Strange? (Questions about sedation arising from Kate's book 'madeleine')

Kates version of the truth. Her book madeleine. I quote this for the sake of research and so in order to find Maddy Mc Cann.

"I wandered into the children's bedroom several times to check on Sean & Amelie.

1. They were both lying on their fronts in a kind of crouch,
   
2. with their heads turned sideways and
   
3. their knees tucked under their tummies
   

In spite of the noise and lights (?) and general pandemonium, they hadn't stirred.

They'd always been sound sleepers, but this seemed unnatural.

Scared for them, too, I placed the palms of my hands on their backs, to check for chest movement, basically, for some sign of life.

Had Madeleine been given some kind of sedative to keep her quiet?

Had the twins too".


Here ends the last paragraph on page 75 of the book madeleine.

Kate and Fiona had been left in the appartment, they were now alone together.
Two experienced anaesthecitians.

Correct me if I'm wrong.  

When Kate writes the above, Fiona has already reported to the police (LI) seeing Kate check on the twins.
That information, by Fiona, is on record. It has apparently to be explained away.

• Note that Kate did not check on the twins when she found Maddie absent. Not one of all those doctors did. Did they? Records anyone?
  
• Not according to her book madeleine, that is.
  
• She even did not switch the light on, wishing them to remain asleep at all costs.
  

Question nr. 1
Are there any parents among us, who have seen children sleeping in the above decribed position?

Question nr. 2
Not one, but both of them at the same time?

Children tend to move in their sleep, don't they?

Question nr. 3
But simultaneously?
Question nr. 4
Is there a medic in the house, enlightening us if this is standard practice: feeling someones back in order to establish chest movement?
Question nr. 5
And last but not least: is there any mention of doctor Kate reporting the unnatural quiet of her children?
I've looked at her May4th and May 10th statements to the PJ, not finding any.


The more I look at her statements, i.e. her version of the truth, the more my mind boggles. Tennis anyone?

For many people this passage will sound quite extraordinary. Doctors, nurses, police officers, ambulance crews, fire officers, paramedics, St John Ambulance staff, and many others are taught in their basic training about the importance of rousing people. Drunks, drug addicts, people with head injuries, and those who have suffered smoke inhalation are roused, and in some cases are to be shaken into consciousness. Failure to rouse a patient should lead to immediate medical assistance being sought, or transportation to the nearest casualty department.

Failure regularly to rouse someone in a police cell is a very serious disciplinary offence, the penalty for which may be dismissal from the service.

It is frankly not good enough to “place the palm of a hand on [a child’s] back, to check. . . basically for signs of life”.

The Royal College of Nursing is quite clear about this.
In “Standards for assessing, measuring and monitoring vital signs in infants, children and young people - RCN guidance for children’s nurses and nurses working with children and young people”

they say, very simply
Infants and children less than six to seven years of
age are predominantly abdominal breathers
therefore, abdominal movements should be counted.
They emphasise “the particular vulnerability of infants and young children to rapid physiological deterioration”
And later discussing recovery room protocols
• following a simple procedure – vital signs should be recorded every 30 minutes for two hours, then hourly for two to four hours until the child is fully awake, eating and drinking.

When we add to this the curious way the children were lying, on their fronts in a kind of crouch, with their heads turned sideways and their knees tucked under their tummies.“ which clearly must restrict the abdominal breathing in a child of that age, the failure by the parents or the other anaesthetist present to modify this posture is very difficult to understand.

Levels of sedation are assessed according to the Ramsay Sedation Scale (RSS)
1   Patient is anxious and agitated or restless, or both
2   Patient is cooperative, oriented and tranquil
3   Patient responds to commands only
4   Patient exhibits brisk response to light glabellar (forehead) tap or loud auditory stimulus
5   Patient exhibits a sluggish response to light glabellar tap or loud auditory stimulus
6   Patient exhibits no response

The twins are clearly in point 6 on the scale. They are failing to respond to external stimuli, cold, light, noise - including screaming, the inevitable jolting of the cots placed so close together in a small room during the search and window / shutter procedures, human touch, and then being picked out of their cots by persons not their parents, taken outdoors into the dark and cold air, into the light and warmth of a neighbouring apartment, where they are placed in different cots.

They have clearly been sedated, But by whom, when and with what ?

Neither doctor performed any of the usual and medically required tests or procedures appropriate to recovery from anaesthesia. It is a matter of record that the twins were not taken to a hospital for assessment.

