Icelandic Doctor Hjalti Már Björnsson and Robert Spencer: Emergency Treatment or Intentional Negligence?

 

Results from a drug test, vital signs measurement of a nurse and recordings from security cameras uncover culpable negligence of the physician Hjalti Már Björnsson and blatant distortions in his medical report.

State Criminal Investigation Police of Iceland and the Assistant Prosecutor of Police Commissioner’s Office of Reykjavik believed, based on available evidence in a criminal investigation, that two Icelanders had poisoned writer Robert Spencer with MDMA and amphetamine when he visited the restaurant Bar Ananas in Reykjavik in May of 2017. Vakur – Society for European Culture has obtained all the police reports of the investigation. This includes a Medical Certificate written by Hjalti Már Björnsson, emergency doctor, at the request of the Police Commissioner’s Office. Almost nothing that the doctor states in his Medical Certificate about what happened is in accordance with what the criminal investigation of the Icelandic police revealed. It seems that the doctor did everything in his power to mislead the police in their investigation of the poisoning case.

Even though Spencer’s life samples tested positive for MDMA and amphetamine and Spencer showed all the main symptoms associated with poisoning due to these substances, the doctor, Hjalti Már Björnsson, tries to convince the police that nothing of that kind had happened. Spencer had only imagined that he had been poisoned. Spencer got scared, the doctor states, and drank too much water to flush out potential toxins.  Too much water intake was supposedly the explanation for Spencer’s serious hyponatremia according to Hjalti Már Björnsson. If the emergency doctor is to be believed, the symptoms were all based on Spencer’s wrong interpretation of events. In his medical certificate, Hjalti repeats a misunderstanding by an Icelandic journalist at DV newspaper regarding a sentence in an article by Spencer, about whom he suspected of having poisoned him. In the certificate to the police and in his report to the Ethics Committee of the Icelandic Medical Association, Hjalti Már states this misunderstanding in the newspaper as being a fact of the case and claims that Spencer told him so at the hospital!

Spencer points out that Hjalti Már did not provide him with any medical treatment or did anything that could be classified as a medical diagnosis while he was in the Emergency Ward of Landspítali Hospital. Jón Baldursson, Chief Physician at Landspítali Hospital Quality and Infection Control Department, has confirmed that there is no record or information in the hospitals registration system of any vital signs measurements made by Hjalti Már Björnsson. No medical data is available which shows that Spencer had “stable vital signs and no dangerous symptoms when he left Landspítali hospital,” as the doctor asserts.¹ No measurements of heart rate, respiration rate, blood pressure or ECG. Spencer’s previous health history was not examined by the doctor. Hjalti Már discharged Spencer from the emergency ward while he was still extremely ill, without giving him any medication. Hjalti Már Björnsson has declined to answer any questions about his alleged emergency treatment and refused to explain why he did not do any of the medical examinations that are considered standard in modern hospitals in similar cases.

MDMA poisoning is known to cause severe damage to the heart and kidneys, cerebral hemorrhage, heart attack and even death. In late April 2019, Robert Spencer was hospitalized for what was thought to be pneumonia. Upon arrival at the hospital, he suffered heart failure, kidney failure, and respiratory paralysis. Spencer was transported in a coma by helicopters from one hospital to another. He was hospitalized for a total of six weeks, of which he was unconscious for 12 days. At a certain point, Spencer showed no vital signs; heart rate and respiration were no longer present, and he experienced what is known as clinical death. Fortunately, doctors were able to restart his heart and respiratory system. It is considered probable that the MDMA and amphetamine poisoning that Spencer suffered in Iceland and the fact that Hjalti Már Björnsson, the emergency doctor, did not provide him with any medical service, is the main reason for Spencer’s health failure in this instance.

—-

At 00.59 on 12 May 2017, the American writer Robert Spencer arrived at Landspítali emergency ward in Iceland and declared that he had been poisoned. On the eve of his arrival, the night before, Spencer had given the lecture “Islam and the future of European culture” at the conference of Vakur – Society for European Culture at Grand Hotel Reykjavík. After the lecture, Spencer, Christine Douglass-Williams, who was also the speaker at the conference, their security guard and several organizers of the conference went to Bar Ananas to celebrate a successful conference. There he was greeted by a young man who claimed to be a loyal fan and offered Spencer a drink, which he accepted; Spencer’s security guard watched the drink being brought and witnessed no untoward activity, and so approved (as it turned out, the poisoning had been prepared out of sight). Shortly afterwards, another young Icelander came and addressed Spencer by name, took his hand and shouted “Fuck you” at him. Spencer says he took this as a message to leave the place. About 15 minutes later, when he arrived at the hotel, he felt numbness in his face, hands, and feet, chest tightness, difficulty in breathing, and a rapid heartbeat. “I started shivering and vomiting,” Spencer wrote in his complaint to the Ethics Committee of the Icelandic Medical Association. “My heart was pounding so fast that I felt like I was in danger. I experienced tremendous anxiety and knew something was terribly wrong. It was clear to me that someone had sneaked some drug into my drink while I was at the restaurant.”²

Spencer had all the symptoms associated with overdose of MDMA and amphetamine

Robert Spencer was accompanied to the emergency room by his colleague Christine Douglass-Williams, his security guard, and Valdimar Jóhannesson, who was involved in organizing the conference. Nurses’ Anna Chernysh’s Emergency Admission Record states that Spencer had an anxiety attack while waiting for a doctor. “Talks a lot and is very scared about his condition,” she writes. According to the nurse’s vital signs measurements, Spencer had a respiratory rate of 30 times per minute. Spencer had a heart rate of 139 beats per minute and an extremely high blood pressure — so-called hypertension — the upper value was 161 and the lower value 113. A blood test showed hyponatremia, or a sharp drop in sodium levels down to 126 mmol / liter. Spencer was soon sent for a drug test that tested positive for amphetamines and MDMA.³

