Windpipe or Food pipe? Experts Battle Over Breathing Tube Placement in Day 4 of Manslaughter Case of Travis Ebanks

By Alric Lindsay

Today, September 10, 2026, was day 4 of the manslaughter trial of Dr Paul Anthony Taiganides.  The Grand Court session focused on the clinical response, diagnostic equipment monitoring, and conflicting expert assessments inside the trauma room following the shooting of Travis Ebanks.

The jury heard testimony from emergency care physician Dr Sean Teeling, supervising nurse Maria Barnes Campbell, radiographer Sandia Stewart, and remote medical witness Dr Lemos.

Dr Teeling’s Clinical Assessment

When questioned by defence counsel Ben Tonner KC, Dr Sean Teeling, an emergency care physician with 25 years of experience, explained that Travis Ebanks arrived at the Health Services Authority (HSA) hospital semi-conscious, highly restless, and hypoxic. His oxygen saturation level was also low.

Dr Teeling added that Ebanks had one intravenous line upon arrival, and a second was inserted by the hospital team to help bring up the blood pressure. Due to severe pain and agitation, he was administered morphine and anti-nausea medications.

According to Dr Teeling, when Dr Taiganides arrived in the trauma room, Dr Taiganides assumed leadership. Dr Taiganides asked about the required blood, and Dr Patrice Angus, who was attending to Ebanks’ airway management, left the room to obtain the blood.  When Dr Angus left the room, Dr Taiganides took over airway management.  Dr Teeling said he was assisting.

Based on Dr Teeling’s testimony, after Ebanks’ blood pressure deteriorated and his pulse was slowing, Dr Taiganides performed an emergency intubation. It was understood from Dr Teeling’s statement that, to verify the tube’s placement, a capnography monitor was connected, which measures exhaled carbon dioxide.
Dr Teeling noted that the capnography device was the “gold standard” and on the monitor, one can see a waveform, with a normal wave form being between 35 and 40 mmHg.

When Tonner KC pressed Dr Teeling on different methods to determine correct placement of the tube, Dr Teeling referred to secondary clinical signs—including listening to bilateral lung sounds with a stethoscope.
“There were a lot of factors that affected our interpretation of the capnography,” Dr Teeling added.

Tonner KC put the question in a different way, highlighting to Dr Teeling that in Dr Teeling’s note, he recorded that the capnography was correctly placed. Dr Teeling responded, saying that the “initial assessment” was that the capnography was correctly placed.

Tonner KC pressed Dr Teeling further, asking whether, upon attachment of the capnography, Ebanks’ oxygen saturation increased and, if so, whether this was an indication that the procedure was done correctly.  Dr Teeling answered, “Yes.”

Dr Teeling added that the team suspected a spinal cord injury from a bullet wound to the neck, which could have led to paralysis from the neck down.  

The Post-Intubation X-Ray and Patient Pronouncement

The court heard that, to verify the positions of the breathing tube and chest drain, Dr Teeling ordered a portable digital X-ray. Capturing the image required moving Ebanks to insert an exposure cassette under him.  Dr Teeling noted that the cassette should be in line with the lungs to take the X-ray.  Reportedly, Dr Taiganides assisted with the placement of the cassette.

At this stage, Dr Teeling said he remained at the head of the bed manually ventilating the patient with an Ambu bag, while Dr Taiganides assisted in lifting Ebanks over a plate. Non-essential staff left the room to avoid radiation exposure.

Ebanks suffered a final clinical crash before the X-ray could be fully processed, which typically takes about five minutes. Dr Teeling reviewed the image after Ebanks was pronounced dead. The X-ray revealed a “whiteout” of the left lung, indicating extensive blood pooling, along with bullet fragments in the left torso.

The court heard that the analysis of the x-ray was “overtaken by events,” being blood emerging from the endotracheal tube, vitals flattened, and the patient’s pupils became fixed and dilated.

When asked by the jury who pronounced Ebanks dead, Dr Teeling confirmed that he did so.

Nursing and Radiography Workflow

Maria Barnes Campbell, a veteran registered nurse and HSA supervisor, testified that she received a radio notification of an incoming trauma patient around 4:00 am. She coordinated with Nurse Richards to prepare the trauma room and mobilise staff.

Nurse Campbell described Ebanks as highly combative upon arrival, noting he verbally complained that he could not feel his legs. She said Dr Teeling and Dr Angus worked on a chest drain.

Nurse Campbell confirmed that Dr Taiganides arrived later.  Nurse Campbell was then in and out of the trauma room.

Sandia Stewart, an HSA radiographer, explained the technical protocol for operating the digital portable X-ray machine. She stated that patient data—including full name, medical record number, and date of birth—is manually entered into an internet-operated system before scanning.  Stewart testified that Dr Taiganides requested the X-ray upon her arrival.

When asked if an image would appear somewhere immediately when the x-ray was taken, Stewart confirmed that the monitor is “seamlessly embedded” in the machine.  “If you want to see the details, you have to be standing over it,” she explained.

Stewart explained that the normal next steps would be that, after the image was captured, both Dr Teeling and Dr Taiganides would be expected to view the scan on the portable machine’s built-in monitor screen.  Later, she would be expected to upload it to the hospital’s system.

Under cross-examination by defence counsel Ben Tonner KC, Stewart noted that Ebanks was stationary during the process; his chest was rising and falling; however, she could not recall any discussion between the doctors after they viewed the monitor.

Examination of the X-ray by Dr Lemos

The afternoon session concluded with a testimony from Dr Lemos via video link. He explained that his formal report was delayed until January 31, 2024 due to an administrative backlog upon his return to the hospital.
Reviewing the X-ray, Dr Lemos identified a severe injury to the left lung, multiple bullet fragments, a right-sided pulmonary contusion, surgical emphysema, and a dilated stomach. He initially noted the endotracheal tube was in situ (in place) on the scan.

However, Dr Lemos revealed that during a subsequent consultation in late June 2024 with the George Town radiography department, teams re-examined the baseline anterior-posterior X-ray alongside an abdominal scan.

“Our conclusion was that the tube was displaced and most likely in the oesophagus,” Dr Lemos testified.

Reportedly, this conclusion was reached after looking at the post-mortem x-ray and not the portable x-ray.

During cross-examination, defence counsel Ben Tonner KC raised this point and challenged the certainty of this finding, arguing that portable X-ray machines produce lower-quality baseline images compared to fixed hospital equipment and are insufficient for definitive post-mortem localization.

Dr Lemos conceded the point, stating, “The tube was in the throat, but where it went—whether into the oesophagus—it was a difficult evaluation. It is difficult to conclude displacement using a portable X-ray.”

The trial resumes on September 11 at 9:30 am with testimony expected from a forensic pathologist and an independent medical expert.