WEBVTT - The fight for life 0:00:02.240 --> 0:00:07.160 Nine podcasts. In this episode, an intensive care specialist recalls 0:00:07.200 --> 0:00:10.440 the efforts of doctors to save the lunch guests and 0:00:10.520 --> 0:00:13.800 how close they thought. Ian Wilkinson came to dine. 0:00:14.200 --> 0:00:18.360 Victoria's mushroom mystery. The mushroom lunch that claimed three lives 0:00:18.480 --> 0:00:21.520 an Australian family's meal is now the center of a 0:00:21.560 --> 0:00:22.760 homicide investigation. 0:00:22.840 --> 0:00:26.240 For bizarre tragedy now grabbing global headlines. 0:00:25.760 --> 0:00:29.520 Aaron Patterson's alleged victims died after eating a family lunch 0:00:29.520 --> 0:00:31.960 she'd serve them at her home. I cannot think of 0:00:32.000 --> 0:00:36.760 another investigation that has generated this level of media and 0:00:36.840 --> 0:00:37.720 public interest. 0:00:37.960 --> 0:00:40.280 Four of the guests of that lunch were much loved 0:00:40.360 --> 0:00:41.600 members of this church. 0:00:42.000 --> 0:00:43.640 Only one will ever return. 0:00:43.760 --> 0:00:48.960 People are feeling very heavy with having lost such wonderful people. 0:00:49.120 --> 0:00:53.680 Today, Aaron Patterson remained here inside her home. She's continued 0:00:53.720 --> 0:00:58.960 to plead her innocence in a court room in Country Victoria. 0:00:59.120 --> 0:01:02.560 Aaron Patterson is on trial accused of using death cat 0:01:02.640 --> 0:01:06.000 mushrooms to kill She's pleaded not guilty to murdering three 0:01:06.040 --> 0:01:08.240 of her former in laws and attempting to kill a 0:01:08.319 --> 0:01:11.880 fourth the town's church pastor. It's up to the jurors 0:01:12.000 --> 0:01:15.240 to decide what happened when Pattison's loved ones sat down 0:01:15.280 --> 0:01:18.600 to eat. So in this episode, we're going to go 0:01:18.680 --> 0:01:22.600 through the evidence of a professor, an intensive care specialist, 0:01:23.000 --> 0:01:26.600 who gave some very detailed evidence as he spoke about 0:01:26.600 --> 0:01:30.640 the treatment that the four lunch guests that's Donegale Patterson, 0:01:30.640 --> 0:01:34.720 and Ian and Heather Wilkinson received at Melbourne's Austin Hospital. Now, 0:01:35.000 --> 0:01:37.920 while all of this was being relayed in court, there 0:01:37.959 --> 0:01:40.800 were a number of family members and Ian Wilkinson himself 0:01:40.800 --> 0:01:41.240 in the room. 0:01:41.560 --> 0:01:42.160 Yeah, that's right. 0:01:42.200 --> 0:01:44.480 There was Ian sitting in the back row next to 0:01:44.560 --> 0:01:48.040 his two daughters, and there was others sitting in the 0:01:48.040 --> 0:01:51.360 front row as well, maybe just under a dozen different 0:01:51.440 --> 0:01:54.400 members of the families. We know that throughout the trial 0:01:54.560 --> 0:01:57.720 many have been present, but there's also a significant number 0:01:57.720 --> 0:02:00.680 of members of the public now attending. They sit in 0:02:00.720 --> 0:02:02.960 the corner on the right hand side of the courtroom, Penny. 0:02:03.000 --> 0:02:05.400 There's also a number of members of the public that 0:02:05.440 --> 0:02:06.880 are sitting shoulder to shoulder with. 0:02:06.840 --> 0:02:10.440 Them, and we did see during parts of this evidence, 0:02:10.480 --> 0:02:12.440 which was at the end of the fourth week of 0:02:12.480 --> 0:02:16.080 this trial, Aaron Patterson sitting in the Dock did appear 0:02:16.160 --> 0:02:19.240 quite emotional at times at times to be quite distressed 0:02:19.560 --> 0:02:23.680 while hearing, particularly about the conditions of the female lunch guests. 0:02:23.720 --> 0:02:25.800 And we'll sort of come back and forth to you 0:02:25.840 --> 0:02:28.799 throughout this episode to sort of update on what was 0:02:28.800 --> 0:02:30.639 happening in the courtroom at the time and different parts 0:02:30.680 --> 0:02:32.600 of the evidence. But there are quite a lot of 0:02:33.880 --> 0:02:35.880 large segments of what was heard in the courtroom to 0:02:35.880 --> 0:02:38.000 make up this episode, because we really want people to 0:02:38.120 --> 0:02:41.520 understand what it was like listening to this particular doctor's 0:02:41.600 --> 0:02:42.640 very detailed evidence. 