Glad to see you all here bright and shiny. Everybody happy? Okay. All right. Mr. Shapiro, you may call the next witness.
Thank you very much. Good morning, your Honor. Good morning, ladies and gentlemen.
THE JURY: Good morning.
With the Court's permission, we would like to call Dr. Robert Huizenga.
Robert Huizenga, called as a witness by the Defendant, was sworn and testified as follows:
Please raise your right hand. You do solemnly swear that the testimony you may give in the cause now pending before this court, shall be the truth, the whole truth and nothing but the truth, so help you God.
Please have a seat on the witness stand and state and spell your first and last names for the record.
I got my medical degree in 1978, so let's see, this is higher math, but I think that is something like 17 years.
Would you kindly tell the jury--well--first, may I mark as an exhibit Dr. Huizenga's curriculum vitae, your Honor?
Is this a copy that you provided for myself and to Mr. Kelberg of your curriculum vitae?
Would you briefly summarize for the jury your education beginning with your graduation from high school.
I graduated from Penfield High School. I was Valedictorian. I went to college at the University of Michigan. I graduated there in zoology with highest distinction and was an all-American wrestler. I went to Harvard Medical School in Boston, Mass.
Went to college at the University of Michigan. Graduated in 1974, zoology, with the highest distinction. 1974 to 1978 I attended Harvard Medical School and graduated there with a major in immunology. I did my clinical training in internal medicine at Cedars-Sinai Medical Center. I was chief resident there following that internship and residency from 1982 to 1983. And since 1982 I have been assistant clinical professor of medicine at the University of California, Los Angeles, and recently changed to associate professor of clinical medicine. And that I think is my education in medicine.
Yes, we did. You are a long-time patient of a partner of my practice and I have seen you on a medical basis when he has been on a leave of absence and on vacation.
We have seen each other at several outings, but I would say it is more professional than social.
Would you tell the ladies and gentlemen of the jury what type of examination you conducted of OJ Simpson on the 15th, Wednesday.
Well, when he came I did a very thorough history. Subsequently, a physical examination. We did various urine, blood and x-ray evaluations. Then of course subsequently we collated a lot of his previous medical records and x-ray reports and x-rays and reviewed those.
And would it help to refresh your memory, as we go through your testimony, to refer to those records?
When you refer to those records would you be kind enough just to tell the ladies and gentlemen of the jury that you are refreshing your memory or referring to your medical records.
And we have provided copies to Mr. Kelberg of the complete file; is that correct, Mr. Kelberg?
Did you discover during the course of that history any preexisting medical conditions or injuries?
Well, initially, and probably the most troubling to me as an internist, he gave an approximately one-month history of drenching night sweats so severe that he would have to get out of bed, towel himself off and go back and sleep in the dry portion of the bed.
Your Honor, excuse me. I hate to interrupt the doctor. I would ask the Court to give a limiting statement about any statement made by the Defendant to Dr. Huizenga.
All right. Ladies and gentlemen, the statements made by the Defendant to the doctor are for the purpose of giving you a basis to evaluate an opinion that the doctor will form on the basis of what the Defendant told him, and it is not to be assumed to be true and it is for your purposes in evaluating the doctor's testimony, only for that limiting purpose. Mr. Shapiro.
So the drenching night sweats are a sign in medicine occasionally of a significant disease. And in association with that he gave me a very strong personal family history of cancer, and in fact he himself had had carcinoid cancer of the rectum, a cancer that can be quite benign or can have more sinister implications. Correlating those symptoms with his physical exam, he had an enlarged lymph node in his right axilla, which is under the right armpit, in addition to clubbing of his fingernails, which is something that can be an inherited condition or it can be also consistent with a lung process, and those things were noted and worrisome for anything from an infection to a cancer to some other sort of autoimmune process.
Yes, we did. Basically subsequent to that initial observation I saw him again two days later and we did further blood tests, further skin testing, and further digging of his past histories trying to get at that particular issue and the exact etiology of that significant enlarged lymph node under his right armpit.
Did you make any recommendations as a result of your initial examination and subsequent follow-up examination?
A biopsy is a procedure where surgically you go through the skin, remove the lymph node and evaluate it pathologically under the microscope to try to get more information as to the exact cause.
