By Sarah Senan and Ryan Gonzalez
The morning of October 7, 2016, brought the resumption of the case of the People v. Darnell Dorsey, Judge Paul Richardson presiding. Pursuant to Cal. Penal Code sections 273a and 273ab, Mr. Dorsey is being charged with assaulting and causing fatal injury to his girlfriend’s 20-month-old child, Cameron Morrison, in January of 2014. Deputy Public Defenders Martha Sequeira and Joseph Gocke represent Darnell Dorsey, while Deputy District Attorney Michelle Serafin represents the People
The prosecution recalled for questioning Dr. Daniel Ichel, a witness who testified earlier in September of 2016. Dr. Ichel is a current pediatric radiologist at Sutter Health in Sacramento. Dr. Ichel read CT (computerized tomography, a series of X-rays from differing angles) scans of the brain and body of Cameron Morrison in January 2014.
Dr. Ichel explained that when he reviews CT scans, he is usually trying to detect any abnormal findings. He stated that, after reviewing Cameron’s CT scans, he found direct injury to the kidney and a loss of blood flow. He continued to explain that a direct effect on one of these organs can cause damage to the adjacent organs.
Dr. Ichel testified repeatedly that there were many visible rib fractures. When Dr. Ichel was asked by the prosecution if he saw any cases of pneumonia, he stated that pneumonia is a clinical diagnosis. Dr. Ichel did find evident indications of non-accidental trauma. However, he did not find any visible bone disease.
Next, Ms. Serafin presented screenshots of Cameron’s CT scans and proceeded to ask questions. Dr. Ichel pointed out the irregular findings on Cameron’s body and flipped through the exhibit and described the visible abnormalities.
Next, Mr. Gocke began the cross-examination of Dr. Ichel. Mr. Gocke began by asking Dr. Ichel how much time he spent reviewing Cameron’s CT scan. Dr. Ichel answered that he roughly spent anywhere from 30 to 45 minutes reviewing the CT scan. He explained that he had no prior history or medical documentation on Cameron’s case, and he instantly reviewed the CT scans once he received them.
Mr. Gocke proceeded to ask Dr. Ichel various questions regarding Cameron’s status. First, Mr. Gocke asked Dr. Ichel whether or not he was aware of a misplaced plug, that contained bacteria, in Cameron’s lung. Dr. Ichel stated that he was unaware of this. Mr. Gocke then asked whether Dr. Ichel knew that Cameron was ill and had a fever of 101/102 degrees. Dr. Ichel did not know this; he was also unaware that Cameron’s teeth were in poor condition. However, Dr. Ichel stated that the condition of Cameron’s teeth are not due to an underlying factor of bone disorder. Lastly, when asked about pneumonia, Dr. Ichel stated that the disease was not evident in the CT scans.
The questioning of Dr. Ichel was re-directed to Ms. Serafin. The prosecution began to ask questions about injury to the skull. Dr. Ichel explained that such a fracture is usually caused by “shaken baby syndrome.” Dr. Ichel explained that, even if Cameron had a staph infection, caused by germs commonly found in the skin, it would not change his original opinion. He explained that the hypothesis he made was because of the rib fractures and lung contusions.
The defense began the re-cross examination. Dr. Ichel was unable to answer questions pertaining specifically to the lungs because that is out of his scope.
The second witness of the morning was Dr. Nancy Laurence. Dr. Laurence is a pediatric radiologist. Her job consists of reviewing X-rays, CT and MRI (magnetic resonance imaging) scans. She stated that she received Cameron’s X-rays in the morning. When Ms. Serafin presented a the X-ray images on the screen, Dr. Laurence recognized them and was able to explain that there were multiple rib fractures. She explained that she was able to make the inference that some of the rib fractures were rather old, possibly more than a week old, and were in the process of healing. She also indicated that there were new bruises, that could be less than a week old.
Mr. Gocke, on cross-examination, asked Dr. Laurence if she had any prior history on Cameron’s case, to which she responded that she did not. She explained that she found findings of non-accidental trauma. When Mr. Gocke questioned how she knew they were related to trauma she responded that she has had one year of experience in this practice and has seen many scans of cases relating to trauma. Mr. Gocke asked if she was aware of the plug that had bacteria, and Cameron’s high fever. Dr. Laurence was unaware of these factors, but still stood by her initial statements.
During the re-direct by the prosecution, Dr. Laurence explained that there was no evidence, on the X-ray, that there was pneumonia present. An indication of pneumonia is normally observant on an X-ray.
The third witness of the morning was Dr. Richard E. Latchaw. Dr. Latchaw is a current Professor of Radiology at the UC Davis Medical Center and has been a practicing physician since 1971. He reads CT and MRI scans daily and has many years of experience. He explained that CT scans are quite static and that, although they are fast, they are more limited. He explains that MRI scans take longer, but one is able to detect more specific information from such scans. Dr. Latchaw has seen over 8,000 scans a year, for 30 years. From his experience, approximately over 25 percent of what he has reviewed have been cases relating to trauma. Like the previous witnesses, he did not look at Cameron’s medical record prior to reviewing his X-rays. Before the recess, Dr. Latchaw was able to explain that the CT scan indicated the brain being a black color, which indicates the brain being dead.