0:02:42.880 --> 0:02:45.920 He gave evidence via video link beamed into the courtroom 0:02:46.360 --> 0:02:48.840 from a remote location for the jury to be able 0:02:48.880 --> 0:02:52.400 to observe, and he really took the jury through the 0:02:52.440 --> 0:02:55.400 final days of the lunch guests who passed away. We 0:02:55.440 --> 0:02:58.840 know three passed away and Ian Wilkinson survived, but we 0:02:58.880 --> 0:03:02.040 also heard a lot about e Wilkinson's medical diagnoses and 0:03:02.080 --> 0:03:04.079 what was going on in terms of his treatment plan 0:03:04.160 --> 0:03:06.480 in hospital as well. We've got a real sense of 0:03:06.520 --> 0:03:10.000 the incredible efforts that were underway behind the scenes to 0:03:10.120 --> 0:03:13.120 do what they could to save all four lunch guests. 0:03:13.320 --> 0:03:16.400 We know that three of them passed away in early August, 0:03:16.480 --> 0:03:19.960 twenty twenty three. But Ian Wilkinson was present in court 0:03:20.160 --> 0:03:23.080 while all of that was detailed, and also his own 0:03:23.160 --> 0:03:27.359 medical history and what went on for him. He was 0:03:27.400 --> 0:03:28.760 sitting there listening to that as well. 0:03:29.280 --> 0:03:31.800 Who you'll be hearing the words of today is Professor 0:03:31.880 --> 0:03:35.200 Stephen Worrelow. Now, as we mentioned, he's an intensive care 0:03:35.200 --> 0:03:39.760 specialist with Melbourne's Austin Hospital and he details some of 0:03:39.960 --> 0:03:42.880 the not only his experience but also the hospitals in 0:03:43.160 --> 0:03:46.560 what you'll be hearing throughout this evidence. So we'll start 0:03:46.600 --> 0:03:49.840 off with what the court was basically taken through and 0:03:49.880 --> 0:03:52.720 this was following some evidence given by the professor that 0:03:53.120 --> 0:03:58.320 Don Patterson had arrived from karen Burrow Urgent Care to Dandyong, 0:03:58.360 --> 0:04:00.440 that he'd then come on to the Austin Hospital and 0:04:00.480 --> 0:04:03.680 at the time that he arrived into the Austin Hospital 0:04:03.680 --> 0:04:06.320 on the thirty first of July twenty twenty three, he 0:04:06.360 --> 0:04:09.440 had already been diagnosed with acute liver failure by the 0:04:09.440 --> 0:04:12.640 critically unwell by the staff at Dandenong. They'd made that 0:04:12.680 --> 0:04:16.200 diagnosis and these different parts of evidence you'll be hearing 0:04:16.240 --> 0:04:20.520 all the referencing specific patients and different lunch guests at 0:04:20.520 --> 0:04:23.080 different times, but we'll begin with what the professor was 0:04:23.120 --> 0:04:25.640 telling the court about Don Patterson. This is while he 0:04:25.680 --> 0:04:28.159 was speaking with Sarah Lenthial from the prosecution. 0:04:28.640 --> 0:04:31.560 The cause of the acute liver failure was considered most 0:04:31.720 --> 0:04:35.320 likely to be amanita mushrooms. Yes, that's correct, and he 0:04:35.440 --> 0:04:39.640 was referred to the Austin in anticipation of rapidly deteriorating 0:04:39.720 --> 0:04:42.000 and needing advanced therapies. Is that right? 0:04:42.279 --> 0:04:43.320 Yes, that's correct. 0:04:43.640 --> 0:04:46.400 Is there a reason why the Austin was the preferred 0:04:46.400 --> 0:04:49.000 destination for a patient like Donald Patterson? 0:04:49.560 --> 0:04:53.800 Yes, The Austin hosts the state Liver Transplant Service, and 0:04:53.880 --> 0:04:58.400 so any patients from Victoria or adjacent regions and nearby 0:04:58.480 --> 0:05:01.120 states would be referred to our of US because we 0:05:01.160 --> 0:05:04.400 have a comprehensive program to support patients and specific liver 0:05:04.520 --> 0:05:10.360 problems up to an including liver transplantation if that's needed. 