s/Frank J. Peretti...........................................s/William Q. Sturner
Frank J. Peretti, M.D.......................................William Q. Sturner, M.D.*
Associate Medical Examiner............................Chief Medical Examiner
*...Pathologist of Record
01-04-94/laj
8 Page Report/Page 1
#3 Natural Resources Drive, P.O. Box 5274, Little Rock, Arkansas 72215
(501) [omitted] · FAX: (501) [omitted]
NAME: WINN, Moton DATE: 06-02-93 NO: ME-387-93
EXTERNAL DESCRIPTION:
The body was that of a well developed, well nourished, somewhat unkempt elderly black male, clad in pants with belt, socks as well as warm-up pants. The decedent was tied with three kinds of ligature by the wrists and ankles posteriorly. The body weighed 125 pounds, was 62 3/4 inches in height and appeared consisted with the reported age of 79 years. The body was cold. Rigor mortis was absent in the neck and the extremities. Lividity was minimal, patchy, red-purple in color and fixed on the posterior surface of the body except in areas exposed to pressure. Lividity was also seen on the left lateral aspect of the chest and abdomen. “Marbling” changes noted over the shoulders, upper chest, upper neck and green discoloration of the upper chest and neck structures were observed. The scalp hair was gray-black, very short with bitemporal receding. The iridies were brown. The pupils were 5 mm. in diameter. The conjunctivae and sclerae were markedly injected on the right side, minimally injected on the left side. No petechiae noted. The external nares showed moderate blood clot. A fabric was tied around the face and knotted behind the right ear and a fabric pink-red material was also present in the mouth. The teeth are natural but in poor repair and many were remotely absent. No dentures observed. The external auditory canals were dry. Examination of the neck revealed no evidence of injury. The chest was symmetrical and intact. No evidence of injury of the ribs or the sternum was evidence externally. Breasts were of a normally elderly male. The abdomen was soft, flat and scaphoid with no scars or injuries noted. Early green discoloration was noted in right lateral flank. The external genitalia were of a normal adult male. The legs showed symmetrical configuration. Hyperpigmentation of the knees and old hypopigmented scars on the thighs and shins. The posterior legs showed similar old scars. The plantar surfaces were rough, callused and dirty with poor hygiene maintained to the feet. No injuries present. No edema or arthritis. The upper extremities revealed fair development with large stuffy hands and dirty irregular nails. The hands were unbagged when initially examined. No broken nails present. Split number three left nail in healing process. No other injuries. No tobacco staining, amputations, arthritis or clubbing. No tattoos, needle tracks or wrist scars were noted. The spine was intact. The anus was clean.
EVIDENCE OF MEDICAL ATTENTION:
None.
EVIDENCE OF OLD INJURY:
A healing laceration of the palmar surface base of the left thumb is noted. It is crusted. A 1 3/4 inch old scar medial to left nipple, transverse in orientation.
8 Page Report/Page 2
NAME: WINN, Moton DATE: 06-02-93 NO: ME-387-93
EVIDENCE OF RECENT INJURY:
There are two postmortem abrasions in the medial lower right upper arm, superior 1 3/16 of an inch, inferior 1 3/8 of an inch. A maroon ecchymosis is present over the posterior right shoulder, 8 inches vertical length, 3 inches horizontal width. An indistinct ecchymosis is present medial to this area in the right upper back. It measures 3 inches vertical, 2 inches horizontal. A similar purple ecchymosis is present over the left upper back, 3 inches horizontal length, 4 1/2 inches vertical length. Two ecchymoses over the left lateral flank and the subcostal and upper iliac region noted. The superior one 2 inches by 1 inch, the inferior one 4 1/4 inches by 3/4 inches.
The right side of the face reveals a red abrasion lateral to the corner of the eye, 2 1/4 inches horizontal by 1 1/4 inch vertical. Immediately posterior is an area of hypopigmentation and skin slippage measuring 1/2 inch vertical by 3/4 inch horizontal. In the lateral right eyebrow and upper right eyelid area, two lacerations/abrasions are seen, the superior one 1/4 x 1/4 inch and the inferior one 1/4 x 1/8 inch.
