KATHRYN HADEN-PINNERI, having been first duly sworn, testified as follows: DIRECT EXAMINATION. Q. Please introduce yourself to our jury.

Size: px

Start display at page:

Download "KATHRYN HADEN-PINNERI, having been first duly sworn, testified as follows: DIRECT EXAMINATION. Q. Please introduce yourself to our jury."

Scott Turner
5 years ago
Views:

1 0 0 KATHRYN HADEN-PINNERI, having been first duly sworn, testified as follows: DIRECT EXAMINATION BY MS. MAGNESS: Q. Good morning. A. Good morning. Q. Please introduce yourself to our jury. A. My name is Dr. Kathryn Haden-Pinneri. Q. And, Dr. Pinneri, who do you work for? A. I work for the Harris County Institute of Forensic Sciences or the Medical Examiner's Office. Q. Do you need a moment to set up your files? A. No, I'm good. Q. All right. How long have you worked for the Medical Examiner's Office? A. I have been with them since June of 00. Q. Tell the jury -- A. 00, sorry. Q. Tell the jury about your educational background. A. I went to college in Tennessee -- I'm sorry, in Louisiana. I went to medical school at

2 the University of Texas Southwestern Medical School in Dallas. I did my pathology residency in 0 Tennessee and then I did a year of fellowship training at the Dallas County Medical Examiner's Office. Q. Are you board certified? A. Yes, I am. Q. And in what area are you board certified? A. Anatomic and forensic pathology. Q. Can you explain to the jury the difference between clinical, anatomic and forensic pathology? A. Sure. Pathology encompasses all of those sciences. Anatomical pathology is the branch of pathology that deals more with anatomic structures. Anytime someone undergoes a surgical procedure where their gallbladder is removed, that goes to an anatomic pathologist. So it's someone 0 who has experience dealing with diseases of the body. Clinical pathologist does more with laboratory tests, blood banking, things like that. A forensic pathologist is a specialized branch of the field of pathology that applies the

3 basic work of pathology to individuals that have died. So we look at disease and disease processes 0 that have occurred in someone to cause their death. We also find traumatic events that may be the reason the person died as well. Q. Can you walk them through the various places where you have been employed where you have utilized your forensic pathology expertise? A. Sure. I started doing forensic pathology when I was doing my residency in Tennessee. residency. I worked as a medical examiner during my Then I did my fellowship year in forensic pathology in Dallas County. And then I 0 worked for two years as a medical examiner in Northern Virginia and then I came down here to Houston to work here. Q. And what brought you to Houston? A. The job pretty much. Q. You have had a few unique experiences that I'd like for you to share with the jury because I find it very interesting. ordinary. It's out of the My understanding is that you were part of the disaster mortuary response team? A. Yes, I am a member of what's called

4 DMORT, which is Disaster Mortuary Operational Response Team; and it's a Federal team of volunteers that get deployed whenever there is a mass fatality situation. Q. And what are some of the operations that you have assisted in in connection with that team? A. Well, I joined in August of 00. So September th, New York City, was my first deployment. After that I was deployed to an event 0 in Georgia, a crematorium disaster where the person was not cremating the decedents. I've been to Haiti after the earthquake. but -- Q. Okay. Seems like I'm missing one 0 A. -- that's the bulk of it. Q. Over the course of your professional career, any estimate as to how many autopsies you have performed? A. Oh, gosh, well over,00. That was the last time I counted, and that was a couple of years ago. So it's probably a couple thousand by now. Q. Explain to the jury what are the determining factors as to whether or not an autopsy is performed on a deceased in Harris County? A. Well, all medical examiners in the State

