Kelly Thomas Trial: Prosecution reopens case to refute defense cause of death claim [Update]

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Testimony resumed Monday in the trial of former Fullerton Police Department Cpl. Jay Cicinelli and former Officer Manuel Ramos.  The two are charged in connection with the beating of  Kelly Thomas, a mentally-ill homeless man.

On July 5, 2011, Thomas was involved in a violent struggle with six police officers, including the defendants, outside the Fullerton Transportation Center. He died five days later.

Updates

Update: 12:42 p.m.: Defense attorneys cross-examine final prosecution witness

Cicinelli defense attorney Michael Schwartz cross examined Dr. Budoff when the trial resumed after the morning break.

Schwartz asked Budoff about research Budoff did on heart abnormalities related to methamphetamine use, or so-called "methamphetamine cardiomyopathy."

He also questioned Budoff about his review of the case, including the autopsy and video, and the process for using CT imagining scans in evaluating heart condition. 

"[Thomas] had a hypertrophy of the heart – it's a thickening of the heart. There are many causes of that," Budoff testified. "He  had a thick heart but not a weakened heart."

Schwartz: "And a thick heart can lead to other problems?"

Budoff: "Yes, including irregular heart rhythms."

Schwartz referred to testimony from Dr. Steven Karch, that described "myocardial remodeling" in Thomas' heart. 

Myocardial or cardiac remodeling causes heart cells to change shape or size because of different stressors.

Schwartz: "What are those stressors?"

Budoff: "Could be high blood pressure, could be drug use, could be alcohol use. Over time the heart can get weaker if the cells are not working well."

Schwartz: "You testified that Kelly Thomas would have a normal life expectancy but that's just the heart is that correct?"

Budoff: "Yes."

Schwartz: "You did not find any heart disease in Kelly Thomas heart is that correct?"

Budoff: "Yes."

Ramos defense attorney John Barnett asked Budoff about myocardial remodeling.

Barnett: "So you wouldn't see within the heart, internally, just the heart as a whole, right?"

Budoff: "Yes."

Barnett: "You wouldn't know there was remodeling in Kelly Thomas heart based on the material you reviewed?"

Budoff: "Yes."

On re-direct from Orange County District Atty. Tony Rackauckas, Budoff testified that reviewing pathology, or direct tissue evaluation, is important in determining heart disease after death. 

Rackauckas: "This remodeling in Thomas' case, could it cause a heart attack?"

Budoff: "It definitely did not cause a heart attack. He had no evidence of a heart attack based on the autopsy. His coronary arteries were clear, which is what you'd expect in a 37-year-old man."

Rackauckas: "Did this remodeling contribute to his death?"

Budoff: "No, it is somewhat irrelevant that he had remodeling when he had a normal heart."

Budoff also testified that the thickness of Thomas' heart muscle contributed to the weight of Thomas' heart. Autopsy results indicated Thomas' heart weighed slightly more than average.

Barnett called Dr. Steven Karch to testify again. He had testified in December that "myocardial remodeling" can be caused by methamphetamine use.  Karch testified that Thomas' death was caused by "methamphetamine cardiomyopathy" - or an abnormally enlarged heart brought on by methamphetamine use.

Karch testified Monday that Thomas died from "cardiac arrest" due to fibrosis and scarring of his heart at the cellular level.

On questioning from Rackauckas, Karch said there was nothing in the testimony of Dr. Budoff that changed his opinion of the cause of Thomas' death.

After Karch was dismissed, Judge William Froeberg told the jury that when they returned from lunch break, he would give them instructions and recess court for the day. Closing arguments will start Tuesday.

If convicted, Ramos faces up to 15 years in prison and Cicinelli, up to four.

Both have pleaded not guilty to the charges.

They remain free on bail.

Update 11:10 a.m.: Prosecution reopens case to refute defense cause of death claim

Prosecutors reopened their case Monday in the trail of two former Fullerton police officers charged with beating to death a mentally ill homeless man in 2011. Orange County District Atty. Tony Rackauckas called to the witness stand a cardiologist who refuted a central assertion of the defense case -- that Kelly Thomas died from a heart attack brought on by years of drug abuse. 

