Intensive care doctor Stephen Warrillow details agonising efforts to save Erin Patterson's mushroom murder victims
Stephen Warrillow detailed the efforts the ICU team made to treat Erin Patterson's victims. (ABC News: Marty McCarthy)
Doctors who treated Erin Patterson's murder victims have detailed their agonising efforts to save the victims and how one came to form the opinion they were dealing with a killer.
Heather Wilkinson and Don and Gail Patterson were killed after they ate beef Wellingtons that were laced with poisonous mushrooms, and served to them by Erin Patterson at her home in Leogantha in July 2023.
Ian Wilkinson survived.
All four presented to the hospital with severe symptoms and were treated by a team led by Dr Stephen Warrillow, who is Director of Intensive Care at Austin Health.
Beef Wellington leftovers from the toxic dish Erin Patterson cooked. (Supplied: Supreme Court of Victoria)
"They were devastatingly unwell," Dr Warrillow told 7.30.
"Certainly the sickest patients in the whole state, but it is unusual to have four patients similarly afflicted, and they were critically ill with multiple organ failure."
That organ failure began in their livers, which the toxin from death cap mushrooms targets.
Dr Warrillow said it was just the beginning of a horrible ordeal for all four of the victims.
Death cap (left) and yellow-staining mushrooms are poisonous fungi found in Australia. (AAP: Joel Carrett, file photo)
"Once the liver fails, it tends to drag down all of the other body organs with it," he said.
"So whilst the liver is the first organ to be affected, what soon follows is the kidney failure, circulatory failure, and more general metabolic failure.
"The blood sugar in the patient's blood collapses, they get a build-up of ammonia, the same as using floor cleaner, so it's a very serious brain toxin, they [then] develop a profound coma, and really the whole body starts shutting down."
Toxins and transplants
Dr Warrillow said all four patients were then put on mechanical ventilators and dialysis-style machines to try and purify their blood.
Don and Gail Patterson were murdered by Erin Patterson. (Supplied)
This was done due to the serious elevation in toxins they all presented with.
"We also administered some specific therapies to try and protect the liver from further injury from Amanita toxin poisoning," Dr Warrillow said.
"Amanita toxin, once it's been swallowed and has been absorbed from the bowel into circulation, tends to hone in on the liver.
"We give multi-dose activated charcoal, so that's ground-up charcoal basically ... we also use other medications such as Silibinin to try and interrupt the toxin poisoning the liver cells directly."
While the ICU teams worked overtime, ultimately in three out of four cases their attempts, though immense, proved futile.
Gail Patterson and Heather Wilkinson were deemed too unwell to even attempt liver transplants to save their lives.
Leongatha Hospital in South Gippsland. (Supplied)
Don Patterson was given one but ultimately he too succumbed to his poisoning at the hands of triple-murderer Erin Patterson.
Dr Warrillow said that surgery takes a huge toll on both the team performing it and the patient.
"Liver transplantation is one of the most complex and lengthy surgical procedures that we would ever do," he said.
"The patient has to be sick enough to need one, but well enough to get through the surgery.
"It takes essentially an entire day and for the theatre team, this is really a marathon.
"Don did have a liver transplant [and] he came back to us in the ICU but unfortunately remained critically ill and despite every effort that we could do to support him after the transplantation, we were ultimately unsuccessful."
'Remarkable' moment
The one person who was able to be saved was Ian Wilkinson and it is something that Dr Warrillow puts down to extraordinary work by the bedside clinical team in the ICU.
Heather Wilkinson and Ian Wilkinson were described as "humble" by a doctor who treated them. (Supplied)
"He was in multiple organ failure," Dr Warrillow said.
"He had very high levels of acid in his blood, higher levels of ammonia toxin in his blood, and looked very much like he was likely to die.
"It's quite a remarkable outcome for him that he was ultimately able to survive and could recover so well in the end."
Dr Warrillow told 7.30 that he and the treatment team had advised Ian Wilkinson's family it was likely he would die and credited his fortitude and the work of his nurses for his survival.
"Ultimately he stabilised and that took a lot of work from, particularly the bedside nurses, to provide extraordinary measures of support for his circulation, and to try and clear toxins from his blood," he said.
"They did a tremendous job with that."
He also paid credit to the families for the job they had done in handling a difficult situation.
"They are experiencing their tragedy and their catastrophic encounter [in] intensive care," he said.
