Article by Peter MacLeod, retired Police Superintendent detective, Nottinghamshire Police
Sedation
In this study we attempt to answer three questions
1 Were the twins sedated on the night of 3rd May 2007?
2 If so, were they sedated by an intruder ?
3 If so, but not by an intruder, then by whom ?
1 Were the twins sedated on the night of 3rd May 2007?
The question of sedation of the three McCann children is one which has caused problems since the very beginning.
Reported facts.
Around 10 pm 3rd May 2007 Kate McCann entered the apartment in the
holiday resort and reported Madeleine missing. The younger twins were
still in their travel cots in the same room, and were asleep.
What followed is a matter of public record. The apartment was
searched, several times, by many people, the surrounding area was
searched by large numbers of police and ex-pats and villagers, and huge
amount of activity was directed to discovering Madeleine’s whereabouts.
All were in vain.
BUT . . . during all of this commotion -
despite a window and shutters having been open for an hour on a cold night,
despite the door slamming shut,
despite curtains blowing into the room,
despite their mother frantically opening and closing wardrobes and cupboards
despite their mother rushing out screaming for help,
despite the entire Tapas 7 group searching throughout the apartment,
despite Kate and the Tapas group shouting Madeleine’s name outside,
despite Gerry McCann’s closing and opening the shutters multiple times
despite Mrs Webster’s similarly attempting to open the shutters but failing,
despite the Police investigating the scene,
despite Gerry’s “roaring like a lion” and then prostrating himself on the floor,
despite both parents repeating this action and wailing
despite Kate’s checking the twins for vital signs,
despite the twins being lifted from their cots by people not their parents, and
despite their being carried out into the cold night air, and to another apartment.
[1.1]
Despite all of this
. . . the twins did not wake
Kate McCann stated in 2011 that she had suspected sedation from the
very first. Given the above perhaps this is understandable.
[1.2]
In her book, “
madeleine’, which she described as “A Version of the Truth”, she says this explicitly.
3 May 2007 (NOTE: this information was not released until May 2011)
p. 75 “
Had Madeleine been given some kind of sedative to keep her quiet ? Had the twins, too ?”
[1.3]
She also reported this to the Officer in the case
3 August 2007 (NOTE: this information was not released until June 2008)
“due to which she now presumes that they were under the effect of
some sedative drug that a presumed abductor had administered to the
three children in order to be able to abduct Madeleine, a situation
which Kate refers to being possible . .” [1.4]
The McCanns then organised their own drug tests
24 September 2007
Forensic scientist from Control Risks take hair samples from Kate and the twins at the McCanns’ own request
[1.5]
A family member was ‘allowed’ to release this to the press.
02 October 2007
“Madeleine was drugged by her abductor”, says her grandmother
[1.6]
Gerry McCann reconfirms their suspicions
19 Nov. 2007
“Gerry McCann: The twins were still
sleeping in the their cots so . . . we tried to leave it as undisturbed
as possible, and they slept very soundly until we moved them out their
cots into another apartment . . which does make you wonder if there was
[sic] any substances used to keep them asleep.” [1.7]
Independent witnesses report and confirm the McCanns’ suspicions
25 April 2008 (referring to early May 2007)
They also wanted to know whether the PJ had any evidence that would
suggest that the person who took Madeleine had used any substance to
facilitate the abduction. [1.8]
5 Nov. 2007
Diane Webster - Fiona Payne’s mother:
“Err the twins were still asleep in the cot and I, with all the noise
going on I don’t know how they slept through it which makes me think
there was, they must have been err drugged with something.” . . .
Q:
“So how would you imagine that they may have been drugged?”
DW:
“Err by the abductor. I think Madeleine would have been drugged as well.” [1.9]
10 April 2008
Fiona Payne: “
But they were
okay, I mean, they were fine, they didn’t, they were asleep, but at the
time it did seem weird . . . they didn’t wake up and, again, that was
quite strange, even in the transfer and, and being handled by people
that weren’t their parents, they didn’t, they didn’t wake up.” [1.10]
Their own private detectives make a statement
11 Oct. 2009
Former police detectives David Edgar and Arthur Cowley . . . are
convinced the abductor went to the family’s apartment on May 3 2007
fully prepared with sufficient drugs, probably chloroform, to knock out
all three children. The fact that Sean and Amelie, then just 18 months
old, failed to wake when the alarm was raised, nor even as they were
taken to another apartment in the cold night air, has persuaded the
detectives that they, too, must have been drugged.
