Hospital responses

Dr McCaskill recongises the start of the illness and yet fails to realise that these are the same “red flag” symptoms of a viral EV71 seizure; Heavy drooling, stridor (and croup) resolved with midzolam (raised as a concern by Alinas GP and documented in her GP medical record)

Also as noted, but unmentioned by Dr McCaskill, Alina’s sensitivity to loud noises, tonsillitis, rash around mouth, a significant change in health following the 18 month MMR vaccination, persistent cough, temperatures (and sweaty head) and eye deviation

It is also worth noting that during times of elevated stress (which resulted in seizures – following CPAP in particular). Interestingly, there is a video to demonstrate the result of stress (elevated cortisol/glucose uptake?) and increased levels of ataxia, shown to the neurological team on the 5th December. Resolved instantly with the simplest of stress relief solutions, a video of both before and after her crying. (supplement C). It was also at this same time, the father was reassured by Dr. Sandi that there was no such thing as an afebrile persistant virus.

The claim that Alina was resistant to the ketogenic diet is extremely false, likely derived from the fact that the neurological team, who were in charge of this diet, (as well as EEG reports) seemed to go to great lengths to hide its effectiveness from publication (for unexplained reasons), but a symptom noticed by the parents very quickly, (who were incredibly frustrated, and met with tremendous resistance from the them in establishing an improved diet ratio) alongside phenobarbitone, anakinra and midzolam the ketogenic diet was very successful in treating Alina, as agreed and recorded on audio by ALL members of the neurological team. Very strangely not a single team member chose to document this. A proposed explanation linking glucose and the EV71 virus is within the diary pages

Enterovirus 71 Infection with Central Nervous System Involvement, South Korea
(2010 Wi-Sun Ryu  et al)

• We detected EV71 rarely in the CSF of our patients. Possible explanations include the transient presence of the virus in CSF, a lower viral load in CSF, and use of an EV PCR assay that had not been optimized to detect EV71
• We confirmed that EV71 commonly involved the brainstem and cerebellum, and therefore ataxia is not uncommon in EV71 infection with CNS involvement

Global emergence of Enterovirus 71: a systematic review – (2022 – Gayatree Nayak et al)

• The most frequently observed disease in EV71-infected patients is pyrexia (eighty-one per cent) with a skin rash (seventy per cent), insomnia (sixty-six per cent), vomiting (sixty-two per cent), lethargy (forty per cent), myoclonus (sixty per cent), and ataxia (forty-two per cent). CSF (cerebrospinal fluid) evaluations were carried out in 47 clients, where 45 were pleocytosis, 94/ml median, 15–920/ml range among them. However, none of them had viruses isolated from specimens of CSF. The most frequently diagnosed vector of CA16 was HFMD, while CA5, CA9, and CA10 were statically identified as HFMD as a source among other recognized HFMD enteroviruses
• In specific congenital malformations and maybe in some instances of diabetes, they can also play a part

It was not only agreed by all the neurological team over the course of her stay that the ketogenic diet was highly effective in not only controlling the seizures, but also an indicator of her seizure activity; high seizure activity was associated with high glucose levels. Reduce seizure activity was associated with high keytone levels. Dr Sampaio even remarks himself “Definitely! it’s the only valve”

A summary of effective treatment for the illness below, derived from the previous decade of  observations and research…

Enterovirus and Encephalitis – (February 2020 Bo-Shiun Chen et al)

• Although EV-A71 also invade the CNS, the infected areas are quite distinct compared with poliovirus. Brainstem encephalitis is the most common neurological presentation of EV-A71 infection

Diagnosis and Management of Autoimmune Encephalitis – Cleveland Clinic

•  It is also important to consider carefully what objective measures will be used to determine clinical response to immunotherapy. These may include but are not limited to: clinical examination, neuroimaging, EEG, neurocognitive testing…”

First-line Therapies:

• Intravenous Methylprednisolone (IVMP): 1g daily x 5 days followed by oral prednisone 1mg/kg (maximum dose 60-80mg daily with a prolonged taper)
• Intravenous immunoglobulin (IVIg): 400mg/kg/day x 5 days
• Plasmapheresis (PLEX): 5-7 exchanges over 10-14 days

Second-line Therapies/Long term immunosuppressive agents:

• Can be given as monotherapy or in combination for refractory disease activity 1-2 weeks from the completion of first-line treatment acutely.
• Rituximab (Rituxan/Ruxience):
• 1000 mg IV repeat dose in 2 weeks (Preferred agent given safety profile)
• Cyclophosphamide:
• 750 mg mg/m2 (maximum 1000 mg) IV once with pre-hydration initially

Adjuvant therapies for long-term immunosuppression and steroid sparing.

