The Litvinenko Inquiry

The Litvinenko Inquiry
Chapter 2: Medical cause of death
8.3 I received detailed evidence regarding the decline in Mr Litvinenko’s physical condition
during the last weeks of his life, and also regarding the care and treatment that he
received during that period first at Barnet General Hospital and then at University
College Hospital. I have summarised that evidence earlier in this Report, (see Part 3,
chapter 4).
8.4 Mr Litvinenko died at University College Hospital on the evening of 23 November
2006. He had suffered two cardiac arrests on 21 November, but had been successfully
resuscitated. He had lost consciousness on 23 November and at 8.51pm that evening
he suffered a third cardiac arrest from which the medical professionals were unable
to resuscitate him. Mr Down, an intensive care consultant on duty at the hospital that
evening, pronounced life extinct at 9.21pm. His view was that Mr Litvinenko had died
from multiple organ failure including progressive heart failure.
8.5 Following Mr Litvinenko’s death, his body and samples taken from it were examined
by a number of different scientists with a view to finding out as much as possible about
the way in which he died. I have detailed that evidence in Part 3, chapter 5 above.
8.6 The post mortem into Mr Litvinenko’s death was jointly conducted by two pathologists,
Dr Cary and Dr Swift. I heard evidence from both. The radioactivity present in
Mr Litvinenko’s body meant that special precautions had to be taken to protect the
health of all those present. It also meant that the pathologists were unable to conduct
all the tests that they might otherwise have undertaken. I have set all these matters
out in Part 3.
8.7 Dr Cary, with whom Dr Swift agreed, expressed himself to be “entirely satisfied” that
the cause of Mr Litvinenko’s death was acute radiation syndrome.
8.8 The pathologists reached this conclusion taking into account a number of factors.
These factors included not only their physical examination of Mr Litvinenko’s body, but
also their review of the detailed medical notes recording Mr Litvinenko’s worsening
clinical condition in the weeks before his death, as well as the results of tests performed
by other scientists on samples taken from Mr Litvinenko’s body. The pathologists also
relied on the fact that they had found no evidence of any possible alternative causes
(such as natural disease) of Mr Litvinenko’s death.
8.9 Although the pathologists were not in any doubt that Mr Litvinenko’s final heart attack
had been the result of acute radiation syndrome, they were unable to reach a firm
conclusion as to the precise mechanism by which this took place. They listed a
number of possibilities in this regard, including sepsis, liver and/or kidney failure, and
the primary effect of radiation on the heart itself.
8.10 I accept the evidence of Dr Cary and Dr Swift. I am sure that the cause of Mr Litvinenko’s
death was acute radiation syndrome.
8.11 I am fortified in reaching this conclusion by the evidence that I received from other
scientists who have conducted tests on samples taken from Mr Litvinenko’s body
in the years since his death. The scientists from whom I heard in this regard were
witness A1, Dr Harrison, Dr Gent and Dr Black.
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