[1.11]
And just before the release of her book ‘madeleine’, Kate says she believes they were drugged.
13 May 2011
Kate McCann:
I believe kidnapper drugged my twins on the night Madeleine was taken.
Kate McCann said the kidnapper who seized Madeleine may also have
drugged her other two children, as she launched a new appeal in the hunt
for her missing girl today.
Mrs McCann said she had to check that twins Sean and Amelie were still
breathing because they did not wake as they began a frantic search for
the missing three-year-old.
[1.12]
Those then are the facts relating to the McCanns’ belief in sedation of the twins, and by extension, of Madeleine.
NOTE:
Levels of sedation are assessed
according to the The Ramsay Sedation Scale. RSS. This was the first
scale to be defined for sedated patients and was designed as a test of
rousability. The RSS scores sedation at six different levels, according
to how rousable the patient is. It is an intuitively obvious scale and
therefore lends itself to universal use, not only in the ICU, but
wherever sedative drugs or narcotics are given. It can be added to the
pain score and be considered the sixth vital sign.
Ramsay Sedation Scale
1 Patient is anxious and agitated or restless, or both
2 Patient is cooperative, oriented and tranquil
3 Patient responds to commands only
4 Patient exhibits brisk response to light glabellar (forehead) tap or loud auditory stimulus
5 Patient exhibits a sluggish response to light glabellar tap or loud auditory stimulus
6 Patient exhibits no response [1.13]
The twins are clearly in point 6 on the scale. They are failing
to respond to external stimuli, cold, light, noise - including
screaming, the inevitable jolting of the cots placed so close together
in a small room during the search and window / shutter procedures, human
touch, being picked up by person other than their own parents, and so
on.
[1.14]
We should remember that
Kate McCann and Fiona Payne are both qualified anaesthetists.
Even a non qualified parent should recognise the difference between a
child which was merely asleep, and one that was sedated. or unconscious.
We return to this aspect in the third question.
So to restate the original question - were the twins sedated ?
The reply must surely be, that having regard to all the available
evidence, we can confirm the parents’ and witnesses original and
subsequent thoughts and say that
on the balance of probabilities -
the twins Amelie and Sean McCann were sedated
Now we turn to the second question
2 Were the twins sedated by an “intruder”.
Medical note for non-medical readers
There are five routes for the administration of sedation.
Injection, inhalation of gas, or by mouth are the most common three.
Absorption per rectum or per vaginam are possible, but specialised and rare.
All methods require some co-operation on the part of the patient.
* Injection of three small children without raising the alarm is almost
unthinkable. Intra-muscular injections take between 3 and 15 minutes to
work. Intravenous injection is difficult. (Paediatric anaesthetics is a
specialised subject: finding a vein is more difficult than with an
adult )
Injection of three children, in turn, in silence, is a
suggestion which is difficult to accept by anyone with experience of
children.
* Administration of sedative by mouth would require
all three to be at least half awake, so they could sit up to drink and
swallow, and in any event drugs taken in this way require time to act.
The fastest acting such drugs in regular use take around 20 minutes to
begin acting.
Each child, in turn, would need to have the drug administered.
* Anaesthetic gas requires equipment for its effective administration, and leaves a distinctive smell. The classic “filling the room with chloroform” ,
or other gas exists only in Victorian novels, and in any event would
overcome the intruder himself, unless he had breathing equipment, in
addition to the equipment for administering to the children. (It would
incidentally also require the window and door to be shut ! ) Even
properly administered gas inhalation normally requires time, measured in
minutes, before sedation begins.
Again, each child would have to be sedated in turn.
Because it has been raised, we must briefly consider the McCanns’
principal private detectives, Edgar and Cowley, and their statement that
chloroform was used on all three children.
[2.1}
Chloroform is the stuff of Victorian melodrama, and like ether has no
place in modern medical practice. It has a distinctive sweet smell that
lingers for a very long time. Inhalation of the vapour gives an
ice-cold feeling that can cause immediate vomiting. Any doctor, and
indeed any
O level chemistry student knows and can immediately
identify chloroform. The liquid produces burn marks on the sensitive
skin round the nose and mouth,
[2.2]
What is interesting is that the McCanns have allowed this suggestion to
remain in the public consciousness, and have never corrected the
impression given. Even less have they specifically repudiated the
possibility of the use of chloroform. Matthew Oldfield was asked in
detail about any unusual smell in the apartment when he entered. He
stated he detected nothing.