• Rituximab 1000 mg every 6 months
• IV cyclophosphamide 750 mg/m2 IV monthly or oral cyclophosphamide 1-2 mg/kg/day
• IVIg 2g/kg dose over 2-5 days repeated every 3 weeks
• Mycophenolate mofetil (Cellcept)
• Azathioprine (Imuran)

Alina only received IVMP, and IVIG. As parents we quickly realised the significance of the 18 month MMR vaccine, chronic virus and the family history, but autoimmune treatment was denied as Dr Sampaio had committed himself to prove this was a genetic cause, notably evidence that he himself was attempting to generate

Pediatric Autoimmune Encephalitis, (2017 Apr-Jun, Massimo Barbagallo et al)

• The autoimmune process may be triggered by an infection, vaccine, or occult neoplasm
• AE is well responsive to immune therapy, with prompt diagnosis and treatment strongly beneficial
• The prognosis is often good in pediatric age, with 85% of full but slow recovery (up to several months) and relapse in the remaining 15%

Anti-glutamic acid decarboxylase encephalitis

• Glutamic acid decarboxylase (GAD) is an intracellular enzyme responsible for the synthesis of the inhibitory neurotransmitter GABA. Anti-GAD antibodies have diverse clinical correlates, including stiff person syndrome, cerebellar degeneration, autoimmune epilepsies, limbic encephalitis, and type 1 diabetes. Pediatric patients with high titers of anti-GAD in the CSF have manifested with focal seizures (often arising from the temporal lobe), cognitive and memory decline, progressive developmental delay, and psychiatric symptoms. The CSF may appear normal or with the presence of oligoclonal bands. The MRI and EEG may show abnormalities arising from the limbic structures. Patients with anti-GAD antibodies usually do not have underlying tumors.
• At present, no clinical trials have assessed the optimal treatment in AE. Accepted first-line therapy for every AE includes high-dose corticosteroids (methylprednisolone 30 mg/kg/day, up to 1 g daily, for 3–5 days), followed by or combined with IVIg (2 g/kg divided over 2–5 days). Steroids are then tapered using 1–2 mg/kg/day orally, on average for another 12 weeks, adjusting the dose according to patient tolerability or possible side effects. If no benefit is noticed, plasma exchange (PLEX), 3–5 exchanges over 10 days, should be considered.
• If there is no significant clinical improvement after 10 days with these first-line therapies, second-line therapy (rituximab and/or cyclophosphamide) should be started. Rituximab (375 mg/m2 every week for 4 weeks) is usually well tolerated in children and so is preferred to cyclophosphamide (750 mg/m2 monthly)

Should there have been any doubt to the success of the procedural treatment the parents begged for (Chronic A71 related/Anti-GAD and highly responsive to the Ketogenic Diet) an almost duplicate case to Alinas condition was published (details below) in 2022 from a case in 2018 that followed the above guidelines, following a patient who’s presentation only differed in having Tonic-Clonic movements in his right arm, as opposed to Alinas left. Once you include the information from the transfer notes, the emails, images and points raised by the parents, the agreed effective medications (such as the Ketogenic diet), then the illness is very easily recognised and treatable. All this information is available within this web diary and the largely unrequired academic research included to verify the prodromal illness as chronic EV71, alongside explanation for the failures in testing equipment used by NSW Pathology

Favorable response to classic ketogenic diet in a child with anti-GAD 65 antibody mediated super refractory status epilepticus. (2022 Jun 7, Deepika Sivathanu et al)

• A ketogenic diet has been sparingly used for the management of post-encephalitic epilepsy and autoimmune epilepsy. However, the data on the effectiveness of the ketogenic diet in the management of autoimmune encephalitis is scarce. Starting KD early in the disease course helped not only in seizure control but also preserved the cognitive and neurological well-being of the child.
• A 7-year-old developmentally normal boy presented to the emergency room with a low-grade fever of 5 days duration followed by multiple episodes of seizures. The seizure semiology included lip-smacking movements and right upper limb tonic-clonic movements lasting for around 2 min.
• Majority of children with autoimmune encephalitis present with seizures in the form of status epilepticus (SE) or super refractory status epilepticus (SRSE). SRSE is the SE that fails to terminate more than 24 h of anaesthetic infusion or recurs on weaning of the infusion. This child also presented with SRSE following a mild prodromal illness.
• CSF oligoclonal bands, anti-TPO antibodies, ANA, and anti-NMDAR antibody titers were negative. While serum and CSF GAD-65Ab were positive (serum GAD-65 antibody titre: 221 IU/ml(0–17) and CSF GAD-65 AB titre:218 IU/ml [0–17]). Hence a diagnosis of anti-GAD-65 Ab-associated AIE was made.
• On day 7, second-line immunomodulation therapy with rituximab (750 mg/m2) was given
• The child is on regular follow-up for more than a year. A serial clinical examination with developmental assessment is being performed at every visit.
• He remains seizure-free and can attend regular school with good scholastic performance. His Modified Rankin score was 1 at the last follow-up

Midazolam had immediate benefit, stopping the first two seizures immediately, and even with deteriorating returns was shown to be incredibly effective as the illness progressed. As did clobazam,and phenobarbitone. The recognised and improved ketogenic diet (post Christmas in particular, once the ration had been established at 4:1) proved effective enough to plan to discharge Alina from the hospital in the New Year after a tonsillectomy.

