Aclu Military Prison Death Reports Part7
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ARMED FaRcrs INSTITUTE OF PATHOLOGY
om« of the Armed FOKes Mediad Eumiocr
14lJ Rcsean;h Blvd., Bldg. 102
Rochille, MD 20850
301-319-0000
FINAL AUTOPSY EXAMINATION REPORT
Name; B'm Darai, Rasoullaba
ISN:l!&(6}
Autopsy ,o.,[(b)(6)
AFIP No. (b}(6)
1981
Date ofDcath,(b){!!)
2006
Date/Time of Autopsy: 29 March 200610900
Date ofRcport: 04 October 2006
Place of Death: Iraq
Place of Autopsy: Pon Mortuary
Dover AFB. Dover DE
DateofBinh:~){6)
Rank:CIVP~----"
Circumstances of Death: This 25 year old male civilian detainee rcponedly sustained head injury as
the result of an assault by fellow inmates.
Authorizatioll for Autopsy: Office of the Armed Forces Medical Examiner. IA W 10 USC 1471
ldentiflcatlon: Presumptive, according to hospital band.
CAUSE OF DEATH: Complications of blollt for« hud injuria.
MANNER OF DEATH: Homicide.
nNALAUTOPSY DIAGNOSES
l.
Blunt foree injuries:
A. Injuries of the head and neck:
l. Left-sided depressed skull fracture (per report).
2. Subacute left-sidc<l subdural hematoma.
3. Subacute contllsions in the left middle parielal and lateral occipiUlllobes.
4. Multiple healing (sulUrcd) JRl:eralions of the left parlelal. occipital and vertex
regions of the scalp.
5. Abrasion (I ineh) of the left lateral $lU"face of the neck.
B. Injuries oflhe torso:
I. Fracture ofthe right acromion.
a. SUbcUlanCOllS and intramuscular hemorrhage of the anterior surface oflhc
right shoulder.
2. Hemorrhage of tile proximal portion of the right spermatic cord.
C. Injuries of the extKmities:
I. Multiple healing (sutured) lacxrations of the poslerior surface of the left forearm.
2. Healing lacerations (2) of the left lower leg.
3. Multiple contusions ofthc right leg.
MEDCOM 0595
ACLU Detainee DeathII ARMY MEDCOM 595
,
AlITOPSY REPORTI{b)(6)
DARAJ, Ruoul Jll».l
II.
Additional findings:
A. Subacute meningocerebl'(lventriculitis wilt! early abscess formal ion.
B. MultirocalllCule to subacute cerebral infarclS.
C. Diffuse acute hypoXic/ischemic neuronal injury.
D. S1atlIs paslleft lIemieranie<:tomy.
E. StatllS pasl venlriculostomy placement.
F. Bilateral pulmonary congestion (right 860 gm, left 740 gm).
1/1.
Tolticology: Morphine and midazolam are present in the blood. Metoclopramide is present only
in the urinc.
MEDCOM 0596
ACLU Detainee DeathII ARMY MEDCOM 596
b
AUTOPSY REPOR,1C )(O)
DARAJ, RlIsoul Jabal
l
---EXTERNAL EXMflNAlJON
The body is Ihat of. well-developed, Ihin appearing male, The OOdy weighs 133 p<)Unds, is 6g inches
in Icnglh and appears compatiblc with the rcpllncd age of2S years, The body lemperature is cool after
refrigeratiOrl, Rigor is preserltlo an equal degree in all extremities. Lividily is fixed and presenl
predominately orllhe poslcrior surfaces Ofille body, except in areas exposed to pressure.
The sealp hair is black. A IS inch curvilinear stapled incision extends from Ihe left nOlltal region
postCfiorly lhrough lhe righl occipital region to tlte left temporal rt:gion, lerminating just anterior \Q the
left eXlernal ear. Facial hair eOrlsists ofa black beard. The irides are brown. The corneae are cloudy.
The cOlljuclivae are unremarkable. TItc sclerac arc white. The exlcTrutl auditory canals. external nares
and oral cavily are free of foreign malerial and abnormal secretions. The nasal skeleton is palpably
intact. The leeth appear natural and in fair condition.
The neck is suaighl, and the trachea is midline and mobile. The clleS! is symmelric. No evidence of
injury of the ribs Of the sternum is evident externally. The abdomen is flat. A healing S inch vertical
incision is present on the right side of the .hM",..n n... r. gernails arejnlact..Jlte c.~tremilics sIto.w
evidence of inj!!!y to be described below (b){6)
tanooICb){6)
---,
(b}(o}
Multiple sears are presenfoifihe POSlC'flor surliee
of the left elbow (area 4 y, x 2 inches) and the dorsal SUlfllCe ofille left hand (2 Yo x 2 inches). Tile
external gcnitalia are those of a nomal adull male. The posterior torso is without note. The bunocks
and anus are umema,kable.
EVIDENCE OF INJURY
Head and neck:
A healing. sutured I inch laceration is present in the right temporal region (pllsterior 10 right external
ear) of the scalp. A healing' 'I, inch laceration is present in the left parietal region ofthe scalp. There
are multilple, healing confluent laceralions in the left occipital region of Ihe scalp coveling an area
measuring I Yo x I inch. There are multiple healing. sutured lacerations in the cenual venex occipital
region of the scalp, covering an area measuring 4 x 2 V. inches. A linear I inch abrasion is on the lell.
'n
lateral surface of Ihe neck. Internal examination reveals a left-sided subacute subduraillematoma.
Torso:
A Y. inch abrasion is present on the pllsterior surface of tile left shoulder. There are muhiple ilTCgular
healiRg lesions on the upper and lower back ranging in size from ItS to Yo inch. Internal examination
shows focal intramuscullU" and subcutaneous llemorrnage in the right upper chest and inlTaclavicular
regions. There is hemorrilage in the region of the righl spermatie cord.
Extremities:
There are multiple healing abrasions and sutured IllCerations on lite dorsal surface of the left upper arm
'I. it>Ch ill
defined confUSion is on tlte dorsal 5Ilrface of the left wriS!. There lU"e multiple healing abrasions on the
and forearm covering an area measuring 2 y, x I it>Ch. ranging in size: from 1f8 10 ',<, inch. A
MEDCOM 0597
ACLU Detainee DeathII ARMY MEDCOM 597
,
Atn'OPSY REPOR:ri<b)(6)
DARAJ, Ruoul Jabal
dorsal surface oflhe left hand and index finger ranging in size from 1116 to 3/16 inch. A focal V. inch
subcutaneous hematoma is present on the palmar surface of the left middle finger. Incision of the left
wrist reveals focal subcutaneous hemorrhage in the ulnar region. l1Icre is a 6 x 3 inch discontinuous
contllsion on the anterior surface: of the right lower leg. There are two healing laeerations on the medial
surface of the left lower leg and the medial surface: of the left ankle ('I. inch each).
EVIDENCE Of MEDICAL THERAPY
Evidence of medical therapy consists of:
I.
2.
3.
4.
S.
6.
Intracranial catheter with lUbing and drainage bag.
Intravascular catheters in the left subclavian region, the right wrist and the left forearm.
A foley catheter.
Probable therapeutic puncture site on the dorsal surface of the right fOOl.
Status postleR hemi..craniectorny with shunt eatheter placement.
Lefl JWietal po"ion of skull placed in abdomen.
INTERNAL EXAMINATION
UEAp:
{See above "Evidence: of Medical Therapy- and "Evidence oflnjury'l
The staples IlK removed and the CDtire scalp is reflected. The posterior portion of the surgieal flap
(aJlllroximately 2 'I. x 2 inches) is dark and appears devitalized. lbe remaining calvarium is removed.
The 1720 gm brain is placed in fixative pending consultative review. No skull fractures life noted. The
atlanto-occipital joint is stable.
=,
The antel"ior strap muscles of the neck are homogeoous and red-brown, without hemorrhage. TIle
thyroid cartilage and hyoid are inlaCt. The larynx is lined by intact white mucosa. The thyroid is
symmetric and red-brown. without cystic or nodular change. 11lc longue is free of bite marks.
hemorrhage, or other injuries.
BODY CAVITIES:
The ribs. sternum, and venebral bodies are visibly and palpably intact. No excess fluid is in the
pericardial, pleural or peritoneal cavities. The organs occupy their usual anatomic positions. There is
no internal evidence of blunt force or pcnel1llting injury 10 the thoraeo-abdominal region.
RESPIRATORY SYSTEM:
The right and left lungs weigh 860 gm and 740 gm. respoetively. The extemalsurfaces are smooth and
deep red-purple. The pulmooary parenchyma is moderately congested and edematous. No man !eslon$
or areas of consolidation are present.
CARPlOVASCUl.AR SYSTEM:
The 460 gm heart is contained in an inlaCt pcricanlial sac. The epicardial surface is smoolh, willt
minimal fal invesUl1enl. The coronary arteries arise normatly, follow the usual disuibution and are
MEDeOM 05Sa
ACLU Detainee DeathII ARMY MEDCOM 598
AlITOPSY REPORT'(bf(6)
,
---J
DARAJ, Ruoul Jabal
widely palent, without evidence ofsignificant ather<lscler<lsis or thr<lmbosis. The myocardium is
homogenous. red-brown. Wld finn; the atrial and ventricular sepia are inlact. The IlOltlI gives rise 10
three inlact and patent mh vessels. The vena cava and ilS major tributaries return 10 the heart in the
uswd distribution. The renal and mesenteric vessels an: unremarkable.
UyER & BILIARy SYSTEM:
The 1620 gm liver has Wl intact, smooth capsule Wld a sharp anterior border. The parenchyma is WIbro",n and congested. with the usual lobular archite<:ture. No mass lesions Of other a!monnalities are
seen. The gallbladder contains approximately 5 ml of green-black bile and no stones. The mucosal
surface is green and velvety. The extrahepatic biliary tree is patent.
SPLEEN,
The 170 gm spleen has a smooth, intael, red-purple capsule. The parenchyma is maroon and congested,
with distinct Malpighian corpuscles.
PANCREAS:
The pancreas is flfTl1 and yellow-WI, with the usual lobular architecture. No mass lesions or other
aboonnalities are seen.
ADRENALS GLANDS;
The right and lell. adrenal glands are symmetric. with bright yellow cortices and grey medullae. No
masses or areas of hemorrhage an: identified.
GENlTOUR[NAR.Y SYSTEM:
The right and left kidneys weigh 170 gm ami 160 gm. respectively. The external surfaces an: inllld and
smooth. The cui surfaces are red-WI and congested, with unifonnly thick conices and sharp
conicomedullary junctions. 1lIe pelves an: ul\n:markable and the ureters an: nonnal in course and
caliber. Tan bladder mucosa overlies an intact bladder wall. The bladder is empty. The urine collection
bag conlains 200 ml ofelolldy yellow urine. The proslate is nonnal in size, with lobular, yellow-WI
parenchyma. The seminal vesicles an: unremarkable. The leSIes are free of mass lesions, cOIltusiOl'ls. or
other abnormalities.
GASTRO!HrESJlNAL TRACT:
1lIe esophagus is intact and lined by smooth, grey_white mucosa. The stomach contains approximately
250 ml of dark greoen liquid material. The gastric wall is intact. Th<= duodenum, loops of small bowel,
colon and appendix are unremarkable.
MUSCUWSKEI.ETAI. SySTEM:
Muscle developmenl is nonnal. No boM! Of joint aboonnalities are noted.
CONSULTATIVE REPORT
Neuropathology Consultation:
The dura is remarbble for adherent surgical material and blood clot in the left frontoparietal region;
two additiOnal foci of subdural hemorrhage are noted in the right parietal region. Thick purulent
MEDCOM 0599
ACLU Detainee DeathII ARMY MEDCOM 599
AUTOPSY REPORTI(b){6)
DARAJ, RuGIII Jlbll
6
exudates ~ identified on the surfaces of the cerebral hemispheres, on the basilar surface ofthe
cerebrum. on the ventral surface of the midbrain and on the cerebellar vermis. i\ 1.5 x I em soft area
associated with an overlying purulent exudate is ~ted in the inferior left temporal lobe. Both cerebral
hemisphel'l:"S exhibit diffuse gyral llaltening and sulcal narrowing. i\ 3.2 x 3 em area of contusion and
IllCCnttion is identified in the left superior JlMiet.allobe, A similar 3 x 3 em lesion is present in the
lateral left occipital lobe. A white plastic catheter, 0.3 em in diameter, is identified in the left middle
frontal gyrus. The eirele ofWil!is has a normal adult conliguration without aneurysms. sigllificant
atherosclerosis. or occlusions.
Coronal sections of the cerebrum show I conical ribbon ofoormal thickness. well demarcated from
subjacent white maner. There is a diffuse dusk discolomtion ofthe cerebral concx. TIle left parietal
and occipitallabe contusions are confirmed; subjacent wedge-shaped hemorrhagic infan;ts, extending
up to 4 cm into the white I1UIlter, ~ associated with each contusion. The brain is akmatous and soft.
A slight tight to left shift is identified that focally compresses the right ventricular !i)'stem more than
the lcft. Definite eingulate gyrus herniation is not identified. TIle ventricular system is lilled with a
purulent cxudate with the left side conlaining more than the right. The shunt catheter is noted within
the ventricular system, The basal ganglia, thalami, and hypothalamus aI'l:' unremalkable. Other than
the previously described purulmt e;o;udate, tnLnsversc sections of the cerebellum and brainstem Ill'l:
unremarkable:. The subslantia nigra and locus ceruleus are normally pigmented for age. The: aqueduct
is slit-like. The spinal cord is not submino:d, but the uppermost cervical cord and cervicomedulJlll)'
junction are unremarkable.
Microscopic sections of meninges demonstrale patchy acute and chronic inllammation with multifocal
abscess formalion; several leptomeningeal vessels have inl1aml1Ultory cells within their walls.
consistent with a secolldlll)' vasculitis. Foci of hcmorrllage, surgical material, and granulation tissue are
also noted in the leptomeninges. Extensive perivascular and parenchymal acute/chronic inflammation
and gliosis are present in several I1:gions of thc ccl1:brum. A large colledion of neutrophils associated
wilh Ilecrosis is IlOted ill the se<:tioll from the left parielal periventricular I1:gion, consistent with early
abscess formation. Special stains for microorganisms reveal a mixture ofshort gram·positi~e
coccobacilli and acid-fast bacteria that are interpreted as contaminants. Multiple foci of rarefaction,
vacuolation. lipid-and hemosiderin-laden macrophages, hypereosioophilic neurons, acute hemorrllage
and subacute inl1aml1Ullion are identified. consistent with muhifocalllCute to subacute cerebral and
pontine infarcts. Numerous hypereosinophilic neurons are identified in the ccl1:bral conex, deep gray
maner, hippocampus, brainstem, and cel1:bellum consistent with diffuse acute hypoxic/ischemic
neuronal injury. The: subdural hemorrhage COI1Sists of inlact and degenerating erythrocytes adjacent to
the dura matter and a well-formed fibrous laytron the arachnoid side. Many pigment-laden
macrophages are pl1:sent. These challges are consistent with a subacute subdural hematoma.
In swnmary, the above changes are consistent with a subacute meningocerebroventriculitis with early
abscess formation, subacute contusions in the left middle parielal and lateral occipital lobes, multifocal
acute to subacute infarcts, diffuse acute hypox.i<:Iisehemic neuronal injury, and a left subacute subdural
hematoma; the subdural most likely occurml at the time of initial trauma with a secondary component
occurring as a I1:sult of mcdical intervention.
MEDCOM 0600
ACLU Detainee DeathII ARMY MEDCOM 600
AUTOPSY REPORT (b)(6)
DARAJ, RlUOul Jabal
7
RAD'OLOGIC EXAMINATION
Full body I1IdiogJ1lphs are obtained revealing, in addition to above, fracture oftlle acromion of the right
SC3ptJla. No evidence of non-therapeutic metallic foreign bodies is identified.
ADDlTlONAL PROCEDURES
•
•
•
•
Documentary photographs are taken by the OAFME staff photographers.
Specimens retained for toxicologic tCSling and/or DNA identification are: blood, bile, gastric
contents, urine, vitreous, lung, I iver, kidney, spleen, adipose tissue aJld psoas muscle.
Selected p<)Mions of organs are retained in formalin.
Pel$Ollal effects are released to the appropriate mortuary operations representatives.
OPINION
According to reports this 25 yell1 old male detainee sustained a depressed skull fracrure as the result of
an assault by fellow inrlUl~. During his hospitalization. he underwent a left-sided craniectomy for
decompression followed by placement ofan intraventrlcular cathether for subsequent hydrocephalus.
His clinical course was complicated by gram negative meningitis and mulliple cerebral infarcts. He
ultimately sucuumbed \0 complications of his head injuries on his 13'" hospital day. Postmonem
lOxicological examination showed only the prcscnce of the therapeutic agents morphine (blood 0.63
mg!l), miduolam (blood 0.09 mglt) and metoelopramide (detected in urine only), The manner of
death is homicide.
