06 October 2011

Dr Thomas Hoogland takes the stand...

Today the Kuala Lumpur High Court will deliver its decision on Prime Minister Najib Abdul Razak and Rosmah Mansor's applications to set aside the subpoenas issued for them to testify in the sodomy trial.

Justice Mohamad Zabidin Mohd Diah is expected to deliver his decision first and then continue on with Anwar Ibrahim's trial.

Najib and Rosmah's lawyers had claimed that they are not relevant and material witnesses for Anwar's defence. Their applications are supported by the prosecution.

Lead defence counsel Karpal Singh, however, has argued that Najib could tell the complainant Mohd Saiful Bukhari Azlan's state of mind when they met, two days before the alleged sodomy incident at the then deputy premier's Taman Duta home in June 2008.

After the court announces its decision, Dutch spine specialist Dr Thomas Hoogland who had performed surgery on Anwar's back in 2004 is expected to take the stand.

9.37am: Court starts with Justice Zabidin presiding.

Now he will deliver the decision. After hearing and reading the affidavits, the court agrees to allow Najib and Rosmah's application.

9.41am: Dr Thomas Hoogland takes the stand. He is an orthapaedic surgeon and is aged 66. He lives in Munich, Germany.

N Sankara is questioning.

"I am here to give evidence as Mr Anwar's doctor," Hoogland said

9.44: Hoogland states his credentials, his academic qualification and that he has a Phd from the Birmingham University.

9.46am: Hoogland says he has performed 14,000 spine surgeries. He has written five books on spine surgery. He is a member of the German Society of Orthapaedics and his main interests is orthoscopic surgery.

10.04am: Hoogland explains the lumbar part of the spine and its functions. He explains that a slipped disc is excruciating pain to the back. It can cause a lot of problems, particularly when standing.

10.08am: Hoogland uses computer images put up on a white screen to explain from the witness stand. He explains that a stepnosis is a narrowing of the canal in the spine.

10.17am: Hoogland says he met Anwar in April, 2001, while he was in prison under police surveillance.

He saw him again in Sept 2004, after Anwar was released.

"Anwar arrived at the Alpha Clinic in Munich, Germany. It was clear and decided then that he undergo surgery."

"He had surgery with local anaesthesia."

10.19am: The witness says he prepared his report on the Anwar surgery and gave Anwar a copy of the report upon the politician's request.

10.21am: He says Anwar has lumbar sclerosis, which affects the patients leg and hand.

"In particular, the left leg, following an old neck problem."

He said he met Anwar on Sept 4, 2004, and he had complained then of being assaulted while in police custody six years’ earlier.

10.24am: The witness says that the longer the nerve is irritated, the more likely it would result in subsequent loss of function.

10.30am: Anwar has problems bending forward and with the mobility of his spine.

10.32am: Hoogland says that based on the system he made the diagnosis of lateral stonosis, which would narrow the canal of the spine.

10.36am: He says Anwar was in the hospital for three weeks, from Sept 6 until 27 Sept 2004.

"There was no complication."

10.43am: Anwar has, however, pain on the left side.

10.43am: Hoogland is asked whether the problem would recur, to which he replies the recurrence rate is 5-20 percent.

"As to sclerosis it is 15 percent."

10.47am: Hoogland says degeneration of the bones is not a natural process, but it is quite normal.

10.50am: Hoogland's medical report is marked as evidence. Hoogland explains the surgery performed on Anwar on Sept 6, 2004.

10.56am: Hoogland's surgery report is marked as evidence.

11am: Hoogland says Anwar's fourth and fifth lumbar disc has healed, unlike before in 2001.

11.02am: Sankara asks for a short break, to which the judge allows.

11.45am:
Court resumes. Hoogland says three months after the surgery, Anwar went again to his Munich clinic in February 2005. The witness says on Feb 7, he did examination and it indicated that Anwar continued to suffer from back pain every now and then.

11.50am: He says there was significant improvement in Anwar's condition before the surgery, but there was not much change after he was discharged from the hospital on Sept 24, 2004.

"The back muscle is important to control the back movement."

11.54am: Hoogland says he has treated many Muslim patients from Middle Eastern countries, and praying is always an issue.

"I advised Anwar to perform prayer to do it carefully and slowly.

"You can bend forward quickly but when you go back, do it very slowly (moving back upright and standing)."

11.58am: Hoogland says he advised Anwar to rise up slowly as it could cause severe pain and injury to the disc.

"When you move too quick, it would result in more rubbing and result in more athritis.

"Anwar has severe athritis."

12.01pm: Hoogland says he last inspected Anwar on Sept 8, 2011. Anwar has athritis and stenosis.

