Autopsy Report: Baker Yassen Rashed Mahmed Al Hussen, Abu Ghraib Prison, Iraq, (Natural) (0012-04-CID259-80136) (Death Certificate Included)

25 year old Iraqi male detainee at Abu Ghraib prison collapsed without known cause or incident. The Cause of Death: Myocarditis; Manner of Death: Natural.

Doc_type: 
Medical
Doc_date: 
Monday, February 2, 2004
Doc_rel_date: 
Sunday, April 17, 2005
Doc_text: 

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CERTIFItW F DEATH SERIAL NUMBER
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NAME (/.ib)(1), .1111 talADE SERVICE NUMBER
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PLACE OF BIRTH I1Al E OF BIRTH
NAME, ADDRESS, AND RELATIONSHIP OF NEXT OF KIN I IRST NAME OF FATHER
PLACE OF DATE IN DEATH

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PLACE OF BURIAL DATE OF BURIAL
IDENTIFICATION OF GRAVE

PERSONAL EFFECTS (To be filled in by (Ore of Deputy Chief of Staff' for Personnel)
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ARMED FORCES INSTITUTE OF PATHOLOGY
Office of the Armed Forces Medical Examiner
1413 Research Blvd., Bldg. 102
Rockville, MD 20850
1-800-944-7912

PRELIMINARY AUTOPSY REPORT
;13)(6)-4
Name:
Autopsy No.: ME04-38

;6)(6)-4
Internment Sequence Number:
Date of Birth: 15 November 1978:
Date/Time of Death: 16 January 2004/0545
Place of Death: Abu Ghurayb Prison, Iraq
Date/Time of Autopsy: 02 February 2004/ 1400
Place of Autopsy: Mortuary Facility, Baghdad International Airport, Iraq
Circumstances of Death: Collapsed wi orming morning prayers.
Authorization for Autopsy: Armed Forces Mtval Examiner, per 10 U.S. Code 1471
Identification: Identification Tag 141"
PRELIMINARY AUTOP
I. NO EVIDENCE OF SIGN RAUMA
II. BILATERAL PULMONARY EDEMA (850 GRAMS EACH).
DI TOXICOLOGIC AND MICROSCOPIC EXAMINATION PENDING
CAUSE OF DEATH: PENDING
MANNER OF DEATH: PENDING
warissinal gicmpl/
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CAPT. MC USN
Regional Armed Forces Medical Examiner

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ARMED FORCES INSTITUTE OF PATHOLOGY
Mee of the Armed Form Medical Enabler
1413 Research Blvd., Bldg. 102
Rockville, MD 20850
1400-944-7912

AUTOPSY EXAMINATION RIZIVITIT
b)(6)-4
Name:
A No.: ME04-38
AFIP Number: 2914569 (b)(6)-4
Internment Sequence Number:
Date of Birth: 15 November 1978
Datc/Time of Death: 16 January 2004/0545
Place of Death: Abu (Thumb Prison. Iraq
Date/time of Autopsy: 02 February 2004/ 1400
Place of Autopsy: Mortuary Facility, Baghdad International Airport, Iraq

Circumstances of Death: Collapsed while performing morning prayers.
Authorization for Autopsy; Armed Forces Medical Examiner, per 10 U.S. Code 1471
Idasdneation: Identification Tag
CAUSE OF DEATH: MYOCARDMS 114
MANNER OF DEATH: NATURAL
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11/07 '04 FRI 12:20 FAX 30131. 45.AFIP/OAFNN

AUTOPSY REPORT ME04-038
FINAL AUTOPSY DIAGNOSES:
I. CARDIOVASCULAR SYSTEM:
A. MYOCARDTTIS WITH FOCAL NECROSIS AND SCARRING
B. FOCAL MODERATE CORONARY ATHEROSCLEROSIS
1.
60% STENOSIS OF PROXIMAL LEFT ANTERIOR DESCENDINGCORONARY ARTERY

2.
40% STENOSIS OF LEFT MAN CORONARY ARTERY

II. RESPIRATORY SYSTEM:
A. BILATERAL PULMONARY EDEMA (850 GRAMS EACH)
DL HEPATOBILIARY SYSTEM:
A. FOCAL HEPATIC STEATOSIS
IV.
NO EVIDENCE OF SIGNIFICANT TRAUMA

