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 http://drkellysdeath-timeforthetruth.blogspot.co.uk/2012/06/dr-kellys-hardening-of-arteries-1.html  and http://drkellysdeath-timeforthetruth.blogspot.co.uk/2012/06/dr-kellys-hardening-of-arteries-2.html

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 doctor.  Furthermore 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.

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. http://drkellysdeath-timeforthetruth.blogspot.co.uk/2012/05/dr-hunt-and-senior-aircraftman.html  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. 

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 doctor.  Furthermore 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.

UPDATE
A further post on this subject following my reading of an article by Nicholas Rufford http://drkellysdeath-timeforthetruth.blogspot.co.uk/2012/06/nicholas-rufford-and-dr-kellys-heart.html
 

Incisions to the left wrist

In Dr Hunt's opinion the cause of death was:

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

2.          Co-proxamol ingestion and coronary artery atherosclerosis

I know that it has been suggested that the co-proxamol ingestion should have been placed as the primary cause of death.  I'm also aware of one writer at least who considers that the heart disease was sufficiently bad that, in a sense, that should be considered as the main reason for Dr Kelly dying.  For the start of this post though I will stay with Dr Hunt's assumption. 

Dr Hunt observed a number of incisions, of varied lengths and depths, to the left wrist.  I'm not going to repeat the quite lengthy information he provides but suggest that the interested reader go to his report http://www.attorneygeneral.gov.uk/Publications/Documents/Post%20mortem%20report%20by%20Dr%20Hunt%2023%20July%202003.pdf 

This pdf is 14 pages long and the relevant section is on page 6 under the heading "Signs of sharp force injury".  Of note is the fact that the complex of wounds extended 8 cm from side to side and about 5 cm from top to bottom.   Now my left wrist is about 8 cm across so it seems that the wounds when considered together occupied the full width of the wrist.  The longest wound was one of 6 cm, most of the others much shorter.  The deepest wound (1 to 1.5 cm deep) was at the elbow end of the complex.  Surprisingly the much shallower radial artery was intact as was the radial nerve.

In talking of some of the shallower cuts Dr Hunt said: 'The impression given was of multiple so-called 'tentative' or hesitation' marks'.  Dr Hunt wrote in the Sunday Times of 22 August 2010 it was a 'classic case of self-inflicted injury'.  It seems to be the so-called tentative or hesitation marks that really convinced him of suicide ... if he was being honest in his assessment.

My worry is the fact that there was evidence that went against the suicide hypothesis as well.  Some of this, perhaps most obviously the movement of the body, may not have been known to Dr Hunt at the time.  Human nature might have played a part here as well: having seen the tentative marks was Dr Hunt then totally sold on the suicide hypothesis, even to the extent of downplaying or ignoring any contrary evidence.


Imagine for a moment malevolent third parties intent on dressing up a murder to look like suicide.  They wouldn't know how sharp a visiting forensic pathologist would be.  The job would have to be really convincing.  An everyday criminal in this situation wouldn't consider mimicking the shallow hesitation cuts in my opinion but the security services of this or another country would be much more likely to.

There has been a suggestion that the wrist cutting covered up an injection site.  I think that's quite possible.  Dr Shepherd, in his report of 16 March 2011 to the Attorney General, states, without any caveats, 'there were no injection sites anywhere on the body'.  This is an unverifiable statement in a report which is generally sloppy and inept.  Much more on Shepherd in due course no doubt 

It was one thing having Dr Hunt on board with the suicide hypothesis.  What couldn't have been imagined I think was the problems created by the ambulance team in their testimonies at the Hutton Inquiry and, perhaps more importantly, their interview that went into the Observer on 12 December 2004, and talking in front of the cameras.  For the paramedics to carry out such an action, fundamentally undermining the conclusions of the Hutton Inquiry, must surely be unprecedented. 

I believe that the actions of Vanessa Hunt and Dave Bartlett were absolutely pivotal in bringing the suicide conclusion into disrepute. 

