Aclu Military Prison Death Reports Part5
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, AR.\IIED FORCES INSTITUTI:OF PA,TIlOLOGY omu of Ih~ Armt'd FOff" Mdkal [ullllner 14lJ Rcscareh Blvd., Bid&- 102 Rockville, MD 208SO 1-800·944·7912 AUTOPSY EXAMINATION REPORT Name: MoU5ll Al Jbori, Mahmood 151Nl1:el Mosa lnlfrmemt Serial Numbel(b)(6) Dale arBirth: (b)(6) 1967 o.lC of Do:athJ~(6)-----.-!200S Dale of Autopsy: S February 200S Al.llopsy No.: (b)(6) AfIP No.: (b)(6) Rank: Iraqi lIIuional. ch'ilian Place orDcath: BucCi. Iraq PIKe of AutoI!'Y' Baihdad. Iraq Dale ofRepon: 14 Man;:h 200S Cln:umsllllcn of lkatb: This 38 )'car-old mile civilian. prnllllled hqi n:lliolllli was in US tl.lSlody at the Bucca cIc1ention facility in Iraq. By rt'pon, lie was shot during, prison riO!. AUlhoriUlion tor Autopsy: The "rrlled Fon:CI Mnilul El.Imlnu, IA", 10 USC 1471. Idclulfinllon: Visual. ~r detention raellity rteOnb: postmortem Iillllcrprinil and DNA profile obtained. CAUSE: OF DEATH: Gun.hol Wound or lhc Tono MANNt:R OF DEATH: Ilomlddc ... MEDeOM 0398 ACLU Detainee DeathII ARMY MEDCOM 398 • , AUTOPSY REPORTtb)(6) "'OUS" AL JBORI. Mahmood hhmullolOS1 FINAL AUTOPSY DIAGNOSES: 1. Pmdratina Gunshot Wound oflheTorso L Indeterminate ranae enl~ wound of posterior aspect (baek) arlen b. c. d. e. r. g. shoulder wilh no IUlTOullding soot or lIipplina Wound paih through akin mcI10ft ti$l\le oCtile upper left back. the Iell scapula. posterior aspect oCtile left cllest w.1t lhrouah the.· rib, left lower luna lobe, diaphraam, liver an(! $lomaeh Wound u§OCiated ....ilh bilileni hemothoraces. 300 ml blood In the riant pleural space and 1,000 ml blood in the left pleural space; hcmopcrn:ilfdium. 100 ml blood; hemoperitoneum, SOO ml blood; frlCture of.he left .:apula; li'acture of the postcriOf lalerll &$peel ohlle left 4· rib: ptl"foratiOll of the left lower hmglobe and left hcmidi.phrapn: dillUplion oflhc left lobe ohlle liver. and multiple pcrfon,liona ohlle ItomKh No nil wound present Multiple metallic ITagmcnlJ inc1udil18 I r,.gmenl ofcopper jackCl and fragments ofbullctcorc are recovered from within the Ilomadr. and 5lIbmillcd 10 US Army CID No cvidc:rw:c ofdose ranae fire Ollihe slcin Direction of wound path: Back to !kInt. downward. iIIId sliilllly leA to righl II. No evideoce of significant nalUl'llI disease, within the limitations of the uamination Ill. No evilkncc of Oilier significant injuriCli a. Minor abrasions of anterior asp«l of Icft knee b. Mi1lOf contulion of back oflcft knee IV. No cvidcnec ofl'Cltraint V. TOJ.icoloiYIAF1P) L Volatiles: Blood Mel vitreoul nuid negative fOfctl\ano1 b. Dnlgs: Blood ncgative for screened medications and dl\lp of.busc MEOCOM 0399 ACLU Detainee DeathII ARMY MEDCOM 399 AUTOPSY R£PORT (b)(6) MOUSA At JBORJ.l\b~moodI.hm.d .\101' ) f:XIERNAL EXAMINATION The body i. that of. well.oeveloped, werl-lIOIIriJhed unclld C.llCIIian male.. The body weip IpplOkimlltely '60 pounds (eslimltocl). is 68" in Ilciibt and appears COIIlpiotible with the fq)lItIN 'ie of 31 years. The body t~ is cold, ttlal of the refri;emion unit. Rip ;. presctll 10 III eqllll lkgRe in.1l calmniriCi. Lividity is pracnt IIld fUlal 00 the posImor IIlf'flCe of the body, except in lIaS aP'*d to pre$IIICe. TIle sc:.lp i. eovcrcd with dulc brown lu.it lVeraJing 1..$ em irllenatJt. FlCi.11u.ir eorWsu of. red brown bwd II'Id mUItIChe. The iriOr:s _ brown, and the eo_ _ .Iiglltly doudy. The sc:lerae tnd eonjullCIivae iIJe pak IIld free of petechiae. Theft' are multiple fm:klc:s ov"'" the fOlene.d. The urtobc:I 8tll 110I pi=ccl. The ClItcn'lll lUdi\OQ' e.naIs. Qtcmal _ and 0fIl u¥ily are IRe of foreign mateO., II'Id Ibnonn.al _ions. The tIIII1 skeleton is palplbly intICI. The lipI_ wilhoul evidmt injury. The: t«lh are natural and in fail condition. The n«;k i. rtrIigllt and the !neW i. midline ItId mobile.. The chest i••ymmetne IIld well ~Ioped. No injury of lhe ribs or .IIemwn i, evident atemalJy. The Ibclomat is ItId lOR. HClIed turgic.llllCll1 _ not IlllIaI D111lx IOI'JO. The almnilicllf'C well dcvdopod with normal range ofmolion. Theft i•• I x OJ an Kiron the rislll knee, II'Id Ibm: is a I .. 2 em tan lTIKult 00 the antmor apca of the riglll thigh. The linlll:l'llaill arc inllCL The lOki of the feet are eallous«l. but they I/"C: clean ItId Itmlrnllic. No tailOlll ~ noced, and ~Ie Incks are noc obIavoi The cxten'IIl &mitalil are those of a IlOmIIl Idult eircumc:iKd mUe. The: lC$1Q are dcac:CI'IdocI and he of m-. The pubic: llail is ""val bUI present in I normal dilUibution. The bIl110cks llIld IIIU, iU"C unrcmattabJe.. An idmtirlulion taB i. on the riglll lim toe. n. r;VIDF.Nq: OF IIiEBAPV i. an endotl¥heal lllbt in pllCe, and thm: is III inlnvenott. CllhelCt in the riglll antecubital fOlll. Thert I/"C 1WO Idhaivc EKG t.M on \he body, one on the uppel" &n1mor ISpeCI of Ihe ri&hllhouldeT II'Id one on the I1ppCf wc:riot aspect of the lell ihoulcSet. There 1ft" IWO Idhcsive ddibrillllor pIds on the body, one 00 Ihe upper IIllcriot ISpeICI of the riglll 5houlder and one on the lllterior Illefal up«1 of the left ~de of lhe dlest. Thefe i. I -C' written on the back of Ihe riglll hand in &Jec:n ink. Theft r;VIDENCE Of INJURY The Ordcrini oflhe followini il\ilD'ia i. ror dcae:riptlve purpose' only llId i, rool iMmded 10 imply order of innietion or relative JCVffily. All wOllIId plthwIYS are &i\"en relative 10 ,Iandard an.tomie po.ition. There i. dried blood .lreaJd"i on the back onhe Iwtdsllld eonnllCflt over the blCk oflhe body, The p.lm. of Ihe hands Ire free or blood. There are two Ibr:uion., 0.2 em in diameler and 1 I 0.2 em on the len knee. Then: ix I ) .. 2 em r.int purple conlU$ion on the back ofllle left kneit, MEDCOM 0400 ACLU Detainee DeathII ARMY MEDCOM 400 AUTOPSY REPORt(b){6) ~ MOUSA AL J80Rl, Mallmood IsllmuJ Mosa • GUMbot Woynd oflbe IorIO There is an indetmninate range entralKe gunshot wound of lhe po:sterior aspecl of lhe lell shoulder. ~ wound is round, 0.3 em in dillllder, with an eceentrie marginal abl'llllion rim from 10 o'dock to 2 o'clock willt a TTWlimum width of 0.3 em II the 12 o'clock position. The entrance wound is localed 14 em 10 lhe lell ofposlerior midline and 28 em bcnCIIlh the lop of\he hud, and lhere is no SOOI or stippling sulTOunding the wound. The wound path P'Cfforates !he skin and soli ti$Sue of the upper left back and the len scapula, and enlen Ihe posterior aspect of lhe left chest cavily tllrough lhe posterior latenl aspect of lhe 4'" left rib. The wound perforates lhe left lower lung lobe, lhe lef\ hemidilllhragm, the liver, and stomach. The wound is usociated wilh bilateral hcmochonccs with 300 ml of blood in the right pleural eavily lind 1,000 ml of blood in lhe left plellrtl cavity; II hemopericardium witll 100 ml blood in the perieaniial sac; and I 1Km0pmloneum wilh sao ml of blood in the abdominal cavity. The wound is also asso<:ialcd with fractures of lhe left scapula and posterior literal aspect of the Jell 4" rib, pllmlchymal defects of tile lell lower lung lobe and lhe lef\ lobe of the live:r. perforation of the diaphragm; multiple perforations of the slomaeh; and hemorrhlge and sof\ ti$Sue dcstNCtion ,dooS the wound path. A fragment of copper jacket and mulliple small melallic fragments of bullet core arc recovered from within lhe stomach. No uit wound is present, and there is no aoidence of close range lire on the skin. The direction of the wound path is from back to front, left to right, and downward. INTf:BNAL EXAMINATION ROpy CAVITiESi The body is opened by lhe u:sual !horlCO-abdomina\ incision and the chest plate is rernovo;l. No adhesiQnll arc present in any of !he body uvitics.. All body organs an: pn:senl in !he noJTDaI an.alomicil position. The vertebral bodies are visibly and palpably intacL The: SubcU!lncoU5 f.allayerof!hc abdominll Will is 2 em thick. !lEAP; (CENTRAL NERVOUS SYSTEM) The $Clip is renoe:tcd. and !here is no skull fractures found. The ul\"';um of lhe skull is removed. The dura mater and fill. cerebri arc inUoct. There is no epidural or subdural hcmon'hagc: pn:SCOI. The: leptomeningCll an: thin and delicate.. The cerebrospinll nuid is clear. The cerebral hemispheres are Symmetricll. The SU\lCtures II the base of the bra.in. including cranial nerves and blood vessels, are intact. Comnal scclionslhrough the cerdlral hmlisphen:s reveal no lesions. arK! there is no aoidencc of infcelion, tumor, or trawna. Thc vcmricles arc of normal size. Tran$VCf$l: sections throujh lhe bmn stem and cerebellum are unmnarka.ble. The dura is stripped liom the basilar skull, and no fractures are found. The .allanto-occipital joint is liable.. The brain weighs 1480 g&ms. MEDCOM 0401 ACLU Detainee DeathII ARMY MEDCOM 401 I AUTOPSY REPORT $)(6) MOUSA AL JBORI, "hhmood hhmlel MOil , Nf:CKi Examinalion of the soft tissues of the neek, iTK;llIding str;Ip mU3Clu, lhyroid gland and larse ~essels. reveals no abnormalities. The anlerior 5lnp muscles of the neck are homogeneous iIIId red-brown, without hc:mol'Thage. The Illyroid ear1i1age and hyoid bone are intacl. The larynK is lined by intKI white rnUCOSlll and is unobS\JUCled. The thyroid glmd is symmetric and red·brown, without cystic or nodular change. ~ is no e~idenc:e of infcclion, tumor, or trauma, and the airway is ~tf11. qRDIOV ASCUUR SYSTEMi The perieardialswfKes are srnool!l. glistening lAd unremarkable; the perkaJdial sac is free of signiflcarll fluid and adhelioru. A mOOc:nte amounl of epican:lial fat is present The coronary anenes arise normally. rollow I right dominanl distribulion and are widely palenl. without e~idencc of significant atherosclerosis or Ihrombosis. The ctwnbers lind ~a1~es exhibil the usual size-posilion relalionsltip and are unremarkable. The myoeardiwn is da1l( red-brown. firm and unremar\ulble; the atrial and venlricular septa are intact. The left ventricle is 1.1 em in thickness and thc righl ~entriclc is 0.2 em in thickness. The aona and ilS major branches arise normally, follow lhe usua! course and are widcly palent. free of signifiCUll athCfQ5Cll:l'O$il II'Id otlter abnormality. The ~enae cavae and Ibcir major tributaries rftUn\to the heart in the LIIlIal distribulion and are &ee of thrombi. The heart weighs 27g 8J'WT15. RESPIRATOR)' SYSTEM; The upper airway is clear of debris IIJId foreign mllerial; the mucosal surfa.ces are smooth. )'Cllow·tan and unremll'kable. The ph:unlll ,lUrfi>CCS are smooth, glistening and unremarkable bilatentlly. The pulmonary parenchyma is red1l'lrplc. exllding 0 slight amount of bloody fluid. The injuries ofllle Iell. lower lung lobe are as pre~iously described. No OIher focal lesions are noled. The pulmorwy lII1enes are nonnatly de~eloped. patenl lAd without lI\rombus or embolus. The right lung weighs 383 grams: the left 237 grams. LIVER Is 811,IARy S¥STt:Mj li~er are lIS previously described. The hepatic capsule is otherwise smooth. glistening and intact. covering dart red-brown, modenlltcly congesled plJtnchyma with no rocallesions noled. The gallbladderconwns 3 1'111 of green·brown. ~coid bile: lite mucosa is ~el~ely and un~marltablc. "The extrahepatic biliary tree is patenl. without cvi<.!cnce ofcaleuli. The liver weiKbs 1169 grams. The injuries of the AI.IMENIARY TRACT; The longue i, free orbite muks. hemorrhage. or oth<:r injurics. The esoph.a.&us is lined by lI"'y-whilC. smooth mucOR. The injuries of the slomilCh llrC ill previously described. The gaslric mucosa is othuwise arranged in lite usual rugal rolds and lhe twnen contains a film of 111'1 fluid. The smlll and large bowel are lllIm11<lrltab~. The panc:reu has a normal pinkIan lobulated appc:arwlce IIJId lhe duelS are clear. The ~ppendi~ is present and il unremar1cablc:. MEDCOM 0402 ACLU Detainee DeathII ARMY MEDCOM 402 AUTOPSV Rt:PORT(bH6j ~IOUSA AL J80Rl, fthllmood "lImnl MOIl • C[NITOVRlNARY SYSIEM; The mull c.apsull:l are MMlOIh and thin. aemj-lrwuplmll and Slrip wilh cue from lhc: underlyinJlITlOOlh, red-brown conical J\II'f~. The cOl1icCi Ire IhIrply dclinCiled from lhc: medulluy pynm;dl, which are m1-PlUJl\e LO Ill'Iand unmnll'lr.able. The c.al)'tl:l, pclVCI and W"elCI'lI Ire unremarkable. While bladder mllCJOSa overlies III intacl blllddcr will. The urirwy bladder conlaiN 60 ml of clear, )'tl1ow urine. The prostate gland il nomutJ in size, with lobular, yellow-llll ~hymL The seminal vesiclcl Ire UII1eJTlnable. The lelles an: free of mUll lesIons. contusions, or OIher abnomlllil;CII. The ri&hl kidney wei.... t 11 pams: lite left 119,r.uns. RETICULOENDOTHELIAL SysTEM; Thc spleen Itu alfllOOllt. intact clpMlle covain& m1.pwplc. modcntely firm pamx:hyma; the lymphoid follicles Ire uruemarkable. The regional lymph nodal appear nomJll. The spleen w~gtts ~9 pnu. END9CRJNt: SYSTEM; The piluiluy, Ihyroid and adrenal Slands Ire unremarkable. MUSCULOSKELETAL SYSUM; Muscle development il normal. No bone or jl)inl abnonnllllies arc noled. MICROSCOPIC EXAMINAT'ON Selecred porlionl of organl are relained in fonnllin, Wilhoul prcpllralion of hillolollic Ilides. ApmTIONAL PROCEDURES Full body radiogJlpha were obtained and rcnco;:tlhe injuries described lbove. Documcnluy phOIOlP'lP1Is arc I&kcn by OAfME pholOil"lphcra MClallic fraamcnll ro;ovcred are Illbmined 10 US Army CID Specimens retlined for loxicologic lesting and/or DNA idenlification arc: vilrcoll$ nuid, femoral blood, helrt blood. leA chesl cavily blood, urinc, bile. liver Ind splcen The dilSCCled 0lllaM ate fOlWlrdcd wirh lhe body Personal errcell arc releued 10 tile appropriale mortuary operalions representalive MEDCOM 0403 ACLU Detainee DeathII ARMY MEDCOM 403 A.UTOPSY REPORl1,,:(b~)(~",-..,..,-,-----, MOUSA. AI. JBORI, Mahmood Ilhmad MOlia 7 OPINION This 38 ycu-old male Iraqi civilian in US custody died ofa gunloot wound of the IOrso, which perforated hilleR lower lllng and livcr. ClIl1sing inlemal bleeding. 8y report. he was shot during a prison riot althe Bucca detention facility. The I1UlI1Ilcr of dealh is homicide. (b){6) C,(b)"b"'I''''----''M'''cdical Examiner MEDCOM 0404 ACLU Detainee DeathII ARMY MEDCOM 404 O£PAATMENT Of DEFENSE #JtMEO JOIICES lfrItTlTUTl! rx '''1lfOI.OGy WAIHlNGTON, DC 211. . . _ ......,........ ...... to ".lIEN! IPENTlflCATION AFlP A«......... N•• be. Soquu.co [(;)(5) TO' ] I'bm~ MOUSAIAl JBOIll, MAHMOOD l, OFrlCE orTIlE ARMED rORCES MEDICAL EXAMINER ARMED FORCES INSTITUTE or MTHOI...OGY WASHINCTON, DC 21lJM.6llllG $SAN: To.~1ot1 A« Dot.R.porIC AUIoPJIJ(bj(6) lon ",f{~(§) tnl: f.bRwy2.o,2l:llH J __ I CONSULTATION REPORI ON CONTRIBUTOR MATERIAL AFI' DIACNOSIS REPORT Of TOXICOLOGICAL EXAMINATION Condilion orSpecim.nl: GOOD Dlle or Incid~nc,{b)(6)J:OOS .... Dlle Re«[\'rd.: UI6l200S VOLATILES: TlIe BLOOD AND VITREOUS FLUID were exarnilKd for the ofethanol all eutofl' of 20 mgldL. No ethanol was detttted. p~stntt DRUGS: The BLOOD was screened for amphetamine, unlideprcsSlrtts, Ifllihisl.Imincs, barbilurales, benzo<liazcpines, tannabinoids, thloroquine, toeaine, deltlromelhorphan, lidocaine:. narcotit ana1sesics, opiates, phencytlidine, pllenothiazinn, sympathomimetk lIllines and verapamil by gas chJOmatopp!ly, tolor test or immWlOlSSay, The rollowina dNp were detected: None we~ fowtd. (b){6) Offia ohll. Armed Fon:es MedicII EumiMf Omce ofl.he A...md FO~I Medic:.al E.umi_ MEDCOM 00405 ACLU Detainee DeathII ARMY MEDCOM 405 _'"-_-_,--_--- -_.- ----- _. -_ _.-.-.---- __-- -- -- -- _ - __ --,,--,,_....... _--.....-._............no_..__..,..---_ -_ -_. _ " ...."001:0 _ _ _ _ ... _ _ .. _ ...... . "~"' BTB MouS.lIJ Jbori. Mr.hmood. l~ ".,.. .... ... .... 0, (b){6) Iraqi Detainee ..n" ....... (b}(6) 1'967 '''' ................. ~- [;1] n-..._ 0 ~- C"c·_ • ~ .,.., • ... -....-.., ...... ... &-lfll.lflam . ........ _ _ ...n ...".,... IUw:....., ....... .... e-... _ _ _ _ _ _ .... _ ........ ....... Gunshol wound oI11le 10110 ~ '''' .. _'''''- _....-<. _ ....... ..... _ ... _--_. --",.__m_.... -...... --....-."' -'- -_.-:r' --, • ........ -"" ....... -.... _- ... -------"'------ - _..."'- __. •• _..... --. _--__ .--_. _- 1;::......."'-......-.......-"-"._-...------__ ....-.-_. _. _._...__ ...... _--_ ....- --- -.- _....._""- _._--" ...... ... _,,--_..... "'-'''---''_._-.'''-'''... .---" _. -. ....,,__......_...---------_----_ ._ ......- .... _ ... ............... _--.....-............ "'_ _..-1 ...."'-. , , '0 _ _ . - . . ' ' ' ' ' ' ' '..... 0 0 - - " ........ < : ou."'....... ., ... l (b)(6) X -(bK6) OSF.tI 20015 ... , _ _ .... _ ... .......... _ _ ...... em (b)(6) •• ~l~dr , ,-,,_ 00.....'2064 eo- AFB. DE 19902 • "...._OCOCOTID_._..................._. -", (b)(6) ~- ... MediclII El<amiflef --(b){6) ' _" ' -..._ -.... MEOCOM 0406 ACLU Detainee DeathII ARMY MEDCOM 406 IREMOVE REVfRSE AND RE·INSERT CARBONS lJEFORE COIJPtETtNG THIS SlOE} ..... DlSPOSITlOH Of' AEUAlNS H.Ud 0# MCWI'ACWl ~AIUCI AEJr,WMS UCEHS( HUloIlIVI AND ITAJE I..... ""~""" INSJ.... U.~ Ol" AIlClM:SS "'" ........ 0# a ~ ClI' CJIE. TCft't lOCATlCIN '" alrEJ(A'f ClfI CAIE"""TOIII" CATt:"'~ """'''''''*'''''' ~ REGISTJl.AT1OH Of VITAl STATlSTICS FlEGISTW'f' tf_ _ MAIlE '" ~ CMlCTOlt CATE AfOll1Ulm -- tTATI 'U_ I'm... SlGJCAJ\ft. '" AUJ~lNCll'tIClUIil "" It VI. 00 FORM ION, APR , , " (BACK) MEDCOM 0407 ACLU Detainee DeathII ARMY MEDCOM 407 "'{(\lEU FOlKES INSTl1'lJfE OFI'ATUUI.OC.¥ Officc ur lhe Armed F..,Cfli Mftlinl f.uminer I·U) K~~;\n:lIl11\·Ii.. llIdll. 102 Roxh'ilk;\ll} :!Q8.S0 1·l\00....-I-I.7'1l2 AUTOI'SV F.XAI\IINATION ItHOItT Namf: 11;lmfd AI Mu I'lIlii. Klt;II~~l1...Y~n Illun:..J lntermcml Scriall:ilunh.:, (b)(6) D;lIC ufBirth: Jbl!~9 Datc ofDcnth (b){6) 2lkl5 Datc of Autops)': 5 february 2005 D;lt"ofR~-pon: AUlullS)' NQ)(b)(6) ,\1'11' No.l(b)(6) !tanl:: lralli natiol\al, civilian 1'lKc ur Ikatll: lluec:L, '''''' I'lnee "r AlIlnps)': 1l1lShd;ld, IrollJ 14 March 2005 Cif'umJlllnCU of DCllth: Thi.~ Jb yC'lf-nld Ql:llf eiviliwI. pr"~um,,d Itl><ji nntinnal w:.. ~ in liS cllstoor 'It lllc 1l1..·CU Ii\."t\."mion (:leili.)' in IroltJ. Ilr rep',n. he w,,~ ~1I<,t durinll n prlll<ll1 ri,~. "ulllori'~1.lon ror Aut"I'~": Tile ,\ ,",cd hrc<'ll l\1.dl<,,1 EX:llnjtter, lAW III USC 1-171. Id<nlifitntioll: Visual. per detentiun Cad lit~· IlTOJilC oblained. CAUS~: ree"r<.J.~: I'l'Stl1hllt.'11I 1i1l~"rpri11t~ ,,,Id DNA OF nEAT": GIIII_,IIOI WUllnd Uflk.I"·uU MEDGOM G408 ACLU Detainee DeathII ARMY MEDCOM 408 , AUTOPSY REPORT (6)(6) • IlAMl:DAL MlJ FAIUJ,Q'leld VaIIeD H• .ad flNAL AUTOPSY DlAGPIOSES: I. Paforuinj; GWlIbot Wound oCOIe Head .. lIldetenninate ranae IllIIrInCIIl wound of posterior -.peet (baek) of lIle head just below the hairline at poslerior midline with no ,unound.in,1OOt or b. e. d. o. r. g. ltipplillj WoW1d path throupskin Illld.lOlt tiaue oflhe Iowa oc:cipillllt&tp II. the tuperiof bMe of the neck, Ihe IIflCOnd cervical vertebra and Ipinal coni, ~arym;. and brid. of ! a t Wound NtOCiated with hctW'efi of the IeCOIld eervieaJ vertebn. tmDcIction Clftbe cerviaillpin.ll mil the level ohbe IWlCOnd eervieal vencbn, IUbc1lchnoid helllOiill... over !he bRIn, uK! hchrM or the nuaI. dhmold Illd nwdllarybonet Stellate exit wound p_1 at the bridp ortbe I'IllK No mcta1lic projectile. recovered or evident l'Idiopphically No evidencoofclole l'IIIp lireOll tlte akin Dilution of wound path: k t 10 front and upward n. No lIVidmu ofsiptificant I\Itul'I.I ditetlC, within !be IimitariOlII orlbe exmUrwlon m. No evidellce lignifiant il\iuriet .. Minonbtuiolll ofrorebo.d IV. Noevidencoofrettraint V. TodcoJosy(AFIP) orotbel' VolatilCl: Heart blood and villwull nuid negative for ethanol b. DnIp: Hean blood ncplivo rot IiC\'C!eMd modiutiOlll and drugs ofabuM L MEDCOM 04Q9 ACLU Detainee DeathII ARMY MEDCOM 409 • AUTOPSY REPORT (b)(6) ) HAMED AL MU FAlUI, KIt*ed V.... " • .ad f.XTIBNAL IiXAMlNADON The body is I!IIl of. well-developcld. well·nouriIhcd W'ltlld C-'CMiIll nWe. T'he body weip ~ d y 160 polllIlk (ettirNIlcd).ls fIT' in hei&ht -.I ~. ~blc with the reponlld qe of 36)U11 The body lerDperallIre II cold, dwl of !he I'dii.,...uon IlIUt. lUgor is praent to ... c:quaI dep In all atremilica. Lividil)' is praenl aDd fiJ:ed on !be poe1erior sun.uo(1he body, exeqJC in IItlU aP*d to prcaurc. The ap is co~ witIl dIIt brown hair ~ 2 em in Ieftilh, Ftci&I blirCOl1liJtl of • bfooMl with &feY bcIrd and mlllllthc.. The irideI UI:l brown, and Ibe eomcu II'C aliahtIY cloudy. 1110 Iclene and conjUlltlivae _ pale IIld he of petechia.. Thc . . 1otw:a.-e1lOt plcrccd. The: cxtenW auclilOly QI1&II; and onI cavily II'C he of romp IIIIllrial .... IbrlUtnW tel3ti0l'll. The lip' II'C wilhoul evidenl injury. The toeth are natut&l and in fIir oondidon. The neek l._abr and !he lIlleheI it mlclLinl= and mobile.. The chell is Iyrnmelric and well developed. No injury of !he ribs or Itcmum it evident alemlJly. The tbdomm it fill .nd 10ft. Healed llII'Jieal '"'" are nol noted 01\ !he IOnO. The ClltremiDelIl'C well ckYcIoplld wilh normal ~ge of motion. 'I'bere fa I 4 em U on the llJIPa" ria'ulhin, and tI1Ilfll if. S an linear _ on the bid: oflhe calf. The IIngemaiIs we In*L Tbc IOIcs oflhe feet _ callou1ed. No WIOOlI are noted, IIld need1e I!1lcb are not obIeI>'od. Tho exlanal aenitalil _Ihoec or. normal adult cirt:wDciled male. Tho tea.ue dacendcd and !tee of fTIUICS. The pubic: hair if plaall in • nonnaI dabibulion. The buttocb and anUi _ UIRIlWbbJe. An idenlilicalion lq i, on the right lint toe. riam EVIDENg OFDIIWY Thm= i. 'II orophar}!lpl airwroy in p'-ee, and lhero il an inbavellOUt eaibeter In the left anteeubilll fouL Thel'll il an ~ A" wrillen on !he badl o(lhe left hand In peen ink. eymENCEQFINJURY The ordainj oflhe followloa injwielia for clesaiptlvc putpOIet only and if notlnlerKkld to imply order of infliction Of rcll,iYC IlCYCrily. All wound Plthwl)'llU'C &IYC1l rellliYe 10 Jtandard Illilomic POlillon. Gunsbo! W9U!MI or!be HC" There is lin indclamil\llle I'IIIgc CllU'lllU iWllhol wound of the posterior qp«:t or !be tae-I, jua:l bdo.... !be hairline. Thc wound II lll'Ulld, 0.2 em In dltmeter, willi III eccentric 0.1 em marJil\lllllbruion rim Iivm !be J o'clodr; 106 o'cloek potilion. 'The entnDl:e wound i. lOClI"'" in the ~erior midline. 18 em bencIth !be top or the 11*, Ind I em beneath the edae of the hllrline. l1lenI is no IIOOl or .applln, on the Jlc.in JUJ1VWItlillg !be ....... MEDCOM G410 ACLU Detainee DeathII ARMY MEDCOM 410 • AtrrOPSY REPORT(bX6) HAMED AI. MU FARn, Kh.leed Y _ Hl..-d 4 The wound path publiCi lIIe U:in and .. 