Kelly Thomas Trial Update: Medical examiner says chest bruises show 'compression' was cause of death

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Bruce Chambers/AP

Jurors see an image of a pool blood left after Fullerton police arrested Kelly Thomas in 2011 as officers Manuel Ramos, second from right, and Jay Cicinelli, second from left, listen during opening statements in their trail.

Joshua Sudock, Orange County Register, pool photo

A medical examiner's photograph shows Kelly Thomas' face at the time of autopsy.

Joshua Sudock, Orange County Register, pool photo

A medical examiner's photograph shows various wounds on Kelly Thomas' body at the time of autopsy.

Joshua Sudock, pool photo, Orange County Register

A photo shows Kelly Thomas taken after the July 2011 altercation with six Fullerton police officers, including defendants Manuel Ramos and Jay Cicinelli.


Video

The fourth day of testimony continued Thursday in the trial of former Fullerton police Cpl. Jay Cicinelli and  former Officer Manuel Ramos, who are charged in the death of Kelly Thomas, a mentally ill, homeless man. 

Cicinelli, 41, is charged with involuntary manslaughter and excessive force and Ramos, 39, faces counts of second-degree murder and involuntary manslaughter for their role in the altercation between Thomas and six Fullerton police officers  on the night of  July 5, 2011. Thomas was hospitalized following the incident and died five days later.

Updates

 

Update 4:45 pm.: Medical examiner says chest bruises show 'compression' was cause of death
 

A defense attorney in the trial of two former Fullerton police officers charged in the death of Kelly Thomas continued to press the medical examiner who conducted Thomas’ autopsy on how she formed her opinion of his cause of death.

Atty. John Barnett, representing defendant Manuel Ramos, particularly focused on the conclusion of Dr. Aruna Singhania that “mechanical compression” of the chest that Thomas experienced during his July 2012 struggle with police was a major factor in his death.

Ramos is charged with second-degree murder and involuntary manslaughter, and co-defendant Jay Cicinelli face counts of involuntary manslaughter and excessive force. The men were among six officers involved in a violent altercation with Thomas outside the Fullerton Transportation Center on the night of July 5, 2011.

Under cross-examination, Barnett asked Singhania when during her physical examination of Thomas did she see “any evidence of mechanical compression."

Singhania: "Just by doing autopsy I can't see anything. I cannot have a cause of death without an investigation."

Barnett asked  Singhania whether Kelly Thomas had broken ribs.

Singhania said she read in one of the hospital reports that Thomas had broken ribs, but there is no reference to broken ribs in her autopsy report. 

Barnett: "Do you think you missed it?"

Singhania: "I did not miss it, I did not see it. X-rays are always not accurate, so I have no idea who is reading wrong."

Barnett: "Can you tell us where on the body the mechanical chest compression occurred."

Singhania: "The only thing I documented is bruising on the left side of the chest and the left arm.”

Barnett: "What is mechanical compression?"

Singhania: "Mechanical compression is the compression or restriction of the chest wall."

Barnett: "Can you tell where that was on this body?"

Singhania: "As I have said repeatedly, all I have is the bruising on the left side of the chest and left arm."

She added that the, "physical evidence along with the clinical finding is important here."

Barnett finished his cross-examination, allowing Cicinelli's attorney, Michael Schwartz, to question Singhania.

Schwartz: "No broken ribs, right?"

Singhania: "Yes."

Schwartz: "No bruising inside the lungs, right?"

Singhania: "That's right."

Schwartz Underneath the skin [on left side of chest] you didn't see any other sign of bruising?

Singhania: "That's right."

Schwartz asked Singhania if she saw the video of the incident for the first time without sound.

"I don't recall, " said Singhania, who earlier said that the second time she watched a video of the incident it was with the synchronized audio from digital audio recorders worn by the officers involved.  

Schwartz: "How much air would a person have to take in if you were a person of Mr. Thomas' size?"

Singhania: "I wouldn't know."

Schwartz rephrased the question, but Singhani said "Again, I'm not an expert in that field."

After Schwartz finished his questioning, Judge William Froeberg asked Singhania about her current employer. 

She said she works for a medical services firm that is contracted by the Orange County Coroner to perform autopsies. Singhania told the judge she has worked for the firm since 1981.

