Autopsy Report: Mullah Habibullah, Bagram Collection Point, Afghanistan (Homicide) (0134-02-CID369-23533) (Death Certificate Included)

"'tc:tt:l-'U'l -_......... - ARMED FORCES REGIONAL MEDICAL EXAMINER LANDSTUHL REGIONAL MEDICAL CENTER TEL. NO. DSN 486-7492 FAX DSN 486-7502 elV. 011(49)6371 ~86-7492 A02·93 FINAL REPORT OF POS1MORTEM EXAMINATION DATE OF BIRTH: DATE OF DEATH: ] December 2002 DATE OF AUTOPSY: 6-8 December 2002 INVHSTIGA TIVE AGENCY: USACIDC, 5S! "# OI34-02-CJD369-23533-SH9B 1. CIRCUMSTANCES OF DEATIl: The decedent is 1I 27-28 year old Pashtun male, who was found unresponsive, restrained in bis cell, Hagram Collection Point (BCP), 0015,4 December 2002. He was dead on anival at tbe 339th CSH, Bagrarn Air Field, Afganistan. n. AUTHORIZATION: Anned Forces Medical Examiner under Title JO U.S. Code, Section 1471. III. IDENTIFICAnON: Visual recognition; postmortem dental ex:amination perfonned; Imgerprints and specimens fur DNA obtained. IV. ANATOMIC FINDINGS: a. PulmoJlaty embolism (saddle). b. Mild pulmonaIy congestion and edema; diffuse anthracosis: c. Mild chronic passive congeslioD (agonal change). d. Multiple blunt fOTce injuries: ( I) Head and neck injuries. (a) Contusions and abnsioDs (remote). fit~r. & head. (b) Linear abraded contusions (3). right neck. (2) Torso injuries: . (a) Abrasions and contu~ioDS (.Don-specific). (b) Curvilinear abraded contusions (patlemed.left upper abdomen and flank). (c) Linear vertical abrasions (brush bum), bilateral back. (3) Ex.tremity injuries: (a) Abrasions and contu"inn... non-~ecific), bilaterAl AI""'. (b) Linear abrasions and contusions (patterned), bi[atClilI foreanns and wrjst~. (..:) Elongated contusions, bilateral anterior medial upper thighs (recent). (d) Contusion. left knee (recent). (c) Deep contusions with intramuscular hemorrhage and necrosis (left greater than right), bilateral pOliterior t:alves and knees (recent). Cf) Auociated patterned abrasions, posterior left calf(recent). Y. TOXICOLOGY: Negative. VI. CAUSE OF DEATIl: Pulmonary CJubolism due to blunt force injuries. YlI. MANNER OF DBA TH: Homicide. CONTrNUATION ON NEXT PAGE n HISTORY &PHYSICAL o OPERATION REPORT NAME .. EXAMINATION (SF 116) b)(6,... (SF S04. SF 10J. & SF JIl6) J REGISTER NO. o CONSULTATION SHEET o NARRATIVE SUMMARY SSN (SF $IJ) (SF S02) PASHTUN,AFGHA~TAN o CHRON RECORD OF !ZJ AUTOPSY PROTOCOL UNIT J MEDICAL CARE • (SF iOO) (SF J01) ~b)(3~1 o PROGRESS NOTE 0 ~r ,~~~ DATETYPED ........ (SF J09) -_ -:, 8 DECEMBER 2002 . .,. 13 JANUARY 2003 OPTIONAL FORM 275 (12·771 MEDICAL RECORD REPORT Prescribe! by "'SA and, CMR FIRMR 141 CFR) 201-'15.505 USAPPC V1.DD p.3 "ttll;j-·/U"ll u~nl·IMM-r::.. I Cli ARMED FORCES REGIONA L MEDICAL EXAMINER LANDSTIJHT. REGIONAL MEDICA L CENTER TEL. NO. DSN 486-7492 FAXDSN 486-7502 eN. 011(49)6371-86-7492 A02-93 CONTINUAnON OF FINAL REPORT OF POSTMORTEM EXAMINATION VIII. OPINION: Based on these autopsyJindings and the investigative: and historical informatioD available to me, the cause ofdeath Dflhi: Pashtun male.tbJ~f4 ___Jis pulmonaryembolism (blood clot that traveled to the heart and blocked the flow ofblood to the lungs). The patterned abla.;;ion on the back ofthe left calf-is consistent with tbe treat ofa boot. The severe injury to the underlying caIfmuscleand soft tissue is most likely a contributing factor. The deceased was not under 1111: pharmacologic effects ofdlugs or alcohol at the time ofdeath. Therefore, the manner ofdeath. in my opinion is homicide. b)(6)-2 LTC (.t'" Me, USA Anncd Forces Regional Medical Examiner o HISTORY & PHYSICAL EXAMINAnON (SF IO.,. SF IDS. tI SF106) o CONSULTATION SHEIrr (SFHJ) o CHRON RECORD OF MEDICAL CARE • (SF 600) rJ PROGRESS NOTE "'-..