This case was reviewed in consultation with Department of Neuropathology. Their written consultation
is illCOrpol1lted into the above report.
(b){6)
C'bC'C"C)
edical Examiner
MEDCOM 0601
ACLU Detainee DeathII ARMY MEDCOM 601
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MEDeOM 0602
ACLU Detainee DeathII ARMY MEDCOM 602
.~...
ARMED FORCES INSTlTt1l'E OF PATHOLOGY
omee at the Armt4 Forces Medkal ExamiDer
'413 Research B1Yd., Bldg. 101
Roc:kviUe, MD 2OSSO
1·)01·JI9-OOOO
AtJJ"OPSY EXAMINATION REPORT
No.J~(b~)(~6)==J
AUlop£)'
AFIP No.: (b)@)
Name: 8TB Muhyi. Tallb. Ullin
J
ISN:(~®
DIU: of Birth:~K6)_ "82
DateofDeflth:(b)(6)
[2006
Rank: Detainee
DatefTimc of Autopsy: 2S MAR 2006
@
]
UllOlus
Pl_ of Death: lnoq
Place of Autopsy: Port Mortuary, Dover
AFB, DE
Date of Repon: 19 MAY 2006
Clrcgmdaoet:l fA Death: This 14 yeat"cOJd detainee was, as reponed. lIOl:ed to have
deaeued urine output Illbout 131.5 hn.f(b)(6) 2006. The detainee was transponed
by ambulance to the 344lll Etna'sency Tnuma Room by ambulance. He urivM TICK
brealhina and his pupils were rued and dilated. He bad. past medical hinary sianifiC8ll!.
for poorly eontroIled Type I diabele3 mellitus (HgBAIC=tQ.4'l». Despiu: llealment
provided the detainee expired.
ADtborizalioa foe Autopsy: OffICe of the Armed Forces Medical EltIIlliner. lAW 10
USC 147]
..........
Idl9lunc.doo:
CiR:Um5Wlli.1 iOcnliflClotion by cuminttiOll of .a:ompanyinll
CAUSE OF DEATH: CompUcatfolll al.Dlabeta: MdIltUll (DIabetlc. Ketoacldosls)
MANNER OF DEATH: Natural
MEDCOM 0603
ACLU Detainee DeathII ARMY MEDCOM 603
AUTOPSY REPORT (b){6)
BTB Muhyi, Talfb, Vmar{b)(6)
]
2
FINAL AUI'OPSY DIAGNOSIS
I.
RcnaI System:
A.
G1omend1r d1lUlges oonsblc:n! wi!h diffuse diabetic J,lomeruI~it.
B.
Hyaline anmolosclaosls.
C.
Seyere autolysis.
II.
Clldiovua1lIl'S)'$teIn:
A.
Morphologically nomal hcan (HeIl't Weight_ 31D-pma)
III
PulmonlIY System:
A.
Pulmonary Congestioo and E.delIla (Lu.ns Wcisba.: Rilhl- ~sraa-;
B.
Lelt.-670-puns)
Bilueral Serous PLewaI Etfv.lioDs (RiaJIt- 5O-m1llilitm; Left - 50millilite:n)
IV.
Hepatobiililry System:
A.
Uve:r.
I. Conpstion
2. MUd .JtetiOS1s
3. 1naused lipofuscin pipIcnI
V.
EndocrineSystem:
A.
AcUenal: No pltboIock d1,eau
B.
Pancrcu: FoeaI peridudll ~ md IUtoI)'Sii
VL
Serous Aieites: 10001Il1lliliten
VII.
No siptiflClnl iDjuries In: identifscd.
vm.
MIDor Ittjurle.: Abnsioo of \be \eft skle of \be f.ce, '.4-indt
IX..
TOJtioolop (AFlP):
A.
B.
C.
CARBON MOI'K>XIDE: The CIfboxybelDtlJ,lobiD MtUnlion in \be blood
Is leu than I".
CYANIDE.: '1'1Jcft Is DO ~ detected in !he blood.
VOlATI1£S: AM.... and 2-pn;lpIDOl ~ddeCted in !he blood and
vilreDWl OWd (eonc:emntiont in maldL).
Blood
D.
X
Aaeu)ne
2-Propanol
29
42
11
Vitmlus fluid
Tr.ce
DRUGS: No screened dntgs olabusc oc medieatlons Ife detcded in the
"'"".
Vl~
Electrolyta. (WRAMC): Sodlwn- II' mmoIIl., Powiwn - not. able to
obUin re:sults, Cbloride - IS mmoll1- Olucose- 10 1'JI&IdL, BUN 37 m&ldL and
Creatinine 11.0 m&,dL
MEDCOM 0604
ACLU Detainee DeathII ARMY MEDCOM 604
, -
AUTOPSY REPORTilb}(6)
8TB Muhyl, Tallb, U~b")(iii6''---
3
EXTERNAL EXMQNAIIQN
The body is lhat of. W'ClI-developcd. weJl-nowUhcd appearing. 66-inch LlIl, l-40-pounds
male whose appearance i5 consistent with therq)Oned IF of 24-ycars. Uvidity Is
pment on the posterior surface of the body el!(:epl in areas c~posed to plU$ure. Rigor is
Jl8"ina and present only in the lower e;o;tremilies.
The scalp is coveRd with brown hair in I nonnaI disuiblJlion. Facial hair consists of.
roou5l.lclle and beard. The irides are brown, and the pupilJ are roWld and equal in
diamdcr. The utemalaudilOry ctIllls and ears are UlIl'eJlI..u.blc. 'The ~ are palent
and the lips are 8lrIUntalic. The nose and maxillae are pllpably uable. The teeth appear
"'''''".
The nec:k is SU1Light, and the tnehea is midline and mobile. The chest is syrnmetrk The
abdomen is flal The ,enil.alia are !hose of I nonnaJ adult male. The IeS\e$ Ire de$Qendcd
and free of masses. Pubic hair is presetll in. nonnaJ distribution. The butt0ek5 and anus
are unrenwkable.
The upper and lower eJI~mitics are 5ymmetrlc and wiihoul clubbing or edema.
The skin of the hands and feet is wrinkled.
CLODIlNG ANI) PERSONAL EftEgS
The following clothins items and penoMI cffocts are present on the body II the time of
autopsy;
• Yellow jump suil (wet)
• Tan shirt (cut down the fT'Ol1lIlDd weI))
•
•
•
•
•
MEQICAJ,INDR\'ENTION
Nasogasltic lube in the left no5lriJ
Endolra<:beal intublUion
One EKG lead on !he torso
Intravenous ao::css in the right Antecubital fossa
A needle pIlIKtute: on the riihl wrist
RADIOGRAPHS
A complete set or po5uuortem tldiopphs is obll.ined and demonstral~the rollowina:
• No blllllt rOKe or peneu.ltna: inju.ries; are lOentirted
EVIDENCE OF IN.nJRY
No significant injuries are identirlCd. The:re is no evidence ofblunl force or penelraling
injuries ~ the 101'10 or utremities. i1lue are no silllificant blunl roree or penettatina
inju.ries of the bud and neck. llKn Is no evidence ortortun:.
Minor lnjllly. There Is. 1/4 -indt .bnslon or !he left sick ofthc r8CC.
MEDCOM 0605
ACLU Detainee DeathII ARMY MEDCOM 605
AtrrOPSY REPORTIL(b~}(~6)~~_~
BTB Muhyl. Tallb, Umar (b}(6)
4
INTERNAL EXAMW.mON
HEAD:
The galea! and subpial lOft tiuues of the scalp are free of injury, The calvlfium is
inlJet. IS is lhe dlU1l miter beneath it. Clear cacbrospinll nuid surrounds the 14()().grIIll
brain. which las unrematbble gyri and sulci. Coronal sections <lemonslnlte ~
dmwcIlion between wllile and pey miller. witbout Ilemorrhlgc: or contllSive injury.
The ventricles an: or nonnal siz.e. The basal pnglia. brail15lem, c:erebellum. and Itterial
systems an: free of injury or other abllOnnllities. TheTe an: no skull fnaure:s. The
atlUlto-oeeipiuJ joint is Slable.
NECK:
The anterior SU1Ip ltIlI5clu of the nc:dI: an: bom:.gcnous and red-brown, without
bemorrlulgc:. The tIIyroid cartilage: and hyoid are intact. The larynx is lined by i~
white mueosa. The thyroid is symmeuie and red-brown. without eyuic: or nodular
chUlge. The tongUe is free otbite!1Wlcs, hc:morrhage. orothe:r injuries.
BODY CAVrrJES:
The rib5, sternum. and vCIlebnll bodies an: visibly and pIIlpllbly intact. There is:so.
milliliters of serous nuid in boIh chest eavities and I(l().mlllililm of Sc:l"OU5 lSl:ites.. The
organs occupy tIIeir IISUal anatomic positions.
RESPiRATORY SYSTEM:
The ri&bland left lungs wei&b 690 and 671).grams. respeetivdy. The: external swfac:es
an: smooth and deep red-purple. The pulmot\ll)' parenchyma is diffusely conges1ed and
edematous. No mau lC5ioN or areas of c:onJOIldation an: present.
CARDIOVASCULAR SYSTEM:
The 31G-gm heart is oonllined In IIllnlJet pc:ricartlial.nc:. The epieardial Surface;1
smooth, with minimal fit investmeIU. The IOl'lII gives rise 10 three: inlJet and puent arch
vessc15. The renal and mcsenlclie vessels an: unremarkable:. (See Cardiovascular
Pathology Consult.atlon Repof1)
YVES A BILIARy SYSTEM:
The lS40-pwnliver has an intact. SII'IOOlh capsule: and a sharp anterior border. The
parenchyma is tUl-brown and congested. with the usual lobular an:hiled.Ure. No ITIISI
lesions orother abnormalities an: sc:c:n. The p1lbllldder oonllim 2G-milliJiters of greenblack bile IDd no stoneS. The mucosal surfaee is ~n and velvety. The extrahepatic
bUiary tree is paten!.
Sf'! fEN:
The ll().pwn spleen has a smooth, inllCt. red·pwplecap5we. The parench.yma is maroon
and COI\ge5ted, witll distinct Malpighlan eorpwcles.
MEDCOM 0606
ACLU Detainee DeathII ARMY MEDCOM 606
S
A11fOPSY REPORT(b)(6)
8TB Ma.by\. T&Ub, VDIU' (b)(6)
PANCWs:
The pmcrus b.lOft, lin tnd b modcntely dccomposcd. No mass le$ions orocbet
IbaonDalil:1a are IeeD.
MWiNA' 5;
Tbc right aDd Icft Idrenal &I1l1ds are Iymmccric. with bright yellow ~ and grey
medullllC. No m·..... or _
of bclrd.h. In: idcotificcl.
GENlIQURlNARY SYSTEM:
Tbc tip and Icft kidDcys _iab 190 and IIO-Jl'&IlII. respectively. The atcmallUJfaas
~ Intact and lliahlly paIllllal' irI.ppearance. The etiI wrfK.eI are ted-WI Uld
COil,U!Cd. with W1ifonnly thiclr.c:ortias aDd dwp OCllticomcdu1lary jllDCliom. The
pclwell are UllI'CIDIIbblc: and !be \ltCtC:1S are IlOi'll1II in counc and caliber. Wbite bladder
mucosa overlla.a intloCl bladd« wall. The b11dder lCOntIins IIpproXUnalely280rnillilitclS of cIcat Yi'llow urine. The proswc is DnnRaI in .ize, willi lobular, yelJow-tall
pIludlym.. The sem.inaI vesicles are unremubblc. Tbc tesU:S are free of.mass lelioDs.
COillUlionli. or ocher lIb'lOIl1l11itlel..
OASJJ«)IN'IESIINAl. 'I1lAC'£
Tbc caopbqus is irItIc:I and lined by ImOOCh. lJ'Cy·wbite lDI''''''' The stomK:b contains
appro..imately'OO-milliliten of brown nun The psuic wall is IIlllCL The dllOdemm,
loops ollllll!l bowel, and colon are lIll/'CI!Wbblc. The appmd.i.. is Pi 'It.
UlWOPATHOLQGY CONSULTATION
13 Api! 2006
Uwcr. Conplion. mild steatOlis, incn:ascd llporusciD p~ There is nodIln. to
lUUCflIllV litDif'JCIllIlivCf dilca.sc.
[(b)(6)
RNDOCRlNB PATHOLOGY OONSl1LIADQN
14 April 2006
Adtenal: No palbotop;: dUoeaie.
PalIcreaI: Pancreu II moally M1101ytic:. In !be _ I n which the ti_ Is not involved
(bytm/olysh) ~ are no .lpIfK:anllbnonna!lties. Thcrc is focal pcri-duetal fibrolil.
Thll findlnAl1 not related to his clinical oonditioll.
~b}(6}
MEDCOM 0607
ACLU Detainee DeathII ARMY MEDCOM 607
;;==
REPORTI~Ib)~"~'
81'8 Muhyl, TalIb, UlDIJ'j(b)(6)
AUl'OPSY
---
I
,
UNAL PAIHQLOLQGY CQNSm.TADON
2A April 2006
Kidneys;
I. Glomerular cban&u consistent with diffuse diabetic glDl'l'leruiosclerosis.
The apilluy walls are thick: spec:i~ stains and EM tllIIy exclude immune
complQ g/omeruioneplLritis (membranous glomerulonephritis).
2. Hyalioe IlI'tCrioloscierosis.
3. Severe .utolysis.
In view oftbe clinial cUlt. (Type I diu.etcs) tile g1ometulll1 and vUQIlu chMge3 lite
COJIIisletll with diab&:s.
[(b)(6)
-
I
CAR.i0YASCULAR PATHOLOGY tQNSULTADON
28 April '2006
DlAGNOSIOS::(b)(6)
Morphologically nO!1Ml heart
History: 2A year old nqi dd.u- with Type I diabelcs and reported decreased urine
output.: tnlUponed 10 emergency room. mived In full Iln'est aDd could 001 be msusciwed
Heut: 31()'jl'&lDI: norm~ epicudi~ ral: probe patenl fonmen ovale: IlOl'nW left
veatrlcu1u dwnber dimensiON; left venlric:ulu avily diill'lletcr ]().mlllimeu:rs, left
ventriQ,lJar free w~1 thickness Ie-millimeters, venlliculu septum Ibickneu 13.
millimetm: right ventrlculu diluion: righr. ventricle thickness 3·millimelm. withOUI
gross SUl'$ or fal infiltrates; grossly nonnal valves ud endocvdium; no gross myocudi~
fibrosis or neaosi5; histologic sectiON show focal epleardaJ and subepletrdial
lymphocytic infiltrlltes in !be lIlIlerior and I.IIlel'lI1left ventricle withoul myocyte necrosis
or scarring, J:i1d • sinj.le sll\lll foc:us of $llbo I ',"can;ll~ replacement fibrosis in the IUCflll
ieft ventricle
Coronuy 1lIeriea:
Nom1~
osu.: left dominance: no gross Atherosclerosis
ConducliOll. system: 1be sinolltrial node and sinus IIOdalIrtel'y are \JIU'elnUklIble. 'The
comPJlC' atrioventricular (AV) DOCIe is IDIad without inflllJTll11lltion, ineTeased fal or
vascularity. The penctnting bundle is centra.lly IoQIed within the fibrool body and is
WlJ'elJIlIlIuIble. The Jl'Ollimalleft bundle lnlInch is intact: the right bundle brlIndl is not
seen in the section. There are no discrt:le byplSS UToCtS between !be AV node and
ventricular.seplUll1.. The AV IIOdal artery and its branches show no dyspluta.
Conunenl: ThesipiflCllflCe of a:unall focus ofsubepicard.i~ chronic inflllmllllllion iii
unknown, as is. s~e fOCUI of subendocardial flbrolis. In the lIbseDceof lilly other
dernonstnoble cause of dealh.lllT)'Ihmia on the buis of coronary vumpum or}on
dwmelopathy cannot be eltcluded.
(b)(6)
---.J
Catdiovascular Plltboloaisl
MEDCOM 060Il
ACLU Detainee DeathII ARMY MEDCOM 608
A.UlOPSV REPORT (b)(6)
BTB Mull,.. Tallb. U_ (b)(6)
7
MlC8QSconc EXAMINATION
•
•
•
•
•
•
•
Uver: COIlle:stion, mild lleatoJis. increased lipofuscin pipnent
Adrenal: repruc:ntttive aec:tions.e bistoIQSicalI, lIlII'eTnafkable
Plflm:u: utclUive .mol)'liJ with rocal peri-ductal filnmiJ
Kidne)'l: OtclUTve ..tol)'lb with h)'*lllle Uferiolosd_iI and &lonla'Ular
capilluy basement membnne thkkenilll
Spleen: oon.&Ci$(ion, otbl:rwise histolosicall, ~Ie
Lunp: mliltiple repraenlaive secticnllbow vucular c:oRJeAion and mild rOClll
anthrKotic pipnem ckpoIitioo. rocal atclcdais. rocal hel'nonblp withoul
I\etno$kkrin l..:len ~ (Iibly ane(ad)
Brain: repramtalive KCtiom are hilloloJ,ically wrenwbble
ADDITlQNc\L PlQCEDfJRM
I.