Singhania was excused for the day and is not subject to recall. 

The trial resumes at 8:45 a.m. Monday, December 9.

Update 3:46 p.m.: Defense questions medical examiner on delay in cause of death determination

A defense attorney in the trial of two former Fullerton police officers charged in the death of Kelly Thomas questioned the medical examiner who conducted the autopsy on Thomas about why she delayed her cause of death findings.

Atty. John Barnett is representing Manuel Ramos, who has been charged with second-degree murder and involuntary manslaughter in connection with Thomas’ death. Co-defendant Jay Cicinelli faces counts of involuntary manslaughter and excessive force.

Barnett started his cross-examination of Dr. Aruna Singhania by asking her to point at photos of Thomas taken during the autopsy and identify which areas on his body indicated discoloration from lividity after his death rather than bruising from the July 5, 2011, altercation between Thomas and six Fullerton police officers including the defendants.

He then questioned Singhania about her cause of death findings.

Barnett: "You did not have an opinion as to the cause of death after your completed your autopsy on July 11, 2011?"

Singhania: "The cause of death was pending."

Barnett asked if Signhania had looked at a security video of the altercation along with a DA investigator and several others before issuing her opinion on the cause of death.

Singhania: "I did not have all of the results back yet when I saw the video."

Kelly Thomas Beating Video

Singhania said after seeing the video, she still did not have a conclusion into the cause of death. Singhania testified she was waiting to review Thomas’ hospital records and for test results, including the microscopic examination.

Singhania said that Thomas had no signs of heart damage or heart disease. 

Barnett questioned Singhania about a post-autopsy meeting at the Orange County Coroners Office where the Thomas autopsy findings were discussed. 

Barnett: "Wasn't it said at the meeting that there was cardiac pathology that could have contributed to cause of death?"

Singhania: "I never said that. I said he had an enlarged heart. How it got interpreted is not my wording."

Under direct questioning from Orange County District Atty. Tony Rackauckas, Singhania said she ulitimatey listed the cause of death as “anoxic encephalopathy” – brain damage or death resulting from a lack of oxygen – due to what she called “mechanical compression” to the chest and injuries to the head and face.

Barnett questioned Singhania about her "mechanical compression" conclusion. 

Barnett: "Did you review the video a second time, before you issued your conclusion as to the cause of death?"

Singhania: "Yes."

Barnett: "None of those injuries told you how he died – how his brain was deprived of oxygen?" 

Singhania: "Not without knowing the circumstances."

Singhania said "the intensity" of Thomas' breathing was important, as Barnett repeatedly asked questions about when compression started and its affect on Thomas' ability to speak. 

In audio of the incident, Thomas' speaking voice becomes much softer and infrequent, slowing toward the end, before he is no longer heard.

Barnett continued, referring back to her 2012 preliminary hearing testimony.

During one response, Singhania said to Barnett: "You misled me in questioning, we're talking about a long period of compression."

Signhania: "After the compression, there wasn't any ability to talk – once he's totally deprived of oxygen."

Singhania told Barnett, "It is the time frame and the intensity, we never talk about the intensity of the spoken word."

Barnett: "So after the compression there wasn't the ability to talk or yell?"

Singhania: "It's still correct." 

Barnett again referred to Singhania's preliminary hearing testimony, in which she testified  about the compression.

Singhania: "It's not a one time point of compression, it continued." 

The issue of when compression started and whether there was a singular moment when that happened continued with Barnett repeatedly asking Singhania if the compression meant Thomas would no longer be able to be heard. 

Barnett used the videotape of the incident, playing it for Singhania on the large screen in the courtroom.

The time stamp shows it begins at about 20 minutes into the incident, and Kelly Thomas is screaming loudly, "Dad, dad, dad." 

Barnett asked whether Singhania had identified a discrete event on the video where the compression contributed to the cause of death.

During this time, Barnett and Singhania both appeared frustrated, as the word "discrete" caused a temporary hangup. 

This led Judge William Froeberg to ask Singhania what the word "discrete" meant to her, with the judge saying "I'm going to ask a Bill Clinton-type question."

Satisfied with her understanding of the word, the judge allowed Barnett to continue.

Singhania, in response to Barnett, said there were a series of "discrete events" of compression during the incident. 

