updated 08/12/10
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1 9:58 a.m., May 20, 1997; and proceedings commenced at
2 10:15 a.m., May 20, 1997, with the court, counsel and
3 defendant present.
4 COURT: Mr. Wadding?
5 MR. WADDING: Thank you, Your Honor. Call
6 Dr. Bennett to the stand.
7 THOMAS BENNETT,
8 called as a witness on behalf of the state, being first
9 duly sworn by the court, was examined and testified as
10 follows:
11 COURT: Mr. Wadding?
12 MR. WADDING: Thank you.
13 DIRECT EXAMINATION
14 BY MR. WADDING:
15 Q. Would you state your full name and spell your
16 last for the record, please.
17 A. My name is Thomas Bennett, B-E-N-N-E-T-T.
18 Q. And your occupation, sir?
19 A. I'm a physician, a pathologist by training
20 and forensic pathologist. I'm currently serving as the
21 Iowa State medical examiner.
22 Q. How long have you been serving as the state
23 medical examiner?
24 A. Governor Branstad first appointed me in March
25 of 1983, so I'm over 14 years now. I did take a year and
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1 a half in 1985 and 1986 and went to Mississippi to serve
2 as their state medical examiner, but since October of
3 1986 I've been here continuously.
4 Q. And could you describe your education and
5 training in achieving your position?
6 A. I have a bachelor's degree from Des Moines,
7 Drake University in Des Moines. I have then my M.D. from
8 the University of Iowa College of Medicine where I
9 graduated in 1978. Once you get your M.D., you really
10 can't do much without your residency training, so I went
11 on to get, first off, hospital pathology training to
12 learn my general pathology, the anatomic and clinical
13 parts, the tissues and the fluids of the body, which
14 includes the biopsies, pap smears, blood tests, urine
15 tests and so forth. And then I went to North Carolina
16 and served as an assistant chief medical examiner for the
17 state of North Carolina learning forensic pathology at
18 that time.
19 When I finished my five years of residency
20 training, I was eligible then in June of 1983 to take
21 that four-day long test prepared by the American Board of
22 Pathology. And if you pass the test, you're certified by
23 the board or board certified. I took it in three areas:
24 the anatomic pathology, clinical pathology and forensic
25 pathology and passed, so I've been board certified since
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1 then.
2 Q. And since 1983 you've been board certified?
3 A. Yes, sir.
4 Q. And since 1983 you've been state examiner
5 elsewhere for a brief hiatus, but state medical examiner
6 here in Iowa; is that correct?
7 A. That's correct.
8 Q. And could you briefly describe what your
9 duties are as a state medical examiner?
10 A. Yes, sir. The state medical examiner duties
11 are outlined in the statutes of Iowa. They are basically
12 five-fold. My first duty is to investigate all of the
13 sudden, violent, unnatural, unexpected deaths that occur
14 in Iowa. It's a big state. I serve instead as a
15 consultant working with the local county medical
16 examiners like Dr. Dolan or Dr. Bickley here in Black
17 Hawk County. I review their work. If they can't be
18 found, then I will pinch-hit for them on the firsthand
19 basis. I review their work, and I follow up on their
20 reports of investigation that are filed with my office.
21 My second duty is to do the forensic
22 autopsies when called upon, so it could be either the
23 county medical examiner, county attorney, law enforcement
24 officer who will notify me of the death and I can work
25 with them to do the autopsy. I promulgate rules and
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1 regulations. I keep records of all that I do.
2 And my fifth duty is to teach. I give about
3 four to ten or more hours of lectures every week on
4 forensics around Iowa, the Midwest and other places, to
5 anyone dealing with these deaths that affect the public
6 interest.
7 Q. And were you requested or notified by Dr.
8 Bickley for autopsy -- to perform an autopsy with
9 reference to Juli Ann Farrell?
10 A. Yes, I was.
11 MR. WADDING: May I approach, Your Honor?
12 COURT: You may.
13 Q. I'm going to show you what's been marked as
14 State's Exhibit "M", marked for identification, ask you
15 if you recognize that?
16 A. Yes, sir, I do.
17 Q. And what do you recognize that as?
18 A. State's Exhibit "M" is a photocopy of what I
19 received from Dr. Bickley, his report of investigation by
20 medical examiner which includes everything that he wrote
21 by hand and was typed on there plus his dictation that
22 was typed and added to it. It's part of my permanent
23 record for this case, also another copy of this.
24 Q. And is that a record that you would normally
25 receive in -- when an autopsy is requested of you?
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1 A. Yes, sir, it is.
2 Q. And is that a record that you would normally
3 receive and keep in your records with reference to that
4 autopsy?
5 A. Yes, sir.
6 MR. WADDING: Ask that State's Exhibit "M" be
7 entered into evidence, Your Honor.
8 COURT: Any objection, Mr. Correll?
9 MR. CORRELL: May I see that, Your Honor?
10 (Complied.) May I reserve my objection, if I have one,
11 and we could proceed.
12 COURT: When do you anticipate --
13 MR. CORRELL: Well, let me just double check
14 this. Maybe this is as good of a time as any.
15 COURT: All right.
16 MR. CORRELL: (Complied.) No objection.
17 COURT: Exhibit "M" is admitted.
18 Mr. Wadding?
19 MR. WADDING: Thank you.
20 Q. And did you conduct an autopsy with reference
21 to Juli Ann Farrell?
22 A. Yes, sir, I did.
23 MR. WADDING: And may I approach again, Your
24 Honor?
25 COURT: You may.
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1 Q. For the purposes of efficiency, I'll see if I
2 can have you identify these documents. The first I'd
3 show you, a photo array packet marked State's Exhibits
4 "L-1" through "L-16", and ask you to review those.
5 A. (Complied.) Yes, sir.
6 Q. And do you recognize those, sir?
7 A. Yes, sir, I do.
8 Q. And what do you recognize those as?
9 A. "L-1" through "L-15" inclusive are
10 photographs which I took with my own camera in print form
11 and had duplicates of which I gave to you yesterday when
12 we met in the early afternoon to just discuss the case
13 briefly early -- or late morning I guess it was. I
14 maintain the negatives for these in my file.
15 "L-16" is another photograph taken during the
16 course of the autopsy. I didn't take this photograph.
17 It's my hands that are seen in this photograph, but it's
18 of Juli Farrell, again, taken during the course of the
19 autopsy to demonstrate the injuries which I -- helped
20 demonstrate some of the injuries we identified.
21 Q. Are those accurate depictions of -- well,
22 accurate depictions of certain processes of the autopsies
23 taken to represent?
24 A. Yes, sir. They are true and accurate and
25 depict what I saw at the autopsy.
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1 MR. WADDING: At this time, Your Honor, I
2 would ask that State's Exhibits "L-1" through "L-16" be
3 entered into evidence.