0:05:10.839 --> 0:05:14.560 Had the Austin treated patients with amanita mushroom poisoning before? 0:05:15.080 --> 0:05:15.599 Yes, we have. 0:05:16.520 --> 0:05:18.960 And have you been involved in the care of patients 0:05:18.960 --> 0:05:20.880 with amanita mushroom poisoning before? 0:05:21.400 --> 0:05:21.919 Yes? I have. 0:05:22.720 --> 0:05:26.560 What was Donald Patterson's condition when he arrived at the Austin. 0:05:26.480 --> 0:05:30.880 He was critically ill and in multiple organ failure. I 0:05:31.040 --> 0:05:32.440 can go into more details. 0:05:32.600 --> 0:05:36.320 Perhaps there were various blood tests which indicated he was 0:05:36.360 --> 0:05:37.440 critically unwell. 0:05:37.720 --> 0:05:41.120 Yes, so we identified that he had a severe liver 0:05:41.200 --> 0:05:46.000 injury and severe liver failure. Measurements of specific substance in 0:05:46.040 --> 0:05:50.599 the blood were extremely high, consistent with severe or massive 0:05:50.640 --> 0:05:54.839 liver injury. We also saw that as blood clotting measurements 0:05:54.839 --> 0:05:59.560 were grossly abnormal, consistent with liver failure, and he had 0:05:59.560 --> 0:06:03.120 a rain of other abnormalities including a build up of 0:06:03.160 --> 0:06:05.560 acid in the blood and a buildup of ammonia in 0:06:05.600 --> 0:06:06.040 the blood. 0:06:06.640 --> 0:06:10.440 Was Donald Patterson receiving various treatments when he arrived at 0:06:10.440 --> 0:06:11.800 the Austin he was. 0:06:12.279 --> 0:06:15.560 Our colleagues at Dandenong Hospital had already commenced a range 0:06:15.560 --> 0:06:17.840 of treatments to try and help support him. 0:06:18.520 --> 0:06:20.600 He was sedated and intubated. 0:06:20.920 --> 0:06:21.480 That's correct. 0:06:21.600 --> 0:06:25.599 Yes, So the court was taken through the professor's evidence 0:06:25.640 --> 0:06:28.320 of what being intubated meant. And as we've mentioned, he 0:06:28.440 --> 0:06:30.960 is a intensive care specialist, so he was saying that 0:06:31.360 --> 0:06:33.960 during all of a lot of these elements he's talking about, 0:06:33.960 --> 0:06:37.400 these people are in the ICU in intensive care and 0:06:37.480 --> 0:06:39.960 on a breathing machine, so they're being ventilated with a 0:06:40.040 --> 0:06:41.680 tube down their mouth at that time. 0:06:41.839 --> 0:06:44.279 Yeah, And the order of arrival was something else that 0:06:44.320 --> 0:06:47.320 the jury was taken through, Penny. We heard that Don 0:06:47.560 --> 0:06:50.919 arrived first and then hours later he was followed by 0:06:50.960 --> 0:06:54.359 his wife, Gail, and then the next morning Gail's sister 0:06:54.520 --> 0:06:58.800 Heather arrived shortly before her husband, Ian Wilkinson arrived. So 0:06:59.120 --> 0:07:01.760 that was the order of for two days, really following 0:07:01.800 --> 0:07:05.840 each other in pretty quick succession was Don, Gale, Heather 0:07:05.920 --> 0:07:06.359 and Ian. 0:07:06.880 --> 0:07:07.680 And a lot of what. 0:07:07.600 --> 0:07:09.760 The court was taken through in this evidence was the 0:07:09.800 --> 0:07:12.680 different treatments that people were given, those efforts of staff 0:07:12.680 --> 0:07:15.200 that you spoke about before, but also a lot of 0:07:15.200 --> 0:07:17.840 the testing and investigation that doctors were doing to try 0:07:17.840 --> 0:07:20.800 and find out what the exact cause was. As you 0:07:20.880 --> 0:07:22.880 just heard there, they believed the cause to be aminita 0:07:22.920 --> 0:07:25.920 mushroom poisoning. There were some other tests that were carried out. 0:07:25.960 --> 0:07:27.920 Here's a little bit more of the evidence. It's no 0:07:28.000 --> 0:07:29.400 one's real voice now. 0:07:29.440 --> 0:07:32.080 Were various tests carried out to try to pinpoint the 0:07:32.120 --> 0:07:34.320 cause of Donald's acute liver failure. 