A woman who allegedly died from sepsis after having a plastic snowflake implanted in her skin would have looked “dreadful” the day before she died, making it unlikely two doctors would miss the signs of a serious illness, a court has heard.
Body modification artist Brendan Leigh Russell is on trial for the woman’s manslaughter in the NSW District Court, facing allegations his work inserting the snowflake caused a deadly infection.
On Thursday, infectious diseases expert David Paterson told the court he had no doubt the woman’s hand was infected but there remained many grey areas about whether septicaemia caused her death.
She was found dead by her young daughter mere hours after the woman spoke with a neighbour, who described the hand as having ballooned to three times its size.
Mr Russell, who ran his modification business at a Central Coast shopping centre, has pleaded not guilty to manslaughter.
He does not deny conducting the procedure but rejects allegations his work caused her death.
Professor Paterson, a defence witness, said he would be surprised if the woman had been suffering from sepsis as she had been up walking and talking the day before she died.
He told the Downing Centre District Court that death from sepsis could be a long process, which could trigger other medical conditions.
The woman saw two doctors less than 24 hours before she died but not in relation to her hand, the court has heard.
She was seeking pain relief associated with chronic migraines she had suffered for several years.
Professor Paterson said it was unlikely two separate doctors who saw her would have missed the “red flags” of a significant infection had she been “really sick”.
“To me there would have been some red flags that would have come up had this person been really, really sick on the 11th, even if that wasn’t the purpose of the consultation,” he said.
“This is not a situation where a person just collapses and dies.
“She may have died from sepsis, I’m certainly not denying that. But I think it’s a cloudy situation with lots of grey.”
Crown prosecutor Chris Taylor asked Professor Paterson if it was conceivable a patient might be hesitant to raise symptoms linked to an “illegal” procedure.
The witness said he could not comment on that but stated a “reasonable” person would have mentioned her hand if it was causing distress.
The court had previously heard from several witnesses who described the woman’s hand as bleeding profusely, being swollen and appearing bruised and infected.
Her neighbour said the woman was exhausted and appeared confused when they spoke on April 11.
She also told friends and family she was in significant pain for several days, and believed the hand was infected, the court has heard.
Witnesses have also testified that Mr Russell would discourage his clients from seeking medical attention if they suffered side effects from his procedures out of fear of police attention.
He denies those claims.
Mr Russell is also on trial for female genital mutilation and causing grievous bodily harm, related to procedures carried out on two other women.
The trial continues.
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