~, (SF" j~SJ) o OPERATION REPORT (SFJI6) o NAFlRATJVE SUMMAI\Y (SFJ02) ~AUTOPSY PROTOCOL (SFSOJJ 0 NAME !~6)-4 J ReGISTER NO. PASHTIlN. AFGHANISTAN UNIT bX3)-1 SSN J DATE TYPED i". -.j 8 DECEMBER 2002 13 JANIJARY 2003 OPTIONAL FORM 275 112·711 MEDICAL RECORD REPORT PrescrD:led by GSA and 1 eMil FIRMR 141 CFRJ 2DI-45.505 USAPPC VI.DD ----_ .... _-------­ ....-.__... _ p-4 ...88-7071 u~n... nM-~ I-I a r-1 1 U..:j U t:I: c:. f a (~~~;) A02-93 .....w.-' I_ POSTMORTEM EXAMINATION: A_ GENERAL: The postmortem examinati on is perfonned in the mortuary afflli:rs tent in Bagram Airfield, Afganistan on 6-8 December 2002. Photographs are obtained on 6 December 2002. External examination was performed on 7 December 2002 and the ..!!!~~~~~=""""''''''''''.r: perfonned on 8 December. The autopsy is perfOlmed by Dr. LTC (P). MC, USA, Forensic Pathologist, the Anned Forces L...-,...,.....~:T"'i~edTi":'c=-alrE5::x::amJ='ner (AFRME). Assisti ng in the autopsy procedures is SSgt ____-'IUSAF•.Forensic Assistant. The autopsy is witnessed by Special Agtonte(6~1 ICW2, USAF, Special Agent in Charge, United States Anny Criminal Tnvestigation Command (USACIDC), Bagrmn Air Field, Afganistan. The autopsy is started at approximately 0900 hours, 8 December 2002. rbX6~2 l B_ PHOTOGRAPHY: Photographs are taken by SSgt Forensic Assistant and are on file in the Medical Photography Section, Landstuhl Regional Medical Center, LandstuhJ, Germany. C. AUTHORIZATION: The autopsy is authorized by the Anned Forces Medical Examiner under Title 10, U.s. Code, Section 1471 at the request ofUSACIDC, with an SF 523, Authorization for Autopsy, signed by th~ AFRME, appointerJ Tepresenrative. D. IDENTIFICATION: The remains are identified visually as fbk6i"4 lt)(3~1 . I by lLTlbx6~1 ~ fb)(3H l ~fficer in r.harge, Bagram Dettmtion FaciJiiy with a sIgned DD 565, Statement ofRecogOitiOl1 ofDeceased. Postmortem dentlll examination including x-rays are perfonned by COLr)(W2 l Forensic Odontologist, U.S. Army. E. MEDICAL RECORD REVIEW: Copies ofthe inprocessing evaluation are reviewed in full. The clinical portion documents the decedent as "appearing we!!". without injuries and offering "moderate resistance to inprocessing". The decedent was "dead on arrival" per the Medical Treatment Faci1ity (MTF) Emergency Room record which was otherwise non-contributory. 3 4Hb-7071 1" 5 U:.HI,HH-I=. I".dr· ~ ~ U.:I Ut:l: E:.,a Ho GROSS AUTOPSY FINDINGS: A. CLOTHING AND PERSONAL EFFECTS: The remains are presented for autopsy clothed in adisposable diaper. No additional clothing or personal effects accompany the body. B. F..xTERNAL EXAMINATION: The remains are those ofa well developed, well nourished Southwest Asian male ofmuscular build that appears compatible with the listed age of27-28 years. Length is 5 feet, 4 inches. The body is we)] preserved and has not been embalmed. Multiple injuries are described below in the Evidence ofInjury Section. RIGOR: Not appreciated at the time ofautopsy (reportedly mildly developed in the small extremities on arrival in the Bagram Airfield emergency room). LIVIDITY: Fixed OD the posterior dependent surfaces. TEMPERATURE: The remains are frozen at the time ofthe photographic docwnentation and cKtcrruU examination. At the time of the internal examination the remains are slightly colder than the ambient air, approximately 30 to 40 degrees F. SKIN: UnremarkabJe except for evidence ofinjury that is described below in the Evidence ofIIYury Section. An apparent smail pox vaccination scar is on the right upper ann. Well healed scars are noted below the right front knee and the left back knee. Two parallel lines ofgray-black "dhesive substance encircle tlu~ back o.fthe head extending from ear