4 COURT: Any objection, Mr. Correll?
5 MR. CORRELL: Well, Your Honor, as the
6 court's well aware, autopsy photos are generally
7 admissible in court. We do have an objection to --
8 there's been no showing that there are -- is a necessity
9 to have 16 autopsy photographs shown. It's -- it could
10 serve no legitimate purpose, and we would object as those
11 are repetitive and -- in nature, and they're designed to
12 be inflammatory, and they are inflammatory.
13 COURT: I'm not sure at this time, because
14 I -- I haven't heard what's described in the photographs
15 testified to or what's depicted in the photographs
16 testified to, so I'll reserve ruling on that and find out
17 whether the -- each photograph is significant for
18 something during the course of the examination.
19 Q. Now, I want to show you what's been marked as
20 State's Exhibit "N" and State's Exhibit "O", ask you if
21 you can identify that?
22 A. Yes, sir, I can.
23 Q. Okay. What is State's Exhibit "O"? How do
24 you identify that?
25 A. State's Exhibit "O", which is the reverse
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1 side, is the -- is an enlargement of the -- is an
2 enlargement of the diagram which I prepared during the
3 course of the autopsy. I take a basic skeletal diagram,
4 and whatever I see during the autopsy, I make little
5 notations in my own handwriting. It's part of my
6 permanent record, part of the permanent report.
7 Q. And State's Exhibit "N"?
8 A. State's Exhibit "N" is a -- an enlarged copy
9 of the diagram I prepared using her outline, the outer
10 body surfaces both front and back, and, again, if I find
11 something I think significant, I note it on this in my
12 own handwriting, and I make this part of my permanent
13 report. I have the originals here with me today for both
14 of those.
15 MR. WADDING: And at this -- at this time I
16 would ask that State's Exhibits "N" and "O" be entered
17 into evidence, Your Honor.
18 COURT: Any objection, Mr. Correll?
19 MR. CORRELL: Could I just very briefly voir
20 dire this witness?
21 COURT: (Indicating.)
22 MR. CORRELL: Dr. Bennett, is what I'm going
23 to show you here, is "N", this diagram, enlarged without
24 any change?
25 WITNESS: But for the little red sticker in
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1 the lower corner, that's -- in the enlargement, that
2 appears to be the same diagram, yes, sir.
3 MR. CORRELL: Okay. On the back in what has
4 been marked as "O", is that, again, the same document or
5 the same skeletal views that were attached and made part
6 of your autopsy with the exception of the affixing of the
7 evidence sticker?
8 WITNESS: Yes, sir.
9 MR. CORRELL: Thank you. I have no
10 objection. Do you want me to put it back up for you?
11 MR. WADDING: Please.
12 COURT: "N" and "O" are admitted.
13 CONTINUED DIRECT EXAMINATION
14 BY MR. WADDING:
15 Q. And could you describe, or maybe in an
16 overview sense, how you perform a -- an autopsy?
17 A. Okay. In general I perform an autopsy by
18 going from the outside to the inside, large to small,
19 which you -- what I do is I start with the decedent,
20 their body as I receive it. In this case she was
21 received wrapped in a white cloth sheet with no other
22 clothing or possessions on her body. Sometimes I have
23 clothing, sometimes I have jewelry or other possessions,
24 sometimes there is fragments of trace evidence or
25 something else.
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1 I examine her whole body. I take pictures to
2 help document and diagram or prepare exhibits for
3 whatever I have seen at the autopsy, and then I start to
4 wash her to look her a little -- at a little bit more
5 closely at her surfaces of her body. If appropriate,
6 I'll get x-rays. If x-rays have been taken already, such
7 as in this case, I won't duplicate them. And then I
8 start the internal part of the autopsy.
9 Now, just to stress, an autopsy is done in
10 such a way to answer the questions that are posed to us,
11 but we also have from memory. We want to be shown at the
12 funeral afterwards too, so we try and do things in such a
13 way that nothing would be seen at the funeral. The
14 internal organs of the chest are opened, are examined by
15 using a Y-shaped incision, and then the scalp is also
16 reflected so I can examine her brain. I remove the
17 organs from her body. I look at them individually, and I
18 take small samples for microscopic examination,
19 toxicology examination, whatever else is necessary. Then
20 I return everything to her body that I haven't saved for
21 other exams and return her to the funeral home.
22 Q. Thank you. And did you follow that course of
23 procedure in this instance?
24 A. Yes, sir, I did.
25 Q. And with regard to the external examination
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1 of Juli Farrell, could you describe what observations you
2 made of any external injuries if -- and using State's
3 Exhibit "N" if possible.
4 A. Okay. State's Exhibit "N" is up here on the
5 board behind me. What I found during the course of the
6 autopsy is that Juli had received injuries to her chest
7 and her face, along the left-hand side of her face, which
8 I've indicated up here as being the prominent dicing over
9 her left face. Dicing is a term I use for multiple
10 superficial cuts, scratches and so forth, and even some
11 abrasions or scrapes along that surface. That indicates
12 that her face has been impacted by a rough surface, very
13 consistent with broken glass. The small pieces of glass,
14 especially in the side window, when they break, they
15 break up in little tiny squares. When those come in
16 contact with the face, you'll get this little pattern of
17 like a little checkerboard or little squares or irregular
18 pattern of cuts and scrapes.
19 I worked on down. She also had some
20 abrasions over her anterior chest and the top of her left
21 shoulder. Little Xs I have up here like on both sides of
22 her neck, Xs on the front of her elbows here, what we
23 call the antecubital fossae, and then down here in her
24 groin also, and in the back of her left hand, those are
25 all for needle stick marks. She had been through some
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1 resuscitation trying to give her fluids to replace what
2 she had lost through bleeding. But then going back to
3 her chest, she had patterned abrasions. These are areas
4 of impact where she came in contact with a surface. It
5 left a scrape, left some bruising, left a pattern of
6 these injuries across her chest and especially her left
7 anterior chest and abdominal wall, which, again, I've
8 tried to diagram, rather crudely, but they're also seen
9 in the pictures, Exhibits "L".
10 MR. WADDING: May I approach?
11 COURT: You may.
12 Q. So when you describe the areas in the groin
13 and on the back of the hand, you're describing areas used
14 for medical purposes? Is that correct?
15 A. That's correct.
16 Q. And when you describe the area of the chest
17 and the face and the shoulder, are you describing areas
18 that were involved in the automobile accident?
19 A. Yes, sir.
20 Q. Okay. And you documented these by photograph
21 as well?
22 A. Yes, sir.
23 Q. Which photographs depict those?
24 A. The photograph "L-1" is a facial photograph
25 which depicts her as she looked on the autopsy table. I
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1 have washed away some of the debris and so forth from her
2 face. That can be seen that she has some abrasions, and
3 the dicing along the left face plus some abrasions of her
4 eyelid and nose. Exhibits "L-2" and "L-3" show the right
5 and left sides of her face respectively, going along with
6 what's in "L-1", but also depicts her ears and the sides
7 of her neck, can also see the needle stick marks and so
8 forth which were from the resuscitation.
9 Q. All right. And the -- you also -- did you
10 have a photo depicting the area of, I believe, the chest
11 that you described?
