The Law vs. the Truth: What Happened in Manchester?

Part 19 - Medical Treatment

Part 19 - Medical Treatment

Introduction

The last few Parts of this series have raised questions regarding how many people were injured during the Manchester Arena incident, how they were injured, the nature of their injuries, the lack of convincing evidence of major blood loss, the fact that so few “survivors” were provably present at the concert, and the peculiar nature of the “survivor” testimonies.

This Part and the next ask what medical treatment was received by those said to have been injured by Salman Abedi’s TATP shrapnel bomb. Obviously, with blood and body parts and seriously injured people everywhere, as the legacy media has made out, there should be ample evidence of casualties receiving treatment.

Predictably, however, the opposite proves to be the case.

The following analysis begins by asking what help was given to those in the City Room who were reportedly injured. The focus is on the 22 named fatalities, for whom the most information is available, and consideration is given to the assistance provided by first responders, principally British Transport Police, Emergency Training UK, and Showsec.

Three North West Ambulance Service (NWAS) paramedics (Patrick Ennis, Lea Vaughan, and Christopher Hargreaves) entered the City Room eventually. What treatment, if any, did they provide?

CCTV evidence of casualties being treated in the City Room is discussed, as are two witness testimonies by members of the public who claim to have treated the injured, namely, Darron Coster and Daren Buckley.

Defibrillators are mentioned in relation to multiple casualties in the Inquiry transcripts. What role did they play on the night?

It is well known that over two dozen casualties were evacuated from the City Room on “makeshift stretchers” and carried across the footbridge and down two flights of steps to the station concourse below, where the Casualty Clearing Station was set up. Why did this happen, and was it justified?

The Casualty Clearing Station and the treatment provided there will be the subject of Part 20.

The most powerful evidence of medical treatment being provided to critically injured patients seemingly comes in the form of multiple interlocking witness statements by medical professionals (paramedics and hospital doctors) in relation to the three named fatalities who were evacuated from the City Room and taken to hospital, i.e., John Atkinson, Georgina Callander, and Saffie-Rose Roussos. That evidence is presented and analysed.

Finally, to underscore the very significant difference between that evidence and the Inquiry’s general refusal to address the medical treatment of specific individuals, Eve Hibbert’s journey to hospital will be discussed through the lens of ambulance driver Garry McMullen’s testimony.

What Help Was Given in the City Room?

Following the detonation of Salman Abedi’s rucksack device, numerous first responders rushed to the City Room as the public fled. Many of them belonged to British Transport Police (BTP), Emergency Training UK (ETUK), and the contracted security provider, Showsec.

British Transport Police

According to the Inquiry report, BTP officers performed the following functions in the City Room (§13.43-13.53):

“Assistance”: Medic PC Ben Davidson assisted Georgina Callander. PC Jessica Bullough assisted Jane Tweddle. PC Jessica Bullough and Detective Sergeant (DS) Christopher Broad assisted John Atkinson. PC Dale Edwards, PC Richard Melling, PC Lee Owen and PC Michelle Johnson assisted Kelly Brewster. PC Bullough assisted Michelle Kiss and Philip Tron.

More specifically, PC Thomas Campbell and PSCO Jon Morrey each applied a bandage to John Atkinson. PC Stephen Corke, PC Mark Emberton, PC Jane Bridgewater, PC Bullough, PC Edwards and PC Michelle Johnson helped with John Atkinson’s evacuation. Sergeant Wilcock “checked on” Wendy Fawell. Temporary Detective Constable Mark Haviland helped to find a makeshift stretcher for Saffie-Rose Roussos, and PC Simon Trow helped carry Saffie-Rose Roussos from the City Room to Trinity Way. Sergeant John Whitaker and PC Corke checked Marcin Klis for a pulse.

Cardiopulmonary Resuscitation (CPR): PC Bridgewater gave CPR to Alison Howe and Elaine McIver. PC Trow gave CPR to Elaine McIver. PC Danielle Ayers gave CPR to Kelly Brewster. PC Johnson helped to give CPR to Sorrell Leczkowski.

Covering the deceased: PC Corke covered Jane Tweddle, Michelle Kiss, and Kelly Brewster. PC Johnson also covered Brewster. PC Bullough believed that it was likely she covered Philip Tron. PC Johnson covered Sorrell Leczkowski.

BTP staff were not issued with tourniquets (§12.130), nor were they trained in the application of a tourniquet (§12.128).

I count 17 different BTP staff here who are officially on record as having attended in various ways to the 22 named fatalities. Yet, what exactly did they do? “Assistance” is a vague, non-medical term, as are checking, carrying, and covering. At most, when it comes to medical treatment, four BTP staff gave CPR to four of the 22 named fatalities.

Emergency Training UK

ETUK was the first aid provider contracted by SMG, the venue owner. However, ETUK staff on the night of May 22, 2017, lacked the skills to “perform to the standard that should be required of an event healthcare service” (§16.120).

Ian Parry

ETUK head Ian Parry appeared not to have treated anyone when questioned by Saunders:

Q. Did you actually yourself carry out any treatment of anybody, or were you directing others?

A. Initially I was doing the assessment, and then directing.

Q. To start with, you went around deciding which could be helped and which were dead?

A. Yes, absolutely. (02:47:00)

Despite instructing his team to concentrate on cases of catastrophic bleeding, Parry made no use of the tourniquet that he had in his pocket because he “forgot he had it on him” (§16.103).

