Air In The Stomach, Empty Lungs: Expert Explains What Happened In The Grim, Final Minutes Of Travis Ebanks’ Life

By Alric Lindsay

Medical data described as “loud alarm bells” took centre stage in the Grand Court today, September 11, 2026, on day 5 of the medical manslaughter trial of Dr Paul Anthony Taiganides. Giving his expert testimony, world-renowned resuscitation specialist Professor Charles Deakin provided a rigorous, minute-by-minute analysis of the critical hour inside the trauma room before Travis Alexander Derron Ebanks passed away.

Using hospital logs, post-mortem findings, a single portable chest X-ray, and his own expert reports dated May 2024 and May 2025, Professor Deakin walked the jury through the chaotic timeline following Ebanks’ arrival at George Town hospital at 4:40 am on January 21, 2024.

The 4:40 AM Arrival: ‘Loud Alarm Bells’

Under questioning by prosecutor Richard Matthews KC, Professor Deakin explained that, upon the arrival of any trauma patient, “Initial management is focused on life-threatening injuries,” which is referred to as a “primary survey.”

Professor Deakin said the “A, B, C” procedures to bear in mind were as follows:

** Airway: ensuring the airway is open, potent and that no debris were found.

** Breathing: examining the chest, including the rise and fall of the chest wall, listening with a stethoscope, feeling for deformities or injuries to the chest wall. These procedures may extend to taking an X-ray.

** Circulation: this includes putting drips in so the patient can receive intravenous fluids.

He added that there was also a “D” procedure, which was to do a disability or neurological assessment. Professor Deakin suggested that this may have been appropriate in Ebanks’ case after considering the level of his consciousness and movement of limbs.

Looking at the actual sequence that occurred when Ebanks arrived, the jury heard that, based on trauma room records, Ebanks arrived via ambulance at 4:40 am. Emergency staff immediately secured intravenous (IV) access to one arm, commenced oxygen therapy via a face mask, hooked up a defibrillator, and began infusing 0.9% normal saline.

Under questioning by prosecutor Richard Matthews KC, Professor Deakin testified that the patient’s initial vital signs painted a terrifying clinical picture:

* Pulse: 152 beats per minute (possibly indicating a heart pumping rapidly to compensate for blood loss).

* Respiratory Rate: 18 breaths per minute.

* Blood Pressure: 100/60 mmHg (markedly low compared to the universal normal baseline of 120/80 mmHg).

* Oxygen Saturation (SpO2): 81% via a finger probe (Professor Deakin said this was “significantly low”). 

Professor Deakin added: “Combined with dropping blood pressure, these vitals were loud alarm bells signalling a catastrophic chest injury.”

Fluid Resuscitation: Saline vs. Blood Transfusion

As Ebanks’ condition fluctuated, medical staff administered a drug to counter nausea, doses of morphine for pain management, and IV antibiotics. To combat the patient’s falling blood volume, doctors administered Gelofusine, a colloid resuscitation fluid.

While Professor Deakin noted that utilising saline and colloids is acceptable as a temporary holding measure while waiting for blood to be prepared, he maintained that restoring blood volume through an immediate blood transfusion is always the best and most appropriate measure.

Despite the severe blood loss, logs showed temporary physiological improvements after a chest drain was initially established:

* At 4:57 am: The patient’s pulse settled slightly to 125 beats per minute, blood pressure sat at 90/59 mmHg, and oxygen saturation crept up to 88%, coming up towards what Professor Deakin considered may be “normal.”

* At 5:01 am: The pulse stabilized further and blood pressure shifted to 109/38 mmHg, showing the immediate clinical benefits of relieving air and blood from the right chest cavity.

The ‘White Out’ X-Ray and Left Chest Omission

The crux of the prosecution’s questions centred on a single portable chest X-ray—the only scan captured after Dr Taiganides performed intubation and the initial chest drainage.

Pointing to a folder with images provided to the jury in court, Professor Deakin explained to the jury how to interpret a thoracic scan.  He noted that, on a normal X-ray, healthy, air-filled lung tissue appears very dark. In Ebanks’ scan, the right lung shows darker areas of healthy tissue alongside damaged sections where the bullet tracked through.

By contrast, the left lung presented an entirely different scenario.  Professor Deakin highlighted that the entire left lung had a cloudy, hazy appearance—what clinicians describe as a ‘whiteout ‘. “This is what it looks like when there is a significant amount of blood,” he added.

Though Professor Deakin conceded it was impossible to determine solely from the X-ray how much blood was present or whether any lung tissue collapsed, the clinical mandate was clear: The appropriate, immediate treatment to address that whiteout was to insert a chest drain on the left side to let the trapped air and blood escape. According to Professor Deakin, no left chest drain was ever put in at any stage of the resuscitation.

