The Litvinenko Inquiry

Transfer to UCH and treatment there
Part 3 | Chapters 1 to 5 | Alexander Litvinenko
3.127 As noted above, Mr Litvinenko was transferred to UCH late at night on 17 November.
He was an inpatient there for a little less than a week before his death on 23 November.
3.128 I heard oral evidence about Mr Litvinenko’s medical treatment at UCH from
Dr Amit Nathwani, a consultant haematologist at that hospital. 135 As with Dr Virchis, I
also admitted into evidence the relevant medical notes. 136
3.129 In summary:
a. Following Mr Litvinenko’s arrival at UCH, he seemed to be responding well to the
treatment with Prussian blue and reported feeling much better since the treatment
had started
b. Professor John Henry, an internationally renowned toxicologist with an interest in
rare poisons, became involved in advising on Mr Litvinenko’s treatment. He died
in 2007, but statements that he had given to the police were read into the record
c. Professor Henry stated that he had received a telephone call from Mr Goldfarb
on 17 November. They discussed Mr Litvinenko’s case and Mr Goldfarb told
Professor Henry that Mr Litvinenko had been poisoned by thallium. 137 Professor
Henry visited Mr Litvinenko at UCH on 18 November and examined him with the
agreement of the haematology team. Professor Henry stated that he agreed with
the diagnosis of thallium poisoning 138 and Mr Litvinenko continued to be treated
with Prussian blue
d. Despite the early improvement in Mr Litvinenko’s symptoms, he began to
vomit blood; and Dr Nathwani thought that this might be an adverse reaction
to one of the antibiotics with which he had been treated. 139 Medical staff were
also concerned that Mr Litvinenko appeared to have an irregular heartbeat, his
temperature was raised, he continued to vomit and he had abdominal pain. 140 An
electrocardiogram (ECG) confirmed an irregular heartbeat. 141 Dr Nathwani felt that
he and his colleagues were in “uncharted territory” with the suspected thallium
poisoning. Dr Nathwani therefore wanted to monitor Mr Litvinenko closely and
considered the possibility of transferring him to a high dependency or intensive
care unit (ICU) where his heart rate could be monitored continuously 142
e. On 19 November, a bed became available for Mr Litvinenko on the ICU. The
police expressed concerns as to security with regard to a transfer to the ICU. But
Dr Nathwani decided that Mr Litvinenko should be moved for his own well being;
he was transferred to the ICU later that evening 143
f. Dr Nathwani assessed Mr Litvinenko’s condition again on 20 November. He was
concerned about Mr Litvinenko’s bone marrow failure and raised temperature
135
Nathwani 18/93-129
136
INQ006652
137
Henry 18/132
138
Henry 18/137
139
Nathwani 18/99-100
140
Nathwani 18/101
141
Nathwani 18/103
142
Nathwani 18/103-105
143
Nathwani 18/107-108
37