Spencer’s behavior and recorded vital signs on arrival at the emergency ward, i.e., restlessness, delirium, anxiety, hypertension, very rapid breathing, and rapid heartbeat are the same as those associated with MDMA and amphetamine overdose. The most serious consequence of hypertension is stroke. Hyponatremia is another known MDMA toxicity that Spencer is diagnosed with, and several deaths from the intake of MDMA have been linked to it.⁴

Dr Þorkell Jóhannesson, Professor of Pharmacology and Toxicology at the University of Iceland, says about the toxicity of MDMA and amphetamines: “The consumer has an extremely hard time staying still… MDMA causes a faster heart rate, high blood pressure and a rise in body temperature… The harmful effects of the substance are various, e.g., severe damage to the liver, heart, brain, and kidneys. It can also cause a cerebral hemorrhage and a heart attack. Low doses of MDMA are known to cause acute death in people with heart disease and severe poisoning or death with elevated body temperature… Amphetamine reduces appetite, stimulates respiration and vital life reactions (respiratory function, heart, and circulation) in the brain stem… If inexperienced individuals take higher doses… it causes restlessness, dizziness, anxiety, and insomnia… They become anxious, restless, even confused, and unwell. Because amphetamines can have significant effects on the cardiovascular system, many people may complain of “heartbeat” and headaches as a result.”⁵

MDMA has a mixed effect, partly amphetamine-like (stimulant) and partly lysergic-like (e.g., LSD which is a psychedelic). The likelihood of MDMA causing discomfort, anxiety or panic attacks increases significantly if the person taking the drug does so without knowing it, or has no experience with it, as was the case with Robert Spencer. The nurse’s Emergency Admission Record states that when Spencer is asked for a urine sample for the drug test, “[he] is escorted to the toilet but cannot urinate x2”.⁶ “I remember that I had a hard time providing the urine sample,” says Spencer in his complaint to the Ethics Committee of the Icelandic Medical Association. “I had to try several times before it worked, later I learned that this is yet another symptom of MDMA poisoning.”⁷

Hjalti Már Björnsson, emergency physician, rejects the results of the drug test and nurses’ vital signs measurements

Hjalti Már Björnsson, emergency physician, disregards the results of nurses Anna Chernysh’s vital sign measurements. He denies Spencer’s claims that he was drugged and ignores the results of a drug test that shows a positive response to amphetamine and MDMA. The doctor claims that Spencer had typical symptoms of anxiety attack and that explains his medical situation rather than poisoning or overdose of amphetamine and MDMA.

In the Medical Certificate to the Reykjavik’s Police Commissioner’s Office and in his objections to Robert Spencer’s complaint to the Ethics Committee of the Icelandic Medical Association, Hjalti Már Björnsson does not mention that Spencer was diagnosed with abnormally high blood pressure which could have led to heart and kidney failure, blindness, and stroke if nothing is done. Hjalti also says that the exceptionally low sodium level in Spencer’s blood sample, which is a known side effect of MDMA, can be explained by the fact that he drank too much water before arriving at the hospital.

Although amphetamine and MDMA degradants were detected in Spencer’s urine sample, they were “false positive” according to Hjalti. The results of the drug test were wrong he claims, and Spencer would “only need to drink a moderate quantity of fluids” and then the problem would improve by itself. There was no dangerous poisoning Hjalti says. Spencer simply believed that something had been sneaked into his drink at a restaurant in the center of Reykjavík and that is the explanation for his anxiety attack.⁸

The police believed that two Icelanders had poisoned Robert Spencer. Because the drug test sample had been destroyed, the case was dropped

Emergency physician Hjalti Már Björnsson would probably have gotten away with this illegal act if it had not been for the recordings on Bar Ananas’ security camera system. Landspítali Emergency Admission Record, Landspítali Emergency Treatment Note, and the results of a blood test that Landspítali handed over to Spencer also sheds light on what happened. According to Icelandic Law on the Right of Victims to Access Criminal Investigation Reports of a Police Investigation that has been completed, Robert Spencer received a photocopy of all police reports from the Reykjavik’s Police Commissioner’s Office on the poisoning case.

In the Police Commissioner’s Office investigation conclusion statement, which was sent to the District Prosecutor’s Office on 25 August 2017, the Assistant Prosecutor of the Chief of Police of Reykjavik states verbatim:

“Footage from the security cameras of the place shows the accused buying the drink in question. The accused Sindri [Geirsson] is then seen handing siphon over to the accused Sigurður [Ólafsson] which he subsequently takes into the local bathroom. When he returns to the bar, he takes the drink in his hand, brings it under the bar table and seems to be doing something with it. Afterward, he repeatedly stirs the drink as if something were being mixed into it. At this time, the defendants look wary as they are concealing something, and it goes without saying that something more is happening than a simple drink order. It is also clear that the drink in question, which the victim can be seen drinking, is the only one he consumed that night and received from an unauthorized third party.”⁹

But the investigation conclusion statement does more than suggest that Sindri Geirsson and Sigurður Ólafsson might be guilty, since at the end of the statement it says: “In light of all this and given the evidence of the case, especially the above-mentioned recordings of the security cameras, I think this case if brought to court would likely result in a guilty verdict.”¹⁰ The police also thought the violation was committed intentionally based on negative attitudes towards Spencer’s political views. Therefore, the offense was also defined as a hate crime.¹¹

On April 5, 2018, or seven months later, the Office of the District Prosecutor sent a request for a follow-up investigation to the Police Commissioner’s Office, requesting that further evidence and information be obtained. This included obtaining a Medical Certificate from the physician Hjalti Már Björnsson and a request to find out whether the blood and urine samples were still present at the hospital. If so,  chemically analyze and measure the blood sample.  Also find out whether the quantity of the substances found in Spencer’s urine had been measured. If this was not done, and if the urine sample is still present, measure the quantity of each substance. The follow-up study revealed that Hjalti Már Björnsson, who was responsible for Spencer’s treatment while at the hospital, did not request at that time to have the quantity of the substances found in the sample measured. The samples had been disposed of at this stage of the investigation, and the case was therefore dropped.¹²

