Post by Hope on Oct 8, 2021 1:37:18 GMT
This is a transcript of Sue Sharp's autopsy report:
GENERAL DESCRIPTION AND EXTERNAL EXAMINATION
This is the body of a short white female appearing to be of approximately
the stated age. Rigor is complete and reduces easily. The body is cold
to the touch. Lividity is present dorsally in small amount, and it no
longer blanches.
The scalp is covered by medium long, wavy, dark brown hair. The pupils
are round and equal. The irides are brown. The sclerae are white
except for some brownish discoloration in the areas exposed to the air
through the open lids. The mouth contains a small amount of bloody fluid.
Defects involve the upper teeth near their bases. These show roughened
edges and are up to l/4 inch in greatest dimension. All of the front
upper teeth are loosened. This includes the central and lateral incisors
and the right cuspid. The nose shows no fracture. The ears each show
blood in the ear canals which is dried but in most areas it is still
moist. The neck shows trauma to be described. The chest is flat. The
breasts are atrophic. The abdomen is essentially flat. The pubic hair
is dark brown in color. The vulva and vagina show no evidence of injury.
The vagina is virtually dry, there being only a small amount (less than
l cc.) of yellowish-white mucoid material attached to the cervical os.
The anus shows no dilatation and no evidence of injury. There is brownish
fecal material in the anal canal. The left thigh shows over its antero-
medial aspect, an oblique rectangular shaped bruise mark with oblique
lines in its center. Overall this mark is 3-l/2 x 3/4 inches in length.
The knees are free of injury. The ankles both show depressed marks in the
area of the previously described ligature and some whitish tape marking
is present on the inner aspect of both ankles. Some is also present
on the outer aspects of the right ankle. As previously described, the
soles of the feet show considerable dried and smeared blood and some
dried blood is present over the flexor surfaces of the toes. The ante-
cubital areas show no needle marks or scars and the posterior aspects
of the body are unremarkable.
WRIST AND ANXLE LIGATURES
The wrists and ankles are encircled with 2 different electric cords.
The two cords are black in color, and both are made up of double
segments. The larger cord shows a brown female plug-in type attachment
at one end. The other end is a male type plug which is black in color.
The wrists are criss-crossed over the individual's abdomen. The volar
surface of the left wrist touches the underlying right wrist, lateral
surface. White adhesive tape is present over the dorsal surface of
the left wrist, and the electric cords cover the adhesive tape. The
tape actually partly encircles the right wrist extending over the
lateral and dorsal surfaces and then back to encircle the left wrist
again, leaving bare the ventral surface of the right wrist. The thin
black electric cord encircles the wrist over adhesive tape and multiple
ties on the thin cord are present over the ventral surface of the right
wrist and adjoining medial surface of the left wrist. The smaller black
wire cord is cut on the dorsum of the left wrist, and the ends of the
cut zone are marked with tags labeled “dorsum lateral and dorsum medial”.
The thin black cord is markedly tight. The tape ligature is moderately
PAR
Continued on page 2
loose and at least 3 and up to 5 turns of tape are present about the
wrists. The tape is marked with tags labeled “left wrist medial" and
“volar right wrist" and a cut is made between these tags and the wrist
tape is removed.
The heavier black cord also loops about the wrists and extends over the
right hand between the thumb and forefinger and connects with a lead
of the cord which extends to the ankle. This connection is accomplished
with the female end of the cord caught in a suggestive double clove hitch
type knot near the dorsum of the right hand. The cord continues between the
upper thighs, just below the individual's vulva down to the ankles. It
is looped around the ankles one time and the major branch from the wrist
extends between the ankles along the medial aspect of the right ankle and
behind the left ankle. It then extends around the right ankle in a single
loop prior to extending about the left ankle in a single loop. A tie is
present on the medial aspect of the left ankle. This tie is remarkably
tight. The small black cord is also looped about the ankles and tied
on the ventral medial aspect of the left ankle in a double or triple
apparent overhand knot. The larger cord is caught up in the smaller one
over the anterior aspect of the right ankle. White adhesive tape wraps
about the ankles at least 5 times beneath the electric cord. Prominent
indentation marks are present on the ankles and wrists in the area of the
ligature marks.
GAG FROM FACE
A facial gag is present consisting of 2 portions of cloth extending
around the lower portion of the face with the anterior portions both
being in the mouth. The under portion of cloth has the appearance
of a blue bandana. The outer portion has the appearance of a nylon
female under garment. Between the two portions, in the region of the
left side of the mouth, exists multiple portions of adhesive tape.
The adhesive tape strips are approximately l/2 inch in width and are
covered with dried blood and run at roughly right angles to the facial
ligatures. The strips of adhesive are up to an estimated 8 inches in
length and 4 of these flap across the left cheek and extend between
the ligatures with tails occuring down to and below the chin in the
near midline or to the left of the midline.
CLOTHING
The subject is dressed in a terry cloth muu muu type lounging dress which
is green to blue to white in color. It is pulled up above the level
of her pubis. The dress is partly blood soaked. It has semi-short
sleeves extending approximately to the antecubital areas.
The gag is embedded deeply in the mouth. The anterior upper teeth
are present over the front of the gag. It is removed in continuity
with the tape strips after labeling appropriately the edges where cut.
The subject also wears a white brassiere which is partly blood soaked
and is in place.
The skin gag mark about the lower cheeks bilaterally is flesh colored and
is not blood covered as is the rest of the face down to the upper edge of
the gag mark, and below the gag mark a small amount of smeared dried blood
is present. The line of the mark is pale and is roughly horizontal,
extending about the upper neck just below the level of the occiput.
The 2 gags are tied on the left posteriorly with at least double knots
on each.
PAR
Continued on page 3
AT 9:45 A.M. I HAVE GIVEN TO DETECTIVE DENNIS EORCINO, PLUMAS COUNTY
SHERIFF'S OFFICE, APPROPRIATELY LABELED LIGATURES EROM EACE, WRISTS,
ANKLES, ALONG WITH THE PORTION OF PREVIOUSLY DESCRIBED ADHESIVE TAPE.
EXTERNAL BLOOD PATTERNS
Considerable dried and some liquid blood is present over the entire face
in a sometimes smudged pattern. Blood appears to have extended downward
from the right side of the mouth and nose towards the posterior head and
neck.
The pattern stops abruptly on the face at the level of the gag mark,
and below the gag mark on the under surface of the chin is a very small
amount of patchy dried and somewhat smeared blood. Few dried dotlets
of blood occur about a stab wound in the near central neck. Few more
droplets of dried blood occur over the skin of the anterior chest
about 3 wounds to be described in the upper chest. Minimal smudged blood
is also present here. A large wound beneath the left nipple shows minimal
blood at its edges, and a small apparent puncture wound just medial to the
larger left breast wound shows virtually no blood at its edges. Blood
is present on the anterior portions of both hands, and minimal blood is
present on the dorsum of the right hand and more is present on the
dorsum of the left hand. The anterior hand blood appears smeared,
whereas the dorsum of the left hand shows some linear drops of blood
especially over the little finger and the long finger. Scattered small
dried blood droplets have extended down over the anterior right thigh
and the area of the anterior iliac crest on the right. Smeared blood
is present on the lower right thigh and the right leg laterally, and
smeared blood is present on the under surfaces of both feet excluding
the arches of the feet suggesting that the individual stood or walked
in blood. Some smeared blood is also present over the lateral surface
of the leg and the thigh on the left side.
Portions of the dried blood from the soles of the feet are gathered
on moist cotton tipped applicators and are placed in appropriately labeled
envelopes.
There is virtually no blood on the posterior aspects of the body except
for a small amount of patchy, sheen-like dried blood over the left
buttock.
HEAD INJURIES
The head and face show numerous zones of blunt force trauma. The left
scalp, at a distance of approximately an inch and a half above the
central portion of the left ear, shows a stellate irregularly outlined
zone of laceration, overall measuring 2-l/2 x l-l/4 inches in greatest
dimension. This extends down to skull bone. The left ear shows, just
above the ear lobe laterally, a deep laceration through the posterior
pinna. It is 5/8 x l/4 inch in greatest dimension, and is oblique. The
ear itself is markedly bruised, and varies from bluish-red to purplish
in color. A laceration involves the anterior upper portion of the ear.
It extends from the adjacent skin of the scalp over the anterior ear
in an overall area of 3/4 x l/8 inch in greatest dimension. A skip zone
is present between the ear and the scalp portion of the wound. A 3/4 inch
laceration is present in the mid occiput posteriorly. It occurs
approximately l inch above the ear level. It is triangular in shape.
The left face in front of the ear shows a 3-inch, roughly ovoid zone
of dull bluish-red discoloration. This area is modestly swollen.
PAR
Continued on page 4
The right side of the face shows, at a distance of l-l/4 inches above
the ear, a flat laceration down to skull bone measuring 5/8 inch in
length. An irregular laceration occurs behind the bruise of right ear.
It measures 3/4 inch in length and extends down to the underlying mastoid
process.
The right upper eyelid shows 2 horizontal rough-edged lacerated wounds,
the upper one l x l/8 inch in greatest dimension, the lower one 3/8 a l/4
inch. Bluish-red bruising and some swelling involves both eyelids on
the right. A curved l/2 inch laceration with a round anterior abrasion mark
is present on the right cheek. A l/4 inch laceration is present just
lateral to the mid portion of the upper lip on the right side, and a
5/8 inch laceration which is horizontal involves the right side of the
upper lip. It is partly surrounded by reddish-blue discoloration, and the
upper lip and lower lip both show bluish-red bruising. The bridge of the
nose on the right side shows a 5/8 x l/4 inch laceration.
LOWER ABDOMINAL WOUND
In the left lower quadrant of the abdomen near the midline is an oblique
l-l/4 x l/8 inch cut. It is surrounded by a small amount of bluish
discoloration of the deep skin.
ARM AND HAND LESIONS
A dull reddish pressure abrasion which is oblique occurs above the left
antecubital space by approximately 2 inches. It is l-l/4 inches in length,
and up to l/4 inch in width. The dorsum of the left forearm shows a
zone of dull red-yellow pressure abrasion over its lower one-third. This
area is l-l/2 x 5/8 inch in greatest dimension, and is arranged roughly
in a vertical location. Considerable reddish bruising involves the wrist
area and the lower forearm area on the left as well as the dorsum of the
hand. Such zones vary up to approximately 4 inches in greatest dimension.