She responded very positively to anakinra (Also an autoimmune drug, a less potent but more specific variation to Rituximab), so much that within 7 days she went from a month’s duration of heavy non-stop seizures to one where she was attempting to communicate and respond. Once this medicine wore off, since it has a short half life, she quickly returned to the previous state of heavy non-stop seizures (awake or asleep). This was also reflected in the EEG charts, videos and noted by ICU and neurologists.

This could have only occurred if the illness was a consequence of elevated Interleukin-1 (Il-1) and subsequently reduced with a very specific medication; anakinra, fitting exactly with the explanation of chronic viral EV71, and this illness was a treatable condition 

Prior to the noted improvement, the parents had agreed to palliative care, however following the success of anakinra, Dr Cardomone postponed this final step as Alina was no longer in a vegetative state. 

Despite obvious improvements he then withdrew anakinra alongside the other effective treatments for EV71; magnesium and midzolam (and this was long before the return of the exome full genetic report) with the clear intention of forcing suffering to Alina

This was highly unethical and manipulative, suggestive of a culpable and purposeful intention to cause or hasten Alina’s death.  

So, the question that really remains, why wasn’t this medicine given to Alina again, or before (on admission)? Alina had a medical history of a chronic virus, with description and images emailed to Dr Sampaio.

Despite every single test returning negative for a genetic cause, Dr Sampaio chose to ignore these and question their reliability. Dr Sampaio did not chose to question the reliability of the viral testing equipment used at Sydney Children’s Hospital, which has a very documented high rate of failure in identifying Enteroviruses (developed within the webdiary)

Since it is now proven that Alina did not have CARS2 dysfunction, what did she have? Given that the genetics team researched and focused on every mitochondrial gene, from POLG  to the very rare CARS2, an illness with slow but noticeable markers and deterioration over 20+ years. Even going as far as fabricating CARS2 as a theoretical possibility in silico in Helsinki. The database of 230,000 gene samples found no matching example related to these symptoms of a mitochondrial dysfunction, so the Hospital invented one.

It would be an interesting explanation to hear how even in month 4 the ICU Doctors and neurologists openly said they didn’t know what this illness was, prior to trial of an autoimmune drug and before the return of the Exome report. (audio within diary) 

An autoimmune drug was trialed and shown to be clearly effective in both reducing the seizures, and when the drug was withdrawn, the seizures returned. The Exome report confirmed all previous tests of no known genetic illness. 

How then could the cause be then considered Genetic? 

The CARS2 gene wasn’t even close in symptoms, however it was the best the hospital could do given an apparent and desperate need to avoid gross medical error by reckless endangerment resulting in an unlawful death, The neurologists chose to falsify this as a genetic illness and thus avoid investigation, accountability, compensation.

Incidentally, the parents were made aware the cost of ICU was in the region of $5,000 a day. Alina spent 104 days in ICU

It was abundantly clear with glucose being a significant trigger to the development of this disease, a fact reported many times by the parents, noted even as early as the 16th November 2017 regarding the change in formula from Karicare (reporting the replacement was making her wheezy). It wasn’t just a parent’s opinion, but a demonstrated fact following testing on 26th December and even marked “seizure!” on the nurses’ report card. Elevated Glucose caused Seizures. It was also agreed by all members of neurological team, both Dr Sampaio and Dr Cardamone were using the incredible response to the diet as a measure of seizure activity, and in trying to from a diagnosis. 

In Court, falsifying medical reports and declarations is a criminal offence.

No letter was received from Dr Lily Foster. Being informed that the ICU has learnt a lesson is of no consequence either to the parents who still suffer from this conversation; a Doctor who gave a detailed and terrifying explanation over the patient’s bed of how morphine would cause a patient’s lungs to collapse, how long it would take, and not knowing if it was painless or not. Then the parents then had to live this scenario only a few weeks later, while holding their only child.  

• Treating your patients with respect at all times
• Recognising that there is a power imbalance in the doctor–patient relationship, and not exploiting patients in any way, including physically, emotionally, sexually or financially
• Communicating bad news to patients and their families in the most appropriate way and providing support for them while they deal with this information

Australian Medical Code of Conduct

Alina and family received far from the best standards of care. The arrogance of the neurologists and their unwillingness to acknowledge the symptoms or experience of others   that was not of their own choosing resulted in multiple arguments, gaslighting, falsification of notes and diagnosis, incredible suffering and abuse to a child, and finally her death.