12 A. Yes, sir, I do.
13 Q. As an impact area?
14 A. Yes, sir. In fact, photographs "L-4" through
15 "L-9" inclusive are all of the external surfaces of her
16 body. The patterned injury to her chest is seen best in
17 Exhibit "L-9". And, again, I have my ruler in here to
18 help organize its size and so forth because it was
19 patterned. The bruising can be seen around it, which is
20 more a dusky reddish-brown color and the patterned
21 abrasion on the skin surface.
22 Q. And you describe that as a -- a patterned
23 abrasion?
24 A. Yes, sir.
25 Q. Why do you describe it with those words?
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1 A. In general, if you just come in contact with
2 the rough surface like a floor or gravel or something,
3 you have just a -- a scraping away of the skin surfaces
4 but no real pattern to it. On the other hand, this
5 appeared to be something that had a somewhat square
6 shape. There are three radiating scratches out --
7 actually, it's above this area. The ruler is in the
8 lower left-hand corner as you look at it here with
9 respect to her body, so this would be the top of her head
10 more towards the end where the little red numbers are.
11 It has, again, a square shape to it, scratch marks coming
12 off to the side. It's consistent with her impacting
13 something of about that configuration.
14 Q. And what other observations did you make
15 externally?
16 A. I also observed externally and specifically
17 over her back, that but for a little bit of an abrasion
18 here on the back outer surface of her left thigh, which
19 is seen in Exhibit "L-5", and also documented up here on
20 the right-hand or back part of Exhibit "N", her back is
21 fairly clean. There is no evidence of any other trauma
22 to her back. The pattern of the pale area here is
23 because of the pooling of the blood, the lividity of
24 postmortem events. Most injuries were to her left side
25 and left front side.
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1 The other three photographs, which I've
2 mentioned, Exhibits "L-6", "L-7" and "L-8". "L-6" is a
3 photograph of her left -- of her right upper side going
4 her total body length. It just helps document that the
5 right side of her face was without many scratches, no
6 real injuries down the right side of her body but for the
7 resuscitation of what I call the three-quarter inch
8 sutured incision up here from a chest tube that was
9 inserted. That was from resusitation.
10 Photograph "L-7" is of her left chest. It
11 diagrams these various abrasions or depicts these various
12 abrasions plus that thoracotomy, which is where her
13 thorax or chest was opened trying to resuscitate her when
14 she bled so massively.
15 And then also State's Exhibit "L-8", the last
16 external picture, which depicts the other patterned
17 abrasion down here on her left anterior chest and
18 abdominal wall extending downwards from that thoracotomy
19 incision.
20 Q. Thank you. And the external injuries that
21 you described as patterned injuries, are -- were the
22 consistent with the history of an automobile accident in
23 this instance?
24 A. Yes, sir, they were.
25 Q. And what did you understand that history to
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1 be?
2 MR. CORRELL: Excuse me, Your Honor. I'm
3 going to object to that. That calls for hearsay.
4 COURT: Sustained.
5 MR. WADDING: May I approach?
6 COURT: You may.
7 Q. I'm going to show you -- is there anything
8 else remarkable about State's Exhibit "N" or the external
9 examination?
10 A. I think we've covered most all the pertinent
11 points on that one.
12 Q. Now, I want to make reference to State's
13 Exhibit "O", marked for identification, State's Exhibit
14 "O", and ask you, you know, just what is that?
15 A. State's Exhibit "O" is an outline of the
16 skeleton, and I wrote on it everything I observed during
17 the autopsy as far as where there was damage between her
18 ribs and just where those damages were located.
19 Q. And is that more in reference to the internal
20 examination?
21 A. It's more in reference to the internal
22 examination plus what I saw by examining her limbs
23 individually. Now, we say we do a complete autopsy, but
24 there are many parts that I don't directly examine
25 because it's not necessary for the course of the autopsy.
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1 I know that she had pelvic wing fractures. However, I
2 did not cut into that area because it would make it very
3 difficult for the funeral director. It wasn't necessary
4 because it was documented elsewhere. I did not see any
5 fresh fractures, so I did not depict any on here. She,
6 indeed, did have some pelvic fractures of the left wing
7 and then down in the ischial area, I-S-C-H-I-A-L, which
8 is where you sit on your pelvis, that part that you sit
9 on. That was not something I would examine during the
10 autopsy. I saw no fractures of her rib cage though skull
11 extremities.
12 Q. What are you depicting then in State's
13 Exhibit "O"?
14 A. The major two things I'm depicting in State's
15 Exhibit "O" would be that there were tears from the crash
16 between her second and third ribs, those little muscles
17 that hold the ribs together that assist with breathing.
18 Those were torn, and when I opened her chest cavity, on
19 the left side there was a big gap in that area that had
20 torn through that normal, smooth, like Saran Wrap lining
21 of the chest cavity. Lower on down here on the left side
22 between the sixth and the seventh ribs, the surgeons had
23 opened that area to go into her chest cavity directly to
24 find her heart and try and resuscitate her and also try
25 and see if they could find where the damage to the aorta,
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1 to the major blood vessels that they felt was present was
2 located.
3 Q. And did you depict those -- did you depict
4 any of those skeletal comments you just made by
5 photograph?
6 A. Yes, sir, I did.
7 Q. And could you describe which ones?
8 A. Yes, sir. Those can be seen in photographs
9 "L-10", "L-11", "L-13" and "L-16". In each of those
10 first three, "L-10", "11" and "13", if the photographs
11 are held with the digital numbers, those little red
12 numbers down in the lower left-hand corner, it would be
13 just as if her head was at the top of the picture and her
14 left side of her body was off to the right side as --
15 your right side as you're looking at the pictures. You
16 can see the tear between the second and third ribs above
17 the thoracotomy incision, shows the dark purplish-red
18 discoloration because of blood back in the back chest
19 cavity in each of these. They show from the far side in
20 State's Exhibit "L-10" to the mid-back of State's Exhibit
21 "L-11" to the full back view in State's Exhibit "L-13".
22 They each depict different aspects of this, so you can't
23 see necessarily all of it in each -- or in any one
24 picture.
25 Q. Thank you. Now, with the injuries that we
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1 have -- that you've made reference to so far in State's
2 Exhibit "O", state's exhibit, and were any of these --
3 that you could attribute to the accident, were any of
4 these fatal at this point?
5 MR. CORRELL: Excuse me. I'm going to object
6 to that form of that question as leading.
7 COURT: Overruled. You may answer.
8 A. Okay. What I identified as far as the facial
9 injuries, the dicing, the abrasions and so forth of her
10 body, no, those would not be fatal. Those were
11 cosmetically bad. They looked very bad, but those would
12 not be fatal, nor would that tear necessarily between her
13 second and third ribs be fatal. It was a serious injury.
14 It would make it very difficult and painful to breathe on
15 that left side, but it would not be fatal. So nothing
16 I've described so far would be fatal.
17 Q. And did your examination discover, or did you
18 find an injury that would, in fact, have been fatal?