On the facts therefore the doctors were in serious and negligent breach of a whole series of medical protocols for which nurses have been struck off the register.
And even more strangely, they have admitted this in statements and in the book. They have made no attempt to suggest that they acted correctly.
If we rely purely on what they have said, we find that it is corroborated by independent witnesses, and it leads to the following conclusion -
They would be guilty of a most serious breach of professional standards, so serious that striking off the Medical Register would be appropriate.

They have clearly been sedated, But by whom, when and with what ?

Which leads me to think that those in the room knew exactly what the answers were to these questions.

Portia my l o used to regularly sleep like that, I wouldn't read anything into that by itself. We also had a new loft ladder hole cut and ladder fitted outside her open bedroom door while she had an afternoon nap one day. She never stirred.

My daughter could sleep through anything, but if she was woke during the night I would be concerned as I knew something was wrong, usually the onset of an illness. My great niece who I care for is a very light sleeper and if she didn't wake due to noise or light I would be taking her out of the cot while running for the phone to call a doctor or ambulance (panicking at the same time!) as I would know something was very wrong.
Kate says the twins were sound sleepers but clearly wasn't that concerned when they didn't stir at all. But GM IMO contradicts this as he said that they used the patio doors to enter the apartment so as not to disturb the children.

Hi Ollie1 and welcome. Didn't KM also say in her documentary that she didn't even put the light on in case it woke the children, and she was trying to make Madeleine out in the dark. The lights must have been on in that apartment when they were all running round searching, lifting blinds etc according to the files, people everywhere, yet the twins stayed fast asleep. In that sort of scenario it would be bedlam, people would have raised voices, they certainly wouldn't be whispering it's impossible to do imo when you are panic stricken.

Thank you for the welcome Candyfloss! but, I have a confession to make...I have been a member for a long time, as Ollie, I had problems logging in so changed my username and password.
I agree that it would of been bedlam and it makes no sense that the McCanns claimed they didn't use the front door so as not to disturb the children, I'm sure entering the front door can't have been that noisey and certainly not as noisey as those shutters being 'jimmied, smashed, broken into!' .

We had a toddler in foster placement with us - he was 2 years old - and he napped on the floor a couple of times in that exact position so it's not uncommon.

Perhaps the twins were in the only possible position
to fit into those far too small baby cots of theirs.

IMO

parapono

nomendelta wrote:We had a toddler in foster placement with us - he was 2 years old - and he napped on the floor a couple of times in that exact position so it's not uncommon.

Yes, but napping is 'zonking out' for a short time, and I agree kids can sleep in some of the funniest places. For how long though, maybe up to 15 mins possibly, it wouldn't bother the circulation too much, but to sleep soundly for an untold length of time as the twins apparently did, wouldn't circulation in the legs bother a mum enough to want to put the child onto its side, [You must be registered and logged in to see this image.] not just leave it there and write a book about it later, along with the bit about the twins being up nice and early the next morning, (when Kate returned from her hour's search which started at 6) and having breakfast with everyone, enjoying the company and not missing Madeleine, fortunately.

Portia wrote:
Are there any parents among us, who have seen children sleeping in the above decribed position?

Yes I have. Both my children slept like this when they were babies.

It's ridiculous really, as young as the twins were you WOULD wake them and ask them (in baby friendly talk) "where's Maddie?".
Even if they have limited vocabulary they could answer (if they had seen anything suspicious) "man taken Maddie" or if they had remained asleep they would just be confused with the question.
So obvious that no one took Madeleine.

bristow wrote:

Portia wrote:
Are there any parents among us, who have seen children sleeping in the above decribed position?

Yes I have. Both my children slept like this when they were babies.

It's ridiculous really, as young as the twins were you WOULD wake them and ask them (in baby friendly talk) "where's Maddie?".
Even if they have limited vocabulary they could answer (if they had seen anything suspicious) "man taken Maddie" or if they had remained asleep they would just be confused with the question.
So obvious that no one took Madeleine.

Yes I have seen babies sleep like that and toddlers too but none older than about 3 years old. \they then seem to still sleep on their fronts but with their legs down, not kneeling.

The main point though Mrs. was sufficiently worried to put her fingers under their noses to check them. F. Payne makes sure she mentions this in her statement as she obviously thought it was strange or why mention it. As a qualified anaesthetist why did she not try to rouse the children. Very strange goings on that night no doubt about it.

