SHAH ALAM: There was a mixture of blood, vomit and saliva in Kim Chol's mouth during the intubation procedure at the Menara Medical Clinic at the Kuala Lumpur International Airport 2 (klia2) on Feb 13, the High Court heard.
Dr Nik Mohd Adzrul Ariff Raja Azlan, 34, who was a doctor at the clinic, said he saw the substances inside the patient's mouth which had blocked his view to search for the trachea opening to perform the procedure (by which a tube is inserted through the mouth into the trachea).
He was testifying at the trial of Indonesian Siti Aisyah, 25, and Vietnamese Doan Thi Huong, 28, who are charged with murdering Kim Chol.
"For this man (Kim Chol), after I opened his mouth, there was a lot of blood, saliva, mucus and vomit mixture which blocked my view to search for the trachea's opening.
"So we had to suck out the liquid before proceeding with intubation using a suction machine," he said in his reply to a question by deputy public prosecutor Wan Shahruddin Wan Ladin.
He said that after the intubation was done successfully, the patient was stabilised but needed to be transferred to a hospital with an Intensiive Care Unit (ICU) setting.
When asked by the DPP on whether the liquid had a foul smell, Dr Mohd Adzrul said the mixture had the typical smell of saliva, blood and vomit.
Meanwhile, a government pathologist in her testimony concurred that both the accused may not have had any contact with VX nerve agent.
Dr Norashikin Othman, 44, from the Pathology Department at the Hospital Kuala Lumpur (HKL), during cross examination by defence lawyers, agreed that the report on cholinesterase enzyme level of Indonesia Siti Aisyah and Vietnamese Doan Thi Huong, could be interpreted as normal.
This came when the High Court resumed the trial after lunch break, where Dr Norashikin, having earlier testified that tests on the deceased revealed his cholinesterase enzyme was very low level at 344 unit per litre, while Siti Aisyah's and Doan's were 6,781 and 7,163 unit per litre respectively.
However, when answering a barrage of offensive questions from Doan's lawyer Hisham Teh Poh Teik and Siti Aisyah's counsel Gooi Soon Seng, Dr Norashikin explained that there were possibilities where humans could have been in contact with VX nerve agent but still had normal level of the enzyme.
Earlier, Dr Norashikin, who specialises in clinical toxicology, testified that when she conducted tests on the remains of Kim Chol, he (Kim Chol) had a low level of cholinesterase enzyme which controls muscle movements.
She said such condition could have been caused by either pesticide or a nerve agent.
Dr Norashikin, who was the fifth prosecution witness, said when she conducted the cholinesterase enzyme test on Kim Chol's remains, it showed 344 unit per litre.
Later into the trial, the prosecution called HKL forensic pathologist Dr Mohd. Shah Mahmood who testified that the victim's cause of death was identified as acute VX agent poisoning.
Dr Shah said he performed a post-mortem on the deceased together with HKL consultant forensic pathologist Dr Norliza Abdullah on Feb 15.
He also told the court that during post-mortem, they found the victim's lungs were heavier than normal weight for adult lungs.
"Average weight of the lung for an adult is usually around 300g," he said, adding that the deceased's lungs were oedematous as well as congested.
During examination-in-chief by deputy public prosecutor Wan Shaharuddin, Dr Shah said they also found marks of trauma on the upper and lower lips of Kim Choi, in the form of bruise and abrasion, and a small laceration, during external examination.
Trial continues tomorrow before judge Datuk Azmi Ariffin.
On March 1, Siti Aisyah and Doan were charged at the Sepang magistrate's court with murdering Kim Chol, 45, with four others still at large.
Kim Chol was later established to be Kim Jong-nam, the estranged half-brother of North Korean leader Kim Jong-un.
The duo allegedly committed the offence at klia 2 departure hall around 9am on Feb 13.
The charge under Section 302 of the Penal Code carries a mandatory death penalty.