The result of the biopsy was revealing abnormally enlarged lymph nodes, a collection of lymph nodes, and the pathology was consistent with a benign reactive lymphoid hyperplasia which may be associated with a number of diseases. But we ruled out a whole host of potential causes, everything from aids to Epstein-Barr virus, cytomegalo virus, toxoplasmosis--there was a cat at the home--and a whole host of cancerous causes. Specifically we were very worried about Hodgkin's disease and we felt that lymph node was consistent with rheumatoid arthritis.
Yes. Would you kindly help our reporter here and spell some of those medical terms and spell them slowly, please.
Can we review that later, your Honor, in the interest of time that the doctor will get together with the reporter?
Did you discover, through your history and subsequent examination, any other surgeries that Mr. Simpson had had prior to him coming to see you?
Would you describe those to the ladies and gentlemen of the jury and try to take them one at a time, if we can.
Okay. In my initial history with Mr. Simpson he kind of presented with that whole array of the typical post-NFL injury syndromes. He had, of course, a number of head concussions when he was playing with the buffalo team. He had a left retinal tear and then he had this whole host of significant orthopedic complaints. Specifically, he had initially a surgery on his left wrist all the way back to 1965 which significantly limited the motion in his left wrist and caused him continuing pain. He complained of some finger problems. He had multiple fractures, which is pretty common in football, and had visibly enlarged knuckles which also can be associated with either fractures or osteoarthritis or other rheumatologic arthritic conditions. He had a significant knee complaints. He had had a history of five to six knee arthroscopies in the past which is where they put a little tube into the knee capsule and inject it with dye so that they can look around at the various components inside the knee to see if anything is torn or needs surgical repairs. And he had subsequently on his left knee had four surgeries. His initial surgery was in 1977 and that is when they had taken out his lateral meniscus, so left knee lateral component. The meniscus is a sponge-like piece of bodily tissue that helps cushion this femur as it loads on the tibia and fibula below. He subsequently, in 1978, had a, quote-unquote, clean-out where they saw six foreign bodies which usually are calcific masses in there. They took out scar tissue and they also took out something called the bakers cyst which can be a sequelae of continuing trauma to the knee and may also be suspicious of other things, including rheumatoid arthritis. His third left knee surgery was in 1986, again cleaning out debris, scar tissue and bits and fragment of the knee that kind of keeps breaking off.
All right. Doctor, I'm sorry. If you could, could you just slow down just a little because--
--it is technical stuff. Some of us need to understand all the technical things that are going on, but take your time. Take a deep breath and slow down.
Okay. Umm, the fourth left knee surgery was in 1991, done here at the Joe Kerlin Clinic, and there they removed the medial meniscus, so basically there is no sponge layer, no cushion there. He also at that time was observed to have essentially huge holes in his articular cartilage. You have this kind of cushioning device in the middle of the knee and then you have an articular cartilage. It is the teflon coating on top of the joints to allow smooth frictionless motion of bones as they move against each other. And given the multiple trauma that he had taken, in addition to possible other rheumatologic diseases that we will get to later, big bits on all three compartments of the knee--there is three compartments: There is the lateral side of the knee, the medial side and there is what is called the anterior side right behind your kneecap. And in all three those he has denuded area of articular cartilage so that the bone was showing through there.
Let me just see if we can put this in perspective. The first thing you told the jury was that he had a typical post-NFL syndrome. Break that down and explain what you are trying to convey to the jury.
Well, in the national football league, something like seventy possibly eighty percent of NFL football players--even though he had somewhat of a longer career than is average in the national football league--the average in the national football league is probably more in the two- to three-year span. Basically even with that short of an average playing career, something like seventy to eighty percent of NFL players suffer from a permanent physical disability, football playing related, that affects them for the remainder of their lives, in addition to a whole host of other things particular to playing in the national football league; affects of drugs. He received multiple cortisone injections, which is--certainly was done in the past, I think all would agree, far too freely and may have certain sequelae downstream.
And also was basically exposed to multiple trauma. You know, what are the effects of getting your head, your kidneys, your liver banged repeatedly against the turf? And then you go through all these other difficult things after your playing career, you know, when you go from one life to another, and you know, the NFL teams really haven't prepared most of the guys for doing anything. He was very lucky that he was very talented and had other avenues, but those are the things that I say of the typical NFL syndrome.
