Matlala trial: State's assault theory takes a beating as pathologist stands firm

The State has failed to get a forensic pathologist to abandon his view that accused number one Musa Kekana's coughing up of blood fits his claim that police assaulted him.

Under cross-examination in the Johannesburg High Court on Monday, Professor Gert Saayman said his view rested on what the medical records actually show.

"It is primarily based on a positive perspective that one draws from the notes and the correlation between the version given by the accused and the alleged outcome. There is a clear history of how the particular assault, for lack of a better word, torture, was allegedly applied, and clinical manifestations cropping up with blood in the immediate aftermath thereof. And the rapid resolution of the problem without there having been any particular therapeutic intervention that could have specifically caused that rapid resolution. Such forms of asphyxial assault are inherently self-limiting and rectify themselves very quickly," said Saayman.

The State tried to link Kekana's condition to a hospital stay about six weeks before his arrest. Saayman rejected this.

"I still say, without reserve, that there is very little basis upon which to suggest that there is any causal link between the initial admission of the patient and the second admission of the patient, or that the second admission was precipitated by or predisposed by the prior admission. There is no substantive basis for that," he said.

The State put it to him that Kekana told police on his arrest that he was not well. State witnesses gave that evidence, but Kekana disputes it. Counsel asked whether this could point to an ongoing infection or a pre-existing condition.

Saayman said the doctors' ongoing tests found nothing of the sort.

"Despite this continuing investigative process and assessment, nothing was found to corroborate that there was a pre-existing infectious condition. And absolutely nothing to suggest that it correlates with his prior admission approximately six weeks earlier."

The State pointed to hospital notes from the earlier admission. These referred to alcohol poisoning. Kekana also told the court he drank a bottle of Hennessy the night before.

Saayman said the notes also referred to possible organophosphate poisoning and food poisoning. Many of these entries carried question marks.

He criticised the absence of a blood alcohol result.

"Why is it that we don't have the actual results of the alcohol analysis that would have been done, and should have been done, contemporaneously? That would probably put to bed, for lack of a better word, this debate as to whether there was acute alcohol intoxication. There should have been a blood alcohol analysis done. That is a quantified value that you get from the laboratories. If that value was at or above a certain level, one could conclusively say that the diagnosis is substantiated or repudiated. But again, we are today hamstrung by the lack of appropriate information," Saayman said.

He said the earlier admission may not have been about drinking at all.

"The reason for his admission to hospital may not necessarily have been the intoxication per se, but the aspiration that followed from the intoxication. That is a completely different matter, and it is what he seems to have been treated for," he said.

He added that an MRI scan at the time showed an extensive subgaleal haematoma, a head injury. "Whether that played a role, contributed or aggravated, I don't know. But this is not a black or white scenario."

The State also challenged the differing histories in the hospital records. One doctor recorded a one-day cough. Another recorded a two-week cough.

Saayman said: "There are at least four versions by different people pertaining to the history that was given. Dr Panicker's clearly stands out, without a shadow of a doubt, and is not aligned with the other versions. The other versions typically align."

He said the one-day history meant the coughing started on the day Kekana presented at hospital. The doctor had noted explicitly that the coughing began after the alleged assault.

The State noted that the emergency medical officer who examined Kekana on 17 April found no physical injuries.

Saayman said: "I do not for one moment dispute that there were no injuries. But the absence of injuries, of course, does not imply the absence of force application."

The court heard that Kekana says he was handcuffed with his hands behind his back. A belt was then strapped around his legs, and at some point the belt snapped. The State asked whether marks on his wrists would be expected.

"How long is a piece of string? It depends on so many variables. Were the handcuffs applied over clothing? What was the nature of the alleged struggle, or whatever caused that belt to snap? Logically, the answer is yes, one would have assumed there would have been some marks of some nature. But the absence thereof, once again, does not mean that it can be excluded that such restraints had been applied," he explained.

The State then closed its cross-examination.

Kekana's defence will call physician Dr du Toit next. She will testify via Microsoft Teams. Counsel said the doctor has a newborn baby and that mornings are difficult for her.

The court will not sit on Tuesday, 3 November. Accused number five, Zandile Nthabiseng Nzama, is writing an examination, and the court was told about this two weeks ago.

The matter was postponed to Thursday, 5 November, at 2pm in court 4F.

Accused one, two and three remain in custody. Bail for accused four and five was extended on the same conditions.

The trial-within-a-trial centres on Kekana's claim that police assaulted him after his arrest. The main trial is on hold until it is finished.

Vusimuzi "Cat" Matlala, his wife Tsakane, Kekana, Tiego Mabusela and Nthabiseng Nzama face 25 charges. These include 11 counts of attempted murder linked to three alleged hits.