2.
l.
.4.
S.
7.
Dotumenaary p/lOIogaphi are taken by OA.FME 5taff photopphen.
Full body rldlographl Ire obtained and demonIlnte no itJjuricl.
Specimens malned ror uu.icolOl)' t$lnl and/or DNA identlftelliOtlIl'e: blood,
"iutous, urine. bile, liver, spleen, btlin, kidney.lun.. adipose lissue, muade aDd
&U'ri<--
The dlneaed orpN are rarwvded ..... ith the body.
Selected p;Jnions 01 orpas are ~ In fonnallll..
JdaniryinJ ITIIlb ilxlllCle: Sc:ar5 on the Ieh rooc and left knee.
MEDCOM 0609
ACLU Detainee DeathII ARMY MEDCOM 609
AlfI'OPSY REPORifb R6",'
BTB Muhyl. Tallb. u;;;'rl(b){6)
"",c--J_-
8
OPINION
This 24 year old male died of complications of dl.abetcs mellitus (diabetic ketollCidosis).
The dccea5ed bad • medical hulOfy slgnificNll for poorly controlled Type I diabetes and
there wu. clinicll impres.Jion of diabetic ketoacidosis in Inq. The kidneys exhibited
cb.Inges tIIIt II'e consistent with. history of diabtetes. The heart was morphologically
normal. There wu no evidmce ofsipiflWll physical injury. The f~icoIogy ~
was significlnl for acetooe in the blood (29.mgfdL) and vi!rtlOul fluid (42·mgfdL) and 2propanol in tile blood (l7·ma/dL) aDd vitte0u5 nuid (tnee). The vitreollS glucose WI5
1Q.m,ldL and tllh levd WJ5 most likely eifllCled by posl·monem mc:l,boJism. TIle
remainder of the toxiooloay Iia'eeII is negative. There were no Sign"jfij'<"U"',,'''',,,',,·
In;,.n- ;.c-.oifuotl "'
(b}(6)
.,t...-" 'Jbr. mln..-.nlfI"othJ. n"'.... I-illi} 6
J(b){6)
"'' ;J
-
~(bbj)(66'r::::]Medical Elulmmer- ~(b~)(~"~==~"'M"oI"''''=''''''"",",,='
;wl"(b")(6iITl-~
MEDCOM 0610
ACLU Detainee DeathII ARMY MEDCOM 610
.~
OEPARTIIENTOF ~Nae
AMEDI'ClIIC:II *I1'l'TUTt Ol'P''''lHOLOO'l'
WAllIHGfOM,DC "'" 11111
..
AftP(b){G)
PA1Ul'JI IDIN'IlPJCADON
AmAco
'",N• • •
Itb)(6)
$tq_
No_
omCi 0' THE AJtM£D FORCES MEOICAL.
!XAMINII:R
ARMED poacu IX51'I'Il1n 0 .. PAmOLOCY
WASHINCTQN, DC 103M '000
r.ruHYl. TA1JB UM.AlI.
SSAN,
AIWIJlI)': (b)(6}
c ~_
Todoolou Aco: ' d,!{I;l}{§) DIU Roporl GuonW: April).2OOll
CONSULTATION RIPOBT ON CONIRfBJlTQR MATERIAL
JJIIDUCNOSlS
CODdftioD
1UPOIlT or TOXICOLOGICAL EXAMlNA110N
orspe! eu: 0000
Date oflltddal:
Dlte Recttved: 313012006
CARBON MONOXIDE, The carbox)'bcmoglobin satumiou in the blood _leu than
1% as detefmined by $jOlii'Cbq:Ollometry with ,limit ofquantitatiOll or I%. c.rboxybc:moglobin
satunlliolll of ()..)% ~ expcctcd for GOD-SlllOkcn and 3·10% for IIl1Okcn. Saturations above
10% Inl coDSlckrcd elevated md we confirmed by lIS chromBlopphy.
CYANIDE: There wu DO C)'IIlide deIecIed in the blood. The funit ofquantiwiall foe'
cy.mde Is 0.25 mw'I- Nonnal blood C)Uide eoaeentrIIioas Inlless than 0.1' rna/L. I..cct.I
conc:.entratilllll ofcyanide we pater than ) miI'L.
VOLATILES; The BLOOD AND VITREQUSFLUID wereexamiDed forlbe
presence of etIwIol (cutoff of 20 !DWelL). accWdebyde. acetone, 2-propeoJ. I-proJl8l101, tbulaIlol, 2-butaoo1. i-wtanol mull-buWlol by hac!sptce p i dKomlto~y.The following
volatiles ~ detected: (eollCCDtr8lioD(l) In mgldL)
BLOOD
VlTIlEOUS FLUID
-~19
17
42
T'raa
Trace" value a;reatef than or equ.aI to 1m&ldL. but leSll than S mgfdL
MEDCOM 0611
ACLU Detainee DeathII ARMY MEDCOM 611
_
--
DUARTlIIeHT CW DlnHU
POIlCU MmvTI Of 'Allollll.OCW
W..,.JGtcIN,OC
, ....
.~.
RElQRTOF IOXlCOLQGICALM EXAMlNADON <CONI
MVHYL TALII
1lMAR):
DRUGS: The URINE was eaullCd (orlCCClnlinophcn, amphttamiDe, IntidepiCSWlts,
t 'WIIlCptnU................
f
.
-----L'--'d>,~..
.
,turaJa, 9'
""'0f'0q_
""",ne,
~ Ijdgn1nc,IIII'COtic .-I,csics, opiltes, pbmc:yclldinc, pbeDothiuines,
salicylate3, l)'JIIpltbomimetic amines aad ~I by ps cbronWoJl'llPby, color test or
immuno.,gy_ The (oUowin, dtull were cIcteded:
....
!U'lt!!·.ml!~"
NODe
were t"otmd.
(b)(6)
MEDCOM 0612
ACLU Detainee DeathII ARMY MEDCOM 612
----.. ... -- --..... ..... - -
CIll'lIlf'lCA1'tOl1DlATN
-.._--_"'CII<UOOO
--
.......... _
..... _ _
BTB M ~. TlIlib. Unw
0, _
~
pO • •
,~
-"'-..
Civiitn
"'
"
.-- -_......_- -- _
.. __.-........-... _.._0""'"
..,....
-~-
(."
•
...... "' ....... "'-
....._TOCIIC.....
CItY"',..........".
_Doe- _1<
,
.,
CAlM",
_
__-_
__.
_
-_
-_
--.- . --_
_
..
--
.... _ _ . . _
e-.. _
.................
.. _-.:,..................
.... -,...
.._.
Coo.... . '" Ciob.- ...... (OiMlItiI:
_~_._IO
e . - _..., .... _
........... C. . . .
:::'
,._...
••
~-,--
_.-
---
(b)(6)
__ --.- ._.._.__ _---......
.............. _ - " ,
<>&Co
"1'§
_.,
MEDCOM 0613
_OOC'O
__
,
O......
ACLU Detainee DeathII ARMY MEDCOM 613
•
ARMED FORCES tNSTITITI'E OF PATHOLOGY
Oftke of Ibe AnMd F _ Medlc:al Ellllalloer
1413 Research Blvd., Bldg. 102
RocIcYilk. MD 208Xl
1-301-319-()(XX)
AUTOPSY £XAMINAnON REPORT
AlItOpIy NQ..{b)(6)
Name: BTB Muhyi, Tallb. Until'
ISN:(b)(6)
~
AFIP
Om ofSlrthi<b)(611982
Dace ofDcetb(b){6)
2006
DatelTime ofAutopsy: 25 MAR 2006
.1I00hn
Date of Report: 19 MAY 2006
No.:
(b)(6)
Rank: I>etau-
Plaoe ofDcath: 1rIq
PI_ of AulOpS)': Pon MortuIty, Dover
AFB,DE
OI"CU'''PDceI of Datil: This 24 )Ql"-old detaiDee was. u rqated. Illlted to llllve
~ urine output at Ibout 1315 ~)
,2006. Tbe dM·i....... wu UVISpOfIed
by ambulance to lhe 344T11 EmaaaiC)' Trauma ROOIJI by ambulance. He anivcd not
brUthln. Uld his pupill ~ f~cd and dll.ted. He hid • past medical bistory ,ipiflCalll
for poorly COlltrOlied Type I dllbelts mellitus (H&BAte-IQ.4'1o). Despite IlUlmalI.
provided the detlinee upinld.
Aul!loriutl.. for AutoP')':
USC 147\
-
Idntlflatloa:
Off~
of !he Armed Fon:a Medicll &1LlJIinu, lAW 10
Cift:wnsWltlaI Idernirlcation by eumirwion of .ecompan)'ina
CAUSE OF DEATH: ComplIQIJ_ olDblbeta MtlUlla (Dlabetle KdOllcklMs)
MANNEROll'DEATII: Hlhln!
MEDCOM 0614
ACLU Detainee DeathII ARMY MEDCOM 614
AurOPSY REPORT1lb)(6)
2
1
BTB Muhyl, Talib. Umarl(b)(6}
FINAL AUTOPSY DIAGNOSIS
I.
Renal Syatem:
A.
Glomerular dlBnJcs constslcnt with diffuse diabeti<: Slomeruiosclero$is.
B.
Hyaline aneriolosclerosiJ.
C.
Severe autOl)'lis.
n.
Cardiovascu.l.c System:
A..
Morphologically normal bcut (Heart WeiJht -3ID-grams)
Ill.
Pulrnona:y Syltan:
A.
PulID0111ry Congestion and Edema (Luna Weiatl\.s: RisJU -690-pms:
Left - 670·1J'lIlIS)
B.
BiJ&te:nI Serous PJeunJ Effusions (Rlpl- 5O-millilileQ; uft - SOmilliliten)
IV.
Hq:wobilliary System:
A.
Uver:
I. Conge.stioll
2. Mild Jtea1OIl$
3. lnaea-llipofuscin pigment
V.
Endocrine System:
A..
Adrenal; No patholoSie di5east.:
B.
Pancreas: FoeaI pcriducW fibrosis IIId IUtoIysis
VI.
Serous MciteJ: llXl-rnlIliliters
VII.
No 'ignifiCllll injuricl; are identified.
Vill.
Minor lojuries: Abruioll of the left ,ide of the
lX.
Toxicology (AFIP):
A.
CARBON MONOXIDE: The CIrbol)'hemoaJobin satullIlion in !be: blood
is lcs.s thall Ul>.
B.
CYANIDE: There is no eyanidcddected in the blood.
C.
VOLATILES: Accl;one and 2-propItlOI are detected in the blood and
vlue:lUS fluid (COlICCnlJalions in mgdL).
_.
Blood
D.
f~
\4-lnc:h
1+.l:wone
2-PropenoI
29
11
Vitreoul Fluid
42
Trace
DRUGS: NosaealCd drop of abllK or medications ate detecu:d in the
Vi\l'elOW EledJ'Ol}1CS (WRAMC): Sodium -115 mmoIJl... Powium -110( able to
obtlin resu!l$. Chloride - 88 mmollL, Gluoose- 10 mydL, BUN 37 mgdL and
Creatinine 11.0 mgldL
MEDCOM 0615
ACLU Detainee DeathII ARMY MEDCOM 615
AUfOPSY REPORT (b){6)
BTB Muhyl, TaUb. UIIIU (b)(6)
3
EXtERNAL EXAMINATION
The body is lIlat ora well-developcd
ell-nourished appearin,. 66-inch tall, l4().pounds
male ....hose appearance is consisrcnt ith the teportcd a~ or 24-ycan. LivMfity is
present on the poSICrior surf~ or the body eAcepl in areas CJlposcd to pte5Slll'C. Rigoc is
puslnj; and present only in the 1000000CJltrcmitics.
The scalp is covered with brl)Wll hair in a normal distribution. Facial hair consists of a
moustache and beard. The irides are brown, and the pupils are fOUlld and equal in
diamCler. The extc::malauditory canals and cara are unremarkable.. The nares are patent
and the lips are atraumatk:. The nose and muillae are palpably stable.. The teeth appear
natural.
The neck is sU'aight, and the u.dIea is midline and mobile. The chest is symmetric. The
abdomen is flat. 'The acnitalia are those of allOmlaJ Idull male.. The tCSlCS are descended
and ftee or 1l'IlI5Ses. Pubic hair is present in I nocmal distribution. 1be buttock$ and anus
arc WU'Cmarli:able..
The upper and lower CJltremitics are symmetric BIld ....ithout clubbinc or edcnw.
The skin of the bands
and feet is wrinkJed.
CLOTHING AND PERSONAL EmCTS
The rollowinl clothing items and personal effccu are prescnt on the body It the time of
lutopsy:
• YellowjumpRlit(l'm)
• Tan sIIilt (cut down the
and I'm))
rrortl
MEDICAL INDR)'ENTlON
•
•
Nasogastric tube in the left nostril
EndotnlCbell intubation
•
•
One EKG led on the torso
lnttavcnous acecss in the right antecubital rQUI
•
A needle puncture on the right wrist
MDIQGBAPIIS
A complete set or postmortem radiographs is obtained and demonstrates the rollo....il\l:
• No blUllt force or pcnctratina Injuries are identified
EyJDENCI OF INnJRY
No signlflClllt injuries are identirlCd. There is no cviclc:nccorblunt roroc or pcnetratiDa
inJ\Iric$ ofthc lOne or Clltremitics. 1bc:rc are 1'10 significant blunt force or pcnctmin,
injuries of the head and neck. 1bere is 110 evidence of tOftllle.
Minor Injury: Th~ is a 114 -inch abrasion of the left side of the face.
MEDCOM 0616
ACLU Detainee DeathII ARMY MEDCOM 616
AUTOPSY REPORT\(b){6)
BTB MIlbyl, TalIb, Vmar l(b){6)
4
INTERNAL EXAMINATION
HEAI>
The galea! and subplea! soft tissues oftbe $ClIlp are free ofinjury. The calvarium is
intaCf. as is \be dura mller benwh il. Clear cctebrospinal fluid surrounds \be 1400.p-am
bfIin, whicllh. IUll'errwbble gyri and suki. Coronal seaiolll demollllnlle sIwp
dcmarcItion between white and pey IlUIUcr. wilhouthemonnageoroontusive injury.
The ventricles Ire of I1OI'lJ\Il size. The basil pnglil. bl'linstcm, cerebellum. and maial
s)'SlCJTlS Ire free of injury or othcc abnomll1itiu. Then are no skuJl fncturcs. The
adlllto-oocipitaljoiJU Is stllble.
NECK:
The I1lIcrior strip muscles of the neck Ire homogenous and rcd-brown, without
hemonbage. The thyroid cartilage and hyoid Ire intllCl The IU)'M is lined by intllCl
w1iite mueou. The thyroid is s)'llllllCtri<: and red·brown, without cystic or nodular
clwlge.. The tongue is free of bile ltW"u.hemollhqe. or other lQiuries.
BODY CAyrTIES:
The ribs. stemum. and vcnebraJ bodies are visibly and pllpably intllCl. Thc:rc: is 50millili!el'S of SCfOUS fluid in both dtest ClIvities and lOO-millili~of serous lSCitcs. The
orpns occupy their usualllllltomic positlOl15.
RESPlRAIORY SYSJV.1:
The right and left lungs weiglt 690 and 67()'pms, respectively. The eltcmaI surfaces
are sl'l"lOOlb and deep red-purple. The pulmonary parenchyma is diffusely congested and
edematous. No mass lesions or areas of consolidation are prescl1L
CARProYASCUI.J\R SYSTEM:
The 31().pn hetn is contained in III lnUlCt pericardial sac. The epicardial surface is
smooth. with minimal fttlnvcstmenl. The aortlI gives rise to three inlaCt and patent arch
vessels. The relI41 and mesenteric veueU are unrerrwbble. (See Ctnliovuc:ular
Pathology Consultation Repon)
WEB '" HILlARY SYSTEM:
The lS40-pam liver lias an inllCl, $lOOOlh c:apsule and a sharp anterior border. The
parenebyma is tan-brown and congcsted, witll the usual lobular areIlitecture.. No mus
lesions or oWer abnormalities are seen. The pilbltddu contains 2().milliliters of greenblll:k bile and no stones. The m"c:osal sulf_ is green and velvety. The catnbeplltic
biliary tree is patent.
Sp! feN:
'The 8Q.grMI spleen has a smooth. intact. red-purple eapsule. 'The parenehyml is mlJ1lOll
lIIld CXllIgesled. with distimt Malpighian eorpuJcles.
MEDCOM 0617
ACLU Detainee DeathII ARMY MEDCOM 617
.5
AtrrOPSY REPORT (b)(6)
BTB M ......yi, TalIb. Vmar (b)(6)
PANCREAS:
The prII'ICIUS Is soft, ta/I aDd Is lllOdentely decomposed. No IfIIU lesions or other
-tJnonDllities are-.