0:07:34.640 --> 0:07:37.840 Yes, a range of investigations were undertaken to try and 0:07:37.880 --> 0:07:42.640 find other possible causes. Those included blood tests, some imaging, 0:07:42.840 --> 0:07:46.320 and ultrasounds to try and test for specific viruses that 0:07:46.360 --> 0:07:49.520 can cause liver failure, to try and make sure that 0:07:49.640 --> 0:07:53.560 there wasn't another possible cause for why he was so sick. 0:07:53.760 --> 0:07:56.400 And what were the results of all those tests. 0:07:56.280 --> 0:07:58.400 There was no evidence of any other cause of his 0:07:58.480 --> 0:08:00.160 acute liver failure And. 0:08:00.120 --> 0:08:02.320 What did you in the team at the Austin ultimately 0:08:02.320 --> 0:08:05.800 accept the cause of the acute liver failure to be for. 0:08:05.800 --> 0:08:09.720 Donald, Amanita mushroom poisoning causing acute liver failure. 0:08:10.120 --> 0:08:13.160 And was that because of the known consumption of mushrooms 0:08:13.200 --> 0:08:14.440 by Donald and others? 0:08:14.760 --> 0:08:18.240 Yes, we had been alerted to a cluster of cases 0:08:18.240 --> 0:08:22.440 of patients that had we were advised, had consumed the 0:08:22.480 --> 0:08:25.720 same meal that it contained mushrooms and that they had 0:08:25.760 --> 0:08:28.240 all become very unwell. And that is not an unusual 0:08:28.280 --> 0:08:29.240 story for Amanita. 0:08:29.800 --> 0:08:33.239 And was that diagnosis also made because of a clinical 0:08:33.600 --> 0:08:36.760 cause highly consistent with Amanita mushroom ingestion? 0:08:37.080 --> 0:08:41.560 Absolutely, his clinical course was pretty typical for a severe 0:08:41.559 --> 0:08:43.440 poisoning of Amanita mushrooms. 0:08:43.880 --> 0:08:47.120 Now, throughout this evidence, as we were talking about before, 0:08:47.160 --> 0:08:49.559 there were treatments mentioned as well, and one of the 0:08:49.600 --> 0:08:53.120 first ones that was mentioned was something called multi dose 0:08:53.280 --> 0:08:56.720 activated charcolind Yes. It was explained that this is something 0:08:57.240 --> 0:08:59.520 that while the amenita poison is in the body, the 0:08:59.520 --> 0:09:02.520 body team to sort of start to recycle that inside, 0:09:02.960 --> 0:09:05.400 and that the use of the charcoal is in an 0:09:05.400 --> 0:09:10.120 attempt to medically remove that poison from someone's bows specifically 0:09:10.400 --> 0:09:12.920 and get that out of the body by interrupting the 0:09:12.960 --> 0:09:13.920 recycling process. 0:09:14.160 --> 0:09:17.440 Yeah, Professor Worlow is explaining that it is largely the 0:09:17.520 --> 0:09:20.800 liver that takes a real hit from this poison, but 0:09:20.960 --> 0:09:24.560 also the bow as well, and he explained that there 0:09:24.600 --> 0:09:29.000 actually isn't really a test to test for toxic mushroom poisoning. 0:09:29.520 --> 0:09:32.840 Rather it's a focus on the treatment of the symptoms. 0:09:32.880 --> 0:09:36.559 So it's weighing up all the evidence and I guess 0:09:37.000 --> 0:09:38.760 figuring out that this is the path that we're going 0:09:38.800 --> 0:09:40.920 to follow. And then that's why he was taking the 0:09:41.000 --> 0:09:43.760 jury through all the different treatments, because, as we know, 0:09:44.200 --> 0:09:48.079 he was trying to explain that sometimes patients get bad 0:09:48.120 --> 0:09:50.079 from this type of poison, but they start to get 0:09:50.080 --> 0:09:52.120 a little bit better, but then they get worse as 0:09:52.120 --> 0:09:55.600 the body starts to recycle the toxins over and over 0:09:55.640 --> 0:09:58.120 and over through the different organs. And it was at 0:09:58.120 --> 0:09:59.920 this point when they were all arriving at the austume, 0:10:00.000 --> 0:10:02.319 you know, this is the final hospital that they attended, 0:10:02.600 --> 0:10:07.280 that they're all in critical, critical ways really and suffering 0:10:07.280 --> 0:10:08.760 from multi organ failure. 