Claims in Hjalti Már Bjornson’s Medical Certificate contradict the outcome of the police investigation into the poisoning case

During the follow-up investigation, the police contacted Robert Spencer by e-mail and sent him a document in English authorizing the police to obtain a medical certificate from Landspítali. According to Icelandic regulation no. 586/1991 on Issuance of Medical Certificates, the doctor is obliged to give a medical certificate to his or her patients, if the patient so requests. Spencer repeatedly asks Hjalti Már Björnsson to send him a copy of the certificate that he had sent to the police regarding his medical condition. But Hjalti didn’t take notice of Spencer’s requests. It was not until two years after the Medical Certificate was issued by Hjalti Már that Spencer received a copy of it himself. It was a lawyer at the Office of the Director General of Landspítali Hospital who helped Spencer get a copy of his own medical certificate.

When reading the Medical Certificate, Hjalti Már Björnsson, reluctance to hand over the certificate to Spencer becomes understandable. According to Iceland’s Regulation on the Issuance of Medical Certificates, the doctor shall not state anything in the certificate other than what he has verified himself. The exact sources on which the doctor’s note is based shall be documented in the certificate. Then it says in Article 4. of the regulations: “A doctor must keep in mind that a Medical Certificate can be a document of decisive importance regarding rulings by public law body and in court cases. In court cases, the doctor may have to confirm the certificate in court.”¹³

The certificate of Hjalti Már Björnsson, emergency physician, dated 18 July 2018, contains statements that are not credible. It describes a scenario that conflicts with timed recordings from Bar Ananas’ security cameras from 22:30 to 23:30 on 11 May 2017, information contained in Robert Spencer’s complaint to the police on 13 May 2017, Valdimar Jóhannesson‘s statement to the police on 23 May 2017 and Þröstur Jónsson‘s statement to the police on 1 June. The certificate also contains various statements that Hjalti Már claims that Spencer had told him in a  conversation to which there are no witnesses, a conversation that Hjalti Már initiated after he told all of those who were with Spencer at the hospital to leave the emergency room. Spencer denies having said anything that Hjalti claims in the Medical Certificate he had told him, as none of it was in accordance with the facts of the case.

The Medical Certificate states, for example:

“He was in Iceland to give a lecture that went well. After his lecture, Mr Spencer said he had gulped down few drinks of strong alcohol to calm his nerves. After that, a man came up to him and shouted insults at him, and he became very afraid that since such a man who was clearly hostile to him was able to come so close to him, he might as well have sneaked something into his drink. He then suddenly felt dizzy, numb around the mouth and fingers, and reddened in the face. After that he said he drank a lot of water to flush out possible toxins but immediately came to Landspítali hospital for examination… The urine sample from Mr Spencer which tested positive for amphetamines and MDMA was recorded in a nurse’s note that was taken immediately upon arrival. According to Mr Spencer’s description, it is therefore taken less than an hour after the alleged poisoning [emphasis added].”¹⁴

Spencer says Hjalti Már invented this description to cover up his violation of good medical practice. Its purpose was to undermine the credibility of the drug test and to support the onset of anxiety rather than amphetamine and MDMA overdose had caused his symptoms. “I never told him I drank alcohol to calm my nerves. I was neither anxious nor tense after the lecture; I was indeed happy and calm,” says Spencer’s in his complaint to the Ethics Committee of the Icelandic Medical Association on September 12, 2017. “The conference exceeded my expectations, was extremely well attended (about 500 people attended*), proceeded peacefully and there was a great and positive atmosphere in the conference hall the whole time. We went to the restaurant to celebrate the success, but not to calm our nerves, as there was no reason to do so because nothing negative had happened.”¹⁵

*Given the population in Iceland it would be like 500,000 people had attended the lecture in the States.

Spencer says that he did not tell Hjalti Már Björnsson that he suddenly felt unwell in the restaurant, drank a lot of water, and from there went straight to the emergency ward of Landspítali hospital. Nor did he tell Hjalti Már that the poisoning had taken place within one hour of him providing the urine sample. Spencer says he felt good at the restaurant and despite the rudeness of one of the guests, and left in a good mood. It was not until he arrived at the hotel that he first experienced toxic symptoms such as numbness, chest tightness, difficulty in breathing, began to tremble and vomited. Spencer experiences a rapid heartbeat and a great deal of discomfort that gets worse and decides to seek medical attention at a hospital. He calls Valdimar Jóhannesson from the hotel and asks him to drive him to the hospital since he had vomited and felt very strange and uneasy.

Spencer’s description of what happened is in line with the testimony of witnesses to the police, timed recordings of Bar Ananas’ security cameras and the hospitals Emergency Admission Record signed by nurse Anna Chernych. At 23.04, Spencer takes the first sip from the glass that Sindri Geirsson had brought him. At 23.13, Spencer finishes the glass and leaves Bar Ananas with his escort.¹⁶ Spencer did not drink water while he was at the restaurant. He did not drive directly to the hospital from the restaurant, as the doctor claims. He took a taxi to his hotel, as the taxi driver Gunnlaugur Ingvarsson testified to the police. According to the emergency admission registration, Spencer arrived at the hospital at 00.59. However, the urine sample from Spencer was taken at 01.15 according to the registration, which is just over two hours after Spencer had been poisoned by the drugs.¹⁷

A misunderstanding of a journalist appears in Hjalti Már Björnsson’s Medical Certificate