19 A. Yes, sir, I did.
20 Q. Could you describe that?
21 A. Okay. During the course of the autopsy, I
22 found that she had sustained a tear to the aorta. The
23 aorta is the large blood vessel leading from your heart,
24 the left ventricle as an arch going first up and then
25 down along the left-hand side of your body along your
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1 spine that carries the blood from your heart to basically
2 the rest of your body. The first two branches are to the
3 heart itself. Next three branches go to the arms and the
4 head, and then it courses down the back. Just after the
5 branch to the left arm originates, which is fairly high
6 up there in the arch, just below that, about a half inch,
7 I found that there was a half-inch tear completely
8 through the aorta wall. Now, that leads not directly
9 into the chest cavity, it leads instead into the soft
10 tissues that are in the mid-part of your chest between
11 each of the chest cavities where the lungs are located.
12 It leads first into this soft tissue area that was filled
13 with blood. The blood that was leading down along the
14 back of the left chest is eventually continuous with
15 that, but it's going through spongy soft tissue, not a
16 real space like the chest cavity would be. The rest of
17 her aorta was fine. I saw no underlying disease of her
18 aorta, but she had this half-inch long tear that was
19 completely through the aorta wall.
20 COURT: Where was that tear again?
21 WITNESS: About one-half inch below where the
22 left subclavian artery starts. It's quite high. It's
23 just where the aorta made its curve over the top and
24 starts going straight down toward the abdomen. Way up
25 there at the top is where that tear was.
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1 Q. And did you document that by photograph?
2 A. Yes, sir, I did.
3 Q. And could you describe which photographs
4 depict that?
5 A. That can be seen in State's Exhibits "L-14",
6 "L-15" and "L-16", all three.
7 Q. And could you describe what you're attempting
8 to depict in those photographs?
9 A. Yes, sir. Okay. I'll start with State's
10 Exhibits "L-14" and "L-15", which are pictures I took
11 myself. If you hold the photographs with the numbers in
12 the right-hand corner, lower right-hand corner, then the
13 center of the photograph that looks pale yellow is the
14 aorta, the inside of the aorta. You see there are four
15 holes going across the middle part of the aorta. The
16 first three holes are the branches to the right arm and
17 side of the head, then the left side of the head, then
18 the left arm. The fourth hole is the tear. So it's just
19 below where the left arm branch is located. Now, I used
20 both of these because they're taken with different focus
21 points. One is taken a little bit more superficial
22 focus, one a little bit deeper focus, so you can see
23 things clearly in one that you can't see in the other,
24 but you can see it's a jagged tear, no evidence of
25 healing. It's a very fresh injury to the aorta tearing
607
1 through an otherwise normal part of the aorta.
2 Q. And "L-16", I believe there's another
3 photograph there as well?
4 A. Yes, sir.
5 Q. "L-16"?
6 A. "L-16" is a good overall photograph, which I
7 believe was taken by law enforcement during the course of
8 the autopsy. Two individuals from the Waterloo Police
9 Department, Keith Smith and Bill Sauerbrei, were both
10 there, and they assisted in taking pictures. As I'm
11 holding the arch of the aorta there, after I've removed
12 her lungs and so forth, you can see the thoracotomy
13 incision, that tear between the second and third ribs and
14 then that sort of diamond-shaped dark red tear in the
15 center of the yellow lining of the aorta, which I
16 described in "L-14" and "L-15".
17 Q. And the type of injury that -- well, this
18 tear to the aorta, would you consider that to be a fatal
19 injury?
20 A. Yes, I did.
21 Q. And the -- how does an injury like that
22 occur?
23 A. Okay. What -- what we're finding is it's
24 important to know the type of a crash itself, because
25 that's something I would rely upon in helping make my
608
1 diagnosis as far as -- as how this injury occurred and i
2 part of what we do in forensics, so I asked like the
3 Waterloo Police Department and also Mr. Ferguson and Joel
4 Dalrymple from the Waterloo Black Hawk County Attorney's
5 Office, I asked the type of a crash. But, in general,
6 what happens is in this crash, when the vehicles
7 collided, she received a blow to the left side of her
8 head -- left side of her body and her chest, and in
9 general here it pushed the left side of her chest in like
10 this. Now, she was restrained, I was told, so her
11 shoulder strap and seat belt are both in place. They
12 didn't necessarily contribute to or even really protect
13 her that much in this crash because it came from the
14 side. According to the reports and what they had told
15 me --
16 MR. CORRELL: Excuse me, Your Honor. I'm
17 going to object to the witness incorporating that as
18 hearsay.
19 COURT: Overruled. You may answer.
20 A. Okay. According to what they had told me, is
21 that the results of an unrestrained passenger in the
22 front seat, so when her car and the driver, Juli Farrell,
23 are being pushed to the left, by inertia the right front
24 seat passenger is coming across, so she is actually being
25 squeezed in the process of having the left side of her
609
1 chest pushed in and being compressed. From this side it
2 actually pushes in and up. Right where this tear in the
3 aorta occurs is where the aorta goes from being
4 free-floating part of the central chest cavity to being
5 something that's attached quite tightly to fibrous
6 tissues along the spine. When you push in from the chest
7 cavity on the side like this, it pushes the heart, the
8 chest, everything inside it up. Anything that's
9 free-floating gets pushed up. What is attached to the
10 spine back here on the other part the descending aorta
11 stays in place, and right where this junction between the
12 attached and free-floating part of the aorta is, is where
13 this tear occurred. So what it is, it's the compression,
14 the pushing of her chest that tears the aorta like this.
15 MR. WADDING: I don't have any other
16 questions. Thank you.
17 COURT: Mr. Correll?
18 MR. CORRELL: Your Honor, on the issue of the
19 photographs, based on the testimony, I do not object to
20 "14", "15" or "16" as identified, "L-14", "15" or "16" as
21 identified by the witness. I believe the photos one --
22 "L-1" through "13" are not relevant to the issue of the
23 cause of death.
24 COURT: May I see the photographs, please?
25 (Complied.) "L-1" through "L-16" are admitted. I
610
1 haven't -- I haven't heard "L-12" described. I'm not
2 sure what that is, so I -- I'll continue to reserve
3 ruling on that.
4 Mr. Correll?
5 MR. CORRELL: Thank you.
6 CROSS-EXAMINATION
7 BY MR. CORRELL:
8 Q. Dr. Bennett, have you, in preparation for
9 your testimony today or in your evaluation of Ms.
10 Farrell, have you reviewed any of the medical reports
11 from any of the attending medical providers?
12 A. Yes, sir, I have.
13 Q. And do you have available to you, Doctor, the
14 records regarding Ms. Farrell at Sartori Hospital?
15 A. Yes, sir, I believe I do.
16 Q. And have you reviewed those documents?
17 A. Yes, sir, I have.
18 Q. When did you first review those, sir?
19 A. I think I first received them over a month
20 ago.
21 Q. You did not have them at the time you
22 prepared your autopsy report; is that a fair statement?