The dorsum of the left hand shows distally, horizontal stuttered cuts
arranged in roughly parallel fashion and commencing on the bases of the
fourth and fifth fingers, and extending approximately to the mid palm
level. These cuts are arranged in 2's or 3’s and sometimes coalesce and
occur from l/2 inch to 3/4 inch apart. They are 3/8 to an inch in length.
The dorsum of the hand also shows dull red pressure abrasions near the
wrist, and the wrist shows one similar zone dorsally. Three of these
are present. They vary from l/8 to 5/8 inches in greatest dimension.
A prominent ligature mark is present about the upper left wrist. A
superficial 3/8 inch cut is present over the middle knuckle of the
dorsum of the index finger on the left side. The palm of the left hand
is unremarkable.
The dorsum of the right hand shows considerable bruising over a 2-l/2 inch
zone. This is reddish-blue in color. Centrally located in this bruise
is an abrasion which is roughly horizontal, and approximately l/2 inch
in length. Three other dorsal abrasions are present. Few are noted
over the fingers along with few superficial cuts of the fingers; one
on the index finger is vertical and approximately l/4 inch in length.
Oblique depressed ligature marks are present on the dorsum of the right
wrist, and bruising occurs on the ventral surface of the wrist in 3
coalescing areas up to l-l/2 inches in greatest dimension. Also the
ventral surface of the palm shows, near the wrist, a l/2 inch zone of
dull red abrasion. A superficial cut occurs at the base of the index
finger of the right hand. It is horizontal and l/4 inch in length.
PAR
Continued on page 5
CHEST WOUNDS
Four stab wounds and a puncture type wound occur in the anterior chest.
One stab wound occurs in the left upper medial chest. It is l/2 inch
long, oblique, and l inch from the anterior midline. lt is 3-l/2 inches
above the nipple line. It extends only into subcutaneous tissue for
approximately l/2 inch. The second stab is 5/8 inch long, and it is
l/2 inch from the anterior midline on the right side. It is 3 inches
above the nipple line. It extends inward through the second interspace,
to enter the ascending aorta at a distance of approximately l/2 inch
above the pericardial reflection. The hole into the aorta is approximately
5/8 inch long. The estimated minimal depth of this track is approximately
2-l/2 inches. It also extends through the posterior aorta and nicks the
anterior spine for l/8 inch.
The third stab is l/4 inch from the anterior midline, l-3/4 inches above
the nipple line, and is 5/8 of an inch long. It, too, is oblique and
like the other wounds, it shows a sharper lower edge than the upper edge.
It extends down to the sternum and nicks the sternum and ends in this
location. The depth of this track is an estimated l/4 inch.
A cutting stab wound occurs over the lower portion of the left breast.
It is 2 inches long and gapes for l/2 inch. It is l inch below the
nipple, and the medial edge is 2-l/2 inches from the anterior midline.
This wound extends inward through a l-l/2 inch hole in the fifth inter-
space and extends into the left pleural cavity. It then extends through
the edge of the lower lobe of the left lung after nicking the left
7th interspace posteriorly at a distance of l inch lateral to the spine.
The hole in the posterior interspace is approximately l inch long and
is oblique. The track fades out in the underlying soft tissue. The
estimated minimal depth of this track is 5-l/2 inches. At a distance
of l inch from the anteromedial end of the larger wound exists a l/8
inch puncture wound. The puncture wound extends inward for approximately
l/4 inch, ending in the underlying fat.
All of the stab wounds demonstrate a track of anterior to posterior
with roughly no left to right deviation or up or down deviation.
The only exception to this is the large cut in the left breast. This
track appears to be extending from left towards right.
NECK WOUND
Anteriorly on the neck is a l/2 inch, nearly horizontal stab. It is
in the near midline and 8 inches above the nipple line. lt extends
directly inward with virtually no up or down deviation. The wound is
from front to back and extends slightly from left to right to enter the
larynx just below the true cord on the left side. The hole here is
l/2 inch long. It then extends totally through the larynx, through the
posterior larynx, through the adjoining esophagus and the track ends in
the anterior cervical spine approximately at the level of C3. A nick
is present in the spine l/8 inch long at the area where the track ends.
Overall the estimated depth of the track is approximately l-l/4 inches.
Hemorrhage is present about the edges of the track throughout its
course.
PAR
Continued on page 6
PRIMARY INCISION AND BODY CAVITIES
The primary incision is Y-shaped. Tone of the skin is good. The sub-
cutaneous fat is approximately 3/8 inch in the infra-umbilical region.
Tone and development of musculature is good. The left pleural space
contains approximately l500 cc. of liquid blood, the right pleural
space approximately 300 cc. The pericardial sac contains approximately
20 cc. of liquid blood. The abdominal cavity shows no excess fluid
or adhesions.
HEAD AND BRAIN
The deep scalp structures show marked hemorrhages around the various
zones of blunt force injury previously described. The posterior parietal
convexities on both sides are covered by a thin sheen of subdural blood,
approximately 5 cc. on each side. Minimal subarachnoid hemorrhage is
present on the under surface of the frontal lobe, the under surface of
the cerebellum, the lateral surface of the right temporal lobe, the
under surface of the right temporal lobe. The vessels at the base are
unremarkable. The uncal gyri show no notches. The cerebellum shows no
pressure cone. The under surface of the right temporal lobe shows a
single zone of contusion hemorrhage measuring l/4 inch in greatest
dimension. The ventricles contain no blood. Multiple slices of pons
and medulla show no gross pathology, and the cerebellar slices are also
unremarkable. The left orbital plate shows a fracture extending from
the midline up over the frontal bone. This occurs under the large lacera-
tion of the left forehead previously described.
Another fracture involves the orbital plate on the right side. It is
horizontal and approximately l/2 inch long.
Another fracture occurs beneath the curved laceration of the upper right
cheek. The underlying zygomatic arch is fractured near its junction
with the orbital rim in this location.
ORGAN DESCRIPTION
HEART: The heart weighs an estimated 250 grams. The epicardial surface
is glistening and smooth. The heart shows no stab wounds. The coronary
vessels are unremarkable. The myocardium is firm and dull red in color.
The endocardium is glistening. The valves show no lesions.
LUNGS: The left lung weighs approximately 300 grams, the right lung
approximately 400 grams. Both lungs show patchy aspiration hemorrhage,
modest in amount. Bronchi contain considerable blood admixed with
mucus. The trachea contains a small amount of similar blood. The lungs
are generally air containing, showing only focal surface grayish zones
of depressed atelectasis.
LIVER: The liver weighs an estimated l,000 grams. The surface is
smooth. The edge is sharp. On section markings are maintained. The
extrahepatic ducts and gallbladder are unremarkable. The liver is a
pale pink-tan color.
PANCREAS, SPDEEN, AND ADRENALS: The pancreas is lobulated, firm, and
yellowish in color. The spleen is approximately 50 grams in weight. It
is light red and firm. The adrenals show no features of note.
KIDNEYS: The kidneys weigh approximately 85 grams. The capsules strip
readily, leaving smooth surfaces. On section the cortices are easily
differentiated from the medullas. The renal pelves are unremarkable.
The urinary bladder contains approximately 6 ounces of pale yellow urine.
PAR
Continued on page 7
INTERNAL FEMALE GENITALIA: The uterus, ovaries, and oviducts all show
no features of note. The endometrium is thin and yellow. There is no
blood in the endometrial canal. The ectocervix shows mild erosion.
MAJOR VESSELS: The aorta is virtually free of sclerosis. The lumen is
widely patent. The vena cava contains no premortem clot.
PROVISIONAL DIAGNOSES:
l. Multiple stab wounds of anterior chest with involvement of
ascending aorta and pericardial sac and left lung.
2. Hemothorax, considerable.
3. Stab wound of larynx, with aspiration of blood.
4. Multiple lacerations of scalp and face with skull fractures
and right orbital zygomatic fractures.
5. Focal fractures of anterior upper teeth. with loosening of teeth.
6. Ligatures of wrists and ankles.
7. Multiple cuts, dorsum of left hand.
MATERIAL TO PATHDLOGI: Representative tissues.
MATERIAL TO CBL TOXICOLOGY SECTION FOR TOX SCREEN: Heart blood and urine.
MATERIAL TO TOX LOCKER: Portion of liver with gallbladder and bile, l kidney, l lung, stomach content.
PHOTOGRAPHS BY: Pierce A. Rooney, M.D.
X-RAYS BY: Sacramento Portable X~ray Service.
PHOTOGRAPHS ALSO BY: Detective Dennis Forcino, Plumas County Sheriff' Office.
MATERIAL TO DETECTIVE FORCINO AT 2:A5 P.M.:
Sample of head hair, pubic hair, right and left
hand fingernail scrapings, oral, vaginal and
rectal swabs, swabs from soles of left and right
feet, hairs from left hand, and l gray top tube
of blood.
Pierce A. Rooney, M.D., Pathologist
PAR:dj
HEART: Sections from the aorta at the edges of the stab show some
attached fibrin and red cells along the jagged margin of the track.
Hemorrhages occur into the adventitia and some fibrin deposition is
present in this location.
The coronary vessels are unremarkable. Myocardial fibers are uniform.
LUNG: The pulmonary parenchyma is focally atelectatic and some
alveoli contain red cells. Small bronchi contain few red cells in
some instances. Large bronchi contain scattered red cells, desquamated
epithelial cells and mucus.
LIVER: The architecture of the liver is preserved.
KIDNEY: Glomeruli are intact. Tubules show some autolytic change
with loss of nuclei. Small vessels are virtually free of thickening
of their walls.
BRAIN: The cerebral sections show hemorrhages in the zone of contusion
described grossly. Subarachnoid hemorrhage is also present.
ORAL SMEARS: The oral smears are composed of mature squamous cells with
a small amount of amorphous debris in the background. Sperms are not
found.
VAGINAL SMEARS: The vaginal smears are made up of sparse mature
squamous cells with occasional mononuclear cells in the background
or bacteria. Sperms are not found.
RECTAL SMEAR: The rectal smear is made up of numerous mature epithelial
cells along with amorphous fecal debris in the background. Sperms are
not found in this smear.
FINAL DIAGNOSES:
l. Multiple stab wounds of anterior chest with involvement of
ascending aorta, pericardial sac and left lung.
2. Hemothorax, considerable.
5. Stab wound of larynx with aspiration of blood.
4. Multiple lacerations of scalp and face with skull fractures,
right orbital fracture.
5. Meningeal hemorrhage, brain with focal contusion of brain.
6. Focal fractures of upper anterior teeth with loosening of teeth.
7. Ligatures of wrists and ankles.
8. Multiple cuts, dorsum of left hand.
CAUSE OF DEATH:
MULTIPLE INJURIES WITH STAB WOUND OF AORTA AND HEMOTHORAX.