to ea·f. The adhesive is consistent with that which is seen in tape products. HAIR: Close shaved black hair cov=s the head. Facial hIlir COJ..LSists ofa bJack beard up to Z inches in length and mustache. The remaining bodyhair. the color ofthe head hair, is in a normal adult male distribution. HEAD/SCALPIFACE: IIYuries arc described below in the Evidence ofInjury Section. No non-trawnatic abnormalities are identified. EARS: Unremarkable. EYES: Brown irides that are partially obscured by mild corneaJ clouding succounding equal 4 mm pupils. The conjunctivae is remarkable for rare petechiae, one on the left upper bulbar and one on the paJpebral conjunctivae. There is early Tach Noire formation. 4 "'86-7071 1" S u.;;.nnnn-I:. ' ,',a" .1.1 u..:s UO;C/a A02-93 NOSE: Injuries are described below in the Evidence ofInjury Section. No non­ trawnatic abnolUlalities are identified. MOUTHILIPS: Unremarkable except for postmortem drying artifact. TEETH: Dentition is in good repair. NECK/CHESTIABDOMENIBACKIANUS: Unremarkable e"cept for injuries that are described below in the Evidence ofInjury Section. The abdomen is flat. EXTERNAL GENITALIA: Normal adult circumcised male with bilaterally descended testes. ARMS/HANDS/FINGERNAJLS: Unremarkable except for injuries described below in the Evidence of~urySection. The fmgemails are irregular with focal small chips on thc left second and third imgers. LEGS/FEETITOENAlLS: Unremarkable except for injuries described below in the Evidence ofInjury Section. The circumference ofthe mid calves measure 14 inches bilaterally. C. INTERNAL EXAMINATION: BODY CAVITIES: The body is opened by the usual V-shaped incision. The pleural and peritoneal surface,:; ar~ sm.ooth and glistening Ilnd the pcrica.ulium is unremarkable. There are no fibrovascular adhesions or abnormal collections offluid. The mediastinum and retroperitonewn show no non-traumatic abnoxmalities. The leaves ofthe diaphragm are intact and the organs are normally disposed. There j~ no evidence ofiujury. HEAD/CENTRAL NERVOUS SYSTEM: Reflection ofthe scalp shows the ll5uaf scattered reflection petechiae. The calvarium is intact. Removal ofthe calvarium shows the epidural space to be normal. No collections ofsubdural blood are present. The brain is removed in the usual manner and appears normal in weight. The leptomeninges are smooth and glistening and the gyri demonstrate the usual orientation and configuration. There is no herniation. The vessels at the base o:f the brain are normally disposed and no anomalies or significant athemsclerosis is identified. Serial sections ofthe brain show the cerebral cortical ribbon to be intact. The lateral ventricles are normal. The usual anatonllcallandmarks of the cerebrum, pons, and medulla demonstrate no abnormalities. The pituitary fossa is unremarkable. The Foramen Magnum demonstrates the normal orientation and the first portion ofthe spinal cord viewed through the Foramen Magnum is unremarkable. 5 p. ? 49S-7071 U~HMHH-t: Mar' 11 U::I U~: ~Ha A02-93 NECK: Examination ofthe soft tissues ofthe neck by separate bloodless layerwise dissection ofthe strap muscles shows no abnonnalities. The thyroid gland and large vessds are Unremarkabl~. The hyoid bone and larynx arc intact. CARDIOVASCULAR SYSTEM: The heart is ofapparent nonnal weight. The epicardium is intact and unremarkable. The chambers demonstrate the usual shape and configuration with no gross hyper1Iophy. The coronary arteries are normally disposed and there is no atherosclerosis. Cut surfaces: of"the myocardium show a normal color. The valves are intact with the usual anatomic relationships. The aorta follows the usual course and exhibits no significant atherosclerosis. The