Detainee, Dahm Spah, was an inmate of Abu Ghraib Prison. On or about August 13, 2003 Mr. Spah was brought to the gate by other detainees and was noted to be pulseless and aprieic. Cause of Death: Arteriosclerotic cardiovascular disease (ASCVD). Manner of Death: Natural.
DEPARTMENT OF DEFENSE
ARMED FORCES INSTITUTE OF PATHOLOGY
WASHINGTON, DC 203084000
REPLY TO
ATTENTION OP
AFIP-CME-T
PATIENT IDENTIFICATION
AFIP Accessions Number Sequence
TO: 2917545 00
Name
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OFFICE OF THE ARMED FORCES MEDICAL EXAMINER ARMED FORCES INSTITUTE OF PATHOLOGY SSAN:E Autopsy: MEM- I 01WASHINGTON, DC 20306-6000
Toxicology Accession #: 041071 Report Date: MARCH 29, 2004
CONSULTATION REPORT ON CONTRIBUTOR MATERIAL
AFIP DIAGNOSISEREPORT OF TOXICOLOGICAL EXAMINATION
Condition of Specimens: GOOD
Date of Incident: 2/20/2004 Date Received: 3/3/2004
VOLATILES: The LIVER was examined for the presence of ethanol at a cutoff of 20 mg/dL. No ethanol was detected.
CYANIDE: There was no cyanide detected in the heart blood. The limit of quantitation for cyanide is 0.25 mg/L. Normal blood cyanide concentrations are less than 0.15 mg/L. Lethal concentrations of cyanide are greater than 3 mg/L.
DRUGS: The HEART BLOOD was screened for amphetamine, antidepressants, antihistamines, barbiturates, benzodiazepines, cannabinoids, cocaine, dextromethorphan, lidocaine, narcotic analgesics, opiates, phencyclidine, phenothiazines, sympathomimetic amines and verapamil by gas chromatography, color test or immunoassay. The following drugs were detected:
None were found.
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Certifying Scientist, Director, 1 13)(3)-1 Office of the Armed orces Medical Examiner Office of the Armed Forces Medical Examiner
FOR OFFICIAL USE ONLY LAW ENFORCEMENT SENSITIVE EEXHIBIT #
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MEDCOM - 502
INTERNMENT SERIAL NUMB
CERTIFICATE OF DEATH
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For use of this form, see AR 190-8; the proponent agency is DCSPER.
FROM:
,b)(3)-1
Commander, Abu Ghraib Prison, Iraq,APO AE 09335E0/110 03 -6 1,0P5 -6 #2,
TO:
_Commander
Iraq
APO AE
NAME (Last, first, M1) GRADE SERVICE NUMBER
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NA NA
NATIONALITY POWER SERVED PLACE OF CAPTURNINTERNMENT AND DATE
IRAQI IRAQ ABU GHRAIB PRISION, 20030811, TRANSFER FROM CROPPER
PLACE OF BIRTH DATE OF BIRTH
UNKNOWN UNKNOWN
NAME, ADDRESS, AND RELATIONSHIP OF NEXT OF KIN IRST NAME OF FATHER
Abu &Kra
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*14144EIVON
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PLACE OF DEATH DATE OF DEATH CAUSE OF DEATH
ABU GHRAIB PRISON 13 AUGUST 2003 MYOCARDIAL INFARCTION
PLACE OF BURIAL DATE OF BURIAL
NA NA
DO NOT WRITE IN THIS SPACE CERTIFIED A TRUE COPY DATE 13 AUGUST 200 SIGNATURE OF MEDICAL OFFICER MAJ, .15113)-1
1.1131.10r 6)(6)-2 ADDRESS
DA FORM 2669•R, MAY 82E b)(6)-2 EDITION OF 1 JUL 63 IS OBSOLETE . MEDCOM - 503 ADDRESS o,. L • ' 71-J.. USAPPC 41.00
DOD 003566
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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
AUTOPSY EXAMINATION REPORT
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Name: Autopsy No.: ME 03-368 (EPW 3) SSAN: NA AFIP No.: 2892218 Date of Birth: Unknown Rank: NA Date/Time of Death: 13 Aug 2003 Place of Death: Abu Ghraib
Prison, Iraq Date/Time of Autopsy: 25 Aug 2003 Place of Autopsy: Camp Sather, Iraq Date of Report: 24 Oct 2003
Circumstances of Death: This Iraqi enemy prisoner of war was an inmate of Abu
prioGhraib Prison. On or about 13 Aug 2003 Mr. lwas brought to the gate by other detainees and was noted to be pulseless and aprieic.
Authorization for Autopsy: Armed Forces Medical Examiner, per 10 U.S. Code 1471
Identification: Presumptive by US Army Criminal Investigative Division (CID). Antemortem fingerprint, dental, and DNA records non-existent.
CAUSE OF DEATH: Arteriosclerotic cardiovascular disease (ASCVD)
MANNER OF DEATH: Natural
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AUTOPSY REPORT # 2892218, EPW#3, Mission# .=& 2
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0 i/a-03 -CID,P,c?-090
FINAL AUTOPSY DIAGNOSES:
I. 3 vessel moderate to severe coronary artery atherosclerotic stenoses
A. Ischemic cardiomyopathy (525 grams)
B. Left ventricular hypertrophy (1.8 cm)
C. Focal bridging of the left anterior descending coronary artery (LAD)
D. Pulmonary congestion (1600 grams)
II. Mild decomposition
A. Postmortem freeze artifact
B. Postmortem bile toxicology consistent with decomposition
III. Fibrous pleural adhesions
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AUTOPSY REPORT # 2892218, EPW#3, Mission# 4 3
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EXTERNAL EXAMINATION
The body is that of a well-developed, thin, muscular, 70 inch tall, 150 pounds
(estimated) male whose appearance is consistent with an estimated age of 40-60 years.
