“Colleagues informed me before the examination that perhaps Georgina’s episodes were caused by the mother,” testified at the trial of Roulas Pispirigou, the pediatric neurologist at the University Hospital of Patras, Polixeni Pelekouda, who said that she had discussed with two doctors about the need to inform prosecutor but also for the installation of cameras in the ward so that the child can be monitored 24 hours a day.

The witness testified that when she was called to examine Georgina because of the episodes she was having, “the colleagues informed me before the examination that maybe the episodes were caused by the mother. Mr. Aris Berzouanis (Rio) gave me this information.”

The pediatric neurologist told MOD that because she prepared the accompanying document for the transfer of the child from the Rio hospital to Aglaia Kyriakou, she requested Georgina’s history from the mother.

“I got a very detailed history from the mother. He described to me the episode of April 2021 before entering Karamandanio. It didn’t seem like a seizure, but I couldn’t put it down. Regarding the episodes after the protest, I understood from the mother that they were not of the same nature as that of Karamandanei. She talked about her children’s episodes as if she were narrating a movie,” he noted.

As the doctor said, from the beginning she took seriously the suspicions expressed by the doctors about the possibility that the episodes in the child were caused by the mother. “Because I took my colleagues’ suspicions seriously, I spoke with two doctors (Bertzouanis and Bellou) to inform the prosecutor and secondly how we would monitor the child 24 hours a day. This was January 24, 2022. When I asked them what they suspected they said airway obstruction with a pillow. We discussed how we would put cameras to monitor the child.”

The pediatric neurologist also reported: “I saw two videos. In one clip the mother “pulls” one the monitor and one the child, and the second doctor into the room. The child was in his usual neurological condition and then had prolonged apnea, severe tachycardia and required resuscitation.”

Chairman: Watching the video where do you end up?

Witness: It was clear from the video that there was no cushion obstruction. Second I was very scared as potentially life threatening by this episode. Not having his body reset with a pacemaker means that if he didn’t get help with Ambu and medical intervention he would have died. My thought was that the episode was dangerous. Second thought was that it wasn’t a seizure. One of the most difficult things is to distinguish an epileptic episode from a non-epileptic one. The low saturation that was present before the episode means that the episode is secondary and caused by something else.

According to the doctor: “There must have been something that triggered these episodes. In addition, the child was receiving antiepileptic treatment. I looked at the child’s file again, I saw the increased troponin, I spoke to Mr. Iliadis because the episode scared me and I spoke to Ms. Marmaridou, the scientific manager of the pediatric clinic. We informed the parents that the child will go to Aglaia Kyriakou and the father reacted very strongly. The mother suggested that they go to Ioannina and I said “no way”. On January 25, the child entered the ICU.”

The witness testified that she was very concerned about the situation she perceived with the existence of the videos and subsequently with the child’s death and thus began to look for the factors that may have led to Georgina’s death.

“After the video and after the death of the child I started thinking about external factors because there were suspicions. It had to be something very fast acting and I came up with some substances. I informed the crime against life division and gave them the list of substances. I took the suspicions of colleagues very seriously. In Greece it is very difficult to protect a child from abuse and the suspicion of a colleague is something that must be taken seriously.”

According to the doctor’s opinion in court, Georgina had not received ketamine when she had the episodes that preceded the seizure. “Ketamine is a drug that causes sedation. The child was not sedated in the episodes preceding death. I believe the episodes I experienced were not ketamine. It does not occur to me that there was a blockage of airways but I cannot rule it out,” he said.

Alexis Kougias: Do you think that the accused was cold?

Witness: She talked about her children’s episodes as if she were narrating a movie.

Alexis Kougias: What should he scream?

Witness: I cannot judge her behavior and feeling.

Alexis Kougias: The fact that she is filming the episode and calling the doctors to save her child, what does it mean?

Witness: This requires a serious degree of sadism.

Alexis Kougias: What effort should the accused make to cause convulsions?

Witness: He wants serious pharmacology research. I can tell you that there will definitely be a way, but it takes research and knowledge.

Earlier, the examination of the medical examiner Sotiris Bouzianis, who performed an autopsy on Georgina, continued in high tones.

The lawyer of the accused Alexis Kougias reacted at many moments of the examination by Edras, saying that the purpose of the questions to the witness is “to neutralize the answers of the medical examiner that lead to the acquittal of the accused”.

The chairperson, visibly disturbed by the defense counsel’s references to “invisible advisers” with spikes in a particular medical examiner, asked Mr. Kouya: “Are you implying something about the director?”

Although the defense attorney apologized, he continued to complain about “misleading questions” while telling the president: “You are here to judge and not to convict the accused. Your position is biased.”

Mr. Bouzianis repeated in court his assessment that Georgina’s death was due to the administration of ketamine which preceded the restraint suffered by the child.

The witness received many questions about the time of Georgina’s death, as he testified that the child was alive during the resuscitation attempt and until 3 past 10 in the afternoon. “I said this based on the findings of the trachea not the heart. I told you about the signs I saw in the trachea, whether they are post-mortem or pre-mortem,” said Mr. Bouzianis.

The witness was questioned about this by the chairperson, who asked him to answer based on the defendant’s position that ketamine was administered during resuscitation

President: The doctors came into the room at 2:30 in the afternoon and said they saw no vital signs. They found only the current of the heart, but there were no contractions. If we have a living person and they are given a lethal dose of ketamine what happens?

Witness: Sedation and hypoxia, because it affects the breathing center.

President: The defendant’s position is that ketamine was administered by nurses and doctors at the time of resuscitation. Since it was administered at that time why did we not have these symptoms?

Witness: I can’t know, I don’t know what the monitor recorded.

President: If we have a person who is being resuscitated and we have no result. Time of death what do we put?

Witness: Usually in hospitals they put a time of death, after all efforts are over.

President: But when has this man died? Haven’t the doctors been trying to help him since the beginning?

Alexis Kougias: That’s what they say. What you are asking about are the opinions of doctors that the defendant has sued for medical malpractice, so they are not valid and cannot be evaluated. I see bias in your use of them. He told us that the child was alive when he suffered the swelling.

The allegation that the child was found to have mild swelling that could only have developed while alive and attributed to the intubation caused the Class Support side to file a request for cross-examination of Mr. Bouzianis with the doctors involved in the resuscitation. The defense also agreed to the request.

Alexis Kougias: When CPR started, was he alive or dead? Doctors say it was dead. Does the swelling you found indicate it was alive or dead?

Witness: It is a vital reaction.

Alexis Kougias: Have you seen swelling anywhere from absorption or aspiration?

Witness: It has not come to my attention.

The chairperson asked the coroner if he found any problems with Georgina’s heart which, if the ketamine had not been detected, could have led to an arrest.

Mr. Bouzianis replied “only the weight”, explaining that the heart was a scholarship “underweight in relation to the age of the child”.