23 A. That's correct. I had verbal reports of
24 them, but I did not have this packet of records. It may
25 have been even more than a month ago, but I did not have
611
1 them at the time of the autopsy.
2 Q. Is it correct that shortly after her arrival
3 that the medical records that you had reviewed from
4 Sartori Hospital indicate that Ms. Farrell was alert and
5 communicative?
6 A. Yes, sir.
7 Q. She was able to answer questions and respond,
8 and it indicates that she was, in fact, oriented, does it
9 not?
10 A. Yes, sir. That's how I understand it.
11 Q. And when you read those reports, would it not
12 be a fair reading of those reports to indicate that those
13 reports, prepared relative to the time of her admission
14 to the emergency room, there was nothing in those reports
15 that indicated that it was not anticipated a full
16 recovery by her; is that not correct?
17 MR. WADDING: I'm going to object, Your
18 Honor, as to relevance.
19 COURT: Overruled. You may answer.
20 A. Okay. I did not see anything that I noted
21 a -- I don't recall seeing anything where the doctor said
22 she should recover, she should not recover. My reading
23 of what the initial examination found, the studies and so
24 forth of what I see in folks that usually recover, I
25 would have expected, based upon what I saw in those
612
1 initial records, that she would have recovered.
2 Q. And my -- but my question is, there is
3 nothing in those reports that they thought otherwise as
4 well the people at Sartori; is that correct?
5 MR. WADDING: Well, I'm going to object, Your
6 Honor. It's asked and answered.
7 COURT: Overruled.
8 A. Okay. I don't recall anything where they say
9 they didn't think she wouldn't recover.
10 Q. And, in fact, she was put on a floor where
11 it -- the type of care and monitoring that she would have
12 been given through the balance of that night would have
13 been consistent with an expectation of recovery; would
14 that be a fair statement?
15 A. Yes, sir. She was not placed in the
16 intensive care unit or so forth at that time. To my
17 understanding she was placed in a closely watched bed but
18 not intensive care bed.
19 Q. And is it not a fair statement to say that
20 that would give some indication as to how they viewed the
21 life-threatening extent of her injuries?
22 MR. WADDING: I'm going to object, Your
23 Honor. Calls for speculation.
24 COURT: Overruled.
25 A. It's consistent with that, that the doctors
613
1 and the medical staff there all worked to place them in
2 the best bed to not over-utilize services.
3 Q. And do you have any understanding, sir, of
4 any of the other people from her car, Ms. Farrell's car,
5 were transferred to any other hospital?
6 A. Wasn't one other person transferred to
7 University Hospitals? I'm not sure who else was -- where
8 the others had gone, but -- wherever they had gone, but
9 one person, at least I saw, was transferred.
10 Q. And is that, I think her name was Tamara, was
11 transferred first to Covenant and then to University
12 Hospitals; are you aware of that?
13 A. Okay. I did not follow her, so that -- that
14 could be. I'll just take your word for that.
15 Q. And based upon your general experience in
16 the -- this area, is it fairly common that when someone
17 is hurt, they are transferred to the hospital that is
18 best able to treat that specific need?
19 MR. WADDING: Again, I'm going to object,
20 Your Honor, on the grounds of relevance.
21 COURT: Sustained.
22 Q. Would you, assuming the record would indicate
23 in this case that one young woman was transferred from
24 Sartori to Covenant, what would be your opinion as to why
25 she would have been transferred there?
614
1 MR. WADDING: I'm going to object again, Your
2 Honor. It calls for speculation, and it's irrelevant.
3 COURT: Sustained.
4 Q. With regard to Ms. Farrell, she remained at
5 Sartori from the time of her admission, which was
6 approximately 11:25 p.m. on October 4; would that be
7 correct?
8 A. That's as I remember, yes, sir. It was
9 between 11 p.m. and midnight.
10 Q. And she would have remained there until -- at
11 Sartori Hospital until approximately 4:45 p.m. on
12 October 5 when she was in the process of being then
13 transferred to Allen Hospital in Waterloo; is that also
14 your understanding?
15 A. I believe so, yes, sir.
16 Q. Now, during the course of your testimony, am
17 I correct that the injury which you, in your opinion
18 you've testified is fatal, was the injury to the aorta,
19 these other injuries would not have been -- not have
20 caused her death; is that correct?
21 A. She could have survived the other injuries.
22 The pelvic fracture, the tear between the ribs, certainly
23 the facial injuries, even the spleen laceration, the
24 capsule could be treated. Those -- those were not
25 immediately fatal nor even that serious that they could
615
1 not have easily been survived.
2 Q. Was there not an x-ray that was taken of Ms.
3 Farrell in the early morning hours shortly after her
4 arrival?
5 A. Yes, sir. I believe there was one taken
6 shortly after she arrived.
7 Q. Okay. And in that x-ray there was no mention
8 of the aortic tear, was there?
9 A. That's correct.
10 Q. And is it your opinion that she would have
11 had that aortic tear at the time that that x-ray would
12 have been taken?
13 A. Yes, sir.
14 Q. And isn't it fair to say that that reading of
15 that aortic tear was missed?
16 A. From a chest x-ray you would not see the
17 aortic tear. You would see bleeding from the aortic tear
18 if the bleeding got to the point that it would produce
19 the mass effect, an enlarged area, it would push away the
20 air containing lung and leave this blood containing blood
21 clot or blood in the chest or mediastinum. You wouldn't
22 see the aortic tear because the aorta is soft tissue and
23 it looks the same.
24 Q. Wasn't there an indication in that report
25 that there was clouding or pooling because of blood?
616
1 A. It says, "I do not believe the upper
2 mediastinum is abnormally widened." It says, "I cannot
3 exclude blood in the pleural space as a result of trauma.
4 However, the mediastinum does not appear abnormally
5 widened." He puts a question on the end of it. That's
6 Dr. Greg Raecker, R-A-E-C-K-E-R, his report on reading
7 the -- the x-ray. He doesn't really describe the
8 clouding until the next day, the next x-ray in the
9 afternoon.
10 Q. The blood that he is referring to in that
11 x-ray, that would have been the blood from this tear,
12 wouldn't it?
13 A. Yes, sir. There's also some blood from that
14 separation of the left ribs, the second and third ribs,
15 because you'll tear blood vessels in that area, and there
16 was obviously some bleeding associated with that, not
17 much, but there will be some bleeding from that.
18 Q. Would you grant that the bleeding, the blood
19 that the doctor referred to there, would have in
20 actuality been the blood from the tear in the aorta that
21 you have just described?
22 MR. WADDING: I'm going to object, Your
23 Honor. I think it calls for speculation and is
24 irrelevant.
25 COURT: I'll allow him to answer if he's able
617
1 to.
2 A. Okay. The majority of the blood would
3 probably be from the aortic tear. The blood at least in
4 the mediastinum, whatever amount of widening there may be
5 in the mediastinum could be that, in the left chest
6 cavity, could be either one. At this point it did not
7 bleed out that much, so you only had a small amount of
8 blood in those soft tissues.
