A doctor has said he has some concerns about the potential impact of medication and other factors on a man at the time he made admissions to murder two days after Ashling Murphy’s body was found.
Dr Johann Grundlingh, whose evidence concluded on Monday, was the last witness called in the trial of Jozef Puska, who has denied the murder of Ms Murphy.
Mr Justice Tony Hunt has sent the jury away until Tuesday when closing speeches will begin after which the judge will charge the jury.
The judge told the nine men and three women he hoped to complete his charge on Wednesday after which they will retire to consider their verdict later that day or perhaps on Thursday.
Jozef Puska granted legal aid to appeal conviction for murder of Ashling Murphy
Wife and two brothers of Jozef Puska to go on trial in 2025 accused of failing to disclose information to gardaí
Ashling Murphy: teacher remembered by her school on second anniversary of death
Hundreds attend memorial Mass ahead of Ashling Murphy’s second anniversary
Mr Puska (33), a native of Slovakia who has been living in Co Offaly for eight years, has pleaded not guilty to the murder of Ms Murphy at Cappincur, Co Offaly, on January 12th, 2022.
M Murphy, a primary school teacher and musician, had 11 stab wounds in the right side of her neck when she was found.
Ms Murphy’s parents Ray and Kathleen, her sister Amy and brother Cathal were again in the packed court on Monday. Several members of Mr Puska’s family, including his parents, were also present.
[ Follow The Irish Times WhatsApp ChannelOpens in new window ]
Dr Grundlingh said he is a medical doctor who worked until recently as a consultant in emergency medicine, intensive care and toxicology in a London hospital. He estimated he would have seen up to 1,000 patients on an annual basis.
He said he had examined medical records relating to Mr Puska from St James’ hospital, including the report of a surgeon who looked after Mr Puska and records from Mr Puska’s GP. He also saw the Garda custody record related to Mr Puska.
He considered a number of factors may have affected Mr Puska when he made his alleged “confession”, in the presence of gardaí and an interpreter, on January 14th, 2022. Those included Mr Puska had some Oxycodone medication in his system, the unfamiliar hospital environment, the fact Mr Puska had surgery the previous evening, and the language barrier.
He said Mr Puska had his last dose of Oxycodone two hours and 20 minutes previous and could have been susceptible to the effects of opiate medication.
Dr Grundlingh said he was of the opinion Mr Puska was not in a fit state to be interviewed and noted his medical team were not asked for their opinion on his fitness to be interviewed.
He agreed the dosage of Oxycodone was not excessive. He said common side effects of Oxycodone include anxiety, confusion and depression and uncommon side effects include agitation, hallucinations, disorientations and dysphoria or depressed mood.
There were no hospital records of Mr Puska being confused, disoriented or hallucinating, he said.
He would have expected the medical team to be consulted about Mr Puska’s fitness to be interviewed, he said. If that was done, he would have expected an assessment of Mr Puska, essentially a capacity assessment, by his medical team, he said.
Under cross-examination by Anne Marie Lawlor SC, counsel for the DPP, he agreed it was fair to say it was speculation on his part to say there could be an issue about the admissions made by Mr Puska.
He agreed the necessary information is required to reach conclusions. He agreed he had prepared a report in May 2022 and had received a report prepared by Professor Michael Ryan, called by the prosecution as an expert witness, whom he agreed is an internationally renowned expert in toxicology.
He agreed his findings were based primarily on the dosage of Oxycodone administered to Mr Puska and on a view that the accused had 12mg of that drug in his system when he made the admissions on January 14th.
Dr Grundlingh agreed, based on calculations concerning the half-life or metabolisation of the drug in Mr Puska’s system, he could have had 8mg of the drug in his system at the time of the admissions.
He agreed he did not know about Mr Puska’s medical records between 2012 and 2023. He said there was a mention he had chronic back pain for which he was taking medication.
He agreed his view concerning Mr Puska’s familiarity with the hospital environment was based on speculation and assumption. He said environment is one of the factors doctors must exclude or consider when assessing if someone has capacity.
He agreed an interpreter was present when Mr Puska made his admissions and there was nothing to suggest he was confused or disorientated.
He said his experience of dealing with surgical notes is there can be “box-ticking”. He believed what the medical personnel recorded in this case was accurate.
In re-examination by defence counsel Michael Bowman SC, he said the issues he had raised were active concerns until excluded.
His view was, if he was the doctor looking after Mr Puska, he would have needed to see him in person to actively exclude that he was not suffering from “a subtle degree of confusion” or there were no factors that made him less suitable to be interviewed. Dr Grundlingh said he would have preferred to see the person himself rather than relying on observations of other colleagues.
