Patterico's Pontifications

2/20/2007

DRJ Pores Through the Border Patrol Trial Transcripts — Medical Testimony (Vols. VIII and IX)

Filed under: Crime,General,Immigration — DRJ @ 1:57 am



The government brought two physicians from William Beaumont Army Medical Center to testify regarding Osvaldo Aldrete-Davila’s injuries. While there are interesting aspects to all of the testimony, the most important part is probably the trajectory evidence at the end of the second witness’ summary.

This testimony is a classic meld of law and medicine so take care if you read it at bedtime or mealtime.

From Vol. VIII:

Witness #6 – Dr. Todd Miller

[Dr. Todd Miller, urological surgeon at William Beaumont Hospital, needed to return to work for scheduled surgeries. The Court allowed the government to suspend the direct examination of Oscar Juarez and take Dr. Miller’s testimony out of turn. Thus, the jury heard from Dr. Miller near the beginning of Oscar Juarez’s testimony.]

Government direct examination (by Debra Kanoff):

184-185 – Dr. Todd Miller is a physician. He has a chemistry degree from Juniata College in Pennsylvania and graduated from Georgetown University Medical School. He did an internship in general surgery at Tripler Army Medical Center in Honolulu, a military hospital in Hawaii, followed by a residency in urology at Tripler.

185-186 – Miller has been a practicing urologist since 2000 and board certified since 2001. Dr. Miller served in the military from 1994 to 2004. He now works as a full-time contract physician at William Beaumont Army Medical Center (“Beaumont AMC”). He is a urologist and a urological surgeon. A urologist is a physician who medically and surgically manages the genitourinary system: kidney, bladder, etc.

186 – Beaumont AMC treats servicemen and women and their dependents, and trauma cases. Dr. Miller thinks the emergency room does rape kits for the FBI. Sometimes Beaumont AMC treats other individuals at government request.

186-187 – On March 16, 2005, Beaumont AMC was asked to treat Osvaldo Aldrete-Davila. Miller was not the attending physician that day but he is the more experienced urologist, so he was the supervisor when Aldrete-Davila had surgical procedures. Miller was only involved in the operating room.

187-188 – Aldrete-Davila was at Beaumont AMC to evaluate the genitourinary system and to retrieve a bullet lodged in his right thigh. Aldrete-Davila had already received medical treatment in Juarez, or in Mexico, where they had inserted a suprapubic catheter to drain urine through the abdominal wall. They did not use a traditional Foley catheter, a drainage tube inserted in the penis, in males, and then into the urethra and the bladder. Miller normally would try to insert a Foley catheter following this type of wound, but he doesn’t know what was done in Mexico.

188-189 – [Kanoff handed Miller GOV EXHS 64, 65, 66 and 68 for use during his testimony.] Miller first identified GOV EXH 66 a photo of Aldrete-Davila, the man he treated in 2005.

189 – A suprapubic tube is used to drain the bladder. It involves placing a tube through the abdominal wall, right below the bellybutton, into the bladder. It can be done under a local or a general anesthesia. Miller doesn’t know how it was done in Mexico on Aldrete-Davila.

189 – Aldrete-Davila’s suprapubic tube is shown in the [unidentified] photo exhibits.

190 – When Miller first saw him, Aldrete-Davila was on his back on the operating table and already under general anesthesia. Other surgeons were doing the prep. Miller’s colleague, also a urologist, was present in the operating room to assist in the genitourinary evaluation and removing the bullet.

190 – The bullet was removed first.

190-191 – The surgeons next did imaging pictures, with contrast (dye), using a mobile x-ray machine called a fluoroscopic C arm. They injected the dye so they could visualize the bladder. They also injected material in the penis to see if there was communication present. “Communication” means:

“A. The normal genitourinary tract will go from the tip of the penis into the bladder, so we should be able to, with a gentle pressure, be able to put contrast into the bladder and fill the bladder, so that we can see the bladder and then the whole way out through the penis.”