Prosecutors had rested their case against Manuel Ramos and Jay Cicinelli on Dec. 11th, but reopened it Monday with testimony from Dr. Matthew Budoff, a cardiologist with Harbor-UCLA Medical Center in Torrance.

RELATED: Kelly Thomas Trial: Prosecutors rest case against former officers charged in beating death

During their case, defense attorneys called medical experts who testified that Kelly Thomas' use of methamphetamines had made his heart abnormally large and left him vulnerable to a heart attack. The condition is known as methamphetamine cardiomyopathy. 

On Monday, Budoff testified he had reviewed Thomas' autopsy and medical records and concluded that "there is no evidence of heart failure.  His heart was not enlarged and that did not contribute to his death."

Prosecutors instead say Thomas died from respiratory failure as the result of excessive force used by officers in a July 5, 2011, altercation with Thomas outside the Fullerton Transportation Center.

Prosecutors sought to reinforce that conclusion with Budoff's testimony. 

Budoff is a professor of cardiology at Harbor-UCLA and testified he sees patients "almost daily" in addition to teaching. 

Budoff said he is board certified in internal medicine, cardiology and in cardiac CT scanning.

In a PowerPointPpresentation, Budoff used slides on a courtroom monitor to show chest X-rays of Kelly Thomas' heart. Budoff used a pointer and said Thomas' heart was "of normal size and not enlarged" in the X-ray taken when Thomas was brought to the UC Irvine Medical Center after the altercation with officers.

Budoff said he has treated many patients with methamphetamine cardiomyopathy and said Thomas' heart showed no evidence of an enlarged heart due to drug use. 

The doctor showed slides of hearts affected by methamphetamine cardiomyopathy and slides of enlarged hearts, making comparisons between those and the scans and x-rays of Thomas' heart.

Rackauckas: "Did Kelly Thomas die of a heart attack?"

Budoff: "No. Based on the autopsy and based on the testimony of multiple people. He did not die of a heart attack."

Rackauckas: "How would you describe Thomas' heart?"

Budoff: "Of normal overall diameter, so the size of it was overall normal, but the walls were thickened. He had some thickening of the walls, but the overall size of the heart, based on CAT scans and X-rays, was normal."

Budoff testified that, based on Thomas' heart condition, his life expectancy would be "normal."

"Males typically have a life expectancy of about 82 years. So based on his heart condition, he would have had a normal life expectancy," Budoff said.

Budoff testified that a contributing factor to Thomas' death was "ineffective breathing."

Defense attorneys are set to cross exam Dr. Budoff following the morning break. 

Update: 7:16 a.m.: Testimony resumes, closing arguments expected this week

The Orange County District Attorney's Office called 11 witnesses to stand in its case against Ramos and Cicinelli, each charged with involuntary manslaughter in the death of Thomas. 

Ramos faces an additional count of second-degree murder. Cicinelli is also charged with use of excessive force.

Prior to a two-week break for the holidays, the defense and prosecution rested their cases. Closing arguments are expected to begin this week in Santa Ana Superior Court.

The prosecution's case focused largely on a surveillance video of the struggle synced with audio from officers' voice recorders. At one point, Thomas is heard saying he can't breathe and calling for his father for help.

At one point in the video a man is heard saying, "I smashed his face to hell." Prosecutors say the voice belongs to Cicinelli. 

Key testimony has come from a pathologist contracted by the Orange County Coroner's Office to conduct the autopsy on Thomas. 

Dr. Aruna Singhania testified Thomas died from a lack of oxygen to the brain brought on by blunt force trauma to face and head and compression to the chest.

Prosecutors also questioned Dr. Michael Lekawa, a trauma specialist at UC Irvine Medical Center who treated Thomas the night of the incident. He testified Thomas remained "comatose" from the moment he first saw Thomas until he died on July 10, 2011.

Lekawa also testified that he agreed with Singhania that the cause of Thomas' death was a lack of oxygen to his brain, due to chest compression and head and facial fractures that Thomas suffered during the altercation with officers. 

Defense attorneys allege Thomas was the aggressor in the struggle and died from heart complications brought on by years of drug abuse. 

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