So you have an expertise in the field of sports and sports injuries as well as internal medicine?
Certainly the non-orthopedic portion of sports medicine I feel I'm quite qualified to discuss.
All right. Let's focus our attention on the knee that you have described. Can you tell the ladies and gentlemen of the jury in lay terms that you would discuss with a person who does not have a medical background, what the condition of his knee was when you examined him?
Well, when I first saw him in the office, which as I said was noon, we squeezed him in during the lunch hour, he basically was visibly limping as he came down the hall. You know, that is the first thing that strikes me. And he really was not walking properly. Umm, on examination of that knee--and we haven't even got to his right knee which was far less severely involved, just had a meniscal tear. When you move the knee there is four different ligaments that hold it in place and there was some laxity there mainly because you are missing the meniscus and you are possibly missing articular cartilage so it is a looser knee. And when you move the knee, the knee should go through a certain range of motion. When I extend my knee you can see it is straight, it is 180 degrees. When I flex it, there is a different range that everyone can flex that knee, but typically it goes back to 135 degrees, 140 whatever. He was able to extend his knee, but really could only flex it to a point where he was limited by 25 to 30 degrees, approximately. That indicates damage there. When you move the knee and put your hand over different parts of the knee, you can hear kcchhh-kcchhh, kcchhh-kcchhh, and basically that is, you know, surfaces rubbing, abrading each other that probably shouldn't be doing that in a perfect world.
His knee--there are knees that are more severely damaged, but according to the orthopedist he was seeing he was essentially--
Let me ask the question. What is your opinion as to the condition of his knee based on your examination and the medical histories that you reviewed?
He had severe wear and tear arthritis of the left knee and was a strong candidate in the relatively near future for a total knee replacement.
KEY QUOTEA total knee replacement consists of basically taking a saw and sawing off the distal portion of the femur and inserting an artificial knee and inserting that down into the tibia and back up in the femur so that when the point comes where the pain is too much and your quality of life is interfered with--he was obviously not able to do a number of things--then it is time to move on to an artificial knee.
On the day I saw him he had significantly limited mobility because of the knee and actually another ankle problem that we haven't discussed, and I think would be significantly limited in terms of fast walking, certainly in terms of slow jogging, it would be very difficult, if not impossible, that day.
Occasionally with activity you can worsen wear and tear arthritis, osteoarthritis, and so that can be a variable. He also--and we haven't talked about it--there were other rheumatologic conditions that may have a waxing and waning and fluctuating cause, but without question this is someone that was not able to jog or move quickly on the basis of his left knee.
The right knee had only a subtle limitation in full flexion. He was probably only down 10 or so degrees, and he had a much milder form of crepitation and in fact he had never had a knee surgery on that knee, although we know from studies done in 1992 that he does have a meniscal tear on the medial side.
Well, again, the meniscus is this kind of rubbery horseshoe-shaped material that is in between the smooth surface of the tibia and the fibula below and the smooth articular surface that is lining the top of the femur and acting as a cushioning or an unloading mechanism.
Yes, I did. He had had multiple right ankle injuries in professional football, and on my examination, when you do a certain test, you grab the ankle and you try to stabilize the distal portion of his shin and then you pull it back and forth. That--there really shouldn't be much give there because you have a number of quite firm ligaments there. And he had significant laxity there and he also had significant pain. The lateral malleolus, is this bump on the outside part of your ankle and anterior and a little bit inferior to that he had significant point tenderness and that was my opinion of why he was limping was because of the pain on that ankle and the--the problems that we discussed on his left knee.
Laxity just is looseness, you know. You should have, you know, with the ligaments--a ligament is something that hooks a bone to a bone. Tendon is something that hooks the muscle to a bone. When the ligaments are all working properly, you shouldn't be able to make two bones jump and move a significant distance over each other.
Were there any other observations you made of his lower extremities below the waist?
Now, let's go above the waist. Did you do any examination between--let's talk about the wrist.
Wait. Let me just finish the question. You told the jury that there was some injury to the right wrist?
He sustained an injury, the exact nature of which I'm not exactly clear, in 1965, but needed surgery of this area. When I did an exam, usually the wrist should come up something like ninety degrees and it should kind of flap down also at about ninety degrees, so you estimate these things in the office. And his left wrist really was only able to come up about thirty or forty degrees. This is not an exact science, but you know, you kind of estimate 45 degrees, and he did not seem to break that plane. And when you forcibly tried to move it up, you know, there was no give and pain.