ADRENAl 5:
The "Itn and Jeft Idren&I &l1lldJ are .ynunccric. with briaN yellow c:oniccs ~ py
medu1lle. No rnallICS or __ of beau .bler- 1ft idmtificd.
GENITOURINABY SysTEM:
The rip. aDd left kidlJeys _iab 190 and 1lll).Fam&, respectively. The.u.te.mallllffaca
are in&acl1Dd .Illbdy &fWIUlu in IppUfIl'JCle. The. cutlUl'fKC:S Ire. fW.l4n and
OCIIlIcsted, wilh Wliform.ly thick corticcI aDd slwp corticomcdu1Ilry jIInctiollI. The
pdva we. unre.rnarbble..m the umcrs 1ft normal in alVI1C.m caliba". While. bl.dder
~ ovcrile.5 lID inlAlX "'wider wall. The. b11dda 0DIllIinI appt'OXbnlldy 280milliliten of dear yellow urine.. lbe. Pf'O'l:Me.1s DOml&1 in.i7A with lobulll, yellow.llIl1
p&rerICbyma. The semiDal vesida are IW'erIWbble. The. It:SlCS are free. of maulesioas,
CDrllUlionl, or odlcr IbnomIalitia.
GASIBOINIAIINALlMCf:
The eJOphlJIa iI intact and llDed by IIt\OOlh, &feY·white IDUCOIL The. ltomKh contaiDJ
approximately Iro.miIlilitcn olbrown nuld. The pmic: wall i. inttd. The duodenum.
loops of IfII&1J bowel, and coklo ~ UIImflIrbble. The apPmdiJ: Is prQe:IlL
HlP6TOPAIHQLOGY CONSllLTAllQN
13 April 1006
Uver: ConptJon. mild ueatOlil, Incrased lipot\llc:lD pipnenL There iI _i"llo
5Uuest any .ipiflc:lnt liver disease.
(b)(6)
RNOOCIUN£
PATHOLOGY CONSULTATION
14 April 1006
AdrelW: No patholo&ie dixue.
Pmc:rcu: Pux:reu is lnI)ItIy llItolyde. In Ihe _1n......tUc:h the 'issue is not in'lQlved
(bytJl#oIysiJJ tbere are DO .ipiflCaDllbnorm&1hief, There iI foe&! peri-dudal fibrosis.
This fUldin.r. iI DOl related to his dlJtk:al c:ondltlocL
(b){6)
MEDeOM 0618
ACLU Detainee DeathII ARMY MEDCOM 618
,
AtrrOPSY REPORT(b)(6)
8TB MulIyI., TalIb, U.w- (b}(6)
RENAL rADlOLOLQGY CONSULIADON
1. O\omeN" c:I:Ianaes CON~ent with diffute diabetic &Iomeru1ose1crosis.
The capillary walll are thlck;.1pOC:ial1Llinl and EM lIlI,y uelude lmmun£
complu &!-woaep!Jrilis (lDembnnouI: JlorDcn1lonepbritil).
2. HyaIme MteriololcJerosia.
3. Sevue autolysis.
1ft view or !be e1inJca1 data (1)pe 1diabetes) !be allxnenaw IUld YUQIlIf clwl&es we
CONbleolwilh diNleces.
(b}(6)
c.wQYASCULAB PATHwroy CONSULIA'D0N
2! April 2006
DlAONOSIOS:(b)(6)
MorphoIoPully DOl'IlW ~
History: 24 yeIr old iraqi dettince w1lh Type I d1.tlete:1 and reponed de<:, : , led urine
outpUt: UWllponed 10 _aelley room. arrived it! fullll1'eSl ADd could not be teSUSCitatcd
Hean: ]IG-sr-; IIOm\aI cpie.rdial fat: ptObe pMelIl foramm ovale: tlOl'I'naIleft
vmtriallw dIan1ba" dimenliofll: Idt YeIItric:ul1f cavity diamew: 3Q.millimeten, left.
Yalrric:ul.- free wall tbickncu Io-millimeten, _tricullf IICpWlll tblekneu 13Olillitnetm: rlabt Yedrieul. dilation: riJht vmtricle thick,,"' 3-millimclfn. witblll,ll
ItO" SCIfl or fa iIlfduues; puuiy normal valves and endocardium: no &TO" myocardial
fibtoJiI or neawia: lliltoloak: IectionIlhow focal eplc.anlial .00 subepk:ardia.l
lympboeytic: lllfiltmes it! the.merior and 1alenI left venariele without myocyte necrosis
Of 1C&I'rilIa. UK! I I . lmall fOCtll of 1IUbendocard1al TqlIICtllleM fibrolb in the IMt=raI
left vmulcJe
Corooary arteries: Normal 0Itia; Ieftdomi n1 ooe; no ItO" Athcroselerosia
Conductioa Iystem: The linoMrial node and lilIUI nodal artery are lIIU'eJt1&fbble.. The
eompaet uriownlrieu1ar (AV) node II mtael willtoullnflammallon. inaeued fit or
vUQllarity. The peDetntin& bundle is eenuauy 10CI.Ied within lhc: fibrous body mid is
t.lIIl'C:nl&tUble. The pro~ left bundle btandI is inb<:t: tile riglll bundle branch is not
IClelI in the Iedion. 11tere are no dilertte bypaP tn<:ta between the AV node and
vmtriatIar ICpUIDL The AV nodal utef)' and [II; bl"ll1dlcs show DO d)'Spluia.
Commau: Tbe lipifiCl.llf;e oflllMll (0CIlI of IUbcplc.anlial chronie inf]&IIlIIW;OlI is
unknown... is I lirI&1e fOl:ll' of lubendocardiaJ f1blwb. in lhc: Ib5alce of Illy ocher
demonstrable cause of dead\, Ift')1.b.mil on the bull of COJOIIm)' VllOqMlIm or ion
chlnnclopatlty eamot be excluded.
(b)(6)
Cardiovaseullf PltholoJil1
MEDCOM 0619
ACLU Detainee DeathII ARMY MEDCOM 619
AUlOPSY REPORT {b}(6}
BTB Mubyl, TIlIb, Um.ar (b)(6)
•
•
•
•
•
•
•
7
MICROSCOPIC EXAMlNAUON
Liver. conlestion, mild steatosil, Increased lipofuscin piament
Adrenal: ~presenwive se<:tions we histoloSk::ally unremarkable
PaIK:reas: extensive autolysis with focal peri-duetal fibrosis
Kidneys: utenSive .utolysis wilh hyaline arteriolosclerosis and glOD"lefUlu
ClIpillary basement membrane thicnninl
Spleen: congestion. otherwi5e histologically Wlfenwkable
Lunp: moltiple ~presentative ~ show vlSCUlu COJlldtion and mild fOClJ
anthnlcolic pigmenl depositioD, foeaJ lleIeewis, focal hemontIage without
hemosiderin laden mac:rophaps (likely artefact)
Brain: represenUilive ~iOll$ tie histologically unremarkable
ADDITIONAL PROCEDURES
I.
2.
J.
4.
5.
7.
Documenfary plIOlograpJu are Well by DAFME staff phOlogmphers.
Full body radiographs arc obtained and demonstrate no injuries.
Specimens reu.illed for toxicoloiY testing and/or DNA identifiClltion ate: blood,
viueous, urine, bile, liver, spleen, brain. kidney,lufti. adipose tissue, mllSCle and
gastric ODnltnlS
11le dissected orpns we forwarded with the body.
Seleded portions of organs we retained in formalin.
Identifying marks include: Scars on the left fOOl and left knet:.
MEDCOM 0620
ACLU Detainee DeathII ARMY MEDCOM 620
,
",,----"L
AUTOPSY REPORT (b}(6c.'
81'8 M.hyt, TaUb, U;;;;;(b){6)
OPINION
This 24 yearold male died of complications of diabetes 1M1li1U$ (diabetic eto.cidosis).
The deemed 1lId. medical history sipifieant farpool'l)' conlroUed Type I diabetes and
!heJe was • clinical impression of diabetic ketoacidosis in Inq. The kidneys exhibited
changeslhM an: eonsistcnt wilb 'history of ditbU:les. The bear! was morphologically
normal. There was no evideooe of aignif'K:alII physical injury. The tolliallogy sc:reetI
wu ligniflC&lll (01: KetoDe in the blood (29-mgfdL) and vitreous fluid (42-mNdL) and 1propanol in Ibc blood (17 -mw'dL) and villeOU5 fluid (!,tao::e), The vitreous Jluec»e wu
1().mg!dL and Ibis level wu D'I05llikely effected by post-monem metabolillll- 1be
remainder of the tollieo!OS)' SCRlell is negative. 1'bete were no S\Kni(JClDt Pbn,iCl.~_ _l
in'''....... ;~"'~_.r ...n"...."
(b)(G)
... --..nf ..e-,k i.
,(b)(6)
" .... ,_I--!(b)(6)
~lb>}(}(66j'=:::JM",""","",·iJEEll.m"""'=~ l(b){6"- - "'="Eiaminct1(bl(6)
J
MEDCOM 0621
ACLU Detainee DeathII ARMY MEDCOM 621
DEPARTIIENT Of O!f!MH
_fOIIeA...-n1'l.Jn Of' 'ATHOLOO'f
.""'1IlJI'OII. Dc:.
I IIII
AFlp,(b)(6}
Pt\DUl'T mlH1'IDCADOH
AftPA
I "N... lk4(b)l6J
..........
omCl 0' THlARMtD F'ORCU MlOIC\.L
ARMED.aRCU lNSTITV11l 0 .. PAT1fOLOGY
WASHIHGT01'(. tIC 2C:MlI , .
..-
MUHYI. TALUl r..rMAA
SSAH:
A.III,.,: (b)(6)
T.'1coIou' Ac<.-Io.1I: lb\16\
Dehlbpo"GeMnItll: Ap1lJ,XlM
CONSULTATION REPORT ON CONTBWvroB HADIUAL
AflP DtAGNOSIS
IlU'ORT 0 .. TOXICOLOGICAL UAMlNAnON'
Coltd.ldo.oISpedmeaa: GOOD
Date olllNid~.t:
DaI.IUc:.tnd: 3130i2006
CARBON MONOXIDE: The eerboxybernoalobin IItlnliotlIn the blood _leu thin
1% u ~ by speeuopbotomelJ)' wilh I lImit ofquanliutlotl or I%. Carboxyhemoalobln
saturaIions or0-3% arc expcetcd lor 1lO1HITIOkcn an4 3·10% ror smoken. Satunitionl cbove
10% arc CODJidered elevated IIlld arc confirmed by ps c/Iromalogrliphy.
CYANIDE; lllcre _ no cylllllcSll detocted in the blood. The limit of quantitatioll for
cyllllicSll ill 0..25 mgIL. Normal blood c)'lllicSll eotIccntrationl _ lcsa than 0.15 maIL Letha1
COllCmtn1iOl\S ofcyllllidc are pater _ 3 ml"L.
VOLATILES: The BLOOD AND VITREOUS nurn 'Nf:le ex.mined fOlIhc
pcscace or clhInol (cuoff 0(20 m,WdL), -wdcbydc., acetone. 2-prop1lkll. l-proplnOl, I·
bulallol, 2-bUW101. i.l-butanol an4 l..butmol by bcad'P'ce pi chromaIoIP'IPbY. The followina
voIl11ilcs wall dcteded: (COlICCIIlrItlon(l) ID maldL)
AccIOllC
BLOOD
VllllEOUS FLUID
29
42
2-PlopeilOl
17
no-
TlKe - vallie pealer Ihan or equal 10 lm,WdL, but leu than 51111"dL
MEDCOM 0622
ACLU Detainee DeathII ARMY MEDCOM 622
..
~
_.
._..
BfjPORI OF TOXICOLOGICALM EXAMINATION <CONI - MUHYJ, TALIB
UMARli
DRUGS: The URINE war saceaed foraeeumlnophen, unphc:wnine,ll'Ilidcp
wibi"""i""". bwbitunles, benmdj,ttpines. cunJbinoids, clIIOfOqIliDe, eocaine,
delctromelhorphal, lidocai...., nIl'COtie .wsesia, opialel, pbeDcyclidiDe. phmothi·zj-.
nlJ.,
.-lk:ylates, I)'JrJpI'Wmimetic aminelllDd venpulUl by aa- chromal:Ojpapby. color Id or
immllDO·...y. The folJowina drup were dcleetecl:
NOIlll were foLllld.
(b)(6)
[(bJ(6J
Offll:. ofthl Armed F _ M_1ca1 ~iDIr
MEDeOM 0623
loo;"
of. . AiiiiiiI , _ ....... """"'"
ACLU Detainee DeathII ARMY MEDCOM 623
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2.5 March 2006
-_._._----,,2006
(b)(6)
,
[(1;)(6)--------
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M..x.i Examiner
I
....... _._.. ___ ..o;!..._ ...
2064
MEDCOM 0624
ACLU Detainee DeathII ARMY MEDCOM 624
,~;""""",
",~,
"
ARMED FORCF.S INSTITUTE OF PAnlOLQGY
omce urtbe Armed Forca Medlc.l Enmhltr
1413 Resean:b Blvd., Bldg. 102
Roekyjll~ MD 208SO
1-301-319-0000
FINAL AUTOPSY REPORT
Name: Hammld, Rud ~iry
ISN: Itb)(6l_ - - 1
Date orBTrtb:l{Pl(6~
DateofDeath(b}(6)
2006
Oaleof Autopsy: 20 feb 2006
~e ofRepotl: I May 2006
Autopsy ~(b)®
AFIP No.;i..b)(6)
Rank: Civilian. Iraqi
Place of Death: BllJhdad,lraq
PiKe of Autopsy: Dover AFBlPon Mortuary
Clrcum_l.aca of Deatb: Iraqi civilian detainee within the Bagh~ central confinement
flll:iHty hospital leU died after developing new onset seizlRli and ,ubseqljC1lt
doc:wncntadon of 5Cvere brain edema wilh reported NUS of intra parencbymaJ
htmorrbage.
AlIlboriulioo for Allopl)': OfJ"tte ortlte Anntd Forees Mcdieel Examiner.lA W 10 USC
1471
Ideoltfkatioa: Identification tags oolM body.
CAVSE OF DEATIf:
unknown origin
HYP)J(ic·iSl:~ic encephalopathy due
to mcningoerocephalitis of
MANNER OF DEATH: N.llltll
,
MEDCOM 0625
ACLU Detainee DeathII ARMY MEDCOM 625
AlrI'OPSY
REPORT[~'b~)(6~)
_
h,e2of6
r(~limlllkL RIl.d Kall:¥:J
FINAL AUTOPSY DIAGNOSES:
I.
Hypoxic-llChemie meephalopalhy with meningoenccp/llilti. of
unknown origin
I. Severe brain edernl with Wl(:II and cerebellar lonsil hernillion
b. Clinical diagnosi.ofencqlhaHli. with new onset lICizures
c. Generalized body edernaand severe pulmonlf)' edeml and
c:ongestion
d. Billttnll acIm1al &land hemorrhage: and necrolIi.
II.
Bronc:hop~ulllOl\i. wilb
thick lirway mllCOWl sec:relions
III. Bladder mllCCSl pcIcchiac. Foley eathc1er in place
lV. RiPJt lower lip. iJmer IUrf~ oon1llllon, Yo inch
V. No evidc:ncc of OIhcr .illllificant nalura! disease or trauma
VT.ldentifyilii Milks, none
VII.
PropCft)' on the bod)'11 the timeofaulOp$), eumilllllion, none
VIII.
Toxicology:
.. CIlJbon Monoxide: l%c:IIboxyhc:moglobin saturation
b. Cyanide: None detected
c. Volatiles: No ethanol detected
d. Drugs: NOlle ofthc Kl'Ccncd for dlUp'substances were detected
EXTERNAL EXAMINATION
The body iJ thaI ofa well-dcvcloped, well-lIOurishcd appearing. mll5Cular, Iraqi, male, 69.:1
inches till, 174 pouoo. wbose apJlClI'IIICC i.COOIistcnl with the reported age of27 years.
P~OfIcm lividity is pUlple red and fixed on \he postcriorsurl'accs ofthe body except in
iIlt:IS previously ex~ to~. Rigor ildiSlipating and the body is cold to louch.
The scalp isc:ovcred with black curly hair in I normal distribulion. The iridcs arc brown
and Ibe pupils arc IVUnd and equII in diamC\Cl'.11lc exlemalludiloryClnlls an= patent.
The can: an= otherwise unmniU'bblc. The narcs arc palenl and the lips arc well developed.
The nose and maxillae arc palpably atlble. The leeth appear lIlltwal and in adequate repair.
MEDCOM 0626
ACLU Detainee DeathII ARMY MEDCOM 626
A11I'OPSY REPORT(bH6)
h,t30r6
HIIIlJllld,Jl"ilL~I"
J
(')(6)
1lIc noek illlraiahl, and the trxhea il midline and mobile. The cheft ill)'ll'lilTlt'lrc. The
abdonIen Is flat. The sen1lllilate IhoK oflnormal mull male. The leslClate dcM:endod
and free of palplble mllSSel. Pubic hair il preacnt in I normal diJinbution. The buttoeb
and 8l\1,If ate 1IIITelIIatbble.