9 Q. And what time was that radiologist -- was
10 that x-ray taken?
11 A. It says, according to the x-ray on the 5th,
12 it was taken at 1 p.m. It says, "Comparison with 10-4-96
13 at 22:49 hours," which is roughly 40 minutes before she
14 was admitted. I'm not sure whether the real status of
15 that the 22:49 is exact or not, it's an admission, chest
16 x-ray, whatever it would be. They say it was 10:49 p.m.
17 basically.
18 Q. And we know that somehow that was a
19 typographical error or mistake?
20 A. It could be. Maybe it's 23:49, somewhere in
21 there.
22 Q. But am I not correct that there was an
23 indication of blood in this area based on an x-ray that
24 was taken relatively shortly after her admission to the
25 hospital?
618
1 A. There is --
2 MR. WADDING: Again, Your Honor, I would
3 object as to relevance.
4 COURT: Overruled.
5 A. Okay. There is a mention of what he felt
6 could be some blood.
7 Q. Okay.
8 A. But he was not clear that it was blood. He
9 just said it could be some blood. These are described as
10 fairly mild findings actually.
11 Q. And isn't it fair to say that people who are
12 involved in automobile accident injuries, one of the
13 things that is always a concern is to whether there is an
14 aortic tear?
15 A. I think most emergency room physicians will
16 go through in their mind the differential to include that
17 if they have chest trauma. What's in the chest? The
18 aorta. What's very serious? The aorta. So that would
19 go through their differential. Now, whether they rule it
20 in or rule it out, how they make their diagnosis, that's
21 a treating physician's choice there, but they probably go
22 through it.
23 Q. That would be the most, if not the most, one
24 of the most serious and important structures to know it
25 status in the chest area, wouldn't it, that aortic arch?
619
1 A. The aortic arch, the heart, the major blood
2 vessels all through that, yes, they're all very
3 important.
4 Q. In hindsight, should not a person who reports
5 an automobile accident who reports chest pain as Juli
6 Farrell did and where there is a finding of blood
7 collecting in the area of the heart by x-ray, should not
8 that patient have been monitored in intensive care?
9 MR. WADDING: I'm going to object, Your
10 Honor. It calls for speculation.
11 COURT: Overruled.
12 A. Now, that's a treating physician's decision
13 at that point. I'm not a treating physician.
14 Pathologists always have 20/20 hindsight, so it's
15 probably something that as a pathologist I'd say maybe it
16 would have been best if she was in an intensive care
17 unit. Well, that's a safe statement now. I'd recommend
18 a treating physician answer that question for you. If
19 they feel they're stable enough to be on the floor, that
20 treating physician feels that, by a floor meaning not in
21 the intensive care unit, then that's that treating
22 physician's decision. That's part of medicine.
23 Q. And that treating physician could have
24 inadvertently made the wrong decision, could he not?
25 A. Can a doctor make the wrong decision? Yes.
620
1 Q. And in this tragic case, knowing those
2 findings some time shortly after her admission, isn't it
3 your opinion that she should have been admitted to an
4 intensive care environment?
5 MR. WADDING: I -- I'm going to object, Your
6 Honor, as to relevance. I believe that -- especially as
7 to relevance since Dr. Bennett has indicated that, you
8 know, from his position as a pathologist or forensic
9 pathologist that everything's 20/20 hindsight and that a
10 better person to answer that question would be a treating
11 physician.
12 COURT: Given his last responses to your
13 similar question, I'll sustain the objection.
14 Q. Wouldn't have hurt had she been admitted to
15 an intensive care environment, would it?
16 MR. WADDING: I'm going to object, Your
17 Honor, again, as to relevance.
18 COURT: Sustained.
19 Q. Doctor, in an intensive care environment, the
20 people or the patients are monitored more closely, are
21 they not?
22 A. That is the purpose for intensive care, yes.
23 Q. And they are monitored on all of their vital
24 signs on, what, a 15-minute basis, would that --
25 A. You'd have to see the protocol for the
621
1 hospital for that. I believe that's a standard for many,
2 if not all, hospitals, but you'd have to see what
3 their -- their standards are.
4 Q. And as time would progress, Juli Farrell lost
5 blood through that half-inch tear, didn't she?
6 A. She did lose blood through that half inch
7 tear. It was slowly. That had walled itself off to a
8 certain extent, but it's like a -- it's almost like a
9 false aneurysm where it started to balloon very, very
10 slowly. The monitoring said she was stable up to a
11 certain point. It's like when the balloon pops, you
12 don't have much choice then.
13 Q. And there would have been tests in intensive
14 care that would have shown that decrease -- or that loss
15 of blood, would there not?
16 MR. WADDING: I'm going to object again, Your
17 Honor, as to relevance.
18 COURT: Overruled.
19 A. Not necessarily. It depends what they're
20 doing for monitoring. If you're monitoring blood gasses
21 continuously and EKG as far as the heart rhythm and
22 electrical activity continuously, blood pressure
23 continuously and so forth, you can do many of those
24 things even on the floor if you check them every so
25 often, and she's fairly stable all the way along, that's
622
1 still doing the monitoring. It's a question of
2 frequency, but it's -- how often you checked. It depends
3 on what they have her hooked up to in intensive care,
4 also what machines she will be utilizing at that time.
5 Q. Would it not have been possible to determine
6 with medical supervision and implementation of medical
7 testing devices, blood pressure, et cetera, that she was
8 bleeding, would not that have been determinable by
9 3 o'clock in the morning?
10 A. By 3 o'clock in the morning? It was known
11 that she had trauma. It was known that she had the
12 fractures of her pelvis, I believe it said at that time.
13 I forget when those x-rays were taken. She was bleeding
14 because she had trauma. She had bruising that was seen
15 various places. I don't know if they knew she was
16 bleeding from a torn aorta. That would be a surprise
17 based upon what I see in the records, I believe.
18 Q. What -- but that was information that would
19 have been discoverable, would it not, at 3 o'clock a.m.?
20 MR. WADDING: Again, Your Honor, I would
21 object as to relevance.
22 COURT: Overruled. If you know, you may
23 answer.
24 A. Okay. It would be discoverable if they would
25 have done a very invasive test procedure called
623
1 angiography where you inject the dye into the aorta and
2 demonstrate that the blood's not staying all inside the
3 blood vessels but it's going out in the soft tissues.
4 Routine monitoring in an intensive care unit would not
5 necessarily pick this up.
6 Q. Do those records not indicate that her
7 condition deteriorated through the evening or the early
8 morning? And please make reference to the nurses' notes.
9 A. By deteriorating, was she -- she was still
10 communicating. By 8 a.m. she's voicing pain, then no
11 pain, voices headache, then back pain, then no pain.
12 Inconsistent there. Moves all extremities. Pedal pulse
13 they had. They could feel the pulse in her feet. When
14 they were checking, her feet were a little bit cool.
