Mutula Kilonzo's death confounded even the UK experts

The cause of death of Senator Mutula Kilonzo was so perplexing that dozens of UK experts are reported to have described it as “very unusual”.

The experts considered Ebola and a deadly snake bite in their efforts to determine what could have triggered such a massive bleeding as found in Mutula’s internal organs.

In a report to the family, Dr Ian Madison Calder, who has investigated sudden deaths in the UK for 29 years, said the widespread hemorrhage in Mutula’s brain, parietal spaces and soft tissues astounded them.

He said it was apparent there was no evidence of trauma or macroscopic evidence of natural diseases from the examination of the body. “The unusual aspect was the wide distribution of hemorrhages into unusual sites. This was especially significant in the brain, where there was bleeding into two separated anatomical sites, as well as into soft connective tissue,” he said in the report.

In his estimation, the cause for this could be “loss of integrity of the blood vessel walls”, his original theory. He said in his practice he had come across cases of “disseminated intravascular coagulation” which occurs mostly in pregnancies. However, he said, the uterine bleeding in such cases occurs directly from blood vessels.

Dr Calder says in the report that without any laboratory data on such a case available, he turned to his senior colleagues. He discussed the possibility of viral infection and Ebola but it did not add up. “Ebola would not have formed this pattern, and there would have been significant effect on those at the autopsy. The other preliminary differential diagnosis was the effects being caused by venom. Again, careful external examination had excluded any points of skin damage.”

The case, he wrote, was discussed with Prof Sit Colin Beery, an emeritus professor of pathology at the Royal London Hospital Medical School, chairman of UK’s Pesticides Appraisal Panel, chair of UK Safety of Medicine, President of British Haematological Society and Prof Robert Forest, the late director of department of Toxicology at Sheffield University.

Others who, he said, weighed their opinion on the cause of Mutula’s death included experts from the Coagulation Reference Laboratory in Geneva and director of Royal Botanical Gardens in Kew, London. Dr Susan Patterson, the director of Toxicology Laboratory at Imperial College, refused to test samples sent to her because they had been contaminated. “This is a very unusual case, and as such, has been discussed throughout a wide spectrum of national and international experts and specialists. It is unfortunate the material for toxicology was contaminated and due to this the key scientist was unable to make a science-based opinion,” he said.

Despite the problems, his view remains that there was some “perturbation” of Mutula’s clotting mechanism. He said the unusual feature of the case include the rapidity of the bleeding and multiplicity of sites. “In my personal and colleagues’ practice we do come across therapeutic bleeding but not of this pattern. I have seen several so called consumptive coagulopathies where clotting agents are actually removed from the circulation. These have been related to obstetric incidents and bleeding related to the uterus and no manifestation in other organs,” he said.

He said his basic thesis was that the acute hemorrhagic condition in Mutula’s case was induced, but the mechanism of how could not be determined, as the samples were defective. “Whether this was caused by some ingested material has to be speculative, but the causation of the vomiting may have some relevance. The whole basis has to be speculative,” he said, concluding: “I fear that on present information this is as far as it is possible to proceed.”

Other unanswered questions in Mutula’s death:

1. Although a half-full Del Monte peach juice was found alongside a Pepsi Cola can by Mutula’s bedside, DNA tests by the Government Chemist show he only drank from the Pepsi cola can. A swab from the juice did not produce any DNA profile.

2. While Mutula was found dead in clean underpants, DNA analysis of the pyjama pair of trouser he wore was found by the Government Chemist to have had semen and spermatozoa stains belonging to him. “Further investigation (scene reconstruction) is recommended,” the chemist concluded.

3. While the preliminary postmortem report by pathologists Dr Emily Rogena and Dr Andrew Kanyi says a vial containing eight small pellets was collected from the scene, the report of the Government Chemist talks of four pellets. In the email exchanges, Mutula Kilonzo Jnr makes repeated references to eight pellets.

4. The vial where the pellets were found had a prescription of 1x2 for seven days. Who prescribed this drug and for what?

5. Although he was alone, he had beside him a plastic hot water bottle, empty Keringet water bottle, three half-litre Keringet water bottles, bottle with water on the floor, Pepsi can, Peach juice, an apple fruit, two toffee sweets and peanuts.