[2.3]
As on commentator has aptly said, an intruder would need nothing more than a bottle of chloroform, a rag,
and a kidney dish for the vomit.
[2.4]
Given a sufficiently heavy dose a child
could be unconscious in 15 seconds.
But importantly it would start to wake immediately the anaesthesia were
stopped. It would wake, cry, and probably vomit. It would
NOT remain comatose for three or more hours, then drift into normal sleep, and then wake the next morning with no after effects.
[2.5]
Observation.
Jane Tanner’s description of the “abductor’ did not include anaesthetic
equipment or gas cylinders, nor even a back pack in which they might be
carried, and nothing was found in the apartment or the immediate
surrounding area.
The “Window of Opportunity”
The window of opportunity for an intruder has been discussed in
another study. This is a straightforward assessment based on the times
taken from Gerry McCann’s leaving the Tapas bar, walking to the
apartment, entering, seeing the children, completing the tasks he
reports, and then leaving by the patio doors. Jane Tanner who left the
table five minutes later by her own account, saw him talking to Jez
Wilkins the street a few seconds before she saw the person who the
McCanns now insist was the ‘abductor’ of Madeleine.
[2.6]
Allowing for the time to exit the apartment and cross the car park to
the point where he was seen, gives the window of opportunity
inside the apartment of around 1 minute and 20 seconds.
In that time he has to
• Enter the apartment
• Sedate all three children
- in the dark
• Select Madeleine as the victim -
in the dark
• Open the shutters and window -
if he used the front door to enter
• Pick Madeleine out of her bed -
in the dark
• Turn her round so that her head is now to his left, rather than to his
right, which is the way he would have approached her in the bed.
• Exit the apartment, either through the opened window and shutters, or
through the front door, which he must then close silently behind
him.
and then
• Walk to the
left along the path in front of the apartment, walk straight ahead across the car park, and then walk to the
right
along the road, and cross the street in front of Jane Tanner, the
father of the very child he had just abducted, and another man who
has his own child in a buggy.
We repeat,
taking into account the travelling time, he has around one minute and
twenty seconds in which to achieve the first seven items on the list
• No equipment or paraphernalia was found.
• There was no smell of anaesthetic gas
• Two children aged 2 years were left comatose for 10 hours
* When they woke no after effects were recorded.
[2.7]
So far as can be ascertained - there is NO substance or technique known to medical science which can do this.
So to restate the original question - were the twins sedated by an intruder ?
The answer must be, that having regard to all the available evidence, we can surely say that
on the balance of probabilities -
the twins Amelie and Sean McCann were not sedated by an intruder.
In fact the evidence and logic is such that this conclusion moves on the legal continuum a long way from merely
“On the balance of probabilities” and very much further towards
“Beyond a reasonable doubt”
We now turn to the third question
If the twins were sedated, but not by an ‘intruder” -
then by whom ?
Specifically we must ask whether the parents were involved
This is a more problematic issue. The parents
clearly now accept
that the twins were sedated, and if they wish to deny the second answer
will have to draw on their medical and expert anaesthetic knowledge to
show why that conclusion is wrong, how it might have achieved, and what
substance or technique might have been used.
In the absence of such an explanation, however, it is surely justifiable
to continue to examine some features of this extraordinary case.
The McCanns have wavered between initial acceptance, through a period of
stout denial during which they aggressively threatened to sue, and
ultimately back to a clear statement that they now believe the children
were indeed sedated.
This is part of the genesis of the story. It repeats some of what was seen earlier.
Initial recognition and acceptance
3 May 2007 (NOTE: this information was not released until May 2011)
p. 75 “
Had Madeleine been given some kind of sedative to keep her quiet ? Had the twins, too ?”
[3.1]
5 May 2007 (NOTE: statement dated 25 April 2008)
“They also wanted to know whether the PJ had any evidence that would
suggest that the person who took Madeleine had used any substance to
facilitate the abduction.” [3.2]
3 August 2007 (NOTE: this information was not released until June 2008)
“due to which she now presumes that they were under the effect of
some sedative drug that a presumed abductor had administered to the
three children in order to be able to abduct Madeleine, a situation
which Kate refers to being possible . .” [3.3]
August 2007
Q: Do you think the children were sedated?
