A senior Pakistani police officer opposed an autopsy on the body of Benazir Bhutto though this is mandated in each murder case, says an official of the hospital where she was declared dead.
"Even if the family of a murder victim refuses to allow the autopsy, no investigation can be completed if doctors do not perform the autopsy and conclusively find the cause of death," The News Sunday quoted Athar Minallah as saying.
Minallah is on the board of management of the Rawalpindi Medical College and Rawalpindi General Hospital.
"The (seven) doctors (who attempted to resuscitate Bhutto when she was brought to the hospital are) worried that their initial report, which did not determine the definite cause of death, is being politically twisted," Minallah added.
He said that avoiding the mandatory autopsy violated the Criminal Procedure Code. According to the lawyer, the doctors told him that they wanted to conduct an autopsy but the Rawalpindi police chief did not agree to this.
The doctors' three-page report concludes with a one line finding on the cause of Bhutto's death: "Open head injury with depressed skull fracture, leading to cardiopulmonary arrest."
Minallah said this did not specify what caused the injury.
"Only the medico-legal report, based on the autopsy, could determine whether a bullet hit the head," he maintained.
Medical Report of Benazir Bhutto:
On 27-12-2007, at approximately 5.35 p.m., a female patient was brought in Accident & Emergency department of Rawalpindi General Hospital. She was brought to the Resuscitation Room and was received by Dr Aurangzeb Khan and Dr Saeeda of Surgical Unit-II. This patient was identified as Mohtarma Benazir Bhutto.
Dr Habib Ahmad Khan, Medical Superintendent RGH, also arrived immediately.
The condition appreciated at the time of receiving the patient was as follows. The patient was pulseless and was not breathing. She was markedly pale. Her pupils were fixed, dilated and non-reacting to light. A wound was present on the right temporoparietal region through which blood was trickling down and whitish material, which looked like brain matter was visible in the wound. Her clothes were soaked with blood.
Immediate cardiopulmonary resuscitation was started. She was ventilated by Ambu bag and within a minute was intubated with endotracheal tube; blood mixed with secretions was noticed in the throat that was suctioned out before intubation. External cardiac compressions were started. A cannula was passed in her right hand and intravenous fluids were pushed in. Inj(ection) adrenaline was given.
No response was seen. Patient was shifted to emergency operation theatre while resuscitation was continued.
In operation theatre, Dr Arshad, anaesthetist, joined the team. Prof. Mussadiq Khan also joined the team at 5:50 pm. As external cardiac massage was not leading to any success, therefore, open cardiac massage was started via left antero-latreal thoracotomy. No blood was seen in the left thoracic cavity or the pericardium. There was no cardiac muscular activity seen.
Artificial assisted ventilation, internal cardiac massage and intravenous fluid resuscitation was continued. She was given intra cardiac adrenaline, calcium gluconate. These drugs also with sodium bicarbonate were repeated intravenously.
Though no cardiac activity was seen but in order to treat fine ventricular fibrillation, electrical defibrillation was carried out. No cardiac response was seen.
Prof Azam Yusuf and Dr Qudsia had also joined the resuscitation team.
Pupils were fixed and dilated, no evidence of any cardiac or respiratory activity was observed. ECG showed no electrical activity.
At 6:16 pm, it was decided to stop resuscitation and patient was declared dead. The thoracotomy wound was closed. Fractured rib due to resuscitative thoracotomy was noticed.
Prof Arif Malik and Prof Saleem also reached by then.
Details of the wound and its surroundings:
There was wound in right Temporoparietal region. Shape was irregularly oval, measuring about 5 x 3 cm, just above the pinna of right ear. Edges were irregular. No surrounding wounds or blackening was seen. There was a big boggy swelling around the wound. Blood was continuously trickling down and whitish material that looked like brain matter was seen in the wound and on surrounding hair. Sharp bone edges were felt in wound. No foreign body was felt in the wound.
Wound was not further explored. Gentle aseptic dressing was used to cover the wound.
Bleeding from both the ears was seen, more so from the right ear. Slight trickle of blood was seen from right nostril also. Blood mixed with secretions was seen in the oral cavity also. Detailed external examination of the body did not reveal any other external injury.
X-rays of the skull AP and lateral views were done after she had been declared dead.
Cause of death:
Open head injury with depressed skull fracture, leading to cardiopulmonary arrest.