Day of conjecture ends as autopsy reveals heart attack was cause of Milosevic's death

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The first results of an autopsy on Slobodan Milosevic last night showed that the former Yugoslav president died of a heart attack, though further analysis is needed to confirm that this was brought on by natural causes.

The findings followed an eight-hour medical examination during a day of rumour and speculation in which Milosevic's lawyer produced a letter from the former leader expressing fears that he was being poisoned.

Zdenko Tomanovic, Milosevic's legal adviser, showed reporters the six-page document written by the former president on the day before his death claiming that traces of a "heavy drug" were found in his blood. Mr Tomanovic said Milosevic was "seriously concerned" that he was being poisoned. "They would like to poison me," he quoted his client as telling him.

The claim appeared to be bolstered by reports on Dutch television that traces of a drug used to treat leprosy and tuberculosis were found in a recent sample of Milosevic's blood.

But last night the UN tribunal issued a statement saying it had "a brief summary of the autopsy results", adding: "According to the pathologists, Slobodan Milosevic's cause of death was a 'myocardial infarction' [heart attack]."

Whether or not Milosevic died of natural causes will become clear with the result of toxicology tests. Yesterday's autopsy was conducted by a Dutch medical team, and in the presence of a Serbian pathologist, one day after the 64-year-old former Yugoslav president was found dead in his cell.

Earlier the chief UN war crimes prosecutor, Carla Del Ponte, said suicide could not be ruled out. There were, she argued, two possible causes: " normal, natural death and suicide".

It was impossible to monitor whether Milosevic, who was receiving medication for high blood pressure and a heart condition, was following the prescribed course of drugs, she added.

A request from Milosevic to travel to Moscow for medical treatment was rejected by the UN tribunal last month. Leo Bokeria, the head of the Moscow clinic where Milosevic had asked to be treated, said his doctors in The Hague suspected he was spitting out the medicines he was given. "They carried out tests to check for the presence of the medicine in his bloodstream because they thought that he was hiding it in his cheeks," Mr Bokeria said.

Whatever the cause of death, Milosevic's demise is a huge blow to the UN tribunal, bringing Europe's largest war crimes trial since Nuremberg to an abrupt end, without a verdict. Ms Del Ponte, who said the defendant's death "deprives victims of the justice they need and deserve", defended her decision to mount such an all-encompassing case against Milosevic, rather than focusing on narrower grounds.

"It is not just a question of conviction and sentencing. It is a question of truth. That is important for the victims, particularly that they have the full knowledge of what happened," she said.

Richard Dicker, the director of international justice at Human Rights Watch, countered: "The prosecutor needs to focus the indictment on the most representative crimes for which there is the strongest evidence. Criminal trials cannot be the vehicle for writing anything approaching the definitive history of the crimes that occurred," he said.

Ms Del Ponte also argued that evidence she had gathered could be used in other cases. She said that Milosevic's death increased the need for the Serb authorities to arrest and surrender the two most prominent war crimes suspects still at large, the former Bosnian Serb leader Radovan Karadzic and his military commander, Ratko Mladic. "The death of Slobodan Milosevic makes it even more urgent for them to face justice," she said.

However, the events of the weekend are more likely to make Belgrade hesitate before moving against Karadzic and Mladic, amid rising criticism among Serbs of the UN authorities.

Milosevic's death came just one week after the former Croatian Serb leader Milan Babic committed suicide in the same prison in Scheveningen, a suburb of The Hague. Babic, once a Milosevic ally, had been an important prosecution witness in his trial.

In Serbia, criticism of the tribunal for its relaxed surveillance of Milosevic's health was widespread. His death has further eroded trust in a country which never had faith in the impartiality of the court.

Court officials may have to review their strategy for dealing with high-profile prosecutions. Milosevic faced 66 counts including genocide ­ the most serious and most difficult to prove. The allegations spanned eight years and involved war crimes in Bosnia, Croatia and Kosovo. By this weekend, the court had sat for 466 days, listened to 295 witnesses and seen about 5,000 exhibits. Mr Dicker said: "In retrospect, separate indictments for crimes in Bosnia, Croatia and Kosovo would have been more manageable."

In Serbia, there was no sign of national grief over the death of the man who led the country for 11 years. Official television and independent media reported the controversy surrounding his death, but also covered commemorations for the third anniversary of the assassination of the former prime minister Zoran Djindjic, who led the ousting of Mr Milosevic in 2000.

More people with candles gathered for a ceremony at Belgrade New Cemetery, where Mr Djindjic is buried, than at the premises of Mr Milosevic's once all-powerful Socialist Party. Only a small queue of supporters waited to sign a book of condolences.

The UN tribunal said Milosevic's body would be released to his family today but it was not immediately clear where it would go - or where the burial or cremation would take place.

Milosevic's widow, Mira, lives in Moscow, as does his son Marko and brother Borislav. But his wife faces arrest should she return to Serbia.