Aclu Military Prison Death Reports Part2
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ARMED FORCES INSTITUTE OF PATHOI.OCY omu orlh Atllltd Fort" Mtdlul EUlIllnft 1413 Resemh Blvd., Bldg. 102 RO(kville. MD 2l)UO 1.1(1).944.7912 fiNAL AlTTOPSY EXAMINATION REPORT Name: BTe Nahar, Muhall'lJYlad SSA\'l: NJA DlteofBinl\: BTB 1933 AUlopsy No.: (b)(6) AfIP No.: (bX6) RII'IIr.: Iraqi Nalionll Plac:e ofDelth: Marine Delcmion FlICilily, l~ PlllCc of AUlopsy: 8aBhdid MOI'Iull)' Blghdad Ahpo.... lraq ~le OfDealh;Jb)(6) 2004 Dalc of Autopsy: 04 OCT 2004 DalC ofRepon: 24 NQV2004 ClrtlilNUnUI of Dellll: This believed 10 be 71 yell old lnqi Nalionll died while in US Marine Corps custody while beini processed inlo lhe Iraqi deuntion prop:mn. The Navil Criminal InvCSliptive ScMcc (NCIS) invesligalion revealed thai the dcl;edcrll surfemt from ulcer diseuc for several ~ (per dcl;cdcnt's nephew) and [he doccdcnt wu doinl quilc poorly just prior to beingcktaincd by the Marines. Alilhorlulio. for AIIIOp,y: OIT....:: of the Armed Forees Medical ExamirloCl'", lAW 10 USC 1471. Idenlllkatioll: ldentificalion b _ on prilOll idCfllificalion tlg on lhe leA grultGe. CAUSE OF DEA Til: Acute Pmtonitis due to I PttfOBtinl Gastric Ulcer MANNER OF DEA Til: Nalll",1 FINAL AUTOPSY DIAGNOSES: l. AlitopSY findinp A. Aclile Peritonhi' due to I Perforating Gastric Ukcr lISOCiucd with ISOO ml of pllf\llcnl ucitcs and severe deh)d",tion. B. Mild to lI'IOdcRte 1IIIcroKlcfOlii (25·50% ~CIlOIi'1 of lhe ri&hl C(Ironlr)'lIId Icflllltaior dCKmdinl brtlnch of the leA COron&r)l ~oy. . C. Mild Ithcrosclcrosiloflhc basilar and right middle ecrcbnl artmes of the bnin. MEDeOM 0099 ACLU Detainee DeathII ARMY MEDCOM 99 AIll'OPSY REPORT (b}(6) BTB Nalulr. Mllhanunad D. Fihrosis of the epicardial surface of the ricbl Yenlricle of lhe hean. E. Lc=ft renal scar. F. Hydrocele orthc rigklteslic\c, n. Mild decomposition IlL TolticololJ ia negative for d/lillKll and drop of abll$4. • MEDGOM OIlIO ACLU Detainee DeathII ARMY MEDCOM 100 AUTOPSY Rf,PORT 1(b)(6"'--j 8TB Nlblr. Mubammad EXTERNAL EXAMINATION The body is lhal of. cachetic, dehydrated 65 V, inch tall, 100 pounds (estimaled) ~i Nalional wbose apPearance: is consistenl with the reported age of7' years. Lividily is fUled posteriorly. Rigor is easily broken in the ex~mjljes. and the lempcraNre is cold &om refrigeralion. The scalp is covered with curly black and gray hair in a normal dislribulion. The irides arc brown and tile pupils arc round and equal in diameter. There arc linear (hying artifacts on each eye and small hypcrpigmenlcd areas on the superior i1Spocts of each eye. The exlernal auditory canals Me dry and free of abnormal secretions. The ears an: unremarkable. The nMes arc palent and the lips arc Slraumatic. The nose and mum" arc palpably slable. Thc teelh appear arc naNraI and hive severe periodontal disease. Facial haireonsisu ofa black muslache and goalee style bun!. The neck is slrai&ht. and tile lrachu is midlillC aod mobile. The chest is symmc:lric. A 2.5 ~ 2.1 cm oval sear is on the kit chest mil a 7.4 ~ 1.4 em oval scar is over the xiphoid procc.ss. The abdomen is nal but has a palpable fluid wave. A 2.1 x 0.7 em oval scar is on llle ri&ht upper quadrant. The genilalia arc th.osc ofa normal adult eireumt:ised male. The lestes are descended and frc:eofmasscs. Pubic !lair is present in a normal distribulion. The lell buttock hilS a 2.0 x 1.5 em abrasion over lhe protruding lell femoral neck. On the right side orthe eentrallowcr back;s a 0.7 J. 0.1 cm oval h~rpigmmtcd area. The anus is unremarkable. The upper and lower cxlremilics arc symmetric illld withoul clubbing or edema. The skin of llle poslerior surfKcs of lhe hands retains ·'tents" when stretched.. On lhe posterior surface oFthe left forearm are five oval sears thaI range in site from 1.2 J. 1.2 ern 10 2.5 x 2.0 ern and arc in a linear Pi-ltem eXlending nom the elbow to lhe wrist. The wrisu and web spacel of the fingC11i arc free of injuries. On the anlerior surface of Ihe right lO\'ier leg arc three round 10 oval sears lhal ranse in size from 1.5 x 1.0 em 10 2.5 J. 1.5 em. A 2.0 x 1.5 em circular scar is on the anterior surface of the len lower leg. The ankles and we" .....c.... nfthIP. l~ are free of injuries. A papcr identification lag inscribed with;(b)(6} j(b)(6) attached to lhIP. lell put loe. is CLOTHING AND PERSONAL EFfECTS The rollowing clothinS ilems lllId personal efTeclS arc present on lllc body at the lime of aUlOpsy: A bright orange jumpsuit willi a piece of cardboard inscribed with(b}(6} lin lhe front pocket. :>lEQlCAL INTERVENTION There are a cluster of four punctate defecl$ over lhe medial surface of the left forearm and a cluster of Ihll:e punctate dcfcelS on the posterior surface of the righl hand. inspeclion by incision is consislClll with needle punclures. MEDCOM 0101 ACLU Detainee DeathII ARMY MEDCOM 101 AUTOPSY REPORT (b)(6) J BTB !'iahar, MlibamllPd RADIOGRAPHS A complele.set Ofposlmonem radiograplls is Oblained and demonstralet!he following; No foreign bodies and no evidence of fraeturc:s. EVIDENCE OF INJURY The ordering Mthe following injuries is for descriptive pu:rposes only. and is nol inlended 10 imply order of inniclion or relative severity. All wound palhways: are given retalive to slandard anatomic position. A 2.1 x 0.1 cm Cf\l5ted linear abrasion is on the anlerior surfacc of tile right wrist and a 2.S J. O. I cm crwted abmion on the posterior SUffICe ofille right roreamt. A I.S x O.S em cru5ted abruion is on thc anterior surface ortlle left wle. INURN"!. EXAMINAJ"ION HEAP: The galeal and subgllieal $Oft tiUllts grthe scalp are fte<: of injury. The calvarium is intaci. as is the dun mater beneath it. Clear cerebrospinal fluid surrounds the soft 1390 gm bl'llin, which has unremarlcable gyri and sulci. Coronal 5tClions demonstrale sharp demarcation betwe<:n while and grey mauer, without hemorrhage orconlusive injury. The ventricles are of normal siu. The basal ganglia, brainslem. cerebellum, and arlenal syslems are free orinjury. There is mild alherosclerosis ofllle basilar and right middle cerebl'lll arteries. There llIe no skull ffllClurc:s. The allanto-oc:cipilaJ joint is stable. NECK; The antmor strap muscles oflhc: neck an: Ilomogenow; and Ald-brown, wilhoul hemorrhage. The thyroid cartilage and llyoid bone an: inlact. The III')'I1X is lined by inlllCl white mucosa. The Ihyroid Sland is synunetric and m1·brown, without cystic or nodular change. The longue is freeofbite matlr.s. hemorrhage, orothet" injuries. BODY CAVITIES: The ribs, Slcmum, and vertebral bodies are visibly and palpably inlact. The pleul'lll cavities exh have 100 ml of decomposition fluid. The pericardial und puitoneat cavities are free offluid collections. The OfgIns occupy lheir uwal analomie positions. RESPIRATORY SYSTEM: The right and left lungs weigh 423 and 43S gin, respectively. The exlernal surfaces are smooth and deep red-pwple. The pulmonary parencllyma is diffiJsely congesled and edemalous. No 1TIa5S lesions or areas of consolidation are present. CARDIOYASCULAR SYSTEM: gin hem is contained in an inlacl pericardial sac. The epicardial surface is smoolh, with minimal fat investment. A 4.2 x 2.6 ern area of epicanJial fibrosis is on the: anterior surface of the right ventricle. The coronary arteries are present in a nonnal distribution, with a righl·dominant pallem. Cross sctlions of the ve:uell show mild The 341 MEDCOM 0102 ACLU Detainee DeathII ARMY MEDCOM 102 ·. .. AUTOPSY REPORT (b)(6) BTB Nablr, Muhammad Pale 5 oU athnoscltrosil (<2j% llmosis) in the righl coronuy and the left dc:s<:ending branch of Ihc left eoronuy artery. The m)'OtWium is homogenous. Rd-bl'OWll. and finn. The: "lIve le.nets an thin and mobile. The Wills of!he left and ri&hl ventricles arc 1.0 and O.3-em thick, respeC1j~ly. The mdocardium iSloIIlOOIh and &IisteNn.. The itOrU gives rite to three inllc:t and !W'ltnt areh vessel,. The renal and mesentcnc vessels arc WII'etTlIBIbIe. UYES &;. BIWay SYSTEM: The 710 em liver lw an intact, iITIOOth taplule and I ~ Interior border. The parenchyma islan·brown and conpud. with the usllallobulu Irthilecwre, No mass lesioru Of OlheT abnormalities are _ . "The gallbladder eontailll. minute lmount of arecn·b1ac:k bile and no IlOIlCS. The gallbladder mlltOuJ surface is a:rem and vclvet)'. The utl'ahepalic biliary tree il pltent. SPLEEN: The 94 em spleen tw I smooth, intact, llId-purplc ClIpiulc. The parmehynu. is maroon and CO<1auted, wilh diflinc:1 MIJpiahlan corpuscles. PANCREAS: The pan<:reas is lirm and yellow·lan, with the lISualloblll., an:ItiICCNIC. No man lesions Of allier abnormalities are lICen. ARRENALS: The riJIII and len Idrenllglands are syrnmetti~, with btighl yellow eorti~eI and grey medullae. No mallei or areA ofhanOfThage are idenlilied.. GENJIOllBlNARY SYSTEM: The tighl and leA kidneys weigh 65 and 64 am, rapec:lively. The exlemallUnlCel have fine lranulatily. A 1.0 x 0.1 cm ICat lhal il eonsillenl with I ruptured renal conical cyst il on the uppeT pole orthe lell kidney. Thc CUI surfaces are red·tan Iltd congested, ..... ith uniformly lhick cortices and Jhup conicomedullary junctionl. The pelves are unremarkable and llle uretn1 are nonnal in course and ealiber. Whi,e bladder mucosa overlies an intlCI bladder Will. The bladder conlllinlllpprOllimalely 40 ml of cloudy yellow urine. The Pl'O$lllc II normal in site, wilh lobular, yellow-Ian parenchymL The seminll vesicles are unretJlukible. The lesles are free of mIlS lesiOl'll, contusions, or Olher IbnormaUlies. The righl lesticle hu I hydrocele Ihll contlinl 30 ml of clear yellow nuid. GASTRQ!NTfSTlNAI· TRACT: ... The elOphlsul il inlllet and lined by smoolh, arey·while mucoli. TIlete ilapproximalely 10 ml of cloned blood in lIle diml esophaJlUl. The Ilomach conllins approximalely 120 ml of tin mucoid fluid. "The anterior sulrit Will hu a 1.6 Jl 1.0 cm perforation ncar Ihe pylori~ Iphin~ler thai ~ommunleales with a 1.5 Jl 0.5 ~m perforation oflhe posterior &Ulri~ Will near Ihe pylone Iphlncle,. Thl:l"c is appmximalely 1sao ml offou\ smellins cloudy lilt fluid In the peritoneal cavily. The duodenum, loops ofsmlll bowel. Ind ~olon Ire unremukable. The ljlpendix is presenl. MEDCOM 0103 ACLU Detainee DeathII ARMY MEDCOM 103 J AUTOPSY REPORT (b)(6) =-oJ BTB Nabar, Mubmmld ADDITIONAl" PROCEDURES • • • • Documentary photogrlphl ~ laken by'(b)(6) I Specimens re14incd for loxicologic tesling and/or DNA idenlifiCilion are: blood. urine. spleen, kidney, lung. liver, bmin, bile, gaslric contents, and psoas muscte. The dissected org&lU are f()fWarded Wilh body. Pef'50nal effecls anl released to the appropriate monuary operations representatives. MICROSCOPIC EXAMINATION Stomach: Acute ulceralion willi severe inflammation with bacleria pruenl. Helicobac:tcrr pylori is nol idfmtificd on either H&E or Diff-Quik saineOllides Panions ofolherorgans are relained in fonnalin, wilhoul preparalion ofltistologic slides. OPINION This believed to be 71 year old detainee died from Kute peritonilis lila! resulted from I perforaling gastric ulcer. The decedent was clKhetic and severely dehydraled which indicates that he had the ulcer fOf a signiflClU1! amount oflime. The manncrof death is nalural. (b)(6) l'b)(6' ~cdkal Examiner ... MEDCOM 0104 ACLU Detainee DeathII ARMY MEDCOM 104 OEPARTMENT OF DEFENSE oUIlIlEO 'OftCEllllamvTI Of' PAntOl.OOY WAlIllNOTOII. oe 10* . _ ......... ,"",__ or PATIENT IDENTifiCATION Ai'll' ,,"",10•• N... bt, Stau.'." ~)(6) TO; ,,- OFFICE Of THE ARMED fORCES MEDICAL EXAMINER ARMED FOAct5 IN5TITUTEor I'AnlOLQGV WAStIlI'lGTON, DC lllJ06 6000 NAJi.U.. MUHAMMAD SSAN: AUlo~,I'(b}(S}1 To1ko1oc' 1.«<0>100.: ~){6f ~ Oal. R.po" C.....ltd: {ktobu II, 1004 CONSULTATION REPORI ON CONTRIBUTOR ArlP DlACNOSIS MATERIAL REPORT or TOXlCOLOCICAL EXAMINATION COlldlltGII GfSpuim~nl: GOOD Dlle Gf Inclde.l: Dile Rtc~ived: VOLATILES; The URINE AND LIVER • cllIGffof20 mgldL. No tthanol WI.S detet;led. 101612004 ~re examined for the ptnenee Gf ethanGI al • DRUGS: The LIVER was screened for amphetamine. anlidepressants. antihiswnines, barbilurlles. bcnzodillZtpines, eannebir>Oids. diloroqlline, cocaine. dextromethorphan, tidoWne, naKotic analgesics, opiates. phencyclidine, pbcllOthia.zineJ, symp.thomimctic amines and vcrapamil by gas clu'olTl&toaraphy, color lest or immllllllaSSllY. The followinB drugs were dete.:led: None were fOWld. (b)(S) L Offiee orllle Anned Fon:a Medial E!WIl;n... J j Offiee of lilt Atmtd Forus McdiG.lI E.urnillCl" MEDCOM 0105 ACLU Detainee DeathII ARMY MEDCOM 105 • ARMED FORCES INSTITUTE OF PATHOLOGY omn of the Armed Foro:u Medkal Eumlner 1413 Research Blvd., Bldg. 102 Rockville, MD 208S0 )·8O().944-7912 FINAL AUTOPSV REPORT J Name: Mooammad, Sher Autopsy No)b){6) SSAN: W. AF1PNoi(b)(6) Dalc of8irth: UllknQwn Dale of Death: (b)(6) ,2004 Date of Autopsy: 30 September 2004 DalcofRcport: t4April200S Rank: Civilian Place ofr>eath: Salerno. Afghanistan -----l aasnm. Place of Autopsy: Afghanistan ClrnmslalKeli ofDnlh: This dull male civilian, pnsumed Afghanistan national, was round dud while I' the: Rcgionallnlm'O&!lion F.ili~. Salemo Fireba.se. Afghanistan. ~2004. and the following day, he By report. he in processed al the: RIF on(b)(6) _ complained OrVanOll! <:old symptoms 1M bodY aches related \0' snue Of in:lCct bite. On eumination by medical pers<IlIMl, his vitlll signs were normal. Several houl"5 laler, he was (oulll! 10 be unresponsive and IlOI brcathing,llJld he was pronounced dead.1 the local medi<:al raciHry. Authorization for Autopsy: Ornee oflhe Armed USC 1471 Idenllfkltlon: Visual, per detenlioo facilil)' Forc~ ~ds; Medlcll E.lmlner, lAW 10 postmortem fingerprints Ind DNA profile obtIined CAUSE OF DEATH: Atherosclerotic Cudknrlmllir D1,eue MANNER OF OEATH: Nlturll MEDCOM 0106 ACLU Detainee DeathII ARMY MEDCOM 106 AUTOPSY REPORT (b)(6) Mohmmad. Shu ] l FINAL AUTOPSY DIAGNOSES: I. Atllerosckrotic cardiovascufacdisease (AFIP Cardiovascular Pathology consultation) a. Moderate coronary alhCJOllClerosia L Left main coronary artery:: 40% luminal narrowing by pal/lologic intimallhic:kening ii. Left anterior descending Ulery (LAD): SO",{, narrowing of proximal LAD by pathologic inlimalthiekening 111. Left drcumnex ll1ery (leA): 20% narrowing ofproximaJ l£A IV. Right coronary Ulery (RCA) I. 20% narrowing ofpn;lximal RCA 1. 70"A narrowing of mid RCA by smooth muscle and proleoglye.an rich neointima, conaistenl with healed plaque erosion b. Cardiomegaly with lell. ventricular h}pt:thOplly i. Hell1. 470 gm (predicted IlOrmal value 343 gm, upper limil453 ""' n. Left ventricular free wallilliekneas. IS mm iii. Ventricular septUm thickness, IS mm ... ... II. Evidence of restrain I White plastic :tip-tie "Flexieurr' aJOIlnd right wriSl with Ilo underlying contusion or ab~sion I. III. Evidence of injury a. Minor abruiona ofcheR. upper back, upper amlS, an.d right knee b. No inlemal evidence of trauma IV. Additional finditlJls a. Neuropathology consultation (AFIP Department ofNeuropBlIIology) i. No gross abnormalities, b~in 1370 gm ii. Microscopically, minimal non-specific findings I. Two small foei of chronic inflammalory cella in the medulla; immunohistoehemically, nue scallcred lymphocytes 2. No microorganisms or viral inclusions identified b. Globoid livet" with rounded bordeQ, 1660 gm i. Hepatic pathology consultation, AFIP l. Moden.te vasc:ulaceongestion 2. Mild ~dllSlin&" ofhepBlocytes with hemosiderin 3. No specific lesiona identified c. Pulmonary edema and congestion; right lung 764 gm.left luna 614 grn d. Simple renal cysts MEDCOM 0107 ACLU Detainee DeathII ARMY MEDCOM 107 AUTOPSY REPORT:L(b~)(~6),---_ _ Mllba'n1llad. Sbtr V. J To~ieology (AFIP) a. Vlllatiles: Blood and vilTeous nllid negative for ethanol b. DI\lgs: Urine negative for Knened medications and drugs of abuse EXTf.BNAL EXAMINAnON The body is tha1 ofa well-developed. well-lIOIUished UllCllld Caucasian male. Ott lop ohhc body, th= is a pairof1&ll, drawstring waist parlt, and a previously cUI wltite ,Ieeveless undershirt The body weighs approximately 180 powtda. is 67' in height and appears approximately 4Q.6O years or.~. The bcldy tempcratull: i, cold, tha1 ofthc: rdiigen1ion unit. Rigor is presenlto an equal degree in all elltremities. Lividiry il present and fixedon the posterior surface ofthc: body. except in areas exposed 10 pressure, and ~ i, moderate facial congestion. The ilCaip is covered with dark brown hair avera,ing 4 em in length with a sligh11y m:eding hairline in the: temporalll:lPoll5. Facial hair oonsists of a dark mUSlachc and dark full beard. The irides are brown. and lhe comcac are slightlydoudy. The ilClmle and conjunctivae lUll congested, but free of petcchiae. The earlobes: are lIOI pim:ed. The elliemal auditDl)' canals, external nm:s and 0111I1 caviry are freeofforeijp\ material and abronnalsccll:ooll5. The nasal skeleton is palpably intact. The lips are wilhoul evidenl injury. The tocth are nalURl and in good condilion. The neck is stnligh\ and the tJar.hca is midline :wi mobile. Thc ckest is S)1TlI'lletric and well developed. No injury of the ribs orstemwn isevident externally. The abdomen is slightly protuberanl and soil Healed surgical scan of the: abdomen are oot noted. The exlml1ities arc well developed with nonnal rangcofmcKion. Thc fingernails an: intact, The IDles of lhe feel are calloused and lightly din ltamed. There is a thick callous on tile anterior aspect of the lel\ ankle, and the skin of the lel\ knee is thickened and lI)llCfkerato1ic. There is a 3 x 0.1 cm pale linear scar on the back of the right forearm. and there are m\llliple plle scan on lhe back ofille right 1Iand, < 0.2 em each. Then: is I I x I em Sl:aron the lilIenl aspccl ofthc: right ankle. Tattoos are not noted, and needle trao:ks arc nol observed. "The exlernal genilalia are those: ofa IIOnnal adult llIlCirnimciscd male. The les1C:S arc dc5ccndcd and lTte of masses. The pubic halr is present in a normlldislriburion. Thc bulloClu and anus arc unremarUble. EVIDENCE OF THERAPY There il a needle punClure mark of the riglll klWer IIpCd of the neck,jusl above the clavicle. covcmi with a pie« ofwllite tape and gauze, and mere il Wldcrlying lSSOCia1Cd 101\ tis.sue lIemorrlLage. ~ is no other evidence of medical intervenlion. EVIDENCE Of INJURy The ordering of the following injuries is for descriplive P\lrpoKl only and. il not intended to imply order of inniction Dr ~lativueverily. MEDCOM 0100 ACLU Detainee DeathII ARMY MEDCOM 108 AUTOPSY REPORT (b)(6) 4 "l.1olllmmld,Satr The~ ill whil~ p1aslic :tip-li~ $!nip around from lh~ rillll Ulemll audilory CaM!. lhe right """;Sl. and Ihere is blood coming There ill 2 I: 0.1 em linnr Ibmiorl on the lower righllide ohhe chut, 1M Ihere ila healing 4 1I 0.2 elll linear abrasion of the upper lefl side ofthc back. There i. a 2.S 1I 0.1 em abrasion on ttlt lat~rt' aspect oflhe upper left 1rTI'l. and lher~ is a) 1 0.\ cm he'lling abruion on Ih~ medill aspecl of the right elbow. ~ is I 2 1I 1 em abrasion on lhe lllcnl upecl of the ri&ht knee:. On int~rnal elIamillllion oflhe heIIi. chcsl snd Ibdomen. there is no evidence of injury. 'NTE8N4L EXAMI:'IATION BODY CAVITIES; The body il opmed by the IIIllII \h:)rxo.lbdcminal incision snd!he chesI plale il mnoved. No adbeIions or abnormal colloc:tions of nuid an: pracrlt in any of the body uvities. AU body or...,. an: p<e$Cfll in lhe nonnallllllOmicll position. The vertdlrtl bodies are visibly Il1d palpably intact The subcuWleOlU fll layer of the Ibdominal wall ;1 ) em thiclt. There is no internal evidmceofblunl fon:eor penelnting illjwylO the lhonco.abdominal region. ... HEADi (CENTRAL NERVOUS SYSTEM) The ICllp il reflCCled, and thete i. no Iubpleal hcrnomta&e or skull fnctUR:I found. The cllvariwn oflhe lkull il ratIOved. The dun maier and fals caebri an: imlCl There: il 110 epidural or subdural bClilC:Wrhlge present. The IepIomeninges an: lhin and delicate. The ctnbrospinal fluid is clear. The cacbnl hcmisphaa an: syrnmctrical. The stnx:lW'CS II the bIse of the brain. inc:ludinl tranill ~ and blood vessels, an: intlCl. Coronal ltCIions through the cc::rdlnl hernitpha'CI ~lod no lc:sionl, and there Is no evidence ofinfcction. tumor, or lnumL The venlricles an: ofnonnsl siz.e. Tr&nSYerSt JlCCtions through the brain stem and ceTdxl1um an: \l1ImTIItkable. The dun is stripped from the basilv skull. and 110 hc:tw"C1 arc: 1Ound. The allllllo-«lCipital joint is stable. The brain weighs 1)70 grams. See '"NeuropIthololY Report" below. NECK; Elliminstion of !he soli tissues of lhe l'CCk, including!lnp muscles, thyroid gland ~d lI.r&e vessels, rcYtllI no Ibnormslilies. The ~terior strap muscles of the na:k arc: homogeneous lAd RId·brown, without hemorrhage. The thyroid c.1ilage lAd hyoid bone arc: intact The IU)1I1 is lined by intact white mucosa lAd is Unobltrul:ted. The thyroid gllrId is symmtltic and rod·brown. wilhout c)'llM: or nodulv change. 