191 – The medical records indicate Aldrete-Davila was 24 years old.

191-192 – Aldrete-Davila’s bladder is directly underneath the suprapublic tube, and that’s where Miller first injected dye. He checked to see if the bladder neck connected with the urethra (the urine tube) and if any dye extravasated (spread) outside the normal system. The urethra leads from the bladder, through the prostate, through the sphincter, and out through the shaft of the penis. He was looking to see if everything was intact.

192-194 – Miller identified GOV EXHS 93, 94, and 95 as x-ray films taken with the fluoroscope, the operating room x-ray machine, on March 16, 2005. The films were taken while injecting contrast (dye) into Aldrete-Davila – the person shown in GOV EXH 66. [GOV EXHS 93, 94 and 95 were offered and admitted without objection.]

194-195 – Miller identified GOV EXH 93 as images from an x-ray film. The first image was of the contrast in Aldrete-Davila’s bladder. The second image showed the contrast injected in the urethra via a retrograde urethragram. No contrast filled the bladder in this test. In the third image, contrast was put in through the suprapubic tube and filled the bladder. Miller used the tube inserted in Mexico.

196 – The x-rays show there is no communication between the urethra and the bladder neck.

196-198 – Miller identified GOV EXH 94 as showing the same x-ray film images as in GOV EXH 93, but this time they had injected more contrast (dye) to better outline the miscommunication between the urethra and the bladder neck. There are foreign bodies on the x-rays that appear to be bullet fragments, and the miscommunication is in the same area as the potential bullet fragments. The images show the fragments from several angles. The images show 4 potential bullet fragments in that location.

198-199 – In order to urinate, you have to be connected from the bladder to the urethra and penis but Aldrete-Davila had a “disconnection” because it was no longer intact. The patient can’t urinate and has back pressure from the kidneys because the bladder can’t empty. That obstruction could cause renal failure and is a life-threatening problem. There is also a possibility of infection and, rarely, of bladder rupture.

199-200 – The first image, where the bladder is filled with contrast, is called a cystogram. The second image was a retrograde urethragram, where the urethra is filed with contrast. Miller also performed a cystocopy, which places a small camera in the urethra to look for a disruption or discommunication. It is also used to see if there is a way to realign an anastomosis – a procedure to repair two ends and put them back together in order to permit communication.

200-201 – During the cystoscopy, Miller found fibrosis (scarring) between the urethra and the sphincter (the control mechanism for urination – like a spigot with an on/off valve). At that point there was no communication, just scarring, because it was disrupted.

201 – Due to the fibrosis (scarring), Miller could not repair the disrupted urethra and put the ends back together. Aldrete-Davila will have final reconstruction surgery in the future.

202 – There are 2 ways to handle an injury like this. The first is to realign and reconnect the urethra in the first 12-24 hours before fibrosis starts. The second is to wait 6-9 months until the scarring has completed. If you don’t wait, there is a high potential for failure when you reconnect the 2 ends. Thus, since Aldrete-Davila did not have the procedure in the first 12-24 hours, Miller recommended waiting 6-9 months for the repair.

202-203 – Based on his history, Miller assumes the injury to Aldrete-Davila’s urethra occurred from the bullet wound and fragments. Miller did not remove the fragments because it might cause more damage (nerves and blood supply for erections and continence) to remove them. Continence is the ability to control urination without leakage. The sphincter controls continence.

203-204 – Miller indicated he can’t tell what damage the bullet fragments caused and whether Aldrete-Davila will be able to regain sphincter control after reconstruction surgery. It normally takes 1-2 months after surgery to know for sure, but there is a high likelihood that Aldrete-Davila will have problems with incontinence (lack of control of urination).

204-205 – There are other procedures that can be done if Aldrete-Davila is incontinent. These procedures include implantation of an artificial urinary sphincter. These must be replaced every 8-10 years, so a 24-year-old person can expect several surgeries.