The posterior scalp reveals two gaping lacerations, the more superior in the midline in the upper occiput having a diagonal configuration running from right upper to left downwards measuring 2 inches in greatest length and 1/4 inch in greatest width. A superior abraded area of skin contiguous with the laceration measures 1 3/4 inches by 1/2 inch.
Inferior and to the left is a larger laceration also diagonal in configuration running right upwards to left downwards. The skull is visible but brain is not seen in the depths of the wound. Small maggots are observed. The wound has a greatest length of 3 3/4 inches and a greatest width of 3/4 inches. An abraded inferior edge is noted which is 3 inches in greatest length and 1/2 inch in greatest width. It is contiguous with the inferior margin of the wound. Soft subgaleal tissue is noted in the lateral inferior margins of the wound.
INTERNAL EXAMINATION
The subcutaneous fat layer measured up to 1/2 inch. Focal adhesions in the left lateral apex which strip with ease, otherwise, no excess fluid or adhesions. Petechiae were not present on the throacic organs. All body organs were present in normal anatomic position. The thymus was not identified. There was no internal evidence of blunt force or penetrating injury to the thoraco-abdominal region.
8 Page Report/Page 3
NAME: WINN, Moton DATE: 06-02-93 NO: ME-387-93
WEIGHTS OF ORGANS:.....(in grams)
Brain..-..................1,240......................................Spleen..-.................50
Heart..-.....................350......................................Pancreas..-.............130
Left lung..-...............400......................................Left kidney..-.........100
Right lung..-.............500......................................Right kidney..-.........90
Liver..-..................1,060
CARDIOVASCULAR SYSTEM:
The pericardial surfaces were smooth, glistening and unremarkable. The pericardial sac contained 4 cc. of red blood tinged fluid and there were no adhesions. The heart was normal in size, shape and configuration. The coronary arteries arose normally, followed the usual distribution and showed moderate to marked calcific atherosclerosis with diminution of the lumen size especially in the left anterior descending branch. No fresh thrombosis was identified. The chambers and valves exhibited the usual size-position relationship and were unremarkable. The myocardium was dark red-brown and firm except for the inferior lateral left ventricle which showed grayish white fibrous scarring consistent with an old myocardial infarction. The atrial and ventricular septa were intact. The aorta and its major branches arose normally, followed the usual course and showed moderate calcific atherosclerosis with thrombosis and diminution of the lumen size in the iliac bifurcation. The vena cava and its major tributaries returned to the heart in the usual distribution and were free of thrombi.
RESPIRATORY SYSTEM:
The pleural surfaces were smooth and glistening on the right side, somewhat opaque from the adhesions on the left side. The pulmonary arteries were normally developed, patent and without thrombus or embolus but were rather bloodless and contracted. The upper and lower airways were clear of debris and foreign material. The mucosal surfaces were smooth, of normal coloration and unremarkable. Hilar lymph nodes were anthracotic, somewhat enlarged but no calcification noted. The pulmonary parenchyma was pale with some aspiratory blood noted at the periphery. No focal lesions were noted.
NECK:
Examination of the soft tissues of the neck, including strap muscles, thyroid gland and large vessels, revealed suffusion of blood due to decomposition but no fresh hemorrhage. The hyoid bone and larynx were intact with no fractures, petechial hemorrhages or discoloration. Salivary glands were small. The epiglottis and vocal cords were thin and delicate. No aspiration, induration, petechiae or injuries demonstrated.
8 Page Report/Page 4
NAME: WINN, Moton DATE: 06-02-93 NO: ME-387-93
ALIMENTARY TRACT:
The tongue was without evidence of recent injury. The esophagus was lined by gray-white, smooth mucosa. The gastric mucosa was gray-tan and the lumen contained 1 teaspoon of rusty colored liquid. The small and large bowels showed moderate fecal material. The rectum was patent. No hemorrhoids present. No foreign material. No injuries. The appendix was present.