Lividity is posterior, purple, and fixed. Rigor is indeterminate secondary to postmortem
freezing. There is mild decomposition consisting of clouding of the corneas, early skin
slippage, and slight green discoloration of the right lower quadrant of the abdomen.
Identifying marks include a 3/4 x 1/2 inch scar on the skin overlying the right patella.
The scalp is covered with straight black hair in a normal distribution. Corneal clouding
obscures the irides and the pupils. The external auditory canals are unremarkable. The
ears are unremarkable. The nares are patent and the lips are atraumatic. The nose and
maxillae are palpably stable. The teeth appear natural and adequate.
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 unremarkable.
The upper and lower extremities are symmetric and without clubbing or edema.
CLOTHING AND PERSONAL EFFECTS
None.
MEDICAL INTERVENTION
None.
EVIDENCE OF INJURY
None.
INTERNAL EXAMINATION
HEAD:
The galeal and subgaleal soft tissues of the scalp are free of injury. The calvarium is
intact, as is the dura mater beneath it. Clear cerebrospinal fluid surrounds the partially
frozen 1450 gm 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 of injury or other abnormalities. There are no
skull fractures. The atlanto-occipital joint is stable.
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AUTOPSY REPORT # 2892218, EPW#13, Mission* 481'"J ' 1 4
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NECK:. The anterior strap muscles of the neck are homogenous and red-brown, without
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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 CAVITIES:
The ribs, sternum, and vertebral bodies are visibly and palpably intact. No excess fluid is
in the pleural, pericardial, or peritoneal cavities. There are fibrous adhesions in both
pleural cacities. The organs occupy their usual anatomic positions.
RESPIRATORY SYSTEM:
The right and left lungs weigh 850 and 750 gm, respectively. The external surfaces are
smooth and deep red-purple. The pulmonary parenchyma is diffusely congested and
edematous. No mass lesions or areas of consolidation are present.
CARDIOVASCULAR SYSTEM:
The 525 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. Cross sections of the vessels show 50-75%
multifocal stenoses of the proximal portion of the left anterior descending coronary artery
with focal bridging, a focal proximal 90% stenosis with calcification and 75-90%
multifocal stenoses of the mid portion of the right coronary artery. There is a focal 75%
stenosis of the proximal left circumflex coronary artery. No acute changes (plaque
hemorrhage, rupture, or thrombosis) are noted. The myocardium is homogenous, red-
brown, and firm. The valve leaflets are thin and mobile. The wall of the left ventricle is
hypertrophied measuring 1.8 cm in thickness. The endocardium is smooth and glistening.
The aorta gives rise to three intact and patent arch vessels. The renal and mesenteric
vessels are unremarkable.
LIVER & BILIARY SYSTEM:
The 1400 gm liver has an intact, smooth capsule 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
green-black bile and no stones. The mucosal surface is green and velvety. The
extrahepatic biliary tree is patent.
SPLEEN:
The 150 gm spleen has a smooth, intact, red-purple capsule. The parenchyma is maroon
and congested, with distinct Malpighian corpuscles. There is an adjacent 10 gram
accessory spleen near the hilum.
PANCREAS:
The pancreas is firm and yellow-tan, with the usual lobular architecture. No mass lesions
or other abnormalities are seen.
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AUTOPSY REPORT At # 2892218, EPW#3, Mission# 4E 5
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ADRENALS:
The right and left adrenal glands are symmetric, with bright yellow cortices and grey
medullae. No masses or areas of hemorrhage are identified.
GENITOURINARY SYSTEM:
The right and left kidneys weigh 200 gm each. The external surfaces are intact and
smooth. The cut surfaces are red-tan and congested, with uniformly thick cortices and
sharp corticomedullary junctions. The pelves are unremarkable and the ureters are
normal in course and caliber. White bladder mucosa overlies an intact bladder wall. The
bladder is empty. The prostate is normal in size, with lobular, yellow-tan parenchyma.
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 contains
approximately 10 ml of green liquid. The gastric wall is intact. The duodenum, loops of
small bowel, and colon are unremarkable. The appendix is present and unremarkable.
ADDITIONAL PROCEDURES
•
Documentary photographs are taken by SGT 66 -2-
•
Specimens retained for toxicologic testing and/or DNA identification are: blood,
vitreous, liver, kidney, brain, bile, and psoas muscle
•
The dissected organs are forwarded with the body
•
Personal effects are released to the appropriate mortuary operations
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representatives of the
MICROSCOPIC EXAMINATION Selected portions of organs are retained in formalin, without preparation of histologic slides.
TOXICOLOGY
Toxicologic analysis of bile revealed an ethanol concentration of 47 mg/dL, acetaldehyde 8 mg/dL, and trace amounts of 2-propanol and 1-propanol all of which are consistent with decomposition. No illicit substances were detected.
OPINION
This Iraqi male prisoner of war died of arteriosclerotic coronary artery disease. Significant findings of the autopsy included severe narrowing of the blood vessels supplying blood to the heart and enlargement of the heart. No external or internal trauma
was noted.
The manner of death is natural.
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AUTOPSY REPOR P# 2892218, EPW#3, Mission# 4
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ON
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, MD MAI, MC, USA 61/ 90 Deputy Medical Examiner
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EXHIBIT_
MEDCOM - 509