📄 Direct examination of Dr. Lakshmanan Sathyavagiswaran (part 8) — Tuesday, June 6, 1995
Address:
C:\DEPT103\CRIMINAL\1995\JUN\6\DIRECT-EXAMINATION-OF-DR-LAKSH.DOC
TRIAL
▲ Day 89 of 167

Direct examination of Dr. Lakshmanan Sathyavagiswaran (part 8)

Witness: Dr. Lakshmanan Sathyavagiswaran
Examiner: Brian Kelberg
Called by: Prosecution • Date: Tuesday, June 6, 1995 • Utterances: 84
Dr. Lakshmanan continues his direct examination with detailed testimony about the major stab/incise wound to Nicole Brown Simpson's neck, explaining that both carotid arteries were transected (completely severed), causing massive and fatal bleeding. He concludes that the absence of cuts along the wound margins indicates no resistance, and that Nicole was likely face-down and unconscious when the wound was inflicted left-to-right — a conclusion he physically demonstrates on Kelberg's own neck using a ruler.
1 THE COURT:

Thank you. Mr. Kelberg.

2 MR. KELBERG:

Thank you, your Honor.

3 MR. KELBERG:

I'm sorry, doctor. Is there something further with respect to the transection I think you said of the epiglottis?

4 DR. LAKSHMANAN:

Yes.

5 MR. KELBERG:

Anything further you wish to add on that point?

6 DR. LAKSHMANAN:

Yes.

7 MR. KELBERG:

And keep your voice up, please.

8 DR. LAKSHMANAN:

The wound also transects the vessels of the neck, which we'll discuss in photograph b-16 when we come to that, or do you want me to discuss it now?

9 MR. KELBERG:

No. Actually I want to start with, is there some significance to you in the direction that the wound appears to have from that photograph?

10 DR. LAKSHMANAN:

Yes. Studying the description of the injuries plus the photograph, you see that this end has got a sharp end, and also when you see photograph b-16, you see the right end of that same wound is also sharp. So this wound is an incise/stab wound. That is, the knife started as an incised wound and then penetrated the neck area, and it travels from left to right going upwards. And if you look carefully at the other photograph, which you can see--which I have reviewed--it shows a bridge of tissue there, which would indicate that is the starting point of this wound. And if you review the description, the area of the--I mean the description of the structures, the structures in the deeper portion of the neck were injured more on the left side compared to the right side. So basically the wound was deeper on the left side, and as it went to the right side, it became shallower.

11 MR. KELBERG:

What is the significance of any of that observation?

12 DR. LAKSHMANAN:

That would also support the opinion that the wound traveled--was inflicted in a left to right direction.

13 MR. KELBERG:

Now, doctor, in the photograph b-13, there appears to be an area that is, as you look at the photograph, to the right of the end of that or the beginning as you've testified of that stab/incise wound. What is that area?

14 DR. LAKSHMANAN:

That is the left side of the neck and that has a stab wound there (Indicating).

15 MR. KELBERG:

Doctor, I would like to invite your attention to photograph b-18, which is the left-most photo on the lower row of this exhibit 352. What is shown in this photo if it bears on what I just asked you?

16 DR. LAKSHMANAN:

You can see the stab wound, the stab wound, the lowest of the four stab wounds on the neck. The left side of the neck has four stab wounds. They've been numbered 1 through 4 from superior or the top of the head to inferior, and I'm referring to stab wound no. 4 here, which is the one that you see in the photograph here (Indicating).

17 MR. KELBERG:

And here being photograph b-14?

18 DR. LAKSHMANAN:

Yes.

19 MR. KELBERG:

Doctor, inviting your attention to b-18 and what appears to be on the left-most portion of the neck of Nicole Brown Simpson, what are we seeing there?

20 DR. LAKSHMANAN:

I'm sorry. I didn't--

21 MR. KELBERG:

I'm sorry. You want--if you'll give me the pointer for just a second. I'm referring to this area on the photograph (Indicating). What are we seeing there?

22 DR. LAKSHMANAN:

That is the left-most portion of this large incise/stab wound, which I already described.

23 MR. KELBERG:

Is the appearance of that stab wound, that area of significance to you?

24 DR. LAKSHMANAN:

Yes. This is what I wanted to bring up. It's a sharp pointed end, and so it started as an incised wound. But then you see a small bridge of tissue there where the penetration of the knife took place, where there's a penetrating component to this wound. It started as an incised wound, but there's a penetrating component. You can see a bridge there. And then the wound continues transecting the structures I already discussed. There's also injury to the vessels I told you in the neck.

25 MR. KELBERG:

Doctor, what vessels are in that area of the neck?

26 DR. LAKSHMANAN:

Both sides, you have the carotid arteries on both sides and the jugular veins, and the carotid artery was transected on both sides.

27 MR. KELBERG:

What does "Transect" mean?

28 DR. LAKSHMANAN:

That is, it was literally divided in two pieces.

29 MR. KELBERG:

What is the effect of transecting a carotid artery?

30 DR. LAKSHMANAN:

Massive bleeding.

31 MR. KELBERG:

And what will be the reaction of the body to a transection of either the left or right side carotid artery?

