Speaker 1: Nine podcasts. In this episode, an intensive care specialist recalls
Speaker 1: the efforts of doctors to save the lunch guests and
Speaker 1: how close they thought. Ian Wilkinson came to dine.
Speaker 2: Victoria's mushroom mystery. The mushroom lunch that claimed three lives
Speaker 2: an Australian family's meal is now the center of a
Speaker 2: homicide investigation.
Speaker 3: For bizarre tragedy now grabbing global headlines.
Speaker 2: Aaron Patterson's alleged victims died after eating a family lunch
Speaker 2: she'd serve them at her home. I cannot think of
Speaker 2: another investigation that has generated this level of media and
Speaker 2: public interest.
Speaker 1: Four of the guests of that lunch were much loved
Speaker 1: members of this church.
Speaker 3: Only one will ever return.
Speaker 2: People are feeling very heavy with having lost such wonderful people.
Speaker 1: Today, Aaron Patterson remained here inside her home. She's continued
Speaker 1: to plead her innocence in a court room in Country Victoria.
Speaker 1: Aaron Patterson is on trial accused of using death cat
Speaker 1: mushrooms to kill She's pleaded not guilty to murdering three
Speaker 1: of her former in laws and attempting to kill a
Speaker 1: fourth the town's church pastor. It's up to the jurors
Speaker 1: to decide what happened when Pattison's loved ones sat down
Speaker 1: to eat. So in this episode, we're going to go
Speaker 1: through the evidence of a professor, an intensive care specialist,
Speaker 1: who gave some very detailed evidence as he spoke about
Speaker 1: the treatment that the four lunch guests that's Donegale Patterson,
Speaker 1: and Ian and Heather Wilkinson received at Melbourne's Austin Hospital. Now,
Speaker 1: while all of this was being relayed in court, there
Speaker 1: were a number of family members and Ian Wilkinson himself
Speaker 1: in the room.
Speaker 3: Yeah, that's right.
Speaker 2: There was Ian sitting in the back row next to
Speaker 2: his two daughters, and there was others sitting in the
Speaker 2: front row as well, maybe just under a dozen different
Speaker 2: members of the families. We know that throughout the trial
Speaker 2: many have been present, but there's also a significant number
Speaker 2: of members of the public now attending. They sit in
Speaker 2: the corner on the right hand side of the courtroom, Penny.
Speaker 2: There's also a number of members of the public that
Speaker 2: are sitting shoulder to shoulder with.
Speaker 1: Them, and we did see during parts of this evidence,
Speaker 1: which was at the end of the fourth week of
Speaker 1: this trial, Aaron Patterson sitting in the Dock did appear
Speaker 1: quite emotional at times at times to be quite distressed
Speaker 1: while hearing, particularly about the conditions of the female lunch guests.
Speaker 1: And we'll sort of come back and forth to you
Speaker 1: throughout this episode to sort of update on what was
Speaker 1: happening in the courtroom at the time and different parts
Speaker 1: of the evidence. But there are quite a lot of
Speaker 1: large segments of what was heard in the courtroom to
Speaker 1: make up this episode, because we really want people to
Speaker 1: understand what it was like listening to this particular doctor's
Speaker 1: very detailed evidence.
Speaker 2: He gave evidence via video link beamed into the courtroom
Speaker 2: from a remote location for the jury to be able
Speaker 2: to observe, and he really took the jury through the
Speaker 2: final days of the lunch guests who passed away. We
Speaker 2: know three passed away and Ian Wilkinson survived, but we
Speaker 2: also heard a lot about e Wilkinson's medical diagnoses and
Speaker 2: what was going on in terms of his treatment plan
Speaker 2: in hospital as well. We've got a real sense of
Speaker 2: the incredible efforts that were underway behind the scenes to
Speaker 2: do what they could to save all four lunch guests.
Speaker 2: We know that three of them passed away in early August,
Speaker 2: twenty twenty three. But Ian Wilkinson was present in court
Speaker 2: while all of that was detailed, and also his own
Speaker 2: medical history and what went on for him. He was
Speaker 2: sitting there listening to that as well.
