PROVIDENCE, R.I. -- A diabetes expert testified Friday that he is 100 percent sure Martha 'Sunny' von Bulow's first cgma was caused by an insulin shot and 99 percent sure the same thing caused her second coma.
Dr. Robert Bradley, president of the Joslin Diabetes Center in Boston and a Harvard Medical School associate professor, was the second expert witness in two days to tell jurors in Claus von Bulow's retrial that insulin shots caused his wife's 1979 and 1980 comas.
Von Bulow, 58, is charged with attempted murder for allegedly injecting his utilities heiress wife with insulin to aggravate her low blood sugar.
The state claims the Danish socialite-financier tried to kill his wife so he could marry his former mistress and inherit $14 million. His 1982 conviction was overturned on constitutional grounds.
Bradley testified for the prosecution after von Bulow's defense attorneys tried unsuccessfully to get the judge to block the earlier testimony by another doctor on grounds it was inconsistent and uncertain.
Superi/r Court Judge Corinne Grande ruled there were no inconsistencies large enough to strike the testimony of Dr. George Cahill.
Cahill's testimony Thursday was among the most important presented by prosecutors, defense attorney Thomas Puccio said when he made the motion.
'He's saying the comas were caused by insulin injection. So we have in his testimony, if believed, a critical part of the prosecution's case,' Puccio said.
The attorney charged Cahill could not testify with 'a reasonable degree of medical certainty' that the two comas were caused by insulin shots.
For that reason, he said, the judge should strike the expert witness's entire testimony or at least his medical opinion, 'because his testimony in a critical area, if believed, could result in a conviction in this case.'
Assistant Attorney General Marc DeSisto conceded that Cahill, under one of the most intense cross-examinations of the retrial, 'did not speak in a consistent tone.'
But DeSisto said the doctor's medical opinion was based on a 'high probability' that insulin caused the comas. He pointed out that the doctor put the probability at 90 percent for the second coma.
The state had called Cahill, a Harvard Medical School professor who has won internadional awards for his research, to interpret a string of blood sugar and insulin readings from Mrs. von Bulow's medical record. She remains comatose in a New York hospital.
After Grande denied the defense motion, Bradley corroborated much of Cahill's testimony, with even more certainty.
Assistant Attorney General Henry Gemma asked Bradley how certain he was the first coma was insulin-induced.
'One hundred percent,' Bradley said.
The second coma? Gemma asked.
'I'd say 99 percent,' he said.
Bradley ruled out the possibility that alcohol or drugs, as von Bulow's attorneys claim, could have caused her irreversibly comatose state, which he described as 'death, massive death, of large numbers of brain cells.'
He said it had to be insulin because Mrs. von Bulow's blood sugar remained low after she was hospitalized in a coma, despite massive sugar injections, indicating insul)n was eating her blood sugar.
'The fall in blood sugar is an immediate trigger. It immediately told me there was an excess of insulin aboard,' he said.
Bradley came to that conclusion on the second coma even without taking her high insulin level into account, he testified.
'It's sort of the frosting on the cake, if you will,' he said.
The only reason he was 99 percent sure insulin caused her second coma, not 100 percent, was 'the outside chance that she might have had a large dose of sulfonylurea,' a diabetes drug that can prompt similar symptoms, he said.
But Bradley said there was no evidence Mrs. von Bulow had taken that drug.
During cross-examination, Puccio cited a study that showed a patient with sugar levels similar to Mrs. von Bulow's without any insulin injection. Bradley said the cases were not comparable.
Puccio also tried to get Bradley to admit aspirin, alcohol and other drugs could have caused her comas.
'Not in Mrs. von Bulow. Not at all,' Bradley said.
