Pathologist gets spanked for using defendant’s statements as basis for determining cause and manner of death

This case defines some limits to what a medical expert can consider in rendering  “with medical certainty” testimony. This should be a message to the odontologists who rely on law enforcement to determine how many people should be considered potential “biters” [e.g. “uncorroborated’ and unscientific”]. The case was remanded, in part, on this issue.

In the state of Iowa, there is an assistant medical examiner who testified at a hearing before trial in a newborn death case that ……….. [read further in the following section].

Later, the Iowa higher court, upon appeal by the convicted mother, ruled that……

“On retrial, should the State attempt to use Dr. Thompson as an expert witness, the district court should prohibit him from testifying that the cause of death was “drowning” and the manner of death was “homicide.” Likewise, it should redact the portions of the autopsy report stating his ultimate opinions on cause and manner of death.”

Here is what went on at the original hearing. (this starts at page 13 of the appellate opinion). The higher court’s basis for reversal is the last paragraph.

The phrase to remember while reading is from the appellate court’s ruling stating “Dr. Thompson’s opinions on the cause and manner of Baby Tyler’s death were based primarily, if not exclusively, on Tyler’s [the mother and criminal defendant] inconsistent and uncorroborated statements to police.”


Motion In Limine hearing testimony of an Iowa state medical examiner.

“At the hearing, Tyler’s counsel questioned Dr. Thompson about the autopsy he performed and the foundation for his conclusions of the cause and manner of Baby Tyler’s death. The following exchange occurred:

  1. Okay. So the examination includes your visual examination, both inside and outside of the body that you’re examining, correct?
  2. Yes, sir.
  3. And then it also includes various . . . scientific tests?
  4. Yes, it does.
  5. In this case, if you based your opinions speaking strictly on medical or scientific evidence, you were unable to give a conclusion as to whether or not this was a homicide, correct?
  6. Just on the autopsy findings, that would be correct, yes.
  7. Okay. And also based just on the autopsy findings, you would be unable to determine whether or not this was a drowning, correct?
  8. That would be correct, yes.
  9. The autopsy findings were consistent with intrauterine fetal demise,[4] correct?
  10. They could be, yes.
  11. They could also be consistent with a baby that died immediately after birth, correct?
  12. It could be, yes. . . . .
  13. Okay. So the specific autopsy, the testing that you did, the toxicology test, the examination of the lungs, all of the things you did, the examination of the stomach contents, all of that led you to an inconclusive determination, correct?
  14. That’s correct, yes.
  15. And the only way that you reached the conclusion of homicide as the manner of death, as drowning as a cause of death, is through observing and watching the videotapes that the law enforcement officers supplied to you, correct?
  16. Yes, it is.
  17. So that would be of Miss Tyler’s interview with the police, correct?
  18. That’s correct.
  19. Okay. So from that standpoint, ultimately your opinion as to whether or not this was a homicide . . . and what the cause of death was, is based entirely on your belief of her statements, correct?
  20. That’s correct, yes.
  21. Okay. [E]ssentially what you’re saying is that since the autopsy didn’t disprove her statement, you’re going to believe her statement?
  22. That’s correct, yes. There’s nothing inconsistent between what she said and what I saw at the autopsy.
  23. Hypothetically speaking, if her statement to the police was the baby was a stillborn, your conclusion then would have had to have been stillborn birth, natural cause of death, correct?
  24. I would probably classify as [stillbirth].
  25. And that’s just because the actual medical examination, medical testing, scientific testing is inconclusive?
  26. That’s correct, yes.

The district court overruled Tyler’s motion in limine. In its ruling, it noted that “in Iowa, the courts are committed to a liberal rule on the admission of expert testimony” and that Dr. Thompson’s reliance on Tyler’s statements to police was “no different than a physician relying on a patient’s history in reaching a diagnosis.” Consequently, the district court overruled Tyler’s motion in limine, “subject to [her] right to vigorous cross examination.”





About csidds

Dr. Michael Bowers is a long time forensic consultant in the US and international court systems.
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4 Responses to Pathologist gets spanked for using defendant’s statements as basis for determining cause and manner of death

  1. csidds says:

    Reblogged this on FORENSICS in FOCUS @ CSIDDS | News and Trends and commented:

    Comments from a veteran forensic pathologist;
    The district court that first allowed that the pathologist could use the mother’s statements to the police that sealed his decision about the cause and manner of death when he testified as an expert in a criminal homicide case. The standards of “certainty” for a death certificate are not so high as the standards for a criminal conviction “beyond a reasonable doubt”. I have always used the standard for a death certificate cause of death as “more likely than not”, in other words “probable”. the State and National instructions for a physician completing a death certificate are of little issue on this matter. For example, California’s instructions for a physician completing the cause of death statement are to “enter the cause of death”. For the manner of death the instructions are to ” check the appropriate manner of death: natural, homicide, suicide, accident, undetermined. For any case that seems like it might be anything other than natural, the physician or someone is supposed to refer the case to the coroner/ME for investigation and certification of the cause and manner of death.

    So the author of the above article was missing the point. The doctor was testifying to his opinion, based on the information he received about the circumstances of death and the consistency of the circumstances with the autopsy findings. Personally, I think the district court was right in allowing the ME to testify. Prosecution and defense should clarify for the jury ( if the ME hasn’t already done so) that his opinion about the cause and manner are not as high as the standard for a criminal conviction, that is, “beyond a reasonable doubt”.

    One of the ironies in all this is that Calif. statutes specifically say that the death certificate shall not be entered as evidence in a court proceeding, yet routinely the DA’s submit it as an exhibit, unchallenged by the defense (in my experience of around 500 homicide trials).

  2. GB says:

    I just came across an astonishing claim in the Christopher Coleman case.

    Dr Michael Baden reportedly claimed a body does not start losing heat for three to four hours after death, and used this to impeach Coleman’s claim that he was at a Gym when the murder took place.

  3. mbhauptle says:

    Reblogged this on Truth in Forensic Science and commented:
    I might add, that a negative autopsy, negative labs, negative toxicology, in an infant without otherwise injury, by “diagnosis of exclusion”, may have had an idiopathic seizure, or be a candidate for genetic testing, and/or pediatric neuro workup.

  4. mbhauptle says:

    For similar reasons, I believe bite mark pattern injury evidence as such must be classified as circumstantial NOT scientific. I thank you. Mary Beth Hauptle, D.D.S.

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