It was the new finding of allegedly very high digoxin levels in autopsy blood in a child who was under the care of Lucia de Berk that resulted in her second conviction and life sentence for murder, i.e., at the 2004 appeal hearings. Moreover, this was despite it already being known at that time that digoxin levels on autopsy blood should be expected to be far higher than blood digoxin in a living patient. Living heart cells extract digoxin from the blood, concentrating it at levels up to 1,000 times the therapeutic digoxin levels in the circulating blood. Heart cells die within minutes after death, allowing this digoxin to diffuse into the blood in the heart and in the surrounding large blood vessels – the sites from which blood is extracted by pathologists for blood chemistry analysis. Moreover, the autopsy blood did not originate from a proper blood sample but was squeezed out of a piece of gauze left inside the body after two autopsies had disturbed all the organs.