Morwell was the scene of the trial of Erin Patterson. (ABC Gippsland: Rachael Lucas)
"And they were remarkably gracious and dignified throughout, their attention and love that they expressed towards their critically ill relatives was really very inspiring.
"They always expressed considerable gratitude and thanks, particularly to the bedside nursing and medical team who worked so hard to try and save the lives of their loved ones."
'Always be haunted'
Despite saving Ian Wilkinson and the best efforts of the medical teams involved three people are dead.
Dr Chris Webster says he has no doubt as to why after his interaction with Erin Patterson at Leongatha Hospital and in the Morwell courtroom but he had also previously treated Heather Wilkinson.
Erin Patterson was convicted on three counts of murder. (AFP: Martin Keep)
He described her death as "particularly distressing" and something that would haunt him.
Dr Webster said he had met Heather once before to treat her for a musculoskeletal injury and that both her and her husband Ian were "humble, softly spoken, unassuming and respectful of each other".
"The combination of that innate kindness and nice aspects of their behaviour and personality made it particularly distressing for me to see Heather pushed into the ambulance, and just before the door was closed, which then blocked our view of each other, she made sure to make the effort to thank me for the care that the hospital had provided.
"That's a very difficult moment because when those words came at me, my mind was [saying], 'But you're going to die.'
"I will always be haunted by that."
Dr Chris Webster described his meeting with Erin Patterson. (ABC News)
Dr Webster has previously told the ABC that he felt Erin Patterson was "evil" and that when she presented to him at Leogantha Hospital and told him she had got the mushrooms from "Woolworths" he felt she was "guilty".
"There was no doubt in my mind from the moment she said "Woolworths" that she was guilty of deliberately putting these poisonous mushrooms in the meal," Dr Webster told 7.30.
The other suspicious part was Erin Patterson leaving the hospital after he had just told her she could have been exposed to poisoning.
It caused Dr Webster to turn to a nurse and demand to know where the triple-murderer was.
"I said, 'Where the f**k is she'?" he told 7.30.
"And Kylie (the nurse) said she left.
"I had just told her she's been exposed to a potentially fatal death cap mushroom poisoning ... why would you be anywhere else than hospital?"
Patterson 'sociopathic' says doctor
Shortly after that Dr Webster made a triple-0 call to police.
Loading...That call would be used as a key piece of evidence in Patterson's trial. He said the moment he dialled the emergency number, he knew it would become a pivotal moment.
"When I dialled that last zero and it started to ring, I knew that what I was about to say was going to be evidence in a court trial one day," he told 7.30.
"I've heard that call played in court and I've heard it quite a bit in the past 24 hours.
"My family is sick of hearing it but I can still hear that stress and tension in my own voice.
"It was still quite a nerve-wracking experience, with the awareness of the weight of observation and scrutiny that was coming later."
Asked why he always thought he was dealing with a killer, Dr Webster said it came down to Erin Patterson's action and demeanour.
Her unconcerned approach to her own potential situation, her answer to where she got the mushrooms and her indifference to her victims when she saw them in the hospital has seen Dr Webster form a view of her as a sociopathic killer.
Erin Patterson was convicted of the triple murder and found guilty on a count of attempted murder. (AFP: Martin Keep)
"She sat quietly in a chair that was only a couple of metres away from Ian and Heather," he recalled.
"That absence of concern for the wellbeing of Ian and Heather, I found that quite stark in terms of its oddness. And that contributed to the ongoing tapestry in my mind of her culpability."
Dr Webster believes Erin Patterson simply wanted her in-laws and her estranged husband's family out of her life.
"She's sociopathic,"he said.
"She didn't want the in-laws in her life, in particular the ex-husband.
"I think because she wanted her children to be her children and not children of a man and a family that she either didn't understand or didn't make efforts to connect with.
"For whatever reason, she wanted people out of her life and rather than doing it the way a normal person does, she made the very true connection in her mind that, well, if they're dead, they'll be out of my life."
The case has captured the attention of media across the globe and seen curious case-watchers descend on the country town of Morwell in Victoria.
For Dr Webster that curiosity stems from a disbelief about how Patterson committed the crimes.
"I think it's difficult ... to wonder how someone could do what she's done," he told 7.30.
"I think the answer is that her brain is not the same as others.
"There's an element of sociopathic evil with no regard for how her actions are going to cause pain and suffering."
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