THERE was no doubt, according to Ian Wilkinson, the only other person to survive the poisonous mushroom lunch at Erin Patterson’s Leongatha home on Saturday, July 29, 2023, besides the cook herself, that Erin was eating her beef Wellington meal along with her four guests.

He told the Supreme Court as much at Morwell last week while giving evidence at Mrs Patterson’s triple murder trial.

However, while three of her guests died less than a week later of multiple organ failure due to clinically diagnosed amanita mushroom poisoning, that is after eating death cap mushrooms at Erin’s place that day, and Mr Wilkinson became gravely ill, spending 54 days in hospital, Erin Patterson spent a precautionary 24 hours in hospital.

How was it then that the other four guests became so violently ill overnight on Saturday into Sunday morning while Erin was able to drive her son to a flying lesson at Tyabb on Sunday afternoon, more than an hour each way from Leongatha, without going to the toilet?

These were among the issues probed during the second week of the trial which not only featured more evidence from the Patterson and Wilkinson families but also the testimony of health professionals who treated the five lunch guests.

Erin Patterson has pledged not guilty to three counts of murder arising out of the beef Wellington lunch in relation to her in-laws Don and Gail Patterson, and Gail’s sister Heather Wilkinson, and one of attempted murder where Ian Wilkinson is the alleged victim. Her defence has claimed what happened that day was a tragedy and a terrible accident.

While her guests Don and Gail Patterson and Heather and Ian Wilkinson presented at the Korumburra and Leongatha hospitals on Sunday morning after a harrowing night of vomiting and diarrhoea, and needed to be transferred to tertiary hospitals in Melbourne on Sunday night and Monday morning respectively, Erin presented at the Leongatha hospital on Monday at 8.05am, a day and a half after the meal, reporting generalised abdominal pain and some diarrhoea but no vomiting.

Cindy Munro, who was acting as a Deputy Director of Nursing at Leongatha hospital from 7am on Monday, July 31, and assisting with the transfer of two of the gravely ill lunch guests, Ian Wilkinson and his wife Heather, to Dandenong hospital, when Erin Patterson arrived at Leongatha hospital, was in a position to make a comparison for the court.

Asked by counsel for the prosecution, Jane Warren, in court last Thursday, May 8 how Erin Patterson looked, after finally being admitted on Monday “just on a basic observation”, Ms Munro said she didn't look sick.

“She didn’t look unwell like Heather and Ian. I recall Ian being so unwell that he could barely lift his head off the pillow and Heather was a little bit unsteady on her feet, but Erin was sitting up in the bed, in the trolley, and she didn't look unwell to me,” said Ms Munro.

Cindy Munro who is in her 25th year as a registered nurse, 11 of them at Leongatha, was one of a number of nurses, doctors, paramedics and other health care professionals to take the witness stand in Morwell during the first nine days of the trial.

One of them was Director of Nursing at Leongatha Kylie Ashton, who triaged Erin Patterson on arrival.

Mrs Patterson, she said, had a high heart rate and blood pressure “on the high side” but later under cross-examination by Colin Mandy SC for the defence she acknowledged she had told Dr Veronica Foote the heart rate was “dangerously fast”.

Erin Patterson she said needed to be convinced about the importance of remaining in hospital for assessment and possible treatment given she was the fifth member of the lunch party.

Dr Foote, a registered specialist in general practice at the Leongatha Hospital, agreed under cross-examination by Mr Mandy that tachycardia (fast heart rate) and hypertension (high blood pressure) were consistent with symptoms of poisoning.

Dr Foote told the court that she had the opportunity to review Mrs Patterson’s clinical observations at around 10.30am that day telling the court that her initial blood pressure was 130 over 90 which is within normal range. Her pulse was 140 which she described as high, and her temperature was in middle of the 35.5 to 35.6 range which is also normal.

This was consistent with clinical details about Erin Patterson provided to toxicology registrar at the Austin Hospital, Conor McDermott, who gave evidence by video link on Thursday last week.