Consulting with external hospitals and offering incomplete information is nothing more than an exercise in confirmation bias. Had Dr Sampaio consulted with Alina’s GPs, a very clear pattern would have been noticed: a chronic enterovirus, after which all other aspects, symptoms and responses of the illness fall exactly into place.

The actual response below from the Hospital when requesting an explanation after their official response to the Medical Board & HCCC: 

“Please note: that any further correspondence received in this matter will be read and placed on file.  If you have a new complaint unrelated to matters already raised, you can lodge this with us by completing our webform.”

• Providing a prompt, open and constructive response, including an explanation and, if appropriate, an apology

Australian Medical Code of Conduct

The actual response from the hospital can be summarized as: lie, deny, don’t reply!

“I do wonder if we gave her too much medicine sometimes”, the reason given when asked why Dr Sampaio withheld medications for a very clear generalised seizure on the 12th January, in which she lost 50% of her cortex over a 7-day period. Implying that he had misjudged the situation on previous presentations, then applied that misjudgment to a new and different presentation (from a different set of circumstances – with an adenovirus, and so a different treatment and response being required).

• Recognising what has happened
• Acting immediately to rectify the problem if possible, including seeking any necessary help and advice
• Acknowledging any patient distress and providing appropriate support
• Only recommending treatments when there is an identified therapeutic need and/or a clinically recognised treatment, and a reasonable expectation of clinical efficacy and benefit for the patient
• Taking steps to alleviate patient symptoms and distress, whether or not a cure is possible.
• Giving priority to investigating and treating patients on the basis of clinical need and the effectiveness of the proposed investigations or treatment
• Placing the interests and well-being of the child or young person first
• Doctors have a duty to make the care of patients their first concern and to practise medicine safely and effectively. They must be honest, ethical and trustworthy

Australian Medical Code of Conduct

• Keeping accurate, up to date and legible records that report relevant details of clinical history, clinical findings, investigations, diagnosis, information given to patients, medication, referral and other management in a form that can be understood by other health practitioners
• Being honest and not misleading when writing reports and certificates, and only signing documents you believe to be accurate
• Taking reasonable steps to verify the content before you sign a report or certificate, and not omitting relevant information deliberately

Australian Medical Code of Conduct

I think you only have to read the notes (even limited in inclusion), and the actions taken by the neurologists to protect the status of the diet, and listen to the audio within the webdiary to realise this is untrue on all counts.  A diet that was so evidently significant in treatment is so obviously absent from the hospital notes.

A contradiction to the Medical Code of Conduct, a promoted adage by the British Medical Journals advice on Writing Medical Notes (2016) “if it isn’t written down, it didn’t happen.”

Comments from the neurologists during meetings include:

“because of the ketogenic responsiveness…” Dr Sandi (18.12.17)

“The fact that she is responsive to the ketogenic diet… the ketogenic diet, I have to agree does seem to be helpful…. The ketogenic diet may have played a role” Dr Sampaio (20.12.17)

“We think it has been a factor… in general principle we are on the same page… we concentrate on the diet” Prof. Annie Bye (27.12.17)

And following improvements to the diet ratio:

“She looks good… a big change” Dr Denise

“So alert… we’re on a winning track with the diet being helpful…. We’re on a winning track with the diet!” Dr Pillai (31.12.17)

“Sugar based? Definitely off the menu!” Dr Emma (03.01.18)

“I don’t disagree the diet does help… the diet is just a small valve… you’re definitely right, it is the only valve” Dr Sampaio (22.01.18)

“because she has been so responsive to the ketogenic diet” Dr Cardamone (06.02.18) – who was focusing his diagnosis based on this undeniable association

I believe that is sufficient proof to confirm that by his own words and actions as well as those of his team, Dr. Hugo Sampaio is a liar.

However, she did respond positively to the interventions. The responsibility of recognising the significance and association with known diseases falls on the knowledge, management, and ability of the leading doctor (Dr Sampaio) to make them satisfactory. However, he appears to had made a snap judgement of an incurable genetic illness from the beginning, so primed himself with excuse for any failure and wrote the notes to only support this; he filtered the hospital notes to exclude or downplay the history, symptoms and remedies that did not match his initial assessment and was inflexible despite the presentation of new information or advice from colleagues. Eventually it became obvious, and so he has since responded by lying, the hospital has supported this with an orchestrated and fabricated genetic report.

• Complying with any relevant policies, procedures and reporting requirements
• Being honest and not misleading when writing report

Australian Medical Code of Conduct

• Assessing the patient, taking into account the history, the patient’s views, and an appropriate physical examination. The history includes relevant psychological, social and cultural aspects.

