by Jon E. Lewis
Q. You have already dealt with this, I think, but could you confirm whether, as far as you could tell on the examination, there was any sign of third party involvement in Dr Kelly’s death?
A. No, there was no pathological evidence to indicate the involvement of a third party in Dr Kelly’s death. Rather, the features are quite typical, I would say, of self-inflicted injury if one ignores all the other features of the case.
142. A forensic biologist, Mr Roy Green, arrived at the scene where the body was lying at 2.00 p.m. on 18 July. He examined the scene with particular reference to the bloodstaining in the area. The relevant parts of his evidence are as follows:
Q. Did you examine the vegetation around the body?
A. Yes.
Q. Did you form any conclusions from that examination?
A. Well, the bloodstaining that was highest from the ground was approximately 50 centimetres above the ground. This was above the position where Dr Kelly’s left wrist was, but most of the stainings were 33 centimetres, which is approximately a foot above the ground. It was all fairly low level stuff.
Q. What does that mean?
A. It meant that because the injury – most of the injuries would have taken place while Dr Kelly was sitting down or lying down.
Q. Right. When you first saw the body, what position was it in?
A. He was on his back with the left wrist curled back in this sort of manner (Indicates).
Q. Did you make any other relevant discoveries while you were looking around the area?
A. There was an obvious large contact bloodstain on the knee of the jeans.
Q. What do you mean by a “contact bloodstain”?
A. A contact stain is what you will observe if an item has come into contact with a bloodstained surface, as opposed to blood spots and splashes when blood splashes on to an item.
Q. Which means at some stage his left wrist must have been in contact with his trousers?
A. No, what I am saying, at some stage he has knelt – I believe he has knelt in a pool of blood at some stage and this obviously is after he has been injured.
Q. Any other findings?
A. There were smears of blood on the Evian bottle and on the cap.
Q. And what did that indicate to you?
A. Well, that would indicate to me that Dr Kelly was already injured when he used the Evian bottle. As an explanation, my Lord—
LORD HUTTON: Yes.
A. —when people are injured and losing blood they will become thirsty.
MR DINGEMANS: They become?
A. Thirsty, as they are losing all that fluid.
Q. You thought he is likely to have had a drink then?
A. Yes.
Q. What else did you find?
A. There was a bloodstain on the right sleeve of the Barbour jacket. At the time that was a bit – slightly unusual, in that if someone is cutting their wrist you wonder how, if you are moving across like this, how you get blood sort of here (Indicates). But if the knife was held and it went like that, with the injury passing across the sleeve, that is a possible explanation. Another possible explanation is in leaning across to get the Evian bottle that the two areas may have crossed.
Q. Had crossed?
A. Yes.
Q. We know, in fact, the wrist which was cut was the left wrist, is that right?
A. That is correct.
Q. And we know that Dr Kelly was right handed.
A. I was not aware of that, but yes.
Q. Were those all your relevant findings?
A. The jeans, as I have talked about, with this large contact stain, did not appear to have any larger downward drops on them. There were a few stains and so forth but it did not have any staining that would suggest to me that his injuries, or his major injuries if you like, were caused while he was standing up, and there was not any – there did not appear to be any blood underneath where he was found, and the body was later moved which all suggested those injuries were caused while he was sat or lying down.
143. Dr Alexander Allan, a forensic toxicologist, was sent blood and urine samples and stomach contents taken from the body of Dr Kelly in the course of Dr Hunt’s post-mortem examination which he then analysed. Dr Allan found paracetamol and dextropropoxyphene in the samples and stomach contents. He described paracetamol and dextropropoxyphene as follows:
The two components, paracetamol and dextropropoxyphene, are the active components of a substance called Coproxamol which is a prescription only medicine containing 325 milligrams of paracetamol and 32.5 milligrams of dextropropoxyphene.
Q. What sort of ailments would that be prescribed for?
A. Mild to moderate pain, typically a bad back or period pain, something like that. And the concentrations of both drugs represent quite a large overdose of Coproxamol.
Q. What does the dextropropoxyphene cause if it is taken in overdose?
A. Dextropropoxyphene is an opioid analgesic drug which causes effects typical of opiate drugs in overdose, effects such as drowsiness, sedation and ultimately coma, respiratory depression and heart failure and dextropropoxyphene is known particularly in certain circumstances to cause disruption of the rhythm of the heart and it can cause death by that process in some cases of overdose.
Q. And what about paracetamol, what does that do?
A. Paracetamol does not cause drowsiness or sedation in overdose, but if enough is taken it can cause damage to the liver.
