Nine podcasts. In this episode, an intensive care specialist recalls the efforts of doctors to save the lunch guests and how close they thought. Ian Wilkinson came to dine.
Victoria's mushroom mystery. The mushroom lunch that claimed three lives an Australian family's meal is now the center of a homicide investigation.
For bizarre tragedy now grabbing global headlines.
Aaron Patterson's alleged victims died after eating a family lunch she'd serve them at her home. I cannot think of another investigation that has generated this level of media and public interest.
Four of the guests of that lunch were much loved members of this church.
Only one will ever return.
People are feeling very heavy with having lost such wonderful people.
Today, Aaron Patterson remained here inside her home. She's continued to plead her innocence in a court room in Country Victoria. Aaron Patterson is on trial accused of using death cat mushrooms to kill She's pleaded not guilty to murdering three of her former in laws and attempting to kill a fourth the town's church pastor. It's up to the jurors to decide what happened when Pattison's loved ones sat down
to eat. So in this episode, we're going to go through the evidence of a professor, an intensive care specialist, who gave some very detailed evidence as he spoke about the treatment that the four lunch guests that's Donegale Patterson, and Ian and Heather Wilkinson received at Melbourne's Austin Hospital. Now, while all of this was being relayed in court, there were a number of family members and Ian Wilkinson himself in the room.
Yeah, that's right.
There was Ian sitting in the back row next to his two daughters, and there was others sitting in the front row as well, maybe just under a dozen different members of the families. We know that throughout the trial many have been present, but there's also a significant number of members of the public now attending. They sit in the corner on the right hand side of the courtroom, Penny. There's also a number of members of the public that are sitting shoulder to shoulder with.
Them, and we did see during parts of this evidence, which was at the end of the fourth week of this trial, Aaron Patterson sitting in the Dock did appear quite emotional at times at times to be quite distressed while hearing, particularly about the conditions of the female lunch guests. And we'll sort of come back and forth to you throughout this episode to sort of update on what was happening in the courtroom at the time and different parts
of the evidence. But there are quite a lot of large segments of what was heard in the courtroom to make up this episode, because we really want people to understand what it was like listening to this particular doctor's very detailed evidence.
He gave evidence via video link beamed into the courtroom from a remote location for the jury to be able to observe, and he really took the jury through the final days of the lunch guests who passed away. We know three passed away and Ian Wilkinson survived, but we also heard a lot about e Wilkinson's medical diagnoses and what was going on in terms of his treatment plan
in hospital as well. We've got a real sense of the incredible efforts that were underway behind the scenes to do what they could to save all four lunch guests. We know that three of them passed away in early August, twenty twenty three. But Ian Wilkinson was present in court while all of that was detailed, and also his own medical history and what went on for him. He was sitting there listening to that as well.
Who you'll be hearing the words of today is Professor Stephen Worrelow. Now, as we mentioned, he's an intensive care specialist with Melbourne's Austin Hospital and he details some of the not only his experience but also the hospitals in
what you'll be hearing throughout this evidence. So we'll start off with what the court was basically taken through and this was following some evidence given by the professor that Don Patterson had arrived from karen Burrow Urgent Care to Dandyong, that he'd then come on to the Austin Hospital and at the time that he arrived into the Austin Hospital on the thirty first of July twenty twenty three, he had already been diagnosed with acute liver failure by the
critically unwell by the staff at Dandenong. They'd made that diagnosis and these different parts of evidence you'll be hearing all the referencing specific patients and different lunch guests at different times, but we'll begin with what the professor was telling the court about Don Patterson. This is while he was speaking with Sarah Lenthial from the prosecution.
The cause of the acute liver failure was considered most likely to be amanita mushrooms. Yes, that's correct, and he was referred to the Austin in anticipation of rapidly deteriorating and needing advanced therapies. Is that right?
Yes, that's correct.
Is there a reason why the Austin was the preferred destination for a patient like Donald Patterson?
Yes, The Austin hosts the state Liver Transplant Service, and so any patients from Victoria or adjacent regions and nearby states would be referred to our of US because we have a comprehensive program to support patients and specific liver problems up to an including liver transplantation if that's needed.
Had the Austin treated patients with amanita mushroom poisoning before?
Yes, we have.