Australian Medical Code of Conduct

Even with limited medical knowledge and only the internet, the parents could accurately estimate the best course of action, action that should have occurred in December or even earlier. The parents have total confidence had this medicine been used earlier, Alina would have made a full recovery, similar to the 2022 paper by Deepika Sivathanu.

The history of the illness demonstrates it falls exactly within the control group and category of chronic metabolic diseases for biopterins. An audio conversation is available within the webdiary with Dr Cardamone regarding the consultation with Prof.Dale. The markers are only valid if the patients medical record is considered. However, Dr Sampaio chose to exclude long Alinas medical history at the first consultation

Ignoring the medical history and providing limited information, and selective bias, so implying this was an acute illness as opposed to chronic has of course returned a different diagnosis. The Medical history was even mentioned in the transfer notes from Canterbury Hospital 

The mum summarises it better in the recorded conversation (06.02.18), even without access to the medical notes she is suspicious of the motivation and attitude of the neurology team: It was only evident on reading the Hospital notes far later, that the Neurologists were hiding a far more significant amount of information

“the communication [with external Immunological Doctors] did not mention to these people the fevers, the upper respiratory tract infections, or prone to croup… if that information is not there, then its mitochondrial, if you add this information, then you have some other diagnosis…. There could be a lot of missing information about her croup, and cough, and fevers!”

The significant reduction in anti-GAD levels and improved thyroid hormone levels is a clear example of the improved response. iViG was indeed repeated a month later, and on this occasion, Dr Sampaio went to extraordinary length in sourcing a glucose free solution from the Red Cross, in recognition and acknowledgment of the consequential and damaging effects of the elevated glucose.

To claim “without apparent benefit” following anakinra is yet another lie, videos available within the webdiary

• Being honest and not misleading when writing reports

Australian Medical Code of Conduct

“does not always return positive results” is a generous interpretation of a test that has 0-3% accuracy in these conditions. Effectively useless. As discussed earlier on this page, the presentation matched exactly that of EV71 encephalitis

“to date viruses have not been found to be a common cause of EPC”

Encephalitis Associated With Glutamic Acid Decarboxylase Autoantibodies in a Child A Treatable Condition? (Christian M. Korff, MD, Aug 2011)

Or…

Enterovirus-Associated Brain Stem Encephalitis Mistaken for Epilepsia Partialis Continua

(Neuropediatrics 2016 – E. Schuler et al)

• Being honest and not misleading when writing reports
• Keeping your knowledge and skills up to date.

Australian Medical Code of Conduct

Correct, and exceptionally low yield, and the poorly calibrated PCR appears to have reported a chronic (-ve strand RNA) enterovirus, as a +ve strand RNA rhinovirus 4/4 times over 12+ days from admission. Similar to the GP’s testing (10/05/17). Only one stool sample was taken in this period (09/01/18), again likely calibrated to look for +ve stranded RNA only.

Enterovirus infection of neuronal cells post-Rituximab”, (British Journal of Haematology, 12 July 2009)

• This case demonstrates the difficulty in diagnosing enteroviral meningoencephalitis due to non‐specific symptoms and the low index of suspicion. It is thought that, in enteroviral infection, the virus is always detected in the gastrointestinal (GI) tract. However, in chronic encephalitis, by the time the disease is presented, the virus has seeded the central nervous system (CNS) and may have cleared from the GI tract and be undetectable in the stool

• “Keeping your knowledge and skills up to date.”  

Australian Medical Code of Conduct

Given Dr Sampaio’s willingness to over prescribe multiple medications approaching that of twice an adult (by her weight), I have no doubt that if he had the ability to recognise or even accurately document the symptoms, recommendations of a far more successful course and approach; such as anakinra, plasmapheresis, rituximab… there are numerous autoimmune treatments, all demonstrated effective against EV71. Dr Sampaio did not even complete first line Encephalitis treatments in his statement, he is excusing himself with “tickbox doctoring”

• Keeping your knowledge and skills up to date.
• Ensuring that your practice meets the standards reasonably expected by the public and your peers

Australian Medical Code of Conduct

Dr Sampaio demonstrates yet further misdirection. He knew exactly the reason why he was dismissed, he even apologised the following day when returning from his tennis holiday that he “just didn’t react in time” to “the different type of seizure”.  Alina had suffered so much prior to intubation. It was not a surprise to him.

However, Dr Sampaio completely failed to contact the GP for Alina’s medical records to confirm the parents reporting of her chronic viral medical history, with one GP advising the father of this very outcome, this failure resulted in endangerment of the patient and subsequent misdirection of opinion by reply to any consult, not allowing for an alternative perspective or balanced suggestion.