And then again, there's a difference between putting her [KM's] fingers under their noses [testimony FP] and checking their backs for breathing [bewk KM]. I know about toddlers sleeping through a lightning storm, a parents' row, a barking dog. But NOT all of those circumstances [lights, screaming, people running in and out, being transported to another location] in combination.

You naturally would grab them (quite frantically) speak loudly to them to check they were ok, you would panic and run around with them.

When my son was very young he suffered quite a few fits and on two occasions I found him unconscious in bed, I grabbed him quickly, feeling panic stricken, I did all I could to wake him. Any normal parent who had found one of their children gone would do the same, protective instinct kicks in and you would frantically be seeing if the others were unharmed.

B++++++s would you just feel their back or put a finger under their nose, such RUBBISH!

sorry to hear about your child having those fits Bristow. As you say terrifying and natural reaction to pick him up and make sure you did all you could to make sure he was safe.

plebgate wrote:sorry to hear about your child having those fits Bristow. As you say terrifying and natural reaction to pick him up and make sure you did all you could to make sure he was safe.

Yes it was a terrifying time plebgate, finding him unconscious puts you into automatic overdrive.
If you had found your child apparently abducted and the other two were sleeping soundly you would naturally grab them in a frantic state, even more so if you had suspicions they could have been drugged!!

bristow wrote:

plebgate wrote:sorry to hear about your child having those fits Bristow. As you say terrifying and natural reaction to pick him up and make sure you did all you could to make sure he was safe.

Yes it was a terrifying time plebgate, finding him unconscious puts you into automatic overdrive.
If you had found your child apparently abducted and the other two were sleeping soundly you would naturally grab them in a frantic state, even more so if you had suspicions they could have been drugged!!

I would have taken my child out of it,s cot and examined it to see any signs of clothing having been intefered with. I certainly wouldn't have left them sleeping like that. maybe I am a poor mother prepared to waken a child but if they thought there had been an abduction then there was a risk to the twins, but the first lifting was to take them to another apartment.

parapono wrote:Perhaps the twins were in the only possible position
to fit into those far too small baby cots of theirs.

IMO

parapono

If that is so and a common occurence. then there wont be any need for Kate to be alarmed about it as she states in her bewk in retrospect.

The way I see it this "sedation" thing has a hugh significant in their scheme of things, that's why kate mentioned it a few times in her bewk.

In a way they're proving the Police was correct in their theoy that Maddie was sedated. The $64M question is when, why and by who?

aiyoyo wrote:

parapono wrote:Perhaps the twins were in the only possible position
to fit into those far too small baby cots of theirs.

IMO

parapono

If that is so and a common occurence. then there wont be any need for Kate to be alarmed about it as she states in her bewk in retrospect.

The way I see it this "sedation" thing has a hugh significant in their scheme of things, that's why kate mentioned it a few times in her bewk.

In a way they're proving the Police was correct in their theoy that Maddie was sedated. The $64M question is when, why and by who?

A child who gets a 'star' every time she doesn't get out of bed in the night is not a good or deep sleeper.

Parents who set up such a system of 'reward' are imo control freaks.

Children who go to sleep at 7.30 each night -no matter what - do imo not exist.

There are several entries in the diary about putting the twins to bed, after 3/5 apparently not so easy as before.

Parents who set up such a system of 'reward' are imo control freaks.

I can't go along with that! We set up star systems when the children were small, and we were the opposite of control freaks. It was a way of trying to encourage the children. I don't remember that it worked, mind you, but it was something that was worth a try.

Miraflores wrote:

Parents who set up such a system of 'reward' are imo control freaks.

I can't go along with that! We set up star systems when the children were small, and we were the opposite of control freaks. It was a way of trying to encourage the children. I don't remember that it worked, mind you, but it was something that was worth a try.

Sorry, It's the sedation issue that I was replying to. It does seem that both the star system and the sedation were used for the same reason, to get the children to sleep at set time and what I'd like to know, if Maddie 'came through' as Gerry once said - how did they get her back to sleep/bed? Because that's very difficult as I've experienced.

Both doctors, each of whom is a qualified anaesthetist, failed to address the simplest but the most important questions.
Why can they not be roused ?
And then -
Given that they cannot be roused, what procedure, and / or what substance has been used to sedate these two children to this extent ?

We now know that any sedation must have been administered within 1 minute and 20 seconds, in a narrow time window between Gerry McCann’s leaving the apartment, and Jane Tanner’s seeing the abductor carrying Madeleine, so obviously the substance was extremely fast acting, and very powerful.