V.
TOXICOLOGY IS NEGATIVE FOR ETHANOL, DRUGS OF ABUSE, AND

CYANIDE
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AUTOPSY REPnerr 144Va¦ /no 3
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The body is that of a well.developed, well
appealing. muscular, 74 inch tall
male whose appearance is ecandatent with the reported age of 25 years. Lividity is
present in the posterior dependent peahens of the body, except in areas exposed to
pressure. Upon initial examination, the body is frozen. Thawing is accomplished

over
four days. Rigor has passed, and the temperature is eventually that of ambient room.
The scalp is covered with straight black hair in a normal distribution. A beard is present
The hides are brown and the pupils are round and equal in diameter. No conjunctival
petechiae are present The external auditory canals are tuuremadcable. The ears are
unremarkable. The nares are patent and the lip are atraumatic. The nose and maxillae

are palpably stable. The teeth appear natural and in good condition.
The neck is straight, and the trachea is midline and mobile. The chest is symmetric. The
abdomen is flat. The genitalia are those of a normal adult male. The testes are descended
and free of masses. Pubic hair is present in a normal distribution. The buttocks and anus

are unremadrable.
The upper and lower extramides are symmetric and without clubbing or edema. There is
no external evidence of trauma.
cLOVINGPlia PERSONAL EFFECTS
The following clothing items and personal effects are present on the body at the time of

autopsy:
-Grey shirt
-Grey sweatshirt
-Orange juropinsit

-
White boxers
-2 pairs of socks, one white, one black
-Blanket

I
MEDICAL INTERVENTION
There is no evidence of recent medical intervention.
RADIOGRAPH$
complete s
et of postmodern radiographs is obtained and demonstrates no evidence of
sAkeletal trauma.
4
SVID5NC$ OLPIJIMY
There is no evidence of signific
ant recent injtuy.
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AUTOPSY REPORT ME04.03a
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INTERNAL EXAMINATION
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The gales" and subgaleal soft tissues of the scalp are free of injury. The calvarium is
intact, as is the dura mater beneath it. aear eerebrominal fluid surrounds the 1300 grn

brain, which has unremarkable gyri and sulci. Corona! 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 of injury or other abnormalities. There are no skull fractures. The

atlanto-occipital joint is stable.
A separate layerwise dissection of the neck is performed. The anterior strap muscles of
the neck are homogenous and red-brown, without hemorrhage. The thyroid cartilage and
hyoid are intact. The larynx is lined by intact white mucosa. The Thyroid is symmetric

and red-brown, without cystic or nodular change. The tongue is free of bite marks,
hemorrhage, or other injuries.
BODY rAYEEMS:
The ribs, atermun, and vertebral bodies are visibly and palpably intact. No excess fluid is
in the pleural, pericardial, =peritoneal cavities. The organs occupy their usual anatomic

positions.
RESPIRATORY SYS'TEM.
The right and left limp weigh 850 gni each. The external surfaces are smooth and deep
red-purple. The pulmonary parenchyma is difftuely congested and edematous. No mass

lesions or areas of consolidation are present.
CARDIOVASCULAR SYSTEM:
The 450 gm 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. The myocardium Is homogenous, red-brown,and firm. The valve leaflets we thin and mobile. The walls of the left and rightventricles are 2.0 and 0.8 an thick, respectively. The endocardium is smooth and I glistening. The aorta gives rise to throe intact and patent arch
vessels. The renal andmesenteric vessels are unremarkable (see AF1P consultation report below).
Lnag_ii,BILLannutm:
The 2450 gm liver has an intact, smooth capsuk and a sharp anterior border. The
parenchyma is tan-brown and congested. with the usual lobular architecture. No mass
lesions or other abnormalities are seen. The gallbladder contains a minute amount of
Ween-black bile and no stones. The mucosal surface is green and velvety.

The
exizahepatic biliary tree is patent
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AUTOPSY REPORT ME114438
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The 360 gm spleen has *
smooth, intact, red-purple capsule. The parenchyma is maroon
and congested, with distinct
Malpighian corpuscles.
PAN-CRA:
The palm= is firm and yellow-tan, with the usual lobular architecture. No mass lesions
or °the: &ham:Wide:1 are seen.
The right and left adrenal glands are symmetric, with bright yellow cortices and grey
medullae. No masses or areas of hemorrhage art identified.

