Pain, harsh exchanges of mails over Mutula death, postmortem tests

NAIROBI: Sordid tales of family pain, betrayal, suspicion, divisions and frustrations are the hallmark of a trove of email communication at the heart of a fresh push to resolve the mysterious death of Senator Mutula Kilonzo in April 2013.

The trove containing communication between family members, lawyers and doctors has been presented to Director of Public Prosecution Keriako Tobiko by a section of the family displeased with the progress of medical investigations into the mysterious death.

At the centre of the current push to investigate the alleged contamination of samples collected from Mutula’s body for detailed analysis are the four children in his first marriage – Senator Mutula Kilonzo Junior, Wanza Kilonzo, Kethi Kilonzo and Musembi Kilonzo.

In the emails attached to their October 23, 2014 petition, the four turn the spotlight on family doctors Andrew Gachie and Luke Musau for alleged delays in handing over alternate tissue samples to the family’s hired UK expert Dr Ian Madison Calder.

Contaminated samples

The earlier samples sent to UK expert Dr Susan Patterson for Dr Ian Calder were, by November 2013, found to have been opened and contaminated. The alleged contamination of the samples has delayed the final autopsy report, which would conclusively tell what killed the senator.

The samples collected from Mutula’s body included blood, urine, bile, liver, vitreous fluid, stomach, muscles, nail and hair cuttings. The samples had been collected by the doctors with the approval of the government chemist, during the postmortem examination on the late Makueni Senator’s body on April 30, 2013.

A good part of it (the fluids) was meant for toxicological tests and is the one said to have been contaminated. The other part, mainly body tissues, was meant for what pathologists called “histopathology”.

Almost a year after his death, alternative tissues samples had not been sent to the UK following the refusal of the UK doctors to deal with contaminated toxicology samples.

According to the trove of emails, the toxicology samples were sent out on May 9, 2013 via a commercial invoice belonging to Nairobi Hospital. They were sent out by one Peter Kariuki and received in London by one Menendez.

In the emails, Dr Gachie confirms that he is the one who handled the specimens after the initial sealing, but absolves himself from any interference. He said they were sent through a reliable courier that delivered them in “good condition”.

“It is not likely that the specimens could have been interfered with during the transportation stage,” he concludes.

Dr Gachie further dampened Dr Calder’s quest for alternate toxicology specimens by informing him there were only two batches; one sent to him and the other to the government chemist.

“We therefore do not have any other specimens kept aside and certainly the ones in the Government Chemist would not be suitable for further analysis. We are relying on the specimens at the Imperial College to provide some guidance as far as toxicology is concerned,” Dr Gachie wrote lasy January 28.

By last February, a section of the family was already fed up with the family doctors, especially Dr Musau, who they accused of not leading from the front. On February 3, Junior’s group boycotted a family-pathologists briefing, insisting on Dr Musau’s presence.

At the time, Dr Musau was said to be travelling out of the country and pleas by another section of the family, led by Junior’s step-brother Muathi Kilonzo, to meet him when he was available met deaf ears from Junior’s group.

“Dr Musau took and was given charge by the family over this process 10 months ago. His presence at the first family meeting with the pathologists is not negotiable. It is a professional obligation. I will not attend that meeting unless he is there. It is unfortunate that as a family we have allowed such professional tardiness,” Kethi fumed.

From then on, Junior maintained that it was time “for everyone” to record statements with the CID over the interference of the samples. Muathi said he would “happily” follow him (Junior) in recording a statement with police.

Junior finally recorded his statement with the police earlier this week, almost a year later. On February 14, last year, the family wrote to Calder, demanding a provisional report he (Dr Calder) said he had long sent in November 2013, but which the family had never received.

They also demanded his provisional view on cause of death and copy of toxicology report “whether final or preliminary”. But in response, Dr Calder demanded from them the “histology” samples (different from toxicology samples which had allegedly been interfered with) for microscopic examination.

He also complained that he had asked for the materials several times, but in vain, hence the delay.

(See: Mutula's death confounded even the UK experts)

Junior responded with claims that the local doctors; Gachie, Emily Rugena and Musau had been “obstructing this matter for reasons known to them.” He added: “The chickens are soon coming home to roost. Judgment day is around the corner.”

