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Critical evidence associated with the Oscar Pistorius murder trial focused on gastric emptying yesterday, with a specialist anesthetist testifying that she agreed with the evidence given by a forensic pathologist who was a State witness. However, Prof. Christina Lundgren said there were numerous reasons why seven fluid oz. (200 ml) of recognizable food was found in the stomach of Reeva Steenkamp five hours after her death, and so it was impossible to state categorically when she had eaten her last supper with Oscar Pistorius.
The issue of gastric emptying was used by the State to try to disprove the Olympian athlete’s claim that he and Reeva ate supper together at 7 pm on February 13 last year. He has also maintained that they went to the bedroom shortly after eating; that Reeva did yoga, and that they then went to sleep. The State, on the other hand, has maintained that the couple ate much later than this and argued rather than sleeping. This would explain the food found in the stomach of the deceased when the autopsy was done.
Prof. Lundgren, head of the Department of Anesthesiology at the University of the Witwatersrand in Johannesburg, said she had a good thorough knowledge of physiology, pharmacology, and diseases in general. She was an expert in gastric emptying. One of the areas anesthetists highlight, she said, was patient safety, because if a patient’s stomach was full during an operation, the food could be regurgitated and could end up in the lungs.
Several general observations she mentioned were that a patient with a head injury could have a full stomach for 24 hours after the incident; that 10 percent of food might be left in the stomach after a period of four hours; and that food with a high fat content could remain in the stomach for more than four hours. Generally it would take at least six hours for the stomach to empty, she said. However, she had a case when a patient had eaten eight hours before an anesthetic, but the stomach contents were not emptied and this caused problems.
Prof. Lundgren then listed a number of things that could delay gastric emptying. These included pain and anxiety, sleep, exercise, smoking, consumption of alcohol, some diseases, anorexia and bulimia, many medications including anti-depressants, a large number of slimming drugs and a lot of herbal medicines, as well as marijuana and cocaine. In addition, she said researchers consider that being a “premenopausal woman” (essentially a young woman) might also be a factor. However, under cross-examination, she conceded that Reeva Steenkamp was not known to be a smoker, that there was no evidence she had drunk alcohol, and that there was no indication she had taken any medication or other substances.
Asked to comment on the gastric contents found in the stomach of the deceased, Prof. Lundgren said she was not a pathologist and that her opinion was based purely on her own experience. From the evidence she had been given to read, she said the chicken stir fry eaten by Reeva Steenkamp during her last supper with Oscar Pistorius may have included insoluble vegetable fibers. While her stomach should have been empty after eating at 7 pm, there were so many factors that could have effected gastric emptying, any determination would be “purely speculative.”
In cross-examination State Advocate Gerrie Nel pointed out that if the deceased had eaten at 7 pm, and since the post-mortem or autopsy was conducted five hours after death (which was around 3 am), there was a total period of 13 hours for gastric emptying to take place. He also pointed out that her body was not refrigerated prior to the autopsy, which would have allowed gastric emptying to continue more rapidly. This, he said, must mean that the evidence for the State of forensic pathologist Prof. Gert Saayman must be probable.
Refusing to comment, Prof. Lundgren said that because she was not a forensic pathologist, all she could do was “go on the literature” available to her. This convinced her that it was speculative to try to establish when Reeva Steenkamp had consumed her last supper with Oscar Pistorius. She said she had “immense respect” for Prof. Saayman, and would not contradict his evidence, but was willing to say his evidence was “his opinion.”
By Penny Swift