1I: tillUC ofw lower oceipita1_1p and uppcf poIIcrior neck II the potterior midline, continuet throuab the JeQOlld "hical vertebra (uis) Irld CCfYiCl1 'Pinal cord, and duooah the ~ jusc below the Ipbemid aillUS mil eribifonn plate, and ex!u IhrouIh !be I11III bonea OUI the bridae of the DOte dUeetly bet-.ceD tbc c)'CI. The WOIlnd is -.ocialed with fr1ll::tuIa of the IeCOIld cc:rvieaI vcrtcbn, c:omplclc tranacdion orlbe cel'Vie.11Iplnal coni II the level of the IIeIlI;lnd cervical vmebra, ditl'ux fUbarxbnoid hanon1IIJ' OVIIlI" lhe bnin, I film ofJUbdunI hlllllOrlha.ae III the baM orlbe bnin., frKtura orlbe muiUIt)'. ethmoid and I11III bones, md hcmorTfwae.d 10ft li$suc dcacnJetion the wound pIlth. _I Th«e I, • ) • 3 em .teUalC exit wound III lhe bridae or the noae. Ioel!td on the IIIteriof midline, 10 em beneath the top orlbe IIl*I and di~y between tbe eyeI. NG metaltk projectilCi Ire retoYm Of evidem ndioppbkally, Irld ~ it no cvidc:nce ofcloK ~ tire on th' skin. The dire:tion orlbe wound. plIlt1 il from b.ek 10 front Irld upwlrd. INTIRNAL IXMUNADON BODY CAYII'llSj The body it opened by the IIIUIl ~ iDcUian and the chat p1Ite it .e1t.... ecL No IIdhcsionI or IIbnofmaI col!oedorll of nuld -.: pr'*'lll in '"Y of the bDdy ClIvities. All body oraan- ~ jA m in the nonnal ~ position. The bodies ~ vi.ibly II'Id plIlplbly inlaet. The IUbeutaneoul (II II)U oCthubdominal wall is 2 em lhick. Vl!It'" HEAPi (CENTRAL NERVOUS SYSTEM) The injuriel oCtile bAd U1l U pmriouIIy dctcribed. The IItIIp Is ~ftc:clcd, and thefe are no otherlkull hctwa found. The calvwiwn orlbe IkuII it ranoY1d. The dun m_ and falx em:bri U1l ilUlCt. Tbcn il no epidunl hallOnt. praenL The 1ept0lTlllrliD,gel1l'e tIM and delieMc. The: ..... eb~ IIcmbp,",ti.. _1)1M'lelric:al The ~ at the t-eoflhe bnin, inclu4iJlt; ennIlIl'lCfYCIand blood ~ e'l, are inlltl CoronalIl:lCUoIII tnrough the cerebral hcmifpt..... revealed no l..ioN, and there iloo cvi~ of infection, tumor, or trauma. The ventrie1cl are of normal Iiu. 1'nrtIYerJe ICCtiooI lhrouBh the brain aem and CCftIbellum ~ W1I'CIl1&I'kIble. The durI it lllipPOd from !he basilar skull, and no hctum _ found. The ItJmalOoOoCipilll join! illlable. The br1in weigha 1440 grcDI. NECKi Examination of lhe 10ft tillU.. of lhc amerior nock, irdudina flnp 1ll1Lle1... thyroid aJand and larae vessela. revaIa no abnonna1itiea. The IDlCti« ItI'Ip Illuaelcl of the neck are IlomoICl1OOUl and fW.bI'OWI\, without Mno"tlap. The thyroid eartilqe and hyoid bone are int-=t. The 1ar)1IX I. lined by intIf:t while mUOOll and i.lIIlObmIcted. The lhyroMl aJane! i• •ynunotric: and m;iebrown. wilbout cystie or nodulal' chartae- Then: II no evidence or infection, tumor. or lnUmI, and lhc IIrway b patent MEDCOM 0411 ACLU Detainee DeathII ARMY MEDCOM 411 • A.UTOPSY REPORT'(b)(6) _ ] , R.\MtD AI. MU FAIUl, K...leed Yaqea HI..-t CABDIO\'ASCVLt\R, SYmMj The paicardialllllfllCel &R ImOOIh, slillmin, and \II1f1:lmafbb1e; the pericanliaI ~ is Ike of signilk8nt .DuM! and tdheIiom. A modcnIe amount of epicanlial fll Is p-mL The CGroMIY arterieJ an'll nomWiy, follow. riglll domiDallt distnlNtion and lie widely patent, without evi<lcnce of signilieml Ilb:rosclaosi.l; or thrombosis. The chIrnbm Jnd valva exhibit tIul UIlla.I siz.c..position rdatiOlllhip and are UllI'eIl1EbbIe. The m)'OC'ldium it datk rW-brown, fum II'Id I.lI1mDII'kIble; the Ilrial and veatriCllIar septa lie intacl. The left valtricle is 1.I em in thickneM and the Fishl Wfltriele i, 02 em in th.idm , The IIllftI. and its mljor bnnehcI .nil: normally, follow the uauaI COIIDe and arIl widely patent, ftcc of li&nificant athr:roscleJwis and ote lIbnonnality. The venae eav., and tbeir major tributmes relLlm to the beart in the uauaI distribulion and &R fRle of thrombi. Tho heart weip 420 grams. AMPIWQRX SXSDMi The upper airNJy i, clear of dc:brU nI foreign ll'IIlerial; die ITIUCOSII -r.oe. Ire lIIllOOlh, )'l'lIoW-tall and unrcmarbblc. The pleural IlUftcc:I &R IlTIOOth, &lisleninl and =arklbk: bilatc:rally. The pu/molwy pIl'mChyma i. rcd-purple, exuding a .light ..-nour'I of bloody fluid, and 110 fOCllIesionl &R noted.. The pulmorwy Irteries Ire normally developed, and wilhout thrombus or embolus. The right l\11li weigtu: S40 grwns; the left S20 8JlIlIlL .-tent LIVER" BIUABY SYSTEM; The hcpati<: capsule is lIIllOOlh, aJisb::nina: and in*t. ooverina dirk rod-brown. modaateJy congested parenc:hyma with no foeallCliona noted. The pJlb'-kler eontaint J mI of bn:Iwn, mllCOid bile; the mucou i, velvety and um:mubblc. The exll'lhcpatie biJiary tree i, pllcnt, without evidau:c ofcalculi. The Iiva' weiahs 1370~. sreen- ALIMENTABY TRACI; The lonJUe il he of bile nwb. bemoll'bap. or other i'liwica. The eIOJlhaius if; lined by gray-white, smooliI mUCOlL The psb'ic muc:osa i, W1'aIlpI in the uauaI rupI folds and the tl'll\Cln conwllS 'lJPI'Ollimllely 500 ml of while thick liquid. The na1Ilrld Iarp bowel ~ unn:maJtab1c. The pmereas hII. nonnal pilj;-tan Iobulaled appeennce and the dllCts are clear. The appmdix ill present and is ~Je. CENrroUBINARX SYSUMj The ..-J CIIpSU1c:s ~ amooth and thin, scm.ioVlnSpUCllt and strip with ease &om the 1lIIderlyinj: smooth, rod-brown corticalllllfllCCS. The corticc:s arc lhuply ck:lincated fi'Orll the medullaly pyrwnidt, which .., rod1llaJlle 10 tan and 1II1I'al1Il'bb1c. The e-Jycc:s, pclvc:s and urctenI ue unrcmubblc. While bladcIer l1IIICOSIo overlies III inlld bIaddtt wall. The urinary bt.dckr contains 15 mI of clew, yellow urine. The pro$Ule gland is l1Ol'TlIIl in.izc. with Iobuiu", ydkrw·tIn parench)'lllL The KlIlirW vaiclclue 1IlIrCmIIbb1c. The teslCI; arc he ofllWS lesions, conlUliOlll, or other abnormaIitiCL The right kidney weight 120 pnI; the lefll20 gJ3llIL MEDCOM 0412 ACLU Detainee DeathII ARMY MEDCOM 412 • t AUTOPSY REPORT (b}(6) J 6 HAMED AL MU FARJI, KIlaleecl Vu*u a_IUd RlJlgJLOENDOTIIELIAL S)'mMj The IpIccn bIJ • smooch, iDtael capsule covering Rd-purple, modtnlcly firm pImlCh)Tlla; !he lymphoid follicla ~ unremarbble. The regional l)'mph nodcI appear normaJ. The spleen weighs ISO grIIllS. IiNDOCRINI SXSTEM; The pituiWy. thyroid and adrenal g1andsm unmnafbble. MUSCVLOSKlLIjIAL SYmMi Muscle development is normal. No boneorjointlbnom1l1.iliCl arellDtcd. MICROSCOPIC EXAMINATION Selected portions of orpnI are retained in formalin, wilbout prepInItion of histoJogie rJides. ADDJDQNc\L PRQCEDVRfS Full body radiognpht were obtained IJld reflcct the ~uriel deleribod above, Documentary photognphll are taken by OAFME photogrlp/lm Spccimem retained for toxieologie lCItina .,clIor DNA identifieation ani: vilRlous fluid, hean blood, urine, bile, liver, sploc:n, and guttk contents The disaec.led 0fIII'IS are fol'Wltdcl1 with \he body Penonal efTccb' lie releued 10 the appropriate mortuarY operationl represc:tlLalive OPlNION This 36 )Ur-old male ~ civilian in US eustody~ or. gWLJbot 'IlIOund of the head, causing fraetures orlho 2 cervical vetlcbra(uis) with lrI!lSCCtion ofw cervical 'Pinal eoni. By report, he.,.,.. abol durilll' priJon riOi11 the BlX:CI. detention facility. The llWlllCI' of dca1h i. homicktc. (b)(6) (b)(6) _---'Medical Enminer MEDCOM 0413 ACLU Detainee DeathII ARMY MEDCOM 413 -- .~. AI1J'. (b)(6) r.upmWMlltn11Qft AnP' ' .N...... S i n . j(b){6) .......... omaornu ARMED roaca MlDICAL ......n rr-n' NUl lift or PAtHOLOGY WA.SIIJHGTOI'(. DC 203M I . ,- HAMED AL tofU PAM, JOI.&I FED S\W(, • U' [(bR6) r ---" 'C.~ '.1: Cb}(~ -:J ........... e.-w: Nl_)24,2OIn .... 7 CONiULTADOf1 punn ON C9NTBWWlR MATIiRIAL .......1 orTOXlCOlOGICAL IXAMIPlAT1Of'I e....,.....,s'. ' . OOOD DII.fllIadd.I.{b)(§l2005 VOLA11LIS: tho pt u.IIoR rud: 211612005 on. HEART BLOOD AND VI'J'REOUS n.vm -.. "mined Cor _;eo(etbmo! lit acukl6oUO 1DJIdL. No ctbIDol_ .Ire:tm. MEDCOM 0414 ACLU Detainee DeathII ARMY MEDCOM 414 _. _- _.- -..... evoflPOCATi 01' _no _ K A S j _","","0 _____ ..__ ~ _ IeT8 ""-m..:l N Mu Farp, K~. YUutl ""-mad -- Ifaql Delairlee ...TOo .... _ _ ... 00 ~ "' ...... --- [(b)(6) _......... -- lli....-.(b;('6i'--- ~969 --._-611 0 ---_ .- .• -• -- """, _ . __ ._ ...... _.............. .... ._-_.-"""'""-""*-...... .............._---.-------_.._-_....,-_ _..._--",,--- -_-.." '''e toe ~ ~ SUMi·lllam ..... ~- -"' "'- ............... _ ....t11 - . . . . .,...TOIEOff -._ e- .. _ _ ..._ _ ... _ '-~"- unshol MlUfId 01 ... lind ......""c· 'iOOO<>M01l.• . . . . - ......"" ~ ..... _co ...-TO_.,... __ TO_..... --.- -_. --, ... -- --- -- - .--._......_- ........--... ------"''''' .... --"----"' . -• --- -- --- ......-.. - .... -- _.- ''''. - ..... __. __ .... _---.. __ .... .........- ._--'"-"" .................. _.. __ .... -- -- _............- --'--_. --_ ....._ _...._ __ .. __ " ... _ ,--_ ... _ ..... _ .... .. _-... _..... .. _-_._ ..-. -.........- - .... ,_.-.... ...--_----_ ._ .... _ ... _ ... _-, .... ...... -.._........ ... ... . "',,' 0ftC/I_~P""" • -", • ", < ~ (b)(6) ..-- -~)i6) 05 F.b2005 . ~- • ...... ~"'III;A'" ,bii6'i........;-··_, _ ........... _ " ' ... - . - . _ ..........._ 0 " .... _ _110 _ _ _ .........., . . . - . ""_ ... , IMedical EXimitler (bX6) (bX6) •• 0.-, Me. ~..,;. if oe 19902 -""'(b}(6} .... ... ,-~- DO,,,,,,, 064 " .., ..-.. MEOCOM 00415 ~ ACLU Detainee DeathII ARMY MEDCOM 415 tREA«)V!: REVERSE AND RE-INSERT CARBONS BEFORE CtJAIPf.ETWG THIS SJOEJ m$,ogmoHOFREM~S No\tIlII! Of WOllI11CUIH P'AU'1o/lIfG N:lMIHS ...... UC%H5E . . . . .fttoN:l ST"TIE ......... INSfAUA'nOlII 0" o\ClllMSi ~" NMIl Of CENIElUl'l' CI'I CM:.... TCll'lT LDCATlOM OF CE.~'I'0" CN:.... ,Cll'h' 0II11! Of 0iISI"0Si IIOfII T"IftCl~Tl(IlrII REGISTRATJOH OF VITAL. STATISTlC$ MGl$nl'I' IT_ _ e-.w MAMf Of fl"Ilo8W,. DMC'ICM 1°""" ~" ........... ....... .......... "Aft 1°""" DGNll'll,.N: 0' .wntOfllUD lNCII\IlDUIrIL USAPA'II1.oo DO FORM ZOU, APR tin (BACI(} MEDCOM 0416 ACLU Detainee DeathII ARMY MEDCOM 416 \ ARMED FORCES INSTITlff[ OF PATHOLOGY Offk~ orlb~ Armro Flll"cn Medical Eumioer 141] Research Blvd.• Bldg. 102 Rockville. MD 20850 1·800.944-7912 fiNAL AUTOPSY REPORT Name: Moluunmed SaJun, Sollaib MlIll500r Inlermen1\ SeriaJoNumbeJb)(6l Date of Birth!(b)(6) 1973 Dale ofDeattl(b)(6) 200S Dale of AUIOPsy:-04 Felmwy 2005 Dale ofRepol1: 12 ApriI200S Circumstances of !k.tb: This 32 ] AlIlop$Y N,o.:!lb}(6) ] AF1P No.: (b)(6) ] Rank: Civjlillll. Iraqi nllional P]IICC ofDealh: Butta. Iraq Plact of Autopsy: B~ IfMl ~aro()ld male, presumed Iraqi nalional. civilian delllinee WlIS found I,lNesporIsive wl\ile in US custody lIllie Bucca detention fllCUif)' in l~. and resuscillllion cfrons _rc unsua:essful. Alilhorizalion f"r Autopsy: om« orchc Armrd Forcci Medlnl Eumillu, tAW 10 USC 1471 Identification: Visual, pel detcntion facility records; posIIJIOneTn fingerprinu and DNA profi Ie obtained. CAUSE OF DEATH: Atherosclerotic <:ardiOYll5Cular diseaw MANNER OF DEATH, Nalural MEDCOM 0417 ACLU Detainee DeathII ARMY MEDCOM 417 J AUTOPSY REPORT ~)(6) MOHAMMED SAlUN, SOhlb Mlosoor 2 nNAL AUTOPSY DIAGNOSES: I. AtheroKlerotic eardiovaseular disease (Cardiovascular Pathology conrollation) a. Modcnte coronary artery athel'O$Clerosls i. L.en arIteriordesc:ending artery (LAD): 40% luminal nilfTOWing of proKimal LAD by pathologic intimaltltickcning with amooth muscle rich intimal proli feration 11. L.efl circumflex artery (LeAl:.5O% narrowing ofproKimal leA by proKimal intim'll thickcning III. Righi coronary arlery(RCA): 60% narrowing ofproKimallo mid RCA by patllologie intimal thickening with Imooth muscle rich ncotintimal proliferation b. Mild dysplasia of atrioventricular nodalll1cry with increased tibrosis in branching bundle and crest of ventricular acptwn c. Heart, 39.5 19TI 11. Diffuse h)1lOKie-iJc:hemic changes of bBin L Bnin, 1674 gm b. AFIP Nellropilthologyeonsuhation i. Sh.rvnken eosinophilic cytoplasm and indistinct nuclei and glia with pyknotic nuc:lci and eosinophilic cytoplasm in eerelml cotteK, basal ganglia, hippocampal formation, brainslem and cerebellum IU. No evidence of significanl injllr)' a. No eKtemal Of internal evidence of Irawna rv. No evidence of physical restraint V. Early dc<:ompositionll changcs L Mold growth over face and back ofneek b. Green diacolontion of upper abdomm c. Focil skin slippage d. FOClIl drying offingelS Co Dark diaeolol1ltion of intemal organs. including bnin f. Decompositional fluid in bilatel1l1 pleural cavities,.50 ml each side VI. TOKicology {AFIP) a. Volatiles: Blood negative forcthanol b. Drugs: Heart blood negative for aerccned mediutions and dnJgs ofabulC ... MEDCOM 0418 ACLU Detainee DeathII ARMY MEDCOM 418 AUTOPSY REPORT ~b)(6) I ) MOHAMMED SALUN, Soh.lb MUloor F:XTERNM EXAMINATION The body is tMl ofa well-developed., _n-nourisllocl C.ueasian male<;lad in a pairofbllll<;k swc:al pllllS witli I wbite NBA logo and I pair of white lloJIer shorts. The body is received on lOp of I grey and red blanket wilb multiple loose mcdi<;al devi<;a including IlIUl:lion conlainc:r wi\h appamll gastric contents, a white plastic boII'd, a facial mask, I 1ll1}'llgostOpe and I While wire. Tbe body weighs IppI'OXimalcly 180 pounds (estimllcd), is n" in height and IppclfS compaliblc wilh lhe rcpol1ed age of32 yean. The body lempmllurc is cold, thll of tile rcmgCl"llllOll unil. Rigor has diuipaled, and \he body is flaaid. Lividity is pn:sent and filted 0l'1 lhe posterior lUfface ofille body, exCepl in arC&l exposed 10 preDUre.. The scalp iscoveml wilb dafk brown hair in I normal disl1ibution av~illll.S em in length on the lop and Ihortcron the $ides. Facial haireonsisu ofa dafk brown beard and musu.che.. The irides are brown. The oomeac: areeloody. The sclepe and eonj\ll}Ctivac are pale and free of petechiae. The earlobes are nol pien:ed.. The external auditOfY canals, exlernal na:u ando!1ll cavity are freeoffOl'eign mller111 and Ibnormal5eCfClions. The nasaJ skeleton is palpably intacl. The rips arc without evident injuty. The let:th are natural and in fair condilion. TheR are early dCCOlTlpoliliol'lal changes including tile previously dCliCribal corneal elouding and 1000ofrigor. There are a150 multiple palelies ofwliite and green mold growth on fau and bllCk of the neek, llle mljorityofwhidl wipcl free easily. ThcJe is gmm diseolontion of the upperibdomcn and darIc dryingoflhe lingers and hands. There is focal slcin slippage around the anlda. The neck is Sb'Iight and the b"lehea is midline and mobile. TbeehCSl 15 symmetric and well developed. No injutyof\he ribs or Slernllll1 is evidenl extemally. Theabdomal is nil and $On. Healed surgica1 SClIQ of the tono are I'IOIlIQled. The CIl~miliesare well developed with normal nmgeofmolion. The fingernails are inlact The $O!cs orllle feel arc ealloll5cd and hyperk.tr.ltolie. There i. a 4 em seaton the len hand at the base of the thumb, and there is I D.S em pusNle on the back of the len upper thigh. No tsnOO5 are noted, and needle Inch are nol obsel'ved. The clttcmsl genitalis are those of a normal adult cireumcised mile. The testes are deseendc:d and free of masses. Pubie hair is presenl in a normal distribution. The bunoeks snd anus are unremarkable. An idenlificationtag is lltM:hed Ul the first toe on the right fool. EVIQENCEOfTIIEMU ~ are I lOla' ofnine adhesive EKG psds on the body, ooeon the right shoulder, one on OTIC on the upper right side orthc~ five on the upper left sideoflhe ehcs! and one on the lower left side of the Ibdomm. Then: is an innvenous eatheter in the righl antecubital fossa. secured with white 1apc, and tllcn: is • xwnd piece: of while Iapc On lhe lower aspect of the upperrighllml. There is no O!bcr evideneeofmedieaJ intervention. the len shoulder, MEDCOM 0419 ACLU Detainee DeathII ARMY MEDCOM 419 R~b)~(6~(=,=,~ AUTOPSV REPORT MOHAMMED SALUN. Sohalb 4 Man~oor EVIDENCE Of 'NJURY On external examination orthe body and internal examination orthe head. chesc and abdomen. there is no evidence of injury. INTERNAL EXAMINATION BODY CAVITIES; The body i~ opened by the u~ual thoraco·abdominal incision ilIld the chCSl plate is removed. Other than accumulation of decomposhiorIIJ fluid (SO ml darlt fluid each pleunl cavity). the pleural. pericardial. and periCOIIeal cavities are unremarkable. All body 0fPIl' are present in the normal anatomical position. The verttbnl bodies are visibly and palpably intaet. The su'beulallCOUS fallaycrofthe abdominal wall is:l cm thick. There is no internal ~idcncc of blunt foree or pmctnlting injwy to the thora<:o·abdominal regiOt1. HEAD; (CENTRAL NERVOUS SYSTEM) The scalp is reflected. and there is no subgalcal hemofT!lage or skull &ao:tures found. The calvarium ofthc skull is removed. The dura maier and falx cm:bri arc intac:l The blain is darltlydiscolorcd from docomposition, but lhcrc iJ no epidum or subdwal hemonhage present. The leptomeninges are thin and delicate. The cerebrospinal fluid is slightly darlt buc tree of blood. The cercl:nl hemispheres ale symmclrical. The s~t\lres at the bucof lIle brain. including cranial nerves and blood vcascls, are intact. COI'lllllI sections thn:lugh the c:crdlraI hemispheres rcvcalcs no lesions, and there is no cvidc~ of infection, nunor, or t..uma. The ventricles are of JJOfTl\a1 si!e. Transverse 5CCtions through the brain stem and cerebellum are unmnarkllble. The dun is ~trippcd liom lIle builar skull, and no fractures are found. The atlamo-occipitaljoint is stable. The blain weighs 1674 pams. NECK; EJr:aminaliOll oflhe soft tissues of the neck, inclooing Slfllp muscles, lIlyroid gland and large vessels, reveals no abnormalities.. The antcr10r strap muscles of lIic neck are homogeneous and red·brown, without hcmontuoge. The th)Tllid ca:lilagc and hyoid bone are inllet. The 1ary1lX is lined by intact white mu(:O$/l and il LmObsttuclcd. The th)'fOid Sland is symrnctric and red·brown. without cystic or nodular change. There is no evidence of infoction, 1lUTlOf, ortnuma, and the airway is patCl1t. Incision and dissoc:tion oftllc posterior n«k dcmonslr.iltes no deep paraccrvical muscular injury. IIcmormage, or fracrures of the dorsal spinous processes. CARDIOVASCtJL,;R SmEM; The pericardia! sutfaces ate smooth, sliSlenirli and iIIlrcITIalkablc; the pcrieardisl $;I(; il ne ofsignificant fluid and adhesions. A modcrale lIITIO\l.I1t of epicrial fat is present. The coronary arteries arise nonnally. follow a right dominant distribution and arc widclypatenl, without evidence ofsignificant atherosclerosis or thrombosis. The charnbtn and valves exhibit the usuallizc·positiOll relationship and ate UMmlarkable. The myocardium is dait; red-brown and unrcmarkable: the atrial and ventricular septa are !nllel. The letl. ventricle il 1.0 cm in mickncss and the right ventricle isO.2 an in thickness. The aol1a and il5 m~or bmnclles arise nonnally, follow lIle usual cowse and are widcly patent, tree ofsignilicMl MEDCOM 0420 ACLU Detainee DeathII ARMY MEDCOM 420 AUTOPSY R£PORT (b)i6) MOHAMM[DSALUN,Sohlb M.._r , alllerotelcosil and otIler abnormalily. The venae cavae the hart in the lWal distribution and ~ and !heir major tributaries I'dUl'TIIO he of thrombi. The hart ~Bhs 395 ~ RESPIRATORY SYSTEM; The upper airway il clear of debril am foreign mllCrial;!he mucoul turflCCS ~ smooth. yellow-tan and unrerTII1UbJe. 111m an; plew'aIldbcsioN involvinJ the lower lett lung lobe. The plWrallurfKCS ~ othcrwille smooth. Jlillmins and unmrwbble billlenllly. The putmorwy parmch)'llUl il rai·pwple. exudina Il1iiht IIllOWlI of bloody nuid; no focal lesions an; notal. The pulmonary ancries .e normally c1cveloped. palent and without thrombus or nnbollll. The rish! hans wcishs 629 pms: the lett 859 grams. LIVER" BlLlMY SYSTEMj The hcpaIK: capsulc is 1Il'lOOth. Jli1lel\inallld intIcI, covcrillS dark rai-brown. rnodentely COl1SCS1ecl plftllChyml with no focaIletionI notal. The pl1blaclttcr contains Ics1lhan I ml of green-brown. mucoid bile; tl1c mllC(lll i. velvety and unmnarbbk. The n~c biliary tree il pIltcnt, withoul r:vidr:llce of ealculi. The liver wciJhs 1936 pms. ALIMENTARYTRACTj The IOt\JIlC illi'eeofbite maritI, hallOftha&e. «other injuria. The CIOphIglJ1 is lined by ply·white, IIIlOOlh mucosa. The pstric IIUlO1I issmngcd in the UIIlal rupl lOlds and !he lumm COl'Itains 200 ml of lCI'tlitolid diSCStin, matr:riaI inerudinS rice and pieca of orange. ~ arelbdomlnal adhesions involvins the nsht IIppCI" qudanl. The Imall and Jarge 'Do_'are ~ unnmarbble. The pancrus has I normal pink·UIn lobulated ~paw"lCf; and the duets are clear. The: appc:ndia is presmt and is unremarkable. CEN'!TQURI NAllY SyUEMj The raW eapsula are smooth and thin, sem;.1nIIIpimlt and strip with ease from the undcrlyin,s smooth. rai·bfown conical The cortices an; 1hIIply c1clincated from the: medullary pyranUds, wllich an; red·purple 10 UIn and unmnarbblc.. The clll}'l:a., pelves and ureters ate unrunarbble. While bItdOet mUC05l overlies an int.c bla:ldcr wall. The ~rwybllddcr contlins5 ml of cloudy yellow urine. The prost.1e Jland il normal in du. with Iobullr. yellow-lll'l plImlCh)'II'IL The seminal vaicle:s an; unmnarkable. The testes are free of mus lesions, comusions.. or other abnormali,ies. The n&ht kidJlcy weiJ,hl 170 pms; lhe left 115 pams. -rICa. REIICULQ£NOOTHELlALSYSU:\lj The sploen has I $Inoot/l, intaet capsule oovcnl\l rai·purplc, moderately finn parenchyma; the lymphoid IOllicles are IUIrUlIII'bbIe. The regionIllymph nodes appear normal. The spleen wc1shs 322 srams. ENpocBINE SXSTEMj The pituitary, lhyroid and admwl .... sJarv;Is are ~u1uble. MUSCULOSKELETAL SXSUMj Muscle dcvelopmcft iI normal. No bone orjoin! abnormIlilic:s are noted. MEOCOM 042\ ACLU Detainee DeathII ARMY MEDCOM 421 AUTOPSY REPORT (b)(6) 6 ..... OIlAMMEO SALUN. SohJlb MaDloor MICROSCOPIC EXAMINATION HEART: See "Cardiovascular Pathology Reporf' below. LUNGS: The alveolar spates and small air passap show evidence of autolysis. Where well prCSCf\led, lhe alveoli are expanded and «lIltain no significant inflammatory component or edema fluid. Then: is nidmce ofperi·monem food upiratioo (no inflammatory reaction). The alveolar walls are Ihin and nOI congcsled. The ll1erial and venous Ylitular systems are notlnal. The peribronchial lymphatics are unremarkable. LiVER: The hepatic IKhiteelure is inlact. The portal aniLS show no inereued inOammatory componenl or fibrous lissue. The hepatic parenchymal cclls are wellpresaved wilh no evidence of eholeslasis. fall)' melamOfllhosis, or sinusoidal abnonnalilics. SPLEEN: The capsule and white pulp are unremarkable. There