Assault and heart illness combined to cause man’s death, court hears
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‘Acute alcohol intoxication’
THE trial of a man charged with manslaughter has heard that the main cause of the victim’s death was heart disease, but that injuries sustained in an altercation were a contributory factor.
Father-of-four Paul Gill, 37, denies killing Patrick ‘Patsy’ Kelly on August 22, 2015, but has admitted assaulting Mr Kelly and causing harm.
Mr Gill, of Sarto Road, Naas, Co. Kildare, has also pleaded guilty to assault causing harm to Mr Kelly’s friend, Martin Curtis, during the same incident.
The trial at Dublin Circuit Criminal Court has heard that the altercation between neighbours arose over a dispute about noise and late-night drinking.
Giving evidence on the third day of the trial yesterday, State pathologist Professor Marie Cassidy said she carried out a postmortem on Patrick Kelly, 57, the day after he died.
She said the principal cause of death was an enlarged heart and the narrowing of blood vessels to the heart, while two contributory causes were acute alcohol intoxication and minor trauma.
Prof. Cassidy said Mr Kelly suffered from severe and significant heart disease, with some arteries blocked by at least 50%, and was at risk of sudden death.
The court heard that at the time of his death, Mr Kelly had a blood-alcohol level of 213mg per 100ml, considered as being in the toxic range, although some experts would place it in the lethal range.
However, Prof. Cassidy said there was no safe level of alcohol and that even one drink could cause the heart to beat irregularly.
Prof. Cassidy said the deceased had been a chronic alcoholic, and that his liver was twice the normal weight, bright yellow in colour, and with a well-defined cirrhosis, due to the long-standing toxic effects of alcohol.
She said Mr Kelly had suffered minor injuries as a result of being punched and possibly kicked, the most significant of which was a 5cm laceration on his forehead.
His other injuries included a large bruise under the skin on his skull, an incomplete fracture of the cervical spine, and multiple fractures to his ribcage, although Prof. Cassidy said the fractures were most likely caused by ‘prolonged and vigorous’ attempts at resuscitation by paramedics.
‘None of the injuries sustained could have been expected to cause death in a healthy individual,’ said the pathologist. However, she emphasised that the evaluation of Mr Kelly’s death could not be separated from the circumstances of it.
‘The stress of the altercation likely precipitated this man’s death,’ she said, explaining that the adrenalin secreted during a fight-or-flight reaction put his ‘already-diseased heart’ under increased pressure.
‘It could be that emotional upset and the threat or fear of injury may cause a rise in blood pressure, precipitating a fatal arrhythmia and death,’ said Prof. Cassidy.
Professor Mary Shepherd, a cardiac pathologist at St George’s Medical School in London, agreed with the State pathologist’s conclusion on the causes of death. Prof. Shepherd added that stress due to an altercation may stimulate the cardiovascular system, even in someone with a normal heart, causing them to ‘die literally from fright’.
‘It’s called takotsubo, a Japanese term referring to the shape of a lobster pot, whereby a person who gets a sudden shock – be it an altercation or being told bad news or witnessing an earthquake – the heart can suddenly contract so much that they collapse and die,’ she said.
The trial resumes on Tuesday.