Aclu Military Prison Death Reports Part10
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ARMED FORCES INSTlnrTE OF PATHOLOGY 0I!ke oftll' Armed Forca MediClI E:IlIIIIIII~ 1413 R~h Blvd.• Bld&. 102 Roc:kvilte. MD 2OBSO 1·301·319-0000 'INAL AUTOPSY REPORT Name; Abdulbrim. MohlllJlfDed AIlWI!' ISN: (b)(6) - Otic OfBlrth.:%)fJ) -1976 Dlte or Dc.th: 2007 DaleofA~y: 3 Mliy 2007@12oo Dale of Report: 23 May 2001 AUlopsyNo.: 1(b)(6) ~ AFIP No.t~(§) ---.J Rank: Detainee Place of Death: Irllll Place of Autopsy: PO" Mol1\lar}' Dover AFB. DE CiralllUta!lca o(Dat,,: This 30 )Ur-old lraqi detainee was reportedly disc:oveml by odJcrddlinea: unraponsive and suITerinB from multiple sharp and blunl fon:e injuries Alltboriuoflo., (Dr Alltopi)': Office ohhe Anned Fon:es Medical Exarniner, lAW 10 USC 1471 Ideatillc:alioll: Presumptive identif~ is established by internmenl serial n\llllber. Post-mortem fiJ!3erprinU and a spec:illle.llUilable for DNA analysis -e obLlined. CAUSE OF DEATH: MANNER OF DEATH: MEDCOM 0895 ACLU Detainee DeathII ARMY MEDCOM 895 AI1rQPSV REPORT (b)(6) AbdllllairilD, Mob.mmed AD".r FINAL AUTOPSY DIAGNOSES: I. Sh." A. 2 , .ad Billal Forft lajllrle.: lad.ed "ouad or the left dlUI I. Wouad ch....cterlsdell: % K 1l8-iacb leaatb, ODe .ad ooc blunt edle, "ltIl ....ppro.lm.Ce deptb 01 Jtraetndoaal Y.-iGeb 2. laju..,. Co: Skia .1)CI.ubnltueo.. tlilue 3. DlrecdOll: Froolco back, "ltbolll.lpiftc:lloClcftlripC or upldoWft dcv"tloo <t. A....oc.. lcd laJuritl: HeDlorrtl..le .10111 the "ou"" p.tb .1Ia" B. St.b "ollad oflhe Itft ebelt: I. Wouod ebaracterblla: 11JlxlJ8.lacb lea(l'" OIle .ad ooe blont edp:, "ICb.1I .pprodm.te depch olpeoetnltioa ors *-Iaeha 1. lajury 10: SkiD, 'UbcaIallCOWi duue, left .aCeriar]'" unereDlll.1 sp.ce, perlcllrdllllD.left """,cride (3-lnu derect), periclrdluDl, left lowfit' lobe ortbe Iuol (lwo ddeeb, clcb I '1..1neh), kft pottcrillr -r' Iotm:o.tal.p.cc l. Dlreetloo: Frolic 10 back lod downw.rd, wltbolll aip.IIkInt rllhllleft dcvlltloa <t. Auod.Ccd lajurle.: Ltft heDloUioru (500 1Il1), IIIceralioo 01 lIIe dbtllltft IOlerior dClaDCU.. coron• ..,. .rt«y C. Stab wOllad o!tlle left Ch"l: Wouod ch....cCCI'lItkt: Z ~ x IJI..lnch Jclllfb, oae .b." ...d oae blual celie. wilh.a .pproxlm.Ce deplb orpeaeCralioll 016Inches Z. laJury to: Ski.., ..bcUC,"eolU tlsaae,lcfl .nlerior]'" Ialc:reOltai .puc, pe..x.rdillm, left "tIItrlde (I 1I4-laeh defect), peTlcardiUDl, left hemldllophrap' (l-llleh ctclecC), left lobe orlbe liver (1 ¥--'ach derccl), .tom.c' (Ia-Iocb derect), left poIlenor SUO Lalc:rrottll.pace J. D1rectloa: Froat to b.ck .ad dowaw.rd, wlCbou' .lplflelaC ripllld'l deviation 4. As$ocl.lceI laJurla: Left helllolborax (500 .. I), "ccralloa ollbe dbtilieft .nCerior d_diol conm.ry .rtery .ha" 1. D. SI.b wound orcbe rip! apper qll.dl'1lllC of the .bdomttl: I. WOIIQd t:b.ruterbcla: I ~ K1J1..lncb lea&tb, one .harp IOd one bluaC edit:, wllb III .pprolim.le depth orpeoetnttoa or I In:-tacbet 2. 1-.llIryCo; Skia nd .llbcatlllCOUl tiIIue 3. Direclloa: FroalCo back. wlcboul.lpfieaoC JcftIripc or apldowD deviation <t. ......odllCed Injuria: HeDlorrtl..ge .Ioallh~ wOllad p.lh MEDCOM 0896 ACLU Detainee DeathII ARMY MEDCOM 896 AUTOPSY JlEPORT (b)(6) A.b6IIlkartlDl, MolI....ed AJl.ar E. 511b _,Id ofUle len IIpper qlladn.' oflb lbelOIDeIl: 1. WOIl.' tb.t1lderiltia: I Yo II: 1.JI..u.e~ kqtJl, Mle IUrp and ODC blaal edCt, wllb I' IpproJ:bBlte depl!l ofpeattnliotl of4'-dlell 1. IIJury 10: 51tln , luballl_llIlluue, olleulalll, ptIDU"CU (I \0\latb tkfctl), II_'e"., dell I~ IliaC tololl 3. Dlrtd!oll; '1'01I110 buk, wkbolll Ilplficllll IdlIript or lip/dow. 'e'rUItion ... Auotlaced luillriel: HemorrblCC Iiollc,lle wOlllld patll F. 81ul1 force I.JaM oflb.Ile••: I. Lac..... tIo. riC'u "Rbe", I I4x \4-I.eh, wllb HfTIIUlldlaC Ibruloll, I Yo II: Yo-Iutb, III' toutlllloD,'. I Yo".II:lIel1 :t. Lat.nticNl riC1l1 lIppereyeUd , Ixl18·lacll 3. PttKlllaillemomacc. ripl eye 4. COllllllloa rlpl preauricular lrea, 1 Yo. 1.lutb, wllb ulld.rfyla11 II: I \4-Iadl defect oftbe "lIporal.kull wilb fracture of lite lipllcJlpotlll baale 5. Stellale lateratioaleft parietlllt.mponlltlllp," I: up to 3lutbn, .itb uud.r1yluC3 x 1-ludl d.fect of Itr.e tcmpof1ll. Ikull wltb mulliple tbdurea If lb. left lemporal bOil. 6. CODtullOD left Itmpo...IKIIlp , 3x :t·ladlct 1. Abrallolll.ftear,II%·llltb 8. "lace fracluru (2) ofUIe a.lerior Illd middle craalal fonae ,. Mailipl. fradura oftb••pbeaokl boH 10. Frac:Cu" of IIII richc Z)'lOm.. rich' orbit, lad liplDI..1boae II. Fradu" of III. kft zypIlll and left muml". .fa... 11. Dltr\u••ub....tboold be1norrllqe II. Addllklalilajuriea A. COIlhl.Io., left .pper alnJlky,' ""lacbes B. Abrallo, alld tolllllJiou, Jen lower IlI:lnmlt)'. nllpac from II ~ iDell I.... 1 'h-tucbes 111. No .lplnealla.hanl.beda Id.adrlcd wilbia tile IImllltiou of tills .ulol")' V. I'eadl'yluc .Im.r 1I1t_: A. Scan 01 Ibc ripl.lde II.Ild .!.dlme offbe llIdomlD, riabll... I l l ' Idt ..rictll.Cllp B. Tlltoc(b)(6) MEOCOM 0897 3 ACLU Detainee DeathII ARMY MEDCOM 897 (b)(6) • AUTOPSY REPORT AW.allut. . Moballl.~ Aa"lr VI. TOllko)oc (AFIp): A. Volltilet: No dUDOI ill ddedlNl Ia. th_ blood lad Yl,reou fluid B. Dnlp: No tel"«Dcd dnap of.b_ OT IIIlN1latiou." fOQad IQ tile ...., C. ea.... M_dde: 11Ie cal'bollyllellloaJObla ..hlntioa la tbe Wood O. .1% eylalde: No C)'IDIH" ddcdcd III tile blood EUEBNAL EXAMINATION The body b thol or. well-de.....:loped, well-nourished Ippeuina. 67·i/lch till. 19S·pound Middle Eutem mole whose Ippeonnce is consistent with the reported lie or30 yean.. Lividil)' is on the posterior 10rso and fixed. Ripis JlUSina. and the ter1lpel'It\n illhII ohlle refriserotion unlt. The ICI.Ip is covered with 2·ineh lona straiiht brown hlir in a nonnoI distribution. There is a I·iach sear on the left parietll SClip. F-=ili hair COlISists ora mollS!lChc lind beard. The irides 11K brown, the comcae 11K cloudy, the rilhl OOnjuncUVi ' - peteehili hemonbage. the left coqjWK:liVi is pile, the Kienle 11K while IIld the pupil' are roWld and equal in diameter. There is blood in tile left exlcmll auditory canol. Th, ri&ht CXIeTtIII.uditory CIIIIi iI cl..... The earl are not pim:ecl. The IIIIU Ire pllent. The nose and ITIIXiIlIlC are ~pably stable. The teeth appear J\lltun.lllld In r.ir condition. with some IIIO~ lIliss.illlThe ned: is straight, and the trachea is midline and mobile. The ehcst Is symmetric. The .bdomcn is soft. and slighdy protubefant. 'fbc:ft Ire two ~ineh scars on the risht side of the abdomen and. 9loS-ineh __ on the midline of the llbdomen.. The lenltsJllln:! tI'IMc of.llOmlI1ldult male. Pubic t-ir is pracnlln • nonnaI distribution. The bunocks IIld MlI! are W'U'CI'lWbble. The~.and lower ClItremities are mnmetrie and witbout elubbina orcdc:ma. There is a tanoo (b)(6) Plcue refer to the evidence of injury section for inj\ll'}" 10 the Iadllld 1onO. CLOTHINC AND PERSONAL EFfECTS The (oIJowina clodlina ilems and pa1OI'lIl dfeds are pment on the body II the time of IUtopsy: • None MEDICAL ImRVEl'I"IJON • None RADIOGRAPHS A oomplCle tel of postmortem • mioJlWPhs is oblIincd and dcmonmates the followilll: Skeletal trIWN IS described bcJow MEDCOM 0896 ACLU Detainee DeathII ARMY MEDCOM 898 • l EVlpENCE or 1NlURY I. Sharp and Blunt Foree Jnjuriel: A. Incised Wowxl of the Left Chest: On the left chest, Ioeated IS-inches below the lopofthe he.<! and cenlcnld 2. inchelleft of tile Ulterior midline, is an incised wound wbidJ measwa 'I. II IIIinch after re-Ipprollinwion. This WOUIld is horizontaIlyorienled. The medial end II blunt and the I.ten! end is sJwp. The incised wound pc:netl'Il.CS wnw subculll'lC<lll5 lissue. The wound pllh is direeted frontlo t.ek, wilhoul aianifltlllt left/riiht or up/down deviation, with an Ipproximate depth of pc:nctntioft of ¥tinch. AaIocialed with the incited wound is hell10tl boIgc alo", the wound palh. 8. Slab Wound of the Left CheSl: On the left thc!t.loeated 16 \4-inchcs below tbe lOp ofihe bead and centeml)· indies left of the antmor midline, i$ a stab WOUlld which ITItUIIrQ: 2 III. 111illCh after ~Ipproximalion. This wound is obliquely oriented llona the 2 o'clock axis. The. o'clock end i. blunt and the 2 o'cloek end II sharp. The II.Ib to' wound penetralCs skin, subcutaneous tissue, \he anterior left 3" intCl'OOSlal.pIC:e, pericaRli~.lcft ventriele oflhe hwt (J-inch def«l). pericanllwn, lower lobeof the left IUIIj (two defects, eac:!l 1 y..inch), and the posterior left .,. intefCOSlfll spIK:e. The woond palb is di~ front to t.:1r. and downward, without significanllcftlrig,hl dcv;lItion, with an lpprOJtimate depth of penetl'1Ilion of .s ~ iaches. As:Iociatcd with tIx: stab wound is left hemolhorax (.500 m1), tralUeClion or the disW left ~lCriordeseendina corollll)' ltlcry, and hemorrl1aJe alona the .......... C. Stab Wound orthe Left Ches!; On the left cbest,locatm I?-Inches lielow the lop or\he head and centerod ) %inches left orthe ~terior midline, is a JIab wound which measures 2 V. x III-inch after re-ilpproximation. This WUIIIld is horizontally oriented. The medial end I. blunt atId the Iala-al end Is sharp. The Slab WOUlld penell'llles skin, I\lbc~ tiuue,!he anlerior left)" inten:osW spece, pericardium,left ventricle orlile bean (l 114·inch deJed), perieardium, left hemidiaphtqln, left Iolie or!he Iiver(2 Yo. inch dcrcet), IlOn'\lll:h (l12«reec). and the posteriM left lOll inl:m:osIa1 spKe- The wound path is dim:led fronlto blcll and downwwd. withoulliardflellll Jd\friaht deviation, with an approximate deplh or penetration or 6-inebel. Associated with !he slab wound is left hernothoru (500 m1), tnnIoction orlbe distal left ~terior deseendins COI'Onary Il1ery, and lIallOlThale a1oo& the wound pmh.. D. Stab Wound orthe Abdomen: On the riihl upper qWldrant orllle: abdomen, located 2-4-inchcs below the top or the held and centered 2·inchcsright orthe ~lCrior midline, is. JIab wound which mC6l\ll'el I Yo x III-inch after rc-approximatiOll. This wound is obliquely orienled aIonl the 2 10 I o'clock axis. The 8 0' clock end is b1unl and the 2 0' clock end issl\arp. The mb wolUld penetrates tllbl and subculaneOUS lissuc:. The wound p8th Is dltKtcd frantlo bKk withoulsipUfican! upldown or Ieftlriahl MEDCOM 0899 ACLU Detainee DeathII ARMY MEDCOM 899 • A.UTOPSY RUORT (b)(6) A.bdlllkllri., Moba• • ~ AaWIIr d~iation, with IItl llppIOXilMlc deplh of penell'lltkm of I ~inches. Associllted with the stab wound is hetnort!Iqe: ilion, the wound path. E. 5ab Wound of the AbQr)mcl1: On the ~ft upper qulldrant ofthe Ilbdomen, IoeIItcd 24-incbc$ below the IOpofthe belld lind eent~ 2-inch" lell. of the anterior midlinc,1s a,..b wound which measures I % x III·inch after re-apprmilMlion. This wound it obliquely oriented along the 210 a o'dock. Dis. The. 0' clock. end is bl\lllt and the 2 0' clotk end is JIwp. The sIIIb wound penctntes skin. SUbeutllllCOllS tissue omentum, fIIIll=85 (I Yrinch defe~t). mesenlCfy anddcscmding colon. The wolllld path is direeted front 10 bKk without signlf)Callt upldown or Ieftlrighl deviation, with an IJIIlfO'ldmIIIe deplh of penetration of 4-inl:hes. Associated with the Slab wound is hell1Of'ttlale llIona the wOUZId pa\h. F. BIIlI'lI Foree Injuries of the Head lind Extremities: The:re I, alacen.tion ofthc right ,ilk of the forellClld, I Yo x %-inch, with a surroundln, c:onl\lSion, 2 x I Yrinche:s, and abruion. I K x Yrinch. Then: i, a laccntion of the upper righl eyelid, I x III-inch. The:re is a contusion of the risht pm.uriculll' aru, I K x l·indl, with 11II underlyina2 II I V.-incl\ defeet of the tempotal bone with fnlctwe of the tempon.l bone. There is a stellate t.omtionof the lett pariel.lL'lemporaillCll1p," x up 10 ]·incbes, with 11II underlyi.. 3 x 2· irdle:sdefccl of tile temporal bone with multiple n.ctures of tile lemp<n/ bone. Then: is a contusion of the left temponl Jt&1p,] x 2-inchc:s. There is 11II abraion of the left car, I II '/..indl. ~ are binae rr.ctW'Cs of the anterior lind middle ClaIIW fossae. Then: ~ mllltipJe hctures of tile sphenoid bone. nen: we multiple billllenll facial fnetures. llsere i. difMe sublll8ClInoid hemonhlge. There is a conlllSion oflbe left ann, 6 II 4-inches. 'There is an abrasion. ] x I-inch, lind conlllSions, ranaina fi"om I x Yz.lnc:b to" x 2 Yrinchcs. of the left lea. ImBNAL EXAMINATION HEAl> See "Evidence oflnjwy". The 1330 gm brain has unremarbblc gyri lind sulci Coronal lCCIionsdemonslnle slllIlJI demuulion between white and grey maner. The ventricles .e of nonnaIlizc. The buII1 aan<.. brlinstem, cerebellllJrl, and llI1erial systems ~ fm: ofinjwy or other non-lrallllllltic abnonnalities. lfW" The thyroid eartilqe and hyoid bone ere IIl\KL ne larynx i, lined by inlaCl white mllCOA. The thyroid aIand II; symmetric and rcd-brown. without cystic or nodular change. The toniue i. fTec of bite rrwb, hen.... ,I..e, or other Injuries. BOOr CAyITIES: See -Evidera::e of Injul)'~. The ribs, stmlllln, and vertebn.J bodies IIl'C visibly and paI... bly inllCL No excess nuid is In the peric:.dial or peritoneal c:lvities. 1be oraOCCI.lpy their \lIlIoIII .....tomic positiolll. MEOCOM 0900 ACLU Detainee DeathII ARMY MEDCOM 900 AUTOPSY RUORT (b}(6) 7 Abd.11wia, Mou• • cd ADlnlr RfJiPIRAIOR'f SYSTEM: Sec .. EYkb..... ofllVury". The riiht aad left IUlIiS weijh 410 and 240 am, rcsptetiVilly. The llllinjuml extmll! .wfeca are IIDOOlIlIllld deep red.purple. The uninjured pull11OMl)' pII'endlyma i. modenltclYeonaesUd and edemalOUS. No areas of COnIIllidatIon are fJRSCl'It. CARQIOyASCULA8. SYSTEM; Sec "Evidence of1rliUl')'~. The heal1 weiJhs 320 am. The unil\iuml epicardial SU1face is ImOOIh, with minimal fat investmenL The uniDjuml COfOn&f)' II'leries are present in a nonnaI distribution, with a riatu-domillllU penem. Cross sections of !he vesseb show 110 I\heroJCI~i •. The uninjured myocardium II homogenous., red-brown, and finn. The valYe leat1ecs are thin and mobile. The uninjlRd endocardiwn issmooth and alislenini. The.ma aiYd rUe to three iruact and pllent areh vessels. The n:naI and ~ v_I. are Illvemarbble. LIVER I: BIUARY SYSTEM; See MEvidenceofInjUl')'''. The 1900 am liver has a smooIh eap$U1e and a shup &ntt:rioI" bonier. The parenc:hym.a is t&n-brown llIld cons: lted, with the lISUal lobular an:hitecbn. No ~ lesions or other l\On·lrlumatie abnormaiitiClIn: seen. The pUbladdet conlliN S ml ofareen-black bile and 110 stones. The mucosal surface is areen and vdVdy. The extrahepatic biliuy uee is patml SPLEEN: The 190 am spleen Iw. smoolh, inlxt, rcd-purple <:lpSUIe. The pwendlyma is l11lI'OOll and eongested, with distinct Mllpighion 0DrpllX1es. PANCREAS: Sec MEvidence of Injury". The uninjured plIlttellS is linn llId yel1ow.1&Il, with the lIJUlI lobular orchitectwe. No m,," lesions or other non-lJ1wnotie abnormalities are ,wen. ADRENAl S: The right and left adrenalillands: ore 1)1M1etri<:, with briallt yellow cortices IlId Irq mcdulroe. No muses or areas ofllemontlage lie identified. GENITOURINARY SYSlEM: The riaht lI'ld left kidney, weish \\0 llId \20 gm, respectively. The extemllllW'fllCes of the kidneys are intad IlId smooth. The cut turfa<:et are rtd·llII and conJeSled, with unifonnly thkk cortices and sharp eortk.omedullary jW1<:lions. The pelo,a are unmnarbbIe and the utelel'S are normoI in course and caliber. Grey_pink bladder . I1UICDIM overlies on. \nIll:t blodder _II. The bll4lkr contolns 100 ml of clell' ~llow urine. The prostate i' nonnaIln s1Je. with lobu", yellow-ton pImldlyma. 'The sc:minol wsicles.e WRnWl<oble. The lestes are flft ofmus lesions, contusions. or other abnonnllli1ies GASTROINTESTINAL TRACT: See "Evideneeoflnjwy". The esophqus is intoe:t ond lined by smooth, grey-white m\,ll;lO$L The $iOmKh eontolns lppfOllimIlely 100 ml ofduit &reen materiaL The MEOCOM 0901 ACLU Detainee DeathII ARMY MEDCOM 901 AUTOpsy REf'ORTL(b){6} ~ AbdlllkllrU:l, Mohmmed AD...., • ,....•. duodenum, loops ofsma!1 bowel and uninj~ toIon are wuerrwbble. The IIppendill is MUSCULOSKELETAL SYSTEM: See "Evidence oflnjury". There are no non·traumatic bone or joint a'ooonnalities. Skeleu.l muscle development is 1IOmIaI. ADDITIONAL PROCEDURES • • Documentary photographs are wen by OAFME stafl'photographen Full body radiographs are obtained • Specimens retained for toxicologkalleSling and/or DNA identification are: spleen, liver. blood, !min, bile. urine. gastric contents, vilrCo\lS. psoas m1lSlCle, adipose tissue, luna and kidney • The dissecld orpns are forwarded with body. • Seleeted portions oforgans are retained in fonnaJin, without prepaRtion of histolosicaJ slidn • PetmIUIl effects are released to the appropriate mortuary operations tq)l'CSmtllives OPINION This 30 year-old mal,(b}(6) ldied ofslwp and blWl\ force injuries. Slab wounds of the left ches1 (8) and (C) Injumt the hean and Ie!\ lung. resultina in massive bleedinl into the left chest cavit)" and also injured the liver and stomach. StabwoWld (E) oflhc left upper quadrant oflhc abdomen injured the omentum, mcsemery. pancreas and large bowel An incised wound (A) of the left chestand stab wound (0) of the nshl upper quadrant of the abdomen did nOl injllre vital stnICtures but contributed 10 ovel'llll blood loss. Blunt force iJliuries of the head resulted in dilTux bleeding on the surface of the min and multiple skul1llld facial fractures. including two hinge li'actures. Toxicological testinl for ethanol, drugs and cyanide was neptive. The CIllboxyhemoglobin $lIturation was I%. The manner ofdeath is homicide. (b)(6) (b)(6) (b)(6) Medical Examiner ~(bij)(~6~)=:JIJ««edlcaf£iim"-iner=-- MEDCOM 0902 ACLU Detainee DeathII ARMY MEDCOM 902 • _._. __._" --- ~ AbdIA8Ih. _fI'._~ -- -- ~oIIl_ Mo/WnWNd. IvffIw . - ----. JI'l. ,,1 ~- I''I ;"";i"" - "" (b){6) Ol- .-• ..'- -.---_.- -_.._-- -- -- -_. - - .. ---_ -- .--............... _ .. ---_ .. _---. _ ..----",,--.._ . _.._-_ ..-.-='" 0 ..... " . . _ _ ..... _i1WIM -;-' --",.-_.. -- ---_01"-_' . ,------' _.- _. -• . • 7 ~c""'='''-'-- •• ----:= • =" b 6 (bl(6) _........_-- - -_-... 0- = . . . . (l:!1(6\ l(b){6) . I. ~, [:~: . ~- ,...,.2iID1 ----_... _ -.......- .--2001 {b)(6j:S/$'2007 _.~ • , eo-~ DIllOw_DE (b}(S) ~ _.-. _. -.- I ~ . _... MEDCOM 0903 ACLU Detainee DeathII ARMY MEDCOM 903 . .~ .. ARMED FORCES INSTITUTE OF PATHOLOGV omee ortlae. Arllled FolUll Medle.1 EII..lan 1413 Resean:h Blvd., BId,. 102 Rockville, MO 201SO 1·301·319-0000 PINAL AUTOPSY REPORT Name: BIB Mmlld, KIII'WM MuhImmId AJi ISN:.lb~(6) I l {b)(6) '1980 Autopsy No.:"",,'"'"__, APIP No.: (bl(S) DllcofDcathlib)(6) 2007 o-c of AlI1opsy: 13 Apr 2007@ 1200 Place of Death: Inq P1ac:c of Autopsy: POI1 Motn.-.y Dale ofRepon: 19 June 2007 Dover AFB, DE o.tc ofOirth Rank: Detainee Ct~III1lII.aees of Dhltll: Thil 26 )Ur-old Il'Ilqi 6elainee was rowd WII'CSpOIISivc by other detaiDtel mld subsequently ~moved from Iife-suppon4 days \&tu after rnedk:aI inten'elliion. Aulboriudo. f.r Autopt)': USC 1471 orrlOC: oflbc: ~ ForteS Mcdieal Examiner, lAW 10 -- IdeotU1CllIioIl: Presumptive identification is CSlIbIiJhed by I wrist identifJqltion bMd. Poll·morltm Iinaerprin~, dall&! QAlllination. and. 5fXCimen suillble for DNA analysis CAUSEOPDEATH: Ldt Yhltrkular Hypert~pbywith Foul S.budocardlal h,lenttttal.ad Rqll.eaaall J1b,.... MANNER OF DEATH: MEDCOM 0904 ACLU Detainee DeathII ARMY MEDCOM 904 ::==J AUTOPSY REPORT (b)(6) Mahlllud, KarwaD Muhammad All 2 FINAL AUTOPSY DIAGNOSES: I. No evldm« of .Igolficut receot Injury II. E"icIeo« or Datunlll disease: /It.. Diffule ueuronal hypoUdilehemlc: challl" illihe ctrebrlllll ....d «rebdilim B. C.rdiolDtpl)', 440 l"JDf C Subeodoeardlal coaplatWt necroai. alld nauldlocal.iQPt cdI cODlnlletloa band lI«redI,IeR "colride D. Len ..mlrkullt bypertrophy wlt1l (ocal.ubtndocardlal ialtnUti.1 and replacemenl fibrOIn Eo BroDcbopaeullloola wllh bilaleral puln101ll1')' tolllfttloQ (1010 cram. ri&ht,8JO cram. len) F. BU.tenl pleunll etrulioD (100.1 rI&ht, 50 ..I let!:) G. Perlcardial effu.ioa (SO ml) H. Peritonc.1 elJullon (SO ml) III. E..ldmce or medical internntloa: Nal(Jpltrk: lube, oropllrie: t1Ibe, mdotrubeal t1Ibe,lll"le-bore lalnnnoul ulhetft' len Deck. Foley calbeter, multiple oeedle pllDclllre .lIn upper aad lolrertJltRmlliel wllh aUOt:laled conlu.lons, EKG leadJ (3) DO lono, denbriUalor 1*1 oud" (1) OD diCit, ad two Itpaf1lle b.p orlDln"enOllJ fiulda (OYle of.o......1Jlllnt .....d one conlllolDI morphiDt .utr.te) /It.. IV. Ideotll'yiDlmarks or IIrtool: Seal'll oCtbe r1lht h.nd, rl&ht COrti...., 'Dd r!