Trip to Wilsons Promontory, November 2021
Charge 1 – Attempted Murder
28. In 2019, the accused suggested to Simon Patterson that they go to South Africa together, travelling as a couple without their children. Simon Patterson agreed. They were to leave in March or April 2020, however, the trip had to be cancelled due to the on setof the Covid-19 pandemic.
29. As an alternative, the accused suggested that she and Simon Patterson go on a hiking and camping trip to Wilsons Promontory.The trip was delayed due to the changing Covid-19 restrictions, but eventually was to take place in November2021.
30. On Tuesday 16 November 2021, the accused came to Simon Patterson’s house in Korumburra to pack for the trip to Wilsons Promontory the following day. She gave him a Tupperware container of penne pasta Bolognese which she said she had made for the children to eat. The two of them sorted out what they needed to (sic) and the accused left. Simon Patterson finished the packing by himself and then ate the pasta before going to bed.
31. Early the following morning, he started to feel unwell. He drove to the accused’s house to pick her up for the trip. [Redacted]were at the house,along with Tanya Patterson who was there to care for the children while their parents were away.
32. Shortly after arriving at the house, Simon Patterson vomited multiple times in the toilet. He attributed his condition to ‘stress’and thought he would be alright, so he and the accused got into his car and left for their trip. The accused drove due to Simon feeling unwell.
33. As they were driving, Simon Patterson suddenly felt an urge to vomit. He quickly wound down the window and vomited. They continued on their journey but had to stop at Meeniyan where Simon suffered vomiting and diarrhoea and spent the morning going in and out of the public toilets. The accused booked some accommodation through Airbnb near Wilsons Promontory and they stayed there that night,as well as the following night. Simon Patterson was sick the whole time they were there, with continual vomiting and some diarrhoea.The accused provided Simon Patterson with electrolyte fluids and water. Simon discussed going to hospital with the accused, who suggested there might be a long wait there.
34. Eventually, on Friday 19 November 2021, the accused took Simon to the Urgent Care Centre at Leongatha Hospital. He was diagnosed with severe dehydration due to gastroenteritis and was admitted to the hospital. Blood test results showed he was suffering from acute renal impairment (kidney injury) with elevated creatinine levels and modestly elevated lactate. Simon was treated with intravenous fluids and his renal function was monitored. It continued to deteriorate despite rehydration. He remained in hospital overnight.The following morning, 20 November 2021, he was feeling better and was discharged with instructions to return to hospital the following day for further testing of his renal function.
35. On 21 November 2021, Simon Patterson returned to Leongatha Hospital as advised. Following further testing, which revealed his creatinine levels were still rising, Simon was transferred to Monash Medical Centre. A faecal specimen test conducted on 24 November2021 revealed markedly elevated calprotectin, consistent with significant bowel inflammation. He remained in hospital as his renal function recovered and was eventually discharged on 27 November 2021.
36. During Simon Patterson’s time in hospital, medical staff undertook extensive testing. The cause of his acute renal failure was presumed to be acute tubular necrosis secondary to dehydration due to the preceding gastroenteritis.However, the testing did not identify a cause of the vomiting and diarrhoea itself. Faecal specimens were negative for faecal pathologies and did not reveal underlying bowel pathology. Ultimately, treating doctors were unable to determine the underlying cause of this illness.
37. Simon was subsequently referred to consult with nephrologist Dr Trung Quachin the community, given he had suffered an episode of severe acute renal failure. His kidney function was monitored by regular blood tests and by 15December 2021 it had normalised.
38. Following this episode, Simon Patterson underwent a colonoscopy on 5 April2022, which revealed benign polyps, but was other wisenormal.
Trip to Howqua, May 2022
Charge 2 – Attempted Murder
39. Sometime after the November 2021 trip, the accused suggested to Simon that they go camping again, as they had missed out on their planned trip to Wilsons Promontory. Simon agreed and they planned a trip to Howqua, again as a couple without their children.
40. About a week before the trip, Simon Patterson went to the accused’s house one evening. The accused was making chicken korma curry and wanted Simon and the children to taste test various levels of spice in the curry. Simon tried the curries and selected his favourite.
41. On Tuesday 24 May 2022, Simon and the accused went camping near Howqua,staying at a public campground. The children remained at home. On the second night of this trip, 25 May 2022, the accused and Simon ate chicken korma curry with rice for dinner. The accused prepared the food for serving, which she had brought pre-prepared for the camping trip, while Simon was attending to the fire. Simon did not see how the meal was packaged or prepared.