Far from helping to treat the named fatalities, Parry advised stopping CPR on Megan Hurley (p. 34), Kelly Brewster (p. 47), and Jane Tweddle (p. 32).

Ryan Billington

The ETUK second-in-command was Ryan Billington, who was only 20 at the time. According to the Inquiry report, Billington radioed to his colleagues:

This is a major incident. Follow major incident protocol. If people have no pulse, we can’t help; treat catastrophic bleeding. (§16.104)

Major incident protocol provides a pretext for abandoning the normal medical practice of treating injured people in favour of rapidly triaging a large number of casualties, unless an airway needs to be opened or catastrophic bleeding can be stemmed.

Billington “instructed people nearby that they should use whatever they could find in order to get people out of the City Room” (§16.107), regardless of the dangers. He liaised with Patrick Ennis (NWAS) (§16.109), who was in agreement. The official records do not mention him treating anyone, however.

Other ETUK Staff

According to the Inquiry report, seven other ETUK staff (Elizabeth Woodcock, Marianne Gibson, Kristina Deakin, Sarah Broadbent, Craig Seddon, Zak Warburton, and Ken O’Connor) “assisted,” “attended to,” “checked,” and “knelt beside” those on the floor (§16.116-16.118).

When asked at the Inquiry “Were all of your first aiders capable of dealing with catastrophic bleeding?,” Parry gave a strange reply: they were capable, but “whether they wanted to do it, psychologically?” (2:50:10). Which suggests that ETUK staff may not, in fact, have dealt with catastrophic bleeding.

ETUK staff did not carry tourniquets (§16.115), so were of limited use in preventing catastrophic blood loss. As noted in Part 11, CCTV footage shows ETUK staff leaving the scene with no obvious signs of blood on their uniforms.

In sum, it is questionable whether ETUK provided any meaningful medical treatment on the night.

Showsec

Seven Showsec staff are cited in the Inquiry report as having dealt with casualties. Jordan Beak used T-shirts as dressings and to cover Michelle Kiss (§16.138). Robert Atkinson “did what he could to assist the casualties” (§16.139). Megan Balmer “did what she could to help the casualties, including applying tourniquets, dressing wounds and offering reassurance” (§16.141). Amy Barratt “did what she could for those who were injured” (§16.143). Usman Ahmed, Jade Samuels, and Akeel Butt “tried to help those who were killed by the explosion” (§16.144). Only Balmer here appears to have provided any kind of medical treatment, and even then it is far from clear to whom she applied a tourniquet.

Other “Assistance”

Many more individuals who sought to assist the 22 named fatalities, including members of the public, GMP officers, Travel Safe officers, and Northern Rail staff, are named in the Inquiry report, and most can be found giving evidence at the Inquiry. Again, however, they were not providing medical treatment per se.

Unarmed GMP officers, for instance, “generally lacked the skills necessary to deal with catastrophic bleeding and other life-threatening conditions” (§13.390).

Darah Burke, a GP who allegedly (see Part 18) happened to be present in the City Room at the moment of detonation, claimed

The trauma I saw was very severe. There wasn’t an awful lot I could do, except to triage survivors and direct help to wherever it was most needed.

When he went to assist Robby Potter on the footbridge — who had supposedly just been blown backwards by a TATP shrapnel bomb (p. 9) and was, according to Rob Grew (another member of the public), “pretty much unconscious” — Burke found that “There wasn’t really a lot of assistance required, if I may say” (p. 61).

It is hard to say for sure, but does the 22:47:06 CCTV image below show Potter on the footbridge with little more than a bandage wrapped around his right trouser leg?

Sources of snippets: Richplanet.net and Mirror

What Treatment Did NWAS Paramedics Offer?

Advanced Paramedic Patrick Ennis

The first paramedic did not arrive in the City Room until 22:53 (§10.120). And when he did, Patrick Ennis was not there to treat any patients:

Q. And when you went into the City Room, was it to obtain further information, to treat any casualties who might be there, or a combination of the two or something else?

A. It was to ... It wasn’t to treat casualties because that wouldn’t have been appropriate at that stage based on my role, but it was to gain situational awareness in order to be able to pass that information back and then to potentially then take one of the strategic roles , i.e. operational commander, until I was relieved of that role.

Q. […] Why at that stage would it have been, to use your word, inappropriate to treat casualties ?

A. Because to be distracted, for want of a better word, by individual patient care at that time would have been to the detriment of the overall management of the greater number of casualties, but also of the overall management of the major incident. So to be able to take on the operational command role, it is necessary to be removed from scene and necessary to not treat casualties at that stage.

SIR JOHN SAUNDERS: That’s part of your training?

A. Yes. (pp. 96-97)

Ennis’ colleague Lea Vaughan confirmed to the Inquiry that the role of a primary triage officer entails that “you sometimes don’t even engage with patient treatment” (p. 65).

This is in accordance with professional standards, i.e., the National Ambulance Resilience Unit Major Incident Initial Action Cards, Task 7:

Source: National Archives

HART Paramedics

NWAS Bronze Commander, Daniel Smith, wrongly believed that he was prohibited from deploying any non‑specialist paramedics into the City Room for safety reasons (§10.154; §12.425-12.427), and forbade them to do so (§14.432; §14.439).

