(Updated 11:38pm, 6 April 2009)
PUTRAJAYA, 6 April 2009: Remand prisoner A Kugan died of swelling or fluid build-up in the lungs, due to acute inflammation of the heart muscle compounded by blunt force trauma, an independent committee investigating the two post-mortem reports on him concluded.
Director-General of Health Tan Sri Dr Mohd Ismail Merican said today Kugan was found to have an underlying acute myocarditis. Additionally, the blunt force trauma could have led to acute renal failure aggravating the acute myocarditis, resulting in acute pulmonary oedema or swelling of lung tissue or fluid build-up in the lungs.
“Acute myocarditis is an acute inflammation of the heart muscle which may be caused by infections or toxins. It is a known cause of sudden death in young adults and gross examination of the heart appears unremarkable in up to 30% of the cases,” he said to reporters here.
Ismail said all body injuries noted on Kugan were insufficient, either individually or collectively, to cause death directly.
“There was no evidence of injuries to the internal organs and no skeletal fractures were detected,” he said.
Kugan, who was detained by the police on 15 Jan for investigation for alleged car theft, died on 20 Jan while in police custody.
The post-mortem done by the Head of the Forensic Unit of Serdang Hospital, Dr Abdul Karim Tajuddin, concluded the cause of death as acute pulmonary oedema.
Kugan’s family requested a second post-mortem, which was done by the University Malaya Medical Centre’s (UMMC) pathologist, Dr Prashant N Samberkar, who gave the provisional cause of death (pending toxicology) as acute renal failure due to rhabdomyolysis (rapid breakdown of skeletal muscle tissue) due to blunt trauma to skeletal muscles.
The discrepancies between the two reports had raised some questions and this led the Health Ministry to set up a committee to investigate.
Ismail said the committee, which was chaired by Kuala Lumpur Hospital senior consultant forensic pathologist Dr Mohd Shah Mahmood and comprised nine other local and foreign doctors including those from Singapore and Saudi Arabia, also found that both pathologists who did the post-mortems had no intention of misleading or hiding any information on the findings.
However, he said, the second pathologist had misidentified and misinterpreted some of the post-mortem changes as being part of the initial injuries sustained by Kugan.
He said the pathologist also misinterpreted the patterned imprint injuries on the body as ‘burn wounds’, as there was no evidence of inflammatory infiltrates or thermal injuries in the skin from the back of the deceased, which would be present in thermal injury.
“It has to be emphasised that the autopsy report by Dr Prashant is a provisional report because he has not completed the autopsy as the toxicology is still pending, as stated in his report,” he said.
Ismail said the committee also was not able to establish how and where Kugan’s body was kept after being released to his family until it was brought to UMMC for the second post-mortem, as it would significantly affect the physical state of the body.
The report would be handed over to the Attorney-General tomorrow and it is up to him to take any actions needed, he said.
Meanwhile in KUALA LUMPUR, police have today obtained documents from UMMC with regard to the post-mortem report on Kugan.
Bukit Aman CID Chief Datuk Seri Mohd Bakri Zinin said the documents obtained from UMMC would be used as evidence in police investigations.
“This morning a few officers from Bukit Aman and Selangor went to UMMC to collect documents related to the second post-mortem done in UMMC.
“The decision was made (to collect the documents) after the results of the second post-mortem report was announced by Health Ministry Director-General Tan Sri Dr Ismail Merican today,” he told Bernama when contacted here today.
Mohd Bakri said police decided to obtain the documents with regard to the post-mortem reports since there were discrepancies in the second post-mortem report done by UMMC as declared by an independent committee.
“From the report of the Independent committee there is an element of doubt in the second post-mortem report from UMMC on 2 March which stated Kugan had suffered 45 injury marks caused by an impact from blunt objects.
“The second post-mortem by UMMC pathologist, Dr Prashant N Samberkar had also stated that Kugan died of damage to muscles and other injuries including the heart, kidneys, stomach, neck, backbone and legs,” he said. — Bernama