32 DR. LAKSHMANAN:

Bleeding and you could have a sudden loss of supply of one side of the front of the brain. You could have seizures, and then ultimately you could die because of the rapid bleeding from this large vessel.

33 MR. KELBERG:

Doctor, the jugular vein, left or right side, will produce what kind of body reaction if transected?

34 DR. LAKSHMANAN:

That can cause bleeding. Sometimes jugular vein transection can result in air being sucked in to the vein and causing air embolism. But the principal usual effect of cutting of any vessel is bleeding.

35 MR. KELBERG:

Doctor, inviting your attention to b-8--b-16--excuse me--does this give a fuller depiction of the depth of that major stab/incise wound?

36 DR. LAKSHMANAN:

Yes. This is the thyroid hyoid--I'm talking about b-16 now--you can see the thyroid hyoid area transected. And if you look behind the larynx, the stab wound is also--the incise/stab wound is also passed through the hypopharynx of the pharynx, that is the structure behind the larynx. And you also have evidence that the sharp force injury has caused injury to the cervical spine. This is the spine you're seeing here in this photograph right here (Indicating).

37 MR. KELBERG:

In photograph b-16. And you're pointing to approximately the middle portion of the wound itself; is that correct?

38 DR. LAKSHMANAN:

Yes.

39 MR. KELBERG:

Doctor--I'm sorry.

40 DR. LAKSHMANAN:

And then what you see here as pale structures is the carotid jugular vein area. In the neck, the jugular vein is on the outer side of the carotid artery, and they both are in a sheet called the carotid sheet. It's a covering around those structures there. So if you read the description of the autopsy report, the left and right carotid arteries both were transected. The left jugular vein was almost transected. There was only a bit of the vein left in the back. But on the right side, the jugular vein was only--had a quarter-inch cut. And this is significant because this also would go along with the opinion that the wound was deeper on the left side and shallower on the right side because the vein was only partially cut. As I told you, the vein is on the outside of the artery. So that would also support that opinion that the wound is shallower on the right side compared to the left side, which again go with my opinion that the wound was from left to right going upward to below the ear.

41 THE COURT:

All right. Mr. Kelberg, would you wind it up?

42 MR. KELBERG:

All right. Could I just have a couple more questions?

43 THE COURT:

No. I'm just giving you--

44 MR. KELBERG:

Warning.

45 MR. KELBERG:

Doctor, inviting your attention again to b-16, did you examine the what I'll call margins of this major incise/stab wound as well as its depiction in b-13 as well as its depiction in b-18?

46 DR. LAKSHMANAN:

Yes.

47 MR. KELBERG:

What are the margins?

48 DR. LAKSHMANAN:

The margins don't show any--margins are the borders of this large wound, the borders, and they do not show any additional cuts.

49 MR. KELBERG:

Is that of significance to you?

50 DR. LAKSHMANAN:

It is of significance to me because that means there was no resistance whatsoever when that wound was being inflicted.

KEY QUOTE
51 MR. KELBERG:

Doctor, what would you expect a person who was about to receive that kind of wound to do if the person was physically capable of doing anything?

52 MR. SHAPIRO:

Objection. Calls for speculation.

53 THE COURT:

Sustained.

54 MR. KELBERG:

Doctor, in your experience, have you studied how people react to threats of incised stab wounds?

55 DR. LAKSHMANAN:

Yes.

56 MR. KELBERG:

Doctor, given the absence of cuts around the margin--I'm sorry. Withdraw that question. Assuming that Nicole Brown Simpson had the capacity, physical capacity to try and avoid that major stab/incise wound being inflicted, what would you expect her to try and do?

57 MR. SHAPIRO:

Objection. Calls for speculation.

58 THE COURT:

Sustained.

59 MR. KELBERG:

Doctor, if there were cuts along the margin, what if any significance would it have to you in identifying what if anything Nicole Brown Simpson had done before or during the infliction of that wound?

60 MR. SHAPIRO:

Objection. Compound, calls for speculation, the latter part.

61 THE COURT:

Overruled.

62 MR. KELBERG:

You may answer the question, doctor.

63 DR. LAKSHMANAN:

If you have additional cuts, that would support that there was some struggle involved. There was some movement of the neck and head involved. So it was not a clean-cut wound as I see it here.

64 MR. KELBERG:

Doctor, if Nicole Brown Simpson was unconscious at the time that that major stab/incise wound was inflicted, would that be consistent with your identification of no cuts around the margin of that stab/incise wound?

65 MR. SHAPIRO:

Objection. Improper hypothetical.

66 THE COURT:

Overruled.

67 MR. KELBERG:

You may answer the question, doctor.

68 DR. LAKSHMANAN:

That would go along with the findings of no additional cuts, single major incise/stab wound which runs from the left to the right, deeper on the left, shallower on the right opinion I have given.

69 MR. KELBERG:

Doctor, did you form an opinion after all of the material, all of the photographs as to when in the relationship of the receipt of all of the injuries that Nicole Brown Simpson received that this major stab/incise wound was inflicted?