Pierce A. Rooney, M.D., Pathologist
GENERAL DESCRIPTION AND EXTERNAL EXAMINATION
This is the body of a short white female appearing to be of approximately the stated age. Rigor is complete and reduces easily. The body is cold
to the touch. Lividity is present dorsally in small amount, and it no longer blanches.
The scalp is covered by medium long, wavy, dark brown hair. The pupils are round and equal. The irides are brown. The sclerae are whiteexcept for some brownish discoloration in the areas exposed to the air through the open lids. The mouth contains a small amount of bloody fluid.
Defects involve the upper teeth near their bases. These show roughened edges and are up to l/4 inch in greatest dimension. All of the front upper teeth are loosened. This includes the central and lateral incisors and the right cuspid.
The nose shows no fracture. The ears each show blood in the ear canals which is dried but in most areas it is still moist. The neck shows trauma to be described. The chest is flat. The breasts are atrophic. The abdomen is essentially flat. The pubic hair is dark brown in color. The vulva and vagina show no evidence of injury. The vagina is virtually dry, there being only a small amount (less than l cc.) of yellowish-white mucoid material attached to the cervical os. The anus shows no dilatation and no evidence of injury. There is brownish fecal material in the anal canal.
The left thigh shows over its antero-medial aspect, an oblique rectangular shaped bruise mark with oblique lines in its center. Overall this mark is 3-l/2 x 3/4 inches in length.
The knees are free of injury. The ankles both show depressed marks in the area of the previously described ligature and some whitish tape marking
is present on the inner aspect of both ankles. Some is also present on the outer aspects of the right ankle. As previously described, the soles of the feet show considerable dried and smeared blood and some dried blood is present over the flexor surfaces of the toes. The ante-cubital areas show no needle marks or scars and the posterior aspects
of the body are unremarkable.
WRIST AND ANXLE LIGATURES
The wrists and ankles are encircled with 2 different electric cords.
The two cords are black in color, and both are made up of double segments. The larger cord shows a brown female plug-in type attachment at one end. The other end is a male type plug which is black in color.
The wrists are criss-crossed over the individual's abdomen. The volar surface of the left wrist touches the underlying right wrist, lateral surface. White adhesive tape is present over the dorsal surface of the left wrist, and the electric cords cover the adhesive tape. The tape actually partly encircles the right wrist extending over the lateral and dorsal surfaces and then back to encircle the left wrist again, leaving bare the ventral surface of the right wrist. The thin black electric cord encircles the wrist over adhesive tape and multiple
ties on the thin cord are present over the ventral surface of the right wrist and adjoining medial surface of the left wrist. The smaller black wire cord is cut on the dorsum of the left wrist, and the ends of the cut zone are marked with tags labeled “dorsum lateral and dorsum medial”.
The thin black cord is markedly tight. The tape ligature is moderately
PAR
Continued on page 2
loose and at least 3 and up to 5 turns of tape are present about the wrists. The tape is marked with tags labeled “left wrist medial" and “volar right wrist" and a cut is made between these tags and the wrist tape is removed.
The heavier black cord also loops about the wrists and extends over the right hand between the thumb and forefinger and connects with a lead of the cord which extends to the ankle. This connection is accomplished with the female end of the cord caught in a suggestive double clove hitch type knot near the dorsum of the right hand. The cord continues between the upper thighs, just below the individual's vulva down to the ankles. It is looped around the ankles one time and the major branch from the wrist extends between the ankles along the medial aspect of the right ankle and behind the left ankle. It then extends around the right ankle in a single loop prior to extending about the left ankle in a single loop. A tie is present on the medial aspect of the left ankle. This tie is remarkably tight. The small black cord is also looped about the ankles and tied on the ventral medial aspect of the left ankle in a double or triple apparent overhand knot. The larger cord is caught up in the smaller one over the anterior aspect of the right ankle. White adhesive tape wraps about the ankles at least 5 times beneath the electric cord. Prominent
indentation marks are present on the ankles and wrists in the area of the ligature marks.
GAG FROM FACE
A facial gag is present consisting of 2 portions of cloth extending around the lower portion of the face with the anterior portions both being in the mouth. The under portion of cloth has the appearance of a blue bandana. The outer portion has the appearance of a nylon female under garment. Between the two portions, in the region of the left side of the mouth, exists multiple portions of adhesive tape.
The adhesive tape strips are approximately l/2 inch in width and are covered with dried blood and run at roughly right angles to the facial ligatures. The strips of adhesive are up to an estimated 8 inches in length and 4 of these flap across the left cheek and extend between the ligatures with tails occuring down to and below the chin in the near midline or to the left of the midline.
CLOTHING
The subject is dressed in a terry cloth muu muu type lounging dress which is green to blue to white in color. It is pulled up above the level of her pubis. The dress is partly blood soaked. It has semi-short
sleeves extending approximately to the antecubital areas.
The gag is embedded deeply in the mouth. The anterior upper teeth are present over the front of the gag. It is removed in continuity with the tape strips after labeling appropriately the edges where cut.
The subject also wears a white brassiere which is partly blood soaked and is in place.
The skin gag mark about the lower cheeks bilaterally is flesh colored and is not blood covered as is the rest of the face down to the upper edge of
the gag mark, and below the gag mark a small amount of smeared dried blood is present. The line of the mark is pale and is roughly horizontal, extending about the upper neck just below the level of the occiput.
The 2 gags are tied on the left posteriorly with at least double knots on each.
PAR
Continued on page 3
AT 9:45 A.M. I HAVE GIVEN TO DETECTIVE DENNIS EORCINO, PLUMAS COUNTY
SHERIFF'S OFFICE, APPROPRIATELY LABELED LIGATURES EROM EACE, WRISTS,
ANKLES, ALONG WITH THE PORTION OF PREVIOUSLY DESCRIBED ADHESIVE TAPE.
EXTERNAL BLOOD PATTERNS
Considerable dried and some liquid blood is present over the entire face in a sometimes smudged pattern. Blood appears to have extended downward from the right side of the mouth and nose towards the posterior head and neck.
The pattern stops abruptly on the face at the level of the gag mark, and below the gag mark on the under surface of the chin is a very small amount of patchy dried and somewhat smeared blood. Few dried dotlets of blood occur about a stab wound in the near central neck. Few more droplets of dried blood occur over the skin of the anterior chest
about 3 wounds to be described in the upper chest. Minimal smudged blood is also present here. A large wound beneath the left nipple shows minimal
blood at its edges, and a small apparent puncture wound just medial to the larger left breast wound shows virtually no blood at its edges. Blood is present on the anterior portions of both hands, and minimal blood is present on the dorsum of the right hand and more is present on the
dorsum of the left hand. The anterior hand blood appears smeared,
whereas the dorsum of the left hand shows some linear drops of blood
especially over the little finger and the long finger. Scattered small
dried blood droplets have extended down over the anterior right thigh
and the area of the anterior iliac crest on the right. Smeared blood
is present on the lower right thigh and the right leg laterally, and
smeared blood is present on the under surfaces of both feet excluding
the arches of the feet suggesting that the individual stood or walked
in blood. Some smeared blood is also present over the lateral surface
of the leg and the thigh on the left side.
Portions of the dried blood from the soles of the feet are gathered
on moist cotton tipped applicators and are placed in appropriately labeled
envelopes.
There is virtually no blood on the posterior aspects of the body except
for a small amount of patchy, sheen-like dried blood over the left
buttock.
HEAD INJURIES
The head and face show numerous zones of blunt force trauma. The left
scalp, at a distance of approximately an inch and a half above the
central portion of the left ear, shows a stellate irregularly outlined
zone of laceration, overall measuring 2-l/2 x l-l/4 inches in greatest
dimension. This extends down to skull bone. The left ear shows, just
above the ear lobe laterally, a deep laceration through the posterior
pinna. It is 5/8 x l/4 inch in greatest dimension, and is oblique. The
ear itself is markedly bruised, and varies from bluish-red to purplish
in color. A laceration involves the anterior upper portion of the ear.
It extends from the adjacent skin of the scalp over the anterior ear
in an overall area of 3/4 x l/8 inch in greatest dimension. A skip zone
is present between the ear and the scalp portion of the wound. A 3/4 inch
laceration is present in the mid occiput posteriorly. It occurs
approximately l inch above the ear level. It is triangular in shape.
The left face in front of the ear shows a 3-inch, roughly ovoid zone
of dull bluish-red discoloration. This area is modestly swollen.
PAR
Continued on page 4
The right side of the face shows, at a distance of l-l/4 inches above
the ear, a flat laceration down to skull bone measuring 5/8 inch in
length. An irregular laceration occurs behind the bruise of right ear.
It measures 3/4 inch in length and extends down to the underlying mastoid
process.
The right upper eyelid shows 2 horizontal rough-edged lacerated wounds,
the upper one l x l/8 inch in greatest dimension, the lower one 3/8 a l/4
inch. Bluish-red bruising and some swelling involves both eyelids on
the right. A curved l/2 inch laceration with a round anterior abrasion mark
is present on the right cheek. A l/4 inch laceration is present just
lateral to the mid portion of the upper lip on the right side, and a
5/8 inch laceration which is horizontal involves the right side of the
upper lip. It is partly surrounded by reddish-blue discoloration, and the
upper lip and lower lip both show bluish-red bruising. The bridge of the
nose on the right side shows a 5/8 x l/4 inch laceration.
LOWER ABDOMINAL WOUND
In the left lower quadrant of the abdomen near the midline is an oblique
l-l/4 x l/8 inch cut. It is surrounded by a small amount of bluish
discoloration of the deep skin.
ARM AND HAND LESIONS
A dull reddish pressure abrasion which is oblique occurs above the left
antecubital space by approximately 2 inches. It is l-l/4 inches in length,
and up to l/4 inch in width. The dorsum of the left forearm shows a
zone of dull red-yellow pressure abrasion over its lower one-third. This
area is l-l/2 x 5/8 inch in greatest dimension, and is arranged roughly
in a vertical location. Considerable reddish bruising involves the wrist
area and the lower forearm area on the left as well as the dorsum of the
hand. Such zones vary up to approximately 4 inches in greatest dimension.
The dorsum of the left hand shows distally, horizontal stuttered cuts
arranged in roughly parallel fashion and commencing on the bases of the
fourth and fifth fingers, and extending approximately to the mid palm
level. These cuts are arranged in 2's or 3’s and sometimes coalesce and
occur from l/2 inch to 3/4 inch apart. They are 3/8 to an inch in length.