Robert Spencer denies telling Hjalti Már Björnsson that the man who approached him and shouted profanities at him may have sneaked something into his drink. There was no discussion about that between them. When Spencer reported the poisoning to the police, the day after he was released from the hospital, he describes two Icelanders he met at Bar Ananas. He does not mention which man he suspected of the act. He did not want to interfere with the police criminal investigation because he was not 100% sure of his guilt. However, the person who was most likely to have given him the drugs, in Spencer’s opinion, was the one who said that he was a big fan of his, Sindri Geirsson. He was quite friendly and offered Spencer a drink which he accepted. Valdimar Jóhannesson mentions their suspicion in his report to the police. The investigative police officer writes: “When Robert saw what the results of the drug test were, i.e., that amphetamine and MDMA had been detected in his urine, the case was reported to the police, and then they [Spencer and Valdimar] went to restaurant Prikið and tried to track down Sindri Geirsson.”¹⁸

Why does Hjalti Már Björnsson claim that Spencer told him that the man who had shouted profanities at him, “a man who was clearly hostile to him”, had sneaked something into his drink? Hjalti Már has probably just read it in the newspaper DV article, “A controversial lecturer poisoned in Iceland”, which appeared in the newspaper on May 16, 2017. The news piece says: “He [i.e., Robert Spencer] says it is quite clear that the man who claimed to be a big fan of his, is not really so judging from his Facebook page. He does not know who it is that poisoned him, but he thinks it is more likely that it is the one who told him to go to hell [emphasis added].”¹⁹ The news piece in DV is based on an article that Spencer wrote in Frontpage Mag webzine the same day. The journalist at DV misunderstands Spencer’s account, because in the Frontpage Mag  article Spencer writes: “… one of these local Icelanders who had approached me (probably the one who said he was a big fan, as he was much closer to me than the ‘F ** k you’ guy) had dropped drugs into my drink [emphasis added].”²⁰

Hjalti Már Björnsson has read the article in DV and decides to put the journalist account (not knowing it was a misunderstanding of Spencer’s words) in his report to the Ethics Committee of the Icelandic Medical Association, and later in the Medical Certificate which he writes at the request of the Police Commissioner’s Office, and then claims that Robert Spencer told him this at the hospital.

Why was the drug test not repeated if the doctor thought it showed a measurement error?

Why does Hjalti Már claim that the urine sample that tested positive for amphetamine and MDMA, “was taken immediately upon arrival”, “within an hour after the alleged poisoning”, “according to Mr. Spencer’s description”? The explanation can be found in the Medical Certificate. In it Hjalti Már writes:

“Generally, it takes about 2-5 hours from oral administration until amphetamine and MDMA are detected in a urine sample using the methods used at the emergency ward of Landspítali hospital. As the samples were positive at the emergency ward within these 2-5 hours, this further indicates that the substances were ingested earlier or that the samples were false positive. The urinary sticks used to screen for drug intake at the emergency ward are not 100% reliable. They can be false positives.”²¹

It is certainly true that drug tests are not 100% reliable, as can be said of any other human activity. According to the US Food and Drug Administration (FDA), urine samples that screen for drug intake show a false positive result in 5 to 10% of cases. This means that Hjalti could have known that there was a 90 to 95% probability that the drug test that Spencer took showed correct results. A reliable result is usually displayed about two hours after ingestion (that time had elapsed when Spencer took the test) and a reliable drug test can be taken 1-3 days after ingestion.²²

“If it’s true,” Spencer said in his complaint to the Ethics Committee of the Icelandic Medical Association, “that I told him I had been poisoned less than an hour before I arrived at the emergency ward, and he thought the toxicity test was therefore unreliable, why didn’t he take another drug test? I was at the hospital until 04:44. Upon arrival, I stated that I suspected I had been poisoned, and I had all the major toxic effects of an overdose of MDMA and / or amphetamine. Wasn’t it proper to check unequivocally whether the test was indeed a ‘false positive’? Not least in light of the serious consequences that MDMA intake can have?”²³

No health history taken

Because MDMA can cause acute death in people with heart disease, cerebral hemorrhage, and heart attack, physicians are surprised that no medical history was taken from Spencer. Especially if Hjalti Már Björnsson thinks it is possible that “the substances might have been ingested earlier”, as he states in his Medical Certificate. American doctor Andrew Bostom asks if Spencer’s health history was taken and possible risk factors from his past investigated. “I don’t recall being asked about anything like that,” Spencer reports. The medical records of Landspítali hospital show that no health history was taken from Robert Spencer. “It’s very unusual,” says Dr Bostom. “This information should have been obtained from an overweight 55-year-old man with a so-called ‘anxiety attack’, who has tachycardia and tachypnea. It would have been especially important to rule out myocardial infarction and / or pulmonary embolus”.²⁴

Hjalti claims to have cured Spencer’s ‘anxiety attack’ in eight minutes. There is no evidence to support the miracle cure

The Medical Certificate states:

“The nurse’s reception record states that Mr Spencer had an anxiety attack while waiting for a doctor and was therefore quickly taken to the examination room. One examination by the undersigned, it was noted that Mr Spencer had a pulse of 139 beats per minute. Then he was clearly hyperventilating, with a respiratory rate of 30 times per minute according to the nurse’s vital signs recorded at 01.12… After the undersigned had talked to Mr Spencer he calmed down a bit and at 01.20 his heart rate dropped to 82 per minute… If Mr Spencer would have had a heart rate of 139 beats / min on arrival due to drugs, the pulse would not not have been 82 beats / min eight minutes later after a chat with the undersigned.”²⁵

The problem with this amazing recovery of Spencer is that hospital registration system does not contain any record of this vital signs measurement. Chief physician Jón Baldursson has confirmed that there is no evidence at Landspítali hospital that Spencer’s heart rate dropped to 82 beats per minute after a short chat with the doctor. Hjalti Már states also in his report to the Ethics Committee of the Icelandic Medical Association that Spencer has received a copy of all hospital records on his case. Hjalti Már thus admits that he has nothing that verifies that Spencer’s pulse rate dropped from 139 beats / min to 82 beats / min in just eight minutes. This is remarkable given that Hjalti Már Björnsson teaches medical students at the University of Iceland the use of health information in medical treatment and the importance of registration to ensure the safety and quality of medical services.