Speaker 1: Who you'll be hearing the words of today is Professor
Speaker 1: Stephen Worrelow. Now, as we mentioned, he's an intensive care
Speaker 1: specialist with Melbourne's Austin Hospital and he details some of
Speaker 1: the not only his experience but also the hospitals in
Speaker 1: what you'll be hearing throughout this evidence. So we'll start
Speaker 1: off with what the court was basically taken through and
Speaker 1: this was following some evidence given by the professor that
Speaker 1: Don Patterson had arrived from karen Burrow Urgent Care to Dandyong,
Speaker 1: that he'd then come on to the Austin Hospital and
Speaker 1: at the time that he arrived into the Austin Hospital
Speaker 1: on the thirty first of July twenty twenty three, he
Speaker 1: had already been diagnosed with acute liver failure by the
Speaker 1: critically unwell by the staff at Dandenong. They'd made that
Speaker 1: diagnosis and these different parts of evidence you'll be hearing
Speaker 1: all the referencing specific patients and different lunch guests at
Speaker 1: different times, but we'll begin with what the professor was
Speaker 1: telling the court about Don Patterson. This is while he
Speaker 1: was speaking with Sarah Lenthial from the prosecution.
Speaker 3: The cause of the acute liver failure was considered most
Speaker 3: likely to be amanita mushrooms. Yes, that's correct, and he
Speaker 3: was referred to the Austin in anticipation of rapidly deteriorating
Speaker 3: and needing advanced therapies. Is that right?
Speaker 4: Yes, that's correct.
Speaker 3: Is there a reason why the Austin was the preferred
Speaker 3: destination for a patient like Donald Patterson?
Speaker 4: Yes, The Austin hosts the state Liver Transplant Service, and
Speaker 4: so any patients from Victoria or adjacent regions and nearby
Speaker 4: states would be referred to our of US because we
Speaker 4: have a comprehensive program to support patients and specific liver
Speaker 4: problems up to an including liver transplantation if that's needed.
Speaker 3: Had the Austin treated patients with amanita mushroom poisoning before?
Speaker 4: Yes, we have.
Speaker 3: And have you been involved in the care of patients
Speaker 3: with amanita mushroom poisoning before?
Speaker 4: Yes? I have.
Speaker 3: What was Donald Patterson's condition when he arrived at the Austin.
Speaker 4: He was critically ill and in multiple organ failure. I
Speaker 4: can go into more details.
Speaker 3: Perhaps there were various blood tests which indicated he was
Speaker 3: critically unwell.
Speaker 4: Yes, so we identified that he had a severe liver
Speaker 4: injury and severe liver failure. Measurements of specific substance in
Speaker 4: the blood were extremely high, consistent with severe or massive
Speaker 4: liver injury. We also saw that as blood clotting measurements
Speaker 4: were grossly abnormal, consistent with liver failure, and he had
Speaker 4: a rain of other abnormalities including a build up of
Speaker 4: acid in the blood and a buildup of ammonia in
Speaker 4: the blood.
Speaker 3: Was Donald Patterson receiving various treatments when he arrived at
Speaker 3: the Austin he was.
Speaker 4: Our colleagues at Dandenong Hospital had already commenced a range
Speaker 4: of treatments to try and help support him.
Speaker 3: He was sedated and intubated.
Speaker 4: That's correct.
Speaker 1: Yes, So the court was taken through the professor's evidence
Speaker 1: of what being intubated meant. And as we've mentioned, he
Speaker 1: is a intensive care specialist, so he was saying that
Speaker 1: during all of a lot of these elements he's talking about,
Speaker 1: these people are in the ICU in intensive care and
Speaker 1: on a breathing machine, so they're being ventilated with a
Speaker 1: tube down their mouth at that time.
Speaker 2: Yeah, And the order of arrival was something else that
Speaker 2: the jury was taken through, Penny. We heard that Don
Speaker 2: arrived first and then hours later he was followed by
Speaker 2: his wife, Gail, and then the next morning Gail's sister
Speaker 2: Heather arrived shortly before her husband, Ian Wilkinson arrived. So
Speaker 2: that was the order of for two days, really following
Speaker 2: each other in pretty quick succession was Don, Gale, Heather
Speaker 2: and Ian.
Speaker 3: And a lot of what.
