KOODATHAI, Kerala — Shaju Skaria, the husband of Jolly Joseph, a 47-year-old woman accused of poisoning six relatives including Shaju’s first wife and his infant daughter, refused a post-mortem autopsy on his daughter Alphine, who died in 2014, and his first wife Sily, when she died in 2016, hospital authorities told HuffPost India.
A statement, signed by Shaju, declining an autopsy on Sily has been handed over to the police by the hospital, hospital authorities said. HuffPost India couldn’t review this document as it is now in the possession of the Kerala police.
This revelation is significant as authorities have, thus far, sought to blame all six deaths on Jolly. Shaju has been questioned by the police twice this month, but is currently not in custody and is yet to be accused of any of the murders.
Now interviews with doctors, and a review of Sily’s medical records, suggest the circumstances around her death could point continuing investigations in Shaju’s direction.
MK Mubarak, the administrative officer of the Santhi Hospital in Omassery told HuffPost India that Shaju “vociferously refused the duty doctor’s insistence that postmortem should be conducted” on his first wife Sily after she succumbed to what appeared to be an acute case of breathlessness. Sily was declared dead at 6:45 pm on 11 January, 2016.
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“The doctor, P Shamseer, who treated Sily had a hunch based on his medical investigation that Sily could not have died of natural causes,” Mubarak said. “He had communicated the same to Shaju and other relatives who were present at the hospital. Shaju Skaria, however, insisted that the death can only be natural and that postmortem should not be conducted”.
When the hospital continued to push for an autopsy, Mubarak said, “Shaju signed a document which stated that postmortem should not be conducted despite the hospital’s insistence that it should.”
The missing postmortems add a macabre twist to a series of deaths that have transfixed this sleepy village in Kerala, a state commonly described as God’s own country.
Police have not publicly shared any evidence
On October 5 2019, the police arrested Jolly Joseph on the suspicion of killing six people over a 14 year period by poisoning them with cyanide. (Here’s a useful explainer)
The police claim Jolly has confessed to the following deaths: Her first husband Roy Matthew’s mother Annamma Thomas’s death in 2002 at the age of 57; Roy’s father Tom’s demise in 2008 at the age of 66; Roy himself in 2011 aged 40; and Roy’s maternal uncle Matthew Manjadiyil in 2014 at the age of 68.
Jolly is also accused of killing Shaju’s two year old daughter, Alphine, who died in 2014, and Shaju’s first wife Sily, aged 41, who died in 2016. Jolly and Shaju married the following year in 2017. Shaju is a cousin of Jolly’s now-deceased first husband Roy.
It is worth noting that, at this stage, the police have not publicly shared any evidence that clearly links to Jolly or Shaju to all six deaths.
It is not even clear if each of these deaths occurred under suspicious circumstances. Indian law enforcement has a poor track record, particularly in cases requiring detailed forensic investigations, said Dr. Sheryl Vasu, former principal of Thrissur medical college and forensic expert. A confession before the police, like Jolly’s, is not admissible in court as evidence though the police can use it to guide their investigations.
The 2011 death of Roy was initially recorded as a suicide after a medical examiner found traces of cyanide in his postmortem. The case was reopened at the insistence of Roy’s brother Rojo, who lives in the United States. The police have exhumed five bodies, except for Roy’s, but are yet to analyse the remains.
As per his medical records, Matthew — Roy’s uncle who died in 2014 — had made at least 20 visits to Santhi Hospital between 2012 and ’14, as he suffered from hypertension and cardiac trouble and had a long history of ill health.
“As he had performed an angioplasty, the doctor in charge, Syed Sabith, did not raise suspicion,” Mubarak, the hospital administrator, said. “Going by the natural history, it was highly probable that he had suffered a natural cardiac arrest.”
Shaju and Jolly’s relationship
Shaju and Jolly’s marriage within a year of Shaju’s first wife’s death raised eyebrows at the time. But Shaju told Huffpost India he was steamrollered into the wedding.
“I did not want to get married to her immediately after the death of my wife. But she insisted that it could be a good arrangement for both my son and her two sons with Roy Mathew,” Shaju said.
When Jolly was first arrested, Shaju stood by her. But when HuffPost India spoke to him on October 8, he said he had found Jolly’s behaviour suspicious during their time together.
“She used to get a lot of phone calls and would never reveal whom she was contacting. I fell out of love with her, but remained married for the sake of the children,” he said.
Shaju’s father, Skaria, also sought to blame Jolly for the murders.
