An expert forensic pathologist on Monday testified that Warren Mottley’s death could be ruled either natural or accidental.
However, Dr Althea Neblett said based on her examination of Mottley’s body, it was difficult to determine exactly which it was.
She was giving evidence as the Coroner’s Inquest into Mottley’s death continued in the Supreme Court.
The younger brother of Prime Minister Mia Mottley died at the Queen Elizabeth Hospital (QEH) on June 29, 2021.
Dr Neblett, an expert witness called by attorney-at-law Francis DePeiza who is representing private doctors at Surgical Solutions Inc. where Mottley had surgery, said her investigations had shown that Mottley died from “complications of his bowel pathology”.
She said due to the fact that Mottley had a “history of bowel obstruction prior to the laparoscopic surgery”, she would be “unable to say definitively when or how the small bowel perforation happened”.
Forensic pathologist Dr Shubhakar Kara Paul, who conducted the post-mortem on Mottley’s body, had previously testified that the 55-year-old died from sepsis due to the perforation of the small bowel during a surgical laparoscopic surgery.
In reading a report that she prepared on June 22, 2021, Dr Neblett said: “Two questions being asked of me are: Do I agree with the conclusion that the perforation occurred during the laparoscopic procedure, and do I agree with the conclusion that this was an unnatural death?”
She explained that bowel ruption, or perforation, can result from physical injury and can be secondary to many factors including inflammation, infection, obstruction, trauma, or an invasive procedure.
“It is difficult to say that the perforation occurred during the laparoscopic surgery and was a result of physical injury, because it is possible that the small bowel can be inflamed due to a small bowel obstruction and, therefore, I can’t conclude that the perforation occurred during the surgery or resulted from physical injury due to an instrument,” Dr Neblett added.
“In my opinion, Mr Mottley’s death was due to complications of his bowel pathology. I said before I can’t conclude that the surgical technique or singular handling of the small bowel led to physical injury to the bowel wall. If, however, this were the case, it can still be concluded that the perforation was a therapeutic complication and the manner can be deemed as natural and, hence, the cause of death can be deemed as natural.
“This, nonetheless, is a debatable topic as some experts may argue that if a physical injury was the cause of the perforation, the manner can be accidental and, hence, the cause of the death will be named as unnatural….Death is due to complications of jejunum perforation in a man with a history of small bowel obstructions…and the manner of death is debatable as it can be natural or accidental,” she added.
Dr Neblett said that based on her post-mortem examination findings, she concluded that there was no evidence of large bowel perforation, descriptively or clinically.
She will be cross-examined when the inquest resumes on August 29.
Coroner Graveney Bannister adjourned the matter until that date after it was revealed that Ezra Alleyne, who was assisting DePeiza in the case, had been hospitalised over the weekend.
Queen’s Counsel Sir Elliot Mottley, who is representing the Mottley family, told the court it “was unlikely” Alleyne would be playing any further part in the matter.
DePeiza told the court it was likely his client would want to hire another counsel as he had provided invaluable technical assistance.
Additionally, with DePeiza scheduled to leave the island Monday and Sir Elliot being unavailable next week, the Coroner gave a long adjournment to allow the private doctors who were being represented by DePeiza and Alleyne to find a replacement.
The Coroner urged the parties to prepare their closing submissions as he was hoping to “wrap up” in a week’s time.
Sir Elliot also requested that additional persons be allowed to give evidence in the inquest.
He said having heard evidence from some of the witnesses, he wished to challenge the claim that a nurse and doctor from Surgical Solutions Inc. accompanied Warren Mottley in the ambulance to the QEH on June 28, 2021.
Sir Elliot, the deceased’s father, said he would also like to challenge the claim that the QEH ambulance does not normally transport patients from private institutions to the hospital.