The IIppet and lower utrerniliCiate aymmctric and ....ithout clubbin. or edema. No
lignificant blunt folU: or penetraUnllrallf'!\l il evident. The body and CJllremitles hive:
gcnepliud edeml particularly the ri&hl thiJ,h. and hindi. 1lIc handlhAve I bllCJtJritty
Rlb$lancc possibly fin,ecprinl ink orother Jimllar materill.
CLOTHING AND PERSONAL EFFECTS
The followin. clolhlng ilmul and pcnonal errecllate present: on the body II the lime of
autopsy:
• None
MEDICAL INTERVENTION
•
•
•
•
•
Naill pstrie lUbe, appropriate posi1ionilll
EndolrlcheallUbe, apptoprille po:silioning
Cardiac monitor pad.. IIIUal localiona
Indwelling intrl'lmOlII cathetera.:
o Riahl mtecubital fosaa
o Riahlllld left illlolllll areal
Foley catheter, IlpprOprille pc»ilillnlnJ
RADIOGRAPHS
A c:omplete let ofpoatmonem ndiograpM is oblIlned and demonllJ'alCiIlO metal or
""""".
EVIDENCE OF INJURY
The inner a1rface of the ript lide oflbe lower tip .... a
~
inch conllllion. No other
injuricl ~ identified
INTERNAL EXAMINATION
HEAP:
The pleal and IUbpleal 1011 11_ ofthc tealp &I'C free of Injury. The calvariwn ia inlM:l,
I I IIlhe dlll'l materbcnealh il. No meninJili1 ilappreciated JrOIIly. Clear ~inal
nuid IJltrJOIInda the 1420 am brain, .... ith nall)ri and llIJTOwod IJUlci. TheR illlnCal
hernialion and cle. cercbellll" lonsill\cmlalion and lICCl'OIil. No IUbdurai or IUbarw:hnoid
helnonilqe is presCl1t. The artetiall)'SlerJt ~ he ofabnormalily. The trInIVCrIC
and siJlllOId anuses hAve IItromboJiI bilaterally. 11lere are no "'ull ht:tura. The atlanlooc:cipiul joinl is 1\tIble. The brain Ilotllcrwlle filtod for ncuropatholoJ)' I:Ol'IIUltalion al the
Armed Forcca Institule o(PatholoJ)'. which provided a JqWI.tc conaullalion report.
MEDeOM 0627
ACLU Detainee DeathII ARMY MEDCOM 627
]
NECK:
The anleriorJtrap muscles arlhe neck are homogenous and ~-brown, without
hemon'hage. The thyroid eartilage and hyoid bone are intact. The larynx is lined by tnllet
while mucosa. The thyroid is symmetric and recI-brown. without c)'Slic or nodular change.
The tongue is me of bile maJb, hmlOlThage. or otherinjuries. Dissection of the upper
po$Ierior IIel::Ic to the level ofC2I3 denIonsll'1le5 no paraeervietll muscular injury and no
ecrvicallopinc fractulU It this level.
BODy CAV([If:S:
The ribs, sternum, and ver1dlral bodies are visibly and palpably intacl. The left ptclll'Il
cavity contains approximllcly200ml ofserosanJUinous nuid. The righl pleural Clvity
contains. small volume or,imilar nuid. The perieaniial and perilOf1ea1 cavities do not
contain an increase in nuid. The orpns oceupy Ih~t ll$Ull1 anatomic positions.
RESPIRATORY SWEM:
The right and left hmp weigh 940 II1d 840 JOl, rcspeclivcly. The eXlet'M1 surfllees are
lIllOOlh and deep red-pII'l'lc. The pulmonary parenchyma is diffusely congulcd and
edematous. No mass lesions are evident. The right klwer lobe i. consolidated and !he right
and left large and small airwaY' conlain thick yellow Ian mucoid seetetions. These
~ioJU focally
obstfucl OT plug the peripheral airways.
CARP(()VASCULAR SYSTEM:
The 420 P heart is contained in an inlacl pericardia! see. The: c:picardial SUrfKe: i.
1mOOlh., with minimal fal investment. The: coronary Ittc:ries ue present in a nonnal
dililribution, willi 1 riiht-dominant PfoltmL Croa JeCliollI oflhe vessel••how no
.ignificant alheroselefOsiL The myocardium i. homogenous. fOi·brown, and linn. 'The
valve lcaneb are thin and mobile. The walls ofthc left and riiht ventricles are I.S and 0.6
-an thick, r=opec:lively. The mdoeanlium is IIllOOth and glislening. The 10111 gives rise 10
three inlaCl and patent ueh vessels. The renal and mesc:nlerie vc:sse1l arc unremarkable.
UVER A 511 !MY SYSTEM:
The 2270 &In liveT IllS an inlKt, smooth eapsule and a sharp Inle:riorborder. The
~nchyma i. tan-brown and congested, with Ihe usual lobular arehitecture. No nws
lesiolll or other abnol1l1alilies are seen. The aaJlblldder eontains a minute amounl of
gJUn-bIKI: bile and no stones. 1lIe mllC05llsurf_ is green and velvety. The
exlrahepalic biliary tree is palent.
SPLEEN:
The 280 gin spleen ha.s a smooth, iruct. l'ed-Pllflllecap5Ule. The parenchyma is mlll'OOl1
and COl\8ested, with distinct Malplghian oorpusclea.
PANCREAS:
The pancreas is firm and yellow-tin, with lhe usuallobulu Itl:hltec:lute. No mass lesions
or ocher abnormalities arc seen.
MEDCOM 0628
ACLU Detainee DeathII ARMY MEDCOM 628
AUTOPSY REPORT'(b){6"-- - ]
h~!o(6
rHunmlcL. RaldJuby,-_,
(b)(6)
ADRENAL'>:
l1le right and lall: lIdrenal glands are hemotlhasic. 30 IJUM cech, with aulOl)'lis and
necrotic purple brown medullae. No Il\&S!a are identified.
GENITOURINARY SYSTEM:
l1le righllll1d left kidneys VlI'cigh 180 and 210 am, respectively. The external surfaces are
intact
~
SITM>Olh. The cllllUl'f_ arc rcd-tan and congested. wilh \lIliformly thick
conices and sharp conicomedulla:y junelions. 'The pelves are unremarkable and the umers
are nonnal in coune and caliber. White bladder mUCosa overilell' an Intact bl8dde:r wall.
The bladder mucosa has IClIllcml pctcelliae. The bladder is empty. The prostate is normal
in ai:te, with lobular, yellow-tan parenc:hyma. The seminal ~mlcs are unremlllbble. The
lestes are free of lIUISS lesiON, contusions, or other .lmonnalitiea.
GASTROINTESTINAL TRACT:
The esophagus i. intact and lined by dark aUIOIyz.ed mucosa. The atomlleh eontains
approximately SO IlC ofgreenish brown semi-liquid material. n.e pstric will is intact.
The duoOcnum, loops ofsmall bowel, and colon are unremarkable. The Ippcudilt is
present.
ADDITIONAL PROCEDURES
•
•
•
•
•
DocumCl\tary phologrllphs are taken by OAFME phololVllPtler.
No trICe evidence or foreign material is collected.
Specimens retained for loxieoJoaic testing and/or DNA idcnlification an::
vitreous, blood, spleen, 'iv~, brain, kidney, lung, bile, gastrie, skWadipoee
tiSSIlC and psoas.
The dillHCted Ofllllll are forwarded with body.
Penonal efTcct.s an: relc:ucd to thcaPJllopriate lTIOfluaryopcnlions
lepT'C$Clltatives.
MICROSCOPIC EXAMINATION
Selccted portions of organs an: retained in forrnalill, Selected 5IIIail tissue pieces are
procened for histologic slides u deacribed below. These .tides have been cxamined and
lhcrc arc no addition.1 sipficant p"thol08ic findinjp olhct" than thoseconlirmed and li5lcd
in the final diaanosi. or internal examination sections of this report.
BlockUsf:
1,2
4,5
1
9
II
M~ardium
Lung
Luna
Spleen
Dura
3 Testicle and m)'OCardium
6 Uver
& Kidney
to Lung
12113 Adren.II gland
MEDCOM 0629
ACLU Detainee DeathII ARMY MEDCOM 629
....etioU
OPINION
This 21 year-old Iraqi, male, civilian, detainee, died ofhypolllc-ixhemic encephalopathy
due 10 meninJOcncephlHtil ofunknoWll origin. The brain was eJ:&ll'Iined by Ibc
Newoplthology, Environmental and Infeetious Oi_ Sciences, and the
Hernalopathology ~la ofthc ArmaI Forces lrlIlilutc ofPllhology, Washington,
DC (Sepantc Tq)Orts). The IIWlIleI" of death ilIl11ttual.
(b)(6)
l(b)(6)
yediCil Examiner ILlI1b_lI_"_ _
MEDCOM 0630
ACLU Detainee DeathII ARMY MEDCOM 630
_..
_
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DO' :~" 2064
MEDCOM 0631
--
•
ACLU Detainee DeathII ARMY MEDCOM 631
ARMED fORCES INSTITUTE OF PATHOLOGY
0fTke af lilt AnlltG Fol'UII Mcdlwl bam'-,",
1413 Reltan:k Blvd., BI4 102
Rockville, MD 208SO
1·)01-119-0000
AtrrOPSY EXAMINATION REPORT
Name: GHADBAN, Talib E.
ISH: (b)(6)
o.c ofBirtb: IICM kDown
0.11 ofee.th.: (b)(6) 2006
o.teofAUIOpS)': IS JAN 2006 u 0910
o.cofRepart: 11 MAR 2006
AulOJlS)' No.: jb)(6)
AfIP No.:(b)(6l'-;,;oo-_ _
Rank: IlOI appIicBble
P\aa: ofDalh: Bqtmd,IIWl
P\KeofAutopsy: PortMortuary
DoverAFB,DE
Clreu. .tu~ .fo-tllt OeI;:edeal Idrninctl 10 the 3441ll Field Hospital on 31 Dec 05
eompWni"i ofbeina li&N~. On O2.IaD 06,1ll1I delaincc i,1'q)Ofted 10 haw:
lIlITend'stroke with wblequenl1eYeft brain twellill&- Dislorted brain anatomy was
-.en in imaJina snxlits eCT KIll). Detainee was .en...-l &om respjrUor on 7 JIIIl 06,
0100, but feedin. wbe kepi in plaoe. Detainee pronounced" IIU(b)(6) 06.
AatbortadGII for AatolUY: Office of the Anned Fon:a Medical Euminer.IAW 10
USC 1471
CAUSE OP DEATH: AT1-IEROSCLEROTIC CEREBRAL VASCULAR DISEASE
MANNER
or DEATH:
NATURAL
MEDCOM 0632
ACLU Detainee DeathII ARMY MEDCOM 632
AUTOPSY REPORT (b)(6)
GHADBAN, Tillb E.
2
AUTOPSY DIAGNOSES
I. CcIltr&l Nervous System:
A. Acute inflJdiOli oflhe rip Cfid...l ~pben= In lemlory oflhe ri&hl middle
cerebnl utay; Ihe Ilistoloaic 1ppul'UlCe is consistent with infllR:l thlIt hu been
'JlpfOxlmatcly one week or IcSlI in dunlion
8. S~falcillt and lnIlStCIItoNl herniation
C. Thrombus, orpnizina. rialll middle cm:brt.l '"~; ~lOSCltrO\ic Ilnd
anerioloscJerolk: vuculat diseu:
II. Cardiovuclllar PtothoIOllY:
A. Cudiomeply 400 punt, predicled ~[310 arams for 138 pound m.lle
B. Mildly thickened and m1undult uiCUlpid valve
C. Foeal mlCfOSCOpic JUbepic:ardiaJ swrina, of unknown slanJficance
D. Left al'lIcrior descendlna artery: 30% lumil'lllJ lWfOwilll by patboloaic Intimal
thickenlnl
£. Ri&hl cotOllIIlY artery: 30% lumir'llli nurowillj by pIlholo81C Intim.lthickeninl
F. There is focal microscopic sllbepicardi.I.clll'Tin8, the sllll1ifictlncc of which is
""'""'-
Ill. Neptln»cJerosis with aranllJu renal $Ul'f-: .pptUWlCt. focal Infarct of left kidney
and bil8lmJ cortic:al thlMina
IV. Evidence ofMedicallnterv~lIlon
A. Nuopsuic feedin8 tube .ppropriately positioned
B. Intravenous.eetSl site in left fcmond crnst
C. Ev)dence oflntravCTlOIIS KCaI sllCll in left and right antecubital fossae
D. Foley wilW}" Q1thela"
E. EKG f*Is on rishl shoulder and left lea
F. Treated deeubitWi ulcer 0l'I right b&lck
V. ToxlcololD':
A. Blood Is neptive for carboltyhemo&lobin (carbon mOllOJl.ide)
B. Blood Md wine IIRl neptive for etlwlol
C. Blood IJ neptlve forcyanide
O. Urine;s neptlve for screened drup of.buse
E. Urine is positive fot lidoc:alnc
F. UriDe is positive fOt JotUtplll'1
MEDeOM 0633
ACLU Detainee DeathII ARMY MEDCOM 633
AI1fOPSY REPORT (b)(6)
GHADBA". Tallb Eo
,
1
t:mRNAL EXAMINATION
The clothed body;s tJw of. normally dewloped, adcqualely nourished. 65-112·inches,
1)1 pounds, Caueaian male whose appearance is consislcnt witb an "Ie IWIJC extending
from the: mickooluc si"th throuah tcVCNh decadn. Lividity is po$lCrior and lied, rip
is pessing, and the: ICmpemlft is I/Iat of the refrigeralion uniL
The scalp is co~mt with medium Icnph black-pying hair. distributed In. male
balding pattern, and. blac:k-py mllStlC:hc and stubble beard.. There Is no evidence of
c:rarUo-fac:ial frIW1IL The comcae are opaeiflCd, the UIIdcrlying irides Ilnl brown, and the
~ls are round and equal. 'The !lCI~ are slig.htly Injected. "The extcmal auclilOf)'
canals are clew. 11Ic cars are unmnubblc. The nares are patent and the lips are
atnumatk. The IIO$C and mulll.c lire paI.-bly stable. The lower j.w iI edentulous;
nWllCl'OU1 teeth of the upper j.w are mi.uingand thole
~t arc
IlIUkcdly worn.
The neck is 1Il'aighl, and the ITIchca is midline and mobile. The chnt is; symmetric. A
circumscribed circular areaoferytherna over the righl epipstrium n-sures linch in
diameter. The abdomen is slightly prolubennt but withoUI IllUi or fluid WI~. The
genitalll are those of. normal circlllTlCiscd -'ult male. The lestes a,re descended and free
ofmasscs. Pllbic hair Is present in. normal dIstribution. There Is. 112 inch resolvlna
contusion on the riahlsidc ofille upper '-:k. Then: Ilnl two circumKTibcd area of
ct')thcma on the right side of the mid-b8ck. A 2-1 f2 inch ciraunscribed are. of
hypcrpigmcntation is presenl at the supcrior aspect ofthc gluteal m:ase. The buttocb
and IIlIUS are unmnarbble.
The upper and lo~ extremities a,re symmetric and witholll clubbing. There Is.
resolving, lIZ inch contusion on the volar $lII'fllCC ofthc riabl forearm. Circumscribed
hypcrpigmcnted areas are presenl on the dorsalsurfllCCS ofbolh riabl and left hands. The
skin of the hands is mildly edemalollS and the fingunall beds are cyanotic. The skin of
the leas. from the soles ofthc feet to the level of the knees II daRer brown thIIlI the lIkin
oftbc remaining body surface.
MEDICAL INTERYENJ]ON
A lla1OpSIIic: fceding tube II positioned throuih the lell: naris. There il evidence or
previous intravascular access In the antee:llbital fo_ bil.ltenlly, u well u In the lell
femoral creuc. A urinary cal~er i.I positioned through the urethra. EKO peds are
present on the n&ht shoulder and left lca. A hc:aIingdccubitus ulcer mcuurin12·114 _ 1
irdl. wilh l gel dressinl placed lrn:r il, is presenl on the lell: side orthe '*ck along the
lateJaJ seapular border. A plutic: coaled hospital identification brac:det printed with the
decedcnt's name encircles the lell wrist.
RADIOGRAPHS
A complete set of postmortem r.d1o&nPha Is obtained and dcmonstJates IIlI absence of
skeletal tnwml and metallic foreiF! bocfies
MECCOM 0634
ACLU Detainee DeathII ARMY MEDCOM 634
-==
AUTOPSY REPOR-n(b)(6",
CHAnDAN, TaUb E . '
•
INTERNALiXAMlNATION
HEAD (See NeuropatholoiY Consult);
The galea! and Sl,lbgalca1lOft tissues oft!IC scalp are fiu ofinjUJy. There are no i1kull
fr1etun::s. and the dun mater WJderIyins the calvarium is In\j(t u well. The atJantooc:cipital joint is stable.