Barnett again played a section of the video, in which Thomas is heard screaming at roughly 20:43 into the incident. 

At this juncture, the Judge and attorneys conferred in a sidebar outside the courtroom. When they returned, Barnett continued questioning Singhania about compression.

Barnett: "After the [preliminary] hearing [in 2012] did you talk to Mr. Rackauckas or other prosecutors about your testimony?"

Singhania: "Yes."

Barnett: “Did that conversation include talking about your testimony about when that compression occurred?"

Singhania: "I don't remember what the wording was."

Barnett: "They [ the prosecutors] asked you today whether holding his feet would contribute to the compression?"

Singhania: "By restricting movement he would still have a restricted respiratory function."

Barnett: "There was compression."

Singhania: "Yes."

Barnett: "And it was a discrete act, right?"

Singhania: "I'm not able to answer that […] I misinterpreted that ‘discrete’ word [referring to her 2012 testimony].

Barrett: "What did you think I meant?

Singhania: "I thought you were just talking about the bruising on his chest and arm."

Barnett was still questioning Singhania when the judge recessed the court for the mid-afternoon break. Singhania was on the stand for the entire time of the post-lunch session, nearly 90 minutes. 

Update 1:16 p.m.: Coroner's official: Lack of oxygen led to Thomas' death

Following a midmorning recess in the trial of two former Fullerton police officers charged in the death of Kelly Thomas, Dr. Aruna Singhania with the Orange County Coroner’s Office discussed her autopsy of Thomas while color photographs of the procedure were projected on a large screen in a Santa Ana courtroom.

Several autopsy photos were shown of Thomas' face and the front and back sides of his body. Singhania used a pointer to identify and describe bruises, contusions, abrasions and lacerations on various parts of Thomas' body. (Some of the photos are in the slideshow above. They are graphic and may be disturbing to some.)

Singhania next described her autopsy of Thomas’ internal organs. 

"The heart size was larger than normal," she said.

On questioning from Orange County District Atty. Tony Rackauckas, Singhania said Thomas' heart weighed 480 grams. She described "normal" heart weight as between 350 and 400 grams. 

She testified that Thomas' lungs were "heavy, full of fluid and there was acute bronchial pneumonia" and his liver was "a little bit bigger in size, 2680 grams." But Singhania said there was no evidence of trauma to Thomas' lungs or liver. 

"There were no obvious fractures [to his ribs] that I could see," Singhania said.

Singhania testified she also performed a microscopic examination and toxicology tests as part of the autopsy.

Rackauckas: "When did you reach your conclusion as to the cause of death."

Singhania: "September 21, 2011."

Rackauckas: "What was your conclusion as to the cause of death?"

Signhania: "Cause of death was anoxic encephalopathy [brain damage or death due to lack of oxygen] due to mechanical chest compression along with blunt cranial and facial injuries [which reduced oxygen to the brain]."

In response to a question about Thomas' breathing during the struggle, Dr. Singhania said, "In the beginning he has enough oxygen and he speaks louder and louder, but then the oxygen declines and he speaks softer and softer." (Digital audio recorders used by Fullerton police officers captured Thomas’ voice during the altercation.)

Rackauckas: "Would it be your finding that Kelly Thomas needed more oxygen during the struggle and he was getting less oxygen?"

Singhania: "Yes."

Rackauckas: "Is it your conclusion that during the struggle there was not enough oxygen to sustain his (Thomas) system?

Singhania: "That is correct."

She testified that "any kind of facial trauma will cause a lot of pain and shock, bleeding from lacerations will cause aspiration."

Rackauckas: Did the facial injuries Thomas received in the struggle contribute to Thomas' death?"

Singhania: "They facial injuries all contributed to his death. 

Rackauckas: "If you're one person holding a person's legs down and other people are holding that person down, would that contribute to what happened?"

Singhania: "All would contribute."

Defense attorneys for Ramos and Cicinelli have said in court that Kelly Thomas died from an enlarged heart, brought on by years of drug abuse. 

Rackauckas asked Dr. Singhania if Thomas died from an enlarged heart.

"He died with an enlarged heart, not from an enlarged heart," Singhania said. "That's (enlarged heart) not part of the cause of death."

After testifying she found no evidence that Thomas had hepatitis, Rackauckas finished his questioning of Singhania.

