Erin Patterson murder trial: Court hears from intensive care specialist who reviewed medical files — as it happened

Our coverage of the Erin Patterson mushroom trial is finishing for today.

Court is due back in session tomorrow.

You can read more about today's evidence with court reporter Kristian Silva:

Another day of evidence has concluded in Erin Patterson's trial. Today, we continued to hear from mushroom expert Tom May but also his colleague at the Royal Botanical Gardens, Camille Truong.

We then moved on to hear from the the manager of the landfill site where Erin's food dehydrator was found and an intensive care specialist who reviewed her medical files along with the results of tests taken after the deadly lunch.

1. 1.Dr May continued to give evidence today, telling the court death cap mushrooms don't have a particular aroma as they age, but that dried death caps smelt "very unpleasant".
2. 2.Dr Truong was sent a package from Monash Health containing beef Wellington leftovers. She said she analysed the leftovers and did not find any death cap mushrooms in the food.
3. 3.Koonwarra tip operations manager Darren Canty talked the court through CCTV footage and still images that showed a red car pulling into the facility and a woman getting out, opening the boot and carrying an item into a shed. A black Sunbeam dehydrator was found in the e-waste bin in the shed.
4. 4.Intensive care specialist Professor Andrew Bersten told the court he reviewed Erin's medical records and found no evidence of a cancer diagnosis.
5. 5.Professor Bersten said tests conducted on Erin after the lunch did not show any sudden damage to the liver or presence of pathogens, but said there was evidence of mild dehydration and an acute diarrhoeal illness.

 The ABC's Alexandra Alvaro has been in court for another day of evidence.

Here's what she heard today.

While the next witness is waiting outside the courtroom, Justice Beale determines there is no time left in the day, so we will hear from her tomorrow.

Court is adjourned.

Mr Mandy confirms Erin's lower haemoglobin levels earlier in her life, and finishes his questioning.

The prosecution brings the line of questioning back to Erin's low potassium.

Professor Bersten says there are many reasons as to why a person would have low potassium.

He tells the court that stress and certain medications can also shift potassium levels in the body.

Dr Rogers then asks about Erin's high haemoglobin levels.

Professor Bersten says it could be due to dehydration or poor kidney function.

She then asks whether Erin Patterson's symptoms could point to a more serious illness.

"Are those things consistent with a severe illness?" Dr Rogers asks.

"They could be, yes," Professor Bersten says.

Mr Mandy groups together Erin's symptoms, including her reports of diarrhoea, abdominal pain, low potassium and high haemoglobin.

Professor Bersten says taken altogether, they formed the basis of his conclusion that Erin Patterson was dehydrated and suffered from a diarrhoeal illness.

Mr Mandy needs to show Professor Bersten some of Erin's previous medical records, so we're out for another five minute break.

Professor Bersten says he agrees the trend must be focused on, but notes the tests may have also been done on different machines.

Mr Mandy then moves onto Erin's potassium levels, which were low and consequently supplemented by medical staff with IV fluids.

By the morning of her discharge from hospital, her potassium levels had risen back within normal ranges.

Professor Bersten says the reference ranges of potassium levels depend on the nature of how samples were taken, but agrees the levels were low and returned to an "acceptable" reference range.

We're back from break, with Colin Mandy SC up to cross-examine Professor Bersten.

He asks about the medical records of Erin Patterson provided to Professor Bersten for his analysis.

"You never assessed Erin Patterson yourself?" Mr Mandy says.

"No, I did not," Professor Bersten replies.

Mr Mandy then focuses on the haemoglobin levels recorded on tests of Erin Patterson's blood.

He says her haemoglobin levels fluctuated during the course of the day, and then cites medical records from 2013 and 2014 showing Erin Patterson's haemoglobin levels were lower.

Mr Mandy says a 2015 reading was elevated when Ms Patterson was suffering from a gastro illness.

Professor Bersten has not seen these records and the defence promises to provide them to him.

Dr Rogers asks Professor Bersten his opinion on Erin Patterson's illness.

"I thought there was evidence that she had a diarrhoeal illness," he says.

He cites a mild level of dehydration at Erin's presentation, and slightly elevated levels of haemoglobin and fibrinogen consistent with a sudden illness.

However, he notes the illness did not appear to be severe and there was no other biochemical evidence of a liver injury.

He again confirms to the court that Erin's vital signs were all normal otherwise.

