forensic Pathologist, that is one recognized by the Home Office, we decided that Dr Hunt would be appropriate.  There are a number of factors governing this choice although the number of Home Office recognized pathologists is quite small and they are not always available.  Dr Hunt was available and he actually lived locally and so was able to get to the scene quite quickly.  As you know he did go to the scene and his observations are recorded. 

When ACC Page attended the Hutton Inquiry on 3 September he told Mr Dingemans:

We were very anxious, from the outset, to ensure the most thorough possible examination of the scene.  I spoke to the Oxfordshire coroner, Mr Gardiner, and we agreed between us that we would use a Home Office pathologist, which is a very highly trained pathologist.

A little earlier he had said this:

Q. Having received the information about Dr Kelly's body being found, did you go to the scene?
A. No, I did not.
Q. What happened after that information had come to your attention?
A. Well, from my perspective I appointed a senior investigating officer [DCI Alan Young], a man who would, if you like, carry out the technical issues around the investigation.  I met fairly quickly with my Chief Constable [Peter Neyroud] and we decided what levels of resourcing and what levels of investigation we should apply to these circumstances. 

I would have thought that ACC Page would have contacted the coroner sooner than later and would suggest that the initial conversation between them would have occurred by 10 o'clock.  It must be remembered that finding the body wasn't totally a "bolt from the blue", significant resources were already available as a result of what had been a missing person investigation.

In the "Dr Hunt interview" in the Sunday Times of 22 August 2010 the first sentence reads 'On July 18, 2003, Nicholas Hunt was conducting a case review at the National Crime Faculty in Bramshill, Hampshire, when he took a phone call that still weighs heavily upon him.'   Dr Hunt would, I think, have been here  Looking at one internet source it seems that the drive from Bramshill to Harrowdown Hill would take a little over an hour, say an hour and a quarter.  My assumption (and hope) is that Dr Hunt carries his forensic suit and other necessary gear in his car. 

Possibly Mr Baker does have a point: what we don't know is just when TVP spoke to Dr Hunt and whether the latter decided to complete his "case review" before making his way to the site where Dr Kelly's body had been located. 

Monday, 18 June 2012

Dr Kelly's "hardening of the arteries" (2)

Dr Shepherd, who was commissioned by the Attorney General's office to prepare a report on the pathological aspects of Dr Kelly's death, has a little bit of further information on the subject of coronary artery disease and the relevant section of his report is reproduced below (with my emphasis):

The significance of the coronary artery disease
Dr Hunt described, confirmed and considered the extent of the triple vessel coronary artery disease identified in David Kelly in his report and in his conclusions.
The fact that David Kelly had not been apparently been complaining of any significant cardiac problems prior to his death is not at all unusual.  There are many possible explanations for this absence of complaint: he may have had no symptoms, he may simply have been stoical in the face of symptoms or he may have had a complete lack of interest in his own wellbeing due to stress or depression.
It is, however, clear that there was pathological evidence of severe and significant narrowing of the coronary arteries which would, in circumstances of blood loss, have contributed to the insufficiency and instability of the blood supply to the heart.  The greater insufficiency and instability caused by the coronary artery disease may well have caused death to occur earlier than might be expected in an individual of similar age but without such severe disease.
In the absence of a medical assessment including concurrent ECGs at the time of death, any comments regarding the link between coronary artery disease and death as a result of haemorrhage must be based on reasonable medical interpretation of the facts.
I note that in October 1983, 24 years before his death, David Kelly complained of angina (chest pain). (TVP/10/0122 - RJ 1/222).  This was self-diagnosed and his GP did not consider the pains to represent angina.  There are no further complaints of angina or any other evidence of cardiac disease in the medical notes.
In my opinion Dr Hunt has identified significant natural disease.  He made a reasonable association and drawn reasonable conclusions with regard to the significance of the coronary artery disease in the death of David Kelly.

As an aside the 24 years he mentions would give the year of death as 2007; elsewhere in his report he uses 2007 and this is indicative of his sloppiness.  In his testimony on 2 September Dr Warner stated that Dr Kelly had been a patient of his for 25 years   He also stated that he hadn't seen Dr Kelly as a patient for 4 years and that it was 1994 seemingly when he had last prescribed (unknown) medication.  The reference to TVP/10/0122 is strange, it looks as if it should be perhaps TVP/10/0123  "Letter: Dr Malcolm Warner/Coroner's Officer 04.08.03", indicative I think of the coroner quietly getting on with assembling his information prior to the inquest in the normal manner.

Very significantly there is this exchange between Mr Knox and Dr Warner:

Q. We know that an MoD health check was done on 8th July.  This I understand was sent to you; is that right?
A. That is right.
Q. Did it say anything significant?
A. No.
Q. Are you aware of anything else which might be of  significance which may have contributed to Dr Kelly's death?
A. No.

A little over a week before his death Dr Kelly evidently got a clean bill of health from the MOD doctorFurthermore Dr Warner, Mrs Kelly and Rachel Kelly have nothing to say at the Inquiry about Dr Kelly having complained about any heart problem. There is no obvious evidence of Dr Kelly being aware of a problem of hardening of the arteries.  