Q. If enough? I think you mean if too much is taken.
A. If too much is taken. I beg your pardon.
Q. What about the concentrations you have mentioned that you found in the blood? What did that indicate?
A. They are much higher than therapeutic use. Typically therapeutic use would represent one tenth of these concentrations. They clearly represent an overdose. But they are somewhat lower than what I would normally expect to encounter in cases of death due to an overdose of Coproxamol.
Q. What would you expect to see in the usual case where dextropropoxyphene has resulted in death? What types of proportions or concentrations would you normally expect to see?
A. There are two surveys reported I am aware of. One reports a concentration of 2.8 micrograms per millilitre of blood of dextropropoxyphene in a series of fatal overdose cases. Another one reports an average concentration of 4.7 microgrammes per millilitre of blood. You can say that they are several-fold larger than the level I found of 1 [microgram].
Q. What about the paracetamol concentration you found?
A. Again, it is higher than would be expected for therapeutic use, approximately 5 or 10 times higher. But it is much lower or lower than would be expected for paracetamol fatalities normally unless there was other factors of drugs involved.
Q. What sort of level would you normal [sic] expect for paracetamol fatalities?
A. I think if you can get the blood reasonably shortly after the incident and the person does not die slowly in hospital due to liver failure, perhaps typically 3 to 400 micrograms per millilitre of blood.
Q. About four times as much in other words?
A. Yes.
Q. Putting it in short terms, you would expect there to be about four times as much paracetamol and two and a half to four times as much dextropropoxyphene?
A. Two, three, four times as much paracetamol and two, three, four times as much dextropropoxyphene in the average overdose case, which results in fatalities.
Q. You have mentioned that it seemed that a number of Coproxamol drugs were taken. Was it possible, from your examination, to estimate how many tablets must have been taken?
A. It is not possible to do that, because of the complex nature of the behaviour of the drugs in the body. I understand that Dr Kelly may have vomited so he would have lost some stomach contents then. There was still some left in the stomach and presumably still some left in the gastrointestinal tracts. What I can say is that it is consistent with say 29/30 tablets but it could be consistent with other scenarios as well.
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144. Dr Allan also said in his evidence that the only way in which paracetamol and dextropropoxyphene could be found in Dr Kelly’s blood was by him taking tablets containing them which he would have to ingest.
145. In relation to an examination of Dr Kelly’s body Assistant Chief Constable Page said in evidence:
Q. We heard about investigations that have been carried out in the post-mortem and toxicology reports.
A. Yes.
Q. And the pathologist said that Dr Kelly’s lung had been removed for tests. Have you discussed that matter with the toxicologist?
A. I have discussed that matter with the toxicologist. The lung was not subjected to tests, and the rationale given to my team by the toxicologist is that the blood was tested for an entire range of substances including volatile substances and stupefying substances. No trace whatsoever was found and therefore they considered that examining the lung would not be relevant because if it was not in the blood, it would not be in the lung.
146. Very understandably the police did not show the knife found beside Dr Kelly’s body to his widow and daughters but the police showed them a photograph of that knife. It is clear that the knife found beside the body was a knife which Dr Kelly had owned since boyhood and which he kept in a desk in his study, but which was found to be missing from his desk after his death. In her evidence Mrs Kelly said:
Q. We have heard about the circumstances of Dr Kelly’s death and the fact that a knife was used. Were you shown the knife at all?
A. We were not shown the knife; we were shown a photocopy of I presume the knife which we recognised as a knife he had had for many years and kept in his drawer.
Q. It was a knife he had had what, from childhood?
A. From childhood I believe. I think probably from the Boy Scouts.
And in a statement furnished to the Inquiry Police Constable Roberts stated: The knife found in possession of Dr David Kelly is a knife the twins, Rachel and Ellen recognise (from pictures shown by Family Liaison Officers). It would not be unusual to be in his possession as a walker. They have seen it on their walks with him. He would have kept it in his study drawer with a collection of small pocket knives (he did like gadgets) and the space in the study drawer where a knife was clearly missing from the neat row of knives is where they believe it would [have] lived and been removed from.
147. It also appears probable that the Coproxamol tablets which Dr Kelly took just before his death came from a store of those tablets which Mrs Kelly, who suffered from arthritis, kept in their home. In a statement furnished to the Inquiry Detective Constable Eldridge stated:
At 1000hrs on Thursday 7th AUGUST 2003 I was on duty at Long Hanborough Incident Room when I removed from secure storage the following items for examination: –
1. Exhibit SK/2 CO-PROXAMOL BOX AND STRIP OF TEN TABLETS taken from Janice KELLY
2. Exhibit NCH/17/2 CO-PROXAMOL BLISTER PACKETS FRONT BOTTOM BELLOWS POCKET these had been removed from Dr KELLY’S coat pocket by the Pathologist.
