Sunanda Pushkar died of poisoning: AIIMS medical board

Sunanda Pushkar died of "poisoning" with the AIIMS medical board, which gave its opinion on the FBI report on her viscera samples, unanimously concluding that there was presence of anxiety drug Alprax in her stomach.

However, the board did not rule out the possibility of any injectable poison, in view of a particular mark on Sunanda's body, and said that the FBI report confirmed the presence of lidocaine in her body, said the medical board's opinion communicated to Delhi Police.

The report ruled out death due to combination of drugs and also said that the medical board is "highly afraid" that this case may have led to a complete "botched up" scenario in absence of the FBI report.

It also said that the Special Investigation team (SIT) probing the case should "thoroughly investigate" if any person had access to injectable agents in view of a syringe mark spotted in Sunanda's body.

"The Medical Board unanimously concluded that the cause of death in this case is poisoning.

"The circumstantial recovery of empty Alprex Tablets (27 tablets) and report of FBI which shows the presence of Alprax in stomach and its contents, spleen, liver section, half of each kidney, blood sample, as well as urine wet clothing, bed cover and bed sheet confirmed the death is due to excessive ingestion of Tablet Alprazolam," the written opinion reads.

It further said, "The Medical Board does not rule out any injectable poison in view of injury number 10 which is an injection prick mark and the same is subsequently clarified by KIMS Hospital as well as the confirmation of presence of lidocaine in FBI report... The dozens of unexplained injuries including teeth bite mark are suggestive of active scuffle prior to death."

The board also said that the fatal dose of Alprax is completely variable from person to person, physical conditions and medical history/duration/dose of intake of Alprax. Exceeding the prescribed dose leads to poisoning.

Delhi Police Commissioner B S Bassi today refused to comment on the medical board's opinion and said that necessary information regarding the case will be shared once the investigation is complete and a report is submitted at the court.

"I would not like to enter into speculations. What is being published or broadcasted in the media could be right or could be wrong. At this point of time, I won't be able to say anything conclusive.

"Once the investigation is complete, we shall send a report to the court. At that point we shall brief media about our findings. And I can assure that the investigation will be complete as early as possible," Bassi told reporters.

In January last year, Delhi Police had registered a case of murder in connection with the death of Sunanda. An AIIMS medical board had found poisoning as reason for her death following which the police had sent her viscera samples to an FBI lab in Washington last year.

The FBI had sent its report to Delhi Police two months back. The report said the radiation levels in Sunanda's viscera samples were "within the standard safety norms" besides mentioning other details.

As police could not firm up about cause of the death based on the FBI report, they requested a medical board of AIIMS to analyse the contents of the report.

The head of the AIIMS medical board, which gave its opinion last week on the cause of Sunanda Pushkar's death, on Tuesday had said that Delhi Police caused "unnecessary delay" in sending Sunanda's viscera sample to the FBI lab on account of which its contents degraded.

"By the time the FBI lab got the viscera samples, the contents had already degraded. There was an unnecessary delay on part of Delhi Police in sending the viscera samples of Pushkar to FBI," AIIMS Forensic Science department head Sudhir Gupta said.

"The Medical Board is highly afraid that this case of deceased Sunanda Pushkar may have led to a complete botched up scenario in absence of FBI report," the fourth subsequent opinion on Sunanda's case read.

"FBI reported the presence of lidocaine, which is an antiarrhythmic drug of heart, and may cause fatality if administered intravenously. This requires further legal investigation as there was presence of injection mark over body of deceased (injury no 10)... There have been reported cases of homicide by lidocaine poisoning," it said.

The board said that death due to combination of drugs as asked by the IO (investigating officer) is also ruled out.

It added that the speculation regarding Sunanda's cause of death as hypoglycaemia, which can happen if a person does not take food for 2-3 days, was misleading.
"However, if a person in having hypoglycaemia, even a small dose of injectable hypoglycaemic agents like insulin or albiglutide (Tanzeum) may lead to fatality," the board said.

It added that the SIT should investigate thoroughly if any person in the vicinity and in access of insulin/ hypoglycaemic agent was there, as there was presence of injection mark over body of deceased.

Disclosing the receipt of the AIIMS report analysing the FBI conclusions, Delhi Police Commissioner B S Bassi had last week told the media that Sunanda's death was not natural but ruled out the presence of radioactive material in her viscera.

Sudhir Gupta, head of AIIMS Forensic Science department, had said the FBI report also said the death was due to poisoning as was concluded by the AIIMS.

51-year-old Sunanda was found dead at a suite in a five-star hotel in South Delhi on the night of January 17, 2014, a day after her spat with Pakistani journalist Mehr Tarar on Twitter over her alleged affair with Tharoor.