Dr. Lakshmanan, there's some additional information on this consultation report form 13 from Dr. Boger. You covered the finding no. 1. What is finding no. 2 concerning?
Regarding a small bone fragment which was displaced by this sharp force injury to the third cervical spine.
It was cut away from the portion of the vertical body, but it was still in--in--in contact with the body because there was tissue still holding it with the body of the vertebra.
And this action of cutting it away is due to the knife that is inflicting this fatal wound; is that correct?
He's just describing it in detail radiologically, what was seen in the radiograph.
Basically, the lower border of the vertical body was cut and a piece of the bone was displaced by this cut.
What, if any, significance does, first of all, the fact that there is this fragment have on your opinions concerning the nature of this sharp force injury?
It further reinforces that it's a sharp border which made this cut of the bone because the edges are smooth and straight.
It is a sharp instrument like a knife that caused this injury. That's what it reinforces.
Is there anything else of significance that you wish to discuss regarding Dr. Boger's consultation report?
Now, if I can just flip the page. Doctor, now we have another document. Are you familiar in general terms with this report?
This is the forensic analysis report, which I alluded to earlier, conducted by our senior criminalist, Mr. Steve Dowell, on the laryngeal specimen as well as the vertebral specimen which he looked at.
Yes. He specializes in tool mark analysis and helps the department try to compare a potential tool which caused a potential mark on a bone to see whether that tool was the tool which caused that mark on a particular bone.
Doctor, can you summarize for us in lay terms what Mr. Dowell did and what his findings if any were?
He examined the--both the cervical spine and the laryngeal specimen which included the thyroid, hyoid area looking at the margins of the cut to see whether there's any foreign material, to see whether there's any fibers--I mean--and he recovered some foreign material from the margins of this laryngeal specimen. He also looked at the margins to see whether it was clean cut and if it was from a sharp instrument. So that is basically his examination. And if you turn to the next page, he did recover some material from the specimen.
All right. Is this first page to discuss what he in fact saw in the course of any examination of the cervical vertebra?
Yes. He discussed in detail the injury which we discussed earlier, giving its dimension, giving its angle and also indicating its appearance.
Let me just, if I could have a marker, indicate that this relates, does it not, doctor, then to these photographs, B-13, B-16 and B-18?
And I've written that on the right margin of the first page. Anything further on the first page?
No. This is the laryngeal specimen he examined and there recovered--he examined the margins as I mentioned earlier. It was caused by sharp force injury. And he recovered a dark colored fiber on the cut margin of the epiglottis. And he also recovered some light gray metallic material which was seen on the surfaces of the larynx. This both were recovered on October 4th, `94, and it was done with the help of LAPD criminalist.
Doctor, were those materials described in the quotation marks "Dark colored fiber" and "Light gray metallic material" both of them saved at the Coroner's office?
Yes. And then he makes a conclusion that the defects he saw in the larynx and spine are consistent with sharp force injury, and here he says that if they do get a suspect tool, he'll make further comparisons of this sharp force injury.
In his discussion, in his conclusion, there is a line saying there is no, quotes, specific unquote, information in the marks to suggest a, quote, specific, unquote, configuration for the tool other than a tool that fits with constraints placed on the tool by information on other marks as described in the autopsy report. Can you summarize in lay terms what that means?
Basically he--he--his--my reading of this report will be that the injury he saw, the larynx, is consistent with the same sharp force injuries we saw in the rest of the report which I've already discussed.
And then the paragraph continues, however a, quote, general, unquote, class of tool apostrophe--I'm sorry--parentheses s, closed parentheses, can be described, and if a suspect tool is located, considerable comparison may be done between features of the suspect tool and the above material. First of all, is the material that is referred to the material that is described in items 2 and 3 under paragraph b of page 2?
The other conclusion is also, they could make comparison to tool itself with regarding to the margins of the wound.