12.03pm: The spine doctor says that Anwar has limitation in the mobility of his back, numbness on the left side and leg.

12.05pm: There was significant pain on the left side and left leg.

"After surgery in 2004, the straight recreation test was negative, however now it is positive."

"Tests that I did there is evidence of compression on the left side. Reflexes were normal."

The witness says Anwar has weakness on his left foot. There is weakness in both strength and sensation.

12.10pm: He says there is some limitation to Anwar's back movement as it is confined to 10 degrees.

"We can bend 90 degrees - no problem, but when bending 15 degrees or 10 degrees, he will have a pain."

12.16pm: Hoogland testifies that Anwar has significant stenosis in the neck.

12.20pm: He also says there is a serious athritis and stenosis on the neck where it will have a curve.

12.24pm: Sankara asks whether a person can have rigorous moving activity using the pelvic.

Hoogland:
As soon as you go extending the painless thing and if you force the motion, there will be pain as certain motions are blocked.

12.27pm: Hoogland shows Anwar's MRI results taken in September 2011.

He points out the area where the fourth and fifth vertebrae is enlarged.

The witness also shows pelvis and the left side are slightly larger than right.

"It would see similar changes when we reached the age of 60 to 63 and result in limitation of motion.

"There is severity of athritis at lumbar 5 level."

12.36pm: He says there was in between the joints in the spine L4 and L5.

12.38pm: He show the athritis attacking Anwar's lumbar 4 and 5. Referring to the MRI scans, Hoogland shows there are bone spurs on both lumbar 4 and 5.

12.44pm: Hoogland says there are signs of arthiritis on the fourth and fifth lumbar resulting in pain.

12.52pm: The spinal canal in C5 and C6 is narrowing.

His diagnosis, there is degeneration of spine at various levels, partial function loss of lumbar 4 and 5, nerve root depletion in L (lumbar) 4 and 5.

"There is stenosis in C5 and C6. His main complaint is back pain."

Hoogland says physiotheraphy was suggested.

12.55pm: Sankara asks for a break and wants a copy of Saiful's in-camera testimony.

12.56pm: Judge Zabidin agrees and says the court will resume at 2.30pm.

2.37pm: Parties return to court.

2.50pm: Court resumes

2.52pm: Hoogland(left) diagnoses Anwar's condition as multi-segmental degeneration of lumbar spine. He explains it is not the whole spine, but towards lumbar 4 and 5, where there is some liquid.

The witness says there is weakness in the foot and numbness to the left and it can be attributed to the L5 (lumbar) bone root.

The MRI scan done this year had earlier been tendered as evidence.

2.57pm: Hoogland explains that Anwar cannot do straight-leg raising tests properly as a result of his condition.

2.58pm: Witness says surgery has led to a lot of improvement, but the disease process has continued since the 2004 operation.

Sankara: He still feels pain since 2004?

Hoodland: We have achieved quite a lot of improvement, but the limitations is limited as there is arthritis, as it has slowly worsened his back.

3.01pm: After surgery in 2004, there was intermittent back pain.

3.03pm: Hoogland says after the operation, Anwar was left with arthritis. Between 2004 and 2008, a little more worsening has occurred.

"The most increased problem could have been in 2004 to 2008. We are dealing with three problems: nerve damage, stenosis causing a lot of limitation in his back, and the damage to the joint has caused the on-going problem."

Sankara: As well as arthritis?

Hoogland:
Yes.

Sankara: Would he able to kneel without pain?

Hoogland: He needs to move slowly to prevent pain. As stated earlier, he has problems to bend 10 to 15 degrees.

3.09pm: Sankara asks next proceeding to be in camera.

3.10pm: Public gallery is empty as judge asks those not related to leave. He said since there is no objection, and orders proceeding to be in camera.

Wan Azizah, however, chooses to wait outside instead of remaining to hear the proceedings in camera.

3.23pm: In camera proceeding finishes and public is allowed back in and. The proceeding for the day has ended.

Trial to continue tomorrow at 8.30am.

source:malaysiakini

cheers.

Breaking News.

Court strikes out subpoenas on Najib, Rosmah

Premier Najib Abdul Razak and his wife Rosmah Mansor will not be testifying in the Sodomy II trial as they are "not material witnesses".

This follows the Kuala Lumpur High Court's decision today to throw out the subpoenas served on them to testify as defence witnesses in Anwar Ibrahim's trial.

In allowing Najib and Rosmah"s application to be set aside, Justice Mohamad Zabidin Mohd Diah said they are not relevant and material witnesses in the trial.

"Hence, I allow the applications and order the trial to continue," the judge said.

Najib and Rosmah can skip trial, court rules

Najib, Rosmah dibenar elak jadi saksi kes liwat Anwar

cheers.

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