Speaker 1: The court was taken through in this evidence was the
Speaker 1: different treatments that people were given, those efforts of staff
Speaker 1: that you spoke about before, but also a lot of
Speaker 1: the testing and investigation that doctors were doing to try
Speaker 1: and find out what the exact cause was. As you
Speaker 1: just heard there, they believed the cause to be aminita
Speaker 1: mushroom poisoning. There were some other tests that were carried out.
Speaker 1: Here's a little bit more of the evidence. It's no
Speaker 1: one's real voice now.
Speaker 3: Were various tests carried out to try to pinpoint the
Speaker 3: cause of Donald's acute liver failure.
Speaker 4: Yes, a range of investigations were undertaken to try and
Speaker 4: find other possible causes. Those included blood tests, some imaging,
Speaker 4: and ultrasounds to try and test for specific viruses that
Speaker 4: can cause liver failure, to try and make sure that
Speaker 4: there wasn't another possible cause for why he was so sick.
Speaker 3: And what were the results of all those tests.
Speaker 4: There was no evidence of any other cause of his
Speaker 4: acute liver failure And.
Speaker 3: What did you in the team at the Austin ultimately
Speaker 3: accept the cause of the acute liver failure to be for.
Speaker 4: Donald, Amanita mushroom poisoning causing acute liver failure.
Speaker 3: And was that because of the known consumption of mushrooms
Speaker 3: by Donald and others?
Speaker 4: Yes, we had been alerted to a cluster of cases
Speaker 4: of patients that had we were advised, had consumed the
Speaker 4: same meal that it contained mushrooms and that they had
Speaker 4: all become very unwell. And that is not an unusual
Speaker 4: story for Amanita.
Speaker 3: And was that diagnosis also made because of a clinical
Speaker 3: cause highly consistent with Amanita mushroom ingestion?
Speaker 4: Absolutely, his clinical course was pretty typical for a severe
Speaker 4: poisoning of Amanita mushrooms.
Speaker 1: Now, throughout this evidence, as we were talking about before,
Speaker 1: there were treatments mentioned as well, and one of the
Speaker 1: first ones that was mentioned was something called multi dose
Speaker 1: activated charcolind Yes. It was explained that this is something
Speaker 1: that while the amenita poison is in the body, the
Speaker 1: body team to sort of start to recycle that inside,
Speaker 1: and that the use of the charcoal is in an
Speaker 1: attempt to medically remove that poison from someone's bows specifically
Speaker 1: and get that out of the body by interrupting the
Speaker 1: recycling process.
Speaker 2: Yeah, Professor Worlow is explaining that it is largely the
Speaker 2: liver that takes a real hit from this poison, but
Speaker 2: also the bow as well, and he explained that there
Speaker 2: actually isn't really a test to test for toxic mushroom poisoning.
Speaker 2: Rather it's a focus on the treatment of the symptoms.
Speaker 2: So it's weighing up all the evidence and I guess
Speaker 2: figuring out that this is the path that we're going
Speaker 2: to follow. And then that's why he was taking the
Speaker 2: jury through all the different treatments, because, as we know,
Speaker 2: he was trying to explain that sometimes patients get bad
Speaker 2: from this type of poison, but they start to get
Speaker 2: a little bit better, but then they get worse as
Speaker 2: the body starts to recycle the toxins over and over
Speaker 2: and over through the different organs. And it was at
Speaker 2: this point when they were all arriving at the austume,
Speaker 2: you know, this is the final hospital that they attended,
Speaker 2: that they're all in critical, critical ways really and suffering
Speaker 2: from multi organ failure.
Speaker 1: And some of the other treatments that were mentioned throughout
Speaker 1: multiple bits of evidence about all of the different patients treatments.
Speaker 1: They all had very similar treatments and very similar investigations,
Speaker 1: and some of the others is something called ascilla binon.
Speaker 1: Now we were told in court that this is a
Speaker 1: specific antidote to aminita mushroom poisoning, so there was an
Speaker 1: attempt to use that also nak which we've mentioned in
Speaker 1: previous episodes, which is a drug that's widely used, the
Speaker 1: professor said for mushroom poisoning with liver failure, but it
Speaker 1: is also used in other situations where someone might have
Speaker 1: liver failure.