He had damage to his elbows such that when he would try to fully extend--again, the elbow should extend 180 degrees, to be perfectly straight, and he had what we call a flexion contracture. It was contracted somewhat flexed, so he really missed the last several degrees, 10 or 15 degrees of straightening out the elbow such that this would be about the best he could do when you said straighten out your arms.
Umm, he had multiple scars, keloids over parts of his upper body and the back, and of course the fingers and the elbows and forearms and hands. He was somewhat bowlegged, you know, in addition to the limp we described, and I think those were the--in addition to the finger things that we talked about, the large--enlargements, those were the major findings.
Range of motion is taking a particular joint and moving it in every direction that is humanly possible and comparing that with a normal population and seeing where your patient falls.
And would you describe to the ladies and gentlemen of the jury what your findings were regarding those range of motion studies.
Range of motion studies revealed limitation in terms of elbow extension, limitation in terms of left wrist dorsiflexion, in terms of left knee flexion, more so than right knee flexion, and those were the major range of motion abnormalities.
And did you--did you come up with any significant findings that were medically important to you regarding Mr. Simpson's condition?
A sedimentation rate is a nonspecific test for inflammation, infection, cancer, something of that nature.
Regarding inflammation, did you notice any inflammation in your visual examination of Mr. Simpson?
He had what appeared to be modest inflammation in the right lateral malleolar area and also in the left knee and it was difficult to tell whether it was a frank effusion, water in the knee, or just a little bit of bony growth after all this trauma.
He had multiple areas that were enlarged, these bony enlargements on his joints. Basically--and here I will refer to my original scribblings. When I saw him originally I just kind of got out a pen and went around his hand and this was his right hand, and basically this joint, right here, (Indicating), was enlarged, this was enlarged, this was enlarged, this, this, this, this bony kind of enlargements that could have been from a degenerative joint disease or old fractures or trauma or getting it stepped on too many times.
Your Honor, I hate to interrupt. Again we have not been provided with that rough draft that the doctor is reviewing. Could I have an opportunity just to take a quick look at it?
Also, doctor, would you let the attorney finish asking the question before you start to answer.
His right-hand had multiple joint enlargements. Basically bony overgrowths located on the proximal joint of his thumb, this proximal phalangeal joint on his right index finger, the proximal joint on his third right finger, both the distal interphalangeal joint and the proximal interphalangeal joint on his fourth ring finger, and again distal interphalangeal joint and proximal interphalangeal joint swelling and hypertrophy on the fifth right finger.
Yes, I did. Here is the left hand and again enlargement of this joint right here, the proximal thumb finger joint, the third pip proximal interphalangeal joint and the fourth both the proximal and the distal interphalangeal joint and again on the fifth finger just the proximal interphalangeal joint.
Those joints were swollen with bony overgrowths signifying some type of trauma or old fractures or inflammatory or osteoarthritic disease.
Well, arthritis, that is--that is obviously a very large topic, but arthritis means, you know, there is something wrong with the joints and you are getting pain from the joints. There are two broad categories that I believe Mr. Simpson suffers from. One is, you know, what's called commonly wear and tear arthritis or osteoarthritis. That is a disease that can be caused by many, many things. Endocrine problems, genetic congenital things, but I believe in his instance the osteoarthritis caused from repetitive trauma and possibly fractures to various joints.