“She should be given the highest penalty if she has indeed committed the murders,” Skaria said.
Jolly is currently in police custody, so HuffPost India could not cross-check Shaju’s characterisation of their relationship.
Why Shaju refused an autopsy on his first wife
According to medical records at Santhi Hospital in Omassery, Alphine—Shaju and Sily’s infant daughter—was brought to the hospital on 1 May, 2014 with breathing trouble and cardiac complaints.
“The duty doctor Dr. Santhosh who was the pediatrician available at the time, had given primary care for the child. She was then referred to MIMS Hospital in Kozhikode. The child was shifted there in Santhi hospital’s mobile ICU,” Mubarak, the hospital administrator said. Alphine died in MIMS two days later, on 3 May 2014. No postmortem was conducted.
“She had suffered a bout of chickenpox in a few months before she took fatally ill,” Shaju told HuffPost India, adding that his family felt Alphine’s death could have been related to her bout of chickenpox. “We even suspected that she may have choked on the food which was given to her that evening. Post-mortem was unthinkable as she was only a child of two years”.
The drama surrounding this investigation has also cast a light on Santhi hospital, which attended to many of Jolly’s alleged victims.
Four months after Shaju’s daughter’s death, hospital records show, his wife Sily was brought to Santhi hospital in October 2014. Medical records state Sily was unconscious and found to have respiratory congestion.
“The family, including Shaju, had complained that she fell ill after having food. So the doctors on duty had washed her stomach,” Mubarak, the hospital administrator, said. “She was admitted for treatment and then referred to Baby Memorial Hospital in Kozhikode.”
Sily recovered, but two years later she was brought back to Santhi hospital with similar symptoms — fainting, difficulty in breathing and altered behaviour, her medical records at Santhi Hospital show.
“Dr. Shamseer found it suspicious that she got admitted for the second time with the same symptoms,” Mubarak said, adding that Dr. Shamseer insisted on an autopsy, only to be opposed by Shaju. Eventually, the hospital agreed not to perform an autopsy, but only after Shaju signed an undertaking recording that the autopsy was not being performed at his behest, hospital authorities said.
Ironically, the fact that Sily had been admitted with similar symptoms before was a reason why the hospital decided against conducting an autopsy against Shaju’s wishes. Her repeated visits were explained away as a history of illness.
Mubarak, the administrator, admitted that Sily’s case was considered to be suspicious enough to demand an undertaking from Shaju, but “not too suspicious” to insist on an autopsy.
Shaju, for his part, told HuffPost India he turned down the autopsy as he saw no need for it.
“There was nothing suspicious as there was a medical history of illness.” he said.
“She fell ill in October 2014, four months after the death of our daughter, Alphine. At the time she was under an ayurvedic medical course of treatment for fertility,” he said. “We wanted to have another child. After drinking the ayurveda medicine she fell ill and had seizures. The second time we thought the same trouble had only resurfaced.”
No right to oppose a postmortem
Forensic experts say Santhi hospital should have insisted on a postmortem.
“In India autopsy is the right of every citizen. Family members cannot deny this right,” said Dr. Sherly Vasu.
If a doctor feels a death is suspicious, the body should be handed over to the police, Dr. Vasu said, adding that doctors are often overruled due to a lack of coordination between hospitals and the police. As per the law, Shaju had no right to oppose a postmortem.
Santhi hospital fails to notice pattern
The drama surrounding this investigation has also cast a light on Santhi hospital, which attended to many of Jolly’s alleged victims. Doctors at the hospital said they didn’t notice a pattern because the deaths were several years apart.
“We realised that they were members of the same family only when the police asked for medical records of all the six patients. The postal addresses matched,” said Dr M Fawaz, who helped the administrative staff collate the information.
“In all these cases poisoning was not suspected because of either the medical history or the insistence of the family members that the cause of death could only be natural,” Dr. Fawaz said. “Seizures, heart and respiratory troubles and other symptoms need not necessarily lead us to the conclusion that poisoning is involved. Such complaints are common among a wide range of patients from victims of snakebite to those who suffer from epilepsy.”
Dr. Vasu, the forensic expert said that the problem was that most doctors did not perform mandatory medical tests to establish the probable causes behind the death of a patient.
“As most doctors are not trained in forensic medicine, they rely heavily on the version of medical history provided by family members,” Dr. Vasu said. “If several members of the family together insist that the cause of death is natural, the doctors could sway and change their opinions.”
“The lack of forensic training should be considered the real culprit here,” Dr. Vasu concluded.