5 0 of Texas are given their duties by Texas statute and that defines what types of cases that we have authorization over. And in the State of Texas anyone that dies of an unusual, unnatural, suspicious death, that falls under medical examiner jurisdiction. So our office will be notified of those deaths and then we'll decide whether or not an autopsy needs to be performed based on the 0 information that's given. If it's a traumatic death, such as a homicide or a suicide or even a motor vehicle accident, we do autopsies on those cases almost all the time. Unless it's a motor vehicle accident where they went to the hospital and injuries are documented and we may not do them then. Q. And I do want to make sure that the record is clear. My understanding is that you have 0 published extensively in the field of pathology and forensic pathology? A. Yes, I have. Q. Okay. And you have held faculty appointments in your field, correct? A. That's correct. Q. Where were those appointments? A. I am a Clinical Associate Professor, I

6 0 think is the term, at Baylor College of Medicine and the University of Texas Health Science Center. Q. Do you also speak on -- speak professionally on your topic in your field? A. Yes, I do. Q. And any professional memberships or organizations that you are part of? Q. Can you tell them? A. I'm a fellow member of the National Association of Medical Examiners. I'm also on several committees with that organization. And I am a fellow member of the American Academy of Forensic Sciences, which is one of our biggest organizations across the country. And I'm currently the Program Chair and Continuing Education Committee Member for the Pathology/Biology Section. Q. Now, you have given us an indication of the number of autopsies that you've performed over 0 the course of your career. Specifically have you been recognized as an expert in your field within Harris County? A. Yes, I have. Q. Okay. You described for us the various circumstances under which an autopsy would be

7 performed. the process. So I'd like to talk a little bit about When -- when a deceased is brought in 0 to the Institute, what mechanism of tracking is used to identify and follow that body through the autopsy process? A. Whenever we are notified of a death and we determine that it falls within the medical examiner jurisdiction, it is assigned a unique identifying case number which stays with them throughout the entire process as a decedent in our office as well as any associated paperwork. Q. And that unique number, that is never used again to identify another body? A. That's correct. Q. And is the number in sequential order? A. Yes, it is starting with No. for the first case of the year until,000 and something at the end of the year. Q. Okay. Let's go through the process, 0 just the autopsy process itself. Once a body is brought into the Institute and is documented, what is the first step of the autopsy process? A. The first thing that we do when we have a decedent is take photographs and document the external appearance of the decedent.

8 MS. MAGNESS: May I approach the witness, Judge? THE COURT: Yes, ma'am. 0 0 Q. (By Ms. Magness) I'm going to show you what's been marked for identification purposes as State's Exhibits No. through 0, and also State's Exhibit. A. (Witness reviewing exhibits.) Q. Beginning with State's Exhibit through State's Exhibit 0, are these photographs of the autopsy performed on the body of Phillip Anthony Little, Medical/Legal No.? A. Yes, they are. Q. And are these photographs photographs that you reviewed in evaluating this case and forming your opinion as to the cause and manner of Phillip Little's death? Q. State's Exhibit, would you examine that item, please? A. (Witness complies.) Q. Could you compare State's Exhibit to the original autopsy report in this case? A. Yes, I have a copy. Q. Can you compare it to your copy?

9 0 0 A. Sure. Q. I just want to make sure there aren't any alterations or deletions and that it's an exact duplicate. A. (Witness complies.) State's Exhibit is an exact copy of the original autopsy report. Q. And where is the original report kept? A. It's in our office, currently in my office. Q. The autopsy report, first of all, is that kept in the regular course of business of the Harris County Institute of Forensic Sciences? Q. Are the entries that are made on the autopsy report, are they made by a person who has personal knowledge of what's recorded? A. And they're documented by someone with personal knowledge, yes. Q. The information that's contained within the report, is it documented at or near the time that the autopsy is performed? A. Yes, it is. Q. Okay. MS. MAGNESS: Tendering State's

10 Exhibit and State's Exhibits through 0 to opposing counsel and offering them into evidence. (State's Exhibits No. and through 0, Autopsy Report and Autopsy photographs, offered.) MR. CORNELIUS: No objection to, Judge. THE COURT: All right. is 0 admitted. You may publish. (State's Exhibit No. admitted.) MR. CORNELIUS: I have no objection to the photographs either, Judge. THE COURT: All right. They are admitted. (State's Exhibits No. through 0 admitted.) MS. MAGNESS: THE COURT: May I publish, Judge? Yes, ma'am. 0 Q. (By Ms. Magness) I just want to begin with the autopsy report itself, State's Exhibit. The autopsy report, again, has the unique Medical/Legal No.. is that date indicative of? November rd, 0, what performed. A. That is the date that the autopsy was