205-206 – Miller cannot do the reconstruction surgery. It will require a few surgeons who are trained in reconstruction surgery. Miller referred Aldrete-Davila to Brooke Army Medical Center in San Antonio, the University of San Francisco, and Duke University – but the person that does this is no longer there.

Ramos cross-examination (by Stephen Peters):

207 – Miller does not know if a Foley catheter could have been implanted at the time of the injury.

207-208 – Miller was not involved in removing the bullet. It was not life-threatening but he thinks it was removed first because it could be removed quickly. The remainder of the operation would take more time. They did not change their medical procedures because an agent was present.

208 – Miller reviewed the urinary x-rays. He doesn’t know if other x-rays were taken to determine the course and trajectory of the bullet.

208-209 – Miller cannot say with medical certainty that there are bullet fragments in Aldrete-Davila. He can only say there are foreign bodies of a density greater than bone. They may be bullet fragments.

209 – The suprapubic tube eliminates the problems from pressure on the kidneys, renal failure, and infection. The treatment Aldrete-Davila received in Mexico alleviated those problems and they aren’t going to happen.

209-210 – It’s been 12 months since Aldrete-Davila was injured. Miller doesn’t know why Aldrete-Davila hasn’t had the reconstructive surgery yet.

210-211 – Miller attended a war trauma course at Fort Bliss in 2003, and he was also certified after attending combat casualty care courses in 1994 and 2001. Miller has been trained to treat combat injuries.

212-213 – [Counsel questioned Miller regarding the effect on metabolism from being shot. The Court overruled a government objection. Miller responded:] It depends on the injuries but a person could withstand being shot without going into shock. But the courses Miller took concerned a nuclear-chemical-biohazard threats and broken extremities so this is outside his area of expertise.

213-214 – Miller reviewed some but not all of Aldrete-Davila’s records. The bullet shattered his symphysis pubis, the bony structure that sits below where the suprapubic tube is inserted. There are 2 pubic symphysis in the body. The one that was shattered is close to the midline on the right side. The symphysis pubis is not a small bone.

214-216 – Miller identified DEF RAMOS EXH 11 as a diagram that accurately depicted the human bony pelvis (i.e., just the pelvis bones). Miller used DEF RAMOS EXH 11 to identify the 2 symphysis pubic bones – circular bones near the midline joined by a ligament.

217 – Miller did not know if the symphysis pubic bones could deflect a bullet or alter trajectory, but he could testify that the right pubis symphysis was shattered by the bullet.

Government re-direct examination (by Debra Karnoff):

217 – Miller testified that GOV EXH 89 was x-rays of Aldrete-Davila. [Counsel noted the labels which indicated Aldrete-Davila’s name and Beaumont AMC. GOV EXH 89 was offered and admitted without objection.]

217-220 – Miller indicated where the symphysis pubic bones are on Aldrete-Davila’s x-rays marked GOV EXH 89. He pointed out the broken bone and foreign bodies. One large foreign body was located in Aldrete-Davila’s right thigh. Miller is not a trajectory expert so he can’t tell where the bullet first hit the bone.

220-221 – Miller defined a trajectory expert, from a medical perspective, as someone who studies the anatomy, the injuries, and the location of entrance/exit wounds, and locations of fragments, bullets, whatever. Doctors don’t normally have this expertise.

Ramos re-cross-examination (by Stephen Peters):

221 – Miller cannot express an opinion on the volume or weight of the fragments.

[Witness excused.]

[Bench conference regarding scheduling. Jury dismissed for the evening. Ms. Ramirez addressed concerns about the jurors presence outside the jury area in the hallway and the public restrooms, and the Judge will check into it. There followed an off-the-record bench discussion.]

From Vol. IX:

Witness #8 – Dr. Winston Warme

Government direct examination (by Debra Kanoff):

180-181 – Dr. Winston Warme is an orthopedic surgeon in the U.S. Army practicing at William Beaumont Army Medical Center (Beaumont AMC). He graduated from the University of Colorado and attended the Uniform Services Medical School in Bethesda MD. He specializes and is board certified in orthopedic surgery, and also specializes/practices in sports medicine. They do not have a board certification in sports medicine yet.