It appears Dr Sampaio is more motivated in falsifying and filtering the hospital notes from very consultation and admission, driven to prove an unlikely disease as suspected by the father from mid December, and supported by the neurological team who also failed to update the Hospital notes with symptoms and responses

“We are actually working as a team… we totally endorse so far what Hugo has done and his investigations” (audio 23.01.18)

The Medical Board, like Dr Sampaio, is possibly attempting to link the illness by clinical observations to juvenile Alpers–Huttenlocher Syndrome?

AHS is an autosomal-recessive disorder induced by mutations in the POLG gene

However all testing including a full exome reported no known fatal mutations, to include additional testing of the POLG gene. Alina did not suffer from Micromicrocephaly. The only connection Dr Sampaio could make to a genetic cause was the late milestone of walking (all others were easily met). Alinas father also did not start walking until 18 months

The opinion of the medical board is based on a the “buffed” notes by the neurological team. It’s believed that all doctors uphold the Medical Code of Conduct. Dr Sampaio is a proven liar by his own words and team’s comments and actions. Perhaps this opinion is based on an incredibly flawed medical belief that chronic enteroviruses do not exist? (developed and explained further within the diary section – autoimmune disease and chronic viruses appear to be one and the same).

Every MRI of Alina clearly indicates “cannot exclude encephalitis”
.

The parents would be keen to hear an explanation of how nearly 40 visits to the GP and alignment of every symptom in line with a chronic enterovirus, as well as specific advice of this development made by a GP, with these very same “red flags” being relayed to Dr Sampaio in an email with images, were simply ignored and unreported in favour of an unsupported genetic diagnosis

Unsupported “Opinion” and “Likely” do not explain or excuse; medicine is applied science, experience, and reasoned logic. There is a code of conduct that is clearly being ignored

The opinion is a credulous support of an incapable and dishonest doctor. Incidentally, the father requested a pediatric virologist/immunologist to review the hospital notes, anyone but a neurologist. The Medical Board employed an anonymous neurologist.

It would appear a doctor who is a proven liar, who is significantly unprepared, and completely out of his depth is in line with the expectations of the Council. The Council seems to afford itself protection of its members and impunity by a self-governed executive privilege.

Based on the numerous online google reviews there would appear to be an almost unanimous opinion that the sole purpose of the HCCC is to find obscure, questionably legal or unreasonable reasons to dismiss any evidence presented by a patient or their family members, and only allowing evidence submitted by the Medical Practitioner themselves, the very same same person who is under investigation.

The investigations against a Doctor made by the HCCC seem to be conducted under “Civil procedures” (i.e. delivery of service), which allows the omission of patient/family provided evidence (such as medical history, audio, video).  Whereas the complaint regarding this Doctor is made under the circumstances required for a “criminal investigation” (cause of harm) since the patient died due to clear gross negligence of a Doctor who failed to follow the Medical Code of Conduct  

It is unclear if the Medical Board and their assessing Doctor are aware of the additional information, but the standing of the Medical profession certainly benefits from a government backed organization that removes any contest to its “independent investigation”

By failing to enforce the Medical Code of Practice would encourage complacency, disregard of professional obligations, damage to the reputation of colleagues, and of course the high costs of unnecessary treatments

The Medical Board and HCCC were both sent a link with both audio and video content and making both parties aware that it proved the fabrication of the hospital notes and actions of the doctors. It offered a very different but very accurate record of events, since this information could not be falsified. The Medical Board did not even open the link.

The Medical Board and HCCC now consider this matter closed, with no further appeals.

Twice a coroners enquiry was requested by direct appeal, and was rejected on the grounds that the Medical Board had sufficiently investigated the matter.

The police will not intervene in matters of medical enquiry, finding absurd reasons such as being unable to open a digital file, or being unable confirm the date of a recording (that information being digitally stamped in “properties” of the file itself)

Australia claims to be a champion of Human Rights, to include “Right to Life”, however there is no actual method of raising an investigation

Requests to the local MPs and the Minister for Health only result in direction to another department of enquiry such as the Ombudsman, which has no legal authority over either the Medical Board or HCCC. 

In NSW, you can only make recordings if you are protecting your interests. further defined by the Supreme Courts in 2015 as a “genuine fear for your safety” (Groom v Police [2015] SASC 101). You would have to ask when would a situation be more applicable? 

Legal advice cannot not act without a coroner’s or medical report, derived of course from the hospital notes, which are buffed and limited. The estimated costs of independent review and legal action cost $100,000+, and unless clarity of the law and situation is confirmed by a Judge they are restricted to the hospital notes too under a “civil investigation”, the Court will not otherwise accept audio and video recordings (that clearly show the true course of events and context). 

The law limits an unlawful death investigation to 3 years, however this there is no stature of limitations for either child abuse or homicide. In the opinion of the father, deliberately withholding effective medication with the intent purpose of causing suffering and death is both of these.  