&ht r~, v. TomolOl)' (AFIP): /It.. Volatlln: No ttullolli dttco:ted 10 the blood .nd "Itreou. nuld B. Drall: LoJ'llRpalll and t-HydroJyllldlZllblm are delUted In the ariDe bUI Dot 10 the blood. Morphllle" detected iD the urlae aDd quandt.ted In the Ilver.t O..o .. ~ c. Carbon MODO:dde: Tlte earboxybellloalobin IAntralloD I. tbe blood Is ' "1. ey.alde; No c:yalllde it detected IA die blood 1 D. I CartloxylIcmOJlobln AtunlIonI 0(0-)%.,. c:lJIKIed (or ................. MEDCOM 0905 ACLU Detainee DeathII ARMY MEDCOM 905 1 AUTOPSY REPORT (b)(6) J M.bmud, K.rw•• Mah.mmlld All EXTERNAL EXAMINATION The body is lhal of a well-developed, well-llO\lrished appearing, 66 inch tall, 140 poUlld Middle Eastern male whose appearance is consistCIII with the reponed age of26 ~ Lividity is 011 the posterior cvs RDd nc<:~ posterior torso and posterior lower exlmnitics and fixed. Rigor is passiJ1&, and the tcmpcm~ is that of the refriaenuion unit. The scalp is covered with 2-inch long 5\nIialu bl-=k llair in. IlOnnaI distribulion. F-=ial IWrconsislS of. JOlIl« and mousachc. The irides are brown, the wmcae are cloudy, lhe conjunclivae are pille, the sclene are while and !he pupils are round and equal in diameter. The exlemalaudilory eanals arc clcar. The cvs are nCM pim:ed. The lIIIleS are plltent. The nose and maxillae are peJpably slable. The teeth .ppear nalullIllIlld in aood condition. There is. 0.5 cm .bl1l5iOll on the lower ainaival. The nc<:k is straiah" and the trachea is midline and mobile. The chesl is syrnmetrlc. The abdomen is soft and n.t. The genitalia are lhose ora normal adult male. Pubic hair is present in. normal distribution. The buttocks and anus are unremarbble. The upper extremities arc diffusely edemalous. The fllli<'mai1s are in1&Cl. The lower cxtmnities are symmetric and without clubbing or edema. CLOTHING AND PERSONAL EFFECTS The followina clothina itcrDll and pmonaI efTcttswxompllSlY the body at the time of au\op!Iy: • • • • • • Blue long-slcevc T·shin While T-shirt Black SweatpllSllS Grecn scNb panlS While sods (2) Grecn towel MEDICAL INTERyEl'fflON • • • • • • • • • • NllSOpstriC tube Orogastric tube ElllklltlChcaltubc Laric-bore intfavCl!Ous c.thcter left neck with auociatc<l underlying soft tissue bc:mcm hagc Foley catheter Multiple l'ICIcdlc puncrure sites upper and lower cxllemitics with assx:iated conttlllions EKG leads (3) on torso Defibrillator pad outlines (2) on chest One bag of intnlVCflO\lS normal saline One bag of inuavCllOUS nuid with morphine sulrale MEDCOM 0906 ACLU Detainee DeathII ARMY MEDCOM 906 AlTT'OPSY RtPORT (b}(6) Mablll.d, Kanraa Malaul.ad AU • MDIOGMPUS A eompkte set of poI(mOf1em radiopp/lJ ill obcained and demonltrateS no hctum and no intemll metal fraamenls INTERNAL EXAMINATION HEAD: The calvarium is inlKl, as is the durll maier beneath iL Clear cereblOspinal n!lid IUrIOllI'lds tIM: 13SO I'" brain (fresh weighl). Please see Neuropltholoty Addendum. There are no skull fnclWa. mtK' l.Iya-wise diuoc:tion of the Ulterior aod posterior ned slruCt\lJes I'eVelIls no injury. The lbyroid eartilqe and hyoid bone ate ilIlllel. The larynx Is lined by InlaCl while ml.lCOa. The lbyroid gland Is symmetric and red-brown, without cystic or nodular clwlge. The lon8ue i. fi'ee of bile marks, helllOlTha&e, or other Injuria. BODY CAyITIES: The ribs, slemum. UlcI verlebral bodies ate visibly and palpably inlaCt. The~ ate bit_len! pIeunIl effusiOnJ (JOO rnl rlihl. SO mlleft). There is. perlurdial effusion (50 ml). There is l pcritonell effilslon (50 ml). The orpns occupy their lISUl1 ans;lomic positions. RESPIRATORY SYSTEM: The rightllnd left lungs weigh 1010 and 830 am. respectively. The exlemallurflCCS ate smooth and deep red.purple. The pulTrlOlW)' parenchyma is severely COIIiesled and edem.stous. FOClllJeU ofcon.solidltion Ire prtxnl. CMDIOYASCULAR Sl'STEM: The 4-40 am heart is conlained in aD lnlact perlCll'dial AC. Ple&X; see Criovascular PatholOJ)' Addendum. The 10",- lives r;'e 10 thtee intlCl snd pttentll'Ch vessel•. TIle renal and mesenteric vessels Ire UJIl'eITISlbble. UYER A BILIARy SYSTEM: The 1800 am liver he an inlKl, smooth c.psule and a stwp antmor border. The pamlCh)'llll is Iln-brown ltId congeaed, with the IIIIII! lobular archllClC'luR. No nw:s lesions or other aMormtIilies ate seen. The galJ~ conllins 20 rnl o(gIftlI·blac:k b1lesnd l'lO scones. The mUC06l1 sud.ce Is sr- and velvety. The e~p.lic biliary lJee is pl1C!tt. SPLEEN; The 360 am spleeu he _ smooth, inllCt, red-purple Clpsillc. The pImlChyrna Is nwoon and conaestal, with distinct Mllpiahisn corpuscles. PANCREAS; The pIl1CRSlS is firm and yellow..un, with the USIIl.llobular archilCCI\Ire. No mass 1esi0tlJ Of otber IbQormaIlties arc seen. MEDCOM 0907 ACLU Detainee DeathII ARMY MEDCOM 907 AUTOPSY REPORT(b)(6) Mlhanld, KII'WID MuulII..ld All s APRENAl,S' The right and left IdreDai glands ale symmetric, with bright yellow cortices and gray medullae. No II1ISKS or 8relIS of hcmoll'bage ale ideruified. GENITOURINARY SYSTEM: The righl and left kidneys weigh 140 and 170 am, respectively. The elttemal surfaces of the Irldneys are intact and smooth. The CUt surfxes are red-W1 and congested, with unifonnly thick cortices and shaJp cotticomedullary junctions. The pelves ale wvanarkabk: and !he ureters are normal in course and caliber. Gray-pink bladder mlllml overlies lIIl lntlet bladder WIlli. The bladder conllins 100 ml of yellow urine. The: prosIllle is I10mIII in size, with lobular, yeltow-1Ill parencbyme. The seminal vesicles are unmJIIllklbie. The testes are me of mass lesions, contusinns. or nther Ibnormlllities GASIRQINIESTINAL TRACT: Thc~phqus is intact and lined by smooth, gray-....nile mllC05l. The stomlCh contains apJIIOltimarely 5 ml of brown liquid. The gISIlie wall is intact. The dl,llldenwn, loops of small bo_l and colon are llRl'elt\&fkIbie. The Ippelldix is present. MU$CULOS"f! £TAL SYS1EM: ~ are no bone Dr joint abnormalities. Skeletal m\ISICle developmenl is normal. Cut downs of the upper and lower eltlmnities and back are WllelT\Arl(able. MICROSCOPIC EXAMINATION • • • Lung: One section oflu.ng demonstrates bronchopoewnonia; another seetlon of lungdemonstl'lles pulmonary edema Liver. No lIignifiCllllt mieroscopic abnormaIilies Kidney: No lignifiCllllI microscopic abnormalities ADpITIONAL PB0Ct:.DUBM • Documentary photographs are taken by OAFME staffpholographen • Full body radiographs are obtained • Specimens retained for toxicological testing aDlUor DNA identification are: spleen, liver. blood. bite, urine. gastric conlenu, vitreous fluid, p$OllS muscle, Ildipose Iiuue, lung and kidney • The diasected organs are forwamed with body. • Selected portions oforpns are retained in formalin, with preparalion of histological slides: of the lungs. liver and kidney • PCfSOlIIJ effects are released 10 ~ appropril1e mortuary opa1loons .epresentatives • The heart and bnin ~ submined for l'urtherexaminlltion by eardiovllSCular paIhology and neuropathoJogy, ~vcly • Re-llSIOCi.lion of the beIn (Dover 119450) and the braiD (Dover /I 945 I) MEDCOM 090Il ACLU Detainee DeathII ARMY MEDCOM 908 AlfTOPSY REPORT(b)(6) , ] MalI.vd, Karwan M..bllDm.d All OPINION This 26 year-old I~i dellinc<: died oflcR ventricular hypertrophy with focal subendocardial inlcmitlal and replacc:mcnl fibrosis. ~ WllS no cyidcnee of recent significant injury or broising on the held. Per inYeSligalive reports, thc1'e we~ oontlieling ~pons ofpos.sible head Inlwna when the lIeccascd was examined at two diffcrent mcdlcallreatment facilities in Iraq. A head CT sun. one facility reportedly dcmorull'lltcd "seycrc anoxic lnin injlJf)' with hernialion, cephalohcmatoma in scalp riihl Ol:tipital and Icft. parietal". Hypoxic thangcs in the brain can mull in herniation, howeYcr thc~ wu no cyidcncc of blunt force lnul/nli or herniation at the time ohutopsy. The heart demonstrated cnIargmlml of the left. ymtritlc, which has been usociatcd with fatal anbylhmias. The brain demonstrated changes consistent with a decrease in blood flow, which could occur as a result ofa cardiac anhythmi.. Micn:lscopic sections ofone oflhe lunas demOnsttllled focal bronchopneumonia, which most likely developed while the deceASed WllS hospitalized for 4 days. Sections of tile liVCT and kidncy were unrcmarbble. ToxicologicallCSting was llCiative for ethanol and cyanide. The carboxybcmoSklbin saturation in the blood was 1%. Two d!\liS associated with rcsuscitation,loruepam. and I·Hydroxymidmllam, were detecled in the urine. A third drug associated with resuscitation, molJlhinc, wu detected In the urine and quantitated in the liver all concentration consistent with therapeutic dosing. Tbe manner of death is M""'. (b)(6) 1 MEDCOM 0909 ACLU Detainee DeathII ARMY MEDCOM 909 =- AUTOPSY REPOR1~b){6) 7 Mlh..ud, Xarwau Muhammad All NEURQPATHOLOGY ADDENDUM l(b){6) BRAIN, AtrrQPSY: DIFFUSE HYPOXIc/ISCHEMIC CHANGES We en:mined the .ppromnmly 138().gJllIII fonnalin-fiud brain submitted in I'llference to IhilI ~ The dura is IIl'Itelll8J'kBbJe without hemorrbagell or masses. The leptomeninges lICe lrall$Iucenl without hemonhages. The ceRbral hcJniJphercs are ll)'IIllIletrical. The gyn.I pauem is nonnaI. The til'llle ofWiI1is has. normal-.dult conliguntion without lIMm)'IIII$, significllIlt atherosclerosis, or Siles of occlusion. The cranial nerves, ccrebellum, and brainstem ate unremarkable. The optic chium is py and soft. There is no evi.deaoeofUl'lCaI, tonsillar, or subfllcine Ilemi.tion. Serial <;orona! se<:tiOIlJ of the <:enbrvm show a corticIl ribbon of normal thickness, well demarcated from JubjllCellt while maner. Myelination ill nonnaI. The ventricular system is of ncrmal size &lid shape. The basal gangli•• hippocampi. thalmni, llId hypothalamus lRO lIlIJemarbblc. Serial sectioningoflhe cerd>elhlln shows some dllllky discolontiolL The left c:erdldlar tonail is more prominenllhan the right. The brainstem is unremarkable. The substantia nigra and loeus ceNlcus are nomtally pigmmted fer .ge. The M(UCduct is patent The spinal cord is not submitted, bUI the uppmnoJl cervical e:orl! and cervioomedullvy juI'letion are unmnarlcable. Summary ofmicroscopic $eCtions: I. left middle li'ootaJ gyrus. 2. left cingulate IP'fU'. J. left ruperiorlmiddle temporal gyri. 4. mamilhuy bodies. S. left buill ganglia. 6. optic chiasm. 7. right thalamus. 8. left pariaallobulc. 9. left hi~pus. 10. Yamis. II. right hippocampu.l. 12. left cerebellar dentale nuelC\1S.13. left c:ercbdlu ton!i1.14. rilhl cerebellar tonsil. IS. dusky ri&ht cerebellum 16. dusky left cerebellum. 17. occipital lobe. 18. S\lbstanli. nilP'. 19. pons. 20. medulla. The tissIIe was procesvrl ill pnffin;. section ~ from each pmllffin block was stained with H&E. Additional sections pI'qlIJ'Cd from selected blocks were stained with OMS and PAS. Mia'OSCOpic soctions demollllttale diffuse neuron.! hypo,;icliiIChcmic changes in lite cerebrum lIlld c=bcIlwn. PurlOnje centoll is noted with developed BerplIIIII gliosis. Neutrophils Ilnl present in the optic chiasm. The tell; thaJ8mUS bas foeaI intnlYllSCUlar bl'llOC!ting SIJ\Icttlla WI Ilnl PAS positiw: and OMS neptiYe. This may represenl fibrin. The Wldertyiog C&IISC oflhe diffuse bypo,;iclisehcmic changes is undetc:rmined. l(b)(6) MEDCOM 0910 ACLU Detainee DeathII ARMY MEDCOM 910 • AUTOPSY REPORT(b)(6) M"Ql_d, ~rwa_ Ma1I.........d All CARDIOVASCULAR PATHOLOGy ADDENDUM FINAL DIAGNOSIS DIAGNOSIS: (b)(6) . .."'tfye HerOsls aod ••ldfOCllls"aSl ce" a»atrurio. bud .1C1W... 1eft I. Su.'-d"_;o;"",,,:OI~_;o;.;;:o ve.lride 2. Left vlIIlTlculllr lIypertropby .llb focalsu.bftldOCllrdi.llLatentlri.I ••d rqllau.nu Rbr'Ollu History: 26 ye.z old I~l detainee found W1I'tSpOIUi\'C by other del.linea, from life suppon ~l.Ited and laW' ~moved Heart: 440 ar-ns. pC:r<:onuibutor, nonnal epicardial r.t: plObe ~tenl fOflllMn o\'llle; concentric left ventricular Il}\IQllOphy: left venlricular I:lIvit}' diameter 10 rnm, left ventricwar he wall tbiclcnets 11 nun, vauricular septum lhicknes.s 18 mm; rishl venlriculardilawion: nabl ventricle Ihicknett j nun, withoul ifOSS SClU'S or abnormal fit intiltmes: iJOssly UlIlmlarUble valves and endoc.ardlum: subelldoc:ardialllemon'tlage, ventricular septum and poslCfOlnedial papillary musc:le: histoloJic sections show left vmlricular myocyle hypertmphy wilh focaIlRlbendocardiai intemitial and Roplacemenl fibrosi.. posterior and septal left ventricle; coaaulatlve necrosi.. postel'Oll'lCdlll papillar)' musele and posterior septum; multifocalsiJl&le cell cotllrKlion blind neaosis (brain dealh lesions) Coronary arteries: Normal oltia, nabl dominance; no iJOSS IthelWClerosis Comment: The subendocan1ial necl'OJis and mullifoeal sinale cell oontraetion band IlCcrosis Ilre se<:cM\daly to MO)lic nil injwy and ClItecholaminc ~Iease followina: a period ofhypopertu.ion. The ClllI$I of the inilial cardiac a=st is uncerU.in, but mlY be due 10 arrh)'lhmia associtted wilh left ventricular hypertrophy and subendoeanllaJ fibrosis. (b)(6) Cardiovascular Pttholoaisl MEDCOM 091 \ ACLU Detainee DeathII ARMY MEDCOM 911 _. __.- --._- - .. _ ._._-- .... C£RflfICATE ~ lIl!A11i IOllERSEAiI) Ac.. clII_ _ _OF..w.sm _- - Mahmud. BTB Karwan. MlJhammad All IraqiO'..... - (b)(6) Civilian ,."."..... '" ""r;.o< " •. _ _ _ ... 0WJIlITY _ ~ ._. - - .--•.-"."- --,---_'_I _......_- - - - --........__- --... --,---_..._ ....-_.._-_ ......- I ~ • c" 1980 OJ 0 1 .............""'" '. o"c·_ [(b)(6f '''"I ..., ~ 0 ~ • . ..... ~TO""cu... O ...... "" ..... "" q, -'_1 em' OIl """'" OIl ..... 011 1IIC1C'A1. tTUBmIf """'" ... ~~ e-..._ "" ",.. _ _ _ ..._, , . _. _. -- -.----. -. _.• •.-_.- - . -- ........ OIl """"""'" -.:11............ TO ...... _C(:M>rn(:foO,. _. _ """Of"... ~ ~~ ,............0 ........ """'"" e . . - _..., ...... _ • I,.tft 0......""' ...... ..,.nb'ic>llal rr,.... b¥' _,..,.. oobl~ """*tiIial and , , _ I fibrog TO ... _ ....... ""'-'Ot•• _ . _ .... ttl _ , OAI,O$O e . . - _ .., ..... _ ~ ......"""" COtGToowa • ...,.""-'" ~""- ... -- [i] ~. .. 0 ~ ~ -_.... _- ...- -_"' ..... '0"__ """""" • ~ •• (b}(6) - ""..""_'" h3 April 2007 , ..."".........,_ ••_ (b)(6) ....,...----- - • ~-'"---- CampBuc:ea CO' ' ' ' ' _.....uo __"''''''''-."., _,_.....,.,"'_."". _""""',0.$ ,'.m>-. . .~ l\r""""~~ (b}(6) I 0"'" '" I!J..,- __ -.-_ _.... _.'''''__ _--------- l"'o'. _ _ • I(bX6'}""';'OOr-·" -- ' ,._... ..... -- n Ilb)(6) ~ I -.- . • Medical Examiner .........""" OIl..,.,..... Dover AFA3l<>VAr_OF _ I .. _..... . _.. . .. _.-,_._.._.._w. . __._._._.. . _._.. l(b}(6) • 6121/2007 • 0 ._--~ DD'~" 2064 , _~ ~ -...cu ... "'- ..... '_,._... _ _........ " ......... MEDCOM 0912 ~ ACLU Detainee DeathII ARMY MEDCOM 912 (REMOVE REVERSE AND RE-INSERT CARBONS BEFORE COMPLETING THIS SIDE) OISPOSrTON OF REMAINS I '''"~, U~" INSTALLJ<TION ~ M RADDRE >0,,," V'"= SJGNATURE Y R CREMA.TORY LOCATION OF CEMETERY OR ( REMATORY DATE OF DISPOSTlOf<l ·1:;I'Ol;TION REGlSTRAl"ION OF \IlTAl STA.TlSTICS RE 1ST Y own.OO oonrty) DATE REGISTERED FILE NUMBER ",m NAME OF FUNERAl DIRECTOR OTllER ADORESS SIGNATURE OF AUTHORIZED tlDI'IlOUAL DD FORM 2064, APR 19n (BACK) USAPA VI.GO MEDCOM 0913 ACLU Detainee DeathII ARMY MEDCOM 913 ARMED FORCES ''''STITUTE OF PATHOLOGY Offic£ oflh" Armal for~" Medical Euminer 141J Research Blvd" Bldg. 102 Rockville, MD 20850 )-)01·) 19-0000 FINAL AUTOPSY REPORT = Name: Nassir Jabrin, Umar Sa'ad ISN;[jpl® Date of Birth; (BTBJ l b}(6) 1985 DateofDeal!{f b){6) 2007 Date of AUIOPSY; 9 Apr 2oo7@ 1300 Date of Repon; II May 2007 Ci",umtlllnC~t Autopsy Noll b)(6} AFIP No.j(b)(6) Rank; Detainee PlaceofDcath; Iraq Plac.e of Autopsy; Pon Monuary Dover AFB. DE of Death: This 22 YCll1-oid Saudi delainee WlIS found deceased in a garbage dumpster. AUlhoriutlon for USC 1471 AUIO~; Office of the Armed Forces Medical Examiner, lAW 10 hlentillcalio." Presumptive identification is established by a ....Tisl idelllification ball'!. Post-mortem fingerprints, dental e"amination. IIDd a specimen suitable for DNA llnal}'$is are obtained. CAUSE OF DEATH: ~hlliple Blunl force Injuries Complicatnl by tl-bnllal St."ngulallon lind Chellf Conlpreulon MANNER OF DEATH: Homicide MEDCOM 0914 ACLU Detainee DeathII ARMY MEDCOM 914 AUTOPSY REPORT (b)(6) 2 Nus'r Jabrin, Urnar Sa'ad FINAL AUTOPSY DIAGNOSES: I. MuUiple 8lunt Foru Injurin: A. Head and Neck: I. DiffuJe bilateral scleral hemorrhage 2. Abruioll of Ihe forehead, %" \"i-inch 3. 8ilaleral periorbital conlusioDS 4. Contusions oflh upper and 10"'er lips and 01'1l1 mucosa S. Abl'1lsion oflhe left lide of Ihe DOle, 'I...lnch 6. Abl'1l.llions (If Ihe right side oflhe ra«. I-inch, ...d right lide of rhe neck, 2.inches 7. Conlusion of the righl side of the neek, t ,,\"i·inc" 8. Abrasion of the left lide of the neck, Jll.inch 9. Contusion of the posterior nec:k, 2 • I-Inch 10. Diffuse lubgaltal hemorrhage II. Hemorrhage in both lempol'1llis muscltll 8. Torso: I. ContllSion of the itA side of the cbtlll aDd abdomen, 9 .. I.inch 2. Abl'1l.lllon or Ihe )eft lide of the Chtsl, I.inch J. Pat1crnrd contusioG orlhe left lower quadl'1lnl of the abdomen and leA hip,) 13-inehes 4. Paltemed abl'1lslon of the right lower quadl'1lnt of the abdomen, Hnch 2 S. Conlusion of the opper richt back, I %. ¥... inch 6. PaJtellltd contusion oflbe upper right back,)" 2·lnchtll 7. Contusion oflbe lo..-tr mid back, %. ~.jnch 8. Rigbl hemolhorax, 200 ral 9. Fracturtll or Ihe anterior Ioeft ribs, 2-_9'~ 10. FI'1ltlu res of 1M itft pubis and ischium II. Fl'1ltl"nl of the rillIt Ischium 12. FI'1lClu rei of Ihl left lrallfl'ene pro«:uel ofthe 2'·-4'~ lumbn vlrtebl'1l1 bodia IJ. Fraclure of ttlt righl sauolliar joint 14. Rupture or Ihl left and right hemldlaphraSm with assoeialcd displacemenl of abdominal conlcnls 'nlo the Ihorax IS. Ruplll.rt of Ibl,tomach with gUlrlc contenu In Ihlleft thorax t6. Mesenltrle hcmorrhage 17. Laccl'1lllon of Ihc rl&hl adrenalsland, 0.5 cm 18. RiSbl plriadrenal hemorrhage y,,, C. [xlrerailil',: I. ConluslOll of Ihl rlShl dbow, I x ,.,.-Ioch 2. Cooluslon ofthl Ilfl,boulder, 2 'I. x I %·Incbu J. Abrasion of Ihe left shoulder, % x Il8-lnch 4. Contusion oflhe Idlann, 2 11. Y,·lneh S. Abrasion oftbe left ..lila, %. lIS-Inch MEDCOM 0915 ACLU Detainee DeathII ARMY MEDCOM 915 AUTOPSY REPORT~(6) Nallir Jabrin, Umar Sa'ad 6. 7. 8. 9, ) Cunlu,iun urlhe IInter\(lr right Ihigh, 8:1 V,-inch AbruiuD5 (2) uf the righlleg, Yo-inch lind lI8-incb Conlusion ortbe left bUllock, 2 s: I_Inch Conlu,ion. (2) of the anlerior lcft thigh, 3 J: 2-inches lind 4 J: I V,.inehc5 II. Evidence of Manual Strangulatiun and Che5l Compreuion A. Neck: 1. DiffuJt bilateral scleral hemorrhage (Set I. A. I.) 2. NlimeroILJ bilater.l petechial hemorrhagu of the upper ebtlll Diffun bilalertl hemorrhage of the anlcrior anti poslcrior 3. neek mUljeulature 4. DlfTuu hemorrhage or lbe thyroid 5. Contusion olthe right side ortbe Deck, 1 s: '/,-inch (lte I.A.7.) 6. Abrasion of the leflside ortbe neck, 318-11lch (su I.A.S.) 7, Contusion orthe posterior neck, 2 J: I-inch ('ff tA.9.) 8. Hyoid bunt .nd thyroid cartilage intacl III. E,'ldence or natural disease: !iff addendum ror canlin\'ll.JCular palbology IV, No evidence of me.liul Intervention V. Identifying marks ur taIlOO.: Vertical SCar on mid chtllt, g.lnch VI. Tos:icology (AFIP): A. Volall1u: No ethannl i. detecled in the blood or vitreous nuid 8. Drugs: No .creened drugs of abuse or me.lication. an detecte.lln the C. D. .,.... Carbon MonoJ:ide: The carbulQ'hemoglubin .aturalion in lhe blood Is Its,thaoJ-;'" Cyanide: No cyanide;s detected In the blood MEDCOM 0916 ACLU Detainee DeathII ARMY MEDCOM 916 AUTOPSY REPORT I,"",,",,;") _ _~ Nauir Jab'in, Urna' Sa'ad • EXTERNAL EXAMINATION The body is that ofa well-developed, well·nourished appearing, 65-ineh tall, IOJ pound male whose appearance is consistem with the ll:poned age of22 years. Lividity is on the posterior torso and posterior utremities and fixed. Rigor is passing, and the temperatull: is 0001. The se.alp is covered with I 1/2-inch long straight brown hair in a normal distribution. Facial hair consists ofa moustache and beard. The irides are brown, the: comeac are doudy. the conjunctivae are unn:marhble, the sclerae are diffusely hemorrhagic bilaterally and tbe pupils arc round and equal in diameter. The externailluditory can.als are dear. The ean IIle not piereed. The nares are patent with blood presenl bilalCJ1llly. The nose and maxillae are palpably stable. The t«:lh appear IlIIturaJ. The neck is straight, and the trachea is midline and mobile. The chest is symmetric, The abdomen;s soft and flat. The genitalia are Ihose ofa normal adult male. Pubic hair is present in a normal distribulion. The buttocks and anus all: unremarkable. The upper and lower extremities are symmetric and without clubbing or edema. PICll.'Ie refer to the evidetlce nfinjwy section for injury to the torso and extll:mities. CLOTHING AND PRRSQNAL F.FFECTS The following clothins items and personal effects an: present on the body at me time of autopsy: • Yellow pants • Three video cameras • Four cassette tapes • One USB cable • Two silver cases labeled "Mobile Disk &temaJ Data Storase" • Two unknown sil""r electronic accessory items MEDICAL INTERV£"''TION • No evidence of medical intervention MDIOGRAPHS A complete set ofpostmonem radiographs is obtained and demonstrates the fol1owins: • Skeletal trauma to the tOfro lIS noted below MEDCOM 0917 ACLU Detainee DeathII ARMY MEDCOM 917 , AUTOPSY REPORT(b)(6) NauiT Jabrin, Umar Sa'ad EVIIlENCE Of INJURy I. Multiple Bl\IJ\t Foree Injuries: A. Head and Neck: ~re is an abrasion of the forehead, Yo ~ 'h·iroch. Thcre are bilate:ra1 periorbital wntusions. Thel'l: is diff\lSe bilateral sdaal hemorrhalle. Tllere are contusions of lite upper and lower lips and oral mucosa, 'I.·inch to 2 l( ~ineh. There is an abrasion orthe left side oflhe nose. 'I.-inc:h. There is an abruion nfthe ri&.ht side of Ihe face, l·iroch. IIId an abrasion of the righl side of Ihe neck, 2-inclles. There is diffuse subgalealllemorrhage. There il hemorrhage in bolh temporali, muscles. B. Torso: There is a contusion oflhe left side of the chw and abdomel1, 9 ~ I-inch. There is abrasion of the len side of the chest, I·inch. There is a semi·cireular paltcmw cOllIWlion of the leA lower quadl"llnl of lhe abdomen and ltft hip, 3 ~ 3-inches. There is a contusion of the right upper bod:, I ¥. ~ 't.-incli. There is a semlcireulill" pauen,ed contusion oftllC righl upper bIlek. 3 JC 2-inclies. There is a confWiion of the mid lower back. 't. ~ 'h-inch. There are fractures of tile IIIterior 2...·9'" leil ribs. There is a right hemothorDJC, 200 mi. There is rupture of the leil and righl hcmidiaphragm with auocialCd di!Jllaeemcnt oftllc abdominal conte:nts inlo llie thorDJC. There is rupture: of tlte stomach wilh gastric contents in the left thorax. There is hemorrhaie of the: mesentery. There is a laceration of the right adrenal gland, O.S em, IIId right periadrel1lllllemorrhage. There life fnlcturt5 of dIe left pubis and iscllium, ri&ht ischium, and right sacroiliac join!. There are fractures of the left transverse processes of the 2"0104'" lumbar ver1ehral bodie,. C. Extremities: There is a wnlusion of the lell ,houlder, 2 Y. ~ I ·f.·inches, and an abrMion oftllC left shoulder, 'I. x 118·incll. There is a conlusion of the righl ann, 2 'IS JC 'h.jnch. There is a contusion oflhe right elbow, I x 't..inch. There is an .bl'llsion oflhc lell Il)(i!la, 't. x liB-inch. There is a wntu,;on of the anlerior ri¥htlhigh, 8 x Yo.inch. There are two (2) contusions oflllC anterior left thigh, 1 x 2-inches and 4 x I Yoinches. There is a contusion of the left bUllOCk, 2 x l·ineh. There are two (2) abrasions oflhe right leg, Y.-inch and 118·lnch. ll. Evidence ofManuaJ Strangulation and Chest Compression: Head and Neck: There is difflJSe bilateral !ilCleral hemorrh'lle. There is a wntusion of lhe rigll1,ide of the ncelt. I x \f,-inch. There is a wntusion of the !ell side of the ncek. llS·inch. There i, a contusion of the posterior neck, 2)1 I.ineh. There i, dilTlISe bilateral hemorrhage of the anlerior lIlld posierior noek musculature:. There is diffuse bilateral hemonhage ofthe thyroid. The hyoid bone and thyroid cartilage are intael. A. B. Tol'$O: There are nwnerous bilateral peteChial hemwmalles oflhe upper chest. MEDCOM 0918 ACLU Detainee DeathII ARMY MEDCOM 918 AUTOPSY REPORT (b)(6) 6 N.ssi. J.brill, Umu S.'.d Il'fTEBNc\L EXAMINATION HEAD; Sec "Evidence of fnjury~. The calvarium is intact, III is the dl.lJa mater beneath it. Clew mebrospinallluid sumlunds t/lc 1550 gm Inin, which hu unrmIarbhle Iyri IU'Id sulei. Corolllli sections demol\Jtnlte sharp demarcation bctwccn wlUle IU'Id grey m.Uer, "'itholrt hemorrhage or conlUsive injury. The ventricles lU'C of llOml.lsiu. The basal sanalia, bfainstem, cercbcllum, and arterial systems an: frtt of ill.iury or other .tlfIomtaiitiel. ~ lU'C no skull fr.ctures, llliJ<' Scparllte anterior and posterior neck dissections are pcrfonncd. ~ ~Evidencc oflnjury~. The thyroid cartilage IU'Id hyoid bone arc intact. The larynlt is lined hy intaet while mucosa. The thyroid gland is symmetric and hemorrhagic. without CY51ic or nodular change. The longue is free ofbitc marks. hemolThagc, or other i'1iuries. BODY CAVIIlES; Sec "Evidencc of Injury". The stcmwn and vertebral bodies lItC visibly and palpably int!lCt. No eltCCSS fluid is in the lell plcural and peritoneal cavities. The Of liaRS o«upy their usual anatomic POSilions. RESPIRATORY SYSTEM; The right and lell lungs weigh 230 and 210 gnt, respcetively. TIll' l'Ktemal surfaces are smooth and dcep red·purple. The pulmonary parenchyma is moderately conlll'5ted amI edematous. No areas of collJ()lidation are present. CARDIOVASCULAR SYSTEM: The heart weighs 390 gm and is adhercntlO thl' chest wall. The hean is sent for cardiovascular pathology l'valuation (5« addcndwn). The aorta giVCl$ rise to lhree intlet and patall.arch "essels. The renal and mesenteric veuels are ulIJ'emarkable. UVER & BILIARy SYSTEM; The 1050 gm liver has an in\ll(;l, smooth cllpsull' and a sharp antcrior border. The parenchyma is lan-brown and congested, with the usual 10bull1 lU'Chite<:turc. No mills lesions or other aboolTllllJities l'Te seen. The gallbladder oonlains 10 ml of green-black bile and 00 stOlleS. The mucosal surface is green and Vl:1\'C\y. The eKlrahepatic biliary uee is patent. SPLEEN; The 70 am spll'cn has a smooth, intact, red_purple capsule. TIle parenchyma is maroon and congestcd, with distinct Malpitltian tol]lU5Clu. PANCREAS: The pancreas is linn and yellow-WI, with t/lc llIUa.Ilobular ar<:hitee:~. No muslesions or other aboonnalities arc seen. MEOCOM 0919 ACLU Detainee DeathII ARMY MEDCOM 919 AlTfOPSY REPORT[{b}(6} NallS;r Jabrin, Umar SC.".Cd; - - - 1 ADRENALS: See "Evidence of Injury". The right Wid left adrenal glands have bright yellow corti~s and grey medullae. No Iloll-lraumatic Icsioos are seen. GENITOURINARY SYSTEM: The righl .....d left kidneys ~igh 120 and 100 gm, respectively. The external SUffaces of the kidneys are intacl and smoolll. The cut surfaces are pale lan. with uni fonnly thick cortices lIlld sharp cortieomedullary jUIICtioll!l. The pelves are unrelll.llri.:able and the ureters life normal in course and caliber. Grey-pink bladder muco~ overlies an intact bladder wall. The bladder conwns 10 m1 of clear yellow urine. The prostate is oonnal in sile, with lobular. yellow-tan parenchyma. The seminal vesicles are unremarkable. The lesleS are free of mass lesions, contusions, or other abnormalities GASTROINTESTINAl TRACT: See "Evidence of Inju')·... The esophagus is intaetllJld lined by smooth, grey-while mucosa. There are 100 ml ofl8ll semi-solid gastric conlents in the left thorax. The duodenum. loops of small bowel and colon are unremarkable. The appendix is presa1t. MUSCULOSKELETAL SYSTEM: Dissection of the subcutaneous tissu<: oftb<: ba<:k and bolh upper and lower extremilies is performed. Set: "Evidence of Injury". 