181-182 – Warme has been an orthopedic surgeon at Beaumont AMC for 7 years. He provides care for servicemen and women and their families, and civilian trauma. He doesn’t know about other services like rape kits for the FBI, but Warme did care for Osvaldo Aldrete-Davila in March 2005 at the request of the DHS and the hospital commander.

182-183 – In caring for Aldrete-Davila, Warme first took a patient history and then did a physical examination and took x-rays. The purpose of the visit was to remove a bullet from Aldrete-Davila’s leg. Warme was the surgeon that was to remove the bullet.

183 – Warme removed the bullet by making an incision where he could palpate (feel) the bullet. It was very superficial and he removed it.

183-184 – Warme identified GOV EXH 63, a photo of Warme’s gloved finger pointing out that he could palpate (feel) the bullet right underneath his finger.

184-185 – As part of his medical history, Aldrete-Davila told Warme that he had been shot. [Defense counsel objected based on hearsay. Overruled – medical exception.] The bullet needed to be removed because it was bothering Aldrete-Davila and because it was needed as evidence in an internal investigation. Warme doesn’t recall doing surgery to collect evidence prior to this time.

185 – Warme identified GOV EXHS 87 and 88 as printouts of x-rays taken of Aldrete-Davila at Beaumont AMC. GOV EXH 87 depicts the left hip over to the right hip. GOV EXH 88 depicts the same from a different view. [GOV EXHS 87 and 88 offered and admitted without objection.]

186 – GOV EXH 87 shows 3 lead objects that are foreign bodies anterior to (in front of) the femur, so they are in front somewhere. The x-ray is lateral so you can’t tell which leg they are in. Warme removed 1 large object. The other 2 metal objects are fragments from the bullet.

187-188 – GOV EXH 88 is another x-ray in which the patient is on his back and the x-ray is from the front to the back. The large metal fragment is in the right leg and the smaller metal fragments are an area of bone called the pubic symphysis. There’s a fracture of the right pubic symphysis and a fragment of bone displaced by the bullet that hit it. This injury was caused by the bullet:

“A. There appear to be five small fragments just in the area of the pubic symphysis, and one large one in the anterior right thigh.
Q. Okay. And you removed this large one. Is that correct?
A. That’s correct.
Q. And it was — you’re in the military. It was what was left of a bullet, correct?
A. Yes.
Q. A .40 caliber bullet?
A. Yes.

188-189 – Warme examined Aldrete-Davila. The bullet entered his left buttock and traveled directly to the pubic symphysis bone. The bullet was deflected when it hit the bone.

189-190 – Warme removed the bullet and gave it immediately to C. Sanchez, who was standing next to him in the operating room. Warme’s part of the surgery was unremarkable.

190-191 – Aldrete-Davila’s most significant injury was to his urethra [indicating on GOV EXH 87 or 88]. Warme can’t tell if the injury to the urethra was due to the bullet or to a bone fragment, but it was from the gunshot.

191 – Because of the injury severing the urethra, Aldrete-Davila sustained an injury that resulted in “protracted loss or impairment of the functions of a bodily member or of an organ.”

Ramos cross-examination (by Stephen Peters):

192 – Referring to GOV EXH 62, Dr. Warme identified the entrance point for the bullet in the left buttock.

193 – The bullet entered on the left-hand-side of the body and hit the bone on the right-hand-side of the body. After fracturing the bone, some of the bullet fragments stayed there and the bulk of the bullet went into the right thigh.

193-194 – Bullets travel in a reasonably straight line. The path the bullet took from where it entered [in the left buttock] to the pubic symphysis bone was straight. However, then it went anteriorly (to the front) and laterally on the limb.

194 – The position of the leg could affect where the bullet winds up.