NECK.:
The lllterior SlTIlp D1US(;1clI of the neck an: homogenous and red-brown, without
hemonbagc. 'The lh)'TOid eanllage and hyoid bone ere intact. The l.,.n.x. Is lined by
intlct white mllCOsa. The thyroid &land is symmetric and red-brown. without cystic or
nodular change. The tip of the lOngue is de$$icaled. but flee of bite marks, bemorrllBge,
or other injuries. The bones of the cervical spine an: in!act and ~ is no evidence of
soft ti5lJlK' IJemc:lrTbaie when la~·wi5C anterior and posterior dissections are extended 10
the $pinal column.
BOOr CAYmES:
The ribs, Ilcmum, and vertebral bodies are visibly and palpably intact. A SO DC Jcrous
effusion is present in the left bemithoru, and. 400 ec serollS effusion is present in the
right !lemithol1lX. The pericardia! $llC c:onlains 20 DC ordeal fluid. TheM. is no excess
fluid in the peritoneal cavil)'. The OlillnS occupy their llSuaI anatomic positions.
RfiSPIRAIORY SYSTEM:
The right and left lungs welib 690 and 56O-gmn.s, respectively. A few filmy 8dhesions
extend from the visceral to the parietll surf'BCeI ofthc right upper lung lobe. The ex~
swfaces are lkep red-purple. The pulmonat)' puenchyma is diffusely conae:sted and
edanalou.s. There is • small unount of white froth in the diSUlI tral:hef, and bronclli. No
oIher significant abnormalily is noted.
CARDIOVASCULAR SYSTEM (See Cardiovascular Petholosy Consult):
The aorta Sives rise 10 three inllCt and pllientarch vessels. No significanllesion is
present in !he thoracle or abdominal scilllmu of the aorta. The renal and rnestnlerie
ves!lels are ~ble.
UVEa &: BILIARY SXSJEM;
The 157~sram liverhas an intact, smooth eepsuIe with pnlminent lobular patlemioSThe pm-enehyma is uniform Illn-brown. No mass lesions or other abnonnalitles are seen.
The p1lbllldder contains slightly less than 10 cc of sreen-blaek bile; there I n no stones.
The mueosa! surfac:e is green and velvety. The extrahepatie biliary tree is patent.
SPLEEN:
The 17().gram spleen has an intact, red-pwple tllpSU!e. Several adhesions extend from
the splenic stafaec: 10 adjacent orpPS and 10 the abdominal wall. The puenehyma is
uniformly deep purple with distinet MaJpishian corpu.seles. There is no evidcrK:c ora
foealle$ion.
MEDCOM 0635
ACLU Detainee DeathII ARMY MEDCOM 635
,
A.UTOPSY REPORT(b)(6)
GHA.DBAN. TaUb Eo
PANCREAS;
The JlUI=&lI is firm aDd. ydJo-ean, with the usuallobul., ~hiteel\lft. No II\llJS lesiON
or other abnonnaJities IU1l seen.
hDRENAI,§:
aIands ~ ~ with bright yello.... eortic~ IIIli i"'Y
medullae. No me,es or areas ofhernorrllap an= idenl.ifltlll
The right and left adreIaI
GENITOURINARY SYSTEM'
The right and left kidRC)'s weigh 110 &lid llO-ar""uespeetivdy. The It)l~ tutfllees
of the kidnqs are flndy lJ"tIuIu. TIteR is I faint weda-hapccl infarec in the IUperior
pole oflhe left lUdD<:y. The Cllt IUI'tKea, IJ*t rrom the ln~ tiJlUC, are reO-tIJl and
COlIgested, widt slight thinning ortbe c:ortices aDd. s/wp COrticomedlllJary jllQttions. The
pelves lie unmnarbhle and the 1ll'CIel'S are nomal in COIll'lC and caliber. White bladder
mllCOJl overlies an Intact bladder wall. l1tc bladder is empty, havlna been drained by the
IlIiJwy catheter. The prostate aJtnd Is enlarged with ycllow-tan ~ochymlaDd.
palpable poorly defined nodules. The.sell'linaJ vesicles are ~mllbble. The IeJIcs an=
free of mw lesions, contusions, or other abnormalities.
GASTROJNTESDNAL TRACT;
The esoph.lgu.s Is iOllct and lined by smocltll, JVCy·white muco-. The stomach containl
approllimatdy 7CHnillilitm or partially diaestcd food. The gastric wall illn1Ar;L The
duodenum,loops ofsmaH bowel, and oolon are unremarkable. The appendix II~.
MUSCULOSJ<EI.ETA.L AND INTEGUMENTARY SYSTEM
MUlCle development is 1lOn1\Il. No bone or joint abnormalities .... noted. All ueasof
hypetpiifl\Cl\w1on are It)lamined by limited dissection; in no InslanCe iJ there evidence or
soft tissue hemonhqe. There ilno evidence ofinjllr)' to the back. wrillS or the _ b of
the legs.
MICROSCOPIC EXAMINATION
Selected portions oforpns are retained in formalin, with preparation of histologic slides
as appropriate.
ADDmONM PBOCEDUPE§lHEMARI(S
•
•
•
•
•
•
Documenwy pbotopphs ~ liken by the OAFME staff pbotoir-phen.
Specimens JUbmittcd for toxiooloO and ON.... analysis: vi~. blood, gastrie
f;OIIlents, bile, urine, bnin, luna. liver, kidney. splcea. adipose. aDd. psoas muscle.
Full body radiographs are oblaiDed Illd reflect i'1iuries dexn1led above.
Selected portions oforpns are retained in ronnalln mid hillOlojlk. lOCIions
prepared as appropriate.
The di-.c:ted orprtJ 1ft forwarded with the body.
PenonaI effec:ts are relcued 10 the WOjAiale moouary ~ns
representatives.
MECCOM 0636
ACLU Detainee DeathII ARMY MEDCOM 636
AUTOPSY REPORT
GRADBAN, TaIib:r..
{b}(6}
6
StlBSPECWen CQNSULTADQl{j1OOJRQPAIHOLQGY
...
{b}{6}
I
•
MEDCOM 0637
ACLU Detainee DeathII ARMY MEDCOM 637
AUI'OPSY RUORT'"'(b~)(6"}- - - ]
GHADBAN, TII1Jb Eo
7
SUBSPECIALn CONSULTATION; CARDIOVASCULAR PATHOLOGY
)'1N..u. DIAGNOSIS
bIAGNOSIS; l{b)(6)
]Beut, ,..1_...... _
. .doG; CardloaepIJ
H1JtOIy; Male d : , _ (dale ofblrth IIZIlmowa).dmltted tg).4.4111 FJeld Hof;pltal 12fJIJ05 wtdI tip_
IJIDptoW of~ IlIbjoeI dIcM(b)(
,06.
Heart 400 pw:M, ,,*k:ced 1lCII:l:llI1310 p u (OT 131 poIllld aWe: ............' OIpIc.dIaI &t; c~ fonmm
ovaIe; left ~..tzlc:ul.- cavlly dlill lei 30 mm, ldI: YWitrIcuIIr he wall
1] mm, YeDtriculIr ICplWI1
~ IS mm, rI&bt WlIbicle thi,l, .. 4mm w11bou1 po. .... or"'·..",,1 fill iaftltnCea; mild1y
thick,,*, mel reI '''"t 1riciJIpld ~vo. oIb« ~ poaly 1JlllTO"r!raNe.; ..... : ... d1wn poaly
IIIINa_bb'c: DO ar- .,--dLa1 ftt-U or _otif; IliItolope IeClioIlIIIbaw CocU ~
Sl.IbepieedM!-mna: Ibere are no Iafllmm'tmy ce.l11nfIltmea,.1flYOCYlIIl roeaOills, ar ccdfomyOJ*lhk
tbI·"
I
.......
'Corn11m)' arteries: Nomal osUa, riIht domI
; roc.IJy mild ~1laIY~'
Left IIIteriaf deewwUna 1rIery: 30% lumb:lll
ow!q by pIlboJoPe jnti".! tbWcmq
)RJibI 00l0IIIr)' 1ZUty:)(M ]tanIa" ~ by J*bolosk Int1mI1 tbickminl
Coaull(lQt
n- ill roc.J ~c A\.bc!pieardla1-rlDa. tilt 'lanlfl- of whJch 11 1lIlkDo"'A.
1bImk you !'or IC1IlIhla thIJ ca. Cor our mUw.
c..e 1OCICl1a ~
1{b)(6)
BlocU mIIIo: 7
SIidoJ DIP; 7 H4.E, 6 MovaI
SWfpllboloJl"
•
MEDCOM 0638
ACLU Detainee DeathII ARMY MEDCOM 638
AUTOPSY REPORTj{b)(6)
CHAnDAN, T.llb E.
•
J
OPINION
This detainee died ofceret!tlll VJ.5Clltar diteaSe, ~rICl.!Jy, of thrombotic ocd\.llion of
!he rish! middle: ~ artery and ischemic chanps of the ce:ntnl nervous system
SUUC:!~ il SlIppJie:s. Cardiome:ply.nd ne:phroscle:rotic clwlae:s support the
in~n lIIat \he de:«de:nl had hypertensi~ disease: of lona SlIlldilli-
Despite: e:xle:nsivl: and cktailcd I:lWnination,!here is no evidence Oflnllll1Ul 01" injury. The
identification of lldoeainc and • bcll7.Odiu.epine in the urine Il'C consistent with the
detainees stalllS IS a hospiuJiud patient with cardiac instability and possibly xizures.
The manner of death is natural.
(b){6)
Ib'-')I""'-IMcdicai EMnUne:t
{b)(6):mcdical
Examiner
MEDCOM 0639
ACLU Detainee DeathII ARMY MEDCOM 639
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DO' ="n 2064
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Dover AFB, OOYer DE
l(bj{6)
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---
MedIclII Examinet
.
•
... - -""'-"-,,",
MEDCOM 0640
•
ACLU Detainee DeathII ARMY MEDCOM 640
,
ARMED FORCES J.NSlTJ'lrn:; OF PATHOLOGY
Oftke or Ute AraMd F _ MtdkaI EuIIIlDtr
'4'3 Researdl Blvd.• Blda.l02
Rocbl1le. MD 20850
301-319-0000
PINAL AtrrOPSY EXAMINATION REPORT
Name: BT8 M~ Hamed Ali
ISH: (b)(6)
DateotBitth:l(b)~)
o.teofDeath:(b)(6)
Au«lp$y No.: (b~
AFIP No.: (b)(6)
Rank; ltIqi Civilian Detainee
11m
2OOl5
Date of Autopsy: 1': FEB 2006 • ICOO
o.te of Report: 29 JUN 2006
Pl_ 01 Death: lnq
PIaa: of Autopty: Port MortUary,
Dover AFB, Dover, DE
C1mJmsI'_ oI'Dealtl: Reponedly, this lnIqi civilian detainee wu usaulted by
fellow dCtlinees
Av.tItoriutloa for AtatopIy:
USC 1471
omce of !he Armed Pon:a Medical EumlneT, lAW 10
IdeadllcatiGn: Presumptive identlnc:.!ion Is esabll5lled by..xompany\nllck:nlifle.tion
lIg IDd clocumentalion. fingerprints and DNA IlI'Il taken 10 compare 10 ucmplus when
available.
CAUSE OF DUTIl:
MULTIPLE BLUNT roacK INJURIES
MANNER OF DEATH:
HOMlODE
MEDeOM 064\
ACLU Detainee DeathII ARMY MEDCOM 641
FINAL AtrrOfSY UPORT:1L{b_"_"
8TB MOHAMED, Hamed A.
_
PqeZoI14
FINAL AtrrOPSY DlACNOSFS:
L
Maltiple Bluat FOfft ."'uoo
A. Head and nedr::
I. Two abrasions of the ford\ead, I 'A l I·jnth and Y.t l ~Incb and loeated 1
Y.r-indle5 below the lop of the ~ and ',Ii left. of the anterior mkIline IQ Y.rInch right of the anterior midline of the head in the 8lIaIomic position; with
associllled JubpJeaI hemonh. . and multiple linear flw:rure5 of the right
side of the frontal. and right ~l bones
2. ConlllSioo of the right ortlit, 3 J. 1 Y.r-indIcs
3. SublXllljllQClivai hemorrhlllc
4. Disconlinuow abtulon oflherighl eheek and nose. 1 l Y.r-inch ~
loc:al~ 6-incbQ below the lOp of the bead and I-inch right of !he anterior
midline of !he bead in the aMtomic position
,. RCCWlJUW. patterned contusion of the right cbcek, 3 II 2-inc:bcs located 6
\;.inches below the lop of the bead and 2 M·lncbes rilht of the lllterior
midline of the head in the anaaomk: position, with usocialed oontusion of
the buocal rnllCOSl and fl"lCture of the right zyaoma
6. Di$contlnuous. IneguJar abrasion of the poIte:rlOl" scalp. 3 M lr. 2-incbcs.
located 2·inc:hes below the top of the Iu:ad and on the posterior midline of
the bead in the anatomic positkln
7. Two conlWic:m orlbe anterior neck, 'A .. \4-inch (IOC11cd 10 *-Lnchcs
below the lOp of !he head and \o;.inch Jefl of the anterior midline of the
neck in the anatomic position) and I :r.l?-Inch (Iocared II '!.I-inche$ below
the lOp of the head and on theanterior midline of the neck in the anatomic
position) and usociated hemonllage o(!he inferior "peel of the left
Aemohyoid muscle and hellXlflhaae of the right submandibular Mlft IWue
8. Acute aubdunillemc:lntwge, left temporal Rlgion
9. Diffuse aubaracbnold bcmorJtIasc
10. Multiple contusions of die brain: right OIbito-fionlal "'8ion, left inferior
temporal ",gion, bilatenl occipltal loba, bilatenl cerebellar bemlspheres
B. Torso
I. Irregular. OUIIlne patterned abmlon oClhe righl dtest,4
lI;
3·inc:hes,
10Clltd 13 .J4..incha; below the top oCtile head and I ~incttq right of die
.lIenor midline of the 10110 in the lIII5lOmlc position. with an associated
I!'CWlguJar pauem 3 lI; 2·1ncb alDtW;]OII 13 *"iochc:s: below the top of the
head and S \;.inclJq righl of the anterior mldline or the head in !he
Illlatomic position
2. Abrasion of the upper lett chest, Ill; \4.incllea, located 16 'l.l-inc:ha below
the lop of the head and I *"incIJes left. of the anterior midline or !he torso
in the lIII5tomle poaillon
MEDCOM 0642
ACLU Detainee DeathII ARMY MEDCOM 642
FINAL A1JI'OPSY REPORT: (b)(6)
BTB MOHAMED, HamecI A.
. . . 3 of 14
3. 1rrepllu outline patterned .tnsion of IIle Iowa" left cbe3t, 4 J. 1 '.4-indIes,
\ocIIted 19 ~incbe:a below IIle top ofllle bead IlIld 7·lndlca left ofllle
anlerior midli:ne of !be lOtIO in IIle MIlOmIe pIIIition
4. Linear abruion of !be lower Id\ bac:k. 416 J. III-Inch, Iocatccl211+1rK:11a
below the topofthe bead IlIld 6 t'-\ncbea left oftbe poIIerior midline of
Ihc lOnO in Ihc lDIIomk position. wllb assoeIated undulyina soft ~
h,,""nt....