A: There is no doubt. (Here he told an anecdote: that Kate called a
colleague of Gonçalo Amaral's in the PJ, in August, to ask them to check
the twins for traces of sedation. Apparently Kate was alone when she
called, and a bit upset. That same afternoon, Gerry called and cancelled
the request.) [3.4]
First denials that the parents had used sedation
August 2007
See previous entry.
“That same afternoon, Gerry called and cancelled the request.” [3.5]
10 August 2007 ( or thereabouts)
Gerry: “you know we’re not gonna comment, on anything but you know
there is absolutely no way we use any sedative drugs or anything like
that an’ you know we we have co-operated with the police we’ll answer
any queries ermm … any tests that they want to do. . . “ [3.6]
Implied acceptance of possibility
24 September 2007
Forensic scientist from Control Risks take hair samples from Kate and the twins at the McCanns’ own request
[3.7]
2 October 2007
“
Madeleine was drugged by her abductor”, says her grandmother
[3.8]
Resumed denials
20 October 2007
Scientific tests now support the denials by Gerry and Kate McCann that they ever sedated their children, it emerged yesterday. [3.9]
25 Oct. 2007
The McCanns, of Rothley, Leics, were asked if reports that they sedated their children were true. Cardiologist Gerry replied
: "It is ludicrous. These sort of questions are nonsense and we shouldn't be giving them the time of day. There is absolutely no suggestion that Madeleine, or the children, were drugged. It's outrageous." [3.10]
Oct 2007
Oprah Winfrey "
And then, there were the... the hurtful rumours
that you drugged Madeleine or that you gave her sedatives; that you
accidentally caused her... her death..."
KM: (
After a long pause) "I mean we know it's all lies."
GM:
"It's just nonsense you know, there's no... that people
can have theories and that's all it is, there's no evidence to suggest
any of that and it's absolute ludicrous, you know, and it's..." [3.11]
Second acceptance of possibility
19 Nov. 2007
“Gerry McCann: The twins were still
sleeping in the their cots so . . . we tried to leave it as undisturbed
as possible, and they slept very soundly until we moved them out their
cots into another apartment . . which does make you wonder if there was [sic] any substances used to keep them asleep.” [3.12]
Independent Witnesses
25 April 2008 (referring to early May 2007)
They also wanted to know whether the PJ had any evidence that would
suggest that the person who took Madeleine had used any substance to
facilitate the abduction. [3.13]
5 Nov. 2007
Diane Webster - Fiona Payne’s mother:
“Err the twins were still asleep in the cot and I, with all the noise
going on I don’t know how they slept through it which makes me think
there was, they must have been err drugged with something.” . . .
“So how would you imagine that they may have been drugged?”
“Err by the abductor. I think Madeleine would have been drugged as well.” [3.14]
10 April 2008
Fiona Payne:
“But they were
okay, I mean, they were fine, they didn’t, they were asleep, but at the
time it did seem weird . . . they didn’t wake up and, again, that was
quite strange, even in the transfer and, and being handled by people
that weren’t their parents, they didn’t, they didn’t wake up.” [3.15]
NOTA BENE: July 2008
Documents in the case including witness statements were released to the
public. At this point Diane Webster’s and Fiona Payne’s statements
(above) became public knowledge, and may have been seen by the McCanns
for the first time.
Public statements that it MUST have happened11 Oct. 2009
Former police detectives David Edgar and Arthur Cowley . . . are
convinced the abductor went to the family’s apartment on May 3 2007
fully prepared with sufficient drugs, probably chloroform, to knock out
all three children. The fact that Sean and Amelie, then just 18 months
old, failed to wake when the alarm was raised, nor even as they were
taken to another apartment in the cold night air, has persuaded the
detectives that they, too, must have been drugged.
[3.16]
13 May 2011
Kate McCann:
I believe kidnapper drugged my twins on the night Madeleine was taken.
Kate McCann said the kidnapper who seized Madeleine may also have
drugged her other two children, as she launched a new appeal in the hunt
for her missing girl today.
Mrs McCann said she had to check that twins Sean and Amelie were still
breathing because they did not wake as they began a frantic search for
the missing three-year-old.