The dorsum of the hand also shows dull red pressure abrasions near the
wrist, and the wrist shows one similar zone dorsally. Three of these
are present. They vary from l/8 to 5/8 inches in greatest dimension.
A prominent ligature mark is present about the upper left wrist. A
superficial 3/8 inch cut is present over the middle knuckle of the
dorsum of the index finger on the left side. The palm of the left hand
is unremarkable.
The dorsum of the right hand shows considerable bruising over a 2-l/2 inch
zone. This is reddish-blue in color. Centrally located in this bruise
is an abrasion which is roughly horizontal, and approximately l/2 inch
in length. Three other dorsal abrasions are present. Few are noted
over the fingers along with few superficial cuts of the fingers; one
on the index finger is vertical and approximately l/4 inch in length.
Oblique depressed ligature marks are present on the dorsum of the right
wrist, and bruising occurs on the ventral surface of the wrist in 3
coalescing areas up to l-l/2 inches in greatest dimension. Also the
ventral surface of the palm shows, near the wrist, a l/2 inch zone of
dull red abrasion. A superficial cut occurs at the base of the index
finger of the right hand. It is horizontal and l/4 inch in length.
PAR
Continued on page 5
CHEST WOUNDS
Four stab wounds and a puncture type wound occur in the anterior chest.
One stab wound occurs in the left upper medial chest. It is l/2 inch
long, oblique, and l inch from the anterior midline. lt is 3-l/2 inches
above the nipple line. It extends only into subcutaneous tissue for
approximately l/2 inch. The second stab is 5/8 inch long, and it is
l/2 inch from the anterior midline on the right side. It is 3 inches
above the nipple line. It extends inward through the second interspace,
to enter the ascending aorta at a distance of approximately l/2 inch
above the pericardial reflection. The hole into the aorta is approximately
5/8 inch long. The estimated minimal depth of this track is approximately
2-l/2 inches. It also extends through the posterior aorta and nicks the
anterior spine for l/8 inch.
The third stab is l/4 inch from the anterior midline, l-3/4 inches above
the nipple line, and is 5/8 of an inch long. It, too, is oblique and
like the other wounds, it shows a sharper lower edge than the upper edge.
It extends down to the sternum and nicks the sternum and ends in this
location. The depth of this track is an estimated l/4 inch.
A cutting stab wound occurs over the lower portion of the left breast.
It is 2 inches long and gapes for l/2 inch. It is l inch below the
nipple, and the medial edge is 2-l/2 inches from the anterior midline.
This wound extends inward through a l-l/2 inch hole in the fifth inter-
space and extends into the left pleural cavity. It then extends through
the edge of the lower lobe of the left lung after nicking the left
7th interspace posteriorly at a distance of l inch lateral to the spine.
The hole in the posterior interspace is approximately l inch long and
is oblique. The track fades out in the underlying soft tissue. The
estimated minimal depth of this track is 5-l/2 inches. At a distance
of l inch from the anteromedial end of the larger wound exists a l/8
inch puncture wound. The puncture wound extends inward for approximately
l/4 inch, ending in the underlying fat.
All of the stab wounds demonstrate a track of anterior to posterior
with roughly no left to right deviation or up or down deviation.
The only exception to this is the large cut in the left breast. This
track appears to be extending from left towards right.
NECK WOUND
Anteriorly on the neck is a l/2 inch, nearly horizontal stab. It is
in the near midline and 8 inches above the nipple line. lt extends
directly inward with virtually no up or down deviation. The wound is
from front to back and extends slightly from left to right to enter the
larynx just below the true cord on the left side. The hole here is
l/2 inch long. It then extends totally through the larynx, through the
posterior larynx, through the adjoining esophagus and the track ends in
the anterior cervical spine approximately at the level of C3. A nick
is present in the spine l/8 inch long at the area where the track ends.
Overall the estimated depth of the track is approximately l-l/4 inches.
Hemorrhage is present about the edges of the track throughout its
course.
PAR
Continued on page 6
PRIMARY INCISION AND BODY CAVITIES
The primary incision is Y-shaped. Tone of the skin is good. The sub-
cutaneous fat is approximately 3/8 inch in the infra-umbilical region.
Tone and development of musculature is good. The left pleural space
contains approximately l500 cc. of liquid blood, the right pleural
space approximately 300 cc. The pericardial sac contains approximately
20 cc. of liquid blood. The abdominal cavity shows no excess fluid
or adhesions.
HEAD AND BRAIN
The deep scalp structures show marked hemorrhages around the various
zones of blunt force injury previously described. The posterior parietal
convexities on both sides are covered by a thin sheen of subdural blood,
approximately 5 cc. on each side. Minimal subarachnoid hemorrhage is
present on the under surface of the frontal lobe, the under surface of
the cerebellum, the lateral surface of the right temporal lobe, the
under surface of the right temporal lobe. The vessels at the base are
unremarkable. The uncal gyri show no notches. The cerebellum shows no
pressure cone. The under surface of the right temporal lobe shows a
single zone of contusion hemorrhage measuring l/4 inch in greatest
dimension. The ventricles contain no blood. Multiple slices of pons
and medulla show no gross pathology, and the cerebellar slices are also
unremarkable. The left orbital plate shows a fracture extending from
the midline up over the frontal bone. This occurs under the large lacera-
tion of the left forehead previously described.
Another fracture involves the orbital plate on the right side. It is
horizontal and approximately l/2 inch long.
Another fracture occurs beneath the curved laceration of the upper right
cheek. The underlying zygomatic arch is fractured near its junction
with the orbital rim in this location.
ORGAN DESCRIPTION
HEART: The heart weighs an estimated 250 grams. The epicardial surface
is glistening and smooth. The heart shows no stab wounds. The coronary
vessels are unremarkable. The myocardium is firm and dull red in color.
The endocardium is glistening. The valves show no lesions.
LUNGS: The left lung weighs approximately 300 grams, the right lung
approximately 400 grams. Both lungs show patchy aspiration hemorrhage,
modest in amount. Bronchi contain considerable blood admixed with
mucus. The trachea contains a small amount of similar blood. The lungs
are generally air containing, showing only focal surface grayish zones
of depressed atelectasis.
LIVER: The liver weighs an estimated l,000 grams. The surface is
smooth. The edge is sharp. On section markings are maintained. The
extrahepatic ducts and gallbladder are unremarkable. The liver is a
pale pink-tan color.
PANCREAS, SPDEEN, AND ADRENALS: The pancreas is lobulated, firm, and
yellowish in color. The spleen is approximately 50 grams in weight. It
is light red and firm. The adrenals show no features of note.
KIDNEYS: The kidneys weigh approximately 85 grams. The capsules strip
readily, leaving smooth surfaces. On section the cortices are easily
differentiated from the medullas. The renal pelves are unremarkable.
The urinary bladder contains approximately 6 ounces of pale yellow urine.
PAR
Continued on page 7
INTERNAL FEMALE GENITALIA: The uterus, ovaries, and oviducts all show
no features of note. The endometrium is thin and yellow. There is no
blood in the endometrial canal. The ectocervix shows mild erosion.
MAJOR VESSELS: The aorta is virtually free of sclerosis. The lumen is
widely patent. The vena cava contains no premortem clot.
PROVISIONAL DIAGNOSES:
l. Multiple stab wounds of anterior chest with involvement of
ascending aorta and pericardial sac and left lung.
2. Hemothorax, considerable.
3. Stab wound of larynx, with aspiration of blood.
4. Multiple lacerations of scalp and face with skull fractures
and right orbital zygomatic fractures.
5. Focal fractures of anterior upper teeth. with loosening of teeth.
6. Ligatures of wrists and ankles.
7. Multiple cuts, dorsum of left hand.
MATERIAL TO PATHDLOGI: Representative tissues.
MATERIAL TO CBL TOXICOLOGY SECTION FOR TOX SCREEN: Heart blood and urine.
MATERIAL TO TOX LOCKER: Portion of liver with gallbladder and bile, l kidney, l lung, stomach content.
PHOTOGRAPHS BY: Pierce A. Rooney, M.D.
X-RAYS BY: Sacramento Portable X~ray Service.
PHOTOGRAPHS ALSO BY: Detective Dennis Forcino, Plumas County Sheriff' Office.
MATERIAL TO DETECTIVE FORCINO AT 2:A5 P.M.:
Sample of head hair, pubic hair, right and left
hand fingernail scrapings, oral, vaginal and
rectal swabs, swabs from soles of left and right
feet, hairs from left hand, and l gray top tube
of blood.
Pierce A. Rooney, M.D., Pathologist
PAR:dj
HEART: Sections from the aorta at the edges of the stab show some
attached fibrin and red cells along the jagged margin of the track.
Hemorrhages occur into the adventitia and some fibrin deposition is
present in this location.
The coronary vessels are unremarkable. Myocardial fibers are uniform.
LUNG: The pulmonary parenchyma is focally atelectatic and some
alveoli contain red cells. Small bronchi contain few red cells in
some instances. Large bronchi contain scattered red cells, desquamated
epithelial cells and mucus.
LIVER: The architecture of the liver is preserved.
KIDNEY: Glomeruli are intact. Tubules show some autolytic change
with loss of nuclei. Small vessels are virtually free of thickening
of their walls.
BRAIN: The cerebral sections show hemorrhages in the zone of contusion
described grossly. Subarachnoid hemorrhage is also present.
ORAL SMEARS: The oral smears are composed of mature squamous cells with
a small amount of amorphous debris in the background. Sperms are not
found.
VAGINAL SMEARS: The vaginal smears are made up of sparse mature
squamous cells with occasional mononuclear cells in the background
or bacteria. Sperms are not found.
RECTAL SMEAR: The rectal smear is made up of numerous mature epithelial
cells along with amorphous fecal debris in the background. Sperms are
not found in this smear.
FINAL DIAGNOSES:
l. Multiple stab wounds of anterior chest with involvement of
ascending aorta, pericardial sac and left lung.
2. Hemothorax, considerable.
5. Stab wound of larynx with aspiration of blood.
4. Multiple lacerations of scalp and face with skull fractures,
right orbital fracture.
5. Meningeal hemorrhage, brain with focal contusion of brain.
6. Focal fractures of upper anterior teeth with loosening of teeth.
7. Ligatures of wrists and ankles.
8. Multiple cuts, dorsum of left hand.
CAUSE OF DEATH:
MULTIPLE INJURIES WITH STAB WOUND OF AORTA AND HEMOTHORAX.
