Pathologist tells jury injection 'not related' to heart failure

The State pathologist has told a jury that an elderly man who was allegedly poisoned by a nurse died of heart failure that was not related to an injection he received from the accused.

Dr Marie Cassidy said the cause of Mr John Gethings’ death was heart failure due to lack of blood supply to the heart and heart muscle, a narrowing of the blood vessels and an enlargement of the heart.

She was giving evidence in the trial of Ms Noreen Mulholland (aged 35), now living in Park Road, Portadown, Co Armagh and previously of Runabeg Close, Kildare, who has pleaded not guilty to four charges in relation to two elderly patients at Naas General Hospital in 2003.

Ms Mulholland denies assault causing harm to Mr John Gethings (aged 77), Baltinglass, Co Wicklow and to intentionally or recklessly administering a substance, Serenese, to him knowing it was capable of interfering substantially with his bodily functions without his consent on March 1, 2003.

Ms Mulholland also denied assaulting Mr Seamus Doherty (aged 80), Rathcoffey, Naas, County Kildare causing him harm and intentionally or recklessly administering a John Gethings (aged 77), Baltinglass, County Wicklow and to intentionally or recklessly administering a substance, Serenese, to him knowing it was capable of interfering substantially with his bodily functions without his consent between June18 and19, 2003.

Ms Orla Crowe BL, prosecuting, has told the jury that Mr Gethings died on March 2, 2003 but emphasised that it was not the State’s case that Ms Mulholland was responsible for his death.

Dr Cassidy said she supervised the exhumation of Mr Gethings’ body and subsequently carried out a post-mortem on it.

She said he had a 1.5 inches in depth bruise in the muscle of his left buttock and concluded that this was consistent with an intra muscular injection given with a very long needle.

A thin gauge needle would normally be used for this type of injection so as to avoid bruising a patient in this way.

Dr Cassidy said there was no bruising found on Mr Gethings’ right buttock or on any other part of his body which are used as injection sites, such as the arms and the legs.

Dr Cassidy agreed with Mr Giollaiosa O'Lideadha SC, defending, that the bruise on the buttock could also be consistent with impact caused by a blunt instrument but accepted that the location and dimension of the bruise suggested it was caused by an injection.

She further accepted that a 16 gauge needle could cause a bruise or might not cause a bruise. She said she would expect a white 16 gauge needle to have caused it because it had a longer tip and the thinner gauge needles had shorter tips.

Dr Cassidy also agreed, after examining two thinner gauge needles which are ehibits in the case that the tip of one was the exact same length as the 16 gauge while the tip of the second one was only a "little shorter".

Dr Pascal Kintz, a pharmacist and toxicologist, told the jury that seven samples of buttock tissues taken from Mr Gethings all tested positive for Serenase. Five of the samples were from the left buttock and two were taken from the right buttock.

He said the highest concentration of the drug was found in the samples taken from the right buttock which he said indicated that this area was the site of the injection.

Dr Kintz agreed with Mr O'Lideadha that it was initially suspected that the left buttock was the site of the most recent injection because of bruising found there but his tests suggested that the right buttock was the site of the injection, due to the higher concentrations of Serenase found there.

He agreed that he was not in a position to comment on whether the bruise was caused by injection or what type of needle was used to administer it. He could also not deduce from the amount of Serenase found in the buttock how much of the drug was actually injected.

Dr Kintz accepted that a drug needed to reach the brain to be effective and that a good circulatory system was necessary for it to reach there. He agreed that someone with a serious heart complaint would not be able to distribute the drug effectively.

The trial continues before Judge Frank O’Donnell and a jury of six women and six men.

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