0:10:09.240 --> 0:10:12.079 And some of the other treatments that were mentioned throughout 0:10:12.200 --> 0:10:17.400 multiple bits of evidence about all of the different patients treatments. 0:10:17.440 --> 0:10:20.200 They all had very similar treatments and very similar investigations, 0:10:20.440 --> 0:10:22.960 and some of the others is something called ascilla binon. 0:10:23.440 --> 0:10:25.480 Now we were told in court that this is a 0:10:25.520 --> 0:10:29.080 specific antidote to aminita mushroom poisoning, so there was an 0:10:29.120 --> 0:10:31.600 attempt to use that also nak which we've mentioned in 0:10:31.640 --> 0:10:35.000 previous episodes, which is a drug that's widely used, the 0:10:35.000 --> 0:10:37.600 professor said for mushroom poisoning with liver failure, but it 0:10:37.679 --> 0:10:41.199 is also used in other situations where someone might have 0:10:41.280 --> 0:10:42.000 liver failure. 0:10:42.200 --> 0:10:44.120 It's used to protect the liver. I think that was 0:10:44.120 --> 0:10:46.840 the way that it was explained, Penny. It's really this 0:10:46.920 --> 0:10:48.880 year this big hug around the liver to try and 0:10:48.920 --> 0:10:51.600 protect it and stop any damage that could follow. 0:10:51.800 --> 0:10:53.839 And some of the other treatments that were mentioned as well, 0:10:53.840 --> 0:10:56.240 which you may hear later in the evidence worth things 0:10:56.440 --> 0:10:59.880 like are using vitamin C as well as plasma exchange. 0:11:00.080 --> 0:11:03.880 So lots of different sort of roads that these particular 0:11:03.920 --> 0:11:05.679 doctors took over a number of days. 0:11:05.679 --> 0:11:07.520 I had a lot of fluid intake. Penny was something 0:11:07.520 --> 0:11:08.320 else that was mentioned. 0:11:08.360 --> 0:11:11.480 Heah a lot of intravenous fluids. And as we've sort 0:11:11.480 --> 0:11:13.840 of set the scene before, it's a hard thing to 0:11:13.880 --> 0:11:16.120 think about, but all of these people at this point 0:11:16.200 --> 0:11:19.400 they are being intubated, there is a ventilation to breathing 0:11:19.440 --> 0:11:22.240 for them, and these doctors are making these decisions around 0:11:22.240 --> 0:11:25.080 them over quite a few hours. And going back to 0:11:25.240 --> 0:11:28.280 as the court heard in this sort of way that 0:11:28.320 --> 0:11:31.520 the evidence was presented, it all started with Donald Patterson 0:11:31.559 --> 0:11:35.080 and going through a lot of his medical points that 0:11:35.120 --> 0:11:37.320 then led on to some of the other patients. But 0:11:37.840 --> 0:11:39.920 it was noted in this part of the professor's evidence 0:11:39.960 --> 0:11:41.640 while they were talking about all these treatments that he 0:11:41.720 --> 0:11:45.000 was continuing to deteriorate further sort of by the time 0:11:45.040 --> 0:11:49.079 it got to the second of August, he was unfortunately worsening. 0:11:49.120 --> 0:11:52.920 His circulation was struggling, and it was then that he 0:11:53.040 --> 0:11:56.319 spoke about a surgery that they decided that they would 0:11:56.360 --> 0:11:58.920 try with Donald Patterson. Here is a little bit more 0:11:58.920 --> 0:12:01.280 of the professor's evidence as he was speaking with Sarah 0:12:01.360 --> 0:12:03.840 Lenthil from the prosecution. It's not their voices. 0:12:04.120 --> 0:12:08.560 Did Donald Patterson undergo surgery on for August twenty twenty three? 0:12:08.960 --> 0:12:13.120 He did, after extensive consultation with a range of senior specialists. 0:12:13.440 --> 0:12:16.000 It was thought that the only possibility of saving his 0:12:16.080 --> 0:12:19.880 life was through a liver transplant. And did that occur, Yes, 0:12:20.480 --> 0:12:24.000 there was an effort to undertake and complete a liver transplant. Yes. 0:12:24.320 --> 0:12:28.439 After the liver transplant was carried out, did Donald Patterson's 0:12:28.440 --> 0:12:29.800 condition improve. 0:12:29.679 --> 0:12:32.640 No, he got relentlessly worse. Unfortunately. 