Speaker 2: It's used to protect the liver. I think that was
Speaker 2: the way that it was explained, Penny. It's really this
Speaker 2: year this big hug around the liver to try and
Speaker 2: protect it and stop any damage that could follow.
Speaker 1: And some of the other treatments that were mentioned as well,
Speaker 1: which you may hear later in the evidence worth things
Speaker 1: like are using vitamin C as well as plasma exchange.
Speaker 1: So lots of different sort of roads that these particular
Speaker 1: doctors took over a number of days.
Speaker 2: I had a lot of fluid intake. Penny was something
Speaker 2: else that was mentioned.
Speaker 1: Heah a lot of intravenous fluids. And as we've sort
Speaker 1: of set the scene before, it's a hard thing to
Speaker 1: think about, but all of these people at this point
Speaker 1: they are being intubated, there is a ventilation to breathing
Speaker 1: for them, and these doctors are making these decisions around
Speaker 1: them over quite a few hours. And going back to
Speaker 1: as the court heard in this sort of way that
Speaker 1: the evidence was presented, it all started with Donald Patterson
Speaker 1: and going through a lot of his medical points that
Speaker 1: then led on to some of the other patients. But
Speaker 1: it was noted in this part of the professor's evidence
Speaker 1: while they were talking about all these treatments that he
Speaker 1: was continuing to deteriorate further sort of by the time
Speaker 1: it got to the second of August, he was unfortunately worsening.
Speaker 1: His circulation was struggling, and it was then that he
Speaker 1: spoke about a surgery that they decided that they would
Speaker 1: try with Donald Patterson. Here is a little bit more
Speaker 1: of the professor's evidence as he was speaking with Sarah
Speaker 1: Lenthil from the prosecution. It's not their voices.
Speaker 3: Did Donald Patterson undergo surgery on for August twenty twenty three?
Speaker 4: He did, after extensive consultation with a range of senior specialists.
Speaker 4: It was thought that the only possibility of saving his
Speaker 4: life was through a liver transplant. And did that occur, Yes,
Speaker 4: there was an effort to undertake and complete a liver transplant. Yes.
Speaker 3: After the liver transplant was carried out, did Donald Patterson's
Speaker 3: condition improve.
Speaker 4: No, he got relentlessly worse. Unfortunately.
Speaker 3: Was it recognized through the day that Donald Patterson was
Speaker 3: dying despite maximal therapy.
Speaker 4: Yes, all of our treatments had unfortunately failed, and he
Speaker 4: was dying despite all of the measures that we were applying.
Speaker 2: We also heard Penny that the possibility of liver transplants
Speaker 2: for Gail and Heather was something that was also discussed
Speaker 2: in that hospital, But the specialists ultimately decided that the
Speaker 2: sisters were too unwell to undergo surgery, and that was
Speaker 2: the decision that was made for Don but not for
Speaker 2: the others.
Speaker 3: And it was spoken about.
Speaker 1: The judge clarified at one point that had this been
Speaker 1: not so much a successful liver transplant for Don, but
Speaker 1: had it happened? And the professor said, yes, we did
Speaker 1: perform the liver transplant, but unfortunately that Don Patterson had
Speaker 1: passed away at the Austin hospital. Following that that he
Speaker 1: continued to get worse despite the fact that they.
Speaker 3: Were giving him.
Speaker 1: I believe he said every there were no other treatments left.
Speaker 1: They'd given him all the treatments, and that was essentially
Speaker 1: the case for the other two lunch guests as well,
Speaker 1: Gail and Heather. But here is a little bit more
Speaker 1: of the professor's evidence as he was speaking with Sarah
Speaker 1: Lenthil from the prosecution. It's not their voices.
Speaker 3: Did she continue to receive maximal treatment and therapy she.
Speaker 4: Was on everything that we had.
Speaker 3: Yes, was an emergency liver transplant considered for Gail.
Speaker 4: There was a lot of discussion about whether it was
Speaker 4: possible to undertake in her given the advanced state of
Speaker 4: a multiple organ failure, so it was certainly considered yes.
Speaker 3: Did she ultimately have a liver transplant.
Speaker 4: No, she did not. The view of the consensus opinion
Speaker 4: of all of the contributing senior specialists from intensive care,
Speaker 4: the liver transplant unit, and toxicology was that she was
Speaker 4: too sick to undergo the necessary surgery.