LIVER AND BILARY SYSTEM:
The hepatic capsule was smooth, glistening and intact, covering a pale tan-brown parenchyma with no focal lesions noted. The edges were sharp. The gallbladder contained 5 cc. of green-brown bile. Approximately one dozen multifaceted black calculi were present and the gallbladder was somewhat thickened with a grayish white mucosal lining. The extrahepatic bilary tree was patent, without evidence of calculi. Portal lymph nodes were not enlarged.
PANCREAS:
The pancreas had a gray-tan lobulated appearance with patent ducts. Moderate peripancreatic noted. Peripancreatic lymph nodes were not enlarged.
GENITOURINARY SYSTEM:
The renal capsules were smooth and thin, semi-transparent and stripped with ease from the underlying smooth, red-brown cortical surface. The cortex was pink-red in color and poorly delineated from the medullary pyramids, which were red-purple. The calyces, pelves and ureters were unremarkable. The urinary bladder contained 150 cc. of yellow serous urine. The mucosa was gray-tan and smooth. Prostate was markedly enlarged, nodular and firm and rubbery in sectioning. The testes were small with bilateral hydrocele sacs present. No injuries seen.
RETICULOENDOTHELIAL SYSTEM:
The spleen had a smooth, intact capsule covering red-purple, very soft parenchyma. The white pulp was indistinct. No accessory spleen identified. The thymus remnant was composed of fat.
ENDOCRINE SYSTEM:
The pituitary was softened due to autolysis. The thyroid was small but otherwise normal on sectioning. adrenal glands were unremarkable and surrounded by a moderate amount of fat.
8 Page Report/Page 5
NAME: WINN, Moton DATE: 06-02-93 NO: ME-387-93
MUSCOLOSKELETAL SYSTEM:
Muscles were pink-red, small but intact. No bone or joint abnormalities were noted. The cervical, thoracic, and lumbar spine showed no obvious old fractures or other abnormalities.
CENTRAL NERVOUS SYSTEM:
The scalp showed extensive subgaleal hemorrhage especially in the left parietal occipital area. The calvarium revealed extensive fractures of the posterior left pareital bone with depression of the fragments and a linear occipital fracture of 3 1/4 inches and a secondary fracture of 2 3/4 inches. The depressed fracture fragments measured 2 1/2 inches, 1 1/4 x 3/4 inches and 1 3/4 x 1/2 inches, respectively. The base of the skull revealed left petrous fracture and two orbital plate fractures on the left side. No other fractures identified at the base of the skull. The brain was softened, showed some greenish yellow discoloration due to autolysis at the base, and showed diffuse mild to moderate subarachnoid hemorrhage throughout. There was no epidural or subdural hemorrhage present. The dura mater and falx cerebri were intact. The leptomeninges were somewhat opaque and slightly thickened. The cerebral hemispheres were symmetric. The cranial nerves were intact. The circle of Willis and related blood vessels were normal in caliber and distribution. Mild to moderate atherosclerosis noted at junctions. Sections through the cerebral hemispheres, brain stem and cerebellum revealed no focal lesions or herniation, however there was blood tinged fluid in the ventricular system. No deep contusions were identified. The spinal cord was not examined.
TOXICOLOGY:
Heart and peripheral blood, bile, urine, stomach contents, small intestine contents saved for toxicologic studies.
..1. ....Craniocerebral trauma.
...............a. ..Multiple depressed skull fractures especially left parietal vault.
...............b. ..Basilar skull fractures, left petrous and left orbital plate area.
...............c. ..Diffuse subarachnoid hemorrhage of brain.
...............d. ..Gaping abraded irregular diagonal lacerations of posterior scalp, ..............two.
...............e. ..Abrasion with small lacerations of right cheek and right lateral eyebrow.