11 0 0 Q. And it identifies the autopsy as performed on the body of Phillip Anthony Little. Now, down at the bottom -- just to be clear, you were not the physician who performed this autopsy, correct? A. That's correct. Q. When it shows here on the autopsy report that the autopsy was performed by a forensic pathology fellow, what exactly does that mean? A. That is someone that's in training in our office to become a forensic pathologist, so we're actually training them in the skills of forensic pathology. Q. And when it indicates "reviewed by Dr. Stephen Wilson," does that indicate that Dr. Stephen Wilson was there to, I guess, observe and assist the fellow as the fellow performed the autopsy? A. That's correct. Q. And there is a second -- actually a second review by the Deputy Chief Medical Examiner, Dr. Dwayne Wolf. Is that indicative of him looking at the fellow's work and then Dr. Wilson's work and signing off and agreeing with the findings? A. That's correct.

12 0 Q. Now, in -- and I understand that neither the fellow or Dr. Wilson was available for trial today? A. That's correct. Q. So were you asked to review both the autopsy reports and the photographs so that you could render an opinion in this case? A. Yes, I was. Q. And did you do that? Q. When you say that the body comes in and is photographed documenting the condition of the body, let me start here with State's Exhibit No.. One of the first things that I wanted to point out here is that there is a placard that is depicted in these photographs and, in fact, in many of these photographs. documenting? What -- what is that -- what is that 0 A. The placard is a number board with the case number, the date that the examination is being performed, as well as the pathologist that performed the examination. And we use that for these overall pictures because it's big and you can see it. In the smaller more close-up pictures, we use a smaller number because that would be too big for some of our

13 other photos. But that is the way that we designate the case number so you could see it in photographs. Q. Now, obviously here we're documenting that there's evidence of medical intervention. Can 0 you explain to the jury what the purpose of this bag over Phillip's hands are? A. Sure. We place paper bags over a decedent's hands when there's a suspicion that there was some foul play or inflicted trauma to the decedent such as a gunshot wound or something -- stab wounds or something like that in order to preserve any evidence that may be on that person's hands. Q. And then State's Exhibit No. is just a photograph documenting the back of Phillip. State's Exhibit No. is the first photograph or one of the first photographs that we have depicting an actual injury. they're looking at there. Tell the jury what 0 A. So on this photograph right above the smaller number, which I was describing earlier, there's a wound which is a gunshot wound, an entrance wound, which is right here that I circled in green (indicating). Q. Once the photographs are taken to

14 0 0 document the condition that the body comes into the Institute in, is there any sort of cleaning process before the actual autopsy itself begins? Q. And can you describe that for the jury, please? A. Sure. After we first examine the decedent, on gunshot wounds we tend to take a photograph of the wound. We call it dirty. So before it's been cleaned, in case there's any evidence of residue, firearm residue around the wound, then we will take the clothes off, take photographs of the clothing and clean the body so that we can see if there's any other wounds or any other scars, tattoos, things like that that we might -- that will be noted on our autopsy report. Q. And what substance is used to clean them? A. Water. Q. You indicated that you document the condition of the clothing. Let me show you State's Exhibit No.. Is that what that photograph is doing is just showing the various items of clothing that Phillip was wearing when he came into the Institute?