is minimal congestion of lhe red pulp. ADRENALS: The conical zones an dislinctive, and lhe medullae an not remarkable. KIDNEYS: The subcapsularzoncs are unremarkable. The glomeruli are mildl)' congested wilhoUi cellular prolifcralion. mC$lllgial prominence, or sclerosis. The lubulCl sllow aUlolysis bUI are unremarkable. TIlere is no interstitial fibrosis or significant inOammllion. There is no lhiekening oftlle walls of the arterioles or smsll arterial cMnnels. The lransitional epilhelium oftlle collecting syslem Is normal. BRAlN: Sec "Neuropalhology Report" below. THYROID: Unremarkable. TESTES: Unremar:li:able. ",,,,,,_,c• ,•sp ..""O<v<•.,"CJU.k:....UPO••Tll""O'k""OG .....LJ.'ElJ:P01UR,TL CV Palh]{b)(6) "D1AGNOSIS:~(b)(6) ]r..todrutr eoTOury ariel')' albuoselrro,lJ; mild d)'spllill of alriovenlrlcular nodal ariel')' "lIb lae~1HiI fibrOib In brancblal bundlc and creU ohUlrleular stplum History: Approximately 32 )'tar ok! male Iraqi delainee found dead in COl Heart: 39S grams normal epicardial fal; closed foramen ovak:; biventricular dilatalion: lell venlricular cavily diamcter 45 mm, !ell venlricular free wilithickncss 9 mm, vClllriclllar sCJllum thickncss9 mm; rigllt ventricle lhickness 4 mm, withoul gross scars or abnormal fat infiltrates; mulliple iIJl()rnalO\lS delicale cortin in rigltt venlricle between MEDCOM 0422 ACLU Detainee DeathII ARMY MEDCOM 422 AUTOPSY REroR~(b){6) MOHAMMED SALUN, Sob.lb M.nloor 7 papillary muscles and free will; feneslrated non·coronary cusp ofaonic valve; olha" valvn lUIl'Cmartable; early myocardill d«Oll1position, otherwise ullJ'Clllartlble; IUslologio; IICIClions show unrctl'l8ltable myocardiW1l Coronary lI1eries: Nonnal oSlia; riglll dominance; moderate Itherosclerosis: Left anlmor descending 1I1CT)' (LAD): 40% luminal narro.....ing ofproltimll LAD by pathologic intimal thickening with smooth muscle rich intimal proliferation Left cireumnn arlery (leA): 50% narrowing ofpl'OltimlllCA by pathologic intimal thickening Right coronary artery (RCA): 60% narrowing ofproltimalto mid RCA by pathologic intimal thickening .....ith smooth muscle rich neointimal prolifCTlltion Conduction s)'Slem: The sinoatrtial node and sinus nodallr1cTy are hislologi<:ally unremarkable. The compact atrioventricular lAY) IKldc shows right downward displacement, and mildly incrused ral and vascularity. The AV nodal lI1ery is mildly dysplastic with predominantly medill thickening and advenlitial fibrosis. Focal subendocllidalll'ld perivilS(ular in\c1Slitial fibrosis is presenl in the crest of the ventmuhl1 seplum. The penetrating bundle is centrally Iocaled in lhe fibrous body and uhibils increased Prolcoillycan and decreased cellular components without inflammation. There are no discel'llible increased proleoglYCIII and fibrosis. The proltimal bundle branches pre inlll;.I.nd also demonstrate increased proteoglYCI:l and dec:reased cellular componenls wilhoul inflammation. There are IllI discemable bypass tracts between the AV node and venlricuJlIJ septum. Commenl: Histol(lgic eltaminaticln is suboptimal due: 10 I'O'I·mortem dec:olfll'Osition: however,lIIe dyplulic AV nodallr1cTy and fibrosis in the bnnchinll bundle and crest of ventricular seplUm are nOl lI1ifactual. Allhough the histologic findinll' would be m(IfC likely to produce bundle branch bIrd, similar chanlles have bun described in usociation with sudden cardiac dealh, tikelydue to ventricular atThylhmia. The etiology of the fibrosis is unclear, pClssibly due to small vessel narrowing or I resolved prior iflnammat<lr)' conditkln:' NEUROPATHOLOGY REPORT Deplrtment ofNeuropalllology and Ophthalmic PllholollY. AffP: "We examined the multiple portions offilted bnin·tiuuc, measurinll2Q II 15 It 2 em in a~gate. submitlcd in reference to this case. This includes liagments consistent with cerdlrum, cerebellum, brainstem and dura. No gross lesions are idenlified. Hist(llOllical sections submilled: I. Cerebral corlelt. 2. Medulla. 3. Mcdull&lllppem1ost cervic.l spinal coni. 4. Cerebellum. S. Pons. 6. Cerd>ellum, dentate nucleus.. 8. Bu.1 pIlllli.. 9. Hippocampal aru. to. Ou,," MEDCOM 0423 ACLU Detainee DeathII ARMY MEDCOM 423 AUTOPSY REPOR~(b}(6} MOHAMMED SALUN, Sohllb MlnltJOr • All sections wcre processed in pllnllmn; hisLOlogical slidell were stained. wilh H &: E. This matcnalwu rcviewed in COnfCftinCC by 51alTin the Dcpanment of Neuropathology and Ophthalmic Patllology. Histologic sections sho.... neurons with shrunken ClO$inophilic cytoplasm and indistinct nuclei, and glia with pyknotic nuclei and eosinophilic cytoplasm, in cefebal C011ex. basal aangU.. l\ippocampal fOTTlUltin, bminslem and «:rebell\lm. These eelllllar features an: consistent with diffuse hypoxic-isebemic chlJlgn. The: din shows no diagnostic histologic changes." AQQlTIONAL PROCEDURES DocWTIenl.lry photognlpfls Ire liken by OAfME pllotognphcrs Specimens retained for lo~ieolollic teSling and/or DNA identification Ire: vitrcO\l$ fluid, femoral blood, hcan blood., unne, bile, spleen. liver, and gaslric contents The dis.sco;tcd organs lIe forwuded wilh the body PCfSOn<ll effeets arc relcasal to the appropriate mortl1ll'Y operations rcpt"esentalive OPINIQN This )2 year-<lld rrWe Iraqi detainee died in US cl1$tody of atherosclerotic cudiovaselliar disease. with modente coronary artery atherosclerosis (three vessel diSCISC) and mild dysplasia of the auiovcntric\llar nodal artel)' wiltl inereased fibrosis in Itle branchinll bundle and cre51 of Ihe ventricular septum. Fibrosis within Ihe heon, panicularly around Ihc conduction system msy initiate cardiac an1lylhmias. There is rIO evidence ofsny external or inlemal trawna or evidcnec of physical reslraint. No other significant naNrsl disease within lhe limitations of the a\ltopsy was found, and toxicologic siudies arc negative. The mllR1lef ofdcath is natural. (b)(6) ",(be'""O'---''''Mcdieal Examiner MEDCOM 0424 ACLU Detainee DeathII ARMY MEDCOM 424 DEPARTMENT OF DEI'EN&E AAMEO 'OIlCEa IM1'ITVT'I rw ~"'TMCIl.OO'l' W.... _TOIl. tie.. : .DOI onlCEOFTHE ARMED mRCES MEDICAl. EXAMINER ARMED rORCES INSTlTlJT! or PATHOLOGY WASHINGTON, DC JOJ06-6000 MOHAMMED SALAM, SOHAIB MANSOR $SAN: Awlo"," .8(~b)~(6~)~==J To.koloo -,"...10_ .,'{bJ16j r; hie RtjlO" C~","lod: rot-u.y27, 200~ CONSULTATION REPORT ON CONTRIBUTOR MA,TERIAL ...rIP DIAGNOSIS REPORT or TOXICOLOGICAL EXAMINATION COlldllloll ofSpccbll~D.t: GOOD Dall ofJaddllll(b}(6} 200S ... VOLATILES: The BLOOD WlIII Dall Rtaivrd: 21161200s examined for the presem:e of ethanol at a cutoff'of20 rniVdL, No ethanol was lklected• DRUGS: The H£ART BLOOD was JCftened for amphetamine, anlidepresS8nIS, aatihiswnines, barbiturates, belUDdillZepines, cannabinoicls, chloroquine, cocaine, dexlrometholphan, lidocaine, narcotic analgesiC$, opiares, phencyclidine, phenothiazines, S)1Tlplthomimclic amine, and vcrapamil b)' gas chromatogr1pl1y, color lesl or immunoassay. The following dr\Igs wcre dctected: None wcre fowld. ... MEDCOM 0425 ACLU Detainee DeathII ARMY MEDCOM 425 _. _....... -_..__. - _._&1_._.r__ .- - --............ -- ... . _" ---_.,-- _ .. ......... ........... ---.... .•_ -"""...... -- - - _-.............. ........... __ _.--.---_.-""-_.... -'(b){6) CU'l'lP1CloTi 01' _YHIOn'!t""" eTe MoIIammecl Salun. SOl'oalb. ManllOOf (bl(6) Iraqi Ot\ainee . I.., " "'oo.11973 6!1 0 l(b)(6) --~ ....._ 1 0 . . . , . . . . . ~ . _ '.~ _ ..__oo- ,.. "ft_ ....:AL .. 01 c..-"'_ ...."' __ __ _ _.._ e-.. _ __ _ _ _ _ 1M ........... ......n. _.._--"""""""'... .-. ''''''''' -.. -.0--_. -_ -'''--........ -,.._0---. _ . _ ......... .. _- _.- - ---...._----_.-_ ---- _.-._-... ... _. __._.__..-..._ __ ... --.-_ _ .. _. __ _ _-, . . . . . _"'---*"'_ .. __ .... _-"'_ ............ _ ... _."....., '._-_ -,_._ -_..........__...._..--_ ....._ _ . __ .__ .- .. - _.. ............. _ ..... _-,_._ _ .... _ ... _-_._ --_...._-._....- ...._.'-"OO- '''''' ......... . . - 1 0 ......' ~ _1O_c..- ,,_ _10_ -'-"-'''-. - ',' • 0_ _ ....., ... ......".., • ~ ........... 10 ~Mode 01 a.alll; Ptto<lIng _ ... """"00ItT (b){6) 1-'1'b)(') 110 1 " ........ - 00,'30...2 . ... , (b)(6) ,(b)(61 ·1;--.....' I,.., " l~" ~"" n_ • -'';;;' =., ...................._-.-...-..........-...... ... 1"1\.1I""_ . _ , , _ ........,. 00Ytr "FB. DE 19902 or -'\bii6r ..... 4 .......... ' -.- " " " , " , , " _ " _ , , . . . . "'" . . ""................... OL ..'MK'tI . . . ~ MEDCOM 0426 ACLU Detainee DeathII ARMY MEDCOM 426 (REMOVE REVERSE AND RE4NSERT CARBONS BEFOAECOMPl£T1NG THIS SlOE) olsposmOH 0' REMAINS OIAIolf 01' ~ ~AIlINO AE_S ....... NSTAU.ATIONORAODM$$ '''' NIoME Of' a~ (If' CJIl"*,,TOfn' l.OCAl~ Of' UUHSl! HUYIlEJI N«J STATE """""'" C6lITUIY ORCl'llEWolOl'Y ..... " """"'""" OATt OJF IASl'OIIIIOH AEQlSfRAnON 01' VITAl SfAnsncs IVGIS"" rr_ _ e:...ww IMTEAIE<asT£I'lED STA'" IUM[ Off 'UCJW. 0NCf0lII I~' .....-. I~ _OS lAGMAnN: OJF ~IOIOMDUM. USAPAV1.ClI DO FOR" 2otU, APR fJl1I8ACK} MEDCOM 0427 ACLU Detainee DeathII ARMY MEDCOM 427 ARMED FORCES INSTITUTE OF PATllOLOGY Office oflhe Anned Forces MediCiI Eumioer 1413 Research Blvd.• Bldg. 102 Roc:kvi1le, MD 201150 (301)319-0000 FINAL AUTOPSY REPORT Name: Mlll"U6. Ali HlIJ'Clo. Interment Serial (b)(6) D.lcofBinh:(b)(6) 1946 DaleofIkath~)@) 2006 Dale of Autopsy: II DEC 2006@ 1200 Date of Rcpon: 28 fEB 2001 Autopsy No:1(b}(6} AFlPNo(b}(6} J Place of Death: Camp Bucca. Iraq Place of Autopsy: Dover AFB Pon Monuary. Delaware Cireumll.oe~ or Dealh: (b)(6) an lraq; National male. was held as 0 detainee ill Camp Bucca. lIaq. I Ie w~ admilled to the lhrater ImClJllelll facility ~IF) Oil 11 November for hean and blood lJ"S."un: problems. On (b)(6) • (bl(B) became hypotcn~i"e and unm;ponsi\'~. He eltpil\'d despite eatdiac n:suscillllive lTICaiUres, AUlhoriulion for AUIOp5}': Offi« of the Armtd Title 10 US Code. Sa:lion 1411 (10 USC 1411), FOI'CC~ Medieal Examiner. in aceordWJ(:e with IdenriflClltion: Positive identification CS!Iblished by invesl;pli"e agency CAUSE OF DEATH: MANNER OF DEATH: ,~alu ...l Pall.e 1 0{6 MEDCOM 0428 ACLU Detainee DeathII ARMY MEDCOM 428 MUTLI.B l<b)(6) AUTOPSY FINDINGS: I. Seven:: Atherosclerotic Cardiovascular Disease I~eatl; CardiOmegaly, 710 gram~ Coronlll}' arteril'$; i. Left main coronary atlcry - 60"10 stenosis with eoncenuic calcification it Left antmor descending coronary atlery - mullifocal 95% stenosis iii, Right coronary artery - muhjfoca' 95% stenosis COr\Cenuie left \'entriculu hypenrophy -left vemricular thickness - 2.5cm; septwn 2.4 cm Remote myocardial infarction. posterior-latcralleft venmcle Diffuse atherosclerosis of the abdomiNlI aona and iliac vessels with multiple ero~ive plilljllC$ II. Lungs: ... b_ c. d. Marked bilateral pulmonary c<lcrna (combined weight 2220 grams) Diffuse anthraootie pigment, pleW1l and parenchymal Emphysema Dmnchopneumonia Ill. Kidneys; a. Marked ancrioloncphmsclemsis (clinical history ofhypenension) IV. Drain; a. lncidcmalan.eriovenoll.'l malformation of the left pons. 0,5 em V. Toxicology: • • • • VOLATILES; The blood and vilrCQus nuid an: cumined for the presence ofeth.nol at a cutoff level of 20 mgfdL. No ethanol is ddl:eted. Peripberal blood contains less than 1% CIIrboxyhemoglobin (COHllb) detcrmined by spectrophotometry with a limit of quanti\ation of 1%, COHllb SlItullltions of 1).3% are expected for non-smokers and 3-1 (lOA. for smokers. SlIturations above I (lOA. are: considered elevated and are: confirmed by gas chromatography. Thcre is RO cyanide delected in the blood. The limit of quantitation for cyanide is 0.25 mgfl.. Normal blood cyanide cotJ«ntratiol\S are less than 0.\5 mgfl. LetI1aJ conecntrotions of cyanide an:: greater than J mgfl.. ORUGS, The blood is screened for acctaminophen. amphetamine, antidepressants, antihistamines. barbiturates. hellUldi&l.epines, cannabinoids. chloroquine. eocainc, dextromethorphan, lidocaine. narcotic w\lIlgcsics. opiates, phencyclidine. phenothiazincs. sallcylales. sympathomimctic lilllines and vcrapamil by gas chromatography, colol test or immunoassay. 'llic rollowing drugs arc detccted; o Lidocaine is detecled in the blood by gas chromatography and confirmcd by gas chromatography/mass spectrometry o Acetaminophcn is detected in the blood by color lO:St and CQnfirmed by immunoassay. The blood contains 17mgfL of acetaminophen as quantitated by ImmullOllSSllY· Pagl' 2 of 6 MEDCOM 0429 ACLU Detainee DeathII ARMY MEDCOM 429 MUTLlOllb}(6} EXTERNAL EXAMINATION Thc: body is thaI of a well-developed, well·oourished, 71·inch lall, 202 pound male. Lividity is fixed on lhe posterior aspect of lhe body. Rigor 1w plIssW and tile temperature of tile body is cold. till'll of the refrigerator. The 5ealp is covered wilh gray IuUr, with frontal balding. Faciaillair consists of a gray beard and mustache. TItc irides an: hv-..el and the con.junctivae are cloudy. The pupils are round and equal in diameter. The eKtemal auditory eanllis are unremarkable. The ears lobes have prominent creases and are otllerl'ise unremarkable. TlIe nares are patent and the lips are atl'llurDatic. TIle 110~ and maxillae are palpably stable. 1110; teeth alO' nlltul'll!. The ne<:k is sU'llight. and !hi' trachea is midline and mobile. l1le chest is symmetric. The abdomen is protuberant. TIle genitalia arc: l!lose of a /lOnnal wul! eircume-ised male. The: lesles are descended and free of masse5. Pubic hair is presenl in a normal distribulion. The bUllOCks and anus nre unremarkable. 1ltc upper and lower extremities arc symmetric: and witoolll clubbing or edema. • CLOTHING AND PERSONAL EfFEqS The deceased is dad in a hospital gown. Personal effeels do nOlllttOmpany the body. • MEDICAL INTf:RVENTION Endotr.lCheal intubalion; inU'llvc:nous access devices in the right neck and left groin; needle marks in both wrists; Foley catheter; eardioc monitor pads antmor ehcst; bandage covering surgical incision right knee (stapled closed) • RADIOGRAPHS A complete sct nf poslJn(>rtl:m radiographs is obtained and deOlQnSlratc:s no acute injuries aside from tllose discussed in lhe evidence of injury • • EVIDENCE Of INJURY External if\juries consist of mid·sternal contusion and internal examination reveals fractures of lateral right ribs 2·7 and lateral left ribs 2..{i ( Injuries consistent with cardiopulmonary resuscitation) Two contusions On the posterior right calf and ankle. 2 I'. x I and 3 x I-inches. respe<:t,,-dy Page 3 of6 MEDCOM 0430 ACLU Detainee DeathII ARMY MEDCOM 430 MUTLlB (b)(6) INTERNAL F.XAMINATION .I:if8I!: Thc galeal and subgalcal son tissues of the scalp ~ frec of injwy. The calvarium is intact, as is till: dura mater bencath it. Clcar ~rebrospinal fluid surrounds the 1340 gm brain, ",..hich has unremarkablc gyri and sulci. Coronal sections demonstrate sharp demarcation between whitc and w-ey maller, without hcmOlThage or eontusivc Injury. 11lc ",entricles an: of normal size. The basal ganglia, cerebellum, and arterial systems are fiw- of injwy or othcr abnormalities. Examination of the mid-section oftbe pons on the left side sho....'S a O.5cm area of appan:m hemorrhage. There an: no skull fractures. The atlanto-occipimljoint is stable. ~: The anterior strap muscles of the neck are homogenous and red-bro....n, without hemormage. The thyroid cartHalle and hyoid bone an: inlltCl. The larynx is lined by intact white mu<'OSli. 111e thyroid is symmetric l\Tld red·bro",n. without cystic or nOOullll' change. The tonguc is free of bite marks. hemorrhage. or other injuries. Incision and disse<.:tion of the posterior neck demonsulltes no deep paraccnrical muscular injury and no cervical spine fractures. BODY CAVITIES: Contusion of the sternum and rib fractures have been describl:d. Otherwise. the ribs. sternum. and vertebral bodies an: visibly and palpably intact. No e,;cess nuid is in the pleural. pericardial Or peritoneal cavitics. The organs occupy their usual anatomic positions. RESPIRATORY SYSTEM: The right and left lungs arc markedly edematous and weigh 1100 and 1120 l!JII. resp«tively. The c,;lemal surfaces are smooth and deep red-purple w;lh marlled anthracotic pigment deposition on the plewa and in Ihe parenchyma. The pulmonary parenchyma is diffusely conl:csted and cdematous and displays emphysematous changes at the upper lobes .. No mass lesions or areas of consolidation are present. CARDIOyASCULAR SYSTEM: The enlarged 710 gm heart is cOlltained in 811 imact pericardial cpi~ardial surface is smooth. with minimal fat invcsmten!. The coronary aneries ltfC present in a nonna! distribution, with a right-tlominant [)Rum!. Cross s.:ctions of the vessels show 6O"Ao stenosis of thc left main coronary artery; 95% multi-focal slenosis of the left Wlterior descending coronary artery and 95% stenosis of the right coronary aner)'. The myocardium is homogenous. red·brown, and finn. The valve leanels arc thin and mobile. The "''alls oftbe left Wid right ventricles an: 2.5 and 1.0 cm thick., respectively. The endocardium is smooth and Glistening. A 2 Cm area of apparent fibrosis on tbe postern-lateral left ventricle is g.mssly consistent with remote myocardial infarction. The anrta shows malted erosive atherosclerosis along the enti", length. The renal and mesenteric vessels IUl: calcific witlt marked alherosclerosis. sac. The LIVER & BILIARY SYSTEM: The 1970 gm liver has an intacl. smooth capsul~ and a sharp anterior border. The parenchyma is !an·bro"'011 ond congested. with the usual 10bIJllll' architeclure. No mass lesions or other abnormalities arc seen. The gallbladder ~ontains 25 ml of llIccn-black bile and no Stones. The mucosa! surface is green and velvefy. The c,;trnh~patjc bi liary tree is patent. Page 4 of6 MEDCOM 0431 ACLU Detainee DeathII ARMY MEDCOM 431 MUTLIB1(b}(6} SPLEEN: The 190 wn spleen has a smooTh, intact red-purple capsule. The parellChyma is maroon and congested, with distinct MaJpighian corpuscles. PANCREAS: The pancreas is mildly autolytic but otherwise firm Ilrld yellow-tan, .....i lh lhc \lSUIII lobular architecture, No mlW lesions or other abnormalities are seen. ADRENALS: The righl and left adtenal glands are symmetric.......ilh yellow C<ll1ices and grey medullae, No masses or areas ofhemonilage arc identified. GENITOURINARY SYSTEM: The righl and len kidneys arc reduced in size and weigh 90 Ilrld 80 gm, respeclively. The extema.lsurfaces are COI\fSCly granular. The CuI surfaces are red-tan and the conicomcdullary junclions an: poorly differemialed. The pelves are unremarkable and lh., uret",." an: normll in coun;o; and ClIliber. ....'hite bladder mucosa overlies l1li intact bladder "'all. The bladder is empty. Thc prUS\lle is normal in size, Wilh lobular, ~lJow-tan parellChyma. The seminal vesicles are unremarkable. The testes are free of mass lesions, contusions, 0< olher aboormalili.,s. GASTROINTESTINAL TRACT: The esophagus IS mUlCt and lined by smooth. gray-white mucosa. The s\Qmach C<lntains approximately 350 ml of brown nuid. 11Ie gastric WIlli is intact. The enlire small and large intestines arc examined along lheir enrire lengTh and the: mucosa is unremarkable. The appendix is present. MUSCULOSKELETAL: No evidence of chronic disease: incision of the soft lissues oflhe back, bUllOCks. lhighs, leltS and wrists show 00 el'idence of injury. MICROSCOPIC EXAMINATION Selected portions of organs are n:tained in formalin and the following histologic slides are made: # I, #2. and #4: Histologic se<;tiolls of the coronary arteries wnfirm the ItTOS5 descriptions 113 and 115: Left Venlricle: multifocal fibrosis #6. Cardiac S(.-ptum: muhifocal fibrosis RighI Ventricle: lUlremarlrable N7 and #8: Lung: bronchopneumonia; pulmonary edema; emphysematous change 119: L.i\"er: no palhologie diagnosis #10: Kidney: hyaline arteriolosclerosis: ditfuse fibrinoid ne<:rosis of arterioles and hyperplasic arterolilis (onion-skin change); tubular a1Il)phy, intcrstitial fibrosis and chronic innlllnmalion: focal glomerular fibrosis 11'11: Pom: arteriovenous malformation Medulla: no pathologic diagnosis 1112: Cortex, main: no pathologic diagnosis #13: Aorta: marked calcific erosive atherosclerosis confinning the gross obsen:alions #14: Left Ventricle (poSlerolaleral): remote myocardial infarclion Plll>dof6 MEDCOM 0432 ACLU Detainee DeathII ARMY MEDCOM 432 MUTLIB ~"b)","")- - - ADlllJIONAL PROCEDURES • • • • Documentary photographs are taken by the OAFME Photographer Identifying marks incilide a $Cars on tlte ~terior righl leg (call) SpedmellS retllineil for loxicological testing and/or DNA idClltification are: vilreOUS fluid, blood, urine, splcen, liver, kidney, IWlg, brain, bilc, gastric contentS, psoas muscle IUld adipose tissue The dissected organs are forwarded wilh the body OPINION BlIsed on these autoJl5>: fintlim"ul1'IlLlIt"-.invemigative infonnalion available to me, lhe cause of dcath of Iraqi detaineel(b)(6) is severe ttuee vessel atherosclerolic cnrdiov8'SCular disease. The markedly CIII~1ieiti SIIoW!l histologic evidence of ptevioll.'l myocardial infarction (bean altaek) and lell ventricular Itypertroplly. Thc lcft ventricle of the hean and lhe kidneys show bolh gross and microscopic change:. consi$letll with long stllllding It)'pC'rtension (high blood prelsure). An incickntaJ arteriovenous malformation of the brain (likely congenital), located in lhe pons. had no bearing on tbc cause of death. Toxicology examinalion is positive for acetaminophen IUld lidocaine. medicatiollS utilized in hospitalized care. The manner ofdealh is natural. l(b)(6) Armed Forces Mediul Examiner Synem (b}(6) Page6of6 MEDCOM 0433 ACLU Detainee DeathII ARMY MEDCOM 433 --...........- -_.- _. _-''''' .......,.,. _ffllT_- . . . 1.• -_... --• --- -__-- -- -- - --___..... _._....-- - .._-'" --""-",-... .... --, . __ ... =r- --.........................,_ .... -_ . -... .... _ ... .___ - ---- - CERT1FlCAT1! Of' DeAlK (O\II[RSUSI Ac.. " , _ _'" ... ,,,,,:,""".. BTB Mutlib. 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'" _ (b)(S) 11 December 2006 ~_OU\"'OCQ"""'T I 0'. ~ .... ~"'''''''''''TRI_'_ _ ........ - .