195 – Warme can’t tell how much the bullet was deflected.

Q. From the left hip to the right pubic symphysis is a line that is not only front to back, but also sideways across the body. Is that correct?
A. Yes.
Q. In other words, from that evidence, would you say that the bullet was fired directly into the back of the person who was shot, or was it fired at an angle through his body?
A. Well, his body was on angle to the bullet.

196-198 – Bullets travel in a straight line. This bullet entered in the left buttock and went straight until it hit the pubic symphysis, where it deflected after hitting the bone. That means you can tell the angle the bullet was traveling based on the path from the left buttock to the pubic symphysis:

Q. Well, if you were to draw a line from the pubic symphysis through the entry wound — right?
A. Uh-huh.
Q. That would — that would be an angle that would go off to the left there, correct?
A. Correct.
Q. And if you drew that line, eventually that line is going to go to where the bullet was fired, correct?
A. That’s correct.
Q. Okay. So what — you would agree with me that the bullet that the shooter — that the person who was shot was standing at an angle to the shooter, that would be reflected by the angle from the gunshot wound to the right pubic symphysis?
A. Yes.

Government re-direct examination (by Debra Kanoff):

198 – Warme can’t tell from the bullet’s path where the shooter was standing. All he can only testify to is the angle of the bullet inside Aldrete-Davila’s body.

198 – It’s possible that the angle is consistent with the person turning and being shot. The shooter would have been right behind the person shot.

Ramos re-cross-examination (by Stephen Peters):

199-200 – Warme clarified to say that the shooter would not need to be right behind the person shot. He would not need to be close, and he could be at an angle. It would depend on how much the person was turned, if he was running and the angle of his leg.

Q. Right. So what you really just mean is that the shooter is facing the rear of the person at some angle?
A. That’s correct.
Q. And you can’t tell what that angle is?
A. I can’t tell.
Q. And this is consistent with a person turning around and pointing back at the shooter?
A. I said that’s possible.
Q. You can’t rule it out.
A. I cannot rule it out.

202-202 – The Judge inquired whether the person who is shot can turn and have his leg extended at the same time. Warme responded that he needed to clarify the term “extension” of the leg. In medical terms, extension means to go backwards. In common language, extending you leg means to go forward. Warme testified that for the bullet to end up in Aldrete-Davila right thigh, he would have had to extend it forward in the way we commonly mean that term, not in the medical sense:

THE WITNESS: So what I meant was, yes, it would appear that the leg, if it was extended to the front, it would have allowed the bullet to end up where it ended up.

204 – [Witness excused.]

204 – [Jury excused for the weekend.]

204-205 – [Bench conference regarding defense request for a memorandum from Supervisor Karhoff to Agent Christopher Sanchez referring the Aldrete-Davila matter for investigation. Karhoff is Rene Sanchez’s BP supervisor. The government, Ms. Kanof, indicated she would produce the memo without an order.]

[Court in recess.]

16 Responses to “DRJ Pores Through the Border Patrol Trial Transcripts — Medical Testimony (Vols. VIII and IX)”

  1. Thanks for all this, DRJ.

    Let me talk a little about what trajectory evidence is and isn’t good for.

    Scenario 1: Lady MacBeth says she shot Kermit the Frog five times because he was coming straight for her. The trajectory angle shows that the bullets entered the back at a 66 degree downward angle.

    That strongly indicates that Kermit was lying down, face down when shot. Lady MacBeth is in a lot of trouble.

    Scenario 2: Dr. House says he was chasing (slowly) Dr. Evil. House says Dr. Evil began to turn back to shoot House. House fires three shots and drops Dr. Evil. The bullet enters clean through Dr. Evil’s back, no sideward angle, 20 degree upward angle.

    Dr. House could easily be telling the truth. Things change very fast in shooting situations; when someone turns to shoot you and you’re prepared to shoot back, they might think better of it and turn to keep running; by that time the reaction to the initial turn has set in, those shots are headed out.