Christine Douglass-Williams and Valdimar Jóhannesson say that Spencer was still delirious after Hjalti claimed that he had calmed down and shown normal vital signs. “Robert was soon examined and we were asked to stay outside for a while. Shortly after we could go back into the room. He was overly excited and talked nonsense, thought he was dying,” says Valdimar. “I knew for a fact that this was something other than an anxiety attack,” Douglass-Williams said. “He talked non-stop about all kinds of events and happenings in his life but did not seem to be stressed but rather completely overactive. We tried to calm him down and I repeatedly told Valdimar, the security guard and the nurse on duty that he did not look like the Mr. Spencer I knew. I had never seen him like that.”²⁶

“Whether MDMA and amphetamine was detected in Mr Spencer’s urine due to poisoning, Mr Spencer has taken the drugs himself, or the fact that the urine test was false positive does not matter medically. What was important was that he had a stable vital sign and no dangerous symptoms when he was discharged from the hospital,” asserts Hjalti Már Björnsson. “Mr Spencer has every right to disagree with that opinion,” he adds, “but it does not change my opinion and it is clear how illogical it is to demand now that I be punished for giving my opinion.”²⁷ Spencer responds that he had come to the hospital for medical treatment and a medical examination of his health, but not an “opinion” colored by personal assessment without a basis in recorded, objective medical measurements. The hospital is equipped with the most advanced research and medical equipment and there is an employee who takes care of recording and storing medical information and other data on patient’s state of health. “If it’s true that I was discharged with stable vital signs and no dangerous symptoms, why is there no record of it at the hospital,” Spencer asks.

Violates Article 23 of the Patients’ Rights Act and the Regulation on the Issuance of a Medical Certificate

In his statement regarding Spencer’s complaint to the Ethics Committee of the Icelandic Medical Association on 26 August 2017, Hjalti Már Björnsson writes about Spencer’s arrival: “Mr Spencer sought help at Landspítali’s emergency ward on 12 May as he states in his complaint to the Ethics Committee. He was accompanied by his bodyguard as well as several Icelanders who had organized his lecture in this country earlier that evening [emphasis added]”.

On September 12, 2017, Spencer submitted an additional statement regarding his complaint and comments on Hjalti Már description of his entourage to the hospital: “There is inaccuracies or misunderstandings here,” Spencer writes. “The truth is that I was accompanied by my bodyguard from the USA, Christine Douglass-Williams from Canada, who also spoke at the conference at Grand Hotel Reykjavík, and Valdimar Jóhannesson who was involved in organizing the meeting. Valdimar was the only Icelander who accompanied us to Landspítali’s emergency ward.”

On 18 July 2018, almost a year later, Hjalti Már then wrote a medical certificate at the request of the police. There he repeats the same distortion. The medical certificate begins with these words: “Mr Spencer arrived at Landspítali’s emergency department on 12 May 2017 at 00.59. He was accompanied by a man he introduced as his bodyguard as well as several Icelanders who had organized his lecture in this country earlier that evening [emphasis added].”²⁸

This is peculiar. In his indictment or reports to the Ethics Committee, Robert Spencer repeatedly mentions Christine Douglass-Williams. Reports that Hjalti Már has read. Her name appears there a total of ten times. She accompanied Spencer to the hospital, was by his side all the time, except of course when Hjalti Már Björnsson expelled Spencer’s entourage from his room. First when Hjalti claims to have cured Spencer of tachycardia, for which there is no data, and then when he claims to have informed Spencer that amphetamine and MDMA were detected in his urine sample. As stated in the Medical Certificate: “When the results of the blood and urine tests were available, I went back into Mr Spencer’s room and suggested that others who were there should step out while health information was being discussed. None of those who were with him in the emergency department seemed to be close relatives, so it is standard practice to ask such individuals to step out when a doctor’s interview takes place [emphasis added].”²⁹

Why Hjalti Már does not mention Christine Douglass-Williams in his reports to the Ethics Committee nor in his Medical Certificate to the police is obvious, considering patient’s rights in Iceland. Hjalti Már’s wording shows that Douglass-Williams was not asked about her relationship with Spencer, whether she was a relative or a friend, and therefore fell within the definition of Article 23 of the Patients’ Rights Act: “The patient’s suffering shall be alleviated as far as possible at any given time. The patient has the right to the support of his family, relatives and friends during treatment and stay. The patient and his immediate family have the right to spiritual, social, and religious support.”³⁰ Spencer was suffering, confused, and appreciative of Douglass-Williams’ presence. There was no reason to expel her from the room. She has been his colleague for many years, came with him to Iceland from the United States, and was also a speaker at the conference. Hjalti Már is fully aware of this. Nevertheless, he pretends she doesn’t exist, has no word that she was at the hospital, nor does he seem to have any respect for the rules that apply to the issuance of medical certificates or regulation regarding patients’ rights.

Did Spencer get information that MDMA was found in the drug test?

Spencer says that Hjalti Már Björnsson was unfriendly to him. “He only told me that ritalin had been detected in my blood,” Spencer writes, “and seemed full of doubt when I told him I had never taken ritalin. Hjalti Már said that the drug test showed the wrong result — without explaining further what the result was — and that I simply had an anxiety attack.” Spencer did not find that diagnosis convincing in any way. “I’ve never had an anxiety attack in my life,” he says. Even after two armed jihadists attacked his event in Garland, Texas, on May 3, 2015. “Shortly after the attackers entered the parking lot at the Curtis Culwell Center, they opened fire,” Spencer recalls. “They were both wounded in a shootout with police and were eventually killed by four SWAT team members. The jihadists were armed with Kalashnikov AK-47 machine guns, and police bomb experts searched nearby for timebombs. I was a main target of the terrorists. Why did I not have a panic attack at that time?”