The specialist paramedics, known as the Hazardous Area Response Team (HART), did not arrive on site until 23:11 (§14.292). As the first ambulance pulled in at Hunts Bank, someone knocked on the window and begged Lea Vaughan to attend to an injured young girl in a nearby hotel. However, Vaughan replied that she was required to attend the incident instead (p. 30).

Of the six HART paramedics who arrived on site, Daniel Smith chose to deploy only Lea Vaughan and Christopher Hargraves to the City Room, which they entered at 23:15 (§14.310), fully 44 minutes post-detonation.

Judging by Vaughan’s recourse to military/battlefield rhetoric, any treatment that she and Hargreaves may have provided to casualties would have been minimal:

Q. […] Is this right, Ms Vaughan, that the clear message from your training and experience is that your role was to carry out the triage process on all those by whom you were confronted in the room rather than stopping at the first one and treating them?

A. Yes. So it ’s a process we call treat and leave, it’s very much a military style of triage. It’s brutal because it goes against anything you’ve ever done before. (pp. 65-66)

Claire Booth had no memory of her or her daughter, Hollie, being given any medical treatment by a paramedic, despite both being triaged as P2, the second most serious category of injury (p. 107).

Evidently unaware that GMP Bronze Commander, Inspector Michael Smith, had, at 22:50, declared the City Room to be “‘safe enough’ for non‑specialist emergency responders and members of the public to be in” (§10.106), Vaughan’s primary concern was not with treating patients, but, rather, with “removing them from the dangerous area […] to a place where they could receive further treatment from my ambulance colleagues” (p. 12).

Christopher Hargreaves told the Inquiry that they had completed primary triage of all the patients in the City Room by 23:27, and that they then started on secondary triage (§14.311). Primary triage involves assigning casualties a P1, P2, or P3 designation and only giving treatment if vital to save life. Secondary triage “involves the reassessment of the casualty using a more sophisticated method of observation and the application of a wider range of treatments” (§20.90).

Did the three NWAS paramedics actually treat anyone? Sophie Cartwright QC asked Hargreaves

If you came across patients who needed lifesaving treatment, such as the application of a tourniquet, that fell well within the role you were being tasked to do in the City Room?

Before Hargreaves could reply, however, Saunders interjected “I think you’ve already included, that’s part of triage, isn’t it?” (47:40). Thus, Saunders implied that Hargreaves was involved in lifesaving treatment, such as the application of a tourniquet.

However, according to the Inquiry report, tourniquets were applied to only four individuals, with no evidence that paramedics were involved:

• Ronald Blake quickly applied an improvised tourniquet (his wife’s belt) to John Atkinson’s right leg (§13.140). Police issue “leg restraints” were applied around the top of both of Atkinson’s legs at 23:14 (§18.73).

• Janet Senior’s handbag strap was used as a tourniquet for Josephine Howarth (§17.49).

• An unknown person (possibly Darron Coster) used their belt as a makeshift tourniquet on Bradley Hurley, but it was later removed (§17.92).

• Darah Burke used his shirt as a tourniquet around his daughter’s arm and a coat around her leg (§17.37).

Even though Vaughan and Hargreaves deployed to the City Room with four MTFA (Marauding Terrorist Firearms Attack) bags containing tourniquets, haemostatic dressings and blast dressings (§14.298), there is no evidence of them having used those items, e.g. to replace makeshift tourniquets with a proper ones.

Vaughan seems to have regarded the situation as being under control:

myself, Chris [Hargreaves] and Paddy [Ennis] had a really efficient system working and I don’t believe that further paramedics would have been of any help at that point. (p. 51)

At no point did Hargreaves think that further paramedics were required (§14.314). Neither he nor Vaughan requested additional resources in the City Room (§14.316). HART team leader Simon Beswick believed they would have made such a request had they needed extra resources (p. 7).

What on earth is going on here? The situation was, supposedly, so desperate that some two dozen people were being evacuated from the City Room on “makeshift stretchers” for fear that they might die. The evacuation process had already been underway for a quarter of an hour by the time Vaughan and Hargreaves arrived. 21 casualties on the night were assigned P1 status (i.e., requiring immediate life-saving intervention). Therefore, why did Vaughan and Hargreaves think that no additional resources (e.g. medics, stretchers) were required? Was the situation really as bad as we are led to believe?

No CCTV Evidence of Casualties Being Treated in the City Room

Despite the extensive interactions with casualties by various personnel noted in the Inquiry report, there is no CCTV evidence of anyone treating a casualty in the City Room.

For example, ETUK’s Ian Parry is seen entering the City Room, and Ryan Billington is seen in conversation with Inspector Michael Smith and Advanced Paramedic Patrick Ennis. But that is the only CCTV evidence of any of the 11 ETUK staff in the City Room in the post-detonation period (see Part 11).

Unreliable Witness Testimony Regarding Treatment

Darron Coster

Darron Coster told the Inquiry that he used a belt as an improvised tourniquet to treat a man’s lower leg (possibly Bradley Hurley). He also claimed to have helped a young man who suffered severe facial injuries and torso injuries. His account prompted Saunders to remark “These people are pretty badly injured.”

From Coster’s interview with ITV, the young man can be identified as Adam Lawler, based on Coster’s claim to have been on the phone to Lawler’s mother, with Lawler himself unable to speak. According to Coster, “Half of his face looked to have been blown away, and I remember him having a nut in his hand” (10:10).