70 DR. LAKSHMANAN:

Yeah. Based on all the crime scene photographs which I had opportunity to see, based on the blood flow on the ground, based on the lack of any blood on the back of the left hand, my opinion is that Miss Brown was on the ground face down when this wound was inflicted. My opinion is that the head was extended backwards and the knife was used to cause this incise/stab wound from the left to the right.

71 MR. KELBERG:

Doctor, if you can--if I can slide over here for a moment and if you could use me and my head and hair, would you demonstrate what is your opinion as to the manner in which that last major incised stab wound was inflicted?

72 MR. SHAPIRO:

Objection. Improper demonstration.

73 THE COURT:

Overruled.

74 MR. SHAPIRO:

No foundation.

75 MR. KELBERG:

You may do that, doctor.

76 DR. LAKSHMANAN:

Assuming that you are face down on the ground and this ruler is my weapon, I would expect the head to be hyperextended this way and start an incision this way from the right side of the neck, run in a horizontal manner and go upwards towards the ear with this part being the deeper portion and this part being the shallower portion (Demonstrating). And the blood flow pattern on the ground which I saw in the crime scene photographs, the lack of additional cuts, the deeper wound on the left side compared to the shallower wound on the right side would support this opinion.

KEY QUOTE
77 MR. KELBERG:

And a six-inch long knife blade would be consistent with doing that kind of wound?

78 DR. LAKSHMANAN:

It could be capable of doing this wound.

79 THE COURT:

All right.

80 MR. KELBERG:

Your Honor, is this a--

81 THE COURT:

Yes.

82 MR. KELBERG:

May I just take this down?

83 THE COURT:

Please.

84 (Brief pause.)

Temperature

devastating

Key Quotes (4)

Dr. Lakshmanan Sathyavagiswaran
It is of significance to me because that means there was no resistance whatsoever when that wound was being inflicted.
Supports the prosecution's theory that Nicole was incapacitated — likely unconscious — when the fatal neck wound was delivered.
Dr. Lakshmanan Sathyavagiswaran
My opinion is that Miss Brown was on the ground face down when this wound was inflicted. My opinion is that the head was extended backwards and the knife was used to cause this incise/stab wound from the left to the right.
The medical examiner's central opinion about the final fatal wound — clinical language describing an execution-style killing.
Dr. Lakshmanan Sathyavagiswaran
Assuming that you are face down on the ground and this ruler is my weapon, I would expect the head to be hyperextended this way and start an incision this way from the right side of the neck, run in a horizontal manner and go upwards towards the ear with this part being the deeper portion and this part being the shallower portion.
A rare and striking courtroom demonstration — the doctor physically re-enacting the fatal wound using Kelberg as a stand-in for Nicole.
Dr. Lakshmanan Sathyavagiswaran
The left and right carotid arteries both were transected. The left jugular vein was almost transected. There was only a bit of the vein left in the back.
Establishes the catastrophic severity and depth of the wound — transection of both carotid arteries is immediately life-threatening.

Evidence (5)

People's 352 (photograph b-13)
Autopsy photograph showing the beginning/left end of the major stab/incise wound to Nicole's neck
discussed
People's 352 (photograph b-14)
Autopsy photograph showing stab wound no. 4 on the left side of neck
discussed
People's 352 (photograph b-16)
Autopsy photograph showing full depth of the major stab/incise wound, including transected thyroid/hyoid area, hypopharynx, cervical spine, and carotid/jugular structures
discussed
People's 352 (photograph b-18)
Autopsy photograph showing left-most portion of the major incise/stab wound with bridge of tissue marking the wound's starting point
discussed
Informal
Crime scene photographs showing blood flow pattern on the ground — used to support opinion about Nicole's position when the fatal wound was inflicted
discussed

Notable Exchanges (3)

Brian KelbergDr. Lakshmanan Sathyavagiswaran
Kelberg offers his own head and hair as a prop and asks the doctor to physically demonstrate the fatal wound. The doctor uses a ruler as the knife and manually positions/extends Kelberg's head to recreate the killing motion, narrating as he goes.
clinical but viscerally striking
Lance A. ItoBrian Kelberg
Ito tells Kelberg to 'wind it up'; Kelberg finishes the word — 'Warning' — acknowledging the signal, then gets two more questions in before the demonstration.
light
Robert ShapiroLance A. Ito
Shapiro objects twice to speculation questions about Nicole's capacity to resist — both sustained — but then loses three successive objections including one to the physical demonstration itself.
strategic

Light Moments (1)

Brian Kelberg
Ito tells Kelberg to 'wind it up'; Kelberg completes the judge's sentence with 'Warning.' — a small, wry exchange that briefly punctuates deeply grim testimony.

Witness Demeanor

(Indicating) — repeated throughout as doctor points to photographs
(Demonstrating) — during physical re-enactment of the fatal wound on Kelberg
(Brief pause.) — end of session

Objections

5 objections (2 sustained, 3 overruled)
Proceeding 6290 • 84 utterances • Prosecution witness
Criminal Trial
Department 103
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📂 JUN 6, 1995 📄 Direct examination of Dr. Laks
JUN 6, 1995 KRT DvH TD