But Muathi expressed frustrations with both local and the UK doctors, reserving particularly harsher phrases for UK doctors: “I must admit the doctors and Calder are more disappointing with each revelation. The UK seems to be a black hole from which we don’t get anything.”

Junior, however, contested Muathi’s claims, saying the “black hole can only be at our own doorsteps”. On March 9, Calder dug in on his demand for histology samples, saying he was getting frustrated with the case. He restated his “not very scientific” view that Mutula consumed something which caused a “catastrophic disturbance of clotting mechanism”.

The following day, on March 10, last year, Junior and his siblings insisted that the samples be sent over. On the same day, Junior made a startling allegation, which was sharply reprimanded by his step-mother. “Both doctors (Gachie and Musau) have disclosed to a person who I know very well that dad was poisoned. The question is why this information is with third parties, or with part of the family. Why is Dr Gachie keeping whatever samples he has in his possession?”

Junior added in the email copied to all his siblings: “There is a deliberate attempt to derail the results of the postmortem (examination) and cover up the truth. The substance that Prof Calder is referring to holds the key. Perhaps we should be told the contents of the pellets that we found in dad’s dressing room.”

Muathi agreed to fresh samples being sent over but demanded guarantees on their integrity, saying the family could not afford another “nightmare” of exposing them to manipulation.

Objection

Together with his sister Kethi, Junior again objected to involvement of the family in the transportation of the samples to the UK, as implied in Muathi’s email. They said it would amount to sanitising the process at a late hour.

They also claimed Dr Gachie had been keeping the tissues for 11 months without the authority or consent of the family. “The samples that arrived in England contaminated were sent without the family involvement in the logistics. The histology has been under the custody of Dr Gachie, who has been under the supervision of Dr Musau. None has told us why or sought our consent to continue to keep them.”

“They should release the histology to Professor Calder immediately. Any attempt to get involved in the logistics 11 months after the fact will only serve to sanitise any previous wrong doing, unexplained and long periods of silence and non-responsiveness or negligence,” Kethi wrote.

Mutula’s widow, Nduku, did not object, but like her son Muathi, demanded security. She said the tissue samples being “the last thing that the doctors are holding” should be safeguarded. She also appeared to hit out at Junior’s poison claims: “I am amazed that the doctors are talking to some members of the family regarding the autopsy. This should not be allowed. If there is anything to report it should be reported at family meetings.”

The following day, on March 11, Junior persisted in questioning about the eight pellets found at his father’s dressing room, and whose content was not captured in the May 14, 2013 preliminary post-mortem report.

“When I asked Dr Musau about them in May last year, he replied that they may have been off the counter drugs for a cold,” Junior said.

According to a June 14, 2013 report by the Government chemist, the pellets contained “enantiomer of ephedrine.” The chemist’s report also stated that the pellets were “seemingly unknown-of in the local market” although they bore a prescription of two times a day for seven days.

Chief Government pathologist Dr Johansen Oduor’s September 19, 2013 postmortem report also alluded to signifficant presence of ephedrine in blood, urine, kidney, liver, muscle, chest and stomach samples taken from the body of the senior Mutula.

Together with the Government chemist, Oduor concluded that a combination of the drug and the caffeine in Pepsi Cola drug found on Mutula’s bedside may have caused his death.

On March 11, last year, Mutula’s family, through Archer & Wilcock Advocates, wrote to Dr Musau and Dr Gachie, asking them to immediately send to Dr Calder the materials he was asking for and while at it, take “utmost care to ensure that their integrity is not compromised”.

Three days later, Dr Gachie agreed and sent 43 tissue blocks in paraffin wax, through a Nairobi Hospital commercial invoice and through, once again, Peter Kariuki. He also absolved himself, once again, from blame of delay, saying he could not have sent the tissues without family consent.

His response provoked a tirade from Junior: “Is he suggesting that they have been keeping the tissue samples with the consent of the family? I am convinced this is not a coincidence. It is part of the wider scheme to cover up, or convolute the entire process. These are criminal acts and should be reported.”

The tissues eventually reached UK, but Calder, in his final report to the family, blamed the “time hiatus of waiting for the histology” and appeared to suggest that they, too, were not handled properly: “This had not been fixed properly and had to be reprocessed.”