Yet, the ITV programme itself clearly revealed that half of Lawler’s face had not been “blown away”:

Source: Manchester: 100 Days After The Attack (26:18-28:31)

As we saw in Part 11, Coster’s claim at the Inquiry to have seen Abedi’s severed torso through the doors to the Arena concourse was demonstrably false. Therefore, there is no reason to believe the testimony of this ex-military man who, as one of the first on the scene, appears to have been part of an operation.

Daren Buckley

Another member of the public, Daren Buckley, allegedly spent 21 minutes in the City Room trying to help (§16.178). According to the Inquiry report, he and his son

were directed to go back through the City Room. They were told it was the safest place to go: the area had been checked. (§16.179)

This seems highly unlikely. The City Room was sealed off very quickly, if not prior to detonation (see Part 10), and members of the public were deliberately kept out; Buckley and his son would not have been directed to exit through it.

Just as Coster featured in ITV’s 100 Days, so Buckley featured in the BBC’s Manchester: The Night of the Bomb. Given the highly propagandistic nature of both programmes (see Part 17), the claims of those appearing in them should be treated with caution.

Defibrillators

Saunders claims that he “heard evidence of officers using defibrillators, performing CPR, applying dressings and, in one case, improvising tourniquets” (§13.39).

This sounds drastic, but a review of the Inquiry transcripts reveals that defibrillators were used only for monitoring purposes and not to administer shock to anyone.

The evidence summary for Megan Hurley (pp. 5-18) mentions a defibrillator being used to check cardiac output (§18.99), as well as police officers performing CPR, but it does not mention shocks being administered. According to PC Whittell, “The defibrillator did not advise that shocks be administered to Megan” (p. 20). Patrick Ennis recalls that “the defibrillator was saying ‘no shock advised’” (p. 22).

The only mentions of shocks in relation to Megan Hurley are by PC Anthony Sivori (p. 21), who “accepts that there are discrepancies between his statement and what is shown on the sequence of events” (p. 22), and Megan’s father, Michael Hurley (p. 18), whose traumatised recollection may be inaccurate.

In the case of Jane Tweddle, a defibrillator “began to analyse heart rhythm at 22.53.57. It gave the instruction to commence CPR, which PC Bullough and PC Whittel did” (pp. 31-32). Ian Parry recalls that the defibrillator indicated “no shock advised” (p. 33).

At 23.08.31, PC Owen Whittell “asked people to stand clear and the defibrillator analysed Sorrell [Leczkowksi]’s heart rhythm. The defibrillator then gave the instruction to commence CPR” (p. 77). Again, there is no mention of shock.

At 23:10, GMP Sergeant Kam Hare “sought to assist Kelly Brewster with a defibrillator. However, he found that, when he unpacked it, there were no defibrillator pads” (§13.422). By the time he obtained another defibrillator, Brewster had died and been covered (p. 13). Therefore, Hare did not actually use a defibrillator on Brewster.

NWAS paramedic Patrick Ennis told the Inquiry that defibrillators were “of limited if any value” on those who were not breathing as a result of traumatic injuries (p. 73).

Student paramedic Simon Butler told the Inquiry that at the Casualty Clearing Station, “we used the defibrillators as a general purpose tool for monitoring heart rates and suchlike […] I don’t think there was people that needed defibrillating […]” (p. 125).

Lucy Favill told the Inquiry that she and fellow paramedic Adam Williams “did not need to shock Georgina [Callander] as they were able to obtain a rhythm after one cycle of CPR” (p. 32).

Dr Mohammed Ibrahim, who performed resuscitation on Saffie-Rose Roussos at Greater Manchester Children’s Hospital, stated that pulseless electrical activity (PEA) was detected, and that under such circumstances, “the heart cannot be restarted simply by shocking, the only way to do it is by replacing lost blood or commencing manual cardiac compressions” (p. 105). This was confirmed by Sister Elizabeth Winterbottom (p. 108).

Therefore, we should not assume from the repeated mentions of defibrillators during the Inquiry hearings that shocks were being administered. Even on the official account, they were merely used to check cardiac output and advise on CPR.

The Dangerous Use of “Makeshift Stretchers”

Saunders’ Legitimisation of “Makeshift Stretchers”

It was noted in Part 9 that, whilst every emergency services commander made serious mistakes in Saunders’ eyes, Inspector Smith anomalously could do no wrong.

The same logic plays out again with respect to evacuating casualties to the CCS:

By that stage, the work of evacuating the casualties had just started. Inspector Smith was heavily involved in that work and in directing it. In evidence, Inspector Smith explained that, absent expert assistance and equipment: “[M]y view was … we need to get them out as quickly as possible and we’ll use whatever we can to do that.” This was the correct decision. Inspector Smith understood by this time, shortly after 23:00, that resources able to evacuate casualties in a conventional way were not going to arrive imminently. He rightly took a ‘needs must’ approach. (§13.429)

Note that Smith took the decision to evacuate casualties to the CCS “shortly after 23:00,” with the first two casualties arriving there at 23:07 (§10.170).

Yet, NWAS Bronze Commander Daniel Smith only arrived on site at 22:59 (§10.146), and he and Inspector Smith had no contact with one another (§10.155; §14.231-14.232). How, therefore, did Inspector Michael Smith know, in real time, that the CCS was being set up on the station concourse, such that he could instantaneously direct that casualties be taken there?

