Dr. Jan Garavaglia testimony (Medical Examiner)

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wenwe4

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Dr. Jan Garavalia...

JA - chief ME for Dist 9 - prior to that deputy chief, prior 10 yrs ME in Tx, and trained

she is MD - St. Lewis, MO - grad in 82 , special pathology ...anatomic pathology look under microscopes, clinical pathology - runs the labs...sub=specialized in forensic pathology , sudden and unexpected death and board cert in forensic biology....

death of Caylee first learn remains 12/11/08 - late morning or early afternoon - chief Hansen alerted her...she was late for airport - weren't sure who that was @ that point....scene recovery often take long time.....engagement prior scheduled...late for airport....call Dr. Schultz - anthropoligist and and Utz could handle it...

takes awhile to recover skeletal remains usually....absence for night was not an issue....returned and reviewed photos from scene and in facility while gone...arrived back and took case back from Utz....look @ photos taken with the body...case discussed went out to scene - suggestions for what needed done - got other consultants.....

show witness SA exhibit CX - one of the things examined hair mat surrounding the skull...eventually came back from FBI...photo looks like bone attached....photo reviewed Cy photo- publish

CX publish - hair mat of the decedent case 81567 - roots grown thru hair.
CY #251 - looking @ hair mat with roots grown thru hair mat...some holes in hair mat from insect activity..

DA - photo - teased out some of the hair to take sample from the hairmat...possible toxicologic use... publish ....scale have 6" scale...length of hair is more than 6"....

photo DC - scale of one of the roots on the hairmat - to compare size of the scale...

items found w/remains DV a blanket....the WTP blanket....taken @ her direction or staff - it was photo'd several times - publish...condition it came into office - not cleaned ....unfolded only....detect some figures - closer photo to show figures more closely....

photo DW - closer photo of figures on blanket - publish....zoom in on figure....piglet riding on pooh's back....

photo DX - photo of other side of blanket - publish...plant material in blanket

photo DZ - amount of plant and root material growing in the blanket - publish - close up edge of WTP blanket w/piglet - shows plant and root material ontop and through blanket

ED photo - other area root growth in blanket - publish -

EB - root material (kc puts on a sweater/shroud over shoulders)

EE - photo more root material into same blanket-publish

2 black plastic bags - root grow thru the holes in the bags - EI photo -publish....

canvas laundry bag found with the remains...roots growing in that ? canvas on outside and shiny inside ...roots only growing on top on the canvas side....#EN - roots grow into canvas bag....publish

fair to say roots growing in and around everything ...no roots in the shorts....shirt completely disintegrated...certainly 2 plastic bags, canvas bag, blanket.....the letters and the stitching around the .....

identify who this child was/ best thru dna - often use teeth or dental comparison...difficult with this child - so young....hopeful to get nuclear dna and through we would get at least mitochondrial dna....sent off sample bone for dna

EO - photo of bone from return from eval...publish ...portion missing from bone - procedure familiar - must remove piece of bone to test from right tibia.....dna identification of remains from lab.....caylee marie anthony...

your job to determine 2 things - cause of death and manner of death....fundamental to her job why ME's exist.....manner of death is based on scientific principles....gather all info and circumstances of the case....all medical history...come up with an opinion (approach)

 

KC back in the courtroom after leaving for a couple of minutes....jury not brought in yet....HHBP up - rise for the jury



 

JA w/Dr.G - provide envelope - canvas bag - received in evidence (kc puts on sweater)
KU - baby blanket (WTP) - received in evidence -
KM - body bag with vegetation - received in evidence after CM checked and confirmed w/JA....
KK - bag containing tied black plastic bag - received
KO - untied plastic bag- received
KR - bag contain shorts in the photo - she didn't see shorts in photo - she examined the shorts not the photos - received
KT - bag containing clothing/letters and stitching - received
KS - (approach counsel for a moment....JA - CM rather than have the Dr. open bag - hair mat - received

when we broke discussing cause and manner of death - manner classification of death based upon all info available...scientific, historic, medical, helps us to determine what happened....bring expertise ....Manner of Death in this Case is HOMICIDE.

based on 3 main items...first we know from observational studies experience - red flag child not reported immediately to LE if there is an injury....

body is hidden - one of the things we look for in homicide

bodies are in closed containers, not always but closed container or plastic bag - look for in a homicide

found in a field decomposed - duct tape on the lower half of it's face...no child should have duct tape on it's face when they died, no reason to [put duct tape on face after died....we see this as homicide

chain of events that ultimately results in person dying....cause is the thing that caused the death.....based upon skeletal remains....homicide of undetermine means.....it is a homicide but don't know the means in which homicide occured...

that duct tape was over mouth and nose possible, suffocation with plastic bag could have .....evidence of chloroform found in investigation of this case...could a child ingesting? chloroform cause death - yes...absolutely(?)

we don't have enough scientific information to determine means.....unless that trauma hurt those bones - can't say ....cannot rule out any trauma even gunshot that went past the bone.....even stomach injury wouldn't show .....not aware of any illness specifically asked for that infor and was told there were none historically...