And have you been involved in the care of patients with amanita mushroom poisoning before?
Yes? I have.
What was Donald Patterson's condition when he arrived at the Austin.
He was critically ill and in multiple organ failure. I can go into more details.
Perhaps there were various blood tests which indicated he was critically unwell.
Yes, so we identified that he had a severe liver injury and severe liver failure. Measurements of specific substance in the blood were extremely high, consistent with severe or massive liver injury. We also saw that as blood clotting measurements were grossly abnormal, consistent with liver failure, and he had a rain of other abnormalities including a build up of acid in the blood and a buildup of ammonia in the blood.
Was Donald Patterson receiving various treatments when he arrived at the Austin he was.
Our colleagues at Dandenong Hospital had already commenced a range of treatments to try and help support him.
He was sedated and intubated.
That's correct.
Yes, So the court was taken through the professor's evidence of what being intubated meant. And as we've mentioned, he is a intensive care specialist, so he was saying that during all of a lot of these elements he's talking about, these people are in the ICU in intensive care and on a breathing machine, so they're being ventilated with a tube down their mouth at that time.
Yeah, And the order of arrival was something else that the jury was taken through, Penny. We heard that Don arrived first and then hours later he was followed by his wife, Gail, and then the next morning Gail's sister Heather arrived shortly before her husband, Ian Wilkinson arrived. So that was the order of for two days, really following each other in pretty quick succession was Don, Gale, Heather and Ian.
And a lot of what.
The court was taken through in this evidence was the different treatments that people were given, those efforts of staff that you spoke about before, but also a lot of the testing and investigation that doctors were doing to try and find out what the exact cause was. As you just heard there, they believed the cause to be aminita mushroom poisoning. There were some other tests that were carried out. Here's a little bit more of the evidence. It's no one's real voice now.
Were various tests carried out to try to pinpoint the cause of Donald's acute liver failure.
Yes, a range of investigations were undertaken to try and find other possible causes. Those included blood tests, some imaging, and ultrasounds to try and test for specific viruses that can cause liver failure, to try and make sure that there wasn't another possible cause for why he was so sick.
And what were the results of all those tests.
There was no evidence of any other cause of his acute liver failure And.
What did you in the team at the Austin ultimately accept the cause of the acute liver failure to be for.
Donald, Amanita mushroom poisoning causing acute liver failure.
And was that because of the known consumption of mushrooms by Donald and others?
Yes, we had been alerted to a cluster of cases of patients that had we were advised, had consumed the same meal that it contained mushrooms and that they had all become very unwell. And that is not an unusual story for Amanita.
And was that diagnosis also made because of a clinical cause highly consistent with Amanita mushroom ingestion?
Absolutely, his clinical course was pretty typical for a severe poisoning of Amanita mushrooms.
Now, throughout this evidence, as we were talking about before, there were treatments mentioned as well, and one of the first ones that was mentioned was something called multi dose
activated charcolind Yes. It was explained that this is something that while the amenita poison is in the body, the body team to sort of start to recycle that inside, and that the use of the charcoal is in an attempt to medically remove that poison from someone's bows specifically and get that out of the body by interrupting the recycling process.
Yeah, Professor Worlow is explaining that it is largely the liver that takes a real hit from this poison, but also the bow as well, and he explained that there actually isn't really a test to test for toxic mushroom poisoning. Rather it's a focus on the treatment of the symptoms. So it's weighing up all the evidence and I guess figuring out that this is the path that we're going
to follow. And then that's why he was taking the jury through all the different treatments, because, as we know, he was trying to explain that sometimes patients get bad from this type of poison, but they start to get a little bit better, but then they get worse as the body starts to recycle the toxins over and over
and over through the different organs. And it was at this point when they were all arriving at the austume, you know, this is the final hospital that they attended, that they're all in critical, critical ways really and suffering from multi organ failure.
And some of the other treatments that were mentioned throughout multiple bits of evidence about all of the different patients treatments. They all had very similar treatments and very similar investigations, and some of the others is something called ascilla binon.
Now we were told in court that this is a specific antidote to aminita mushroom poisoning, so there was an attempt to use that also nak which we've mentioned in previous episodes, which is a drug that's widely used, the professor said for mushroom poisoning with liver failure, but it is also used in other situations where someone might have liver failure.