    I haven’t any comment on the trajectory evidence in the instant case, but this is a tricky area; sometime trajectory absolutely shatters a story, other times apparent inconsistencies are not so inconsistent.

    –JRM

    JRM (355c21)

  2. JRM,

    That’s interesting. You’ve piqued my interest because there apparently is the issue of anterior and lateral movement in this case, although we don’t really know if that was due to the bullet’s path or the deflection. But as I read the testimony, it’s not accurate to say Aldrete-Davila was shot directly in the back since the bullet entered the left side of the body and went straight to the right side of the body. I think the testimony means that Aldrete-Davila had to be turned sideways to the shooter or moving in a way that left him angled toward the shooter. It also seemed clear that Aldrete-Davila’s right leg was extended forward as if he were walking or running.

    If so, this testimony helped and hurt both sides.

    Obviously, I don’t know much about trajectory. All I know is what I’ve seen on TV or read in the Bone Farm-type fiction, so basically I’m ignorant on trajectory. It was interesting that the doctor wasn’t able to provide much trajectory information, either. Maybe he isn’t really a trajectory expert, or maybe the length of time between the injury and this surgery interfered with the doctor’s ability to express an opinion, or maybe it was because his part of the surgery was of minimal invasiveness and limited his opinion. It might even be that you can’t make an effective trajectory analysis on a live patient the way you can in a post-mortem.

    DRJ (605076)

  3. This testimony is hard to decipher without the exhibits.

    Throughout the trial, none of the attorneys does a good job of describing, e.g. witness demonstrations of things they did or saw others do, where witnesses are pointing on exhibits or even describing beyond barest details what the exhibits are. Nor does this judge tend to jump in to make her record as complete as possible.

    Without more information about what “left side of the buttocks” mean, the significance of the trajectory testimony in the TX is difficult to gauge. Is “left side” to mean two inches from center? Three? Four? Five?

    Even with this information, what does it mean without knowing exactly where Aldrete was on the vega when he was shot? Was he running straight or at an angle? And without knowing where Ramos was on the levee or vega [testimony varied as to whether he was shooting from the levee or the vega] it’s still not too helpful.

    Tracy (b404ed)

  4. Trajectory analysis from a wound of someone scrambling down a levee, around boulders and shrubs, and across a river, all the while looking back to see how well he’s escaping … should be considered barely more scientific than voodoo.

    Wesson (c20d28)

  5. Tracy, I agree with it’s hard to visualize a lot of the testimony without being able to see the exhibits.

    Wesson, that’s obviously true but it was my understanding that Aldrete-Davila was shot on the grassy vega. That should be a more level surface than the drainage ditch and levee, although I realize trajectory would still be difficult.

    DRJ (605076)

  6. “…Aldrete-Davila was shot on the grassy vega.” I have never heard “it” called that before. 😉

    Seriously. Incontinence and impotence at age 24, with no guarantee that it will not be permanent, and the danger of worse complications, is a very strong reason for revenge, even to the extent of committing perjury in order to put the people who shot you in prison.

    nk (2ab789)

  7. “…the grassy vega. That should be a more level surface than the drainage ditch and levee…”

    I’m speed-reading through the TX because I haven’t nobly volunteered to summarize it for the interested public, so I can tell you that when you get to either Compean or Ramos’ testimony, one of them says that he couldn’t tell whether Aldrete was walking slowly/limping because the ground was so uneven – I think it’s even plowed in places.

    Tracy (b404ed)

  8. Thanks, Tracy. As you said earlier, it’s hard to get a feel for this area without access to the exhibits. Of course, the prosecution made a point of putting on evidence that the area between the levee and the river (the vega) is US government property. Maybe the government has leased the land for cultivation to the area landowners. It’s not unusual to find government surface leases in New Mexico but I don’t know how common it is on Texas lands.

    NK, I’d like to see you try a case. You have a fine eye for substance and detail, and you never miss a thing.