If Dr Kelly was oblivious of his heart disease then he wouldn't have thought 'even if the pill swallowing and wrist slashing doesn't work I should be able to rely on my dodgy coronary arteries'.  It does seem to me that the more those who agree with Hutton emphasise the part of the coronary heart disease in the death then the other two contributors could be seen as less reliable in the causation of death.

A further post on this subject following my reading of an article by Nicholas Rufford

Dr Kelly's "hardening of the arteries" (1)

In his now published report of 25 July 2003 Dr Hunt describes the condition of Dr Kelly's heart at post mortem on page 8 of the pdf

Quite correctly his report uses medical terminology but at the Hutton Inquiry he presents the relevant evidence in language more suited to the layman:

Q. Can you say what significant findings you made on the internal examination?  
A. Yes, in terms of significant positive findings, there was evidence that at the time of his death Dr Kelly had a significant amount of narrowing of the arteries to his heart, his coronary arteries by a process called atherosclerosis or, colloquially, hardening of the arteries.  That was the only positive evidence of natural disease, but I could not find evidence that he had had a heart attack as a consequence of that.
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Q. And in summary, what is your opinion as to the major factor involved in Dr Kelly's death?
A. It is the haemorrhage as a result of the incised wounds to his left wrist.
Q. If that had not occurred, would Dr Kelly have died?  

A. He may not have done at this time, with that level of dextropropoxyphene.  
Q. What role, if any, did the coronary disease play? 
A. As with the drug dextropropoxyphene, it would have hastened death rather than caused it, as such.  
Q. So how would you summarise, in brief, your conclusions as to the cause of death?  
A. In the formulation, the cause of death is given as 1(a) haemorrhage due to 1(b) incised wounds of the left wrist. Under part 2 of the formulation of the medical cause of death, Coproxamol ingestion and coronary artery atherosclerosis. 

In his Opening Statement on 1st August Hutton refers to Dr Hunt's preliminary post mortem report of 19 July 2003 and says:

The post-mortem report will be referred to in greater detail at a later stage in this Inquiry. However, it is relevant to state at this stage that it is the opinion of Dr Hunt that the main factor involved in bringing about the death of Dr Kelly was the bleeding from incised wounds to his left wrist.
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Dr Hunt also states: "It is noted that [Dr Kelly] has a significant degree of coronary artery disease and this may have played some small part in the rapidity of death but not
the major part in the cause of death."

I think that it can be agreed that what Dr Hunt wrote in his report has to be his definitive point of view and that it is perfectly sensible, even desirable, to explain that in layman's terms to an audience of non specialists if the exact sense is retained.  So far, so good.  Then, seven years later, on 22 August 2010 something quite extraordinary and unprecedented happened: Dr Hunt elaborated on what he wrote in his report and subsequently said at the Hutton Inquiry.  An article appeared in the Sunday Times that day and we read:

During the autopsy, Hunt discovered that Kelly was suffering from a severe form of coronary heart disease called atherosclerosis, although he had been unaware of this.

Two of his main coronary arteries were 70%-80% narrower than normal, creating a significant risk of cardiac arrest. "If he had dropped dead in the canteen at Porton Down [the government research establishment where he had worked] and you had seen his coronary arteries, you would have had a very good reason to believe that was the only reason he died," said Hunt.

His condition greatly reduced the ability of his heart to withstand sudden blood loss, and also made him more susceptible to stress. It also made his heart more vulnerable to a synthetic opiate in the painkiller he had taken, co-proxamol. The prescription painkiller was withdrawn in 2007 after it emerged that overdoses, either accidental or deliberate, were causing up to 400 deaths a year. It contains dextropropoxyphene, a synthetic opiate that can cause the heart to develop an abnormal rhythm, leading to cardiac arrest.

Two points worth making here: firstly it can be seen that Dr Hunt is making a lot more of the atherosclerosis seven years later, he should have made this clear at that earlier time.  Secondly, what on earth was he doing talking to the papers about this?  He is answerable to the coroner and there is no indication that he spoke to Mr Gardiner or sought his permission.  His behaviour was totally unprofessional and unacceptable.

The subject of the Sunday Times interview was raised with the Attorney General Dominic Grieve as number 74 in the Schedule 

I won't discuss the detail of 74 for the moment because the response was mainly concerned with the blood at the scene, not the subject of this particular post.  Suffice to note that it glosses over the behaviour of Dr Hunt: The interview with the Sunday Times and justification for it is a matter for Dr Hunt but there is nothing in the account that undermines the findings of the Inquiry.  Well I'm sorry but the question of justification for the interview should NOT be just casually passed over in this way.

Dr Hunt's cavalier behaviour is in stark contrast with that of the ambulance team who were interviewed by Antony Barnett for the Observer of 12 December 2004:

Dave Bartlett and Vanessa Hunt sought permission from their employer, Oxfordshire Ambulance Trust, before agreeing to be interviewed. They spoke as individuals and not as representatives of the trust.  

A further interesting point arises here.  Assuming that the Ambulance Trust had a broad idea of what the content of the interview was likely to be then that suggests that it wasn't just Vanessa Hunt and Dave Bartlett who were concerned about the conclusions of the pathologist!