Here I will detail how I believe he died.
Disease
The only natural pathology in David Kelly’s body was in his coronary arteries.
It is usual, and obvious, that if one severe pathology only is found in a body – then this is assumed to be the cause of death. It would be absurd to attribute a cause of death to kidney failure when the kidneys are perfectly healthy.
David Kelly’s coronary arteries were in an appalling condition.
I am ignoring the “scratchings” on his left wrist and the toxicology results.
Heart – this was the only organ to show any natural pathology. Cutting through the coronary artery’s showed severe and extensive arterial disease.
The coronary arteries arise from the base of the aorta and spread out, like the roots of a tree, to carry blood to the muscle of the heart. There are two main coronary arteries – Right and Left – supplying the two ventricles of the heart.
- almost 100% blockage
Left Coronary Artery –
- the left anterior descending artery – 70% blockage with an old complete blockage, now cleared, further on
- the circumflex artery – 65% blockage
David Kelly’s coronary arteries had very severe disease.
It would be typical of a person who smoked or who had a very adverse lifestyle or diet; or possibly, an illness not revealed by a post mortem.
A Heart Attack - I
In lay terms David Kelly had a “heart attack” – of which there are two types.
Blood clot
The body reacts to the break in the lining of the artery, over the plaque, by trying to “seal” the break – just as though you had a cut (see figure). A clot builds up on the fractured surface. Now life hangs in a balance.
If the clotting forces are strong the clot will get bigger and block the artery – a very bad outcome – possibly fatal.
If the clot dissolving forces are strong the clot will get smaller – a very good outcome. Various drugs – classically aspirin - help this dissolving process.
However - there was no sign of any blood clot in David Kelly’s coronary arteries.
There was evidence of an earlier blockage in one of the distal arteries that had later opened again.
Thus he didn’t die from a heart attack caused by a blood colt.
A Heart Attack - II
Another form of heart attack happens when the normal beating of the heart is disrupted.
If David Kelly had become very stressed during his meeting with his Managers & Civil Servants (M&CS) his blood pressure would have risen. Also his heart rate would have gone up – and the workload on his heart would have shot up. If he had drunk lots of coffee that could have made it worse.
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| Normal ECG – 64 beats/min |
The increased workload on his heart would have meant that his heart needed lots of fresh oxygenated blood – but his coronary arteries couldn’t supply this.
He would have developed a very fast and abnormal heart beat – medically a tachy-dysrhythmia (a fast–abnormal rhythm).
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| ECG - a fast–abnormal rhythm |
His heart muscle would have run short of fresh blood and he may have had severe chest pain – angina. Strangely, especially, in older people the symptoms of a heart attack can be very mild or misleading.
At the same time his heart, starved of fresh blood, would fail to pump blood as it should. Slowly blood would have backed up in his lungs. Then his lungs could no longer contain the blood and he would have started to cough up blood stained fluid. This would likely have appeared at his mouth as a pink froth.
By now, however, some help was to hand and he had an oxygen mask put over his face. This would have eased his breathlessness but he would have carried on coughing up blood stained froth.
This, I am sure, was the source of the brown stains on his face.
Brown stains on face
The oxygen mask would have been held in place by an elastic strap that ran around his neck.
This fits precisely the description by the paramedic Vanessa Hunt. She wondered if he had something tied around his neck.
Her paramedic partner, David Bartlett, laid great emphasis on the very strange brown marks. He mentioned this to Lord Hutton – but it was quickly ignored. He stressed to me that they were roughly similar on the right and left side of the face. He said that it didn’t look like vomit. And vomit would have run out of one side or other – but not both.
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| Oxygen mask strapped on David Kelly’s face |
I believe that the pink froth coughed up would collect on the inside of the mask. It would gradually run down to the lowest part of the mask – where the elastic strap was. Then the blood-stained fluid would drain out of the mask – down along the line of the elastic strap. As David Kelly had a light beard the fluid would accumulate in his beard – and dry quickly. The died blood froth would turn brown.
Dr Hunt describes this brown staining as “vomitus”; he may have been reluctant to call it what he thought it was – and decided vomitus was his best alternate description. Old dried blood will turn brown and may look like vomit. He describes the brown material, just as Vanessa Hunt did, with the added detail –
“There was a band of what appeared to be vomitus running from the right corner of the mouth slightly upwards over the right earlobe tip and then on to the mastoid area. This appeared to have relatively uniform and parallel sides.”
The description of the brown stain having “relatively uniform and parallel sides” is a very clear description of fluid having drained along the length of an elastic strap of an oxygen mask.
If this had happened in a hospital environment then his nurses would have changed his mask for a new one and cleaned his face and beard.
If left unattended these bloodstains on his face/beard would darken and turn brown. This is exactly what the paramedics described and Dr Hunt describes.
Dr Hunt’s description is so exact that I don’t think that there could have been any doubt in his mind that he was describing an artefact created by the strap of an oxygen mask.
Laboratory testing
At Harrowdown Hill, and at the mortuary, many swabs were taken of David Kelly’s body.
Typically a swab is like a long cotton bud. The cotton head is rubbed against the area to be sampled and in so doing it collects liquid or debris from the sample site.
The brown stains on the face were sampled several times.
In the field they were sampled –
- AMH 20 – sample from Right side of neck x2
In the mortuary Dr Hunt sampled them as –
- NCH 03 – sample from mouth
- NCH 35 – sample from Right side of face
- NCH 36 – sample from Right cheek
All of these samples were tested by James Green, the forensic biologist, of Forensic Alliance Limited. This company performed virtually all the forensic work in this investigation. The tests on the samples were all positive as bloodstains. They also confirmed this as David Kelly’s blood.