Pierce A. Rooney, M.D., Pathologist
GENERAL DESCRIPTION AND EXTERNAL EXAMINATION
This is the body of a short white female appearing to be of approximately
the stated age. Rigor is complete and reduces easily. The body is cold
to the touch. Lividity is present dorsally in small amount, and it no
longer blanches.
The scalp is covered by medium long, wavy, dark brown hair. The pupils
are round and equal. The irides are brown. The sclerae are white
except for some brownish discoloration in the areas exposed to the air
through the open lids. The mouth contains a small amount of bloody fluid.
Defects involve the upper teeth near their bases. These show roughened
edges and are up to l/4 inch in greatest dimension. All of the front
upper teeth are loosened. This includes the central and lateral incisors
and the right cuspid. The nose shows no fracture. The ears each show
blood in the ear canals which is dried but in most areas it is still
moist. The neck shows trauma to be described. The chest is flat. The
breasts are atrophic. The abdomen is essentially flat. The pubic hair
is dark brown in color. The vulva and vagina show no evidence of injury.
The vagina is virtually dry, there being only a small amount (less than
l cc.) of yellowish-white mucoid material attached to the cervical os.
The anus shows no dilatation and no evidence of injury. There is brownish
fecal material in the anal canal. The left thigh shows over its antero-
medial aspect, an oblique rectangular shaped bruise mark with oblique
lines in its center. Overall this mark is 3-l/2 x 3/4 inches in length.
The knees are free of injury. The ankles both show depressed marks in the
area of the previously described ligature and some whitish tape marking
is present on the inner aspect of both ankles. Some is also present
on the outer aspects of the right ankle. As previously described, the
soles of the feet show considerable dried and smeared blood and some
dried blood is present over the flexor surfaces of the toes. The ante-
cubital areas show no needle marks or scars and the posterior aspects
of the body are unremarkable.
WRIST AND ANXLE LIGATURES
The wrists and ankles are encircled with 2 different electric cords.
The two cords are black in color, and both are made up of double
segments. The larger cord shows a brown female plug-in type attachment
at one end. The other end is a male type plug which is black in color.
The wrists are criss-crossed over the individual's abdomen. The volar
surface of the left wrist touches the underlying right wrist, lateral
surface. White adhesive tape is present over the dorsal surface of
the left wrist, and the electric cords cover the adhesive tape. The
tape actually partly encircles the right wrist extending over the
lateral and dorsal surfaces and then back to encircle the left wrist
again, leaving bare the ventral surface of the right wrist. The thin
black electric cord encircles the wrist over adhesive tape and multiple
ties on the thin cord are present over the ventral surface of the right
wrist and adjoining medial surface of the left wrist. The smaller black
wire cord is cut on the dorsum of the left wrist, and the ends of the
cut zone are marked with tags labeled “dorsum lateral and dorsum medial”.
The thin black cord is markedly tight. The tape ligature is moderately
PAR
Continued on page 2
loose and at least 3 and up to 5 turns of tape are present about the
wrists. The tape is marked with tags labeled “left wrist medial" and
“volar right wrist" and a cut is made between these tags and the wrist
tape is removed.
The heavier black cord also loops about the wrists and extends over the
right hand between the thumb and forefinger and connects with a lead
of the cord which extends to the ankle. This connection is accomplished
with the female end of the cord caught in a suggestive double clove hitch
type knot near the dorsum of the right hand. The cord continues between the
upper thighs, just below the individual's vulva down to the ankles. It
is looped around the ankles one time and the major branch from the wrist
extends between the ankles along the medial aspect of the right ankle and
behind the left ankle. It then extends around the right ankle in a single
loop prior to extending about the left ankle in a single loop. A tie is
present on the medial aspect of the left ankle. This tie is remarkably
tight. The small black cord is also looped about the ankles and tied
on the ventral medial aspect of the left ankle in a double or triple
apparent overhand knot. The larger cord is caught up in the smaller one
over the anterior aspect of the right ankle. White adhesive tape wraps
about the ankles at least 5 times beneath the electric cord. Prominent
indentation marks are present on the ankles and wrists in the area of the
ligature marks.
GAG FROM FACE
A facial gag is present consisting of 2 portions of cloth extending
around the lower portion of the face with the anterior portions both
being in the mouth. The under portion of cloth has the appearance
of a blue bandana. The outer portion has the appearance of a nylon
female under garment. Between the two portions, in the region of the
left side of the mouth, exists multiple portions of adhesive tape.
The adhesive tape strips are approximately l/2 inch in width and are
covered with dried blood and run at roughly right angles to the facial
ligatures. The strips of adhesive are up to an estimated 8 inches in
length and 4 of these flap across the left cheek and extend between
the ligatures with tails occuring down to and below the chin in the
near midline or to the left of the midline.
CLOTHING
The subject is dressed in a terry cloth muu muu type lounging dress which
is green to blue to white in color. It is pulled up above the level
of her pubis. The dress is partly blood soaked. It has semi-short
sleeves extending approximately to the antecubital areas.
The gag is embedded deeply in the mouth. The anterior upper teeth
are present over the front of the gag. It is removed in continuity
with the tape strips after labeling appropriately the edges where cut.
The subject also wears a white brassiere which is partly blood soaked
and is in place.
The skin gag mark about the lower cheeks bilaterally is flesh colored and
is not blood covered as is the rest of the face down to the upper edge of
the gag mark, and below the gag mark a small amount of smeared dried blood
is present. The line of the mark is pale and is roughly horizontal,
extending about the upper neck just below the level of the occiput.
The 2 gags are tied on the left posteriorly with at least double knots
on each.
PAR
Continued on page 3
AT 9:45 A.M. I HAVE GIVEN TO DETECTIVE DENNIS EORCINO, PLUMAS COUNTY
SHERIFF'S OFFICE, APPROPRIATELY LABELED LIGATURES EROM EACE, WRISTS,
ANKLES, ALONG WITH THE PORTION OF PREVIOUSLY DESCRIBED ADHESIVE TAPE.
EXTERNAL BLOOD PATTERNS
Considerable dried and some liquid blood is present over the entire face
in a sometimes smudged pattern. Blood appears to have extended downward
from the right side of the mouth and nose towards the posterior head and
neck.
The pattern stops abruptly on the face at the level of the gag mark,
and below the gag mark on the under surface of the chin is a very small
amount of patchy dried and somewhat smeared blood. Few dried dotlets
of blood occur about a stab wound in the near central neck. Few more
droplets of dried blood occur over the skin of the anterior chest
about 3 wounds to be described in the upper chest. Minimal smudged blood
is also present here. A large wound beneath the left nipple shows minimal
blood at its edges, and a small apparent puncture wound just medial to the
larger left breast wound shows virtually no blood at its edges. Blood
is present on the anterior portions of both hands, and minimal blood is
present on the dorsum of the right hand and more is present on the
dorsum of the left hand. The anterior hand blood appears smeared,
whereas the dorsum of the left hand shows some linear drops of blood
especially over the little finger and the long finger. Scattered small
dried blood droplets have extended down over the anterior right thigh
and the area of the anterior iliac crest on the right. Smeared blood
is present on the lower right thigh and the right leg laterally, and
smeared blood is present on the under surfaces of both feet excluding
the arches of the feet suggesting that the individual stood or walked
in blood. Some smeared blood is also present over the lateral surface
of the leg and the thigh on the left side.
Portions of the dried blood from the soles of the feet are gathered
on moist cotton tipped applicators and are placed in appropriately labeled
envelopes.
There is virtually no blood on the posterior aspects of the body except
for a small amount of patchy, sheen-like dried blood over the left
buttock.
HEAD INJURIES
The head and face show numerous zones of blunt force trauma. The left
scalp, at a distance of approximately an inch and a half above the
central portion of the left ear, shows a stellate irregularly outlined
zone of laceration, overall measuring 2-l/2 x l-l/4 inches in greatest
dimension. This extends down to skull bone. The left ear shows, just
above the ear lobe laterally, a deep laceration through the posterior
pinna. It is 5/8 x l/4 inch in greatest dimension, and is oblique. The
ear itself is markedly bruised, and varies from bluish-red to purplish
in color. A laceration involves the anterior upper portion of the ear.
It extends from the adjacent skin of the scalp over the anterior ear
in an overall area of 3/4 x l/8 inch in greatest dimension. A skip zone
is present between the ear and the scalp portion of the wound. A 3/4 inch
laceration is present in the mid occiput posteriorly. It occurs
approximately l inch above the ear level. It is triangular in shape.
The left face in front of the ear shows a 3-inch, roughly ovoid zone
of dull bluish-red discoloration. This area is modestly swollen.
PAR
Continued on page 4
The right side of the face shows, at a distance of l-l/4 inches above
the ear, a flat laceration down to skull bone measuring 5/8 inch in
length. An irregular laceration occurs behind the bruise of right ear.
It measures 3/4 inch in length and extends down to the underlying mastoid
process.
The right upper eyelid shows 2 horizontal rough-edged lacerated wounds,
the upper one l x l/8 inch in greatest dimension, the lower one 3/8 a l/4
inch. Bluish-red bruising and some swelling involves both eyelids on
the right. A curved l/2 inch laceration with a round anterior abrasion mark
is present on the right cheek. A l/4 inch laceration is present just
lateral to the mid portion of the upper lip on the right side, and a
5/8 inch laceration which is horizontal involves the right side of the
upper lip. It is partly surrounded by reddish-blue discoloration, and the
upper lip and lower lip both show bluish-red bruising. The bridge of the
nose on the right side shows a 5/8 x l/4 inch laceration.
LOWER ABDOMINAL WOUND
In the left lower quadrant of the abdomen near the midline is an oblique
l-l/4 x l/8 inch cut. It is surrounded by a small amount of bluish
discoloration of the deep skin.
ARM AND HAND LESIONS
A dull reddish pressure abrasion which is oblique occurs above the left
antecubital space by approximately 2 inches. It is l-l/4 inches in length,
and up to l/4 inch in width. The dorsum of the left forearm shows a
zone of dull red-yellow pressure abrasion over its lower one-third. This
area is l-l/2 x 5/8 inch in greatest dimension, and is arranged roughly
in a vertical location. Considerable reddish bruising involves the wrist
area and the lower forearm area on the left as well as the dorsum of the
hand. Such zones vary up to approximately 4 inches in greatest dimension.
The dorsum of the left hand shows distally, horizontal stuttered cuts
arranged in roughly parallel fashion and commencing on the bases of the
fourth and fifth fingers, and extending approximately to the mid palm
level. These cuts are arranged in 2's or 3’s and sometimes coalesce and
occur from l/2 inch to 3/4 inch apart. They are 3/8 to an inch in length.