In NSW Australia, you would effectively have to wait until laws are revised on use of recording devices before you can report child abuse and homicide

The maternal grandfather has diabetes, the grandmother has a number of nerve related conditions; ankylosing spondylitis and hemiplegia, frequent red eye and what is believed to have been bells palsy. Often, she is bed ridden and takes various medications such as vigabatrin. 

Alina's mother suffered from deteriorating vision and hypothyroid during pregnancy, which was finally diagnosed as Hashimoto's Disease (an autoimmune disease)

The father suffered initially from alopecia in both calves, two years before Alina was born

https://edm.bioscientifica.com/view/journals/edm/2015/1/EDM14-0084.xml

This progressed to a monthly cycle of testicle pain, lethargy, vertigo for 3-4 days, followed by diarrhea. After 6 years of several pelvic scans, this was suggested as Chronic Pelvic Pain. 

Interestingly all family members suffered in sites of immune privilege. Viruses are communicable, and this is more than coincidental.

Medical Science is based on false belief


Introduced in 1983 the RT-PCR replaced Northern Blotting in identifying viruses. An alteration and assumption was applied in 1989 to try and make RT-PCR more accurate by streamlining its operation, consequently more commercially viable too. The true consequence is catastrophic. 

Or even…

And hence these papers were accepted as the standard medical interpretation regarding EV infections. Doctors do not believe in chronic (non-polio) enterovirus infections, they are not taught and barely researched. 

However, these papers were based on poor laboratory design

The papers above were based on the methodology of the 1989 experiment by Kwok & Higuchi, so are of equal terrible design, that limited the testing to only identify the +ve (antisense genomic viral) stranded enterovirus RNA. Hence the belief that chronic enteroviruses do not exist, or are self resolving.

Consequently for 30 years, medical science has been working blindly, stemmed from these papers by only identifying half the virus types, by only identifying the acute variations.
 RT-PCR has become the global industry standard for identifying and excluding viruses as a root cause for persistant illness
. This error includes the body of works and opinions from the consultants of Immunology and Neurology papers written since. 

This is not exclusive to enteroviruses. Other single stranded +RNA viruses in which RT-PCR is used to identify include:

• Nidovirales (Arteriviridae, Coronaviridae, Mesoniviridae, Roniviridae)

• Picornavirales (Dicistroviridae, Iflaviridae, Marnaviridae, Picornaviridae, Secoviridae, Comovirinae, Bacillariornavirus)

• Tymovirales (Alphaflexiviridae, Betaflexiviridae, Gammaflexiviridae, Tymoviridae)

• Astroviridae
• 
Caliciviridae – includes Norwalk virus
• 
Flaviviridae – includes Yellow fever virus, West Nile virus, Hepatitis C virus, Dengue fever virus, Zika virus

• Hepeviridae

• Nodaviridae

• Statovirus

• Togaviridae – includes Rubella virus, Ross River virus, Sindbis virus, Chikungunya virus

For the Picornavirales alone, there are 81 non-polio and 3 polio enteroviruses that can cause disease in humans. Of the 81 non-polio types, there are 22 Coxsackie A viruses, 6 Coxsackie B viruses, 28 echoviruses, and 25 other enteroviruses. This does not include the novel enteroviruses such as C105… recently discovered.
You may recognise a virus on this list. COVID of the Coronaviridae family. 

https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html

Symptoms very similar to a Chronic Enterovirus infections:

• Difficulty breathing or shortness of breath
• Tiredness or fatigue
• Symptoms that get worse after physical or mental activities
• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Cough
• Chest or stomach pain
• Headache
• Fast-beating or pounding heart (also known as heart palpitations)
• Joint or muscle pain
• Pins-and-needles feeling
• Diarrhea
• Sleep problems
• Fever
• Dizziness on standing (lightheadedness)
• Rash
• Mood changes
• Change in smell or taste
• Changes in period cycles

The nearly 30 years of this firm belief in the medical community that Chronic Enteroviruses do not exist, they are self resolving. So many “auto-immune” diseases that are explained so more readily by the -ve RNA strand, which on acute infection is present at 100:1 ratio, and from successive generations of replication this is reduced to a demonstrated 1;1 ratio. In particular when you consider the have an affinity to “seed” in areas of immune privilege, where they are not cleared from the host easily, areas like the Central Nervous System. 

This includes the Vagus Nerve; the Gut-Brain connection. Now consider all the organs along this nerve; the heart, the lungs, the pancreas, the thyroid. 
1% of the global population has type 1 diabetes, 9% have type 2.

Auto-immune diseases are where the medical community believes the body mistakenly attacks itself. 


The body is a billion years in design, its does not now seem plausible that it would simple “attack itself” without reason. RT-PCR is 30 year in use, and its being used incorrectly.