All right. And, doctor, with reference to Mr. Dowell's use of the term general, unquote, class of tools, does that have meaning to you with respect to any limitations placed on the forensic pathologist in identifying a specific knife on the basis of the findings made by Mr. Dowell and Dr. Boger?
It would mean that if you have a suspect weapon, it would be--there would be other similar weapons of the same class because any instrument which has the same sharp edge could cause similar injuries of this nature.
Is this conclusion an indication of a limitation to the ability of a forensic pathologist to identify a specific knife rather than a general class of knives such as a single-edged knife of approximate dimensions based upon the findings made by Mr. Dowell and Dr. Boger?
And let me invite your attention to the second of the 20-H forms. This is the form that appears to depict the schematic of the human body with the human skeleton shown. Are you familiar in general terms with what is shown in this particular diagram?
This is the diagram used by Dr. Golden to document the cervical spine injury which he saw, and I showed him the photograph B-16 or B-13, and he has diagrammed the injury to be the C-3 area, body of C-3.
The spine is made up of different pieces of vertebra, and each vertebra has a part to it which is called the body of the vertebra, which is the front of the vertebra. And that is what is meant by the body of the vertebra. And the wound on the spine--the body of the vertebra was three-quarters of an inch by quarter inch deep and it was transverse, that is horizontally oriented. C-3 is the third cervical, and he's repeated it here, body of C-3. And the most--he also indicates that the spinal cord is negative. That is the injury did not go into the spinal cord, it only ended in the spine.
For the record, your Honor, on this form, I'll write in with the blue marker B-13, B-16, B-18.
Doctor, does there appear to be something to the left as you look at the diagram to the left of the schematic of the front of the body?
Now, we're going to put up two boards, your Honor, 1-B and 9-B, from our collection.
And let me invite your attention to--again, this is board 1-B and form 15. And I want to discuss now any samples that were preserved by Dr. Golden at autopsy for toxicological analysis, from what you've said before, for drug, alcohol, screening purposes. Does this form 15 show what if anything was preserved by Dr. Golden from the Nicole Brown Simpson autopsy for that purpose?
He saved heart blood and urine as is indicated on the right side on the toxicological specimens collected.
Let me outline that box area that you were pointing to on form 15. Does he also indicate the type of analysis that he wishes to have performed?
And you've indicated an area that I'm now circling also in red on the form 15; is that correct?
Now, doctor, let me invite your attention, if I could, please, to this other board that is 9-B. And page 1 of this board has some kind of printed document dated 6-21-94. Are you familiar with this document, doctor?
And in general, how is this type of document produced in the course of the Coroner's office operation with respect to a sample submitted such as Dr. Golden has indicated on the form 15?
The specimen submitted at autopsy is logged in by the toxicology section. The canary copy--if you remember what I said, it's a four-layer document, the 15. The canary copy goes to the toxicology laboratory. Based on the request by the doctor, the toxicology laboratory will retrieve the specimen and run the specimen for the drugs requested. "Head screen" normally would refer to the drugs listed in this report, alcohol, methamphetamine, cocaine, narcotics and PCP. So these drugs were tested for based on the request of Dr. Golden on June 14th.
And is this report generated following any such testing by employees of the Coroner's office?
Is it generated at or about the time of the events which are recorded on the document as having been the test results?
Are you familiar--there's a column--a number of columns. Let's start in the far left-hand side of this first page. And it describes a column for "Tissue," and underneath, there appears to be a series of entries, all with the same word, "Blood." What does this reflect?
And this--in this case, this would be blood taken from the body of Nicole Brown Simpson?
That is the analysis requested, which would be the drugs which are included in that "H" screen.
That would indicate the drugs which are analyzed, which would basically be the drugs which were requested.
Well--yes. It's alcohol which is present in the wine and other liquors people drink.
And if we move to the next column, there's something, "Level found." In general terms, what is that column to reflect?
It is to reflect two things. One, the amount--if the drug is present, and if it's present, how much is present.
There appear to be after the first entry two initials--two letters, "ND," "N" as in Nancy, "D" as in dog, that is repeated for a total of five entries. Does "ND" have some meaning to you?