1bere are no llOlI·U1lumalic bone or joinl abnormalities. Skeletal muscle development is normal. • • • • • • • ADDITIONAL PROCEDURES DocunleOtary phOIOllfllphs are taken by OAFME slaffphotollraphers Full body radiographs are oblained Specimens retained for toxieologicaltesting and/or DNA identification are: blood, spleen, liver, brain, bile, urine. gastric contents, vilreous, psoas musele, adipose tissue, lung and kidney The dissected organs are forwarded with body The heart is retained for consuhation Selecled panions of organs are retained in formalin. without preparation of hislological slides Personal effecls are released to the appropriate mortuary operalions representalives MEDCOM 0920 ACLU Detainee DeathII ARMY MEDCOM 920 • AUTOPSY REPORT [fb){6) Nassir Jabrio, Umar Sa'ad QPINION This 22 ycar..:lld mll.lJ(b}(6} Idied ofmultiple blum for<:e injuries complicated by manual strangulation and chcsl compression. There wen: blunl force injuries to tbc head, n~k, torso, and upper and lower extremities. There wen: injuries to the head, neck and torso consisteDt with rrurnu.allitl"llllgUlatioD and chest comp~ssion. Toxicological testing for ethanol, drugs of abuse, medications, and cyanide was negative. The carboxyhemoglobin concentmtion was less lhan 1%. The manner of death is homicide. (b)(6) (b)(G) b)(G) J MEDCOM 0921 ACLU Detainee DeathII ARMY MEDCOM 921 AUTOPSY REPORT[lb)(6) 9 Nault Jabtln, Umar Sa'ad ADDENDUM DIAGNOSIS(bj(6j :Coni:~nital h~art disease' I. Pulmonic stenosis "'JllI sub~.I~ular fibrous band, status post ~aJvuloplnty 2. Bkllspid aortic vah'e 3. Patch repair of alrial septal dderl History; 22 at autopsy )"~arold Iraqi detainee found in a garbage bag at int~em facility; lI0:rn0lomy SCll!" noted Heart; 280 grams; diffuse fibrous pericardial adl\csioll!l and 2 ~ I cm hematoma on posterior $Ufface Qf left ~entride at apex; patch repair ofamal septal ~f~: oormalleft ventricular chamber dimensions: left ventricular ravity diameter 25 mm, left I'cntricular free wall thickness 13 nun, "enmcular septum thickncss 15 nun; right ventricular hypertrophy; right velmicle thid:ness 7 mm; endocardial thickening, right ventricle; puimonic steROsis: endocardia/fibrous band below pulmonic valve extending inferiorly from commissures of anterior and right pulmoni~ cusps, absenllefi pulmonic cusp; thi~kened tricuspid val\"e leaflets; bicuspid aortic vall'e; conjoined anlerior leaflet with midlillC raphe between left and right corosmry cllSpS; Sulure material and fibrosis. ancerior right ventride; histologic .sections show mild subendocardial interntitial fibrosis, posterior left "emride, otherwise unremarkable endocardium; fural bune marrow embolus, epicardial coronary artery, anterior left ventricle COTOIUll'}' arteries: Normal ostia; right dominancc: no gross lItherosckrosis Cumment: The primary abnormality appears to be pulmonic stenosis, possibly arising in a bicuspid pulmonic valve. However, because iller<: ha$ been prior valvuloplast}", the morphology of the pulmonic valve has heen allered and the original pathologic condition cannot be detennined with CCrtWllly. Also. thc wincideDce of bicuspid pulmonic and aortic val"es is extremely rare. [~)(6) Blo<k> mod., , ban Shd~ mod.: S HollE 1 Cardiovaseu)ar Pathologist MEDCOM 0922 ACLU Detainee DeathII ARMY MEDCOM 922 -.. __.---- --.- ------ - ...""'- .__.. - ._-- - -_. - ---.__. -_ ...... ... __-- _ -.--,_.. -,_---. -,...-'-"._.._- _.------""""-,,-.... __ ... -.--- .--elRTlI'lCAl'l! 01' OIATH (O'4ItSEA$,l (tyO-~ ........ - _OOIICII' ... .-_~- Na. Jabtin, Urnai' S.'ad, (b)(6) CMllan ................ "'000010' _ _ (b)(6) S,udi ArabIJ ~ 1985 I!J 0 • -., ... ""'""'- ...."'" , ~ ~ _ ... "' • ......0 ... ..........-'O~O CIT"IR .,...... _-~- , , 'I''''' .. 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I _"IU'''__ oo,lII'J, 2064 ""."C""''''''"'_'_''_'''_ MEDCOM 0923 ~ ACLU Detainee DeathII ARMY MEDCOM 923 ARMED FORCES INSTITUTE OF PATHOLOGY omce of the Anacd Forca Medical. ~baet 1413 Re:xarch Blvd., Bida- 102 Rockville, MD 20150 301·319.ססoo FINAL AVTOPSY REPORT AulOJlSY No.: (b)(6) Nlltlc: MuhaInnuId. KhaYri N,aim CIOIt: (b}(6) ~~J Date of Birth:\b){6) 972 Datc ofne.th: i~)(6J 07 (Found) DatclTimc of Autopsy: 06 MAR 2007@ \100 Dateof Repon: 06 JUL 2007 Iy AFIP No.:(b)(6) Rw.: CiviliUl,""o..""~ilM'#" Pl.ec of Death: rr.q P1.ec of AulOpSy: Port Mortuu)', Dover AFB, DovCf, DE ClrcDlDlItllllcn of Dealb: 1'hilI34 yeu--old dviljan deIaincc was intcmed -' Compowxl 3-C. c.mp Rernem.1nnce II, Theater IntenIlDenI FItCiUIy, c:.mp Croppo:r, BaabW.I..-q when, .., reported. he was folmd uruesponsive in I IaIrioe slIall with • pair of ycllow Uousc... lied around IUs neck. Aaltloriudoa for A.to~7: Office o(1tIc AImed Fcm:es Medical ExaminCf,lAW 10 USC 1471. JdcadncatlOIl: Presumptive idcnlifiCllion by cumination o(papers in cue file. Post· mortem ~illj(n ruitablc for DNA araI)"is itobtained. CAVSE OF DEATH: -uptlyxla ftc 10 IlnlllplalioD MANNER 0' DEATH: Honalclde MEDCOM 0924 ACLU Detainee DeathII ARMY MEDCOM 924 FINAL AlITOPSY REPORT: (b)(6) Mulwnll\8d, KNyri Naim 2 nNAL AVfQPSY DIAGNOSES I. Str"lu"doa: A. A nearly c:ontipow: li~ mark i. around the neck B. Petechiae ofCOIljllllttiVIC of the rilllt ItId left, upper and lower eyelids and lhe mllOOSa of the upper lip C. Hemonhage of the Idl: ~h)'Oid mUIC!e. I x 1f4 inch O. HemGlIhlle of the .10ft tissue sunoundinllhe left 110111 of the hyoid bone. 1f4 x 1f4 inch E. Hnnorrhage of the poslCrior spinous muscle beneath the IiptllR IIIIl'k, 112 x 112 inch F. Additiolllll injuriet: 1. Abnsion of the left lide of the fa«1Ielld. 2·112 x I inch 2. Subplul hemorftIa&e, left pariellll.. 2 x I inth 3. Subpial hen'lOn'!lqe, occiput, 114 x 114 inch 4. Hemol'l'tlqe of tile left temporalis muscle, 3 x 21nc:bes ,. Abfuion of the lad of the left c"viele. 1/4 x 114 inc:h 6. AbBsiorl of the "&hl.ide of the che$t, 3/4 x 1/4 inch 7. Abrtalion of the left lideofthe 1 _ back. 1/4 x 1/4 inch S. AnioN (3) of the 1etl: elbow, Bll&ina &om 112 inclt to 3/4 inch in J!'CIlcst dilTlelWon 9. Contlllkwl oflhE.-erum. 2 x I inclt 10. Contusion of the left buttoc:k. 2 x I inch II. Olber nodiap: A. EdemItous ItIftIS; I. Riahlluna, no IJ'IIIII (expecud 360-'70 J1WII5) 2. Left lun.. 710 lP"IlM (expoc:lCd 3U··tlO gramI) V. Po.t·.orUm dlaalet: A. Uvidily it fixed on the posterior _flOe oflhe body except in the areas exposed 10 pressure B. Rip is resolYinl in 111 C. Cloud COmeK fOW'extmni~ VI. RecoYerm evldeace: A. HMdbap B. Nail clippinp and finJemaiJ elipper C. White fillers from back of while I·min and red fiber from yellow lIhin vu. TO.lkelop (AFtP): A. VOLATILES: No ethanol detected in the blood and vi!lllOlIS nuid MEOCOM 0925 ACLU Detainee DeathII ARMY MEDCOM 925 FINAL AUTOPSY REPORT: 1(b)(6) ~ ) Muhammad, Khayri Naim B. DRUGS: No acn:ened drugs ofabuselmediea1iolU dde<:led in !he urine C. CARBON MONOXIDE: The carboxyhemoglobin satImIuon in !he blood was 4% as dctennined by !pecbophotomelJy with a limit of quantitalion of I%.' D. CYANIDE: None drtected in !he blood VIII. Microscopic uamillatloll: Lung, right 10VllCr lobe - focal infra-aiveolWl edema and vascular congestion , ClIbo><yl>em<l$lobln NlUnlioRl of0.3% .... upeclod 'Of lIOfI-omol.... ItId 3-10% 'Of l'Il'IOkmL MEDCOM 0926 ACLU Detainee DeathII ARMY MEDCOM 926 nNAL AlJT()PSY REPORT: (bH6) MuIwnJnad, Khayri Naim • EXTERNAL EXAMINATION The body is thai ofl ~Il-devcloped,_II-nourished male. The body Is 61 inches in length, weighs 120 pounds, tnd tppeII'I oompetible with the stated qe oD4 yetn old. The body is cold. Uvidil)' is rlllcd on lbe po5(erior surfaee ofdle body except in the areIS exposed to pR:ISIR. Rigor is resolvina in all four exlremities,. InjLll')' to the head tnd neck are cb:ribed in "Evidente oflnjuty". The held is ~mll._~jiJaJi<:. The Jcalp lIlIir is grcy-bllCk and SnighL FlCial haireonsisu of. thin mousllChe and IlUbble. The irides are brown. The comeae are cloudy. The eoq;unclivle are eon~stcd with petechile of both upper IIld lowereyelidl. The stief*! are white. The extem.lluditory ClMls contain dried blood. The oral Civil)' Itld llItes are !Tee of foreign material or Ibnonnll secraions. The nuaI skeleton Is palpably in*!. The oral mllCOSl of the upper lip has petechise. The teeth are IlIturaI and in poorcondilion. T'here is. 1 x 118 inch sear on the bottom of the chin II the midline. The cbest is symmetric. The gaUlIli. are those of an adult, ein:urncitcd rnale. The upper and lower extremities are symmetric tnd without clubbillll or edCIltL The fingernails are intact. Then: is. 2 x 1/4 inch scar onlbe posterior right arm. lllert is. 1-\12 x IIg inch ICaI" on the posterior right fOl'Clml. There is. 2 x 118 inch sear on the posterior left wrill.. There is. I inch area ofhyperpil'flented skin on the anterior left. hip. The~ iI. 1/4 inclt scar on the posterior left leg. CLOTHING AND PERSONAL Em:OS The body is clad. yellow shirt (with blood on the left shoulder), white t·shirt, yellow tro\lSCt'l, llIld white WldctWCat. Brown paper evidence bags are SClCUnx:! over both hands. On the yellow shirt is I reO fiber. On the white t-sltirt (between the t-shirt and ~Uow shirt) is. white fiber. On the left wrist is an [0 iii with the name (b)(6) =~-J J l(b}(6} MEDICAL INTEBYEHTION There is no evidence of medical intervmtion. RADIOGRAPHS A complete Jel of!lO't·mortcm rsdiographs iI obtained. EVIDENCE OF INJURY I. Slrlll(UbtiOIl: A nearl)' contiguous JiplLll'e lTII.rlt is around the neck COIIIistina primarily of. nx:! abruion. AI the anterior midline, the IlptUre mark is 114 lnc:lt wide and localed 10-112 incites below the top of the head. To the left of the anterior midline. the Iigalure mark is dim:1ed upward III 10 de~ .:Jile. To the riabl of the anterior midline, the IigatLll'e nwk i. din:eted upward III 10 degree ana1e.. At the left CllT, the ligature nw:k is In inch wide llIld 10000ed 9-112 inches belowthe top of the head. The ligature nwk continues ICI'OU the p:llterior neck. At the !lO'terior midline, the ligatLll'e marir. is I inch wide and 9-114 incites below the top of the head. At the right ear, the ligature nwk is 114 inch wide llIli 100000d 9-112 incites below lite top of the head. Petechiae arc noted 00 theCOT!iunet;vae of the rijht and left, upper and lower eyelids and the mlJCOSl of the ~ lip. Sel*'Ste anterior neck diueet;on MEOCOM 0927 ACLU Detainee DeathII ARMY MEDCOM 927 FINAL AUTOPSY REPORT: (b)(6) M~. Kbl,yri Naim , shows a I K1/4 ineh MrnorrlIa&e of the left ,temo-hyoid musele and a 1/4 K1/4 inch hnnol'l'tlaJe of the Klft «srue lIUITOUndil18 !he left born of 1M hyoid bone. The hyoid bone and thyroid cartilllp are inlKL A sepafllle poslerior neck diuection,oows a 1/2 x 1/2 inch hemo!rlIaae of the spinous muscle beneath the Iipnue mark. U. Addll~ ..lllIJ.. ria: Tbtre il a 2-112 x I indl abrasion ofthe left ,ide oflhe forehead. There i, a 2 KI Inch IIlbplCllI hemorrbqe of the left parle"-l and a 114 K 114 inch IIlbpleal hernorrtw&e of the occiput. There b a ) x 2 ineh heTnOlThage of the left temporalil mUJ<:k.. On the head oflhe left elevicle i, a 1/4 x 114 inch Ilbnsion. There iI a)14 K 1/4 ineh abrasion of the riaht side oflbl: chest. There iI a 1/4 x 1/4 inch abmion of the Io~r left btck.. On the left elbow are three (3) abruionllhat ranp from 112 ineh 10 )14 inch in lI"eatesI dimension. Posterior superficial incilionl reveal a 2 x 1ineh COIIIUSiOll of the IICNm and a 2 x Iinc:h contusion of the left bulloCk. INTERNAL EXAMINATION HEAD: (CENTRAL NERVOUS SYSTEM) See "Evidence of Injury". The -.lp il rclk:eled. The calvarium of the Kull i, removed. Tbt dura mater and faiK ~bri are inllCl. The leplutllCllingeli are thin and dellcate. The cerebnl hemispheres an: symmetrical. The strucIUres at the bue ofthc brmn arc intact. Col'ONll seeDOrIJ through the eerebellwn and ll'aIlSVerJe seetions tIuough the braillltem and cerebellum reveal no Ic:siorIJ. The brain weighs 1$20 pamI. =, See "Evidence of Injury~. The thyroid canila&e and hyoid are intact. The lhyroid b ,ymmenic and red·brown. wit!lOUl c)'llic or nodular Chanle. The \aryIIlI i, lined by inact while mucosa. BODY cAymES: The ribll. sternum. and >'t'l1ebnl1 bodies are vWbly and Jl&lP-bly inlK1.. There b no excess fluid in any of tile body cavitia. There are multiplc denIe Chelionl ofd\c riaha lung. The organs otaIpy !heir umalanatomic posiliorllRESPIRATORY SYSTEM: The lIJ'PCI" airwly i. clear ofdebri. and forelan material; the mucoallW"faoes are 1ll'IOOlh. yellow-un and unn:markable. There are multiple dense adhesions oflhe lobes ofthc riallt 1Wli- The right and left lunp wellh 720 and 710 1f'lN. respecti>'t'ly (eKpected, 360- $70 II"lIfTI rig.hllung and 325 - 410 lram left lung). The pulmorwy .-mJChyma i. red·purple exudin, modentc amounll of blood. No mtSIlesionl." present. The diaphraam is inlaCt. The pulmonary al1eries." normally developed Uld patenl withoutthrombul or embolus. MEOCOM 0928 ACLU Detainee DeathII ARMY MEDCOM 928 FINAL AUTOPSY REPORT:(b)(6) Muhammad, Khayri Nairn • CARDIOVASCULAR SYSTEM: 'The bean weighs 390 pms (expmm 224 -446 g:ranu for body lenath). 'The paieardial .wrfaces In.moodl, a1isleninl and II1ImrIIlbble. The periclJ"dial.sllC i. free of Ilipificant fluid or Idbesiona. There ill illCRAXd epieardial fal. The con:lIIary arteries follow lbeir uauaI COlllX and an: widely patent. The aria! and ventritular aeptum In inUlCt. The valvea In llIlI'elllatbbIe. The left vmaicular .septUm rnetlallfa 1.3 cmtimelen and Ifle left ventricular free: wall rneuute:I 1.2 centimeters. The riglu ventriclllar free wall is 0.3 ccntilTldera Ihick. The aona and illl major branches ube normally and follow the IDU&I course. There it mild non-calcific aWroaclerotic diaease oflhe 1011&. The vena cava and its maJortribut:aries return 10 tIw; heart in the usual distribution and are free of thrombi. yYER & BILIARY SYSTEM: The 1530 &Jam liver IllS an inllCl, smooth capsule and a sharp anterior border. The p&Jenchyma is modcnIlely congested and taD-brown with the uslla1lobular ud!i\CCtllf'e. No mass IesKlns or other abnormalities arc: seen. The gallbladder contains 8 milliliters of &JeelI bile. The Cll.~tic biliary troc it \*CftL SPLEEN: The 210 pam (cxpocted 150 - 200 pIN) spleen IllS a smooth, inlll:t, red-purple capsulc. The pamlChyma ill maroon with unremartablc lymphoid follicles. PANC8£AS: The pancreas is firm and yeJlOWoWl, with the usual lobular It\':hiteeture. No mass lesiol\l or ocher abnorma!ilia In seen. ADRENAl S: The n&ht and lel\ adrcnall1.allds are aynunetric. with briiht yellow cortices and redbrown medullK. No Il\UICS or Ireas of hemon'hqe '"' identified. GENITOURINARY SYSTEM: The n&hl and lel\ tidncyll weilh 120 and 1)0 am. rc:spectivcly. Thc clltemallUrfKet are inlKt and smooth. The cut surfflCet 1ft rtd-tan. The pelves are Ill'lrtmatbble and the are normal in course and calibt.-. White bladder mucosa overlies an inlKl b!adda" wall. The b1.ddeTcontains 20 millililenofyellow wine. The proswc gland and testes are wwemartable. IftlCfS Gh$TROINTESTINAl. IMeT: The qophqus ill intact and lined by Il'IlOOIh, grey-while mucoea. The stomach contains 150 milliliters ofl*tially digested food panicles. The IIIOD\IICIl, colon, and appc:rwfuc aR llllrClJIARable. MU$CULOSlCfl EIALi MllSCle development i. normll. No bone or joint abnormalities arc identified. MEDeOM 0929 ACLU Detainee DeathII ARMY MEDCOM 929 FINAL AUTOI'SY Rr.rORT:~(6) Mohammad. Klmyri N~im 7 ~IIClmSCOI'IC t:XAMINATIO~ Lung. righl I. , J. 4. 5. 6. ,.7. IO,,"~'f lulll.· f'l<nl imr:l-31, ,·"Ius LxI~llla und ,'asculnr eOllj;eslion AnrIITIO...."I.I'IUK]mllR.;S arc IRk,'n hy 01'. FME ..lull' phnlocmph~r.;. FILII bod) r~tli"gruphs arc obmin,'ll alltl d~l11o"~lrute lhe injuri~s liS d~scribed. Srecil11~l1s l'\.'U1incd I"r tuxicoloJ:\}' (~.'I in!: llllll/or DN i\ ;denLilical;"," urc: Blood. vilrcoll.< fluid. bile. 'Irill~.IiY''T.lung, ~itlney. spleen. hruin. psoas muscle. lKlipu:so: tissuc Ilndj;ustric conl'·lll•. rh~ d;;."-'Cl,·d urj;llns m~ I"rwmd...'ll "ilh III<: body. Sd~CI,x1 l'ur1i,ms of flrj;)U), ~I'\.' r~lain,.J in rannulin. l'crsonal ~nC~I_' arc rde"scd In lh~ lIppl'l',lprimc morluary opera-LiullS rcpr~scnluL;,"cS. Rcc<we"..1 cyillcnce: 1\" Ik"S<.Tibctll.hove. rclcm'ed IU <..:10. Superlici:ll incisions uf III\: pu.<I<:rior surface of Lhe hod}" Ilml cXlrcm;I;,,-s (St...: E,-idcnce "rtnJury) J)O<':ul1l~nl:lr)· phOlOj;r:,phs ()I!INUN -I hi. H yeuf.()ltI mal~{6~ c:::::::~(J;ed or usphyxia Jut: 1(, slranguI01;on. I'he lnxicoloj;)' screen ",as IICj;IHj"". Th.· ~anll'T of dClIIh is humicide. (b)(6) (b)(6) (b)(6) j IOOic81 ESlIlllil\er MEDCOM 0930 ACLU Detainee DeathII ARMY MEDCOM 930 _ _....___--.Nul ••• ,oo4, - _. _ , Noolm - .. - pc.o, . , - -- -- --....... ... - -- - -- -'...... -. --- _ , . . . . . . . .'11I11 ---- ..----1~)(~ /'" --- --- - ..- -_.. __.... _._ .. - _-- --------- ;----------1""',-,-'-"''--1 -~ " -'.... __-_ -_ .. _.. _ . - -_ _.-- - -- -_ .. _ .. 1& . •• ........ _ =:.... • -- .... .. , ;....=:::1._'-- ~-- =' .... 0 •• _. . -.v-_ ••• .."1"" .. ,._-,,, " " -_. --"'-..... __ ...- -- " (b)(6) (b)(6) • M1rd1200' ... MEOCOM 0931 - _-- ACLU Detainee DeathII ARMY MEDCOM 931 --_. ,--..- _ _ I; .,, ......- _. ---- - ._~-"'" -- - . . ~- 1- _.. • MEOCOM 0932 ACLU Detainee DeathII ARMY MEDCOM 932 ARMED FORCES INSTITUTE OF PATHOLOGY 0fJIa oftbe.-4.rlMd Folftt Medal Eual.er 1413 Researeh Blvd., BI4 102 RoUville, MD 208S0 301-319-0000 FINAL AUTOPSY REPORT Name:~RTR Ahll.LAhnwl KMl8f:::J SSAN:f[(b~){~6l~=""" _ Date of Birth: Jm(b1!.f:t )941 DateofDeath~(b)(6} 2007 Dalcmmc of Autopsy: 09 JAN 2oo7@0900 Dale of Rcpoc1: 06 APR 2007 Autopsy No.: j{b)(6) Af1P No.: ~(b",){",6) _ _- , Rank: Civilicl P~ofDea1h: ltIq Place of Autopsy: Port Mortualy, Dover AFB, DoVCT, DE Cll'C1lmataaftS of Datb: This 59 year-old civilian was dcU.ined 81 Camp Ripper, AI Asad, II1lCj when. u reported, he died during an interrogation with a human exploitation team member. Per report, he .ppeared to have fainted thirty minules into the inlemlgation and bcaune unresponsive, Autborization for AUloP')': Office oftbe Am1cd forces McdiCll1 Examiner,lAW 10 USC 1471. IdeatUleadoD: Presumptive IrIentirteaUon by eJWnination ofpapcn: in _ mortem fingerprinlS and specimen suitable fot DNA analysis are obtained. file. Post· CAUSE OF DEATH: Atbervadel'Otic cudiovucu.lu d1Jeue MltnJ ¥alva proa.pu widlaDDalar ealcilleatioa MANNER OF DEATH: Uadeurmlae' MEDCOM 0933 ACLU Detainee DeathII ARMY MEDCOM 933 nNAL AUTOPSY REPORT: (b)(6) 2 BTB AbdaI, Ahmad Kha11lf' FINAL At1IOPS)' DIAGNOSES I. "t~olo&k dlapOIa: A. CWiOVUCIIW system; I. Foeal heaIcd aubendocaldiaI infaret, IItefa1 tnd po5(Crior k:ft ve:nlriele 2. Left vmtricu!lr hypertrophy with subelido_ldial and perivueulu iMenllti.al fibrosis 3. Mil1ll valve JWOlapse wilh annular talcifiealion 4. Foe-) modente coronuy a1heroIclero.u S. Cardiomegaly, SJO pm! 6. Mild .lberoIeIerolic diseue of the ION IIld If1erieI of the base of!be braio B. Respiratory l)'SIem: I. Conaested lunas: i. RJpt IWJ&, 740 Jr&IM ii. Left luna. SOO pmlI 2. No evidence of pu1molWY thromboelnboUsm It No "Ideate .faiplfkaal ~t Injury 111. Millor loJ.rla: A. AtnJion o(!be posterior left fortlml, 1111 inch B. Abtuion olthe posterioc left band. 1/8 inch C. Healina abrasion oflhe forehead, 111 inch IV. Evidllll:tl of _edlelolllltenllltiool A. Inlrlveooua Cllhl:ltn In the nallt IlIld left Intecubital fosae B. Defibrillator pel! mark/abrasion, left side of the ehest, 2 x 'h inch V. 'ost·_onelll chlDla: A. Lividity il fixed on the pot!erior surfoce of the body excepc in arelII exposed to ptaJUIe B. RJp II pISICd In III extmnities C. Cloody comcIe VI. TodCClJery (AFI'): A. VOLATILES: No ethanol dI:IectaI in !he blood and YiInlOIII fluid B. DRUOS: No ICftImed drup ofabllselmedk:aliOl1l detected in the urine C. CARBON MONOXIDE: CarboJtybemoaJobin SlfUrltion in the blood was ICIIlhan I"'· D. CYANIDE: No cyanide detected in the blood MEOCOM 09304 ACLU Detainee DeathII ARMY MEDCOM 934 FINAL AUTOPSY REPORT: l(b){6) 8TB Abdal, Ahmad Khalaf 3 EXTERNAL EXAMINATION The:: body is thai ofa well-developed, well-nourished white male. The body is 66 inches in lcnath, weighs 17S pollllds, IIlld appears eompaliblc with the Slated age 0(59 years old. The body is cold. Lividity is fixed OR the posterior sunace of the body except in Ihc area exposed to pres.rure. The head and neck are suffused. Rigor has pused in both the upper and lower extremities. The head is nonnoccphaIic. The scalp hair is areylblack with male ~ttem beJdness. F.:ia1 hair col\$isu ofa grey moustacllc and beard. The irides are indistinct. Theeorneae are cloudy. The COl\iunt\IVK are congested. The Sl:leJlle are while. The extemalallditmy eIlllIs, nasal cavity, and orlI cavity are free of foreign matcrial and .boomud 8llC",liora. The earlobes are not pien:cd.. The IIUllI skeleton is palplbly imacl The lips are without evident iJUury. The teeth are natunI and in poorc:olldition. The upper two in<:ison are absent with • denture in place. There are l'IO petechiae of the om mucosa. ~ is. 1f4 x 111 skin tag ofthc right eyelid. The neck is stnlipt, and !he rraellea is midline and mobile with no evicS-:e ofinjury. There. are multiple skin t.p of the neck ranaing from Iii inch III 114 inch in peelest dimension. The chesl is symmetric. TheJe are multiple 1/8 inch !kin ta&s in both axillae. The abdomen is flat. The aenitalia are those oh IlOfll'Ill1llduh male with no c~i6ence of injury. There are two. I inch, round scars on the bel:k.I~(b~)(~6)"",;o;-;,, latlOO~)(6)_ _ '~~~I1bere is. 2 It 1 It 1 Ineh skin tqofthe natal fold, The anus is unrenwbble:The ~ and lower extrem.iti=. are symmetric and without eIubbing or edema. (bl(6) (b)(6) b)(6) (b)(6) ::::It.tlOCls;(b}(6} 'tattoo[(b)(6) tanodb)(6l - - =~---~,:_:::;;:=::J!attoo littOQltbl(6) ~ ~~~~~IiitlOOS~~:~(b~}(6 b}(6) jb}(6) [tartooIlb)(6} ttallOlii'{b)(6l_ (b}(6) b 6L lattOC{b)J6LJhc:re is.1 ineb circular sear of the anterior right thigh. There are two circular scar.J of the lateral rightles. ( iDch and 112 inch, rapeetiyely. There is. U4 It 1111 inch skin 'j0fthe posteriO[ rigblleg. l{bK~ '1 laflOO,{bj(6) __ There are two cireular.sean of the latenl1 left leg, 314 inch and 1-112 inch. respectiyely. The palms oflhc: hands and .ales of the feel are callous. CLOIlllNG AND PERSONAL ERECTS The body is in an Onlllge shirt (cuI). wllite l-shirl (cu.l). onoge pMlS, and white bolten. Brown plIpCl" evidence bap are seaued with evidence tape OYCl' both hands. MEPICAL INIIIM'.NIJQN InlnlYCflllus eatheleB are in the rightll11d left antecubital fossae. Theft! is • 2 x 112 inch abrasion of the lell. side of!he chC51 consistenl wilh defibrillator pad pillOCml:nL BADlOGBAlIlS A complete set ofpostmonem l'lIdioJraphs is obtained and do not demonstn.te evidence ofjnjwy. MEDCOM 0935 ACLU Detainee DeathII ARMY MEDCOM 935 "NAL AlrrOPSY REPORT 1l b)(6) BTB Abdal, A.hm.t KN.lar • [VIDENCE QF INJURY ~ I•• III inch hctIlna Ibrasion orlhe bchetd. Then: I•• III Inch tbrIsion of the poslerior left forearm. "'llleft iJ I 111 inch .bruion oCtile postaior left hand. INTtBNAL EXAMINATION HEAD: (CENTRAL NERVOUS SYSTEM) The xtIp iJ nltlcctcd. The calvari11m orthe skull II l'CfIIOYed. The dun IlIIlcr IIld falx cerebri are inlld. There i. no epidllrlll or Rlbdwal hanorTtIIae presenL The \epIomeninaa are thin IIld 6elicale. The a:n:blll hemisphaa llel)"llUrlelrieal The slnIctumI II the blIK or the Inin. includilll fnIliai Pel'YeS IIld blood vaJel. ate inlKt. 