UK Expert refuses to sign Mutula Kilonzo death report

The Star

UK doctors probing the cause of death of Makueni Senator Mutula Kilonzo have refused to sign the final autopsy report citing “frustration” in course of their work.

Prof Ian Calder, an expert on sudden death hired by Mutula’s family, claims the toxicology specimens given to him were “opened and possibly contaminated”. Mutula was found dead on his Maanzoni ranch on April 27 last year.

Calder and another expert – Dr Patterson – were to find the actual cause of death after the preliminary post mortem concluded it could not be ascertained pending more tests.

Calder has already concluded that Mutula died of “multi-organ haemorrhage due to possible coagulation deficiency”. He however says he is unable to make a final conclusion on what exactly caused this deficiency.

“Without basic science applied to non-contaminated specimens I cannot put my final signature to my report,” Calder is said to have told the family last December.

In October last year, chief government pathologist Dr Johanes Oduor presented his own report to the CID. His conclusion was that Mutula’s massive internal bleeding was occasioned by “disseminated intravascular coagulation.

Mutula’s family had grown impatient with Calder and had written a letter last November raising concerns on prolonged delay in giving a final report on the cause of death.

When Calder responded, the family was shocked to realise he had already sent a provisional report demanding more material for toxicology.

Dr Luke Musau, the family physician, demanded that the report be sent to him and the family only. It is not known to whom Calder sent the report.

Two weeks ago, he said he is feeling “very frustrated”. Calder said despite asking for tissue samples from Mutula’s body several times he has not got them.

He said he may be regarded as negligent if he were to make any conclusions without seeing all materials Calder said he found the case “quite unique” and had discussed it with top experts across Europe. He said the case had proved to be “intellectually and pathologically very challenging”.

According to the post mortem report seen by the Star, three sets of toxicology, virology and histology samples were obtained from Mutula’s Valhala home and at Lee Funeral Home prior to the autopsy and at the post mortem.

Samples collected in duplicates included blood from the femoral vessels, urine, bile, liver, vitreous fluid, stomach and small intestines, muscles, nail cuttings and head hair cuttings. The family pathologists got the samples under permission of the government chemist.

Samples collected from the scene were a white mattress cover with stains, a stainedpillow case, a dark grey pyjama T-shirt with stains and a clean pair of dark grey pyjamas. Samples of maize and peas he had eaten before he slept, his spectacles, cooked vegetables, an apple, a packet of Del Monte peach fruit juice and a vial containing eight small pellets were also collected.

Also collected at the scene were a vomit sample from the bath tub, éclairs sweets, an empty container of Pepsi Soda, vomit found at the entry of the bathroom, peanut skins, mouth and nose swabs, a striped mult- coloured shirt, a pair of beige khakitrousers, underwear, a pair of beige woollen socks and his handkerchief. Dr Musau is said to have taken urine and two blood samples at Lee prior to the autopsy.

According to the report, Mutula’s body had a reddish fluid oozing from his mouth and nostrils. His chest and right upper arm had changed colour and his flanks (part between hips and ribs) had bluish-green discolouration. But it is the internal examination of his body that shocked pathologists.

There was massive bleeding in many organs. The muscular tissues (myocardium) were bleeding (focal haemorrhage), pericardial sac contained 30ml of straw coloured fluid and his aortic valve had hardened (calcified). His lungs were congested and the right pleural cavity had 300ml of blood.

His stomach and intestines were empty on opening but were swollen with gas. The two had what pathologists described as “diffuse mucosal haemorrhage”

His liver had “focal sub capsular haemorrhage”; the posterior wall of urinary bladder had “focal haemorrhage” and his right eyeball “conjuctival haemorrhage”. His spleen looked shrunken with “hilar haemorrhage” and his pituitary gland was bleeding too. His ears, sinuses, triceps muscles (left arm) and brain were bleeding internally.

The blood vessels in the brain looked congested. The characteristic wavy depressions of the brain (gyri and sulci) were flattened and narrowed due to what doctors speculated was “increased intracranial pressure”. His heart had not ruptured thereby knocking off heart attack as a cause.

Mutula’s unique case has been discussed at the UK’s Royal College of Pathologists, Royal College of Physicians, Universities of Liverpool, London and Sheffield and the British Society of Forensic Medicine.

It has also been discussed with forensic pathologists, toxicologists, hematologists and pharmacologists at highest levels who have all agreed on the coagulation deficiency theory.

Calder told the family Mutula must have consumed something that caused a “catastrophic disturbance of the clotting mechanism”.

“It is the ultimate causation on which I have drawn a blank. That is the reason why I need to see the microscopy to eliminate or include an important causation,” he said.

The mystery of Mutula’s death has now deepened. It not known at what point thesamples were opened and contaminated, by whom and for what.