The dorsum of the hand also shows dull red pressure abrasions near the
wrist, and the wrist shows one similar zone dorsally. Three of these
are present. They vary from l/8 to 5/8 inches in greatest dimension.
A prominent ligature mark is present about the upper left wrist. A
superficial 3/8 inch cut is present over the middle knuckle of the
dorsum of the index finger on the left side. The palm of the left hand
is unremarkable.
The dorsum of the right hand shows considerable bruising over a 2-l/2 inch
zone. This is reddish-blue in color. Centrally located in this bruise
is an abrasion which is roughly horizontal, and approximately l/2 inch
in length. Three other dorsal abrasions are present. Few are noted
over the fingers along with few superficial cuts of the fingers; one
on the index finger is vertical and approximately l/4 inch in length.
Oblique depressed ligature marks are present on the dorsum of the right
wrist, and bruising occurs on the ventral surface of the wrist in 3
coalescing areas up to l-l/2 inches in greatest dimension. Also the
ventral surface of the palm shows, near the wrist, a l/2 inch zone of
dull red abrasion. A superficial cut occurs at the base of the index
finger of the right hand. It is horizontal and l/4 inch in length.
PAR
Continued on page 5
CHEST WOUNDS
Four stab wounds and a puncture type wound occur in the anterior chest.
One stab wound occurs in the left upper medial chest. It is l/2 inch
long, oblique, and l inch from the anterior midline. lt is 3-l/2 inches
above the nipple line. It extends only into subcutaneous tissue for
approximately l/2 inch. The second stab is 5/8 inch long, and it is
l/2 inch from the anterior midline on the right side. It is 3 inches
above the nipple line. It extends inward through the second interspace,
to enter the ascending aorta at a distance of approximately l/2 inch
above the pericardial reflection. The hole into the aorta is approximately
5/8 inch long. The estimated minimal depth of this track is approximately
2-l/2 inches. It also extends through the posterior aorta and nicks the
anterior spine for l/8 inch.
The third stab is l/4 inch from the anterior midline, l-3/4 inches above
the nipple line, and is 5/8 of an inch long. It, too, is oblique and
like the other wounds, it shows a sharper lower edge than the upper edge.
It extends down to the sternum and nicks the sternum and ends in this
location. The depth of this track is an estimated l/4 inch.
A cutting stab wound occurs over the lower portion of the left breast.
It is 2 inches long and gapes for l/2 inch. It is l inch below the
nipple, and the medial edge is 2-l/2 inches from the anterior midline.
This wound extends inward through a l-l/2 inch hole in the fifth inter-
space and extends into the left pleural cavity. It then extends through
the edge of the lower lobe of the left lung after nicking the left
7th interspace posteriorly at a distance of l inch lateral to the spine.
The hole in the posterior interspace is approximately l inch long and
is oblique. The track fades out in the underlying soft tissue. The
estimated minimal depth of this track is 5-l/2 inches. At a distance
of l inch from the anteromedial end of the larger wound exists a l/8
inch puncture wound. The puncture wound extends inward for approximately
l/4 inch, ending in the underlying fat.
All of the stab wounds demonstrate a track of anterior to posterior
with roughly no left to right deviation or up or down deviation.
The only exception to this is the large cut in the left breast. This
track appears to be extending from left towards right.
NECK WOUND
Anteriorly on the neck is a l/2 inch, nearly horizontal stab. It is
in the near midline and 8 inches above the nipple line. lt extends
directly inward with virtually no up or down deviation. The wound is
from front to back and extends slightly from left to right to enter the
larynx just below the true cord on the left side. The hole here is
l/2 inch long. It then extends totally through the larynx, through the
posterior larynx, through the adjoining esophagus and the track ends in
the anterior cervical spine approximately at the level of C3. A nick
is present in the spine l/8 inch long at the area where the track ends.
Overall the estimated depth of the track is approximately l-l/4 inches.
Hemorrhage is present about the edges of the track throughout its
course.
PAR
Continued on page 6
PRIMARY INCISION AND BODY CAVITIES
The primary incision is Y-shaped. Tone of the skin is good. The sub-
cutaneous fat is approximately 3/8 inch in the infra-umbilical region.
Tone and development of musculature is good. The left pleural space
contains approximately l500 cc. of liquid blood, the right pleural
space approximately 300 cc. The pericardial sac contains approximately
20 cc. of liquid blood. The abdominal cavity shows no excess fluid
or adhesions.
HEAD AND BRAIN
The deep scalp structures show marked hemorrhages around the various
zones of blunt force injury previously described. The posterior parietal
convexities on both sides are covered by a thin sheen of subdural blood,
approximately 5 cc. on each side. Minimal subarachnoid hemorrhage is
present on the under surface of the frontal lobe, the under surface of
the cerebellum, the lateral surface of the right temporal lobe, the
under surface of the right temporal lobe. The vessels at the base are
unremarkable. The uncal gyri show no notches. The cerebellum shows no
pressure cone. The under surface of the right temporal lobe shows a
single zone of contusion hemorrhage measuring l/4 inch in greatest
dimension. The ventricles contain no blood. Multiple slices of pons
and medulla show no gross pathology, and the cerebellar slices are also
unremarkable. The left orbital plate shows a fracture extending from
the midline up over the frontal bone. This occurs under the large lacera-
tion of the left forehead previously described.
Another fracture involves the orbital plate on the right side. It is
horizontal and approximately l/2 inch long.
Another fracture occurs beneath the curved laceration of the upper right
cheek. The underlying zygomatic arch is fractured near its junction
with the orbital rim in this location.
ORGAN DESCRIPTION
HEART: The heart weighs an estimated 250 grams. The epicardial surface
is glistening and smooth. The heart shows no stab wounds. The coronary
vessels are unremarkable. The myocardium is firm and dull red in color.
The endocardium is glistening. The valves show no lesions.
LUNGS: The left lung weighs approximately 300 grams, the right lung
approximately 400 grams. Both lungs show patchy aspiration hemorrhage,
modest in amount. Bronchi contain considerable blood admixed with
mucus. The trachea contains a small amount of similar blood. The lungs
are generally air containing, showing only focal surface grayish zones
of depressed atelectasis.
LIVER: The liver weighs an estimated l,000 grams. The surface is
smooth. The edge is sharp. On section markings are maintained. The
extrahepatic ducts and gallbladder are unremarkable. The liver is a
pale pink-tan color.
PANCREAS, SPDEEN, AND ADRENALS: The pancreas is lobulated, firm, and
yellowish in color. The spleen is approximately 50 grams in weight. It
is light red and firm. The adrenals show no features of note.
KIDNEYS: The kidneys weigh approximately 85 grams. The capsules strip
readily, leaving smooth surfaces. On section the cortices are easily
differentiated from the medullas. The renal pelves are unremarkable.
The urinary bladder contains approximately 6 ounces of pale yellow urine.
PAR
Continued on page 7
INTERNAL FEMALE GENITALIA: The uterus, ovaries, and oviducts all show
no features of note. The endometrium is thin and yellow. There is no
blood in the endometrial canal. The ectocervix shows mild erosion.
MAJOR VESSELS: The aorta is virtually free of sclerosis. The lumen is
widely patent. The vena cava contains no premortem clot.
PROVISIONAL DIAGNOSES:
l. Multiple stab wounds of anterior chest with involvement of
ascending aorta and pericardial sac and left lung.
2. Hemothorax, considerable.
3. Stab wound of larynx, with aspiration of blood.
4. Multiple lacerations of scalp and face with skull fractures
and right orbital zygomatic fractures.
5. Focal fractures of anterior upper teeth. with loosening of teeth.
6. Ligatures of wrists and ankles.
7. Multiple cuts, dorsum of left hand.
MATERIAL TO PATHDLOGI: Representative tissues.
MATERIAL TO CBL TOXICOLOGY SECTION FOR TOX SCREEN: Heart blood and urine.
MATERIAL TO TOX LOCKER: Portion of liver with gallbladder and bile, l kidney, l lung, stomach content.
PHOTOGRAPHS BY: Pierce A. Rooney, M.D.
X-RAYS BY: Sacramento Portable X~ray Service.
PHOTOGRAPHS ALSO BY: Detective Dennis Forcino, Plumas County Sheriff' Office.
MATERIAL TO DETECTIVE FORCINO AT 2:A5 P.M.:
Sample of head hair, pubic hair, right and left
hand fingernail scrapings, oral, vaginal and
rectal swabs, swabs from soles of left and right
feet, hairs from left hand, and l gray top tube
of blood.
Pierce A. Rooney, M.D., Pathologist
PAR:dj
HEART: Sections from the aorta at the edges of the stab show some
attached fibrin and red cells along the jagged margin of the track.
Hemorrhages occur into the adventitia and some fibrin deposition is
present in this location.
The coronary vessels are unremarkable. Myocardial fibers are uniform.
LUNG: The pulmonary parenchyma is focally atelectatic and some
alveoli contain red cells. Small bronchi contain few red cells in
some instances. Large bronchi contain scattered red cells, desquamated
epithelial cells and mucus.
LIVER: The architecture of the liver is preserved.
KIDNEY: Glomeruli are intact. Tubules show some autolytic change
with loss of nuclei. Small vessels are virtually free of thickening
of their walls.
BRAIN: The cerebral sections show hemorrhages in the zone of contusion
described grossly. Subarachnoid hemorrhage is also present.
ORAL SMEARS: The oral smears are composed of mature squamous cells with
a small amount of amorphous debris in the background. Sperms are not
found.
VAGINAL SMEARS: The vaginal smears are made up of sparse mature
squamous cells with occasional mononuclear cells in the background
or bacteria. Sperms are not found.
RECTAL SMEAR: The rectal smear is made up of numerous mature epithelial
cells along with amorphous fecal debris in the background. Sperms are
not found in this smear.
FINAL DIAGNOSES:
l. Multiple stab wounds of anterior chest with involvement of
ascending aorta, pericardial sac and left lung.
2. Hemothorax, considerable.
5. Stab wound of larynx with aspiration of blood.
4. Multiple lacerations of scalp and face with skull fractures,
right orbital fracture.
5. Meningeal hemorrhage, brain with focal contusion of brain.
6. Focal fractures of upper anterior teeth with loosening of teeth.
7. Ligatures of wrists and ankles.
8. Multiple cuts, dorsum of left hand.
CAUSE OF DEATH:
MULTIPLE INJURIES WITH STAB WOUND OF AORTA AND HEMOTHORAX.