A subsequent post-mortem examination validated Deakin’s analysis, revealing that no major arteries or large blood vessels had been cleanly severed. The massive internal bleeding did not stem from a single arterial puncture but directly from the heavily torn lung tissue itself, meaning a functioning left chest drain could have continuously evacuated the blood and allowed the remaining lung tissue to expand.

The Decision To Insert The Tube & Its Correct Placement

The court then turned to Advanced Trauma Life Support (ATLS) protocols regarding airway management. Professor Deakin affirmed that the “gold standard” for a deteriorating trauma patient is endotracheal intubation—passing a secure tube through the mouth directly into the trachea to connect the patient to a mechanical ventilator or Ambu bag and optimise oxygen delivery.

When questioned about the skill required, Professor Deakin noted, “True competency is only achieved by performing intubation regularly.” He added that this is generally handled by specialist anaesthetists, though other emergency doctors are capable.

Professor Deakin was then asked whether Dr Taiganides’ decision to prioritise immediate intubation over bilateral chest drilling was justified.

Professor Deakin explained:

[For] a patient who is deteriorating, who has low blood pressure, penetrating wounds, and bleeding in the chest cavity, the priority is to insert a chest tube in each side of the chest.

If you have a bullet wound to the chest wall, then the lungs can collapse.  That collapse can be made worse by blood.

A build-up of pressure can squash the lung.

The aim of the chest tube is to allow air to escape [and allow the lungs to expand].

In Ebanks’ case, Professor Deakin said shortly after arrival at the hospital, a chest tube was inserted in the right chest; however, no chest drain was put into the left chest at any stage.

Ultimately, Professor Deakin concluded that, in the chaotic circumstances present in the trauma room, it was “Difficult to know if the chest drain on the left was a priority or if inserting the tube was a priority”; however, both were important.

Professor Deakin was then asked to explain images given to the jury outlining the ideal, correct placement of the tube inside Ebanks’ windpipe.

Professor Deakin said:

The gullet sits immediately behind the trachea.

When the tube is inserted, it can potentially go into one of the two openings, [being] the gullet or the windpipe.

He added:

[The tube] may inadvertently slip into the oesophagus. Putting it into the oesophagus is not a problem if you recognise this and remove the tube [and correctly place it again].

Professor Deakin was then asked about the importance of the length of the breathing tube.

He said that, “Generally, for a patient with Ebanks’ stature at 183 centimetres, you want an optimal distance… 22 centimetres would have been an optimal length for Ebanks.”

He added: “This is a basic check once the tube is inserted.”

The prosecution directed Professor Deakin’s attention to an image shared with the jury which contained an annotation of 28 centimetres.

The prosecution asked, “If it went to 28 centimetres, where would it have gone?”

Professor Deakin responded, saying that the tube would have gone “Down into the right lung.”

He added that an insertion to 28 centimetres suggests that “The person [inserting the tube] wasn’t aware of the consequences” or the basics of tracheal intubation.

He concluded that the insertion was “not commensurate with someone who is competent with tracheal intubation.”

When asked about the position of the tube as shown by the portable X-ray machine, Professor Deakin said that, at the time the X-ray was taken, the tube was in the food pipe and not the windpipe.

When pressed about the importance of this, Professor Deakin said:

[This is] absolutely vital.

Oxygen levels will fall very quickly.

[In] seconds rather than minutes.

He added that when checking if the tube is correctly sitting in the trachea, it is important to look at chest movement, use a stethoscope to hear breathing in and out, and apply the “gold standard” by using capnography to measure exhaled gas in the form of carbon dioxide. “Presence of carbon dioxide confirms the tube is in the right place,” he explained.

When asked whether it was fundamental to check the capnograph, Professor Deakin explained:

It is a core competency.

If you get it wrong, the consequences are catastrophic for the patient.

He continued:

The use of a [portable] X-ray is not a recommended method of confirming tube placement. It takes time for an X-ray to be organised. Meanwhile, the patient’s oxygen levels could fall if the tube is incorrectly inserted.

He doubled down, saying, “You need to be 100% certain you can interpret a capnography trace.”

In Ebanks’ case, Professor Deakin said his opinion was that there was a “Gross deviation from the standard expected” from a surgeon with vast intubation skills.

Expert Addresses State Of Ebanks’ Spinal Cord

Finally, Professor Deakin addressed a defence theory suggesting that Ebanks’ spinal cord was divided by a bullet.

Responding with his opinion, Professor Deakin said:

The spinal cord takes signals from the brain and passes them down to the arms and legs.  If you have a complete transection, you would have complete paralysis.

He continued:

When Ebanks was admitted [to the hospital], he was able to move his right leg and arms.  This demonstrates that the spinal cord was not completely transected.

The prosecution then showed the jury a video on screen in court, highlighting that Ebanks was moving his arms upon arrival by ambulance.

Adjournment

After the series of questions, Justice Richards asked the jury to retire until Monday, when defence counsel is expected to cross-examine the expert witness regarding the physical positioning of the endotracheal tube and relevant standard of care required for insertion.