When ETUK’s Ryan Billington was giving evidence to the Inquiry, Saunders put the following words in his mouth:

Q. […] And then eventually, it dawns on people that actually the paramedics aren’t coming. And then they have to say: we’ve got no alternative, we’ve got to get them out, we’ve got to take them down.

[…]

A. Me and Mr Ennis were trying to get people out as soon as possible. (pp. 137-138)

“Correct decision”? “Rightly”? “No alternative”?

Contrary to its usual pedantic concern for process and protocol, the Inquiry expressed very little interest in how casualties were transferred from the floor onto makeshift stretchers. Specifically, Pighooey observes,

The process of moving a severely injured casualty to a stretcher is a tricky procedure, even for trained staff with specialist equipment, who have experience of dealing with such casualties. How a group of people with no such training or equipment were able to safely transfer several injured casualties from the floor onto improvised stretchers is yet another aspect of the Manchester Arena incident, which the Inquiry chose not to explore. (01:08:50)

For example, in relation to Georgina Callander, GMP Officer F2 (whose identity was concealed) claimed at or around 23:08, “It’s like this girl here, this lady is breathing but I don’t know if she can be moved at all” (p. 13). Patrick Ennis told him that Callander was “critical” and will “have to be moved in a minute, she’s one of the highest priorities” (p. 13).

In the absence of fire and ambulance crews attending the scene as they were meant to, and with certain victims in an apparently critical condition, was it really acceptable to start moving casualties out of the City Room on trestle tables and the metal crash barriers that had stood in front of the merchandise stall?

Sophie Cartwright QC put this to Ennis, and encountered pushback:

Q. […H]ere we have a patient [Callander] with plainly an injury that requires some consideration and care to her stabilisation to enable her to be moved; would you agree?

A. I wouldn’t... I would suggest that within the context of this incident that her rapid extrication was the priority. (p. 51)

Remember, Saunders endorsed this logic. He paid no heed to the obvious risks involved, outlined by Davis (2024, p. 284):

This method of evacuation was quite a remarkable feat. Severely injured people need to be immobilised before they can be moved. They may have undiagnosed neck or other spinal injuries, unidentified internal bleeding, etc. Moving a badly injured person is a delicate procedure. Yet, somehow, […] victims were taken out of the City Room […] at an extremely rapid rate of more than one per minute. Why this dangerous, cavalier way of evacuating the injured was deemed necessary is not entirely clear.

Indeed. What difference would it have made had the injured been left to lie in the City Room until appropriate medical assistance arrived? Inspector Smith himself had declared the City Room to be “safe enough” at 22:50 (§10.106), after armed police had swept the room and kept guard thereafter. Why, therefore, was he so keen to get casualties out, rather than trained medical professionals in?

An unidentified individual is carried down the footbridge steps on a makeshift stretcher. Source: Daily Mail, Image 37

Davis (2024, p. 284) is correct that it would have been much safer to treat casualties in the City Room initially and then carefully transport them directly to waiting ambulances.

For example, Bradley Hurley told the Inquiry

I think they must have just lifted me [sic.] whole body from maybe underneath, I don’t even know how they done it. It was so painful to get moved on to it and I was like screaming and swearing. (p. 191)

Once allegedly on the stretcher, every movement made him scream in pain. He felt like he would slide off: “The whole thing was just so painful and I just felt so unsteady and unsafe” (p. 192).

Other evacuees on makeshift stretchers had similar things to say. Claire Booth, for example, said of her daughter Hollie:

She was being carried down head first and obviously every step that they took her down, she was sliding further forward on the barrier. She was also sliding sideways and thought she was just going to slide off the side because she wasn’t fastened on to it in any way. She had to hold her head up and sort of grip on to the edge of the barrier, just to try and keep her balance so she didn’t slide off. That’s just a horrific way for anybody with injuries like that to have to be moved, but I do accept it was the only way we were getting out of that room on that night. (pp. 111-112)

Pighooey (01:19:50) has confirmed that the girl shown above is Hollie Booth.

Freya Lewis was moved onto a red trestle table and carried down the stairs, despite reportedly having sustained extremely serious injuries, being one of the closest victims to the seat of detonation (see Part 17).

In the worst case of all, when attempts were made to transfer John Atkinson from an advertising board on which he had been dragged along the floor to a metal barrier for the purpose of getting him down the steps, the board gave way and he fell a short distance onto the metal barrier, which must have been very painful given the extent of his injuries (§14.253).

Why No Proper Stretchers?

Why, if the situation was so desperate that risks were being taken by moving seriously injured people in unsafe ways, did no one think to notify NWAS Bronze Commander Daniel Smith of the severity of the situation and request back-up? Why did he not notice the obvious fact that most of those arriving at the CCS had been transported on trestle tables and crash barriers? Why did he not, therefore, call for proper stretchers?

Paramedic Joanne Hedges was asked at the Inquiry

It’s far better to be sat on a stretcher rather than the floor of a station. Why was consideration not given to treatment on a stretcher in that casualty clearing area?

Hedges replied “I can’t answer that” (p. 69).

Paramedic Helen Mottram was asked

Q. Were you surprised at the time that what was being used were makeshift stretchers as opposed to actual stretchers?

A. Yes.

Q. Were you told or did you know for any other reason why actual stretchers were not being used?

A. No. (p. 43)

The fact that only one proper stretcher was used on the night (for Lucy Jarvis [§17.26]) suggests that the incident was not being treated as a genuine medical emergency.