Pierce A. Rooney, M.D., Pathologist
GENERAL DESCRIPTION AND EXTERNAL EXAMINATION
This is the body of a short white female appearing to be of approximately the stated age. Rigor is complete and reduces easily. The body is cold
to the touch. Lividity is present dorsally in small amount, and it no longer blanches.
The scalp is covered by medium long, wavy, dark brown hair. The pupils are round and equal. The irides are brown. The sclerae are whiteexcept for some brownish discoloration in the areas exposed to the air through the open lids. The mouth contains a small amount of bloody fluid.
Defects involve the upper teeth near their bases. These show roughened edges and are up to l/4 inch in greatest dimension. All of the front upper teeth are loosened. This includes the central and lateral incisors and the right cuspid.
The nose shows no fracture. The ears each show blood in the ear canals which is dried but in most areas it is still moist. The neck shows trauma to be described. The chest is flat. The breasts are atrophic. The abdomen is essentially flat. The pubic hair is dark brown in color. The vulva and vagina show no evidence of injury. The vagina is virtually dry, there being only a small amount (less than l cc.) of yellowish-white mucoid material attached to the cervical os. The anus shows no dilatation and no evidence of injury. There is brownish fecal material in the anal canal.
The left thigh shows over its antero-medial aspect, an oblique rectangular shaped bruise mark with oblique lines in its center. Overall this mark is 3-l/2 x 3/4 inches in length.
The knees are free of injury. The ankles both show depressed marks in the area of the previously described ligature and some whitish tape marking
is present on the inner aspect of both ankles. Some is also present on the outer aspects of the right ankle. As previously described, the soles of the feet show considerable dried and smeared blood and some dried blood is present over the flexor surfaces of the toes. The ante-cubital areas show no needle marks or scars and the posterior aspects
of the body are unremarkable.
WRIST AND ANXLE LIGATURES
The wrists and ankles are encircled with 2 different electric cords.
The two cords are black in color, and both are made up of double segments. The larger cord shows a brown female plug-in type attachment at one end. The other end is a male type plug which is black in color.
The wrists are criss-crossed over the individual's abdomen. The volar surface of the left wrist touches the underlying right wrist, lateral surface. White adhesive tape is present over the dorsal surface of the left wrist, and the electric cords cover the adhesive tape. The tape actually partly encircles the right wrist extending over the lateral and dorsal surfaces and then back to encircle the left wrist again, leaving bare the ventral surface of the right wrist. The thin black electric cord encircles the wrist over adhesive tape and multiple
ties on the thin cord are present over the ventral surface of the right wrist and adjoining medial surface of the left wrist. The smaller black wire cord is cut on the dorsum of the left wrist, and the ends of the cut zone are marked with tags labeled “dorsum lateral and dorsum medial”.
The thin black cord is markedly tight. The tape ligature is moderately
PAR
Continued on page 2
loose and at least 3 and up to 5 turns of tape are present about the wrists. The tape is marked with tags labeled “left wrist medial" and “volar right wrist" and a cut is made between these tags and the wrist tape is removed.
The heavier black cord also loops about the wrists and extends over the right hand between the thumb and forefinger and connects with a lead of the cord which extends to the ankle. This connection is accomplished with the female end of the cord caught in a suggestive double clove hitch type knot near the dorsum of the right hand. The cord continues between the upper thighs, just below the individual's vulva down to the ankles. It is looped around the ankles one time and the major branch from the wrist extends between the ankles along the medial aspect of the right ankle and behind the left ankle. It then extends around the right ankle in a single loop prior to extending about the left ankle in a single loop. A tie is present on the medial aspect of the left ankle. This tie is remarkably tight. The small black cord is also looped about the ankles and tied on the ventral medial aspect of the left ankle in a double or triple apparent overhand knot. The larger cord is caught up in the smaller one over the anterior aspect of the right ankle. White adhesive tape wraps about the ankles at least 5 times beneath the electric cord. Prominent
indentation marks are present on the ankles and wrists in the area of the ligature marks.
GAG FROM FACE
A facial gag is present consisting of 2 portions of cloth extending around the lower portion of the face with the anterior portions both being in the mouth. The under portion of cloth has the appearance of a blue bandana. The outer portion has the appearance of a nylon female under garment. Between the two portions, in the region of the left side of the mouth, exists multiple portions of adhesive tape.
The adhesive tape strips are approximately l/2 inch in width and are covered with dried blood and run at roughly right angles to the facial ligatures. The strips of adhesive are up to an estimated 8 inches in length and 4 of these flap across the left cheek and extend between the ligatures with tails occuring down to and below the chin in the near midline or to the left of the midline.
CLOTHING
The subject is dressed in a terry cloth muu muu type lounging dress which is green to blue to white in color. It is pulled up above the level of her pubis. The dress is partly blood soaked. It has semi-short
sleeves extending approximately to the antecubital areas.
The gag is embedded deeply in the mouth. The anterior upper teeth are present over the front of the gag. It is removed in continuity with the tape strips after labeling appropriately the edges where cut.
The subject also wears a white brassiere which is partly blood soaked and is in place.
The skin gag mark about the lower cheeks bilaterally is flesh colored and is not blood covered as is the rest of the face down to the upper edge of
the gag mark, and below the gag mark a small amount of smeared dried blood is present. The line of the mark is pale and is roughly horizontal, extending about the upper neck just below the level of the occiput.
The 2 gags are tied on the left posteriorly with at least double knots on each.
PAR
Continued on page 3
AT 9:45 A.M. I HAVE GIVEN TO DETECTIVE DENNIS EORCINO, PLUMAS COUNTY
SHERIFF'S OFFICE, APPROPRIATELY LABELED LIGATURES EROM EACE, WRISTS,
ANKLES, ALONG WITH THE PORTION OF PREVIOUSLY DESCRIBED ADHESIVE TAPE.
EXTERNAL BLOOD PATTERNS
Considerable dried and some liquid blood is present over the entire face in a sometimes smudged pattern. Blood appears to have extended downward from the right side of the mouth and nose towards the posterior head and neck.
The pattern stops abruptly on the face at the level of the gag mark, and below the gag mark on the under surface of the chin is a very small amount of patchy dried and somewhat smeared blood. Few dried dotlets of blood occur about a stab wound in the near central neck. Few more droplets of dried blood occur over the skin of the anterior chest
about 3 wounds to be described in the upper chest. Minimal smudged blood is also present here. A large wound beneath the left nipple shows minimal
blood at its edges, and a small apparent puncture wound just medial to the larger left breast wound shows virtually no blood at its edges. Blood is present on the anterior portions of both hands, and minimal blood is present on the dorsum of the right hand and more is present on the
dorsum of the left hand. The anterior hand blood appears smeared,
whereas the dorsum of the left hand shows some linear drops of blood
especially over the little finger and the long finger. Scattered small
dried blood droplets have extended down over the anterior right thigh
and the area of the anterior iliac crest on the right. Smeared blood
is present on the lower right thigh and the right leg laterally, and
smeared blood is present on the under surfaces of both feet excluding
the arches of the feet suggesting that the individual stood or walked
in blood. Some smeared blood is also present over the lateral surface
of the leg and the thigh on the left side.
Portions of the dried blood from the soles of the feet are gathered
on moist cotton tipped applicators and are placed in appropriately labeled
envelopes.
There is virtually no blood on the posterior aspects of the body except
for a small amount of patchy, sheen-like dried blood over the left
buttock.
HEAD INJURIES
The head and face show numerous zones of blunt force trauma. The left
scalp, at a distance of approximately an inch and a half above the
central portion of the left ear, shows a stellate irregularly outlined
zone of laceration, overall measuring 2-l/2 x l-l/4 inches in greatest
dimension. This extends down to skull bone. The left ear shows, just
above the ear lobe laterally, a deep laceration through the posterior
pinna. It is 5/8 x l/4 inch in greatest dimension, and is oblique. The
ear itself is markedly bruised, and varies from bluish-red to purplish
in color. A laceration involves the anterior upper portion of the ear.
It extends from the adjacent skin of the scalp over the anterior ear
in an overall area of 3/4 x l/8 inch in greatest dimension. A skip zone
is present between the ear and the scalp portion of the wound. A 3/4 inch
laceration is present in the mid occiput posteriorly. It occurs
approximately l inch above the ear level. It is triangular in shape.
The left face in front of the ear shows a 3-inch, roughly ovoid zone
of dull bluish-red discoloration. This area is modestly swollen.
PAR
Continued on page 4
The right side of the face shows, at a distance of l-l/4 inches above
the ear, a flat laceration down to skull bone measuring 5/8 inch in
length. An irregular laceration occurs behind the bruise of right ear.
It measures 3/4 inch in length and extends down to the underlying mastoid
process.
The right upper eyelid shows 2 horizontal rough-edged lacerated wounds,
the upper one l x l/8 inch in greatest dimension, the lower one 3/8 a l/4
inch. Bluish-red bruising and some swelling involves both eyelids on
the right. A curved l/2 inch laceration with a round anterior abrasion mark
is present on the right cheek. A l/4 inch laceration is present just
lateral to the mid portion of the upper lip on the right side, and a
5/8 inch laceration which is horizontal involves the right side of the
upper lip. It is partly surrounded by reddish-blue discoloration, and the
upper lip and lower lip both show bluish-red bruising. The bridge of the
nose on the right side shows a 5/8 x l/4 inch laceration.
LOWER ABDOMINAL WOUND
In the left lower quadrant of the abdomen near the midline is an oblique
l-l/4 x l/8 inch cut. It is surrounded by a small amount of bluish
discoloration of the deep skin.
ARM AND HAND LESIONS
A dull reddish pressure abrasion which is oblique occurs above the left
antecubital space by approximately 2 inches. It is l-l/4 inches in length,
and up to l/4 inch in width. The dorsum of the left forearm shows a
zone of dull red-yellow pressure abrasion over its lower one-third. This
area is l-l/2 x 5/8 inch in greatest dimension, and is arranged roughly
in a vertical location. Considerable reddish bruising involves the wrist
area and the lower forearm area on the left as well as the dorsum of the
hand. Such zones vary up to approximately 4 inches in greatest dimension.
The dorsum of the left hand shows distally, horizontal stuttered cuts
arranged in roughly parallel fashion and commencing on the bases of the
fourth and fifth fingers, and extending approximately to the mid palm
level. These cuts are arranged in 2's or 3’s and sometimes coalesce and
occur from l/2 inch to 3/4 inch apart. They are 3/8 to an inch in length.
