Doctor reveals mushroom antidote was in short supply after fatal meal: Trial day six, as it happened

That concludes the evidence for today. Supreme Court Justice Christopher Beale has dismissed the jury for the day. Here’s a wrap of what happened today:

• Darren Fox, whose store Hartley Wells Betta Home Living in Leongatha sells appliances, told the court that in November 2023, an employee told him she had sold a dehydrator to Erin Patterson.
• Ian Wilkinson, the lone survivor among the four guests who fell ill after the fatal lunch, was called to the witness box.
• Ian described his relationship with Erin as friendly and amicable, he said she “seemed like a normal person”.
• Ian told the court he and his wife, Heather, were excited about being invited to the fatal lunch and thought their relationship with Erin might improve as a result.
• Turning to the lunch, the jury heard that Heather and Gail offered to help Erin plate the food, but she rejected the offer and did it all herself at the bench. Ian said there were four large, grey dinner plates – and one smaller plate in a different colour, which Erin ate from.
• Ian recounted that after the group finished eating, Erin told them she had cancer and was very concerned. The group then prayed for Erin and her children.
• Ian and his wife Heather fell sick the evening of the lunch. “It continued right through the night. We had vomiting and diarrhoea,” he said.
• Beth Morgan, a registered doctor and an advanced infectious diseases trainee at Monash Health, was the last witness to give evidence on day six.
• Morgan recounted being told by a pharmacist that there wasn’t enough antidote for four patients, but said they would obtain it from another hospital.
• Erin has pleaded not guilty to the charges and claims the fatal lunch was an accident

The trial will continue tomorrow.

Thanks for following our live coverage.

Award-winning photographer Jason South has taken these photos of Ian Wilkinson, Lisa Shannon and Cindy Hyde outside court. All three gave evidence today.

Ian Wilkinson leaves court.Credit: Jason South

Lisa Shannon.Credit: Jason South

Cindy Hyde.Credit: Jason South

Dr Beth Morgan, a registered doctor and an advanced infectious diseases trainee, was the last witness to give evidence on Tuesday in the trial of accused triple murderer Erin Patterson.

Morgan was the overnight medical registrar at Dandenong Hospital the night Don and Gail Patterson were taken there for care.

Don Patterson.

That night, she was taking referrals from the emergency department for medical patients who do not require surgery and need to be in hospital for longer than four hours (which means they cannot stay in the emergency department).

Morgan says the initial history for the couple included mention of 30–40 episodes of vomiting and diarrhoea, which had started following midnight the night before.

She says Don had mild abdominal pain on his right side. He was quite sweaty and light-headed, she recalls, but oxygen saturation appeared normal for someone without respiratory issues.

“Donald himself was quite alert. He did appear sweaty and was quite distressed by the presentation, but his vital signs were relatively stable at that time; he was not febrile, as in, he didn’t have a fever,” Morgan says.

Morgan says some tests indicated that he could be suffering tissue hypoxia or organ damage. “I was quite concerned that there was evidence of liver damage at this time,” she tells the court.

Don Patterson (left), Gail Patterson, Heather Wilkinson and Ian Wilkinson were poisoned by a mushroom meal.

The doctor tells the jury she was concerned that Don wasn’t suffering from a gastroenteritis caused by food poisoning, so she called the toxicology registrar, who requested additional information about what was consumed at the lunch on July 29, 2023.

“I initially told him that there was a beef Wellington containing mushrooms that had been consumed. It was also along with an orange cake for dessert,” she says.

The toxicology registrar expressed concern about the delayed onset of symptoms, some 12 hours after lunch, which could indicate a serious toxin syndrome. “At that point, he suggested that if it was related to mushrooms, it was possibly caused by the ingestion of the amanita phalloides mushroom,” she said.

Amanita phalloides is commonly known as the death cap mushroom.

At that time, Morgan said they had no evidence that anyone else was experiencing the metabolic acidosis, kidney injury or liver injury that Don was, so they did not access silibinin, the antidote to death cap mushroom poisoning.

Don was given a liver protective drug and was later admitted to the ICU.

Gail and Don Patterson

Morgan tells the jury that Gail, who was assessed by a different registrar, had regular vital signs, and it was determined she was suffering from food poisoning and was admitted to a short-stay unit.

Gail also eventually came under the care of Morgan, who suspected she may have been suffering from severe gastroenteritis or suspected mushroom poisoning.