Yes. It means not detected. And there is a legend and a key in the bottom portion of this report that says "ND" means not detected.
The next column--and I'll get back to the specific number that's found as the first entry, but let me move to the next column under "Assigned toxicologists." And for those five "ND" entries, the same initial and last name appears, L. Mahanay. Is this the same Mr. Mahanay that I believe you described earlier, was a criminalist who was asked to take some bloodstain samples from the, I think you said thigh area of Nicole Brown Simpson at the Coroner's office on June 13th, 1994?
And then the last column deals with date analyzed; and as to Mr. Mahanay's entries, it appears that the date is the same, June 21st; is that correct?
And is that date--is that date intended to reflect when the tests have been completed and reviewed by the toxicologist assigned?
Let me move back then to the top entry for the ethanol and start with the assigned toxicologist, J. Park, p-a-r-k. Who is--I don't know if that's a Mr. Or Ms. Park?
And the date analyzed would reflect the date that Mr. Park is to have analyzed the blood sample submitted for the presence of alcohol in this case finding drinking alcohol, ethanol?
Now, doctor, in the "Level found" area, there appears to be some entry. Does that entry have any meaning to you?
Yes. That would signify that alcohol was present and the amount was .02 gram percent.
As part of your training as a forensic pathologist, do you learn about the concept of alcohol being drunk, absorbed by the body and reflected on testing in blood samples taken from the body?
Basically, we do the alcohol testing routinely in all our traffic accident fatalities, which is a requirement by the law in the State of California, and the legal limit for being under the influence is .08 grams percent. And we also--the other exposure to alcohol-related deaths is people who have the syndrome of alcoholism who are found dead and without any medical attendance. We do autopsies on them, and we would determine what the fatal level of alcohol was if alcohol played a role in their death. The other situation would be somebody who goes for a party and they drink a lot and the young person who has not taken much alcohol in the past and consumes a lot and then dies from it. In that case, the alcohol intoxication is also analyzed. So our role in the alcohol analysis and interpretation would be mainly in quantitative interpretation. I'm not an expert on the effects of alcohol per se.
Are you, however, trained to evaluate, number one, what happens within the body to the alcohol that is imbibed? That is, you drink a drink of alcohol, let's say wine for example. What happens in the body to that alcohol that's in the wine?
It's absorbed from the stomach itself, some portions of it and portions of the intestine and then it's taken to the liver and metabolized by some enzymes in the liver, and some of the alcohol also is excreted into the urine. And that is briefly the metabolism of alcohol.
Doctor, is the alcohol that is going to be absorbed by the system primarily absorbed in the intestinal area?
And the alcohol initially, however, ends up in the stomach if it's drunk in the appropriate manner; is that correct?
Being a liquid, if it's not--it will be within very short time, within 20 to 30 minutes, should be going to the intestine. But also, as I said earlier, portion of it can be absorb in the stomach.
Now, doctor, are you also--withdraw the question. In order to detect a blood level of alcohol, must the alcohol have been absorbed either in the stomach or in the intestines?
And is there a time frame in general terms for alcohol to be absorbed from the time a drink is drunk until the time it is absorbed in the intestines as well as the stomach?
Doctor, are you also familiar in general terms with the relative concentration of alcohol as it is contained in various kinds of drinks?
A rough idea, because you have variation in different wines, the concentration of alcohol. You have variation in the different hard liquors, the concentration of alcohol. So you need to know the specific type of alcohol ingested to know the exact concentration. For example, port wines will have 20 percent alcohol in it. Some regular house wines will have 10 percent alcohol in it. Your hard liquors like whiskey will have 40 percent, which is 80 proof. So it varies. So you need to know what type of alcohol was consumed.