1llerc: il no evidcnc:c: of infCll;tion, tumor. or trauma, and lhe airway il patent lIlcilion IlId dissoction of the posterior neck dernonstrlles no deep plTleervitll musculat injury, hemorrilllge, or frlClura orlhe dorsal spinous proceuti. C"BDIQV &sCUI,AR SYSTEM; The perieudiallllrf_ are smooth, gHstertingllld unremltksblc; the pcricardill SIC is free of si8nmc~1 fluid ~d adJteslDlll. A modellue &mOunt of epicardial flt is presenL The MEDCOM 0109 ACLU Detainee DeathII ARMY MEDCOM 109 AUTOPSY REPORTl(b){6) Mohammad, Sb~r ] , coronary arteries arise normally in a right dominant pattern and rollow tho: usual distribution. The chamb0:r5 and valves exhibillhe usual size..position n:lati()/\$hip and me unremakablc. The myocardium is dark red·brown, firm and unrenurllable: !he uria! and ventricular septa are intact The left vanntle is l.S em in thickness and !he ri&ht vcntride i. 0.4 em in lhickness. The aorta and its major branches arise normally. follow the usual course and are widely patenl, fJee of significant alherosclcrosis and otber 1Ihnorm.ali1y. The venlle cavae and !heir major tributaries n:tum 10 !he hem in the usual distribution and we fn:e of thrombi. The heart weighs 470 gnms. Sec "'Cardiovascular Pathology Rcpon" below. RESPIRATORY SYSTEM; The upper airway is elear of debris and foreign material; lhe mucosal surfaces we smooth, yellow-tan and unremarkable. The: plC\lrlll swfllCes _ smooth. glislening and unremarkable bilatenlly. The pulmonary Jl8fCflChyma is red·purple, exuding a moden.te amounl of bloody fluid: 110 focal lesions are noted. The pulmonary ancries are nonnal1y developed. patenl and without thrombus or embolUJ. The right lung wei&hs 764 gJ2fIIS: the left 614 grams. LIVER <\ 81LlABY SYSTEM; The liveT is g10b0id with very rounded marxins. The: hepalic capsule is smooth, glistening and intlll:1, covering <lrrlt red·hrown, modmlely congested and slightly firm pamlCtJyma with no foca/lesions noted. Thegallbladdcrconllins 8 ml ofgn:en·brown. mucoid bile; the mucosa is velvety and unremarkable. The extrahepatic biliuy lrcc is patent, without evidence of calculi. The liver weighs 1660 grams. ALIMENTARY TRACT; The longue il free of bile marks, hemorrnage. or Olher injuriea. The esophlJUS is lined by 81lIy-whitc, smooth mucosa. The ga.stm: mucosa is znngcd in !he usual rugal folds and lhc: lumen contains 20 ml of fluid. The small and targe bowel are unremarkable. The pancreas has a normal pink-Ian lobulated Ippeanzllie and the: duelS are clear. The appendix is pn:sent and is wvemarkable. GENIIQORINARY SYSTEM; The renal capsules are smooth and Illin, semi·transpatenl and strip with ease fJom the undc:nying smooth, n:d-brown conical swflCe$. The conica are shllll'Iy delineated from the medullary pyramids. wllich _ red-pwple 10 lirI and untemarkable. There are multiple smooth walled simple c}'ltS. IIp 10 I an in diameter. The calyccs, pelvl:$ and llfe\eQ are otherwise lIIVl:l1UlI"kable. White bladder mucosa ovc:nies an inlact bladder wall. The urinary bladder contains 30 ml of clear, yellow wine. Tb: prostale gland is normal in size. with lobular, ~lIow-tan parenchyma. The seminal vesicles are lWemarkable. The testCi are tree ofrnass lesions. contusions, or other abnormalilies. The right kidney weighs 170 gtams: the left 148 grams. RETICULOENDOTHELIAL SYSTEM; a smooth, intact capsule coveri,,& red-purple, moderately finn parenchyma: the lymphoid follicles are unremarkable. The Iqlional lymph nodes appear normal. The splcen weighs 22S grams. The spleen has MEDCOM 0110 ACLU Detainee DeathII ARMY MEDCOM 110 • AUTOPSY REPORT (b)(6) Mohmmad,SIIn ENOOCRINESYSTEMi The pituillry, thyroid PM:! adrenal &IMds we unn:marbble. ~ruscULQSKELETAL SXSTUI i Muscle6evelopuelil is nonTUIl. No bone or joint tbnorrnalilic:s arc noted. MICROSCOPIC f:W1INADON HEART: Sec "Canlioyasculw PathololY RcponR belo"". LUNGS: Thc alYe(llar spaces and sman air passages are eJlpanded ""illl foeal edeml nuid. bill no significant innammllory c:omponenl. The alveolar ""Ills are Ihin II'1d modemely congested. The lUtmal and ymollS yasc:ular systems are 1lOfTTII1. The peribrondliallymp!u.I;Q are lItlrCnlarbble. LIVER: Sec "Hepatic PatnololY Report~belo'N. SPLEEN: The caplllie and ""hite pilIp are urnrnar1lable. Tllen: is minimal conSC:Slion of the red pulp. ADRENALS: The corticil tones are distinc:tive. and the medullae: are not remark.lble. KfDNEYS: The: sllbcapsular zones are \Inmnarbble. The slomeruH are mildly congeSled witholll cellular prolirmtion. mesaneiaJ plOminenec:, or sclefOSis. The llibules an: wcll pl"esef'led. Then: is no intersliliallibrolis or lignificanl innunmllion. There: is no thickening of the ""alii of !he anmoles or lIlllll lUterial channela. The lranailional epithelium or the col1ectins system is nClr1Tlll. BRAIN: Mlilliple seclions ofbl1l1n demonllrlle an unremarkable COI'Ifiauralion of JI'IY and ""hile malleI' ""hieh Is appropriate for alC. TItm: is no evidence of atrophy. innammalion, hemorrhage. or neoplasm. Sec: "Neuropalhology Report" below. CARDlOV MCULAR 'AItiOLOGy REPORT Oqlartment of Cardiovascular Palhology, AFW: "AFIP DIAGNOSIS: ~b)(6) Moderale coronary alherosclerosis, mid righl coronary lIrtCl')'; cmiomegaly ""ith leA yentrieular hypc:nrophy History; 4G-SO year old M&hani mle delaine.:. 67"". 170 lbs, rO\lnd dead in US cuslody HaI:I.: 41S pwnlI (predicted nonnal Ylllle J.4J grams, upper limil4S3 grams for a 170 Ibs man); normal epicardial fal: closed foramen ovale: normal cardiae chamber dimensions: lell ~ntricular cavity diameter JO mm.left ytnlricular !Tee ""alllhicknes5 IS mm, yentriculu septum thickness IS mm: ri&hl ~~nlriele thickness 4 mm. wilhout gross Kim Of abnormal rll inlillrales; fenestraled aortic yalye le.nets, otherwise unremlllbble MEOCOM 0111 ACLU Detainee DeathII ARMY MEDCOM 111 • AUTOPSV REPORT~J 7 Mobammad., SIIu v,lves and eIldocardium; 110 lIfO$5 myo<:ardial fibln$;s Of necrosis; histologic aectiOll$ show mild lel\ ventricular m)'O':ytt hypenrophy, olherwi$e unnmarkablc Coronaryarlcria; Nonnal oSlia: right dominance: fTIOda"alc atherosclerosis: Len main coronary artery: 40% luminal narrowing by pathologic inlimal tlliuming Lel\ anterior descending artery (LAD): SO% narrowins ofpraximal LAD by pathologic intimallhickening. 110 OIher aigni !leanl nlJTOwing Left cin:umnu ant:ry{LCAj: 200/. narrowing of proximal LeA, no other signifieanl narrowing Right coronal)' ancl)' (RCA): 20"A. narrowing of proximal RCA, 70% lWTowing of mid RCA by smooth mU5Clc and proteoglycan rich neointima, coosislent wilh healed plaq~ erosion; dis~l RCA and posterior descending artcry~n." NEUROPATHOLOOY REPORI Department of Neuropathology and Ophthalmic Pathology, AFlP: "This cue was reviewed in confeRnCc 01\ 7 Apr OS. [1 Wll$ also secn in consultation wilh the Departments ofrnfttlious and Paruitic Diseases Pathology. M\lhip!e irregular sections of font1.llin·fixed brain, IS x 14 x 1.5 em in aggregate, and a 4 x 3 "m f~ent of grossly unl"l'mtrkable dWll WCR s\lbmiued for ~iew. No significant gross abnormalities were identified in the submitted sect;OI\$. Summary ofmicroseopic sections: I. Bual ganglia.. 2. Inferior tcmporal iYfII5. 3. Cinplate iYfII5. 4. ThalamllS, hypolhall111us, and S\lbstania nigra. 5. Cerebral cortcx. 6. Pom. 7. Medulla. 8. Cerebell\lm. Thc tissue was proeessed in paraffin; a section prepared from each IW'Iffin block was stained with H&E. Additional sccliom prepared from ~1Cl:ted paraffin blocks were stained with l1IIyJoid pre<:\Irsor protein, CD45RB, 8I'Id CD68. Microscopic secliOl\$ of the medulla show two small foci of chronic inflammatory celts. Immunohistochemical staining for C04SRB highlight rare scattered lymphocytes in the medulla. Occasional vessels with ...·idened perivascular spaees containing a few hemosiderin-laden macrophages are also noted. No micl'OOfganisms or viral inclusions are identified. These features are minimal and non-specific." HEPATIC PATHOLOGy REPORT Department of Hepatic Palllology, AFIP; "There is modCTllte vaseulaTcongestlon. No other specific lesion is identified except for mild "dusting" ofhepatocytes with hemosiderin. CIlI~ of death cannot be determined;n this section of liver." MEDCOM 0112 ACLU Detainee DeathII ARMY MEDCOM 112 • lL AUTOPSY RF.PORT 1b,,)(',,'_ _ Mohmrnad. Siler 8 ADDITIONAL PROCEDURES Documenwy phologn.phll are taken by OAFME pltotographcn Specimens retained COl' tOKioologic lesting and/or DNA idCTllifical;on are: vir:reous Ouid. heart blood, urine, and bile The dissected organs are forwarded "';Ih the body Pl.'fSOlIll effects are released to the appropriate mortuary operalioll5 repre~nlalive QPINION This adult male Afghanistan deu.ina: died in US custody ofalhefQsclerolie caniiovaKulllf disease, with modCl1llc coronary artery atherosclerosis (70% oe<;lusion of right coronary anery; lhue vessel disease) IIld cardiomegaly (enlarged hurl, 470 gm) willi left ventricular hypcnrophy. He also has an unusual, gJoboid shaped liver; however, n.oevidence ofanychn:mic or ac:tiw: liver disease was found microscopically. He hIS evidence ofreslraint ("nexicuffs" around the right wrist); however. there is no evidCII<:t ofsignificant trauma to explain ,he death. The manner of death is natural. (b)(6) (b}(6) -- [MediCII Examiner MEDCOM 0113 ACLU Detainee DeathII ARMY MEDCOM 113 DEPARTMENT Of DEFENSE ARMIro '0IlCU 1NS1IT\JTI! Ill' , AlIIOUlOY . .. WA,SHIII(1fO.II, DC '"'JOt IllIG == ~ ~. AFIP,(b)(6[l ' ' 'r PATIENT IDOOIDgTlOH AeU''JO,"_NK.lIor_,",_, --l (b)(6) H.... OF'l'ICE O'TIlI ARMED FORC£S MI:DICAL SHER, MOHAMMAD EXAMlI'!R ARMED FORas lHSTlTtrTE 0' PATHOLOGV SSAN; WASKlNGTOJ(, DC 1tlJ1M 6000 TGlk<lloDAel: 0.1. Rcpor1 C ~QNSULIAnoNBEPQ.RI A'IP DIAGNOSIS AKlopay: J~~~l("6)'-J r ·,.."llb)(6} ted: 0eI0ber IS, 2004 ON CQNJRlBUfOR MATERIAL RtPORT 0' TOXICOLOGICAL EXAMlI'ATION C04dlM4 ofSpedllJellt: GOOD D1Ile of '"ddeal: Dl.tc Re«lved: 10I4nOO4 - nx VOLATILES: BLOOD AND VITREOUS fl.UlD wet'Ccxamined for !be presence of ethanol,'. eulolfo(20 mildL. No ethanol was detected. DRUGS: The URINE WQ screened for lIDIpbe:tamine, antidcpnssants, antihistomlnes, benzodiuepioes, eannabinoids, dIloroquine, cocaine, dextromelhorphao, lidocelllC, lysergic acid diethylamide,llIIl'COtic anaIpiC$, opiatea, phencyclidine, pbeoothiazines, barbl~s, sympatbomimctic IlDines and urapamil by au chromatopphy, f.010l' test or immUllOUSly. The foHowinS druSS were dceectcd: None were found. (b){6) (b)(6) ... OffICe «tile Armed Forces Medical Eumi.ller MEDCOM 0114 ACLU Detainee DeathII ARMY MEDCOM 114 ARMED FORCF.S INSTITUTE Of l'ATIlOLOC" orncc oflhc Armcd FOrCl'li Mcrllclli Examiner [<It) RC$<;~rch Blvd.. Bldg. 102 Rochille. MD 1U85U 1-800_9+1_7'112 FINAL ,\UTOI'S" Jo:XMIINAonON nEI'ORT :Jir(""~f<~6)~=;1 Nalllc: BTB Ahrohl:IIIVo_H.asaJ flah Ibmed Halllc 1\ utupsy NQ. SSAN: ISN (b)(6) ArlP No,: I~){~l . Dalc of Binh: 8TD 1977 R:lIlk: 1m'll Nalional D~le of Dcalh: (b)(6) 2004 Ph,e.: of Dealh:,\Im Gharih I'ri:OOl1 Dalc of AUIOp$y: 04 OCT 2004 Pillee of "lIIllps)': Oag!«bd Monuary Dalc of Rcpon: ()4 NOV 1()().l Ilaghdild Airpon, I,Jq • CircumSiances of Dealh: This hclicv~"[lo be 17 y~ar old II:lqi ~alional WaS a dClain•.., in lhe Abu Gh~rib Prisoo, Ir.lq, Ih,,, dbl of;ll""rfor:ltillJ; b;,lIisllC injlll)' oflhe IOrm) hv SUitaillcd whilc in lhe p-rison )"atd. The lIc<;roenl ""as witncssed 10 suthlcnl)" collallsc while with a group of delairH:es alld "':1$ founll 10 hal'': a possihle glll\shol wound of Ihc ches\. CID inl'csligalion indicaled \"iclim "'liS injured wh'en 11 gllllfighl occurred oUlsi,k the prison ~nd Ille t1eeedcnl II"llS hil wilh ihrulllld from this Ii\;lll. The SIISf'l.'Cle<I shrill\l.d lI"as rceo"cre<! on Ihc grollmJ ncar Ille dccedent D~-spilc an cntcr,!;.'11l Illllr:K:(IIOnl~'o lhe dCl:cdcm lI,cd of his hum)'. AUlhorlzallon for ,\ UIOpS~': Office of the Amll'd FOlces :-'kdkal USC 1471. E~alllillCr, 1:\ W ldrnlincalioo: tdcnliliemion is cslablished hy ,'isual insp'-clioll of prison III r~'C"rUs. CAUSE Of DEATil: Perforating BaliiSlic Injury ofth,;, Tmso ~IANNF.R OF DEATII: I~omicide F1K\L AUTorsy DI,\GNOSJo:S: I. Pcrforalin,!; Ballislic InJ uT}' of Ihe Torw A. lnjllriesuflhc Torso 1. rrobable emry injur}' is incI'fJ'lIml';'c1 imo thoraeolomy inc,sloll :rnd IS i<lenlifie~1 as a 1.0 em ar,;,<1 ofim:,i;ulmily 11lon~ Ih.: incision ncar Ill.' xiphoid process Ihal is 18 inc he'S bclQ"OthC lOp of thc head ( 19 hICks \\'hen rc·"pproxim<l,ed) and in Il,e anlcrior midline. All o\"al dcfe"Ct is in the ri~ht si.~lh and scvenlh coslnl canibges. hI.'1lealh the skin im:l!lularil)", 2. A 1.0 x 1.0 em shored C~il ,,"ollnd Ih:1I lws" lri:Lllgular skin lall :ll 5 o'clock alID a .1.5 X 1.4 elll l"Cel:lI1sular abr.,.ion MEDCOM 0115 ACLU Detainee DeathII ARMY MEDCOM 115 AlITOPSY REPORT (b)(6) BTB AlIru.emy, H _ nllll Hamed ltame .urrounding the defect, i. 22 Y, inchel below the top of tile held and 2 inclleI riabt of tho poIterior midline. 3. Projoctile pith: petforation oflhe akin &lid mllKle inunedi.tely tigbt or tbA xipboid proeea .1 tbA riabt .bth «1l1li CIl'Iilage, the left lobe oCtile liver, the inlfthepatic portion or the inferior ~ UVI, tho held orthe panereu. the tight adten.Il gIancl, the ti&hl renal vein, lIuperlorbtlneh oflhe right renal artc:ry, the: ~pole of the rishl kidney, the po5terior Ispeet of the righl IcaIJet or the dilpluaam. the ri&ht twell\h rib IIltd the 1.1era! portion or the body orlbe tim IlIrl\bar venebra and perforation or the 1IIUIc:1e and akin of the mid-right blell:. 4. Ptojcd.ile dim:tion; Fronl to back, left 10 right and .lightly ...... ....-xi.. . . fiDdill&;s: Billferal hemotborax (approximately m ml riJbt aQd 200 mlleft); hc:mopeIiloneum (approximately 50 millmlUDdina apleen> 6. Trac:e evidenc:c: ruovem;l: None 5. B. Peaetnting IrUury of the Left Lower lei I. A 0.1 :r; 0.3 em crulled ltIperf'Cial penetrating injury orthe werallllrt8c:e oflhe left lower leg inlO the skin only. 2. Tnee evidence~:mtall pay-black metallic hpnen.t. c. Other injuries I. Four _ t (da)'l) IllpG'flciallnciaed wollDda or the left ~"""'" U. Medical Interventioa 1. Tboncotorny incilion of the billlenl fil\h inleRlOltallplCel ""'-= 2. 0leSl tube illlG'lion .aile in the left .,.. intcrwlllllpKe. 3. Needle JlIIIIdlIn WOIIIld with IlImlIIrIdinJ ecchymoli. on the left Ado oftbe neck.. •. Needle puncture nwb oyerthe veiN orthe Wlterior II.Ifface or the riglll artII. ,. RiJbt I'eInoraI trillljle punctw'e lite with IUnainina IUIIlfe malerial in the IIda. m. No Iliplificanl tIItvnl d i _ idenlinecl, within Iimiu.tions or the examination. IV. IdentH'yinl marb I. (b)(6) , 3. ..... ..... !IlIOO (b)(6) MEDCOM 0116 ACLU Detainee DeathII ARMY MEDCOM 116 I AUTOPSY REPOlntCb )(6) BTB ,o\brUelIIY. B.... JIIalI BI~ BI. . 4. (bJ.L6) (b}(6) V. Pale] DrS IlAItoo(b)}6} --l- ToxicoloJ)' is neplivc rorethanol. Diazepam (O.OS mgfI..) and NorQiucpam {O.06 mWLl are present in the chest blood. MEDCOM 0117 ACLU Detainee DeathII ARMY MEDCOM 117 AUTOPSY REPORT(b)(6) BTB Abralle.:lY. D.... ~ "'1&40fl Raa.d HIJIW The body i. chat of a _1l-developed.lhin appearina 68 inch Ion" 130 pounds (estinu.tcd) lPqi nuJe whole appeannce is consistent with the reported lao of approximately 27 yara. LiYldily is fixed poIIeriorIy with preaaute bearina area pallor. Rip i. euilybroken in the extremities, MId !he ICIlIPtl'ture Is cold £rom re&iaenzion. The Kalp ilcovCRd with black curly baiT in 111llm\I1 distribution. The iridet are brown, MId the pupila are round and equal in diamete:l'. The 1IXterna\ auditory e&nlb are dry. The ears. are ~le. The naret are pllCl'lt and !he lips are atraumllic. The note and maxillae are palpably stable. The IceIh appcarnllural and in p4~. The faeial hair tonDaU of a lOll« II)'le beard Illd mllltadMl. The neck isltnlabt, and the Il'Ichea u midline Illd mobile. The ehes! it Iymmetric. '1"heR are iIljltriea ofttle chcst that are Ii.ted below. The abdomen is flil. The am.i~lil are \hose of I DOmlI1 adult clrwmdsed male. The let1ea are descended IDd free of mas-. Pubie hair il pteaent in I normal diltribution. The bunoc:b and anUl are """""""',. The upper and lower extremitia are symmetric and wilhoutt;lubbina Of edema. Thefe are Il\IIltiple line. tcIl'lI ofvarioualCI'\WLI on ' .... ehow_ohrl........n ..... """1m", Il!erIIsunau of the left em. (b}(6) ItattooJ(b)(6) l'b)(6L (b){6) ~UllOO(b)(6) ~(b)(6l tatlOOf (b)(6) taIlOO'(b)(6) ~bl(6)~ , CLODIING AND URSONAL EFfECTS The followlnll clothinll hCRII mel penonal effecta are preaenl on the body It the lime of autopsy; It. blood lOIked dark colored I......irt is in the body baa- MEplCAL INIERYEHIlQN A non-sutured tboraetomy incision ofthc lifth illleroorlal apace beaina on Ihe left flank and tnvaaa the ltCmum and tamlnatcs on \he riabt thea. the pericardium i. IlIrgicIlly opened. I puncture milk IUn'OIlIlded by an 8 .. 1 ern ec::c:hyrnoail i. over the leftjuplu vein, I chelt Nbc aite is in the left seventh intawatal spac:e. four (4) puncture rnub are on the anterior .wface oftlla ript upper ann, and I puncture mark i. in the riabt femoral tr\lIDale and llauoc:iated with IUture materilL RAlUQCBAPHS A complete set ofpoltmol1c:m radiographa II obIained and demonltrltel the fu1lowina: A metallic fiqrncnt in tbc left leS: no Iona bone hCIura; and no othe\' foreian """~ MEDCOM 0118 ACLU Detainee DeathII ARMY MEDCOM 118 AUTOPSYREPORT(b)(6) lTD AbraHlIl)', H.... rtlib D.mtd H._ heeSof' EnoENCE OF lNJVBY Tht 0l"lItriDJ o(thc fo1lowina i'1iuritl 11 for dtlcriptive pllfpOttl only, and i. not inlalckd to imply order ofinlliecion or relative ICVtrity. All wound path.,...)" Ire liven n=lative to daDdlnl. IIIIlOmic poIition. J. Pafonlina8lliistic lrljlll}'o(lhe: Tone> A.1.nj1lricl of tile Torso 1. ~1~ entry i'1iury 11 QlCOl pol.ted into the Ibonleotomy inciJion and is Identified u. 1.0 I:RI IrCI of il'nlJll1arity Ilona the indJion near the xipboid proeeu I1W i. 18 inctlea below the lOp of the held (19 inchel1¥ben f'HIlP'Oximatcd) and in the anterior midline.. kJ. oval6efCd ia in the riaht aixth and ICV«Ith COItII Clrtil.p, beneath the lkin irnlJ\llarity. 2. A 1.01. l.Oan Ibom:I exit IIt'OWMI Wt hI. . 1riangul....ltin II' 115 o'cloelt CId. 3.5 x 1.4an rccWlJUlar.tlnlion IUI"I'OIlDdina Ihe defect, II n 10'. incha bdow the lOp oflbe head and 2 inchcI riahto(thc poatcrior midline. 3. Projectile pub: Puforuion of the lkin and rnuacle inunedilldy ript of the xiphoid process lithe riJh! lixth _Ill cartil.ae. the left lobe of the liver, the inlrWlcpatic: portion or the inferior vena c.va, th~ head of the ~ tile rilht adrmaI ,1IIld. the riabt mill vciD.' .upl!riol"lnllCh of the ript renal "cry,1he UJlPCI" pole of tile riatd kidney, the po$ICrior aapec:t of the rilbt 1eIt1u ofllle cliapbraam. the riaht t'Nclftb rib and lbc la1efal portion of the bodyofthe Iirsc lumbar vcnebra and pcrfonlion orthe muar.k: Ind Kin of the mid·ri&ht baek. ... Projcclile dirClction: Front DO back-left to riJh! and .liJhtly _. S. AAocia!cd 6ndinp: Bilalcral hcmoIhoru (-wroximal:ely sao mI ri&ht and 200 mlleft); llQllOpCll'itoneurn (approximately.so mllUl'nJUl'ldi,. JPIccn) 6. Trace evi4c:nce _cn4: None B. PmctrItinIlrtjury of the Left Lower Lea 1. A 0.7 x 0.3 em ctUIIlld IIIpCffici.J lI.inl injuty ofllle lalenl aurf_ o(thc Ictllo_1e& into the Itin only. :L T'tIu evidc:ncc recovtl"CIli: small py-black Il)eUlJic fnropnent. c. Other ilUuria I. Four RlCClII (da)") aupuficiallncllCd wouneb of tile left fOl_IIl. MEOCOM 0119 ACLU Detainee DeathII ARMY MEDCOM 119 • AtrrOPSY REPORT (b){6) aTB AttraMlQ)'. a.... ,,.h BiDed Rime Pille 6 ofl INTIMAL EXMmlATION HEAD: The pkallnd subplcaJ toft tinun oftbe IC:&ip arc froe ofll\iury. The calvar1l1ll1 15 \ntK1,. 15 the dura materbencatb it Clear caebit4pinal nuld tumlundJ the I laO P brain. which b. 'ClIII'emUbblc I)'ri Illd 1UIcl. CoronaJ fClCtiOQ demonstrate sharp demIreItion between white and FY mauer. witbDut beInolTbage or contuJive injury. The ventric:la.-e ofnonnaJ. Au. The . . . pl1iIil, brainslCm, cerebellum, mxt meriaJ l)'JIemIare froe of lqjury or Olber abmtmllitics. 'T'blft are 1'10 UuU &aetures. The atIlDtCHlCCipital )oint it tbble. NJ!CI(: The Illlcriorltrlp muaclcs of the ned; arc ~smous mel red.orown, wilbout baDontY&e- The tbyroid CIltilage il intact. The hyoid bone is hcturecl bUI not lAllCWecI wilh ..y ImlOUJldin& ee:ch)'lllOais. Tbe 1aryDll is linccl by intact while muco... The lhyroid is 1:)'IlUIlCtric and red-bfuwn, without q'5tic or nodlliar clwJp. The \.Onsue I, froe of bite mcb, hcmoi,I• • orOlber iDjurics. aopy CA)'ITIE§: The nlll(a:eept wbere POCecI above) Uld Ibc va1dnl bodic. are visibly and palplbly inltCl. Tbcn arc lppfUxima%dy 200 ml of blood in the left plcunl cavil}' mld 500 ml of blood in the ri&hI plcunl eavily. ApprmUn.iely 50 mI of blood IIIImIImdt the IIpleen. The OIP'I occupy Ibcir lIIUIIllWOmic positioua. RE!i.P!R.AIO&)' SYSTEM: am. The riab11Uld left Juo&s weip 250 and 274 .~vdy. The Iunp ate atelectatic::. The atemllllUf_ are smootb IDd deep red-purpJe. Tbe pulmonary parmcbyma il ditfulcly congated aIld edemalOua. No IDaRI Iesi~ or aut of co!'IMIlidrolion arc ,,,,,,,,- CARDIOYASCULAR SYSTEM: The 2!8 am beIrt is contained in. ~ y opened pericatdiaJ ~ The epicardial IUlfICe i. smooth. willi minim.o! fat inveamena. The coronary arteries." ~I in I nonnaI diariblltion. with • riaht-domiUll pIUc:m. Crou teeOollt of thl= valC~ Ibow DO atbtn)5C1erOfi1J. The m)'OCriurn il bomopxiC)Uf, nld-brown, and film.. The nlve leaflelJ are lhjl'j IIld mobile. The walls orlbe lell &Ild riIbl vauril:let are 1.2 and O.2-cm thick. 'l4jMdvely. The elllkM:.roilllll i. mIOOdI and a1i1:llllllifli. The Ulrta Jiv. riM: to lhree inmel &lid pdent m'l:b _b.. The.ma bu mild 8lhaornatola IIU'eUinJ. The: r-.t (oc:ept where noted move) md meHDteriI: vcaeb arellllRmlrUblc. LIVER A BQ.lMY SYSTEM: The U7S p1I1ivcr II.. tile lnjunell ~bed. The ..,enchym. i. tan-bll)WJl nI congested, with Ihe lIIIlIIlobullr archilllctUnl. No mau lesiON or other Ibnorm.tlitiellare --. The pllbWldcr C(lllWM • mi.nlIlO In'IOUllt of p-om-bllclr bU, and no.cona. The pllbllddet mue:osal.urr_ i. areen Illd ~Ivdy. 11Ie otnhqlltic: bllicy Inle WpIlent. MEDCOM 0120 ACLU Detainee DeathII ARMY MEDCOM 120 AUTOPSY RUOR-t(b}(6) BTB Abrabemy. U..... Jl1ab B.-.d a __ r p.