The dorsum of the hand also shows dull red pressure abrasions near the
wrist, and the wrist shows one similar zone dorsally. Three of these
are present. They vary from l/8 to 5/8 inches in greatest dimension.
A prominent ligature mark is present about the upper left wrist. A
superficial 3/8 inch cut is present over the middle knuckle of the
dorsum of the index finger on the left side. The palm of the left hand
is unremarkable.
The dorsum of the right hand shows considerable bruising over a 2-l/2 inch
zone. This is reddish-blue in color. Centrally located in this bruise
is an abrasion which is roughly horizontal, and approximately l/2 inch
in length. Three other dorsal abrasions are present. Few are noted
over the fingers along with few superficial cuts of the fingers; one
on the index finger is vertical and approximately l/4 inch in length.
Oblique depressed ligature marks are present on the dorsum of the right
wrist, and bruising occurs on the ventral surface of the wrist in 3
coalescing areas up to l-l/2 inches in greatest dimension. Also the
ventral surface of the palm shows, near the wrist, a l/2 inch zone of
dull red abrasion. A superficial cut occurs at the base of the index
finger of the right hand. It is horizontal and l/4 inch in length.
PAR
Continued on page 5
CHEST WOUNDS
Four stab wounds and a puncture type wound occur in the anterior chest.
One stab wound occurs in the left upper medial chest. It is l/2 inch
long, oblique, and l inch from the anterior midline. lt is 3-l/2 inches
above the nipple line. It extends only into subcutaneous tissue for
approximately l/2 inch. The second stab is 5/8 inch long, and it is
l/2 inch from the anterior midline on the right side. It is 3 inches
above the nipple line. It extends inward through the second interspace,
to enter the ascending aorta at a distance of approximately l/2 inch
above the pericardial reflection. The hole into the aorta is approximately
5/8 inch long. The estimated minimal depth of this track is approximately
2-l/2 inches. It also extends through the posterior aorta and nicks the
anterior spine for l/8 inch.
The third stab is l/4 inch from the anterior midline, l-3/4 inches above
the nipple line, and is 5/8 of an inch long. It, too, is oblique and
like the other wounds, it shows a sharper lower edge than the upper edge.
It extends down to the sternum and nicks the sternum and ends in this
location. The depth of this track is an estimated l/4 inch.
A cutting stab wound occurs over the lower portion of the left breast.
It is 2 inches long and gapes for l/2 inch. It is l inch below the
nipple, and the medial edge is 2-l/2 inches from the anterior midline.
This wound extends inward through a l-l/2 inch hole in the fifth inter-
space and extends into the left pleural cavity. It then extends through
the edge of the lower lobe of the left lung after nicking the left
7th interspace posteriorly at a distance of l inch lateral to the spine.
The hole in the posterior interspace is approximately l inch long and
is oblique. The track fades out in the underlying soft tissue. The
estimated minimal depth of this track is 5-l/2 inches. At a distance
of l inch from the anteromedial end of the larger wound exists a l/8
inch puncture wound. The puncture wound extends inward for approximately
l/4 inch, ending in the underlying fat.
All of the stab wounds demonstrate a track of anterior to posterior
with roughly no left to right deviation or up or down deviation.
The only exception to this is the large cut in the left breast. This
track appears to be extending from left towards right.
NECK WOUND
Anteriorly on the neck is a l/2 inch, nearly horizontal stab. It is
in the near midline and 8 inches above the nipple line. lt extends
directly inward with virtually no up or down deviation. The wound is
from front to back and extends slightly from left to right to enter the
larynx just below the true cord on the left side. The hole here is
l/2 inch long. It then extends totally through the larynx, through the
posterior larynx, through the adjoining esophagus and the track ends in
the anterior cervical spine approximately at the level of C3. A nick
is present in the spine l/8 inch long at the area where the track ends.
Overall the estimated depth of the track is approximately l-l/4 inches.
Hemorrhage is present about the edges of the track throughout its
course.
PAR
Continued on page 6
PRIMARY INCISION AND BODY CAVITIES
The primary incision is Y-shaped. Tone of the skin is good. The sub-
cutaneous fat is approximately 3/8 inch in the infra-umbilical region.
Tone and development of musculature is good. The left pleural space
contains approximately l500 cc. of liquid blood, the right pleural
space approximately 300 cc. The pericardial sac contains approximately
20 cc. of liquid blood. The abdominal cavity shows no excess fluid
or adhesions.
HEAD AND BRAIN
The deep scalp structures show marked hemorrhages around the various
zones of blunt force injury previously described. The posterior parietal
convexities on both sides are covered by a thin sheen of subdural blood,
approximately 5 cc. on each side. Minimal subarachnoid hemorrhage is
present on the under surface of the frontal lobe, the under surface of
the cerebellum, the lateral surface of the right temporal lobe, the
under surface of the right temporal lobe. The vessels at the base are
unremarkable. The uncal gyri show no notches. The cerebellum shows no
pressure cone. The under surface of the right temporal lobe shows a
single zone of contusion hemorrhage measuring l/4 inch in greatest
dimension. The ventricles contain no blood. Multiple slices of pons
and medulla show no gross pathology, and the cerebellar slices are also
unremarkable. The left orbital plate shows a fracture extending from
the midline up over the frontal bone. This occurs under the large lacera-
tion of the left forehead previously described.
Another fracture involves the orbital plate on the right side. It is
horizontal and approximately l/2 inch long.
Another fracture occurs beneath the curved laceration of the upper right
cheek. The underlying zygomatic arch is fractured near its junction
with the orbital rim in this location.
ORGAN DESCRIPTION
HEART: The heart weighs an estimated 250 grams. The epicardial surface
is glistening and smooth. The heart shows no stab wounds. The coronary
vessels are unremarkable. The myocardium is firm and dull red in color.
The endocardium is glistening. The valves show no lesions.
LUNGS: The left lung weighs approximately 300 grams, the right lung
approximately 400 grams. Both lungs show patchy aspiration hemorrhage,
modest in amount. Bronchi contain considerable blood admixed with
mucus. The trachea contains a small amount of similar blood. The lungs
are generally air containing, showing only focal surface grayish zones
of depressed atelectasis.
LIVER: The liver weighs an estimated l,000 grams. The surface is
smooth. The edge is sharp. On section markings are maintained. The
extrahepatic ducts and gallbladder are unremarkable. The liver is a
pale pink-tan color.
PANCREAS, SPDEEN, AND ADRENALS: The pancreas is lobulated, firm, and
yellowish in color. The spleen is approximately 50 grams in weight. It
is light red and firm. The adrenals show no features of note.
KIDNEYS: The kidneys weigh approximately 85 grams. The capsules strip
readily, leaving smooth surfaces. On section the cortices are easily
differentiated from the medullas. The renal pelves are unremarkable.
The urinary bladder contains approximately 6 ounces of pale yellow urine.
PAR
Continued on page 7
INTERNAL FEMALE GENITALIA: The uterus, ovaries, and oviducts all show
no features of note. The endometrium is thin and yellow. There is no
blood in the endometrial canal. The ectocervix shows mild erosion.
MAJOR VESSELS: The aorta is virtually free of sclerosis. The lumen is
widely patent. The vena cava contains no premortem clot.
PROVISIONAL DIAGNOSES:
l. Multiple stab wounds of anterior chest with involvement of
ascending aorta and pericardial sac and left lung.
2. Hemothorax, considerable.
3. Stab wound of larynx, with aspiration of blood.
4. Multiple lacerations of scalp and face with skull fractures
and right orbital zygomatic fractures.
5. Focal fractures of anterior upper teeth. with loosening of teeth.
6. Ligatures of wrists and ankles.
7. Multiple cuts, dorsum of left hand.
MATERIAL TO PATHDLOGI: Representative tissues.
MATERIAL TO CBL TOXICOLOGY SECTION FOR TOX SCREEN: Heart blood and urine.
MATERIAL TO TOX LOCKER: Portion of liver with gallbladder and bile, l kidney, l lung, stomach content.
PHOTOGRAPHS BY: Pierce A. Rooney, M.D.
X-RAYS BY: Sacramento Portable X~ray Service.
PHOTOGRAPHS ALSO BY: Detective Dennis Forcino, Plumas County Sheriff' Office.
MATERIAL TO DETECTIVE FORCINO AT 2:A5 P.M.:
Sample of head hair, pubic hair, right and left
hand fingernail scrapings, oral, vaginal and
rectal swabs, swabs from soles of left and right
feet, hairs from left hand, and l gray top tube
of blood.
Pierce A. Rooney, M.D., Pathologist
PAR:dj
HEART: Sections from the aorta at the edges of the stab show some
attached fibrin and red cells along the jagged margin of the track.
Hemorrhages occur into the adventitia and some fibrin deposition is
present in this location.
The coronary vessels are unremarkable. Myocardial fibers are uniform.
LUNG: The pulmonary parenchyma is focally atelectatic and some
alveoli contain red cells. Small bronchi contain few red cells in
some instances. Large bronchi contain scattered red cells, desquamated
epithelial cells and mucus.
LIVER: The architecture of the liver is preserved.
KIDNEY: Glomeruli are intact. Tubules show some autolytic change
with loss of nuclei. Small vessels are virtually free of thickening
of their walls.
BRAIN: The cerebral sections show hemorrhages in the zone of contusion
described grossly. Subarachnoid hemorrhage is also present.
ORAL SMEARS: The oral smears are composed of mature squamous cells with
a small amount of amorphous debris in the background. Sperms are not
found.
VAGINAL SMEARS: The vaginal smears are made up of sparse mature
squamous cells with occasional mononuclear cells in the background
or bacteria. Sperms are not found.
RECTAL SMEAR: The rectal smear is made up of numerous mature epithelial
cells along with amorphous fecal debris in the background. Sperms are
not found in this smear.
FINAL DIAGNOSES:
l. Multiple stab wounds of anterior chest with involvement of
ascending aorta, pericardial sac and left lung.
2. Hemothorax, considerable.
5. Stab wound of larynx with aspiration of blood.
4. Multiple lacerations of scalp and face with skull fractures,
right orbital fracture.
5. Meningeal hemorrhage, brain with focal contusion of brain.
6. Focal fractures of upper anterior teeth with loosening of teeth.
7. Ligatures of wrists and ankles.
8. Multiple cuts, dorsum of left hand.
CAUSE OF DEATH:
MULTIPLE INJURIES WITH STAB WOUND OF AORTA AND HEMOTHORAX.
Pierce A. Rooney, M.D., Pathologist