'There i. mild. non«x:lusive Ilherotclerotk dilate orllle 1lUries. CoronalIlCd.ions Ihrou&b Ille cachill hemisplltta lind IJWISYmC sec:lions lhrouab the bl'linslem tnd a:"bdllDlllln: UIIr'al\I.rUbIe. The brlin weiabs 1440 anms. lI.El:K' The IlIIelior IIld posterior IU'Ip mlDCles of the ncdr. ate homogenous IIld n:d-brown, witboul helTlMhqe (sept.rale IlIterior tnd posterior neeIt diuec:tio",). The th)TOid eartillae and hyoid ate inllel. The lIrynx i.lined by ina.:! white mueoa. The thyroid is IyII1l'MtIic: tnd mt·brown. withoutl:)'Slic or noduilr ehtnge. BODY CAvmES: The ribs, Remum., Il'Id vertebrll bodies Ire visibly lind ptJptbJy inlle!. Then: i. 20 milliliten o(lCrosanauinous nuid In ete:h o(1he thor.:ic ""ilies. No excess n\lid II in the periclrdlal or perilOflca1 ClY\lies. The orprtI occupy their UIIIlllllltoll'lic positions. BESPlRATORY SySTEM: The upper tifway it clw ofdebrit tnd ron:lgn ITIIlcrial; the mUC05ll surfaces_ smooth, yellow-tIn and unn:marbble. The n,hl and left lunp ~iah 140 aid 500 paml,le3pC'Ctively (expeelOd )6().510 aramstnd )2$.... 80 1fMIS). The exlemt! surfaces Ire JmOOIb. alistenina tnd IlIlreIl\Ifbblc. The pulmonary parenth)'ml il n:d-purple exuding .lia!ltto modcnlle amounlJ or blood. No mISS lesions or areas ofconsoIidll.ion lie pRJCIIL The pulmonary arteries lie nonnaIly developed Illd pIlenl without thrombus or embOlUI. CARPIOVASCuv"R SYSTEM: The 5)0 pm (expteled 26j-46Q rvams) hetrt is conlllned in III inllCt pericardia! laC. The he.., was relllnecl and tent rorcan;llollUCultr pttholoay consultation (see IlIt1endum). The IaOI1..I hu mild IlheroIclenxic diseue. LIVER" BILIARy SYSJEM: The \800 JRm liver hts III in\IICI. smOOlh caplulc and a slwp IlIler10r border. The parene!lymlls moderIlely colJlested and tan·brown with the usllllllobllltr trdIllCdun:. No mass 1esi0lll OT other IbnormaillieJ Me teen. The pllblldder conllln. 20 mlllililCl'1 of green bile. The Ulrahepatlc biliary tn:e i. palent. MEDCOM 0936 ACLU Detainee DeathII ARMY MEDCOM 936 FINAL AUTOPSY REPORT~(b)(6) BTBAbdaI,AhmadKhalaf L,- - - - , SPI Ern: The 250 gram lipleen has a smooth, ill1lld, ted·purple ~u1e. The p&rCnchyma is l1W'OQn with WIl'Cmarbble lymphoid follicles. PANCREAS: The pancrtU is finn and yellow·tan, with the usual lobu/lIT arcltitectun, and has lIUlo!ytk: changes. No mass lesions or other abnomWities are ~n. APRENALS: The ript and left adrenal glands ate symmetric, with bripu yellow c:ortit;eS and Rd· broWllmedull1lC. No masses Ol'lITC&! ofhcmorrhage arc identified. GENITOURINARY SysttM: The risht and left kidneys _iab 210 and 220 sm, respedively. The eltltmal surfaces arc intact and smooth. The cut surfaces ate red-tan. The pelves lITC IIlU'UllaJltable and the umclli arc nonna! in course and caliber. White bladder mucosa overlies llll inllCl bl.sder wall. The bladder contains 120 millHilelli ofclCllT yellow urine. The prostate gland and testes are UlIl'ClDarlcablc. QASJROINIESIINAI. TRACT: The esophagus is int81:tand lined by slllOOlb, grey·whlte mucosa. The stomach contains less tIwl S rnillilite:rs of brown mucous. The stom.,h, duocknum, loops ofsmall bo_l, and colon have diffuse mucosa bcn'lOfrllagcldccomposilion change. The appendix is llJlmlWbble. MUSCULOSKEI.EIAI,· MlI$Cle development is noma!. No bone or joinl abnonnalilies are identified. ADPWON..u. PROCf,D!!Bti§ I, 2. 3. 4. S. 6. OGcumentary p~oppbs are taken by OAFME staff pbolOpphcrs. Specimens retainccl for IOxioology testinl1 ancIfOT DNA iclcntifieation ate: Blood, vitreous fluid. bile, fivCt',IW'l& kiclncy, spleen, brain, mUICIc, urine, adipose tWue and gastric contc.nts. The c1i~ orpns arc forwarded with the body. The heart is maincd for consUltation. Sclceted pnrtions of orpns arc rctainecl in fonnalin. Pcnonal effOClS arc released 10 the appropriate mortuary Operatiollll representatives. Posterior inci!ions of the Kin and su~ !Oft liuue dcmonslnlle no eviclcnoc: ofinjut)'. MEDCOM 0937 ACLU Detainee DeathII ARMY MEDCOM 937 , ] FJNAL AUTOPSY REPORT: (b)(6) BTB Abdal. Ahmad Khalaf OPINION This S9 year-okl male, BTB1(~{6) died ofathetoklerotic cardiovueulu diseuc and mitral valve prolapse with MIlular calcitl",tion. Histologic sections of the heart demonSU'ated a healed myocardial inCuction (heart altack). 'I'hef': was no evidellce ofsianificant injury. The IOlicology screen was negative. At the time ofhiJ dealh, pet report, he wu beinll intenopted by I human cKJlloitatlon team member. The contribution of being intelTOlIIIled as I precipitating event leading to his death is IIDCCI1ain. ThIlS, the manner of death is undetermined I (b){6)'--------' C' (b){6-r-Medical ~ Examiner ~b){6) lMedi"'l Examiner • lrlllnher b1t"OnnWoa IJ oblalned 1'* ""fORo c""'&ln& l!lc _ 10 lhb rqoon will be ...... (1M'IlI _ l o r dolU, ... _/IdInalt MEDCOM 0938 ACLU Detainee DeathII ARMY MEDCOM 938 FINAL AUTOPSY REPORT: (b){6) BTB AbdaI, ANn.d Khalaf 7 ADDENDUM Csrdkwucalar 'adtololJ COlnllltatloa: DIAGNOSIS: (bH6) I. Foea.l moderate coronary atlleroKlerosis 2. Left ventricular h)jIClbOphy with subcndoc&rdial and perivascular interatitiaJ fibfosia. and roeal healed IUbendoc:ardiai inrartt, lateral and posterior left Yaltriele .l. Mini vaI~ prolapse with IIIllIJIar eak:lfieItion Heart: 515 IJ"lM (posl-ftxalion); nonnal epieardial &I, probe palcnt fofamen ovak:; left vc:Nritular b}pabophy: left ventricuJ#e.vity dilU'Mla" 30 mm, left vemril:lJlar free wall thIeknc:u 14 mm. Yelltrieuw JePlUlIl tItict- r 16nun; rigbl ventriele thieknesr Smm~ mitral valve prol8pse: thickened and redundan1 valve Iea1lets with boodina and annular ealcifialioa of posterior 1eIlIel; other valva unrc:rrwbble~ mild mdocardial thiekenina in left YaltriClJ1ar outflow trad; no aron myoeardial filnoJis or necrosb; histolosic ICCtions rhow left YelIbielliar myocyte hWC1tr¥l) and 5I1bendoc8rdial and peOVQClJlar intmtltiaJ fibrosir, Illd focal.rubmdocardiaJ ~I fibrosis in WeraJ and posterior left walls (bea.led inflll'Cl) Coronary arteries: Normal ostia; right domillInce; foea.I modenIle atheroxlerosis: 33% Iwninal narrowint, of prollima1left anterior deIoend:ina anery by puboIosic intimal thickening with inlimal foem cell infilll'aleS; 60% IlIfTOWina or proxillWJ left c~llnl11ex arteIy hy fibroathcroma.tous and fibroealcifie pllquc with adventitial fibrosil and cIvonie inflammation; 30% narrowina of proximal right torol'Wry arteIy by pathologic intimal thicUnina with intimal foam cell infihmer MEOCOM 0939 ACLU Detainee DeathII ARMY MEDCOM 939 ___ - CERTIfICATE OF DEAn! jO\'VlSEAS) -- "'em clII_ _OF.,........., ... .. .......... _ - BTB Abelal, Ahmed, Khalaf . ...Tl(IN fIl'O_~ ..,..""' ...... --- 1", _ _• _ -- "'" t€<t _ ........... OF ""' _ ... _ -- _ __-,... -... """"ll. ~" ... _ 0 - ... _ , _ _ coJ<liovaoculat d..... , Mill'1I ...... prolapH " ""'... """""'" ONIET_w'" ... _ Y"""'"'" TO W ... ___.. _-... tAUSO""'W'" OUU" "" <;OH;>r«lH -- - . - ,,:. ,"(b}(6) I -..... ott '"''''' ...... Civilian I,., oEGO:OO _.- .... wil~ ..... lIiat cok:il\ClliOn TO --",,--,. ..,....,CQHOrIItlN, .. _ .......... ---- -- __.. --------~ ..........\'\NG CAUIE, .. .,... """"" . _ .-_",. TO_"'~ <mo;_O::_C""c>",,,Nt ...... _ ..... 1'" ....... OF ....... .......- [II - "'" 0 "" - , -- ... .... "' ....... -,-r----- -_ .... _- ...-....... """-TO~.,....... "' ... ~ "ifl.' lb}J6) (b}(6) l(b)(6) 9 January 2007 {IOIU'.• _ ' _ 2007 I~Q n.._ ' ........ _ ...... " " .._ _ .....__,.__ Of ' .... ooc.'•.., _ •_... r::.'~~~'~' (b)(6) I 0- "'" \il""- •_ ""_........... ..... -:.<="""._.........,...... _ nA""_. ~., -. _- I Medical Examiner =:~==~ i .tt -~---------r1i:i~C':;:;:;;.,;,;,~~~~~~~l------------------_j -_...- .... .... ...-_---... .. -_._..-.-.....woooo_ _..-"""""-""' .... .---,,--"''''_ it;W) 91512001 ____ _. l(b}(6) I -..co......- -" _ .. _ ... _ _.........,.,, MEDCOM 0940 ACLU Detainee DeathII ARMY MEDCOM 940 I -.:1101_ (b)(6) _Of .......... _ " ' " __ _TIOOO1""irll.IT~lWT'aI ""," - -- ~...n _"....._ " 0 ' .. ''0 00 ~ -,1oPR 1f71 SAC us-,pA ..., "" MEDCOM 0941 ACLU Detainee DeathII ARMY MEDCOM 941 ARMED FORCES INSTITUTE OF PA THOLOGV om~ o'lht Anu4 Fol'«I Medical Eumlou 1413 R.csearell Blvd., Bldg. 102 Roc:kYillt,!dO 20850 30\·319-ססoo AlfJ'OPSV EXAMINATION REPORT NIllle; Ibrahim, Sadir Ahmed ISN; tbX61 DatcofBinh: unkMWII Date of Death.: (b}(6) ,2008 DaWTime of A1IIOpsy: 20 FEB 2OOI@09OO DfIIc ofRepon: 11 MAR 2008 AUlopsy Nt>. (b)(6) AFIPNo.: (b}(6) Rank: Detainee PlaceofDealh: Iraq Place of Alllop5Y: Port Mortuary, Dover Air Foree 8Isc:, Dover, DE 0' Clrt1IlDslaotft [kall!: This Ir.qi mak was beaten by olhtr Iraqi Nationals wlltn they dilCOvuccl him attempting 10 planl an Improvised Explosiyc Device (lEO). American forttS subJcquCtllly took eu.scody of tum and brought him fOf medical tmI1met11. Initially, M was lIU1eO for vemricular fibrillation and hypothcrmiL Upon stabilization M had JeYen.I complicalions including a6eaCllSUi mmtal stallQ, (Gl.,gow Coma Scale 3), renal f.illlR. gc:nmJittd.seizures, and &nISIfta. "Tllc:K conditions _~ eonsilkred ilTC'ltfSible &1M! the deciJion was made to tre. forcomfon. Seven days &ftcr admission he dc-velopc:d armytbmias, wllidl JIIOiP~ 10 lSy5lok:. AUlhorkalioo ror Aulopsy: Amxd folnS Medical Examiner. per 10 U.S. Code 1411 IdlHllifkal_: Accompanying doamJr:nts eslablish prawnptiVii ldenlificalion; samples from fingerprint,lknu.l, and DNA examllllUons obcained for posilive idtntiflCliiOll. CAUSE OF DEATH: Complaliolll of Bhlal Force I.juries MANNER OF DEATH: Homldde MEDCOM 0942 ACLU Detainee DeathII ARMY MEDCOM 942 AUTOPSY REPORT (b)(6) IBRAHIM,Sadb' AIllllcd 2 EXTERNAL EXAMINATION The body is thaI of. wcll-developed, _ll·llOUrished Caucasoid male. The bod)' weip 170 pound5 and measures 6S inches in lenatli. Lividi!)' is lixed on the posterior surftces oflhe body. Rigor is passing. The body tcmptnllun: is cold 101OUCh. Decomposition cMJl&es consist ofskin slippage on the lower cxtremil~ and '*:11.. Injuries oftbc head ~ described below. The held is 1IOI1JlOCCphaJic. The 3CIIlp is covcred with stralglu black hair of medium length in a IlOmIlII distribution; fKia! hair consists ofa bcanllllld rnOU$UChe. The right iris is brown. the oomea is clear. the conjlll"lCliva is cry!hematou£. and the sclera is yellOW; the left iris is Jny and sarrcd and lhe left alobc is shrunkcn. A finn. movable nodule is palpable on the 'atcnJ aspect or the letl orbit. The external auditory canaJs ~ clcar. "The I\IIU contain mucllS. The rIO$t and nwlillae arc palpably stab~. The teeth arc nalunJ and in good condition. The neck is Straight. and the lraclica is midline and mobi~. Injuries of the IOrso arc desaibcd below. The ehcst issymmctl'k The abdomen is mildly pmtllbcnnt. The 5:miIllHa.e those oIa nonnaI adult cirewnc:ised mak. There is moderate .lI(:rotaJ edema. The testes are d~. Pubic: hair is ptcscm in a normal distribution. The '*:11. is symmetric. The upper and lower C'xuerniUcs arc S)'IIlll)C\ric: with mild 10 Il'IOdcme: edema oIthe dillal ponlons. The fillim.ill are inl.ct, except for a chip ofthc nail ofthc left ril'li rlllgcr. ...... Identifyina marks COnliS1 oran imgular SCllI' (1I~" in diameter) of the do~um of the right CLOTHING AND URSOlUL [(FErn No clothina; ilCI\U or pe1Wl\Il efl"eas arc Jl'UCfIt on the body. the time of autopsy. MEDICAL INTERVENTION Medical inlCrVention prncnt on the body at the time of autopsy includes: - Two fasc:lo'OIRy lnc:biol'lS p.)/4"1II'Id a·1I4i on the anteriol" and laleral surfllCeS or!he rialitlea • Blue ped wn.pped lI"Ound fuc:ioIom)' incisions • Luge bon: lntrav.uc:ular c:athclCr. left subclavian - N~le punctute maRs, bilateral anlC-elibillll fossae • lnlravucullrl:lllhcter, left wrist • Three incisions (1I4" 10 I" Iona), 1_\CBl left cl'lcst MEDCOM 0943 ACLU Detainee DeathII ARMY MEDCOM 943 AUTOPSY REPORT (b}(6) l IBRAHIM, S.dlr Abmed RADIOGRAPHS A complete set of postmortem nuliogn.phs is oblained and demonstrates the following: • Cone·shaped metal li'agnu:nt on literal aspect of the lell. orbit - Fntelurc, lell. tnlIUverse pl'OCe$!l oflhe third lumbar vo::r1ebnr. - Frachl~,llteraJ as~1 of the riiht sixth rib EYIDENCE OF INJURY The ordering of lhe following injuries is for descriptive purposes only, Md is not inlended 10 imply order ofinOiction or relalivc severity. All wound pathways are given relative to standard anatomic posilion. l. Blunt force injuries A. Head and neck A cluster of helling IbruiOll5, lIS" to 1/4" in gn:llest dimension, covers M area of 1-114" x I" on the lell. forehead. A I/S" healing .brasion is on the upper lip. A 112" It liS" hellinS abrasion is on the left ev. A 0.5 em contusion is on the rishtlaleral aspec:l of the tongue. A 1 em It 5 em subgaleal hemorrhage is on the right fronlalll5ptCtoftlte skull. There is mild. but diffuse, subullcltnoid hemorrhage. B. Tof$O Two healing contusions, 1_1/4Mand 2" in greatest dimension, lie on the left side oflhe chest. A 12" It 10Mcontusion ClItCllds OVCTthe left II~raItorso from the lower c!lest 10 the pTOltimalleft thigh. A 2·112" It 2" contusion is on the right side of the back, jll5t below the SClpulL Three heali"iMnsions, 112" to I" in greatest dimension, are on the middle oflhe back. A 2S" X 13 Mcontusion with hemorrhage into the underlying soft tissues involves the lower btlek and buttocks o:tendilll from lite lell. 5ClIpul.. around the lateralupccts of the butloeks, and down to the proximal posterior lhigJu. A 112" It lIS" healing abrasion is on the scrotum. The lateral aspects of right ribs five and six are fractured. 11Ie left transverse process oftlte third lumbar vertebra is f..eIUl'lld. Both testes have inttapartnchymal helTlOfThl,ge. C. Extren\ities 'Ihret eontusions, 112Mto 3" in greatest dimension IrC: on the anterior righl arm. A 112" x 114" contlWon is on the posterior right shoulder. A I" x 114" healing abrasion is on the poslerior right ann. A I" x I" conlusion is on the posterior riglt! forearm. A 2" x IISM healing contusion with focal hemorrhage inlO the underlying soft tissues is on the posterior right wrist. AIM x lIS" healil18 contusion is on the anlerior left shoulder. A ChlSler of contusions, 1/4" 10 I in greateSl dimension, coven 1/1 area on" x 1-112~ on lbe lIlIlerior left ann. A 6-112" It 3" contusion is on the anterior Icll. upper extremity extending from the distal lU1Tl 10 the mid forearm. A I" x lIS" healing contusion with focal hemorrhage inlO lhe tmderlying soft t;55~ is on the pGSlerior left wrist. ft MEDCOM 0944 ACLU Detainee DeathII ARMY MEDCOM 944 AUTOPSY REFORT(b)(6) IBRAHIM, Sadlr Abmril 4 On the Mtero-lateralllSpKi of the right thigh is an I 1-112" x 11-112" «lnTU5ion. A 6-ln" x 2-ln" healing abrasion is on the anterior riglltleg. Two healing abrasions, 1/4" and In" in grealest dimension, ~ OfIlhe dorsum oflhe right fOOL A 3" x I" wntusion with hemorrhage inlD lhe underlying soft tissues is on the right poplileal fossa. A tlUS\er ofhealing abraslons and contusions with hcmOlTbage intO the WJdcrlyins soft tiSSllC5, 112" 10 2" in grealeu dimension, WVe!S an area ofS" x.5" on the posterior righl ,''- Two contusions. 2" and)" in greatest dimension. ~ on the 8l\terior lcft thigh. A dustCl' of healing abrasions. lIB" to )f4" in sreate5t dimension, covers an area of \6" x 4" on the anterior left lo_r extremity from the knee to the dorsum o(the foot. A 4" x 2_ In"l:OIItmion with hcmorrllage into the: underlying soft tissllCll is on the left poplitcal fossa. A e\\l$I.erof,,",ing abrasions and conlusions with hcmorrllage mlO the. underlying soft lissues, 1/4" to 2" in gTeIIlesl dimension, covcrs an area of)" x )" on the posterior left Ics- Two contusions. In" and I-In" In greatest dimension, lR on the postero-lateral left leg. INTERNAL EXAMINATION HEAp AND CENTRAl. NERVQUS SYSTEM: (See Evidence oflnjtuy) Jhe,e ~ no skull fractutes. The dW'll mater is inl&Ct with no evidcntt of hemorrhage. The leptomeninges aR: lhin and delicate. The brain weigbs 1270 gm and has unrernarkllble gyri and suld. The cerebBI hemispheres ftIC symmetrical and the struclures at the base of the brain. including the crtU\iaf nerves are intact. The orn:bl"al artcri.es ~ palen\. Coronal sections demolUlrlIle sharp tkmllJCation between wllite and Sray matter. without hc:molThage orconluSive injury. The vel'urides are not enlqed. The basal ganglia. brainstern. and cerebellum are free of injury or other abnol'llll!ilies. The atlanto-oc:cipiLal joinl is stllble. A cone-shaped metal fragment recovered &om the soft tissues of the left orbit. (See Evidence oflnjwy) uyer-by-laycl' dissection ofllle anlcrior slRp muscles of the ne<:k reveals homogenous and red-brown soft tissue, withoul hemorrllage. The thyroid cartHage and lIyoid are intact. The larynx is lined by in\aCtl'ritite mucosa. The thyroid gland il symmetric and red-brown. without cystie or nodul/lr change. The puathyrtlid glands are not identified. The lTIlljor vessels ofllle neck are inllCl- MEDCOM 0945 ACLU Detainee DeathII ARMY MEDCOM 945 , AUTOPSY REPORT (b}(6) IBRAHIM, S.dlr Ahmed BODY CAVII!ES: Excess sero-s.anpineoU!l nllid is present wilhin cac:h body cavity: 350 ml in the risht plelJflll, SO mI in the left pleural, 10 ml in the pericardial, and 50 ml in the peritooeal cavities. The 0/'BIfIS OCCllpy their U!I\U.I anatomic positions. The lubclltancollS fatla)'CT oflM abdominal wall is 3.5 an thick. MUSCUl.OSKELETAL: (Sec Evidence of InjW')') No non-tnlwTUllic abnormalities orthe muscl~ or bona of tile appendiclllar and axial skeletons are identified. RESPIRATORY SYSTEM: The ail'Wllys are clear of debris and forei8JI malerial and 1M mucosal surfaces m smooth, yellow-!BIl, and unremarkable. The ri&hl and left lunSI wei&h 960 and 820 sm, respectively. The external slifraccs arc smoolh and deep red-pwple. The pllimonary parenchyma il difTlI~ly congested and cdcmaloUS. No mass l~ions orareu of consolidalion are presenl. The pulmonary arteries arc normally dcw:loped and patent. The dilpltragm is inlaCt. CARPIOVASCULAR SYSTEM: The 450 gm ~ is contained in an intacl pericardial sac. The epieardiallurflll:e is smooth. with minimal fat investment. The coronary arteries arc unremarkable in di$lribution, with a ri&ht-dominant panem. Cross sections of the v~ls show no luminal JWrowing. The myocardium is homogmous, red-brown, and firm: the atrial and venUiclllar septae are intacl. The valve leaflets arc thin and mobile. The walls ortlle left ventricle, interventricular septllm, and right w:ntricle arc 1.4, 1.4, and 0.4-cm thick, respectively. The endoardillm is smooth and glistening. The -.ort.I giv~ rise to three intacl and pIltent a/Ch vessels; there are mlllti-fot:al thin yellow linear p1aq~ (filly nreaking) orlM descendina 1IIOrta. The renal, mesenteri<:, and mac v~ls as well as the venae: cavill: arc unmnarkable. HEPAJQBILlARY SYSTEM: The 1820 gm liver has an intllCl, smooth capsule and I sharp anterior border. The parenehyma is !BIl-brown and congested, with wucmarbblc loblllar lIJ'Chitectwe. No mass lesions or other non-laumatie abnotmaliti~ are seen. The gallbladder contains a minute BmOllI1t oflfCCll·b1a<:k bile and no stones. lbe mucosal surface is green and velvety. LYMPHORETICULM SYSTEM: The 250 gin 5jlleen hal a smcoth, in1llCl, red-purple capsule. The parenchyma is maroon and congested, with distinct Malpigbian COI'JllLWI~. Lymph nod~ in the hilar, periaortic. and ilia<: regions are ~markable. MEDCOM 0946 ACLU Detainee DeathII ARMY MEDCOM 946 AUTOPSY REPORT (b)(6) IBRAHIM, Sadlr Aa.mcel , • ENDOCRINE SYSTEM; The. pituitary ,land is unrenwbble wirhlnlhe seJII U,":iea. The th)'l'Oid a1and has bttn dc:st;ribed<see NECK.. above). Thc. riaN and leR.dmIal slandl_symmetric. with briabt yellow c.ortlUI and m1-brown medulllC. No m&SIeI or uas on~lIIOl'fN.acare idenlified.. GENITOURINARY SySTEM; (See Evidence of Injury) The. righl and left kidneys weill! 21 0 and 170 IITI. fell)eCllvely. The txlemalsurl"aces are in~ and ,mooIh. The CUI surfaces ~ m1-1arl and conseslcel. with unifonnly thick eorliees and shafp c:ortieomedullary jUl'lCliOlII. The. pelves and Ilrflen an unremarklble. White bt.ddcr mucosa overlies II/l ;nbd bl.ddcr wall. The bl~r Is empty. The prostate has lobular, yellow-tan pamll:hyma and is J10I cn1araed.. The seminal vesicles an unrenurItable. GASTROINTESTINAl. TRACT: The esophagus illn~ and lined by 1mOOIh, py-while mueosa. The Jlomach c:onllilll approltilT\lllely 30 ml of pink viscous fluid. The: aasttic wall is inlKl. The dllOdenum. di.taI1ooJll ofinteltine, and colon are WIl'tm&,klble. n.e p&llCIUS I. finn and yellow_ Ian. with Jobul/lr /lrChil«JUre. Seclioningoflhc panerus reveals diffuse, bUI mild pareru:hymal helJ'lDlThllgc. The .ppendix il present. ADDITIONALPROCEPVRt5 I. Doewnc:nwy pho\ogrlIphs are lakm by OAFME stafT. 2. Personal efT«15 are n:leased 10 lhc appropri.te mDTtUIry opcrltions tq)n:senlllives. 3. Spec:imens n:wned for loxic:olDiY testing and/or DNA idenli fication lIl'e vitreous fluid, bile, blood. lung,liVCT, spleen, kidney, adipose tiulIe, heart 1TI11KJe. bllin, gastric contents. ancI psoas muscle. 4. The diuectcd organs lIl'e forwarded with body. .5. Tl"Il(:e evidence and/or foreign material arc collected and malncd by OAFME. MEDeOM ()9.(7 ACLU Detainee DeathII ARMY MEDCOM 947 AUTOPSY REPORT (b}(6) 7 IBRAHIM, Sadlr Ab..td MICROSCOPIC EXAMINATION Sclecltd pMions of orpns ~ retained ill fOl'Tl\lllin for prepanrioll ofhi5tolol)' slides. Slick Key: I-luna. inlerVentrieulw septum (he8rt), liver: 2· tung, left ~ wall (hcar1), pancrus; ]·Iun" ri&hl &ee wall (bean), spleen; 4- tuna. left kidney, adTmai gland; Sluna. adrenal ,llllld, skeletalllluscle; 6- ri&ht kidney, thyroid ,land, ton,ue; 7. cerebellum; 8· midbrain; 9- brail\$lelD; 10- hippocampus; 11- cerebntl eoltelt HISlg!ogy: Brain: DilTuse neurooal eosinophilia and pybosis; mild subarM:bnoid 1'lemoTrllage TlIlIsue: no $ianilicanl pathologic change Skeletal musele: no signi(1ClIll1 patholO&ic change Lunp: multi-focal h)'l.li~ a1veo1armernlnnes; diffuse pullTlOntII} edema and congalion with airsJ*e hcmorTflagc Heart: no sianilicanl pathologic chan&e Liver: mild to 1flO(\er.te: maero- and micro-vesicular steatosis Spleen: no sisniOcant pa1hoJoaic change Kidneys: lU~lar cell necrosis, tubular ClISIs, Ind mononuclear cell infilltlles Th)'TOid gland: no sisnificant pathoIosit dlange Adrenal Qlantis: no significant puhologit change Panc:rctIS: mild autolysis, but olhcrwUe no li&\liliCllllt patholoait than&e MEOCOM 09048 ACLU Detainee DeathII ARMY MEDCOM 948 • AUTOPSY REPORiC b}(6) IBRAHIM, Sadlr Abmed FINAL AUTOPSY DIAGNOSES: I. Slunt force il\iuries A. Head and IlCCk l. CluSier of healing abrasions, left forehead 2. Healing abrasion, upper lip 3. Healingabra$ion, leA ear 4. Contusion,lOngllC S. SubpJeal hemorrhage, right ftontal skull 6. Diffuse subaracltnoid hemorrhage B. Torso I. 2. 3. 