origins oithe major vessels are nonnally disposed and unremarkable. The great vessels ofvenous return are in the usual position and unremarkable. RESPIRATORY SYSTEM: The laIynx, trachea, and bronchi show no abnonnalities. The right and left lungs appear slightly heavier than the normal weight. There is moderate diffuse anthracosis bilatcra1ly. Cut surfaces show the usual deep red to pink parenchyma exuding a mild amount ofblood and frothy fluid with no evidence of injury. Examination ofthe pulmonary artery in-situ reveals a large branching errtbolua (blood clot) c;xteniling into both the right and left pulmonary arteries. The embolus is mildly finn. focally coiled, and smaller than thc circumference ofthe pulmonary vessels. There are focal smaJl fibrinous patches on the external surface on the clot. The embolus " ,,' is moderately tenacious upon removal HEPATOBILIARY SYSTEM: The liver is ofapparent normal weight. It has a smooth, glistening capsule. Cut 3urfACCS lihow the usual anatomic landmarks with a deep red-brown parenchyma exhibiting a mild nutmeg pattern. The gallbladder contains approximately 20 cc ofbile. No abnormalities are present in the mucosal lining. The biliary tree is normAlly disposed and no ubnonnaliticli are demonstrated. INTESTINAL TRACT: The pharynx and esophagus are unremarkable. The stomach lies in the normal po~ition and contains Q small amuunt ofthick green-yellow fluid. No pills or residues are identified. The mucosal lining is intact. The small bowel and large bowel are unremarkable. The appendix is unremarkable. LYMPHORETICULAR SYSTEM: The spleen is ofapparent nonnal weight and has a smooth glistening capsule with an unremarkable parenchyma. The thymus is not identified. Lymph nodes show no notable pathologic change. URINARY SYSTEM: The right and left kidneys are ofapparent normal weight. The cortical surfaces are smooth and glistening with good preservation oftbe cortex and good corti co-medullary differentiation. The pelves and ureters are unremarkable. The bladder is unremarkable and empty. Mar· 11 U::I 08: 29a U~RMAA-E 186-7071 p.8 DOD 003152 A02-93 . t 654 _m_~__~.____~__~___J INTERNAL GENITALIA: The prostate is palpably unremarkable. 00 cut sections, the testes show no abnormal masses or evidence ofinjury. ENDOCRINE SYSTEM: The pituitary, thyroid. adreoals. and pancreas show the usual anatomic features without evidence ofnatural disease or injury. MUSCULOSKELETAI.. SYSTEM: No fractures are identified and the skeletal muscle demonstrates the normal appearance. The bone matrow, where visualized, is unremarkable. D. EVIDENCE OF MEDICAL TREATMENT: Consists ofEKG leads adherent to the uppo: chcst bilaterally and the right uppcr abdomen. There are bilateral femoral needle punctures With associated dried blood. E. EVIDENCE OF INJURY: Multiple blunt force injuries. (1) HEAD AND NECK INJURIES: ExtemaHy. an irregular crusted abrasion. Yi inch in greatest dimension is on the right upper forehead. On the right lower forehead above the eyebrow is a ~inch greatest dimension irregular crusted abrasion. Multiple irregular red-purple patchy contusions are on the right cheek covering an area of 1 Yz inches. On the prominence ofthe lower nose is a Yz x Y.. inch irregular crusted abrasion. On the left upper forehead just adjacent to the midline is a 1 x Y4 inch elongated crusted abrasion. To the left ofthis is a Yz x 1/8 inch elongated crusted abrasion. A l{.. x y~ inch crusted abrasion is on the left side ofthe back o:fthe head, in the occipital area. On the right side of the neck there are two paraliel, faint. linear abraded contusions. each averaging 1 ~ x ~inches with Y~ inch separation between th~ two. They average