“I was told the patient was stable apart from having a heart rate of 140 but they looked well and that their investigations so far were unremarkable,” said Dr McDermott.

Results included pH, blood gas, bicarb, lactate and potassium levels, all within normal limits, he said, besides the pH which was slightly high and the potassium slightly low at 3.4 where 3.5 is the low side of normal.

“I was told that she complained of diarrhoea, like the other patients, but I was told also that this hadn't been observed while the patient was in the department (at Leongatha).”

The statement that he was “told by someone that Ms Patterson had not been observed to have diarrhoea in the hospital” was challenged under cross-examination by the defence, but Dr McDermott stuck to his statement, agreeing it was additional information added from his memory after contact with doctors at Leongatha on Monday, July 31, 2023.

During an exchange between defence counsel Colin Mandy and Simon Patterson earlier, on Day Four of the trial, Friday, May 2, Mr Mandy asked Mr Patterson if he could remember having a conversation with his wife Erin, back on December 20, 2021, about a Sinus tachycardia issue with her heart some years earlier. Mr Patterson acknowledged he vaguely remembered the conversation.

Erin initially resisted assessment and treatment at Leongatha, despite being told by Ms Ashton that she “would probably need to go on the NAC treatment (N-acetylcysteine) like everybody else, even as a prophylactic, to make sure we preserved her liver from toxins”.

Mrs Patterson discharged herself against medical advice at 8.10am on Monday, July 31, claiming she needed to make arrangements for her animals and children at home but returned to the hospital shortly before 10am and was ultimately transferred to Monash Clayton by ambulance at 1pm later that day.

In the evidence given last Thursday by Tanya Patterson, who is married to Simon Patterson’s brother Matt, she visited Erin at Monash Clayton on Tuesday morning after a text message exchange between the two on Monday night in which Erin said she was still feeling nauseous, dizzy and tired.

By the Tuesday morning around 9.30am however, Tanya was in the hospital room at Monash with Erin when a toxicologist came in to present her blood test results, saying Erin was “fine and well enough to go home”.

Erin asked about her potassium levels with the medico responding, according to Tanya, that the potassium levels were fine and “that for someone who has had diarrhoea as much, it really wasn't as low as they would have expected it to be”.

Under cross-examination, Tanya Patterson was asked about her relationship with Erin, which she acknowledged had always been good, going on holidays together as families, to the point where Erin loaned Tanya and her husband Matt $400,000 to build their home.

In the days leading up to her admission, allegedly while suffering from diarrhea and nausea, Erin Patterson told her children she wouldn’t be able to attend church on Sunday morning because she was feeling unwell but insisted on taking one of her children to Tyabb for a flying lesson on Sunday afternoon that was ultimately cancelled just before they arrived, stopping for food at the doughnut van at Koo Wee Rup on the way home but not to going to the toilet.

She also expressed an intention to pick up her children from a school on Monday, more than an hour away from Leongatha, but ultimately agreed for Simon to collect the children instead.

“I'm glad that you're feeling healthy enough to make that drive,” Simon Patterson told the court about his phone conversation with Erin on the Monday.

On Day 10 of Erin Patterson’s murder trial, on Monday, May 13, the court also heard from Dr Laura Muldoon, an emergency registrar at Monash Health, who gave evidence that she was involved in the care of Erin Patterson in a consulting capacity as part of the Monash Health toxicology department after she was transferred from Leongatha on Monday, July 31.

She said that while there were reported symptoms of nausea, diarrhoea and some abdominal pain, possibly associated with amanita phalloides mushroom poisoning, Erin Patterson’s tests revealed that there was no clinical or biochemical evidence of amanita poisoning nor evidence that any other toxicological substance had been ingested or consumed.

“I noted that she looked clinically well. She had some chapped lips but otherwise looked very well,” she said displaying normal vital signs for blood pressure, heart rate and blood gas parameters.