0:12:33.000 --> 0:12:36.280 Was it recognized through the day that Donald Patterson was 0:12:36.360 --> 0:12:39.040 dying despite maximal therapy. 0:12:39.240 --> 0:12:42.719 Yes, all of our treatments had unfortunately failed, and he 0:12:42.800 --> 0:12:46.160 was dying despite all of the measures that we were applying. 0:12:46.760 --> 0:12:50.760 We also heard Penny that the possibility of liver transplants 0:12:50.760 --> 0:12:53.439 for Gail and Heather was something that was also discussed 0:12:53.480 --> 0:12:56.640 in that hospital, But the specialists ultimately decided that the 0:12:56.679 --> 0:13:00.840 sisters were too unwell to undergo surgery, and that was 0:13:00.880 --> 0:13:02.440 the decision that was made for Don but not for 0:13:02.480 --> 0:13:03.199 the others. 0:13:03.240 --> 0:13:04.360 And it was spoken about. 0:13:04.400 --> 0:13:07.480 The judge clarified at one point that had this been 0:13:08.080 --> 0:13:10.320 not so much a successful liver transplant for Don, but 0:13:10.360 --> 0:13:12.319 had it happened? And the professor said, yes, we did 0:13:12.320 --> 0:13:16.760 perform the liver transplant, but unfortunately that Don Patterson had 0:13:16.800 --> 0:13:19.959 passed away at the Austin hospital. Following that that he 0:13:20.280 --> 0:13:22.520 continued to get worse despite the fact that they. 0:13:22.360 --> 0:13:23.040 Were giving him. 0:13:23.280 --> 0:13:26.040 I believe he said every there were no other treatments left. 0:13:26.040 --> 0:13:28.280 They'd given him all the treatments, and that was essentially 0:13:28.320 --> 0:13:30.920 the case for the other two lunch guests as well, 0:13:31.040 --> 0:13:33.400 Gail and Heather. But here is a little bit more 0:13:33.440 --> 0:13:35.800 of the professor's evidence as he was speaking with Sarah 0:13:35.840 --> 0:13:38.320 Lenthil from the prosecution. It's not their voices. 0:13:38.679 --> 0:13:41.880 Did she continue to receive maximal treatment and therapy she. 0:13:42.000 --> 0:13:43.440 Was on everything that we had. 0:13:43.520 --> 0:13:47.240 Yes, was an emergency liver transplant considered for Gail. 0:13:47.600 --> 0:13:49.600 There was a lot of discussion about whether it was 0:13:49.640 --> 0:13:53.600 possible to undertake in her given the advanced state of 0:13:53.640 --> 0:13:57.040 a multiple organ failure, so it was certainly considered yes. 0:13:57.320 --> 0:13:59.880 Did she ultimately have a liver transplant. 0:14:00.440 --> 0:14:05.080 No, she did not. The view of the consensus opinion 0:14:05.240 --> 0:14:09.160 of all of the contributing senior specialists from intensive care, 0:14:09.880 --> 0:14:13.400 the liver transplant unit, and toxicology was that she was 0:14:13.440 --> 0:14:15.840 too sick to undergo the necessary surgery. 0:14:16.040 --> 0:14:19.920 On three and four August, did Gal's condition continue to decline? 0:14:20.320 --> 0:14:23.560 Yes, she progressively became more unwell, and. 0:14:23.560 --> 0:14:26.200 As we spoke about before, the doctors again said they 0:14:26.240 --> 0:14:29.280 discussed whether they could try for surgery with Heather as well, 0:14:29.880 --> 0:14:33.160 but that she was not well enough at that point. 0:14:33.200 --> 0:14:34.680 But will bring you a little bit more of this 0:14:34.720 --> 0:14:36.920 evidence so you can sort of hear what the professor 0:14:37.000 --> 0:14:39.520 was describing when he was talking about the teams that 0:14:39.560 --> 0:14:42.640 were coming together to try and decide what the best 0:14:42.640 --> 0:14:44.720 course of action for these people were. Here's a little 0:14:44.720 --> 0:14:45.880 bit more of what the court heard. 0:14:46.200 --> 0:14:50.800 How was Heather Wilkinson's condition by second August twenty twenty three? 0:14:50.920 --> 0:14:55.800 She had a rapidly progressive deterioration of her multiple organ failure. 0:14:56.320 --> 0:14:59.200 Was a decision made to list her for an emergency 0:14:59.240 --> 0:15:00.000 liver transplant? 