Umm, the osteoarthritis means than the smooth articular cartilage is damaged. Articular cartilage, as I alluded to before, really has several functions. One is so that you have that smooth ball bearing joint with that teflon surface and the other function is if you have a weight-bearing joint, it actually happens to unload so that, you know, the bones won't take all the pressure in a certain way and possibly fracture more easily. So that is what osteoarthritis is. It is damage to that smooth glisteny surface by repetitive trauma or fractures. The other type of arthritis is--that--that Mr. Simpson has that we haven't--
Another type of arthritis is rheumatoid arthritis which is a very difficult disease to understand. It is a disease of unknown origin, it has a fluctuating course, and it is a disease that has total body symptom. You can feel tired, fatigued, you can have night sweats, you can have lymph nodes, you can--your spleen becomes enlarged. But essentially it has a list things that it does to the joints. There is this capsule around joints called the synovium. It is a capsule that encases it and that layer somehow for some reason thickens, inflames, your body just decides I'm going to--I'm going to attack my own joint. You know, it is a loose association. You could say someone that got a kidney transplant and the body rejects it. The body almost is trying to reject a certain portion of your own joint. And in that instance there are a list of things that happen. You know, you get stiff in the morning. You tend to have multiple joints involved, especially hands and wrist. You tend to have a symmetrical involvement on both sides of the body. You tend to have the disease--something under the skin as well called nodules. You tend to have characteristic changes on x-ray with erosions into the bone. You have characteristic pathologic changes when you examine affected tissue under the microscope. And you know, those are the main clinical findings in rheumatoid arthritis. And again, sometimes there is even a theory a lot of trauma can precipitate rheumatoid arthritis. It is not an absolutely popular theory, but it's--it has been mentioned, and on the other hand, rheumatoid and osteoarthritis can kind of work together, as it were, and sometimes coexist and intensify.
When you saw him on the 15th did you have any opinion as to how these conditions would affect his mobility?
Well, he was visibly limping to my eye, and my initial impression was that it was mainly the osteoarthritis or the wear and tear disease. I wasn't fully appraised of some of the background. I hadn't got all his old records. But I think that really he is limited, specifically lower extremities, by his arthritis, and he certainly was limited to a way on the 15th of June where he would have a very difficult time moving quickly in his lower extremities.
No, I don't believe that is--I think that these are long-lived symptoms. There can be some fluctuation, as I said, based on overuse, based on certain other variable, including the use of medications, but generally speaking, at the level of osteoarthritis he has it becomes a persistent daily thing and not like early arthritis where you have some, you know, totally symptom free days. He was not of that.
Was there any medication that Mr. Simpson was taking, to your knowledge, for these conditions?
800 milligrams which is a non-steroidal anti-inflammatory. It is knock-off of aspirin essentially. He was not taking a huge dose of this. He was not taking enough that most rheumatologists would think that that was a treating level of drug to really ameliorate rheumatoid arthritis but basically just to occasionally knock down symptoms. And in arrears we found out--I found out because there was my first visit with him that he had also been put on sulfasalazine which is a disease modifying drug for rheumatoid arthritis, but that in fact he had stopped taking that about a month prior to my seeing him.
Do you know--did you make a recommendation as to whether he should re--begin the course of sulfasalazine?
Yes. Once I got to know him and collated all his past records and re-saw him on subsequent visits, including in the jail, and determined that at least a portion of his problem was a flare of rheumatoid arthritis, we did make that recommendation.
And in that visual examination would you tell the ladies and gentlemen of the jury, starting with the head, what you observed. And would it help you if I showed you some photographs?
Sure. I can talk about each photo individually or just go through body parts, whatever you--
I have shown Mr. Kelberg a series of photographs. With the Court's permission I would like to place them quickly on the elmo.
All right. They will be marked then as Defense 1249, June 15th physical exam photos.
Well, initially I was looking over every part of his head, including his scalp, for any evidence of hematomas, which is a--after you get some direct trauma, a little bleeding under the skin, think bump, you know, you know it as a goose egg. We were looking very carefully for scratch marks. I was looking for any area of a chipped tooth and ran my fingers around all of his teeth in his mouth. We were looking for any evidence that anything had kind of pulled on his ears and looked very carefully behind his ears and examined his skin. In addition, I did a very careful physical exam of his nose. I do that routinely, looking for any evidence of the use of cocaine and his nasal passages were entirely normal. Looked very carefully on his neck for any evidence of pulling or tugging or any bruise. Basically a bruise is some evidence of direct contusion without laceration, and saw none. There was no purpura which is a black and blue type of mark if you break a blood vessel under the skin. There was no evidence of change in skin color other than some these of these old darkly pigmented evidences of old abrasions and the multiple cuts you get as a football player.
Did you make any--did you find anything of significance in the examination of the left profile of Mr. Simpson?
Specifically did you find any evidence of bruising, scratches, cuts or abrasions?
Would you describe your findings regarding the profile of the right side of the face.
The right side of the face was likewise completely clear. The right neck and jaw area also showed no evidence of any acute recent onset trauma; scrapes, scratches, bruising.