After follow-up tests on Gail showed worsening metabolic acidosis and elevated lactate levels, Morgan spoke to the toxicology registrar and a decision was made to administer the silibinin.

The pharmacist told Morgan there wasn’t enough antidote for four patients but said they would obtain it from another hospital.

“I expressed that we’re probably going to need this for at least four patients, and unfortunately, the pharmacist advised us that we didn’t have that available to us … but they were going to obtain it from an external hospital,” Morgan tells the court.

A decision was made by 7.20am to move Ian and Heather Wilkinson from Leongatha Hospital to Dandenong Hospital, and Morgan made arrangements for the transfer.

The next witness is Lisa Shannon, a registered nurse who worked for five years at Korumburra Hospital. At the time, she was working as an after-hours coordinator.

On July 30, 2023, about 10.10am, Shannon met with Don and Gail Patterson after they presented to the urgent care.

Shannon says they had reported feeling unwell since the night before, after eating a beef and mushroom dish. “Don was considerably sicker than Gail on arrival,” Shannon remembers.

She tells the jury Don was struggling with nausea, vomiting and diarrhoea when they arrived. Gail indicated she still had diarrhoea but was not vomiting.

Gail Patterson

“I remained in the urgent care room, couldn’t leave, because that was quite busy with both of those patients,” says Shannon.

She recalls that she cannulated the pair and gave them intravenous fluids. She also checked their heart rate and carried out an i-STAT test to examine their blood electrolytes.

“We’re looking at potassium, sodium. If you’ve got diarrhoea and vomiting, they’ll often become elevated or decreased for both. Donald and Gail at that time, they were within normal limits,” she says.

Shannon says she spent most of the time taking Don to and from the bathroom every 10 minutes, and Gail back and forth.

Gail and Don Patterson

At 12.15pm the couple was moved to the ward. Shannon says she continued to care for them there, as they were so unwell that they required one-on-one care.

“It became obvious that Donald was becoming worse. He was very lethargic. Blood pressure was going down a little bit, his pulse was going up a little bit, which sort of shows signs of [him being] unable to tolerate keeping any fluids,” she says.

The jury heard this was unusual for someone suffering typical diarrhoea and vomiting.

Shannon says tests after 3pm on July 30 showed Don’s lactate levels were very high, signalling a metabolic disorder or liver failure, which would require immediate transfer to a tertiary hospital with an emergency department and an ICU.

Shannon says her shift finished at 3.30pm, and with it, her involvement in Don and Gail’s care.

She finishes giving evidence and is excused.

The jury has returned from lunch following the questioning of Ian Wilkinson, the sole surviving guest at the beef Wellington lunch.

The new witness on the stand, Cindy Hyde, was a transport officer for the Royal Flying Doctor Service at the time of the alleged murders.

On July 30, 2023, Hyde said they were paged at 8.34am and dispatched from Wonthaggi to Don and Gail Patterson’s house.

Don and Gail Patterson.

Hyde said the couple had been experiencing vomiting and diarrhoea for about eight hours and told them they had attended a dinner party the day before.

The jury heard Don had told Hyde’s colleague that they had eaten beef Stroganoff.

“Preliminary vital signs such as blood pressure, heart rate, oxygen levels, were they within a normal or abnormal range – all normal limits. Gail’s heart rate was a little bit elevated, but it wasn’t out of scope for us at the time,” Hyde said.

The couple told Hyde they had taken anti-nausea medication, which had been effective for Gail but not for Don.

Hyde said they transported the couple to the Korumburra urgent care centre, a journey that took about three minutes.

“Gail walked into the emergency care, we pushed Don in and then we transferred them onto the beds,” Hyde said, adding that they then transferred the couple’s to the centre’s staff.

Hyde is excused without cross-examination by the defence.

After the afternoon wears on, Ian Wilkinson’s voice is growing more broken and croaky as he speaks.

The jury heard that as the lunch guests were leaving, there had been nothing out of the ordinary about the discussion on that day.

Defence barrister Colin Mandy, SC, finishes his cross-examination with this statement:

Mandy: It was just a normal lunch.

Wilkinson: Yes.

Ian has finished giving his evidence. He’s taken a seat in the courtroom where a male family member can be seen placing his arm across the pastor’s shoulder.

After discussing Erin Patterson’s crockery collection, Colin Mandy, SC, moves to questioning Ian Wilkinson about his statement to the police on September 19, 2023, in which he said Erin had announced during lunch that she had suspected cancer.