She will face cross examination from defense attorneys following the lunch recess. 

12:10 p.m.: Jury reviews photos of Thomas after beating 

The trial of two former Fullerton police officers charged in the death of Kelly Thomas resumed today with prosecutors showing photographs taken of Thomas following a July 2011 altercation between him and six Fullerton police. Thomas died five days after the incident.

The color photos, projected on a large screen in a Santa Ana courtroom, showed Thomas with eyes closed, a bloodied face and head with his hair and beard matted with blood, and tubes into his mouth and nose. (One of the photos is in the slideshow above. It is graphic and may be disturbing to some.)

The photos accompanied testimony from Fullerton Fire Department Paramedic John Zillgitt, who was part of a six-person crew that treated Thomas following the altercation outside the Fullerton Transportation Center.

Former officers Manuel Ramos and Jay Cicinelli have been charged with involuntary manslaughter in connection with Thomas’ death. Ramos faces an additional count of second-degree murder, and Cicinelli has also been charged with excessive force.

Under questioning from Asst. District Atty. Jim Tanizaki, Zillgitt testified that it took about three minutes to get to the Fullerton Transportation after receiving the call. 

Tanizaki: “Where was Mr. Thomas when you reached him?”

Zillgitt: “Lying on the ground, handcuffed, rolled up on his side, laying on his shoulder with his back exposed.”

Zillgitt said other paramedics "had already been treating Thomas when I first saw him."

Tanizaki: "Did you observe the face of Kelly Thomas at that time – were you the "patient care" individual?

Zillgitt: "Airway, breathing, circulation are our priorities. Physically my hands were not on Mr. Thomas, so I stepped back to have a big picture view of what was happening. There was a volume of blood matted in his facial hair.

Tanizaki: "What did you see next?"

Zillgitt: [Fullerton Fire Dept.] Capt. [Ron] Stancyk directed one of the crew to set up the ENG (heart monitor)."

Tanizaki: "Then what did you observe?"

Zillgitt: "Mr. Thomas' breathing was very shallo. You could not see his chest rising and falling. We saw facial movement and bubbles coming in and out of his nose while he was breathing. We tried to remove that blood to make it easier for him to breathe."

Tanizaki: "Did you determine he was in respiratory distress?"

Zillgitt: "Yes."

Zillgitt said Thomas was placed him on a backboard to immobilize his spine, a collar was put around his neck and he was strapped to the board. From there, Thomas was carried to an ambulance.

In response to Tanizaki, Zillgitt said when he "entered the ambulance I could see he needed assistance to breathe."

Zillgitt: "There was no rise and fall from chest, no bubbles from nose.

The paramedic said an "AMBU-bag" was used to help Thomas breathe. He described the rubber bag as the shape of a football attached to a plastic mask, which is placed on a patient's mouth. Squeezing it pushes air into the lungs.

Zillgitt: "His heart was asystolic, which means his heart had stopped inside the ambulance […] We performed CPR on the way to the hospital and I also attempted to start an IV to give him medications."

Zillgitt said it took about three minutes to get to St. Jude's hospital in Fullerton.

Tanizaki: Was there a change in heart rate before you got to hospital?

Zillgitt: "He stayed in asystole from the scene to the hospital. We continued using the bag to breathe for him in the ambulance to the hospital."

Tanizaki: "He  never became responsive in your presence? 

Zillgitt: "No sir."

Zillgitt said a doctor and staff at St. Jude’s worked on Thomas about "30-to-40 minutes" while he and other crew members prepared to take Thomas to the UC Irvine trauma center.

Tanizaki: "Did his condition change in the time you brought him to St. Jude's?"

Zillgitt: "While he was at St. Jude's ER, they placed a tube into his airway and he also had regained a pulse and heart rhythm.

Tanizaki used the courtroom projection screen to show the two pictures of Kelly Thomas's head and face after the incident.

Zillgitt said the pictures show Thomas "cleaned up" from what he looked like initially at the scene.

The second color photo of Thomas, eyes shut, head on a pillow, remained on the projection screen for the next few questions until it was taken off as Tanizaki finished.

In his cross examination, Ramos' attorney John Barnett asked about procedures to remove any blood in Thomas' throat or airway.

Zillgitt: "If we saw blood inside the airway, we would use suction. We were concerned about that possibility." 

