which is approximately a foot above the ground. It was all fairly low level stuff.
Q. What does that mean?
A. It meant that because the injury—most of the injuries would have taken place while Dr Kelly was sitting down or lying down.
Q. Right. When you first saw the body, what position was it in?
A. He was on his back with the left wrist curled back in this sort of manner (Indicates).
Q. Did you make any other relevant discoveries while you were looking around the area?
A. There was an obvious large contact bloodstain on the knee of the jeans.
Q. What do you mean by a “contact bloodstain”?
A. A contact stain is what you will observe if an item has come into contact with a bloodstained surface, as opposed to blood spots and splashes when blood splashes on to an item.
Q. Which means at some stage his left wrist must have been in contact with his trousers?
A. No, what I am saying, at some stage he has knelt—I believe he has knelt in a pool of blood at some stage and this obviously is after he has been injured.
Q. Any other findings?
A. There were smears of blood on the Evian bottle and on the cap.
Q. And what did that indicate to you?
A. Well, that would indicate to me that Dr Kelly was already injured when he used the Evian bottle. As an explanation, my Lord—
LORD HUTTON: Yes.
A. —when people are injured and losing blood they will become thirsty.
MR DINGEMANS: They become?
A. Thirsty, as they are losing all that fluid.
Q. You thought he is likely to have had a drink then?
A. Yes.
Q. What else did you find?
A. There was a bloodstain on the right sleeve of the Barbour jacket. At the time that was a bit—slightly unusual, in that if someone is cutting their wrist you wonder how, if you are moving across like this, how you get blood sort of here (Indicates). But if the knife was held and it went like that, with the injury passing across the sleeve, that is a possible explanation. Another possible explanation is in leaning across to get the Evian bottle that the two areas may have crossed.
Q. Had crossed?
A. Yes.
Q. We know, in fact, the wrist which was cut was the left wrist, is that right?
A. That is correct.
Q. And we know that Dr Kelly was right handed.
A. I was not aware of that, but yes.
Q. Were those all your relevant findings?
A. The jeans, as I have talked about, with this large contact stain, did not appear to have any larger downward drops on them. There were a few stains and so forth but it did not have any staining that would suggest to me that his injuries, or his major injuries if you like, were caused while he was standing up, and there was not any—there did not appear to be any blood underneath where he was found, and the body was later moved which all suggested those injuries were caused while he was sat or lying down.
143. Dr Alexander Allan, a forensic toxicologist, was sent blood and urine samples and stomach contents taken from the body of Dr Kelly in the course of Dr Hunt’s post-mortem examination which he then analysed. Dr Allan found paracetamol and dextropropoxyphene in the samples and stomach contents. He described paracetamol and dextropropoxyphene as follows:
The two components, paracetamol and dextropropoxyphene, are the active components of a substance called Coproxamol which is a prescription only medicine containing 325 milligrams of paracetamol and 32.5 milligrams of dextropropoxyphene.
Q. What sort of ailments would that be prescribed for?
A. Mild to moderate pain, typically a bad back or period pain, something like that. And the concentrations of both drugs represent quite a large overdose of Coproxamol.
Q. What does the dextropropoxyphene cause if it is taken in overdose?
A. Dextropropoxyphene is an opioid analgesic drug which causes effects typical of opiate drugs in overdose, effects such as drowsiness, sedation and ultimately coma, respiratory depression and heart failure and dextropropoxyphene is known particularly in certain circumstances to cause disruption of the rhythm of the heart and it can cause death by that process in some cases of overdose.
Q. And what about paracetamol, what does that do?
A. Paracetamol does not cause drowsiness or sedation in overdose, but if enough is taken it can cause damage to the liver.
Q. If enough? I think you mean if too much is taken.
A. If too much is taken. I beg your pardon.
Q. What about the concentrations you have mentioned that you found in the blood? What did that indicate?
A. They are much higher than therapeutic use. Typically therapeutic use would represent one tenth of these concentrations. They clearly represent an overdose. But they are somewhat lower than what I would normally expect to encounter in cases of death due to an overdose of Coproxamol.
Q. What would you expect to see in the usual case where dextropropoxyphene has resulted in death? What types of proportions or concentrations would you normally expect to see?
A. There are two surveys reported I am aware of. One reports a concentration of 2.8 micrograms per millilitre of blood of dextropropoxyphene in a series of fatal overdose cases. Another one reports an average concentration of 4.7 microgrammes per millilitre of blood. You can say that they are several-fold larger than the level I found of 1 [microgram].
Q. What about the paracetamol concentration you found?
A. Again, it is higher than would be expected for therapeutic use, approximately 5 or 10 times higher. But it is much lower or lower than would be expected for paracetamol fatalities normally unless there was other factors of drugs involved.
Q. What sort of level would you normal [sic] expect for paracetamol fatalities?
A. I think if you can get the blood reasonably shortly after the incident and the person does not die slowly in hospital due to liver failure, perhaps typically 3 to 400 micrograms per millilitre of blood.
Q. About four times as much in other words?
A. Yes.
Q. Putting it in short terms, you would expect there to be about four times as much paracetamol and two and a half to four times as much dextropropoxyphene?
A. Two, three, four times as much paracetamol and two, three, four times as much dextropropoxyphene in the average overdose case, which results in fatalities.
Q. You have mentioned that it seemed that a number of Coproxamol drugs were taken. Was it possible, from your examination, to estimate how many tablets must have been taken?
A. It is not possible to do that, because of the complex nature of the behaviour of the drugs in the body. I understand that Dr Kelly may have vomited so he would have lost some stomach contents then. There was still some left in the stomach and presumably still some left in the gastrointestinal tracts. What I can say is that it is consistent with say 29/30 tablets but it could be consistent with other scenarios as well.
144. Dr Allan also said in his evidence that the only way in which paracetamol and dextropropoxyphene could be found in Dr Kelly’s blood was by him taking tablets containing them which he would have to ingest.
145. In relation to an examination of Dr Kelly’s body Assistant Chief Constable Page said in evidence:
Q. We heard about investigations that have been carried out in the post-mortem and toxicology reports.
A. Yes.