The Evacuation As Spectacle

The evacuation of casualties from the City Room provided a spectacle to influence public perception: everyone remembers the “desperate scenes,” rather than asking what happened to common sense and basic medical protocols.

Was it mere coincidence that those scenes just so happened to be caught on video and shown by the Mail no later than May 24, 2017, and again in the BBC’s Manchester: The Night of the Bomb (43:50) a year later?

A still from a video showing casualties being taken down the steps from the footbridge on “makeshift stretchers” while a stream of people run up the steps. Source: Mail (18:42).

It is not known who shot the video and sold it to the Mail, but from the camera position it can be inferred that it was taken from down by the tram lines, after the trams had been halted and the area had been cordoned off. As Pighooey proposes, it was likely a long-lens photographer from near the camera position below.

Source: Pighooey (01:32:50)

Ignoring those on “makeshift stretchers,” why were the “walking wounded” plus at least one casualty in a wheelchair (likely Thomas McCallum [pp. 9-10]), not taken down in the lift, rather than two flights of steps? We know the lift was working, because police officers called it at 23:19 before realising that it was too small to accommodate a makeshift stretcher (p. 44).

Why did Victoria Coutts and PC Gareth Wray not use the lift to transport the casualty in the wheelchair? Source: Richplanet.net

Why did PC Lauren Moore and PC Mark Emberton not take these casualties down in the lift? Source: Richplanet.net

Perhaps those helping (other than those assisting Atkinson) simply forgot about the lift in the chaos of the moment. The unnecessary assistance of casualties down the steps, however, certainly added to the spectacle.

Summary

Nothing about the evacuation of casualties to the CCS makes sense from a medical perspective. Moving seriously injured people without first immobilising them is potentially very dangerous and risks litigation if things goes wrong. Allowing them to slide around on “makeshift stretchers” is even more dangerous.

And for what? Many casualties were placed on the cold floor for a long time (two hours in some cases) when they arrived at the CCS.

Instead, it would have been far better to send lots of paramedics into the City Room, which Inspector Smith had deemed “safe enough” for that purpose at 22:50, and which was surrounded by armed police from that moment on.

Unfortunately, however, ambulances were arriving at Manchester Central Fire Station at 22:50, as a direct result of Daniel Smith’s instruction to rendezvous there, even before he was appointed as NWAS Bronze Commander (§10.83-10.84).

Even so, one might have expected basic medical protocols to override an extremely high risk evacuation procedure. There was no reason not to expect additional support from NWAS and GMFRS to arrive during a Major Incident in one of Britain’s largest cities.

Given the lack of a credible medical rationale for evacuating casualties on “makeshift stretchers,” what was the real reason for it?

Davis (2024, p. 285) contends that “casualties” were evacuated to the CCS, rather than non-specialist paramedics coming to them, “to ensure those not party to the hoax did not enter the City Room.” That is consistent with Hall’s hypothesis that the City Room was a controlled environment (see Part 10), and is far more credible than the ridiculous explanation that has been offered to the public.

Atkinson, Callander, and Roussos

There are three very significant counter-examples to the Inquiry’s tendency to keep treatment details vague or concealed. They are the three named fatalities who were evacuated from the City Room and taken to hospital, i.e., John Atkinson, Georgina Callander, and Saffie-Rose Roussos.

Atkinson

In Atkinson’s case, he was assessed by Senior Paramedic Philip Keogh, Senior Paramedic Michael Ruffles, Emergency Medical Technician Laura Worrall, and Dr Michael Daley (§14.448). At 23:47, Atkinson went into cardiac arrest, and at 23:50, he was placed into Ambulance A368 (§14.449).

Prior to departure, Daley and Ruffles performed a bilateral chest compression, which involved inserting cannulas into both sides of Atkinson’s chest to release any air that might have been present that would prevent his lungs from inflating (p. 21).

Keogh gave a non-committal description of his time in the ambulance:

I do not recall exactly what I did in the ambulance, but it would have been necessary to connect the equipment inside the ambulance to John to ensure observations were in place and would continue. For example, the defibrillator would have been connected to John. I could see that John had some monitoring equipment on him already as he went into the ambulance. Things were then connected up to the vehicle in order to continue to monitor John. (p. 19)

Daley left the ambulance and returned to the CCS at 23:51:15 (p. 20). Keogh did the same at 23:57:57 (p. 29). Worrall drove the ambulance, which set off at 00:00, with Ruffles alone in the back with Atkinson. Ruffles “supported John’s breathing and administered atropine for his bradycardia,” and he administered sodium chloride via IV (p. 30). The ambulance arrived at Manchester Royal Infirmary at 00:06.

There, according to Dr Joseph Godfrey, a consultant in emergency medicine, a full trauma team performed cardiopulmonary resuscitation on Atkinson, administering tranexamic acid, adrenaline, atropine, and saline to increase blood pressure (p. 32). Atkinson was intubated. “Intravenous and intraosseous access was achieved,” he was administered further adrenaline and O negative blood, and a bilateral thoracostomy was carried out to inflate the lungs (p. 33).