“Were the results of those normal or abnormal?” Normal, she said.

Another doctor, Varuna Ruggoo, a consultant emergency physician at Monash Health, who took over the care of Erin Patterson on Tuesday, August 1, 2023, in the Short Stay department of the hospital, also gave evidence on Day 10.

She said Mrs Patterson had received IV fluids and treatment with N-acetylcysteine for presumed liver issues overnight and had also undergone a liver function test noting the results were all within normal limits.

“The plan given to me was to wait for the toxicology review, with a repeat of the blood tests, including the liver function, and to decide whether she needed ongoing management or whether she was fit for discharge if she remained stable,” said Dr Ruggoo.

She said that after reviewing Mrs Patterson’s vital signs and blood tests the toxicology registrar concluded there was no evidence of any sort of liver toxicity, that Mrs Patterson was stable and able to be discharged from a toxicological point of view.

Dr Ruggoo conducted a final observation of Mrs Patterson, asking her directly if she still had any abdominal pain, if she had experienced any vomiting and diarrhoea, the answer to all of which was 'no'.

Having reviewed Mrs Patterson’s vital signs, Dr Ruggoo deemed her “fit for discharge” at 1pm.

Erin Patterson had been in hospital from 9.48am on Monday, July 31, 2023, when she presented at Leongatha Hospital, and was given the all clear to be discharged at 1pm on Tuesday, August 1.

Four large plates, one smaller

During his evidence at the triple murder trial in the Supreme Court in Morwell last week, Korumburra Baptist Pastor Ian Wilkinson was clear in his recollections about who ate what and from which plate.

“Did every plate have the same food items on it?” he was asked by Crown Prosecutor Dr Nanette Rogers SC last Tuesday, May 6.

“Yes,” said Mr Wilkinson, noting that everyone had an individual pastie on their plate, a pastry case fully enclosing steak and mushrooms, with green beans and mashed potato on the side.

“And that includes Erin's plate?”

“Yes.”

While Mr Wilkinson said much of the conversation about the meal involved some good-natured banter about Don being willing to eat half of Gail’s beef Wellington, he said he recalled that Erin was definitely eating her meal.

“I can't say with certainty how much she ate, but she was definitely eating it. I don't remember anyone saying ‘you didn't eat much' or anything like that.”

He went on to say that little if any of the cake that Gail had brought, or the fruit that Heather had contributed to the meal were eaten afterwards “because we were all fairly full from the main course”.

Questioned by both the prosecution, and Colin Mandy SC for the defence over the type of plates used, Mr Wilkinson said Erin rejected an offer from Gail and Heather to help plate up the meal, which he said was served on “four large, grey dinner plates and one smaller plate of a different colour”.

While the four larger plates were taken to the table by Gail and Heather, according to Ian, Erin “picked up the odd plate”, a smaller and orangey-tan coloured plate, and carried it to her place at the table.

Erin alone had plated up the food, rejecting an offer of assistance from Heather and Gail.

During cross-examination Mr Mandy probed Mr Wilkinson over what he recalled about how much Erin had eaten at the table and his evidence that different coloured plates were used.

In fact, Mr Mandy put six similar questions to Mr Wilkinson about the colour and size of the plates.

“Let me suggest to you that there weren't any grey or stone-coloured plates in Erin's kitchen on that day?” asked Mr Mandy, also variously suggesting that there was no smaller plate, that all plates were the same size, that there might have been two or three plates the same, and two different.

“My memory is that there were four plates that were the same”, he said, going on to repeat that Erin’s plate was smaller and different in colour.

However, while the five people at the lunch, including the host Erin Patterson and four of her in-laws ate all or at least part of their meals, they had a significantly different impact on the guests and the woman accused of their murders or attempted murder.

The trial continued in the Supreme Court at Morwell on Wednesday, after a day’s break for administrative purposes.

Justice Beale told the jury last Thursday that the way the case was progressing he expected it to be concluded earlier than indicated.