The paramedics who treated Russian opposition politician Alexei Navalny after he fell violently ill on a plane last month found no increase in his blood sugar in initial tests and saw no signs of a metabolic disorder, five medical sources, speaking out for the first time, told Reuters.
Their accounts contradict the public diagnosis given by the doctors at Emergency Hospital No. 1 in Omsk, where he was treated, who said Navalny had fallen into a coma due to a metabolic disorder and experienced blood sugar levels four times higher than normal.
Three sources with knowledge of Navalny’s initial treatment by four paramedics before he was taken off the plane and at the airfield said glucometry, a glucose test, showed his blood sugar was 3-5 mmol (millimoles) per litre – within normal limits.
“There was no diabetes there, it was all checked at once and ruled out,” one of the sources said. “The indicator was normal, there was no problem in carbohydrate metabolism.” Reuters did not independently review the results of the tests administered by the paramedics.
Two other sources, also aware of his treatment at the airfield, told Reuters that Navalny’s blood sugar was not abnormal. Four of the five sources said the paramedics who saw Navalny observed a clinical picture of poisoning, with symptoms including stupor rather than any signs of a metabolic disorder.
“It was indescribable. Navalny was in a stupor, a state of confused consciousness, he could not explain anything,” said one of the sources, who had knowledge of his treatment at the airfield.
Germany, where Navalny was taken for further treatment after two days of treatment in Omsk, has said he had been poisoned by Russia with a rare nerve agent, Novichok. Berlin has demanded an explanation from Moscow, amid calls for sanctions. The Kremlin has said the accusations are “groundless” and that it has seen no evidence of poisoning.
Contacted for comment on the accounts of the paramedics’ findings, Alexander Sabaev, chief toxicologist of Omsk’s Emergency Hospital No. 1, disputed them.
“No, this is not true, the ambulance team saw sugar 13 mmol per litre,” he said. “Metabolic parameters can only be found by biochemical analysis, which can only be done in a hospital.”
A sugar level of 13 mmol per litre is well above normal.
Sabaev said further that Navalny had a “tendency to coma” and noted the paramedics did not administer atropine, a drug used when particular kinds of poisoning are suspected.
Three sources who said the paramedics saw clinical signs of poisoning said they gave him some unspecified injections to treat his symptoms but did not give atropine on the airfield because they did not suspect that kind of poisoning.
Sabaev said last week he had initially suspected poisoning because of what the paramedics and Navalny’s allies had told him and gave Navalny a small dose of atropine to treat a problem with his lungs once he was in the hospital..
Some medical sources have said that probably saved Navalny’s life, due to his critical condition. Atropine is used widely in emergency situations, including to treat the effects of pesticides or nerve agents such as Novichok, the banned substance Berlin said it found in Navalny’s body.
In his same public comments last week, Sabaev said he had changed his mind about poisoning after receiving laboratory test results that he said did not show any sign of toxins.
The information battle over what happened to Navalny has serious implications for relations between Russia and the West.
German Chancellor Angela Merkel has come under pressure to halt the nearly-completed Nord Stream 2 pipeline that will take gas from Russia to Germany.
The Kremlin has asked Germany to provide evidence of poisoning. Berlin state prosecutors announced on Friday they would hand over information if Navalny, who is emerging from the coma, agreed.
Asked to comment on the accounts of the paramedics’ observations and the initial test results, Kremlin spokesman Dmitry Peskov told Reuters he did not have information on “what kind of tests were taken from the patient by the doctors who met him at the plane, whether they took any tests at all and who these doctors are”.
An outspoken opponent of Russian President Vladimir Putin, Navalny was taken ill on 20 August when he collapsed on a domestic flight. Before boarding, he drank a cup of tea that his allies say was poisoned.
The paramedics at the airport in Omsk received a message from the pilot of the plane via air traffic control that a passenger with likely poisoning was on board, and based the therapy on this diagnosis, three sources said. Three sources said those with Navalny told the crew it must have been poisoning. Reuters was unable to reach the pilot or air traffic control for comment.
In the first 12 minutes after landing, the paramedics ruled out possible diabetic coma and stroke, they added.
“They worked by a method of elimination, excluded all those diagnoses that are now being voiced,” said one of the sources.
Anastasia Vasilyeva, Navalny’s ally and his doctor for the past several years, said the politician had never had metabolic problems and his sugar levels were normal.
“He is a healthy man, he did not have any serious abnormalities at all,” Vasilyeva told Reuters.
A source who observed the process of Navalny’s treatment in Omsk Emergency Hospital No. 1 said that the dozen or so clinicians treating him were in no doubt. “Everyone was sure that this was poisoning, the clinical picture was like this,” the source said.
The hospital did not immediately respond to questions sent on Saturday morning about this description of the medical team’s conclusions.
The regional health ministry, which oversees Emergency Hospital No. 1, reiterated that Navalny had high blood sugar levels and had been diagnosed with a metabolic disorder once hospital tests were complete.
Navalny is now being treated in Berlin’s Charite hospital, which has said he was suffering from “severe poisoning”. Asked about the sugar level in his blood and whether he had a metabolic disorder, a spokesperson for the hospital said: “We do not comment on ‘assumptions and speculations'”.
One source at the Omsk Emergency Hospital No. 1 told Reuters the order to release Navalny and let him be airlifted to Germany came directly from the Kremlin, with no reason given.
“We were sitting in the office (in the hospital) when a call came from the Kremlin and they said to release the patient … and the work started,” the source said. “Everyone breathed a sigh of relief.”
Kremlin spokesman Peskov denied the account. “No. This is not true,” he said. “The presidential administration does not supervise doctors either in Omsk or in other cities of our country.” (Additional reporting by Maria Tsvetkova and Rinat Sagdiev in Moscow and Andreas Rinke in Berlin; Editing by Mark Trevelyan and Philippa Fletcher)