~1Gra SPLEEN: The I07gm spleen hu. srnootb, intact, red-purplc capsule. The parenchyma iJ; maroon and congested, with dilltincl Mlllpighilli corpuscles. PANCREAS: ~ pII1CreII is finn and yellow.tIll, with the usuallobll1v Itthileeture. No mISS leslOlU or other abnonnalitiell are teen. NlBfNAIS: ~ ri&ht Uld kft IdrmaI at.lds are l)'IM\etrie, with bright yellow cortices and grey medullae. No mIUCIor areu of!'lemontlage are identified. GgNJTOURINARY SYSTEM: The right and left kidneys wrigh 95 and 94-1lJll. respectively. The cxtem-.! surfaces are inlaCt and SIIlOOth. The cullUffac:es are red-tan and congealed, with uniformly !hid!: cotticet and 5harp eomcomedullary jUlletiom. The peJVelI are IlImimarkable and the urelel'l are noma! in eourse and caliber. While bJllMer mllC:O$ll overlies an il\Ulet bladder wall. The bladder contIinJ approxin\llely 50 ml ofcloudy recVyellow urine. Thc prostaIc is DOnna! in size, with lobular, ydlow-tan parmchymL The seminal vesicles are lIJIl'eln&fbblc. The testes are free ofnws ~ions. cootusiOfll, or 0CheT almol1Ilalities. GASTROINl1!SIINAL TRACT: The eaophagus is inltoet and 1lJ1cd by smooth, gey.whitc mucosa. The gasai<: Will is inUcL The duodenum, loops oismall bowel, and colon are unrernarbblc. The 'PPCndix il pl'QeDl. • • APDmONM PltOCIQURE$ Doeumenwy pholOJl'lPhJ are taken bYI(b){6) I Specimenl retained for toxic:ologic testing anlllor DNA identification are; blood, urine, v!im)US nuld, spleen, kidney, liver, brai.ll, lung. bile, guaie contents, and • psoai muscle. The dissected orpns arc forwarded wilb body. • Personal efibcts are nleued 10 !be IppItIpriale II\Ortuary opcntions repreaallativea. MICROSCOPIC EXAMINATION Selected portiollS ofOrpnll arc retained in t'ormalin, wilbol.ll preparation ofhillologic s1idea. r MEDCOM 0121 ACLU Detainee DeathII ARMY MEDCOM 121 AUTOPSY REPORT 1l b}(6} BTB AbraHm)'. Hu•• PIU Hamed HilDe r OPlNJON Thil believed to be 27 year old lrI;qi National WII • dcl&inc:c< in !be Abu Gharib PriIOll, lnq, lhIl died dc. periOrJ;tilii balliltic iDjlll')' of !he IOrIO he sustained while in the prison yanl. A forC'ip body ftom. gunfiJin that WII OUUlring outside the prison walb hit !be del:cdent. The diaupMl1 md lIOrdiueparn found in \be ~ blood ~ of undet~incd. origin. The mWlet of 4eatb is homicide. (b){6) ~(b~)(~')C]MedicaiExlllliocr MEDCOM 0122 ACLU Detainee DeathII ARMY MEDCOM 122 ARMED FORCES INSTITUTE OF PATIIOLOGY Office ofille Armtd Fona Mtdkal E.. mlller 141J Rf$ure~ Blvd.. BIda-102 20850 1-800-9«-7912 Rockvll~, MD FINAL AUTOPSY EXAMINATION REPORT Name: Hlbi~, Fru M. (b){6) SSAN: DelllneeNumbcr DaleofBlrtb: 11n~"nWJ1~-Dale of [Hllb: (b)(6) 2004 Dale of AUlops)': 30 AUG 2004 Dale of Report: 12OCT2004 AUlop,)' No.: (b)(6) AFIP No,: (b)(6) Raak: Detainee in U.S, ClISlody Pllce of Deatb: Ir"'l Pllce of A"lops)': SlAP Mornwy, Blghdad, Iraq Clrcunulances of Dealb: Thil Iraqi mile wu I detainee in U.S. clWady II All" Gbra.ib prifon in Baghdad, Jsaq. A STOuP ofprilOnet1 became unruly and the ifWlI' used lethll force 10 $Ubdue the CTl)wd. A IhoI:sun wu fired and lrnl dflaince Wllllruc:k and ki1lal. AUI~orlzallon (or AUIOPSY: Armed Forta MaliCllI Examiner, per 10 U.S. Code 1<&71 IdenllnUIIOll: Circumllllllial idenlily il etIabliahai bv MIICl'Work acc:ompanyina tile l detainee and hi. dcsisnalion IS detainee number {b)(6l ~ CAUSE OF DEATH: SbOllulI Wound oflbe Cbal MANNER OF DEATH: HomIcide MEOCOM 0123 ACLU Detainee DeathII ARMY MEDCOM 123 AUIOpS~(b)(6) Hlblb, Fru M. l FINAL AUTOPSY DIAGNOSES: I. Sbotlun Wounds orttle Tol'lo Ind Bolb Arms A. Ptuetnilul Sbollun Wound of Ihe Chen I. Enlrlott::: Lefl side of the hick; nn evidence or dose-rlole dlschlrae or I firearm on lIIe lurroundlnllktn 1. Wound PIIII: Skin, lubculaneoullluue, Ind mUlde of Ibe left blck, poslerlor Ieft9 1l1 rib (wilb fndure), lower lobe of left lu Oil, lefl Ilrlum, rlilbt Itrlom, upper lobe of tbe right tunl, Inlereo"ll 'pitt:: below tbe nlerlor .,ped of tbe rlgbll"' rib, muocle nd SUbcutaneous tissue orlbe rlilbl upper chesl J. Recovered: l).eformed melillic rorelln bod)' IOClled in the subcutaneoultlssue orlbe rlibf upper cbesl 4. Wound D1rulloo: Left to rlC1l1, blck to frool, Ind UpWlrd S. Assodlled lojuries: BllJlfetll bemolbonces (rlcbtl4QOmlllllllen: left llGO-mlllllllen), bemopericanlium (SOmlllilliers) B. Perforalluc Sbolcun Wound of lbe RlCbf Upper Blck I. Eolrance: RlIhl upper blck: 00 evidence of dose-uoile dlscbarce ofl firearm on IIIe surroundlnl skin 1. Wound Pllb: Sklo Ind Subcullneolls11ssue of Ibe rlChl upper back (tlnleollal wouod pllh) J. EIII: Right upper blck: no projeellle recovered 4. Wound DlncUon: ~ftlo rlibl Ind sllCbl1y .pwlnl C. Perforalhll S"ollun Wound oftbe Rllbt Arm I. Enlrance: PosterlOl'" rlCbl arm: no evidence or dose-ruce dlscl:llrae ofl IInltlD 00 tbe surrouodloC skin 1. Wound Palb: Skill, subculaneous tislue, and musde oftbe poslerlor rlChl arm; mUlCle,subcul..eoullluue, aod skill of fbe aOlerior rlilbl arm J. Esh: Anterior rlCht arm; no projectile ncovertd 4. Wouod Direction: Len 10 rlcbt and back to fronl (",itb Ibe bod)' in anltomIc position) D. Perforallnc SbolluO Wound of the Left Arm I. Entrance: Poslerlor ldllrm; no evidence ofdose-rlnce - dlscbarae of I firearm on lhe surroundlnc,kln 1. Wound '1111: Skin, lubculantllllSlisslle, and muscle ofille poslenor lefl Itm; muscle, ,lIbculaaeous llulle, and skin of lbe 10ferlor lefl urn J. Exit: Anlerior lerl urn; no proJecllie recovertcl 4. Wound DIrection: Lefllo rlCIll, back 10 rront, aod dowDward (wllb IIIe bod)' In analomic posillon) MEDCOM 0124 ACLU Detainee DeathII ARMY MEDCOM 124 • AulOp.y (b}(6) ... J HabIb, Fru M • 11. No rvlder>cf of ,110 lflulll oltQral disuse processu, wltbln 1'IIe lImlt,llool of Ibe rumiDltloD III. ChOlt. of nrl)' to mo~ralf demmpollflCNI IV. The r«'llvtrtd proJo:rtUt Is plated In I 'abtltd «Illlalotr .nd Illfllt<! O\ltr 10 the lOveltll.flllll: IltDl who 10'11 prutlll lllbe aulopsy .... MEDCOM 0125 ACLU Detainee DeathII ARMY MEDCOM 125 • • A.tOPI)',{b}(6) Habib, Fns M. EXTERNAl· EXAMINAtiON The remains are received clad in. CUI .w.y green shirt and white, boler IVIle .1IoTU. No idenlifi«lion band iSlI<Med on !he body. but the sequence ofnwnbert (b)(6) lis written on Ihc Iowerc;lte:st left of the: anterior midline. The body il in an early!O moderate ewe ofdccompo$ilion. with changes that include clouding of the tomcae, lou oftur&or of the glob« of the eyes. marblingoftbe soft tluue, and ge:ncralim:! skin slippage. Bloody Ouid is prmenl in the oral cavity. The body ilthlt or. wcll-dc~lopcd.well-nourished appearing. 70 %·inchn, l&O-pounds (estimated), White male. The age (If the individual it; unknown. Lividity is posIcnor and filed, except in areas Clposcd to pressure. Rigor has passed. The body lelTlpe:rJlUl'e i. that of the refrigention unit. The scalp is eoVtfed with medium length, black hair in Il'IOITTlal distribution. Facial hlir consists of. black beard.. The irides ate brown and the pupils arc round and equ.al in diameter. The external em arc I,lnmmlfuble. The nose and mui11x are palpably It.ble. Tbe teeth arc natural and in rair condition. The neck is mobile and the ncllea is midlille. The dle$t is s)'llUllelrlt. Thc abdomen is nal. The cl(temalgcn.italia are those ofa notmailiduit. ci~umeised. male. Both testes an: descended into the scrotum. Pubic hair il present in a nonnal distribution. There il no evidence ofclttemal ITaUmlllO lhe urogenital area.. Tlle bullocks and anul are unremaltable. The upper and 10IVeT extremities an: symmetric and withollC clubbing or edema.. The fingernails are intae:l No tattoos or oiher significant idenlifying body malts an: noled. • • £VIDENC£ OF MEDICAL ''''''I[BV£NIION Elecb'OeardioJl'Vll monitoring INds on bot.b Iidcs orthe upper chest and on the left Iowu quadrallt of the abdomen Gauu dressing il tied at'O\Ind the wrilll and feel RADIOGRAPHS Full body Blliogrsphs are obtained aMlbow a metallic foreign b<KIyon tile rigllt silk of the upper torso. [VIDENCE OflNJYBY I. S"OIf:UII Woulldl ollbe TOr1o Illd Bolb Arm. ... A. Peottntlol SbOlcull Wound or the Chnl There i. an entran<;c lhotgun wound on the Icft .ide orthe lnek, .ilualed Igindles below the lop ortlte head and J ~-inc;hes left orlhe po.lenor midline. No lOOt depolition or gunpowder stippling il present on lhe surroundinglkin. The JlI6-inch wound has I III-inch marlinsl abruion between S and 8 o'clock. The wound path aoa through the skin, lubcullU1oCOlllliuue, and muscle Olllle left aide MEDCOM 0126 ACLU Detainee DeathII ARMY MEDCOM 126 A.IOP')' (b)(6) ... 5 Habib, J1ru M. of the back and enters !he plCl1ftl cavil)' thtougb the posterior aspect oflhe lell: 9'" rib, which i. fracrund.. The path !hen continues tlltough the lower lobe of the left luna. the perKardium, both alri_oCthe heart, the: paicanlium, and the upper lobe of tile rigblluna. The "WOund pub then aits the righl pleural «vii)' below tile lIllteriCK upocl arlbe righl ~ nll aod perforates the .. best ~ll mlllCUlal1JlC. A defonneci, metanic: projeclilc is ~red from the subcut.aneous tissue ofttle right upper chesL The projectile is p\ao::ed ill I labeled eontainer and turned over to the investisatinl USAClD qenl lnjwics associated wilb the wound path include bil.l1cral hanotho_ (right 1<tOO milliliten; hll't 2100-millilitcn) aud hemopericardium (SQ-millililcn). The diredion oflhe wound pllh i.left to righi, back 10 &ont, and upward. B. Pufor.tiDI SlIIotp. Wond of the RIebl Vpptr Back There is lID mlrancc shotgun woWld 01\ the right upper back•• ituated 16-indles below the top of the head and 7 III·incbc5 righl of the posllnor midline oflhe body. The SII6-ioch wound h.u. Y, x 5/I.ind\ eccentric mllpna1 abrasion bftween 6 and 12 o'clock. No lOOt deposition or gunpowder uipplinJ; is praenl on the surroundil\i skin. The wOWld path iOC$lhroush skin Ind IUbcutaneous tiSliuc prior to cxitinll th~ body throllgh I V.-indllkin defect sinwed IS-ine~ below the lop ofllle hnd and &-incl1el right oflhc poIlerior midline. A \I, It \1,inch eccentric marpnilabraliion is pteWll between 121ll1d 6 o'clock. No bullet or bullet fragmenls are rocovered. The direction of the wound parh is left to righl and slightly IIpward. C. Perfonllol Sllollun Wouod oflbe Ri&bl Arm There is an entrance sholSUn woWid on the poIlenOr aspect of the righl ann, lillisled 6-inehes below the lop of the risbllhOlllder and 2·inebes medial of the posterior midline oflhe fighlann. The 1/4·inch, irregular, defoct ils\lffO\lllded by a minimal fina ofeonlllsion. No toOl deposition or sunpowder Itippling is preseat OA the Illmlundlna skin. The wound pith gOCI through the skin, sllbeulllneoulli"~ and muKle ohbe posterior righl arm and the musele, aubeUIlneoUI liuue, and KiD of the Ullerior righllml. A Y,·inch elil wound within I I Yo Jr I-inch arel of COf\lWIion is silualed 6-inclln below tile lOP of the riabt shoulder Illd I YriDc.hes literal to the Ulterior midline of the right arm. No build or bullet &qmentl are I'CICOvercd. The dircc:tion of the wound path is left 10 right and bid:; to fronI. ... D. Perlontla, SlIot'llo Wond oCUte un Arm 11Iere ia Ul rotrance abotaun wound on the poslerior aspect of the left ann, sitllated S-inehes below the lop of the left shoulder Uld 2-inelles mediI! to the posterior midline ohbe left arm. The 1I4-inr:h, irregular. ovoid defect IlII 00 anocialed 1brui<N1 or eotlllllion. No lOOt depositiOll or gunpowder stippJ.ins i, presm' on the t\IrrOIIIIdillg wn. The wound path glleS through. the skin, Iubeullneoullissue, snd mlllClc oflhe posterior left ImI and the mlllCle, IUbeUlMeoul tilillC, Ind lkin of the Ulterior left arm. A Yrinch nit WOWId within a l-ineb areaofcontllsion iuitlllled 1 U.....inr:hes below tbc top of tile left MEDCOM 0121 ACLU Detainee DeathII ARMY MEDCOM 127 • • Alltop.y (b)(6) Ihblb. F'ra M, .... dIoulder and Yo-inch mcdiallO lilt Interior midline oflbe left. ann. No build or bullet ftagmmlS are reeovered. The direclion orthe wound path is left to right, bac:k to front, and downward. INTERNAL EXAMINATiON HEAD: The iealp i. WJinjWlld.. There IAlIlO mil frxl\lra orother evidenee ofsignifieanl trauma pramt. The ealVllnwn i. removed 10 demonsttlte an &b$ence of epidUl'llI or IIlbdul'IJ IIemomllge. examination of the b...m reveal. I IIOrrDlIl pattern of I}'ri and sulci. Seri.llecli0nina reveals no evidcnu oflnurnatic or .tn.umalie abnonnalities. The _ I . lithe bull ofw brain haVil. llClf1M1 dillnoolion aod appeannec. The brain weight 1)8().grams. NECK: The thyroMt canilage and hyoid bone arc intM:L The lmyrut i.lined by intact white mlleOla. The tbyroid gland i. l)11Ul'Ietric and ted-brown, wilhoul c~ic Of nodu.lar e"-nge. The lonauc i. ~ofbite matb. hc:morrtIa8e. or ocher injuries.. BODY CA,yrnf.s: ... The riba, sternum, and vcrtebnl bodies arevisibly and palpably inlad. Injuries 10 !he ~t and mediastinum have bcm delcribed prev:iOU$ly. TIme is no abnomull aceulllulalion ornllid in the peritollC*l cavity. The organs occupy Ibeir USllII anatomic positions. Rf.sPIRATORX SysTEM: The ript and I~ tunp weiJh 320 and !80-pams. rapeelivcly, and have the previously described injuries. The exlemal,wflU5 II'e deep ~Ie. No mus lesiON or lI'US olcoruolidalion II'e presenL The pulmonary arteries II'e me of emboli. CARDIOVASCULAR SYSUM: The l!().gJaITI heart /las \he previously delcribcd injuries. The epiunlill sUl'hu il .mooth, with minimal fae lnVCSfJtlent. TheCOfOlWy arteries Ire plUellt in I normIl dittribution, with I righl~ putern. Croas sa:tions o(1he VeaR'- show no lipli.licanl,\herOlClerosi... The m)'OClldiwn i. homogenous, red-brown, and finn. The vllve lea.OdI are thin IlId mobile.. The WIl'- of tile left Ind ripl VCfttticles lIe 1.4 and O.S-centimeteJ1 ttUck, respectively. The endocItdiwn il smooth and ali.tenin&- The aortl Jives rbe to three inlltt and palenlltdl v~l... The renalllId meaenleOc v_'are ttnrernIfIaIble. ..... LIVER" BILIARy SySTEM: 1110 14S().gJaITI liver /las III intae:t, smooth capsule and • sharp lIlter10r borda. The parmch)Tlll it lIn·brtJwn and conaestod, with the USUIllobullll" I1dtiteetUJe. No mIlS lesions or otha IbnonnllitiCi are seen. The pl1blldda il empty. The IlIUC011I.urflCe illJ1lClllllld velvety. The extrahepllic biliuy l1ee is palenL MEDeOM 0128 ACLU Detainee DeathII ARMY MEDCOM 128 • - AIlIOpSy!C b)(6) 7 Habib, Fn.s M. SPLEEN: The ISO-gram spleen Ius a smooth, intact, red,pUlllle capsule. The paunchyma is $Oft, maroon, and congested, with early decompositional changes. PANCREAS: The pancrellS c:xJtjbiu early 10 moderlllc dClXlmposirional change!!. ADRENAL GLANDS: The right and left adrenal glands are symmetric, with yellow conices, gray medullae, and early decomposilioml changes. No Il'IlISSeS or areas ofhemolThage are ;dWlilicd. GENITOUBJNARY SysTEM: The right and left kidneys weigh \40 and lID-grams., respectively. The extemll! swfaccs are intact and smooth. The CUI surfllCcs are red-11lI and congested, willi uniformly thick wrt;ces and sharp corticomcdullary junctions. The pt;lves lilt lIIUcmarkablc and the umen: are normal in COline and caliber. White bladder mucosa overlies an inlacl bladder wall. The urinary bladder contains ISO-milliliters of light yellow urine. GASTROINTESTINAL IRACT: The esophagus is inlllCt aB;1lincd by smooth, hemorrhagic appearing muwsa. The stomach contain!; approximately lQO.miJlilileTS food particles, including beans and rice. The gastric wall is intaet. The duodenum. loops ofsmall bowel, and colon are IJIII'emarkable. The appendix is present MUSCULOSKELETAL: No non-lraumalic abnormalities oCmuscle or bone are identified. MICROSCOPIC EXAMINATION Selected portloll.S of organs an: retained in formalin, without preparalion ofhislologic slides MEDCOM 0129 ACLU Detainee DeathII ARMY MEDCOM 129 Autopryl(b)(~ ... ---- II Habib. Fns M. ADDITIONAL PRQCEDUR€SlBEMARKS • Documentarv Dholognphl are laken by OAFME staff phologJapher.!(b)(6j ~b)(61 I • Specimens retained for !O~K:ologie testing and/or DNA identification life: eavity blood, splec:n,liver, brain, bile, urine. lung, gullie COnlen15, kidney, and psou muscle • • Full body radiogntphs are obtained and demomlralC the metallie fo~ign body subsequently R!eOVCTed from the right chest wall The di$SeCled orgam and clothing are forwarded wilh body OPINlQN This White male detainee in U.S. custody died as a l"eIIult ofa shotgun wound to tile chest that causal injUl')' to the lungs and heart. There was also extensive bleeding into the chest cavill'. A metallic projectile wu TfICOvered li'om the subcutaneous liSlluc of the righlupper chest and turned over 10 the USAClD Agent who was present II the autopsy. Additional shotgun wound paths involved the right upper back and both arms. The location BfId ~an.nce Dfthe wound paths involving the right upper back and right arm make illitel)' thaI a single projeclile te$ulted in both wounds, with re-entry Qrthe projectile into the right arm after exiting the right back. The manner or d~Lh il homicide. {b)(6)'-- (b}(6) ... MEDCOM 0130 ACLU Detainee DeathII ARMY MEDCOM 130 DEPARTMENt Of" DEFENSE AItIIIIW ~u IIIImvr'I! 01' .... TMCll,.OO1' W..,..OOOTOOl. DC ..,.. I AflP(b)(6) I'ATlllU IpENIJrICAT!OI'f ..m Au s .... N • •hu ....._ _ (b)(6) TO: N._ ornel: orTHI: AlUtED FORCES MEDICAl. KABIB. rMUt,,__ OIU've to: (bJ~1 SSAJ<l: An.pg: i(b''')(1'J6),---~ T••....., Aft_ II: (!l1(6) 00,* Rtport ec....tat, 5 ; obol U.1OO( EXAMINER AJtMr.D FORCES lHSTtTl1J1or PATHOLOGY WASM1l'ICTOH. DC lDJ" "00 CONSULTATION sEmBI ON CONTRl8\t[QB MAURJAL AnI' DIACNOSIS REPORT or TOXICOLOGlc...L VUoMINAnON Coodltioo ofSpec;laMo.: 0000 DOlt of locldull(b)(6) 2004 Dolt Received: 91712004 VOLATILES: The BLOOD and URINE were naminal for !be presence of ethaDol ala CIllO'"of20 mWdL. No ethanol wall dete<:ted. DRUGS: The BLOOD wall screened forocewninophen, ampheWnine, ontideprenants, ontihiswnines. barbituntcs, benz:odiuepincs, cannabinoids, dlJoroquine, e«aine, dextromelhofphan, lidocaine, narcotie analsesic:s, apillt$, phcnc)'l:lidine. pheDoIhiozines, saJieylatcs. sympathomimetic aminu and Ycnopamil by gu CIlrom.lOpplly, color lest or inununousay. The followina drugs were dCIe(II:d: None WCIe found. (b)(6) (b)(6) ... MEDCOM 0131 ACLU Detainee DeathII ARMY MEDCOM 131 ARMED FORCES INSTITUTE OF PATHOL.OGY orr_ of Ihe Anned Forca Medicil E"J11ln~r 1413 Rn~ucb Blvd.. Bldl. 102 Rockvlll~. MD 10850 1·800-944·7911 FINAL AUTOPSY EXAMINATION REPORT Nalll~: Alltopsy No.: (b)(6) AFlP No.:{b)(6) Rink: Detainee in U.S. Custody Pllccofo..llh: Iraq Pllc~ of Alilops)': BIAP Mortuary, Ghafar, Husham N. SSAN: Detainee Number, (b)(6) Dale of 8Irt": IJn~nnwtt Dlle of DUlh:llb)(6} 2004 Dale of Autopsy: 30 AUG 2004 Date of Report: 12OCT2004 Baghdad. Iraq ClrclllllslllICn of DUlh: This Iraqi male was I cletainee in U.S. euslody It Abu Gluaib prison in Bllghdad. lrllq. A group of prisoners became lUII1Ily and the guards used lethal force to subdue the crowd. A shotgun was fiml and Ibis dewn« was stnICk and killed. AUlhorWllon for Autopll)': Armed Foras Medical ExllJliDcr, per 10 U.S. Code 1471 .... Idllllificitloo: CircumSWtliai identity is eublished bY DalltO'IOrt. aceompall)'ing the detainee and his designllion u detainee nlltrlber (b)(6) CAUSE Of' DEATH: ShOllua Wound of the Utad MANNER OF DEATH: Homicide .... MEOCOM 0132 ACLU Detainee DeathII ARMY MEDCOM 132 =oJ AUloplyl(b)(6) Ghalar. HUlhm N. l F1NALAUTOPSV DIAGNOSES: I. Shotgun Wo.nd of Ihe Hud A. ... PenetNillag Shottun Wound of Ihe Hud I. Enlr.nce: Rlgllt side of tbe back of the hud; no "Idenet of flose-nonge dlSflll'le of. llre.rm on the surrounding sc.lp 2, Wound P.th: RlCIlI p.r1d'kKf!plt.1 snip. p.rlet.I-off!pll.1 skull, right cerebrum., Idl cerebrum J. Recoverfd: Ddormed mtbllJe fon:lgn body I~'led belWrell Iht medl.1 Upt('l of Ibe left front.1 lobe .nd lhe overlyilll dUNI ... Woulld Direction: Rlehllo left, b.fk to fl"OlIt, .nd upward 5. Assod.led IaJurln: Subg.lul. Iiubdunl.nd sub.nfbnold hemorrb.r;n. bll.leNiI bullu skull fNidures, fertb"l fonluslons, IlId booe fNilmeols Iione tbt htmorrlllgk woulld pllh II. No tVldellft of slgllififlnl nlIunl dllust prOl:nses, within llle lImit.tlops or tbe u.mln.llon III. Chlnl" of urly 10 mo!lenle decomposilion IV• The recovued proj«llle Is pllfed In .I,heled tllnlmlner Ind gIven 10 lbt Invnlit'llng,gtllt 10'110 wu presenl lillie IlIlopsy V. Toslwloty Is posldve for morphlne.t I un~~nl,.tloll of 0.13 mcfl.ln the blood. No elll.ool or olhu druls of Ibult are dtl«IW. MEDCOM 0133 ACLU Detainee DeathII ARMY MEDCOM 133 Autop.)' (b)(6) Ghrlr, Hu,blm N. J EXTERNAL EXAMINATION The rem.aill5 ~ received withoul clotliing. No idcnlifiClilion lnncll are pretent on the body. The unclad body i.that of. well-dcvelopcd, well·nourished appearing. 69·inchet, 14O-pouncb (CSlimated), While mile. The Ige oftlle individull i. not kno\Vll, Lividity il po5tmor and fixed, except in r.JCU exposed to pressure. Rip 1111 plS$ed. The body lemperature il that of the refrigeration uniL Early 10 modcr'Ile dccomp05itiOll chlnp are prc:sc:nt, including mild ,kin .lippage. prominenl VllCUl,r mubling. and cloud ina of tile corneae. The lCalp is covellld with medium Icnl\h. brown hair in I nonnll distribution. F.,ial hir eon,islI of. beard and mu,taehe. The irides are brown and the pupil. ~ round and cqll<ll in diameter. The ClIlcmal urs are lllvemarbble. The nose and muillae arc palpably liable. Bloody fluid is present in the narcs. The leetll are olllll'lli and in fib" condilion. The neck i. mobile lUld the tndlCl i. midline. Thcchcst it s)'IIIfl1Ctric. The abdomen is nat. The external genitalilarc tl10se ofa mnnal adllil male. Pubic hair is shaved. There is no evidence of external ,",umlto lhe urogcnilllarea. The bullOCks and anus arc unremarkable. Ihere arc r.JCU ofhypopigmenlation presenl on the lower trunk and the cltmnitics. The upper and 10WCT Clltmnilia are 5)'fDlMlr1c and withoul clubbing or edcmL The IlngernaiIJ are inlaCt. No 1lI1toos or signiflC.llU identifying body marks are Pl'C$ellt. Blacle writina is prc:sent on both aides of the cllcst: (b){6) is on the ristu side and a series of iIleJible numbm is on the left side. • • • • • • EVIDENCE OEMEDICAL INURVENTION Vascular ICCCSS dcvica in the lell.-m, both antecubilll fossae, and the left subel,villl area (ml-ptric: inl\lNlion Endotncheal intubation Eoley c:alhetel'iution EleclrOcudiosrarn monitorinl pads on tile upper ri&Jtt clieat and the left hip Contusion over the stemwn. corulatcnl with cardiopulmonary IClu.scilation RAD'OGRAPHS Full bod)' radiognphsare ob~ncd and show a metallic fOlllign body in the head. EVIDENCE OF INJURy Sbotlun Wound of tbe Htld There is a pcncrrstinl balliJlic mlrance wound on the riglll side of the bllCk of tlie head. situated .4 318-incllea below the top of the lind lUld 2 Y.-incllcs righl of the poslerior midline. The ovoid wound is Yo I )1!1S·inchel, willi a III IS-inch marginll I. MEDCOM 0134 ACLU Detainee DeathII ARMY MEDCOM 134 Alitopry(b)(6) ... 4 Gblflr, H••bltll N. abruion from the) 10 6 o'clock posiriona. No SOOC deposition or gunpowder stippling i. prw:ot on the sW"lOUnl1ina skin. The wound path goes through the occipital Kllp tnd inctuda • .5116 l[ lIB-inch dcfC<:1 in the righlside of the occipital bone, with appropriate beveling. The WOWld palh through the bmn perl"ontes the ripl ocdpilil. right parieu~ IlId bolb ftonlallobes. A slightly defomted., round, metallic projc<:dtc is recovered from the duR overlying the medial upecl orlbe left fronllliobe ohlle brain lithe anlaior midline. The pntjec:tile is piKed in ,labeled eontainer and lUmed over to the investigating USACID Igent p~t.t the autopsy. The 'NOund direction is righllo left, baek 10 Iionc. and upwud. lnjwies asaoeiatod. with !he wound path include (mc linear ffact\lJe$ atmdilli «ross the middle fossae of the bullar :stull, • I-inch linear fracture DC the occipilJll bone ulendinll from the 4 o'clo<:k position of tile mlDllCC wOUb:i skull defe<:1, and subpIal, subdllRl, and IUb&l'ltMOid hemonbap. brtcred ca'ebral contusiORI and bone fragmenu alona !he hemorthlgic wound path an: a1$O pmenI. INTERNAl. EXA.MINATION IlEAD: lnjwies orlhe head have been deseribed ~\lJly. The ~esscls at the base ofltw: brain have. nonn.l distribulion and IppclrWleC. The lmin weip 11~.gnms. NECK: The thyroid cartilage and hyoid bone are intKt. The IIlj'lIlI is lined by in\.ICt wbite muc05L The thyroid gland is l)'ITUnetriC and red·brown, without cystic or nodular change. The tongue is free of bile marks, hemollbqe, or other lqjuries. BODY ChVIIIES: The ribs, sternum. and vertebral bodies are visibly and palpsbly int.cl. 80th pleural cavities contsin I OO-milliliten of decomposition fluid and the perican:liaJ IlIC contains 2{)" milliliters of decomposition nuid. There i. no sb!lonnsl KClJmulltion of nuid in the peritonul Clvily. The orpm occupy their usull In.atomic positions. RESPIRATORY SYSTEM: The ri&hl and left lungs waah sso and SS().grams, respeclively. 