4.45pm
‘Not enough for four’: Doctor reveals mushroom antidote was in short supply after fatal meal
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Dr Beth Morgan, a registered doctor and an advanced infectious diseases’ trainee, was the last witness to give evidence today in the trial of accused triple murderer Erin Patterson.
Morgan was the overnight medical registrar at Monash Health the night Don and Gail Patterson were taken there to be cared for.
That night, she was taking referrals from the emergency department for medical patients who do not require surgery and need to be in hospital for longer than four hours (which means they cannot stay in the emergency department).
Morgan said the initial history for the couple included mention of 30–40 episodes of vomiting and diarrhoea that had started since midnight the night before.
She said Don had mild abdominal pain on his right side. He was quite sweaty and light-headed, she recalls, but oxygen saturation appeared normal for someone without respiratory issues.
“Donald himself was quite alert. He did appear sweaty and was quite distressed by the presentation, but his vital signs were relatively stable at that time; he was not febrile, as in, he didn’t have a fever,” Morgan said.
Morgan said some tests indicated that he could be suffering tissue hypoxia or organ damage. “I was quite concerned that there was evidence of liver damage at this time,” Morgan said.
The doctor told the jury she was concerned that Don wasn’t suffering from a gastroenteritis caused by food poisoning, so she called the toxicology registrar, who requested additional information about what was consumed at the lunch on July 29, 2023.
“I initially told him that there was a beef Wellington containing mushrooms that had been consumed. It was also along with an orange cake for dessert,” she said.
The toxicology registrar expressed concern about the delayed onset of symptoms, some 12 hours after lunch, which could indicate a serious toxin syndrome. “At that point, he suggested that if it was related to mushrooms, it was possibly caused by the ingestion of the amanita phalloides mushroom,” she said.
Amanita phalloides is commonly known as the death cap mushroom.
At that time, Morgan said they had no evidence that anyone else was experiencing the metabolic acidosis, kidney injury, or liver injury that Don was, so they did not access silibinin, the antidote to death cap mushroom poisoning.
Don was given a liver protective drug and was later admitted to the ICU.
Morgan told the jury that Gail, who a different registrar assessed, had regular vital signs, and it was determined she was suffering from food poisoning and was admitted to a short-stay unit.
Gail also eventually came into the care of Morgan, who suspected she may have been suffering from severe gastroenteritis or suspected mushroom poisoning.
After follow-up tests on Gail showed worsening metabolic acidosis and elevated lactate levels, Morgan spoke to the toxicology registrar and a decision was made to administer the silibinin, the antidote to death cap mushroom poisoning.
The pharmacist told Morgan there wasn’t enough antidote for four patients but said they would obtain it from another hospital.
“I expressed that we’re probably going to need this for at least four patients, and unfortunately, the pharmacist advised us that we didn’t have that available to us at Monash Health, but they were going to obtain it from an external hospital.″
A decision was made by 7.20am to transfer Ian and Heather Wilkinson to Dandenong Hospital.
Of the four guests who dined on beef Wellington at Erin Patterson’s house in 2023, only one survived. On Tuesday, that guest – Ian Wilkinson – will tell his story for the first time when he takes the stand as a witness in the cook’s murder trial.
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