Autopsy Number: 03-366-B. According to reports, other detainees brought this Iraqi male detainee to the gate. He had apparently complained of chest pain during his detention. He appeared to have been dead for some time. Cause of Death: Arteriosclerotic cardiovascular disease. Manner of death: Natural.
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
Autopsy No.: 03-366~
AFIP No.: 2892219
Date ofBirth: unknown Rank: NA
Date ofDeath: 11 Aug 2003 Place ofDeath: Abu Ghraib Prison. Iraq
Date ofAutopsy: 23 Aug 2003 Place ofAutopsy: BIAP, Iraq
Date ofReport: 2 Oct 2003
Circumstances of Death: According to reports, other detainees brought this Iraqi male detainee to the gate. He had apparently complained of chest pain during his detention. He appeared to have been dead for some time.
Authorization for Autopsy: Office of the Armed Forces Medical Examiner, lAW 10 USC 1471 Identification: By prisoner number, DNA sample and fingerprints obtained CAUSE OF DEATH: Arteriosclerotic cardiovascular disease MANNER OF DEATH: Natural
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FINAL AUTOPSY DIAGNOSES:
I. Arteriosclerotic cardiovascular disease
A. Left anterior descending coronary artery
1.
Segmental 80% stenosis of the proximal segment
2.
80% focal stenosis ofthe mid segment
B. Right coronary artery
1.
50% multifocal stenoses ofthe proximal segment
2.
50-75% multifocal stenoses ofthe distal segment
C. Mild to moderate atherosclerosis of the proximal aorta
D. Focal 90% stenosis ofthe basilar artery ofthe brain
II. Cholelithiasis, incidental
III.
Early decomposition
N.
No significant trauma
v.
Toxicology negative for ethanol and drugs of abuse
.... ".
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EXTERNAL EXAMINATION The body is that of a 65 inches tall, 180 pounds (estimated) Iraqi male who appears to be older than 50 years. Lividity is posterior and fixed, and rigor is absent. The body is partially frozen.
The scalp is covered with gray-black hair in a normal distribution. There is a beard and mustache. Corneal clouding obscures the irides and pupils. There are no petechiae of the sclerae, conjuctival, or buccal mucosa. 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 are in poor repair.
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.
There is early decomposition consisting ofcorneal clouding, superficial skin slippage on the buttocks and right calf, and slight green discoloration of the skin.
CLOTHING AND PERSONAL EFFECTS The following clothing items and personal effects are present on the body at the time of autopsy: The body is received nude at the time of autopsy.
MEDICAL INTERVENTION There are no attached medical devices at the time ofautopsy.
EVIDENCE OF INJURY The ordering of the following injuries is for descriptive purposes only, and is not intended to imply order ofinfliction or relative severity. All wound pathways are given relative to standard anatomic position.
On the skin ofthe right knee is a 0.4 cm superficial red abrasion. On the anterior left ankle is a 0.3 cm crusted healing superficial wound.
INTERNAL EXAMINATION
HEAD: The galeal and subgaleal soft tissues ofthe scalp are free of injury. The calvarium is intact, as is the dura mater beneath it. Clear cerebrospinal fluid surrounds the 1300 gm brain, which has unremarkable gyri and sulci. Coronal sections demonstrate sharp demarcation between white and grey matter, without hemorrhage or contusive injury.
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The ventricles are ofnmnIal size. The basal ganglia, brainstem, and cerebellum are fre,e
ofinjury or other abnormalities. There is a focal 90% stenosis ofthe basilar artery
without plaque hemorrhage, rupture, or thrombosis. There are no skull fractures. The
atlanto-occipital joint is stable.
NECK: Layer wise neck dissection reveals 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 synunetric and red-brown, without cystic or nodular change. The tongue is free ofbite marks, hemorrhage, or other injuries.
Incision and dissection ofthe posterior neck demonstrates no deep paracervical muscular injury and no cervical spine fractures.
BODY CAVITIES:
The ribs, sternum, and vertebral bodies are visibly and palpably intact. Each pleural
cavity contains approximately 10 ml ofdecomposition fluid. The organs occupy their
usual anatomic positions.
RESPIRATORY SYSTEM:
The right and left lungs weigh 550 and 425 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 250 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 ofthe vessels show the left anterior descending coronary artery has approximate 80% segmental stenosis ofthe proximal segment and 80% focal stenosis ofthe mid segment. The right coronary artery has multi-focal 50% stenoses ofthe proximal segment and 50-75% multifocal stenoses of the distal segment. The myocardium is homogenous, red-purple, and soft. The valve leaflets are thin and mobile. The walls ofthe left and right ventricles are 1.5 and O.3-cm thick, respectively. The septum measures 1.5 cm in thickness. The endocardium is smooth and glistening. The aorta gives rise to three intact and patent arch vessels. There is mild to moderate atherosclerosis ofthe proximal aorta. The renal and mesenteric vessels are unremarkable.
LIVER & BILIARY SYSTEM:
The 1300 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 multi-faceted black stones. The mucosal surface is green and
velvety. The extrahepatic biliary tree is patent.
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SPLEEN:
The 50 gm spleen has a smooth, intact, red-purple capsule. The parenchyma is maroon
and congested, with distinct Malpighian corpuscles.
PANCREAS:
The pancreas is finn and yellow-tan, with the usual lobular architecture. No mass lesions
or other abnormalities are seen.
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 50 gm each and maintain fetal lobulation. 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 normal in course and caliber. White bladder mucosa
overlies an intact, empty bladder. The prostate is nonnal 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 autolyzed, grey-white mucosa. The stomach
contains less than 10 ml ofred straw-colored liquid. The gastric wall is intact. The
duodenum, loops ofsmall bowel, and colon are unremarkable. The appendix is present
and unremarkable.
ADDITIONAL PROCEDURES
•
Documentary photographs are taken by OAFME photographers
•
Specimens retained for toxicologic testing and/or DNA identification are:
vitreous, blood, liver, brain, kidney, and psoas
•
The dissected organs are forwarded with the body
•
Personal effects are released to the appropriate mortuary operations
representatives
MICROSCOPIC EXAMINATION Selected portions oforgans are retained in formalin, without preparation of histologic slides.
TOXICOLOGY Toxicologic analysis ofblood and liver was negative for ethanol and drugs of abuse.
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OPINION This Iraqi male detainee died of arteriosclerotic cardiovascular disease (ASCVD). Significant findings ofthe autopsy included blockages in the blood vessels supplying blood to the heart and the base ofthe brain. The reported history ofcomplaining of chest pain prior to death is supportive of a cardiovascular death. There were no significant
injuries.
The manner ofdeath is natural.
MAJ,MC,USA
Deputy Medical Examiner
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REPLACES DA FORM JS6~ I JAN 71 AND DA FORM JS6S-R(PAS), 26 SEP 75, WHICH, ARE OBSOLETE.
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