- [~}O_ O$""m>...,.,... •• _-~ Medical Examiner ................... Dover AFB, Dove!' DE l(b}(6} .............. """" - . ' .... " _ .. _ .. _ ......... " """" ... -nw. MEDCOM 0434 ACLU Detainee DeathII ARMY MEDCOM 434 ARMED FORCES INSTITlfTE OF PATHOLOGY omcc oflhe Armed Forcft Medical Examiner 1413 Rest'an:h 81vd., 8Id&-l02 Rockville. MD 20850 (30 I) ) 19·0000 AUTOPSY EXAMINATION REPORT Name: Atiah..J(haIifah..Hamadi l5N; (b)(6) Dalc ofBinh l (b)(6) 959 [)ate ofOtoatll (b)(6) 2006 DatcITime of AutoP5)': 06 DEC 200611100 Datc of Repon: 09 FEB 2006 AutOp$y No.L(b)(6) AFIP No.: (b)(6) Rank: DctiTn« Place of Death; Iraq Place of Autopsy: Pon MonUllt)' Dovet' AFB, Dovcr, DE Ci,..,umstancCl of ~alb: This 57-ycar-old. detllinee was inlcrned at Camp Iii RC1I1C:mbrance, Iraq durinll Opc:l1Ition Imqi F~om. InvCSliglll.ivc n:poru Stille lhat, (b)(6) {b)(6) jWU admilled to the 21" Combat Suppan Ho,pilal (C5H) wi!h complaints of chelL ~ and was diagnosed with an acule m$K:ardial inflltClion. On (b)(6) (b)(6) .{bli61 lc:ondition ""Orscncd and he became unresporuivc. Allll<cssive attempts til reSliscitalion were unsu(:CC'$Sful. Authorization for Autopsy' Office oflhe Armed Fon:cs Ml'<lieal Examincr. lAW 10 USC 1471 Identillullon: Prcsumpli"e identification by accompanying rcpon~, A ONA sampk is laken for prol1le PUfJXlSCS should an excmplll1 becomes available for positive identification. CAUSE OF DEATH: Acute myo... N1ill infl,..,!;on MANNER OF DEATH: Nalunl MEOCOM 0435 ACLU Detainee DeathII ARMY MEDCOM 435 AUTOPSY REPORTI"'(b~)(~')'--, , ATlAH, Khlllifll.h Hllmlld; FINAL AUTOPSY DIAGNOSES: I. Natural disease diagnoses A. Atherosclerotic cardiovascular disease I. Acme thrombus middle dre:lIl1lnex coronary artery 1. Luminlll ni\lTO"ing, 70% Ortlle kft main coronary artcry 3. Luminal narrowing; 80% or'lle proximal, 90% ofthc middle and 900/. or the distal left ,,"lerior descending corol1M)' anery 4. Luminal narrowing; 60% of the proximal. 900/. orthe middle and ncar 100ai occlll$io n (pinpoim lumen) of the distal riij.hl coronary arteries 5. Ciffus<: aneriosclcrotie and IItherosclcrmic plaque fOl'Tl1ll1ion throullhoutthc thoraeic and abdominal aorta 6. Cakific plaque fOl'Tl1lltion and Iwninal narrowing of Doth renal arteries 7. Acutc and healed myOClll"diai infarction involving th(' left vemriele 8. Cardiomegaly (horderline); 450-lll1lms (expa;ted heart weillht J44-grams, upper limit 439-grams) B. BilalerDJ alrophied and granular kidneys (right- 70·gnlms. left - JO·grams) C. Bilateral pulmonary edema (right lung - 64Q-grantS. left lung- 670-grams) II. Evidence ofmedkal inlervemion A. OrotraeheallUbc, approprilllel)' placed B. Angiocatheter sutured in till: leA subclavian vein C. Multiple (14) sel f-adhesive elcctroeardioKJ"'ffi elcclrodcs affixed to Ih" 'Interior cllest. left arm and left thigh D. Urinary catheter E. lntnlVenou5 catheters in the dorsum of both distal foreanns f. Multiple lherapc'Ulie punchu.: marks on the left neck and shoulder. righl antecubital fosSll. and right lower quadrant of the abdomen G. Identification bracelet On the right wrist printed withl(b)(~ I ~l. Hemorrhage into the wperficial strap mll5Cks and leA lobe of tile thyroid gland \ II. Traumalic diagnoses A. Trauma of the head lind neck I. No evidence of ligature: marks or slnUlguJation On Ihe neck after external e1l\"amination and layerwise antcnor and posterior neck di=tions B. Trauma of the 10rso I. Faint red contusion On tbe lower ehesl along the right anterior axillary line. I ~ " Yrinch 2. Healing contusion on the lo"'erebest along the left mid-cluvicular line. 1 " '4inch 3. Area of ecchymosis aoove tile left IlRterior superior iliac spine associated "ith a lherllpeulic punCture. 2 113" %-in<:hes 4. Comusion below tbe angle of the lefl scapula, I )( Yrinches S. Superficial hemorrhage ;nlO the left middle lrapezius and rtIomhoid muscles. 4 1'>" I ''''-inches, "ithout injury 10 the underlying paraspinal muscles MEDCOM 0436 ACLU Detainee DeathII ARMY MEDCOM 436 AUTOPSY REPORT{b)(6) ATIAII, Khamah Hamadl ) 6. No evidence of additional trauma aftet external uamination and disseelion of the subcutaneous tissues and muscles C. TtlIuma of the utremities I. Contusion of the right antecubital fossa associated with therapeutic ptlllCtures. 2 ~ x 1 'I.-inches 2. Contusion on the tip of the distal phalanx of\he I" digit of the right fool. 1/8inch 3. Ecrhymosis in the right popliteal fosSll, 3 x 2 I'S-inches 4. No evidence of additional trauma after external examination and dissection of the SUbcUUlnCOUS tissues and mUs<;les IV. Post-mortem changes A, Lividity is fixed on tile poslerior surface ortlle llody except in areas exposo.d 10 pressure B. Rigor is present 10 M equal degree in all extremilies C. Grttnish discoloration of the skin of the right lower quadrant of the abdomen V, Toxicology results A. Volatiles: The blood and vitreous fluid were examined fOf Ihe presence of ethannl at a cutoffof20 mgldl. No ethanol WIIS detected. B. Drugs: The blood "''as scrc<:rted for amphetamine, antidepressants, antihistamines, barbiturates. bcnrodiazcpines, cannabinoids, chloroquine, cocaine. dextromeLhorphan. lidocaine, natrotic analgesics, opiates, phencyclidine.. pheoothiazit'ICS. symJlllthornimetie amincs and V<:raparnil by Jllts cllromatngraphy, color test or immunoassay: 1. Positive meloprolol: Metoprolol was detected in the blood by IP'S chromatography and confirmed by gas ellromatography/mass sp«lrometry. The blood contained \I, mglL of mcloprolol as quantiUlted hy gas chromatography/mass spectrometry. C. Carbon Monoxide: The Carboxyhemoglobin saturation in Ihe blood is less than 1% as determined by spectrophotometry with a limit of quantiration of 1%. Carboxyhemoglobin salW1ltions of 0-3% are expected for non-smokers and ), 10"04 for smokers. Saturations above 10% are considcmi elevated and arc confirmed by gas chromatography. D. C~'anide: No cyanide is detccted In the blood. The limit of quantitation for cyanide is 0.25 mgIL. Normal blood cyanide concentrations arc less than 0.15mglL. Lethal concentrations of cyanide are ~ater than) mg/L MEDCOM 0437 ACLU Detainee DeathII ARMY MEDCOM 437 ,- , AUTOPSY REPORlj(b}(6) ATIAH, Khalifah Hamidi EXTERNAL F.XAMINATION The body is lhal of a weJl-developed. well-nourished appearing aduh male whose appeariUlce is consistent wjlb the reported age of 57-yean. The remains are 69·in<:hes in ICnglh. and weigh I82-pounds. Lividit)' is present and fixed on the POSU:TiOT surface of the body, except in an.:as exposed to p=sun, Rigor is present 10 an equal degree in all cXlmllilies. The temperature of the body is thaI of the refrigcl1Ilion unit The scalp is covered wilh curly short black hair with gn.y 81 the tanples and early male patlem baldness. The fllCe has grey and brown stubble wilb a trim ~'Tey streaked black moustache. The irides an: brown, the oomeae hazy. and the pupils are round and equal in diameter, The selt", are white, the conjllf>Ctiv3e congested with no evidence of"",techial hemormBge, The extcm.11 auditory canals an.: free of foreign material and abnormal sccn'lions. The ears are unremarkable. "The nares are palent and the lips are atraumalic. The nose and nuxiJlac arc palpably smble. The teeth appall" nBlural and in poor condition, No evidence of trauma is noted on the head. 1llc ned is Straight, and the trachea is midline and mobile. The chest is symmetric. The abdomen is nat. The genhaJia a~ lhose ofa normal adult circumcised mal~. "The l<;Stcs are dcscended and froc of masses. Pubic hair is prer.em in a nonnal male distribution. The bUlloclls and anus are unremarkable. No evidence ofsillnificanttrauma is noted on the torso. The upper and lower e/(tremities are symmelric, without clubbing ur edema. No evidence of significanltrauma is nOled on the ulTm!ilics. Ide111ifying marks include the following: • Mulliple h)'popigmented scars on the anterior leflleg, up to ....·inch in greatcst dimensions • An obliqucl)" orienled (along the 5 to 11 o'clock 8llis) elliptical scar on the inlerseapular skin oflhe back, 2 .... " \f.-iTIChcs • A hyperpigmented scar on the medial border oflhe niht scapula. 'I. /( ~inch • A hypopigmented scar below the righl glutcal crealie. 2 /( 'h-inchcs • Hyperkenllotic patch on the rilj.hl latcnll malleolus. 7/8 /( \f,-inches CLOTHING AND PERSONAL EFFECfS "!lie following clothing ilems and personal effects accompanied the bod)' to lhe mortuary atlhe time of autopsy: • One pair yellow pajamas • A light green quillo:djaeket • A white shon slccve cotton tcc shin • A pai r of brown socks • A knit ski cap • Pair of brown shower shoes • 1\ single knit black glove MEDCOM 0438 ACLU Detainee DeathII ARMY MEDCOM 438 AUTOPSY REPOR1(b){6) ATIAH, Kh.lifllh Hlmldi 5 MEDICAL INTERVENTION • • • • • • • • OrolrllCheal Nbe. appropriately placed Angiocalheler sulured in lhe left subclavian vein Multiple (14) self-adhesive eleclrocardiogram electrodes affixed to !he anterior chest, Icft arm and left thigh Urinary catheter Intravenous catheters in the donum of both distal forearms Mulliple therapeutic pUllClure mms on the left neck and shouldeT. righl antecubital fossa, and right lo,,"-cr qUDdrant of !he abdomen Identificalion bracelet on lhe right wrist printed wilh l(b)(6) Hemorrhage inlO the superficial map muscles and left 10~"'~"r".c,CmC,ro=i'd glund RADIOGRAPHS A complete sel ofposlmonem radiographs is obtained and demonS\nlle no evidence of sillni flcant lrauma EVIDENCKOf INJURY The ordering of the following injuries is for dcscripti\'e jI\lrposcs only. and is not intended to imply order of inlli"ion Or relative severity. There is a faint red contLCIion on the lower chest along the right anterior axillary line measuring 1 '/, x V,·inch, On the 10wCl cheSllllong lhe left mid-clavicular line is a healing I x Yo-inch conNsion. There is an area of ecchymosis measwinll2 1/8 x ,/<inches above the Jeft anterior superior iliac spine associaled wllh a therapeulic punclure. Injuries to the back include a supmicial hemorrhage into lhe left middle lrapeuus and rhomboid muscles measurill1l4 ~ x 1 ~-inchcw wilhoUl injury 10 !he underlying paraspinal muscles. Injurit:S 10 lhe exltemilies Include a contusion, measuring 2 l', x 1 Y...inches, in the tight anlecubital fossa associated with therapeulie punClures. l1lcre is a contusiol\ on the tip of the distal phalal\X of the I ~ digit of the right foot measurinlll18.inch in diameler, In the right popliteal fossa is a 3 x 2 y.-inch tImI of ecchymosis. Ir"oTERNAL EXAMINATION HMD: The galeal and subl:llleal soft lissues of!he scalp are free of injury. The scalp is renCCloo. The ca1~arium is intact as is the dUnl mater benealh il. There are no epidural or subdural hemorrhages presem. The leptomeninges arc Ihin and delicate. Clear cerebrospinal nuid surroWlds the I280·gratn brain, which has unremarilable gyri and sulci. The cerebral hemispheres are symmelrical and dcmonstnlte mild vascular congestion. The structures at the base of the brain. including cranial nerves and blood vessels are intact. Coronal sections demonslIate sbarp dcmllfC.lllion between white and grey malter. wilhout hemonh.sge or eontusive injury. 11le ventricles lite of normal si7.e. The basal gatllllia, brainstem, and cerebellum are free of injUl). or olher abnonnalities. The anerial S)'SletnS MEDCOM 0439 ACLU Detainee DeathII ARMY MEDCOM 439 AUTOPSY REPORT~)(6) 6 ATlAH, Khallfah Hamadi are free of injury. Focalatherosderotic plaques are noted in the basilar and vcnebrlll arteries. The atlanto-o<:cipiUlI joint is stable. NECK: 11>e anterior stmp muscles ofthc neck are homogenous and red·brown. Focal hemorrhage is noted in tbc superficial left strap muscles and the left lobe of the thyroid gland and described under "Evidence of Medical Intervention". The thyroid cartilage and hyoid an: intact. The laI)"ll!< is Iined by intaet white mumsa. The thyroid is symmetric and red·brown, without cystic or nodular change. l1lc Ionllue is free of bite marks, hemorrhage. or other injuries. Incision and layerwise dissection of the anterior and posterior neck demonstrntes no evidence of trauma. deep plIrnccrviCllI mUllC:ular injury, or cervical spinc fnlctlUl:s- eopy CAVITIES: The body is opened by the usual thol'llCo·abdominal incision and the cllest plate is removed. No adhesions are present in any of the body cavities. There is a 3D-milliliter collection ofserosanguinoU5 fluid in the right pleural cavity. The remaining body cavities havc no abnormal wllections of fluid. All body organs are present in the nonnal anatomic position. There is no internal cvidence of blunt foree or penetrating injury to the thoraco.abdominal region. RESPIRATORY SYSTEM: The upper airv.-ay is clcarof debris and foreilPl material: thc mucosal surfaces are smooth. ycllow-tan and unremarkable. The pleural surfaces aft: smooth, glistening and unremarkable bilaterall)·. The external surfaces are smoolh and dark red. The pulmonary parenchyma is diffusely congcstcd, bol:8Y red, and edematous, exuding moderate amounts of bloody fluid. No mass lesions or areas of consolidation are present. The righl and left lungs weigh 640 and 67o-grams, respectively. CARDIOVASCULAR SySTEM; The pericardial surfaces lire smooth, glisrening and unremarkablc: the pericardial sac is Ii"« ofsignific.ant fluid or adhesioltS. The coronary arteries oriS(: nonnally: follow the usual distribulion in a right dominant pattern. Three vesSieI athcrosclefOlie coronary artery disease is presenl with luminal narrowing in lhe following distribution: left main coronary Mery - 70%; left anterior descending coronary artcry _ prox;mal (gO%), middle (90%). and distil (900/.); righl eoronary artery - proximal (60"/0). middle (90%). and distal (ncar occlusion -pinpoint lumen); left cireumflex coronary artery (900/.) with acllle thrombus formalion in the middle segment of tile vcsscl. Scaning and fibrosis is rIOled in the 5Cptum and posterior free wall of the left vcntricle. The remainder oflhe myocardium is homogCTIOus, red-brown. firm and unremarkable. The valve leafletS arc thin and mobile. The walls of Ihe left and rigln ventricles are 1.2 and D.3-ccntimeters thick. respectively. Th¢ endocardium is smoolh and glistening. The aona and ilS major branches arisc normally, follow rhe usual course and are widely patent. There arc mulriple calcific atherosclerotic plaques along the thorll(:ic and abdominal aorta. There i~ caleific plaque formation and ncar occlusive luminal narrowing ofooth r<:nal arteries. The venac cavae and its major lributaries n:tum to the heart in the usual distribution and MEOCOM 0440 ACLU Detainee DeathII ARMY MEDCOM 440 AUTOPSV REPORT(bX 6) AnAH, Khlliflh IlImldl 7 arc free oflhrombi. The mesenterie vessels Ire llI'n~mlrklble. The heart weig.h$ 45(). KJWTlS (pmIieled hean weighl 20S-4J9·gnms for I ISI·pound 11llIl'l). LIVER" BILIARY SYSTEM: The hepetic capsule is smooU1. Jlistenilllland imlCl, oow:ri"i dirt,; red-brown. moder.tely Congesled perenchynuo with no focallesiOlIs PRlenl. The gellbladder roIlllil\$ SO·milliliters of y.ree:n·brown, bile; lhe m\ICOSI ""'" velvety and unmTUlrk.blc. The exll'llhepalic biliw'y I , " is plteDl. "';lhoul cvidcn« of nkuli. The liver ...'Cighs 1960·grlms. SPLEEN: The 300·grarn spleen Iw DsmooIh. inllC1, red-purplc ceplule. The perench)'I1U. is maroon and congested. willi d;S\incl MaJpighian corpuscles. PANCREAS: The pancrcu is finn and )·ellow·lan. wilh lhe usuallobull1 IfChileclure. No mw lesions or olller Ibnormalilics IfC seen. ADRENALS: The rillhl Md left edrenll Jlandsare symmetric. with bright ycllow conices and grey medullae. No m3.UCS or areas of!lelT\OT1'fl&&e are icH-nlified. GENITOURINARy SySTEM: The right IIl1cl len kidneys weigh 70 and lO·g"""s. respccliw=ly. The eXlernal surfaces arc inlact and g"lOull1. The CUt surftlCes are rc<!.tln and conge~ted .....ilh uniformly thick c<lnio;;cs and blurring of the conicorm-dullary junctions. The pelYes are unr<:nllirkable and lhe Urelel1llrt nonnal in course and caliber. While bladder mucosa oYcrliu an imacl bladder ....all. The blllddcr conlDins no uri~. Thc prulilate is normal in size. with lobular. ycllu..... tIr\ parenchyma. The seminal ''<'siclcs are unremarkable. The lCSlCS lU'e free of mass lesion~. conlusions. or olher abl\Ormalilies. GASJROINTESIINA L TRACT: The nophagu, is inlact and lined by ",,1001h.l!Jey-whitc mucolil. There is a 3 x 2 'h-inch area of hemorrhage oflhc mucosal surfaC<' in the fundus of the stomlll:h. The slomach contains approximately 2S0'mi llililers of lhick brown nuid with fragments of p.anially divcsted food. The duodenum. loops of snlall bowel. and colon arc llnl'l!marlulblc. The appendix is pre~n1. Museu La-SKELETAl. SYSTEMi MU$Clc development is normal. No bone or joint abtlormalilics or i'liuries are noted. MEOCOM ().4.041 ACLU Detainee DeathII ARMY MEDCOM 441 • AUTOPSY REI'ORT (b)(6) ATIAIt. Khllifah Jbll:lldl ADDITIONAL PROCEpUR£S • • • • • • Documentary pholOpphs we taken by QAFME stalT pOOI0Jr8.phers Specimens ~tlinoed for 10.ic:ologic: testillg and/or DNA identification are; han blood, vitreOus 1111id. ea5fTic eolltentS. bile, $JlIeen, livC!", IlII1¥. kidney. brain, Iclipose tissue, and psoas mUKle Full body ~ioaraPhs we ob~ned and dnnonsttate the Ibove findings Selecla! portions of 0l'lans all' retained in furmalin, histological slides all' p~ed of selected orsans The di!Rctcd 0fi&IIS ~ fOfWankd with the. body Pet'$OlIDl dfecll are released 10 the mortuary arraiB repre5enlilives MICROSCOPIC EXAMINATION Selected ponions of O\illns all' retained in formalin. SLlPl; SUMMARY; I. Left Ulterior delCcndine eoronary ~.ry 2. Riehl coronary artery 3. Circuml1ex coronuy artery 4. Circumflex coronal)' artery with """"bo, S. Rieht ventric:le 6. Septum 7. Left venukle 8. Anterior left ventricle 9. Lat~-nJ left ventticle 10. Kidlie)'. lune II. Spleen. lung 12. Liver, hUll lJ. Kidney, lung 14. Aort&.lung l. Canliovasculal (/l1·9, 14); IlillOloeic sections of th<' letlc Ullerior descending and righl coronary amries demonstrate al leasl9O'K luminal narrowing by fibroea!eiflC: plaques. Sections of 1M !eft circumflex oomnary artery show Kute ruplure ofa fibroalhcroma with occlusive thrombus and ~terthen 90% h,rminallWlOw;ng. Focal myocyte hypertrophy is Ken in mJcrolCOpic s«tLonS oflhe right ventricle and "'!"urn. Hislolog;c Jeelions of tile left ventricle show the Pl'C5l:llee of contraction bands, a Ileutrophili<: ;nfihlllte, tr&n5mullll replKement fibrosis, intC\'$litial fibrosis. and focal myocyte hypertrophy. Fibroc:alcifie plaquoe:s are iIffi\ on microscopic evaluation of rcpresentatlve- sc<;\ions of tile aona. II. Pulmonary (III 0·14): Vascular ron~Jtion. no significant patholoeic diagnosis Ill. Liver (~12); Vasclilar eon~stion. no siGflifieant pathologie diagllO$;s IV. OenitOllrillary (1110, 13): Kidneys demonstrate aneriosc1erosis, focal ~Ieros;s and focal tubular necrosis ~Iomerular V. Spleen (III I); Vascular con~stion. 110 sill"ificarll p3loologic diagnosis MEDCOM 0442 ACLU Detainee DeathII ARMY MEDCOM 442 AUTOPSY REPORT (b)(6) , ] ATI"'H, Khalifah Hamadi QPINIQN This 57_year_old detaine~Jb}(6) died Man Acute Myocardial Infarclion. An acute thrombus was identified in the left circumflex coronary artery. Microscopic and gross eXJllllinalion of the hean demomtraled evidence of an Kute and healed infarct ~vere coronary atherosclerosis ofthrcc vessels (left anterior descending, righl and leA circumnell coronary arteries) WlIS noted both on gross and microscopic examination. His heart weighed 450-groms and the expected hean .....eight for his size (11l2-pounds) is 344-grams with an upper limit of 439-IV3fIIS. No signifiCllnt traumatic injuries were identified at aUIOpSY. Toxicology lesL'l fOI ct/wnCIl. sc",ened drugs of ahuse. carbon monoxide, and cyanide an: negative. Supratherapeuli<; levels ofmeloprolol .....ere detected in th<; blood. TIlcsc levels an: significantly below toxic or lC'lhallcvels and an: u~lated to the <;ause and maimer of death. The manner of dealh is natural. (b}(6) (b)(6) @'b~'~"~'==JMMed;<;al Examinel (b}(6) MEDCOM 0443 ACLU Detainee DeathII ARMY MEDCOM 443 _._..__ _.-- .......- -_.- ---- -.- -- -_. - --- -.--_....- ---- - _. -- -._ . ----_._, ............. ----_ ... - --..... -_ _ -,.,. . ----_ . _..--_ . .... _ .. _ ... -.-- -_ _. -. .... _.. ---... .... ........._.-.....- -... _----_- ...- CElmflC.OoTf 01' D&A1H ......... .. ~-- ~,Jj .......... "' ........ -""" ""',."'...,., I.., (bleB) , (b){6) CIvIlian 8TB Allah. IWIllfall, ",""",I ~959 I!l 0 -"'''''' • ·"c·..... • ~ - ...._ r o ..UMUI ' " ""'" Of _ _n-.. 01"1 ... _ _-~- "'"",",-- ......, . _, 0... ,. .... e:_ _ _ _ _ .. _ ~"' ...... .....'"... , ~- , ro ...", _~_It'lI_ , _"'COCIIT<l'O.-cTI..~ ~- _~KlIIIt"'UM _ . _ ~ - . & . . c , _'0_ ...... , . ---,~_."- , o n c o _ .......... [;l _ O f ...'" • ------ •• O~ . (b}(B) 6 0ecftrrGeI' 2006 I ""...- n_-.:g;;::: __. __ _---- ............ _.- -"'~- Baghdad Iraq r . - _ ... _ _ ... _ OCICA..D_ _ .... _ ~ _ -_ _-- .......... _ _ IMediceoi Examine, ..........""" Dover AFB. Dover DE COR " --- .,.. ~ , 1(bi{6j-"",...._L-_...- ..... (~,,£,.='" "~;r ~ ,_ _..... _"' ..... ..."'OCQ_.' ......... .. ..... rw6'-..""""-.........__.. _-_.. - .. -- • ~ ... ~1{b)(6) ----- ~ :::..-:::..OO::-~":.":'"'_:::::::' ... -.:.~ .Ii"_"::._._.._._......_ .._._ DD'~ 2064 -.....__'_n_""' _ _......,..........._-.... MEDCOM 0444 ACLU Detainee DeathII ARMY MEDCOM 444 ARMED FORCES INSTITUTE OF PATHOLOGY orner oftbe Anned Foret:! Medlnl Euminer 1413 Research Blvd.• Bldg. 102 Roch·ille. MD 20850 1-301-319·0000 AUTOPSY EXAMINATION REPORT Name: BTB Muhammad H1lJ]Iad, Bnayyan Internment ~~LNnllP)(§} Dale OfBinttj(bU&t_JJ93 1 DaleofOtadrb)(6) 2006 Dale!Time of Autopsy: 04 DEC 2006 @12oohrs Date of Repon: 17 JAN 2007 AUlopsy NO.