The Litvinenko Inquiry
JIEp7Zyr
JIEp7Zyr
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<strong>The</strong> <strong>Litvinenko</strong> <strong>Inquiry</strong><br />
Chapter 2: Medical cause of death<br />
8.3 I received detailed evidence regarding the decline in Mr <strong>Litvinenko</strong>’s physical condition<br />
during the last weeks of his life, and also regarding the care and treatment that he<br />
received during that period first at Barnet General Hospital and then at University<br />
College Hospital. I have summarised that evidence earlier in this Report, (see Part 3,<br />
chapter 4).<br />
8.4 Mr <strong>Litvinenko</strong> died at University College Hospital on the evening of 23 November<br />
2006. He had suffered two cardiac arrests on 21 November, but had been successfully<br />
resuscitated. He had lost consciousness on 23 November and at 8.51pm that evening<br />
he suffered a third cardiac arrest from which the medical professionals were unable<br />
to resuscitate him. Mr Down, an intensive care consultant on duty at the hospital that<br />
evening, pronounced life extinct at 9.21pm. His view was that Mr <strong>Litvinenko</strong> had died<br />
from multiple organ failure including progressive heart failure.<br />
8.5 Following Mr <strong>Litvinenko</strong>’s death, his body and samples taken from it were examined<br />
by a number of different scientists with a view to finding out as much as possible about<br />
the way in which he died. I have detailed that evidence in Part 3, chapter 5 above.<br />
8.6 <strong>The</strong> post mortem into Mr <strong>Litvinenko</strong>’s death was jointly conducted by two pathologists,<br />
Dr Cary and Dr Swift. I heard evidence from both. <strong>The</strong> radioactivity present in<br />
Mr <strong>Litvinenko</strong>’s body meant that special precautions had to be taken to protect the<br />
health of all those present. It also meant that the pathologists were unable to conduct<br />
all the tests that they might otherwise have undertaken. I have set all these matters<br />
out in Part 3.<br />
8.7 Dr Cary, with whom Dr Swift agreed, expressed himself to be “entirely satisfied” that<br />
the cause of Mr <strong>Litvinenko</strong>’s death was acute radiation syndrome.<br />
8.8 <strong>The</strong> pathologists reached this conclusion taking into account a number of factors.<br />
<strong>The</strong>se factors included not only their physical examination of Mr <strong>Litvinenko</strong>’s body, but<br />
also their review of the detailed medical notes recording Mr <strong>Litvinenko</strong>’s worsening<br />
clinical condition in the weeks before his death, as well as the results of tests performed<br />
by other scientists on samples taken from Mr <strong>Litvinenko</strong>’s body. <strong>The</strong> pathologists also<br />
relied on the fact that they had found no evidence of any possible alternative causes<br />
(such as natural disease) of Mr <strong>Litvinenko</strong>’s death.<br />
8.9 Although the pathologists were not in any doubt that Mr <strong>Litvinenko</strong>’s final heart attack<br />
had been the result of acute radiation syndrome, they were unable to reach a firm<br />
conclusion as to the precise mechanism by which this took place. <strong>The</strong>y listed a<br />
number of possibilities in this regard, including sepsis, liver and/or kidney failure, and<br />
the primary effect of radiation on the heart itself.<br />
8.10 I accept the evidence of Dr Cary and Dr Swift. I am sure that the cause of Mr <strong>Litvinenko</strong>’s<br />
death was acute radiation syndrome.<br />
8.11 I am fortified in reaching this conclusion by the evidence that I received from other<br />
scientists who have conducted tests on samples taken from Mr <strong>Litvinenko</strong>’s body<br />
in the years since his death. <strong>The</strong> scientists from whom I heard in this regard were<br />
witness A1, Dr Harrison, Dr Gent and Dr Black.<br />
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