4. C. Mulliple (2) contusions, leA chest Contusion,left IlteraltOl'1O Contusion. right back Multiple (3) healinglbruions, middle beck S. Contusion, lower back and btlttocks 6. Hc:alingabruion, scrotum 7. Multiple (2) right rib fractures 8. Fractu~. left IJ1:nSVene process oflhird lumbar vettebrll 9. Bilateral intraparenchyma1 hemorrhage, testes Extremities I. Right ~r a. Multiple (3) contusions, lllterior arm Con1U5ion, posterior shoulder b. c. Healing allrasion, pll$Ierior arm d. Contusion, posterior forunn e. Healing eontusion, posterior wri~ 2. Lel\ upper a. Healing contusion, anterior shoulder b. Chlstcr ofconlusions, anterior arm c. Contusions, distal ann to mid forearm d. Healing conlusion, posterior wrist 3. Right lower I. Conlusion. antcn>-lateral thigh b. Heallngahrasion, anterior leg c. Multiple (2) healina abrasions, fOOl d. Contusion, popliteal fOSSIl e. Clusterofahruiom and contusions, po~eriOT leg 4. leA lower a. M...ltiple (2) cont~ions, anterior thigh b. Cluster of heallnll abruioll$, anlerior knee. leg and fOOl c. Conlusion, poplitell fossa Cluslerofhealing abrUons and contusions, posterior leg d. e. Multiple (2) contusions, postero-Iaterallea MEDCOM 0949 ACLU Detainee DeathII ARMY MEDCOM 949 .. AUTOPSY REPORT""(b~)("6" - - - 9 IBRAIIIM, Sadlr AbIDed II. Ill. Other evidence recovery • Cone-shaped metallie fragment from ld\ orbit Nlturll disease: and anatomic fil'ldinp A. Cardiomegaly (bean weight 450 gn'!; expe<:ted weight range for. 170 poulld per$OI1ls 305 to 375 gm) IV. V. B. C. D. Mild peripheral al~rerosis Glolllll ischemic changts orille bnin E. F. Mild intraparcnchymal hemorrllagc. pancreas AIIlIS&I'Ca Diffuse alveolar damase Medical intervention A. Two fa$(;iotomy incisions. anlerior and 181m.! nih! leg B. Blue pad WI'apped arol.Wld fasciolomy incisions C. Large bon: intravascular catheter, left subclavian D. Needle puncture marks, biialcllll anle-l:"ubilal fouae E. lnlfllvascullll' CBlheleT, left wrist F. Three incisions, lalerallef\ che$I Post-monem changes A. Mild decomposition B. C. Passing rigor F!:ted poSierior Jivor VI. Identifying maOO; - Scar. riShl hand VII. Toxicology result, A. B. C. D. Volatiles (blood and vitreous nuid): no ethanol dClCCled Sc~ned dnlgs of abuse and medications (blood): I. Positive benmdiazepine: Lorazepam dete<:ted io the blood at a concentration of 0.049 mf'L 2. No other screened drugs ofab\lsc or mcdlClllions dc'Ittted Carbon monoxide: not lUted, no suitable specimen Cyanide (blood): none MEDCOM 0950 ACLU Detainee DeathII ARMY MEDCOM 950 · . AUTOPSY REPORT~(6) IBRAHIM, S.dlr Abllled to OPINION Thi, Iraqi malt (b}(6) ,died ofcomplieBlions or bluM fo~t injuries. Aftci suslaininlla bee.ling resulting in injuries 10 the head. 10<$0, and extremities he developed (ll,diac arrhythmias, respiratory failun:, renal failure, and seizures. These clinical chan&cs were likely due: 10 the metabolk: insulll susUlil!Cd from lhe bealin&. howe\'" an asphyxial contribution 10 his death cannot be excluded. Despite initial rtslUCitauvc efforts hi! oondilion progressively wo~d and lie died. Toxicolosy tests for ethanol. cyanide, and SCf"ned drugs ofabu$e ~ negative; Lorazepvn detecled in the blood is consistent with medical-relllttd and cornfon·related measures. The mlll'lllel' ofdeath is Ilomicide. (b}(6) (b)(~=:JMedical Examiner j MEDCOM 0951 ACLU Detainee DeathII ARMY MEDCOM 951 ARMED FORCES INSTITUTE OF PATHOLOGY Office oflhe Armtd Fort'C'l' MPllfcal Euminer 1413 Research Blvd.• Bldg. 102 Rockville. MD 20850 301-319-0000 FINAL AUTOYSV EXA!l:lINATlON REPORT Name: Jabar~~a.Ud TlnYU"-----, J SSAN!(b)(6) Dalc of D"lc of Dcalh(b)(~~2008 Dale and lime of AUloPSY: 27 FEB 2008 0900 Dale of Rcpen: 01 MAY 2008 ninh~:l6i~l~[6~IJiJ83 CirC\lm~l~nO<'$ of A\lIO~Y No.: f{b)(6) AFIP No,Rb)(6) 1 Rank: CIV Place of Dcath: Iraq Place of Aul-Opsy: Pon Monl.llU)· Dover AFB. Dovcr DE DUlh: 25 year old male ci,'Hian dC1ainee reponc'<ll r eollllp~d durinG inlerview Authorization for AutOP5}': Office of the Anned Forccs Medical Examiner. lAW 10 USC 1471 hlcntifiuliun: Pn'Sumplin CAUS~: OF DEATIl: Se."ere n,ellibolie dcrangcmcnl due to lIeule adn:nOl:Orliul insufficiency MAN,'>iER OF DEATH: NlIlunll MEDCOM 0952 ACLU Detainee DeathII ARMY MEDCOM 952 AUTOPSY REPORTl(b){6) JABAlt WalidTawfiq 1 EXTERNAL EXAMINATION The body is Ihal ofa ""CII-developed, well·nourished male thai weighs 137 pounds. is 68 incho:s in lenglh and appears conlp!tible willl Ihe repoI1ed age of25 years. The body is cold .Iller refrigeration. Rigor is p!ssinll in all cXlremilies. Lividity is prescl1l and fixed on the posterior surfaces orlhe body. except in areas exposed to pressure. The head is nonnocephalk, and the scalp hair is black. Facial hair consi.sts of a black beard Md mustache. The irides are dark. The comcae are cloudy. The conjunclivae arc unremarkable with no evidence of pcte<:hial hemorrhages, The sclcroe are white, The external auditory Callais. external narcs and oral cavity are free of foreign materia) Wid abnormal secretions. The nasal skeleton ami maxilla an: palpably intact The upper and lo"er lips a", dry and chapped. The teeth arc I1lItural and in good condition. Examination ofihe neck reveals no evidence of injury. The chest is unremarhble. No evidence of injur)' ofth", rib~ or the SlcmUI1l is c"idcnt ",xtemalty. The abdomen is flat. The extcrnal genitalia are thosc ofa n<)nllal adult male. The: posterior torso and anus an: without I1Ote. The extremities show no evidence of injury. The fingernails are intnet. CI.OTHING AND PERSONAl. F.FFr.crs • • • • • Pair of black sandals. soiled Black lonll-sh:eved shin with thc nnblem "Down Nour", soilCli. TIU] and olange striped 101l1l-sleeved shin Pair of blue sweaL panlS rair uflan ~wc-~t pwtts MEDICAL INTERVENTION • • • • End<>tl1leheal tube Nasogastric rube Intravascular cathct~rS ill l>oth anlecubital fossae. the right wrist IlI1d righl inl,\uinaJ region foley cathekr with alt:lehcd collection system "VIDENCE Of INJURY ThCR is a Y. inch contusion present on lhe righllowet lip. RADIOGRAPHS A complele sct of postmortem radiogrnph.~ is obtained. There is no evidence of iikeletal ill,iury ot melanic fureign material. INTERNAL EXAMINATION !~Of)Y CAVITIES- The body iii opened by the usual lhoraco-abdominal incision and the chest plale iii removed. TIte ribs, sternum. and vCTlebr~1 bodies are visibly and palpably intaci. No adhesions a", presem in any MEDCOM 0953 ACLU Detainee DeathII ARMY MEDCOM 953 AUTOPSY REPORT.C1Cb-,-",," JABAR, W.lid Tll.wfiq l _ ofllle body cavities. Approximau,ly 100 ml of amber nui<l is preSl'lu in the left lho=i.., cavity and 50 ml in the right thoracic cavity. All body organs are p~m in IlOrmalanalOmical posilion. The subcutaneous fal layer of the abdominal "'-all is \.; irn:h thick. HEAD AND CENTRAl, NERVOUS SYSTEM; The scalp is reneeted. The galeal and suhgaleal soft t;SSIJCS ofthc scalp arc rree of injury. There lire no skull fract~s. The ulvarium of the skull is removed. Thc dura mater and falx eerebri are illlacl. Then: is no <:pidullli or subdural hemorrhag<: present. T1lc leptomeninges are thin and del;eale.1be ee~bra1 hemispheres are symmetrical. The structures attllc base of the brain. including cranial ""I'\'es and blood vessels are inract Clear cerebrospinal nuld surrounds the 1440 l!\lllm brain. which has unn:markable gyri and sulci. After fixation. coronal sections lhr"ul!h the cerebral hemispheres reveal no lesions. Transverse seetions lhrough tile brain Slem and cerebcllum arc unn:markable. The allanlo-occipital joint is stable. The upper spinal cord is unremarkable. NECK; Thc anlerior SlTap muscles of tile neck arc homogen<lllS and re<J·brown. without hemorrhage by layer·wise dissectioll, The thyroid cartilage and hyoid bone an: imac\. The larynx is lined by intact white mucosa. The lunllue is fn:e of bile marks. hemorrhage, or other injurie•• CARO]OVASCtJIAR SYSTEM: The 2~O llranl heart is conlllincd in ~n inlact Jk'ricardial SlIC. The epicaroial ~urface is smooth. wilh minimal fal investmcDl. 111e coromU"y aneries arc pn:scm in a normal dislribulion. "ilh a righl. domi "anI p;lllcm. Cross st:etions of Lhc ""sscls show "i<ld~' patenl lumina. The myocardium is homOGenous. red-brown. and fiml. The valve leancts are lhin and mobile. The endocardium i. smoolh and glisteninll. The anna l!\ives risc to three intact and patem arch vessels, The renal WId mesenteric vessels arc unrcmat1<:able. RESPIRATORY SySTEM: Th" upPi'r airv,ay is clear of debris and foreign material: Lhe mucosal surface~ are smoolh. yellow_ lan and unremarkable. The pkW'll1 surfaces are smooth. glistcoing and unremarkable bilaterally. The pulmonary parenchyma is diffusely congested. exuding mo<lenne amoums of blood and frothy nuid; no focal lesions an: nOled. The pulmonary aneries arc nomlally de"e1oped. paten1 and without thrombus or embolus. The rightlun!! weillhs ~20 grams: the Teft 650 grams. IIEPATOBIk!ARY SySTEM: Thc 1420 gram liver has an imact smoolh capsule eovcriny dark rcd·brovlll. moderalely congested tan·brown p:1Tt,nch)~na with no focal lesions noled. The gallbladder contains 8 011 ofgreen·brm'n. mucoid bile; the mucosa is "Cl"cly and unremarkable. The eX1T1lllepalie biliary Irce is palenl. .....ilhou! e,idellee of calculi. MEDCOM 0954 ACLU Detainee DeathII ARMY MEDCOM 954 , REPORTI(b~'~(6~'== AUTOPSY JABAR. Walid Tawfiq GASTROiNTESTINAl. SYSTEM: The esophagus is lin.:d by l!T1ly-while. smoolh mucosa. The gaslric mu~osa is iITTlInSed in the usual n1l;al folds and the lumen is empty. The small and large bowel are unremarkable. Farmed stool Is prescm in the recllli vaull. The pancrcilS has a nnnnal pink-Ian lobulated appcamncc and the ducts are clear. The appendix is pre~nl. GeNITOURINARY SYSTEM; The righl and Icrl kidneys caeh weigh 130 grams. The renal capsules are smOQlh, scmi-tr2llsparent und strip wilh eus<: frum Ihc underlying 5moolh. red·brown cortical surfacc. Thc oonices arc sharply delincaled from thc medullary pyramidS. which arc red-purple 10 tan and unremarkable. The calyccs. pelvcs end ureters lITe unremarkable. White bladder 'nueosa overl;es an inlaet bladder wall The bladder i.~ empty. Appro.~imatc1y 10 ml of urine is present in the collection bIlg. The t(:!;tes. prostate gland and semina.! "esic1es are without '\(lte. LYMPtIORliIl(;ULAR SYHEM: The 160 gram "pk'Cn has a smooth. imaet capsule coveri"ll ~d·purple. moderntdy lir'" parenchyma; the I~ mphnid follicles are "nri.~nurkabiL·. Lymph rlOdcs in Ihc hilar. periaortic and iliac ",gions are unremarkable. Ga.'lric (greater cllr..mure) lymph nodes appc.1I mildly ;,:nlarl:\w. ENl)QCR1NE SYSTEM: The thyruid gland is symmclric a'id red·brown, 1";1110,,1 cystic or tWdulnr glands are poorly dise~mible flOm the adjacent adipose lissuc. l·h:ml:\~. l"h~ adrenal MUSCULOSKEI.ETAL SYSTEM: No abnormalilies of the nlll5\:les. hones or joInts are idemHh,d. Lonllitudinal incisions of the p"~terior surfaces of the tot"SQ. upper and lower el«ll:mitks show no evidence of injury. AODITIO!'Jtlli PROCEPURES I. Oocumcnlary phot0l:lraphs all: taken by the OAFME photographcr. 1. Personal effects arc rclc:.sed to the appropriatc monuary operations wpresemadves. 3. Sp«imens retained for tO~ ieol01O" \esting and/or DNA identifiC31,on are: "itreous nuid, blood. urine. splecn.li"cr. lunll. kidney. bile. adipose lissue and psoas mll5l:lc. ~. Thc brain lIJ1d hean are retained rOl" funhcrcxamination. The rc:mainin:: dissected organs are forwarded wilh bodr. MICROSCOPIC EXAMINATIOr-; I. !-leart (slides 1-4): No sil:lllilicallt microscopic abnonnalily 1. I.ungs (slides 5. II. D): I\Clite bronchMlveolllr pnelll11onia. right 10\\ cr lobe: bilateral pulmonary alveot:tr ';{lngeslion \\-ilh palchy pulmonary edema MEDCOM 0955 ACLU Detainee DeathII ARMY MEDCOM 955 AUTOPSY .JABAR, J. REPORT@I(b~)(~'[) W~lid Liv~r (slide T.,,'foq =:----:J j 6): No significant microseopic abnonnalily 4, Spleen (slide 6): No significant microscopic abnonna]ity 3. Kidneys (slide 1): Tubular autolysis 6. Lymph nodes. peri-gasl.l"ic (slide I 0): Follicular h>'ll':rplasia 7, Brain (slides 16, \ 7): No significaHl micrOS<.:opic abnonnaJil}' 8. TiS$ue from rellion o( adrenal glands {righl slides &.14; len slides 9.15): Scauered fragments of adrenal medullllT)' lissue withoul ~'\'idence o( adl'efllli conical tissue (9.14.15); ponions of l)'mph nodes and periph~ral neur~\ lissue. no adreMI tis$uc see" (8). FINAk AUTOPSY O1AGNOSF~'\ 1. ,\drelloconical alrophy A. Melabolie imoalallCe (per proturo\) l. HyponalTemia. hyperkalemia. hypogJyc~"ia and melabolic acidosis 2. ECG finding o(prolonged Q1' inte....·31 (per prolocol) I!. ACU1" bronchoah-eolar pneumonia (rillhlln"cf lobe) A. Bilmernl pulmonary congeslion Wilh patchy pulmonary edema B. Bilateral pIcural effusions (righl 30 ml. left 100 ml) Ill. Toxk..,logy: ACelone is presctll in lhe hlood and urilll:; nlropine is presenl in the urinc OPINION i\ceol'di"ll to repons. lhis 23 year old male civilian delainee coll"pscd while being interviewed. Re$uscitali,'c effons Wen.' slaned at Ihe scene and he wa< transponed In the medical facilily whe", he w:u found tn be hypolcnsive. hypothermic. and have a GCS of). Initiallaboralory testing ~ho,,~'ll signi ficalll m~'1abolic derangement (h>'ponaucmia. Ilypokalcmill. metabolic acidosis llIl() hypoglycellli,,). Ahhough the decedent was initially slabih..d. his coodilion conlinucd 10 worsen onlil his den';se on me (o!lowing day. Review of me a,'ailable medical records revealed a hislory of a '"hunger s\rike" for approximately 7_ 10 days prior 10 dealh and unspe<:ifled "kidney" probiems for whieh die decedent ....'as laking daily h)'droconisonc. AU10pSy examination showed no e"idcn~c oflrauma Microscopic examination showed acute I1ronchnpneul\1onia of lhe Idl lung llnd hilateral adrenal cortical atrophy. ToxicologiC''' examination shuv..ed Ihe presenec of atropine inlhe uline and aCClOIIC (Irace) in lhe blood al,d urine. Aeule ad.... llOC<>nical insullidency may prcseO! as a "eri.fs" in patientS with "hroni,- nd",nocortfeal insufficiency precipitated h)' an)' (om, of Slress or from tOO rapfd wilhdra....al of "xogel1oU5 steroids in those w/lose: ad .... nal glands ha,'c been suppressed by longlerm administralion. 1 Findings include Oyponalreillia. hrpcrklllemia. hypoglyecm ia. melabolic acidosis and ptolonllation of the QT inlerval l 011 EKG. Untn:alC<l patients ha'-c a poor ProllllOSis.J 'e",....". R, Kum..-. V...... r.. Robbi"~ P.. hologic 8.. 1. of D....",. W.8. S."I>J<~Co. 1994. ,. F-<l" PII 1151 , Kjrklll>d. L.. Adc<nal Cf"~ Ike 18. 2007. inTI"'"'' w"'''<dis"ill(·I'um.m<d 'l\!ric1iS him , KI.U<,. K.. Ad""",i tn,uffkkllt}, ."d Adre".1 C,hi>. J"" ;0, 2007. hllp·II""')':,-<'",-di>;!lqolD'tmtl,,~,,pic16.b!m MEDCOM 0956 ACLU Detainee DeathII ARMY MEDCOM 956 AUTOPS\' REPORT (b)(6) JABAR, ""sUd Ts",nq 6 In lhe cum:'ll Cbe I..... ~1iol"lO' of lhe: .,J11:...1 ~Irophy iii unce!Uin. Conlribuling wesson: illCluded pneumonia al'l<l c!eclh'e food depri"alioll, I'us~m ~~icoIO¥Y sho",~ lhe presence of the ltM:rnpeUlic sub$lsnce 'lropine and lnIee II/11OlInlS of lICClOfle. Act'IOfle is. b) ·prodUl."t uf fm mclabolism and can be seen lIS a:'e$\lh offood ckpri"ation. III SUIl'II1Wlry, lhi$ dKedclll mO$t likely had Ionll iilanding (chronic) -'~noc:ortical iMufficiency .....!lich ~ to ",,,,,... iMUff>c:ienc)' (··crisis~) in lhe fllct' of infcclious (pno:wnOl1i.) and food ckprhlllion $ll'eUOrt.(b)(6) succumbed 10 scn'lt: mc1abolic demnllcmenl due 10 Kille ao:!lt:noc:onlcal insufficicncy. The: mll/mCr of dealh is Illlilltlll. This case is ~~iewcd in conlllllatiOt'l .....ilh lhe I)(;partmcnll of End<xrine and RCTUlI Palholo\lY. The lane, is pcnditl$- Upon completion an addendum repon ....ill i$sued if cOCltribulol}. (b)(6) MEOCOM 0957 ACLU Detainee DeathII ARMY MEDCOM 957 ___.- -- -.- 1,:-"-.. _.... ... ,.., --- "'...' 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'" ..n ......' .. 20081743 (b)(6) -"' (b){6) ' """'"" (b)(6) 51712008 27 February 2008 I,.. 0..........0.,..... ote\lItIIU> .. , ... """" --~_ IMedieal Examiller [)o,fb'i16T I .... , DD'~ 2064 H>lC.O,....... ,_ _ CWOf. . . . . . . .0 _ ~----- ...'.......T""'' ' .......... DoverAFB. I 0"'" "" I!JNO - MEDCOM 0958 ACLU Detainee DeathII ARMY MEDCOM 958 ARMED FORCES INSTITUTE OF PATHOLOGY M~dk.1 Eumillu 1413 Ruearch Blvd.. Bldg. 102 Rockville. MD 20&SO 1-301-319-0000 (FAX 1-301·319-Q63S) omn of ch~ Armed ,"oms FINAL AUTOPSY REPORT Name: HUSSEIN, HV.der Abdul ISN:(b)(6} Date ofBii'th: Unknown Date ofOealhl(b){6) h008 Dale of AUlOpsy: 22 MAR 2008, 0900 hoUl'S Dale ofRepon: 30 APR 200& 1 Autopsy No,[<blf6) AFt? NoJ(b)(6) ] Rank: Civilian Iraqi Detainee PllIee ofDealh: Camp Bucca, Iraq PIKC of Autopsy: Dover Mortuary Facility. Dover AFB. OE Cireumlfanr;oes of Dc!.Ch: I(b)(6) an Iraq civilian detain« of Ullknown agc hu a well documenled history of and trealment for Dilaled Cardiomyopathy during tWO prior admissions in JanUllI)' and February Of2008.~I-t .._""'._~mhlCd 10 the "Thealer Inlcmm~nl FacililY (TlF) hospital, Camp BllCcII, Iraq, (b)(6) 2~ with a eomplainl orMnot fcclinR well':. Over tItc following four day.s..!( By---- suffered cardiac arrestl\\'ice. On (b){6) '08. he sufferal a third cardiac lII'TCSl and could not be rcs~i\.ll<:d. No llddilional ~nincnt informalion is available. 0" AuchorizalioD for AUloply: Officc of the Arm<:d Forces Medical Examiner. IA w 10 USC 1471 IdcnlirIUCkl.: (bJ\6) idcntilial by lOt IIlgs and his TIF number. Fingerprints. dentaleliarting and sample for DNA idenlification arc obtained. ::Jwas CAUSE OF DEATH: Dilaled Cardiomyopathy MANNER OF DEATH: Nalural MEDCOM 0959 ACLU Detainee DeathII ARMY MEDCOM 959 AUTOPSY REPOR1iSI(b~'~(6~1 HUSSEIN, Hydu Abdul _ , EXTERNAl. EXAttllNATION The body is Chal of a wdl-developcd. While male 73 incllcs lall. 287 POUndllll>d appcan of middle aile (unknown date of birth). The body build is obese with Bod)' Man IndelC or 37.9. (18.5-24.9 is normal: 25-29.9 is OVl!!" weiW11and 30.0 lII>d above il considered obese). UvidiLy is consiSlent wich supinc po$ition. ril>'Or is equally prescnt in all eXlremities. and the body tcmpcn.lurc is lll&t of \he rcfrigenllion ",nil. The scalp and facial hair, beard and mUSl8Che. are blaek. The irides arc brown. and tile pupilsllR' round lIlllI equal in diameler. Thc eomcas are d",n and the sclerae are IIntcmarbble. The elClemal auditory eanll1s and cars arc unremarbble. The n~ an: patel'll and the lips arc lllraumatic:. The nose and m;u:illac arc palpably 5llIble. The t«lh appear IInrcmarbble. The CongllC reveals no evidence oflrallm& or bite marks. The I'ICck is 5traig)n. and the lr&l;hcll il midline and mobile. 'fl1c cl1cst is symmetric. The abdormn is markedly proluberant. The IlCTlitalia arc lho$c ofa normal adult circumcised mate. The lesles arc descended lIlllI free of masses. Pubic lI&ir is ptcsenl in a normal distribution. The right bllllo<.:k reveall d«-ubilUS ulceration right or lhe midline and an incised and drained abscess mOfC literally. The anllS is 1I",,~marbble. The upper and lo~r extremities are symmetric; reveal marlr.cd edema and no clubbinJl. No evidence oflrauma is presenl on examinalion 01" dissection ortlle eXlremities. The chest and abdomen reveal remarkablc stretch marks. A lalloo f(b)(6) ---"""] Rb)(6} 1A large remolC healed longillldirull surJical 5QI" il noted on lhe left uppcrehcsl eloso: 10 lhe anterior axil1lUY line. No other idencifying maoo are noted. CLOTHING AND PERSONAL EfFECTS The body was rc.:civcd ulH:lad. A silver-colorcd ring is noted in the left middle finger. The rin8 is rcmovro, photographed and submillcd 10 lite mQftuary slllfTror proper disposilion. MEDICAL INTERVENTION Evidcnc:c of medical interve.ttion: El'ldotraehc:a1tl,lbc; Nasa-plric lube; EKG pads; Mulliple inlravenous access lirIC! and. urinary elltheter. RADIOGBAPHS FilII body radiographs.1Id a cr-sean ~ oblllincd and demonstrate rcrJ1O{e intemlll fixillion of dislllilefl forcann. No recent skeletal frac\u~s ~ noted. EVIDENCE OF INJURy MEDCOM 0960 ACLU Detainee DeathII ARMY MEDCOM 960 REPORT;~(b~)(6j"==:: AUTOPSY HUSSEIN, Hyll~r Abdul J INTERNAL EXAMINATION HEAD: The IlI'leal and subgaJeal soft tissues of lhe scalp ate edematous and fret: of injury. The calvarium is inliK:l, lIS is the dura maIer beneath it. Clc.v cerebrospinal nuid surrounds tho: l400 e.m min. which has ul\J"Cmarkable llJri and suld. The surface vessels revnl marked COflllcstion. Coronal s<:cIiORll dc:monslrat~ slwp deman;lllion between white and t.\rey maner. without hcmo"hab'e or oontll5ive injury. The ventricles arc: of nonnal size. The basal ganglia.. brairutem. eaebetlum, and arterial Sf$lCfTIS are free of injury or other abnonnalities. There are no skull frac:tum. The atlant(H)(:(:ipita\ joint is stable. NECK: The anterior strap muscles of tile neek are homogenous and ted-brown. without hemorrhage. The thyroid eartilage and hyoid are intact The IllJ'}'flx is lined by intact tllll muc05ll. Thc thyroid is symmetrK: and red·brown. wilhout eystic or nodullll' ellanSC. Tile longue is fm: of bite marks. hemorrhage. or other injuries. There is no de<:p pa:1Itervieal muscular injury and no cervical spine rraaun:s. BQDY CAVITIES: The ribs, sternum. and vertebr/ll bodies an: visibly and palpably intact. The Chesl cayilies reveal bilateral pleural effusion of e1C11r st",w-colored fluid: 300 ec in the len and 200 ce in lite rillht. The pericardial sac contains 200 ec of clear slll.w-eolOfeG fluid. and the peritoneal cavity contains effusion fluid. approximately 300 cc. Tile heart appcal1l grossly enlarged and the major organs occupy their u:lual anatomic ~itiOfls. The abdominal wall adipose tissue mcuul'CS 2~ in thickness. RESPIRATORY SYSTEM: The right and lefllungs lIle mu\(edly heavy and weigh 1220 and 830 gm. respe<:tiI'CI)'. The: external surfae~ are. ","OOIh and deeprtd-purple. The pulmonary perenehyma is diffusely conge~ and markedly edematous, oozing frothy nuid. Two dark red welldemarcated area an: noled in 11K: bIlK ortlK: lower lobe ortlle rigllt lung and the apex of the lower lobe of tlte left lung, mensuring) '/, )t 2 '/, )t 2" and 2 )t 2 )t I '1:,' respeetivel~. Seelions through these areas revcal finn dwt red parmehyma. with gross appeararx:t: of pulmonary infarction. The lungs are phcllogrllphed fordoeumenlation. The pulmonary vessels are norrtUllly positioned and are grossly f~ ofthrombo-emboli. CARDIOVASCULAR SYSTEM: The: Itean is mmedly en1arsed. weighs 790 grams and is conlained In an intact pericardial sac. The epicardial surface is smooth, with increased fat investment. The coronary aneries arc: present in, nannal dislribution. Cross sections of the coronasy vessels reveal no sig.nifieanl alhcroselerotie changes. The myocardium is homogenous, red-brown. and soft. The cardiae chambers are dilated. The valve Ie,nets are tlUn and mobile except for a lhickened and sliUht1y shortened mitral valve. The tricuspid. pulmonary, mitrallilld &Onic valves ITICI5llte 1).8. II and 7 em. rtsptttively. The mitral valve is retained for further examination. The walls of tile left and rigllt ventricles and MEDCOM 0961 ACLU Detainee DeathII ARMY MEDCOM 961 AUTOPSY REPORT~b){6) HUSSEIN. Hyder Abdul 4 lhe intcr'o'entrlcular $Cptum lire: lB. S and 18 mm. l"Cspecli,·cly. The endocardium is smooth and l:listeninJ;. 11Ic aorta l:ives rise to three intact and palelll are:h vessels. TlIc TCl1al and mesenteric vessels pre: unremarkable, LIVER &. BILIARY SYSTEM: The JlOO am liver has an inlact. smooth capsule and a slIarp anterior border. The parenchyma re:vcals a mnmcll appcurance eonsistcnl wilh conl:~$Ii~ hcan failure:, wilh lhe usUllI lobular architecture:. No mll$5 lesions or other abnonnplilics are: seen. T!lc gallbladder wall is slightly thickened and COI1tains dan l:reerl bile. A l:alt stone mcasurinll I cm in diameter and multiplc minute Ilall stones are: noted in the: lumen, pholollraphed and re:lPincd, The extrahepatic bililU)' tree is grossly palenl. SPLEEN: The 780 gm spleen;s enlllrgl:d and h", a smoolh. inlllc:l. red_purple capsulc. The parenchyma is maroon and congested. with distinct Malpigh;an corpuscles. The major lymph nodo:s cnrounlere:d during ellaminalion are: not enlarsed and are: unremarkable. PANCREAS: n.c panc:rcas is finn and yellow·tan. .