The Litvinenko Inquiry

Part 3 | Chapters 1 to 5 | Alexander Litvinenko
3.166 As I understand Dr Harrison’s evidence on this point, his view is that in this case there
was certainly a major intake of polonium 210 by ingestion. There may have been an
additional, but minor, intake by inhalation, or there may in fact have been no intake by
inhalation at all.
3.167 I also note in this regard an observation made in the course of oral evidence by
Dr Swift, one of the two pathologists who conducted the post mortem. He stated that,
whilst it was not possible to state with certainty the route by which the polonium 210
had entered Mr Litvinenko’s body; “given the clinically recognised severe pharyngeal,
so the back of the throat, and oesophageal, the food pipe or gullet, inflammation, it
has most likely entered the body through oral means.” 197
3.168 The conclusion that most if not all of the polonium 210 found in Mr Litvinenko’s
body had been ingested rather than inhaled is relevant, amongst other things, to the
question of whether Mr Litvinenko’s death could have been an accident. Put shortly,
it seems less likely that he could have accidentally eaten something than that he
accidentally inhaled something. I shall return to this point in due course.
The medical cause of Mr Litvinenko’s death
3.169 The evidence on this issue comprised two lines of scientific investigation and analysis,
which were, to an extent at least, interdependent.
The pathologists
3.170 First, there was the evidence of the two pathologists, Dr Cary and Dr Swift, who
conducted Mr Litvinenko’s post mortem. 198 The post mortem took place at the Royal
London Hospital on 1 December 2006. Special safety precautions were taken
because of the radioactivity that was then still present in Mr Litvinenko’s body. Even
so, Dr Cary stated that the procedure had been: “one of the most dangerous postmortem
examinations ever undertaken in the Western world”. 199
3.171 Dr Cary summarised his findings in the form of six conclusions, with which Dr Swift
agreed. I shall record those conclusions here.
3.172 First, Dr Cary stated that:
“the changes in the internal organs are typical of those seen at the end stage
of multi-organ failure in an intensive care setting. There is no macroscopic
evidence, and by that I mean to the naked eye, of any underlying natural disease
process that would have preceded the presentation with an acute illness on
3 November 2006.” 200
3.173 Second, Dr Cary noted that due to the hazardous nature of the tissue samples that he
had taken from Mr Litvinenko’s body, he was unable to follow what would otherwise
have been the routine procedure of examining these samples under the microscope
to try to obtain further information about the cause of death. That said, Dr Cary
observed that the medical records from Mr Litvinenko’s time in hospital provided
useful information in this regard – there was clear documentation, for example, of
197
Swift 2/90-91
198
INQ003002; Cary 2/17-82; INQ003187; Swift 2/82-99
199
Cary 2/42
200
Cary 2/64
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