Thanks for sharing your expertise. I hope you don't mind another question or two directed toward you? I find it curious that there are no contusions or lacerations anywhere given the precarious climb over the pipes and sharp angles of the hatch rim into a small opening on the tank. Possible, but not probable that there is not one mark on her. The sheer absence of
anything seems off to me, not to mention no trail of her was detected by SAR dogs. I feel there is just as much a lack of compelling evidence to rule this an accident as there is to rule out homicide.
Signs of strangulation would be more obvious as would any sort of rape trauma, as you point out. Would it be so easy to assign cause of death as drowning if EL had been asphyxiated somehow prior to immersion in tank?
In comparison, in an unsolved similar case near my home the autopsy revealed the girl was asphyxiated to some degree prior to immersion in a bathtub, so death ruled a homicide though also no signs of trauma. They don't even know if she was alive or not before she ended up in the tub. How in the world, then, was it concluded EL was alive when she entered the tank and asphyxiated by water? Generally, it seems extremely difficult to prove drowning as cause of death. For anyone not familiar, here is a reference; not the most authoritative out there but a decent summary.
http://forensicpathologyonline.com/E-Book/asphyxia/drowning
Just curious, if the video did not exist would the autopsy might have been more comprehensive and the manner of death ruled undetermined? From a medical or scientific standpoint, do you think that there is enough in this report to set this apart unequivocally as an accident? To me, Given there is no clear overwhelming physical evidence reported supporting that EL was alive when she went into the tank it seems professionally questionable to rule this death anything other than undetermined.
Hi there! I will be happy to answer any questions. Please keep in mind that I am still learning and my clinical experience is somewhat limited given the fact that I have only seen only a handful of autopsies of bodies which were recovered from water.
Okay, first of all, when a body is recovered from water there are some questions that have to be answered by the autopsy findings. One of them and the most important is: Did death occur prior to or after entry into the water?
If the death occurred prior to submersion then the autopsy would reveal no water in lungs, lungs would not be hyper inflated and there would be signs of some other cause of death: natural, toxicological or traumatic.
If the death occurred after submersion you would have quite a few indicatives that would suggest it. One of them is the presence of secretions and foam in the respiratory tract, they are a mix of water, mucus and surfactant from the lungs that has been whipped up by respiratory efforts. This is a vital phenomenon that indicates the victim was alive at the time of submersion. While the foam disappears after a week from the moment of submersion, the secretions linger around for quite a while. This is why the medical examiner found scant secretions in Elisa's respiratory tract. Such secretions could also be found in case of head injury, heart failure or drug overdose but there are no indicatives that Elisa could have sustained neither of these.
Another sign is the presence of water in the lungs. If the body has been found in water and there is no other cause of death (head injury, drug overdose or heart failure which could also be causes of fluid in lungs) then it is obvious that the death occurred due to drowning because the presence of fluid in lungs cannot be reproduced by passive flooding of the lungs with water.
I believe this is how the medical examiner concluded that Elisa was alive when she entered the water because I have read about both these indicatives in her autopsy report.
About the lack of injuries due to her climbing into the water tank: was there a ladder she could have climbed in order to get into the tank? I don't know, if there was a ladder then that could explain why she has no injuries from the climb. Perhaps she was a skilled climber?
Could she have been carried into the tank by someone else? Evidence from the autopsy suggest that she was still alive when she entered it. This is just my opinion but how in the world could she have been carried into the tank while still alive without any signs of struggle? Also, presuming she was dead, how could she have been carried into the tank without any injuries? She weighed maybe like 45-50 kg so it would have been difficult for the presumed attacker to just carry her into the tank.
And generally, yes, drowning is a bit problematic to prove as a cause of death because the lack of characteristic signs and is largely a diagnosis of exclusion. However, the findings from the autopsy do not suggest any other underlying condition that could have caused the presence of fluid in lungs or secretions in the airways such as heart failure, nor was she under the influence of drugs or sustained a head injury.
Edit: they did note a small abrasion on her left knee. Also, in response to your question about the SAR dogs, my knowledge is that they wouldn't have picked up her scent because she was in a metal tank. Also it could have been a few days until this search was conducted so they wouldn't have picked up her scent especially if it had rained or something after her disappearance.
