Autopsy Report: 47-year-old Male, Al Asad, Iraq (Homicide) (0009-04-CID679-83486) (Death Certificate Included)

Autopsy No: ME04-14; 47 year-old white male detainee died while in US custody. Cause of death: Blunt Force Injuries and Asphyxia; Manner of Death: Homicide. Autopsy revealed deep bruising of the chest wall, numerous displaced rib fractures, bruising on the lungs, hemorrhage into the mesentery of the small and large intestine. Examination of the neck structures revealed hemorrhage into the strap muscles and fractures of the thyroid cartilage and hyoid bone. According to report provided by the US army CID, the detainee was shackled to the top of a doorframe with a gag in his mouth at the time he lost consciousness and became pulseless.

Friday, April 30, 2004
Sunday, April 17, 2005

Office of the Armed Forces Medical Examiner
1413 Research Blvd., Bldg. 102
Rockville, MD 20850

Narne: Autopsy No.: ME04-14
SSAN: L-'____---' AFIP No.: 2909185 Date9!" Birth: 7 JAN 1957 Rank: fbX6 l Iraqi Army
Date·ofDeath: 9 JAN 2004 Place of Death: Al Asad, Iraq Date of Autopsy: 11 JAN 2004 Pla~e of Autopsy: BIAP Mortuary, Date of Report: 30 APR 2004 Baghdad, Iraq
Circumstances of Death: Iraqi detainee died while in U.S. custody.
Authorization for Autopsy: Office of the Armed Forces Medical Examiner, lAW 10 USC 1471
Identification: Identification by accompanying paperwork and wristband, both ofwhich include his name and a detainee number, 3ACR1582
CAUSE OF DEATH: Blunt Force, Injuries and Asphyxia
MANNER OF DE~TH: llomicide
I. Multiple Blunt Force lnju~,ies
A. Cutaneous abrasions and contusions of the scalp, torso, and extremities .
B. Deep contusions of the chest wall musculature and abdominal wall
C. Multiple, bilateral, displaced and comminuted rib fractures, with lacerations of the pleura
D. Bilateral lung contusions·
,E. Bilateral hemothoraces

F. Hemorrhage into the mesentery of the small and large bowel
G. Hemorrhage into the left sternohyoid muscle with associated fractures of the thyroid cartilage and hyoid bone
TI. History of Asphyxia, Secondary to Occlusion of the Oral Airway
TIl. Pleural and Pulmonary Adhesions
Hypertensive Cardiovascular Disease

