Sunanda Pushkar death case: Gaping holes, loose ends in police probe, say experts

New Delhi: A couple of days after the final post-mortem report on former Union Minister Shashi Tharoor’s wife Sunanda Pushkar was leaked to the media, the forensic community believes there is more to the case than meets the eye. The experts Firstpost spoke to preferred to stay clear of the controversial aspects of the high profile case, but hinted that there’s something fishy about the whole investigation and wondered whether the police intended to come out with truth. The final report submitted by All India Institute of Medical Science, where the autopsy was conducted on 52-year-old Sunanda a day after she was found dead in Hotel Leela on January 17, to the Delhi Police on September 30 said she died of “poisoning”. But the report, prepared by a three-member panel of doctors including Dr Sudhir K Gupta, Dr Adarsh Kumar and Dr Shashank Puniya, did not specify which poison caused the death. [caption id=“attachment_1753171” align=“alignleft” width=“380”]  A file photo of Sunanda Pushkar and Shashi Tharoor. Courtesy: GettyImages[/caption] The panel analysed the viscera and toxicology report (earlier prepared by the CFSIL that had said no poison was detected) and found the traces of acetaminophen (a paracetamol), caffeine (found in seeds, leaves and fruit of some plants here where it acts as a natural pesticide that paralyses and kills certain insects feeding on the plants), cotinine (an alkaloid found in tobacco) and ethyl alcohol in her body. The report says, “Mild foul-smelling gas was coming out and tache noir was present in left eye.” According to doctors, tache noir is an ocular change seen in the eye after death in case eyes remain open. The doctors have “reserved the opinion on specific poison/ chemical since there are a lot of limitations in the viscera report”. Notably, the latest report has been prepared by the same set of doctors who had conducted autopsy on January 18 and observed that the death was “sudden, unnatural and due to drug overdose”. “Paracetamol is widely available and prescribed. It is cheap to buy over-the-counter, making it a common drug taken in overdose. It can cause serious or fatal adverse effects at around 150 mg/kg for many adults. There is considerable interpatient variability which depends on age, health and substances taken with the paracetamol. When taken in overdose, the liver conjugation becomes inundated, causing paracetamol to be metabolised by an alternative pathway. This results in a toxic metabolite, N-acetyl-p-benzoquinone imine (NAPQI), which is itself inactivated by glutathione, rapidly preventing any harm. When glutathione stores are depleted to less than approximately 30%, NAPQI reacts with nucleophilic aspects of the cell, leading to necrosis. Necrosis occurs in the liver and in the kidney tubules that causes death. “Toxicity is increased in patients with induction of the P450 system through drugs such as rifampicin, phenobarbital, phenytoin, carbamazepine and alcohol,” forensic expert Dr Shashank Jain told Firstpost. When asked the initial findings of drug overdose were ruled out in the latest CFSL report, he said, “The authenticity of the report depends on how soon the post-mortem was conducted and how successfully the viscera were preserved for further examination.” When reminded that all her organs, including kidney, liver, lungs and heart, were working properly before the death as suggested in the latest CSFIL report, Dr Jain said, “I do not believe in this. How come such a claim is made so confidently when the post-mortem was conducted around 24 hours of the death and then viscera were sent for examination? There are a lot of limitations of viscera.” CFSL doctors listed a number of poisons/chemicals - nerium oleander, snake venom, heroins, polonium 210 and thallium - which can be the cause of the death but did not specifically name any one of them. “If the any of the poisons listed above was administered in her body, then it cannot be tested in Indian labs,” he added. Another forensic expert, who refused to be named, told Firstpost, “It is extremely easy to end someone’s life with the overdose of paracetamol. But if the death occurred because of this, it can be suicidal as well as homicidal. But the points to be noted here if she committed suicide by ingesting it, why several bruises and an injection mark were on her body. This cannot be ruled out that she was administered a paracetamole overdose through injection.” Notably, as per the preliminary report, Sunanda’s body had 15 injuries, all of them caused within 12 hours before her death. All the injuries “were caused by blunt force”. The injury number 10 is an injection mark, says the autopsy report. Hinting at an attempt of cover up, he said, “Why were the bed sheet and pillow cover where her body was lying not provided to the CFSL. Had she been poisoned, she would have vomited or excreted saliva and it could have been traced on the pillow cover. There were chances of finding vaginal discharge on the bed sheet. It could have helped the doctors arrive at a conclusion.” Although Delhi Police Commissioner BS Bassi told reporters on Friday that the final report is “inconclusive” and ruled out any CBI probe into the incident saying that his police are competent enough to investigate the case, a senior told Firstpost an FIR would be filed soon. “We are still awaiting for the final decision of the doctors,” he said.