A world expert on death cap mushroom poisoning has blasted as ‘nonsense’ speculation there would be no trace of the toxin that killed Erin Patterson’s lunch guests.
The physician, who asked to be referred to only as Dr L, told Daily Mail Australia that the active poison in amanita phalloides mushrooms, amatoxin, would have remained in the organs of Erin’s three relatives after their deaths.
He said autopsies on her former in-laws Gail and Don Patterson, and Gail’s sister Heather Wilkinson, who died after eating a beef wellington lunch at Leongatha, in Victoria’s Gippsland region on July 29, would reveal the poison.
‘Amatoxin would remain detectable in post-mortem liver and kidney tissue from post-mortem samples as well as gallbladder fluid obtained during the autopsy,’ Dr L said.
Don and Gail Patterson are likely to have suffered kidney injury from extreme dehydration, allowing the lethal Amatoxin to target their livers which killed them
During autopsies on Don and Gail Patterson before their burials in a shared grave (above , in Korumburra Cemetery)their livers, kidneys and gall bladders would have been found to contain Amatoxin
He rejected claims by Australian toxicologists that there would be no residue of the toxin for forensic police to examine.
One Melbourne toxicologist said that ‘the toxin found in death cap mushrooms are only detectable for about 48 hours after ingestion’.
He claimed that detectives might have to rely on urine samples taken in the first two days after Erin Patterson’s lunch guests were admitted to hospital.
He feared blood samples taken from the lunch guests to monitor their kidney and liver function might have been discarded ‘because the seriousness was not realised by the hospital’.
But Dr L, who has consulted on cases of ceath cap mushroom poisoning around the world, said police could examine samples from the Pattersons’ and Mrs Wilkinson’s organs, rather than having to investigate whether their hospital blood or urine samples were retained.
Presuming that post mortem examinations were made on the three dead lunch guests, as police raided Erin Patterson’s Leongatha in the aftermath of the deaths on August 4 and 5, Dr L said there would be plenty of evidence.
Toxicologists at the Victorian Institute of Forensic Medicine are believed to be examining samples taken from the victims and informing Victoria Police’s Homicide Squad which is investigating the deaths.
If the fourth lunch guest, Pastor Ian Wilkinson who remains in hospital, has already had a liver transplant, his old liver could also have been sent for analysis after it was removed and replaced.
Daily Mail Australia is not suggesting that Erin Patterson was responsible for the deaths of her husband’s relatives.
Ms Patterson is a person of interest in the investigation as she cooked the fatal lunch for her estranged husband’s parents Don and Gail Patterson and Gail’s sister Heather Wilkinson, who all died.
Dr L earlier detailed the physical torment the lunch guests would have suffered.
He described amatoxin as ‘a very clever poison’ in the way it catastrophically attacks a person’s body and essentially ‘melts down a person’s liver’.
Despite this process, liver material would remain in the no longer functioning organ.
He said the poison is so potent that you do not even need to consume part of an actual mushroom to die, but simply eating or drinking liquid in which the mushrooms were cooked or boiled can be enough to kill you.
A medical expert on poisoning by Death cap mushrooms (above) has described how they kill someone who has consumed them, and how little an amount can be fatal
Erin Patterson (above outside her Leongatha home where she hosted the Beef Wellington lunch with a dish suspected to have contained Amanita Phalloides mushrooms) is being investigated by Victoria Police
Dr L said the Leongatha case was making waves with experts overseas because of the rarity of such poisonings becoming police matters.
Dr L said the Leongatha case was unique in becoming a police matter, even though many people die each year after unwittingly consuming the death cap mushrooms, thinking they were harmless.
‘Hundreds of people die every year and are poisoned, the most occurring in China’s Yunnan province, in Kunming, but also in Assam in far eastern India, Southern and Eastern Europe, Russia and Guatemala.
‘And hundreds of dogs die. It’s a worldwide phenomenon.‘
Dr L has outlined what would have happened to Don and Gail Patterson and Heather Wilkinson, why they died, why Ian Wilkinson survived and how they all could have been saved and returned home ‘long ago’.
FIRST SIGNS OF POISONING
‘Typically what happens is when people eat Amanita Phalloides they will say “this is the most delicious mushroom I have ever eaten”,’ Dr L said.
He said after eating the Beef Wellington, the Pattersons and the Wilkinsons could easily have gone home and ‘had no symptoms whatsoever for at least six hours’.
‘The onset of symptoms happens between eight and 12 hours later and it is quite dehydrating vomiting and diarrhoea, but folks don’t necessarily attribute it to the mushrooms but think “I’ve just got a bit of food poisoning”.’
About midnight on that Saturday, the Pattersons and the Wilkinsons began to fall ill and went to Leongatha and Korumburra hospitals on the Sunday.
A post mortem on Heather Wilkinon, who died six days after eating the Beef Wellington, would have revealed the deadly Amatoxin in her organs, while her surviving husband Pastor Ian Wilkinson’s liver may have already been removed and transplanted
‘By then they are extremely dehydrated and if you did a liver function test, there would be an unmistakeable rise in their liver enzymes,’ Dr L said, but doctors had no way of knowing that the four had eaten lethal Death Cap mushrooms.