-ilh Ihc: usuliliobular architecture, No mass lesions or othc:r abnonnalities are seen. ADRENALS: The riGht and len adrclllli glands arc symmelric, wilh bril:ht yellow eonices and grey medullae. No masses or areas of IIemorrhilj;e are idenlified. GENITOURINARY SYSTEM: n.c righl and left kidnc:ys wdah 270 gm and 240 l:rams. respectively. The external surfaces are intac!' smooth with mild pcrsisknt Iobulalion. The cuI surfaces arc rcd·1l\Il lind conacstcd, wilh unifonnly Lhick conic:es amI sharp conioo-medullary junctions, Tile pelves = unrcmartll.ble and t!le uretCR arc: nonnal in course and caliber. White blao::\deT mucosa overlies an inlacl bladder walt. TlIc bladdcToontains a small amount ofclcar yenow urine with a urina!)' cathcler in place. Urinc is submined fOT toxicology. 1lIe pmsliltc is normal in si:u, wiLh lobular, yellow-Illn pasenchyma. The seminal V'CSides II.~ unremarkablc, Thc lestcs are: frtt or mass lesions. contusions. or olhc:r abnormalities. Bilateral hydroccles a~ noted. CASTROJNTESIINAL TRACT: The C$OphalluS is intact pnd lined by smoolh, gre:y·whilc mucosa. The 5Iornacll contains II small amounl of dark green nuid. The gastric Willi is intPCl, The duodenum, loops of small and largo: intestines slii:htly edematous bul otberwi$C are: unn:maJkab!o:, MUSCLES &: SKELETAL SYSTEM: Grossly \Il1R:maJkablc with no significant patholollieal changes. No evidence ofrccenl skclcllll lrauTTUl is noted during eltllmin:llion or radiologicall),. MEDCOM 0962 ACLU Detainee DeathII ARMY MEDCOM 962 AUTOPSY REPORT(b)(6) HUSSEIN. Hyder Abdul 5 TQXICOLQCv Corbon Monoxide: CllIbollyllemoglobin satullItion leSs than 1%. Volat;les (Blood and Urine): No ethllllOl 'NUS detected. CY8llide: No cyanide detecled. $clftncd dru;S of abuse and medicatiOllli (Blood): P05ilive Iknzodiaupine (MidlWlllllT1); delected and confirmed. _ Pe»itivc BenzOOiaupim: (]·HydrollymidllUlllllT1). delee'ed and confirmed. ADDITIONAL PROCEDURES Documentary pholOgrBphs alt' tllken by an OAFME pholographer. Full body llIdiographs l\lld CT-5Cal'I art' obLained. ElIamination, wilh skin incisions, of 11ll: elltremlties and bDl:k 10 rule OUI tlllUIDa. Specimens retained for toxiwlogical ar>dlor DNA identification arc: blood, villeOlIS, bile. urine. gastric contents and tissl.lC.' samples ofheart. kidney. liver. lung. spleen, brIIin. adipose tissw:, and muscle. S. Reprcgntative seetions of organs alt' It'wncd in formalin for microscopic examination. 6. Per10IIal effects. a silver-<:oloml rin¥- is p/tologlllp/lod antllt'lcascd 10 lhe: mortuary stafT For proper disposition. I. 2. 3. 4. MICROSCOPIC EXAMINATION Selected ponions of organs are It'lained in formalin. Histological slides IU'llIl5 follows: 1-4: Hean: Foca1subcno:locardial scarring: Prominent perivascular fibrosis; Focal hypertrophic myocyte$; Recent septal myocardial infan:tion with eonlfBl:tion bands and ll<:ute inflammatory cell infihlllle. S: Mitllli valve: ,hiekened milllli wive wi'h fibro$is and hyalinization. 6-9. II: Lungs: Largc areas of parcndtymal infllrtlions; inerused number intra·a1veolar hcmosidlt'n and anthracot;c pi&mettt·llIden mael1lplulges; pulmonary congestion and edema. No evidence: of pneumonia. 10: Kidney: Focal lllt'lS of acute tubular necrosis. 12: AdIt'nalglands: Unlt'mariable. 13: Spleen: Congestion. focal inrlllt'tion. 14-16: BllIin: Unremarkable. 1-16: Postmonem aUlol)'sis MEDCOM 0963 ACLU Detainee DeathII ARMY MEDCOM 963 AUTOPSY REPORT (b)(6) HUSSEIN, H)'der AbeI'l 6 FINAL AUTOPSV DIAGNOSIS A. Cudio.....,....r S)1ilcm: Cll1diomcpl), (Cardio BoYUs). 790 &IWIIS Four ellllll'\ber dilalBlion consiSltnt wilh dilat~ c:ardiom)'OllllIh)'. Congc:sli..c Hesn Failure: • 8ilat~ hemotho_. pc:ric:an:lialllld IXritonc:ll effllSions. _ PullTKlnary edema. righl 1.120 ifI'II5 and left 130 grams. • Ikpalomegal)' ...·ilh nulfMS appc:uvoc:e. • analt:Bl pulmOlllI")' infarc:lioru.. • OeneraJiud cdtm~. • 8il~IC",1 hydroceles. Focal subendocardial and pc:riVII5Cular fibrosis. Thickened (fibroKd and hyalinized) milral valve.llIIknown diolo&>,. B. Other Fllldlnp: Obesil)'. 8MI 37.9 (nonn(l\ 18.5-24.9. ovcrwciglll 25.0-29.9. obese 30.0 and above) Pulmonary infardion. AeUle lubular nccrosis ofkidney. Chronic: eholt:c:)'$Iilis and cholelithiasis. Righi Glute.1 absc:eu. evidt:nec: of rteCnl il'l<:ision and dflinDiC. Pusive congcsliOll of liVt:\'. spleen and kidneys. Earl)' signs otdt:~lopin8 de<:ubiws ulccralion. C. IDjUria No cvidencc of blunt fort:e. sharp fo," or firearm injuries. D. ToIkoI0ID': No evidence of ethanolill' dNllS ohbusc. Posi,i~ for Ikntodiutpinc and ilS mtUlbolilel. OPINION (bl(6) a civilian Iraqi dcuincc= ofunkllO¥m agc. died from eardi. disease (Dillie<! Cllrdiom)'Opilhy, c:ardiomepl)' and c:onaC$live linn failure). No cvidence oflrluml is noted durill& IUlopt)'. TOll.;cologic:aJ rtSUl13 ~ ncpli\'c for cthanol and dNas ofabuJc and posilive for DcrllOdiurpinc and illl mft.lbolhcs (cOllsistenl with documenled medi<:allralmc:nll. and is IlOn-cOlllribulory 10 MItOps), conc:hJ5ions. MllU'Il:r of dc.lh is nillunrll. r H ["1" " (b}(6) MEDCOM 0964 Medial Examiner ACLU Detainee DeathII ARMY MEDCOM 964 _.-.. __.....-_ ---.... _.' . -_.- ... .-- - - ---_. -_.-_ .. .-._- ....... --_..__- .... --, _ _- - - -.._ ,,- • , caAi_11I01fDUlll /OlD _00...,....0 """","" Hyder, AbdIll Uti 1_:"""""- ""_... ... .... ~ .... (b){6) Ii] . -.~ ~ • 0 0""'_ • --- _.- --'''- ...... _...--...... ---_ ..-_.._----_ -_ .... -.. --. ---'--.--._ .-- ---""--'. ----_........ _...... _"' .......... -... _.--_.--" ...... "'" .. ...... _._ . .. __ .... ""-...,._--__......_-_ -.-_D_........... . _-_. __ ... _---.. _- .__.,I" , "'''''''' .,_._ _-_... ..._._".' .....-I""" --...__ ._. _.._-"--_ _-...... _00_00- • ""'''''_""n." •, -"" e- .. _ _ _ _ .. _"'_"'_~"""'-IG""';'" , c.." : _l 1'l\I "-...- ... ."..... , • ril- ~- 0- . • ~ (bi(6) I"~" ,,"" (b)(6) ......... -~ :zooe 1n7 •• I CII~ E\o.oI;Q l~ I~-~- • ,- -"''"'''"''''(b)(6} (b}(6} • Oovw MS, 00Yer De ~- • ... DO ,~ 2064 MEDCOM 0965 ACLU Detainee DeathII ARMY MEDCOM 965 ARMED FORCES INSlTTtrn: OF PATHOLOGY 0f8« oftbe: A..-d F,IUlI MC'dil:lol EUllli.er \4\J Research Blvd., 81... 101 Rockville:, MD 20150 301-319-0000 AUTOPSY EXAMINATION REPORT NlIIJll::_BTB-'~tuhammC'dAI-Ilha"";' Tah. DaMr ISN: (b){6) Date of Birth: UlIkDown Dale ofDeatt(b){6) DatclTime of AUlopsy; 1 Apr 2008@1130 D.le ofRepor1; 10 Apr 2003 l(b)(6) Autopsy Nn.: AFIP No_ (b)(6) 1 Rank: Il'Jqi Ciyilian Place ofDu.th: II'Jq PIKe of Autopsy: POl'! Monuary Dover AFB, Doyer, DE ORllllUUaea ofDealh: Per lllvesti8.11on, this lnoql male wu fldmitted 10 lhe 31" Com'-l SlII'Bical Hospibll on 16 M~h 2003 for mUl1iple medical problema, lncludln8 .CUIc renal l"allure:, umreated di.bc~ mcllilus, and an acute myocardial infarction. While in 1he ~pital he underwent AIrier)' for pstrointcSlinal bleeding, and was.Jso lIe.~ for COf11lnllCd R:lIll f.ilure and another myocllJdial infarction. Despite ,"","lve medical int~nlion, he e\lCl\lually succumbed 10 his mUlliple .ilments. AIllloriZlllloll for Alllop.y: Armed Forces MC'diea] Examiner. per 10 U.S. Code 1471 lde:alilicalioa: Presumplive idcnlifltalion I. established by examinalion of~rk in lhe case file. Posl-rllOflcm finllCrprinUl and. specimen suitable for DNA analysis ~ obblincd•. CAUSE OF DEATH: MANNER OF DEATH: NII"nl MECCOM 0966 ACLU Detainee DeathII ARMY MEDCOM 966 AUTOPSY REPORi~)(6) Muhammed Al·lanawi, Taha Daher 2 EXURNAL EXAMINATION The body is lhat ofa weU-dcwloped, weUoflOIlrishcd unclad male. The body weighs 273 pounds and is 73 inches inletlgth. The body is cold. Rigor is pusing. Lividily is preselll and fixed OIl the poslerior surfaee ofllle body, exeepl. in &lUJ exposed to presJUJe. The head is nonnotcphalie, and the _Ip hair is b\aek &lid gray. Faeial hair consists oh beard and musllehe. The irides are browrl. Thc eomeae are cloudy. The conjunctivae arc congested. The Sl:lcl1le &R: white/red. The eyelids &R: cdemalous. The external alldilory eall&1s., extetTll.lnares and ol'llli e&vity arc free of foreigrl mllterial and abnomlal 5c:Crelions. The earlobes haw creases biratel'llllly. The nUll skeleton and muilla are palpably inllel. The lips are witholll evidmt injury. "The lIppet" Ieeth are absent and the lower teeth lU"t: in poor eondition. Elwnil1&tion of the IlOCk reveals no evidence of injury. No evidence of injury of the ribs or !he stemwn is evident externally. The abdomen is $Oft and distended. Then: is a 10 Y. inch vertical stapled ineilion on the midline of the abdomen. The eX1e1Tlll1 genitlllia are lhose of an iiduh eireumci$ed male, and the scrotum and penis are edematous. There are numerous pinpoint pustules on the posterior 101'10. The anus is unremarkable. The extremities are diffusely edenwous. The fingernails are shon and inlact. Underneath the wrap and gauze on the left foot 15 a n«rolie ulcer, 2 x 2 inches" and tile I- and 2"" toes on the left fOOl are absent. Scars and tattoos are not noted, CLOTHING AND PERSONAL EFFECTS No items of clothing or pelXll1&l effeeu lICCOmpany the body. MEDICAL INTERVENTION • EKG leads (5) on the tono • • • • Stapled incision, mid abdomen Foleyea!heter Triple-lumen catheter, right femOl1llarea Wrap and gilllU on left foot. labeled with "'29 Mar 08 0930~ MD'QCWHS A complete set ofposlmortem radiographs is obtained and demonstrates the medical ilUervention and natul'llli disease u noted. EVIDENCE Of INJURY No signifieant il\iuries are identified. MEDCOM 0967 ACLU Detainee DeathII ARMY MEDCOM 967 =- AUTOPSY REPORT (b){6) J Mulwnmed Al-lthawi, TlIh& o.her INTERNAL EXAMINATION BODy CAVITIES; The body is opcntd by the usUDllhora<:o-abdominal incision and the these plate is removed. The ribs, sternum, and venebral bodies are visibly and plIJpably intatl. All body organs are ~t in normal anatomical position. There are dense Ieft.-sided plawal adhe$ions. T'here is 100 ml of Krosan8uioolJli fluid in the Iell plalral cavity. Theft is I SOO ml ofsc:rosanguinous fluid in 1M perilOlleal cavity. The subcUWleous fllla~oflhe abdominal wall is 1 % inch thick. HEAP AND CENTRAL NERyOUS SYSTEM: The $CaJp is reflected. Thc gIIleal and subgalelll sollliSlllles of the $ClI.lp are free ofinjury. There arc no skull fntc1~. The calvarium of the skull is I'mIOved. The dUfa mater and falx cerebri are intact. There is no epidunl or subdWlllllcmorrllagc plt:5a11. The leptomeninses are tIlin and ddleate. The ~n11 hemispheres are symmetrical. The structures a1lhe btie oflhe brain. inc:1udinll ereial nerves and blood veuel5, are intact. Clear ~reblwpillal fluid 5IllTOUIlds the 1410 gram bnin, which has UII1'CmllfkabJc &Yri and sulci. ComnaJ sections thtough the cerebral hemispheres ~ar no lesions. TransvctK stetiOTl.l through the no stem and eerebeJlum are unremarbble. The allanlOCKX:ipillol joint is sIIoble, NECK; The anteriw suap muscles oflhe neck are hornogellOll!l and red-brown. witboul bemorrlage. The tbyroid cartilage and byoid bone are inlld. The IllI)'lIX is lined by inl8cl white mllCOSL The IOnSlle is free of bite IIW'b. hemorrhage, orOiber injuries. CARDIOVASCULAR SYSTEM: The 660 gram beart is contained in an int8Cl pericardia! sac. The epic8tdial sunllCc is smooth. wilb minim.al fat investment. The coronary arteries an: ~l in a normal distribution. They lkmonslrlte the followingllTlOUlllS ohtherosclerolic stenosis: approximately 9S% ofthc proximal left anterior d~ndins C(ll'OlllU1a~, approximately 50"Aoofthc mid rilbt coronary anery. and approximately 9S%ofthe proximal and mid len circumflex coronary artery. The myocardium is homogenous, pale llIII, and modenllely firm, The valve leaflelS are tbin and mobile. The endocardium is smooth and slistenins. The aona lives rise to three inllet and patent llcll vessels. and demonstrales SCYere calcifie dianSf' distally. whicb extends into the Iliac arteries. The renal arlericsdemons\nlte approximately 75% atheroscleruie stenosis bilaleRlly. The lI1C5CIIteric vessels an: unremartable. RESPIRATORY SYSTEM: The upper airway is clear oflkbris and fo~i8Jl material; the muc05llI SUrfllCCS are smooth, yellowllIII and lIlI~markable. The right pleural surface is smooth and slisten[ns; the left pleural surface is llIII·wbile and fibrotic. The pulmonary parencbyma is dHl\~ly congested and edematous, exuclina lillie amounts of blood and frotby fluid; no focal lesions are noted. The pulmonary ancric:I are MEDCOM 096B ACLU Detainee DeathII ARMY MEDCOM 968 AUTOPSY REPORT (b)(6) Muhammed Al-Itlllwi, T..... Daher flOmIIlIy developn!, palent. and without dIromMor ~bol\lS. The riahlllllll wciJ,hs 1090 arams; !he left 1070 If&I'IS. HEPAIQBILIARY SYSlEMj The 2]]0 pam livn has an intact smooth capsule coverinalln-red moderately congestccl pmll(:hYJlUl willi no foul ~ noted. The pJlbllldder is markedly distended IIld conWIllI SO ml of al'eC1l'brown, mucoid bile; !he muCOMl is ~vet)' and unmnarkable. 'The nlflhcP'olic bililfY tl'Ce is palent. without cvidcll(:e ofc.lculi. GASTROINTESTINAL SySTEM: The csop/lagllS is lined by Sr1ly·white. 5/TlOOth mucosa. The pstrie mucosa is arranacd in !he lI$llIl ruaal foldsand the lumen ecmllins approltimately SOO ml ofLhick. yellow malcrilol. 1'hcre is. <I inch IUIU~ ill(:ision on Ihc mucosal surf.e of tile dlJlll slOmlCh. The small bowel is WIl"Cmarbble. The serosil SlIrftoee ofthc 1Jr&e bowel is dif!Uscly 6artt purplc-al'lly. The p&nCraS Iw. ~Ie Ian lobuliled .ppcll'llnCC and !he duelS arc clcer. The .ppendix is prucnL GENITOURINARy SySIEM: The riaht kidney wciglu; 200 a,ramt: the left 200~. The ren.1 capsula arc smooth and thin, scmi41'.n'P'Kru and Slrippcd with casc Ifom lhe ulldcrlyina granulu, red-brown conical runted. The concx is sharply delinealed from lhe medullary pyramids, which arc red-purple 10 Ian and WIl"Cmarkable. The calyces, pclves and urcten: arc lWCmarlcablc. White bladder mucosa ovcrlia an intact bladder wall. 1lIc blldder conwns I CllhelCl' and is empty. The testes, prCIlllte gland and scmillll! vaiclcs arc wllhouIl1oOle. LyMPHQREDCULAR SysTEM: The 460 gram spleen hu. smooth, inUlCt capsule covenna red-palo Ian, modcrIllely firm pal'Cll(:hyma; the lymphoid follicles arc unremark.ble. Lymph nodes in the hilII'. pcriaonlc and mac regions arc not cnhll'lcd. ENOOCRINE SYSTEM: The thyroid Sland is symmetrically enlqed and red-brown, withoulcystic 01' nodularchanae. The riglll and left adrcnaIslandsarc symmetric, with briallt yellow conites and red-brown medullae. No muses or arcu ofhemormage arc identified. MUSCULOSKELETAL symMj Thm: arc deamcllti~ chanses ofthc 6"" and 1*' ccrviCIII, and ~-12"" thoracie ~nebral bodifi (seen radiolosic.lIy). No abnormalhies oflTlUJCle lit idenlirleCl. MEDCOM 0969 ACLU Detainee DeathII ARMY MEDCOM 969 , AUTOPSY REPORT1l b}(6) Muhammed Al·ll!ulwi. Taha Daher ADDITIONAL PROCEDURES l. Do<:~ntarypholOsnphs anl Ulkcn by an OAFME slIffpholOpphcr. 2. Specimens rtlained for loxicology testing and/or DNA idenliflelliion are: vitreous fluid. blood, spleen. liver. lung. kidney. bf'llin. myocanlium. bile, gutrie contents. adipose liSSlloC and psoas muscle. J. The dissected 0IJ1nS art flll'WlJ'ded wilh body. MICROSCOPIC EXAMINATION Selected. portions of organs a«: «:tained in fonnalin, without preparation ofhistolocy slides. MEDCOM 0970 ACLU Detainee DeathII ARMY MEDCOM 970 AUTOPSY REPORTlb}(6) Muhammed AJ·lthawi. Talul Daher 6 FINAL AUTOPSY DIAGNOSES: I. Hypertelllin a1hmneknlllc cardlovatCUla... dltease: A. Nu.-..ocdu.ive alberosderotk .Ieaosb oflbe left anlerior de.«adlac and len t1l"C11mfln tOrour)' al1"rKlI, alld approdmaldy 50% alll"ro.derotic u ....o.u of lbe nlbt coroDar)' arler)' B. Alberoulerotlc .leaotu oflbe ""nalalUries, appro.li.alel)' 75% bilaterally C. Diffu.e C1Iklllc cbaDle of the dbtalaorta and Itiac arteria D. CardlolMply. 660 Ira. . £. Grou bypel1"llIlvc dlanlft oflbe kklney. II. Addltfonal nndlnp: A. Bllaleral puhnonar)' ('OIIIClIIoa. "lbl109O lJ"IIlIII, len 1070 lralll' B. DeIlSC l"ft·.ldN pleul'lIladbetlOlu C. Left pleu....1cavity, 100 11I1 serosanlulnoll. nuld D. Perifoanl C1IVIty. 1500 .llCros.nllllllolU nllht £. HbfOr)' of ullfreal~ dlabeles .dIU... wlCb a ..e..rotl" ulffr a..d ....lulnl dlalll on tbe left fOOf F. Hblol)' ofuppe... lulrolntali..... bleedinc. wllJl. 'Illpled abdomlllallncblon and a .lIlured pstric IlIcbioll G. Grou!)' ne..rotic lI....e bowel H. DifJURIy enl.....ed thyroklwllb 110 foallcllioa. identified III. No evklrnce ohlpllneantlaJul)' IV. Evidrtll:e of M~lcallnte.....entlan: AI noted abon. V. IdeJltlf'ylllllllulIs and 1a1l00ll: None 1I01ed. VI. POII....Ol1eJII Cballlcs: .... noted .bove VII. Tos.ltoloJ)' (AFlP): A. Efb.nol: No ethanol Is dctcctecl In the blood and v1l"0II' n,,/d. B. O.... gs: No .crcmed drup or.busr.re det«:Ced In tbe blood. D1tt1azem 1J drtected III the blood .t a level of 0.78 mafl- No I;llb... lllrdkatioll, are drte..trd In lbe blood. C. Carbon Monoxide: The carbo.ybentOpbln .. !a.... lla.. l. lhe blood b a. than I-I.. O. Cyanide: No eyall/dc is dele..trd IlIlhe blood. MEDCOM 0971 ACLU Detainee DeathII ARMY MEDCOM 971 1 AUTOPSY REPORT (b H6,;;'co:=_ 7 Muhammed AI-ltllawi, Taha Daher OPINION This Iraqi mak(bl(6l !ditd ofhypmensive atherosclerotic cardioYa$QJlar disease. Then= was ebnoR complel~ blockagc ofl.....o ofthc three lTllIin coronary arteries, and rnodmIl~ blockag~ oflhe lllird. TIlerc was also atherosclerotic disease ofthc lIOrta and meriu supplying blood 10 the leas and kidneys. TIle heart and Jddneyslkmonstraleo:! chanlles cons.iJlent wilh hypel1~nsion (high blood prcss~). The decedent also had a lIOIl·healing ul~ron hilleft fool, consistent with the given hislOl)' ofunlreated diabetes. Additionally, the d«uIent's stay in the hospiUlI was complicat~d by progressive kidney failure. a myocardial infarction (heart allaCk), and bleedinll in the gaslroinlcSlinal tract. ToxicologicaJ 1CSlini was posilive for. medic.lion used to treal hypcrt~nsion, but othcnvisc: neptiv~. The manner of death is MIura!. (bl{6) (bl(6) MEDICAL EXAMINER ~ MEDCOM 0972 ACLU Detainee DeathII ARMY MEDCOM 972 ' . _.--_. __. _--------..0'.-- - - ----- --- --- -_. -_.-_. _-- - - ...._- --"--". - ---_.... --_ .. _----_...--_._. _-_ ._-..y_.....-. - ...... - --_ -"-.-'" ....... _ -- ;,,-==.-._-- ....__... -_ -------_ -_....__._-_. QA........... OI' . . .TlI/Dl .,~ - ow. BT8 MuIwnrned. Al-lItWWI, TIM DIhIr (b}(6) ~ D- O- • <_r,_ ~ _ i' • -.- ... ... ~ '1),.. , • , ~ ...... , •... Clio'" ... •• ... • -- - - -- .--='~-~. . .-"":"'=.",.-_.\'"_.___ '_.d---_---.. ___._ .·"Exaallo. -.--"--.",,"" -_- .._. :--- .._....-.==., • Ii!- I l(b)(6) l(b)(6) 1~_2OOI l(b){6) • 1" (!Q® (b){6) Dowr~_ee.-DE (b)(6) DO'''' 2084 O· • • .- I - -. MEDCOM 0973 ACLU Detainee DeathII ARMY MEDCOM 973 •. ~.. ARMED FORCES lNSTlTtITE OF PATHOLOGY Off'ICe ort1lt Ana~ Fol'Ull MINlIaoI Euml..er 1413 ~Ii Blvd., BIdS. 102 Rockville, MD 2OSSO 301-319-0000 nNAL AUTOPSY REPORT Name: BTB Mansur. Ziyad Hamid SSAN:l~~ ~ DaJt; of Birth:L(b)(6OJ961 Dale ofDeaIh!(b)(6) ~OO& D&terrinlC of Alilopsy: 09 APR 2008@ 1100 Date ofRepon: 26 AUG 2008 Autopsy No.;~)(6~ AFIPNo.: 1(b}(6) _ ~ Grade: Civilian. Detainee PllIl::e ofVe'III: Iraq Plate of AIIIoP')': Dover Mortuary Dover AFB, DE ClreallUtllaen or Dnlb: This 41 year-old clctainee wall beins detained in Theater Internment Faeili!)' mF) CAmp BlIlXa, when as reponed, he was observed by another detainee 10 be s!laking while sleeping. A detainee attempted to wake him lIlld he was noted to be LUVeSpOlI$ive. He was canied 10 eompoUDd Suards who inilieted lif~vjn8 measures. All resuseilalive trICISlU'eS ~re lII'LSUC«:SSful. AutboriutlOQ lor "1I10PIY: Office ortlle Armed Forces Mcdieel Examiner, lAW 10 USC 1471. IdQltirtelltioB: Presumptive identification via fCview orall accontpfJl)'lng paperwort. Post·mOl1Cm fingerprints taken and dental «am performed. Suillble specimcn for DNA lUIIIIy$is obtained. CAUSE OF DEATH: Uncldc... llled MANNER OF DEATH: UndetenlUled MEDCOM 0974 ACLU Detainee DeathII ARMY MEDCOM 974 FINAL AUTOPSY REPORT: {bItS} 8TB Mansur, Ziyad Hamid 2 EXTERNAL EXAMINAIION The body is that of. weU-developed, well-nouri5hed male. The body is 'flPI'OxinWely 62 ~ inches in length. weighs 1S2 pounds. and tppeus compatible with the $WcO 'Be of 41 years old. The body is cold. Lividity (faint) is tixed on the posterior SurfllCe of the body except in the area exposed to pressure. Riior is mJOlvin(l. The scalp hair is brown/grey with male pattern beldness. f'teill hair consists of. beard. The irides are indistinct The: comc:ae Ire cloudy. There are Jl:.ttered peteclUae of the upper n&ht eyelid and lower left eyelid. The: remaining COnjunetiVlloC are pale with no petechiae. The sclerae 8l'e white with drying lU1ifaet The: oral cavity, external nares, and eJCtcmaI al.ditOf)' canaU are free of foreign material or abnonnal secretions. The lips are drY. There are no petechiae oflhe onl mlJlXlSl The: chest is symmetric. The aenitaliaare!hose ofa cirewncised adult mille. The pubic hair is shaved. The anus is 1lttaI.u1'\.Itic.. 'The upper and IOWCfeJCtremitieslle symmetric and wilbout clubbing or edema. The fingernails are intact. On the ri&hl ann is, I x I-inch 5cal". On the n&hl knee is a I x I-inch 5cal". On the left ankle at fOOl are multiple.scars thatmcasure up to 2 inches In maximum dimension. CLOIWNG AND PERSONAL EFFEOS The body is clad in yellow pants, wttite plllIlS, wltlte underwear, and white (-shirt (CUI). Two iclentUication tags lIQCompany the body. MEDICAL INfERVEJIfIlON No evidenee ofmedical iMervention is ptc:sftlt on the body. RADIOGRAPHS A complete set of post·monern radiopphs is obtained and demonstrate II radio01*!1IC fragmenl in the ri&htleg (metal fraamentrecovered fi'om denae fibrous tissue, photognpllcd and pl.ced in ,labeled evidence container). EVIDENCE OF INJURY Tllete is 110 evMien.ee of eJCtemal or inlmlal recenl injury. Im8NAL EXAMINATION BODY CAymES; 1'he ribs, sternum, and venebraJ bodies are visibly and palpably intact. No exCC$S fluids or adhesions are present in any ofthc: body cavities. The organs occupy their usuaJ anItOmic positions. HEAP (CENTRAL NERyOUS symM) and NECK; The plea! and subaalealsofl. tissucll ofthesmJp are free ofinjury. There are no IhlII fractures. The dura mater and falx oerebri are intlct. The leptomeninses are thin and delicate. The unfixed brain weighJ 1380 arams and is n:uined for Neuropathology consultation (see NeuropatholosY consultation). MEDCOM 0975 ACLU Detainee DeathII ARMY MEDCOM 975 flNALAUTOPSY REPORTlt{b)(6) BTB~, Ziyad Hamid 3 The anterior SlnIp mll3Cles of the neck are homoge/lOlU and red-brown without hemonilage (by layer-wise dissection). The thyroid cartilage and hyoid bone are inLlel The larynx iJ lined by intact white mucosa. The lOngue is ~ of bite marks, t1cmonilagc, Ol'" other injuriell. The thyroid iSl)'llUT1etl'i<: and red-brown, without C)'ll:ic or nodular change. Incision and dissection orthe posterior neck demOllltl'.les no deep paracervical muscular injlU)' and no cervical spinal column filICtures. RESPIRATORY SYSTEM: The upper ail'Wlly is clear or debris and rorei&,\lIUlterial. The mucosallurraca are lfl'looUt. yellow_WI and unremarkable. The ri~t &tid left lw:l£l weigh 650 and 540 &faI1Is, respectively. The pulll'lOl'Wy parenchyma is 1e:I-purple eJluding moderate amounts or blood. The pulmonary llnCriesare nonnaIly developed and patent wilhO\lt thrombti$ Ol'" embollll. CARDIQyASCULAR SYSTEM: The heart weighs 290 pns and il contained in an intact pericardia! sac. The heart is retained rOT eardiov.scular pathology consultation (see cardiovascular consultation). The aona and its mljor branches arise normally and rollow the usual course and are unremarkable. The vena cava and its IIUljor tributaries return to !be heart in !be usual distribution and are free or thrombi. LlyER" BILIARy SySTEM: The 1780 gram liver has an intae!, smooth capsule and. stwp anterior border. The parenchyma is W1-brown with the usual lobular an:hltecture. In the right dome is. 3.0 It 3.0 centimeter red nodule. No oIhcTabnonnalities Ire seen. The gallbladder contaim less !han I milliliter orblle. The extrahepatic biliary rree is plllenL SPLEEN; The 250 gram spleen lias allTlooth, intae!, red-purple Clp$lile. The ~l'ICllyma is maroon with unremarkable lymphoid rollicles. PANCREAS: The pancreas is red-tan with a lobu.llted appearance. No mass lesions or other abnomvJities are seen. ApRENAL,,: The right and left adrmll glands are symmetric, with bright yellow cortices and redbrown medullae. No masses or areas orhcrrrOl,hqe are identified. GENITOURINARY SYSTEM: The righ! and leA kidneys wei&h 140 and 140 grams. respectively. The elttemaJ lIItfaces lie intae! and smooth. The eut lUffaces lie dan-red and the cor!elt is delineated from the medullary pyramids. The pelves are unrernarlt.abIeand the urder.l are normal in CO\II3e and caliber. The bladder contains scan! urine. The prostale and IC!lleS lie unmnarb.ble. MEDCOM 0976 ACLU Detainee DeathII ARMY MEDCOM 976 • FINAL AUTOPSY REPORT: (b)(6) 8TB MINUr, Ziyad Hamid QASJRQ!NlWINAL IR.ACT: The esopIIaaus is intld and lined by IIIlOOlh, Ifq'-white mucosa. The flOllIICh., small bowel, eoIo!