    DRJ (605076)

  9. 7

    There was testimony by one of the other agents who arrived after the shooting that OAD was walking abnormally on the Mexican side before he was picked up and that the other agent thought at the time that this was because he was crossing a cultivated field. I don’t remember any such testimony about the vega on the American side. As someone mentioned you can find satellite images of the shooting location on google maps. The resolution could be higher but you can get some idea of the area.

    James B. Shearer (fc887e)

  10. 6

    Staying out of prison is a strong motive for perjury also. I didn’t find the convicted agents testimony credible.

    James B. Shearer (fc887e)

  11. James is right. I do think that the testimony that the ground was plowed was with regard to the other side of the river. And I think even that somewhat dated sattelite image shows that.

    And we’re not there yet – summary-wise – but I didn’t find the agents’ testimony credible either.

    Tracy (b404ed)

  12. DRJ #8,

    Thank you for the compliment but more importantly thank you again for your hard work on this.

    nk (79f144)

  13. I haven’t read the rest of the summary but I have been involved in a number of cases involving trajectory. The x-rays will give you a good image of the trajectory and the entrance wound, the trail of bullet fragments and the bone injury give one line. The bullet then ricocheted into the opposite thigh. I was once involved in a trial where an outraged (and armed) husband found another man in bed with his wife. The husband shot the other guy with a shotgun. There were two versions of what had happened. Amazingly, the husband’s defense was that he shot the naked man in his wife’s bed in self-defense.

    The defense lawyer contacted me and I told him that, if he brought a skeleton to court, I could put a cardboard tube in the pelvis (The injury was very similar to the one in this case but worse), that reproduced the path of the pellets. He could then put the skeleton in the position alleged by the shooter. If he could stand with the gun in the position the defendant said he was in, and sight down the tube, he could support the possibility of the story.

    That’s what he did and the defendant was acquitted. Sounds like the agents (I haven’t read their testimony) should have had the lawyer from my case. The description of the bullet line does not sound like he was shot from behind while running away. Maybe he was turning to run. With the x-rays and the entrance wound, you could reproduce the relative positions. In my case above, it was a shotgun, which will also give you distance from the muzzle from the diameter of the shot pattern.

    Mike K (416363)

  14. Mike K,

    I like the cardboard tube idea. It’s something a jury could see and I, as a reader, can visualize to understand this better. It sounds like that lawyer was lucky to have you as a consultant.

    As I understand it, the evidence is consistent with both the prosecution and the defense version of events. The government can argue that Aldrete-Davila’s right leg was extended because he was walking or running. This is consistent with testimony that Aldrete-Davila was running away. If Aldrete-Davila was shot at an angle instead of straight in the back, it undercuts the government’s argument that he was running away but only slightly, because Aldrete-Davila’s body angle could have been caused by the terrain or because Aldrete-Davila looked back to see if he was being chased/shot at.

    The defense can argue the evidence is also consistent with its version. If Aldrete-Davila was turning when he was shot and if he had a shiny object in his left hand, turning to the left would make Aldrete-Davila’s left arm/hand and the shiny object more visible to someone standing behind him. It’s my understanding that Compean claimed he saw a shiny object in Aldrete-Davila’s left hand, so this angle supports that claim.

    DRJ (605076)

  15. The thing about medical testimony in a case like this is to make the defense or prosecution scenario possible. Most of the rest is lawyering. I have spent hundreds of hours testifying in civil and criminal trials and the lawyering usually decides the case. One reason, of course, is that obvious facts generally result in settlement or pleas. That applies to med-mail just as much as criminal trials. I hope every young lawyer has read Anatomy of a Murder, the book was better and subtler than the movie. The author was a Michigan Supreme Court Justice.

    Mike K (6d4fc3)

  16. I think the testimony means that Aldrete-Davila had to be turned sideways to the shooter or moving in a way that left him angled toward the shooter.

    Compean testifies that Aldrete was running away to the left at a 45 degree angle.

    Tracy (b404ed)


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