0:15:00.280 --> 0:15:02.600 There were discussions about whether that would be possible. 0:15:02.680 --> 0:15:03.920 Yes, was it possible? 0:15:04.240 --> 0:15:07.400 Ultimately no, she was too unwell to undergo the complex 0:15:07.480 --> 0:15:10.960 and extensive surgery required for a liver transplant, all. 0:15:10.960 --> 0:15:15.840 Right, and after extensive consultation between the medical teams, was 0:15:15.840 --> 0:15:18.520 it acknowledged that Heather was not going to survive. 0:15:18.800 --> 0:15:21.840 It was very apparent that this was not survivable. 0:15:21.960 --> 0:15:24.440 Yes, it was at this point, Penny, that we could 0:15:24.480 --> 0:15:26.800 see in the courtroom seated in the back road, there 0:15:26.840 --> 0:15:31.120 was a number of family members of Heather's visibly upset. 0:15:31.280 --> 0:15:34.360 There was hand holding and hands on knees and you 0:15:34.360 --> 0:15:37.760 could see almost shoulders touching as a sign of support 0:15:37.840 --> 0:15:40.760 while these final hours and days of Heather's life were 0:15:40.800 --> 0:15:41.520 being described. 0:15:41.800 --> 0:15:43.760 And as we've taken you through in this evidence, this 0:15:43.800 --> 0:15:45.600 is the order that everyone heard in the courtroom to 0:15:45.800 --> 0:15:48.440 quite a bit of detail about Don, then Gayle and 0:15:48.480 --> 0:15:50.840 then Heather. So by the time these family members were 0:15:50.840 --> 0:15:53.880 hearing this evidence, they had previously also heard it about 0:15:54.080 --> 0:15:57.240 about the Pattersons as well. And it was after it 0:15:57.320 --> 0:16:01.200 was put through the professor's evidence that all these three people, 0:16:01.280 --> 0:16:05.000 including Gail and Heather, had passed away at the Austin hospital. 0:16:05.000 --> 0:16:08.680 They came to Ian Wilkinson as part of the evidence, 0:16:08.680 --> 0:16:11.560 and as you mentioned, he's sitting in the courtroom watching 0:16:11.600 --> 0:16:16.280 all of this unfold and initially what the professor was 0:16:16.320 --> 0:16:19.440 sort of asked about was again the very similar questions 0:16:19.480 --> 0:16:21.320 that he was for all of the patients. But what 0:16:21.360 --> 0:16:25.240 did all of these staff conclude was the cause of 0:16:25.280 --> 0:16:28.760 his liver and organ failure and what sort of investigations 0:16:28.800 --> 0:16:29.320 they had done. 0:16:29.480 --> 0:16:31.760 The way that it was described to the jury was 0:16:31.880 --> 0:16:36.640 after Ian Wilkinson arrived. His condition also declined in the 0:16:36.720 --> 0:16:38.920 days after he arrived, and he had high levels of 0:16:38.960 --> 0:16:42.040 acid in his blood and an abnormal heart rhythm as well. 0:16:42.120 --> 0:16:44.200 But the way that it was explained to the jury 0:16:44.240 --> 0:16:47.600 was that the passes condition did slowly improve from about 0:16:47.640 --> 0:16:50.360 the fifth of August twenty twenty three, and he was 0:16:50.400 --> 0:16:54.000 eventually taken off breathing tubes about the fourteenth of August 0:16:54.120 --> 0:16:57.360 that same year. But he explained that it was very 0:16:57.480 --> 0:17:00.640 very slow. This process was very very slow coming out 0:17:00.640 --> 0:17:03.360 of an extreme critical illness. 0:17:03.480 --> 0:17:05.520 Let's hear a little bit from the professor's evidence on 0:17:05.560 --> 0:17:08.120 those initial concerns and treatment. 0:17:08.600 --> 0:17:12.080 What do medical staff at the Austin conclude about the 0:17:12.080 --> 0:17:14.440 cause of Ian Wilkinson's acute liver failure? 0:17:14.680 --> 0:17:17.119 That it was due to amanita mushroom poisoning. 0:17:17.280 --> 0:17:20.040 For the same reasons we've discussed in relation to the 0:17:20.080 --> 0:17:20.639 other three. 0:17:20.920 --> 0:17:22.440 All right, that's correct. 