“Why should I have an anxiety attack after a successful event at Grand Hotel Reykjavík? The conference was well attended, our lectures well received, and the whole meeting proceeded peacefully and courteously. The idea that I had an anxiety attack in the aftermath of this success did not make any sense. The fact that the doctor emphasized this point of an ‘anxiety attack’, and said it explained my symptoms, did not give me any peace of mind, nor did it help me to relax. I knew there must be something else that explained my discomfort.”³¹

Hjalti says that it is absurd that he had hidden Spencer information that MDMA had been found in his urine sample, but then stated it in the referral letter that he had handed to him. Spencer says it is certainly strange that Hjalti hid this information from him and then put it in the doctor’s referral letter. He can only speculate that Hjalti hoped that he did not read the report or did not know what MDMA was. Hjalti could not avoid having this information in the doctor’s referral letter because the results of the drug tests are unequivocal. It appears on Landspítali’s medical record signed by nurse Anna Chernysh. The fact that that the Hjalti put it in the referral letter is not a proof that he mentioned it to him at the hospital. Spencer says that if it were true that Hjalti had informed him that MDMA and / or amphetamine had been found in the urine sample, he would of course have told his entourage about it. “I would have both told them about it while we were in the hospital and talked about it on the way back to my hotel,” says Spencer. “Something I would certainly have reported because it confirms my suspicion that I was poisoned. None of them heard about it until later, after I came across it in the doctor’s report at the hotel.”³²

Valdimar Jóhannesson and Christine Douglass-Williams say in their testimony to the Ethics Committee that it did not come up until the next day. “Doctor Hjalti, who was standoffish, did not want to talk to me about the condition of RS,” says Valdimar in his statement. “He was downright hostile and actually looked like he wasn’t sane, surly, full bearded and untidy. He did not report that RS had been poisoned and discharged him early in the morning. There were no words that toxins had been found in the urine sample when we drove back to the hotel. It came as a surprise the next day when it was revealed in a printed report that these substances Ecstasy  and amphetamine was actually found in the urine sample.”³³

Christine Douglass-Williams agrees with Valdimar’s statement. She writes: “Mr. Spencer was released just after 4am after the night in the hospital. I continued to be troubled, and so I called my husband back in Canada via phone upon returning to the hotel. My husband is a policeman and he asked me to make sure Robert Spencer gets a copy of the medical report. I articulated to my husband repeatedly that I was worried about the condition of Mr. Spencer and alarmed by the doctor. I told him that I felt that Mr. Spencer was in too rough a shape to be released so soon because Mr. Spencer was complaining of pressure on his chest and not being able to breathe, plus he could not settle down to rest. The only reason why I did not attempt to insist that Mr. Spencer return to the hospital was because I was concerned about the doctor and I told this to my husband.”³⁴

“On the way back to the hotel Mr. Spencer never mentioned that the doctor had found any signs of poison in his samples. I felt sad for him, he looked really depressed, he claimed he must have been given something, but going to the hospital the doctor told him it was nothing he could find. After we arrived at the hotel Mr. Spencer was complaining of pressure on his chest and not being able to breathe, plus he could not settle down to rest. The only reason why I did not attempt to insist that Mr. Spencer return to the hospital was because I was concerned about the doctor and I told this to my husband. Robert subsequently located the medical report and saw that he had ingested a mix of amphetamine and Ecstasy. I questioned Robert again if the doctor even mentioned the Ecstasy. He said no. Mr. Spencer’s symptoms of a pressure on his chest, difficulty breathing and feeling sick continued on until we left Iceland, even though symptoms lessoned significantly as time progressed. The symptoms of panic, we later found out was a symptom of the Ecstasy.”³⁵

Given Hjalti Már Björnsson’s fabrication and dishonesty in the Medical Certificate to the police and his reports to the Icelandic Medical Association, there is no reason to believe that he informed Robert Spencer of the result of the drug test, even though he put it in the referral letter, which was unavoidable since another member of the health profession at the hospital knew about it.

No medical studies done and drug test not repeated

Two American doctors, Andrew Bostom and James Lincoln, have serious reservations regarding Hjalti Már Björnsson’s alleged emergency treatment. The risk was high, the treatment unsatisfactory and negligent. In his complaint to the Ethics Committee of the Icelandic Medical Association, Spencer compiled questions that Dr Andrew Bostom considered necessary for the hospital to answer:

• Was a simple ECG or ECG taken as well as a simple pulse oximeter, and if not, why not? Because Spencer, an overweight middle-aged man, has hypertension and symptoms such as numbness, hyperventilation, it is important to have an ECG to check for or rule out coronary artery disease or acute myocardial infarction.
• Was any quantification done of the MDMA and methylphenidate found in Spencer’s sample? If so, what was the result, if not, why not? There is reason to investigate this because the interaction of methylphenidate and MDMA is known to significantly increase the risk of cardiovascular toxicity.³⁶
• Alcohol consumption associated with oral MDMA is known to increase plasma levels of MDMA and potentiate toxicity of MDMA. Hjalti Már’s referral letter and the results of a blood test show that Spencer had consumed alcohol. Would it not have been appropriate to take another urine sample and screen further for drugs, given that the toxicity of MDMA is increased with alcohol consumption?³⁷
• Why was Spencer not informed that hyponatremia is a known MDMA toxicity, and if the sodium deficiency had worsened, it could have profoundly serious consequences, even death?³⁸
• Are objective, vital sign measurements available in Landspítali’s emergency ward showing that Robert Spencer’s heart rate has dropped from 139 beats to 82 beats / min in less than eight minutes?

It is important to explain how this was measured. With palpation? With a chart recorder that may also have measured blood pressure, or possibly with an oxygen saturation meter, i.e., an oximeter attached to a finger that measures the quantity of oxygen in the blood?