[3.17]
How then are we to make sense of this ?
Firstly we note that on occasion the question being asked is whether the
children were sedated, but the McCanns answer a totally different one.
The parents deny sedating the children themselves, but often do not
address the question of whether they were sedated by someone else.
Some forensic linguistics analysts have proffered views on why this might happen.
It is also striking that we are never told of the laboratory which
performed the analysis on the hair samples, we are never shown the
results, and in fact we have to turn to an
Indian newspaper to find these details. Here it is stated that a company called TrichoTest performed the analysis.
[3.18] [3.19]
And yet even then we have this strange passage,
“All the hair samples produced negative results. While this didn’t
totally exclude the possibility that the children had been sedated,
especially given the time that had elapsed, it meant nobody else (including the PJ and the media) could prove otherwise.” [3.20]
The emphasis is not on the twins’ welfare or whether some noxious
substance had been administered. Kate McCann is purely concerned with
whether there is sufficient “proof”
against the parents. But at the same time she is by implication admitting that the twins might have been sedated.
There are other bizarre aspects of the hair analysis. Laboratories
advertise their ability for analyse for a period of 90 days. The
McCanns’ samples were not taken until 24th September, almost six months =
144 days later. Although it is possible at that stage to test for
continuous drug use, it is not believed in any event that a single dose
of a drug, given in the tiny amount appropriate to a 2 year old would be
sufficient for successful identification on analysis.
Kate describes the process as leaving her looking as it she had alopecia.
[3.21] The laboratories state they need one sample taken from close to the scalp, no larger than
“a shoelace tip” [3.22]
Whilst this may simply be “journalistic licence” to evoke sympathy
from the reader, or to add some human interest, that could be accepted
if the book were not described as
“very truthful”.
So we look to the statements
Gerry McCann made three statements. 4 May, 10 May, 7 Sept. 2007
Kate McCann made two statements. 4 May, 9 Sept. 2007
In each of these in relation to the continued sleeping of the twins
through the entire episode, and the possibility of sedation there is
precisely -
NOTHING.
The whole issue is simply side-stepped. Even in the book it is glossed over
p. 75 “I wandered into the children’s bedroom several times to
check on Sean and Amelie. They were both lying on their fronts in a kind
of crouch, with their heads turned sideways and their knees tucked
under their tummies. In spite of the noise and lights and general
pandemonium, they hadn’t stirred. They’d always been sound sleepers, but
this seemed unnatural. Scared for them, too, I placed the palms of my
hands on their backs to check for chest movement, basically, for some
sign of life. Had Madeleine been given some kind of sedative to keep her
quiet? Had the twins, too? It was not until about 11.10pm that two
policemen arrived from the nearest town, Lagos, about five miles away.
To me they seemed bewildered and out of their depth, and I couldn’t
shake the images of Tweedledum and Tweedledee out of my head. I realise
how unfair this might sound, but with communication hampered by the
language barrier and precious time passing, their presence did not fill
me with confidence at all.” [3.23]
There are some strange and worrying aspects to this extract.
The use of “
wandered” as a verb of motion during this frantic phase of a search for a missing child.
On the previous and adjacent pages we find ”
Yelled”, “hitting out at
things”, “banging my fists on the railings”, ” running from pillar to
post”, “ran back”, “dashed over”., “throwing open” “hurtling out”
“started screaming”,” was hysterical”, “sprinted back” and many
other more intensely active verbs clearly carefully selected to give a
real impression of terror, speed and urgency.
[3.24]
Here we are given
“wandered into the bedroom” as the verbal
phrase defining the action of the mother of an missing child checking
that her two remaining children who she suspected had been
anaesthetised,
were still alive ! [3.25]
A number of other points surely present themselves for further comment.
• The strange way in which the children were lying,. Though this position is in itself not unusual, there is the fact that
both were lying in the
same way
• The fact that
“despite the noise and pandemonium they hadn’t stirred” still less woken.
• Kate describing this as
“unnatural”.
• Kate placing the palms of hands on their
backs, to check for
“chest movement”.
• Her chilling use of the phrase
“. . .basically, for sign of life”
• Her thoughts
“Had the twins too [been given some kind of sedative]
?”
For many people this passage will sound
quite extraordinary. Doctors, nurses, police officers, ambulance crews,
fire officers, paramedics, St John Ambulance staff, and many others are
taught in their basic training about the importance of rousing people.
