The lethal dose of ketamine received by Georgina she was her cause of death on January 29, 2022, according to medical examiner Sotiris Bouzianiswho performed an autopsy on the child.

The witness, who was summoned by the Crimes Against Life Department (YDEZI), as he testified at the trial of Roula Pispirigou, a month after the child’s death, to carry out tests, confirmed to the Joint Jury the conclusion of his report that Georgina died from strong dose ketamines. “Ketamine is the cause of death. I do not differentiate the cause of death. It exists and I can’t ignore it” said Mr. Bouzianis.

He also pointed out that the fatal dose that killed the child was taken while she was alive and so it was metabolised and detected in the tests carried out, while on the contrary the substances rocuronium and adrenaline, which were administered during resuscitation at “Aglaia Kyriakou” after the arrest, were not detected because Georgina was already dead. “Anything not found has been posthumously given” said the witness characteristically.

The coroner told the court that initially, the cause of death was “unspecified” and so requested toxicological and histological tests. “There was no clear cause to justify the death. Macroscopically we didn’t find a clear cause of death, it didn’t look like anything” he reported.

President: You mentioned the substance ketamine in your report…

Witness: Yes, it’s the one given to me by the toxicology labs.

President: You initially gave an unspecified cause for the death of Georgia Daskalaki.

Witness: There was no clear cause to justify the death. Macroscopically we didn’t find a clear cause of death, it didn’t look like anything.

As the medical examiner testified, it was found in Georgina amount of ketamine which is equal to 6.5 milligrams per ml. He also explained that: “Depending on how ketamine is administered, it also depends on how fast its metabolism will be. If administered intravenously it can be metabolized in the first minute. If it has been given intramuscularly, orally, etc., the metabolism time increases.”

Chairman: When someone has no vital signs does the metabolism work?

Witness: No, substances are not metabolized. Metabolism only works if one is alive.

Prosecutor: Cause of death listed as fatal ketamine poisoning. Does this fit with other findings?

Witness: No, we would have put it.

Mr. Bouzianis said that due to the amount of ketamine and because the substance that was administered was more than normal, hypoxia was created, i.e. the body was being oxygenated but not as much as it should have been and because of this there was also a related finding in the liver.

Panelist: Is there variation in the time of action of ketamine? Variation and symptoms?

Witness: Certainly when death occurs quickly for example, we would have more findings.

Speaker: If it has been given intravenously to the oximeter how quickly would we have a reading?

Witness: After 3-5 minutes. We have to see how it was given, whether it was given all at once or gradually.

Conference (right): Did he take everything that was found in the toxicology?

Witness: During resuscitation, not everything given is metabolized.

Conference: What is the reason that rocuronium and adrenaline were not found? What is given during resuscitation is not metabolized?

Witness: Anything not found has been given posthumously.

Speaker: If the heart only has an electrical signal would it change?

Witness: No.

Dimitris Georgakopoulos, defense attorney: If ketamine had been given through the gastrostomy would there have been a residue in the stomach?

Witness: Probably yes.

Dimitris Georgakopoulos: How is the metabolism time related to the complete elimination time from the body?

Witness: I think ketamine after three hours is undetectable.

Regarding the child’s heart, the medical examiner testified that it was weighed before entering the formalin and weighed 47 grams.

Alexis Kougias: What life expectancy did this child with this heart have? Could she end up with a 47 gram heart combined with a seizure?

Witness: It could, but I can’t say when.

The defendant’s defense emphasized to the court during the examination of the witness that her position is that “the child was alive and during resuscitation they gave him ketamine and he died of asphyxiation.”

Mr. Kougias asked the witness questions to show that little Georgina was alive during the resuscitation, citing swelling found in the child’s throat and arguing that the ketamine was administered by doctors either by mistake or to intubate her.

Alexis Kougias: Can any injury, swelling, ecchymosis be recorded on a dead body?

Witness: Anything recorded we’ll know when it’s done.

Alexis Kougias: Can someone cause anything related to blood flow to a dead person? Has swelling been recorded, for example, in someone who has been dead for 15 minutes?

Witness: No, it cannot either swelling or redemption. These are only alive.

Alexis Kougias: What was the reason that tests were ordered? Who contacted you?

Witness: I was talking to YDEZI, the Crimes Against Life Department. Initially, the first order was from the Vineyards department.

Alexis Kougias: Is it usual for YDEZI to intervene?

Witness: It has never happened to me before.

Alexis Kougias: How many days later did YDEZI intervene?

Witness: On February 22, 2022, I received the order.

Al. Kougias: Do you remember if back then there were shows that said there was a mother who killed three children?

Witness: Everyone saw them.

Alexis Kougias: Did they ever tell you that they suspect that the accused has taken the lives of two other children?

Witness: No.

Alexis Kougias: How do you comment on Mr. Papagianni’s (Onassios) claim that he was fitted with a pacemaker because his parents requested it? Has he ever heard of a pacemaker being put in because parents ask for it?

Witness: Alas if treating physicians operate on what parents will say.

Alexis Kougias: Should the tachycardia have been recorded on the pacemaker?

Witness: Yes.

Al. Kougias: Do you have any doubt that a defibrillator was used in CPR?

Witness: No.

Al. Kougias: Is the nurse who says it was not used telling the truth or lying?

Witness: In this case, lies.

Alexis Kougias: You say this substance (s.s. ketamine) has not been administered to Daskalaki Georgia according to the medical file. What did you base your answer on?

Witness: I addressed Mr. Theodorou from YDEZI, and he sent me a paper signed by Mrs. Mavrikou (s.s. doctor Aglaia Kyriakou). In these medicines that he wrote us, there is no ketamine.

Alexis Kougias: I and everyone else were under the impression that ketamine is an outpatient drug. Now would you put her on inpatient medication?

Witness: When I asked the question I did not know that he would send me paper and there would be no ketamine inside. On the paper that Mrs. Mavrikou sent me, it says hospital medication.

Alexis Kougias: If you knew that the child had been intubated, would you be surprised by ketamine?

Witness: It wouldn’t surprise me if I knew he’s been intubated. I would think that maybe ketamine has been administered as well.

The witness, responding to other questions from Mr. Kuya, said that “if the child was dead, he did not need to be intubated.”

Alexis Kougias: If you were informed about the intubation procedure, would you ask if ketamine was included among the drugs in the resuscitation bag?

Witness: Of course.

Alexis Kougias: Would you rule out the mother having any involvement until 14:28?

Witness: Of course.

Alexis Kougias: At 14:28 the accused stops having contact with the child, when was ketamine administered?

Witness: It’s not such an easy question…from the interval at 14:28 or 14:25 onwards, I would also put in the intubation stage as a vital reaction was found.