Russell client could have lived: expert

·3-min read

Emergency expert surgical treatment likely would have saved the life of a woman whose hand became severely infected after a body modification, a trial has been told.

Body modifier Brendan Leigh Russell, 40, has pleaded not guilty to the woman's manslaughter after inserting a plastic snowflake under her skin in the weeks before her death in April 2017.

She complained of pain from the site and discharge, leading Russell to reopen the wound on the back of her hand, wash it out and reinsert the implant two days before her death.

Some other implants were also inserted into her fingers.

Russell's Sydney District Court trial has been shown images taken during the procedure, conducted in a shopping centre parlour on the Central Coast.

The woman's hand was "obviously infected and emergency and expert hand surgical intervention was required", forensic pathologist Johan Duflou told Russell's trial.

"It definitely goes against all my knowledge of safe medical practice to insert a foreign material into an infected site," the professor said.

The woman, whose identity is shielded by the court, would "very likely" have survived following the medical intervention.

But Prof Duflou was unsure whether she'd have regained full function.

The testimony was contained in a transcript released by the court on Tuesday, after a judge banned media and relatives of the victim from observing the hearing last Thursday, citing technical issues.

The University of Sydney Central Clinical School professor accepted he'd treated no more than 10 hand infections in his career and none since the 1980s.

But he recalled having "bashed into my head as a medical student" that hand infections were serious and dangerous and patients could deteriorate rapidly.

"So certainly, (it's) something that is ... in any event basic medical knowledge," Prof Duflou said.

The night the woman died, Russell allegedly told her by phone that her hand wasn't infected - "it's just irritated".

That was a well-worn phrase wheeled out for the body modifier's clients, according to a regular of his parlour, who witnessed the phone call.

The hand had looked "green and yellow (and) was clearly infected" three days before the death, the woman's mother told the trial.

Russell's lawyer suggested other possible explanations for the woman's death beyond Prof Duflou's conclusion of sepsis.

Elevated procalcitonin levels - an indicator of sepsis - could be a result of a severe hand infection in the absence of sepsis, Michal Mantaj suggested.

"Whether a localised infection which is not causing sepsis can elevate procalcitonin levels to the calculated level potentially that was found here, I don't know," the witness replied.

Mr Mantaj also suggested mixed drug toxicity from medications may have wholly or partly contributed to the woman's death.

Prof Duflou accepted it may have contributed but disputed its significance, saying the woman likely would not have died without the infection.

"The features were entirely consistent with sepsis," he said.

"The problem is, if there is not sepsis here, how to explain those various markers in the setting of a significant infection.

"I don't think that you can reasonably come up with a diagnosis that encompasses the abnormalities. That is, the naked eye, the microscopic and the biochemical abnormalities comfortably sit within any other diagnostic category."

Russell has also pleaded not guilty to two further charges related to clients he operated on in 2015 and 2016. Both women survived.

The trial is due to resume on Thursday afternoon.

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