15 0 0 A. That's correct. Q. Is there any point where the body is x-rayed? Q. And what is the purpose of x-raying the body? A. The x-rays help us localize any bullets that may still be in the body. Q. Once the body is cleaned and the next step of the autopsy process has begun -- which is I'm assuming the secondary external examination? Q. And what -- what is it that you're looking for during this portion of the examination? A. So once we have the decedent cleaned, we will again look for trauma that may have been obscured by overlying blood. We'll document it, 0 we'll measure it, and again photograph it in the clean state. Q. State's Exhibit No. is Phillip in a cleaned state and is the first indication that we have here of an injury. I'm going to show State's Exhibit No.. It's a little more -- a more close-up view of that injury, and then, finally, State's Exhibit No. is a close-up of that wound.

16 0 What kind of injury is that? A. This is a gunshot wound of entrance. So, it's the entry point for the bullet. Q. And was there any corresponding exit wound on Phillip's body? A. No. Q. That gunshot wound, when Phillip was x-rayed, did the x-rays indicate any projectile that had remained in his body? A. Yes, it did. Q. Can you tell the jury approximately where that injury, that wound was located? A. The entrance wound is located on the left lower back still overlying the rib area on the back. Q. Okay. Other than that gunshot wound, did you -- I'm sorry. Is there any indication 0 during the autopsy that there were any other external injuries that were observed that would have contributed to his death? A. No, none that would have contributed to his death. Q. After the external examination, is there then an internal examination of the body?

17 Q. Now, in a case like this when we're dealing with a gunshot wound, it seems relatively obvious as to what caused the death. Why is it necessary to then go one step further and do an internal examination? A. Well, the internal examination is very important in these cases so that we can see exactly what was injured. When we do that, it will give us an idea of how immediately incapacitating the injury 0 may have been. If it did, in fact, cause the death of the individual. So it's very important that we 0 track the bullet path as it goes through the body. Q. And explain to the jury the process of conducting the internal examination. A. When we do the internal examination, we reflect the skin through what's called a Y incision and we remove the front part of the chest plate. And by doing that we can pretty much look at every organ in the internal body cavity with the exception of the head. So once we take that and expose the organs, then we can look for any trauma to those organs and follow the bullet path if there are those. Q. During the -- when you reviewed the

18 0 findings of the internal examination, does the autopsy report indicate the path that the bullet or projectile traveled through Phillip's body? Q. And will you describe that for the jury, please? A. Sure. So the bullet enters the left mid-back area, mid to lower back, and after going through the skin, it goes through the muscle that's between or just below the ninth rib. It goes through the diaphragm, which is the muscle that enables us to breathe. It goes through the left kidney, the 0 stomach, the liver. It goes back into the -- through the diaphragm, goes through the heart and then it strikes the inner surface of the sternum or the breast bone, which is where part of the bullet was recovered. Q. Now, in describing the path of the bullet, you've indicated multiple organs that that bullet traveled through. As a result of that trauma, is there going to be significant blood loss? Q. The projectile came to rest underneath the sternum. Is there an indication in the autopsy

19 report that that projectile was recovered from Phillip's body? Q. And I'm going to show you specifically State's Exhibit No. 0 and then a little bit closer view, State's Exhibit 0. that was recovered? Is that the projectile 0 Q. Now, there was an indication in the autopsy report that there was also a fragment that was recovered from Phillip's shirt. to show you State's Exhibit No. 0. And I'm going Is that the fragment that the autopsy report is referencing? Q. And I think that's further documented in State's Exhibit 0 and State's Exhibit No. 0. I'm going to show you what's been introduced as State's Exhibit -- that's State's Exhibit ; and this originally, I guess, was a 0 white T-shirt. There is also a red shirt that Phillip was wearing. Exhibit No. 00. Let me show you State's In looking at these defects in his clothing, is that consistent with the gunshot wound that you have previously described?