,. Multiple left rib frIclwea: ~ Ibrougb 4" &nlerior.1"' Ihroup ""IKerai
..t poslC:rior left nOs with associllCd left. banoIboru (400-mUJUiters
of liquid blood)
6. fBcture of!be body of the lIanum
7. HCI1lOrIbqe ofllle soft tissues ILmlUlldlnl the second IIIondc vctlCb....
bil.atcl'ally
8. Clpsulu bemalQrnaofthc Inkrior riahllobc ofthc Ilvet
II. Hemonbage of the left peri·rmallOft. tbIueI
r-
C. EJ.uemlllea
I. Abl1llion of the anleriorrilbl forann.16 J.l+incb,located 7-1nc::he$ below
the elbow and I+inch literal 10 Ibe 1QICrl0l' midline of the riabl upper
es.lremity in Ihc I.lIItomlc position, with an assocIMcd 11 I-inch
ecch)'JIlOlla
1. Conrusion of the posterior right forearm, I It 'A-inch. Ioe.ccd '-incbeI
below \be elbow Illd I M·lnches medial to the posterior midline of the
righl uppefutremity in the I.lIItomic poshlon with II$QC{lted 10ft tilSUC
""""""'"
3. Conrusioll of the dol'IW'I'I of the left hand, I l,4 1 l"-inch. located 1114·
lnchcI below the elbow and 114-lncbell1.lteral to the poaterior midline of
Ihc IdI: UpperU.ttemily in tbeanllontic poaition
4. Abl1llion of the IIIlcrior riahl thigh. I J. 11I·lndl. 1OCJ.led 18 ~lnchcs
above the!lcel and 1·lnch lateral to the IIItcrior midline of Ihe riPi lower
extremity, with an associated 2 ~ 1 21+incIt ccd!)TIlOI1a
,. Conluaion ofthc medial right bIee, ~ 1 ~indl, loea.ted 17 M-inchcI
above the hccl and 4-1nc:bcllllCdlai to the anterior midline of the ript
Iowcr exttemlty. with IllOdllcd 10ft tiuuc edcmI
6. Clul(ef of abruJor. ofthc prolimalllll.erior rilhllcllo ~linI in .i;r.e from
11I6-inch to \4-incb and CIDYUin& UlIf'CI \oi It '.4-1ndI.located 14 ~1nchcI
above. the !'Icc:! and on Ihc anterior midline of the rilhllower u.U'ClI\lly
7. Conrusloo of the medial ript Ie&. I 11 I+lnch. Iocaled 13 M-Incbca IOove
the beel and 3 'l4-incha medial 10 theanterior midlincofthe ri&htlower
exlmmity
8. CooIUIIOlI ofthc right popliteal fos.sa, 7 \4 114 \4-lnchcs,locatcd 1414·
inctlcs Ibove. the hcel and I-inch medial to the posterior midline of the
right lower allel1lity with auoclated lOR tiauc ben1ot-mIge InlO tbc
postcriorthigb
9. FainlCOIlIU:Sionofthelcftkncc:, I .. t·incb,lOCJ.ted 17~inchaaboYethe
hcel and 3-incbe:t mcdialllO Ihc anterior midline ofthc IcI\ lower extremity
MECCOM 0643
ACLU Detainee DeathII ARMY MEDCOM 643
nNAL AuroPSV REPORT: l<b)(6)
BTB MOHAMED, Hamed A.
1
Page' or I'
to. Square 2 J. 2 patterned contusion of the left popliteal fasu, 4 'A. J. 4-inches,
located 15 "'·inches above the heel and an the: posterior midline of the left
lower extremity
II. FTaa~ of the: medial COlldyle of the right humerua and oIecnnan
ptllCZ$S of the right ulna with usodlted soft tissue edema and ecchymoses
of tile rigIU elbow (4 x 2 ~inches) and right &/Itecubital fOS$ll (3 'IIi J. 3 ~
"""~)
12. Fracture of the olecfllllOn pi" ' of the left u1nII with BSSOcilted soft
tlulle edema and 4 'IIi J. 4-inch eochymasil aftbe left amecuhltal fO$H
n.
Natural D1Icase
A. Mlid to maderale IfItltBcosb
D. SeYen' two-vesJel CXll'Oll8Q' llheroscIemsis
1. The pl'OJtlmalleft anterilll"CDfOtlIfY artery hu 90* luminal narrowing
1. The proximal right COfOMI) artefy hu 75* luminal narrowing
B. MDd~ atherosclerosis ofthc abdominal aorta
C. Mild hepatic steatosb
D. Bilateral ncphrolClemsis (gross)
a Cyst of the left kidney
Ill.
EvideDoI or MedkallllterftlDtlon
Ie ~"""
B. e.tdif,e monitor leads; both I.haIllden,left lllenal torso, abdomen, and both
"'''''
C. Urinary bladder catheter
D. Triple lumen cathe!er, right groin
E. Splin~ with. elastic wraps, both upper extremities
F. Double lumen Cllheter, ri&ht hand
IV.
M1almal deoolDpoIfllOll
V.
ToxItWOIY
A. The blood is tested forCllboJ.yhanoglobin And none i, found
B. The blood b tested for cyanide IIld none is found
C. The blood and vitreous fluid are tested for ethanol and none is found
D. The blood b scremed for medicatiom and drup of abuse and Atropine is
deteeud but is not qU&lltiwcd in the blood
EXTEiNAL EXAMINATION
The body b thai of I well-developed. wdl·oouriJhe,d IppearinI68-\ndI, l46-powxI male
whose appearanee is c:onsistenl with the reponed age of 53 yell$. Uvldity b posterior
and fixed. Rip b equal in 11I1 extremities, and the tempenfl1te Is thll oflbe rehigetllUOII
~~
MEDCOM 0644
ACLU Detainee DeathII ARMY MEDCOM 644
.
PINAL AUTOPSY REPOIlT: (b)(6)
..... !1 fI.4
BTB MOHAMED, ~ A.
The sc:aIp is coveted with IhorlIl'lY hair in I male pIllCtn b&Idneu distribution. The
lride& Itt blue,the pupilJ ue rowM1 md equa.I in diameter and the Cl;IIIIUJ uedoudy.
1benl b subconjunclival hel'llOrrlap pre$mllt the riaJu lalUl1 euubua. The QtemII
IUditory eanab are clcer. The ears are IIZlRl'RIIbble. The IIIteI are ~l UId the lip'
ue auaumalic. The nose IlIId IMAUI~ are palp1bly 1tIb1c.. The teeth appear IIItUI'aIIIIld
in rtir coodition, wllh remoIe loa 0( Ihc lert upper otntnI inciaor.
The neck Ja .tn.I&hi, and the tndlea II; midline and mobile. The chell Is uymmctric.
The abdomen I. niL Thc acnital1a are those of. nannaI Jdl.llt male. The tescel are
dacmded and free oIlJlU5a. Pubic hilT I. pl'eIelll in. nonn.aI dislribulion. The
buuocb and anus are IIIlrmlarkabIe.
The upper Md lower eJltremilic:l are symmetric: and without clubbin,oredema.
CI.OTHING AND PERSONAL EfIIEc;rs
The followinl c10thlna hems Md penonal cffeeu at" PfQI:nl OQ the body.t the tUne of
aulOpSy:
•
Blue hospital aown
MEDICAL lNl'EByJWI1ON
•
•
•
•
•
•
&dotm:!lealwbe
CardIIC monilOt leads: both IhouIde~ IcflllleralIOf1o.lbdornen. UJd both
Ihip
UriIwy bladder catheter
Triple lumen catheter, riabl Jl'OIn
Spllnu with clastic WI1IJI', both upperextrtmltlel
Double IWJICD eatbelcr. n&hl hand
RADIOGRAPHS
A complete set of postmortem rldlolflP/u Is obtained ~d dcll'lONtnles the foJlowina:
•
•
•
•
•
FrldW1l of the rilllllyJOll1lllc pf'lKDl
Fl'KtUrcs of &be righl Nde of tbc I'matal bone and \he riJh! puieu.1 bone
MultIple left rib frw:ll.tre5
Fraeturea of the olecnnon procesl ollbc ri&hl ulna and the medial condyle of
the ri&hl humerus
FnaWll of the olecranon pr-.. of the left lIlna
The orderiaI of the followin& injuria Is for deacripelYc pwpoICI only. and Is 1\01
intended 10 imply onk:r ol WIlction or rcllliYc severily.
MEDCOM 0645
ACLU Detainee DeathII ARMY MEDCOM 645
..
FINAL AurOPSY REPORT: 1(b)(6)
BTB MOHAMED, Hamed A.
L
Pqe6 of 14
Dlut F_1JlJuriel
A. Head and Nec:k
Thereare two abl'asions or the ript forehead which meuure I WJ: J.tneh and
Va:l: ~inch and are Io<:aICd I ~inches below the top ofw head Ind JA-inch
left. 10 ~inch rign of the IJlterior midline of lbe !lead in the analomk
po5ition. Underlying these abrulons is pleal and subpletl hemorrhage and
multiple linear fnctwa ot'thc rtP1lside oCthe frontal.ud right parictI1
bones. There are multiple contusions ohlle brain that 1ft located in lbc: righl
orbilo-frontal region, the left infcriOl: temponl region. both occlpil&l lobes and
both ocdlcllar hemispher= There is. unall (less IJwI S-millilitC3) lubdunJ
hematoma overlying the left tcmporallobe, and a diffuse lublraehnoid
hell\lotoma IhaI
is diNrlbutcd over the superior cerebral hemispbcrel
bllaterJlly.
There is. 3 1 2·im:n teclIngular, pIltemed contusion of tile ri&bt dIcek.
located 6 ~incbes below the top oflhe head tnd 2 ~-iDcbes right of the
mterior Dtidlinc of the head in the anatomic position, wilh usociated
a:lII.tusion oftbc buccal m~ md fnaure of the right ~)'8OIIUllic process.
There Is • I 1 lh-inch discolltinuou:s abrasion of the riaht dIcek and nose,
located 6-indles below the top oflhc Ilcad and J·inch rishl of the potlerior
midline oflbe bed In the lIlIl.omie position. 1'befe Is. 3 It I ~inch ripl
periorbital contusion with an IWOCillted IUbconjunctival htrnontIage ,,&he
right latefll canthus. 1'bere Is • discoouinuoul. 3 Mx
irregular abnsion
of the posterior scalp. kx:aled 2-~ below the lop oflbe bead and on the
posterior midline of the he.t in the anaIQDlic position.
2·m
There are two cootusions of the anterior neclr: which IT1CISlll'e I It ~indI
(located II ~inctles below the lOp of the Mad Uld on theantcriormkliine of
the neclr: in the alIItomic position) and lA It \4-incb (located 10 ~[ncbcs below
the top ohlle bead and Yl-inch left of the anlerior midline of the ncdt in the
&nllooUc: position). As.wcilled with these contusioM are bemonhage of the
inferior aspea of the left uernohyoid lIU18Cle and hemorrhage of the right
submandibular 50ft tissue
8. Tono
There is a faint, I l[ !.4-iodt abrasion on the left chest.locaIed 16 ~Incba
below the top of the bead and Ilt-lnctles left of the anterior midline. On the
lower [eft chest. [0ClltIld 19 ~~ below the top of tile held. ancl7-inctte:s
left of the anterior midline, is • 4 It I l4-incb IneguJu outline patterned
abruion. ~ is 14 I l-iDdI im:guluoutJine pettemed abruion on the
right dICIt located l:llt-Incbes below the top of the bead and I ~ind1es ript
of the 8llteriDl" midline. with an associated reclIlI8ulu pattern 3 l[ 2-incb
contusion located 13 ~lncbes below the top of tile bead IDd 5 *-Incbes right
of the anterioc midline of the tol1O in the aoatomlc position. On the left back.
located 22 ~·inctles below the top of tile bead and 6 *,Inches left of the
MEDCOM 0646
ACLU Detainee DeathII ARMY MEDCOM 646
FINAL AUfOPSY REPORT: (b)(6)
BTB MOIlAMED.1lIlaed A.
J
.... 7ol14
posterior midline, is 14 ~ l[ lf8-ineh linearabruion with underlyinS
subc:utancouJ hemontaee.
1M left chest is ulemally rrwkedly deformed. with multIple underIyinSrib
fl1ldures; the 2001 throllJh 4· CIU:rior lel\ ribs (cannot exclude medical
InterVenlion). the 2"" throuah 'I" IIten11le1\ nlls and the 2"" posteriot left rib
Ire fI1Idured with assod.ted left bemotharu (400-milliten of liquid blood).
1M body of the sternum is frM:twed (e&mOl uelude medic:al intervention).
There is 1 small elpsul.. Ml'llItoma ohlle inferior ri&lll lobe of the liver, and
there Is I small left peri-rcnal soft tissue hemonhlge. Then!. is focalsol\
lis5Ue hemonhase of the
II the level of the ".. thoracic vertebra.
'**
C. Elltremitiell
I. Riahl Upper Elltremity
The~ are frlll:lure5 of the medial condyle of the riaht humerus and the
olecranon of the ript ulna with assocllt ed soft IUsue edema and I 4 :r. 2
l+inctl et:dlymosls. Th~ is I1so I 3":r. 3 *-Inch et:dl)'IDOllis in the
riaht antecubital foua, located 12 *-inchcs below the top of the sboulder
and on the IIIterior mldline of the riibt upper utremit)'.
On !be: anterior rishl forunn.loc:ated 7-inches below the elbow and l+
inch Iaten! to the IIlterior midline of the foreann 1$ I '" :r. 'h-inch Ibrasion
and associated 2 :r.l-illch ecdtymosis. There is I 1 :r. \4.inch oonluslon on
the posterior rlpt fotunn, loceted $-iDches below tile elbow and I ~.
inches medial to the posterior midline of !be right fOR:ll'm and associated
soft tissue hemonh.,e.
1. Left Upper E:r.uernity
Th~ is I fracture of the proximallefl ulna (olecrJlloo) with associated
sofl tlssueedema. There is I1so 14" l[ 4-incb ccchymo&1s in the left
antecubllll fossa. located 12 \4.inches below the topofthe shoulder IIIli
on the Interior midline of the left. upper extremity.
There is I 1 \4:r. ~Inth contusion Qll the dorsum of the left 1wId.located
12 \4.inchcs below the dbow and I \4.lnch Iatenllo the posterior midline
of the Idt upPer e:r.tremity.
3. Right Lower E:r.ttemit)'
There Is I 1 :r. lf8-inch abrulon on the Ulterior ript thlJlt, 1oeI.ted 28 ~
Indies lbove the beel and I-inch latmJ to !be anlftlor midline of the riJltI
lower e:r.tremity: thete is I1so I 2 ~ x 2 'h-1ncII a:clt)'lllOSls associlted with
thiliinion. On the medial sunlCe of the rishl knee, there is I ~ :r. l+
inch oontusion locIl.ed 17 *-incbes above the heel and 4-1nches medial to
the anterior midline of the riJlttlower e:r.uem.it)'.
MEDCOM 0647
ACLU Detainee DeathII ARMY MEDCOM 647
1l b>j><i66}}--===
FINAL AUI'OPSY REPORT: m
BTB MOHAMED. Hamed A. ,,-
PapSoll4
On the pro1imal anterior right lee. there is • dURer of abrasions whicb
range in size from 1116 to 'A·iftdl covering an lIl'eI. of \o!I Jl '4-inch, locMed
14 ~iJdles above the heel and on the anlUior midline of the ri&lll lower
U.~ly. On the medial righlleg,!here is. I :r; \oio-inch contusion 10000ed
13 *-iDches above thcbccl and 3 ~incbcs mcdl&110 the IIDterior midline
oflhe rip! lower exttemlty.
thefe is. 7 'A 14 l.4-inch IXIllnuion}ocucd 14
\4-inchea above the Mel and J.lnch medW to the posurior nUdline of !he
10 thll right popliteal loua,
riatll lowec utrmUt)'.
4. Left Lower EJtlJMlJty
Thele is. I x I-inch (amlOOllUlSiOll with. taint panem on the mcdieJ left
knce,10CILtd 171+iDctIes above the beelllldJ·inehes medial to the
anterior mlcllinc of the left lower almnil)'.
10 the left popliteal fQUa, ~ is ,4 W x 4-iDch contusion wilh. square 2
x 2 pattern IocaIed 15
above !he bed and 011 the posterior
*"inc:bes
midline of tbc left lower extremlty.
INTERNAL EXAMINATION
HEAP:
IJVuries to tbc bead are delaibed above (lee "Evidence of Injury.I.A." above). The
brain _iglu 1,340-granu and 15 submiued for Neuropalholosy OOJUultation. See the
anachcd Neutopatbology COf\$u1tllldendum for complete dcuib.
NECK:
uyer-wi$e dlssca:ion reveals that the anterior SU'Jp muscles Qf tbc neck are bomosClllltU
and ~WD: tbete Is hemorrhage It the base of tile left ltemoilyold muscle. The
thyroid canUaae and hyoid bone are intl.ct. The IIlf)1lX is lined by intact white rn'lC0$t!
The thyroid gland is syrnmc:tri<: and red·brown, wilhoot eyWc: or noclulu dllIDge. The
tonsue is fm: of bite rnarb, hernonilqe, or other Injuriea.
lDci5.ion mI diuedion of \he posWior ned; demonstretes no deep ptnceIVicaI muscular
irI/UrY mI no cerviCl1splne f'ractureIr;.
SODY CAY!TIF$:
The vertebral bodies are visibty and palpably Intact. Injuries and changa involvin& lhe
nDII, sternum mel left pleural cavity are dumbed Ibove (He ''Evidence Il\lu:ry. loB.").
ThcR is no uoeu fluid Is In !he right pleural. pericudial, CII: peritoneal cavities. The
orpn5 oocupy their lI$U4I aIlIItomic posilloos.
RW!RATO&Y SYSTEM:
The risht ud left lunp -ish 590 ud 61D-grams. respectively. The u.1emIJ surfaces
are smooth and deep red-purple. The pWlJKJIlIlY parmc:hyma i5 diffucly oonaested and
MEDCOM 064B
ACLU Detainee DeathII ARMY MEDCOM 648
FINAL AtrrOPSY REPORT: (b)(6)
BTB MOHAMED.Hamed A.
"'90114
,...,....
edemuoua with antbnaKlc pigment. No mass lesions or areas ofconsolidation an:
CABDIOVbSCUW SYSTEM:
The 4]O.gIUl bun is submitted for CardiovlSCUlarPatho!ogy consuIwion. Sec Ibe
lluadJed Cardiovascular Pa!holoay consult addendum for complete deuits.