~~g{b~)~{6~)::::~ -----l AFJP No.: (b}(6) Rank: Dcuinee Pl~o(Dealh: Iraq PiKe of AUlopsy: Pon Monuary. Dover AFB, DE of Death: This 75 ycar-old elderly ma.le civilian detainee suffered a prolonged hospitalization due 10 pnewnonia and eventual !ltplie and eardiog"nie shock wlliell progressed to mulli-organ system failure. '1l1e ethies committee of llie Camp Cropp"r TlF Hospital determined that eontinuation oftreatmenl ",as nol warranted due to futility. Aeeordin,gly, <:ardiac support (vasopresoors) was Wilhdrawn and the detainee expired. Cluum~tlneel AUlhoriZlltioD for Autopsy: Officc ofllle Anned Forces Medical Examiner, lAW 10 USC 1471 Identification: Presumptive identification based on accompanying p3p"rwork CAUSE OF DEATH: Acute and OrgaaWDI mrru.st AlveOlar I)lmagt MANNER OF DEATH: Natural MEDCOM 0445 ACLU Detainee DeathII ARMY MEDCOM 445 AUTOPSY REPORT~(6) BTB Mullamrnad Hamad, Bnyyan 2 FINAL AUTOPSY D1AGNUSIS I. Pulmonary Systcm: A. Aculf and OrganWnl mm.lSf Al~tolar I>amagf (Lunl WfillllSRighi 1ll8o.gnnu; Lth 17SO-gnms) B. Silico-allthruOlic NGlluies C. Bilal"..1Plfu...1Adllnions D. Bilalfnl ~I"1lUS Pleu...l Effusions (Leh lOO-milliliten; Righi 100· mlllililen) n. Cardiovascular System: A. Hrart Wfilhl 460.gnm, B. ~I"1lUS Perkardial Effmlon (50-mlllilJlfn) C. Mild AlheT'OulrrOlls of Ihf Aorta D. Chronic Innammation of the Epicardium Ill. Hfpalobilliary Sy~tem: A. Panl~e Congntlon {Livfr Wfigbt I'SO-gnms) B. Adhesions BrtwKn lbf Liv... and 80lb Hfmidiaphnlms C. Mild Portal Triadhis and Fibrosis IV. Rfhculoendolbflial Systfm: A. CongtsliOllllftbf Splfftl (SplKn Wfigbl2SO-gnms) B. Adbeslons Bttwun lllf SplKn and Mulliplf Loops of Howfl V. Gastrointestinal Sy,tfm: Abdominal AdhfsionJ Cfnilourinary Systfm: VI. A. Simplf Cortical CySIS of BOlh KidnfyS B. MUd Cbronic I')'floafpbrllil C. Benign NfpbrosclcroJis (hyallnf artfriol05clfrosls) VIl. Othfr findings: A. Anasarca I. !SO-millllfn ofucitn B. Multiplf Decubllus Ukfn: i. Rigbt forearm, \Ii-inch Ii. Right BUllock (4), Ranling From II,-inch 10 I-inch in C~lflll Dimcmion ill uft BUllock (2), 2-lacb and 2 'I.-inch iv. Left PostftiorThigh (2), Yo-iacb and Y,-inch v. Righi Knu (2), I-inch and I \Ii-inch ~i. Lfft Knef, l-ineh vll. Righi Leg, Y....incll viii. Righi Latfrlll Malltolus, \Ii.inch ill". Ldt Latf... t MaUtoluJ, Y,·inch C. Blister of Illf Righi Hul D. Skin Tag: Right Should... E. Mulliplf Brown and Whitf Macules On thc Torso and [.I",mllics F. Dryillg and Cndl.ing oftbf Lips C. Drying and CradrJng ofthf Planfar SurfaCfl of Both PUI VIII. Evidfnce of SignlficanlllljuF}': None LX. [vldellee of Medical Inlfrvention: MEDCOM 0446 ACLU Detainee DeathII ARMY MEDCOM 446 AUTOPSY REPORT J~"j)(~6)~=~ 8T8 Muhammad Hamad, BoaYYIlll X. A. 8. Traeb_tomy EKG Lead! on th~ Antuior TOl1lo C. Right Chest Tllbco D. PerculllIIeCllll EndOicopic Gastrostomy Eo Stapled Vertlcallllcbl(lD orlbc Abdomen, 7-lnches F. Dressings: Runock.t (3) l. Ii. RighI Knee AbdQmtn I... Cbtst v. Ne<:k G. Foley Catheltr H. I. J. Ar1crial Line, RighI Wr\1I )otrntnOUI ActuS, RilCbl Subdavillll Multiple Needle Punclure$; i. Subclavian (4) IL Left Wrist (1) ....n POIl-morlem Chlngu: A. B. XI. m. J LividIty;' fixed on the posterior ,unaet of the body u«pl in Ire., uposed to prQ.$ure Rigor hu pund Skin IHppag. C. T01kology (AFtP): A. CARBON MONOXIDE: The carboKYhemoglobin uturalloo in lb. blood is 1·,.. B. CYANIDE: No cyanide is defected in the blood C. VOLATILES: No fIb_polis detected in Ibe blood and "llreolls nuid D. DRUGS: No sereeotd drugJ of abu.w or medicalions are delected in tbe blood MEDCOM 0447 ACLU Detainee DeathII ARMY MEDCOM 447 AUTOPSY REPORTl~b}(6} BTB Muhammad Hamad, Bna}'}'aB I 4 EXTERNAL EXMUNATIQN The bod}' is lhat of a wei l-dcveloped, well-nourished appearing 611 >'rincll lall. 198pounds malc wllose appearan<.:e is comment with the reponed age of7S-yelll'S. There is gel'll9"a1iw:! edema of the torso lllld extremities. Lividily is fixed on the posterior !lIIface of the body except in areas exposed to pressure. Rigor has passed. The body is cold 10 the touch. The body is lying on blue hospital chucks. There is a male p8nem baldness hair distribulion. The irides are bown, and lhe pupils an:: round lllld equal in dilllllcter. ~ extemal audito!)' canals and can are lIIUCmatkable. The nares are palenl and lhe lips are all1lumalic. The oost: and maxillae arc palpably slllble. The teelh appear nalu!'lIl with excess WcaT. The denlition is poor. The face is edemalOus. The li~ arc dry and c!'llcked. The neck is straighl. lllld the tl'l1Cllea is midline: and mobile. The cllest is symmetric. The abdomen is pmtuberanl. There. is a \trincll muoo scar on the luwer abdomen. The ~nilalia arc those of llll adult male. The penis""" scrolum are edeml.lOUJ<. The lestes are descended and free of mllSSCS. Pubic hair is present in a nonnal distribulion. The llllUS is unremarkable. Multiple decubitus uJeers are observed on the: righl forearm, \4·inch; righl buttock (4). ranging from Y._inch to I-inch in greatest dimension; left bUllock (2), 2·incll and 2 'I•. inch; left posterior thigh (2), 'I.·inch and \4.inch; right kn~ (2), I·inch and I 'h-inch; left knee, I-inch; right leg, \I,·inch; righllateral malleolus, 'h-inch; and left lateral malleolus, 'h-ineh. One of !.he dccubilUS ulcers on lhe left bUllock extends inlo lhe underlying mus<:le. There iii a bliSler on the righl heel. I. skin tag on lhe righl shoulder lllld multiple tan and while macuJes on lhe extremities and torso. The upper and I~ ex~mitie5 are symntetric. The plantar surfacn of both feet are dry =-::J and cracked. [(b){6) CLOTHING AND PERSONAL EFFECTS The following clothing ilemS and pc~nal effccts are preliCnt on the body at tllc lime of autopsy: The body is received unclad. There is a green personal effects bag tied to the left wrist. The contents oflhe bag arc docwnenled photograpllically. The bag contRins foreign and United SlalC$ eum:ncy. pcTSOnal papers, lWO pholOS and an idenlificl.tion brncelCl MF.DICAL INTERVEJ\TION The follo,,·inll • • • • • medieal inteJ'\lentions IJe presenl on lhe body at !.he time of aUlopsy: Trnclleostomy EKG Leads on Ihe AnteriorTorso RighI Cllest Tube Percutaneous ElId~pi", GaslJm:lumy Slapled Venital Incision oflhe Abdomen, 7·inches MEDCOM 044B ACLU Detainee DeathII ARMY MEDCOM 448 , AllfOPSV REPORT (b)(6) BTB Muhammad Ihlllad, BDayyall 0 Dreu1nas: 0 0 0 0 0 0 • 0 0 BllttOCks (l) Righi Knee Abd_ 0... N'" foley Catheter Arterial Line, Righi Wrist Intravenous Aeee:ss, Righi Sube!avian Mulliple Needle Punctwes: • Left Subclavian (4) 0 Left Wrist (I) RADIOGRAPHS A complete sel ofposln\Oftefl'l radiopphs and eorTIpulerittd tomotnlphy ~ are ~ined and demonstrates • • • • the following: ColllOlidatiOIl of both IIlIIIS Pericartiial effusion ConUUl lnthc disul colon No blunl force or pellet. aUrIi injuries llJe detecled radio8fllphically EVIDENCE OF INJpRy Thc..e is no evidence of any si""irIcanl injury. INTERNAL t;XAMINr\DON HEAD: The saleal and ",bgal"1 soft tiiS\leS of the lealp are free of injury. The calvarium is intaet. as is \he dW1l maIer beneath iI. Clear om:brospinal fluid SUlT'O\lnds lhe \44()..gram bnin, which has unremarkable gyri and sulci. CoronalscelionJ demonstrale sharp demarcation bet....ftII while and ll1"y manu. without hcmorTha,ge orconlusive injury. The ventricln are ofnonnal size. l1lc bassi lanalia. brainslem. cen:bellum. and anerial S)'SIC1TIS arc free of injury Of' otber abnormalities. 1IlanlCHlCCipital joint ill sable. """= ~ no skull fractures. The Iil&<' 1lle Interior ,trap muscle, of the neck are homoscnous and R:!d·bro,,'TI. withoul hcmottba¥e. l1lc thyroid carliJaae and hyoid IRl intact The larynx is lined by Inllcl while mucosa. The thyroid is symmctrk IUId recI-bro....ll. without cystic or nodular change. The IO~ is free of bite marts, hemotthaae. or cnhe. injuries. BODY CAVITIES: The ribs, "emum. and vcnebral bodies an: visibly and palPl'bly inUle!. Thc~ is 100millllttrs ofserou, fluid in bolh chest cavities, 'so·milliliters of serous fluid in \he pericardium and 2S0-millililers of serous fluid in the peritoneum, The organ' occupy lheir usual IJIltomic positions. MEOCOM 0449 ACLU Detainee DeathII ARMY MEDCOM 449 AUTOPSY REPORT (b)(6) 6 8TH Muhlmmad lIamad, Bnayya.. RF.,SPIRAIORY SYSTEM: The right and left lungs weigh 1880 and 11So-Itfalll$, rrspo:etively. There arc: limK adhesions betWttn both 1\lflllS Ind the pkWll and bolll hemidiaplnanu. The extmlal swfaces an: rou&J1, irregular and W1-bro....lI. The pulmor'la/')' partl'lChynu. is diffuKly congeSled, edemalous and finn. There an: mulliple SIUS of1.&ll consol~lion preKnt in botlllungs. CARDIOVASCULAR SYSTEM: The 460-&rSffl heart is eonlained in an inlacl ptriurdial sac. The epicardial surface is smooth. with minimal fll inveslmcnt. The: coronary artaics are present in I nomal distribution, with a right-dominaru paltcm. Cross stetiollli of lhe w:ssels show wide: palmey. Thc myocardium is homogenous. red·broWlt, and firm. The val,~ leaflets arc: thin and mobile. The walls of the left and righl vmllieles an: 1.1 and 0.4-<:entimelCrs thidt, respectively. The endocardhun is smooth and glilileninil. The tlQrta gives rist 10 t~ inlaCt and patent arch w:ssels. There ill mi Id Itherotclerosis consisting of filly streaks in the tlQltI. The: reDllI and mesenterie vessels are ul\fCntarkable. LlyER &: BILIARy SYSTEM: The 19S0·gram liver Iw lit inlact, smooth capsule and I sharp IItlcrior border. The parenchyma is 1.&II-broWlt and congested. with the usual lobular archileCI~. The cUt surfICe hwi a ~nulmcl( appeantnee. No mus lesiollli or olhcr abnonnllilics Me Ken. The gallbladder conCains I 2o-milUters of grec:n·bhlCk bile and no stones. The mucosal surfaee iSllrecn and velvely. The excmltepalic bililry tree is patent lbcre are adhC5iollli between the li\"Cr and boch hemidilplu'allms. SPLEEN; Thc 2So-gram splcen has a smooth (in areas not involved by adhesions), inlact, red_ pwplc clpsule. There arc adhesions belween llle spleen and multiple loops of small bowel. The: pilrenchyma is maroon and congested, wilh distincl Malpillhiln corpuscles. PANCREAS: The pancreas is firm and yellow-Ian, with the usual lobular ll/'ChitKcure. No mass leliions Or other abnormalities are seen. ADBEN6LS: The right and left adrenal Wands a~ Jymmelric. with brighl yellow cortices and Ii~Y medullae. There is significanlautol)'s;s SoCC1l. No maJSCll or areas of hemorrhalie are idenlified. GENITOURINARy SySTEM: The right and len kidne)'s each weip 22o-grams. The eJllemai swfa«s are intaeland grtUlullll". The: cui surfaces an: red-tan and oonlCSled" ....i th uniformly thick cortices and sharp conicomedullill)' jW1Ct;01U. lbere are mulLiple smooth walled conical cym identified in both kidneys- The IlIfFI cyst me3$LIl'CS I \.\-cenlimetcrs in diamckr. The pelvcs are wtremarbble and the ureters arc t>OmIll in COW'K and caliber. The bladder MEDCOM G45Q ACLU Detainee DeathII ARMY MEDCOM 450 AUTOPSY REPORT (b}(6) 7 BTB Mubammad Hamad, Bnayyan mucosa overlies an intact bladder walland is focally hyperemic. The bladder oontains approximately 5-millililers of clear yellow uril\e. TIle prostale is nonnal in size. with lobular, yellow-tan parenchyma.. The seminal vesicles an: unremarkable. The tcstes arc free of mass lesions, contusions. or oIlier abnormalities. GASTROINTESTINAL TRACT; The esopllBgus is intact and lined by smOOth, grey-white mucosa. The s!Olllach;s empty and thert: is very mild erythema of the mucosal surface. The gastric wall is intac!. The duodenum, loops of small bowel, and colon are unmnarkable, There an: multiple adhesions between the snull bowel, oolon and splccn. The appendiK is prt:seTlt. PULMONARY PATHOLOGY CONSULTATION (AIiIP) 08 JAN 2007 -Acute llrllanizing diffuse alveolar dmage -Silico-anmoolic nooules Lungs show mostly organizing diffuse alveolar damage \\ith focal acute areas (h),!,line membranes). As is typical of palients on a respira\(lr, thert: is focal acute innammation. No organisms art: sccn on OMS. Stains for CMV. adenovirus and herpes virus are negative. MICROSCOPIC EXAMINATION • Lung (Slides I through 5) Sec pulmonary plltholollY consultalion. • Kidney (Slide 6) Thert: is a simple cortical cyst and mild chronic inlerstitial innammation with occasional sclerotic glomeruli. A rare inlerstitial eosinophil is secn. Some of the tubules are distended and have atrophic epithelium and conwn p pink gnmular matcrial (mild "lhyroidization There is a mild narrowing of the lumens of aneriolcs eauscd by thickening and hyalinization of their walls.. • Liver (Slide 7) There is congestion of the ccntrilobular sinusoids and peri-ponal and pottal chronic innammat;on. Occasional acute infllmmatory cells are seen, Mild fibrosis is secn. • SplecT1 (Slide 8) The splcCTI is congested and otherwise U1\1emarkablc. • Brain (Slide 9) There are no significant pathologic findings. • BJadderlProslale (Slide 10) l1Icre are no significant pathologic Iindiogs • Heart (Slides II throug.h J3) There an: chronic inflammatory cdls secn in the epicardial fal. Otherwise there arc no significant pathologic findings. M ). MEDCOM 0451 ACLU Detainee DeathII ARMY MEDCOM 451 AUTOPSV REPORT (b)(6) 8 BTB Mubammad Hamad, Bnayyan ADDITIONAL PROCEDURES I. 2. l. 4. s. 6. 7. DocUIllC'IIllU)' pholOgraphs ~ lIlkell by OAfME §Illffphotographers. Full body flIdiogrophs ~ obtained and demonslfllle no sigJIificant blunl fon;e or penetraling Irauma Specimens relllined fOT loltkology testing 8IId1or DNA idenlitiCllliollare: Blood, ,'ilTeous fluid, bile, urine, brain, lung, li~r, splef:n, kidney, adipose lis!il.le and psoas muscle The dis$eCled organs lITe forv.-arded with the body. Selected portions of organs are retained in formalin. llislologic 51 ides lITe prepared on: Lung. kidney, liver, spleen, brein, bladdCT and hean. Personal effects are released 10 Ille app:opriaic mortullty-'1'Cralions reprcsenlalivcs. Idenlifyin~ marks include: A llIttoo on[(b)(6) t(b){6) J OPJNION This 75 year·old ITUlle, BTB(b)(6) Idied of &CUle and organizing diffuse alveolllT damage. The eliology of this CQndilion is most likely the previously clinically diagnosed and trealcd pneumonia. Complicalions of these wndilions included a clinical hislory ofsepsis, shock and multi-oJ'lOlll sy!item failure. Multiple decubitis ulcers WCrt: seen on eJllemal ex"",inalion and are most likely due tn prolonged hospitalization with II debil itating jllne'n. The lo:ticology screen is negative for cyanide, ethanol, and screened drugs of abuse and mediClllions. The caroo:tyh<:molliobin salW1ltion WlIS not elevated. Th", mwmer of death is natural. (b){6) (b){6) (b)(6-'-Medical Examiner MEDCOM 0452 ACLU Detainee DeathII ARMY MEDCOM 452 _M_ _ ........ ----..... . ,---...... --- -_ ....... - --.--- -_.._-- --- -- --_..__ --- _....- - ------_ -' _ ..__-..._. ..--,. .... _... _. __.- eauR:AJf 06l)£.O.tH fO\I£~ ~.1IIo1 _Of"..,._ -"'-'-- (b)(6) BrB Muhammad. Bnayyan. 00_ Do"""""". ",,- (b)(6) 1931 IiJ ~ 0 .~ ~~ co, ....,"" • 0...... ,_ --'"T_ ~ ~ • ...... '" --. '" "" •nuT"""",,,, • . _1C~ em OIl ...... "".,... -~- _ _""<lEA'" e -.. _ _ _ _ ......., ........ '" <lEA', ", _,._,-.,. -_ . --,....__ ... .-- ----_--.-... _._- -.,.... - . . , coooomco<" _ , W<lI!O> ~.ilr'" ............. ""'"' _<lEA'" """"- -.d 0'pIIIdng CWffuM Medii 0 - . _''''<:<IN>fT''''O_TL.~ ... _ _ _Do 1C , '0_"""'" """'.. _ ~ CCINllITCI'I ~- • ""'" '" '" ~ ,,' ~ 0 • - -• . . _- ........"'_1C _ _ _ ---- _.__.-I ,._.. ___.....-. -_ . _.. _. __ .... _----""_.. . - - -- -- --.._ --_ . _-_..._......__.........._.__ ___...._---_. _... __ -_._..-._.._,. - ....-_-.... • ~ • (b)(6) (b)(6) ...,... ".<lEA'" ~.- (b)@L ......,."" <lEA". "-."-'2006 , ..... "'¥lUI THlfI'LWMO " " '. . _ _ ao: W<lI<.AL IIf'''''''' ~ December 2006 I n"" 0.- 1iI.- _ _ . _ . . . CAl.ClS . . . , • . . . , _ ""C....D_<lEA",,,,,,,,_nA''''''' • M~~m~r (b)(6) (b){6) Dover "Fa, Dover DE .~ (b)(6) 111812007 .. DD'1ll'I, 2064 ......-. ... ... MEDGOM 0453 ACLU Detainee DeathII ARMY MEDCOM 453 ARMED FORCES INSTITUTE OF PATHOLOGY Offiee of the Armed Forces Medical Enminer 1413 ReSCll1Ch B1~'d,. Bldg. 102 Rockville, MD 20850 (JOI)319-0000 FINAL AUTOPSY REPORT Name: MUHAISIN. Jam~'~C== Iraqi NationalJ)elain~[(b)(6) Dale OfBirthi~(~t..J19J7 Dale ofDcath:(b)(6) J 2006 Dale of Autopsy: 04 DEC 2006@ 1230 Dale ofRepo": 16 JAN 2007 Autopsy No: (b}(6) AFIP No:'(lVill Rank: Civilian Place ofDealh: Camp Bucca. Iraq PlllCC of Autopsy: Dovcr AFB Port Mortuary, Dela"'-aAl J [was Circumstante$ of Ikllth:!(b){6) a 69 ycar-old male. Iraqi National. held as a detainee in Camp Bucca, Iraq. He reportedly S\llTered 11 myocaniial infat(tion on 2J November ""hieh Will complical<:d by post·infarttion arrhvtmias. Despite advanced care including 2006. cardiovcrsion and inl\lbalion he died on (b)(6) Authorizalton for Aulopsy; Office of the Armed Forces Medical Examiner. in aewn1ance with Tille 10 US Code. Section 1471 (10 USC (471) I dentifiutlon: Identification established by invtst;g.llh·e agency CAliSE m' DEATH: Atherosc]erol;e CardlovlUculir DiselUe MANNER OF DEATH, Natural Page 1 of7 MEDCOM 0454 ACLU Detainee DeathII ARMY MEDCOM 454 Muhauin!lb}(6} AUTOPSY DIAGNOSES: I. A.Heart: Cardiomegaly, 540 grams Calcific slcnosis. 60% of the lell main coronary artery Calcific slenosis. 99% of the proximal left antcriordescending coronary artery Slenosis, 8O'Y. of the proximal righl coronary arlery Acute myocardial infarelion. left venlrieulo--septum Severe aortic alherosclerosis with plaque erosions B. Lungs: Marked bila1eral pleul'lll and inlraparench)"lTIa.l anthrocolie pil:"lcnl deposition Marked pulmonal)' edema (combined lung weight 2000 gm) Bilateral pulmonary effusions; 500 ml right, 400 left Acule bronchopulmonary and lobar pneumonia Emph)'scma C. Kidneys: Arteriolonephroselerosis D. Thyroid Gland: Pollicular adenoma and nodular hypelplasia E. Proslale Gland: Benign nodular hyperplasia II. No eXlernal injuries III. E"idcncc: of medical lrl:almenl includes placement of a rlJlSOgllSlric lube: cndotrocheal tube intravaseuJor devices in the left side of the neck. boih antecubital fossae. ldl wrist and len groin; needle puncture marks with $UJTounding ecchymosis on the back oflhe right hand: cardiae monilor/defibrillator pads on lhe anlerior chest and abdomen; a Foley catheter is in thl: penis IY. Toxicological eUOlinlitron: VOLATILES: The blood and vitrt:OlLS fluid are DCgalive for ethanol at a cutoff levd of 20 rng/dL. CARBON MONOXIDE: The carboxyhemoglobin (COHgb) SIItutlltion in the blood is less than 1% as delennined by spectrophotometry with II limit of quantibtion of 1%. Salurations above 100Ao are oonsidered elevaled and are confinne<! by gas chromalograplly. CYANIDE: There is no cyanide detected in lhe blood. The limit of quanli18\ion for cyanide is 0.25 mg/L. Normal blood cyanide concenlralions are less than 0.15 mg/L. Lethal concentralions of cyanide are g.rea.1er than 3 mglL. IJIWGS: The blood is screened for amphetamine, antidepressants. antihiS!lllttines. barbiturales. benzodill7..epincs, calU1abinoids. chloroquine. cocaine. dextrometoorphall. Page 20f7 MEDCOM 0455 ACLU Detainee DeathII ARMY MEDCOM 455 M"haisin (b)(6) lidocaiM. naR:Olic: analgellic:s. opiates. phenc:yelidi~. phmothillZines. sympathomimetie and verapamil by gas ehromatography, eolor tesI or immllllO&SS&Y. The followina drugs are detected: (I Beruodiaupine, Miduolam, is detected in lhe blood by immWlOllSSay and eonfirmed by ps ehromalographylmus spectn;lmelry. The blood eontains 0.08 m&fL of Miduolam as quantitated by gas ehromalOgraphy/mass SptClfOn1etry. ami~s Benzodiaupine, Alphahydroxymidazolam (a metabolite of MidI201am). is detected in me blood by gas ehromalOllraphy and eontinned by gas ehromatography/mass spectrometry. The blood eontains 0.03 mJl/l of Alphahydroxymiduolam as quantilaled by gas ehromatography/mass speetromc\Ty. (I o Bell7.odiaupine, (Lornepam), is ddeeled in the blood chromatography/ll\lU speetrometry. The blood conlains 0.033 Lol"Uepartl as quanlilllted by gas chromatography/mass spectrometry. by ... m¥il of Lidocaine is delected in the blood by immunousay and eoniimled by gas ehromatography/mass Speclrometry. (I EXTF.RNAI, EXAMINATION The body is lhat of a well.developed 67·ineh laJi. 164 pound Caucasian malc whose appclU'llnee is consistent with the reported age of 69·yea.,. Lividily is fixed on the po~lerior aspecl of the body and rigor has passed. The lempenl1un:: is cold, thal ()f the refr;geraliOl\ unit, The scalp is ~'Ovt:n::d wilh brown hair ",ith fronlal balding and lemporal lP"eyinll. Flll:ial lllir consists of a brown mU5laehe. The irides arc brown and the pupils an:: round and equal in diameter. The external audilOry canals an:: free or rortign malerial. The ears an:: unremltkable. The nares are palent and lhe lips are atraumalie. The nose and maxillae are palpably liable. The teelh are nalural. and the traehea is midline and mobile. The ehesl is symmetric. The abdomen is moderalcly protuberant The gcnilalia are those of a normal lIdull eirtunleised male. The lesles an:: descended and fn::e of masses. Pubic hair is pn::senl in a normal dis!ribut;on. The bunoeks and anus are unranarkable. The nt:ek is The ~tr1lighl, up~ and lower extremities are symmetrie and without dubbing or cdema. CLOTlUNC AN" PERSONAL EFfECTS The deceased is unelad and pcl'J'lOnal efTeclJ arc not pn::sent on the body at the lime: of autopSy. Pa.,.e) of7 MEDCOM 0456 ACLU Detainee DeathII ARMY MEDCOM 456 Mubll'inl (b}(6) MEDICAL INTERVENTION E~idence ofmedicaltreatrnent includes placement of a nllSOgllStric tube Ind endotrachealtubc; inuavascuJar devices in the left side of the neck, both antecubital fossae, left wrist and left groin; needle puncture marks with surrounding ecchymosis are on the back of the righl hand; cardiac monitor/defibrillator pads on the anterior cbest and abdomen; II Foley catheter is in Ike penis RAmOGRAPHS A complete set of postmortem mdiogmphs is obtllinc:d and shows no acute injuries or abnomtalities_ EVlDENCEOF INJURY l1lere are 110 external injuries. INTERNAL EXAMINATION HEAD: The galea! and subgalelll soft tissues of Ihe sulp are free of injury. The calvarium is intact. as is the dUTll mater beneath it. Clear cerebrospinal fluid SUrT(lunds the 1320 gin brain, which has unremarkable ll)'Ti alld sulci. Coronal sections demonstrate sharp demlUCll.tion between white and grey mailer. without hemorrltage or eontusive injury. l1tI: ventricles are of normal siu. l1le basal ganglia. bniinstem, cerebellum, alld arterial syslems are free of injury or other aboormaJities. There are no skull fmclures. The atlanto-occipital joinl is ~le. ~: The anterior slrap muscles of the neck are homogenous and red-brown. withoul hemotthage. The lhyroid cartilage and hyoid are inla(:t. The larynx is lined by intact white mucosa. The thyroid gland is bilaterally enlarged llIl(\ nodular wilh cystic changes. greater on lhc righl rhan left. A well circumscribed I em nodule is on lhe lefl lobe and frequenl cysts, mnging in size from \ to 2 .. m. are present. The right lobe shows sevenll cySts ranl:ing from Ito J em in ~alest dimension. A poorly defined 2 em nodule is present and on se<:tionih8 contains dark brown fluid. The longue is free of bite marks.llcmorrhage. or other injuries. In<:isioh and dis.