1hc: CIlte:m.llwfllCCS are mlOOth and deep red-purple. with moderate anthracotic mottling. The pulmonary JnmICbyrnl iJ difliucly coniested and edemltouS. No mUll lesion. or IreIJ of consolidation are present. The: puhnonary ~eries an: unrmwbble. CABD'OVA$CULAB SymM: The n{)..gram bean i. c:onlaincd in an intllCt periclldililie. The epicardial .lIrl'lICC is ImOOlh, with minimal fit invalment. The corolW)' lI1cries arc: Plaalt in lDOnnll ..... distribution, with I ripHlomilllllt panem. Crou II:ICtions oftlle v_Is 5bow no .ignificant Ilhcrosclcrolil. The m)VCUdium i. homogenous, red·brown, and soft. with CII1y dCCOfTlpositiOl\lI changes. The valve leaflets an: tbin and mobile. The Wills ofthc left and ri&hl ventricles are 1.I and O.l..c:mtimllcn thick, respectively. The endocardium illlTIOOth. The IOtta aivea rise 10 lllree inl.lcl and patent ardlvessels. Flft)' JUUkins of the aOlU i. noted. The rerul and mesenteric vessels are W'lremutcsble. MEOCOM Ot35 ACLU Detainee DeathII ARMY MEDCOM 135 ... , UCOpsr'~(b~)(~6)';;;::= A Gbafar. HUlbam N• LIVER" BILIARY SYSTEM: The IOSQ-grmn liver hIS an intacl. smooth capsule and a sharp anterior border. The pareneh)1T11 is lan-brown and congested. with the lI$uallobular ilI'Chitedure and changes of early decomposition. No mass lesiOTlS or other abnormalities are seen. The gallbladder conlains IS-millililers of green-bllCk bile and no Slones. The mueouJ surface is green and velvely. The extrahepalie biliary lree il palenl. SPLEEN; The 240-gram spleen has a smooth. intllCl. red-purple capsule. The parenchyma is soft, maroon, and congested, with changes of early decomposition. PANCREAS; The panereu hu the usual lobular Ill:hilecture and early dccompositional changes. No mlSllcsioM or other abnormalities are seen. ADRENAL GLANDS: The righl and left adrenal glands are Iymmetric, with yellow col1ices, gray medullae, and decomposilional changes. No masses or aras ofhemolThage are identified. GENITOURiNARY SYSTEM; The right and left kidneys weigh ISO and 12Q-grams. respectively. The external sunllCtS are intacl and lmlooth. "The cuI suniICes are red-Ian and congesled, with uniformly thick conices and distincl conicomedull,ary junctions. The pelves are unremarkable and the urcten are nonnal in course and caliber. While bladder mUC05a overlies an intact blildder WIll. The urirwy bladder is empty. The prostale gland is lIIITCTTIarklble. The lesles have no masses and exhibit no evidence Of!rallrtliL GASTROINTESTINAL TRACT: The esophlgus is inl&cl and lined by smooth, hemonflagic appearing muco$l. The stomach eonlailUl approximately 7Q-milliliters ofdark brown fluid. The gastric WIll is intact. The duodenum. loops ofsmall bowel, and colon arc unremarkable. The appendix is present. MUSCyLOSKELE'fA,L: No non·traumatic abnormalilies of muscle or bone are idenlified. MICROSCOPIC EXAMINATION SelCCled portions of organs are retained in fonnalin, without preplT3lion ofhislOlogic slides MEDCOM 0136 ACLU Detainee DeathII ARMY MEDCOM 136 Autopsy (b){6) ] Gb.rar. Husb.1!! N. • • • • 6 ADDITIONAL PROCEPUBESIREMARKS '~'!!l=== Qocume'1tllJ:Y_photograph, are lum by OAFME 'tlffpholograplter<!b}(6) (b}(6) Specimens retained for lOaicologic testing IUIdIOI DNA idenlification are: heaJ1 blood, spleen, liver, brai'1, bile, lung. kidney, adipose, ami P.'l(las muscle Full body radiographs are obtained and demonstrate the melallie foreign body subsequently rc<:overcd from the brain The dissecled orglllli arc f_wed with body I OPINION This White male detainee in U.S. custooydjed ... a l'e$ult ofa ,hotllWl wOIJnd oflhe head that caused injury to the skull and brain. Toxicology was pCIISitive for morphine, wllich was likely the result of medical therapy received prior to dealh. One melallie projectile w... recovered from the hud and turned over to the invcstigating USACID &gmt who was prcSCllt atlhe autopsy. The manner ofdeath is homicide. (b)(6) (b)(6) L -~~=",------' ] Medleall:nmlner{b)(6) J MEDCOM 0137 ACLU Detainee DeathII ARMY MEDCOM 137 DEPARTMENT Of DEfENSE ..._D RlItCU IlIItmIl"t: OF '''',"OlDGY WAlIHINOTOtl, DC ZIlIOllllllll PADENT IDENTIFICATION AFIP Attt.u1D... Number SfiI_.... (bItS) N.... ._==-_ OHM""" HUSHAM N'l{b)(6) OFfiCE OYnlE ARMED FOACES MEDICAL EXAMINltA ARMED fORCES INSDTUTE OF PATHOUX;Y WASKlNGTON, DC 1llJOt.6OOO S$AH, A_lOps>" (b)(6) TodnlJot:J Accaolo.lI: ~b}15\ I DIlle Rop<>r1 c.....l«l: Sepwnbcr27,l0()4 CONSULTATION REPORT ON CONTRIBUTOR MAITRIAL AFIP DIACNOSIS REPORT OF tOXICOUX;ICA1. EXAMINATION CODdition ofSpecjlD,n~: 0000 Dill of laeld,.t: (b){6 20004 Olle Rec,lvld, 9f1t2004 VOLATILES; The BLOOD AND BILE were examined for the prexnce of ethanol cutoB'of20 ma/dL No ethanol was detected. I' a DRUGS: The BLOOD was screened f01' 1lCetamirlopben, amp~ine.llItideprcssan.1S, antihiswnincs, barbitllnle" benzodiazepines, eannabiooicb, chloroquine, oocalne, dextromctborphan, lidoclinc, narcotic IlIllg9ia, opial9, phencyclidine, phellOlhiuill9, salieylill', sympathomimetic amines and verapamil by gas chromatography, color lc:st or imrnuooassay. The following dnJgs were detected: Positive Opille: Morphine was detecled in the blood by inununoas5lY and confirmed by gas spec::tromelty. The blood contained 0,2) mgIL ofmOl'phine as qUllllilated by gas chromatogrnplty/mlW speclJOmelty. chromalograplty~ (b)(6) [(bl{Sl Office of 11M: Armed F _ M.dial ElWniner MEDCOM 0138 - ~ Oflice of the Armed Forces Mldical Enmi_ ACLU Detainee DeathII ARMY MEDCOM 138 ARMED FORCES INSTITUTE OF PATHOLOGY omte orth~ Arm~d Fortts Mtdlul EumJncr 1413 Rrstmh Blvd.. Bldg. 102 Rockville, MD 208S0 1·8(1()-944.7912 FINAL AUTOPSY REPORT Name: Najtm. Fawu Badaa IThi National Dl:tainec R~~ing Syslcm: (b)(6) DateofBirth:~b)(6) JI962 Date of Death(lb.l(6J~004 Date of AUlopsy: 191une 2004 Dale of Report: 13 OclOber2004 N'-O;\.,~(b~)(~6~}=~ Autopsy AFIP Rank: If1l,qi civilian Pllee of Death: Abu Glvaib, Iraq Place of AUIOPSY: 1J~&hdad.1Rq No.:~(6) Clreumstanus of Dealb: This 42 ycar-old male Iraqi civilian Will in US custody .llhe Baghdad Centf1l,l ConfLllCrncnl FlICilily in Abu Gltruycb. Iraq. By report. hc began making gasping sounds, which awokc another dclainee, The de«dcnl \V;IS found 10 be unrnponsive and pulseless. and rCSUSoCitation efforts well: llDSuccessful. Alilborlzalion for Autops)': The Armed Fon:n Medical Eumincr, lAW 10 USC 1..71. Idenllncatlun: Visual and docllmenl~lion :lCCompanyinlllllc body; fingerptinls and DNA sample obtained CAUSE OF DEATH: Undtlermined MANNER OF DEATH: Vndtlcrmlncd MEDCOM 0139 ACLU Detainee DeathII ARMY MEDCOM 139 AUTOPSY REPORT({b)(6) NAJEM, Fawaz Bada. 2 FINAL AUTOPSY DIAGNOSES: l. No evidence of any definitive signilieanl trauma a. Minor COfltusions of abdomen and left ann n. Cardiovascular Findings (AF[P Cardiovucular Palhology con5uIWion) Mild coronary athCT05Cleroais i. 40% lumina1nillTOwing of pro~imal left anterior descending coronary anery II. 20"4 luminal narrowing of proximal left circumflex coronary ancry iii. JO% luminal narrowing of proxi rna I right coronary anel}' by intimal thickening b. Moderate dysplasia of atrioventricular nodal artery i. Noincreasedfibrosilofseptum L III. Additional Fiooings; probable anifacll of lCSuscilalion or freezing of body a. Film ofpcriloneal blood of upper abdomen, <: SO 011 b. Hepatic findings i. Subcapsular ilCCumuJation of blood over right lobe of liver; capsule grossly intact ii. Pan:nchymal clefts and focal disruption of right lobe ofljver I. Histologically, no inflammatory re5pll1UC, fibrin or clot fOlTllltion, or other evidence of any vital reaction IV. Mcdieallntcrvenlion L Endotral;heal tube in place b. InlJavcnous catheter in left antet:ubital fOWl e. One adhesive EKG tab on abdomen V. Early to modcrale dcrornposilion L MaJbling oftona, anns alld legs b. Marll:cd facial and scalp congcstion and darll: diseoloration c. Corneal opacification VL Toxicology (Af[P) a. Volatilcs: Hcarr blood and urine ncgativc for elh.allOl b. Cyanide: Hcar1 blood negative c. Drugs: Hun blood negative for screened medications and drugs of abuse MEDCOM 0140 ACLU Detainee DeathII ARMY MEDCOM 140 AUTOPSY REPoRTi~(b>j)(I06)r:::::= J NAJ£M, Fawq Bad.- EXTERNAL EXAMINATION The body is lhal of a well developed. well-nourished male clad in a p.ir of yellow "Reebok" shofb;, a pair of greydrawsuing pants, and a previously cUI, wllite I-shirt. The body weighs approximately I~O pounds, is 61' in heigllt and appears compatible with the reponed age of 42 years. The body is cold, the temperature Lhat oflbc refrigeralion unil. Rigor is waning. Uvidity is present and (i1led on the po5lerior swfaoc of the body, except in an:a.s exposed to press~, and over the face and head. Early 10 modCl'lllc decomposilonal ehanges an: prt:SCl1t. consisting of dilJusc marbling Oflbc bad., upper arms and legs; early marbling of the sides of the abdomen; plllti.aJ corneal opacification; and dark discoloraliOll and congeslion of the face. scalp and neck.. The scalp is covcrt:d wilh black lIair with liootal and parietal alopecia bul otherwise in " nonnal distribution, averaging 3 em in length. Facial hair consists of a darIc muslllChe and full beard. The irides appear dark, but an: partiaUyobscured by cOfT\elI clouding. The sclerae and COIIjllllClivae arc congcsted. especially of tile left C)'C, but there are no pc1cd1iae. The earlobes an: nol picro::d. The extcmallllditOQ' can.a!s, external nares and oral cavity arc free offolcigo matmal and abnormal secretions. The nasal skeleton is palpably intact. The lips arc withOllt evident injUJ)'. The teeth Ill: I\illUraI and in good condition. Euminalion oflhe neck ~Is the trachea to be midline and mobile. The chest is symmetric and well developed. No injury of the ribs or sternum is evident extemally, The abdomen is Blighllyprotuberanl and soft. Then: is. 2 II I em dark mllCule on the mid right side oflhe back. The extremities arc wen developed with nonnaJ range of motion. There is a 2 x I em hyperpismen1ed patch on the back of the righl wrisl. Then: are thick calIUSC!l on lalQa) aspect oftbc righl ankle and on !he !IOles ofllle feet. wllich an: also din stained. The fingernails arc soon and inIaC!. No talloos are llOIed. The external genitalia are thoscofa nonnal adult ein:wneisc:d male. The testes wedesccnded and 11ft: ofmasscs. Pubic llair is partially shaved but present in a normal disttibution. The: bUllOCks and anus arc unrcmark.able. There is an idC:lltilicalion band witlltlle name and photograph ofllle decedent around the left wrist. and there is an identification lag with the name of the decedent and date ofdeath on the IirR loe of lIIe left fool. ThCfl! arc CIUSCS arolUld the I:ltCl'llI asptell of the ankles consistent with poslrn(HtCm 5CCuringofllle body. EVIPENCEOfIUEBA.py T'here is In endotracheal tube in place secured with wllite tape aroWld the lIead. and there is an ad1lc:sive £KG tab on the lowet right side of the abdomen. Thm: is a ncc(\le punctun: mark with SUlTl)lUlding cccllymosis in the riglll ant«ubitaJ fossa. and there is an intravenous catheter secured with wllile tape in lhe left antecubilal fossa. MEDCOM 0141 ACLU Detainee DeathII ARMY MEDCOM 141 AUTOPSY REPORTm'(b~}("'6)'-1 NAJEM. Fawn Badu • EYJDENCE OF INJURy There is a 2 II 0.3 em red conlusionjust above the wnbilicus. and then: is a 3.5 II 2.5 em red contusion oflh<: lower right asp«t of the abdomen. On lhe anlerior (palmar) i1Spcct of lhe left lower forearm and wrist, there is a 4 II 3 cm red brown contusion, and tllen: is a 3 II 2 cm contusion oflhe left thenar region. On Clllernal eumination of the body. there is no other evidence oftraumL lNIEBNrltL EXAMINATION BODY CrIt VITIESj The body is opened by the usual thoraco·abdontinaI incision, and the chest plale is removed. No adhesions or aboolTnlll colloctiOllS of nuid are present in the plCllnl or pericardia! cavities. There is a film of blood in the upper pentonul cavity, less l./wt SO mi. No adhesions or abnonnal collections of nuid are present in the pailooeal cavity. All body organs are present in the nonnaJ analomical position. The subcut3nCOus fat layer of the abdominal wall is 2 em thick. There;s 110 inlcmal evidence of blunl fon:c or pcnelJaling injury 10 the Ihoraco-abdominal region. HErltDj (CENTRAL NERVOUS SYSTEM) The scalp is reneeled. and there is nwkcd aubgaleal congestion and fixed lividity, but no aubgalcal hcmonhage Of skull fractures fouod. The calvarium of tile skull is removed. The dura mater a.nd falx cen:bri are intact. There is no epidural or subdul'l hemontagc present. The leptomeninses are thin and dcliClle. The combrospinal nuid ;s dark with decomposilional change, most prominent over theocciput; however, lhere is no evidence of any subarachnoid hemorrhage. The ecrebn.1 hemispheres are symrtlcerica.l. The SIJ'liCtllrCS at the base of the brain, including cranial ncf"(es and blood _Is. arc intact. Coronal scdions lhrough the ccrcbntl hemispheres revealed no lesions, and there is no evidence of infection. twnor, or traumL Transverse sections through the brain stem aod ccrdIelllUll arc unremazkable. The dura is stripped from the basilar skull. and no m.c:tuR:S an: found. The atlanto-occipital joint is stable. The brain weighs 14SS grams. NECK; Examination of the soft tissues of the neck., including Slnlp museles. lhyroid gland -.nd liIi" vessels, reveals 110 abnormalities. The anterior strap muscles orthe neck an: homogeneous and red·brown, without hcmorrtlagc. The thyroid cartilage and hyoid bone an: intact. The laryruc is lined by intacl white mU(;(l5/l and is unobstructed. The thyroid gland is symmetric and red·brown. withoul \:)'Slic or nodular change. ~ is no evidence of inFection. l\lmOr. or trauma. and the airway is patent Inci,ion and disseclion of !he posterior neck demonstrates no deep paraecrvical muscular injury. hemorrhage, or fraclures oflhe dolRl sp1nous proceues. MEDCOM 0142 ACLU Detainee DeathII ARMY MEDCOM 142 s CARDIOVASCVLAR SYSTEM; See "Cardiovascuillf Pathology Report" below. The pericardial surfaces ~ Wloolh, gli$lcning and lInn:markablc; the pcrieardial sac is me ofsignificatlt nuid and adhesions. A modcralc amount ofepicardial fal is present The coronary artcri<:s arise IlOnna\1y in a right dominant pallem and follow the U$IIaI distribution. There il mild atherosclerosis with focal art:3$ of luminal stenosis of the eoronary 1Irteries. willlolll evidcrl(:c of thrombosis. The myocardium is dark red-brown, finn and unremaskable; the alrial MId venllicular septa ire inllltl. The lell ventricle is 1.5 em in thickness and the right ventricle is 0.4 em in thickness. The llOI1a lIlld ill major branches arise rlOI1TI.lIlly. follow the usual course and IlI'e widely palalt. ~ ofsignificanlatherosclcrosis and other abnormality. The venlc cavae and theif major tributaries return to the heart in the usual dislribuliOfl and are free ofltuombi. The heart weighs 435 groms. RESPIRATORY SYSTEM; The upper airway is clear of debris and foreign material; the mUC(lSlI surfaces are smooth, yellow'llIn and WV'erIlaritable. The pleural $IJrfaceli are smooth. glistening and wrn:marlcabJe bflatenlily. The pulmonary parenchym.a is red·pwple and edemalous, exuding • modenuc amounl or bloody fluid; no roullesiOrlS IlR: noled. The pulmonary arteries are noonally developed, patenl and without Ihrombll5 or embolll5. The righl lung weiglu 60S grams; the left 480 grams. LIVER & BILIARy SYSTEM; The hepatie capsule is smooth. glistening and intael, eovering darlc. red-brown, modmJtely congested parenchyma. Then is rocal accwnulation or subcapsular blood and underlying parenchymal disruption. with clefts and splitting or the parenchyma wi.houl associated betnorrtlagc:, consistent with rQuseitlllion or postmortem ehanges. The gallbllldder conlains S ml or green_brown, mueoid bile: the mucosa is velvety and un.renwkable. The extrahepatic biliary tree is patent, wilbou, evidence or calculi. The liver weighs 1940 grams. ALIMENTARy TRACT; The longue CllhibilS no evidencc of rocen' injUl)'. The esophagus is lined by gray-while, smooth mucosa. TIle gilStrie mucoSil is manged in the usual rugal folds and lhe Iwnen eontains a film of dark fluid. The $ITIaU IlXl I~ bowel an: unl'CllU.lbble. The panereas tw a lIOnna! pink-lan lobulated appc:arance and the dUClS ~ clear. The appendix is prescm and is unmnarbble. GENITOURINARY SYSTEMi 11Ie renal capsules an: smooth and lhin. semi'lrar!Spllrenl and strip wilh ease from 'he underlying smooth. ml·brown cortical swface:s. The C(lnices are sharply delineated from the medullary pynrnids, which an: red·purple to WI and lII\l'Cmarllable. There is a $ingle dart ca.lclIlus in the righl rtml pelvis. The cal)'l:es. pelves and U!'l:ICfS an: olherwise W1femarkable. While bladder mucosa overlies an imaet bladder WIlli. The urinary bladder contains 20 ml of cloudy, yellow urine. The: prostate gland is symmetrical wilh lobular, yelloW-ian parenchyma and no nodules or masses. The seminal vesicles are unremazkable. The testes an: fi-ee of ml$S lesiol'l$, contll5ions, or other abnonnalities. The righl kidney weighs 210 granu; the left 220 pams. MEDCOM 0143 ACLU Detainee DeathII ARMY MEDCOM 143 AUTOPSY REPORTI(t,b'i<".6j,-== 6 NAJEM, Fawn Badaa '" RETICULOENDOTHELIAL SYSTEM; The spleen lias a smoolh, intact capsule oovering red-purple, moderately firm pMMCIlyma; tile lymphoid follicles are unmnarkable. The regionall~ph nodes appear normal The spleen weighs 260 garns.. ENDOCRINE SYSIF.Mj The pilUiwy, thyroid and adrenal glands are unremarkable. MUSCULOSKELETAL SYSTEM; Muscledevelopment is normal. No bone or joint aboonnalities are noted. MICROSCOPIC EXAMINATION HEART: See "Cardiovascular Patbology Report" below. BRAIN: See "Ne\lfOpathology Report" below. LUNGS: The alveolar spaces and small air passages are e~panded and conlain no significanl inflammatory component or edema fluid. The alveolar wtIlls are thin and mildly congested. The arterial and venous vascular systems are normal. The peribroneltiallymphalies are unremarkable. LIVER: There are numerous clens and splits of lite parencbyma. focally witb lakes of red blood cells. HoweveT, there is no inflammatory response or evidence of organiution of the bemorrilage, with 1'10 fibrin or clOl fonnation. The hepatic archiltclun: is otherwise intact The portal areas show no increased inflammatory component or fibrous li$liue. The heplltK: parenchymal cells are well·preserved with mild focal steatosis but no c:vidence of choleslasis, or sinusoidal abnol11laJilies. SPLEEN: The capsule and white pulp are unremarkable. Thcre i5 moderale congestion of lhe red pulp. ADRENAlS: The cortical zones a.re dislinctive and well supplied with lipoid. The medullae Ill: DOt remarkable. KIDNEYS: The suhcapsuhu 1.ones are unumarbble. The glomeruli arc mildly congested without cellular proliferation. mesangial prominence, or sclerosis. The tubules lI'e well pre$erved. There is no inler'$litial fibrosi.:l or si8llificant infll11Tlmation. There is 110 thickening or the walls or the arterioles or small arterial channels. The lnLrlSitional epithelium of the COlle<:lillg s)'!lem is lIOrmal. TESTES: Unremarhble THYROID GLAND: Unremarkable MEDCOM 0144 ACLU Detainee DeathII ARMY MEDCOM 144 AUTOPSY REPORT[(b)(6) 7 NA.JEM, F.wn B.d.. CARDIOVASCULAR PAIHOLOGY REPORI Department ofCardiov8SCular Pathology. AFlP: "ARP DIAGNOSIS;(b)(6) ] I. Moderatt dyspl"I. of 'lrlovenlrlcu I,r nod.1 .rtery 2, Mild coron.ry .rtery .tbuosclu1llIb HistorY: 42 ~arold mile Iraqi delainel:. 67", 150 Ibs. death in custody Hoo: 435 grams (pmIicted nannal value 322 grams. upper limil 425 grams for a 150 Ibs m.le); normal epicardial fat; dosed foramen ovale; left ventriCUlar hypertrophy. left venlricular cavily diamc:leT 35 mm. left ventricular froc wall thickness J5 mm. verUricuJar seplum thickness 15 mm: right ventricle thickness 4 mm, without gross scars Of .bnormal fat infiltrates; grossly unremarkable valvcs and endocardium; enlarged membranous seplum; no gross myocardi.1 fibrosis Or necrosis> hislologic se<:lions show mild Icft ventricular myocyte hypertropby. olhe:rwise ullremarbble Comoaa arteries: Normal ostia; righl domin:l!lCC; mild alherosclerosis: 4{)% luminal narrowing ofproximallcft anlerior descending, 20% narrowing ofproximallel\ circumflex. and 30% narrowing of proximal right coronary artery by pathologie intimal thickening Conductipn System: The sinoatrial nodc il unremarkable. The sinus nodal artery shows minimally increased prolcoglycan. The .triovenrricular (A V) nodal a.rtery shows moderale dysplasia in its posterior approadlcs to the compact AV node and in i15 penctrating branches in the vClllricular septum. but fibrosis is not significantly inc:rcased in the septum. TIle penetraling bundle is caltnlly located between the node and vCl'llricular seplum. The right proximal bWldle branch is unn:markable. The left proximal bundle is not SCCll in these sections. Comment We do nOI see an obvious cardi.c cause ofdealh. Moderate dyspluia of tile atrioventricullT nodal artery is often ll$.S()Cialed willi increued fibrosis in lhe crest ofthe ventricular septum. representing a potential substrate for canli.c arThythmia. HowevCl', increased fibr05is is not scen in Ibis case. Wec;mnot exe1l1dc the pouibility ofeardiae arrltythmia related 10 various ion channelo~thies orcoronary vasospasm." NEVROfATHOLOG¥REPQRT Department of Neuropathology and Ophthalmic Pathology, AFlP: "We reviewed multiple small fragments ofdura, cerebrum. brainstem and cerebellum submitted in formalin;n reference 10 tllis case. No gross abnonnalities are present Represenlalive sectlona were processed in paraffin and sections stained wilh H&E. and immunohistochemical melllods Corbeta amyloid precursor prtIlein (BArP), and glial fibrillary acidic protein (GFAr). This material wu reviewed in conferel'1ce by the sraff of Neuropalllology. Sections show few neurons within lite cerebral cOr1ex with shrunken or vacuolated cytoplasm and hypcre!lromatic nuclei, findings interpreted as non-specific acute neuronal injury. Stains for BAPP and GFAP lTe negalive:' MEDCOM 0145 ACLU Detainee DeathII ARMY MEDCOM 145 REPORT'r'b~)(~"C= • AUTOPSV NAJEM, FawQ Radii APDrtlONAL PROCEDURf:S Doeumenwy pllcllographsllR: taken by OAFME ph.olo~B Specimens retained for toaieolollic lestil\i arnVot DNA idet1tificalion are: vitreous nuid, lIeart blood, urine, and bile The disset:led organs are forwarded with. lhe body Personal effects lit! released to tile lijlpropriale mo"u~1)I operations reprcsenlalive OPINION Based on available investisalion and complete lumpsy examination. nO definitive cause of death for trus 42 ycar-old male Iraq; civilian in US clislOdy in Iraq could be determined. There is no evidence of any significalllirauma to ClIplain lhe death. There is I film of blood in the upper abdomen, and a small accumulation of.ubcapsular blood over the righllobe of the liVCT wilh &iliIOCialcd subeap$Ular parenchymal dislUplion. However. the minimal amount ofhemonlugc, lack of capsular laceral1lm. ~ microscopic lack ofvitel reaction indicates this illikely a post-mortem anifacl, either from reslIS(:itatioll efforts or freezing Oflhc: body. There are non-sped fie canliac findings. including modenu: dysplasia ofthc: atriovenuicular noohl ar1cry. However. there is no associaled increa.sed septal fibrosil, which can be a potenlial substnr.IC for cardiac armythmia. There is also mild coronary artery atherosclerosis. but no luminal narrowing grealer lllan 40"1. was fouoo. A cardiac armylhmia relaled to various ion channclOlJalhies or coronary vasospasm eannol be excluded. Therefore, lhe cause of dealh;s ba1 clilS5ilied as unddcrminN. and the manner ofdcalh is undetermined. (b){6) ~(b~)~(6~)_~==~MeoiealEitamiiter MEDCOM 0146 ACLU Detainee DeathII ARMY MEDCOM 146 OEPARTMENT OF DEFENSE ARIlIEO fOIICU INiTfIVft CIl' 'ATHOlOGY WAIMUIGTON. oc: IllJOlIIOO PATIENT IDENTlnCATIOl! APIP A~lonl.I'I."'bfr_Snl.u"'l ~b)(6} 1'1.... OFfiCE OFTHE ARMED FORCES MEDICAL NAfEM. FAW At. B. EXAMINER ARMED FORCES INSTlTlJT£OF PATHOL.OGY WASHINGTON, DC 10306-6000 SSAN; A.