The case of Roula Pispirigou (35 years old) has shocked all of Greece. Dubbed by the Greek media as the Medea of ??Patras (Medea because of the myth of the woman who killed her children to take revenge for a love abandonment and Patras being the town where she comes from), she was sentenced to life imprisonment at the end of the month. passed by the death of his daughter Georgina, 9 years old. Roula is not only accused of the death of her eldest daughter – who died as decreed by the Mixed Criminal Court of Athens at the hands of her mother, who allegedly administered ketamine, the ruling states – but they accuse her of the death of his other two daughters: Malena (four years old) and Irida (a six-month-old baby).

It was Georgina’s death (in January 2022) that made the researchers go back in time and review the cases of the other two girls, who had died previously: Malena, in 2019, nine days after starting chemotherapy to treat leukemia; Irida, in 2021, with severe congenital heart disease. After reviewing both deaths, investigators modified the criteria and ruled that they had been asphyxiated. Consequently, Roula was charged with triple murder.

Currently, the trial for the death of the two youngest children is underway. Not so that of the older girl, finalized at the end of last month with the sentence of life imprisonment for Roula. The judges did not hesitate to condemn her, although a group of scientists, led by the Spanish immunogeneticist Carola García de Vinuesa, tried to defend her innocence during the process, which lasted 14 months. Vinuesa had previously participated in the case of the Australian Kathleen Folbigg, who spent 20 years of her life in prison accused of the death of her four babies and who a few months ago was acquitted of all charges thanks to science. found that the most likely cause of death in two of the babies was cardiac arrest due to a genetic variant.

Georgina, Roula’s eldest daughter, suffered cardiorespiratory arrest while she was admitted to the hospital. The little girl accumulated a string of pathologies: she had suffered a stroke a year before – which left her quadriplegic and required the implantation of a pacemaker; she suffered from epilepsy (without responding to treatment); She was fed through a gastrostomy tube and had lost a quarter of her weight… After her death, and pending the results of the autopsy, her cause was declared undetermined. The post-mortem forensic analysis revealed pathology in the liver and heart, although it also detected ketamine in her body.

The toxicologist at the Aglaia Kyriakou children’s hospital – the center of Athens where she was treated – stated that she had not been administered it, and that is where the accusation began to be made against Pispirigou, who was blamed for having injected it into her daughter.

During the process, Vinuesa presented in court part of the conclusions of the report that he prepared together with his colleague Todor Arsov. It states that “the multiple pathological findings in the three girls constitute reasonable medical explanations for their natural deaths and suggest a hereditary congenital liver and heart disease with variable expressiveness.” And he concludes: “There is no clinical or scientific evidence to suggest that the mother was responsible for the death of her three children.”

The document includes the reflections of Professor Robert Flanagan, a renowned toxicologist with experience in forensic toxicology, who recalls that “ketamine is a drug widely used in surgical procedures.” For this reason, he considers that “most likely” it was the hospital’s own health workers who administered the substance to the little girl.

He points out “that it is not unusual” for emergency procedures to “omit” the use of a drug from the medical records and also argues that the fact that ketamine was not found in Roula’s possession “is an important factor.” In this sense, he describes as “extremely” important to access “hospital records to establish the availability” of that substance in the hospital, something that the judge denied, according to Rania Dimakopoulou, a Greek pathologist who collaborates with the defense, told La Vanguardia.

Flanagan’s request was not trivial. The report details that in 2020 the center carried out a clinical trial in which this substance was present, which indicates “that it was used routinely in the hospital two years before Georgina’s death.” She also remembers that up to five vials are part of the center’s emergency medical kit and that Georgina’s own hospital reports stated that the medical staff had administered ketamine twice previously, while she was admitted.

The magistrate also ignored the scientists’ request to carry out in-depth genetic research. “When you have three girls with a similar pathology such as vacuolar degeneration of the heart and liver, you have to suspect an inherited disease,” he commented to this Vinuesa newspaper at the time.

Flanagan’s opinion is not the only one included in the report. Vinuesa and Arsov also gathered the position of Peter Fleming, a pediatric intensivist and expert in sudden infant death, who maintains that “the anomalies found in Georgina’s autopsy, both in the heart and in the liver, have some similarities with those found in the autopsy of his two sisters, raising the possibility of an inherited underlying metabolic cause or contributing factor.”

In this sense, he reasons that “the insertion of a pacemaker in Georgina in June 2021 is further evidence of an underlying heart condition that could contribute to her repeated episodes of collapse.”

Despite the conviction, both Flanagan and Fleming, says Vinuesa, “remain convinced that the administration of ketamine was most likely hospitable” and continue to defend “that there is no evidence that the girls were murdered.” The defense will appeal.