15 Q. And isn't that a significant indication, sir?
16 A. Oh, in retrospect. Can you have cool feet
17 for other reasons? Certainly. But, you know, is this
18 something that in retrospect, taken in the constellation
19 of everything else that I saw at the autopsy, it could
20 be. It's a very -- very non-specific finding, but it's
21 something to consider.
22 Q. And isn't it a fact that there is no report
23 in there about the -- her blood pressure being taken or
24 any tests taken during the approximate 6, 7, 8 o'clock in
25 the morning?
624
1 MR. WADDING: Again, Your Honor, I would
2 object to relevance.
3 COURT: Overruled.
4 A. I don't see a blood pressure given at those
5 times. There's one at 4:15 and one at 6 a.m.
6 Q. And don't those reports indicate some
7 difficulty?
8 A. She's deep breathing well at 4:15. She's --
9 Q. The blood pressure, doesn't the blood
10 pressure indicate some reason for follow-up?
11 A. At 4:15 the blood pressure was 130 over 50,
12 and at 6 o'clock the blood pressure is 136 over 60. My
13 blood pressure perks along at 95 over 50, so she's not
14 necessarily going into shock based upon that. This is --
15 her pulse is 110, her pulse is 88, pulse is 84 at
16 3:30 a.m., blood pressure 122 over 70. That's not
17 outside the realm of what you can see with young people.
18 Now, granted, she's in a hospital setting, but that's not
19 outside the realm of what we can see.
20 Q. Okay. Would you not agree, with those
21 figures, those test results, that she should have had
22 additional observation and additional tests run by
23 8 o'clock Saturday morning?
24 MR. WADDING: I'm going to object, Your
25 Honor. It calls for speculation.
625
1 COURT: Sustained.
2 Q. Do those records not indicate that during the
3 course of the morning her condition worsened?
4 A. Her status did worsen during the course of
5 the morning, which is why they took her to the CT scan at
6 1 o'clock and so on and did more testing.
7 Q. And there is a radiologist, I believe it's --
8 I don't know quite how to pronounce it, but it's like Dr.
9 Cammoun. Did you find his report there?
10 A. Yes. The emergency CT scan of chest.
11 Q. And wasn't it recommended -- and he's a
12 radiologist, is he not?
13 A. I believe so. I don't know him.
14 Q. Okay. Isn't it noted in those reports that
15 at 12:46 on October 5th that there was the -- this
16 finding by him, there is a sign of a tear, recommended
17 angiogram to rule out aortic tear?
18 A. That 12:46 down at the bottom is the time it
19 was transcribed, I believe on the 6th, which is the day
20 after. So I don't see where 12:46, as far as the time of
21 this CT scan, but it does state up here, "One should rule
22 out aortic tear. Hemothorax on the left with blood in
23 the mediastinum. Would recommend angiogram to rule out
24 aortic tear." Yes, sir, that's on the report. Now, when
25 that was taken, when it got to them, I don't know.
626
1 Q. And what that doctor was saying should be
2 ruled out is ultimately what caused her death, isn't it?
3 A. That's correct.
4 Q. And that was known some time while she was
5 still -- or that request for that angiogram was made
6 while she was still at Sartori Hospital obviously; isn't
7 that a fact?
8 A. Yes, sir. The -- I believe so. I'm not sure
9 when that request was transmitted to them. I don't know.
10 But she was at Sartori Hospital certainly when the
11 CT scan was taken.
12 Q. And do you recognize Dr. Robitaille? Was he
13 the emergency room treating physician?
14 A. Make sure I get their names right here. It's
15 not that I don't trust your pronunciation. I -- do you
16 have that page?
17 Q. I don't have it in order, but it's spelled
18 R-O-B-I-T-A-I-L-L-E.
19 A. Okay. That would be fine. I don't doubt
20 that. There's also an E.R. report from Dr. Dan Phillips
21 too.
22 Q. And in regard to Dr. Dan Phillips, in his
23 report that you have in front of you, does he not
24 indicate that the patient failed and began to
25 decompensate early in the a.m. with loss of blood
627
1 pressure which became crucial?
2 MR. WADDING: I'm going to object, Your
3 Honor, as to relevance.
4 COURT: Overruled.
5 A. It said, "And apparently early in the morning
6 had begun to decompensate slightly with loss of blood
7 pressure which became critical while attempting to do a
8 CT scan to delineate acute processes in her chest." So
9 slightly was the term. I don't know if you had mentioned
10 that term before.
11 Q. And that was at -- does he indicate that was
12 at 2:30 a.m.?
13 A. It says 2:30 in the afternoon. Dr. Dan
14 Phillips notes says approximately 2:30 in the afternoon
15 and then again 2:30 in the afternoon.
16 Q. With regard to the situation of Dr.
17 Robitaille, did he not dictate an addendum to his medical
18 records regarding Ms. Farrell?
19 A. Yes, sir, he did.
20 Q. And are addendums to medical reports usual or
21 unusual?
22 A. The majority of them don't have them. They
23 just issue another report, but I see them. I do it
24 myself.
25 Q. Does he not, in that addendum, indicate
628
1 verbatim, "This possibility of a pneumothorax had not
2 been reported by the other radiologist?"
3 MR. WADDING: I'm going to object, Your
4 Honor, as to relevance.
5 COURT: Overruled.
6 A. In the addendum I'm looking at I don't see
7 any mention of what you just said. What -- what are you
8 talking -- which part are you referring to?
9 Q. I believe -- maybe take the time, I believe
10 in your possession there is a report that includes the
11 language I just referenced dictated by Dr. Robitaille.
12 MR. WADDING: I just simply request that Mr.
13 Correll show it to him.
14 COURT: Would you, please, Mr. Correll.
15 MR. CORRELL: Pardon?
16 COURT: Would you please show it to him? It
17 might help speed things up here.
18 MR. CORRELL: (Complied.)
19 A. I was looking at at wrong addendum. He has
20 another addendum. There is one addendum at the bottom of
21 his E.R. report. There it is, the page before. The --
22 the addendum that he dictated on the 9th of October,
23 three days -- four days after her death.
24 Q. And would you read what he says relative to
25 that issue in that addendum?
629
1 A. Okay.
2 MR. WADDING: I'm going to object, Your
3 Honor, as to relevance.
4 COURT: Overruled.
5 A. The original chest x-ray they were looking at
6 to the left apex, what Dr. -- he and Dr. Cammoun see has
7 been described before by another radiologist as capping.
8 He thinks that this is possibly some blood. Dr. Cammoun
9 also mentioned that there is indication that there might
10 have been a pneumothorax to the right side, but we could
11 not see the line of the lung where there is a
12 pneumothorax. This possibility of pneumothorax had not
13 been reported either by the other radiologist.
14 Q. And isn't it fair to say that the first
15 radiologist they're referring to was the gentleman who
16 read the x-ray some time shortly after her admission?
17 A. I believe so.
18 Q. And during that reading of that x-ray there
19 was no mention of the pneumothorax, and is that -- isn't
20 that what she ultimately died of?
21 A. No. She did not die of a pneumothorax. She
22 died of a hemothorax, in essence, the blood loss.
