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Tests focus on medicine cocktail
Injuries ruled out as death cause

New Delhi, Jan. 18: The preliminary findings from Sunanda Pushkar’s autopsy have ruled out physical injuries as the cause of her death, pointing to the possibility that the wife of Union minister Shashi Tharoor died of either a lethal cocktail of prescription drugs or poisoning.

Doctors at the All India Institute of Medical Sciences (AIIMS) who performed the autopsy on Pushkar had observed injury marks on her hands.

But a senior doctor who spoke on condition of anonymity told The Telegraph that these injuries could not have contributed to her death.

“The injuries on the hands were trivial and couldn’t have caused the death,” the doctor said.

Earlier this afternoon, Sudhir Gupta, a professor of forensic medicine at AIIMS who led the medical team investigating Pushkar’s death, had said she had a “sudden unnatural death”.

He also said there were injury marks on her body but declined to reveal the site of the injuries or their significance.

The autopsy team has sent samples of her tissues for toxicology and microscopic examination that forensic medicine experts say could provide information that may help determine the cause of her death. The results of these studies are expected within two days, AIIMS doctors said.

Pushkar, who was 52, was found dead on Friday evening in a hotel suite in the capital that she was sharing with her husband. Police sources today claimed that Pushkar had checked in alone on Wednesday into a room in the hotel and Tharoor had joined her the next day and the couple moved to the suite on the same floor. ( )

A senior AIIMS doctor said the preliminary autopsy findings indicated she died sometime between 1pm and 7pm on Friday.

“The term sudden unnatural death suggests that the cause of death is not a natural disease process, but either an accident, or a suicide, or a homicide,” said B. Suresh Kumar Shetty, associate professor of forensic medicine at the Kasturba Medical College (KMC), Mangalore, who is not connected with the probe.

“Toxicology studies can tell what substances someone consumed hours or even days before death,” Shetty said.

Amid speculation that Pushkar was ill and could have been taking prescription drugs, doctors said they could not rule out for now the possibility that a prescription drug she might have been taking might have interacted with some other substance.

Without drawing any parallel with Pushkar’s case in the absence of confirmed information, the doctors pointed out that it was dangerous to combine drugs called benzodiazepines with alcohol. The doctors referred to alcohol because of its easy availability in a five-star hotel and not because they had any evidence that Pushkar had consumed any.

Studies also show that a benzodiazepine called alprazolam, used to treat excessive anxiety and panic disorder, is more toxic in overdoses than other benzodiazepines.

An overdose of alprazolam can lead to coma and death. A combination of alprazolam and alcohol can also be lethal. “Certain medicines should not be combined with alcohol, barbiturates, for example,” said Ramesh Kumar, former head of forensic medicine at AIIMS.

The Hungarian-British author Arthur Koestler and his wife had committed suicide in 1983 by consuming barbiturates and alcohol.

An AIIMS spokesperson said the final autopsy report would be sent to the sub-divisional magistrate.

Forensic medicine experts say the goal of the toxicology and microscopic examination of the tissues would be to try and determine the trigger mechanism in the body that eventually led to cardiac arrest.

Around 3.30am on Saturday, Tharoor had visited AIIMS with complaints of chest pain and uneasiness. An AIIMS spokesperson said he had been examined and found to be stable after which he was discharged from the hospital.