On examining both items I saw that they were identical. They were marked M & A Pharmacy Ltd and had the wording CO-PROXAMOL PL/4077/0174 written on the foil side of each of the blister type packs.
I can say that enquiries have been made with M & A PHARMACHEM who are the manufacturers of CO-PROXAMOL. The batch number shown on the tablets in our possession was checked with a view to tracing the chemist that these tablets had been purchased from. I can say that this batch number relates to approximately 1.6 million packets of tablets that will have been distributed to various chemists throughout the country.
148. In relation to the question whether Dr Kelly took his own life the opinion of Dr Hunt was as follows:
[16 September, page 23, line 14]
The orientation and arrangement of the wounds over the left wrist are typical of self-inflicted injury. Also typical of this was the presence of small so-called tentative or hesitation marks. The fact that his watch appeared to have been removed whilst blood was already flowing suggest that it had been removed deliberately in order to facilitate access to the wrist. The removal of the watch in that way and indeed the removal of the spectacles are features pointing towards this being an act of self harm.
Other features at the scene which would tend to support this impression include the relatively passive distribution of the blood, the neat way in which the water bottle and its top were placed, the lack of obvious signs of trampling of the undergrowth or damage to the clothing. To my mind, the location of the death is also of interest in this respect because it was clearly a very pleasant and relatively private spot of the type that is sometimes chosen by people intent upon self harm.
Q. Is that something you have found from your past experience?
A. Yes, and knowledge of the literature.
149. Professor Keith Hawton was requested by the Inquiry to give evidence in relation to the death of Dr Kelly. Professor Hawton is an eminent expert on the subject of suicide and is the Professor of Psychiatry at Oxford University and is the Director of the Centre for Suicide Research in the University Department of Psychiatry in Oxford. He stated in his evidence that the majority of those who commit suicide do not leave a suicide note or message. He further stated:
Q. Did you form any assessment of whether Dr Kelly’s death was consistent with suicide?
A. I think all the information we have about his death and the circumstances of his death strongly point to his death having been by suicide.
Q. And what would you say drives you to that conclusion?
A. Well, the first thing is the site in which the death occurred. We have heard that it occurred in an isolated spot on Harrowdown Hill. In fact it was, as I think you have been told, in woodland about 40 or 50 yards off the track taken by ramblers. The site is well protected from the view of other people.
Q. Have you been to the site?
A. I have visited the site, yes.
Q. And what did you notice there then?
A. Well, I noticed, first of all – what struck me was it is a very peaceful spot, a rather beautiful spot and we know that it was a favourite – it was in the area of a favourite walk of Dr Kelly with his family.
Q. What other factors have you considered relevant?
A. The nature of his injuries is very consistent with an act of self cutting. The doctor – I have read Dr Hunt’s report , who is the Home Office forensic pathologist. I have also seen the photographs of the injuries to Dr Kelly’s body; and the nature of the injuries to his wrist are very consistent with suicide.
Q. Why do you say that? We have heard from some of the ambulance personnel who did not themselves see very much blood. We have heard from others who did see more blood. What is relevant here?
A. Well I am referring here particularly to the nature of the cutting which perhaps I would prefer not to describe in detail.
Q. Right.
A. But it—
Q. Perhaps you can just explain why you do not want to describe these matters in detail.
A. Well, one of the concerns I have is that there is now good evidence that reporting and portrayal of detailed methods of suicide in the media can actually sometimes facilitate suicide in other people.
Q. So it is perfectly obvious there are lots of members of the press here. If you had to say anything to them about the reporting of your evidence today, what would it be?
A. I think with regard to the specific method of suicide, I would prefer that that was kept as general as possible.
Q. For those reasons?
A. Yes.
Q. You have talked about the cutting. What else do you consider to have been consistent with suicide?
A. Well, the situation or the circumstances in which Dr Kelly’s body was found are consistent, in that he had apparently removed – his glasses were found by his body in a way – in a manner suggesting that they had been taken off by him, as was his cap; his watch had been taken off, was removed from the body.
Q. What does that in
dicate?
A. It suggests that he removed the watch to give him better access to be able to carry out the cutting.
Q. And was there anything else that you saw from the pathologist’s report that assisted you in your conclusion?
A. Well, the instrument that was used, which I have seen a photograph of, and the family, as you know, I think, have been shown a copy of a similar instrument, a large penknife – I will call it a penknife, but it is a rather primitive style of penknife – is very similar to one that he had in his drawer in his study, and it was one I think you heard yesterday he had had since his childhood.