42. Early the following morning, 26 May 2022, Simon Patterson started to feel sick. He opened the tent door and vomited outside.He continued to vomit and experience diarrhoea while the accused packed up the camp. The accused drove Simon to Mansfield Hospital,stopping along the way so that he could vomit.
43. At Mansfield Hospital, Simon was treated with intravenous fluids and anti-nausea medication. His vital signs were unremarkable.Ultimately, Simon was discharged later that day after he had stopped vomiting. The accused booked accommodation in Mansfield through Airbnb and provided him with electrolytes.His condition seemed to be improving.
44. The following morning the accused drove Simon Patterson home. That night, he stayed at his house by himself. He was still feeling unwell.
45. Early in the morning on 29 May 2022, Simon Patterson got up before sunrise and tried to go to the toilet. He was having trouble making it to the bathroom and called the accused for help at 5.20am. The accused came to Simon’shouse. He felt weak. The accused called an ambulance at 5.45am.
46. Simon Patterson was taken to Monash Casey Hospital by ambulance. His vital signs were significantly abnormal, with very low blood pressure. He was treated in the ambulance with intravenous fluids and adrenaline, but his blood pressure remained low for a further90 minutes despite these treatments.
47. Simon Patterson was admitted to Casey Hospital in haemodynamic shock.Initial blood testing revealed severe lactic metabolicacidosis, hypothermia,multi-organ failure, marked elevation of ALT suggesting liver ischemia and a blood film consistent with severe sepsis. An abdominal CT scan demonstrated severe bowel pathology with portal venous gas in the left lobe of the liver, a small volume of gas in the mesenteric vessels to mid-distal ileum and pneumatosis coli in the small bowel consistent with established infarction(necrosis or tissue death). Simon Patterson was admitted to the intensive care unit and was intubated. He received various medications including broad spectrum antibiotics.
48. Simon Patterson remained at Casey Hospital in the intensive care unit. He was critically ill and clinically very unstable, requiring multi-system support.
49. During his admission, he underwent various procedures, including:
- a. Upper GIendoscopy (camera into the oesophagus and stomach, showing segmental severe mucosal changes with discolouration in the oesophagus), laparotomy and resection(removal) of 132 centimetres of ischemic small bowel due to necrosis on 29 May2022;
- b. A repeat gastroscopy, further exploratory laparotomy and further resection (removal) of another 40 centimetres of ischemic small bowel due to necrosis on 31 May 2022;
- c. A laparotomy for control of post-operative bleeding on 4 June 2022.
50. Various tests, scans and other investigative procedures were conducted by medical staff to determine the underlying cause of Simon Patterson’s presentation. Blood cultures taken on 29 and 30 May 2022 yielded no growth (did not produce abnormal results).A faecal specimen taken on 31 May 2022 detected Clostridium difficile (C diff) toxin A/B gene but the more specific immunoassay was negative. C diff was again detected on 16 June 2022 but was negative on 23July 2022.
51. Pathology of the resected small bowel reported extensive mucosal necrosis,consistent with shock and inadequate blood flow. No chronic disease or acute infective cause was reported, and there was no evidence of thrombosis,vasculitis, dysplasia or malignancy.The remaining small bowel, large bowel,caecum and transverse colon were healthy.
52. Ultimately, doctors were unable to determine the cause of this illness.
53. Simon Patterson was extubated on 14 June 2022. He was transferred to St John of God rehabilitation centre on 22 June 2022, following a 24-daystay in hospital. He remained in rehabilitation regaining strength after his period in intensive care until 8 July 2022.The accused offered for Simon to stay at her home while he recovered, and he stayed with her for a few weeks after being discharged from rehabilitation. During this period of time, Simon did not eat a great deal, and tended to prepare his own food so as not to be a burden. The accused would usually prepare the evening meals which they woulds hare as a family.
54. On 14 July 2022, Simon Patterson started seeing a general practitioner, Dr Christopher Ford, who he already knew through church and bible study. Given the nature of his symptoms during the first two illnesses, Dr Ford referred Simon to a gastroenterologist,Associate Professor Christopher Mills. Arrangements were made for Simon Patterson to have weekly blood tests for a month and then fortnightly blood tests to see if a cause of the illnesses could be determined and to monitor his recovery, including his potassium levels. His first blood sample was collected the same day – 14 July 2022. No abnormalities were detected.
