by Antoinnette Borbon, Jane Fitzsimmons, Marya Alloo and Andrew Reis
As the prosecution’s “case-in-chief” comes near an end, it has been bringing forth a deeply emotional surge of outbursts from Deputy Public Defender Martha Sequeira. Ms. Sequeira’s intense emotion throughout this case goes as far back as the beginning of the trial. But today, things spiraled out of control between her and the prosecution’s expert witness, Dr. Omalu.
Judge Paul Richardson often had to pose as referee to the shouting match between the doctor and defense counsel Sequeira.
Dr. Omalu has also testified as an expert for Deputy Public Defender Dan Hutchinson, in the case against James Mings. In fact, it was his testimony that would narrow down the exact cause of death along with the elements and factors which led to the decedent’s last breath. It was at the request of Hutchinson that the brain stock was tested, thus getting defense an acquittal on the charge of second degree murder in the case against Mings.
Today, Dr. Omalu testified for the prosecution’s case.
Dr. Omalu received his MB, BS [M.D.] degree from the University of Nigeria in 1991. He received his MPH [Masters in Public Health] degree in Epidemiology from the University of Pittsburgh in 2004. He also received his MBA [Masters in Business Administration] degree from Carnegie Mellon University in 2008. Dr. Omalu holds four board certifications in Anatomic Pathology, Clinical Pathology, Forensic Pathology and Neuropathology. Dr. Omalu was the first to identify, describe and name Chronic Traumatic Encephalopathy [CTE] as a disease entity in football players and wrestlers.
Dr. Omalu testifies in court 60-70 times/year. He has little faith in the accuracy of predictions by CT scans and MRIs; he prefers sophisticated neuronal tests that can zoom in on the brain 1,000X or more. These tests are conducted postmortem and are invasive.
In 2012, Dr. Omalu conducted a neuropathology test of Sam Stone’s eyes and brain.
He stated that, as a neuropathologist, “we use differential diagnosis, meaning we assume the person has all diseases and then begin a process of elimination.”
At first glance, Omalu stated, “Sam’s brain was normal upon initial, external inspection — there were no genetic abnormalities, but there were contusions at the poles of his brain and the brain was in a state of shock.”
Raising his tone, Dr. Omalu emphasized, “I found MULTIPLE contusions in the brain!” Along with the finding of the contusions in the brain, Omalu also discussed that he found “congenic swelling, meaning the brain had become flattened out or attenuated, which indicated head trauma was caused by force without immediate death.”
On top of all those findings, Omalu also underlined the fact that “There was bleeding between the halves of Samuel’s brain and blood on top of the corpus callosum that came from a tear in a blood vessel. We call this pathognomonic of non-accidental, traumatic brain injury. There was bilateral and dorsal hemorrhaging.”
“There was evidence of angular rotational acceleration-deceleration, to which the midbrain is particularly susceptible. This type of acceleration-deceleration destroys fibers of the brain and causes leakage in cell membranes. There was excitotoxic injury, which is seen after severe trauma.”
“Differential densities between the skull and brain at different ages are important. The brain of an infant has more water, therefore is more resilient following head trauma.”
Shockingly, Omalu testified that “A yellowish discoloration of Samuel’s brain (dural matter) indicated more than one bleeding event, or more than one episode of traumatic head injury.”
“CT scans and MRIs showed a likely hypoxic-ischemic injury in Samuel’s brain, meaning his brain was deprived of oxygen or glucose. However, we can see this is not correct by opening up the brain. He did not experience hypoxic-ischemic injury and his spinal cord was not injured, which we would usually see.”
Omalu then took individual slices of the brain and had them put into microscopic slides for him to further examine the matter of the brain. He explained, “I examined microscopic slides of different regions of Samuel’s brain and found a presence of white blood cell infiltration, signaling axonal damage. There was evidence of a disruption of the tubules transmitting proteins anterograde and retrograde to the brain. Proteins gather around this disrupted area and it is severed. This was apparent in Samuel’s autopsy.”
Omalu reiterated that “Unresponsiveness, respiratory system interruption, brain swelling, and seizures are all secondary to the primary injury that initiates this cascade of events.”
Along with the examination of the brain and dural matter, Doctor Omalu also examined the eyeballs of the infant. His findings indicated, “Samuel’s eyes showed findings with evidence consistent with traumatic brain injury. There was bleeding into all 6 layers of the retina — globule hemorrhages. The
blood began at the optic papilla, then the equator of the eye, to the anterior end of the retina. There was traumatic retinal detachment, meaning forceful separation. I was able to see bilateral hemorrhages.”
The doctor yesterday narrowed the cause of this bilateral hemorrhaging in Sam’s eyes down to trauma or coagulopathy. Dr. Omalu, today, ruled out the latter. “Coagulopathy does not cause retinal detachment and this detachment cannot occur postmortem. We can rule out any causes other than traumatic head injury.”