Speaker 3: On three and four August, did Gal's condition continue to decline?
Speaker 4: Yes, she progressively became more unwell, and.
Speaker 1: As we spoke about before, the doctors again said they
Speaker 1: discussed whether they could try for surgery with Heather as well,
Speaker 1: but that she was not well enough at that point.
Speaker 1: But will bring you a little bit more of this
Speaker 1: evidence so you can sort of hear what the professor
Speaker 1: was describing when he was talking about the teams that
Speaker 1: were coming together to try and decide what the best
Speaker 1: course of action for these people were. Here's a little
Speaker 1: bit more of what the court heard.
Speaker 3: How was Heather Wilkinson's condition by second August twenty twenty three?
Speaker 4: She had a rapidly progressive deterioration of her multiple organ failure.
Speaker 3: Was a decision made to list her for an emergency
Speaker 3: liver transplant?
Speaker 4: There were discussions about whether that would be possible.
Speaker 3: Yes, was it possible?
Speaker 4: Ultimately no, she was too unwell to undergo the complex
Speaker 4: and extensive surgery required for a liver transplant, all.
Speaker 3: Right, and after extensive consultation between the medical teams, was
Speaker 3: it acknowledged that Heather was not going to survive.
Speaker 4: It was very apparent that this was not survivable.
Speaker 2: Yes, it was at this point, Penny, that we could
Speaker 2: see in the courtroom seated in the back road, there
Speaker 2: was a number of family members of Heather's visibly upset.
Speaker 2: There was hand holding and hands on knees and you
Speaker 2: could see almost shoulders touching as a sign of support
Speaker 2: while these final hours and days of Heather's life were
Speaker 2: being described.
Speaker 1: And as we've taken you through in this evidence, this
Speaker 1: is the order that everyone heard in the courtroom to
Speaker 1: quite a bit of detail about Don, then Gayle and
Speaker 1: then Heather. So by the time these family members were
Speaker 1: hearing this evidence, they had previously also heard it about
Speaker 1: about the Pattersons as well. And it was after it
Speaker 1: was put through the professor's evidence that all these three people,
Speaker 1: including Gail and Heather, had passed away at the Austin hospital.
Speaker 1: They came to Ian Wilkinson as part of the evidence,
Speaker 1: and as you mentioned, he's sitting in the courtroom watching
Speaker 1: all of this unfold and initially what the professor was
Speaker 1: sort of asked about was again the very similar questions
Speaker 1: that he was for all of the patients. But what
Speaker 1: did all of these staff conclude was the cause of
Speaker 1: his liver and organ failure and what sort of investigations
Speaker 1: they had done.
Speaker 2: The way that it was described to the jury was
Speaker 2: after Ian Wilkinson arrived. His condition also declined in the
Speaker 2: days after he arrived, and he had high levels of
Speaker 2: acid in his blood and an abnormal heart rhythm as well.
Speaker 2: But the way that it was explained to the jury
Speaker 2: was that the passes condition did slowly improve from about
Speaker 2: the fifth of August twenty twenty three, and he was
Speaker 2: eventually taken off breathing tubes about the fourteenth of August
Speaker 2: that same year. But he explained that it was very
Speaker 2: very slow. This process was very very slow coming out
Speaker 2: of an extreme critical illness.
Speaker 1: Let's hear a little bit from the professor's evidence on
Speaker 1: those initial concerns and treatment.
Speaker 3: What do medical staff at the Austin conclude about the
Speaker 3: cause of Ian Wilkinson's acute liver failure?
Speaker 4: That it was due to amanita mushroom poisoning.
Speaker 3: For the same reasons we've discussed in relation to the
Speaker 3: other three.
Speaker 4: All right, that's correct.
Speaker 3: Now we have been discussing one August. How was Ian
Speaker 3: Wilkinson's condition? By two August he.
Speaker 4: Was extremely unwell with advanced multiple organ failure.
Speaker 3: What about three August.
Speaker 4: He became more unwell, deteriorated further, particularly as circulation was
Speaker 4: requiring considerably more support.
Speaker 3: Did you commence a plasma exchange on that date?