<;ectioll of the posterior neck demonstrates no de<:p paraeer\'ical muscular injury and no cerviCIII spine f1'&Ctures. 1.(lngitudinal inci,ions of the: back. bunocks., thighs. ankle, and "'Tist r.how no evidence of injuries. BODY CAVITIES: The ribs, Sternum, and vertebral bodies are visibly and palpably intact. No excesr. fluid is in the pericardial or peritoneal cavities. The righl cher.t cavity conlains 500 ml of serosanguinous fluid lind the left contains 400 ml of ICrosanguinous fluid. The organs occupy their usual analomie positions. Page 40f7 MEDCOM 0457 ACLU Detainee DeathII ARMY MEDCOM 457 RESPIRATORY SYSTEM: The right lind left lungs are grossly edemalous and .....eigb 1140 lind &60 gm, respectively. Bilateral pleural adhesions an:: easily broken witll gentle dissection. The exlernal surfaces arc ol/tcrwisc SlIlooth IIlld dcql red-purplc wilb marked deposilion of antlwcotic pigment on tile pleura and wilbinthe lung parencbyma. The pulmonary parencbyma is markedly congested and edemalOus. No mass lesions or areas of consolidalion an:: pTCSCIlt CARDlOVASCULAR SYSTEM: The 540 gin Ilea" is contained in lin inlact pericardial sac. Tile epicardial surface is smoolll, wilh minimal falinveslment Tile coronaT)' aneries arc presenl in a normal distribution. Wilh a right dominant pallem. Cross scuiolls of lhe vessels show marked allieros<:lefOsis: - 99% (pinpoint lumen) calcific alenosis of the proximal left anlerior descending coronary aner)' ·30% calcific slenasia Oflhe proximalla mid righl caronary mery .60% calcific slenasis of tile left coronary anery The myocardium is homogenoll$, red-brown, and linn. The valve leaflets are lhin and mobile. The walls of the left and rilllll ventricles are 1.7 em and 0.5 em thick, respectively. The endocardium is smootll and glistening. A definilive area of myo-necrosis ia nol identified. The llO"a shows marked erosi....., alherosclerosis a1anllthc loolllCic and abdominal segments. LIVER & BII.IARY SYSTEM: The 1960 gill liver has an inlact. smooth capsule:ll1d a sharp anterior border. The parenchyma ia lan-brown and congested, with llie usual lobular arcllileclure. No mass lesions or Olher abnormalities are seen. The gallbladder contains J5 ml of green-black bile and no Slones. The mucosal surface is green and velve!)'. The extrahepatic biliaf): tree is palent. SPLEEN: The 260 Illll spleen has a smooth, intact, red-purple capsule. mll1'OOn and congesled. willi distincl MaJpighian corplL'I(:\es. The parenchyma is PANCREAS: The pancreas is firm and yellOW-ian, with lite usua.llobular arehitcclllre. No mass lesions or Olher abnormalities are SttR. ADRENAl S: TIle right and left adrenal ~l!flds are symmetric. with yellow cortices and grey medullae. No ma.~s or areas ofllcmorrhagc are identified. GENITOURINARY SYSTEM: The right and left kidneys are nodular: lhe righl kidney "'eighs 160 gm and the left weillhs 140 gm. The extemaJ surfaces are rough and granular and the capsules slrip Wilh difficulty from the co"ical surfaces. Thc CUI surfaces arc red-Ian and The pelves are congesled and lhe corticomedul1ary juncliolls an:: poorly demarcated. unremarkable and the urelcrs are nannal in course and caliber. While bladder mucosa overlies an inlact bladllcr wall. The bladder is emply. The prostalc is moderately enlarged. with labular, )'t'l1ow-lan parenchyma. A l.cm, well eireumscribed nodule occupies llle right lobe. The seminal vcsicles are unremJlrk.able. The testes are free of mass lesions, contusions, or other abnormalities. Page 5 of7 MEDCOM 0458 ACLU Detainee DeathII ARMY MEDCOM 458 Muhlisln (b)(6) -~ GASTRQINTESTINAL TRACT: The esophagus is intlll;t and linnl by smooth, grey-white mucosa. The stomach eontAins approximately 50 mJ of dark brown fluid. The gastric wall is inUte!. The duodenum, loops of $ll\aJl intestine and colon are unremarkable. The appendix is present MICROSCOPIC EXAMINATION SeleeLed portions of organs are re1ained in fonnalin with prepnration of the following histolog.ic slides: l. Brain: frontal cortex and hippocampus -110 pathologic abnormality Brain: pons - no pathologic abnormality 2. J. Brain: ccrebellum - no pathologic abnonnwity Thyroid gl.nd. len - follicular adenoma, 1cm 5/6. TI,yroid gland. nghl -nodular hYP"l'JIlasia (fld~malOus goiter): follicular adcllOlIl1I. 0.5 ,. om 7. 8. 9. 10. Prostate gland - bcnill" prostatic hyperplasia Corol1lU')· artery, proximal LAO - confinns t~ J:TOSS OOOel"\'ation Coronary aneries,lefl and ril;ht - confirms the gross observation Hean.ldl venlride: acute inflammation with myocyte neerosis and contraction bands Hearts: septum - acute inflammation with myocyte necrosis and contraction bands II. rillht ,·crttricle· no pathologic abnonnality 12. Aona: severe lItherosclerosis 13. Li,·er: certlro-Iobular congestion Kidney: hyaline aneriolosclerosis: infemitial fibrosis 14/15. Lung: acute bronchopulmonary and lobar pneumonia; emphysematoUS change ADDITIONAL PROCEDURES • • • • Documentary photographs are taken by tbe OAJ'ME Photographer SpecimelU retained for IOxicoJogical testing and/or DNA identification lire; vitreous fluid, blood. bile. liver. spleen. kidney. lung, brain. psoas muscle I\1Id gastric contents The dissecttd organs are forwarded with the body I'ersolllll efTects are released l<) the appropriate mortuary operations representatives. Page6of7 MEDCOM 0459 ACLU Detainee DeathII ARMY MEDCOM 459 MUhailin[(b){6) '1 OPINION B~snl on lh~ autQOSV findings and the invwiga1ive informal ion availabl.. to me, lh.. cause of death o~(b}(6~ --.Jis severe atherosclerotic cardiovascular disease complicated by an acute myocardial infarction and acule pneumonia. Additional incidental aUlopsy findings (non contributory 10 the cause of death) include a follicular adenoma and nodular h.)'J'CfPlasia of the thyroid gland and benign bypertroph.y of the prostate gland. ToKicology findings show medications consist~t with ho~pi\.lll care IlO<J resuscitation. The manner of death. is nallll8l. (b){6) ~ Anned Forces Mtdkal Examiner 5)'Slem Pagc70{7 MEDCOM 0460 ACLU Detainee DeathII ARMY MEDCOM 460 _.-- .- -- . --- _. -*-_..---- CDTlfICAllI Of DuTl1/01l£IlUASj _.,_-_ .... -- -~"'ClviHan ''U -- - SlB MuMllin, Jamll, '41""'""'''' ~-- ''''' -.......-.... _.~- (b)(S) Ii! ~ 0 .~ -- -- -, --*-_. . . -*--_.- --.,.. -"e-*__.---. . ._....._- _....--~~ .... ....co_ , -' -~ -~ ,- ~ ~ eo,,,,,,,,, ~- ~ ....._ T O ..... • . . _Ie:- _ _ Cfn' "" ...... "" ........ ..-. . , , otIUN... _ __""UN C'IlA'" _.._- _.-_ -- -_...,-_... .--- GwIf ' " OfA'" • - • "'._oIic~ "" "'"""'" """"""• . . - '" OfA... _ ~ . ~ o;o.e-. __ " - l O e . - _...,. _ _ o.. ...... ~ . _ . _ - ---... . TO_V",,* onu_CANt_ , • -- -- - --_ ..._- ..... ----=--..- _ .. ___ --........ _'" --. __ ......... -_ __. __ _---- _- --.,_._ ---"-_ .... ... _.. -_. .._.- _..... _....._ -........___ """"'" ....'" 1_ _ _ _ 0 , GJ ~ , ""''''_'''~_" ...... , -~ ~~ 0 ~ l(b}(S) 1b}(S} 1 "" 1 ........... '" -~:=.~ [(bXS) ',0<16 . ... ,.._ , ...",, _ _ .... _ _ _ Of"" OlCCAKO_ .... "'<O:O·..... ",. _ , _O>_~_ (b)(6) '(~ 12n1l2008 --~-- ~- ....... ~1Ul_._ • Mlldal Examlner '". OoverAFS, Dover DE l(b)(6) _;::;;,;;;",;,;,;--- 00':1:\, 2064 ...... n ... Ooo ..... .......... " " _ - . . _ ......... _ _ . . . . . . . . . . . . MOICIo .... MEDCOM 0461 .... ~ ACLU Detainee DeathII ARMY MEDCOM 461 ARMED FORCES INS11TIITE OF PATIIOWGY Office of the Anned .'orees Medical Enm;nu 1413 Restwch Blvd., Bldg. 102 Rockville, MD 20850 1-301-319-0000 FINAL AUTOPSY EXAMINATION REPORT Name: FURAYII AL MEHLAWY, SSANL(~®tasi1..H~_l!!i'_- Alltopsy Date ofBinh fBTB1{b)(6) 1933 t DalcofDeatIi(b)(6) 12006 Datdfime of AUlOPSY: 4 Nov 2006@ 1000 Dale of Report: 18 Jan 2007 NO.!,!(~b~)(~6);=~ AFIP No,I(!?f(§) ~ Rank: Iraqi Civilian ~lainec Place of~ath: AI Qailm, Iraq Place of Aulopsy: Port Mol1llafY, Dover AFB, DE Circumstances of Duth: This 18 year-old Iraqi Civilillll Detainee "'1lS found unresponsive on his sleeping mal after reportedly being suangled by another delainee. Authorization for Autop"Y: Office ofllle Anno:! Forces Medical Examiner,lA W 10 USC 1471. Identification: Presumplive idenrifiClluon is establiShed by a wrist idcntificallon band. A DNA sample is taken for profile purp<!$t5 if an exemplar becomes available for positi"!: identification, CAUSE OF DEATH: ASPHYXIATION DUE TO LIGATURE STRANGULATION MANNER OJ,' DEATH: HOMICIDE MEDCOM 0462 ACLU Detainee DeathII ARMY MEDCOM 462 FINAL AUTOPSY REPOKT(b)(6) Funyb AI Mebl....I, MUDluir HUIIIM! P'c e20f6 FINAL AUIOpsV DIAGNOSES VI. E"ldtnCf! of Lig_Iu~ Slraas:ulllllon A. Thtre is. drftllnftrtJlli.l, di$coatiauOillluptrlki.' p.nemtd .bn.sloa o. lilt aeck dtmoastralillc 11l6-IDtb periodicity, direcled boriulD,,11y B. Thl _brallo. croua lht lupcrior 113 Oflht lhyrold cartilas:t 10 'h-lac:het htlO'lf thllOp oflhe hud and uttndl on both lidel of the neck, pUling I ¥... lncbet I).clo.... boLb "rs, .nd mUI.riag up to ~lIcb ill ....idtb C. 1111 layt....wlM anltllor Deck dlu«1lon demolutralet bemom.gt in tbt deep lDlIJoCullllun (cricotbyrold mllKln), bililenily O. Auocl.ted injuries I. 1111 hyoid boac IIld lbyroid artiJ.gc.n ialla 2. Tbt polltrior ntck dlss<<11011 dtmODSlnlln ao iajury 10 Iht uadtrlyllig toft tinllt J. Tlltn: is connutnl ptttebiu illille ...lIeculae of lilt 1lIryal, bUIltnlty 4. Ptltchln.~ pramt oa Ihe mUCH' of Ibe lo.... u lip .ad tbe riglll Ind left bulblr Ind inftrior palpcbnl conjuacll".e 5. CoPCettiOIl ,f bolh lunp (ri&bllunl 'OG-cnml, left Inng SOO-CnmJI) Ind l'r'lh in botb m.lnllem bronchi n. No licnificlIllllalunJ distuc U Idenl1fitd ...Ithi.. tbe limiLltioDI of tbi. cUlIllnltiCIn lU. Thtre 1111' evidence ,fmedlc.l Lbtnpy IV. Idenlifyins: Body Mlrlu or TlttOCl' A. Sur, left upper chesl, I-Inch B. Scar,ltft db,...., I-Inch V. Tbe~ VI. TOllcolol)' (AFiP) A. Volaillet: No tlh.nol b dcltded In the blood and bile B. I>rup: No drup of.buse Cll medicatlonl Ire dettCltd in Ihe blood e. elrboo Monoxide: The carboxybcmoillobialaluralion III tbe blood is less thn I '¥. D. CYlllldt: No CYlnldt II dttected III the blood Is no evidence ,f phy,lnl Ibule MEDCOM 0463 ACLU Detainee DeathII ARMY MEDCOM 463 FINAL AUTOPSY REPORT [(b){6) Forayh Al Mehlawi, Munla5irlH".~m"'.'d~- PageJof6 EXTERNAL EXAMINATION The body i5 thai of a wtJl-developed, well-nourished appearing, muscular, 10-inch, 126pound male whose appearance is consiSlent wilh 1lle ttponed age of is years. Lividity is lixed and postenor (except in areas exposed to pressutt), rigor is absern, and lhe ternperatllte is that of the refrigeration uni!. The scalp is covered with 3-incl1 brown hair in a nonnal dismbUlion. The irides are brown, the comeae are cloudy and lhe pupils are round and cq..... l in diameter. There arc pelcchiae in both inferior palpebral <:onjunctivae and on both bulbar conjunl;livae. The extem41 audito!,), canals arc clear, and the ears are unremarkable. The n~ arc patent. There are petechiae on the m\lC()Sl! of the lower lip. The nose and m&;\;iIlae arc palpably stable. The teeth appear natural and in good <:ondilion. The ne<:k is straight. and the ll'achea is midline and mobile. The ehest is symmelrie with a I-inch sear on the upper left ehest. The abdomen is flat with greenish discoloration. The genitalia are those ofa normal adult circumcised male. The lestes are descended and flee ofmasses. Pubic hair is present in a normal distribution. The posterior IOrso is unremarkable. The bunacks and anus are unremarkable. The upper and lo~r extremilies are syrrunetric and wilhout clubbing or edema. There is a J _inch scar on the left elbow. CLOTHING AND PERSONAL EFFEcrs The following clothing ilC1T15 and pclS<lnal effccts are present on the body al the time of aUlopsy; • • • Otange shin and pants White boxer shorts White T-shin MEDICAL INTERVENTION • There is no evidence of medical interVention RADIOGRAPHS A complete 5et ofpo5tmonem DJdiographs is oblaine<! and demon5lnl.lcs the following: • No fl'llClUKSOT metallic foreign bodies are idenlified MEDCOM 0464 ACLU Detainee DeathII ARMY MEDCOM 464 FINAL AUTOPSY REPORT!(b)(6) Funyb AI Mehl....i, MUDI.slr lIamad =-oJ EVIDENCE OF INJURY There is a ~ir(:wnfen:ntial, discontinuous supnficial paltemed abrasion on lhe neck demonstnl1ing 1116-inch periodicily lhat is directed horizonlally. The abrasion crosses the superior one-third of the lhyroid cartilage 10 Y.t-inches below the lOp of the head and then e;<tends on bolh sides of the ned., passing I %-inches below each ear, measuring up 10 Yoinch in width. The layer-wise anterior neck dissection demonstrated hemorrhage inlhe deep musculature (cri~othyroid muscles), bilaterally. The hyoid bone and lhyroid canilagc wen: intact The postct'ior neck dissection demonstrated no injury to the underlying soft !iss...... The valleculae of lhe larynx demonstrate <;onfluent pete-;:hiac, bilaterally. Petechiae were JlTC$Cnl on the inner lower lip, bolll sclerae, and both inferior conjunctivae. INTERNAL EXAMINATION HEAD AND CENTRAL NERVOUS SYSTEM: The galcal and sUbgaleal50ft tissues oflhe scalp are free ofinjury. The calvarium is inlact, as is the dura maIer beneath it. Clear cerebrospinal fluid surround$ lhe I S30'gram brain, which has unmnarkable gyri ltlld sulei. Coronal seclions demonstrale sharp demarcalion belween white and ~y mauer, without hemorrhage orconlusive injlU)'. The ventricles are of normal site. The basal ganglia, brainstent, cerebellum, and arterial systems are free of injlU)' or olller abnorrnaJilie:s. Then: are no skull fn«:tures. The allanlo-occipilal join! is slab Ie. NECK: S«: "Evidence of [njury," above. The thyroid gland is symmetric and ~-bro"'l1, wilhoU1 cystic or nodular change. The tongue is free of bile mark$. hemorrhage, or other injuries. BODy CAVlTlES; The ribs, Slemum, and vertebral bodies arc visibly lind pal~bly inlllcl. No e;<cess fluid is in the pleural, pericardial. or peritoneal cavities. The organs occupy their usual anatomic positions. RESPIRATORY SYSTEM: The righl and left lung:s weigh 600 and SOO-grams, rcsp::ctively. The extemalswfa>:es an: smoolh and deep red-purple. There is froth in both mainSlem bronchi. The pultrK>l1ary parenchyma is diffusely congested and edemalous. No mass lesions or areas of consolidation are present. eMPIQV ASCULe.R SYSTEM: The 300-gram heart is ~ontained in an intacl pericardial sac. The epicardial surface is smooth, with millimal fal investment The coronary aru:ries are pre5Cnt in a normal dislribution, with a righi-dominant pauem. Cross sections of the vesscls show no luminal narrowing. The myocardium is homogenous, red-brown, and firm. The valve leaflets art! thin and mobile. The waHs of the left and right ventricles are 0.6 and 0.2-cm thick, respectively. The endocardium is smooth and glistening. Tlte aorta gives risc to lhree inlaCl and palent arch vessels. The renal and mescnteric vessels arc u~markable. MEDCOM 0465 ACLU Detainee DeathII ARMY MEDCOM 465 FINAL AUTOPSY REPORT (b)(6) Fura)'h AI Meblawj, MUlllulr lIunad LIVER &. BILIARy SySTEM: The lsoo.aram liver hu &rI inlaCt, smooth eap:$u1e and a $harp tnterior border. The parmc:hyma is tM-brown and congestM, with the usU4llobular an:hitecture. No IIlU' le$ions or other abnonnalities an: lttn. The: pllbladder contains 2·milliliters of areen· black bile and no stollCS. The mucos.al surface Is areen and velvety. The extr8hepBtic biliary tree is pater!!. SPLEEN: The I ()().gram splee:n bas a s.mootll, intaet, red·purple tapsule. The p81'C1l(b)'Tlla is m.IllOOrI and cong~. with diSliru:1 Malpighlan. corpus.clcs. PANCREAS: The panl:reas is !'inn and yellow-WI., with !he or other abnormalities are seen. usua.llobularlll'ChileC~. No rruw ksiOl'ls APRENALS: The right and left adrenal glands are symmetric. with bright ~1I0", conkes an.d llrey medullae. No masses or areas ofbemorrhage are identified. GENITOURINARY SYSTEM: The right and left kidneys weigh IOO·grams ea<:h. The utetnal surfaces are inlar:t and $ffioolh. The Cllt surfa<:es an: m:l-tan and c:ongested, wilh unifonnly thick cortices and sharp corticomeduJlary junctions. The pelves are unmnarklble and the ureters an: nonnal in COUf$C and c:aliber. Gray-pink bladder mucosa overlies an intKt bladder wall. The bladder contains no urine. The prostate is normal in size, with 10bu!Br, ydlow-tan parenchyma The seminal vesicles are unremarhble. The Itstes are fret ofmass lesions, contusions, or otber abnormalities. GASTROINTESTINAL TRACT: The esophagus is intact and lined by smooth, gray-white mllCOSlI. The stomacb contains approximately 400-miIliJiten of semi·solid rood material. The gastric wall is inlaCl. The dU(X\enwn, loops of small bowel and eolon are unremarkable. The appendix is a*nl. MUSCUl.OSKELETAL SYSTEM: There are no bone or joint aboonnalities. Skeletal muscle development is normal. Superficial JIOsterior incisions of the torso and eXll'mIities are negative for soft tiuue hemormage. MEOCOM ()(66 ACLU Detainee DeathII ARMY MEDCOM 466 YI1\AL AUTOPSY REPORT,(b)(6) hrayb AI Mebla.... i. MunlQlr lI.Imad MICROSCOPIC EXAMINATION Sel«ted portions of organs are retained in form.alin, wilh preparation of histolngical slides of!be following organs: heart lung, liver. kidney. and brain. The findings are: I. LW1S;S: P'ulmonary edema ....d vascular eonaestiOIl Heart: No significanl mieroscopie abnonnalilies 2. Kidney ....d L.iver: No significant microscopie abnonnaJilies 3. Drain: No significant mieroscopic abnormalities ADDITIONAL. PROCEDURES • • • • Do<;umenlUy pbolo&rll.Phs are taken by OAfME sWfpbolograp/len Specimens retail>ed for loxicologie teSling and/or DNA identification an:: vitn:oLtS bumor, blood, spleen, liver, bile, gastric content!., kidney, 1\1llg. brain, adipose tissue ....d psoas The disse<:led ori8'1S an: forwarded with body Personal eff«1S are releued to the appropriale mortuary operalions represenlatives opn."ON This 18 )'CIlI"-old Iraqi detainee died as a ~ull ofasphyxiation due to ligalure slrMgulaliOll. There W1IS a eircwnfeTential. di.9OOlllinllOll4 superficial panemed abrasion 01l the n«k, The anterior n«k dissection demonsuated btmorrhage in the deep musculalure (crieolhyroid muscles). bilalerally. The hyoid bone and thyroid cartilage ~ inlaet. The posterior ned: dis~ion dernolUtrlted no injwy to lhe undeTlying soft tissue. The w.lIeeulae of the IU)'I\ll dernon!ttated hm.... ,I..age bilatenolly. Petecbiae ~ presenl on the mucosa oflhe lower lip, both xlerae, and both inferior eyelids. There was no evidcnee of pbYlical abuse. Micl'O$COpic studies weT1: non-contribulOTy to the ClIUSIl of de.th. Toxicology studies were nepliw for etIwtol and dnJgs of abuse. The mllllller of death il homicide. (b)(6) (b)(6) (b)(6) Medical Examiner (b}(6) MEDCOM 0467 Medical Examiner ACLU Detainee DeathII ARMY MEDCOM 467 --....., .',-- -....._.-.. - - _._..... - -.------,- _.._-- -- ---..,_ __ - -_.- _.. __ . -""---- TI! Dl' lIU1I1 ~ CtitI _ _ P_" I - . .-. BTB fUlllYII1>I. Mel'Uw. MUIllaIlr, Ham.cl "" <N<'.... • _ "" ...... ,,"'" ~b)(6) 1gea 0"-' k _ ~ • ... ... ... ~ <"'"._"."... flltl£< ....... .....""....... ----...fl' _.._-_ ....-_ .. __ -_ -._._.---. --""--,,, -e-.. _ _ c.. . _T<>oo _ _ -_ -- .... _ ....... ... _ __ :::=':-"'-"''--~ /-,-------,--.,.,-,---:;:""""r.;:;;;;,,i,,:';=;:;;:;=-------f-;' ~ , AopIIyxIo .......... III .. ' III _ " . _... _<1\.,.-'0 .......• _ ,. ..-'" ... .................. =.:~ao.._ ---' ]·~o;-~·~·~·;-;_;"~==f·;;,-::';·:o:-:::o:~,:;;~;-~~-~::;,-~=.,,=E[:;·e:,-:;;~rJ-~"~-;·~~~:::;·:·:':·:..~~-1 0 l ..... ' _ --_. , -- ._..--- -- . .... ___ ........ - . _ .. _..- _----.. _....... c _ .... _ _ ... _ ",,,"",,,, l(b)(G) (b)(G) , ...... "" ....... "_."-'I 1>1. a;olm Iraq' 12llO5 '_.. _ ... .... _"" _ _ ....... , .... J(b)(G) ~ _ OC~." .... ~.-.. ......... fT.... _ ~-_._--_... (b)(G) MEDCOM 0468 IMadc:aiI Exaomlner ACLU Detainee DeathII ARMY MEDCOM 468 ARMED FORCES INSl1TIJTE OF PATHOLOGY Office of the Armed Fon:n Mediad Examiner 1413 Resean:h Blvd.• Bldg. 102 Rockville, MD 20850 (101)J19-0000 FlNAL AUTOPSY REPORT Name: HAMlD,,fadiUadwL_ _ Interment SerialJb)(6) Date of B;"h!~bJl6f:JI978 Dale ofDeaIb (b)(6) J2006 Date of Autopsy: 25 OCT 2006@ 1230 D'lIe of Report: 14 FEB 2007 1(~b)~(6~)=~ AUllJp$Y No: AFIP Nd(b)(6f ----J Place ofDcath: Camp Bucca. Iraq Place of Autopsy: O<Jver AFB Port Mortuary, Delaware ] "'as a 28 year-old male. Iraqi National. held as a Circumsllinces of Death, 1(b){6) detainee in Camp Bucca, Iraq. Hc "''as discovered unresponsive in his room by cellmates. Rcsusciuuion efTol'1S. ineluding advlllll:cd life support measuru, were unsuccessful by medical personnel and he was pronounced dead at 10481(b)(6)-----a006. Authorinlion for Autopsy, Office oflbe Armed Forces Medical cJI;aminer, in accordanee ...ilb Tille 10 US Code. Section 1471 (10 USC 147\). Idenllfication, Positive identification established by invcstigative ageney CAUSE OF DEATH, Probable C.rdi.c Arrhylhml. S«ond.ry to Conctntrlc LeO Vtntriculu Hypertropby MANNER OF DEATH: Nllunl AUTOPSY FINDINGS: I. A.llean: 470 grams Concentric left venlricular hypertrophy {sec clmjillC consultation palle 5) Coron:1J')' aneries widely patent B. l.ungs: Bilateral pulmonary wernli (combined weight 1450 grams) C. No external injuries Page 1 of7 MEDCOM 0469 ACLU Detainee DeathII ARMY MEDCOM 469 HAMlDlm(b~}(~6}'---~ II. Toxicological Examination: • VOLATILES: The blood and urine aR' negati~ for ethanol al a c\llofflevel of20 mgfdL. • Peripheral blood contains less than 1% carboxyhemoglobin (COHgb) detomnined by spectropholOmeuy with a limit of quantitalion of 1%. COHgb saturaliollS of 0.3% arc expected For lIOn-smokers and 3-10% For smok.ers. Salurations above 10% ate considered elevaled 8J1d are confirmed by gas chromatography. • There is 110 cY8J1idc dClccted in thc blood Thc limil of quantitaJ.ion for cyanide is 0.25 mgll•. Normal blood cyanidc concentrations Il1C less lhan 0.15 mgfL. Lethal conccntrations of cyanide are greater than 3 mgfL. • DRUGS: The blood is screcned for acctaminophcn, amphelaminc. anlidepressants. antihistamincs, blIrbiturates, benrodiazepines, cannabiooids, chloroquillC, cocainc, dcxlTomcthnrphan, lidocaine. narcolic llMIgesics, opiates, phencyclidilll:, phcnothiazines, salicylatcs, sympathomimctic amines and verapamil by gas chromatography, color lest or immunoassay. Thc following drllg is dClCded: o Lidocainc is detCded in lhe blood by gas chromalography and confinned by gas cliromalog.raphy/mllSS spectromctry. EXTERNAL EXAMINATION The body is that ofa wcll-devclopcd. well-nourished. 