It's used to protect the liver. I think that was the way that it was explained, Penny. It's really this year this big hug around the liver to try and protect it and stop any damage that could follow.
And some of the other treatments that were mentioned as well, which you may hear later in the evidence worth things like are using vitamin C as well as plasma exchange. So lots of different sort of roads that these particular doctors took over a number of days.
I had a lot of fluid intake. Penny was something else that was mentioned.
Heah a lot of intravenous fluids. And as we've sort of set the scene before, it's a hard thing to think about, but all of these people at this point they are being intubated, there is a ventilation to breathing for them, and these doctors are making these decisions around them over quite a few hours. And going back to as the court heard in this sort of way that the evidence was presented, it all started with Donald Patterson and going through a lot of his medical points that
then led on to some of the other patients. But it was noted in this part of the professor's evidence while they were talking about all these treatments that he was continuing to deteriorate further sort of by the time it got to the second of August, he was unfortunately worsening. His circulation was struggling, and it was then that he spoke about a surgery that they decided that they would
try with Donald Patterson. Here is a little bit more of the professor's evidence as he was speaking with Sarah Lenthil from the prosecution. It's not their voices.
Did Donald Patterson undergo surgery on for August twenty twenty three?
He did, after extensive consultation with a range of senior specialists. It was thought that the only possibility of saving his life was through a liver transplant. And did that occur, Yes, there was an effort to undertake and complete a liver transplant. Yes.
After the liver transplant was carried out, did Donald Patterson's condition improve.
No, he got relentlessly worse. Unfortunately.
Was it recognized through the day that Donald Patterson was dying despite maximal therapy.
Yes, all of our treatments had unfortunately failed, and he was dying despite all of the measures that we were applying.
We also heard Penny that the possibility of liver transplants for Gail and Heather was something that was also discussed in that hospital, But the specialists ultimately decided that the sisters were too unwell to undergo surgery, and that was the decision that was made for Don but not for the others.
And it was spoken about.
The judge clarified at one point that had this been not so much a successful liver transplant for Don, but had it happened? And the professor said, yes, we did perform the liver transplant, but unfortunately that Don Patterson had passed away at the Austin hospital. Following that that he continued to get worse despite the fact that they.
Were giving him.
I believe he said every there were no other treatments left. They'd given him all the treatments, and that was essentially the case for the other two lunch guests as well, Gail and Heather. But here is a little bit more of the professor's evidence as he was speaking with Sarah Lenthil from the prosecution. It's not their voices.
Did she continue to receive maximal treatment and therapy she.
Was on everything that we had.
Yes, was an emergency liver transplant considered for Gail.
There was a lot of discussion about whether it was possible to undertake in her given the advanced state of a multiple organ failure, so it was certainly considered yes.
Did she ultimately have a liver transplant.
No, she did not. The view of the consensus opinion of all of the contributing senior specialists from intensive care, the liver transplant unit, and toxicology was that she was too sick to undergo the necessary surgery.
On three and four August, did Gal's condition continue to decline?
Yes, she progressively became more unwell, and.
As we spoke about before, the doctors again said they discussed whether they could try for surgery with Heather as well, but that she was not well enough at that point. But will bring you a little bit more of this evidence so you can sort of hear what the professor was describing when he was talking about the teams that were coming together to try and decide what the best course of action for these people were. Here's a little bit more of what the court heard.
How was Heather Wilkinson's condition by second August twenty twenty three?
She had a rapidly progressive deterioration of her multiple organ failure.
Was a decision made to list her for an emergency liver transplant?
There were discussions about whether that would be possible.
Yes, was it possible?
Ultimately no, she was too unwell to undergo the complex and extensive surgery required for a liver transplant, all.
Right, and after extensive consultation between the medical teams, was it acknowledged that Heather was not going to survive.
It was very apparent that this was not survivable.
Yes, it was at this point, Penny, that we could see in the courtroom seated in the back road, there was a number of family members of Heather's visibly upset. There was hand holding and hands on knees and you could see almost shoulders touching as a sign of support while these final hours and days of Heather's life were being described.