A. Hypertrophy ofthe left ventricle ofthe heart (2.0-centimeters)
B. Cardiomegaly (450-grams)

Enlarged, Nodular Prostate Gland

VI. Toxicology is negative for ethanol, drugs of abuse, select therapeutic medications, and cyanide
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EXTERNAL EXAMINATION The remains are received clad ina white shirt, white pajama type pants, and white undershorts. Feces covers the clothing from the waist down. The body is that of a well­developed, well-nourished appearing; 68-irtches, 195-pounds (estimated), White male, whose appearance is consistent with the reported age of 47-years. Lividity is posterior and fixed, except in areas exposed to pressure. Rigor is present but passing. The temperature of the body is thatofthe refrigeration unit.
The scalp is covered with medium length, curly black hair with some graying and frontal balding. The irides are brown and the pupils are round and equal in diametef.' The external auditory canals are freeofabhormalsecretions or foreign material. The ears are unremarkable. The nares are patent and the lips are atraumatic. The nose and maxillae are palpably stable. The teeth are natural and in poor repair, with several missing. Facial hair consists of a gray-black beard and mustache.
The neck is straight and the trachea is midline and mobile. The chest is symmetric. The abdomen is protuberant. The external genitalia are those ofa normal adult, circumcised, male. The testes are descended and free ofmasses. Pubic hair is present in'anormal distribution. The buttocks and anus are unremarkable.
The upper and lower extremities are symmetric and without clubbing or edema. A Y2­
inch scar is on the lateral aspect ofthe proximal left arm. Multiple small scars are on the dorsal aspect ofboth hands. ' A l-inch scar is on the anterior right ankle. No tattoos or other significant identifying marks are, noted.
MEDICAL INTERVENTION There is gauze dressing on the left wrist. No other evidence of medical intervention is noted.
RADIOGRAPHS A complete set ofpostmortem radiographs is obtained and demonstrates the injuries as described.
EVIDENCE OF INJURY The ordering of the following injuries is for descriptive purposes only and is not intended to imply order of infliction or relative severity. All wound pathways are given relative to standard anatomic position.
I. Blunt Force Injuries
A. Injuries of the head and Neck No cutaneous injuries are noted on the face or neck. Reflection of the scalp :eveals a 1 Yz x %-inch contusion on the right frontal scalp and a 1 ~ x I-inch contusion on the left parietal scalp. There are no associated skull fractures, epidural, subdural, or subarachnoid hemorrhages or other injuries to the brain.
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A detailed examination of the anterior neck structures reveals a % x \!.a-inch hemorrhage into the left. sternohyoid muscle. There is a linear fracture through the left side of the thyroid cartilage and a Jracture through the left side of the. hyoid bone. The cervical spineis free ofinjury.
B. Injuries ofthe Torso There is a confluenceofred-purple.,.black contusions surrounding the torso between the breasts and the costal margin, with some sparring of the mid back. A few satellite contusions, up to 2..,inches in. greatest dimension are associated with this large area of contusion. The posterior .aspecto(this.large .area of contusion is deep purplein color and the upper posterior.,lateralaspectofthis area is.yellow~black in color. A distinct 5 x 4-inch area of ecchymosis is on the lateral aspect of the left mid chest. Two distinct I Yz x I-inch contusions are at the ti.ght posterior-lateral edge of the large area ofcontusion. Two linear abrasions, liS-inch and Yz-inch in length, are on the upper posterior left shoulder. There is a 1 'I.!-inch abrasion on the posterior upper right shoulder. A 1 Yl x 1 y;,.·inch purple contusion is over the left lower quadrant of the abdomen. A 2 Yl x I-inch area of ecchymosis is over the right inguinal area.
There is abundant hemorrhage into the muscle and adipose tissue of the anterior chest wall. The right chest wall has fractures of ribs three through seven anteriorly and ribs six tlrroughtwelve posteriorly. TheJeft chest wall has fractures of ribs two through nine anteriorly and ribs seven through twelve posteriorly. There are: fractures ofthe lateral aspect ofribs, nine and tenon the left side. Fifty.,milliliters of blood are in each pleural cavity.and many ofthe rib fractures are displaced and associated with pleural lacerations. Both lungs have scattered contusions but no lacerations are noted. There is a horizontal fracture through the mid portion of the body of the sternum.
A small area of hemorrhage is present in the left adrenal gland. No injuries to the kidneys are noted. Scattered areas of hemorrhage are noted in the mesentery ofthe large and small bowel.
C. Injuries of the Extremities A Yl-inch abrasion is on the anterior aspect of the right wrist. Multiple superficial linear abrasions are on the posterior aspect of the right hand. Three linear abrasions, y.. to Yz-inch in length, are on the proximal lateral right arm. A 2 Yl:-inch wide, weeping abrasion with some desquamation of skin is circumferentially present around the left wrist. There. is a I x Y2-inch contusion on the proximal posterior left arm. Two abrasions, Yl x 3/8-inches and I x 'I.!-inches, are on the posterior aspect of the left upper extremity near the elbow. Two fine linear abrasions, 3-inches and I 12-inches in length, are on the. posterior left forearm.
A 2 x 1 Y2:-inch contusion is on ,the anterior right legjust distal to the knee. There is a 3 x 2-inch contusion on the proximal halfof the anterior right leg. A 2 x 2.,inch light purple contusion is on the medial aspe.ct ofthedistal right leg. There is a 2 x 1 Yz­inch contusion and two Yl-inch in length linear abrasions over the right lateral malleolus. A '12 x Y4-inch abrasion is on the anterior left knee. There is a 5 x 3-inch 5" AutoPSY REPO'Rl' ME04--14
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light purple contusion on the anterior left leg.. A'I x . Yz,.inch contusion is on the anterior left ankle.
HEAD: The calvarium-is intact, as is the dura mater beneath it. Clear cerebrospinal fluid surrounds the 1380-gram brain, which has unremarkable gyri and sulci. Coronal sections demonstrate sharp demarcation ,between white and grey matter, without hemorrhage or contusive injury. The ventricles are of normal size. The basal ganglia, brainstem, cerebellum,and arterial systems are free: ofinjury or other abnormalities. There are no skull fractures. The atlanto-occipitaljoint is stable.
NECK: The neck structures have the previously described injuries. The larynx is lined by intact white mucosa. The thyroid gland is symmetric and red-brown, without cystic or nodular change. Thetongue is free of bite marks, hemorrhage, or other injuries. The cervical spine is free of injuries.
The vertebraLbodies are visibly and palpably intact. No excess fluid is in the peritoneal ('""') and pericardial cavities. Scattered adhesions involve both lungs and the chest wall. The '",iP" organs·occupy their usual anatomic positions.
RESPIRATORY SYSTEM: The right and left lungs weigh 790 and 590-grams, respectively. The external surfaces are smooth and deep red-purple, with heavy anthracotic pigmentation. The pUlmonary parenchymaiscongestedand.hastbepreviously described injuries. No mass lesions or areas ofconsolidation are ,present.
CARDIOVASCULAR SYSTEM: The 450.:.gram heart is contained in an intact pericardial sac. The epicardial surface is smooth, with minimal fat investment. The coronary arteries are present in a normal distribution, with a right-dominant pattern, Cross sections of the vessels show no significant atherosclerosis. The myocardium is homogenous, red-brown,. and firm. The valve .leaflets are thin and mobile. The walls ofthe left and right ventricles. are 2.0 and O.S-centimeters thick, respectively. The interventricular septum is 2.0.,centimeters. thick. The endocardium is smooth. The aorta gives rise to three intact and patent arch vessels. There is mild atherosclerosis involving the arch of the aorta. The renal and mesenteric vessels are unremarkable.
LIVER & BILIARY SYSTEM: The liver weighs 2350-.gramsand is free of injury. The parenchyma is tan-brown and congested, with the usual lobular architecture. No mass lesions or other abnormalities are seen. The gallbladder contains lO-milliliters:ofgreen-black bile and no stones. The mucosal surface is .green and velvety. The extrahepatic biliary tree is patent.
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The 90-gram spleen has a smooth, intact, red-purple capsule. The parenchyma is maroon
and congested, with distinct Malpighian corpuscles.