70 Y,.inchcs tall, 178 pound Caucasian male who appears oldcr than his reponed agc of 28 years. Lividity is marked and fixed On lhe poslcrior aspeCI ofthc body. Rigor is passing and lhe lemperalure is cold, that oflhe rd'rigeralOr. An idenlification lall is aroulld lhe right greal1OC. Thc scalp is covered with black hair in a nonna! disuibution. Facial hair consisls of a black. beard. Thc irides ~ brown and thc pupils are round and equal in diamctcr. The extcrnal audilOry canals arc: cICM. The ears Pre unremarkable. The nares arc palcnt llIld ~ lips are alraumatic. The nose and maxillae are palpably ~lable. The ~th are natural. Thc rocck is straight, and the trachea is midline and mobile. TIle Chesl is symmetric. The abdomcn is nal. TIle genitalia are those of a 1lO1I11aJ &dull circumCised male. The lestcs are descended and l'rce of masses. Pubic hair is present in a nonna! distribution. Thc bunocks and anus arc unremarkablc. The upper and lower exll'emilics are sfmmcuic and without clubbing or Wernli. CLOTHING AND PERSONAL EfFECTS The following clothing itcms arc presenl on the body al the limc of autopsy: • Yellow coloR'd boxcr shorts • Ycllowcolorcd l·shin • Yellow colored Ions panlS • Pcrson~l effects arc nol pfes¢nl with thc body Pagc20f7 MEDCOM 0470 ACLU Detainee DeathII ARMY MEDCOM 470 HAMID(b)(6) J MEDICAL INTERVENTION • • • • EndomIc:heal inlubation Introvenous cathclers in the righl IUTTI and groin Foley catheter in the peni~ Cardiac monitor pad on the left upper t>ack RAPIOGRAPHS • A tomplete sel of postmoltcm nldiographs is obtained and demonstrales no traumatic injurie~. l;iVIPtlNCE Of INJURy There are no e"temal injuries. INTERNAL EXAMINATION I-lEAD: The galeal and ~ubgaleal soft tissllCJl ofthc scalp are tiu of injury. The eaJvarium is intact. as is the dura maIer beneath it. Thcre an: no skull fractures. Clear cen:brospinal fluid surrounds the 16JOgm brain, which has urrn:marl::able gyri and sulci. The atlanto-occipilal joint is slab Ie. The brain is rerem;d ror consultation follows: llt the AFIP Neuropathology DcpartmCllt and lheir report We examined lhe 16JO wam fonnalin-fixed brain suhmined in reference 10 lhis case. SolM unremarkable cerebral dura is received: no dural hemoTThage or sinus thrombosi~ is seen. The leptomeninges arc clear wilh slight congcstion; rIO ex\lllale or henlQntJage is identified. The cerebral hemispheres are symmelric. with Inildly compressed gyri lhat are normal in configuralion. No softening or comusion is identified. Thc cmnia! nerve stumps are unremarkable. The circle ofWiJlis has a normal configuralion. No ancurysm. atherosclerosis, or ocdusion is found in the intracranial anerics. The brain stem and cerebellum an: externally oonnal. No subfllicial, lrW1Stentotial, or tonsillllt herniation is secn. Coronal ~lions of cerebrum show no abnonnalities in cortex. while maltcr, Or deep gray ntaller nudei. The lateral and 3" venaides are grossly normal. The hippocampi are symmemc and nonnal in size. • PagcJ of7 MEDCOM 0471 ACLU Detainee DeathII ARMY MEDCOM 471 HAMIDI(b)(6} ~lorilonlal sections of the brain stem and. I;eKbcllum Kv~l unremarkable cut surfaces. The subslanlia nigra and locus ceruleus llJ'l: normally pigmented. The lllIucduct is patent. The 4'" ventricle is grossly normal. The spinal cord is not available for examination. Hi~tologicaJ $«tions: I. Right superior/middle frontal gyri (superior inked black). 2. Right interior parielallobule, 3. Right superior/middle temporal gyri atleve\ ofmamilllU)' bodies (superior inked blaclc). 4. Bilaternl cingulatcd gyri (left inked black). S. Right calcarine fissUlt' ",ith basal occipital g,yri. 6. Right hippocampus at level of mamilJary bodies. 7. Right hippocampus at level oflateral genirolate nucleus. 8. Right caudatelpulamen with basal forebrain. 9. Right putamenlpallidum. IO.llilateral thalamus./hypothalamus al kvel of mamillary bodies (left inked black). II. Right thalamus at subtllalamic nueleus. 12. Midbrain with subslalltia nigra (left inked black).13. Pons (left inked black). 14. Medulla (left inked black). I S. Right cerebellum with dentate nucleus and folia. 16. MedulllU)'-eervical jWlCtion (left inked black). 17. Left hippocampus at levcl of lateral geniculate nucleus. All tissue sections were processed in paraffin; sections were stained with H&E. This material was reviewed in conference by staffof the Department ofNeuropalhology and Ophlh.almic Pathology. Histological sections show scattered lreas or ~cule neuronal injury in Ihe deeper layers of the cerebral conex, deep grapy mailer nuclei, hippocampi (eA I and dentate gyrus).. and cerebellum (Purkinje cells). HiflTlOClnlpal sclerosis is not identified. A sinllle small focus of perivascular chronic inflammatory cells is noted in the right hippocampus at the level of the mamillary body. Some scattered blood vessels throughouttbc brain have 5ntal1 numbcr9 of perivllSCular hemosiderin·laden macrophages. The brain sbows acute neuronal injury. 11 rUlU-specific finding that i~ commonly associated with h)'lXlxic-iscllemie change. Features diagnostic for malformation. storage disease, infection or neoplasm an: not identified. No contusion or IICute hemorrhage is seen. ~: The anterior strap muscles of lhe neck are homogenous and red·brown, without hemorrhalle. The thyroid canilage and hyoid bone are intact. The laryllX is Iined by inlllCt whilc mucosa. Thc thyroid is symmetric and red·bro"'lI, without cyslic or nodular change. 'The tongue ill rn:e of bite maIlls, hemorrhage, 01 otOO injuries. Incision and dissection of lite posterior ned; demonstrates IlO deep paraccrvica1 muscular injury and no cervical spine fractures. BODY CAVITIES: The ribs, sternum, and vertebral bodies an: visibly and palpahly intact. No ellcess fluid is in tbe pleural, perio:ardial or peritoneal ca~ities. The organs occupy tbeir usual anatomic positions. RESPIRATORY SYSTEM: The right and Id\ lungs an: markedly edematous and weigh 730 and 720 gm, respectively. The external swfaees are smoolh and deep red-purple. The pulmonlI)' parenchyma is diffusely congested and edematous. No mass lesions or areas of consolidation are pnlsent. Page40f7 MEDCOM 0472 ACLU Detainee DeathII ARMY MEDCOM 472 HM.UD (b)(Il) CARDIOVASCULAR SYSTEM: ~ 470 gm heart is mildly enlarged and is contained in an inlaCt perieanlial $&C. The hcan is IdCTl'ed for consultalion at lbe CV Path Institulc and their rtpOn folio....,: DIAGNOSIS: (b}(ll) CODcntric left veDtrlclllar bypeMropb)' Hun: 470 lUllIIIS (pmlicled normal value)SI) arams, upper limit 46) grams for a 178lM man): 1IOI'TI\8.1 epicardial fal; closed fonmcn ovale: conccntrk left ~mtricular hypC:1'lroph)': lttl. ~muicular c:avity diameter lSmm.lefl \'Cnuiculnr 11ft. WIlli thicknc:ss 15mm, venlril.:ular septum thickness 17mm. ri~t ventricle thickllCSS 5mm. ..ithout gros$ $CI.I'$ or abnonnDI fat infillnnes; arouJ), UllTemarllable valVC3 and mdoeaJdium: roo &ross myocardial fibrosis or nccl'(Xis; tuSloJOKic sections $how mild left ~cntricubt mYOC)'te hypertrophy, olherwise unremarkable. Coronary Merlo: Nonnal O$tia: riiht domilllnCc; no ifOSI atherosclerosis COndllCtinn s)'1'tcm: The si_lrial node and nodal artcry lIlll unremarkable. ~ cnrnpact atrioventricular (A V) node shows mild lfagmentalion ..i!hin tbe centrallibroul body, wilhnul inflammation, necrosis, incruscd fat or proteoglycan. The pcnctraIinl bulKlle is «:nmll)' 10000ed and unremarltable. The lefl prOlIimal bundle 1Jnux:h is inlXtlllld u~markablc. The riglll bundle branch is not Ken in these scaions. 1'1lcn: arc no discernible: b)-pIlSI IntCtS between the A V node and vcntricular septum. 1bm! is no dysplasia Oflhe AV nodal artery. LIVER'" BILIARy SYSTEM; The 1820 gm liver /IQ an inlXl. smooth capsule and a sharp anlerior border. The ~nchym.& is lM·bro--on and congested, with the: lIIual lobular lIl'CtuUlCturc. No mass lesions or olher abnonnal itic:s lIlll scm. The: gallbladder contains S ml of gr«:n-black bile and roo StOl'lCS. The mllCOSal turfacc is green and velvety. The exlt'lhcpatic biliary tree is palent. SPl.EEN: Ttw: 250 gm spleen M$ a smooth, intact, rcd-pw-ple capsule. The maroon and congested, ..ith distillf;\ MaJpighiall CClI')lI.ISClcs. parcnch~'ma is PANCREAS: The pancreas is finn and ycllo..~tan, wilh the usuallobulu tlt:hitCCltlle. No mass lcsions or other aboormaJilics arc seen. ADSENALS: The righl and left adrcrml glands arc symmetric, wilh brighl yellow coniccs and ~y medullae. No mISses or arcu ofhernontlqc arc identified. QENO'QURINARY SYSTEM: The right and left kidneys weigh 170 and 160 gm. Jl:'spectively. "The external surfaces Irc intaellllld srnoolh. The cut surl"lltt.I arc !'Cd·lan and congested. with uniformly thick c:oniccs and sharp c:ornoomeduUa/)' JunctiotU. "The pelves arc lIItI'Cmarbble and the t.ll'C\CI"I arc normal in COUI'IC and caliber. While bladokr mucosa overlies an inlac:t bladder wall. The bladder is empt)'. The prostate ~and is IlOITIl&I in ,itc:. wilh lobular. yellow·1&Jt Page 5 of7 MEDCOM 0473 ACLU Detainee DeathII ARMY MEDCOM 473 HAMJDtb )(6) parrnchyma. The seminal vesicles (:OllIusions. or other abnormalities. Il'e lIl\mllarbble. The tutes arc free of mass lesions. GASTROINTESTINAL TRACT: The esophagus is intact lIIld lined by smooth. grey-white mucosa. The illOlnlCh contains IppfOlI:imately 90 ml of brown pattially digcsted food. The pwie wall ;, inllCl. The duodenum, loops llf smal! bo_1 and colon arc unremarkable. The appendiJI is prestnt. MUSCULOSKELETAL: No {Illumatic abllomlalitic:s or hc/To(IlllUlIlC of SUhcUlaIlCOlIS tissue, mU5I:lc or bone ~ idcntifi\'d. Nontraumatic abnormalities Il'e lICK idcmiliai. ADDITIONAL PROCEDURES • • Documelllary photographs IIl'C lakcn bv the OAFME.PIlot021lohc:r,-__ ldentifvil\lt maoodn<:ludc a llU!OO (b)(6) (b)(6) • • Spc<:imens retained for loxicological testing and/or DNA idmtifleation lire: vilmlwl fluid, blood. urine:. splecn.liV1:r. kidney. lung, bik. ga5lric oonlenu. and psoas mU5l:1e. The disse<:ll:d organs IIl'C for....arded ",ith the body MICROSCOPIC EXAMINATION Selected portions of organs IIl'C retained in fonnaJin "'ith preperaJiOll of the following histologic slides: Hem: sec: cardia<: consultation paac.5 Brain; sec: ne:W"(lpathology consultalion pages 3/4 I. I,i~ sinusoidal and cenlrolobular congmion. otIlcrwisc no pathologic abnormalily 213. Lung: fll<;aJly mlll'kcd al yeolar congestion. otherwise no palhologic abnormality 4. Kidney; VlISCular conllcstion. oLllcrwisc no patholollic abnonnality S. Spleen and Adrcnlll Oland: no patholoJic abnonnality 6. Pancreas: mild autolysis. otherwi.se nQ patholOSK: abnormality Pa~6of7 MEOCOM 047" ACLU Detainee DeathII ARMY MEDCOM 474 QPINION Based on lh~sc nUlop$)' findilJl'\!! and tile investigalive infonnalion available 10 me. lhe caU5C of dealh ofmis Iraqi dC1ll.inedjb5(6) 'is probable cardiac arrh)'lhmia scoondar}'lo concentric left v(11l1icular bypl'r1rophy. ~ft ventricular hypcr1toph)' is llSSOCialed wilh cardiac arrhythmias and sudden death. Additional autopsy findings include mllrl;ed pulnlonl1/)' congestion and gcneralized conge:stion of the liver, spleen and k.idneys: findings consislenl wilh a fata] cardiac liIThymmia. There are no signs of ext~maJ or inlrmal trauma. Toxicology teSl;ng is POSilive for lidocaine: a drug used in cardiac l'CSuscilBtion allcmptS. and is otherwise negative for ethanol or screened drugs of abuse, The manner of dealh is natural. (b)(6) L Armed Forces Medical Examiner SYltel(b}(6l Pag~70f7 MEDCOM 0475 ACLU Detainee DeathII ARMY MEDCOM 475 _... _._. __ . ---_.,----. -_.--..........._ -_. -'" ._. - -- - ..........- - --_.-- --,---,_ - _. _-- - - _"'- -_. __..... -- -'_1 C6111I'ICATlOl' ou. fH (OVfRSlAt) BTB Hamid. F8d~, J"~ Op (b)(S) CMlian ... "" "" ~-- ~-~ ;1918 ~(b)(S) Ii] 0 -. • ~~ ...'c· ..... ~ 0- ... --. ... • u ..... -~- "'"OIl "-''''.,... _1.... _ _ _-- . _ n....... ."......_no . . .__-"'_"1 e -.. _ _ _. __ .................... .... _ _ Moo'" __-_..,"''*' "' ' ' --, . .... _... --_ .... ....-.-.-._ . .... _... -.--- -_ -- ..-.. _ ... _-_ ... -------.--, p, • t' .........,.""........... " 1ofI . .,,- _""'1.£Acaoo TO ....... • _"'-'-"_.....-'0 _ O I l <:<JOGTtJOO ... '"'- coo_"1c , ~ ....... , "' ""'""-""'""'"""j.... , . ..... """"'.. _no • iii --- _... ---.. .- ~ (b)(6) , 0 ~ ~ [0' _ l(b}(6} ....."' ... TOur_ ....... • _- - _. ......_.-_''''....._.._--..... -,,,,n,,,,- .. . .,_._ _-__...__.....___----,,-.. .-._.. _ _'...__ n_.. __. . . ,. __. . .... . . ............... --- (b)(6) ,"",,-'" . . p"... _ ....___ 2008 2.5 Odobllf 2.006 Ie .......__D_....... . ,...... --...'DAT ...."""'.-....,,_._.... O"O .. _ _ .... _ - ·~j{6i....,..Q1'''"''---- b)6 ,......'''''''''_ (b)(6) o-~ £- ...- ClrTlll SIJOCI, a,Sf f t O _ .. _ _ .... _ I ..,,- • Mediclll Examinef Oovef MS, ~r DE (b)(S) .... .... ..... ..... I ... _ . ~ ...... ........a<I . . . . . . . 00' M"'" 2064 MEDCOM 0476 ACLU Detainee DeathII ARMY MEDCOM 476 ARMED fORCES INSTITUTE Of PATHOLOGY Offiee of tile Anncd Fo!"'Cfl Medinl Eumincr 141 j R~arch Blvd., Bldg. 102 Rock-ville, MD 20850 1-301-319-0000 VINAL AlITOPSV EXAMINATION REPORT Name: ~BTB) HAZZAA AL DOULAIMEE, "'j6,) ~ _ =r SSAN: Ifbl(6)_ Date of Birth: (BTBJlb}~UI982 Dale ofDeath: Ilb)(6) j2006 Dale/Time of AUlopsy: 17 OCT 2006@ 1700 Dale of Report: 17 NOV 2006 Autopsy No.: l(b)(6) --~ AFlP No.: Ll~))6~'::cc: Rank: Iraqi Civilian Detainee PlllCC of Dcalll: Camp Bucca. Iraq Place of Auoopsy: BIAP Monuary, Baghdad. Iraq CireumSllnCts of Duth: This 24-year-old Iraqi Ch'ilian Delainee SUSlllined a gunsool wound from U.S. Army soldiers during a firefight on 30 SEP 2006. He was resuscitated, =eived surgery and was stabilized prior 10 his lJaTIsfer 10 Camp Bucca. He was ambulating with assiStance and malting prog= when he was fO\Q\d unresponsive in his room. and could nOl be resuscilated. Author'lulioD for AutoPS}': Office of the Armed Forees Medical Examiner, [A W 10 USC 1471. Idenlillnlion: Presumplive identificalion is established by a wrist identificalion band. A DNA sample is taken for profile pulpOSCs if an e~cmplar becomes available for posilive idenlification. CAUSE OF DEATH: GUNSHOT WOUND Of THE BACK COMPLICATED BY PULMONARY EMBOLISM MANNER Of DEATH: HOMIClDE MEDCOM 0477 ACLU Detainee DeathII ARMY MEDCOM 477 FINAL AUTOPSY REPORT: l<b)(6) ] (BTB) HAZZAA AL DOULAIMEE, Ezaldio A""aoau flNAL AUTOPSY DIAGNOSES I. Gunshol Wouod orthe Back A. Entnmce WolUld I. Location: On the lower right back. 25-inches below me top of the head and 4-inches right of the posterior midline of the back in thoc anatomic position 2. DimensiollS: An ovoid entraoce wound measuring Yo x 3fl6-inch with eccentric marginal abrasion up to !t.·inch on the lateral border B. Wound Path: Skin and subcutaneous ti.!.sue of the lower right back. muscles of tile lower right back, the spinous process of the 4'" Iwnbar vem-bra (fractu~), muscles of the lower left back. subcutaneous tiS5Ul: and skin of the upper left bUllock C. Exit WO\lnd 1. Location: On the \IPper left bUllOCk. 29-inches below the top of the head, 3g V,-in<:hes above the hed and 7·inches left of the posterior midline of the back in the anatomic position 2. Dimensions: An ovoid deft(;t measuring J !t. ~ 2 V,-inches. consistent with a debrided e~it wound; packing material is presem surrounding the e~it wound D. Recovered: No bullet or bullet flllgll1ents 1IR ~eovered: multiple radioopaque metallic fragments of no evicknliary value 1IR observed radiographically in the ~llion of the left buttock E. Direction: Slighlly back to front. right to left and slightly downward F. Associated Injuries I. A non-Qbstruetive thromboembolus with valve markings and tributary casts is located at the bifwclllion of the right and left pulmolUll)' arteries ("saddle embolus''); multiple small obstruc1ive thmmboemboli are noted in the .smaller lmIn<:hes of the right and left pulmonary aneries 2. Deep venous thromboses in the deep veins of the right and left legs J. Bleeding into the wound tract II. No lignificanl nalural diseasCl or p~listingconditions art identitled, within the limitations of Ibis uamillltion, Ill. Evidenu of Medinl Tberllpy A. A closed, 9.;neh surgical incisiOTl is on the abdominal midline B. A medical dressing and packing an: present on the lower righl back C. A "acuum drain and a J-inell closed surgical in<:ision with packing is on the lower left back D. Needle stick marks an: on the right subclavian ~gion IV. Pon-Mortem Cblnges A. Rigor is passing and equal in all extremities B. Livor is posterior and fi~ed e~cepl;n areas exposed 10 pressure C. Marbling is present in IR'IS oflivor MEDCOM 0478 ACLU Detainee DeathII ARMY MEDCOM 478 FiNAL AUTOPSY REPORT: [(6)(6) I (BTB) IIAZZAA AL DOULAIMEE, Euldin Awanad Pagd ofS D. Corneal clouding, bilaterally V. ------:J Idenlif)'ing Body Marks A. Tauoo ~m~(6) [(b)(6) B. MultipleirTeguJar scars on the right ~ in a:; Y.xl'.-inch area and J8J1ging in size: from punctate to Y, x "'·inch VI. Tbere ill 00 evitleoce of pbyslcal abuJt A. Layer-wise anterior neck dissection is negative for trauma 8. Incision lUId dis:;cction of the pIIllerior ncck demonstmtes no deep paraccrvical muscular injury and no cervical spine fractures C. No petcchiae are present on thc conjunctivae or 011ll mw;osa D. Extcrnal examination is negative fOT trauma E. Radiographic skeletallUl'VCY is negatiVl: for trauma VIl. Toxicology A The blood D.nd urine arc tested for ethanol and none is found. B. The urine is scn:cned fOI medications and drugs of abuse and !he following medications arc detcc\Jcd: I. Oxymolphone (a nBr\;Olic analgesic) is detected in the urine. but is not present in the blood. 2. Oxycoclone (a narcotic analgesic) is detected in !he urine, but is not present in the blood. EXTERNAL EXAMINATION The body is that ofa wcll-devclopcd, well·nourished appearing, 67-inch, 150-poulll;1$ (estimated) male whose appearance is consistent with the reponed age of24-yean. Lividity is pDllerior and fixed with marbling in lU"eali of lividity. Rigor is paSi5ing and equal in aU extremities. and the ICmperatW'C of tile body is cold 10 lOuch. The scalp is covered with black hair in a normal distribution; facial hair corusiSl1 ofa fuJi beard and moustache. The irides are brown. the comcae cloudy, the conjunctivae pink. without petechiae and the pupils arc round and C<jual in diameter. The external auditory eanaJs are patent and free of foreign material. The eatS an: unremarkable. The n.e.n::s Btl: patent and the lips arc atmumatic. The nOK and maxillae arc palpably stable. The tccth appear natUl'll!. The neck. is Itmight, and the trachea is midline and mobile. 'll1e chest is Iymmetric. The abdomen is remarkable for a dosed, 9-ineh midline surgical incision. Injury to the posterior torso is described below (see ~Evidence of Injury.'? The genillliia are those ofa normal adult male. The teste3Btl: d~nded and free of masses. Pubic hair is present in a normal dislributiQn. The bunocks and anus are unremarkable. MEDCOM 0479 ACLU Detainee DeathII ARMY MEDCOM 479 FINAL AlITOPSY REPORT: l(b){6) : Pa~40f8 (8TH) HAZZAA AL DOULAIMEE. Ezaldin Awanad The upper and lower extmnities an symmetric and without clubbing or edema. CLOTHING AND PERSONAL EFFECTS The body is received unclothed and without personal effects. MEDICAL '''7ERVEl'fTION • • • • A closed. 9-inch surgical incision is on the abdominal midline A medical dll:SSing and packing an present on tile lower right back A '-acuum dBin and a 3-inch closed surgical incision with packing is on tbc lower left bad: Needle Slick mark! Me on the right subclavian region RADIOGRAPHS A OOmplete set of postmortem rndiographs is obtained and demonstrates the following: • • • • • No long bone frllClures No rib or skull fractures No fractures oflbe bones oflbe hands or fed Fracture of the spinous process of the 4" lumbar vcrtebra Multiple small radio-opaque melallic fragments an observed in the region of the left buttOCk EVIDENCE or INJURY The ordering oftlte following injuries is for descriptive purposes only. and is not intcndcd to imply order ofinniction or n:lative severity. All wound pathways arc given relative to S1lU1dard anatomic position. Gunshot Wound ofthc Back A gWlShot enlJal1Ce woWld is on the lo....-er right bad:. 25-inches below the top of the bead and 4-incltcs right orthe posterior midline orthe back in the anatomic position. Thc ovoid entrance wound measures 'I. x 3/16-inch with C«enuic marginal abrasion up to 'I.. inch on the lateral border. The wound path perforates the skin and subcutaneous tissue of thc lo....·er right back, muscles of the lower right back, the spinous process oflbe 4'" lumbar vertcbra (fracturd). muscles of the lo.....e r left back, subcutane(lus tissue and skin of the upper left butwck. The bullet exited via an ovoid defect mcasuring 3 Y. x 2 JI,inches (oonsistent with a debrided exit wound; packing material is present surrounding the exit wound) and located on the upper left butlOCk, 29.inches below the top of tile head. 38 Y.