~IIIY,I(b}(6} To"mlov A<us,"'" .:I(b)(6) DolO R.por1 Gtnr'O'ed; /"". 30. 2004 J--- CONSULTATION RfPORI ON CONTRIBUTOR MATERIAL AI'" DIAGNOSIS REPORT OF TOXICOLOGICAL EXAMINATION Condition or Specimen.: GOOD D.le orJnddent: Dale ReceiVed: 612212004 VOLATILES: The HEART BLOOD AND URINE were exarnined for the pi_nee of ethanol at a cutoff 0(20 mgldL. No ethanol wu dct«ted. CYANIDI:: There wu no cyanide tktel:led in the heart blood. The limit of quantitation for cyanide is 0.25 mgIL. Nonnal blood cyanide ConeenlnliOll5 are less tIwl 0.15 rngIl.. Lethal concenlnlions orcyanide are grealer tIwt) mlV'l. DRUGS; The BLOOD was screened ror amphetamine, antitkpreuants, atItihistamincs, barbilUratcs. benzodiazepillC$, cannabinoids, cocaine, dell.Ul)methorpban. lidocaine, narcotic an.Jgcsics, op;alts, pbc:m:ycridine, phenothillZines, sympathomimelic amlnes IlIlII verapamil by gas chrom.lognphy, color lest or immUllOUsay. The fullowing drugs were detected: None were rOWld. (b)(6) (b)(6) Offlceoflltc A"ne,n"oras Med;ClTExaminer ] Office Ofll!e A,med forus Medical Examine' MEDCOM 0147 ACLU Detainee DeathII ARMY MEDCOM 147 ,\~:'IEU FORCES INSTITLJI'E OF 1',HIIOI.UC" Ortke of 1he Armed r-orcc~ '" edil'~1 .: \:lUlin.'r I~IJ RC$C~rch Blvd., llI<ll:, W2 RlX~"i1k ;"1 [) 20830 I·SOO·9~~· 7f) 11 f.'1"',\!. AUTOI'S\, REI'OIlT N~",~: l\htll\llb~,alt, f{,;It1h Mol\;l'l,med N;"I"n~1 [)~l;lillCI' f!gl(Jn,n~ Sys,en~~t(6~ D"l~' Ol'l.li"h:f\b)(6) 11'l5~ 1);11': of D,'~lh: (!lllflL~(I{)~ O:"e of Anlul'sy: J') JlInc l()O.l I):,'e of Rep"'1: 22 $cplcl11hcr 2(J04 ,\mUI'Sy N'I.J~)(6) ,\I'll' Nil,: (b)(6) "I,:, R.. If".kji el' 11;~n 1'1"",' 1),::,lh: Ann Ghr:,il<. lr:II] I'h:e AlIlUl'SY: llal:h.I",I. Ir.... "r "r ('Irell ll1SIl\lletS Ilf lleath: This 52 ~'Car-o'" mak Ir.\lli el\'ili:l" eullaf'S<"t1 while spt':IkinJ: '0 ",her dcl:,inccs ",hill' in US euslody II' Ihe B~llhtllk1 (',,'Ir:,1 C""lin,'"",nl l':lCili,y in Abu Ghruy<:h, In"!. Ill'" f<:5USC;l:Olj"C eITons ,wro nnsu""."..flll, Alllhuriull'lli for AlllOp,y: The Armed l'oret:! :\Il"'k:ll E,,,mincr. 1,\ W 10 usc 1~71. l<11'lllltlnliul1: V;su~l anti ,\oc,mlClllaliul1 xoollll'al1Y"'lllhc "utiy: IiUl,'CrprllllS anti DNA J.1mple oblain,..J MEDCOM 0149 ACLU Detainee DeathII ARMY MEDCOM 148 AlfJ'OPSY REPORT(bH6) ABD AL RAZAJC. RJadb Mo.... mm«l 2 FINAL AtrrOPSY DIAGNOSES: I. Alhemsclcrotic Catdiovucular Disease a. Severe coronary atherosclerosis with CIIlciflClllion i. Left RUin tonllW)' ulery, SO% lumiw IWTOwing by fil"oulcifie pl'lluc ii. Total occll1l1ion ofproxirMllcft M\.crior dcscendins ulery (LAD) wilh hWed p1l.que rupture IlIld 0ll~ thrombus: 7j% MnOwinl of mid LAD by tibroatbr:rom-; 65% Il'fTOwing of distal LAD by fibroulciflC; plaquc; 10I1li occlusion oframllll intermedius by healed ruplllre wilh 6brointimallhiclteninl and anooth muscle ptOlifention iii. TOIIII occluPon ofplOximallO mid le;ft cin:umfielt .ctefy(LCA) by orpniud Mel roeanalized thrombus: 10'% tibroulcific rwrowinl ofdisllol LCA: 90% MITOwing of obtuse nwWMlulCf)l wilb Iibrointill\l.l thickeninlantl arnooth muscle proliferation iv. Ript coronary artery (RCA), 25% nllTOWing ofproltimaJ RCA by Iibroealcific plaque; 4tI% nanowinll of mid RCA by fibtoatheroma; 10'% fibrocalciflC; narrowing of distal RCA: 9S% DIlTOWingofpos!erior desundinl artery by fibroclcilic p1'llue and IITlOOth muscle proJifaation b. Healed tnnslnunl myocudilli infarction I. Involves anterior,lepta! and latenlleft ventriclc mid ventricle to op<X ii. Microscopically, transmural tibrwia and fal ~lllCel1'lCl'lt in anterior,lepta! and lateral walls of left ventricle iii. Aneurysmal dilatation iv. Epican1W fiblOUl Idhclions at apn of left veruricle c. CanliomegaJy with biventricularhypc:rtrophy i. Heart 666 am (prulicled norma( value; )4) gm) ii. Left ventricular Cllvity diameter 60 mm iii. Left ventricular free waUtrudmcu 10 mm iv. MicrolCOpically, bivcntricular myocyte hypertrophy with IUbcndocaridal and paivucv.lar interstitial fibrosis d. Moderate to severe alherosclCl'lEia of the aorta I. Diffuse calcific intimal plaque formation ii. Focal plaque rupture with associated hcmorrllage e. Pulmonary edema i. Riahtlung 965 gama Ii. Leftl\lllg818grarns u. No cvidcnceofany sianificanl trauma a. Abrasion," x) em on back ofriiht forearm b. Contusion, 1lt 4 cm on back of right hand MEOCOM 0149 ACLU Detainee DeathII ARMY MEDCOM 149 AUI'OPSY REPORT (b)(6) A.BD A.L RAZAK. RJub Mohammed 01. ) Additional Findillp .. Subcutaneous lipoma Ilfilntcnor letl side orlltck b. RJsht rtllaJ eakull.ll (kid~ lIone:) c. Prottalic h)pdbophy d. S)mmetrical1y cnllrJtd thyroid sland lV. Mtdicallntesvmtion a. Endotnchtalllbc in pl.c:c b. 1'1tm: Idhcsive EKCi tabs on body v. Elrty 10 modcnlt decomposition .. Ditrusemarll1inao(body b. ComeaJ opICitication VI. TOlIicoiolY(AFlP) .. VolaliJea: Heart blood md urine neptive rordhaml b. Cyanide: Heart blood negative c. Drugs: Heart blood ncptivc llx- sacc:ned medications anti dnap ohbuse r MEDCOM 0150 ACLU Detainee DeathII ARMY MEDCOM 150 AUTOPSY REPOR1j{b)(6) I 4 ABD AL RAZAK, Rladl1 Mol1Jmmed EXTERNAL EXAMJNATION The body is that of a well developed, well-nourished male clad in a previously eul, white long .leeve drirt-dras r'dish dash') and wllite boXeT shorts. The body weighs appl'O)l;imlldy 170 powtda. is 71" in heightlllllllppearl compatible with the reported age of 52 yean. The body is cold, the ~rc: \hit oflM rc:mgmtion unit Rigor i. waning. Lividity is present and filled on the posterior surface of the body, except in lllalI expo$Cd to pressuM,and is especially pronounced on the faee. Early 10 moderale dccompolitol1lll changes are pnsent, consisting of dilfuse marbling and dixo\onlion of the body and corneal opaciftcation. The scalp i5covcn:d with black and grey hair in II nonnal distribution, 8vefl1ging 4 em in length. Facial haireon.siltsofa dak mllSbK:he and grey facial stubble. The irides appear dark, but are partially obsalred byeomeal clouding. The IKler:le and conjunctiv.e are congeslcd, especially on the leI\, with 110 petechiae. The earlobes are IIOl pien;cd. The extanalaudilof)'e.ws. extemallW'ef and olal cavity are fRc offorelgJI material and Ibnonnalsccrc:tions. The nailalilkeleton is palpably inlaet.. The lips are without evident injury. The teeth are natunll and in good condition. Examinatiolll of the neck reveals the lJacheI.ll be midline and mobile. 11lcn: is apalpable 3 ;I 2 em subcutaneous nodule on the amerior left side oflhe oeck.. 'The ehesl is I)'rnJ'I'Idrie and well developed. No injury oflbe ribsOTstemum is evident externally. The: Ibdomen is slightly procuberant and $Oft The extranilies are well developed with nomtllil'lllge of motion. Then: is a4 x J.5 em scar on the upper anterioraspeet of the right forearm, and thefe are irregular IIC8f1 over the left knee. The fingernails are short and inlaet. No laltoos are nocod, and needle trICks f t noc observed. The Clltemal genitalia are those of a IIOrmal adult eirc:wnc:bed 1I\81e. The tllllle:s are de:secndcd and fi'ec: of mUSCII. Pubic hair is presenl in a 1IOnna! disaibution. The: buttoeb and Mll.lll are unremarbble. 1ltcnl is IIl'l identification lag on the firll toe oflbe lell foot. EVIDENCE OF THERApy 1llere is an endotracheal tube in place ICClLRld with white tape around the head, and there are lMlc: adlle&ive EKO tabs on the body, two on the uppercltesl and Olle on the left Ihlglt. Then: is a band-aid on the right antecubital fossa over a needle pWlCture man with IlIlJOWIding eecltymosis. EYJDENCE OF INJURY Thc:fe is 54:1 3 em Ibruion on the back of the right foreamt and there is a 7 x -4 em conntsion on the bact of the right hand. On extemalllld internal exllmination oflhe body, there is 110 other evideneeoftrauma. MEDCOM 0151 ACLU Detainee DeathII ARMY MEDCOM 151 AUTOPSY REPORT (b)(6) ABO AL RA7.A.K., RJldb MoblmrncO , INT£RNAL EXAMINATION BOD)' CAymES: The bod)' i. opened by the IIIIIaI tIxnco-abdomina incilion. and the thClt pille i. mnoved. TbtTe islpplOXinwel)' SO m.I of RlOSll'pUnolU fluid in eac.h plc:ural ..-e. and there are mulliplepleurll ~ of the ri&hl dl$ cavity. No IdhtsiOll' or Ibllormal colletrions of fluid are 1* lcnl in the pailollal cavily. AU body orpnI un: preKlIl in l/le nonnaJ 1l'IIl0l'llical position. The IUbcutMcous &llaya- of the ~ I wall is .. em tbic:k. TbcR is no inlcmal C'-idel_ ofbltn force or penetrating injllt}' 10 the lhorac:o-abdominal ~ HEAD: (CENTRAL NERVOUS SYSTEM) The tulp il rene.:ted, MIl theI'e i. no IUbaaJetl hemonhage or skuU fi1rdurcs round. The calvarium or the sk\IIl is_ved. The din mala and fab: ~ are intllCt. 1lltR= is no epidural or .ubdun.l hanorrtIqe presenl The 1qAoJ.ltllinp are thin and 6clic:atc. The _ebiosplrl.ll fluid is dut with ~tional change. IJlOII prominenl OYCT &he occiput; howeYa, lhefe i. no evideflce oran), ~ i d hemon1ll.ge. The mebial hemispheres are~. The Ilr\ldutelll!he bale orthe brain. induding eranial ~ and blood vessel.. an= inlKl CoreNI JCCtiOl'll Ihrouah Ihe eeretnl hc:misph_ revealed no 1e$ionI, and Ihere i. no evi4c:nee or inrClC:lion, tumor. or numa. TIW\SYersc: sections lhroush !he brain Item and Cllnlbc:llum are 1llll'enlIl'k1ble. The dUl'l isllripped from l/le basilar skull. and no li-KtureIll'll JOund. The ulanto-orx.ipital joint is stable. The brain weighs 1180 pns.. NECK: On di :tion orthe soft tiuuc ortht nedc, there is a wdl-c:imnnseribcd yellow))[ 2 em nodule just under the skin on the anlerior left aide or the neck. adjlll:ellt to the lll)'l'Oid artilage. On seetionina. the nodule is unironnl)' fatly. c:onsillent wil/l a lipoma. Enminllion or the: 10ft I~ or the nedc, induclina strap IIIUIl:les, th)'l'Oid gland and larw: v_1a, otheIwise reveals no abllOl'TI\a1itiell. 'Thc= anterior $O'ap mU$l:1es of the neck an; hornoameollJ and reQ.brown, without hemorrllage. The thyroid cartilage and hyoid bone are intKl The IIr)'lU I. liMld b)' ill1al:t while mllliOSlo and ia 1IllOlmNl:ted. The th)'l'Oid gland i5 IaIp bUI A)'llImctric MId red·brown. without c:yatit or IIOlbIlar ttlaflgc. There i. no CYidax:c or lnro:tion. lwDor. or trauma, and tho airway is patenl Incision and diuection or lhe poIlenor neck dcmon.sl~lell no deep pllnl;crvlaJ mUJCular injury. hcmonilage, or frlctulU or the dorullpioollS pI'O("CSICI. CABDIQVA,SCULAR SXSTEM; There are dense apical adheaiona or the heart to the pericardial lit. and there is marked aneut)'It'fIAI dilalIlion orllle left vmlritill. Sec ''Cardiovll5Cular Pathology Report" below. A moderate amounl orepiclll1ial fal i. present, and the heart wtighs 666 gnuna. The aona and ils major bBnl:hes arise nonnall)' and folloW the lI5UIl course. There il diffiue modente 10 ICYenl athcrolclc:roli. orthe aorta with e:o:lenIiVII: ClIlcirle inlinuJ p1lllue formation and fOClll plaque rupture willt assoc:iated henuihllgc. lbe _ _ ClIYa11: and their major tributaries return 10 the heart in the UIlIai dillribution and are !Tee or thrombi. MEOCOM 0152 ACLU Detainee DeathII ARMY MEDCOM 152 - ,. ,\UTOI'SY ItEl'ORl' (b){6) ,\[U) ,\L R,\Zt\K.I{i:1l11! "loll;lmm~t1 RESI'IRt\TORY SYSTE~t: The lIpflCr :lirway is c1cnr of ,kllris amI rOI'l:i~1l l11Jh:ri,il; II ... Inuc~lI Stlrrac~'S ~r~ ~Jl1uOlh. }-.:l1o\\'·[ao ami unrcnmtt:lhlc. TlII.,.,: arc SC::IIl<:rc'I.l pkurolt aoJh..."ion" IllI: nglu dlCSl c;ll'il)'. The pleuml sur(;lCCs M: otherwise SlllO<lth. glistcninJ: :m\lul1l'1.'1nark:lblc tlilalcmll)'. The fluhno[\ary p:lrc!lChym:1 is n.... I.pllfl>lc :,!ld c<!clIlm,llls, cxu,Jing :1 ulQl,lCrollc :Im"Ulil uf hluolly flui<.l; no foc"l l.:~;(Ins nrc noIcd. 11..., rJtllrnl"~,ry :,n.."!lCS II«' IlOnllally dcn:lopl.'tl. patent lUlll wllhum throlllllUs or o:Inhulns. rill: l'i"hl hUlg \\'t;\gh~ 'N,S gr"oIm,; lhe 1..11 Kill or J;rnllls. 1.1 "foR & 1ll1.lAlt\' SVSn:M: 11m ocrmit capsule is smooth. ,l:lislcning ml<l 1111:11:1, co"mng .brk n:t1·hruwll. modcr.llcly congested p;m:m;h}111J with no foc<ll Ic~jons 1I0lCII. The ~allhl: .. kt~r ~..nllaillS :) 1111 of W'C'-,,hmwil. mllcoid hik; Ihe mucma i~ vdvcly :mllnl1rcmark:.hle. n,e cxll';lh111alic biliary II\.'C is 1""ClII, Wilhoul evid""lcC of calculi. 'J1'1: liwr wc,.\;hs !.\LJS IITam.•. AI.lME1''TARY TR,\CT: 'n,e lougue cxhibibl nn ('vidcllCe of r,-..:elll i'Ullry. Tile el<Ophallll~ i.• lilled hy gr~y-\\"hile. SIllO<)lh 01l1l,;OS3. 'nll: gaslrie llIllCU.\.l' i, :,mlll1;<.,1 in Ih.: uSlI:11 I'Ilg:rt fold.• :lmJ lhe lumcro oonlairos 100 ml rof <Ian.: nui<l. TIl<: small :ulll I;u'gc rnlwel un.: ullrcll"'r~uhlc. The IKlller.::as h:15 a Ilnmlal pink·lall k1b\11",... t :'p!'ICar,lOlC" a",1 Ihe ,luelS "re de:,r. rhe al'[>Cndi.• is pn•.'setll and is ullmnan.:ahlc. GENITOIJRINAR\' sysn:o\'l: The renal e;lj15ulcs i,n: smoolh :,m! lhin. lICllli_lr:ulspareuI "n.l snip "'illl .'aSl: frulll Ihe llIlIk-rlyin!: smooth, rl:d-browlI conical surr.1l"~ n,.:: conicCl' are ~harply dclillcmcd rrorn Ihe 1l11:dutlar)' lIyrnmlds. which un: n..'d·rurple ILl Ian and unrcmark;rblc. Th,'re is a single ,brk calculus in the riGh' ren.,l pc.·lvis. 1110.: c"I,.....<.-s. p.:I...:s alld urders arc olherwi5\) unrem:lrk3ble. While hl:ldtkr ll1U~-osa O\l<:rlk$ an inlOlCI bl:.od<'T \\'all. 'nle unn,,!)' hladder c\}n~,il\$ 50 nil of elOtKly, }'l:llow urine. 'n.." pn\Slale waml is ",larycd "'11 'ylllmcirical with lolllltar, yellow-Iall l':uc:nch}lll:l ;,00 no lk1llulcs (>f rna....'!<.'S. 'n,C scrnirml \"c.~ieles arc IIlll"Clnarkable. The 1,'SICS ;m: lice of ma.~ 1t.'$i0llS. ",nlll~i..n~ or nIh..... allllonnalilks.. 'llle nl;,ht kiduey weigh, 2071Pnls: llle left 2)5 sr.'>lls, nt;TIClJl.m:NOOTllt:I-IAI. SYHpl: TIlc .~pICl:n h:l$ a smonlh, i"l:lCt capsule co\~ng. 1\'II-l'\Ifl'k. Ill()o,kr~lcly liml IlafI.'llClI)1ll.,'I; Ihe l)lllphoid follick-s arc UIlIl.·rn;rrkahlc, The ~iol1:11 1~T1tl'h IIO&:S appe:Ir ullfmal. TIM.' spleen weighs 278 ~,,\S, ENOO(;UlNE SYSn:i\I; . . . The puuilary and :ldrcn:rl gl:lIIds ;'!'C ullrcnmrk:,blc. 11,e I"~>ld gland ,s symmetrically eufarll''lI, hUl free 0 f IIlldulcs or masses. - i\IUSCUl.OSKEU,TAI. SYSTF.i\I: . . . ':\\Il.,c,\c.I\::\,tlroprncIU is 11Orrn;,I. No bollC ,Ir JOllll a!lnor!ll:rhucs ;II\; 1101.'11. MEOCOM 0153 ACLU Detainee DeathII ARMY MEDCOM 153 AUTOPSY RBPORTlb}(6) ADD AL RAl.AK, R1adll Mohmmed 7 M'CBOScoP'CEX.\MINATIQN Heart: Soe "Cardiovuculaf PathololY Repon" below. Selected ponioru; ofolhu orptII are rdaiMd in fonnalin, without pl'epantion of histolock alides. CARpIOVASCUkAR PATUOLOGy RE19RI Depattmml ofCatdioVQClllar PathoIoIY, AFIP: "AFlP DIAGNOSIS:(b)(6) I. Se¥en caro••". .~el'OKleroW,,1111 nldfklltloa, tbl'ft vessel disuse 1. Healed lraalm....1iduedo. wltb 1.Ile-r)'fmlll dll'llltlOll, 'Durior, sepl.1, •• d I.ttnllclt w.tricle 3, Canllo-e.ly wltlllliVeolricular hl'ptrtroplll' History: S2 ye. old IIUIle lrsqi cktIIincc, S' II", 170 Ills, found d=I in bed tk.aI1: 666 aramt(pml.ieted oonnal value 343 gnma, upper limit 4S3 varna for a 170 Ills male); foeal cpitlrdi.l fibrous adh~ollllll1 apex of left ventricle; closed foramm ovale: aneurysmal diLatatiOll of Ie.ft YCIltricle: left venuicular Clvity diameter 60 nun. left ventricular free wall thickneu 10 nun, YCIltrieulu IICpQU'll thiekneillO nun; right ventricle thielr:neu 4 nun; endocardial thickening in left .mum anclleft ventricle; unremarkable valvcs: healed tnnanural infarct, anterior and septal wall. of left ventricle, mid ventricle to apex; lubendocardial h)'pCl'Ul'li., anterior Incllateral waUl of left ventricle; hiJIolope sectiOlU IlIow biventrieular m)'OCyte hypertrophy with subendocardial and penvuculu intClSlitisl fibrosiJ; tranlmural fibrosiJ and fat I'CfIlatement in IIIte.rior, leptal, and lateral walls oflcft ventricle. ComOn ll1eriCl: Normal OItia; rilht domillllll:e: lCYere calcific atheroaclerois: leD main COlJ!JW)' artery: SO% luminal narrowing by fibroealcific plaque LeD IQterior descendiol utqy (L.AQl: Total occlusion ofprox.imal LAD with healed plaque rupture. and organized thrombus; 7S% narrowing of mid LAD by thin capped fibroalberoma and 6S% narrowing ofdiltal LAD by fibroc.leific plaqLlO; lotal occlusion of TamUS intelTTlCdilll by healed rupture wilh fibrointimal thickening and amooth muscle proliferation LeO circumflex artery fLCA): TOIiI ooclusion ofpro.imalto mid LeA by orpniud and recanaJiz.ed lhrombul, 70% fibroealcirlC narrowins of diltsl leA; 90% narrowilll ofobtuK marginal Ulcrywith fibrointimallhickening and ~ooIh mlllClc proliferation Rjght corpnyy artery CRCAl: 2S% narrowilli ofprox.imal RCA by fibroealcific piaque,4O% nlllOWing of mid RCA by tbin eapped fibroatheroma, and 70% fibrocaJcific narrowlna ofdillil RCA; 9$% narrowing OfPOllerior deJcencling ll1ery by fibrocllciflC plaque and IJDOOIh muscle proliferation." MEOCOM 01504 ACLU Detainee DeathII ARMY MEDCOM 154 AUTOPSY REPORTL(b)(6) I ABO AL RA1.AK, Rlldb MClbllnmw 8 ADDITiONAL PROCEDURES Full body radiographs are obtained and show no ~vidence oflrauma. Documenlary photographs are taken by OAFME pholOpaphers SpecimeTII retained for loxicologic lesting andfor DNA identifiealion are: vilrcOWi fluid, heart blood, urine, and bile Th~ dissected organs are fOfWatded wilh the body Per.sollll efTeets are released to lhe appropriale mortvary opet1llions represenlluive OPINION This.52 year-old mille Iraqi civililfl in US custody in Iraq died of atherosclel'Olic cardiovlSCular diSU$e. Wilh sevt:re coronary aMery disease and. healod myocardial infarction (previOWIIlcart IlIack), extensively involving the left ventricle. There is no evidence of any significanl trauma. The llWIlICl"o(death is narural. [''1(6) (b)(6) _ _ _~IModical Examiner MEDCOM 0155 ACLU Detainee DeathII ARMY MEDCOM 155 DEPARTMENT OF DEFENSE AIIM(D FOftC:Q lH5murf OF " ..T>tOlOGY W.uHlI«IT1JH, OC .'",. UOG TO: IWI'ICE OFTlU: AIIMH) HIKCES MF.I)lCAI. EXA.\llNF.1l AIl~l [0 FOll(;I\llINSTITUl'r. 111" ....1"11( ll.oGY W...SIllSGl'ON. OC ~OJII6-_ /\lID AI. IlAZ.M'. RlAlJI I M. ss....,,: "'olo"u'dbJ(61 To.i<""'u A<C'dJ.Mta.: (b)(6) Ilal< Rct-I (;".~...,C'd: CONSULTATION KF.I'OltT ON CONTlUlltll'OR MAn:RIAL A ~11' OIAGN(JSIS IIEI'ORT Ol'TOXTCOI.OGICAL EX,IM1NATIO"~ en",liliu" "fSp«;ml'nl: GOOD I)al~ IIf I"eidenl ~'2()();( Dale R«ei.'w: lJ22J2004 \lOlXrJLES: ~ IIF.ART IlLOOO ANI> URJNI:: ...."re eXllIJIincd for Ihe: prc:.K"nc.c of clhal",lll1 I (l!lofT" of 20 mgldL. No ,,!Imno! W:I' dclc"CICd. "":l.' CYA,'lIOE: 'Oler" no cyanide dC!CXlOO in the t!cart blovd. The Iimil of \juanl!IOlio" tor cYllIIide: ill IUS maJl., N"mlat blootl cpnidc (oncl'lllTUlions ilre less Than 0.1 S mlVl.. Lethal cmlCemr.llimu llf e:yaniLle OlTe Jl1eawr lhan J nlgll.. DR UGS: 'nllJ II E.\ RT IILOOIi Wal: ,;o:n.... t\<.'I! for lln1t,hctamine. anlidcprcS5al!l.s. hu,l!;mralC$. bcn;u>di:l)'cpincf, camc,hiooids, cocai..." dC"'u'oolCtlll)lphan. tilk>caillc. n:lfe:'>lie 3Ilol11"s;cs. ""iOli:Jl. flhc'1lc)'ClidillC, phcI101hia~jnc ... $)"JI1palhomimclic aminl'$ :llld ''Cmpamil by cllronl31tllll'llphy. >:olor lCS! or illlmullOas:s:JY, TIt<: following drugl WC'l'l: a"lihi~\:ImineJ. "'IS dcrCl:lw: (b)(6) .. [<bH6l. _ om~>: , _ "r It I\: Amlc,t 1'"t"C<!S Melllc"l li~alllil\cr MEDCOM 0156 ACLU Detainee DeathII ARMY MEDCOM 156 - AI~M~:n I'ortn:s IN!lTrnrn: (l~'I'KrIlOUI(;\' Office "f lhe Armed ~'''rt~ l'ltdit,)1 E:l'"niner I ~ 13 /{f;;;o;;ll'I:h Ill,',l.. 1lI,1~. 102 R..d ,'i1k M112lfll~U I-MU(j.f/.l~.N I ! ,\UTOl'S\' EX.\o\IINATIO;.l /tHOR.,. NlUYIC: ljTB ,\Ilia. ,\b<lul K, ,'''l!'r~} ~.,.: (~(6l Pri5Ol\l:1" ~(b)(6) Mil' N".;/bH6) D:lle "rl1irlh: IlTU I'NO Dale (lr lk:ull: IlTli (b)(6) It,,"k: t'IV ,'I,,,,' ,.j 11.:,"1>. All" (.hr~ib f'rison !IIlM D:lle nr Al""f'tI}'; I Jml<: llllU I);,le "rRcpnrt: 2') Jlln 2H(~ I'!.",,, ,,( ,\"I"llS~: III \I' ~1",<:,1C Ci,...umJI:lllff5 uf I)e,nlo: This ne,'" ..",t \\hik in 'I" ,·u", ly III J\I'l1 (ihr..ib priWIl. tty "'r"m he (ompbill<.-u "r clh.'S1 1"'11I h. hi5 s..n :\1.11 11.11 ,..,lbp. J. A".hllra,ullln rllr Alllol'~} : orrto:c ul" III<: ,\nll...,.1 F"rI:"~ ;.. koJ",:,1 Ex:.uull1ol.-r. 1,\W 10 USC 1..111 - MEDeOM 0157 ACLU Detainee DeathII ARMY MEDCOM 157 AVTOPSY REPORT (b)(6) BTB Idtla, AWII 2 FINAL AVTOPSY DIAGNOSES: I. AtbcJotclerotic cardiovuc:ular d.itea$a A. Left llIle:rior clesec:nlling coronary artery with multifoeal stCllOlell ranJin& Dl;xn S0-8O% B. Ri&!lt coronary.-tery with multifoc:aJ .ten,*, ranging from so- e. "" Left cin:umflcx con:mary lI1ay with focal SO% Itcnoais D. Modenlo 10 Ie"," atheroacJcrosi. of the d.iatallOrta E. lbickenill$ of tbe min.! nlve Ieal\etI F. Pulmonarycongeltion (ripll800 gnma. left 650 grama) G. PTomincnt facial suffusion H. Bil.tcnl cariobcw _II (Frank'. sign) n. V. Pleural adhcsioBl Starus poll: awmeIedomy, mnote Fractura oftbc IDlcriorriba (ri&!lt is,left 10-1) consi.lent with ean:liopulmorwty n:suscitalion No aignifiean.1 tnwna VI. Toxicology negative m. IV. ("' • MEOCOM 0158 ACLU Detainee DeathII ARMY MEDCOM 158 AUTOPSY REPORT (b)(6) 3 BTB Aida, Abdul EXTERNAL EXAMINATION The body La thai ora thin IT\.Ile appearing srcalcrtJun '0 years oflgc and melSllring 69 inches in length and weiping approximalely 160 pounds. Lividity il posterior, purple, and find. Rigor I. passing. The scalp is covered wilh gny hllir in I nonnll distribution. There ia a py m1lltlClle and beald. Corneal clouding obscures the irides and pupils. Theextemll auditory canal. lIe IIIII'm'IIJbbla. The can arc lignifieanl (orbilalcral ercascsortllc earlobes (Frank's sian). 