Barnett: "You had someone check to see if there was blood in the airway?”

Zillgitt: "Yes. We would have suctioned if we saw a need for it." 

Barnett: "And there was none there?"

Zillgitt: "Correct."

In his cross, Cicinelli attorney Michael Schwartz asked about the coagulation of blood on Thomas' beard and face. 

Schwartz: "Is 'volume' of blood a term you use?

Zillgitt: "Yes, sir."

Schwartz: "Did the amount (of blood) cause you any concern regarding blood loss?"

Zillgitt: "The amount of blood didn't appear to be enough that someone would bleed to death. The concern was about the trauma that caused that."

Schwartz: "Did you cut his beard hair in the field?"

Zillgitt: "No, we wiped it off."

Schwartz: "Any gasping or gurgling?”

Zillgitt: "No sir."

Schwartz: "Was he always breathing before being taken to ambulance?"

Zillgitt: "As far as I know, yes sir."

Schwartz then asked Zillgitt if he had had any interviews with Asst. District Atty. Tanizaki. Zillgitt said he met with the Tanizaki in recent years to discuss the questions he would be asked in the trial. Zillgit said the last meeting was at the close of trial Wednesday. 

After a brief sidebar between the attorneys and Judge William Froeberg, Schwartz continued his questioning of Zillgitt.

Schwartz: "How long was he [Thomas] asystole?"

Zillgitt: "In that transport tie to the hospital, approximately three minutes."

On redirect, Tanizaki asked Zillgitt about his previous meetings with him. 

Tanizaki: "Did I ask you to change your testimony in this case and just to tell the truth as you saw it?"

Zillgitt: "Yes sir."

Tanizaki: "Is it still your testimony that you could not observe any respiratory signs [in Thomas]?"

Zillgitt: "That was a judgement on my part, but he was in need of the AMBU-bag either way."

Orange County District Atty. Tony Rackauckas questioned the next witness, Dr. Aruna Singhania, a forensic pathologist with the Orange County Coroner's office. She performed the autopsy on Kelly Thomas on July 11, 2011. Singhania said she’s done nearly 12,000 autospies during his career.

She said Thomas weighed 219 pounds at the time of the autopsy.

A diagram of the full front and back of a male figure was projected on a screen in the courtroom. It was an image of the diagram Singhania had marked up during her autopsy of Thomas. She used a pointer to identify her notations on the autopsy record. Her notes documented bruises, contusions, abrasions and other injuries on the face, arms, legs and back of Thomas. 

When she finished detailing the external injuries to Thomas, the trial recessed for its morning break. 

10:07 a.m.: Day 4 of trial set to start with questioning of paramedic

Judge William Froeberg's courtroom was packed to capacity on Monday when attorneys presented their opening statements in the high-profile case. 

But the number of spectators has dropped. About half the courtroom's seats were empty as the trial started Thursday.

According to a tweet sent from Orange County District Atty. Tony Rackuackas' Twitter account, the DA planned to start the fourth day of the prosecution's case by questioning Fullerton Fire Department paramedic John Zillgitt. Orange County coroner pathologist, Dr. Aruna Singhania is scheduled to take the stand afterwards.

Two witnesses testified Wednesday: Fullerton police crime scene investigator Dawn Scruggs, who collected evidence from and took photos of the scene of the altercation outside the Fullerton Transportation Center on July 5, 2011.

The second witness Wednesday was Fullerton Fire Department paramedic Capt. Ron Stancyk. Stancyk, who, along with other emergency personnel, treated Thomas at the scene and took him to St. Jude's Hospital in Fullerton. 

Stancyk testified that Thomas had a "slow rate of breathing, a pulse rate of 60 and blood in his nose" and that his breathing "was not normal." He said Thomas was not responsive when he first saw him. 

Stancyk was with Thomas at the scene and in the ambulance that took Thomas to two hospitals. Stancyk said Thomas never regained consciousness during the time he was with him and at one point Thomas' heart stopped, requiring resuscitation. 

An autopsy showed Thomas died from a lack of oxygen to the brain because of pressure on his chest and bleeding in his nose. Defense attorneys dispute the cause of death and  said in court Monday that Thomas died of a heart attack brought on by an enlarged heart aggravated by years of drug abuse. 

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