-inches abo--e the heel and 7·jnches left of tile posterior midline of the back in the anatomic position. No bullet or bullet fragments are recovered; multiple radioopaque metallic fragments ofno evidentiary value are observed radiographically in tile • MEDCOM 0480 ACLU Detainee DeathII ARMY MEDCOM 480 FINAL AUTOPSY REPORT: ~) (BTU) HAZZAA AL DOULAIMEE, [zaldin Awanad j PIge50f8 region oflhe left bUllock. The wound pRth is directed slighlly back 10 fion!. righl to left and slightly downward. Associated y,;th the wound path is bleeding into the wound lrilCI; a nOIl-obstNCli\lt' lhromboernbolus with valve markings and lribuwy castS iii localed at the bifurcalion of the righl and left pulmonary aI1eries ("li3ddle embolus") y,;th mulliple small obstruclive lItromboemboli noted in the smaller branchelioflhe righland left pulmonary aneries, and deep vcnous lhromboseii in !he: deep veinli ofthe righl and left legs. INTERNAL EXAMINATION HEAD AND CENTRAL NERVOUS SYSTEM: The galea! and subgalcal soft tissues of the scalp an f'r«o of injury. The calvarium is in\lll:t, as is the dura maleT beneath il. Clear cerebrospinal fluid surrounds lhe 1,J40-gram brain. which has IIJIJ'l:markable gyri and suki. Coronal sections demonstrate sharp demarcation between while and gray maner, y,;tlloul hemorrhage or eomusive injury. The venlricles an: ofoormal size. The bas.aJ ganglia. brainstcrn. cerebellum. and lI1erial sYSlems are free of injLlf)' or Olher abnonnalities. There are no skull fractures. The allanto-occipital joinl is Slable, "'""', Layer-wise dissection ofllle anterior sll'ap muscles ofthc neck reveals homogenous and ml·brown lissue Y,;thoul hemorrhage. The thyroid cartilage and hyoid bone are intact. The larynlt is lined by intaCl white mucosa. The lhyroid gland is symmetric and redbroy,1\, without cystic or nodular change. The tongue is fiee: of bile marks, hemorrhage, orolher injuries. Incision and disseclion of the posterior neck demonstrates no deep paracelVical muscular injury and no cervical spine fraclures, BODY CAVITIES: The ribs and stemW'l\ an: visibly and palpably intact. No eltcess fluid is in the pleural, pericardial. or periloneal cavilies. lbe organs occupy their usual analomic positions. RESPIRATORY SYSTEM: The righl and left lungs weigh 540 and 400·grams, respe<;:lively. The external surfaces an smooth alld deep red-purple. The pulmonary parenchyma is diffusely congesled and edematous. No mass lesions or art:as of consolidation are present Multiple small ocdusi\lt' tIlromboemboli an: noted in the smaHer branches oflhe right and left pulmonary arteries. CARDIOVASCULAR SYSTEM: The JSO.gram heart is contained in an intact pericardia! sac. The epicardial surface i$ smoolh. with minimal fBt inveslmettl. The coronary arteries are prescnl in a normal distribution, with Brighl·dominam panero. Cross sections oflhe vessels show no luminal narrowing. The myocardiwn is oomogenous, ml-brown, and finn. The val\lt' leafletS an: MEDCOM 04el ACLU Detainee DeathII ARMY MEDCOM 481 • FINAL AUTOPSV REPORT: ~) (BIB) HAZZAA AL I)OULAIMEEc,'FC7'",Odli:,CA".~'.nad Page 6018 thin and mobile. The walls of the left and righl ventricles an: 1.2 and O.S-cenlimetcn. chick,lespectivcly. The cndocardiwn is smooth and glistening. Upon opening.he pulmonary artery while i" silu, a llono()Cclusiw. thrombocmbolus with valve markings and tributary casts is located at the bifurcation of the right and left pulmonary arteries ("saddle embolus'i. The llOrta gives rise 10 three inlacl and patent arch vessels. The renal and mesenteric vessels are unremarkable. LlVER& BILIARY SYSTEM: The 1,870-llrllm liver has an intac!, smooth capsule and a sharp anterior border. TIle parellChyma is lan-brown and congested, wilh the usual lobular archite<;IUIC. No mass: lesions or other abnormalities are secn. The gallbladder contai"s a minute amOunt of green-black bile and no Slones. The mucosal !lUlface;s ~n and velvet)'. The exlJ'1lhcpalic biliary uu is palenl. • SPLEEN: The 290-gram spleen has a smooth, intaet, red·purple capsule. The parenchyma is maroon and wngested, with distinct Malpighian corpusdes. PANCREAS: The pancreas is firm and yellow.tan, with the usual lobular architecture. No mass Jesioml or other abnormalities are seen. ADRI:."NAlS: The right and lel\ adrenal glands are symmetric, with bright yellow cortices and gmy nledulJae. No masses or areas of hemorrhage are identified. GENITOURINARy SYSTEM: The rightllIld left kidneys "..eigh 150 and ISO-grams, respectively. The external surfaces are intact and smooth. The CUI $urfaCC$ are red·lan and congested, with uniformly thick cortices and sharp eorlieo-medullary junctions. The pelves are lUIl'CIIIarkable and the ureters are normal in course and caliber. Gray-pink bladder mucosa overlies an intact bladder wall. n~ bladder conl8ins approximately 75-miHiliters ofyel1ow urine. The prostate is r>OnnaJ in site. wilh lobular, yellow_tan parenchyma. lbe seminal vc:sides are unremarkable. The testes are free of mass lesions, contusions, or other abnormaJ ilies. GASTROINTESTINAL TRACT: The esophagus is intact and lined by smooth, gray-while mucosa. The stomach contains approximately25·milliliten of tan fluid. The gastric wall is intact. The duodenum, loops of small bowel and colon are unremarkable. lhc appendix is present. MUSCULOSKElETAL SYSTEM: There is no non·traumalie bone or joint abnormalities. Skeletal mU$Ctc development is normal. MEDCOM 0482 ACLU Detainee DeathII ARMY MEDCOM 482 FINAL AUTOPSY REPORT: [(b){6) (BTB) HAZZAA AL I)OUUIMEE, E:uoldin Awanad Page 7 ors MICROSCOPIC EXAMINATION Sclet:ted portions of organs an: retained in formalin, wilhout preJllll'8.tion of histological slides. ADDITIONAl- PROCEDURESIBEMARKS • • • • • • Documcntary photographs an: \lIknl by AFMES stalfphotographel'$ Specirrn:ns retained for toxicologic testinlllil\dlor DNA idnltification are: hcan blood, vitreollS fluid. g3SlI'ic contents, urine, bile. spleen. liver. lI1/1g, kidney. brain, lld.ipose tissue, and psoas mU'lCle Full body radiographs are obtained and demonstrate the s\;eletaltrauma described ahove and the presence o(multiple small metallic foreign bodies swroundinillhe exit wound Projectiles are not reco\'ere<! Selected pol1ions of organs an: retained in formalin, without pt'CJllIl'8.tion of histological slides Tbe dissected organs are forwarded with the body • MEDCOM 0483 ACLU Detainee DeathII ARMY MEDCOM 483 FINAL AUTOPSV REPORT:.~(b~)'~'~'O-~ (BTB)IIAZlAA AL DOULAIMEE, Euldhl A....Il.d OPINION This 24-year-Qld Iraqi civilian detaiMC{b)(6) died of" gW\5ootofthc back he sll$Uined while in .lirelighl with U.S. Army personnel. Ue was stabilized and tmlSpOl'IC(i to. mcdieal facilily where he ....-as ambul.til\& with assiSUUlCC wheD he ....-.s, fDund ~nsive in his hospital bcd. A8j;rcssive re$U5Cilalioo was 10 no avail. The gunshOi enlT1ul« wound was localed on the righl lo.....cr back.:IlId ptssed through the skin and 50ft tissue ofme lo...-cr right bal;k. the spinous process ofme 4'" lumbar vencbra and the soft tissue ofme left lower back before eJCitinllthe upper left buttoe:k. There WWI no evidence of close range lire. nor were any oflhe projectile m.gmentS thai were observed radiogmphieally recovered. A signifielUll complic:alion of this gunshot wound ....-as multiple ocelusive and non-oecl~ve lhrombocmboli in lhe pulmonary aru:ries. Toxieologieal tcsIing wu neg'live for ethanol. and positive for the rwrolie analgesies Oxycodone and Oxymorphone in the urine but nol in the blood. The nwtnerofdeath is homicide. (b){6) (6)(6) IMedicai Examiner j{_'_"'_' _ MECCOM ()(64 ] ACLU Detainee DeathII ARMY MEDCOM 484 _... __.- .-- - Cl'RnfICATI! 00 OEo\TH (OV£RS£Il$J AclO'doI_ ~-- -~~ - BTB Hazzaa AI Doulal, Ezaldin. Awanad -_.-... _ (b){6) Civilian __ ,-.. """...SfC"""""""" ........ """"'"" IVIV>I:. -.-- - -- - .-- - -....... ---" "'. 1-_._,-_. _-,...... - - - -___.... -~ NO''''''''~ "''"" '" I,., ~. l(b)(6) ~ 1962 @ 0 .....,.. OUTIII ~ ,.~ ~ • • -~ -"" ...... ,,- ... "",,,,"""'OOlCE~ --....... .. -,.--_.-_ . _... .. --_ . ... . C/lY"""""" '"' 0"'" ""...".-us OllClll_, ~.- ~ C'''C'""", ~ _l<»M _ _ -~ "OW::M."'''T£MEN1 _.,,---'" -- """""AI. .........,. """""" " '" <- ... _ , - - - ... ".. , ........ '"' COI01tIN ....cn.. WOINO m_'" , - . . . . , - _ ... w.j d ItMt bid< """"IllicIl bI' GunsIIot _ ~" ,..... _~,f'_.l£<QNO'" ~ .- _..-""" .........,""'""' ~- ----. ",,-_ . ,,-_... OT'C.A _ _ """"",,,,"I ----- , , '''''''''_Ofl_ _Of"..'" ---- -- .- [i)~ ~ 0 ~ - --....._- .... <lEA'" <>JIl fO.....-..C'UOO:. """,,- I •. _ _ _'"'" I"" _ ,.__._-... __ ....-. - ..... _... ....... ..... _---.-- -_. ._._ --_.... _...._...........__ ....--_._-----........_ .. -_._.. _.-.. .. _.• ~ ~ _OIl'" (b)(6) " -oo.nr-_ '17 Oclobef 2006 "~}(6T-- I 0- "" 1iJ~"',......... .... ..... 0LAelt"" w ......._ "'_."_''''''''!l,(b)@ '20De{b)(6) Camp Bucca ,"'.. _ _ _ ""_0£<.....0 _ 'H oc:a..-u>" ""' .... """""no_'_'"" "''"'O_ .-... CAuIU ..... . -.....AIDo'"..-aoo·_. (b)(6) , 11912007 , • _._------~ <"6i(6)'--" . IMedlca1 Examiner Baghdad. Iraq l(b}(6} ..... DD'~ 2064 -. ",_ OD<.O.CS''''' """' ....,. ""''' _"""""'_........ " 0IHIClI_-..... MEDCOM 0485 ACLU Detainee DeathII ARMY MEDCOM 485 - ARMED FORCES INSTITUTE OF PATHOLOGY Offl« oflbe Armnt Fon:ts Medi~.1 Eumlner 141J Res<:arch Blvd., Bldg. 102 Rockville, MD 20850 1·30\-319·0001) FINAL AUTOPSY EXAMINATION REPORT Name: (BTB) ABBASS AI.-ZUBAIDl, ~~S~N~·;~;m.M~~"iMm~~m~.~. ~=:-- ISN: (b)(6) Dale of Birth: f,BTB!{b)(6) [1942 Date ofOeath:,(b)(6) 12006 DatcffimeofAUIoPSY: 15OCT2006@1000 Date ofRepor1: 19 JAN 2007 AUlopsy No.f{b)(6) AFIP No.: "(:~"')(~6).----r~ Rank: Iraqi Civili.lut Detainee Place of Death: Camp Cropper, Iraq Place of Autopsy: SlAP Mortuary, Sagbdl'ld, Iraq of Death: 'Inis 64-year-4Jld Iraqi male was a delainee al Camp Cropper, Iraq and undergoing lKallnent for tubercUlosis. He bad no olher known medical problems. He was foUlid wuesponsive, and allhough ACI.S prolOCQI TC;suscitation was initialed, he expired. Cin:umslao~ea AUlhoriulion for Autopsy: Office of the Arntcd forces USC 1471. Med;~al Examiner, lAW 10 Ideotilialioo: PTC;sumptive idenlification is establis!lcd by a wriSt identificaliOl1 band. A DNA sample is \.Iken for profile putpOscs if an exemplar bcl:oml2 available for posilive identifi~a1ion. CAUSE OF DEATH: HYPERTENSIVE AND ARTERIOSCLEROTIC CARDIOVASCULAR DISEASE MANNER Of DEATH: NATURA.L MEDCOM 0486 ACLU Detainee DeathII ARMY MEDCOM 486 FINAL AUTOPSY REPORT: ~(6) (BTB) ABlIASS AL·Z;UBAIDI, Nljim M. FINAL Al.ITOPSY DlACNOSES T. Canllovutular Dlnue A. Coronary lIl'tery disease I. Luminal narrowing (7S%)ofthe ld main toronary lIl'tery 2. Luminal narrowing {9O%)oflhe re-canalized left anterior descending coronary lIl'tery with calcificalion 3. Luminal narrowing (9lW.)ofthe left cin:umflex coronary lIl'tery with calcification 4. Luminal narrowing {>9O%)oflhe right coronary artery with calcification, evidence of plaque rupTure and fresh lhrombus formation 5. Remote left posterior wall and seplal inf~tion n. Cardiomegaly (helll't weighl SIO-grams) C. Aortic atherosclerosis with uJoeralion and calcificaTion D. Focal, diffusc glomerulosclerosis and arteriolosclerosis of lhe kidneys n. Otber Findings A. Right renal calculi: Four irregular. green-brown calculi llJl: recovcred from the renal pelvis, and range in sizc from 0.3 to 0.5-eentimetcrs B. Prostatic hypertrophy: The prostale is enlarged in siz.c, 5.0 x 3.0 x 3.0oenlimclers (no discrete nodules llJl: idenlified), with lL'ISOCiated muscular hypcnrophy of the bladder C. Bullae of The tight and left upper lobes of the lungs D. Pulmonary congestion E. Mild 10 moderate pulmonary emphysema F. Muhiple lung and hilar lymph node secTions are negative for mycobacterial infection (see Atlachmcnt I for complele details) lIT. Evidence of Medical Thcnpy A. A pmperly located endotracheal lube B. An Inl"'venous line in~"ed in the righlllOtccubilal fossa C. A surgical-1ypC mask coverinllthe nose and moulh D. Rib fractures: anterior right 6 rib and anterior left 2"" through 61to ribs IV. Pos1-Mor1em Chlnges A. Uvor is poslerior and fixed except in anas exposed to pressure B. Rigor has plL'lsed (absent) in all extremities C. The body is cold 10 louch V. Identifying Body Marks A 0.7)( Q.S-(:enlimeler broWTl papule is on the left. groin VI. Nn evidence nf pbysicalabuse VJI. T,,~icolngy A. The blood and urine llT1: tested fnr ethanol and none is found. MEDCOM 0487 ACLU Detainee DeathII ARMY MEDCOM 487 FINAL AUTOPSY REPORT: j(b){6) Plge 3 of8 (81'8) A8BASS AL-ZUBAIDI, N'ljlm M. B. The urine is screened for medications and drugs of abuse; Ethambutol (M antimycob$:terial medication) is detected in the \lrine but is nol quanlitaled in the blood. EXTERNAL EMMlNA1'ION The body is!lult ofa well-developed, ",.ell-nourished appearing. 70 ~inch aod 150pollnd (cstimated) male whose appc8rlUl« is consistent with the ~potled agc of64·years. Lividity is posterior and fi:ted. Rigor is absenl (passed), and the temperatUR' is cold to touch. The scalp is cove~d with gray hair in a normal distribution; facial hair consists ofa moustache. The irides are hazel. the oomeac arc cloudy and the pupils are round and equal in diameter. The external audirory canals are patenl and free of foreign material. TIle ears are unremarkable. The nares are patent and the lips are BTrlIwnatic. The nose and mu:illae are palpably stable. The teeth appear natural and in fair condition_ TIle neck is stTlliaJtt, and the trachea is midline and mubile. TIle chest is symmetric. The abdomen is f1al. The genitalia are tllose ofa llOrmal adult male. The testes are descended IIJId free ofmaS$CS. Pubic hair is presem in a nonna! distribution. The buttocks and anus are unr.:.ma<kable. There is a 0.7 x O.S-ccntimeter soft bnlwn papule in the left inguinal fold. The upper and lower eX1~mities an: symmctric and "ithout clubbing or edema. The fingernails are trimmed and inUlet. CLOTHlroG AND PERSONAL EFFECTS The following clothing items and personal effects are present on the body at the time of IUropsy; • • • Yellow top Yellow pan~ While boxer shons MEplCAL INTERVENTION • • • • A properly lotated endotf8chealtube An intravcnous line iru;c:r1ed in the right antecubital fossa A surgical-type mask covering the nose and mouth Rib fractW!:s: anterior rigbt 6'" rib and anterior left 2001 through 6"' ribs MEDCOM 0488 ACLU Detainee DeathII ARMY MEDCOM 488 FINAL AUTOPSY REPORT: l(b){6) (BTB) ABBASS AL-ZUBAIDI, Nljira M. PIge4of8 RADIOGRAPHS A complete $tt ofposunortem radiogntphs is obtained and demonstrates the following: • • No fractures of the skull, axial skeleton, or 10llg bonts No metallic foreign bodies other than medical thernpy EVIDENCE OF INJURY Th~ is no cvidence ofrecem. significant injury. INTERNAL EXAMINATION HEAD AND q."NTRAL NERVOUS SYSTEM: The galeal and subglleal soft tis.sucs of llie scalp are free of injury. The calvarium is intact. as is the dura mater benealh it. Clear cerebrospinal f111id SIlfJOllnds the 1,240-gram brnin. which has llnremarkable gyri and sllici. Coronal se<:tions demonstnlte sharp demarcation between white and gray mailer. witboUI bcmorrllage or COnlusive injllT)'. Tile ventricles are of normal si7.c. The basal ganglia, brainstem, and cerebellum are free of injury or other abnormalities. There ~ mild atherosclerosis of the arteries at the base of the brain. There IlIe no skull fractu~. The atlanto-occipital joint is stable. NECK: By layer-wise dissection, llle anterior strap muscles of the neck lII'I: homogenous and redbro"'n. without hemorrilage. The thyroid cartila~ aoo hyoid bone are inlact. The larynx is lined by intact while mucosa. The thyroid gland is symmetric and red-brown, wilhoul cystic or nodular change. The tongue is free of bite mwb, hemorrhage, or olher injuries. eDDY CAVlTlES: The sternum and vertebral bodies lII'I: visibly and palpably intBCt. Injuries 10 the ribs lII'I: described above (see "MtdicaJ Intervention, ~ above). No CllCCSS fluid is in the pleural. pericardial, Or peritoneal cavities. The organs occupy their usual anatomic positions. RESPIRATORy SYSTEM: The rigllt and left lungs weigh 840 and 72S-grams, respeclively. The external surfa«s are smooth and deep red-jIlJrple. Bullae are grossly identifiable in the apices or both lungs. The pulmonary parenchyma is diffusely congested and edematous. No mass lesions or areas of consolidation an: presen!. CARDiOVASCULAR SYSTEM: The 5 IO-gram heart is eonrained in an inlllCt pericardial sac. The epicardia) surface is smooth, with moderate rat inveslment. The coronary arteries arc present in a normal distribution, with a right-dominant panCTD. Cross sections orlbe vessels sltow moderate to marked luminal nlllTl)"ing ofthe left main coronary artery and scvere luminal narrowing of the left anterior descending and left eireumflex COTOrlar}' arteries. The MEDCOM 0489 ACLU Detainee DeathII ARMY MEDCOM 489 FINAL AUTOPSY REPORT: (b}{6) (BTB) ABBASS AL-ZUBAID1, NaJlra 1\1. PaCa.5 01S tumen of the ri&hl toronary &nary -PJICaB 10 be of a pinpoinl diameter. All of the &nenes an foc:ally e.kified. '\lit; myoc:ardium is homogenous, red·brown, and firm ex~ in the posIeriOl' left venlride and posIerior teptum ~!here is a cImK while tear. The valve leaOets an thin and mobile. The wallsofthe left and rigln ventrio:les an 1.2 and 0.3-c:entlmcter1 thick, ~pectively. The mdoeardium is 5tnOOth and i1i5lenin... The aorta giw:s rUe 10 three inlaC:l and palenl arch _15 and ~ multiple lIhaoselerotit plaques and uleemion with ca/tifiQlion along the enlire length. The renal and Il1C5enleric: vessels are Ulll'tff'l.lrkable. COfOfWy LIVER &; BIUARY symM: The I ,440-aram liYff has an inlaCt. smooth capsule and a sharp anterior bonier. The parenc:hyma is Wl-broWII and congested, with the usuallobuJar archil«lure. No mass lesions orother abnormalities an seen. The gallbladder c:onWt\ll 2·milliJil<:J$ of ~n blac:k bile: and no SIOI'Ie:S. The mucosallUrfaoe is green and velvely. The ~tic: biliary llft is patenl. SPLEEN: The 130-gmn spleen has a 5mOOth, inUlCt. red-pwple capsule. The parenchyma is maroon and congcsted, with distillC11ympho>d follicles. PANCREAS: The pllIlClUS is autolytic and saponified, ",i!h 1bll usual lobular archilecture. No tna5Ii lesions or other abnormalities ARl secn. ApRENALS: Tbc righl and left adrenal Cland5 are aUlolytit and symmelrk, with brillhl yellow c:ortic:es and il'lllY medullae. No RlU$e$ Of areas ofl\nnotThai:e ARl idomtil'ied. GENITOURINARY SYSTEM: The right and left kidneys weigh 200 and 160-grM1S, respectively. The eluema! surfac:es are intaet and smooth. The cut surfaces are m1-t.an and rongnted, with uniformly thi<:k cortices and sharp eonko-medulhu')' junclions. The pelvis of the righl kidllC)' contains f(l\l\" imgular brown stones which range in size from 0.3 10 O.S-c:entimeters: the left kidney pelvis is unremarkable. Both urctmlan nonnal in course: and taliber. Gray-pink blfldder mueosa overlies an intlCt, hypcrtrophk bllldder wall with lrabeculae. The bladder oontahu approllimalely 300milliUters of tloudy yellow urine. The proSllle is Ullarced, wjth cy,u conlaining viKaLlS brown fluid and yellow-tao parenchyma. The seminal vuiele$ an: unrcmar"bble. The lCSles arc ~ ofmass lesions. contusions, or other abnonnalilies. GASTROINTESTINAL TRACT: The esophai!J$ is inrlK:l and lined by smooth, lUlIy-while mLll:osa. The s!Omath conlains approximately 200-millilil<:J$ of brown-green fluid with food panicles. The gll$lrk wall Is inllCt. The duodenum. loops ofsmaJl bowel and colon are unremarkable. The "ppc:ndill is pnlscm. MEOCOM 0490 ACLU Detainee DeathII ARMY MEDCOM 490 [t FINAL AUTOPSY REPORT: b)(6) (BTB) ABBASS AL-ZUBAIDI, Najim M. ] Page 6 ors MUSCULOSKELETAL SYSTEM: Then: is no non-traumatic bone or jointl\bnQmuliities. Skeletal muscle development is normal. Superficial incisioJls of the posterior 10130 and extremities an: negative for soft tissue: trauma. MICROSCOPIC EXAMINATION Selected portions of organs are n:lained in formalin. with preparation ofselected histological slides. RESPIRATORY SYSTEM ~ (Slides 1-5): Muhipk sections an: ellamined which demonstrate mild intentitial fibrosis and macrophages with anthracotic pigmcnt. Mild 10 moderalc emphYSCl1Ultous changes and vascular coogc:stion an: noted. Special stains fail to demonstrate mycobacteria (set: Attachment I for complete details). HUar lymph node (Slide 6): Anthracotic pigment is present in macrophages; otherwise an unremarbhle lymph node. Special stains fail to demonstrate mycobacleria (see Altachment I for complete details). GENITOVRJNARY SYSTEM Seminal Vesjcle (Slide 7): Cystic dilatation and inspissation of secn:tions Kidneys (Slides 8 and 9): Focal, di~ glomerulosclerosis and arteriolosclerosis. Mild. focal chronic inflammation and focal calcification is present. CARDIOVASCULAR SYSTEM Left ventricular myocar(l"um and sear (Slide 10): Hypertrophic myocytes with en1arlled nuclei, intcntilial fibrosis and dense cndocardial-based se..... l&ft main coronary arterY (Slide II): Luminal narrowing (75%) b)' intimal hypenrophy. cholcslCrol clefts and chronic inflammation. !.&ft anterior descendinll cpromyy lOcO' (Slide 12): Luminal narrowing (900/0) by intimal hypertrophy, cholcsterol clefts and chronic inflammation. Recanalization of the artery and focal calcification an: also present. Left cjn;umflell coronary artery (Slide 13): Luminal narrowing (90%) by intimal hypenrophy, cholesterol clefts and chronic inflamltUllion. Rishl wronary artery (Slide 14): Lwninal narrowiog (>90%) by intim.al hypertrophy, cholesterol clefts and ChrOllic inflammation. Plaque rupture wiOt hemorrhagc into Ihe media and fresh thrombus formalion are r\Oted. ADDrrIONALPROCEDVR&~MARKS • DocumcntllI)' photographs nre mken by AFMES smlfphotographcrs MEDCOM 0491 ACLU Detainee DeathII ARMY MEDCOM 491 1(~b)~(6~)':;;==.J fiNAL AUTOPSY REPORT: (BTU) ADBASS AL-ZUBAIDI, ~iJlm M. • • Page 7 Drs Specimens retained for toxicologic testing llIIdIor DNA identification are: heart blood. vitmlWi fluid, gastric wntcnts, urine, bile, spleen. live!", lung. kidney. brain, adipose t;55U!:, and psoas ffiU5Cle full body radiographs are obtainl:d and demonstrate the absence of skeletal trauma and the absence ofrneudlic foreign bodies • SCle(;led portions of organll are retained in formalin. with prepanl1ion of • • histological slides The dissected organs are forwarded with tile body Personal efreds are released to 1~ moJt\l.lll')' aff..irs represcnlalives OPINION This 64·year-old Iraqi civilian dctainee(b){6) Idled ofhypenensive and arteriosclerotic cardiovascular disease. The observed cardiomegaly, microscopic evidence of cardiac hypertrophy and the microscopic changes in the kidneys are typical of this condition. There is evidcllCc oh remote myocardial infarction, as well as a fresh thrombus in the right coronary artery. II was n:ported lhat he was being lreated for tuberculosis, bUI no microscopic evidence Oflhis disease was observed. Toxicological testing for elhanol was negati~e. EtharnbUiol (an anlimycobiloClcrial medicalion) was dell~c1ed in the urine bul no1 quanl;1.llted in the blood. Thenl is 00 evidence of physical abuse. The rib fntClunlS are most likely an artifact of cardiopulmonary resuscitation. The manner of death is naluraJ. (b){6) (b){6) Medical Examiner MEDCOM 0492 ACLU Detainee DeathII ARMY MEDCOM 492 -..__.- ..... r _ _ _01"-"_ --- _.--- , - ---- -..,-...-- ---"" ~Tl!Of'otA1H~ BTB AbbItt AJ ZUbald. Nlljim. 0 .. -- CMIian ""..01" ..... ... -.. - ---- "....... ...._.,,--... - -_.. 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