Forensic pathologists view Folbigg homicide as unlikely

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Another branch of science – forensic pathology – has come under the microscope at the Kathleen Folbigg inquiry in Sydney.

This follows earlier sessions when geneticists and cardiologists explained their science and why, sometimes, scientists draw different conclusions when viewing the same data.

Two forensic pathologists today acknowledged injury is not always present in smothering cases, but they don’t believe Kathleen Folbigg killed her children.  

Pathologists Dr Matthew Orde and Professor Stephen Cordner submitted reports to the current inquiry into Folbigg’s convictions indicating natural causes best explain the reasons for the deaths of Caleb, Patrick, Sarah and Laura Folbigg.

Their mother has served 20 years of a 30-year sentence for the manslaughter of Caleb and murder of her other three children.

Cordner, who undertook a retrospective assessment of the children’s deaths in 2015, indicated his views have not changed.

He says Caleb and Sarah’s deaths should be regarded as SIDS cases, that Patrick’s death was explained by his epileptic illness, and that Laura died from myocarditis.

Orde, an Australian pathologist now working in Canada, echoed those views.

Determining cause based on evidence

During examination, the inquiry found a source of disagreement between forensic pathologists examining Laura’s heart tissue to determine the severity of her myocarditis.

The tissue samples viewed in the original post-mortem by Dr Allan Cala – scheduled to appear later this week – and pathologists undertaking retrospective analyses are, probably, different.

As Cordner explained during his examination, multiple, small samples of heart tissue are obtained during autopsy, stained to enhance their resolution and inserted into cassettes for microscopic viewing.

Meadow’s Law and bad statistics

The inquiry’s judicial officer, Tom Bathurst KC, asked whether this explained difference in the views of pathologists, given Cala described Laura’s myocarditis as “patchy and mild”, whereas Cordner in his 2015 report described the condition as “widespread and at least moderate”.

This cuts to the core of a forensic pathologist’s role in studying cases of people who die suddenly, unexpectedly or violently. All forensic pathologists who have studied the deaths in the last decade have largely agreed that Patrick’s cause of death is explained by epilepsy and Laura’s by myocarditis. Others have viewed Caleb and Sarah’s deaths as either unexplained or SIDS.

Ultimately, forensic pathologists make their assessments on the evidence presented to them, combined with their experience in the field.

Sign-less suffocation possible, but unlikely

One thing which has proved a point of debate through this and the previous inquiry is the evidential quandary that suffocation, the basis for Folbigg’s original convictions, is difficult to ascertain.

That’s because, sometimes, cases of suffocation have no signs of injury.

Yesterday, Professor Peter Fleming indicated that in his long experience as a paediatrician, the only time he could conclude a manner of suffocation was due to the presence of plastic bag (it hasn’t been suggested this is a cause of death in the Folbigg children).

“It is rare and difficult to prove [suffocation],” Fleming said.

“There are very rarely instances where we can say absolutely for certain this was suffocation, and the only instances I can think of, where it’s been absolutely clear in that were instances where a child had a plastic bag over their head.”

Cordner and Orde today agreed with the inquiry that the absence of signs of injury did not exclude a plastic bag as a cause of death.

Orde, however, said it can also be considered that the absence of injury may be because no smothering took place.

“There are other potential competing causes of death, identified by the history, the circumstances and the autopsy findings,” Orde said.

“So it’s not just the absence of injury, I’m saying there are other factors coming into play in the discussion.

“There’s nothing here to suggest that smothering did occur.”

More on the Folbigg inquiries

• Expert: It would be extraordinary for someone to suffocate Folbigg children without leaving a mark
• Video: Inquiry hears that new evidence puts the conviction of Kathleen Folbigg in doubt
• Folbigg inquiry head must decide on evidence now, “can’t wait for science to fully develop”
• Researchers affirm science behind G114R study
• Scientists grilled on advocacy and accuracy
• Calmodulin variants “not benign” say Danish experts