There is “no evidence” that an admission to murder made by Jozef Puska after undergoing treatment in hospital was related to the effects of any drug, a Central Criminal Court jury has been told.
The only drug still in Mr Puska’s system when he made that admission in St James’s Hospital, Dublin, on January 14th 2022, two days after the killing of Ashling Murphy in Tullamore, was Oxycodon, Professor Michael Ryan, who has qualifications in pharmacology and toxicology, said.
The maximum amount of Oxycodon still in Mr Puska’s system by 6pm on January 14th was 8.25mg and there was no evidence the admission made by him related to the effects of Oxycodon or any other drug administered to him at the hospital, he said.
He had never heard of anyone’s ability to communicate being affected by taking less than 10mg of Oxycodon, an opioid analgesic similar to morphine, the witness said.
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He had never heard of anyone confessing to murder after being administered a small dose of Oxycodon, he added.
Prof Ryan was giving evidence on Tuesday in the continuing trial of Mr Puska (33), of Lynally Grove, Mucklagh, Co Offaly.
A native of Slovakia living here 12 years, Mr Puska has, through an interpreter, pleaded not guilty to the murder of Ms Murphy (23), at Cappincur, Tullamore, on January 12th 2022.
The jury has heard Ms Murphy died as a result of 11 stab wounds to her neck.
Mr Puska, the jury also heard, was admitted to St James’s Hospital on January 13th 2022, having said he was stabbed in the stomach in Blanchardstown the previous day, and was discharged on January 18th.
The jury has been told Mr Puska made certain admissions, through an interpreter, around 6pm on January 14th after being told by Detective Sgt Brian Jennings he was a “person of interest” in the investigation into the death of Ms Murphy, including that he had said: “I did it. I murdered. I am the murderer.”
On Tuesday, Prof Ryan said he was head of University College of Dublin’s Department of Pharmacology for ten years and taught on issues including the effects and side effects of drugs.
He told Anne Marie Lawlor SC, for the DPP, he examined an “extensive” file of records concerning Puska’s hospital treatment and time in Garda custody with a view to examining whether any of that could have had a bearing on Mr Puska having made admissions.
He prepared a report concerning whether any medication or substance in Mr Puska’s system or body had any bearing on his having making admissions to gardaí after 6pm.
He had concluded, at the time of making the admissions, there would have been no influence of any of the drugs affecting his behaviour at that time.
He said the medical issues for Mr Puska began on the morning of January 13th when an ambulance was called to bring him to hospital where he underwent laparoscopic or keyhole surgery on the night of January 13th 2022. The operation ran from about 20.45pm for two hours.
He agreed with Ms Lawlor the medical team had found “no significant damage” to Mr Puska. The puncture wounds he had sustained were all closed, he said.
Professor Ryan said the matters he had examined included all the drugs administered to Mr Puska, the dosage, and their “half-life”, how long they stayed in the system. From the time a drug is in the system, it begins to have effect but is also being metabolised and absorbed, he said.
Morphine, for example, would be gone from a person’s system within two to three hours, he said.
He concluded that much of the drugs administered to Mr Puska would have been eliminated from his body by the time he made the admissions about 6pm on January 14th.
He had also factored in that a hospital patient is monitored very closely postoperatively, he said.
If a patient is in pain, they are given analgesics and Mr Puska was administered Oxycodone in dosages which were “absolutely at the lower end of the scale”, he said.
He was given dosages of 2mg at 23.47pm on January 13th and another one mg five minutes later, he agreed. He got further dosages of 5mg at 3.42am on January 14th, another 5mg at 11.38am, another 5mg at 15.31pm and another 5mg at 16.04pm.
He had concluded Mr Puska could not have had more than 8.5 to 9mg, probably about 8.25mg in his system, by 6pm on January 14th. This drug is administered orally so not all of it would be absorbed, he added.
The witness said he also factored in that Mr Puska was monitored during January 14th and was reported to be alert and orientated with mild to moderate pain.
He said substantially higher dosages can cause side effects such as dizziness, nausea, vomiting and constipation, he said. The patient and the pain they have can lead to higher dosages, involving hundreds of milogrammes, and care has to be taken because of the drug’s addictive potential, he said.
Studies have found that, below 10mg, there are no side effects, he said.
Under cross-examination, Prof Ryan agreed with barrister Seoirse O Dunlaing, for Mr Puska, he has no clinical experience but said he has some personal experience as a patient.
He said he used his expertise in pharmacology and toxicology to reach his conclusions and the fact Mr Puska was being monitored by medical professions while in hospital.
He agreed Mr Puska had no family members with him in hospital at the relevant times and that he had communicated through an interpreter. He said his focus was on the drugs administered to Mr Puska and not on the Garda statements and notes related to the admissions made by Mr Puska.
He was not aware of one detective having recorded on January 14th that Mr Puska had asked that Garda whether he, Mr Puska, was speaking to him earlier. He was provided with very extensive Garda notes but had considered his responsibility was to examine the drugs administered and their effects, not the Garda records, he said. A post-operative situation is stressful and he did not consider it was unusual for Mr Puska to have asked the Garda what he did.
Dr Affan Bajwa said he examined Mr Puska at Tullamore Garda station at 2.33pm on January 18th 2022 and had indicated to the member in charge Mr Puska was fit for questioning. He had no active medical concerns about Mr Puska’s health when he left the station, he said.
Mr Justice Tony Hunt has told the jury there are two more prosecution witnesses left and has released them until tomorrow while legal issues are addressed in their absence. The trial will resume before the jury tomorrow when the prosecution case is due to conclude.