Drunks, drug addicts, people with head injuries, and those who have
suffered smoke inhalation are roused, and in some cases are to be shaken
into consciousness. Failure to rouse a patient should lead to immediate
medical assistance being sought, or transportation to the nearest
casualty department.
Failure regularly to rouse someone in a
police cell is a very serious disciplinary offence, the penalty for
which may be dismissal from the service.
But we are told that a qualified anaesthetist merely
“. . placed the palms of my hands on their backs to check for chest movement, basically, for some sign of life”. [3.26]
The Royal College of Nursing is quite clear about this.
In “Standards
for assessing, measuring and monitoring vital signs in infants,
children and young people - RCN guidance for children’s nurses and
nurses working with children and young people”
they say, very simply
Infants and children less than six to seven years of
age are predominantly abdominal breathers
therefore, abdominal movements should be counted.
They emphasise “the particular vulnerability of infants and young children to rapid physiological deterioration”
And later discussing recovery room protocols
•
following a simple procedure – vital signs should be recorded every 30
minutes for two hours, then hourly for two to four hours until the child is fully awake, eating and drinking. [3.27]
When we add to this the curious way the children were lying,
on their fronts in a kind of crouch, with their heads turned sideways and their knees tucked under their tummies.“
which clearly must restrict the abdominal breathing in a child of that
age, the failure by either of the parents or the other qualified
anaesthetist present to modify this posture is very difficult to
understand.
Levels of sedation are assessed according to the Ramsay Sedation Scale (RSS)
1 Patient is anxious and agitated or restless, or both
2 Patient is cooperative, oriented and tranquil
3 Patient responds to commands only
4 Patient exhibits brisk response to light glabellar (forehead) tap or loud auditory stimulus
5 Patient exhibits a sluggish response to light glabellar tap or loud auditory stimulus
6 Patient exhibits no response [3.28]
The twins are clearly in point 6 on the scale. They are failing
to respond to external stimuli, cold, light, noise - including
screaming, the inevitable jolting of the cots placed so close together
in a small room during the search and window / shutter procedures, human
touch, and then being picked out of their cots by persons not their
parents, taken outdoors into the dark and cold air, into the light and
warmth of a neighbouring apartment, where they are placed in different
cots.
it is hard to believe that neither parent would have picked them up, but
there is no evidence that they did. It is also worthy of note that
Dr. Fiona Payne was with Kate McCann at this time. It seems no one was
with the twins.
Although it is capable of interpretation this piece is placed in the
narrative of the book around 11:00pm, an hour after the discovery. It
is placed between the incident when both Kate and Fiona Payne shout
“something short and to the point” at Mrs Fenn, and the arrival of the police at 11:10pm.
[3.29]
Kate herself states
p. 74
“He’d [Gerry had] asked Fiona to stay with me. I was in
our bedroom, on my knees beside the bed, just praying and praying and
praying. . . “ [3.30]
The next paragraph talks of Kate’s
“sitting on the bed”
whilst Emma Knights from Mark Warner came in, and then goes on to talk
about Kate’s being out on the veranda when another woman appeared, and
so on.
In other words neither doctor was in the twins’ room performing any
clinical checks for vital signs, or carrying out any procedures for
rousing them.
Both doctors,
each of whom is a qualified anaesthetist, failed to address the simplest but the most important questions.
Why can they not be roused ?
And then -
Given that they cannot be roused, what procedure, and / or what
substance has been used to sedate these two children to this extent ?
We now know that any sedation must have been administered within 1
minute and 20 seconds, in a narrow time window between Gerry McCann’s
leaving the apartment, and Jane Tanner’s seeing the abductor carrying
Madeleine, so obviously the substance was extremely fast acting, and
very powerful.
The two anaesthetists did not have that information, but must
nevertheless have believed that sedation had occurred within the
previous half hour between Oldfield’s visit and Kate’s.
So what precisely did the two qualified anaesthetists assume had been used, and how did they suppose it had been administered ?
Why did they accept that the dosage had been exactly correct for children of this age and size ?
Was it still being absorbed and was the level in the tissues still
increasing ? Were they coming round, or were they drifting into even
deeper level of unconsciousness, coma, and possible death ?