1"Ilcrt is prominent facial .ufJUsion. 'The nares are patent and the lip. arc alnlllnlltie. The nose and maxillae are palpably stable. The teeth appear JU,lllRl with partial upper plates. The neclr. ia maipl,lIIId the lnclIca is midline and mobile. The cht:s1 il ')TIlmC1ric. 'The sbdomcn i. flat. The iC'JIi1alia arc lhose ofa nonnaI adult male. The tCltes aredcsccnded and free ofmuscs. Pubie hair i. presenf in a nOl'mai distn"bulion. The buttocks and anlll Ill: untemarbble. The upper and lower extremities are Iymmetrie sncl without clubbing oredema. Identifying marks and scan incllMic a J Yo inch oblique _on !he rightlowcr quadrant of the abdomea. On !be posterior riabl ann and illnnn is a 6 l J Yo inch _ of dcpiamenllltion of the slcin and 1CIl'. On !he midline ofthc Iowef bu.k is I Y, inch JCII'. 1'1tcre i. carty decompolilion consisting of Rin slippage and vascular marbling. CLOTHING AND PERSONAL EffECTS The followingclothina items and pcnonal dTecll arc prcscm on the body at the lime of autopsy: • • Brown shirt Only undcrputlJ • GTIly l-slUrt • While shin • • • MEDICAL 'NTERVENTION Endottxhcal tube in the orophlryrui: lhat enlers lhe tnChelI IntraVCftOllJ eatltcter (IV) in the back of!be left haod EIectroeatdioJrtlPh (EKG) pad. on the chest BADIOGRAPHS A complcle let ofpostmoflcm rMiograplu: is obtained and demonstntCithe follo....ina: No radiopaque projectilct or fnan maner 1lterc are Ji-aetules of the riglll ~DENCE O~ INJURY rand left i"'=1 MEDCOM 0159 ribs on tlte anlerior upoc:lJ. ACLU Detainee DeathII ARMY MEDCOM 159 r • AUTOPSY REPORT (b)(6) BTB AItIa, Abelol INTERNAL EXAMINATION treAJ): The pleal and JUbpleal ",tt ti5SIJCI: of !he IClIlp ate free oriQjIll)'. The calvarium il intKt, U Is the dura Il'II.ler beneath it. Cleareaebiospinll fluid IUmlIIndI:!he 12'0 am brain, whieh Imt uDI'em-ub1e I)'ri and JUIci. Coronal_lions dcmoNtnlc sharp demareation between while and gey mltlCr, without hanonIuigc oreontusivc injury. The venrric.lea ~ o(normal me. The basal &Malia, braillStem, cerebellum. and anerial ')'Item. at'l fi'ec olilliury «other Ilmormalitia. There.-e no Mull he!urcl. The atlanto-occipital joint illUlblo. NECK: The anterior Itnp ml*:1ea of the DId: _lIomocmolll and rW-bl'Own, without hemorrbl&c. The th)TOid ul'lilaac and ")'Oid are inlloC:t The larynx i,lined by inlaCl white m~ The thyroid Ill}'lTllMtric and red-brown, without cystic or DDdular cIwlge. The lOngue 1,11'01' orhite I!Wb, hemorrhage, orOl!ler injuria. BOOY CAVITIES: The IlCmum and venebnl bodies are visibly and palpably inhet. No cxeas fluid i, in the pleunJ. pericardia!, or perilonc:al Cllvitia. The orpnl ooeupy their lIflLal anatomic positions. RESPIRATORY sysTEM: Tbo:n: aredt:llK fibrous adhesioM ofbolll pleural eavities. The ri&hen left loop _ish 800 and 650 .espodi~ly. The extemailUtf,ees are deep red-purplc. The pulmoaary paraehynu. i. diffilscly eongested., ecIernalOlK. No mass Iesionl Ol" areas am. ofOOnIOlic!ation are pR:SCfIl. CARPIQ\IASCULAB. SYSTEM: r The 400 am hCU'l i. eonl.med in an intacl pericardial De. The epicardi,llUrf_ is .moo!h. willi minimal fal investment. The conmary aneries In present in I normal dislritNtion, wilh a ri&hI-domilWlt pattem. Crosa tcetions oflhc vessell .now 50-80% mliltifoea!lIcnote:1 of the left IIIllerior descending c:ororwy IJ1cry, foul 50% ...lcific f1mosil oflhe left cifl:\llT\flelt COfOnaf)' artery. and SO-1S% mll!tilOcallleJlOlell ofthc . right coronary artery with a focal as% IICnOIis. The myocardilllll is homogcnolll, reelbrown, and linn. The milral valve is lhickCllCd and fibrotic bill thCl'l:: are no vegelalions. 1M remalnilll valvo Ioaneu are thin and mobile. The .,..1111 orthe left and ri&hl wnlriclcsarel." and 0." em thick, lcspedivdy. The endocardium is lmooth and glistenin&- The.orta Iw mod_Ie to feVlR atherotcl_il and givCl rise 10 Ihree inl-::t and palctll ardI VC$KI.. Tho RNI and mcxnteric vessell are lInn:marbbllll. MEDeOM 0160 ACLU Detainee DeathII ARMY MEDCOM 160 , AutOPSY REPORT (b)(6) BTB Altl.. Abdul LIVER" BllJARY'SYSTEM: Tbe 1100 em livertw an inllel, IIIlOOth uplUle and a aharp anterior border. The parendlyml ia tan-brown and conJested, with tile lIIuallobular an;bi~M~. No Il'IUS leaiona or oth« abnormalitiea an seen. l1le pllbladderconlains a minute: &moIlnt of ~laclr: bile and no alOllClI. The mYCOS&llllrfac:e ia pan and velvety. The cxtl'lhcpatic: biliary tree ia patmL SPLEEN: The 200 em spleen bas a arnooth. inl&d, red-pwple eapsule. The pllenchym.a ia mllOOn and conacstClCl, with di.dnc:l Malpipillll c:orpusclu. PANCREAS: 'The panc:rc:u ia firm and yellow-tan, with \he 1IlUa11obu11l architecture. No _Icaions or olhcr IbnomWities are __ ADRENAIS: The ri&hl and kft adrenal atandJ ~ .ymmdrie, with bript yellow c:ortieca and pqo medullae. No maua Of _ ofhemorrtlJ,se &I'C identified. GENITOURINARY SYSTEM: The riaN and left kicIlleya waJh \7j and 200 JlI'I, respectively. Thc: extmllll twfac:a are mlJleC and II'nOOCh. The cut turfac:a are 1"ed4llll and conped, with uniformly thick cortices..s dlap cortieomedullwy junc:liona. The pelves an; ul'ltenwtable and \he umen are nonnal in COUlW IIld ealibcr. White bl.sdermucou overlies an inlac:1 bl&ddec Will, Tbe bladder conIIiNi Ippmlirnately 10 ml of c:1oIIdy urine. The prostate ia normll in.ju, with lobular, yelloW-Ian parencb)'IIIL The seminal vcaieles arc IIlIl'ClTWbbIe. The Ic&les arelTee oftnIA leJiona, c:onlu$iona, or 0Ihcf Ibnomtllitin.. GASTR01NIPS1JNAL JJlACT: The eaoph.lJuJ ia intact and lined by ImOOIh, lfCY-White mucou. Tbc MInICh c:onllilU &ppI'Ollil'l1lllely 50 ml ofdart sreen liquid.. The JUIric: i. inlac:L The duodenum, !oopsofanall bowel, and colon 1ft; urutmllUble. The Ippendil i. SUfIieaIly IbJel'lL _n ADDnnONAL~EPUBE§ • • • • Doc:umalllly photographs are t<en by (b)(6) Spcc:imClll rtt&ined fOf 100ic:.ologic: testilll and/or DNA identification I"': blood. urine:, splcm, Iivc:r, lune. kidney, adipose. bnin, bi Ie, JUlric:, and psoas Tbe diUCded orpna are fol'Wllded with the body Personal efTllCU are ",leased 10 the appropriale monual)' opc:raliGllI representltives MICROSCOPIC EXAMINAT'ON Selected portioN oforplll are retallllld in formalin, without prepanlion ofhillologie .lidea. MEDCOM 0161 ACLU Detainee DeathII ARMY MEDCOM 161 • AtrrOPSY REPORT (bH6) r BTB AJUa, AheM TOXICOLOGY TOllioolopc _)'til orb1ood mel bile wu neplive for ethanol and drup ofabuse. Cyanide _ not dCCceled. OPINION This elderly Iraqi male died of.lhetwclerol:ic cardiovueular disease (bJoebge oflhc ar1criet thaI lupply blood and OJl:YBell 10 lbc beItt). The rib fIXtures flO(ed.t IUtopsy an conIistenl wilh eardiopulrnOMl)' lU.lSeiwioll (CPR). 'T1Ioeft was no lignifieanl Inuma.. The manner of death i. nl1l1l'Sl. (b)(6) (bK6) MEDCOM 0162 ACLU Detainee DeathII ARMY MEDCOM 162 ,\R,\IEIl FOltC.:S Ii"STlTUTE OFl',\TIIOLQr;\, orne., "r lh~ ,\rlllcli F(lI'"c~ illcdi"'ll Ex:, ,uincr - 14lJ Il.c:l<:~n"h l!lv.i..llld);_ 10~ l{t)Ckvillc. ~ID 20H.sn 1-800·Q.... ·7<)12 FIN/\!. ,\UTOI'S\, ltEl'OIlT Nn,jCb )(6) "':arne: ,\ wad I\J·Ju\\~ldi. IIWlsdn AU1Qlls.\' l:S IIcIAin"" (b}t6) Ihle "r IIlrlh(b)(6j --,-1')2\1 Ihl" 'If 1)(:llh: ~}(6} 2~ '\1'11' (b)(6) It:mk: Ir:"li N~li"n:ll "'n., r, l'lnn' or 1"·,,11,, B:,ghlbd. Jr:l\l 1'1",,( "r A"lops,.: I.Sr\ An""''''lda 1I1'''lU"",",lbl:"lln''l I)alr "r ,\ul"l'~r: III ~l,'" 2()O-l l)'llr lOr Rep",,: II JllN ::':C"J(M "r p...,,,mSln"trS O"':llh; l"his 15 )"'ar olJ m:lk. an Jr.Jqi :\mi"nnl. "'''s ,) Jcl"incc:11 Ihe C"'llnd lbgh<J;tI! Del"'r..:" Facility (,\bll (;)o",ib). Orr(b){6) ~f)(~ he I\:p"'Mcdly a,,"'plly rol1aps...od ;u"II":<:3n1c unconsciolls. Rcsuscit:II,Ul\ ":c~ inlll"I\-..1 mill conliulled durin\; IJ:Il"'I"'" 10 I"'" f~ciliw hr>stli.t~ere 11<: died. Ac",rJi n~ IU f\."C"rtl.~ pr""i(ktl l>~' the in\"CSI;l:~l;,"" "l:ency. (b)(6) h:.KI a P;L"1 IIlcdi"allll~Hlr~' "i~nili~anl fur tliak'tL'" n\oClIim.'l. hypcncllsion and pn.>\'iOlL" t1l)'ucuruiaJ infur~li,,". - ,\ uI!lnril:lli"n for c\ ul"I,"'-; USC 10171 omw of .he Am...'<.1 F"re~., [denlififalin,,; rmulIl[lli,'c itk.'I,lilkuliOl' :Inti repo'" :>t'PI'lied hy .he in\'.:SIi~"li,"""I. '\ll"",:ollda. 1l:I1:.KI.1DlI) /0. k'ltkul EXUIl';'I(.'T. tAW III ·om pli,la.;d br c"'llo:.ris"" I" phOI0l'mphs )' (b)(2) ('I n, LSA MANNER ()Jo" DEATH: NAwnl .MEDCOM 0163 ACLU Detainee DeathII ARMY MEDCOM 163 , AUTOPSY REPORT (b)(6) "wlKl A).Juwadl, Rassa. nNAt AlfI'OPSY DIAGNOSES: t I. Seven AtlluOIclerotk Cudlovuclllir Ducllu L Ria;llt Corollary Arttry: 95% to p'apoIDI.lmosb b. Ldt Coroalr)' Artery: 80% .ICDOSb wllb cOllccDlrlc rtIlclntllloli e. Pror.lmal Left Desc:eadID' COrDIlI.ry Artery: 90"1'• • UIO." d. St.tIl. POll Remote Postfl'ior Left eo Severe Aortic Atlleroulerosb Sepl.llllfll'~llon II. Aortic Allcury.m (Scm) III. C.,dlomclllly (8IGlm) IV. Muked Ncpbrosclcro.b V. No ulenl.1 injuria DOlfi! VI. Toxleolol)': lU'Clllve for dMlp of .blse.ad dhallol -. MEDCOM 0164 ACLU Detainee DeathII ARMY MEDCOM 164 AUTOPSY REPORT ~b)(6) "'wad Ahlawldl, H...em l EmMA EXAMINAtiON r The body illhat of. wcll4cvclopcd, wel1·nourilhcd 70-inch tall, 200 pounds (estimated) Cauasi-n male whoH appeannee I. CO/l:I[SlCnt with the reported age of7S years. UvWity Is bed on l!Ic posterior upcct of the body and rigor Iw pUlCd. The tempcnture of the d«.eued is eold, WI or!he ~ (ri8eration IInit The tulp I. covered with white hair and thc:R is frontal and occipital balding. The irides are hazet,llId the pupil. are I'O\IIId and eqUId in diarneler. The external auditory canals are free of ~a1 secretiom Of blood. The ean mll lIllJm\arbblc and they are not pierced. The nan:I Ilre pIItcnl and the lips are _traumalie. The II05C! and maxillae ue patp.bly~. The dIe d is edeNlilou. The neck illttaichl, and the uw:ne. is midline and mobile. The thnt i. symmetric. The abdomen is mlldlYptO(ubera'u. The Senital!. are !hose of. normal adult cin:umciscd male. The testes are descended and free of 1TIlISIeI. Pubic hair ;. present in I normal diJtribulion. The bllttoe:ks and IIlUS Ilre wwuhark:ablc. The uppc:r and lower extremities are Iymmetric: and without evidence o(c:lubbina. edema, and iJUuries. A wcll-ciralmx.n1led. '1... inch YemKOid lesion i. DOled on the poIterior· medial aspect oftbe mid right leg. TIlltoOS are IlDI present and lICaI"II are noted in the rollowinalocations; • All oblique I Y. II: lfl6-inc:tl wdl..flealecl tear b on me donal ~ artlle len r._" • • • ""'" A yertical Y. V.. inch well-healed IQr is inferiOS" to tile left knee An ovoid % 'II Yrinch well-healed ~ is infcnor to the right knee An oblique I 'II lIS-inch well healed Km" is on the anterior up«:t oflhe Ien.ale II: CLgmlNG AND PERSONAL ERECTS Tbc fotlowina clolhinaltems and perwonaJ efTecU; an: preJent on lbe body atlbe time of aulOply. • A Ionasleeved cWt Ill'Cn sltir! without a label • Bid brief's • Additional hems or pawnal effccta are not ptaCnt MIDICAL IND:RVf.!''TIQN Eleetrocatdiopun monitor pada an: .fflXed 10 !he anterior Qped oflhe ehClt. PUnetl= marb COl\Iment with intnlvcnO\ll devica an: noted In the left antecubital rona and right aspecl or the lJOin. (' -" MEOCOM 0165 ACLU Detainee DeathII ARMY MEDCOM 165 AUI'OPSY REPORT (b)(6) A.,nd Al-Jlwld" Hlllltln 4 EVIDENCE OF INJURY INTERNAL IiMMINAJmM HEAD: The gaJcalllld IUbgaleallOft l i _ ohlle IClIlp are free ofinjury. The ealvanum i. intact, lIS i. tbe dUTl mater benealh [L The brain weiJhll500 gin and hIS ullRmlfbble IYri and wlei. CoronIIICCIlOM demonItTIte Ihaql deman:ation between while and grey matter, withoul hemon1ugo or eonrusive injlU')'. TIle YenlnclCll arc ofnonnalliu. The basal ganglia, brainstem, and c:erebc:llum arc free of Injury orother abllOfTTlalillea. Mild atberoselefOSi. (20-30%) il noted in the builar anery; olh_iso lbe remainder oflhe arterial.ystem il rree ofabnonnalilies. There arc no Ikult fraetura. The Itlantooccipital joint is I..ble. NECK: 'The anterior Itrap mlllC:lcs of the ned; &Ill homo.enolll and red-brown, wilhout hemorrllage. The thyroid eartHale IlId hyoid bone are intae:t. The lllJ)'llx iliined by inlaet muc:ou. The thyroid Bland i'l)III'Imdnc and red-brown, withoul cyslic or nodular chanac. The tORpe il free of bite markJ, helllOl"riul.e, or olllet i'1iurics. BODY CAYITIES: The n"bl, sternum, and vertebral bodies arc viJibly and palpablylntatt. No CXl:CSl fluid il in the pleural, pericanlial, or peritoneal Clviliea. The orlllli occupylheir llIuallllllomie poIitiGnl. RESPIRATORY SYSTEM: The riSlu and left lunp arc cdematow and weiah 800 and 820 l1li, respectively. There il pItImincnt IlIlhnc:olic pigment dcpoJition on the pleura as well lIS tJuouanout the luna parcnc!lyma. The external surfac:cs arc olberwiJe deep red-purple. The pulmonary parcnc!lyma i. diffulCly c:onscsted and cdemllo.- and exudcJ edeml fluid on cuI ICCtiotll. No IllUI leJiol1l or areas of eonJOlidalion are pl'CKlll. CARDIOYASCULAR SySTEM: T'henl i. marked calargcmenl oftbe heart. The beut wciibJ 820 gm. The epicardial Jurfate illmoot!t, with minimal fal inYCStlTlCllI. The coronary artcricJ are ptelenl in a normal dlllribulion, with a riabl-dominant pattern. Croa:.lCCliotll of the vcsscll &how ,JeY«e a1heroKlerosis. The proximal aspect oflhe left coronary artery lhow 80% calcine ooncentric JlCl'IOIiI: the proximal left anterior dClCClldin. ooronlry anay IhoWI 90% IICnOIis. 1bc nabt coronary andci~umftCi arteries show lO-Sl)% ItCnOlil. The myocardium it red-brown and ftac:cid. The wall. of the left and righl ventricles meuurc \.\ and 0.3-cm, respectively. Cut lCCtiotll of the len ventricle .how a 2 x I em arcl of fibrosia on the postcrior-Icplal left ventricular wall conailtcnl with remote myoeardial infaretion. The val~ IcafIdi are thin and mobile. The proximal aona il involved by an MEDCOM Ot66 ACLU Detainee DeathII ARMY MEDCOM 166 , AtTrOPSY REPORT (b)(6) "wid AhTIIW.dl, B_1, r • em~. Prominent calcific athaoaelerolil orlbe ,bdominal-ortlo obseura tbc origilll oflbll renal and m~lme vesselL UyER" BU.lARY SYSTEM: The 1900 am IiWI' hq an intael• .-aoth c.psule and ••harp '!lterior border. The paradlyma il wHwoWll Ind eonpcd, with the IIJUiIIobuIill' an:hilccture. No I1WI ~ or other IbllormaUtia In: Ietn. The pllbl.ddef (OlIlaint 23 ml If=l·bllCk bile and no lIotlll'. The mueoal $Utf_ is s:n:cn and "elvely. The exll'al\epltie biliary tnre iJ patent. or Sfl FEN: The 240 I1IlIpIccn hal. 1mOOth. inr.ct. recIopurplc eapsu.lc. The plI'alChymll is maroon lind conptcd, with diatincc Malpigllian ClOI'JIUSC'Ies. PANCREAS: The pall(1UI i.linn and yellow-tan, with the lIIuallobular archilocl:ure. NOrn&$l lesions or 0llIa" lbnomlaiitiQ are IIeG\. ApRENAI.$ GLANDS: The right and len WaIIl ..handl are 1)1l'imetric, with yellow cortica ,nd s:reY medullae.. No mMSCI 01' Ir_ oChemormaae are idcntirled. QENITOURJNMY SYSTEM: The "-"I and left kiclneyl weish 120 am. e-r.h. The cxlemall:aJ"U1es are ranovcd with JlUI difficulty ft'om the wxIerlyina JI'IIlular, du*y, conical MIl'C.uI oClhe kM1ne)'l. Both lddne)'ll dernonstmc oortiul cysts nnaina ill siu li'om ~ 10 t'. ern. The eIll turf_ U'e tan-brown and c:onacsted with poor dcm.ateation of the cortioo-mcdullary junclioas. 'The pelvet are unrematUblc and \he \IretelW are.-mal in counc and uliba-. The b1Mda- i.lnlKt and empEy. The pl'l:lWle &land j. nonul in size with lobular yellow-lul parcnc:h)'fM. The aeminal vesicles aR tulmIWbble. The ICStCi arc free of _"eRd IM8 ICiions, eonllllions, Of ocher abnomIaIiliCi. QASTBOINl f'.S IINAL TRACT: Tho etOPhlgus II inlaCl and lined by IIIlOOlh. py muooa.. The stonaeh contains <400 ml of partially diptcd food illCllIding com and beans. The pslric wall is intact. The dllOdalum.1oops: of_all bowel. and colon '"' unremarkable. The appcndil is prc$ClIl. ADDnaONAL'SOCEDURES • • DocummwyphotoJrlp/ll arc taken by (b)(6) Mending tbc IU.y arc SA(b)(6) (b)(2) detlChment em • Specimens n:Wned for IOxicoloaic lcstios aDdIor DNA idcntirlcation are: brain, liver, Iplcm, peoalI IlIl1Xlc, kidney, luna. vitreoul nuid. bklod, Ilomach content&, • and bile The diacetcd orpn.I are!Ofwanlcd with body MEDCOM 0167 ACLU Detainee DeathII ARMY MEDCOM 167 , AUTOPSY REPORT~(6) _ _ A,..d A!-Jawldl, RlUJtla • Personal etrects are released 10 the appropriate monuary operations rcpresc:ll~tives MICROSCOPIC EXAM'NATION Selected ponlons of orgam ~ retained In formalin, without preparation ofhistologic slides:. TOXICOLOGY AFJP ....CCClSion Number;llb}(6} Dated 7111M 2004 Volatiles: Blood and Bile- No ethanol detected Cyanide: Blood- no cyanide detected Drup: Blood- no drugs of.bulC detecled, positive for Ilroplne (a resuscitation medicalion) OPINION -!and This 75-year-old man:<bl(6) Iraqi Nalional detained at the Baghdad Ccntm Detention Facility died of&eVe11l athcrolclcrotic cardiovascular disea$/:. Hil condition "".. complicated by muted cardiomegaly. The manner of death il Natural. (b)(6) L-'Medltll EIIJIllaer MEDCOM 0168 ACLU Detainee DeathII ARMY MEDCOM 168 OEPARTMENT OF DEFENSE IIIIMn 'OIleES IldtmrTE OF ~AnlOlOOY WIlSItI'lGTON. DC 10101_ AFlr II,..-.iftoo.N....._ (b)(6) TO: Of'FlCE OFTlI£ ARMED fORCES MF.DICAl EXAl'.IlNtR AJ(M~:D fORCf:S INSTITUTE OF ,.",TlIOI-OCV WASlllNGTON. DC lQJ.06..6OOll :O,nlt ,\WAOAWAWAOl.llUSSEfN SSM;: A.... p.y: (b)(6) T",icolo\o' ..... «S.Io" II: Q&@l_ I Ihtt It.,,OI'1 (;....... ,«1: lillie 7. ~CJO.I CQNSUP't\TION REPORT ON CO~TRllIUTOR "IATf:RIAL ... "IPDI...GNOSIS REI'ORT OF TOXICOLOGICAl. £X... M.",... nON Conllilion IIf Sp"im~"J: (joon O:d~ of In~ill~nl:(b){6) :!:()O.l lhte 1te~~h'~lI: S/2712()().1 VOLATILES: TIle BLOOn AND BILE were l:nmined for the presence: nf<:IMnoI al a eUInITof20 mgldL. No dhanol \YM lIck-.;:lell. CVAN/I)E: Then: Willi 110 <:y:lllitk dcl,:<:leJ in the blood. TIle rimit of 'llWltltal;on for _ cyanide b 0.25 m&fL. Normal blood cyanide enne~~l\rutiuns are les.~ than 0.1 S mgfL. Lethal (oneenlr'tllions ur cy:m;de lIl"C ~realCr ll'llln J mglL. DltUGS: The DLOOI> W3' scrt.... nl.od f(lr acetaminophen, an,pllCl;unine:. anlidCJ>l'.'S,:ml~. 1mbiturillCS. bcn7.odi:w:pincs, unn"biooill:l, rocain..:, dc~tRH11~1horphan. lidocaine, IW«It;c analgesics, npialc~.llhcncyclidinc.llhcll(llhi~zinc:5.,alicylalt" symp:llhOlllinu.:tie IImines and "'~T:Ip:lJ11il by 1::Ili chromatol:r3llhy, color ICSI or immuno3ss:lY. Thc follo....inllll"'SJ ....ere dCleCllod: a"tihi5Iarni~. I'ositi\'e '\lropine:: ,'lropinc \\.~J.5 detected in Ill<: blood by G-" chroll131oGruphy and eonfinned by llall chromuloyraphyfl1\:tn Specll'OlIIclry. (b)(6) 1 (b)(6) MEDCOM 0169 ACLU Detainee DeathII ARMY MEDCOM 169 ... ARMED FORCES INSTITUTE OF PATHOLOGY Office of Ille Armed Forces Melileal F:ultliner 1413 Researcll Blvd.. Bldg. 102 Rockville, MD 20850 1-800·944-7912 FINAL AUTOPSY REPORT Name: Mohamed Ali. Faffiad Allcltl&te spellinp;(b)(6) Date of Birth: rWllu'KiWil Dale ofDcath:(b)(6) Dale of Autopsy: 26 April 2004 Date ofRepon: 22 November 2004 12004 N9:,:1~(b~l~I';I;= Autopsy AFIP No.: l(b)~) Rank: Civilian, Iraqi National PlaceofDcath: Mosullraq PllICC of Autopsy: Mosul, Iraq Cinu mllllnn. or DUlh; Thi. approximately 21 yearo(lld male civilian. pruwned Iraqi national. died in US custody approximately 12 hours aller being llpprehel>ded. By reporl. physical fore<: was rcqui~d during his initial apprehension during I raid. During hi, eonfmement, he was hooded.•Ieep deprived. and subjected to hot and cold environmental conditions, including l./lc usc: of cold water on his body and 1Iood. AuthorlZllllon for AUlop.y: Office oOhe Anoed Fo",e. r.tellle,,1 Eumincr, lAW 10 USC 1411 Idenllnnllon: Vi.UlII. per detention fllCilily =ords= profile obtained poSlmo~m fingerprinlli and DNA CAUSE OF DEATII: Undetermined MANNER Of DEATH: Undclermlned MEDCOM 0170 ACLU Detainee DeathII ARMY MEDCOM 170 AUTOPSY REPORT(b)(6) Moblmnl, f'arhd 1 FlNAL AUTOPSY DIAGNOSES: l. Evidenc:e ofrc:slrainl .. While plastic: "Flacurrs~ II'OIlnd uch wrill b. Abnsions and contIISions II'OIlnd wrisl$ II. Ellidmceofinjury .. MillOf abnaions aDd conlUSionsof atremitics b. ~tion abov"e righl eyebrow. I cm Co ContwionofrightUckofncck d. Minor abmions of left side: offorehud e. Subgaleal hmMll'1'Ngeofbila1cnl &ontal KgiOns of$CIIlp ( JntramuiCular hcmormageofanleriOl' &Spec! of right slloulder J. No internal evidenceoft~umI 111. No evidence of significant n.alura! disease willtin the limitaliom ort!lc exllrtlin.ation a. Cardio\l&iCular System: No specific pathologic changes (AFIP CardiOlllSCular PatholoiY amsullation) i. Heart weighl, 4S0 grtl ii. HiSlologically. left lIenlncular m)'OC)'tc h)1lCi lIophy 'alillt focal mild submdocanlial interstitiallibrosil iii. Contraclion band ncclWis. anterior riihl \ICfItncle III. Mildly lhickened intnmu~l coronary arteries II. Mild mediallhickmingoflhe linus nodal ar1ery III. Focal mild dysplasia ofpmetrating bn.nchesoflhe AY nodal artery without incruscd fibrosil in the CTe5t of tho: nllmclllar ",,,,,, b. NalfOJIalholoi}' System: (AFtPNeuropalllologyConsultalion) i. Cereb~ledem.. b~inl400gm ii. Early acute nwronal injury e. l.iller (AFlP Hepatic Patllology Consultation) i. Microlleliclllar steaCOIi.. etiology undetenninod ii. Marked congestion, likely .gon.l d. Pulmonary edema: right luna 700 gin, lcft lung 900 ¥JlI IV. Early 10 moderate decomposition .. Green discoloration of abdomen b. Focal akin Ilipplge Y. Elli<k:nce of mcdieal intel'llention •. Endotracheal tube in pIKe b. [nt~lImous catheter in tho: left antecubital fO£$l e. lnlnllenoul cal!lct" in the ria/tt inguinal region d. 'Jlu'ee adhesille EKG tabs on anterior Iorso e. Pulse o:o:imeter on left index fingff MEOCOM 0171 ACLU Detainee DeathII ARMY MEDCOM 171 AUTOPSY REPORT (b){6) MobUlfCl. F....lIId r. } Curvilinear .b~ion 01\ upper chest. consiSlenl wilh defibrillalion I. Fnclwes ohnlerior aspect orld)" rib lind ri&hl ~~. lind 6· ribs. VI. coMisle," wilh CPR C"OrlS Tox.;cololY (AFIPI ... Volaliles: Mix.ed voI.liles consislenl wilh poMrnonc:m prodllClion; matdL i. Blood: Ketone 20. 