GENITOURINARY SYSTRIK.
The right and

left kidneys weigh 220 grams each. The external surfaces are intact and
smooth. The cut surfaces are red-tan and congested, with uniformly thick cortices and
sharp corticomedularyjunctions. The pelves are umemaztable and the

ureters are
flannel in course sad caliber. White
bladder mucosa overlies an intact bladder wall.
The
bladder contains no urine. The prostate is normal in size, with lobular, yellovmanparenchyma. The seminal vesicles are unremarkable. The testes are free of mass lesions,
contusions, or other abnormalities.
GASTROINTESTINAL TRACT:
The esophagus is intact and lined by smooth, grey-white mucosa.

The stomach containsapproximately 30 cc
of brown fluid. The gastric wall is intact The duodenum, loops of
small bowel, and colon are unremarkable. The appendix is present.
ADDITIONAL PROCEDURES

Documentary photographs are taken by AFIP photographer.
Specimens retained for toxicologic testing and/or DNA identification are: blood,
spleen, liver, brain, bile,
The dissected organs are forwarded with body

• Personal effects are released to the appropriate mortuary operations
representatives

DIICROSOVIC EXAMINATION
Cassette Summary:
1.
Right ventricle

2.
Anterior ledt velltricle

3.
Interventricular septum 4

4.
Liver

5.
Spleen

6.
Kidney

7.
Brain

8. Lung
9.
Lung

10.
Pancreas

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Microscopic Description:
BRAIN: unremarkable.
LUNGS: eosinophilic proteinaceous material within alveolar spaces bilaterally.
HEART: see AFIP consultation below.
LIVER: focal macrovesicular steatosis without inflammation or increased fibrosis.
SPLEEN: autolytic; otherwise unremarkable.
PANCREAS: autolytic; otherwise unremarkable.
KIDNEY: autolytic; otherwise unremarkable.
CONSULTATION FROM DR.
CARDJOVASCULAR Yf11Z4OW.I ;45 I 71 0-14..•)g•i:-.• I S IIMI Jr •
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Heart: 450 grams; nomad epicardial fat; closed foramen ovals, normal left ventricular
chamber dimensions: left ventricular cavity diameter 40 mm, left ventricular

floe wall
thickness 13 mm, ventricular septum Welcome 15 mm; right ventricular thickness 4 mm,
without gross scars or abnormal fat infiltralet marked post-mortem deco
changes, otherwise unremarkable valves, endocardium , and myocardium; histologic
changes show multiple foci of internitial and replacement fibrosis, some of which are
associated with lymphocytic infiltrates; a section from the posterior left ventricle shows
a subepicardial focus of granulomatous inflammation with central fibrinoid necrosis;

special stains including Brown Brenn, Brown-Hoppe,

OMS, and
V1 arthin-Stany are negative for microorganisms.
Coronary Arteries: Normal ostia; right dominance; focal moderate atherosclerosis:
Le
ft in coronary artery: 40% bunion] narrowing by pathologic intimal thickening
Left
anterior descending coronary Jittery: 60% narrowing of proximal LAD by
pathologic intimal thickening no other significant atherosclerosis.

Diagnosis:
I
1.
Myocarditis with focal necrosis and scarring

2.
Focal moderate coronary atherosclerosis

Comment: In most instances myocarditis is caused by viral organisms, however the histologic appearance in this cue is atypical with areas of granulognatous inflammation
and Ebrinoid necrosis. appearance of sarcoidosis. All special gainsThe granulomas do not have the usual non-neon:lazing for microorganisms are negative. Otherpossible causes of myocardlitis includes various bacterial, fungal, and Mycobacterial

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organisms, and negative stains do not indicate absence ofdisease. This case was also
reviewed by the Infectious Disease Department.
MELON
This 25 year-old detainee died as a result of MYOCARDITIS (Inflammation of the
heart). There is no evidence of significant trauma. The manner of death is NATURAL.

MD
MC USN Regional Armed Forces Medical Examiner
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Doc_nid: 
3330
Doc_type_num: 
72