• Was the patient asked about his basic health history and possible risk factors from his past investigated? Such information needs to be available to rule out possible myocardial infarction and / or pulmonary hemorrhage.
• Why does Hjalti question the results of an objective analysis of urine that finds methylphenidate and MDMA in the urine test, at the same time as Spencer’s recorded vital signs show he suffers from tachycardia, hyperventilation, and serum sodium of 126? Especially because MDMA explains the inappropriate secretion of aldosterone, which is one of Spencer’s symptoms.

Hjalti Már Björnsson did not answer any of the questions that the American doctor directs to him nor does he perform any of the medical examinations that he considers pertinent and is standard practice in modern hospitals in comparable cases.

What motivated Hjalti Már Björnsson? Intentional negligence? Hate crime?

The nurse’s vital signs measurements shortly after Spencer’s arrival, the blood test and the drug test show results that are considered medically serious. That data exists and Spencer has received a copy of those documents. When it comes to Spencer’s health however when he is discharged from the hospital – after being in  Hjalti Már Björnsson’s care for 3 hours and 45 min. —  there exist no recorded vital signs or any medical records at all confirming that Spencer had “stable vital signs” and “no dangerous symptoms” when he left the hospital. The American physicians believe that the valuation of Spencer’s condition at the hospital was unsatisfactory and that the discharge was premature and poorly substantiated.

“Then he also states,” says Hjalti Már about Spencer’s statement, “various facts that I, and I think all doctors, know about MDMA and related substances.”³⁹ Hence Hjalti Már knows in fact about the danger that Spencer was in, but he does nothing to alleviate it. His emphasis is on finding reasons for discharging him from the hospital as quickly as possible instead of ruling out serious causes of the illness. Looking at the case, both the lack of diagnosis and treatment during hospitalization and the violation of Spencer’s legal rights after he was discharged from the hospital, the question arises whether there is more to this than medical malpractice. If Hjalti Már Björnsson is guilty of intentional negligence, the description of the violation fulfills the definition of a hate crime, because the perpetrator has no personal connection with the victim other than a negative attitude towards his political views.

Sources

[1]) Hjalti Már Björnsson. Svör við athugasemdum Roberts Spencers dags. 12. september við greinargerð undirritaðs. 13. November 2017, p. 1. Gögn siðanefndarmáls nr. 2/2017.

2) Robert Spencer. Kæra á hendur Hjalta Má Björnssyni bráðalækni á bráðadeild Landspítalans vegna brota á siðareglum lækna Codex Ethicus. 8. August 2017, p. 1. Gögn siðanefndarmáls nr. 2/2017.

3) Bráðasjúkraskrá, Móttaka bráða- og göngudeildar (Fv-G2/G3). Robert Bruce Spencer, 12.05.2017 00:59 and Meðferðarseðill, Bráðadeild (Fv-G2). Robert Bruce Spencer, 12.05.2017, 01:01. Anna Chernysh nurse.

4) MDMA. Wikipedia, https://is.wikipedia.org/wiki/MDMA,  09.01.2021.

5) Fíknefni og forvarnir. 2001. Fræðslumiðstöð í fíknivörnum, p. 70 and p. 52-53. Dr. Þorkell Jóhannesson. 1984. Lyfjafræði miðtaugakerfisins. Menntamálaráðuneytið / Háskóli Íslands, p. 68.

6) Meðferðarseðill, Bráðadeild (Fv-G2). Robert Bruce Spencer, 12.05.2017, 01:01. Anna Chernysh nurse.

7) Robert Spencer. Athugasemdir Roberts Spencers við greinargerð Hjalta M. Björnssonar. 12. September 2017, p. 5. Gögn siðanefndarmáls nr. 2/2017.

8) Hjalti Már Björnsson. Lnr. 0786. Læknisvottorð. Robert Bruce Spencer. 18. July 2018, p. 1 and 3.

9) Rannsóknarniðurstaða máls nr. 007-2017-026175, 25. ágúst 2017. Lögreglustjórinn á höfuðborgarsvæðinu.

10) Same source.

[1]1) ,,Byrlun á Bar Ananas. Lögreglan taldi Íslending hafa eitrað fyrir umdeildum rithöfundi. Sýnum fargað og málið látið niður falla“. DV. 30. January 2020. (https://www.dv.is/frettir/2020/01/30/logreglan-taldi-islendingana-hafa-byrlad-robert-spencer/)

[1]2) Beiðni um frekari rannsókn. Embætti héraðssaksóknara, 5. April 2018, p. 1. Upplýsingaskýrsla. Geymslutími blóðs og þvags hjá Landspítalanum. Lögreglustjórinn á höfuðborgarsvæðinu, 2. July 2018. Viðbótarsamantekt. Aðgerðir í kjölfar rannsóknarfyrirmæla, Lögreglustjórinn á höfuðborgarsvæðinu, no date.

[1]3) Reglur nr. 586/1991 um gerð og útgáfu læknisvottorða. Heilbrigðis- og tryggingamálaráðuneytið

6. Desember 1991.

[1]4) Hjalti Már Björnsson. Lnr. 0786. Læknisvottorð. Robert Bruce Spencer. 18. July 2018, p. 1.

[1]5) Robert Spencer. Athugasemdir Roberts Spencers við greinargerð Hjalta M. Björnssonar. 12. September 2017, p. 4. Gögn siðanefndarmáls nr. 2/2017.

[1]6) Rannsóknartilvik. Mál nr. 007-2017-026175, 16.06.2017. Öryggismyndavélar Bar Ananas. Samantekt atvika, p. 4-5. Lögreglustjórinn á höfuðborgarsvæðinu.

17) Meðferðarseðill, Bráðadeild (Fv-G2). Robert Bruce Spencer, 12.05.2017, 01:01. Anna Chernysh nurse.