20 0 Q. When you reviewed the findings from the internal examination, did you find any other sign of disease or defect that would have contributed to his death? A. No, I did not. Q. As part of the autopsy procedure, is there -- are there samples taken, blood samples taken from the deceased in order to determine if they have any drugs or alcohol in their system at the time of death? Q. And is that toxicology report included as part of the official autopsy report? A. Yes, it is. Q. And State's Exhibit, the autopsy report, also has a toxicology report. review this report? A. Yes, I did. Did you 0 Q. Just in terms of the findings, it says that the specimen that was used here was femoral blood? Q. Are there -- are there different specimens that you can use and how is it that you

21 come to decide what sample, representative sample to use? A. Well, in the course of the autopsy we do collect blood in addition to urine, if there is any, bile from the gallbladder, we take some liver, any stomach contents; but typically the best sample to use is blood. We like to get it from a peripheral 0 0 source, meaning away from the heart and lungs because the closer you get to those organs the more -- or the less reliable your results are because there might be some diffusion contamination from the heart to the lungs as the drugs are going through those organs. So peripheral femoral blood is our preferable source for toxicology testing. Q. And when the toxicology testing was performed on the sample taken from Phillip, it appears that he was not under the influence of any drugs or alcohol, prescription drugs or street drugs for that matter? A. That's correct. Q. Okay. So he sustains this gunshot wound and associated with the injury there is a significant amount of blood loss. Do you have any opinion one way or the other as to the amount of

22 time that he would have been able to maintain consciousness? A. I can't put an exact minute to it, but I can tell you that the injuries that he sustained were not immediately incapacitating. There would be 0 a period of time where he could still do something such as walk, talk, run, you know, drive short distance with these injuries because as the blood is being pumped through the body he's still getting oxygen to his brain because the way the defects are, the blood is pooling inside the body and so it takes time for that to build up. So there would be 0 a period of time for him to be able to function. Q. So, in other words, his death was not instantaneous? A. That's correct. Q. And there was nothing in terms of drug or alcohol within his system that would have numbed or dulled his ability to be aware of his surroundings or to feel the sensations of pain? A. That's correct. Q. Having reviewed the autopsy report and the photographs that were taken during the autopsy report, do you have an opinion as to the cause of Phillip Little's death?

23 A. Yes, I do. Q. And what is that opinion? A. The cause of death is penetrating gunshot wound of the torso. Q. And did you form an opinion as to the manner of death of Phillip Little's death? A. Yes, I did. Q. And what is your opinion? A. The manner of death is homicide. 0 MS. MAGNESS: I'll pass this witness. THE COURT: Mr. Cornelius? CROSS-EXAMINATION 0 BY MR. CORNELIUS: Q. Dr. Haden-Pinneri, we have met before. My name is Skip Cornelius, but we've never talked about this case before, right? A. That's correct. Q. Just a couple questions for you. The fragment that was recovered from the shirt, was there any attempt to determine if that was a copper jacket or a lead fragment from the projectile itself? A. From the photos it did not look like there was any sort of jacketing on it but all I know

24 0 is that it was described as a metal fragment but I don't know if they did any further testing or anything on it. Q. And the projectile that was found in the body, was that lead or do you know? A. It looks like it's just a lead fragment. Q. Okay. The path of the projectile, particularly whether it went up, down or on a plane, what was discovered? A. The wound path goes from the left side of the body to the right side. It goes from the back of the body towards the front, and it goes upward. And it does mention that the jacket from 0 the -- under the sternum was not jacketed. Q. Okay. So the bullet was traveling -- and this is from head to toe -- Q. -- up? A. Correct. MR. CORNELIUS: Okay. I don't have any other questions, Judge. THE COURT: MS. MAGNESS: Ms. Magness? Nothing further, Your Honor. THE COURT: May this witness be

DUNG NGUYEN - October 28, 2013 Recross-Examination by Ms. Gutierrez. MS. LOGAN: Thank you, Judge. KATHLEEN MCKINNEY,

DUNG NGUYEN - October 28, 2013 Recross-Examination by Ms. Gutierrez. MS. LOGAN: Thank you, Judge. KATHLEEN MCKINNEY, DUNG NGUYEN - October, Recross-Examination by Ms. Gutierrez 0 MS. LOGAN: Thank you, Judge. KATHLEEN MCKINNEY, having been first duly sworn, testified as follows: DIRECT EXAMINATION BY MS. LOGAN: Q. Good