Dr Alistair Rennie, also a consultant in emergency medicine, stated that additional treatment included two cardiac ultrasounds, which both showed cardiac standstill, rapid blood transfusions, bilateral chest drains and advanced life support (p. 34).

Despite those best efforts, Atkinson was pronounced dead by Godfrey at 00:24 (p. 34).

Callander

Callander arrived at the CCS on a “makeshift stretcher” at 23:28. NWAS EMT Lucy Favill performed chest compressions from 23.29 until 23:30:37 (p. 32), while paramedic Adam Williams provided oxygen through an airbag (p. 30).

Bronze Commander Daniel Smith told Williams “If she’s not viable” (p. 32). Williams understood this to mean to stop resuscitation efforts if “futile on a patient who had injuries that were not compatible with life,” in line with mass casualty triage protocols (p. 33).

Williams was unable to gain intravenous access to provide drugs to slow Callander’s bleeding, possibly because of reduced blood pressure. He cut away Callander’s hair to dress a head wound that he noticed. After one cycle of CPR, the defibrillator detected a pulse-generating rhythm, and Williams also detected a pulse (p. 33). He and Favill therefore continued to provide ventilation assistance to Callander, placing an oxygen mask on her face at 23:35:59 (p. 34).

At 23.36, Callander was moved onto a spinal board and an ambulance trolley (p. 34). Ambulance A347 was the first to depart at 23:40 (p. 35). EMT Sian Edmunds (NWAS) drove the ambulance, while paramedics Adam Williams and John Buchanan monitored Callander (p. 34).

Buchanan addressed Callander’s head injury and tried in vain to cannulate her left arm (p. 37). Williams observed her pulse oximetry levels (78%), heart rate (65), respiratory rate (six to eight breaths a minute), and Glasgow Coma Scale (3) (p. 36).

With the ambulance only 60-90 seconds away from the hospital, Callander went into what Williams called a “re-arrest,” showing no cardiovascular output and pulseless electricity activity (PEA). Buchanan restarted chest compressions and Williams began ventilation (p. 37). They repeatedly checked her pulse.

Dr Alison Sheehan (a consultant in emergency medicine) stated that Callander was in PEA cardiac arrest when she arrived at Manchester Royal Infirmary. Half an hour of advanced life support was not enough to save her (p. 40). Dr Alistair Rennie advised that resuscitation be stopped.

Roussos

Roussos’s journey to Royal Manchester Children’s Hospital in Ambulance A344 began at 23:17:13, with Emergency Medical Technician Gemma Littler driving and paramedic Gillian Yates in the back with her (p. 89).

Yates tried to give 100% oxygen to Roussos, but she resisted having the oxygen mask next to her face, so Yates held the mask near her face so as not to cause distress (p. 80). She decided against trying to apply a tourniquet to Roussos’s leg but did apply a tourniquet to her right arm in order to be able to insert a cannula to administer tranexamic acid,” a blood clotting agent (pp. 81, 121). She found a barely detectable radial pulse (p. 136).

Once at the hospital, according Dr Rachel Jenner (a consultant in the paediatric emergency department),

paediatric cardiac arrest resuscitation attempts were commenced according to advanced paediatric life support protocols. These included chest compressions and intubating Saffie. Intraosseous needles were inserted into both her left and right humerus, bones of the upper arm, through which emergency blood transfusions and adrenaline was given. (pp. 96-97)

Jenner was then joined by Dr Paul Farrelly, Dr Omar Wasim Hashmi, Dr Jordan Oldbury, on call paediatric surgery registrar Bashar Aldeiri, consultant anaesthetist Dr Mohammed Ibrahim, and Sister Elizabeth Winterbottom. Farrelly and Aldeiri performed bilateral thoracostomies and left chest drains on Roussos (p. 98).

After ten minutes, it was agreed that Roussos’ injuries were unsurvivable (p. 99).

Analysis

As discussed in Part 15, there are multiple interlocking witness accounts, coming from a range of medical professionals, in the cases of Atkinson, Callander, and Roussos.

Some of those professionals, such as Gillian Yates, Paul Farrelly, Rachel Jenner, and Mohammed Ibrahim, gave oral evidence at the Inquiry confirming their witness statements. Most of the others (excluding Aldeiri) are said to have provided witness statements (but did not give oral evidence).

However, none of those witness statements seem to be publicly accessible via the National Archives, as they are all meant to be. This seems like yet another example of key evidence going missing or being made deliberately hard to find if it does exist.

Strictly speaking, all the public has is the word of Operation Manteline officers that those witnesses stated what they did, plus the fact that none of those witnesses has publicly said otherwise.

The public has not seen any primary empirical evidence to corroborate the accounts of the medical professionals concerned.

Having said that, there is also no publicly available evidence directly contradicting what is alleged to have taken place in the ambulances and the hospitals. Sceptics have no obvious way of disproving the claims of those medical professionals.

Therefore, although there are a great many reasons to doubt that a TATP shrapnel bomb was detonated in the City Room on May 22, 2017, the official narrative is perhaps at its strongest when it comes to the medical treatment of Atkinson, Callander, and Roussos.

Proponents of the narrative want us to assume that those three named fatalities are representative of a much larger pool of seriously and critically injured victims.

The fact remains, however, that they are only three cases. A similar level of detail when it comes to medical treatment is not available for any other named victim. Statistically, the three of them cannot be said to constitute a representative cross-section. In the vast majority of cases, treatment details are hard to find.

