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 http://www.attorneygeneral.gov.uk/Publications/Documents/Schedule%20of%20responses%20to%20issues%20raised.pdf

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 http://webarchive.nationalarchives.gov.uk/20090128221550/http://www.the-hutton-inquiry.org.uk/content/tvp/tvp_17_0001.pdf 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 http://chilcotscheatingus.blogspot.co.uk/2010/11/death-of-david-kelly-possible-important.html

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