January 27. On this date in 2004, three medical experts wrote The Guardian newspaper a letter stating that it is highly improbable that the primary cause of Dr. Kelly's death was hemorrhage from transection of a single ulnar artery, as stated by Brian Hutton in his report.

 January 27. On this date in 2004, three medical experts wrote The Guardian newspaper a letter stating that it is highly improbable that the primary cause of Dr. Kelly's death was hemorrhage from transection of a single ulnar artery, as stated by Brian Hutton in his report.

Our doubts about Dr Kelly's suicide

As specialist medical professionals, we do not consider the evidence given at the Hutton inquiry has demonstrated that Dr David Kelly committed suicide.

Dr Nicholas Hunt, the forensic pathologist at the Hutton inquiry, concluded that Dr Kelly bled to death from a self-inflicted wound to his left wrist. We view this as highly improbable. Arteries in the wrist are of matchstick thickness and severing them does not lead to life-threatening blood loss. Dr Hunt stated that the only artery that had been cut - the ulnar artery - had been completely transected. Complete transection causes the artery to quickly retract and close down, and this promotes clotting of the blood.

The ambulance team reported that the quantity of blood at the scene was minimal and surprisingly small. It is extremely difficult to lose significant amounts of blood at a pressure below 50-60 systolic in a subject who is compensating by vasoconstricting. To have died from haemorrhage, Dr Kelly would have had to lose about five pints of blood - it is unlikely that he would have lost more than a pint.

Alexander Allan, the forensic toxicologist at the inquiry, considered the amount ingested of Co-Proxamol insufficient to have caused death. Allan could not show that Dr Kelly had ingested the 29 tablets said to be missing from the packets found. Only a fifth of one tablet was found in his stomach. Although levels of Co-Proxamol in the blood were higher than therapeutic levels, Allan conceded that the blood level of each of the drug's two components was less than a third of what would normally be found in a fatal overdose.

We dispute that Dr Kelly could have died from haemorrhage or from Co-Proxamol ingestion or from both. The coroner, Nicholas Gardiner, has spoken recently of resuming the inquest into his death. If it re-opens, as in our opinion it should, a clear need exists to scrutinise more closely Dr Hunt's conclusions as to the cause of death.

David Halpin

Specialist in trauma and orthopaedic surgery C Stephen Frost

Specialist in diagnostic radiology Searle Sennett

Specialist in anaesthesiology rowenathursby@onetel.net.uk

Follow-up letter on February 11, 2004...

Medical evidence does not support suicide by Kelly

Since three of us wrote our letter to the Guardian on January 27, questioning whether Dr Kelly)'s death was suicide, we have received professional support for our view from vascular surgeon Martin Birnstingl, pathologist Dr Peter Fletcher, and consultant in public health Dr Andrew Rouse. We all agree that it is highly improbable that the primary cause of Dr Kelly's death was haemorrhage from transection of a single ulnar artery, as stated by Brian Hutton in his report. On February 10, Dr Rouse wrote to the BMJ explaining that he and his colleague, Yaser Adi, had spent 100 hours preparing a report, Hutton, Kelly and the Missing Epidemiology. They concluded that "the identified evidence does not support the view that wrist-slash deaths are common (or indeed possible)". While Professor Chris Milroy, in a letter to the BMJ, responded, "unlikely does not make it impossible", Dr Rouse replied: "Before most of us will be prepared to accept wristslashing ... as a satisfactory and credible explanation for a death, we will also require evidence that such aetiologies are likely; not merely 'possible'. "

Our criticism of the Hutton report is that its verdict of "suicide" is an inappropriate finding. To bleed to death from a transected artery goes against classical medical teaching, which is that a transected artery retracts, narrows, clots and stops bleeding within minutes. Even if a person continues to bleed, the body compensates for the loss of blood through vasoconstriction (closing down of non-essential arteries). This allows a partially exsanguinated individual to live for many hours, even days.

Professor Milroy expands on the finding of Dr Nicholas Hunt, the forensic pathologist at the Hutton inquiry - that haemorrhage was the main cause of death (possibly finding it inadequate) - and falls back on the toxicology: "The toxicology showed a significant overdose of co-proxamol. The standard text, Baselt, records deaths with concentrations at 1 mg/l, the concentration found in Kelly." But Dr Allan, the toxicogist in the case, considered this nowhere near toxic. Each of the two components was a third of what is normally considered a fatal level. Professor Milroy then talks of "ischaemic heart disease". But Dr Hunt is explicit that Dr Kelly did not suffer a heart attack. Thus, one must assume that no changes attributable to myocardial ischaemia were actually found at autopsy.

We believe the verdict given is in contradiction to medical teaching; is at variance with documented cases of wrist-slash suicides; and does not align itself with the evidence presented at the inquiry. We call for the reopening of the inquest by the coroner, where a jury may be called and evidence taken on oath.

Andrew Rouse

Public health consultant

Searle Sennett

Specialist in anaesthesiology

David Halpin

Specialist in trauma

Stephen Frost

Specialist in radiology

Dr Peter Fletcher

Specialist in pathology

Martin Birnstingl

Specialist in vascular surgery

On September 25, 1999, David Kelly converted to the Bahá'í Faith at the Bosch Bahá'í School in California. David Kelly was a prime source for the false information of Iraq's purported possession of weapons of mass destruction in the lead-up to the invasion of Iraq in 2003.

On August 11, 2003, the Independent carried an article about David Kelly, noting "In October 2002, Dr Kelly gave a slide show and lecture about his experiences as a weapons inspector in Iraq to a small almost private gathering of the Baha'i faith, which aims to unite the teachings of all the prophets. Dr Kelly had converted to the religion three years earlier, while in New York on attachment to the UN. When he returned to England he became treasurer of the small but influential Baha'i branch in Abingdon near his home.  Roger Kingdon, a member, recalls: 'He had no doubt that [the Iraqis] had biological and chemical weapons. It was clear that David Kelly was largely happy with the material in the dossier.'"

On July 17, 2003, David Kelly was found dead from an apparent suicide, two days after appearing before a parliamentary Foreign Affairs Select Committee. An authority on biological warfare employed by the British Ministry of Defence, and formerly a weapons inspector with the United Nations Special Commission in Iraq, David Kelly was a prime source for the false information of Iraq's purported possession of weapons of mass destruction in the lead-up to the invasion of Iraq in 2003.