The path toward expanding the charges against the doctors who are being held in pretrial detention for the death of Giorgos Mazonakis, while also seeking to determine the liability of the person or personswho supplied the anesthetic drugs propofol and midazolam to the clinic on Karneadou Street has opened following the detection of these specific substances in his system.
According to reports, from the Mazonakis family’s perspective, the toxicology tests clarify the cause of his death, as they believe it resulted from the simultaneous use of the two sedatives, propofol and midazolam. Due to their potent effects, each of these substances can cause respiratory depression, and it is evident that their simultaneous administration multiplies the sedative effect.
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Most of the substances detected during the toxicological tests conducted by the Mazonakis family’s expert witness, George Fitsialos, came as no surprise to the singer’s relatives, who were aware of the treatment regimen he was following.
The key findings that emerged—and which essentially complete the picture of what happened at noon on September 9 on Karneadou Street—are the detection of propofol, midazolam, and flumazenil. These constitute strong and indisputable evidence that Giorgos Mazonakis was not merely rendered unconscious—but through a combination of substances: propofol and midazolam. According to Mr. Fitsialos, the combined use of the two substances intensifies sedation.
Subsequently, in an effort to wake him up, they administered the antidote to midazolam, which is flumazenil. Propofol has no antidote, a fact that Dr. Ioanna Gaka, according to witness testimony, learned only after she had already administered it to Mazonakis and after it became necessary to call an anesthesiologist.
It should be noted that the DNAlogy laboratory conducted a test to detect 1,600 substances, while official results from the Aristotle University of Thessaloniki laboratory are pending and will be included in the case file. It is considered unlikely that they will overturn or even substantially alter the picture.
Four issues are now coming to the fore:
1. The liability of Dr. Ioanna Gaka is reinforced, as stated in the indictment against her: She herself testified that Giorgos Mazonakis had not concealed from her the substances he had taken, and as a doctor with access to the electronic prescription system, she could easily have seen the medications he was taking.
2. At the very least, Ioanna Gaka (the degree of responsibility of her husband and co-defendant must be established) used the substances propofol and midazolam, even though their use is prohibited by law in a general medical practice. Even to purchase propofol preparations from a pharmacy, an electronic or handwritten prescription is required, accompanied by a medical report for a specific patient issued either by a hospital, or a private clinic. To date, the investigation has not uncovered any such medical report pertaining to Giorgos Mazonakis. Consequently, criminal charges are expected to be filed for both the procurement and the use of these substances, and of propofol in particular.
3. The fact that at least Gaka knew what she had administered to Mazonakis raises clear questions about how she acted once the National Ambulance Service (EKAV) had been called. As has been reported, she stated that the patient collapsed while she was attempting to insert an IV catheter. Later, when the machines in the clinic “spoke,” it was determined that the man had been undergoing plasmapheresis for 42 minutes when he went into cardiac arrest.
And yet, if the National Ambulance Service (EKAV) had been informed of the exact procedures that had been performed and the medications that had been administered, there might have been time to save Mazonakis with a different course of treatment. As medical examiner Grigoris Leon stated earlier today on SKAI, in the event of a collapse following the administration of such substances, the National Ambulance Service (EKAV) should have been notified immediately, and the paramedics should have been fully informed. Calling EKAB in a timely manner, with a clear description of the substances and the failed attempt to reverse the sedation, could have increased the chances of survival, It should be noted that neither Gaka nor Theodoropoulos were even willing to accompany the man who collapsed in their clinic-business to the hospital.
4. Who supplied the Karnadou clinic with anesthetic preparations, given that their use is prohibited in clinics and is restricted to hospitals? The supplier or suppliers are expected to face justice.
The eight substances found in Mazonakis’s system
It should be noted that eight substances of particular interest to the criminal investigation into the circumstances and cause of his death were detected in Giorgos Mazonakis’s system.
The singer was undergoing treatment by a psychiatrist following his discharge from Dromokaiteio Hospital. As a result, the substances olanzapine and aripiprazole were detected; these are primarily prescribed to treat schizophrenia and bipolar disorder.
Toxicology tests also detected cocaine as well as benzoylecgonine, indicating both recent and past use of the drug. Benzoylecgonine is produced by the body when the liver metabolizes cocaine—its presence, therefore, is a significant toxicological marker of prior exposure to cocaine.
The fact that Giorgos Mazonakis, during Gaka’s initial testimony, was honest about the substances he had taken, increases the responsibility of the doctor who, in order to treat the agitation she observed and described, proceeded to administer not one, but two powerful sedatives, and subsequently the antidote to one of them. It is believed that the cocktail of sedatives contributed to Mazonakis’s death.
It should be noted that lidocaine, a local anesthetic, was also detected in the toxicology tests.
Source: Proto Thema