What
were the likely or possible side effects - vomiting, breathing
difficulties, lung congestion, ventricular or atrial fibrillation, brain
damage, liver or kidney failure, or any of the many other possible
sequelae that both will have studied at length and been examined on in
detail.
What precisely did they identify or diagnose ?
Medical Note for non-medical readers - shortened (see earlier)
There are five routes for the administration of sedation.
* Injection
* By mouth
* Inhalation of anaesthetic gas
being the three most usual.
Observation.
Jane Tanner’s description of the “abductor’ did not include anaesthetic
equipment or gas cylinders, nor even a back pack in which they might be
carried, and nothing was found in the apartment or the immediate
surrounding area.
Reminder
The McCanns, and many of their Tapas7 friends are medically trained.
Both Dr. Kate McCann and Dr. Fiona Payne are trained to a high standard in anaesthetics. In fact both were Junior Registrars.
Their continued insistence on sedation by an ‘intruder’ as a viable
proposition, when combined with the unambiguous admission in their
statements, in interviews, and in the book, of clearly defined
professional negligence in their manifest failure to provide, or even
consider, any form of resuscitation or aftercare, is baffling.
But these qualified anaesthetists simply put a palm on a child’s back,
or a finger under its nose, (according to Dr Fiona Payne). There is no
record of whether each child was turned, undressed and examined minutely
for needle stick marks, or had its mouth, nose and throat cleared or
checked for the presence of a chloroform soaked rag, had its breath
smelled for evidence of drugs, gas or ketones, had its pupil response
monitored, had its heart rate taken, had other reflexes tested, or was
roused until fully conscious. These would be standard procedures.
There is no record of proper and medically correct post-anaesthesia care. None. Nothing.
On the contrary, what evidence there is points to the twins’ having
simply been left for a considerable period unattended, and then some
two hours later scooped up out of their travel cots, in the bedclothes
in which they slept, and being carried, still sleeping, out into the
cold night air and round to an adjacent apartment where they were again
left to sleep.
[3.31]
Neither doctor performed any of the usual and medically required tests
or procedures appropriate to recovery from anaesthesia. It is a matter
of record that the twins were not taken to a hospital for assessment.
On the facts therefore the doctors were in
serious and negligent breach of a whole series of medical protocols for
which people have been struck off the register. [3.32]
And even more strangely, they have admitted this in statements and in
the book. They have made no attempt to suggest that they acted
correctly.
If we rely purely on what they have said, we find that it is
corroborated by independent witnesses, and it leads to the following
conclusion -
They would be guilty of a most serious breach of professional
standards, so serious that striking off the Medical Register would be
appropriate.
We are given many instances in her own book of Kate McCanns’ loss of
control, kicking out at inanimate objects, hitting railings with her
fists, throwing herself on the floor, wailing and so on. We are however
also given clear examples where she was
not acting in this way,
being more calm and professionally purposeful, going out into the street
to see what was happening, having a blunt discussion with a witness in
the apartment above, “
wandering” into the twins’ room, and ultimately “
keeping vigil” in total silence for the rest of the night.
[3.33]
However, it must be said
• For a normal distressed and anxious parent to behave in this way
towards two apparently anaesthetised children would be unforgivable.
• For an educated professional person it would be grossly negligent.
• For two qualified anaesthetists it is absolutely unthinkable.
If we find that it is indeed unthinkable,
then we must wish to believe that their actions were not negligent,
that they were not in breach of any protocols, and that their apparent
lack of action does not bear any negative interpretation.
But
for that to be true they would have to have known precisely why the
twins were unconscious, what substance had been administered, in what
dose, by whom, and when.
And they have always denied this.
But despite that, and to address the original question, having regard to the available evidence, we may be tempted to take the
charitable view, and to conclude that,
on the balance of probabilities,
the parents may have been involved in the sedation of the twins.
PLEASE NOTE: I am fully aware that this logical progression may offend, and that lawyers may wish to say it is defamatory.
If so, I not only apologise unreservedly and withdraw it, but on receipt
of any complaint of defamation will immediately refer the matter to the
GMC, with a view to the striking off the Medical Register of
Dr Fiona Payne and Dr Kate Healy / McCann.
The GMC is the proper authority in matters of this nature.
This is not a matter for legal argument.
It is a question of professional competence.
Complete article with references and appendices: http://whatreallyhappenedtomadeleinemccann.blogspot.co.uk/2016/08/chapter-5-sedation.html
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