Doctor Says He Explained Zara Qairina S Cause Of Death To Family Despite Mother S Claim

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Testifying as the fourth witness in the coroner’s court, Dr Pavankumar Balachandran from Queen Elizabeth Hospital’s Neurosurgery Department said he also recalled informing family members about Zara’s time and cause of death after she succumbed to her injuries on July 17. — Borneo Post picKOTA KINABALU, Sept 9 — A neurosurgeon told the inquest into the death of 13-year-old schoolgirl Zara Qairina Mahathir that he had spoken to her mother and some family members after realising she had suffered irreversible brain damage and faced a poor prognosis.
Testifying as the fourth witness in the coroner’s court, Dr Pavankumar Balachandran from Queen Elizabeth Hospital’s Neurosurgery Department said he also recalled informing family members about Zara’s time and cause of death after she succumbed to her injuries on July 17.
Accused by Zara’s mother of not being informed of the cause of death, Dr Pavankumar insisted he had spoken to family members, including her mother, when he first realised Zara’s poor prognosis and again after her death on July 17.
“As far as I recall I have explained to the mother and some of the relatives regarding the time and cause of death,” he said during questioning.
Lawyer for Zara’s mother, Rizwandean Borhan, said he was instructed by Noraidah Lamat specifically to ask whether he saw the investigating officer (IO) engaging with her, to which Dr Pavankumar said he did.
Rizwandean: I have been instructed by the deceased’s mother who said the IO never talked to her on July 17. Can you explain this?
Dr Pavankumar: I can only state that they were discussing. I saw the IO explaining to the mother.
When asked whether he thought a post-mortem should have been conducted, Dr Pavankumar said it was typically discussed between the IO and the forensics department and was beyond his scope.
“Normally, we hand the case over to the IO and they will discuss it and come to a consensus on what to do next. I don’t normally keep track as we leave it up to the police and forensics department,” he said.
Earlier, in his witness statement, he told the court that Zara showed no clinical signs of improvement since being admitted to his ward at 6.40pm on July 16, gradually deteriorating before succumbing to her injuries at about 1.07pm the next day.
The cause of death was severe traumatic brain injury with hypoxic ischaemic encephalopathy.
Dr Pavankumar said such injuries usually have poor outcomes, and in this case Zara was at the lowest level of consciousness — measuring E1VTM1 on the Glasgow Coma Scale, which assesses eye, verbal and motor responsiveness.
“This is the lowest level of consciousness whereby the patient has lost the ability to breathe on her own, hence she has to be intubated and put on a mechanical ventilator,” he said.
The doctor said he then called for a family conference, where he noted the presence of Zara’s mother.
“I have explained to the investigating officer and the deceased’s mother regarding the cause of death. After the investigating officer’s discussion with the deceased’s mother, he instructed that the body can be sent to the Department of Forensic Medicine,” he said in his witness statement.
Meanwhile, counsel Datuk Ram Singh raised questions about the presence of the anti-seizure drug Phenytoin, which was detected in her body during the toxicology report.
Both Dr Pavankumar and third witness Dr Janefer Voo, who was the first to attend to Zara when she was admitted, said they did not administer the drug.
Dr Voo said she had prescribed 10 types of medication to stabilise the patient, including Fentanyl, Rocuronium, IM ATT, Tranexamic Acid and Cefuroxime, but not Phenytoin.
Dr Pavankumar said Zara had sustained such severe and irreversible brain injury that in this case, prophylactic medication would not have changed the outcome.
Last week, Queen Elizabeth Hospital pathologist Dr Jessie Hiu testified that traces of Phenytoin were found in Zara’s kidney tissue. - malaymail

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