Doctor, does the level that is detected in Nicole Brown Simpson, .02 percent, have meaning to you if you assume the following circumstances? That Nicole Brown Simpson visited the Mezzaluna restaurant at approximately 10 minutes to 7:00 on the evening of June 12th, 1994; that she left that restaurant sometime between 8:30 P.M. and 9:00 P.M. with some testimony saying that she left about 8:45ish; that in the course of being at the restaurant, a bill was opened by the server, and from the time the bill was opened until the time the bill was closed, meaning that no additional food or beverage had been ordered, an hour and 14 minutes passed within this time frame of 10 to 7:00 arrival and the time frame then of leaving 8:30 to 9:00, 8:45ish; and that assume further that Nicole Brown Simpson during that time had up to two glasses of a wine from a bottle provided by the restaurant, of a typical California wine, and that Nicole Brown Simpson died at approximately 10:15 P.M. on June 12th, 1994. Given those circumstances, does a level of .02 percent have any significance to you in saying whether or not that is consistent with that set of circumstances?
Doctor, approximately what percentage of alcohol is absorbed from a single glass of house wine?
A significant percentage will be absorbed from the stomach and the intestine. And I'm not an alcohol metabolism expert and I'm only going to give you some general knowledge which I have in the field. So a glass of wine can cause a level of anywhere from .02 to .03 depending on the concentration of the alcohol in the wine and other perimeters--
--and other--other perimeters associated with it, depending on the concentration of the alcohol in the wine.
Doctor, have you in fact--you don't practice it as a regular part of your practice as a forensic pathologist to analyze the rate of absorption of alcohol from drinks in the human body; is that correct?
But do you in fact have experience and training as part of your training to be a forensic pathologist in your practice in knowing about that?
As I told you, I have general idea about the knowledge about the alcohol metabolism, and my experience and expertise is mostly on levels which cause death. And I already told you that I'm not an expert on explaining the effects of alcohol in the body.
And I'm not going to ask you about the effects of alcohol. But in understanding levels of alcohol, do you have training as to the rate at which the blood alcohol will show itself from drinks that are imbibed by the decedent?
In a very general manner. As I told you, a glass of wine can cause a level of .02 to .03 if the alcohol level in the wine is about 10 percent. And the metabolism of alcohol is if--in an average person, would be .015 percent per hour if--if the person does not continue to drink. And based on that, you can make some calculations. But I would not want to offer an opinion on that because I'm not an expert in that field.
I understand, doctor. But just talking the general terms of a .02 to a .03 blood alcohol level associated with a single glass of 10 percent alcohol house wine; is that accurate?
And if somebody had two glasses of that--first of all, does the weight of the individual have some bearing on what the blood level will be of the alcohol?
The weight would have, the amount of alcohol you take would have a bearing, the concentration of the alcohol would have a bearing, what food was ingested with the alcohol would have a bearing because--so a lot of factors are there. And also what other effects you have on the emptying of the stomach would have a bearing. So there are many factors which have to be taken into consideration before you offer an opinion on this kind of question.
And I'm asking you in general terms. I'm not going to ask you an opinion specifically. In general terms, a glass of wine as described can result in a blood alcohol level of a .02 to .03; is that correct?
And how long does it take in order to get that blood alcohol level, assuming a person doesn't take more than the one drink?
That is the rate at which the alcohol is digested by the body, and that I gave as an average rate of .01--.015 grams percent per hour.
So when you say "Metabolize," would that translate into a lowering of the blood alcohol level by that amount, assuming the person doesn't drink any more than the one drink?
And is a .02 percent level, as found in the alcohol specimen submitted on behalf of Nicole Brown Simpson, a level which can be used by you with your experience to assess how many drinks Nicole Brown Simpson had from the time of approximately 7:00 o'clock until the time of her death?
Yes. There are people who specialize in alcohol metabolism who can give a better opinion on this aspect of the analysis than me.
And would the same apply as to the burn-off rate as to the specific individual; that that would be a matter that can be determined with an appropriate expert who focuses on that area of science?
Doctor, in your opinion--one final area. Let me withdraw that. We're going to talk about stomach contents and time of death later on; is that correct?
And is one of the aspects I understood you to say, that alcohol may have an impact on stomach emptying?