23
Pneumothorax means there's air in the chest cavity from
24 the lung collapsing. This is blood in the cavity from
25 the aortic tear.
630
1 Q. Did not the first radiologist miss that?
2 MR. WADDING: I'm going to object, Your
3 Honor, as to relevance.
4 COURT: That's repetitive. We covered that
5 before. Sustained.
6 Q. Doctor, isn't it likely, had Juli Farrell
7 been transferred to another hospital earlier, that she
8 would not have died of these injuries?
9 MR. WADDING: I'm going to object to that,
10 Your Honor, as calls for speculation.
11 COURT: Sustained.
12 Q. Can a ruptured aorta be treated?
13 MR. WADDING: Object to that again, Your
14 Honor, as being speculation. Speculative and --
15 COURT: Overruled. You may answer if you're
16 able.
17 A. To answer the question can it, it can be. It
18 depends on location. It depends on many, many factors.
19 But there have been some successful treatments.
20 Q. And those would be treated by cardiovascular
21 surgery with a heart surgeon; would that typically be the
22 situation?
23 A. We've had them treated by emergency room
24 doctors at Broadlawn's Hospital from gunshot wounds where
25 they've just gotten in there and done it. The ideal
631
1 person would be a cardiovascular surgeon because they're
2 so trained in it. But can other doctors do it?
3 Certainly, and successfully too in those cases, in
4 certain cases.
5 Q. People can and have been successfully treated
6 for a half-inch tear in their aorta; is that not a fact,
7 sir?
8 A. Individuals have been successfully treated
9 for half-inch tears, that's correct. Depending upon
10 where it is in the aorta, this is very, very high and
11 hard to get to, but they have been treated successfully
12 in other cases.
13 Q. In that same area; isn't that a fact?
14 A. I can't answer that. It's a very, very high
15 injury here. It's a very inaccessible area, and it's in
16 a young girl where the tissues are very elastic and have
17 pulled back quite a ways. It's difficult.
18 Q. Would you have thought that should have been
19 tried?
20 MR. WADDING: I'm going to object, Your
21 Honor, calls for speculation.
22 COURT: Sustained.
23 Q. Isn't it fair to say that had that effort
24 been tried, you cannot rule out that she would have
25 survived her injuries?
632
1 MR. WADDING: Well, I'm going to object to
2 that as well, Your Honor. It calls for speculation.
3 COURT: Sustained.
4 MR. CORRELL: Nothing further.
5 COURT: Mr. Wadding?
6 REDIRECT EXAMINATION
7 BY MR. WADDING:
8 Q. The -- you indicated that tears in the aorta
9 have been successfully treated. Is that a fairly common
10 thing?
11 A. Fairly common to have them successfully
12 treated?
13 Q. Yes.
14 A. No. In my -- of course, my experiences are
15 not the ones that survive obviously, but in my readings
16 in the field and so forth, it's a very serious injury,
17 and oftentimes the death can occur right while they're on
18 the operating room table, because once you open it up to
19 get to that area, to close it off, you've taken off
20 everything that's walled off that area, so you've got
21 this major rupture through the major blood vessel.
22 That's the most critical time.
23 Q. And you say that's a major blood vessel.
24 What do you mean by that?
25 A. When I say it's the major blood vessel, it's
633
1 the largest blood vessel in the body with the highest
2 pressure of any artery in the body.
3 Q. If you were -- how would you describe the
4 procedure of fixing a tear of this nature?
5 A. It's like trying to -- I compare it to like
6 trying to sew a balloon back together just as it starts
7 to pop.
8 Q. Now, the -- can you describe the position of
9 this tear in relationship to the heart?
10 A. Yes, sir. If you imagine the heart being
11 like my fist right here, the arch, as it comes up, is
12 only about an inch or so as it comes up and starts to
13 make its curve, so it's only about probably two, two and
14 a half inches or so from where the aorta starts, the
15 valve coming out of the top of the heart to where this
16 tear is. It's very high up here. It's way in the back
17 of the mediastinum. And as can be seen in Exhibits "14",
18 "15" and "16", or "L-14", "15" and "16", it is way up at
19 the very top right where the blood vessels take off to
20 the -- to the left arm. In my experience, even with my
21 incision which is much larger than anything a surgeon
22 would ever use, it's hard to get to this area. It's very
23 hard to get to this area.
24 Q. And the tear that you observed in the aorta
25 of Juli Farrell, is that consistent with the history of
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1 being involved in an automobile accident?
2 A. Yes, sir, it is.
3 Q. And the history that you were made aware of
4 in this instance?
5 A. Yes, sir, it is. Entirely.
6 MR. WADDING: That's all the questions I
7 have.
8 COURT: Mr. Correll?
9 MR. CORRELL: I have nothing further.
10 COURT: Thank you. I do have one question.
11 I probably missed it. When was the autopsy performed?
12 WITNESS: The autopsy was performed on the
13 6th, Sunday the 6th starting at 9 p.m. We went down to
14 Mercy Hospital at Iowa City to do it.
15 MR. WADDING: Your Honor, my apologies. I
16 would move to reopen.
17 COURT: To talk about "L-12"?
18 MR. WADDING: Yes. I just wanted to --
19 COURT: Go ahead.
20 FURTHER REDIRECT EXAMINATION
21 BY MR. WADDING:
22 Q. Dr. Bennett, could you grab the photograph
23 that is marked as State's Exhibit "L-12", and do you
24 recognize that, sir?
25 A. Yes, sir, I do.
635
1 Q. And what do you recognize that as?
2 A. State's Exhibit "L-12" is a photograph I took
3 myself of the spleen. It is about as big as the palm of
4 your hand, and it's up underneath the left rib cage just
5 under this left-hand side right in line where all the
6 other injuries were on her left side of her body.
7 Q. And that was -- was the spleen in this
8 instance also injured?
9 A. Yes, sir, it was, and that can be seen in
10 photograph "L-11." Exhibit "L-11", this fracture on the
11 outer surface of the spleen is where the capsule that's
12 otherwise like -- it's also like a Saran Wrap covering of
13 the spleen. It is split. She was bleeding from that
14 area also. Not much, but she was bleeding from this --
15 this laceration of her spleen.
16 Q. Okay. Have you described as "L-11", is that
17 actually "L-12"?
18 A. L with 12, yes, sir.
19 Q. And the -- is that consistent with the
20 injuries that you observed on the left side of Juli
21 Farrell?
22 A. Yes, sir, it is.
23 MR. WADDING: Ask that State's Exhibit "L-12"
24 be entered into evidence, Your Honor.
25 COURT: Mr. Correll?
636
1 MR. CORRELL: Same objection I previously
2 made.
3 COURT: "L-12" is admitted.
4 MR. WADDING: I don't have anything further,
5 Your Honor.
6 COURT: Anything further, Mr. Correll?
7 MR. CORRELL: No, Your Honor.
8 COURT: Thank you.
9 MR. WADDING: Your Honor, at this time the
10 state rests its case-in-chief.
updated 08/12/10