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

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