2·~17 it Urine: Kc10rIC 67. }·propanol ) b. Drup: Coosillenl willi ~scilalion elTor1ll i. Udoc.inc cklec:tcd ;n the urine ii. Urine negative for other JCl'CeIIcd mcdicallOllJ and dtugs ohb\lSC MEDCOM 0172 ACLU Detainee DeathII ARMY MEDCOM 172 , AUTOPSY REPORT (b)(6) Moblmed, Fartlad EXTERNAL EXAMINATION The body iJ!hat ofan WlClad well-developed, well-nourished male. The body wcighll approltimately 190 pounds. is 72" in height and appears compatible with the reported age of 27 years. The body temperatun: i.cold, lIut of the reliigmltion lIIlil. Rip las dipipatecl. and tile body is ftaccid. Uv;&ty is present and exeept in areas expo5ed 10 preuure. li~ed on the posterior IlUrfac:e of the body, ~ is early 10 moderate decomposition COI\S;llingoffocallkin slippage ofllle armtI. !pun dillCOlomion of the abdomen, and earlyeomul c1011ding. The sealp is covered with dan: brown luiT IIVCrlIgina7 cm in length. Facial haireonsislS of a dark muslache and dark faei.1 slUbble. The irides ue brown, and theeomeae are sliaflily cloudy. The selene and conjunctivae are pale and free ofpdcchiae. The earlobes lire not pia«d., The exlem.al.udilOtycanals, e~lerml nares and enl c.vity ate free of fOf'e;gn material and lboomtal ~tions. The nasa1 dr.clClon is ~lplbly intxl. The lips are withoul evidenl injllJ}'. The leeth are nalural and in JOOd eondition. The neck il slraighl and the lJ1IChea il midline and mobile. The chesl is symmelric and well developed. No injll1)' of tile rib.l or lIemum il evident e:w.temally. The abdomen is nal and soft. Healed surgical stIlt'S are not noted. The: exlral'liliel are well developed wilh nannll range of motion. The Iingemai~ are irUel, TlllOOSare not noted, and needle lrncks arc not observed. The el\lCmal genitalia are l/w$e ora nonn,1 adult circumcbcd male. Thc teJlelli are descended and !Tee ofmusea. The pubic llair is shlVed but il present in I nonnal distribution. The buttoeks and anus are Wll"ernat'kable. A tlg with lhe nll11e of the decedenl il JeCll~ 10 lhe riglll firJt loe.. EVIDENCE Of1I1EBA'Y There is III endollXheallUbe in place, and IIlcre are Weoe lIdhesive EKQ tabs 01\ tile body. two on the upper chest and one on the lower leftlideofthe abdomen. There is an intravCl\ClllS cl.lhe1er in the left anlccubilal fO$$l. and there i'lll intnlveoous cathCler in the riBllt inauinal region. There 12 x 6 em ov.1 eurviUne.v Ibrasion on the upper riglll side ofille chesl, consiSI wilh defibrillaJ:ion IUempts. There il a plllJe O.dmeler lIpcd over the end ofttle left index finger. There are fraclurt:ll of tile anlenor llpeel oftlle right 3" rib and left 2- -4"1Jld 6" ribl, consistent with CPR effON. i,. [Y'DENCE Of INJURy The on:k=rina of the following injuries il for desaiplive purposes only and il not intended to imply order of infliction or relative seventy. All wound palhw.ys Ire given relalive 10 sllndlll1l anatomic position. There is bilileral periorbital ecchymosis. more pronounced over the lower lilia Ind slighlly more prominenl 01\ the left lide. On the left lide of the forehead. there an: two MEDCOM 0173 ACLU Detainee DeathII ARMY MEDCOM 173 , AoUTOPSY REPORT(b)(6) Mobam"" ra,bad diagonally orienlo:d parallel, linear abruiol\$. The medial one meuures 4 I 0.2 em and the laml one is) x 0.\ an. Then: arc multiple SJMI1. ill-defined areu of excoriation and superficial abruiGn over the central forehe3f1 IlrId bridge oflhe 1M)5e. There is a I cm la<:cntionjuslaoove the laleral aspecl of the risJn eyebrow. Then: is a 6 x 6 cm red brown conlusion on the right lateral aspecl oflhe IlCCk.just below lhe angle ofthc mandible. Upon reflecting the scllp. there is bilale",l frontal subg.deil scalp hemorrhage. The mOSI prominent area is) x 2 em, surrounding the lacel1llion near the len eyebfOw. There is arl III I em faint abrasion of the anterior aspect of lhe right shoulder. ;md there ils fainl) I ) em red contusion of llIe anterior aspecl of lhe left shoulder. There is a 9 x 0.2 cm curved linear abl1l5ionjusllo the left oflhe umbilicus. There is. I x 0.) em :lbruion oflhe lower left aspect of the abdomen. Upon opening lhc chesl.llIere is inlramuscular hemorrhage oflhe anlerior aspecl ofllle right shoulder. There is. 12 x II em area of contusion and fainr abrasion on the anterior fateral aspect of tile right upper arm. There is I 6 x 2 em red eonlusion on tIw: a.nlcrior mediaf aspect oflhc righl upper arm. There arc ttuu ill·defined bands of erythema lIlld 1M eomusion over the biek oflhe feft wriSI, 7 x) em in aggregile. !NTfBNAL EXMtllNAoTION BODY tAo VITIF,Sj The body is opertlld by the usuaf t1lllfl'co-abOominaJ incision and the chest plae is removed. No adhesions arc pn:scnl in any of the body cavities. There is 100 ml of serosanguinous fluid in each pleural $pace. There is no signifieanl pcrie:lrdial or peritoneal fluid. All body organs arc p~t in the oonnil aJ\3lcmical posirion. The vcr1ebnrol bodies arc visibly and p,alpably inll;loCl. The subf;.utanClOUS f;rt layer of lhe abdominaf wall is 2 cm thick. There is no inlemal evidence ofbfunt foro: or pcnctnlling injury 10 lhe abdominal region. Ilf.ADi (CENTRAL NERVOUS SYSTEM) The scalp is rc:f1cctal. and no skull fractures arc found. The eilvarium of !he slcuJl is ranoved. The dura maier and falx ocrebri arc inIaC!. There is no epidural or subdural hcmon1l;Ige present. The lcp10mcninges arc thin and delic31e. The ecrebnl$Jlinal nuid is elcM. The cerebral hemi$phcrc:s are symmetrical. The S1ructurcs at the base of the brain, including cranial nerves and blood vel$lCl$, arc intact. Coron.al sections Ihrough the cerdll1l1 hcmispbercs revealed no lesions, &lid then: is 00 evidence of infection. lunt01'. or lIaWni- The ventricles arc of normal size. T~svCl'SC SCCIions through the bfain stem and cerc:bellum arc unremarkable. The dura is sbippcd from lhe ba.lilar skull. and no fractures lIl'C fOWld. The allanto-oeeipilal joinl is stable. The brain weighs 1400 lP'.uTls. MEDCOM 0174 ACLU Detainee DeathII ARMY MEDCOM 174 , • AUTOPSY REPORT lb)(6) Mohlmtd. Farllld NECKj Examinaaion of the soli. tissues of the neck, inetlldilll strap muscles. lh)TOid g1i111d and lqe vessels. reveals 110 1IbllOmIlIlitia. TM anterior ilnlI muscles of the nn::k an: homogmCOWI and red-brown, without hemont\lIge. The 1h)TOid W!itage and hyoid hone are intact. The larylIx is lined by in\.IC.1 while mucoa ancI ilunobs!l"UCtod. l"he thyroid gland ;, $)'Il1Illcuie and red·brown, without ey5lie Of nodular chanp. There ilno evjden<:e orinfeclion. lwnor. or \f1.UJI1'- and !he airway is pIItml. lneision and dissection of the posterior neck demonstrates: no deep pN1lleClVieal museular injury, hemorrhage. or fractures orllle donal lpinouJ proc«SCS. CARDlQVASCULAR SYSTEM; The pericaniiaJ Jurfaces are Sll'IOOIh. IlisU:NlIg and urnm:llbble: the periQrdial sac i. free of significant nuid and afhesionL A mocIc:nle amourM of epicardial fal ill pRSCflt The corona:y arteries uiiC IIOmIIJly. I'ollow the lISl.W distribution and an widely palmi, wilhoUlcyidenee of sisnllieant athmlsclel'O$is Of lhrombosis. The dwnbcn: and ~Ivcs nllibil the u.sual,@position rewiOll5hip and are ~ The m)'OQl'llilim is dirk red·brown. firm and WlRfIlaJUble:!he atrial and ventricular ICpU. are intact The lel\ ventriele i. 1.3 em in thickness and lhe righl vc:ntriele il 0,4 an in Ihicknes5. The aorta and its majw branches ariK normally, follow the lISUII QJIIne and are widely paler11, free of .i.,u6canl ~Iherosclerosisand other abl"lOlmilJity. The _ QVile:and their major tribllltries return 10 the h=t in !be uslUll distribution and are free ofllwmbi. 1M heart wei;hs 4SO grams. Sec ·'Ca.rdfovucular Pathology Rcpo"~ below. REsrl RAIQRX SVSTEM: The upper airway is dur of debris and fomgn matmal; the m_l surfll:cs are JmOOlI\, yellow.taft and unremarkable. The plC\UlI surfaces are smooth. lfIiSlcnilll and UIIl'CmarkabJc bilalerally. The pulmona:y puadl)111l i, red·purple, exudina mocIenIe ilTIOUniS of bloody fluid: no focal lelions are noled. The pulmonary artmes are normally developcd. palCl'11 and wilhoul thrombUl or embolus. The rishl lung weighs 700 arams: lhe left ?OIl JI'WTII. LIVER &. BILIARY SYSTEM; The hcpatie eapsule il smooth, alistming and inlleL eovering dartc red·bnr.vn. moderately c:angcstcd. parcnehyma with no focal lcsiOlll nOled. The pllbl:addcr eontains 10 ml of grcen-brown. mucoid bile; the m\llCOU is velvety and unremllritablc. The exUlhcpalic biliazytRe is palent, wilhoul evidence ofealculi. The river weighs 1450 gams. ALIMENTARy TRACT; mns. hemonh&&c. or other injuries. The esophagus is lined by pay-white, IIl'IOOlh mueosa. The psrric mllCOSl il &rIlI111cd in the USUI! ",pi foltls and the Iumcn ill asmlially ctnpty with only a film of muco.... The Imlll and lUi': 00-1 iIt!: lUImTlaIbble. The pancraI hal a normal pinlt.lart lobulated apJ)CIlI'al>CC iInClthc ducts are clear. The appcndia: il prncnl and is unterl\lricable, The IOngIIC il fi'ee of bite MEOCOM 0175 ACLU Detainee DeathII ARMY MEDCOM 175 AUTOPSV REPOKTf(b)(6) 7 Mobamed. Fnhd GeNITOURINARy SYSTEM; The renal cllp$ute;, are smooth and thin, semi-transparent and strip with case from !he underlying smooth, red·brown cortical surfaces. The cortices are lIIarply delineated from the medullary pyn.mids, which are red-pulllle 10 Ian and lIlUemarkable. The cal~, pelves and 1Ifda-s are wlI'~lTwbble. White bladder mucosa overlies an iIHad bladder wall. Thc urirwy bladd« contains 200 ml of dear, yellow urine. The pr05tate gland is nol1Tl.al in size, lIrIml\arkablc. The Icslcs are withlobulilT, yellow-till p#CllChyma. The seminal \'csicles ftee of mass lesions., contll5ions., orother abnormalities. The ri~l kidney weighs I SO grams: lheleR t60gnms. = Rt:T1ClILOENDOIHELIAL SVSTEi'li The spleen has a smooth, intact capsule covainll raj·purple. moderately finn parenchyma; lhe lymphoid follicles are W1I'emlliable. The tcgional lymflh nodes appear normal. The spleen weighs 160 p1I$. f:NpOCRINE SYSTEM; The pituitary, thyroid and lIdrenal glands are untcmarklbl~. i\lUSCUI,OSKELEIAL SystEM; Muscle development i5 normal. No bone or joint allllOmlalilies are llDled. MICROSCQPIC EXAMINATION HEART: See "ClIIlliovasculllJ Pathology Report" below. LUNGS: The alveolar spaces and small air passages are expanded and conlain no significant inflammatory component or edema Ouid. Thoe alveolar walls are thin and stighlly congested. The 3tIerial and \'COOUI vascUlar systems are normal. The pc:ribron<;hiallymphltics are unremarkable. UVER: The hepatic an;hilettUtc is intllCl. The port31 areas show no incrused infilUMlatOl')' component or fibrous tilSUC. The hepatic parcnchymal cells arc wellpn:scrved wilh no evidence of cholcslllSis or sinusoidal aboormalitics. Sce "Hepatic Pathology Repon" below. SPLEEN: The cajnulc and white pulp:ft un.remartable. There: is minimal congeslion of lhe red pulp. TESTES: Unremarkable. THYROID GLAND: Unremarkable. "DRENALS: The conical:tOnes:ft dislinclive. and lhc medullae are nOl remarkable. MEDCOM 0176 ACLU Detainee DeathII ARMY MEDCOM 176 • AUTOPSY REPORT(b)(6) Mobamtd. Fnbad KIDNEYS: There ia moderate autolysia. The subcapsular tonc:l are unremarkable, and the Jj.IomeruH are mildly lXlf1iested without cellulv prolifeRlion. mesanpal prominence, or Jelerosia, TIlere il no inlelltitial fitmnil or s.ignincallt inf\ammllion. Then: il no thKkenina of the walls of the ll1erioles or SlTllllI anerial dwlnels. BRAIN: See "NeuropllholoiY Report" below. CARDIOVASCULAR PATHOLOGY REPORT Oqar1ment ofCardio...asc:ul.,. PIlhoIoBY, MIP: "AFIP DIAQNOSIS: (b)(6) No specific pathologie ehanses HillAry. ABb male dehlinee, death in eustody tIua: 4SO vams; normal epic:ardial fit; c\o$ed foramen O\IIle; nonnal eardiac: ehamber dimensions: left Y1:ntriclilar ca...ity diameter 30 mm.lcft ...entricular frr:e wall thickness 13 mm, ... ~riclllar sepllIm tlUekness IS mm; righl ventriculardilllItion: righl venlricle Ihickness4 mm. without groll Jean; or abnon'llal fll infillrales: BJOssly nonna! "'Il...es and endoeardium; no groll myoc:anlialfiblOlilor nco:rosis; histologic sections show left ...entricular myocytc hypcrtrophywith foal mild lu~iaJ in1efllitialfiblO$is; lXlf11rXlion band necrosis, anlerior ristu ... entriclc; II'lildly thickened intnmural coronary arteries Coronvy Meriel: Nomuol oSlia; right dominance; no iJOIIllhcrosclerosis CondUCljon ''fI!m: The linoatrial node is histologically Ilnrcmarhble, bUllhe«: is mild mcdiallhickenina of the linU' nodal anay. The compillClalrio"'cntricula, {AV) node $howl mild fragmentation (MalWm fibcrs)wilhin!he central fibrotl$ body, but ia otherwise unremarkable. Thc pet".clJllini bundle is centrally located withoul inflammalion, increased fll, 'lUCulirity or proteogl)'Clll. The pTDximai bundlc branches Ire intact and unremarkable. There 's focal mild dysplasia of ptnctratina branches ofthe AV nodal artcry, but no significanlly increued fibrosis in the crcst of lhe ...entricular $eptum. CommeOl; The heart weisht of 4S0 anms may renco:tl(lmedcifClC of lell ventricular hypertrophy, dependina on lhe subjoct's body weillu," NEUROPATHOI.OGY REPORT Department or Neuropalhology and Ophlhllll1ie P1lholoIY. AFW; I "NeuropalllolOiY conlull (b)(6) We re...iewed the Ii... e H&E stained mieroscopie seetions aubmitted in reference to Ihis case. Microscopic seclions demonstrate multiple 1ICCii0ns ofitey and while matter. cerebellum and spinll cord/modulla. Sections show widened pericellular and peri... ucul .... Spices and MEDCOM 0177 ACLU Detainee DeathII ARMY MEDCOM 177 AUTOPSY REPORTi\"fbbj><iO"'=== Mohamed. rarhad 9 scattered neuroll$ with cytoplasmic eosinophilia and shrunken, pyknotic nuclei, moSI prominent in !he dentate nucleus and cermeJlum. These morphologic features represent cerebral edema and early acute neuronal injury. This material was reviewed in conference by the stafTOfLhe Depanmenl of Neuropathology and Ophthalmic Pathology:' HfiPATIC PATHOLOGY REPORT Division of Hepatic Pathology. AF1P: "Liver: (I) Microvesicular stcatosis, etiology lmdetennined (2) Marked congestion Some tOllins ean cause microvcsicular fat. usually &SlIocialed wilh profound metabolic disturbances, but it can also be stress-related. There is no way to distinguish between these by histology alone.. The congestion is presumably agonal. There is some lipofuscin pigment in centrilobular hepatocytcs. but no bile stasis. The Masson stain shows no fibrosis to suggesL underlying cl\ronic livCT disease. The PASO and iron stains show no lipofuscin or hemO$idcrin laden macropbages Lo sussest hepatocellular necrosis." ADDITIONAL PBOCEDYRJiS Documentary photographs arc l..JIen by OAFME photographers Sp«imcm retained for toxicologic Lesting and/or DNA identification arc: vitreous fluid, hean blood. urine, bile, $pleen, liver, lunll, blllin, kidney, and psoas musclc The disS«tcd organs are forwarded with the body MEDCOM 0178 ACLU Detainee DeathII ARMY MEDCOM 178 AUTOPSY REPOR1\b)(6) Moham~, Farhad ::.:J 10 OPINION Based on available investigation and complete autllp5y uwnination. no <.Icfinitive .:ause of death for Ihis approKimately 27 yeal"-old male Iraqi civilian in US custody in Iraq could be determined, There is evidence of multiple minor injuries: howevcr, there is no definitive evidcnce of any lrauma significanl e:nough to eKplain Ihe death. TIte injuries indude bilateral periorbital ecchymoses ("blackeyes'l: abrasions and contusions of the face, torso,;md eKlremilies: contusion of the side oflhe neck: and subgaleal hemonilage orthe scalp, There is evidence ofres1rain~ consiS1;ng or"neKicufTs" around the wrists with associated minor contusions, and asphyxia from various means cannot be completely excluded in a restrained individual. There are non-specific cardiac findings, including mild medial thickening of the sinus nodal artery and focal mild dysplasia ortlle penetrating br.w:hes of tile atrioventricular nodal artery. However, there is no associated increased septal fibrosis. which can be a potential substrate for cardiac antlythmia, There is no gross evidence ofatherosclerosis ofthc coronary arteries, A cardiac arrhythmia related 10 various ion ehannclopathies OT corona.ry vasospasm c:mnol be eKcluded. The: decedenl was al$O subjecled to cold and wet eonditions. arid hypothermia may have contributed to hi. death. Therefore, the ClIUK of death is best classified as ulldetenninCll, arid the manner of death is Undetermined. (b)(6) (b)(6) Medical Euminer MEDCOM 0179 ACLU Detainee DeathII ARMY MEDCOM 179 DEPARTMENT OIF DEFENSE All_ED ~ INSmuTlllf '41MOl.OG'1' W,ullllillOii,De 21... III AFrY. (b)(6) 'AIIIan IOErqlllCAI,ON An' Ac,",loft. N~ ..IIt. s.q...a.. (b)(5) "" N.... MOHAMED. r4SHAD OFfiCE or THE ARMED FORCES MEDICAL EXAMINER ARMED FORCES INSTITUTE OF PAT1fOLOGY WASHINGTON,DC 211JOllillOO SSAN' AYlOptE ,(b){6) T..lle• ....,. A.........: .lbK6) Itopor1 D.c., IotAY 11 2004 CONSULTATION REPORT QNCONTRIRUXOR MATERIAL AflP DIAGNOSIS REPORT OF TOX1COLOGIC4L EXAMIN4TION Condition of S~ti.mcnl: GOOD Date .fTDclcknll~~L)OCM Date Rrcelnd: Sl312004 VOLATILES; The BWOD AND URINE wcneumincd (or the prtsence of ethanol (cutoff 0120 msldL). acetaldehyde, acetOflC, 2-ptOpaIlOl, I-propanol, t-butanol. 2-butanol. isobulanOl and I-butanol by hcadspaee g.u dIromalOil'aplly. The (ollowing volatiles were detected: (COllCClltmtiOn(S) in mgldL) A_ BLOOD URINE 20 " ,, 2-PropanoI DRUGS: The VRINE wa.I serttned for acctamirIophcn. amphctlm.ine. antidqnessanl.l. antihistamines, bart!itw1lICS, bcnzodiu.cpillCS, cannabinoids. cocaine. ckll.tromeihorpllan, lidocaine, narc:olic analKcsics, opiates, phencyclidine, p/lenothiwncs, $IlieytalC$. sympathomime'lic aminu and vetlpltllil by SIS chromatopp/ly. colo. tcst or ill\tTlunoassay. The (oUDWin; drugs were detttTed: Positive Lidocaine; Lidocaine WIS dclCCted in the wine by guchromaloinlphy and confirmed by gas chromatography/mass spectrometry. (b}(6) (b)(6) MEOCOM 0180 ACLU Detainee DeathII ARMY MEDCOM 180 ·.~. ARMm FORCES INSTlTUTE OF PATHOLOCY Onke of till Armed FoTta Mtdlul ElIlDller 1413 Rnan:k Btvd.. Bide. lin Rod(~llle. MD 101S0 1-100-944-7911 PRELIMINARY AUTOPSYEXAMlfiATION REPORT Nallle: Abbu. Moharnad Abu! Autopsy No.lltb}(tI) SSAN: PrisonerNumber{t!ll§L An' No.: Pend!n, o.lf-O'BIrtll:LblI6) 194B Dale ofloddtor,Jb}@ '2004 DIIllorAulo,.,: IOMAR2004 DI'e (lrJleport: II MAR 2004 Rnk: EPOW Plitt of De-Ill: a.ahdad.lraq PlutorAuloPl)': Baghdad Intcmaliolll.l Airport OretnUllaca orOnlb: Clmllllll.lca of Dellb: This '5-year-old male Enemy PrilOller ofWu had. hi&lory ofisehemic heart dllUSC. Hil pas! medical history ilK:ludes hypertenlion, hypcn:holesten:llemia,.oo posaibly two prevklua myoeardial infarctions. Hil mtdicatiollll included 'lenolal. Zocar, and aspirin, IS well as lubllnaual nilfO&lyeerill as needed. On the eYenlng o/(b)(6) 2004 he complained ofchesl pain and IIlortnesll ofbrellh. He was Imluahl to the medical clinic for evaluation w'here he became unresponsi~. Rcsuseillltioo efforu. ine1udina Advanced Cardiac Life Support at • mediCi! lteItmenl (.dlily, weR unJllCcesaful, AUlboriDdol for AUlo(IIY: Armed Forces Medical Euminer, per 10 U.S. Code 1411 Idullfkatiolll Identification is obtained by paperwork aecompanylng tile body, including a photograph wilh a matchina pri_ nwnber. MANNEROVOEATH: Na.. ~1 TIIISI Dadl.., an pnllmiul)'.ud .ull}ed III ..ocIIlklIllou ptlldll. filrtbcr 1a"..llptiH ..d 111110",101)' _till.. MEDCOM 018\ ACLU Detainee DeathII ARMY MEDCOM 181 2 ABAS, Mobomad A. [<Df(6) - PRELIMINARY AUTOPSY DIAGNOSES: Aibenlllduollc Cudlovucalu Dlnue I. A. 8. C. D. E. HIllOry ofmlle..lc bean db_ Clrdlomttlly, IDIrtud (btlrl wdlbl620 IU..I) COroDIl')' 111Itn»c:1tnllis, focilly .... e~ DllYuH myocardlalsclniac ArterioDtpbl'Olderosis, mUd II. Marked 'ulmo. .l')' Ede.lDll III. Remote peIIetntlDI blUlsdc lajury of tile left bllttock A. Eatuou: I.rerlor-mtdllli IIptd of left buttock (sclr) B. WOlad Pltb: Sltlll. subcullatoal Ilpu, lad muscle of Itft buttock, mu.clt of prcuflmll Idt Ibicb C. Recovered: MrtlWc (onlcD body eOCllplllillltd III fibrO\ls IISIlIe ",Ubla mOlclt af praxllllllltft ~l&b D. Waolld DlrKlloo: Len la rl&~t, blCk 10 froot, lod dowa"'lni IV. Frlctlres o(!be ~ lad 6 rlbl oa tbe rllbt, _llltd wltb btmorrbl,e lalo dlnl "'IU mllcullture lid IbrlSloDlilbermlllDjlry oftbe cbnl (raulCllltlOll drorb) V. LI«rllJoo oflbe OOH lad Ibrasloll oflbe rlgbl ludex fioler VI. TOlllcotoc 'eDdln, Q (b)(6) (b}(6) Depal)' MedicI! EllImJur MEDCOM 0182 ACLU Detainee DeathII ARMY MEDCOM 182 , ARMED FORCES INSTITUTE OF PATIIOLOGY O~ o'lb~ Armed Fon:n Medkll ElI.mlller 1413 Research Blvd., BId&- 102 Rocll;ville, MD 20850 1-800-944-7912 FINALJI,.UTOPSV EXAMINATION REPORT Name: BTB Abdullah, Sud Mohammed SSAN:N/A ~ Date of Birth: Erm (b)(6) 1950 DatcofDeath7b)(6) 2004 DfIte of Autopsy: 28 FEB 2004 Dale ofRepol1: 25 JUN 2004 ~ ~ ~'~(b~)(;6);=:::j Autopsy NOO.. "FIP No.: ~b)(6) Rank: Iraqi Civilian Place of Death: Abu Ghraib Prison PI~ of Autopsy: SlAP Monwuy Baghdad Airport. Iraq ClrCllmslallCC'S of Dtalb: This believe<! to be 54 yel1r old Iraqi male civilian ....:15 • deuinee of the U.S. Armed FCKt:e5 at Camp Ghanci. Abu Ghraib Prison, Iraq, when lie was brought to the main pte unconscious by other detainees. The decedent reported IIIl inability to urinate to medics culier on the day ofllis death. When broughtlo llle gate the othel" . detainees reported the decedent W8$ diu)' and nauseated prior to Io$ing. ConSCIOusness. AUlhoriJ:lltlon for AUIOPSY: omu ortlle Anned FolU5 MedicJl Examiner, lAW 10 USC 141\. IdenllrlCatlon: ldc:nlifiealion is nttlblisl1ccl by visual CXaminalion by CID agents. CAUSE OF DEATH: Acute Peritonilis scwndary to Perforating Gawic Ulcer. MANNER OF DEATH: Natural MEDCOM 0183 ACLU Detainee DeathII ARMY MEDCOM 183 , AUTOPSY REPORT (b)(6) BT8 Abehlll.... Sud Mohammed FJNAL AUTOPSY DIAGNOSES: I. Acute Peritonitis_dary 10 Gastric Ulcer pcrr~ion A. PerfOllllina pwic ulcer orp)'1orie repn of 1M Ilom.cll -oc:i:atcd wilh 900 mIl orpurulcnt lIKilQ and IibrillOlll alldlle on the surflCe of llle inteslines, liver Inclspleen. II. Mild Ilhm:tsclaosis orlhc ri&hl c:oronllf'y ~tr)' « 2S% stenosis). III. Dense fibn:lllS Idhesions ortlle left lWllllO the paliN! pleuf1l orlhc left hemilhotalc. tv. Milddccomposilion. V. Toxicology is neplive for ethlll'lol. drup orlbuJe Ind c)'lInidc. MEOCOM 01&4 ACLU Detainee DeathII ARMY MEDCOM 184 3 AUTOPSY REPORT (b)(6) BTB AWalla., Sud Mobammecl EXTERNAL EXAMINATION TIle body is lhal ofa well.oevcloped 11 In illth ione. 18S-I90 pounds (estimated) mak: Inqi dvilim whole ~e il oonIiSlc:nt,..jth the reponed 1ge of S4 yean. Uviclity beaolllCof dart 5Idn piamentlliion IIld cufydccompolition. Rip il _ily broken, IIld the tempetature it ambient. Marbling ofllle Kin orllle anm, abdomm ~ lower lei' _ (OItIislent with cufy dec:om.poIition changes. is llimeullto _ The lealp is coveml wilh bhK:k and ltIIy IIllir in a normal diltribution. The irides Ire obllC:umf by eloltded c:orneIlI but appev d.alIr: colored IrId the pupilllppcar round and equal in diameter. The conjundivK Ire free orinjuries. The e:ttenulalll!ilOryeanals Ire city IIlCI Cree orJbnonnal scc:retionJ. The left ear il mlssina the lop portion of the helix (remote illiury) and !be ri&hl ear is unrenwbble. The IIIteS Ire palent,the lIIJ.Illeplum is inl*:llrld lhe lipllre atmJmatie. The nose and nwdlllC: Ire palplbly ItIble. The teeth IppCU IUIlum and in Cair repair. The nedc ililfliaht. A 0.7 x O.S em I\eYUI ilon the posleri01 neck. The lnehero il midline IIlCI mobile. The ehest Is l)'IItITIdrie and rree or utemal injuries. A S.2 x 3.1 em oval arel oChype7pigmented lkin lion lhe rigltllideoCthe abdomerL The Ibdomen il Oal IItd rrc<: or palpable masses. The genitlliia are those ora 1'10OI\I1 adull eireumeised male. There Ite mulliple pinlc (hypopigmented) ueas ofskin on the glans penis. The tesles lite daemded and rrcc ormaue.s. Pubie lIair i. praent in I normal distribulion. The left bUllock h.. I 4.9 x 1.9 em oval lear. The InUI i.ltraumatie and hll non-lhrombosed exlcmaillemonholdi. The upper and lower c.lternities Irc symmetrie and wilhout clubbing orederna. The linsemlill are ehippinS and spUlIins and tile web JPaeeI between llle Iinael'5 und loea Ill: free orinjuries. A 9.S x 3,S lrreau1ar sear il on the Interior IateralllpCCt ofthe lell thigh lIlCIa 5.2 x 2.2 em Kif' il immediately below the left knee. CLOTHING AND PEBSONAL EFnCTS The followinS elothina itemlllld person.1 elTcclI arc PfQent on tile body lithe lime or .utopsy: The decedent waI received nude for .ulopsy Ulminalion. MEDICAL ImRVENTION There Ire no medical applianees on llle body 'lllle lime orlutop.y. Cardiopulmonary te:luaeil.tion w. rcponedly done 1\ the time ortlle decedent'l eollapse. RADIOGRAPHS A complete set ofpoalmOl1em radioBflPIu i. obUined and Air IInckr tile di.pllraam No tona bone l"racturea or Coreian bollia. MEOCOM 0185 demonat~tes the rollawinl; ACLU Detainee DeathII ARMY MEDCOM 185 AUTOPSY REPORT (b)(6) BTB AbdIlU.Il. S.lId Moll.mmed • EVIDENCE OF INJURY The orderin. ofille followin. injuria il fOfdescriptive PUlJlOsei only, and ill not inlended to imply order ofinnic1ion or relative ICVcnty. All wound pathwa)'S are liven relative to 51andanl.,atomic position. INTERNAL EXAMINt\T'Q~ HEAP: The lIaleal and subple.J.on tissues oftlle scalp arc rue ofinjury. The calvarium Is intact, u Is the dUI1l mater benealh It. Clear ecrebrolpilllli nuid IUffOIlndlthe 14SO wn bnin. which is soncncd. discolored and has lIlIm'Ililrkable Il)'Ii and Slllei. Coron.1 sections dcmorutl'lle shaf1)demarcation bctwftn white and ,""y maUer. withollt hcmolThaac: or eont\ll;ve Illiul)'. The vcnlriclcs are of normal siM. The bull pnaliu. bl1linstem, cerebellum and uteri.1 Iystems are flft of injury or other Ilbnol'll\lllities. 