Would you agree that as of the 15th in the entire area above the neck of Mr. Simpson there was no evidence of any physical contact?
And is this the way he appeared when you conducted your visual examination on the 15th?
Would you describe your findings to the ladies and gentlemen of the jury, please, regarding the front torso area of Mr. Simpson.
The front torso area on the 15th revealed no evidence of any bruises, scrapes or scratches of any sort. There were old scars and I believe on the upper right he had a little keloiding dark area on his upper chest, but no, no acute injuries.
Was there any evidence of any recent injuries whatsoever to the front torso of Mr. Simpson?
May I direct your attention to the back of Mr. Simpson. Is this the way he appeared on the 15th?
Well, here we looked very carefully for under the armpit, whether, you know, someone had grabbed in the triceps area or obviously very carefully on the elbows as well and up on the shoulders. And I saw no evidence of any trauma or any direct bruises or injuries or discoloration of his skin other than previous scars from long, long time ago.
Umm, his right upper extremity, his shoulder, biceps, triceps area, as well as the elbow, did not show any areas of bruises or any cuts of a recent nature.
On--I can't seem to find the left arm at this point. We are unsure we will get a photograph of it. But would you describe your findings of the left arm in the same area to the jury.
The left upper extremity, shoulder, biceps, triceps, elbow region, did not reveal any evidence of any trauma.
All right. Doctor, so you don't strain your neck looking up at the monitor, where you have your notes there--
We now progress to the leg area and the knee area. Would you describe your findings and what this depicts.
I'm going to refer to my physical exam here because he had a large keloid area from a distant procedure.
A keloid is an overaggressive scarring. Basically tissue undergoes a lot of different stages of healing, and in certain situations under certain conditions, including genetic and there are certain racial proclivities, some people actually form too much of a scar. The scar actually can have three-dimensional components that obviously plastic surgeons, if they are doing a procedure--in this case it was a biopsy--don't want that overgrowth of scar tissue, but in that upper thigh area, and it was the left inner mid-thigh, he had keloiding biopsy scar and that was also an old--an old injury. He also had a small skin tag which is a normal epidermal extravasation of skin in that left upper thigh. That also was a normal non-worrisome finding.
Let me show you the right upper thigh area. Would you describe your findings regarding Mr. Simpson's condition on the 15th.
On the 15th there was no evidence of any trauma or bruising or any evidence of recent trauma.
Let me show you some photographs that I believe were taken on the 17th. Do you recognize those photographs?
Umm, he has the obvious multiple biop--excuse me--surgical incisions on the left knee. You can see the railroad tracks. On the 15th he had no evidence of any trauma. On the 17th, on the right knee--I would have to look at the pictures--there was an ever so small little dot of a scrape that I had specifically looked at and photographed on the 15th and had not appreciated.
I will show you additional photographs. We will see if there is anything else--were these also photographs on the 15th--on the 17th?
Again, it is difficult to see, but my previous comments would hold on the 17th, and again I would have to see the exact picture, but there was a very small dot where it just looked like very tiny circular abrasion, probably only one or two millimeters, basically like even an infected hair that you would pick or some sort of just local dot that was a scab over that knee. And other than that, there was no evidence of any trauma and that was just seen, as I said, on the 17th and not on the 15th.
Reexamined on the mouth on the 17th and likewise found in chipping of any teeth or any sharp edges that appeared to be of recent origin in his teeth.
Yes, they are. That is my nurse, Linda Kita, and we had a special lab technician from Cedars hospital that accompanied us as well to make sure that all the tests were done very properly for the types of tests we were looking for.
Let's now go to your observations of the hand area of Mr. Simpson on the 15th in more detail.
And let me show you a photograph. These--photographs were taken on both the 15th and 17th of this area?
Let me show you a photograph. I think this was--do you know when this photograph was taken?
Okay. Let's go with the left hand since we have it up there. Was that the way--well, describe what you see in the photograph.