We know, very sadly that the virus can be passed vertically (even during gestation, Alina was exhibiting Myoclonic jerks on hearing loud noises, and mum had a troublesome pregnancy, late delivery by C-section) as well as between direct family & partners. From research into this illness, the virus has evolved to produce more chronic RNA variations than anticipated. The actual illness is very mild, exceptionally (as suggested and personally experienced). The damage caused by repetition from an over responding immune system is catastrophic. 

And we know from experience with Alina, the triggers are elevated stress and cellular glucose for Enteroviruses EV71. 

This mistake, to rapidly prepare samples for diagnosis has become standard medical practice, forming the basis of significant incorrect diagnosis, vaccine design and research and teaching since. It appears that half of immunology is fallacious pathological science, the chronic half.
 

After trying to calm Alina for about 90 minutes in a stressful situation, the noisy ICU ward at Sydney Children’s Hospital. Noticing she was developing “Ataxia” a video was taken (as noted 5/12/2017). I had tried a lot of tricks, distractions, cuddles, books & toys. She always enjoyed playing with wallets, they had lots of pockets, coins and cards to take out and inspect

After 90 minutes I needed to use the rest room, so left Ali briefly. When I returned, she was significantly different, co-ordinated and acting like her typical self, playing with wallet and taking it apart

I asked the Nurse what had happened? “Oh as soon as you left, she got upset & started to cry. I picked her up and she had a cuddle for a minute, so I put her back down”

Charles Darwin was curious why Humans were the only animal that truly cried when stressed. It would appear in the example that crying offers the benefit of tempering chronic viruses

Alina was particularly stressed in hospital (elevated cortisol?), especially noticeable during the set-up of an EEG – which takes 10 minutes to glue the sensors to your head and during she was not allowed to be touched. The overlap with stress was discussed with the Neurology team

She was at her most relaxed in the environment of her Mum and Dad, Aunts and friends, listening to normal conversations, having her hair played with. Ali had particular friends who just made her laugh uncontrollably and was besotted with; Rahul, & Prachi. (Videos playing with watch and necklace, and being teased with hanging keys) as seen in the videos introducing Alina

Association of Enterovirus and Diabetes

• Lead researcher Dr. Maria Craig, an associate professor at Children’s Hospital at Westmead’s Institute of Endocrinology and Diabetes in Sydney, said, “The finding implies that enterovirus infection is a very important cause of Type 1 diabetes.” Craig noted that the idea that enteroviruses are involved in the development of Type 1 diabetes is not new, but this study makes use of new data that makes the association more likely.
• Dr. Didier Hober, a professor of virology at University Lille in France and author of an accompanying journal editorial, said, “The increased incidence rate of Type 1 diabetes can be explained by a role of environmental factors, especially enteroviruses, like coxsackievirus B.” However, it is unclear whether enteroviruses are involved in all patients or just some, he added. “Enteroviruses could act as inducers of the disease or as accelerators of the progression of the disease. A persistent infection or consecutive infections could play a role,” he said. 

http://www.diabetesincontrol.com/cold-viruses-appear-linked-to-type-1-diabetes/

• Dr. Craig has also linked the cause to a chronic variation of Enteroviruses
• EV infection and autoimmunity
  • Enterovirus VP1 capsid stained + in pancreatic tissue in a child repeatedly positive for islet cell antibodies 
  • No inflammatory changes in islets No reduction in beta cells No insulitis, apoptosis 
  • Findings suggest that (chronic) EV infection contributed to positive islet cell autoantibodies
  • Enterovirus infection is likely to be implicated in some cases of type 1 diabetes, and possibly other forms (type 2, fulminant)

http://www.virologyresearch.unsw.edu.au/virology/wp-content/uploads/2013/08/VIM09_MariaCraig_PancreasBlood.pdf

• Metabolic abnormalities of diabetes mellitus such as hyperglycemia and hypoglycemia could have a damaging effect on the CNS, which may cause seizure; indeed, in endocrine disorders, seizures could be the result of neuroinflammation, autoimmunity, or of metabolic disturbances
•  In particular, anti-glutamic acid decarboxylase antibodies (GAD-Ab) have been associated with T1DM and a large variety of neurological conditions, including epilepsy (43, 44). GAD-Ab have been detected in 80% of patients with new diagnosis of T1DM

“Seizures and type 1 diabetes mellitus: current state of knowledge”, European Journal of Endocrinology 2012 (PDF, 227k)

From Alina’s first admission to Canterbury Hospital, it was noted a “high stepped gait”

Diabetic Neuropathy and Gait: A Review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688977/

Additionally, the images sent to Dr Sampaio of “cheese triangle sized white patches”, or Ash-leaf spots typically associated with Tuberous Sclerosis also are interruptions of the mTOR pathway 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520048/

Entero means from [within] the gut

Hippocrates, the father of medicine is attributed to stating “all disease begins in the gut”