Vomitus on the body and on the ground (2)

Concerns had been voiced that the vomit found at the scene hadn't been tested.  The Attorney general has called in two forensic specialists to consider the work of Dr Allan and Dr Hunt and these are their comments on this particular point:

Professor Flanagan
It is of no significance that that a sample of the vomit was not collected for analysis.  By definition drug in vomitus outside the body is not available for systemic effect, and in this instance blood, urine, vitreous humour, and stomach contents were all available for analysis.

Dr Shepherd
e) Lack of sampling of the vomit

The fact that David Kelly has taken a large number of Coproxamol tablets is confirmed by toxicological analysis.  Examination of the scene shows that, at some point after he had started to bleed from the injuries to his left wrist, he vomited at least twice.

The scene examination indicates that both of these areas of vomiting appear to lie to the side of his left shoulder and head.

The blood staining of the right knee of his jeans would be consistent with him turning to his left hand side and kneeling to vomit at these sites.

In my opinion the sampling of the vomit at the scene may have provided some confirmation of the component drugs within the vomit but it would not have assisted in quantifying the number of tablets taken and so would have been of no advantage.

My thoughts

1. I don't know what would normally happen about sampling vomit in these sort of circumstances and really can't sensibly comment on this.
2. Shepherd makes the same assumption as others ... that David Kelly took a large number of coproxamol tablets.  Yet there is no proof of this.  The two components of coproxamol were found in the body but they are both injectable or the tablets could have been crushed and fed into the body by a gastric tube.  We don't know.
3. I imagine that Shepherd is saying that the vomiting occurred after the bleeding started on the basis of his assumption that Dr Kelly knelt in his own blood.  Another possibility would be if vomit was found on top of blood but I don't think that had been reported.
4. One would really need to see photographs of any pools of blood to the body's left to be able to assess whether their positioning and the siting of the vomit ties in with a kneeling position.
5. It must be remembered that the bloodstain on the right knee of the jeans as seen and measured by Mr Green is about ten times larger than that viewed by the ambulance team.
6. Did Shepherd assume that Dr Kelly knelt in his blood to vomit in order to explain away the blood on the right knee?  At least some of the vomiting may have happened with Dr Kelly's head slumping on to the top of his left arm.
7. The observed position of the vomitus in relation to the body leaning against the tree is wrong.  It's possible then that the body was repositioned in almost the same position as it was before being propped against the tree. 

Was 389 ml of water enough?

In my last post I noted that there was 111 ml of water left in the half litre Evian bottle.  If Dr Kelly had indeed ingested 29 tablets he used only 389 ml of water with which to do it, assuming he started with a full bottle.  This works out as an average of a measly 13 ml per tablet, presupposing that the tablets were swallowed individually.  Putting it a more intelligible way: this amount of water is barely the capacity of an English tablespoon which is 15 ml.

I raised this as a concern with the Attorney General's Office.  This can be seen at number 27 in the "Schedule of concerns and responses":

Given the amount of water left in the bottle by the body, he would not have been able to swallow 29 pills.

Dr Shepherd expresses the view that in his opinion it is "entirely possible to ingest 29 or more objects (including tablets) and particularly those that are designed to be swallowed, using only 300 mls of water"

I totally disagree with Dr Shepherd.  It might be possible to swallow a tablet with one tablespoon of water.  In the real world Dr Kelly wouldn't be able to restrict himself to this small amount of water for each of 29 tablets, there would be some where he would be using more of his ration than 13 ml.  Clearly then this would have to be compensated by using less than the 13 ml for some other tablets.

Shepherd talks of a lesser quantity of 300 ml which would make the swallowing all the more challenging.

In an earlier post I had mentioned that alcohol rather than water would be used if one is trying to commit suicide by co-proxamol ingestion.  When the toxicologist Dr Allan gives his evidence he reads out the warnings that come with co-proxamol tablets.  This includes "Avoid alcoholic drink"  As ever Hutton fails to react to the information he is given.