..2. ....Suffocation.
...............a. ..Gag surrounding and over mouth and cheeks tied with knot
.......................behind right ear.
...............b. ..Pink-red cloth stuffed in mouth.
...............c. ..Bloody fluid in mouth and blood clot in nares.
...............d. ..Absence of petechial hemorrhages.
..3. ....Posterior and left anterior lividity, moderate.
..4. ....Early green discoloration and “marbling” of shoulders, chest and upper neck.
..5. ....Ecchymoses of posterior right shoulder, two and posterior left shoulder and upper back, one.
..6. ....Ecchymoses of left flank over subcostal region and iliac crest, two.
..7. ....Multiple hypopigmented scars of upper and lower legs, bilateral.
..8. ....Healing crusted abrasion, base of left thumb.
..9. ....Old scar of right knee.
10. ....Transverse scar medial to left nipple, remote.
11. ....Superficial abrasion of mid central lower forehead, single.
12. ....Ligatures x3 surrounding wrists and ankles, tied together posteriorly.
13. ....Old buckshot recovered from subcutaneous region of chest.
14. ....Arteriosclerotic cardiovascular disease.
...............a. ..Old myocardial infarction, inferior left ventricle.
...............b. ..Moderate to marked focal calcific atherosclerosis of aorta.
...............c. ..Marked calcific atherosclerosis of lower aorta and iliac bifurcation
....................with thrombosis of vasculature.
15. ....Minimal to moderate atherosclerosis of cerebral vessels, junctional.
16. ....Suffusion of strap muscles without obvious hemorrhage; absence of fractures and
..........petechiae of larynx.
17. ....Cholecystitis with cholelithiasis.
18. ....Focal adhesions, left lung.
19. ....One teaspoon of rust colored liquid in stomach.
20. ....One hundred fifty cc. of clear yellow urine in bladder.
21. ....Small hydrocele sacs of testes.
22. ....Moderate to marked prostatic hyperplasia.
8 Page Report/Page 7
NAME: WINN, Moton DATE: 06-02-93 NO: ME-387-93
OPINION:
It is my opinion that Moton Winn, a 79 year old black male, died from craniocerebral trauma with suffocation. The decedent was found face down on the floor of his residence in the bedroom in Proctor, Arkansas at approximately 11:00 p.m. on 5/31/93 with a blanket over his head. The victim's feet and hands were tied together behind him with small diameter white rope and a piece of red electrical wire and a brown extension cord. The blanket had an area on it that appeared to be blood. A small hand ax was lying on the blanket near the victim. When the blanket was removed, the victim's face had an orange towel tied around his mouth. There were several open wounds that appeared to be blunt force injuries. The victim lived in a small home in the country. The house was not very clean. No obvious signs of a struggle were noted. The victim's front door has three dead bolts and the back door has a bar that goes across the door. The bar was lying next to the door. The victim smoked cigarettes and numerous cigarette butts were found in the house. The victim was last seen alive May 28, 1993 at 4:30 p.m. The victim's car was missing from his residence.
Autopsy findings revealed multiple skull fractures beneath two gaping lacerations in the posterior scalp. The fractures were depressed and there was extensive subarachnoid hemorrhage of the brain. In addition, the gag around the face accompanied a gag present within the oral cavity itself obstructing the flow of air. There were bruises of the posterior shoulders and the left flank. Early decomposition changes with “marbling” of the upper chest and shoulders was noted. Significant natural diseases present with an old myocardial infarction and thrombosis of the iliac artery bifurcation. In addition, a very large nodular prostate glad was noted and gallstones were present. He may have consumed alcoholic beverages prior to his demise. Other toxicologic studies revealed no other drug substances in the body fluids.
MANNER OF DEATH: Homicide.
s/Frank J. Peretti...........................................s/William Q. Sturner
Frank J. Peretti, M.D.......................................William Q. Sturner, M.D.*
Associate Medical Examiner............................Chief Medical Examiner
