“Naming a blood clot as the cause of Navalny’s death would take an autopsy. This version surfaced surprisingly soon,” says ER doctor

Shortly after news of jailed opposition leader Alexei Navalny’s death was made public, the 112 Telegram channel and the propagandist television network RT wrote that the ambulance crew had spent half an hour trying to resuscitate him before finally declaring that his death was the result of a detached blood clot. Alexander Polupan, a practicing emergency room doctor who was part of the team that resuscitated Navalny in Omsk in August 2020 after a failed assassination attempt carried out by Russian FSB officers armed with the chemical nerve agent Novichok, told The Insider that it would have been impossible to diagnose a detached blood clot on the spot.

“They couldn’t have named this diagnosis as the cause of his death. They could only have diagnosed him with ‘sudden cardiac arrest’ and listed its possible causes without jumping to conclusions. A detached blood clot is a lay term; the proper medical term is pulmonary embolism. Diagnosing it would have required lifetime imaging, which was never done, as far as we know, because there was no equipment onsite, or the results of an autopsy. At the moment, the cause of death has not been confirmed and is therefore ineligible.

“Pulmonary embolism has a specific clinical presentation that may make this diagnosis likely. But considering that the ambulance crew was called in after the cardiac arrest, the clinical picture would not have been different from a heart attack, for instance, or the effect of exposure to a poisonous substance.

“If thromboembolism is suspected, the first step of the examination protocol is transthoracic echocardiography. It helps detect cardiac overload, which can then be verified by pulmonary angiography. It is unequivocal that they had no opportunity to do either. Therefore, such a diagnosis is nothing but a wild guess. Propaganda came up with this version surprisingly soon.”

Polupan also spoke of pressure from his superiors back in the late summer of 2020, when Russian officials were claiming that Navalny’s moaning and loss of consciousness following the FSB’s Novichok assassination attempt were the result of “low blood-sugar. At the time, the international community was pressuring Moscow to allow Navalny to be transferred abroad to receive medical care.

“My boss called me to say a decision had been made at the top level that the patient should not be transported - and that I must not take him anywhere. When I replied that it was the Germans who would be doing the transfer, not me, and that my only job was to assess his ability to travel, I was told to inform [Navalny’s] family that he was not transportable - and that absolutely everyone [doctors in the consilium] would say the same. And that if I said anything different, the consequences would be grave. The exact meaning of these words was not specified.”

Early in 2023, Polupan co-authored an open letter from doctors demanding medical assistance for Navalny (who was already in a Russian prison at the time).