The prosecution finishes its questioning, and before the defence gets a change to question Professor Bersten, we head to a break.

Professor Bersten is asked about a stool sample taken from Erin Patterson, designed to find foreign pathogens.

"The indication is that no pathogens were detected," Dr Rogers says.

"That's correct," Professor Bersten says.

Professor Bersten is then asked to explain sophisticated blood and liver tests that were run on Erin Patterson.

The tests were run on blood taken at Leongatha Hospital when Ms Patterson first presented.

He says many of her results fell within standard, reference ranges.

Professor Bersten also notes her creatinine and haemoglobin levels had fallen towards reference ranges since the initial tests.

He again states that the ratios of urea to creatinine in Erin's body were not consistent with dehydration.

Erin Patterson was transferred from Leongatha to the Monash Medical Centre, where she stayed overnight.

The notes from her ambulance transfer state she was stable during her transfer between the facilities.

Her vital signs were within a normal range when she arrived at Monash.

Dr Rogers says toxicologist cleared Erin Patterson at Monash, and Professor Bersten agrees.

Professor Bersten notes point-of-care tests conducted on Erin Patterson, which provide rapid results.

It found normal lactate levels, normal urea levels, creatinine levels at the upper end of the reference level and slightly high haemoglobin levels.

Professor Bersten says the readings were not consistent with dehydration.

Earlier in the trial, we heard Don Patterson suffered from extremely high lactate levels following his poisoning with death cap mushrooms.

Dr Rogers asks Professor Bersten about gastroenteritis, its symptoms and its causes.

She then asks him about Erin Patterson's alleged illness after the lunch.

He says there were three components to her illness: her initial presentation, the notes from the ambulance service and the notes from Monash Health.

Professor Bersten and Dr Rogers begin going through the series of events following Erin's first presentation to hospital.

They note a nurse documented "liquid bowel actions", and normal vital signs aside from a high pulse.

The next witness called into the box is Professor Andrew Bersten.

Professor Bersten is an intensive care specialist, and was supplied with medical records relating to Erin Patterson.

Dr Rogers begins with the alleged cancer diagnosis.

"Is there sufficient evidence in Erin Patterson's medical files to support the assertion she was diagnosed with cancer?" she asks.

"I could not find evidence to affirm that statement," Professor Bersten replies.

After identifying the item deposited, Mr Canty tells the court he had an employee look for the item deposited, describing it as looking like a microwave.

He says a police officer came to collect it the same day.

The defence has no questions and this concludes Mr Canty's evidence.

Up next, a statement from Senior Constable Paul Burns from Wonthaggi Police Station is read to the court.

Senior Constable Burns describes going to collect the dehydrator from the tip, taking photos of it in the e-waste bin.

These photos are then shown to the court.

Senior Constable Burns says he then wrapped the dehydrator in plastic and deposited it in the evidence room at the Wonthaggi police station.

Mr Canty says police contacted him on August 4 with details of an EFTPOS transaction linked to the Koonwarra Transfer Station and Landfill at a certain time and date.

A printout of the EFTPOS transaction is shown to the court.

Mr Canty says he then matched the transaction against their own records.

The transaction shows that the item deposited was under the category of less than 40 litres of e-waste.

We're taken back to the CCTV footage, and some still images that have been picked out of it.

Mr Canty says Ms Patterson's car can be seen stopped outside a storage shed, which contains an e-waste bin, a bin for mattresses, batteries and other miscellaneous items.

The following still image shows a woman carrying an item into the shed.

Another photo is shown to the court of the black Sunbeam dehydrator in the e-waste bin at the tip.

Two more still images are now shown to the court from another angle.

These are a bit more zoomed in and from overhead, showing Ms Patterson’s red car at the tip.

Darren Canty is the operations manager for waste management specialist Dasma Group.

The Dasma Group operates the Koonwarra Transfer Station And Landfill where a dehydrator was found.

He tells the court he was contacted by police regarding the tip, and made a copy of CCTV footage which showed a woman arriving in a red 4WD.

Footage is then played to the court, showing a red car pulling into a large gravel carpark next to a shed.

A person gets out and opens the boot, and is seen going towards the green shed. The person comes back, shuts the boot.

Mr Canty confirms this is the footage he copied and sent.

We return for the afternoon session in courtroom 4.

The prosecution calls its next witness, Darren Canty.