[1]8) Framburðarskýrsla vitnis Valdimars H. Jóhannessonar. Mál nr. 007-2017-026175, 24.05.2017, p. 2. Lögreglustjórinn á höfuðborgarsvæðinu.

19) ,,Eitrað fyrir umdeildum fyrirlesara á Íslandi“. DV. 16. May 2017. (https://www.dv.is/frettir/2017/05/16/eitrad-fyrir-umdeildum-fyrirlesara-a-islandi/).

20) „Icelandic Leftist Posions Robert Spencer“. Frontpage Mag. 16. May 2017. (https://archives.frontpagemag.com/fpm/icelandic-leftist-poisons-robert-spencer-robert-spencer/).

21) Hjalti Már Björnsson. Lnr. 0786. Læknisvottorð. Robert Bruce Spencer. 18. July 2018, p. 3.

22) Leigh Ann Anderson Pharm.D. 2019. ,,Can a Drug Test Lead to a False Positive?” (https://www.drugs.com/article/false-positive-drug-tests.html) ,,In fact, previous data suggests 5 to 10 percent of all drug tests may result in false positives …“ Drugs.com. Alan Carter, Pharm.D og Carly Vandergriendt. 2019. ,,How Long Does Molly Stay in Your System?“ ,,Molly is detectable in urine one to three days after ingestion. MDMA that enters the bloodstream is carried to the liver, where it’s broken down and excreted. It takes one to two hours before molly is first excreted in urine [emphasis added].“ Healthline Media. (https://www.healthline.com/health/how-long-does-molly-stay-in-your-system).

Robert Spencer. Athugasemdir Roberts Spencers við greinargerð Hjalta M. Björnssonar. 12. September 2017, p. 23) Gögn siðanefndarmáls nr. 2/2017.

24) Same source, p. 4.

25) Hjalti Már Björnsson. Lnr. 0786. Læknisvottorð. Robert Bruce Spencer. 18. July 2018, p. 2 .

26) Robert Spencer. Athugasemdir Roberts Spencers við greinargerð Hjalta M. Björnssonar. 12. September 2017, p. 9-10. Gögn siðanefndarmáls nr. 2/2017.

27) Hjalti Már Björnsson. Svör við athugasemdum Roberts Spencers dags. 12. september við greinargerð undirritaðs. 13. November 2017, p. 1. Gögn siðanefndarmáls nr. 2/2017.

28) Hjalti Már Björnsson. Lnr. 0786. Læknisvottorð. Robert Bruce Spencer. 18. July 2018, p. 1.

29) Same source, p. 2.

30) Lög um réttindi sjúklinga. Upplýsingarit fyrir starfsfólk í heilbrigðisþjónustu. 2020. Heilbrigðis- og tryggingamálaráðuneytið, p. 31.

31) Robert Spencer. Kæra á hendur Hjalta Má Björnssyni bráðalækni á bráðadeild Landspítalans vegna brota á siðareglum lækna Codex Ethicus. 8. August 2017, p. 1. Gögn siðanefndarmáls nr. 2/2017.

32) Robert Spencer. Vottaðar yfirlýsingar / tölvupóstar frá sjónarvottum, lögreglu og starfsmanni Landspítala Íslands, no date, p. 2. Gögn siðanefndarmáls nr. 2/2017.

33) Same source, p. 2-3.

34) Robert Spencer. Athugasemdir Roberts Spencers við greinargerð Hjalta M. Björnssonar. 12. September 2017, p. 10. Gögn siðanefndarmáls nr. 2/2017.

35) Robert Spencer. Vottaðar yfirlýsingar / tölvupóstar frá sjónarvottum, lögreglu og starfsmanni Landspítala Íslands, no date, p. 3. Gögn siðanefndarmáls nr. 2/2017.

36) ,,The combined use of methylphenidate and MDMA … potentially enhances cardiovascular and adverse effects.“ Hysek CM, Simmler LD, Schillinger N, Meyer N, Schmid Y, Donzelli M, Grouzmann E, Liechti ME. ,,Pharmacokinetic and pharmacodynamic effects of methylphenidate and MDMA administered alone or in combination”. Int J Neuropsychopharmacol. 2014 Mar;17(3):371-81.

37) ,,Alcohol can increase plasma levels of MDMA and potentiate MDMA toxicity“. See also ,,Regarding the neurotoxic effects of MDMA in humans, the increase in MDMA plasma levels might have clinical significance taking into account that these substances are commonly coadministered.“ Hernández-López C, Farré M, Roset PN, Menoyo E, Pizarro N, Ortuño J, Torrens M, Camí J, de La Torre R. ,,3,4-Methylenedioxymethamphetamine (ecstasy) and alcohol interactions in humans: psychomotor performance, subjective effects, and pharmacokinetics”. J Pharmacol Exp Ther. 2002 Jan;300(1):236-44.

38) Kalant H. ,,The pharmacology and toxicology of „ecstasy“ (MDMA) and related drugs”. CMAJ. 2001 Oct 2;165(7):917-28. Review: ,,This vogue among teenagers and young adults, together with the widespread belief that „ecstasy“ is a safe drug, has led to a thriving illicit traffic in it. But these drugs also have serious toxic effects, both acute and chronic, that resemble those previously seen with other amphetamines and are caused by an excess of the same sympathomimetic actions for which the drugs are valued by the users. Neurotoxicity to the serotonergic system in the brain can also cause permanent physical and psychiatric problems. A detailed review of the literature has revealed over 87 „ecstasy“-related fatalities, caused by hyperpyrexia, rhabdomyolysis, intravascular coagulopathy, hepatic necrosis, cardiac arrhythmias, cerebrovascular accidents, and drug-related accidents or suicide. The toxic or even fatal dose range overlaps the range of recreational dosage.“

39) Hjalti Már Björnsson. Svör við athugasemdum Roberts Spencers dags. 12. september við greinargerð undirritaðs. 13. November 2017, p. 1. Gögn siðanefndarmáls nr. 2/2017.