Sensitivity Around Eve Hibbert

In contrast with the explicit treatment details offered by the Inquiry in relation to Atkinson, Callander, and Roussos, Eve Hibbert’s journey to hospital was dealt with very differently.

Garry McMullen drove the ambulance which departed at 00:18 and arrived at Royal Manchester Children’s Hospital at 00:25:22 (p. 95). We can infer from these timings that this was the ambulance which officially took Eve Hibbert to hospital (p. 22).

Look how careful Nicholas de la Poer QC was to avoid any mention of injury or treatment to Eve:

I am not going to go into any detail as to precisely what you did during that first period that you were at the scene. What I hope you will feel you’re able to agree with is that there was a particular patient that you were allocated to.

A. Our first patient, yes, that’s correct.

Q. Again, I’m not going into detail here. As you dealt with that patient, did you have a facility available to you or to any paramedic or any other person you were working with to record what medication was being administered? Can I stress, I don’t want to know what medication was administered, if any; I just want to know about the facility to record it. (pp. 90-91)

Thus, Eve Hibbert’s treatment in the ambulance was effectively redacted and replaced by a pointless generic question about whether any facility was available to record the administration of medication.

A discussion then ensued around the “LifePak 15” defibrillator. De la Poer referred to a “theoretical example” in which it might be used (p. 92), followed by a pointless hypothetical example in which it is switched to treat a different patient. McMullen replied “Yes, that would be theoretically correct […]” (p. 93). Thus, where Eve Hibbert was concerned, the Inquiry dealt purely in abstract hypotheticals.

De la Poer continued:

We don’t need to linger on the details […] Again we’re dealing with this very much in a summary form […] I do not want to go into any detail in relation to that person that you transported. (p. 95)

McMullen duly obliged, stating that when they arrived at the hospital,

My colleague dealt with the patient and did specific handover with regards to injuries to the team. Whilst that was happening, I was preparing the stretcher. (p. 95)

Eve Hibbert was thereby transported from the CCS to hospital without so much as a word from the Inquiry in relation to her identity or the treatment she received. McMullen’s testimony was thereby rendered all but pointless, as the public learned nothing of any substance from it.

Conclusion

For a mass casualty incident involving 22 fatalities, 59+ hospitalisations on the night, and hundreds more reports of injuries coming in following the establishment of the Manchester Emergency Fund, one would expect it to be easy to find persuasive evidence of medical treatment being administered to scores of casualties.

The opposite proves to be true, however.

Understandably, first responders, including BTP, Showsec, and ETUK staff with only basic first aid training were not able to administer medical treatment in any meaningful sense.

BTP staff gave CPR to four of the 22 named fatalities, but otherwise, they merely “assisted,” checked, carried, and covered.

ETUK’s Ian Parry “assessed” casualties, forgot about the tourniquet in his pocket, and advised others to cease CPR in three cases. Ryan Billington sought to evacuate casualties by whatever means necessary, regardless of the risks. Despite the instruction only to “treat catastrophic bleeding,” ETUK staff do not appear to have treated anyone with catastrophic bleeding.

Showsec staff “did their best,” but only Megan Balmer is explicitly cited in the Inquiry report as applying tourniquets and dressing wounds (§16.141). It is far from clear which casualties she applied tourniquets to, however, as the only four mentioned in the Inquiry report were attended to by other people.

When North West Ambulance Service (NWAS) paramedics belatedly arrived in the City Room, there were only three of them, and in line with Major Incident protocol, they seem only to have triaged casualties (in the sense of assigning a P1, P2, or P3 classification), rather than administering any treatment.

There is no CCTV evidence of casualties being treated in the City Room, and two witness testimonies of having provided treatment, by Darron Coster and Daren Buckley, are demonstrably unreliable.

Despite repeated mentions of defibrillators in the Inquiry transcripts, close inspection reveals that they were only used for monitoring purposes and not to administer shock.

Pace Saunders, there was no sound medical rationale for unsafely moving seriously injured people onto metal barriers, advertising boards, and trestle tables and carrying them across the footbridge and down two flights of stairs. Nor was there any sound rationale for doing so from a safety point of view, as Inspector Michael Smith well knew when he ordered the evacuation.

More likely is that sending reported casualties out, rather allowing additional NWAS and GMFRS staff in, was necessary to preserve the City Room as a controlled space. The evacuation of casualties was turned into a spectacle to persuade the public that such emergency measures were necessary when they were not.

The best evidence of critically injured patients receiving medical treatment comes in relation to Atkinson, Callander, and Roussos, where numerous medical professionals allegedly provided witness statements to that effect. At least four of them gave evidence at the Inquiry in relation to Roussos.

Even though that evidence cannot be directly disproven, the fact that the corresponding witness statements do not appear to be publicly available is problematic, and the public has seen no primary evidence to corroborate them. Even if they are true, three cases is nowhere near a broad enough cross-section to establish that scores of other people were also seriously/critically injured.

Eve Hibbert’s journey to hospital was conveyed entirely in abstract, hypothetical terms by the Inquiry, owing to Nicholas de la Poer QC’s systematic manipulation of Garry McMullen’s testimony. This is typical of how medical treatment was obfuscated by the Inquiry.

In the final analysis, there is no good reason why it should be so difficult to find clear and obvious, irrefutable evidence of seriously injured people receiving medical treatment in a mass casualty event.