Post-mortem on Jong-Nam shows death due to VX (nerve agent) poisoning

SHAH ALAM: The post-mortem report on Kim Chol better known as Kim Jong-Nam showed that death was due to VX (nerve agent) poisoning following acute onset exposure, the High Court, here, learnt today.
According to Kuala Lumpur Hospital (HKL) head of Forensics Department Dr Mohd Shah Mahmood, who testified as the sixth prosecution witness in the trial today, said he conducted the post-mortem alongside his subordinate Dr Nurliza Abdullah at 12.45pm on Feb 15 which was witnessed by ASP Wan Azirul Nizam from the Sepang police district headquarters.
"Based on the post-mortem examination findings, supporting clinical history and positive laboratory investigation results, I am of the opinion that the cause of death was VX (nerve agent) poisoning following acute onset exposure," he said.
He added that the results of the post-mortem revealed that the deceased had been on medication for "diabetes, hypertension and gout in blood, urine and tissues".
Earlier, the toxicology report from analysis on the remains of Kim Chol revealed that he had low levels of the cholinesterase enzyme which contributed to his death.
HKL pathologist Dr Nor Ashikin Othman, 44, who conducted tests on Jong-Nam's blood sample said the condition could have been caused by either pesticide or the work of nerve agent.
The cholinesterase enzyme test on Kim Chol's remains, she said returned a result of 344 units per litre which was low in comparison to enzyme level for both the accused Indonesian Siti Aisyah, 25, and Vietnamese Doan Thi Huong, 28, were 6,781 and 7,163 units per litre, respectively.
The enzyme, she said is important to ensure proper muscle and heart function.
Jong-Nam had also been in stabile condition following medical treatment by the doctor at klia2 Menara clinic prior to being sent to Putrajaya Hospital.
Menara clinic doctor Dr Nik Mohd Adzrul Ariff Raja Azlan said he had found Jong-Nam unconscious after being informed by his nurse at the clinic during the time of the incident.
"I checked his vital signs when he was placed at the treatment room.
"His blood pressure had shot up to a very high 220/129 before it went down to a low 70/40.
"His oxygen saturation level dropped from normal to 40% and I was unable to get a pulse reading," he said.
Nik who is the fourth prosecution witness in the trial said he then administered one ampule of atropine and adrenaline each to Jong-Nam in an effort to ensure that his heart was pumping more blood.
"After administering the medication, the patient was fixed with a high-flow mask to increase his oxygen level.
"His oxygen saturation level improved up to 67% while his blood pressure reading was at 92/70," he said adding that the improvement in his vitals signs eventually saw pulse registering a 19/100 beats per minute.
Questioned by deputy public prosecutor Wan Shaharuddin Wan Ladin on whether Jong-Nam had saliva and mucus drooling from his mouth and nose, he said following an examination on his mouth, he noticed a mixture of saliva, vomit and blood.
"As his oxygen saturation levels was still low despite all non-invasive action taken, I decided to incubate him by clearing his mouth and throat off those fluids before placing the oxygen tube and hydro mask.
"His oxygen saturation levels improved to 94%, while his blood pressure stabilise to 108/70 and pulse was recorded at 90/100 beats per minute," he said.
However, despite being stabile, Nik said that Jong-Nam needed to be transferred to a hospital with an ICU setting.
"I can't remember exactly how many of us carried him on the stretcher to the ambulance.
"There were maybe four or five of us, including the nurses and paramedic as well as one police officer," he replied to a question by defence counsel Gooi Soon Seng.
Nik said he learnt of Jong-Nam's death when a paramedic informed him after the ambulance had arrived at the Putrajaya Hospital.
Siti and Doan along with four others still at large, were charged with the murder of Kim Chol, 45, at the KL International Airport 2 (klia2) departure hall at 9am on Feb 13 this year.
It was reported that Jong-nam was at Klia 2 on Feb 13 to board a flight to Macau when two women approached and suddenly wiped his face with toxic liquid which was later identified as the VX nerve agent.
Jong-nam, who travelled with a passport bearing the name of Kim Chol, died while on the way to the Putrajaya Hospital. He arrived in the country on Feb 6.
The murder charge under Section 302 of the Penal Code carries the mandatory death sentence upon conviction.