0:17:22.760 --> 0:17:27.120 Now we have been discussing one August. How was Ian 0:17:27.119 --> 0:17:29.520 Wilkinson's condition? By two August he. 0:17:29.560 --> 0:17:32.880 Was extremely unwell with advanced multiple organ failure. 0:17:33.400 --> 0:17:35.160 What about three August. 0:17:35.280 --> 0:17:40.320 He became more unwell, deteriorated further, particularly as circulation was 0:17:40.400 --> 0:17:42.560 requiring considerably more support. 0:17:42.880 --> 0:17:45.320 Did you commence a plasma exchange on that date? 0:17:45.520 --> 0:17:48.360 I recall I think it was on the third Yes, 0:17:48.600 --> 0:17:53.280 for August, did he continue to deteriorate. Yes, the acid 0:17:53.280 --> 0:17:56.000 in his blood was higher and he needed more additional 0:17:56.000 --> 0:18:01.119 support for his circulation, and he developed an abnormal art rhythm. 0:18:01.400 --> 0:18:04.360 Now, the professor gave evidence that before there was any 0:18:04.400 --> 0:18:07.960 improvement in the condition of Ian Wilkinson, they did perform 0:18:08.080 --> 0:18:11.000 some surgery on him as well. Yes, it was. It 0:18:11.040 --> 0:18:13.480 wasn't a liver transplant like with Don Patterson. It was 0:18:13.520 --> 0:18:16.600 what was described as a laparoscopy, which it was sort 0:18:16.600 --> 0:18:20.000 of explained through the professor's evidence that they were worried 0:18:20.240 --> 0:18:22.600 about issues with the bow and they needed to get 0:18:22.640 --> 0:18:26.639 in and see that through sort of through his abdomen 0:18:26.720 --> 0:18:29.679 and that. But once they had performed this surgery. They 0:18:29.720 --> 0:18:33.720 actually didn't find that there was any significant issues yeah, 0:18:33.760 --> 0:18:36.720 with his bow, So it wasn't a liver transplant or 0:18:36.720 --> 0:18:39.520 anything that Ian underwent. Quite a different surgery to Don. 0:18:39.840 --> 0:18:42.720 And as you mentioned before, there was these As everyone 0:18:42.880 --> 0:18:45.120 knows Ian Wilkinson, he's given evidence in. 0:18:45.080 --> 0:18:45.760 This trial too. 0:18:45.800 --> 0:18:48.679 He he did survive, but it was after quite a 0:18:48.680 --> 0:18:51.600 bit of time in different hospitals. And here's a little 0:18:51.640 --> 0:18:53.800 bit of what the professor said when he was being 0:18:53.840 --> 0:18:58.320 asked about Ian's recovery and ultimately how close they thought 0:18:58.359 --> 0:19:00.000 they came to Ian losing his life. 0:19:00.040 --> 0:19:00.480 Life too. 0:19:00.800 --> 0:19:03.639 Here's more of what the court heard. It's voiced by actors. 0:19:03.920 --> 0:19:08.480 Did he continue to improve over the days that followed that, Yes, it. 0:19:08.480 --> 0:19:11.360 Was very slow because he was coming from a situation 0:19:11.920 --> 0:19:15.760 of extreme critical illness, but he did slightly improve over 0:19:15.800 --> 0:19:16.760 that time. Yes. 0:19:17.440 --> 0:19:20.120 Was he eventually excubated on fourteen August? 0:19:20.640 --> 0:19:20.920 Yes? 0:19:21.760 --> 0:19:24.840 Was he discharged from the ICU to the ward on 0:19:24.920 --> 0:19:25.840 twenty one August? 0:19:26.080 --> 0:19:26.439 Yes? 0:19:26.880 --> 0:19:30.800 Was he discharged to a rehabilitation ward at Heidelberg Hospital 0:19:30.920 --> 0:19:35.200 on eleven September? Yes, and he was eventually discharged home. 0:19:35.760 --> 0:19:36.119 Yes. 0:19:36.600 --> 0:19:38.720 How close did Ian Wilkinson come to dying? 0:19:39.040 --> 0:19:41.320 We thought he was going to die. He was very close. 0:19:42.119 --> 0:19:44.400 At this point, Penny, we were able to look over 0:19:44.480 --> 0:19:47.159 and see Ian Wilkinson. As we mentioned earlier, he was 0:19:47.440 --> 0:19:50.120 seated in the court room and he appeared incredibly stoic. 0:19:50.240 --> 0:19:52.760 He was seated there with his arms crossed, sort of 0:19:52.800 --> 0:19:56.600 staring blankly ahead while all of this information about him, 0:19:56.640 --> 0:20:00.080 his health information was being read out to the jury. 0:20:00.280 --> 0:20:03.520