The brown stains were of dried blood and not “vomitus” as labelled by Dr Hunt.
I therefore believe that David Kelly was wearing an oxygen mask prior to his death. Additionally that he was coughing up blood stained froth typical of that found in sudden heart failure.
The observations of Vanessa Hunt, David Bartlett and Dr Hunt all support this interpretation.
Death
As David Kelly’s heart began to fail the heart muscle would have eventually run out of oxygen and the heart-beat would have broken down. Then lots of separate parts of the heart muscle would beat individually and the heart would cease to pump blood.
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| Fatal ventricular fibrillation |
Death would follow in a few minutes.
This breakdown of the normal beating of the heart is called ventricular fibrillation (VF).
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| Defibrillation of David Kelly’s heart |
The only practicable treatment, outside of a hospital, is a big electrical shock to the heart. This will stop the heart dead in its track – and with luck it will restart with a normal, or near normal, beat.
The electrical shock can be applied to the heart by an electrical defibrillator.
For some years these have now been made as portable, battery operated, automatic devices – Automatic External Defibrillators (AEDs).
I believe that David Kelly’s heart deteriorated and went into VF.
Wherever David Kelly was - an AED was available.
Two big sticky AED electrodes were put on his chest and defibrillation attempted. The process starts with a low power discharge. After a pause of a few seconds the defibrillation would be repeated at a higher power – until it succeeds, or fails.
Defibrillator Electrodes
The paramedic – David Bartlett – insisted that David Kelly had been taken to a hospital in or near London – not Oxford. This very positive information had come to him via the paramedic grapevine.
I reassured him that David Kelly’s body had been taken from Harrowdown Hill to the John Radcliffe Hospital. I have photographs of the hearse carrying his body away.
Then I had a very clear account from a Hospital Consultant (I will call him Dr H P) that David Kelly was brought into the Accident & Emergency unit of the Royal Berkshire Hospital, Reading, Berkshire on the night of the 17/18th July 2003.
Suddenly David Bartlett’s account made sense.
Both David Bartlett and Dr H P’s account describe a scenario where David Kelly’s body was taken to a hospital – before it ever ended up on Harrowdown Hill.
This fits perfectly with the findings of the two very expert helicopter searches; namely that there was no body on Harrowdown Hill when they searched the area – ending at 04:15.
The account given by Dr H P is that when David Kelly arrived in the hospital his shirt was unbuttoned – to apply ECG electrodes. But – the nurses saw two electrodes already on his chest! They pulled them off quickly and put on four sticky standard ECG electrodes. The ECG machine showed a flat-line – a dead heart. A few more quick clinical tests confirmed that David Kelly was dead.
As proposed in Chapter 7 his body was removed on the basis of National Security.
I believe that the two electrodes on his chest were automatic external defibrillator (AED) electrodes. These are quite big, compared to ECG electrodes. Hospital nurses, in 2003, may not have been familiar with these electrodes. At that time hand-held metal paddles were the norm in most hospitals.
As I described in Chapter 12 – “Two Pathologists” – Dr Hunt noted “a small group of post mortem “abrasions”. This observation by Dr Hunt is completely consistent with the prior use of a pair of self-adhesive defibrillator electrodes.
Microscope view of Lung
A sample of lung was prepared and stained in the usual manner so that it could be examined with a microscope.
The lungs, and other organs, act as a storage organs for blood. If the blood volume increases the lungs can accommodate a lot of blood. Likewise, if the body loses a lot of blood the lungs can empty themselves of blood.
Normally the lung contains about 400mls of blood.
In a person who had died from blood loss (as Dr Hunt alleges), it would be expected that the lungs would lose a lot of this 400mls of blood.
Under a microscope the lung tissue would still be visible – but it would “dry” – depleted of the usual content of blood.
Dr Hunt’s description of the microscopic view of the lung doesn’t fit this scenario.
He says –
“The lungs show small areas of collapse and minimal focal oedema (fluid collection).”
This is clearly not the description of “dry” lung – but that of a “wet” lung.
This is not consistent with death from blood loss; it is consistent with death from sudden heart failure.
Conclusion
I believe that David Kelly was subject to excessive psychological stress during his meeting. Excessive – given that, unknown to all concerned, he had very severe heart disease.
This produced sudden oxygen shortage in his heart muscle. In turn lead to sudden heart failure and eventually fatal ventricular fibrillation. I think these events would have taken some time – possibly an hour or more.
In this time he was given oxygen via a standard oxygen mask and unsuccessful external automatic defibrillation.
Key points
- Vanessa Hunt describes brown facial marks – as though he’d been gagged.
- David Bartlett also emphatically describes the same marks – ignored by Lord Hutton.
- Dr Hunt describes linear, parallel facial marks – but calls it “vomitus”.
- Laboratory testing, however, confirms these marks as blood stains.
- David Kelly has very severe heart disease.
- David Bartlett says that David Kelly’s body was not taken to the John Radcliffe Hospital but one in or near London.
- I have an account from a Hospital Consultant that David Kelly was taken to The Royal Berkshire Hospital in Reading. When he arrived there were two large electrodes on his chest. Subsequent examination confirmed that he was dead.
- Dr Hunt describes post mortem abrasions on his chest – quite consistent with the use and removal of defibrillator electrodes.
- Dr Hunt’s description of David Kelly’s lung sample under the microscope is not consistent with blood loss – but is consistent with sudden heart failure.
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