THE CORONER’S Court on Monday heard that Zara Qairina Mahathir’s treatment records would helpful in assessing to determine the source of phenytoin detected on Zara’s kidney tissue.
Senior forensic pathologist Datuk Seri Dr. Bhupinder Singh Jeswant Singh, agreed with Datuk Rizwandean M Borhan that it was helpful to find out how the phenytoin was there.
Rizwandean: So that means the deceased treatment records would be helpful to assess on that question of epilepsy?
Dr Bhupinder: Yes, but what I was trying to look at is that if it can be ruled out from the notes that the person was given phenytoin during the treatment, so that was a proper way of management of the individual. That’s why phenytoin was there. If it is not given in the hospital, the person could have been on the drug before.
Rizwandean: Doctor, you said, the deceased admission notes and medical records will be helpful to assess her anti-mortem injuries and treatment records. Meaning to say, the deceased treatment records would have shown whether she has been treated for epilepsy?
Dr Bhupinder: Not for epilepsy. This treatment of phenytoin is given to prevent seizures when the person is having hypoxic brain damage.
Rizwandean: Did you ask for further medical records or treatment records to assess or determine whether the deceased was given phenytoin?
Dr Bhupinder: Its not my prerogative to ask for records.
Rizwandean: Doctor, did you ask for the deceased’s past treatment records to assess whether the deceased was treated for epilepsy? Did you ask for it?
Dr Bhupinder: I have no records of that to ask them. I only depend on records given to me.
Rizwandean: Let me read the second last paragraph. Toxicology analysis conducted in the Department of Chemistry Laboratory did not detect common drugs in the deceased’s liver sample. Phenytoin was detected in the kidney tissue. My question, Phenytoin is also used for preventing seizures during neurosurgery?
Dr Bhupinder: Yes
Rizwandean: Refer to page 9 of your witness statement, you said, ‘Was the deceased on any treatment for epilepsy, or was the drug administered to her in the hospital where she was admitted for her traumatic brain injury?’
Dr Bhupinder: Yes
Rizwandean: Doctor, did it ever occur to you to ask for the deceased’s past medical records from the deceased’s mother or family to determine whether the deceased did indeed have epilepsy?
Dr Bhupinder: Its not my prerogative to ask questions. I only get what I get to comment on the records which I have with me, not to get records from and these records should be adduced in the court, not by me.
Rizwandean: Doctor, without past medical records of the deceased and you yourself admitted you have not asked for any medical records of the deceased, you should not have made a suggestion with all due respect that the deceased was on a treatment for epilepsy. Am I correct to say that?
Dr Bhupinder: I didn’t make a suggestion, I just to rule out whether the deceased was on any treatment or not. It’s not a suggestion to say that she was on epilepsy. It’s a question asked here.
Rizwandean: Dr Jessie Hiu said, “Toxicology analysis conducted in the Department of Chemistry Laboratory did not detect common drugs in deceased liver sample.
Phenytoin was detected in the kidney tissue. Phenytoin is an anti-seizure medication used in the treatment of epilepsy. It is also commonly administered as a prophylactic treatment in cases of severe traumatic brain injury to reduce the risk of early post-traumatic seizures.” Doctor, am I correct to say that in Dr Hiu’s report, she never suggested the deceased to be on treatment for epilepsy?
Dr Bhupinder: No, she didn’t. Neither did I.
Rizwandean: Any reason for you to put in italics in the last paragraph of your page 9, “Was the deceased on any treatment for epilepsy?” Any reason for you to put that in italics, doctor?
Dr Bhupinder: Just to rule out whether the person was on treatment before or not. Otherwise, where did the drug come from?
Rizwandean: Doctor, you wanted to suggest in your witness statement that the deceased may be treated for epilepsy. Am I correct?
Dr Bhupinder: Yes. If she was treated and the drug was given to her earlier, that shows why the drug is there. If it was given in the hospital surroundings, it would give you a proof that the drug was given in the hospital.
Rizwandean: Doctor, there is no medical records of the deceased to show that she was treated for epilepsy. And you have also stated that you have not asked for the deceased medical records on treatment of epilepsy. My question is, as an expert, you should not have stated “Was the deceased on any treatment for epilepsy?” in view of the above. Am I correct to say that?
Dr Bhupinder: Yang Arif, this being an inquiry and inquest, I am just suggesting to the court to get the information because we don’t have the information. It was a suggestion in my statement, so that we can inquire to find out where the drug came from. Was the patient on it or was the drug introduced to the patient? That was all.
I’m not saying the patient was on epilepsy treatment. It’s just for help the court. I’m here to help the court, So let that be put on record that I’m not siding anybody. I’m just coming to help the court understand what the situation could have been. That’s all.
Rizwandean: Okay, doctor. When you said ‘Was the deceased on any treatment for epilepsy? I’m also saying that you should not have said this without the medical records because journalists will pick up this statement and report this on the news. Am I correct? It will be highly reported about epilepsy.
Dr Bhupinder: Yang Arif, I am not here for the journalists or anybody. I am giving and stating an opinion as to during the findings of this, what it could, where could the particular drug have come from.
And I’m suggesting to the court as a witness to find out where did the drug come from. I’m not suggesting that the person is on treatment. Was she on treatment or not, or was the drug given to her while being treated in the hospital. That’s all I need the court to find out.