In particular, Mandy focuses on whether Erin said she had been diagnosed with cancer or whether there was a suspected cancer diagnosis.

Erin Patterson.Credit: Jason South

“She plainly said that she had some sort of cancer. Her voice was low at that point. I couldn’t quite catch exactly what kind of cancer she was naming, but she named a type of cancer. She went on to speak about the scan and that this was a serious, serious situation, a situation that made her afraid for the future of her kids,” Ian says.

He said Erin did not outline a specific course of treatment.

Asked by Mandy whether he got the feeling that the cancer was still in a diagnostic stage, Ian says he understood the treatment wasn’t yet specified.

“Erin was fairly clear that the diagnosis was given,” Ian says.

There was some discussion about what to do with the children, he adds. “And there was a little bit of discussion about Don’s brother Rob in Botswana, who’s also suffering from cancer,” he says.

After an hour-long lunch break, the jury has returned to court, and Colin Mandy, SC, has resumed his cross-examination of Ian Wilkinson about the lunch on July 29, 2023.

Ian told the jury that the guests could sit wherever they wanted. Almost immediately, Mandy moved into a line of questioning about Erin Patterson’s crockery on the day of the lunch and how she’d set the table.

Here’s a little of the cross-examination about the single plate the jury has heard was a different colour to the others:

Mandy: I suggest to you that there was no uniform set of plates that were being used by Erin on that day. That is, there wasn’t a set of four plates that were all the same.

Wilkinson: My memory is that there were four plates that were the same.

Mandy: And let me suggest as well, that there weren’t any gray or stone colored plates in Erin Patterson’s kitchen.

Wilkinson: I remember four gray plates.

Mandy: And likewise, let me suggest this, that there was no smaller plate. All of the plates were the same size.

Wilkinson: The plate was smaller, the different coloured plate.

Mandy: Is it possible that there were two or three plates that were the same and two other different plates?

Wilkinson: No.

Defence barrister Colin Mandy, SC, has now started his cross-examination of Ian Wilkinson.

The jury heard that as Erin prepared the meal, Don Patterson and Ian discussed a book they had recently read.

Ian said he had overheard his wife and Gail Patterson offering to help serve the meal, but Erin had declined.

In that context, Ian said he’d noticed Erin plating the meal.

Here’s a brief exchange between him and Mandy on the topic:

Mandy: Did you see where Erin got the beef Wellingtons from?

Ian: No, I didn’t see that.

Mandy: I suggest to you that you saw them come from a tray, possibly an oven tray.

Ian: Yes, but I didn’t know where that tray came from. I only saw them at the kitchen bench.

Mandy: Do you have a recollection, though, now, of a tray?

Ian: Not a clear recollection.

Mandy: Can I suggest to you that you said previously that the veggies and beef Wellington were on plates served from a tray, possibly an oven tray. Does that assist your memory?

Ian: Yes, I think I’ve said that.

Mandy: And all of the beef Wellingtons came from that tray that you saw Erin … did you see Erin holding it, or was it on the bench?

Ian: I can’t recall.

Mandy then referred Ian to a conversation he had with police in the hospital on September 5, 2023, where he said that the veggies and beef Wellingtons were served from a tray, possibly an oven tray.

Mandy: Does that bring that image in your head or not really?

Ian: Um … yeah, I think it does.

After first suspecting the eye fillet, Ian Wilkinson finally learned the cause of the food poisoning: mushrooms.

His doctor, the pastor recalled, had received communications from Dandenong Hospital indicating suspected mushroom poisoning.

“He was very frank, he said it’s an extremely serious situation. He said: ‘There is time-critical treatment available’. And he was very concerned that we be transported quickly to Dandenong,” Ian recalls.

“Arrangements were already in progress. It was during that conversation that the first ambulance arrived.”

Ian was loaded into the first ambulance. A second ambulance arrived, too.

When they got to the hospital, Ian said he could hear Gail Patterson’s voice in the pod next to him, but he had no conversations with her or Don.

The jury heard Ian’s last memory of the aftermath of the lunch was receiving a charcoal substance to drink at the hospital. He was then intubated and sedated, and later moved to the Austin Hospital, where he received treatment for death cap mushroom poisoning.

He was at the ICU at the Austin until August 12, 2023, when he was moved to a ward within the same hospital. On September 11, 2023, he was discharged to the rehabilitation ward at Heidelberg Repatriation Hospital for about two weeks, before returning home on September 21, 2023.