The·pancreas is firm and yellow-tan, with the usual lobular architecture. No mass lesions
or other abno.rmalities are seen.

The right and left adrenal glands are.symmetric,with yeUow-orangecortices and gray
medullae. Hemorrhage into the left adrenal gland has been previously noted. No masses
are identified.

The right and left kidneys weigh.210and 230-grams, respectively. The external surfaces
are intact, smooth, and without evident injury. The cut surfaces are red-tan and
congested, with uniformly thick cortices and sharp corticomedullary junctions. The
pelves are unremarkable and the ureters are nonnal in course and caliber. White bladder
mucosa overlies an intact bladder wall. The bladder contains approximately 20-milliliters
ofdark yellow urine. The prostate gland is enlarged, with yellow..:tan, nodular
parenchyma The seminal vesicles are unremarkable. The testes are free of mass lesions,
contusions,. or other abnormalities.

The esophagus is intact and lined by smooth, gray-white mucosa. The stomach contains
approxitnately 30-milliliters ofdark green fluid. The gastric wall is intact, with evidence
ofmiJd, liffuse gastritis. The duodenum, loops. ofsmall bowel, and colon are remarkable
for the.previously described injuries. The .appendix is present.

• Documentary photographs are taken by OAFME Photographer PH3 ["HS)-'
USN ~----~

Specimens retained for toxicologic testing and/or DNA identification are: vitreous fluid, cavity blood, spleen, liver, urine; brain, bile, lung, kidney; and psoas muscle

The dissected organs are forwarded with body

Clothing and personal effects are released to the Army CID agents present at the autopsy

MICROSCOPIC EXAMINATION Selected portions ·of or~ans are retained in formalin, without preparation of histologic slides.
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This47.;.year-old White male,/b)(6).4 ~ d~ed,ofbluntforce injuries and asphyx!.a., The autopsy disclosed mUltiple bhmtforce injuries,.including deep contusions ofthe chest wall, numerous displaced rib fractures, lung contusions, and hemorrhage into the mesentery ofthe small and large intestine. An examination ofthe neck structures revealed hemorrhage into the.strap muscles and.fractures ofthe thyroid cartilage and hyoid bone. According to the investigative report provided by u.s. Army CID, the decedent was shackled to the top ofa doorframe with a gag in his mouth at the time he lost consciousness and became pulseless.
The severe blunt ' force injuries, the hanging position, and the obstruction ofthe oral cavity with a gag contributed to this individual's death. The manner ofdeath is homicide.
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