Autopsy Report: Dahm Spah, Abu Ghraib Prison, Iraq (Natural Death) (0140-03-CID259-61190)

Autopsy No: ME 03 -368 (EPW 3); male Iraqi enemy prisoner of war. On or about August 13, 2003, decedent was brought to the gate of Abu Ghraib by other detainees and was noted to be pulseless and apneic. Cause of death: Arterioscloerotic cardiovascular disease (ASCVD). Manner of Death: Natural. No external or internal trauma was noted. Related CID report indicates that detainee had been engaged in a hunger strike prior to his death.

Doc_type: 
Medical
Doc_date: 
Friday, October 24, 2003
Doc_rel_date: 
Sunday, April 17, 2005
Doc_text: 

ARMED FORCES INSTITUTE OF PATHOLOGY
Office of the Armed Forces Medical Examiner
1413 Research Blvd., Bldg. 102
Rockville, MD 20850

~'·fI'
1-800-944-7912

AUTOPSY EXAMINATION REPORT
Name: fb)(6)-4 Autopsy No.: ME 03-368 (EPW 3) SSAN:L-_______----1 AFIP No.: 2892218 Date of Birth: Unknown Rank.:NA DatelTime of Death: 13 Aug 2003 Place of Death: Abu Ghraib
Prison, Iraq DatelTime ofAutopsy: 25 Aug 2003 Place of Autopsy: Camp Sather, Iraq Date ofReport: 24 Oct 2003
Circumstances of Death: This Iraqi enemy prisoner of war was an inmate ofAbu
b
Ghraib Prison. On or about 13 Aug 2003 tIwas brought to the gate by other
)(6)-4
detainees and was noted to be pulseless and apneic.
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 nEATH: Arteriosclerotic cardiovascular disease (ASCVD)
MANNER OF DEATH: Natural

DOD 003198
AUTOPSY REPORT AFIP# 2892218, EPW#3, Mission# 4875
~b)(6)-4 I
FINAL AUTOPSY DIAGNOSES:
I. 3 vessel moderate to severe coronary artery atherosclerotic stenoses
A. Ischemic-cardiomyopathy (525 grams)
B. Left ventricular hypertrophy (l.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
lli. Fibrous pulmonary adhesions
DOD 003199

AUTOPSY REPORT AFIP# 2892218, EPW#3, Mission# 4875
rb)(6).4 J
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 ofclouding of the corneas, early skin slippage, and slight green discoloration of the right lower quadrant of the abdomen.
Identifying marks include a % x Y2 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 umemarkable. 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 ofmasses. 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 ofthe scalp are free ofinjury. 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 ofnormal 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.
DOD 003200
AUTOPSY REPORT AFIP# 2892218, EPW#3, Mission# 4875
~b)(6).4 J
NECK:
The anterior strap muscles ofthe 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 ofbite 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 ofconsolidation 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 nonnal
distribution, with a right-dominant pattern. Cross sections of the vessels show 50-75%
multifocal stenoses ofthe proximal portion ofthe left anterior descending coronary artery
with focal bridging, a focal proximal 90% stenosis with calcification and 75-90%
multifocal stenoses ofthe mid portion ofthe right coronary artery. There is a focal 75%
stenosis ofthe proximal left circumflex coronary artery. No acute changes (plaque
hemorrhage, rupture, or thrombosis) are noted. The myocardium is homogenous, red­
brown, and finn. 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 finn and yellow-tan, with the usual lobular architecture. No mass lesions
or other abnonnalities are seen.

DOD 003201
AUTOPSY REPORT AFIP# 2892218, EPW#3, Mission# 4875
fb)(6).4 I
ADRENALS:
The right and left adrenal glands are symmetric, with bright yellow cortices and grey
medullae. No masses or areas ofhemorrhage are identified.

GENITOURINARY SYSTEM:
The right and left kidneys weigh 200 grn each. The external surfaces are intact and
smooth. The cut surfaces are red-tan and congested, with unifonnly 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 is empty. The prostate is normal in size, with lobular, yellow-tan parenchyma.
The seminal vesicles are unremarkable. The testes are free ofmass lesions, contusions,

or other abnormalities.

GASTROINTESTINAL TRACT:
The esophagus is intact and lined by smooth, grey-white mucosa. The stomach contains
approximately 10 ml ofgreen 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 fb I
)(6}-2

Specimens retained for toxicologic testing and/or DNA identification are: blood, vitreous, liver, kidney, brain, bile, and psoas muscle


The dissected organs are fOIwarded with the body


Personal effects are released to the appropriate mortuary operations
representatives ofthe 54th Quartermaster Company.

MICROSCOPIC EXAMINATION
Selected portions oforgans are retained in formalin, without preparation ofhistologic
slides.

TOXICOLOGY Toxicology analysis ofbile revealed an ethanol concentration of47 mgldL, acetaldehyde 8 mgldL, and trace amounts of2-propanol and I-propanol all ofwhich are consistent with decomposition. No illicit substances were detected.
OPINION
This Iraqi male prisoner ofwar died ofarteriosclerotic coronary artery disease. Significant findings ofthe autopsy included severe narrowing ofthe blood vessels supplying blood to the heart and enlargement of the heart. No external or internal trauma was noted.
The manner ofdeath is natural.
DOD 003202
AUTOPSY REPORT AFIP# 2892218, EPW#3, Mission# 4875
~b)(6)-4 I
b

~:~ rIMD
)(6)-2
MAJ,Me,USA Deputy Medical Examiner
.,
.,
MEDCOM -76
DOD 003203
."'~",
.
(...."""'"
.....n.
" , . .7
..'"';"~
~".."
~J
REPLACES DA FORM 3565, I JAN nAND DA FORM J565-R(PAS), l6 SEP 75, WHICH ARE OBSOLETE.

MEDCOM -189
DOD 003316

Doc_nid: 
3286
Doc_type_num: 
72