'T'IlcK arc no skllll fracturn. The atlllllto-oeeipi\.ll jo;ntll 11111 Ie. """', The anterior Itl1lP muscles or the neck are homolC"lOUS and led·brown, withotlt hcmontlsge. The thyroid car1ilage and hyoid bone arc inIac\. The larynx illinec:l by inlaCI pay-white rnuCOSI. The lhyroid &land ISlymmetric. red-brown and wilhout c)'Slic 01 nodular change. The ton&uc il fAle of bite marks, hcmontlage. or other injuries. BODy CAVITIES; The ribs. sternum, and vertebral bodies are visibly and palpably intac\. 'The: right pleuflll cavity containllppfOaimately <tOO ml of bloody nuid. The pericardial sac cont.ins approaimalely 30 ml of serosanguineous nuld and the peritone.1 cavity contains approaimalely 900 mJ of purulent ascites. The organs oe<:llPy their IIsual anatomic positions. RESPIRATORy SySTEM: The niht and len lungs each weish I tOO gm. The ClltCl'TLQllurfaccs ale lmooth and deep red·purple. The pulmonary parenchyma i,diffusely C1lllgesled .nd edemalOUs. The len lunt: is densely MlhCft:ntlO the panet.1 pteul1l of entire len Ilemithonu:. No mill lesions or arcu ofeonsoticlation are presentln either lunj.. CARplOyASCULAR SYSTEM: "The 475 am hean is cont.incd in In int~t pericardia. SIC. The epic~rdill sur(ll:e il $rlloolh. with minim.1 fit investment. The Cororlary ."cncs are present in a normal distribution. wilh. rigbt-dominant paUcm. Cross sce1Mms of the vessell.now mild .thcll)l(:lcrosis (< 25% stenosis) ofthc len IlIItcriordesccndina branch ofthc len coronary utery lind nallt coronary utery. The myocardium is hOlTlOllenQus,l'lld-brown. IJld lirm. The valve IClf1ets are lhin and mobile. The walll of tho len Ind rillh' vcnlriclcs arc: 1.2 and O.3-em thick. respectively. The endocardium is smooth and MEDCOM Ot86 ACLU Detainee DeathII ARMY MEDCOM 186 , AUTOPSY REPORT (b)(6) BTB Abdull.b, S..d Mob.mmed alistcning. The aorta aives rise to tbree inlaet and palent areb vesselsancl has mild atberosclerosis. The ~nal and mesenteric: vessels a~ unrc:mmab1e. LIVER It. BILiARY SymM: The 1275 grn liver bas an intICt, smootb capsule and a sharp anterioroorclcr. The parenchyma is tan-brown and congested, wilb the usual lobular an:hitel:lure. No man lesions or other abnonn.lities '"' _no The gallbladder contaIns a minute amount or green-black bile and no stones. The gallbladder mucosallurrace il ~ aBel velvety. The extrahepatic biliary tree is patent. SPLEEN; The 175 gin Ipleen has 'Imooth, intICI, reel-purple capsule. The parmehyma is maroon and congested., with distinct Malpighian eotpllKles. PANCREAS: The pancreas is firm and yellow-tan, with the Ulual lobular an:hitecture. No mass lesions orotber abnormalilies are seen. AD&ENALS: The right anclleft adrenal glands are lyJlunetric, with bright yellow conkes and gray medullae. No masses or areas ofhc:morrllqc are iclmtified. GENITOURINMY SYSTEM; The right and leR kidne)'l weigh ISO gill and t30 gm, respectively. The exlenlallurfaces Ire coarsely granular. The cut surfaces ore reel-tan and con&eSled, Wilh uni formly lhick cortices and sharp conicomeduHary junctions. The pelves '"' unremarkable and the ureters arc nonnal in course and caliber. White bladder mUClml overlies lUI 'nlacl bladder wall. The bladder contains a scant amount of urine. The prostale il nonnal in size, with lobular, yellow_tan parenchyma. Thc scmiMI vc:sicles are unremarlcable. The Icstes arc: free ofmau lesions, contusions, orother abnonnalilics. GASTROINTESTINAL mAeT: The esophagus iI inlact and lined by smooth, gray-white mucos;l. The stomach contains no food. A petforating ulcer, 1.5 x 1.0 em on the mIlCQ5l1 surfllCe of the stomiloCh and 0.6 x 0.6 em on the scroaalaurface, is in lhe pyloric repon oflhe stomach. The greater omCl1lum is adherenlto tile serosal surface of tile s10maeh andaurrounds the pcrforolion of the stomach 10'.11. The abdominal cavity contains llJlP'Uximately 900 ml ofpurulenl ascitcs and fibrinous material covering the intCSlines, liver. and spleen. The duodenum, loops of small bowel, lUld eolon are unmnarlr.ablc. The appendix il Pl'C$col. • • • ApDITIONAL PROCEpURES Doc:umenWy photographs are lakcn by an OAFME pholograpllcr. Specimens retained fOl"toxicoloaie testing and/or DNA idCl1tiflcalion are: blood, splcen, liver, lung, kidney, brain, bile, gastric conlents, ill'ld psoas muscle. The dWccled otpnlve forwarded with body. MEDCOM 0187 ACLU Detainee DeathII ARMY MEDCOM 187 AUTOPSY REPORT (b){6) BTB AbdoUab, Slad . ... Moh.l~mC=~ • 6 elTeellI are releued 10 lhe appropriate mortuary open.tiollll representatives. ~nal MICRosconc EXAM!NADON Selected portiON oflllJlllS are retained in formalin, without preparation ofhistologie slides. MEDCOM 0188 ACLU Detainee DeathII ARMY MEDCOM 188 AUTOPSY I REPORt~b){6) 7 BTB Abdullah, Sud Mobmmed OPINION This believed 10 be 54 year old Iraqi mille died from acute pcritonilis (innammation of IIIe abdominal tIIVily) thaI was Cluscd by IIIl ula:r Ihllt perforated lllrouiIJ lite stomach will. The &Ulric contents and secmions spilled inlo lhe Ibdominll tllvity causing lhe innammalion &lid infection. The d«edenl was IIlOitlikely septic (bacteria in the blood sYSlem) and lhat caused his dehydration and kidney failure. His kidney failure \VlUi manifcatccl in his inability 10 form urine. Kidney flilure would then cause acidlMsc derangements. wltich then caused a fllal etlrd;oc arrhythmia. The manner of death is natul'lll. (6)(6) (b){6) MEDCOM 0189 ACLU Detainee DeathII ARMY MEDCOM 189 _-_ nII_. . . __ . - _.-... ....--- ............ -...,eM" ---"'-...--. ...," -,". _.-,... ---_. .. ... • ._. -_ . __ . _-.. _. -_. _-- - - ---_.- _....- ..... -"""-----..._........ _._olio__.. . __--- ...- -.... -- -_ _ ......... _. ... __..._-....--. -..-...- ----"'-...-"--....-_ . .-.-,-..... _"' _.--_ . .... _- ...... _--• .---- -',_.....-- --.1;-" -- -_....... _ ......... _ .. .,-_ ................._._ __ . . .. -_ .... . _. __ ... _-_. ... I.. ..........- _. -,--...... --_ ....._ _ ...__ . __ .. ",--_ ... _ ...... _ ... _-,_. - ......._......_...... ._._ _----_...._. _.._-_._.-..... _... _.- .... _. __. _....... ", CIl' 0IIII,"1'0'''1&''' ___ -"'II. l3T8 AbllIIWI, Sucl. Mohemmed , ,,,,,, Ii:! 0 "....... '-' l(b)(6) _ ....t."" "" ~ ~- -.. "_"0 ...._"''''C...... G'_ _l ~ ......... .--_ D' ... e -.. _ _ _ _ .. _ ~ '00-......_..._ ...' p", IloiIlia 18COIId.., to ••..J -~-- • -~ ...-" _ .......0 ~0 . ,(b)(6) 21 ,tIb2lll)l . l'r~{:;\-2&):i'·~·"-- , .... ,... .......",. (b)(6) [(b){6) •• 1 "".~ <+ DOIlll'l.20 I~:"-'" Al:v Gtnlb ,...,. _ --~- .-. ..... _ _ me • .,. _~-_._ _._-~._- t....._ .. _ _ , ~_ tl.d'e"~ 00¥er Af'B. DE lt9D2 (b)(6) -_-.n. .......,..... --,~totleM'tmI!t"'"· ..... ACLU Detainee DeathII ARMY MEDCOM 190 , , ARMED FORCES tNSTITUIE OF PATHOLOGY omre orlb Anned FOrel!l Medkal En.mlller 1413 Resean:h Blvd., Bldg. 102 Rockville, MD 208S0 1·8(1().944-7912 FINAL AUTOPSY EXAMINATION REPORT Autopsy No.: (b}(6) Name: BTB Ahmed, Hassan Ebb I -----.J AFlP No.:I-<~l@ JUnk: Iraqi Civilian SSAN:NIA Dale of Birth: B:ta 1943 Date orDeath:J~)(6[:2004 Dale of Autopsy: 28 FEB 2004 Dale of Report: 29 JUN 2004 PllICe ofOeath: Tikril,lraq Place of Autopsy: BIAP Mortuary Baghdad Airpon, Iraq Cin:ullUlan«ll of Delich: This believed to be 61 year old male lra.qi civilian was a detainee of the U.S. Anncd Forca It the DetentIon Central Col1eelion Facility, Tikrit, Iraq when lie was diKovcred deceased in his bed when he failed to rcpon 10 the morning bead count pmc:edlll't. The deeedcnl iqIOl1cd a medical history of diabetes and renal disease at the lime of his CIIprure. r AUlhoriutill. for Autopsy: Office of the Armed forces Medical Examiner, lAW 10 USC 1471. IdtllliflCIIUon: IdenlifJelltion is establisllcd by visual cxamil\lltiol'l by elD agents. DNA testing was pc:rfoJmed and is on file f"orcomparison should elCemplars becomc aVililablc. CAUSE OF DEATH: Atherosclerotic Can!iovucular Disease MANNER OF DEATH: Natural r MEDCOM 0191 ACLU Detainee DeathII ARMY MEDCOM 191 AUTOPSY REPORT (b)(6) 2 BTB Alllned, H _ Ekab FlNAL AUTOPSY DIAGNOSES: l AlbetoKlcrol;e Canliovueular Di$ea$e I. Moderate ealeificd alhcrosclerosis of the right eoronary .net}' (50% .Jtenosis), the left eifQlll'\fiex ('0% .Imoail) and left anlerior desc.ending branches ofllle len eoronlf)' Il'tety (* 7'% rtenosi.). 1. Moderate ~ie atherosclerosia with bilateral renal artery takeoff stenosis. l. Bilateral renal atrophy with U:r.lnllarenehymal arteriole Ilherosclerolia mid marltcd anerionepllroseleroli. and eortieal ",0. 4. Cn.nialll'tety atherose~ oflhe vertebn.l, blililar, polterior eommuniealingand middle eerelnl arteries. D. Mild 10 moderate deeomposition. 1II. Toltieolo&)' is positive for ethanol, Ketone. j·propanoland aeetaldehyde (u.rinc only) in lbe blood and urine. ONp ofabule """ not detected.. r MEOCOM 0192 ACLU Detainee DeathII ARMY MEDCOM 192 AUTOPSY REPORT[(_",,"C-'_ _ 3 BTB Abmed, H...all Ekab r EXTERtlAL EXAMINAIION The body ilIlhat or. cachctic mille InIqi Mtional. The body ....eighs approximately IJO pounds, is 69 ~ inches in Ienilh an4llppW'5 the reported ageof61 yean.. The body tcmperalure is ambient. Rigor b presenllO an equal degree in lilt extremities. Lividity is diffieulllD assess because of dark Kin pigmcnlllion bul is present and lixed on the poskrior surface ofthc body, except in u=sexposed lopre$SUfe. There is mild to ~Ie deeomposition ofthc body with muofskin slippase on the posterior SClIlp,lhe right wrist and anterior right lowe!" leg and marlliing of tile skin of lite back, buttocks, posterior surface oflhc arms and legs. palms ofthc hands and the abdomen. The scalp hair;s black and gray and lhedecedcnt hM frontal baldness. Facial hair consisu ofa fiJlI gray and black beard and mllS1aChe. The irides are brown. The comeae are slightly eloudy. The c::onjunctivlIe aM heofinjuries and hcmon1lages. The sclerae are ~ of hemorrhages. The cltlCl'ml auditoryeanals, extemal nares and oral cavity are free offoreign material8Jlll abnormal sec:n:tions. The naslIl !leJllUrn and SkeletDll is palpably intact The lips are without evident injury. The lcdh arc natU"] and poorcondilion with multiple WIJqllIIired caries. Examination oflhc neck reveals no evidence of injury. The hyoid bone and tIIyroid cartilage are intact. The chest is 1m: ofll\lurics and dcfonnitics. A 3.3;1t 1.2 em oval scar is on !he anterior !ell coital mJJgin and a 3.2 x 2.3 em oval.car is in \he: lell upper quadrant ofthc abdomen. No injury oflhe ribs or sternum is evident externally. TIl<: abdomen is nat and li= ofpalpab!e masses. The Qtemal genitalia Ife lbo5e ofa nonnal cireumcised adult male with bilalel'a1 dcscc:nded tc$IeI. The testes are free ofpalpablc masses. The bUllOCks and anus are unremarkable. The Clltremitics show Injuries that will be desc:ribcd below. The fingernails arc inlllcl An 11.5;1t 4.5 em &rCII and an area of1.0 x 3.0em ofnon-dcscript black ink writing is on the medial swfaceand lateral surface of the left knee. ~ively. There is I paper idcntiflCllicm l.agaffixe<! to the right wrist and right second loe. The back has a 2.5 x 2.0 em sear immedi81ely rightofmidlinc in Ihe thoracie R:gion and a 2.5 x 2.0 em oval sear immediltely below the sear just described. CLOTHING ANn PERSONAL EFFErn The following clothing items and per$Onal eITeets are present on the body at the time of autopsy: A blue shirt. I green sweater,a white linen Wldergarment, and two white socu. MEDICAL INTERVENTION There is no medical inlervention. RADIOGRAPHS r Full body po$tmortem l1Idiogn:phs are obUined and demorwratealhe following: I. No long bone fractures 2. No foreign bodies MEDCOM 0193 ACLU Detainee DeathII ARMY MEDCOM 193 AUTOPSY REPORT[("b'",6;-, BTS Ahmed, H.-san Ebb _ • EVIDENCE OF INJURY The ordering of Ihc: following injuries is for descriptive purposes only, and is ROt intended to imply orderofinniction or relative 5eYcrily. All wound pathways ~«= given relative \0 ~landard anatomic. position. A 2.4 ~ 1.4 em cn.l!lcd abrasion and a \.5 x 1.4 ern crusted abrasioo are on the forehead. A \.0 x O.S em abBsion is on the nose. On the volar surface orlhe right foreacm are rnuhiple oval purple eontusionslhat avenge 1.0 em in diameter. A 1.5 x 0.4 em crusted abrasion and a 1.2 x 1.2 em crusted IIbrasion are on the medial.nd the laleralsurfaeeofthc len forearm, respectively. On the posterior lurfau orille left hand Ire a 2.5 x 1.5 em purple ctlntusion and I loS x 1.0 em purple contusion. Then: is a 1.8 x 1.7 em crusted alxuion with $uITOundina contusion on the lalcrallurfacc afllle lell knee Ind I 1.5 x I.Oem cnl!ilcd abruion immediately below the len patella. Over the spinolls proce5Se$ ortlle lumbar spine is I 1.8 x 1.1 em contusion. INTERNAL EXAMINATION HEAP: The galeal and $lIbgaleal son tiS$Ues oftlle scalp are free ofinjury. The calvvium is inlllCt, as is !he dlU3 mater benealh il. There is congestion and pooling of blood over the posterior aspect of tile bl1lin from livor mOl'li!. Clear cerebrospinal fluid SUITOUndS tile 1325 gm brain, which has unmnubble gyri and sulci. The brain parenchyma is son and pinklrc:d from refrigeration. Coronal sections demonstrate sbarp deman:ation between while and grey maUer, without hemorrllagc or contusive injury. Thc ventricles are of nannal siu. The basal ganglia, brainstem, c:crroellum, and arlcrial systems art: free of injury or other abnonnalities. There are M skull f",Clures. Tho atlanto-«eipital joint is stable. lbcn= is athcrosclerosis of the vertebral, basilar and middle cerebl1ll arlmes. ~: The IlIlterior stnp mU$(:les ofllle neck are homogenous and red·brown, without hcmonhage. The thyroid cartilage and hyoid bone are intact. The larynx is lined by intllCt gr1Iylwhite mucosa. The thyroid gland is symmetric and red-brown, without cystic or nodular change. The tOngue is free o(bite marks. hemolThagc, or other injuries. BODY CAVITIES: The rihs, sternum, and vertebral bodies are visibly and palpably intact. jO ml o( serosanguineous nuid are in each hemithorax. No excess fluid is in the pericardial or peritoneal eavitiCll. The organs occupy thcirusuil anatomic positions. f1f$PIRAIQRY SYffiM: The rigJu and len lungs weigh 7jO and ru gm, respectively. The exlernal surfaces are smoolll and deep red-purple. The pulmonary parenchyma is diffusely congesled and edematous. No mass lesions or U1lU of consolidation are presenl. MEDCOM 0194 ACLU Detainee DeathII ARMY MEDCOM 194 --J AurOPSY REPORT(b)(6"1 BTB Ablmd. Buslll Ebb , CARDIOVASCULAR SysTEM: The 390 sm heart is contained in an inltoCt pericardial sac. The epieardialsurface is smooth, with minimal fat investmCRt. The coronary arterics are present in a nonnal distribution, with a riglu·dominant panern. Cross stttions ofthc vessels show moderate calcified atherosclerosis of the riiht coronary al1ery (50% stenosis), the left circumnex (50'A. stenosis) and left anterior descending branch ofthe len coronary artery(5(). 75% stenosi,). The m)"OCardium is homogenous, red-brown, and finn. The val~ leaflelll are thin and mobile.. The walls ofthe left and right ventricles art; 1.3 and 0.-4 em thiek, respectively. ~ endocardium i, smooth and glistening. The aol1a Jives rille 10 three intact and patent arch vessels. The renal al1eric:s have moderate stenosis of their origins It the aorta from lOl1ie atherosclerosis. The IIICSCrtteric vessels Ire unremarkable. UVEB & BIl.IARY SYSIEM: 'The 1125 gm liver has In intact, smooth eapsule and I sltarp anterior border. The parcnch)lnla is tan-brown and congested, with the usual lobular archite<:turc. No mass lesions or otber abnormalities are seen. The gallbladdcrcontaill$ about 4 ml of arecnblack bile and no stones. The gallbladder mucosal surface is green and velvety. The extrahepatic biliary tree is patent. SPLEEN: The 80 gm $plcen hu a smooth, intad, red-purple capsule. The parench)lnll is mlltOOn and congested. with distinct Malpigltian corpuscles. P....NCREAS; The pancreas is soft and yellow-tan, with the usual lobular an:hitc<:turc. No mass lesions OTothcr abnonnalitics arc seen. APRENAt.S: The right and left adrenal glands arc symmetric, with bright yellow conices Ind grey medullae. No muses or lll'ClIS ofhemorrnagc are identified. GENITOURINARy S)'STEM: The riiht and left kidneys weigh 55 and 60 gm, respectively. The external surfaces an: coanc:ly granular with multiple rcnaI cortical cysts, nmpng from 0.3 -1.0 em in diametCT. The cut surfaces arc dane red_tan and congcsted, with unifonnly thick cortiocs and sharp corticomcdullary junc:tiolll. There i, marited intra-renal atherosclerosis of the arterioles ofthc rmll parcnchymL Thepclves arc unremarkable and the ureters arc nonDllI in course and caliber. White bladder mllC05ll overlies an intact bladder wall. The bladder contains approximately 100 ml of cloudy yellow wine. The prostate is nonnal in site, with lobular, yellow-ian parenchyma. The seminal vesieles are unremarkable. The testes are free ofmass lesioll1i, contusions, or other abnonnalitics. GASTROINTESTINAL TRACT: The esophagus is intact and lined by smooth, grey-white. mucosa. The stomach conllilU 1WroximSlely 500 ml of brown fiuid and rare food particles. The gastric Will is intact. MEDCOM 0195 ACLU Detainee DeathII ARMY MEDCOM 195 AUTOPSY REPORT[b)(O) ] 6 BTB Allmed. HUSlIl Ebb TIle grelIter e"rva of the stomach is densely adherent 10 the duodenum. The d"odenum, 1001'$ of small bowel, and ealon are otherwise WlI'el'lIaftable. The appendix is present. • • • • ADDITIONAL PROCEDURES Doewnentary pholOpphs are taken b)' OAFME photographer. Specimens mlined for tOlieologie testing tmdIor DNA identification are: blood, urine, spJeen. liver, lun&. kidney. brain, bile, gutrie contents, and psoas muscle. Tho dissected organs are forwarded with bod)'. Personal effeclS are released to the appropriate monulr)' operations representatives. MICROSCOPIC tiXAMIl'fATION Selected portiOfl& of organs are retained in (onnllin, without preparation of histologic slides. MEDCOM 0196 ACLU Detainee DeathII ARMY MEDCOM 196 AUTOPSY REPORT"'bN """----., 7 8TB AbIQel1, HUlla Eklb QPINION TIll. believed to be 61 year okllnql male died from ailleroselerocie eudiovllICUlar dilCllSC. The: medlaniam ofde:lth i' often eardiu: arTh)1hmi. secondary 10 the dillellllXl myoc.ardium Ind eonduellon ')'$l.eln. The prumce of')'Itemic atherosclerosis and the marked renal ehanp. includina raYlllrophy, is llUyatiVl: of the dccedentl\avill& diJbetes mellituL The mamer ofdea1h i. natural. (b)(6) \(b)(6) Medieal Examiner MEDeOM 0197 ACLU Detainee DeathII ARMY MEDCOM 197 DEPARtMENT OF DEFENSE ARIIED FORCES INIlITlIn 01' ......ntOLOOY W.uHlNOTON, De 21»0• .... ....F1Pj(b)(6} WIENI IDENTifiCATION AI'tl' ACftlJIon. N~.. b., Sequ •..., N....1('l(6) OFfiCE OF THE ARMED fORCES MEDIC.... L EXAMINER ARMED FORCES lHSTITlTTE OF I'AnJOLOCY WASHINCTON. DC 203066000 l - AHMED, HASSAN EKA8 SSAN, Aatoptl,lt b)(6) Todcolall' AfftUlo. I, ~ ~po" 0.1e' MARCH IS, 2004 CONSULTATION REPORT ON CONTRlBtrrOR MATERIAL AFIP DIACNOSIS REI'ORT OF TOXlCOLOCIC.... L EXAM INATtON COfIdiliOfl ofSpKimns: GOOD D.t~ oflncldenl' D.I~ RKeivHl: 313J2004 CVANIDE: There was no cyanide detected inlhe cheSI blood. The limit ofquantiwion for cyanide i! 0.25 IIlgIL. Normal blood cyanide concenlr/llioll5 are lesll than 0.1 5 IIlgIL. Lethal concc:nlrBtioos of cyanide lITe grealer thin) mJlL. VOL.ATILES: The BLOOD AND URINE were e~amined for the pre$UICC of ethanol (culoffof20 mgldL), acetaldehyde, aulone, 2-propanol, I-propanol, I-butanol, 2·butanol, isobutanol and I-butanol by Ileadspac:e gas chn:ln\alOlJ'llphy. The following volaliles were detected: (conccntration(!) in mildL) Acetaldehyde Ethanol Acetone I-Propanol BL.QOD 69 T_e TrICe UIUNE Trace 31 T~ 6 Trace - value grealer thao or equal 10 ImiYdL, but less thin 5 mildL DRUGS: The BLOOD was Krccned for amphetamine, antidepressants. anlihi!tamiroes, barbiturates, benzodiaupiroes, annabiooids, c:oc:aine, dextromethorphan, Iidoc:aine. I\IlI'COtic analgesics, opiate5, phencyclidine, phenothiazines, sympathomimetic amines and vempamil by las cltromatogtaphy, color tC$l or immUllOllSSllY. The following drugs were detCCled: None were found. r b !tb)(6) _ orrICC oClhc Armed Fon:cs Medical Examiner MEDCOM 0198 }(6) , orrJCl! oflhc Armed Fort:eJ Medical Examiner ACLU Detainee DeathII ARMY MEDCOM 198