Nat Cary's statement at inquest into G20 protest death contradicts findings of another specialist
Ian Tomlinson is likely to have died from injuries sustained when he was pushed from behind by a police officer at the G20 protests in London, a forensic pathologist has told an inquest.
Dr Nat Cary conducted his postmortem a few days after video footage showed PC Simon Harwood striking Tomlinson with a baton and pushing him to the ground near the Bank of England two years ago. Tomlinson, 47, collapsed and died less than three minutes later.
Cary said he believed the way Tomlinson fell to the ground was likely to cause a "blunt force trauma" to his abdomen. He said damage to the liver was the "most likely" cause of the internal bleeding, but the blood loss could have been caused by other burst veins. He believed this led to rapid internal bleeding, which would have caused Tomlinson to collapse to the ground and go into cardiac arrest.
Cary said the video footage showed that Tomlinson was unable to properly break his fall, and his elbow became trapped between his body and the pavement. He said bruises on the outside of his body, as well as those to his abdomen, were consistent with this. "There is every prospect that the elbow has basically made contact with the ground and there has been a transmitted force through to the contents of the abdomen," he said.
Cary's findings contradict those of another pathologist, Dr Freddy Patel, who was the first to examine Tomlinson's body in the presence of four police officers after his death. Two other pathologists, Dr Kenneth Shorrock and Dr Ben Swift, have concluded the newspaper seller died of internal bleeding.
In his evidence earlier in the week, Patel said he spent several hours looking for a cause of the internal bleeding but, when he could not find a source, concluded through the "process of elimination" that Tomlinson had died of natural causes.
He specifically concluded that Tomlinson, a father of nine, died from sudden "arrhythmic" heart attack caused by coronary artery disease.
However, Patel accepted that any heart attack may have been triggered by Tomlinson's encounter with the police officer 150 seconds earlier, conceding there was a "compelling association" between the two incidents.
The jury has heard that Patel has twice been suspended by the General Medical Council in the past seven months after disciplinary hearings into his botched postmortems. They include cases where he was found guilty of dishonesty, clinical failings and refusing to abandon his original conclusions of a heart attack. Patel conceded he sometimes got things wrong but denied being deliberately dishonest or lying.
Cary, who is also a specialist in coronary artery disease, said there was no evidence from his postmortem that heart attack was the cause of death.
Whereas Patel believed Tomlinson's most blocked coronary artery was 80% to 90% blocked, a body tissue expert said that the same artery was 50% blocked. Cary's opinion was that the same artery was between 60% and 70% blocked, which he said was very unlikely to have triggered a heart attack. "This is not the sort of blockage in atheroclerotic disease in coronary arteries that causes sudden death," he said.
A pivotal element within the inquest is the extent to which three litres of fluid found in Tomlinson's abdomen consisted of blood. Patel was the only pathologist to observe the fluid, which he described as "a large-volume intra-abdominal bleed".
However 12 months later, after reading how other pathologists had found Tomlinson died of internal bleeding in the abdomen, Patel changed his description to "[bodily] fluid with blood".
Patel told the inquest he did not know what proportion was blood but believed it was mostly bodily fluid. He said a sample he took of the fluid was inadvertently discarded.
Cary told the jury that he could not be sure from photographs of the amount of blood. But he added that despite Patel's altered findings he was confident the quantity of blood in the abdomen was "substantial" and enough to cause Tomlinson's collapse and subsequent death.
"Clearly at the time Dr Patel took that sample, he must have thought that a significant proportion of it was blood, because he was going to submit it for toxicology as blood."
Source: http://www.guardian.co.uk/uk/2011/apr/15/ian-tomlinson-g20-inquest-death
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