And as we've taken you through in this evidence, this is the order that everyone heard in the courtroom to quite a bit of detail about Don, then Gayle and then Heather. So by the time these family members were hearing this evidence, they had previously also heard it about about the Pattersons as well. And it was after it was put through the professor's evidence that all these three people, including Gail and Heather, had passed away at the Austin hospital.
They came to Ian Wilkinson as part of the evidence, and as you mentioned, he's sitting in the courtroom watching all of this unfold and initially what the professor was sort of asked about was again the very similar questions that he was for all of the patients. But what did all of these staff conclude was the cause of his liver and organ failure and what sort of investigations they had done.
The way that it was described to the jury was after Ian Wilkinson arrived. His condition also declined in the days after he arrived, and he had high levels of acid in his blood and an abnormal heart rhythm as well. But the way that it was explained to the jury was that the passes condition did slowly improve from about the fifth of August twenty twenty three, and he was eventually taken off breathing tubes about the fourteenth of August that same year. But he explained that it was very
very slow. This process was very very slow coming out of an extreme critical illness.
Let's hear a little bit from the professor's evidence on those initial concerns and treatment.
What do medical staff at the Austin conclude about the cause of Ian Wilkinson's acute liver failure?
That it was due to amanita mushroom poisoning.
For the same reasons we've discussed in relation to the other three.
All right, that's correct.
Now we have been discussing one August. How was Ian Wilkinson's condition? By two August he.
Was extremely unwell with advanced multiple organ failure.
What about three August.
He became more unwell, deteriorated further, particularly as circulation was requiring considerably more support.
Did you commence a plasma exchange on that date?
I recall I think it was on the third Yes, for August, did he continue to deteriorate. Yes, the acid in his blood was higher and he needed more additional support for his circulation, and he developed an abnormal art rhythm.
Now, the professor gave evidence that before there was any improvement in the condition of Ian Wilkinson, they did perform some surgery on him as well. Yes, it was. It wasn't a liver transplant like with Don Patterson. It was what was described as a laparoscopy, which it was sort of explained through the professor's evidence that they were worried about issues with the bow and they needed to get in and see that through sort of through his abdomen
and that. But once they had performed this surgery. They actually didn't find that there was any significant issues yeah, with his bow, So it wasn't a liver transplant or anything that Ian underwent. Quite a different surgery to Don. And as you mentioned before, there was these As everyone knows Ian Wilkinson, he's given evidence in.
This trial too.
He he did survive, but it was after quite a bit of time in different hospitals. And here's a little bit of what the professor said when he was being asked about Ian's recovery and ultimately how close they thought they came to Ian losing his life.
Life too.
Here's more of what the court heard. It's voiced by actors.
Did he continue to improve over the days that followed that, Yes, it.
Was very slow because he was coming from a situation of extreme critical illness, but he did slightly improve over that time. Yes.
Was he eventually excubated on fourteen August?
Yes?
Was he discharged from the ICU to the ward on twenty one August?
Yes?
Was he discharged to a rehabilitation ward at Heidelberg Hospital on eleven September? Yes, and he was eventually discharged home.
Yes.
How close did Ian Wilkinson come to dying?
We thought he was going to die. He was very close.
At this point, Penny, we were able to look over and see Ian Wilkinson. As we mentioned earlier, he was seated in the court room and he appeared incredibly stoic. He was seated there with his arms crossed, sort of staring blankly ahead while all of this information about him, his health information was being read out to the jury.
Yeah, he certainly didn't show any visible reactions to when particularly as the prosecutor turned through the screen through the video link to this professor who was giving evidence from the Austin hospital from his office you could see all of his many qualifications behind him and said, quite frankly to him, how close did this man come to dying?
And it was quite a.
Moment in the courtroom where I feel everyone sort of stopped not only to look at Ian Wilkinson, but sort of to acknowledge what was happening around them. And he showed no visible signs and just continued to watch the evidence. Says he has on every other day that he's.
Been there, incredibly composed.
Now, the court has also begun hearing from a number of new witnesses for the fifth week of evidence and we'll be bringing you this in our next episode. Thank you for listening to this episode of Say Grace. Please press the follow button in your app to get our next episodes as soon as we publish.
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By me Penelope Lesh and me Erin Percy.
This podcast is produced by Genevieve Rule.