\, and "PPtndiJI are ~ The srom.cb eonlailllSO mimliltTS or partially diJe'led food particles. MUSCULO$Kf' EIAL; Musele devdopmen, is nonnaI. No bonr; Of joimabnonnalities are idenlirlCd. MlCRQSCOfIC EXAMINATION Modcnlc ~iap with ~ Ul1Incolie pipnenr; no significanlpllholos:ic ctitgnosia l.un&. RiJht ("ide 1): ModaUe COfl&CSUon with ICaltel'al ~ pipnem and focal tun&, Left (slide I): Kidney (slide J): Spken (slide J): Lint (slide 4): I. 2. J. 4. 5. 6. 7. ..... Modcrau: COllI "ion; no silnifieanlpllhologic dlqnosis Modcrau: C<Jn&e$Iion; no lipificanl ~ic diqnosis H_Jioma; modoente. conltftlion APDngoNAL'RQCEDUBES Speeimc:n.l retained (Of toxlcolOlY testing andtot DNA identification _: Blood, vilftOWl fiuicl.liva-, wine, lun&, kidney, spleen, p!IOU muscle, adipose lissuc MId pstrie conlents. The distcetcd 0f'PIlI are fOJ"WMled with the body. The bnin and han are rcWncd for consuJlIIlion. ~lcclCd poniOIlJ of 01Plll1II'I: retained in rorm.Jill. PcrsonaI crrcetl are relcucd with the body. Reco~ercd evidence: As lbcribcd above, rNined by OAFME. Skin Incisions of the posu:riOf tono, bultlKb Mel extremities tevcal no cvjdcnc:c of - DocumcnwyIlllot0llAl)hs_~by(b)(6) aulOJlSY is (b)(6) (OAFME). (OAFME). ASIIistina w1lb the CONSULTADONS I. Cardiovascular pIItholosY (ICC cv Path consultation forcompl~ f'CpOl1): L Diqnosls: Modcme dyspIasiJ of sinoatrial nodal arID)' and intrvnwaJ cororwy utene, in Cf'CSt of VI!fIlricular JCplWll b. Comrncn,: The comlation bcfv,WI small vesscI ditcasc in the cardiac conduction system and SlIddcn alb Is unclear, l*'Iieularly In the absence of "gnineu" ~na in the crest of the septum. Frqmenl.llion of the AV node (pcnistcnl fetal d.ispcnion) hQ aim been ponuWcd u a potential JOuteC of _try lIdtyantl)'thmiL II. Neuropatholoar (SCi: AFIP consult.lion for complete report): L Mild brain swelllng; Ulll'ellIIrkabtc Icptomminger, no pSi cvidcnce of herniation or midline shift; no focallcsions identificcl b. On miCfOSCOpi~ c:xaminatlon Ibm Is mild IIlbcpendymala1iO$is ofthc ~nttal lurf_ of the eorpus c:allosum. l1'I£JC changes are mild and nonspecirt~. No other pIIthologic. cltangcs are noled. MEOCOM 0977 ACLU Detainee DeathII ARMY MEDCOM 977 , -=== REPORT~)(6)- FINAL AUI'OPSY BTB MlI/lS1II", Ziyad Hamid fiNAL AUTopsy plAGNOSES I. No evldeaee ofslplrJeUlt luau Ira.... II. Nltural disetlte: A. Moderate dysplasia of li_lriaI nodal artery and intrNnurai ooronary ancrles in cl'e$l of ventricular septwt1 8. Hemanlioma oflhc JiV'Cr III. Evi6eltCe or m",1eaI .tervnUn: None lV. IdeolifylDl .....kJ: As deKribcd Ilbove V. POII-morteltl c1a. .lft: As dcsc:ribcd .bove VI. Tou<:ololY (AJIlP), A. VOLATILES: No ethllllOl deteeud in the blood lIIUl vitreous nuld B. DRUGS: No sacc:necI drugsof.buselmedieatioll$ detecled in !be blood C. CARBON MONOXIDE: The eatboltyMmoalobin satuntion in the blood was less than 1% O. CYANIDE: No cyanide was detected in the blood OPINION ]was, by repon, o~ed 10 be shaking while sleepinJ. When anoI:ber penon anemp(ed 10 wake him, he was nolOd 10 be WIIeSpOnsive. At autopsy cxcnil\llion, there: is noevidence ofrceent bllllll f~ injury, sharp Coree injury, or gunshoc woUllds. The metal fragment rcoovemi from the riglll1c8 is COll$iSIel11 with mnotc iqjla)'. The pclochille of the eyelids Ire non·specific; however, asphyxia C8IIlIOt be complelcly eltcludcd. CardiOVllSCUlar patholosy consuJwion was signifieanl for dyspJasLa ofw nodal and inuamural COl'OIWJ' arteries. However. the corn:lation between sudden delith and this finding in the absence ohignificant scarring i! unclear. Mic;ro!C(Ipic; examination WIll non<ontributory. Neuropathology consu!tBtion WJ! non-C:OfIbibutory. The IOxicology ~ WJ! negative. With no evidence ofre«tlt injllfY, neptive IOJtkology, and non-conlributory miClOSC:opic examination (incll1ding the: heart and brain) the: cause ofdea!h i! wxktemlined. ThUli the manner ofdeaah is This 41 yeal"-old detainee, (b)(6) UDdelemline(\l. (b)(G) (b){G) Medic;al Enmlner , It addillonalln",""",iool bo<ur>u .oallAble Ihoo _~ I In .....'''''.....110 llIis ropon dwla<: In 1"0 CIIIX """ _ _ otdalh, ...ilI be rudr. MEDCOM 0978 ACLU Detainee DeathII ARMY MEDCOM 978 .- -- - _...-_.- CEImflC4T1! 0' DUoTl1 (OIIfJ'lSf;II.t) ~_ - --- ,_ a_I_ -o.--_ . __ _ . _--"'_."' -,_ -._ -_..__-,.... _ _c.--. . -" . _c_ .-----. -"--"- ....., _ " ' .. c~ .... ~-BTB Mansur, lived. • ~""""", (b}(6) "".. '" - 1M . -.. ..-,00 (b}(6) 15157 00 0 ......... , -~_. Civilian ...""" .... Ow -~ C1o(b}(6) -"'''''''''''. .",,,...,.,,, ~- • S............. _0 ..... _'lJOooo' • T1lU ......... ....._.00lQlAiQ> ..... atY<>I ....... "" ...... , ... ........ n, ~ ...... "' ......... e-- .. _ _ . ._... _ -... Nj , .... .... ........ U"II....''''''.II .... ......., _""~"""'=."'-'OTO ""'._._TO '=r"" eoo-_ ..",,",._... L.NJ<ot.'"'" c.wa. • _. """"'_ TO"''''''''''''''' 0 - _ ..... ____ ... , , -- _ .... _-.........- -- -----, ---. _I""'""'' ' ' ' .... -"""......._--'''' . _--.......... -_ . _... _.-..._ ... . _---... _-..... _·-T -- --I . ..._ ...... -. __ """" .,_._-_...-......_.....-..._..... _-_,. -_._. _- .... _.._.... .... """'" '" ......... """""", """"" 1iI- ~ 0 ~ , ........ "'."..-. . . - '" 0Nlh : U"diOlIOO".'" , (b)(6) 11><11 9 April 2006 (b)(6) "" "'_ ... ,... ,.,.._ (b)(6) (b)(6) (b)(6) I bE.-- ~- - l ..... _ _ 0 •• • ' ... , . . . - . -... _ , '""" _ C"UOU . . " • ..., _ ..'~"""... _u DoYer MS, Dover DE (b)(6) ... -~~._ .....-. .. _ _ . _ .. _ DO',,", 2064 ... _ _ . _ ... _ _ OIOOOU.... MEOCOM 0979 ACLU Detainee DeathII ARMY MEDCOM 979 ARMED FORCES INSTITUTE OF PATHOLOGY omee ortbe Armed Forea Mediul Eumlnef 1413 Researeh Blvd., Blda. 102 Roel:vl1le, MD 208SO 301·)19.0000 AIFrOPSY EXAMINATION REPORT Name: BTB Kaziru, Husayn Uwayyid (b)(6) _ ISN: (b)(6) ~ DaleofBinh: 8TE(b)(6) 1978 DateofDealh: (b}(6) Date/T1me of AUIOJ-)': 07 July 2008@ 200S Autopsy No.: '(b)(B) AfIP No.!fb){6) Rank: Detainee PI.ce of DeaIh: Camp Bueca, lraq PllICe of AlllOpS)': Port Mortuary, Dover AfB, DE lJ30hn. Da~ of Report: 25 August 2008 Circ:Ullltflllled orDnlb: This 39)Ul" old deWnee was reported missing following an inte/1l1l'lent saW nlllllbel" (lSH) hudlOOUllL A XIJdI orlbe compound found !he decedent lying down in I !nll. The decedenI wu removed from the tenl and medic.J lreatment !W1ed. AalboriutiOD 'or Aalopsy: Armed Fon:es Medical EumiDer, per 10 U.S. Code 1471 Idellliftc.-tioll: J>nswnptive idc:ntifieation is made by internment scIUJ number, psoes musele Is retained for DNA identification ifnecOed for future Klentifieation. CAUSE OF DEATH: Stralllfl"tioll Amplaled by lDulliple blulIl roree iDjurla MANNER OF DEATH: Homklde MEDCOM 0980 ACLU Detainee DeathII ARMY MEDCOM 980 AUTOPSY REPORT(b)(6) KA1JM. Hlaayn Uwayyid Husayn 2 EXTERNAL EXAMINATION The body is dw ofa well-dcveloped, well·nourished Male dad in the itena listed below. The body _iabs 210 pounds, measures 71 inches in Iengtll wi appears consistent with the reported. of39 )Ul1 Lividity is fixed on the posterior surface of the body exeept whc~ exposed to pres.sure. Decomposition changes include green discoloration and rnartlling of the upper and \ower exuemities. Riaor is equal in all exlmnities. The body, whieh has been previously ftozen,lscold. Injuries to the head are described below in "Evidence oflnjury.M The head is: normocepbaIic. The IC&lp is covered with short dark black hair with temporal graying in a nonnal distribution. The irides are hazel and the corneae are clear. The extemal audilOry IaII&1s are free of nuid. The un are unremarkable. The llllR'S and the lips are unrcmarbbla. The nose and maxillae are palpably inlaCl- The teeth are nalUl'al. The neck is SlI"aight. and the U1IChea is midline and mobile. Injuries to lhe 10rso are described below in KEvidencc oflnjwy." The abdomen ilIaoft. The aenitalia are !hose of. normal ..:lull cireumc:ised male. The testes are descended and free of masses. Pubic hair has been shaved close to the skin. The bac:k is \lllf'C:markable. The buttocks and lII1US are WlI'CmarkabIe. Injuries to lhe extremities are desc:ribed below in MEvideooe of tnjury." The hands are IlOIIeCUfeCI in paper Np. The lingemails are inlad. ldentificalioll up are affixed to eac:h 2-linaer. There are no idtntifying marks to include laItoos. CLOTHING ANO PERSONAL EFlECIS The followina c10lhina items and perJORal effects are present on the body at the lime ofal/topsy: • TOrD white briefs MEDICAL 'NTEBVOOION Medical intervention presenl on lhe body II the time ofaltopsy includes: • EndotrKhW tube (appropriately piKed) • Electroeardioamn pickup on the left latmJ IOnO RADIOGRAPHS A QOIllplelC SId ofpllSlmortem .-.diolJlphs is obtained and demOll'tntes the Injuries described below. EVIDENCE Of INJURY The orderin& of the followina injuries ill flit descriptive purposes only, and ill nollnttrlded 10 imply order of infliction or ~lative sevenI)'. INJURIES TO THE HEAD AND NECK; ~ is lII1' x j-inch confluent dark blue·purple conlusion over the entl~ forehead and both ptriorllital regions. A I x I_inch oval .bracIed oonlUlion is located above lhe J.teralleft eye. Two oval abraded OOIllUliom are below the right eye, J x 'n-inch and ¥. x ·;'·inche5 respectively. A ¥. x '/,-inch oval abnded conlusion b below the left eye. A 2 x 2-inch .bnw!ed contusion oovers tbe MEDCOM 0981 ACLU Detainee DeathII ARMY MEDCOM 981 AUTOPSY REPORT(bH6) 3 KAZlM, HIISa)'ll U_yyid HUSliyn chin. ~ coajllllttiYK and sdeBt IlJl: diffusely bemohhqic. There ill dit'fuse $Ubpleal hemorthqe Md biWeral illnm~., bemorrba&e of the tempol1llis mlllll:u1l1tUre. l1lae is intJamllllC\lt. heIrIiX,bq;e oft!Je left proximal upect of the medial body of the aternodiedomastoid m\l5de (~iIldl), iIlIerior epeel of the left aternobyoid mldCle (%-inch) and pmximL! Uped of the ri&hl.lel'IlOhyoid mUllCle ('I. .ildl). Tbe inferior ri~ thyroid J,laocI baa focal (1/4-iocb) illlJ1plltl1dl)'l1W beIrla..hIae. There is benlOl rbqe mlO the .lIOft tissue SUITOunding the right gre-aer hom of the thyroid cartililie. INltIBIES TO THE TORSO: Tbtrc an: multiple, IJOIlped, oval contusions 011 the right side of the ehest ranging from y..-illeh 10 }Ill-inches in nwdmurn dimension. Two oval contusions 011 !he left aide of!be chest measure up 10 1-Yt-iDcbes in mlltimum dlameler. The left lower quadrtnt oftbe abdomen Iw:. I ~ x I Y.rinch oval cootuaion. The entire hick dcmonIlrIles multiplc. ~ oval contuliotlll (right side gTelItCI t!wl the left side) nngina from \4-illeh 10 l-incll in &f'Nl$ dimension. There ill .aoft tissue IIlld InballlldCU1. hell)(llThase oflbe central upper bKk IltId riabt shoulder measurina 2 x 2-Yt 1lId) x l-inc:belI respectively. There is 10ft lissue aDd inuamllSCV1ar hemonhlse of the centnl1lowcr ISpect of tile bck lad LIIerI1 left ISpeet of tile lower II1elll1 bKk measuring 6 x I-Ii and.5 x 2-illChes respectively. Th~ an: &actutes oflbe anterioraspccU of!be 56, f/" lIDCI"" right ribs IlId lateral ~oftbe 9"left rib. Lumber uansverse processes an: fractured on !he rishl.ide of the ) .. and .. and on !he left side of the 46 vettelne. Tbere is diffux hell10rrnase of!he posterior medilSlinurn aDd IUmIUDdina !he thoracic vtrtebne II the CO$IOVenebl1ll jUDCtiOllll. There is a conIUSlOl'l 10 the pomriOl' w:all of !he left ventricle of the: heat!. There is a wbdural hematOl'lUl sunoundina!he thoncic JPinai con:IlIIld intnplmlChymal hClToOuhage oftbe spinl1 cord at the l~l of the 9" tborac:lc vertebra. There IlJl: bilaleft1 bemotbonces, SO millililers OIl the risht llIld 75 miUilitmon the left. There i. diffuse lebopaiolellial hemorrllage, approximately 200 mil1ili~ and hemoperilOne\lm of200 milliliters. INlURlfS IOTHE gxIR.EMmES; The Ulterior upect of the rishl arm dell\OlllltrtlleS IWO oval contusions. 'I.-inch 10 I-Vo-incbes in nwdmwn dimensiol\f.. The posterior aspectof!he risht arm hat multiple oval contusions ransins from 'I.-inch 10 ~inch in &JUles! dimension. The anterior aspecl of the left arm hu three avaJ conluSlonr rlIlIsil1&!Tom \4-lrKh 10 I-~Incbet in ,reatestdimension. The anter101' aspect of the left forearm Iw: an oval contusion meuurina 2 x 2·inches. The posterior latcrlll aspect of tile right thigh hat multiple, iWuped, oval conlUliions ranging from v,-inch to ~inch in maximum dimctl5ion. Anterior aspect oftlte left leslw an ova! contllSion mearurinll2 x 2-inche•. There ill subcullrleOUS and intramllSCular hemorrhlge to the lllterior aspect of the risht arm {6 It 2-incbes),!O the posterior aspecIofthe right upper arm (S It 2-inches), 10 the di.slallau;ra1 aspect ofllle righl thigh (3 It 2_ inches), 10 the po,.erior lateralllllpe<:1 o(!he rishl thigh (8 x 2-inches),!O!he posterior laterall.'lpecl of the left thigh (3 x I-Ill-inches) and to !he proximal anterior aspect of the left leg (2 It 2·inches). INTEBNAL EXAMINATION BODy CAyml!S; ltIjuries an: described in MEvidence of Injury." The orp.ns occupy their uslJl1lU1atomic positions. The subcutaneous flliayer oflhe abdominal wall i'lIllf'm1I1kable. MEOCOM 0982 ACLU Detainee DeathII ARMY MEDCOM 982 , AUTOPSY REPORT,(b}(6">- - KAZlM, HUSlyn Uwayyid Husayn HEAD AND CENTIW. MERVOWS SYSTEM: Injuries an: described above in "Evidenu of Injury." There are no skull fracturu. The dura mater is mt&CI with 00 evidence of hemorrllage. The leptomeninges an: thin and delicate. Cloudy light red cerebrospinal fluid surrounds the 15)0 gram brain, which is softening and mabIe. The gyri and sulci an: unremarkable. The ce~brlll hemispberc:s are symrnetrie&l and the stnICtures at the b.se of the brain, including the cranial nerves and blood vessels an: intact. Corooal $CCtions demonstrate sharp demareation between white and gray mattel", without hemonhage OJ" contullive injury. The ventricles are ofoonnal size. The basal gangli.. brail1Stcm, aDd cerebellum are me ofinjlD)' or· olhcr abnormalities. The lItIanto-oecipitai joint is stable. ~ Injuries are described above in "Evidence oflnjlD)'." The thyroid cartilage and byoid bone are intact. The I.lryM is lined by intact white mueosll. The thyroid IIland is symmetric, without cystic or nodular chanlle. Incision and dissection of the posterior neck demonst:rates no deep pMICClVical muscular injlD)' and no ecrviul spine: fracUIJ'CS. RESpIRATOR)' SYSTEM: The airways are clear of debris and foreign material and the mllCDsaI surfaces an: smooth, yellowtan, and \IllJ'ClIWuble. The right and left lungs weigh 530 and 560 &rams. respectively. The extemal surfaca are smooth. No mass lesions OJ" areas of consolidation are presenl. The pulmorwy arteries are normally developed and palmI. The diaphBgm is intact CARPIOV ASCULM SYSTEM: Injuries are described above in "EvideneeofInjury." The 390 8'1IlD bean is contll.ined in an intllCt pericardial sac. The epicardial surface is smooth, with minimal fat investment The COTODIlY arteries are present in a nOlIllal di5lri!Jution, with a rigJn-dominant pattern.. Cross sections oflbe vessels showno stenosis. Where uninjured the myocardium is homogenous, red-brown, and flCTD. The valve leaflets are!hin and mobile. The walls of the left ventricle, inletVentricular septum, and right ventricle an: 1.1, 1.1, and O.J<entimeters thick, respectively. The cndol;ardium is smooth and glistenin&. The aorta gives rUe to three int&CI and patent AlCh vessell:. The renal, mesenteric, and iliac vessels u well u the venae cavae are lIllt'mIAtkabJe. HEPATOBIWARy SfSTEM: The 1530 gram liver bas lID intact, smooth capsule and a sharp anterior bordet. The parenchyma is tan-brown and congested, wilh the usua.I JobuJararchitectute. No mass lesions or other abnormalities an: seen. ~ gallbladder contains 10 milliliters of green-black bile and 110 stones:. The mvoosaJ surface is grun and velvety. The extnlhepatic biliary tree is patent. LYMPHOREDCULAR SYSTEM: The 200 gnun spken has. smooth, intact, red-purple capsule. The parenchyma is friable, maroon and congested, with Indi.stinct Malpigbian corpl1SCles:. Lymph nodes in the hilar, peri.anic, and iliac regions are WlmDarkable. MEDCOM 0983 ACLU Detainee DeathII ARMY MEDCOM 983 , AUTOPSY REPOR1(b){6) KAZIM, HLlS3.yn Uwayyid Husayn ENDOCRINE SYSTEM: The pituilaJy gland is UlIf'CIIlllI'kablc. The thyroid gland Iw been described (sec: NECK. above). The rigbt and Ict\adrcnal glands arc symmetric, with bright yellow cortices and red-brown medullae. No mwCll or areas ofbemolTbage lIl'll idelllificd. GENITOURINARY SYSTEM: The rig.bl and leftlddneys .....eig.b 120 and 90 grams. respectively. The external $IIlflCeli are intact and smooth. The cut surfllCC$ are pe.!e Ian witb unifonnly thick coniccs and sharp cortieomcdullaJy junctions. The pelves arc IIllmIIIII"kable and the IJl'etCl!llll'll normal in course and caliber. White bladder mucosa overlies an intact bladder wail. The bladder <:ontains approllimlltcly 120 milliliters of clCllr yellow urine. The prostate is nonne.! in size, with lobular, yellow-tIIrI ~nchylllll. The $CrninaI vcsiclC!l m: unremarkable. 'The tC!lCS are free of m.IIS! lcsioll5, <:ont\lSions, or other aboonnalitiC!l. QASIROINIESTlNAL TRACT: The esophagus is inlllct and lined by smooth, gray-white mllCOJll. The stomach contains appl1lximately 350 milliliters oftan-brown partWly digested food particles and viSCOllJ fluid. The gasuic wall is in!llCt. 'The duodeoum, loops ofSIllaiI bowel, and colon lIl'll ~ble. The pMCl'C3S is finn and yellow.tan, with the usuailobular architoctuR. No mass Icsions or other ahllOlTllll1itics arc seen. The appendix: is pracnl. MUSCULOSKBJ HAL; No llOD-traumatic abnornulitics of the mll'Cles or bollCS of the appendicular fJld lillie.! skeletons arc identified. ADDnnONALPROCEDVRES I. Documentary photographs lIl'll taken by OAFME stIIff photographer. 2. Personal effects arc released to the ippropriate mortuary operations repccsentatives. 3. Specimens retained. for toxicology testing and/or DNA identification 1Il'C; vitROus. blood, bile, wine, gastric contents, brain, m)'OClllllium, IUIIg, liver, spleen, kidney. adipose tissue IIIld psoas muscle. 4. Thedissocted organs arc forwarded with body. MICROSCOPIC EXAMINATION Scleded portiOllS of organs IIl'C retained in formalin with tbc following tissuc submitted for histological cvlliualion; Slide! 1,2, and 5; Han; Decomposition ~hangcs and pcmible ex!nlvllSCular red blood cel1ll Slide 3; Bladder; No signifiCIIIII pathologic chanse Slide 4; Thyroid: Decompo!lition ~han&e! and poaible cxlravllSCU1ar red blood cells in the J\IIlO\Illding soft tissue MEDCOM 0984 ACLU Detainee DeathII ARMY MEDCOM 984 =:J AUTOPSY REPORT'(b)(6) KA1JM, Husayn UwaY)'id Husayn 6 FINAL AUTOPSY DIAGNOSES: I. Blunt force injuries: A. Injuries to the head md ncck I. Multiple conlullions ancIabradcd contusioDS of the face. 2. IntramWICUJIJ" hemnrrhage of the llJ1lcrior ncclr. musculature. 3. Soft tiSIlllt hemorrhage SlUJOunciing the right greater hom of the thyroid autilaae 4. Hemorrhage of the right thyroid g111ll1. B. lojuries to the torso: I. Multiple contusions (0 the cbest Illd back 2. Multifoca18lellS of marked inlratrlllSCll1anIle hemonhage of the back 3. Multiple rib tIaetun:s 4. Posterior mediastinal hcrnol"l"hagf; S. Contusionofthehcart 6. Perithoracic vertebral hemorrhage 7. SubdUl'lli hcma!Oma of the thoracic spi.nal cord a. lntraparenehymal hemorrhage of the thoracic spinal cord 9. Fraenues of the lumbar lrlMVenc procCS$l"$ 10. Bil.ltel1lJ. hem01:horaceS 11. RetroperiDlOneal hemorrhage 12. Hemoperitoneum C. lnjuries to the extremities: l. Contusions of all four extremities 2. Marked intramllSCuJlttirC hemorrhage oflhe right upper, rigbllower aod ~ft lower extremities. II. Evidenceofmedica1therapy: Aanotedabow m. Post-mortem changes: M IIOted above IV. Identifying milks: None identified V. Natunl.1 dixax and pre-cxisting collditiona: None idmtificd within the limitations of the elt&lllination VI. Toxicology: A. Volatiles (VitreOWI fluid): No ethanol detected B. Screened drugs ofabuse.nO scrccDCd medications (Urine): None delected C. Carbon monoldde (Blood): Leg than 1% D. Cyanide (Blood): None detected MEDCOM 0985 ACLU Detainee DeathII ARMY MEDCOM 985 AUTOPSY REPORT(b)(6) KAZlM, Husayn 7 Uwa·~'Y'f""id"""_"","', OPINION This 39-year-old ~(6) ~died from strangulation complicated oy multiple blum foree injuries. The de<:edent shov.ted evideme ofstrangu1ation and additional blunl force injuries of the head, torso and all extremities contributina to death. ToldcolOi)' analyses ~ Ilegalive for ethanol, 5Creened mediCliliol15 and se~ed drvgs of abuse. The manner of dctlIh is bomicide. (b)(6) -, (b)(6) 1~(b~)(~6}C=JMtdical Examiner (b}(6) _ _ [Medical Examiner - - - ' MEDCOM 0986 ACLU Detainee DeathII ARMY MEDCOM 986 _ ........'-"--"- p"o_ II ...-~-- -- -----... _ -- , QJl1lflCJlTl! Of' DUont ~ I J _._.._-_.- --- -- ........ -,• -• ---,_ . __.... _........... _. _-- - - -... _.- 8TB Kazim, Huuyn lJ'wayyid, Husarn Oop ~ ""'CO. . . ",r(W .. "" Cb)(6) CMlian ~ ............... __ I!I 0 ~- ~ ~- • ............. ",lIIlCl.OIfD _IT._ -""' - ...... " '-.. <:m' "" """"""OJ... " eouM"'_'" -- --_ --".- ... ~~ .... _.._--_ .'-__.. -. --_ -._ ---. __.. - --"' ",_ _._ .... __ ---.----_.0...0 . . _ _ _ _ . . _ , _000-...._.....-'0....... , $lI.;' .... 'eco"$ ... t.,._ba> ........ • _<»0'_."'" ... ,. .-", ~ L:oU........ c.uM,. _ _ _ ,. 0_ _' __ • .... c._ _ O O ' _ T ~ [i] -'''~''''..o "'O!!':' ... I b)(6} ............ _._ '" 1IO:::='';i.", ~ D~ I 0- "" 7 July 2008 --- _-_ ... ............ l 11b)(6) • ~ ~ O\..OCI .......'" I!I~ - h._..__. . . _I0_. . _. . . . . . . __. . . . . . ____ •... _"'" _ ... ............ ............. • (b}(6) '2008 " -".. (b)(6) l(b)(6) WJnOO8 ,---"_ _....- ....... _ o r n c .... lIOCOlUI_'_'.. C'UOU ...... TlD-. . '.......,..""_ DoYe, AFB, DoYel DE (b)(6) Medical EIWTIlII8f ............ -_ . . _,- .... _. -.... ... _..... _..... _. _-. ",._H.., ... __ -'- '-'-"'-"'-~","-"'.- """-"CO. . . . . . . . . _ ' _ " _ ... _ MEDCOM 0987 ~ ACLU Detainee DeathII ARMY MEDCOM 987 ARMED fORCES INSTITUTE Of PATHOLOGY om« ottbe Al'lIIed Fol'CCI Medkal EumlDu 1413 RcseaR:h Blvd., Bldg. 102 Rockville. MD 2(l8S0 1-301-319-0000 AUTOPSY EXAMINATION REPORT Name: BTB At!.. Muhammlld Najib Abu-Wafa SSAN:JIill.6.l Aw:: Approlli~cly» yean old DIlle ofDeath[(b)(6} 2008 Oatdfime of Autopsy: OS SEP 20081(9)0 DIItcorReport: 19NOV2008 Autopsy No.:_ (b)(6) AFlP No.:,(b~)~{6~) Rank: Civilian Detainee PllICe orDeath: Iraq Place of Autopsy: Pon Mortuary ==-' DoverAFB,Dover.DE Clreull\Stalicet of Otat": This approl;imatcly S2-year-old civilian maIC~!'''