approximately 10 inches below the top ofthe head and three inches to the right of the anterior midline. Just to the len of these is a silllllar. filintc;r. patIOhy AbrAded contusion in approximately the same dimensions. On internal examination there i:; IIU underlying evidence ofinjury. (2) TORSO INJURIES: Externally, an ovoid 1 x ~inch abrasion is on the mid upper chest which has a tan-yellow "parchment" appearance most likely representing a postmortem injury. On the right lower upper chest just below the level ofllie nipples is a 1 x 3/8 inch vertically oblique elongated abrasion. A ~inch greatest dimension faint gray-purple contusion is in the right lower chest. TIrree ovoid ~inch greatest dimension gray-purple contusions are arranged linearly along the left lower costal margin. Associated with these is a faint dark pmple contusion covering an area 2 Yz inches. This extends as a curvilineaJ.-abraded contusion to the left, along the costal margin across the U~HMHH-C: 4BS-?O?1 p.9 DOD 003153 A02-93 left flank and mid left back. The extended portion measures 10 Yz x V4 inches. On the left mid back is a Yz inch greatest ~mensionred contusion. Multiple vertical parallel linear abrasions are on the right mid back in a "brush bunt" type pattern covering an area of7 x 1 V4 inches. Faint similar brush bum type abrasions are noted on the left mid back. There is no evidence of underlying injmy on internal examination. (3) EXTREMITY INJURIES: Multiple ovoid dark purple.contusions, the largest averaging !I:. in greatest dimension cover an area of2 Yz x ~on the anterior right upper arm. On the right inner ann are multiple irregular partially ovoid red-purple contusions, each averaging 1 Yz inch in greatest dimension and covering an area of2 Yz x ~inches. A y,. x V,. inch crusted abrasion is on the right lateral posterior elbow. On the distal right forearm a 3 ~ x Y.. inch red-pmple contusion encircles the anterior distal right foreann, extending around the lateral side. An elongated dark purple contusion with associated scattered small irregular abrasions, the largest averaging 3/8 inch in greatest dimension, covers both the back and front of the right wrist. Two parallel, vertically oblique linear abrasions. each 2 Y:z x ~inches. are just beneath. the left upper imer ann. Patchy red­purple contusions are scattered over the irmer upper ann to the elbow covering an area of 5 Yz x 2 inches. On the left upper, anterior· forearm are pat;hy irregular rcd-pwplc contusions covering an area of4 x 2 inches. A dark pmplc contusion with associated 3/8 inch greatest dimension scattered abrasions is on the left inner wrist encircling the lateral and posterior wrist. Associated with this is a linear abrasion encircling the posterior wrist. On the right upper anterior thigh. 2 Yl inches below the groin, is a vertically oblique elongated red-purple contusion 4 liz x 1 liz inches. A vertically oblique red-purple contusion, 12 II.. x 2 inches is on the left anterior irult:T Lhigh 2 Y2 incht:S below the groin extending downwards to the left inner knee. On the right back of the knee and calfis an elongated red-pwple contusion, 7 Yz x 7 inches, which extends across to the anterio­lateral side. On the back uftllC lcft knee IUld calf is a 11 x 7 11£ ineh red-dark purple contusion which extends upwards above the back ofthe knee in a linear fashion. On internal examination. confluent hemorrhage extends deep within the muscle which is focally llt:l:lotic. On the left calf, centrally located, is a patterned abrasion consisting of multiple parallel horizontal linear abrasions the largest averaging I Yz x ~inches, these are closely spaced. On the mid anterior left lower leg adjacent to the midline is a y.. inch ovoid abrasion. 