Is that something on which you have reviewed literature in forensic pathology text?
Is that material that you have read, material which you have relied upon in forming a part of the basis for any opinion you may hold with respect to the impact of any blood--any alcohol--excuse me--on the stomach emptying process?
In general, doctor, what level of alcohol is required to have any significant impact on the rate of stomach emptying?
The information I read is 30 percent alcohol can have an impact on dealing, emptying of the gastric contents.
And when you say 30 percent, are we talking in the same types of percentage terms as .02 that's up there or what?
Is there anything further with respect to this first page of the toxicological analysis, doctor?
Let me flip the page. Now, what is this second document? It appears to be dated August 31, 1994.
That is an extension of the toxicology screen I had requested in June, in end of June to--on the blood--on the blood of Miss Nicole Brown Simpson.
Just to complete the toxicology screen because it was a head screen. I just want to make sure there were no other drugs in--present in the blood like basic drugs, phenothiazines.
In the tissue column, there appear to be two blood entries, but also an urine entry. Do you see that?
Again, we see an assigned toxicologist for each of the tests that are requested. We've already covered Mr. Mahanay. Who are Mr. Muto, and I'm not sure if that's Mr. Or Ms. Budd, B-U-D-D?
Mr. Budd is another senior toxicologist in our department who has been there over 15 years. Mr. Muto is the chief of toxicology in our department.
And does "ND" indicate the same thing it did before, that none was detected as to the drugs that were being analyzed?
Doctor, I want to move our 1-B board over and flip to the form 16. Let me just get a marker if I could, please. On this particular form, doctor--let me start actually in the upper right-hand corner where there is--appears to be the preprinted word "Brain" and the letters "Wt" and then some entries underneath that. In general terms, doctor, what is that area of this form to encompass?
The--records the weight of the organ, and also, if there's any pathology, they enter the pathology there.
Doctor, as you recall from yesterday, you talked quite a bit about a brain contusion seen in photograph B-33. Would you expect if Dr. Golden had seen that brain contusion, that there should be an entry somewhere around this upper right corner of form 16 to reflect that?
Is the failure to have entered some kind of indication of that brain contusion a mistake?
Not necessarily because some of my doctors don't enter it there, but they enter it in the diagram containing the brain. But in this case here, they indicated no injuries on the brain diagram also. So I would say it's a mistake.
Would your answers be the same as to the significance of this mistake to the questions that were asked about the significance of him writing "No injuries" on the form 29 regarding the brain?
Doctor, I want to drop down to the mid portion of form 16, and there appears to be the word "Stomach" and then some entries underneath that and there also appears to be some writing to the right of it.
Starting with "Stomach," what is that particular entry on the form, a preprinted entry on the form intended to encompass?
It--it reflects the contents of the stomach, and he has described the contents.
Is that in fact what you expect from one of your forensic pathologists conducting an autopsy in a case such as Nicole Brown Simpson; that the contents of the stomach will be examined and that there will be a description of the contents provided in this area of form 16?
He wrote the contents was 500 cc of stomach contents with pasta and he has mentioned rig--rigatoni and he's also mentioned spinach as some of the contents of the stomach.
And is there an entry between the pasta/rig and the spinach that you've indicated?
Doctor, is this what you would expect to see with respect to a description of any stomach contents observed by Dr. Golden in the course of the autopsy?
Retake the stand for a second and let me just outline that in blue on the form 16.
And I'll outline the area of the brain, your Honor, and for that, I'll write B-33 to reflect the photograph to which it may refer.
Doctor, does your office in its medical examiner's manual have a protocol to be followed regarding stomach contents?
And referring to page 63 of the same manual that we talked about I think earlier today on section--I'm sorry. Not this manual. We talked about it yesterday on homicides. Page 63 under gastrointestinal system, does it say the following? "The esophagus in its mucosa should be described. The contents of the stomach should be noted and the mucosa described. The duodenum, small bowel, appendix, colon and rectum should be described. The bowel should be opened in all homicide cases, and in other cases where appropriate, the pancreas should be described." Is that what the manual indicates?