Well, there is a jagged laceration that extends from the distal interphalangeal joint of the fourth left finger and it comes in almost a snake-like fashion and just it--it slices coming down in this way, (Indicating), and then it almost seems to change in the plane and then it is a deeper cut. On the top, some of the very superficial--if you just go through the outer layer of the skin, the epidermis, you won't bleed because there is no blood vessels in that outer layer of the skin and you have to go deeper to get into the dermis and then this is various layers of the dermis. And in the inferior portion where it extends to just above the proximal interphalangeal joint is where it became a little bit deeper but still it was quite what we would call a very superficial wound. And essentially the part that was a little bit deeper was a half of a centimeter in length and it didn't appear exactly straight.
Thank you. Did you observe this injury on Mr. Simpson on the 15th, as well as the 17th?
Okay. Okay. On his third finger he had a lesion that had the appearance of a fishhook and basically from the top it came down and kind of fished in a direction toward his fourth index finger. And you can see it crossed this joint line and it appeared to have an angulation or a beveling to it such that it was an injury from this type of direction, (Indicating), and it was--fishhook when it was measured was about a centimeter and a half or a little bit under, you know, three quarters of an inch plus or minus. Umm, he had a second laceration on that third finger that you can also see in the picture there, which was--
You can see the inferior portion--actually I can point it out right here. From this area--now, I can't point it out.
All right, doctor. Why don't you step down behind the projector there. I think you might get a clearer view.
Okay. This was the lesion that we just described. There was approximately a--one centimeter--laceration that was just proximal to his distal interphalangeal joint right here on the left third finger, (Indicating), and it had a angulated or beveled approach that seemed to come more from this direction, (Indicating), and it also had some amount of a shaggy border to it. It wasn't exactly clean. And it basically extended right in that direction there, (Indicating).
Do you have any opinion as to--let's leave that up for a second--as to how the injury above the knuckle was caused?
Do you have any opinion as to how the second injury depicted on that photograph was caused?
And regarding the two other injuries that you described in the earlier photographs on the side of the finger, do you have any opinion as to how they were caused?
Anything with a sharp edge, sharp metal, glass, umm, anything with not a blunt surface.
A knife is a possibility, but to me the edges looked a little bit ragged, but that was a possibility, but it seemed to me to be more consistent with glass, but certainly a sharp object can do that.
Is that referring to the fishhook injury above the knee--above the knuckle now. Let's talk about the one above the knuckle. What is your best opinion as to how that injury was caused and what is your reasoning for that?
It was caused by a sharp object. Umm, I looked very carefully to see if it was a tooth mark, because obviously that is one of the more common things to happen right over a knuckle, but those tend to have very jagged serrated--puncture like--appearance and I didn't see that. And obviously those need prompt antibiotics, so I didn't believe it was that. I also looked to see if it could be a scratch, but a scratch will never give, you know, a angulated cut of that nature. And so basically concluded it was a sharp object. And that was probably the smoother of the cuts that I observed.
And within the range of sharp objects that you have described that could be potential causes for that, what is your best opinion as to what caused that particular injury?
And would you describe to the ladies and gentlemen of the jury and to his Honor what your expertise is in emergency rooms.
Well, from approximately June of 1979 to 1984, I probably worked and moonlighted in nine or ten different emergency rooms probably at an average of twice a week, which would be two twelve-hour shifts, something like 24 hours a week for, you know, for a period of five plus years.
And have you treated for injuries or cuts that are similar to the one depicted in this photograph?
There can be. Typically glass may have more of a jagged area, but occasionally glass looks just like a knife. A glass cut appears very similar to a knife cut.
In this wound, do you have an opinion as to what is more reasonable as the cause for that injury?
This wound, as I said, was one of the--appeared to be slightly cleaner than the others, but I think for the constellation of all the wounds it seemed more likely that glass was the cause.
Yes. All right. Ladies and gentlemen of the jury, we are going to take our mid-morning recess for fifteen minutes at this time. Remember all my admonitions to you. Doctor, you can step down. You are ordered to come back in fifteen minutes. All right. We will be in recess for fifteen.
he had severe wear and tear arthritis of the left knee and was a strong candidate in the relatively near future for a total knee replacement.
he would have a very difficult time moving quickly in his lower extremities.
as of the 15th in the entire area above the neck of Mr. Simpson there was no evidence of any physical contact... by someone else.
he was visibly limping as he came down the hall. You know, that is the first thing that strikes me. And he really was not walking properly.
something like seventy possibly eighty percent of NFL players suffer from a permanent physical disability, football playing related, that affects them for the remainder of their lives.