People’s Expert Radiologist Continues Testimony
By Ryan Gonzales
The prosecution’s radiology expert, Dr. Richard Latchaw, testified that by looking at the SWAN (susceptibility-weighted angiography) images of Cameron Morrison’s brain, one can see that the victim suffered from “diffuse axonal injuries,” or brain injury in the form of extensive lesions in white matter of the brain.
Prior to Dr. Latchaw’s testimony of the Swan images, Deputy DA Michelle Serafin asked the witness multiple hypothetical questions. Ms. Serafin inquired if a person can go into cardiac arrest due to brain damage.
Dr. Latchaw explained that if there is significant damage to the medulla oblongata (part of the brain stem, regulating many autonomic processes), that causes hemorrhaging and then the heart and respiratory functions can fail, thus leading to death.
Following these statements, Ms. Serafin questioned if Dr. Latchaw ever witnessed a child go into cardiac arrest due to pneumonia. Dr. Latchaw responded no.
Ms. Serafin hypothetically asked if a child did die from cardiac arrest due to pneumonia, what the cause would be. Dr. Latchaw stated, in order for death to occur from cardiac arrest due to pneumonia, a “non-traumatic infectious case” had to be present, but it did not apply to this particular incident.
Additionally, Ms. Serafin inquired about the possibility of a child dying from cardiac arrest as a secondary effect of the pneumonia disease, and whether there would be any diffuse axonal injuries in the brain. Dr. Latchaw responded no.
However, Dr. Latchaw testified that he observed diffuse axonal injuries in Cameron Morrison’s brain.
In People’s Exhibit 16 SWAN image series 9, Dr. Latchaw described black areas within the ventricle of Cameron Morrison’s brain, showing the “small hemorrhages” that illustrate DAI (diffuse axonal injury). Dr. Latchaw simply stated that the blackened areas that occurred in the victim’s brain represented “blood that doesn’t belong in the white matter.”
Dr. Latchaw continued to show the jury multiple SWAN scans of Morrison’s brain, with examples of the blackened area or hemorrhages that indicated DAI.
Ms. Serafin inquired about reperfusion (the action of restoring the flow of blood to an organ or tissues) injuries in relation to diffuse axonal injuries. Dr. Latchaw testified that reperfusion injuries can occur in the restoration of blood flow into the brain after the patient has suffered “hypoxia” (lack of oxygen to organs) or “ischemia”(lack of blood flow to organs), all of which he testified could occur from cardiac arrest.
Dr. Latchaw stated that the reperfusion starts allowing new blood to come into the brain, thus the brain swells and hemorrhages. However, he stated that the effect of reperfusion can be seen on the MRI, but not the reperfusion itself.
Ms. Serafin then asked the doctor if there were any reperfusion injuries to Cameron Morrison’s brain. Dr. Latchaw testified that there was no blood flow to the brain; thus, if the flow was never reestablished, Morrison could not suffer from reperfusion injury.
Dr. Latchaw concluded that it was not hypoxia or ischemia that caused the victim’s brain damage, but trauma-induced injury.
During the cross-examination, Deputy Public Defender Joseph Gocke questioned Dr. Latchaw’s knowledge of Cameron Morrison’s medical history prior to his investigation, as well as inquiring if he had an objective opinion about the case.
Mr. Gocke stated that Dr. Paul Lee, another professor of radiology at UCDMC, had testified to having had “significant” discussions about the case with Dr. Latchaw. Dr. Latchaw did not recall having any conversations about this particular case.
When Mr. Gocke asked if Dr. Latchaw had the victim’s medical record, the doctor testified that he only had the SWAN images and Dr. Lee’s reports.
After further questioning, Dr. Latchaw testified to not knowing that Sutter Davis Hospital indicated cardiac arrest and that CPR had occurred prior to Cameron Morrison being admitted to Sutter. Therefore, due to not knowing past medical records, Mr. Gocke stated that Dr. Latchaw would not have any way of knowing if a person was anemic based on the reports he received, to which the doctor agreed.
Next, on redirect, Ms. Serafin questioned the purpose of reviewing the victim’s MRIs. Dr. Latchaw stated that he researched the images and reported his findings and opinion. For this particular incident, Dr. Latchaw stated he found a “post traumatic issue and brain swelling that led to brain death.”
Ms. Serafin then listed all of the victim’s injuries, including fractured ribs, liver lacerations, brain and retinal hemorrhaging, and inquired if this was consistent with diffuse axonal injuries and hemorrhages.
Dr. Latchaw responded, “Yes.”