Now, doctor, first of all, how is the stomach contents examined in the course of an autopsy?
When you open the stomach, you look at the contents and describe what the contents are, and you also, if you're going to save them, you collect them in the appropriate containers which I showed earlier on Tuesday.
How does one examine the stomach contents? Is it while it's in the stomach or after it's been removed from the stomach?
Usually you can--you can examine a portion of it in the stomach, but also you take it out and then examine it.
I believe you testified on Tuesday when we were looking at the tray of instruments that an instrument is provided for the measurement of the contents of the stomach; is that correct?
An ounce is about 30 cc's or six ounces about 180 cc. So about three ladle's worth.
All right. Doctor, now, on June 13th, when you examined or at least saw the body of Nicole Brown Simpson, was any police officer from the Los Angeles Police Department present with you?
Did you receive any information on June 13th as to what if anything Nicole Brown Simpson had eaten at Mezzaluna restaurant on June 12th, 1994, between the hours of 10:00 to 7:oo at night and roughly 8:30 to 9:00 at night?
On June 14th, did you see Dr. Golden performing any aspect of the autopsy of Nicole Brown Simpson?
I went down to see whether--whether he was doing the autopsy, but actually I--he was almost completed with the autopsy when I saw him.
Now, doctor, when you went down--I think you indicated with these forms that Detectives Lange and Vannatter were listed on the form as witnesses to the autopsy. Do you know those two gentlemen?
Did you see either of those two gentlemen in the area of where the brown Simpson autopsy was being conducted?
I--not in the autopsy room that day. I don't recall talking to them in the autopsy room.
Did you receive any information on the 14th of June from any source whatsoever as to what if anything Nicole Brown Simpson had eaten at the Mezzaluna restaurant in the time frame I gave in the earlier question?
Now, doctor, on the 14th of June, did you have a conversation with Dr. Golden regarding the stomach contents of Nicole Brown Simpson?
I--when I went down, as I told you, he was almost completing the autopsy, and I asked him did he save the stomach contents, and he said no.
Well, I just asked him because he's--because--I asked him whether he had saved it because it's an useful item to save if you think there's a medical value to it. But in this case, I thought we should save it because of the nature of the cases we were dealing with so that it will be available for anybody else who wants to examine it. Because the policy in our office is only to examine the contents and describe it and describe the volume, not to save stomach contents unless it's needed for toxicological purposes.
Let's break down your response and do some follow-up questions. Doctor, first of all, in what circumstance or circumstances do you believe that the stomach contents itself can have value to you as a forensic pathologist?
For us, the value would be to--to save it would be for cases where there's a drug overdose where you suspect suicide wherein you will have a drug level of a drug in the blood and you'll want to see how much of medication is left in the stomach which will support your opinion as to whether it was a suicide because you'll have so many tablets of the medication left in the stomach and you'll also have a high level in the blood. The other reason we save stomach contents in drug overdoses, we--sometimes the person might have ingested a drug and you may identify the tablets and your routine screen may not pick up the drug. So then you can analyze the medication in the stomach and then go backwards to check the same substance in the blood. So we principally save stomach contents in cases of drug overdose wherein we can correlate for the purposes of manner of death, as I indicated, and also sometimes assist us in the process of determining the cause of death wherein you do not find the drug in the routine drug screen.
Doctor, would another circumstance in your opinion dictate saving the stomach contents if food poisoning were a suspected source for the person's death?
That would be another reason why we would save it, in case you have a person who has had either bacterial food poisoning or poisoning from any other drugs as I mentioned.
Doctor, when you were asking Dr. Golden whether he saved the stomach contents, did you entertain in your own mind that Nicole Brown Simpson may have died from a drug overdose?
Did you entertain in your mind that Nicole Brown Simpson may have died from food poisoning from a restaurant she visited on June 12th, 1994?
