ONE of the heroes of the health response to the medical mayhem caused by Erin Patterson, when she poisoned her four lunch guests that day, Saturday, July 29, 2023, was young, nightshift registrar at Dandenong Hospital, Dr Beth Morgan.

Of course, they were all heroes in the days and weeks that followed.

There were literally dozens of doctors and health care staff trying to deal with the shocking emergency, with one arm tired behind their backs, in the absence of confirmation from Erin Patterson that wild mushrooms, in fact, death cap mushrooms, had been included in the meal.

That they were able to save one of the victims in those circumstances was indeed a miracle.

After a horrific night of 30 to 40 episodes of vomiting and diarrhoea for Don Patterson, and a similar scenario for the other three, Gail Patterson, Heather Wilkinson and Ian Wilkinson; that had started at midnight the night prior, Don and Gail were transferred from Korumburra Hospital to Dandenong, arriving at 6.39pm on Sunday, July 30.

By the time Dr Morgan, arrived to start her shift at 9.30pm and take over the care of Don and Gail, time was already of the essence.

But Simon had already spoken to Erin earlier that day, telling her that his parents and aunt and uncle were sick in hospital.

In evidence he said: “Mum and dad and Heather and Ian are all crook and have all been admitted to hospital.”

It was time enough for Erin to volunteer the information that she had foraged for wild mushrooms in the lead up to the lunch, even if on her own evidence it hadn’t dawned on her that death cap mushrooms had found their way into the meal.

We now know that she did it on purpose, to people she claimed to love.

She cried crocodile tears on the stand, telling the jury how Heather had sat with her at playgroup because she was shy and didn’t really know many people.

How helpful Gail had been when her kids arrived, and how Don, a highly regarded local maths-science teacher, had helped the kids with their lessons.

It was Dr Morgan, who only graduated with a Bachelor of Surgery from Monash University in 2019 who pursued the death cap mushroom possibility like a terrier.

“I was concerned that this wasn't just a gastroenteritis caused by food poisoning, necessarily. I wanted to get some more information from our toxicology team, so I spoke to Mark (toxicology registrar Dr Mark Douglas) about the presentation and then he wanted me to sort of go back and get some more information about what was consumed at the lunch on Saturday.”

Medical notes from emergency doctor, Dr Constance Peterson, included details from Simon Patterson, that the four had attended lunch at his ex-wife’s house where a meal including beef Wellington with mushrooms had been served.

But despite that, Dr Peterson was still of the opinion that the condition was likely due to food poisoning.

That wasn’t enough for Dr Morgan.

Having established there was no evidence of ischaemic bowel with Don, she called the toxicology registrar on call, Dr Mark Douglas, at 10.30pm on Sunday night.

He expressed concern about the delayed onset of the symptoms, which is a classic indicator of eating amanita phalloides mushroom, and was “more indicative of a serious toxin syndrome as opposed to a food poisoning”.

At 11.30pm, the pair initiated a call to lead toxicologist Dr Yit Leang but unfortunately, in the absence of information about the condition of Heather and Ian, and confirmation about death cap mushrooms, Dr Leang didn’t call for the specific antidote for amanita phalloides toxicity called Silibinin.

“Based on the story that we knew so far, Dr Leang's advice was that at the moment there wasn't enough evidence - it wasn't clearly like a cause and effect of having had a specific mushroom called amanita phalloides, the death cap, so at that point the specific antidote to that wasn't indicated at that stage.”

She advised that the current treatment, without the Silibinin, should continue.

It wasn’t until 6.50am the following morning, at the urging of Dr Morgan, that the Silibinin was called for, but the on-call pharmacy at Dandenong didn’t have sufficient supplies for four patients and would be getting it from somewhere else.

By that stage Don and Gail had been admitted to intensive care were likely to be transferred to the Austin Hospital for a possible liver transplant.

At 7am, Dr Morgan also called Dr Chris Webster at the Leongatha Hospital to discuss the treatment of Ian and Heather Wilkinson, advising him that they had adopted the view that it was a case of amanita phalloides poisoning, something that Dr Webster was in a position to ask Erin Patterson about when she presented at Leongatha Hospital less than an hour later.

In an interview published by the Herald Sun on Tuesday this week, Dr Webster said he realised Erin Patterson was "a disturbed sociopathic nut bag" after revealing to her for the first time that authorities were on to the fact that the meal contained death cap muchrooms.

"If she said she picked them, it would have been a very different mindset for me because there would have been an instant assumption it was all a tragic accident." said Dr Webster to the Herald Sun.

But when Erin Patterson gave the one-word answer, to his question about where the mushrooms came from, "Woolworths", he said he thought "you crazy bitch, you poisoned them all".

Dr Webster said he retained some regrets about the incident, principally not probing Heather more about the meal, but ultimately it was the passing gratitude of Heather to hospital staff as she was being pushed back in the ambulance that would stay with him.

Dr Webster's Triple 0 call to police HERE

In her summing up, at the end of the trial, Crown Prosecutor Dr Nanette Rogers made it clear Erin Patterson could have helped the people she supposedly loved.

She said she knew buying dried mushrooms from an Asian grocer was just a fiction, that she had purchased the Sunbeam dehydrator in April 2023 specifically for the purpose of putting death cap mushrooms in the family meal and she ought to have told the doctors so.

“From 2.23pm, at the latest, on Sunday, July 30, when she spoke to Simon Patterson, she knew that Don and Gail were in hospital. She knew that doctors wanted to know the source of the mushrooms to help in their desperate efforts to save the lunch guests,” said Dr Rogers.

It wasn’t until the next morning that doctors had enough information to call for the Silibinin.

But even then, no one, except Erin Patterson, knew for sure that death cap mushrooms were in the meal until painstaking DNA analysis in a laboratory some days later showed the presence of death cap mushrooms in the dehydrator and some of the body samples taken from the victims.

It was the task of the director of intensive care at Austin Health, Professor Stephen Warrillow, to report for the court record, the terrible injuries suffereed by the victims and the lengths to which hospital staff went to try and save the Wilkinsons and the Pattersons, ultimately getting just one of them, Ian Wilkinson, home to what was left of his family, after 54 days in hospital, 21 in intensive care.

And that after Ian was at death’s door for many days.

For the trial, the prosecution provided a long list of medical witnesses, many of whom gave evidence over the course of the 10-week trial, all of them involved in the care of Don, Gail, Heather and Ian.

In August 2023, the families expressed their deep gratitude to hospital staff for their efforts.

“We also wish to express our deep appreciation to the staff of the hospitals that have cared for them. Their tireless efforts, expertise, and compassionate care for our families have been a source of comfort during this difficult time.”

According to ‘Dr Google’ (Therapeutic Guidelines website), under optimum conditions, and with timely details about eating wild mushrooms, the overall mortality rate from death cap mushrooms is about 20 percent.

(With thanks to Brooke Grebert-Craig from the Herald Sun.)