4tH::i-"/U"/1 p. 10 u..::Jn.".nn -r=, 1-1"1::111 AOZ-93 IU. MICROSCOPIC EXAMINATION: HEART: Sections ofthe myocardium reveal intact striated muscle fibers. There is no evidence ofatrophy. hypertrophy, and recent or old myocardial infarction. LUNGS: The alveolar spaces and small air passages are expanded and contain no significant inflammatory component. There is focal mild edema fluid. The alveolar walls are thin and mildly congested. The arterial and venous vascular systems are normal. The peribronchial lymphatics are unremarkable. LIVER: The hepatic architecture is intact. The portal areas show no increased inflammatory component or fibrous tissue. There is mild central micro and macrovesicular steatosis. The hepatic parenchymal cells are well preserved with no evidence of cholestasis or sinusoidal abnonnalities. SPLEEN: The capsule and white pulp are unrentackable. There is minimal congestion of the (ed pulp. KIDNEYS: The subcapsular zones are unremarkable. -The glolJlC:ruJi are mildly congested without cellular proliferation. mesangial prominence. or scle.rosis. The tubules are well preserved. There is no interstitial fibrosis or significant inflammation. There is no thickening of the walls ofthe arterioles or small arterial channels. The transitional epithelium ofthe collecting system is nOImal. BRAIN: Multiple sections ofbrain demonstrate an umemarlcable configuration orgray and white matter. which is appropriate for age. There is no evidence ofatrophy. inflammation, hemorrhage. or neoplasm. TESTES: Sections show Donnal spermatogenesis with no evidence of jnflammation or neoplasia_ SKlN: Sections show unrema.rkable epidermis, dermis. and subcutis with normal adnexal structures and no evidence ofinflanunation. SKELETAL MUSCLE: Multiple sections show intact skeletal muscle fibers with focal interstitial extravasation ofred blood cells. There is no evidence ofany acute or chronic inflammation. or necrosis. PULMONARY EMBOLUS: Multiple sections show well formed blood clot, with alternating layers ofplatelets admixed with fibrin and layers afred blood cells ("'lines of Zahn")" There is no evidence ofrecannulization. 9 p. 1. 1 4HS-70·'1 U~HMHH-I::. M!Ir 11 U:.::s UI:t::.::Ila ~2-93 IV. TOXICOLOGY: Samples ofvitreous fluid, bile, and tissue samples ofJiver, heart. and kidneys arc submitted foctoxicolQgic analysis at the Anned Forces Medical Examiner's Forensic Toxicology Laboratory, Anned Forces Institute ofPatho]ogy (AFIP), Washington, DC: ­ AFIP'Accession No'.: 2859166/01, Toxicology Accession No.: 027070 dated 6 January 2003_ Volatiles: The bile and vitreous fluid were examined for the presence ofethanol at a cutoffof20 mgldL. No ethanol was detected. Comprehensive drug screen (liver): No drugs were found. V. SPECIAL STUDIES: a. (Radiogrllphio studies). Full body postmortem skeletal x-rays are performed at the Bagram Airfield Medical Treatment Facility and showno fractures. b. Alternate light source eXaIIlination: EXillllina.tion ofthe necJc USing an alternate light source reveals no injuries other than those that are seen grossly and are described above in the Evidence Injury Section. VI. EVIDENCE: Evidence is collected under standard chain ofcustody procedures and are listed as follows: Head and pUbic hair, fingernail scrapings, oral and anal swabs, and specimen ofblood. The evidence is retllmed by Special Agcntlb)16~1 ~ USACIDC, under standard chain ofcustody procedures. 6)16~2 ;;iCJa06 Date LTC (P). MC, USA ~~~ARME~~D~F~O~R~C£ES~~nB~~~ICALE~ThffiR bX6)-2 ~rd.6 MAJ, MC, USAF Deputy Medir.al Examiner Date 10 p .. 4,: CERTIFICATE: OF DEATH. (OVERSEAS) Acle de d6c~s (D'O..lr,,-Mer) USAPA V1.00· DOD 003299