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.
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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.”
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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:
- Okay. So the examination includes your visual examination, both inside and outside of the body that you’re examining, correct?
- Yes, sir.
- And then it also includes various . . . scientific tests?
- Yes, it does.
- 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?
- Just on the autopsy findings, that would be correct, yes.
- Okay. And also based just on the autopsy findings, you would be unable to determine whether or not this was a drowning, correct?
- That would be correct, yes.
- The autopsy findings were consistent with intrauterine fetal demise,[4] correct?
- They could be, yes.
- They could also be consistent with a baby that died immediately after birth, correct?
- It could be, yes. . . . .
- 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?
- That’s correct, yes.
- 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?
- Yes, it is.
- So that would be of Miss Tyler’s interview with the police, correct?
- That’s correct.
- 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?
- That’s correct, yes.
- Okay. [E]ssentially what you’re saying is that since the autopsy didn’t disprove her statement, you’re going to believe her statement?
- That’s correct, yes. There’s nothing inconsistent between what she said and what I saw at the autopsy.
- 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?
- I would probably classify as [stillbirth].
- And that’s just because the actual medical examination, medical testing, scientific testing is inconclusive?
- 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.”



