A jury hearing evidence at the trial of a man accused of murdering Lorraine Cox in Exeter was told it was unlikely she died from a diabetic episode.
Failed asylum seeker Azam Mangori, aged 24, of Mary Arches Street, Exeter – also known as Christopher Mayer – is on trial at Exeter Crown Court where he denies murder.
He has pleaded guilty to preventing the lawful burial of 32-year-old Miss Cox’s body.
Medical expert Dr Paul McNally told the jury there was an ‘exceedingly low’ probability Miss Cox died as a result of her Type 1 diabetes in the early hours of September 1, 2020, in Mangori’s room above the Bodrum kebab house.
And the diabetic consultant said he believed Miss Cox’s death was not as a result of ketoacidosis – a life-threatening series of symptoms that can take up to 12 hours to develop that can lead to a diabetic coma.
Dr McNally said the chance of Miss Cox suffering a sudden cardiac death, which can be associated with diabetes, was ‘exceedingly remote’.
He told the court how a hypoglycemic diabetic – when blood sugar levels drop to below normal levels – can fall unconscious, be brain-injured, but remain alive because the heartbeat continues.
He said Miss Cox did not experience hypoglycemia on the night she died.
He said the chance was ‘lessened’ because she had eaten a kebab one to one-and-a-half hours before she was last seen alive, which would ‘substantially affect’ the glucose in her blood.
Dr Mc Nally, who based his findings on toxicology reports, said: “It’s my opinion that ketoacidosis does not explain the death of Lorraine Cox.”
The diabetic consultant added: “The likelihood of sudden cardiac death as a cause for Lorraine Cox is exceedingly remote based on the evidence I have reviewed.”
Dr McNally said: “We know that when a patient become unconscious from a severe hypoglycemic episode, although they may succumb to brain injury within one to two hours, it doesn’t mean their heart stops beating, as their heart is able to metabolise energy in other ways to keep the heart going.”
The expert witness told the jury a Type 1 diabetic would have to be ‘very intoxicated’ to impact their ability to recognise if they were hypoglycemic.
Home Office Pathologist Dr Amanda Jeffery told the jury the cause of Miss Cox’s death was unknown.
She said how Miss Cox died was ‘unascertained’ because of the decomposition of remains when they were recovered by police.
Dr Jeffery said she ‘cannot completely exclude’ Miss Cox was smothered, or died as a result of sudden cardiac death or a seizure.
She said two possible causes of death were asphyxia and strangulation
The jury heard Miss Cox had a vest top in her mouth when her remains were recovered.
Dr Jeffrey said it was ‘quite a long way at the back of the throat’, had the ‘possibility of obstructing the airway’ and ‘could have caused death’.
Dr Jeffery told the court: “It appeared to have been pushed into the mouth. A reasonable portion was in the back of her throat. It was saturated with body fluids.”
She added: “I simply can’t say whether it was pushed in before or after death.”
The jury was told the post-mortem found no evidence of mouth or neck injuries to suggest Miss Cox tried to remove the garment.
And there were no injuries found to say she was physically assaulted when she was alive, or had a knife used on her before she died.
The jury was told how Mangori used two knives to ‘disarticulate’ Miss Cox’s body – mutilation carried out after she died – ‘neatly and cleanly’ cutting off her limbs.
Dr Jeffery said of the system: “It suggests of the person having at least a degree of anatomical knowledge or understanding.”
Forensic toxicologist Alicia Pitcher said testing for amphetamine, ecstasy, cannabis, ketamine, heroin, methadone, diazepam and cocaine found no evidence of drugs in Miss Cox’s system.
She said decomposition prevented alcohol analysis.
Miss Pitcher told the jury toxicology results showed Miss Cox was ‘not suffering from ketoacidosis at the time of her death’.
The trial continues.