cross -exam
CM - Dr. G....live in Orlando area...period of time 4 months prior to remains being found....aware of media attention....I don't watch news and listen to NPR - aware but not to the extent others....circus like atmosphere? don't know....a lot speculation about the case....if remains found ...she was hoping it would be Lake County - would have liked it to be out of Dist. 9, she came back to handle case....news or references prior about chloroform? told that by investigation there was a question of chloroform....reasoned perhaps it may have been used ....one of the possibility to examine....bring in an expert? brought in a toxicologist who had dealt with bones - not a common thing - Dr. Goldberger...Uof FL - sent to him piece of left femur....picture was tibia taken for dna...piece of the left femur sent to Gold... look for chloroform and other volitle chemicles....alcohol, isoporpenol....anything contributed to this child death....not a myriad very limited what to do with bone - whatever tests on bone could be were done....tried...all tests negative (he only looked for volitle)

present when DR. W. Spitz ? (object- sidebar)
 

Dr. Warner Spitz come down to help autopsy - no ....are you aware he came (object-overrule) learned JB called and (object- ovrrule)

I was aware he was coming down...get everything ready....

Are you aware Dr. Warner Spitz did a 2nd autopsy (object

Goldberger an MD? NO PhD....

scrapings of the soil, the hair, the bone, scrapings from the bone marrow - washings from cranial cavity - tested GCMS - scrapings of cranial cavity and washings - and for Benzo aka Xanex......did not open the cranium - no absolutely not.....no trauma found - no anti-mortem (prior to that) found post-mortem trauma - animal activity...you could see that.....on the bones no evidence of trauma...didn't find ? either - no did not

despite all Dr's no evidence to establish this childs death.....the means of the Homicide could not be determined......the circumstances of death didn't fit anything other than a homicide...way body found.....you learned from Melich....is standard......learn from media - nothing from media would be in my decision......homicidal means it's probably a homicide...not probably! based upon scientific observation info about children dying....observational systematic studies....how we know our world.....went thru all drownings....100% EMS has to do with drowning.....absolutely has to do with this case....you can never ever determine a manner of death by just exam body...we have to know red flags for homicide (object by CM 0verrule) by experience and known how homicides occur not reporting a child missing.......tossed in a field in bags to rot...in a bag to be hidden - never seen in accidental death....duct tape anywhere attached to a child's face to me is a homicide.......what part of that is scientific? We know 100% accidental deaths are reported unless there is a reason......if you don't report - you are risking? that child life.....youre saying 100% no way this death is accidental? No 100% when the person finds the child they call for help - there is a chance the child might live.......about morality? no - looking @ bx's - no matter how stiff that body is....there is always a chance that child could be saved.....circumstantial evidence says it must have been homicide can't explain it any other way....I answered red flags....You need to answer My Question...sorry dont understand! Objection-susttained.......CM you question did not ask a yes or no answer -......new question....cause of death - don't know .....manner of death homicide.....manner of death is defensible based upon systematic observational studies of other cases of homicide, accidental, natural death.....if found 4 or 5 months earlier would you have better chance of determining death? absolutely

duct tape in lower mandible. - correct

CM asks for a minute - confer w/JB - no further questions

redirect -

JA - Dr. G....Cm asked you about defense desire to do second autopsy.....make attempt to keep body in same condition as received...except what they removed for dna and tox screen...packaged nicely to keep in tact roots etc......tox screen exclude acute use? we would not find anything positive in those bones not expect to find even @ time of death....very difficult to find anything in bones - long shot - remiss if didn't try.....June of 2008 - body missing - body out for 2 months if found in August.....certainly skeletonized by then.....very little soft tissue...internal organs completely gone.....

Re-cross to those issues

Dr. you are excused.


eta: Dr. G said ethical moral and legal obligation to seek help for the child.....as caretaker for child wellbeing (something to that effect - went by so fast didn't get it)


 


KC is angry! saying something to JB -

media is well understand pixelate pictures before put out.......absolutely no picture taking with cell phones.


JB - testify as to how it was proferred....
JA - happy to as long as it ....how it was made...

HHBP thought you want me to look @ the tape.....then testify....let's proceed

KC looking intently @ screen....eyes brows furrowed......no blinking......same expression...turn head to right slightly and back.... almost no movement from her....she turns to JB for a second....review more pictures ....michael warren anthropologist up next....jury left room ....don't want these images displayed to public...

kc staring intently ....at screen......face forehead reddens.....breathing same....she looks @ someone talks to DS - complaining about something....she appears angry about something....

kc is talking ..... looking @ screen..she just reacted by taking a deep breath and moving her position......furrowed brow throughout....Mike on IS saying

superimposed images of the recovered skull with Caylee's pictures.....match remains up with face of the child.....

JA ...in fact cause of death....a single piece of duct tape - evidence shows there were 3 ....graphically show the end of her life....skull has scale and tape scale ....1:1 ratio of the tape.....discussing whether the tape is the murder weapon...this suggesting it is..

JB - don't know but hearing a lot of testimony chloroform....lets throw everything @ wall and see what sticks....not supported by anything can't be testified ...goes to very root of 403.....sufficient measurements to cause this death...if that is what they want to argue I understand...someone testify to measurements, this child age or anthropoligst...


HHBP - just a second




 
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