55. Whilst staying with the accused, Simon Patterson became ill again. On 22July 2022, Simon and the accused ate lunch together– a beef stew with rice which the accused had prepared, and which only the accused and Simon ate.The children were not at home for lunch. At 5.19pm, the accused sent Simon a message on the Signal application, asking him to bring back the ‘empty stew plate (or full stew plate if you didn’t eat it)’. Simon responded that he ‘certainly ate it’.
56. Shortly after midnight the following morning, 23 July 2022, Simon Patterson started vomiting and suffering from diarrhoea. He attended Leongatha Hospitaland was transferred to Monash Medical Centre, where he remained for a few days.An abdominal CT scan was performed on 23 July 2022, and the results compared to the abdominal CT scan performed on 29 May 2022 (the day of his presentation to Casey Hospital). The major finding was a collection in the left upper quadrant with the anterior aspect touching the transverse colon. A repeat CT scan on 9September 2022 showed a decrease in size in this collection. A faecal specimen was sent for testing with no abnormal results detected. Simon was then discharged on 25 July 2022 and returned to the accused’s house.
57. Doctors were unable to definitively determine the cause of this illness at the time, however, the abdominal collection and the proximity of this illness to the recent admission with bowel resection with a prolonged ICU stay could result in a presentation with vomiting and diarrhoea. An infective gastroenteritis was investigated with a faecal specimen and no infective cause found.
58. Shortly after he returned to the accused’s house, the accused told Simon that she resented him and regretted asking him to stay with her. Later that day, Simon Patterson packed his belongings and returned to his own home.
59. On 25 August 2022, Simon consulted with Associate Professor Mills. Associate Professor Mills spent a long time going through Simon’s history, which he noted was highly unusual. The clinical history taken from Simon indicated that he had been completely well up until 2021. Associate Professor Mills had never seen a case like Simon Patterson’s before. He considered Simon’s presentation to be ‘unique’ because of the severity of the medical picture in a young person with no suggestion of pre-existing organ dysfunction.He also noted that Simon was well at the time of the consultation. Associate Professor Mills wondered whether Simon Patterson had contracted an infection called Clostridium Difficile (C diff) following a severe acute gastrointestinal illness,and considered this the most plausible answer at the time; however,noted its unusual presentation and sequelae. As a precaution,he ceased Simon’s use of Pantoprazole, which is a risk factor for recurring C diff,however, he did not form a conclusive viewabout the cause of SimonPatterson’s recurring illnesses.
Trip to Wilsons Promontory, September 2022
Charge 3 – Attempted Murder
60. After Simon Patterson returned home, he and the accused continued to havecontact. In late August or early September 2022, Simonand the accused spoke onthe phone. The accused suggested they catch up in person on a suitable day.Simon was pleased and encouraged,so immediately agreed. The accused suggestedthat they catch up during the day when the children would be at school. Simonsuggesteda walk at Wilsons Promontory and the accused offered to bring lunch.They made arrangements to go for a walk.
61. On the morning of Tuesday 6 September 2022, Simon Patterson did a routinestool sample for his gastroenterologist, AssociateProfessor Mills.
62. The same day, the accused and Simon went for a walk at Wilsons Promontorytogether, without the children. The accused broughtthem each a separatepre-packed lunch. The accused gave Simon his lunch – a pre-preparedchicken curry wrap in aluminium foil.The accused ate what appeared to be thesame filling except on a plate without the wrap.
63. Shortly after eating lunch, Simon Patterson began to feel unwell. They wenton a short walk on the beach before he went to thetoilet with diarrhoea. Hestarted to vomit and suffered some diarrhoea during the car trip home.
64. The accused and Simon drove to Donald and Gail Patterson’s house, asthey had collected [Redacted] from school. Simon continuedto vomit at hisparents’ house, and they called an ambulance for him.
65. Inside the ambulance, Simon noticed that he started to slur his words andhis muscles felt increasingly weak. He suffered a ‘seizure’requiring intravenous medication for seizure termination and was in a reducedconscious state. Simon was admitted to Monash CaseyHospital intensive care unitwith extremely low potassium levels. He went into polymorphic ventriculartachycardia (a potentiallylife-threatening heart rhythm) and was intubated.Simon received aggressive electrolyte replacement via central venous catheterthroughthe initial hours of admission. He remained in hospital for three daysas he recovered and was eventually discharged on 9 September2022.
66. The routine stool sample which Simon had provided on the morning of 6September 2022 before his walk with the accused was unremarkable– itindicated no obvious bacteria, parasites or inflammation in his intestines.
67. Again, his treating doctors could not determine the cause of this illness.