Because I felt that given the nature of the case, it would be good to save the stomach contents so that if anybody else has questions as to our findings, we'll have it available for their evaluation.
Because by the 14th of June, I had been informed of the--the high profile nature of these cases.
KEY QUOTEAs to the practice of forensic pathology, what does "Defensive medicine" mean if anything?
To--to save sometimes specimens even if you're--it's not indicated medically so that it's available if any other person wants to look at a particular specimen. In this particular case, that's what it would apply to.
Well, doctor, it's not a matter of how I want to put it. Is that what your thought process was on June 14th?
Now, doctor, as a result of that thought process--and let me withdraw the question for a moment if I might. Doctor, does judgment have any role in the practice of forensic pathology?
Because in--"Judgment" is a term you--I mean "Judgment" comes with years of experience and you know that in certain cases, you may need to do a little more than what is necessary in other cases, and that's what you would refer to as "Judgment."
Doctor, would it be accurate to say that the safest way one could cover your backside in the practice of forensic pathology is to save absolutely everything that you come in contact with in the course of the autopsy?
Now, doctor, in fact, have you reviewed literature in recognized forensic pathology text dealing with what is a suggested ideal protocol for the handling of stomach contents?
And have you considered and relied upon that in forming any opinion as to whether the practice at the Los Angeles County Coroner's office should be to save the stomach contents in every criminal homicide case?
I reviewed the literature, and based on our own experience, we only save it when it's needed.
Have you also relied in part on what you have read as a suggested ideal protocol?
Is one of the materials you have read in this area again from Spitz and Fisher's medical legal investigation of death, third edition on page 29 as follows? "An ideal postmortem evaluation protocol of the rate of gastric emptying should include: "No. 1, a description of the nature, amount, size and condition of the stomach contents; "No. 2, a microscopic examination of the contents if the contents are difficult to identify or are partially liquefied by the digestive process; "3, an examination of the small intestine for undigestible markers, for example, corn kernels, tomato peels to see how far ahead certain digestive foods travel; "4, a toxicological examination of both blood and stomach contents for drugs and alcohol; "5, an evaluation of the prior medical and psychological status and related medications and drugs." is that what you read and is that in part what you relied upon?
Does it mention saving the stomach contents to protect your back side in a high profile case?
Doctor, did Dr. Golden describe on form 16 the volume that he found in the stomach?
Doctor, inviting your attention to page 11 of Dr. Golden's protocol, do you find there a description by Dr. Golden of an examination of the stomach contents?
And before you have to answer another question, I think we have a cup of water for you.
What has Dr. Golden included as a description on page 11 for the stomach contents?
"Examination of the gastric contents reveals approximately 500 ml of chewed semi-solid food in the stomach. Recognizable food particles are identified as follows: Pieces of pasta appearing to be rigatoni, fragments of apparent spinach leaves; and the remainder chewed, partially digested nonrecognizable food material."
KEY QUOTEAnd what you just read, let me outline in red, and I'll write the words "Stomach contents" words at the top on the blow-up, page 11. Doctor, you indicated 500 cc, cubic centimeters. The report actually indicates ml. Is there some relationship between cc's and ml's?
Now, doctor, from the description given by Dr. Golden, he has indicated recognizable food particles. Is this to represent a naked eye identification of the stomach contents?
And according to the ideal postmortem evaluation suggested in Spitz and Fisher, a microscopic examination of the contents is in order in this ideal evaluation protocol if the contents are difficult to identify; is that correct?
Go ahead. Go ahead. No. I'm just concerned because the doctor is obscured by the exhibit.
Doctor, given the description by Dr. Golden of the stomach contents, in your opinion, was there any basis under this ideal protocol to have a microscopic examination?
Because you can--you have recognizable food fragments there and he has clearly identified them as rigatoni and spinach and there's no necessity for a microscopic examination.
Doctor, assuming that there's been testimony in this Court from a server at the Mezzaluna restaurant that Nicole Brown Simpson on the night of June 12th, 1994 had rigatoni as part of the food that she had at the restaurant, does it appear that Dr. Golden has accurately described that in his protocol?