The two anaesthetists did not have that information, but must nevertheless have believed that sedation had occurred within the previous half hour.

So what precisely did the two anaesthetists assume had been used, and how did they suppose it had been administered ?
Why did they accept that the dosage had been exactly correct for children of this age and size ?
Was it still being absorbed and was the level in the tissues still increasing ? Were they coming round, or were they drifting into even deeper level of unconsciousness, coma, and possible death ?
What were the likely or possible side effects - vomiting, breathing difficulties, lung congestion, ventricular or atrial fibrillation, brain damage, liver or kidney failure, or any of the many other possible sequelae that both will have studied at length and been examined on in detail.
What precisely did they identify or diagnose ?

Medical Note for non-medical readers

There are five routes for the administration of sedation.
* Injection
* By mouth
* Inhalation of anaesthetic gas
being the three most usual.

Observation.
Jane Tanner’s description of the “abductor’ did not include anaesthetic equipment or gas cylinders, nor even a back pack in which they might be carried, and nothing was found in the apartment or the immediate surrounding area.

Reminder
The McCanns, and many of their Tapas7 friends are medically trained.
Both Dr. Kate McCann and Dr. Fiona Payne are trained to a high standard in anaesthetics. In fact both were Junior Registrars.

Their continued insistence on sedation by an ‘intruder’ as a viable proposition, when combined with the unambiguous admission in their statements, in interviews, and in the book, of clearly defined professional negligence in their manifest failure to provide, or even consider, any form of resuscitation or aftercare, is baffling.

But these qualified anaesthetists simply put a palm on a child’s back, or a finger under its nose. There is no record that of whether each child was turned, undressed and examined minutely for needle stick marks, or had its mouth, nose and throat cleared or checked for the presence of a chloroform soaked rag, had its breath smelled for evidence of drugs, gas or ketones, had its pupil response monitored, had its heart rate taken, had other reflexes tested, or was roused until fully conscious. These would be standard procedures.

On the contrary, what evidence there is points to the twins’ having simply been left for a considerable period unattended, and then some two hours later scooped up out of their travel cots, in the bedclothes in which they slept, and being carried, still sleeping, out into the cold night air and round to an adjacent apartment where they were left to sleep.

We are given many instances in her own book of Kate McCanns’ loss of control, kicking out at inanimate objects, hitting railings with her fists, throwing herself on the floor, wailing and so on. We are however also given clear examples where she was not acting in this way, being more calm and professionally purposeful, going out into the street to see what was happening, having a blunt discussion with a witness in the apartment above, “wandering” into the twins’ room, and ultimately “keeping vigil” in total silence for the rest of the night.

However, it must be said that for a normal distressed and anxious parent to behave in this way would be unforgivable.
For an educated professional person it would be grossly negligent.
For two qualified anaesthetists it is absolutely unthinkable.

If we find that it is indeed unthinkable, then we must wish to believe that their actions were not negligent, that they were not in breach of any protocols, and that their apparent lack of action does not bear any negative interpretation.

But for that to be true they would have to have known precisely why the twins were unconscious, what substance had been administered, in what dose, by whom, and when.

And they have always denied this.

All very good and valid points which the a bunch of Drs. (two aneasthetists amongst them) ought to answer for, or at least told the Police that from the start.
Not only they failed to tell the Police about their suspicions that the twin were possibly drugged, Fiona on seeing Kath feels the twins breathe by placing her finger under their noses did nothing to help Kate neither she or Kate think of taking the twins to hospital, and we are talking two aneasthetists here in a circumstances where Maddie disappeared mysteriously and they did not think to check out the twins unusual sleep pattern.

So the pertinent question why kate made a big issue of this in her bewk is a mystery. What point was she trying to insinuate, that if Maddie is found and forensically proven to be drugged then she's right that the abductor sedated all her children in that short window opportunity before taking away Maddie? The mind boggles that she even pre-empt that?

No matter how one looks at it, Kate's mention of the sedation from hindsight, and her negligence to rouse the twins are all odd and suspicious behavior.

PeterM on form this morning. Excellent points.

Snipped from Aiyoyo post:
"No matter how one looks at it, Kate's mention of the sedation from
hindsight, and her negligence to rouse the twins are all odd and
suspicious behavior.

Yes exactly. Looking at it from" hindsight" how ridiculous it all is.