They were transferred to hospitals in Melbourne, with Gail Patterson and Heather Wilkinson dying on Friday, August 4, and Don Patterson dying the following day.
Dr L said a lack of quick diagnosis of amatoxin poisoning – which could have easily been traced via a urine sample – would have contributed to their deaths, along with their extreme dehydration, which prevented the poison being expelled.
The lethal poison that is Death Cap mushroom Amatoxin would take 8-10 hours to start causing vomiting and diarrhoea and then slowly kill off the kidneys and cause an agonising ‘melt’ of the liver
Police believe the four guests who ate Beef Wellington at Erin Patterson’s Leongatha house (above) ingested one of the most deadly plants in the world, Amanita Phalloides or death cap mushroom
‘You need to restore kidney function because when they were very, very dehydrated, they would need a lot of fluid to restore the output of urine which is the way the poison is expelled from the body,’ Dr L said.
‘It is readily eliminated by the kidneys – peed out – after several hours as long as the kidneys are working.
‘But the problem is the terrible vomiting and diarrhoea is like when you get cholera, maximally dehydrating, and when this happens your body drastically reduces blood flow to the kidneys to preserve the blood supply to the brain and heart.
‘And so with reduced blood flow to the kidneys they are not working, getting cleared out with a flow of urine, and the very high concentration of Amatoxin in the kidneys is causing injury to the tubules of the kidney.
Don Patterson, who died a week after dining on Beef Wellington at his former daughter-in-law’s house would have had suffered Death Cap Mushroom posion in his kidney and liver , a expert said
‘We doctors need to give volume, lots and lots of saline to restore blood flow to the kidneys.
‘If they didn’t get enough IV fluid they may have already developed serious kidney injury by this time.’
‘The target organ of Amatoxin – which is a very smart poison – is the liver, and it is liver failure that kills patients.
‘You can’t beat this poison with a stick – cooling, freezing or drying the mushrooms has no effect in getting rid of the amatoxin and the gastric acid in your stomach has no effect on it, nor digestive enzymes or the metabolic process.
‘What gets eliminated by the kidneys if they are working is exactly the amount of poison that goes in, as it undergoes no transformation whatsoever in the body.
‘When you eat these mushrooms, the poison gets very rapidly absorbed and passes through the cells that line the gastrointestinal tract and into the portal blood supply which goes to the liver.
‘When you eat a fatty meal, the gall bladder contracts to place bile into your intestine to break down the fat, and bile acids are very highly conserved and recycled over and over, every meal.
Erin Patterson, outside her Leongatha house in the days following the deaths of her ex-husband’s family members, is a target by police because ‘she cooked those meals’ but who say ‘it could be very innocent’
‘Every time the gall bladder contracts and these bile acids get into the blood supply, and the liver cells will suck bile acids out of the portal blood and into the liver.
‘The problem is amatoxin effectively attaches to these receptors on the liver cell and gets transported into the liver cell as if it was a bile acid … the liver pulls in the Amatoxin out of the portal blood supply and this happens over and over again.
‘Every next meal this is happening like a brand new poisoning by the amatoxin and if you aren’t expelling the poison via your kidneys because they are working because you are massively hydrated, your liver dies.’
Dr L said there’s two parts to the discomfort and the pain you would experience when dying from amatoxin poisoning.
‘The worst part in terms of physical suffering is the GI (gastrointestinal) syndrome of painful abdominal cramps with repetitive retching and severely dehydrating diarrhoea.
‘Once patients are admitted, pain can be managed except perhaps for the existential pain experienced when one realizes that their liver is melting down in an unstoppable manner.’
Sisters Heather Wilkinson (left) and Gail Patterson (right), would have died from kidney and liver failure, but could have been saved if doctors had known what they were poisoned with and had acted early to rehydrate them with saline drips and milk thistle medicine
The doctor said if police were testing the food dehydrator Erin Patterson said she dumped at the local tip, they could test for the mushroom’s “DNA’ rather than traces of its Amatoxin poison
Police officer at the tip where the mushroom or vegetable dehydrator was allegedly dumped by Erin Patterson when she panicked after the deaths of her husband’s relatives
Dr L said that apart from being lethal, amatoxin’s other danger was that it was ‘extremely water soluble’ and would be absorbed in the juice or gravy of a pie or casserole.
‘So when you cook it in something, boil or fry it, it seeps in very quickly,’ he said.
‘When you eat the mushroom, it gets absorbed into the gastrointestinal tract super fast.
‘But you can drop a mushroom into a glass of water and its gets absorbed very fast. You don’t have to eat the mushroom, if you drink the water you will get poisoned.
‘And it only takes a tiny amount of mushroom. There was the case of a 6ft 2ins man who ate a tiny bit of mushroom he picked off the grass in a mental health care facility. He was dead within three to four days.’
Asked about where amanita phalloides or death cap mushrooms rated in comparison with other poisons from plants, such as deadly nightshade or Belladonna, Dr L said ‘this is a lot deadlier’.
He said that if Victoria Police were interested in examining a food hydrator used by Erin Patterson, as reported in the media, they would not have to test it for Amatoxin, but instead could identify traces of amanita phalloides ‘by its DNA’.