Speaker 4: I recall I think it was on the third Yes,
Speaker 4: for August, did he continue to deteriorate. Yes, the acid
Speaker 4: in his blood was higher and he needed more additional
Speaker 4: support for his circulation, and he developed an abnormal art rhythm.
Speaker 1: Now, the professor gave evidence that before there was any
Speaker 1: improvement in the condition of Ian Wilkinson, they did perform
Speaker 1: some surgery on him as well. Yes, it was. It
Speaker 1: wasn't a liver transplant like with Don Patterson. It was
Speaker 1: what was described as a laparoscopy, which it was sort
Speaker 1: of explained through the professor's evidence that they were worried
Speaker 1: about issues with the bow and they needed to get
Speaker 1: in and see that through sort of through his abdomen
Speaker 1: and that. But once they had performed this surgery. They
Speaker 1: actually didn't find that there was any significant issues yeah,
Speaker 1: with his bow, So it wasn't a liver transplant or
Speaker 1: anything that Ian underwent. Quite a different surgery to Don.
Speaker 1: And as you mentioned before, there was these As everyone
Speaker 1: knows Ian Wilkinson, he's given evidence in.
Speaker 3: This trial too.
Speaker 1: He he did survive, but it was after quite a
Speaker 1: bit of time in different hospitals. And here's a little
Speaker 1: bit of what the professor said when he was being
Speaker 1: asked about Ian's recovery and ultimately how close they thought
Speaker 1: they came to Ian losing his life.
Speaker 3: Life too.
Speaker 1: Here's more of what the court heard. It's voiced by actors.
Speaker 3: Did he continue to improve over the days that followed that, Yes, it.
Speaker 4: Was very slow because he was coming from a situation
Speaker 4: of extreme critical illness, but he did slightly improve over
Speaker 4: that time. Yes.
Speaker 3: Was he eventually excubated on fourteen August?
Speaker 4: Yes?
Speaker 3: Was he discharged from the ICU to the ward on
Speaker 3: twenty one August?
Speaker 4: Yes?
Speaker 3: Was he discharged to a rehabilitation ward at Heidelberg Hospital
Speaker 3: on eleven September? Yes, and he was eventually discharged home.
Speaker 4: Yes.
Speaker 3: How close did Ian Wilkinson come to dying?
Speaker 4: We thought he was going to die. He was very close.
Speaker 2: At this point, Penny, we were able to look over
Speaker 2: and see Ian Wilkinson. As we mentioned earlier, he was
Speaker 2: seated in the court room and he appeared incredibly stoic.
Speaker 2: He was seated there with his arms crossed, sort of
Speaker 2: staring blankly ahead while all of this information about him,
Speaker 2: his health information was being read out to the jury.
Speaker 1: Yeah, he certainly didn't show any visible reactions to when
Speaker 1: particularly as the prosecutor turned through the screen through the
Speaker 1: video link to this professor who was giving evidence from
Speaker 1: the Austin hospital from his office you could see all
Speaker 1: of his many qualifications behind him and said, quite frankly
Speaker 1: to him, how close did this man come to dying?
Speaker 3: And it was quite a.
Speaker 1: Moment in the courtroom where I feel everyone sort of
Speaker 1: stopped not only to look at Ian Wilkinson, but sort
Speaker 1: of to acknowledge what was happening around them. And he
Speaker 1: showed no visible signs and just continued to watch the evidence.
Speaker 1: Says he has on every other day that he's.
Speaker 2: Been there, incredibly composed.
Speaker 1: Now, the court has also begun hearing from a number
Speaker 1: of new witnesses for the fifth week of evidence and
Speaker 1: we'll be bringing you this in our next episode. Thank
Speaker 1: you for listening to this episode of Say Grace. Please
Speaker 1: press the follow button in your app to get our
Speaker 1: next episodes as soon as we publish.
Speaker 2: For more reporting on the case, check out the Age
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Speaker 1: To acknowledge the traditional owners of the land that this
Speaker 1: podcast was recorded on and wherever you're listening to it now.
Speaker 1: Say Grace is created and hosted.
Speaker 3: By me Penelope Lesh and me Erin Percy.
Speaker 1: This podcast is produced by Genevieve Rule.