~·_~~_~~ housed al Camp Bucca. Iraq. AVlilBblc investigative: reports indicate thlll'{b)(6) collapsed to the wncrete floor orhi, tcnl as reported by fellow detailXC'S. Emeracncy medical pmonnel responded and reponed thailbl~n:Jated to them that he had fallen. Despite agg.ressive medical intcrvcnli~(b)(~umbcd to his injuries. AUlboriZllooli for Aulopsy: Armed Forces Medical uaminer. per 10 U.S. Code 1471 Identificalion: Presumptive: idenlification by ac:«lmpanyinS rcports, identification tags and documental ion. A postmortem dental examination, postmortcm fingerprinl cllamination, and a postmortem DNA SIlTIple an: liken for prolilc purposccs should ell:&mplan become available for positivc identiflCltion. CAUSE Of DEATH: BluDt force tno",ma orllie bud MANNER OF DEATH: Aecldeal MEDCOM 0988 ACLU Detainee DeathII ARMY MEDCOM 988 , AUTOPSY REPORT (b)(6) ALI, Muhl.mad N.jib Aba-War. EXTERNAL EXAMINATION llliuries will be deseribed in detail in. sepan~ -:tion. and will only be briefly .1Il1dcc1 III in the remainder oflhc report, for ~ oforicntlliion and eompletencSll. The body is lhal of. wcll-dev1:lopcd. well·nourished appevina. adult male. The body is 1'C'ClCivcd UIlCIothcd. The de!;edcnl is wrapped in. mulliple layers ofclOlh sheeu.nd abIorbcnl peds. The Almalns lie 69-inclles in length, and wei&h I SI-poWlds. Liyidity is prc:senl and fixed on the poslerior smace ofille body except in UQS exposed to prcsslllC. JUaor is Pl'C5Clll 10 III equal dearec in all alrcmilicJ. 'The temperalUAl of the body is lhal of the Almgenujon unil. The head il nOfmOCephalic. The ri&hl occipitlll scalp is covered with curly black and while llair, the rcmlirKler ofthc scalp is wvcd. Faci.1 hir colIIlsLI of. arty and while beard and mustllClle. The irides arc brown. The comeac are haq. The pupils are round .nd equal in diameler. The sclerae are muddy and withoul petechial hcmolThagc. The eXlCmal.udhory canals. eXlernal nares, and oral cavil)'.re I'A:e of foreign malerial and abnonnal secretions. Thc cars are on rcmarbblc. The IWa are palCtll and !he lips arc .traumalic. The uppet and lower !Tenula in the oral cavily arc intlCl. The nasal skeleton and maxillae arc palpably intICI. The tuth appear IIItural and In f.ir condition. The IlCl:k is stnlight, and the lrachea is midline and mobile. Thc chesl is symmetric. The .bdomen Is fiat. Tbc 8enitali. arc lhose of. normal adull circumo:iscd male. The lesles an: descended and fl'DCofmaucs. Pubic hair iI prescnlln a normal male distribution. The bullOCb and anus arc unrcmarbble. The uJIPCT and lower extremities arc symmcltic and without c1ubbinll or edema. There is .mputlllion of the distal tipsoflhc I' and 2"' dillill ofllle left hind. The finaemaill lie inlact and the nail ~.re cyanolic. There is hypertcrllo$ls ofille I-Is ofboih feel. Idcnlifyina marks include mulliple JCIl1: • A 2 In" III-inch well healed hypopigmcnlcd Kar on the r1&hllo~quadrant of thc abdomen • A well healed 4 It I In·inch tear is on the left upper chest with absente ofthe lell; nipple • A 4 x In·inch vel1icaUy oriented hypopigmcnted teat In the midline ofllle lower .""""', CLOmlNG AND PERSONAl. EfFECTS Noclothing ilems or I'C"'OI\lIJ effects accompany the body It the time of.ulopsy. MEDCOM 09lI9 ACLU Detainee DeathII ARMY MEDCOM 989 , AUTOPSY REPORT (bH6) ALI, M.b.lIIl11.d Najlb AbtI·War. • • • • • • • • • • • • MEDICAL INTERYENDON A puze dres$ing. lealred bElIelIlh die chill, DCIven the calvarium and the e)'Cs On lhe left f"ronlll, J*ielll,1tId temporal JCIlp ill.., II 1'4-inch curvilinear SlIpIed surgical incision A chin cxilillll (rom !he IeftoccipitailCalp tonIail\llS-millililel'l ofred tinged fluid A VCTltrieulOSlomy tube exitl the rialu pariet:a1 scalp Anaioc:lthcter In the niht subclivillll speee Urinary bllddtT cadJeler Rectal lempcl'lture probe Intl'l~nous "!helen in the riahllllteeubital fossa, ri&hl vollt wrist, volar left foreum. and dorsal righl fool A clear plulic idenlifJCllion tq in circles !he ri,taI......nsL (b)(6) f1lStie identification lIa.in ein::les lhe left wrill, (b){6) [(b)(6) Multiple ther1lpcutic needle punet\ft lites on the forehead, abdomen, left upper chest, and bolh ..,kles (j&\lU blndIge on medi.llefl ankle 1 BAPlQCRAfHS A complele set of postmonem radioVlJlhs b obcained I~ OenlOI\ltn.tcs the followlna: • MedicallnteM:ntlom u listed .bove • Hailed fraclure of the left uhw Ilylold • Bone flap remo~ fi'om lhe left fronlo·temponI\ ealvlrium • Midline shift ImUn to the ripl • Edema onlle Jell. hemi$~ with effacemenl ofille left I.teral ventricle • DiJ.Led rishtl.tertlJ ventricle posteriorly, blood In poster warned • Blood collection in both frontal lobes, .merior ~ bilaterally • SubdUl'lI hemonftagc: lnvolvllll the frontallobcs, riihl jVe.lcrthan left • Linear skull &acrure of lhe ri&hl occiput • Biliteral pleural effusions and patchy consolldalion ofille lunp • No internal metallic li-agrnents EYIDENCE OF INJURy The orderill1l orlhe following injuries is forde$cripCive purpose$ only, and il not inlended to imply order of infliction or relatIve severity. There is an im:gular tillCar li'acture of the posteriOlllpe<:t of lhe pc:trous portion of lhe riahllCmpora.l bone rxlendina IIlteriorly inlo lite ri;ht middle cranilll fOll8 and I'O'lCriorly into the ri&ht posterior c:rani.J fossa and posterior ri&ht parietal bone. On the posterior rishl t:houltler Ire multiple vertically oricn~ fine superfieia! Ilnelr .bruions measurina up 10 2 1f2·inches Jenilh. Addilionll.ul(lj)I)' Ondinp penainillllO the held arc described in ~ Evidence OfMcdicaJ IntetVentJora andfor 1nteml.1 Examination-Head And Central Nervous System ". MEDeOM 0990 ACLU Detainee DeathII ARMY MEDCOM 990 REPORT·(·",,,iii6)-~ AUTOPSY ALI, Mubmm.d NtJlb Abu-W,ft • Evldmu ,f I,Jury ceo,l); Incision Ind disseclion ofl!le posltrior neck, subcutaneous liuues of the torso and cxtmnilies. demonstnltes no dcq:l \*XC'Iiell mllSC\llar injury, no cavical $pine: fractures, Of evidenee of blunl fora lf1lWT\I. BODy CAVlTlfS; The body is opened by che usuallhorlc:o-abdominal incisiofllnd lhe ehesl p1ak is removed. The ribs. stemlllll,llld venebtll bodies are visibly IIld f:*lplbly ill\lf:l. No .dheli(lflS are presenl in the pleural, peric:anlill. or periloflul tavities. There U'I: bililmll p1eunl dYi~ioltS (righl·27S·millilitm., Ien·17S·milliHcm). There are 4SO-millililet'S of S\l'llw tolOfed nuid in the perilonul uvily. All body oraanJ are pratIll in l!leir 1lQnI1a1 anlIlomie posilions. Then is no inlnNIl evidcnc:e of blunl fOl'l:e or pmdl'ltiflllinjury 10 the lholal:o-abdomirull reaion. The sulx:UutnOOllS fall'yer of the abdominal is]'4-incnes lhiel:. HEAp AND CENTRAL NERVOUS SYSTEM; (See above ~Evideoce of InjW'Y") The scalp is renecled. Subplea! IlenlOoTlllse is USOl:ialed wllh the underlyins frKNres and medical inlervention. There is. non-quanlifiable subdwal hemorrluiae in Ihe riahl anlCrior eT1lni.1 foss.. The ther1.peulie mcdital devices are documenled and removed. The 1480-pwn brain IIld dllrl are mnoved and piKed in formalin for fomtal NcuropalhoJoay tollllullalion. formal Ncl/l'DDUlfw{ogy CorwdUlllon: GROSS DESCRJPTJON: Brain weight: /•.JOJ grums 1M :pe(;/men corulm ollhe InlroerarrkV duro and "'oln all," /MIu". A ret'tnt crunltcfumy hWi ruu/ltd I,. fM. absente ol/he ptU/erlor-la/tru/fronloJ, laftrol purielUUfuptrlor.fUltruJ /emporuJ tmd OIlftrlor-Ja/era/ acelpf/aJ por/lon aflM /'./1 "",bra/ TIlt w¥al /lIIDrgln of IItt dural deleel cons/.III ala raw a.f I~",d dllf'Q/ lam with alluelttd blad III/Wet. Tht rlg/ll ctNIl'Ulry dura ami lite loJx cerebrl are In/acl. The purum,dlan dllTQl arachnoid gnmulallon¥ (Irf red·bluek due /0 ,""mIlIDied acllie .fllburUl:hnoItl blaod. Seal/tred ¥Irolllb olrtd·black. CODglllaltd blood up la O.Jan/lmffen Ihickond I-t:tntimf/tn In gnoJUI dlomtler odJltrllloosely 10 lhe Inner ¥urjUa ollltt rlghl ond Itft paromedion duro. 1M lejl ¥urloce oflltt falx ctrtbrl. eN'lIe loosely IJIIIM or«hnoJd rut;/lJu aftach poramedlan ctrebral hem/:phere. ~ I'tMlU .f/nwer an pattnt. dJ,,"" A motkrlJfely Ik,p cranlllCl"",y groo." /ndenlJ IItt Itft ctrehrallurjtrll. autllnlnlt un e/ellO"d (1ternlal,dj al'Ul a",a opproxlmtJlely 9 (aflftrlar-pwltrWr) lIy 6 (donal·wtrlroJj Cenll_ltrl invollllflg lire laluoJ parlt/a/. flllerol aflfulor IlI'fNhinh oa:/piial and MEDCOM 0991 ACLU Detainee DeathII ARMY MEDCOM 991 AUTOPSV REPORT'(b){6) ALI, M"bI",m.d N.jib Ab.W.r• s .fIIl'trlor l~mporal/fJbl!5. A ~n"lculostOmylllbe has ln~n Ins~,,~d InlU I~ft dor5al mid fronlallobe approxlmm~/y J c~nlifMltrsfrom Iht _dial margin. RttJ./N'aW1l t:ONIr:a1 canluslons c/rQrar;/trlztd by cOrllcal hefllOrrho~s, carllml Mcrosls. lepfoIMnlngtol ond carlir:alIQCtrollon and ctJr/lr:al and sllbr;arllr:ol htma/omas (up 10 1.5 c~nli1Mlers In gr~alesl dlnunslon) an sllualed In: anltrlor parlJon o/iht It/llnftrlor I~mporal gyrus. 1M anltrlor porllan oflhe I~ft SlIptrior lemporal gyrus. 1M posurlor porllon ofltf/ slIptrlor Itmporal gyrus. lilt left laural pmltwl'olH. Clusltrs ofsimilor contusions ar~ also presenl over the Itft inftrlor Itmporal poI~ (4;0; J ern/lnultr), 1M I~ft Inftrlor franlal pol~ (4 x 4 c~nllmtltr), 1M rlgN/n/trlorfroll1al pole (3 x 3.J «nllmtler) and 1M rlghlln/trlor I~mporalpol~ (1.5 x 1 untllfltltrs). Tht~ Iso Ihln r~d-brlJwn sl/wachnoid MmrH'rhagto>'Cr lire bost oflht: pans and 1M urtbellar ptdU1tt:/e. A Ihln. horlson/al rim ofsimilar sllborachnoid hemorr/rQge (probably gra~JlalffJffQl) Is prtnnl owr Iht posurior margifa ofIht rlghl und J~ft urebelliN' IItmlspheres. l~jI ExctpllZS /tOIed. Iht leplom~nlnguarethin. dtllr:ale and Irunspar'nI. The cerebral gyri on soft, while andjlalleMd due 10 swtlllr/t bUI huve on anatomicall)' normal configuralion. Tilt ptrlstllar, ptrimtStncrpholic and basal clsltrN are compltl,ly ~ffocrd due to brain sw~1IIng. Dttp fen/or/oJ groows indenl ~(JCh UncIlS, 0.8 ctnllme/trs on 1M I,ft ond 0.5 cenlimtlerson lilt rlghl. Tht: left groo~ is conllnuous wllh a lejl parohlppor:ampol grlHJ~~. The brallUltm il displocrd rightward wllh su/lseqll<!Pl/ jlullening ofthe rlglu surfau oflht midbrain. 11It «r,btlliN' lonsi/s or~ d~flJrnud due 10 pnxsun agalnslilltforamen magnlUl'l. The ar/trits ollhe bo.ft oflhe brainfol/ow a normal dlslribullon tmd lhere are no Q1Itltrysmol dilalallons or !iltes 0/occlusion. COrQNlI seclions oflht urtbrum re~a1IMaboWlnDltd abnormalillts. In oddllion. lhert is a swollen I~ft ctrtbral htmisphtrt wilh a sharplydemorcaltd IIJnt ofsaftMSS. gra)'-whlle discoloro//on and blurring oflht grey mo/lerlwhll~ malltr margins dut 10 Ischemic Mcrosis In the tntln mSlrlbu/lon oflhe I~ft middlt ctrebral arury. TMr~ Is a promintnt rightward shift oflhe «rebral htmisph~ns with rightward boWing oflhe in/trlltmlsplltrlcflSSuu and slibfalcillt! IItrnlal/on oflilt rlghl clngulalt g)-"lIS. T1r~ wnlriculoslomy 'I/be f'trfON1fn 1M Itftfronlallobe In a venlrol·mNla/ dinClion and f'trfomlts Ih~ mldUnt corpus ctJ1losum wMr~ Ihtre Is Intuwntrlc"'ar ht:morrhogt and un upproximaltly J c~ntilfltltr in diaJMltr Itft mtdlallhalamk hematoma. 1M ~ntrlclilur xyr/tm Is disrupl~d ollhe a~ noted WlnlrlculoslomyptrforolJon In 1M corpus callosum. The bDdi~s of/lit laltrall'tl/lrl(:l~san nul tnlarg~d Tht occlpllal horn oflilt righllalerul ven/rleft Is /arger /hun lilt Itft (1.5 un/fmtltr In diamtler ~l O.J (:~nllmtltr) r~fttetlr/t SUmt tkgnt ofprOJ:lmoJ obslruclion. The Aqu~duct ofSyMus Is MEDCOM 0992 ACLU Detainee DeathII ARMY MEDCOM 992 , AUTOPSY REPORT (b)(6) ALI.lIohhlll.....d N.jlb A111;1-w.r. Nwopgtho/ogY CtWHItel9fl (Co!!lJ; pat.1I1 ""ith __1PI4J siu fIIId ronfl'lII'OJIOII. Thtt choroid plexus ISlUfu_bJbl. lind 1M .~1IdymD1 nnf«u rIrf smooth fIIId gJulm/ng. MICROSCOPIC EXAMINATION: Bloch O/IUsW joI- mlaoscoplr _/,..t1cm rIrf ullfOWd.frgm: (I) I.ft IOJ.roI froJltoJ 100,. (1) tI1II.rfCf' t:OfPVI callosllm, (J) I.ft mrt!JQI Sir/OJ' bo<f)o, (.) 1,/1 UlICIlI". (S) ItIt lhoIoMUS. (6) rlllll Ilippoc_plU. (7) l.jI occip/iol 10M. (8) riglll o«Ipitm loIJt, (9) calldaJ ",/dbt'QI,., (10) mtdlfllo, (I I) hit (tnbrllfim DIId (12) d_. SKtlonsfroM bloch 1·12 an I/o/Md wflll H cI E.. Srcllons 1·11 01" Qlso SIQ/Mdwll" OF"P oIId p.-ylold. Blrlscltowsty GIld LFS ItcJudquu DIId 1IMlIUlOJIQf",d/tN 1M n. COMMENT: TIwr. U wldupnlld grty and w/liit _II" edt_ and Kal/"RI «III. UCM"';C "'firoftOl I""" (" red "'....Olll "J lit HCllons oflM I,ft ctr,bnun (blocks I. 2•• oJ 7) COtISW,III ",1111 OCIll' flt/(Ir(I1cm wll'c" Is probably nwmJ /0 lilt Itft /rOIlS aaltltt:lonf)' ItrmIotIorL Thtt tlCfif, MtItOtTltogt of lilt Itft Slrlat, bo<f)o Ottd 1M 1IdjllC,III corpllS UlIIOIfiM tmd pooI,d blood lit Ineoet:fp/loIltorlt of1M rip Ill/,ro! velllr/cl, 01" nlolld 101M ~"'frQI1011 of1M ....ltlr1cli/OJlomy lfik Thtt orrtJY ofcortkol COlIIlll"fDm tM - r ' l l o/tllt crfIlt1«lollty dtftcl Is dw 101M ,..II-S_ of1M bra/II ogalllJt tlw boM -rill rISlIll/"Ifram IhI fiffdtrly/", bro/ltswtlli"" Thtt l,jllUtCOIlIIt;rOJu ruuJlld from 1M 1./1 CIrIINaI nwlli/tl.;> ftJIlO rlglrt MId/I", s"/fI·;> It/I clllglJ(I/' IY'W hlrniQI/oIt·;> I.ft transt,lIIarloJ 1ln<tJ. m-s 1M nMOlltil1l'tslons opptQl' 10 bt pri_il)' dw 10/rQfiJ/tQ, &utd 011 1M .scrlbrd /rtIClllrts. Iitt Impaa ocr:_d Ott fltt r/flll sidt of1M Iwad (kmporoJlporitloJ) ..../l/clt wofild Inllllll, IQ/,rol ,00QI1oII occtl"otk"" "'Mllttr dw IQ _ blow or Qfoil. 1M bi/ll/trQI. ~IQIIsfibdwroIMlfIll/o"", U corulSftlll ....(1" 1114 Thtt bllll/,rol/rOltUJI lind fI'"fXH'OJ conkol COrI/lUlofU olld slIbccnlctJI /ltmorrhagu tmd lilt (tnhro/.J'tW/IIng an mtN"I_rt Qn lilt 1./1 Iitt rl,,- mdll1fl/""., _ _ S~ISf/W of_foIlllltll 0 blow. ' ' 'It II _Id be IltlpfuJ 1/_ «Jll1d SO)I "..rMroptllllc Inwgu offhls ptJIi,lII f(J /fIOrI t:/,orf)' S'por"'. III, priMary tffic/S O/'M IrtJfifftQ from 1M ucondory t11ld '''troptlllk .Jf«1S.. NECK: 1M antrrior $!rap muscles ohhr neck at!: bofno&eneous and red-bn:lwn, without hell'lOl'ri.-ae.. The thyroid ~i1qe and hyoid bonr ate I~t. The larynx is lined by InlSCl wIlite mucosa. The tonaue is IRe ofbi~ matb, hemorrbq., or otheT injuriell. Incision and diuection of the posterior neck ~Ies roo deep patKltI'Vical m1lKU1.,. Injury or ceNical spine fraclUres. MEOCOM 0993 ACLU Detainee DeathII ARMY MEDCOM 993 (b)(6) AUTOPSY REPORT __ . _ ALI, Mubammad Najlb Abu-Wara 7 RESPIRATORY SYSTEM: The upper ail'WllY is clear of debris and foreil:Jl material; the mllCOSliI ~urfllCes lie smooth, ycllow-an and unrmwbble. The pleural surfaces of the righllunglle smooth, glistening and Ullr'mW'kable. Then: lie scallC!'Cd loose plcunll adhesions surrounding the left lung. The pulmo~ puenchyma i~ salmon pink with anthracotic changes. congested and edematous, eltuding CGpiousamounlS of blood and frothy nuid. No mass Icsions or lIftS of consolidlltion lie present. The right and left lung~ weigh 7aO IIId 76Q. jp'aI11s. respectively. CARDIOVASCULAR SYSTEM: The periCltdial surfaces are smooth, g1istenins and unmnarkoblc. The J20·grwn heart is I;OOlIined in 111 inlact pe:ricLlrdial sac free ofsignificlIIl fluid or adhtsions. The epicardial SUrfllCe is smooth. with minimal fat investment. The coronary arteries arise nonnally. follow the usual distribution in a right dominlllt pattern,lIe widely petent, and without evidence oflhrombosi~ or significanl alherosclCT05is. The myocardium is homoaencous. red_brown, linn and unremarkable; the atrial and ventricullt septle lie inIac!. The walls of the left and righl ventricles ItC 1.0 and O.2.cenlimetel1l thick. respectively. Thc valve leanets are thin and mobilc. The aonallld ilS majorbRnches arise normaUy. follow !he: usual course IIId lie free ofsignificant abnormllities. Therl' i~ mild focal athcrosclerotk: slreaking oflhe abdominal aorta. The VCnlle cavae and lheir major tributaries mum to the heart in the usual distribution and are free oflltrombi. The rl'MoI and mesenleriC vc:ssels are unrl'malkablc. HEPAT081L!ABY SYSTEM: Tile hepatic capsule is smooth. g1iS1C:lling and inllCl, covcrinll dalk red-brown, moclcRlely congesled p4m1Chyma. No mass lesions or olher abnormalilies lie noted. The gallbladder conlains 3-millililel'1 of green-brown mucoid bile; lhe ffillCOSll is velvety and unremarkable. The Clttl"lhepatic biliary llee is pllent and witholll evidence of calculi. The liver weighs 1460-grwns. GASTROINTESTINAl TRACT: The esopItllllus is inllCt and fined by smooth, lVIy-white mucosa. The gastric wall is intact and the stomach contains apps'Oltimately 20-millifiLel1l or lhin brown-llray fluid. The gastric mucosa is arranged in the usual nagal folds. The duodenum. loops of small bowellUld colon are unrcmltuble. The appendilt is not identified. Synthetic mesh is idcnlified in the rigllt inguinal canal. GENITOURINARY SYSTEM: The ri~htlUld left kidneys weigh 160 and 141).grams. respectively. The renal capsules arc smooth and thin. semi-transparent lUId slrip with ease from the underlyinll smooth. redbrown cortical surface. The cui surfaces are red-an and congested. with uniformly thk:k cortices and sharp corticomedullary jlUlCtiot'lS- The pelves and ealyces arc unremarkable. MEDCOM 0994 ACLU Detainee DeathII ARMY MEDCOM 994 AUTOPSY REPORT(b){6) ALI, Mubammad Najib Abu-Wafa I 8 GenjlourjJWY system (conll: The umCfS are normal in course and caliber. While blatlder mueO$l overlies 10 inllet bladder wall. The bllldder conwns approxillll1ely I()()..millilitCfS of cloudy yellow urine. The prosialC is normal in site, with Iobul..... )'('Jlow-tan parenchyma. The semiOlI vesicles are ~marbblc. The IeSlCS are fm: of mISS lesions. contusions. oro/her .bnomlalilies. LYMPHORETICUI.AR SYSTEM: The 28Q.gram spleen h..,. smooch, inllCl CIpSlIle covering maroon. moderalely firm ~nchyma; lhe Iymplloid follicles ~ unrcrrwbblc. Lymph nodes in the lUlu. periaonic.1lId iliac resions are DOl enluged. ENDOCRINE SySTEM: The pituitllf)' gland is examined irHitu and is unremubble. The th)'fOid 1IllllX! is symmetric IIIId red-brown, willloul c~lic or noduluclwlile. The panCtelS is finn and yellow-llll. with the usual lobulu IIfclIiteetlll'e. No mISS lesions or other abnormalities are DOled. The right and left Ildrenal sJl1Idslll'C 5)'TTImelriC, with brighl yellow conioes IIId arey medutlat. No masses 01' IleIS ofhemotrhaae identified. MUSCULOSKELETAL SYSTEM: Mll5Cle development appears nonnlll. No non-tl'1lumlllic bone or joiDllbnonnelities are IIOted. ADPIIIONALPROCEPURES I. Documenwy photolBPhs are liken by OAFME staffpllolOgnphen;. 2. Specimens rt:lIined for toxicology testing lIIdIor DNA identification art:: Blood. vil1'eO\lS nuid. urine. gastric contents, bile. !Jean, spleen, iiver, lung. kidney, Ildipox tissue, and skeletal mU$Cle, 3. Full body I'1Idiogmphs are obtained and demo<utra\C: the above findinas. 4. Selected ponions of organs are retained in formalin. 5. The dissected orglns are rorwatded with the body. 6. Personal effects arc rclcued 10 the mort1ll1)' affain lCJMC:5Cnlllives. 7. Identifying body marks that inc:lllde multiple scars have been documented. MICROSCOPIC EXAMINATION The brain is rt:moved and plllCcd in fonnlllin for formal Neumpathology eonsuilition. Selected ponions oforpns are retained in (amalin, without preparation o(histologic slides by OAFME. MEDCOM 0995 ACLU Detainee DeathII ARMY MEDCOM 995 AUTOPSY REPORT (bt(§) ALI, Muhamm.d Nlljlb Abw-W.f. 9 nNALAUTOPSY DIAGNOSES: I. Evidence ofuawna A. Unear frlletures of the calvarium involving the righl temporal, parieral,lIlId occipital bones B. Superficial.bruiollll on the posterior right shoulder C. Subgaleal and subdlll'll hemorrhage II. Evidence of closed head lrlllll1Ul and subsequent medical intervmtion (per formal Nelll'DplI1holoiY consullalion) A. Diffuse grey and white mailer edema with ischemic neuronal injlll')' B. Left IrBnscranieetomy herniation C. Left 10 righl midline: shift with left cingul.te gyrus and the leftlftlrtSteruorialllllCaf herniatiollll D. Cortil:al colllusions of the frontal and lentpoBJ lobes, bilaterally E. Subaracltnoid Illd intTaventril:u!&r hemorrhage Ill. N.lIIral disease dillino5CS A. Evidenoe of prior appendel:tomy B. Evidell(:C of prior ri~t insuinal hernia repair C. Mild IIthcrosclerotil: streakingofthe.bdominal aorta D. Healed fracture of the left ulnar styloid E. Partiallllllpuwion of the distil I- and 2'" digits oflhe leftlwKl F. Absence of the left nipple. tnwnlltic, healed IV. PoslmOrtem changes A. Lividity is filled on the posterior surf_the body except in areIlI eKposed ,..,..~ B. Rigor is pcaentlo an equal degree in a11l:Ktremities VI. ToxiQ:llogy results A. Volltiles: lhe blood and ViltcOUS fluid were examined fot the p~nee of ethanol at a culoffof20 mgfdL. No ethanol was deteded. B. Drugs: The urine: was screened for aoelaminophen, antphetamine, antidl:pressanlS, antihistamines, barbiturates, beruodi~nes, cannabinoids, chloroquine, coc:aine:, dextromelhorplum, lidocaine, ~otic anaIgcsil:S, opiates, phcnl:yclidine, phcnothiuines, saJicylales, syrnpathomimetk: amines, and verapamil by Bas chromatognlphy, color test or imntWlOlSSlY. 'The following dNgs were deteeeed: I. Positive Opiatei Morphine WIU delccted in urine by aa.s cltromatography/lTlllSS spectromClry. The blood l:OflIaincd in 0.18 mgIL of morphine as quanlitaUd by gas chromatographylrnass spectrometry. 2. POJ!jljye LJdocainl: Lidocaine wasdelecled in urine by gas chromalography and COIIfirrned by sas chromatography/mass spectrometry, MEDCOM 0996 ACLU Detainee DeathII ARMY MEDCOM 996 10 VI. Toxicology results (conn: C. Carbon Monoxide: The carboxyhemoglobin saturation in the blood was leu than 1% as dclennincd by spectrophotometry witb the Iimil ofquanlilalion of 1%. Catboxyhemoalobin $lIll,1ration.s 0(0-3% arc expected for non-smoketS. Saturalions .bow; 10% lII'e eonsid~ eleWlIed arc eonfinncd by gas chromatopphy. D. Cyanide: Th~ was 110 cyanide dw:cted in !he blood. The limit of quantiwion (ot cyanide is 0.25 mgldL. Normal blood cyanide ConeerllnltiOns lII'e less than 0.1 S mglL. LethDl eonccntnuions ofcyanide are grealcr than) mafl, QPINION 1 J'his anomxillW..elv 52-year-old male detainee at Camp Bw:ca Iraq, BTB (b)(6) (bl!6) Idied as the miult o(blunt fcm:e If1Iuma of the head. Autopsy findings show evidence ofskull fractures Mil 5Ubsequenl medieal inlerVencion. No aross or x-ray eyidence of=1 pcne11'lting or additional significant blunt force trauma is identified. A formal NClIlllJlBlhology COlWllulion ill oblained and dernonslnlles the findings described above. Post motIem analysis o(the body "uids for ethanol, carbon monoxide, cyanide, and screened illicit drugs ofabll!le ue negative. ~ presence of morphine in the blood al\Cllidouine in the urine are eonsiSlent with the reported hiSlOlY ofm«licaJ intervention and do nol contribute to the: caU5C or manner ofdutlt.;(b)(6) injuries are consi.mnt with a blow to the head or a fall. llie ~view of available investigative reports, medical records, and Neuropathology consultation taken in cOl1ilQ'lClion wilh l'l!: absenoe ofdefensive injuries SUSieslS that an accidental fall is more likely the cause of,(b){6) !injuri9. A blow to the helld cannot be ruled OUi as the cause of the closed head trauma. However, with leUO/Iable Imdieal certainty the manner of death is best classified as accident. Should additional information become available that would change the cause or rnllTll1Cl" of dalth, an amcndc:d report will be issued. :=J (b)(6) (b)(6) MediCiJ ExamineT • MEDCOM 0997 ACLU Detainee DeathII ARMY MEDCOM 997 _.-- _. __ . -_... - --'''. CUTlflC'IlT~ 01' DUoTl1 /OIIt'1UJ!A.Sj -~- BTe Ali. MuhMuTlad Nljib. Atlu-Wafa OP .......... • -_.- 1,,--"""'(;;X;;.,-- 1IWlC" 00' ........:0 -- Civilian ..... 00' ...... ~-- iii ~ - - - -- --- --- - , -,, --- -_._-- -- -- --. - " ' - --_. __ . . _._ ..... , _OO'_Th 0 ... .,..",. c"'c·_ _ ~ _TIl''''' cmol_' ~- !Ilu.... ~ ...... 00' O€<T 00' "" ~ _ n _ Cln''''' ....... OOn.... ----.....-, _ -- 0001' _'_lIlA'" e - _ _ _ _ _ ... _ ..-"'_ _ .. _._. -_ . --,..,,-_ .-- ----_--.--, ........... ~ tIMCT!.. , ......... Tl>OU.., . • 8UIl 0ITl/I'0'... _ " .... /ot<Io.....,"'... _ • _ _,0',,__ ,. _CQoOOI1...... _ . ,......... ,O _""",c.oca," _. _ _ ... 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