Now, doctor, there is in this ideal--and let me ask a couple of clarifying questions. When someone suggests an ideal protocol, does that mean that something less is not reasonable, a protocol that is less complete is not reasonable?
"Ideal" means what--what one would like to have in a particular situation, which is complete.
Limitation of resources is a different factor in this--because limitation of resources will prevent you having what is sometimes ideal.
But you also have to take into consideration what is medically necessary in our office.
And what I'm asking is, is there a distinction between what may be medically necessary and what may be ideal if you had unlimited resources and the best of all possibilities available?
That is correct. If you had unlimited resources, we could save everything on every person we autopsy. But we have to use our medical knowledge and then do what is necessary on every case we handle in our office, only do things which are medically necessary.
Judgment--as being the Chief Medical Examiner for the county, I felt in my judgment from years of experience, that some cases, you need to do a little more even though it's not medically necessary. And sometimes, even though we don't do it on every case, we may have to do it because you like to have certain results available even though you know it's going to be of no use.
And in this case, did you make a judgment on June 14th that because this was a high-publicity case being followed by the media, that it would have been safer to save everything even if there was not a medical indication for doing so?
In this particular situation, it was my--no. In this particular situation, it was my judgment to ask him to save it. That's why he saved it on Goldman. I asked him to save it on Goldman's autopsy.
Did you feel there was any medical reason to save the stomach contents of Mr. Goldman?
The same reason I gave you earlier. Because I felt it's good to have the specimen available in case we need to have it available for the--any other person who wants to evaluate it or if there was a suspect who was found so that a different person may have a need to evaluate it.
Now, doctor, just a couple more questions on this ideal protocol that call for an examination of the small intestine for undigestible markers, for example, corn kernels, tomato peels to see how far ahead certain digested foods travel. What does that mean, if anything, to you as a forensic pathologist?
Some food material like nuts and corn kernel, which you just mentioned, don't get digested in the stomach and they're difficult food material to digest and they pass through the intestinal track, and that can be sometimes used to determine when the last meal was eaten if you have a person who has died. Normally, the stomach empties in anywhere from--depending on the amount of the meal a person has taken, from two hours to four hours depending on what was eaten. And if you have particles which are not digested in the stomach, you can find that they reach to the lower portion of the small intestine called the ileocecal value in about eight hours. So--
I-l-e-o-c-e-c-a-l value. So what is being discussed here is, when you open the intestinal track, you can see where the location of these undigested corn kernel and nuts are present. But for this, you need to tie the intestine in different segments to make sure that when you remove the intestine from the body, they don't mix up and you have a correct evaluation and not an incorrect evaluation.
Now, doctor, for nuts or similar kinds of difficult to digest materials to pass into the intestines, would you expect that, assuming they had been eaten at the same time as what's identified in Dr. Golden's summary of the stomach contents, that that would have passed as well, passed into the intestines?
We're going to talk in much greater detail about the time of death issue and the use if any of stomach contents for that. But for our present purposes, doctor, is there anything else about your discussion with Dr. Golden regarding the stomach contents that we have not discussed as to why you did it?
Nothing else. It was just my instruction to him to save Goldman and when I found he had not found Nicole's stomach contents.
Doctor, the last factor in this ideal protocol calls for an evaluation of the prior medical and psychological status and related medications and drugs. I assume of the decedent?
Because she didn't die from a drug overdose and there's no indication that she was on drugs when we did the autopsy and the toxicology screen is also negative.
Examination of the gastric contents reveals approximately 500 ml of chewed semi-solid food in the stomach. Recognizable food particles are identified as follows: Pieces of pasta appearing to be rigatoni, fragments of apparent spinach leaves; and the remainder chewed, partially digested nonrecognizable food material.
Because by the 14th of June, I had been informed of the--the high profile nature of these cases.
Is it something akin to covering your backside?
I--I don't have the expertise to go into those details.