Throughout questioning, Dr. Omalu failed to answer questions briefly and gave information beyond what was asked. He was countlessly reined in by the defense’s sustained objections on the grounds of narrative.
DDA Mount asked, “Are you aware that [another] doctor found abusive trauma in the form of fractures of Sam’s posterior ribs?”
Omalu responded, “Yes. The ribs of a 3-month-old have a certain amount of give; they can sustain movement without injury, especially the ribs closer to the outside of the body. However, a violent compressive injury squashes the ribs on the spinal column.”
Mr. Mount then speculated, “Could Sam’s ribs have been fractured at the same time as his other injuries?”
Omalu reiterates, “Callouses mean the injury was about 2 weeks old, so it could have happened at the time of the older head injury. But there was no way this infant could have lived with such severe brain injuries for weeks” He asserted that the labored breathing happens “within minutes of the injury sustained but no longer than one to three hours.”
With the ever so present idea of subdural hematomas being a possible cause of death in Samuel Stone’s case, Omalu was asked by Mr. Mount to elaborate on the presence of subdural hematomas in infants. Dr. Omalu explained “50% of babies have subdural hemorrhages due to vaginal delivery, but they are
of no forensic consequence. They heal and are not typically bilateral or dorsal.”
When asked if a subdural hematoma in an infant can re-bleed, Omalu responded, “In re-bleeds, new blood vessels that have formed have thin walls and are more likely to rupture, but one blood vessel cannot be on both sides of the brain. Samuel’s brain had a bilateral re-bleed, and the only possible explanation is acceleration-deceleration trauma. A fall almost always causes unilateral injury.”
Asked by Mount to restate the cause of death, Omalu reassured to the court room that, “Sam’s injuries were not sustained from a fall. It was non-accidental. An infant’s motor abilities are very small and the injuries incurred would require a lot of mass and energy.”
The injuries present on/in the infant, in Omalu’s terms, “are the worst internal injuries a 3-month-old can have without any external injury. It was very severe. If it was an accident, we would expect to see significant abrasion or bruising. A fall could not generate enough force — it would have to be violent force.”
Omalu stated that it was important to note that “a child’s neck is more susceptible to rotational movement. The neck is not strong enough to resist, as when a baby is being violently shaken. From my examinations, I concluded that Samuel’s injuries were caused by adult-induced, non-accidental head trauma.”
In cross, Ms. Sequeira, in an attempt to steamroll the witness, bombarded Dr. Omalu with abrasive questions, spat out too fast and loud for him to understand, but they all ended in a determined, “YES?”
She went so far as to ask, “You charge however much you can milk from whoever is hiring you, yes?”
Shocked, Dr. Omalu answered her questions evasively – even contemptuously. He attempted to elaborate on everything, and in no time the defense and doctor were having a shouting match. Judge Richardson had to interrupt, repeatedly, to remind the professionals how a courtroom works.
In wrapping up what was heard in the afternoon, Sequeira continued with the same type of “yes or no” questions. At this point, a very emotionally charged Sequeira began questioning the doctor about his previous cases. In a previous case that Dr. Omalu had testified in, a dismissal took place due to a plea, because Omalu had proved that the child had been thrown with violent force, after being shaken.
Sequeira, questioning the doctor stated, “How can you manage how violent the shaking is if it’s unnoticed?” Sequeira, continuously badgering the doctor, focused on the doctor’s reasoning behind the death by saying, “But in your opinion, it was your opinion.”
An agitated Omalu stated, “This is not my opinion, it is a scientific fact, I studied the brain, I got degrees, I tested everything. These are not opinions!”
Sequeira then responded by saying, “But do you know that people disagree with your findings – Dr. Coulter disagreed with what you are saying.”
Omalu emphasized that what Coulter stated was based off of an MRI and CT scan, which are not very elaborate. By dissecting the brain and its dural matter, Doctor Omalu has the ability to further diagnose the cause of death.
Next to testify was, Detective Matthew Jameson. Matthew Jameson has been a Woodland Police Officer since 2005. He currently is a Yolo County Deputy Sheriff, and has been for the past 4.5 years. Jameson was asked to show a layout of the Stone’s house, and what was examined.
From his examination, Jameson had taken measurements of the height of the bed which the infant had supposedly fallen off of. His examination indicated that the bed to the wood floor came to “2 ft and 10 in.”
Deputy Public Defender Monica Brushia asked Detective Jameson why they would cut out the section of wood floor where the baby was said to have fallen.” He replied, “Well, we thought we may have needed it but we didn’t.”
“So you never tested the wood for DNA, blood, anything?” asked Ms. Brushia. “No, not after Stone told us his statement and we knew we weren’t looking for blood.”
After a day of intense and informative testimonies, the case wrapped up for the day.