ATHENS – Hospital staff told police that they were concerned about bizarre behavior in a Greek mother whose 9-year-old daughter later died before she was arrested on charges of using a cat sedative to kill her.

Roula Pispirigou, 33, was kept in pre-trial detention after appearing in court, guarded by a phalanx of police officers as an angry crowd screamed “Death!” and tried to get their hands on her.

Before she was taken into custody in the western city of Patras, Greece’s third-largest municipality, authorities talked to nurses, staff, and medical examiners at the hospital where her daughter, Georgina, died in January.

“The only person who was in Georgina’s room for the last 20 minutes of her life, before the side effects of the drug kicked in, was her mother,” the case file read, according to Kathimerini.

Court documents, media reported, said the autopsy revealed Georgina died from a lethal dose of ketamine less than 20 minutes after it was administered and that medical staff said they had visited the girl an hour before she died.

Her mother informed doctors a little before 2:30 PM that her daughter had suffered cardiac arrest, the newspaper said.

A hospital nurse told police she saw the accused approaching the nurse’s desk and that the casual way Pispirigou walked and that she waited to seek help showed the mother was not alarmed.

The nurse also said  an oximeter that had been placed on the child in order to notify staff in case of a drop in pulse had been tampered with, and that Pispirigou said the day before the death that they “had seen nothing yet,” and that, “the big episode has not yet taken place.”

Her two other children had also died in the previous three years, raising further suspicions, but she hasn’t spoken out in the case which shocked the country and saw her put in protective custody to keep other inmates away from her.

Her mother and sister were also summoned, media reports said, as well as her estranged husband, the deaths of the three children a buzz on social media for months before the arrest.

Postmortem toxicology tests showed Georgina had received ketamine, an anesthetic drug often used in animal surgeries, which had not been prescribed by her treating doctors as she was being treated for a heart condition.

She also reportedly asked hospital staff whether there were security cameras in the room but there was no report if that raised any concerns either.

The testimony said that whenever Georgina experienced convulsions, bradycardia, or other serious issues, she was alone in the hospital room with her mother, but it wasn’t said why staff allowed the mother to be there after so many suspicions were raised about her behavior.

The investigation led a magistrate to seek access to the suspect’s telephone and Internet records searching for clues and further evidence against the accused who for now is charged with the murder of her Georgina.

No motive has been suggested as to why she would want to kill the child but the newspaper said the magistrate wants to know how she got her hands on the drug ketamine that’s available from veterinary pharmacies.

A panel of senior coroners is also leading a review into the deaths of the suspect’s two other children: a 3-year-old girl from liver failure in 2019 and a 6-month-old girl in 2021 from a suspected heart defect.

She has denied any wrongdoing, and her lawyers have pointed to the possibility of medical error as a defense without indicating how that could have happened three times.

Her family said she was assaulted while in detention but police said that didn’t happen, no report on what they said had happened to her.

Pispirigou was examined by a doctor and no injuries were reported, while police said that she had made a statement that the alleged incident did not occur as her case has riveted the country

An investigating magistrate assigned a new lawyer, Konstantinos Zardas, to represent Pispirigou after two other lawyers refused to do so, the paper said, the accused denying she killed her daughter.

In a TV interview earlier, the defendant criticized news reports that described the three deaths as suspicious.

She said: “I find myself in a position to defend myself against things that are unspeakable… this was a house that was filled with joy,” she said in the Feb. 17 appearance on private Star television. “How could I hurt my own children? I gave birth to them, raised them, and was always with them. It doesn’t make sense.”

(Material from the Associated Press was used in this report)