WEB&: BILIARY SYSTEM:
The 1.17o-aram liver has lUI intacl:. smooth ctpSule IlIld a sharp anaeOor border. The
parenchyma is yellow-tan to brown and congested. w~ the usua1lobular architecture.
IrUIIJ)' to the liver is described Ibo~ (see ~Evidence oflnjllJ)'. I.B."). The pIlbladder
eonltins a minute amount of gn:en-bllClr. bile and no Ilones. The muooul swf_ is:
green and velvety. The extrahepatic biliary uee is patent.
LYMPHOREDCULABSYstEM:
The 17o-anm spleen Iw a smooth, intact, led-purple capsule. The parmdiyma is
maroon and coopted. with dist~ MalpiihlanCOfPllSCk&. The reaional1ymph DOdes
appear normal In siu: the earinallymph nodes contain anthnlcxJ(ic piamenf.
PANCREAS:
rum uxI yellow-tan, with the usual lobular ardtilectUle. No mass lesions
ocber Ibnormalities an: seen.
The pancr9S is
Of
ADRENAl S:
The right and left admlal g11llds an: symmetric. with bright yeJlow cortices aIld grey
medullae. No masses Of areas ofhemonhlp an: ldentirted.
GENOVYRINARYSysTEM:
Therlght and left kidne)'$ weigh 120 and IIG-pntS. m1pectively. Injuries to the kidneys
an: de&cribed above (see "Evidence of InjllJ)', I.B~). The utem.ll swfaas. an: intact and
sranuJar. wilh a fluid-filled cyst It the left upper pole. The alt SurllCCll an: rD:l-fan and
cooaestM.. with unifonnly thldt cortica and sharp cortico-mecluJlary jWlQJons. The
pelves an: unn:nwkable and !he ure1CtS an: normal in course and CJliber. Pink-areY
bllldder mucosa overlies an Inlact b11d4er wall. The bladclereonLiins no urine. The
proalIfe &land is normal In size, wilh lobular. yello.... -tan parenchyma. Theseminll
veslcIea are unremarkable. 1be teltes an: free of mass lesions., confUSIons, or other
llboormaIiliea.
GASfR O IN11iSTINAL TRACT:
The esophqus b intact and lined by smooth. grey-white muOOS.l. 1llc stomach contains
IpproxUnately »millm~ ofbrown f1uici. The psuic wall is intact. The duodenUlll,
loops of small bowd and colon an: llllrefllatbble. The appendix is presenl.
MUSClJLQSKfi! fT& SYSTEM:
No non-Irlumalic abnonnalities of the muscles. bones or joints an: noted.
MEDCOM 0649
ACLU Detainee DeathII ARMY MEDCOM 649
FINAL AUI'OPSY REPOR.T: L,{b.cJl.c"
BTD MOHAMED, H . . . . . A.
_
Pace 10011.
MlCBosconc RUMINATION
Se1cded portioos of oraans are R:tained in formalin.
BRAIN:
Sec the IlltaCbcd Ncwopalhology CIIlI$Ult addendum for lXlmplete details.
HEART:
Sec the 8"oched Cardiov&$O.llar Pathology ODDSult addendum forwmpldc
"""'.
ADPmONALPBtlCmUBE '
•
•
DOCllnrnf8ry pbotogr3phs arc taken by AFMES photograpbm
Specimens ret8lncd!'of toxioological testingUldlor DNA idcDtulCalion are:
v;tIWU5. blood. spleen. Jlvet', IWlg. kidney. bile. 8IUmc CODtelltS••uP'*" tWI,lt
and
psoas muscle
•
The body is sutured closed without embalming 8ltd tbc disscctcd O£gutS arc
•
forwarded with body
There are no personal effeeu
MEDCOM 0650
ACLU Detainee DeathII ARMY MEDCOM 650
Pace 11 0(14
FINAL AUfOPSY REPQRT:{b)(6j
81'8 MOHAMED, Hamed A.
OPINION
r
This $J·)QfoOld ~I dvillan detllinec (b){6)
died as, result of multiple
bllUll force Injuries be recdvo:lln uncJeuclreumswxes. Severe Injuries 10 !be held.
torso llDd ulremilics wen: present in Ioc:atioM which lin! lIlllikely to uve been selfiD!Ilaed or in an lCl:itIentalltWlflCf. Both elbow joinls were fractured in an W1USu.at
manner (olecrenon frac:l.ures) tbaI. suuesu del1ben.le _wt by anolher pmon or
persons. Contusion CltI soft tissue hemon'l1age of !be right foreann suuests that the
da:eovd wu bowxl arowld!be time !be injuries wen: inflicted; at le.asl 20 Jql8I'tie and
dlslinet blWlt force injurles are observed. Toxic:ologic8lleSting was Iltptive for ethanol.
CIJboxyhemoalobin. cytnide IfId dtup of Ibusc. Atropine (I mediCllion used in
resuscitltion procedurt:s) wu dd!ll"tf1(\ but lIOl qu8lItiLIted in the blood. The llIUlnCl" of
dC:lllh is homicide.
(b){6)
(bU6)
(b){6)
(b)(6)
Medic:8J Euminer
MEDCOM 0651
ACLU Detainee DeathII ARMY MEDCOM 651
..
FINAL AUTOPSY REPORTI{b)(6)
8TB MOHAMED, HImtd A.
PapUoC14
APDENDtlM 1: NEUROPATHOLOGY CONSULTATION REPORT
(PAGE 1 OF 1)
Thlt mall:rial wu reYiewecl in conferenu on I JIlIl 06.
BBin, IlIlOpIy: Multifocal tnllJlllle iQillria: I.HelllOrrllqic: contusions, -.ute, right orbitofronW rePon.left inferior tCllIpon!l)'IUS.
biIatcnI occipiw Iobe:s, IlJId bllatetal
c:erdldlar hemispheres.
2. SubarKbDoid bmlCmMIC-, KlIte, diffUse.
J. Subdur&l hera.tom.a, aeute, \cft temponl
n:Pon.
4.
_.
~1m>tiJ,
mild.
S. Hypo:Ucf~dIanaa.
We examined the approximately 1350-gnm (onnaJia-fixEd bniD .ubmittcd In
tefere~
10 thb
Sllgbtly IlIherenl subdwallJemonbaae It IlOkd in the ami o(the left temponllobe.
SlIbuaehnoid he:IIlOTTbIIC is pl'CSClllovcr the convexilies of the ~CRInJ buabpbcres.~,
mild gyraI flaaeniog and suJcallWlOWin& ia DOled ova both tm:bnl hemiJpberQ: lllhcfwiH.
the gyral pIIt1m1 iJ normal The cnnial DerveJ 1ft; ummarbbk. The drelc of WilUs \OIlS
disseded from the hue or!he bn.ilI and fQlllld 10 have. normaIllhaIl cDnfIluntlOll without
IlI\CUl)'SIIlI, 'ianifleant athaolclCl'Oli., or sites of occhaion. Cortical cootUliON '"' IckIll1fied u
follows: • 1.5 x 0.8 em lesion inyolving the righlanterior I)'IUS rectuJ IlJId olflldOry wIelD with
foeaI cxtmlion inlo the mcdill, inferior frontal pole; I 0.1 x em contlUKlft on the riahtorbital
.un-;. I.S x I em Inion on the io&:rior-latenl Jurfxc oflhe left inferior 1emporal prot:. Ii
x" em left o«ipitiliobe lesion, which Clcte!IdJ inlo the occipital pole; multlfoul eolltulioal on
the riabl occipilal pcMe. RIlJiD& In size froo1 0.4 em to 2.0 ell1: .) I[ 2 em left eerebdlu bIon;
and ." lC 2 em right I;<:n:bellw eontw:loa. There ill no oidmu orlOllSillar, uncal, Of ~ralciDc
herniation. The braiNtem is UIImIIllktble.
0.'
MEDCOM 0652
ACLU Detainee DeathII ARMY MEDCOM 652
.'
Par 13 ott..
FINAL AUI'OPSY REPORT: (bH6)
BTB MOHAMED, Hamed A.
ADO£NDUM 1:
NEUltOPA11IOLOGY CONSULTATION IlBPORT
(pAGE10F1)
Serial coronaI-=tions of!be eaebrwn eoofum!be presmce oethe prniouIly cb;ribcd
emtuJiom:: otbuwise, the eortieal ribboo iJ ohonnl1 thick""" Wl:1I delllUQ.1Ied &om subjacent
....mit; mllfler. A £oeaIlla of dusk discoJorlI1iOll b icknliriM in the medial kft occipital Iobc
eerdlraIconu.. Myelinaliorlls normal. TIle woaicular I)'IlaIl 11 nomW lh&pc md 1Iiu. The
baAl pnall.. bJpPOUDlpi. thaJImi, and hypothaillDlllllZe Wlr'eIlWbbIe. SerialIeClioning ortbe
ccrebclllllll malt difl'use dusky diJc:oJontion of the folia IllId eon1imlJ the pt:seoce of the
preYiously ckKribed COftflllioM.1be subslentit nip and l~ cml1C11S IR llOnDI1Iy piPJtl1\ed
f« ap. The aqueduci iI; "it-like. The IpinaI. o;ord iJ not 1UbmIttcd, but the uppc:rmost c:emc.I
cord and cervicomcdullN}' jllllCtion ate IWelIWbble.
SlD:II.muyofmkroxopic .eaiOI1I: 1. Ri&bt II}TW I'CIctm conlUllon. 2. Ri&hl orbit&l·fuwaI
CDftllIlIioa.. 3, Ript superior &vntaI1Yf'IS lIlbuxlmoid ht:monba&e. 4. W nrperior parieW
~id hemonhqe. S. Left inferior Iallponll)TUS contusion. 6. Left occipilallobc
contusion. 7. Ri&bt oeclpitalloOe (:Q!\(1.IJiolI.l. Left medial occipital iobI=. 9. Left
uudar.e/plltamen. 10. Ldll"""mrnJaJobui palUdus. 11. Tha1&m\ll. 12. Ldl. COtpIIS u1JoNm mil
periventriculu ttea. 13. Left. bippoelll\put. 14. Midbrain. 15. POllS- 16. CerdJeJlIIID. 17. Riabl
embcllar cont\lSIOD. II. Lett ctrtbdlareontusion. 19. Medulla. 20. Ctrvlcomcdullary
jllIlClion. 21. Dun.
The. tiu~ wu poecsscd in puaffm; a lOClion preplJed from eath pIl'Iffin block was stained
....;t!l Ht.E.
MieloJcopie I«tions frolll tile If,I\ dura demoll$l1Ml intact Rod celli on the IUbdlll'l1.umee,
consiltCnt with ILlI acute lubdunl hrll)()rrlIap. Sections from the risJrt lUpCrior frontal 1YNI,lcft
nrperior pu1eW lobe, mamllllr'f body, kft inferiortempon.llobe, cerebellum, and bninstem
Ihow Intad red celli ~thout III u.sociatcd infWllm.1or)' ree.etion wilhiD Ihe leptomeninges,
comlpOndina 10 tc:ute lublncllnoid bealOlJba&c.
Seeti04l from lite rlabt Olbital-&oDtaI reaion. left tempond lobe, and bil.ters! oecipitLllobes
demonJtn.te Il:ute heUlOlTbl.e and ncuolalion ~thin Ihe ccn:bnJ tortex, ccmJinenl with .cute
~ COlltl1lions and usociatcd edem•• Sc.ttered hyperm;sinophilic neWOllJ are noted, which
are Indicative ofaeule bypox.lcJIldtemlc oewonal IzUUJY. Rare Hirano bodies and
llJ'IIlulovlCuolu dcaeneratlou are identified in Ihe left b1PPOCIlllpuJ. collli.lmi with nan-specifie
lICurodc,CflCrltive elwtaes. ArtcriololClel'Oli. ~Ih auoclaled ICartered perivQCU!ar
hcmoIidcrln·llden InIClOphiael ill1so noted.
MEOCOM 0653
ACLU Detainee DeathII ARMY MEDCOM 653
.'
FINAL AuroPSY RKPORT:I<bj(6)
BTB MOHAMED. HarMd A.
J
Pap 14 of 14
ADDENDUM2: CAJU>IOVASCULAR PATHOLQGY CONSULTATION
REPORT
(PAGE I OF 1)
DIAGNOSIS:~)(6)
nNAL DIAGNOSIS
lRe...t, pc..1 _n_ eumlDadOD: Snere corollary .tberoKienllb, twa Vealet
diRue, 90% lummll D.~IDI ofp,...dmaJlefllllt.rillr dl'#f:lldlD,uttry wltb baJed piaqui rupture
_lid 75% IlalTOwlJl ofpro:dma! rilbt CORII..." artery
HUIoQ': ll8lli maJe detainee, date of birth 1ll\known: stemaI and rib £racI.ures, rule oul myocardial contusions
Hun: 425 pnJ;!'IOnna! epiaudial fat wilh 110 eonIusions seen on \he external surface oCtile heart; closed
fOlmlen ovale; normal ean1iac clJamber dimen.sions.: lelt wlitricular cavily dillTlClU 30 nun, leA ventricular free
waJllhianess 14 nun, ventricular septum thickness 14 nun, right ventricle thi<:kncss4 nun, without gross ~
orabnormaJ fat infiltrates; valves &lld endoeardium lJ05'Iy WlI'emarbble; no IJOss myoo;ardial occrosis or
fibrosiS; histologic scetioT15 show mild left ventricular myocyte bypertrophy wilh foal! intentitilll and
replacemenl fibrosis, focal myotiber disamly aM rare basophilic degenel1ltion ofmyoeytea;
Coronary ll1erics: Nanna! ostia; righl domin4ncc; focally severe eoronlll)' lltherollClerosis
Left IDlerior de5tCn<llng Irtel')' (LAD): 90% IlIrTOwing of proximal LAD by fibroea1afic pl-.que with healed
plaque rupture
Right OOI'OIllU)' anery (RCA): 75% narrowing ofprollimal RCA by fibroalheromatous p1aqur;
I"H"
_
~
SWfpathologist
BIocU ucIo: 7 {S bcM, 2 ~ onmal
Slides .....: 9 (7 HaE, 2 MOWI)
MEDCOM 0654
ACLU Detainee DeathII ARMY MEDCOM 654
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MEDeOM
-~-"--""_.-.",
06~5
ACLU Detainee DeathII ARMY MEDCOM 655
J
ARMED FORCES INSTITUTE OF PAl110LOGY
~
cllhe Armed ForC't!l MedIal E,umlnCf
141) R~h Blvd., Bldg. 102
R()("kvilie, MD 20850
301·319-0000
AUTOPSY REPORT
AINOPSY Nt> .Jb)(6)
AFll' No_:~b)(6.L
N.....: RAZZAK. Abdul
I$N: 1(b)j6)
Rank: Ch-,n..
Datc of SInh: pN ~"".. n
Da,e of lle:olh: (b){6) 12007
Place of ~I": Na,·.l Hospi,.1 Vuant""anlO a.y. Cub.1.
}'Ixe of Autop~y; toI~vall{mpital GWIJIl;analTlO Bay. CUN
1
Dol,e IUId lime of AUloPSY: 30 Dt:c 2007 11:00 AM
o..le of Report: 20 FEB 2008
ar<um~tIInce. of Dutil: Thjj delaine.. .uccumbed to 11l\lIli.. y.<Icm orpn f.'I= COlnphc.tin,
IIlI'h..l:ol;c colon <arot'cr despite appropria", lldjm'am 1JIer.py
Authorizarlon for Autopsy: Off"", of II", Armed Fon:es MediCllI l.'.xanuner. lAW 10 USC 1471
hk"tinntlon: I"",.,mptj'e
'ime of apPfl=hrluiotl
identtl~
i. c~.bli.bc:d b~ CQI1IU.UOU' 1OO.t1'C"",1'l« In cu,tody from
CAUSEOI'DEATH: MULTISYSTEM ORGAN I'AlLURE DUE TO
CAR(.1NOMATOSIS
MANNEN OF DEATH: NATURAL
MEDCOM 0656
ACLU Detainee DeathII ARMY MEDCOM 656
I
Al"TOPSY R.:POU (b)(6)
'1tA7.1... K.A ...... J
(b)(6)
1
£xn~RNAt.
eXAr.UNADON
The body is lila! of I IIOImIlly dt~cloped. Cach«IK apptarin. male. 65 inches
1000g, ..-eighing lUI cSlimwcd I 10 pound). :wi older in llppellflll\CC than the recorded age
or 60 ye;ml;. Uvidily;s pMlcrior. Rigor;s resol~ing. The body Is cool 10 touch.
Gray-bliICk hair up 10 1f2 ineh in length coven lhl: lICaJp in lhl: usual fN.!e p;<ucm
of dlSlfibulion. The l>Clerae ~ iClCrk; tile irido ~ brm...n; and lhe pupils ~ round. 0.3
em and eqllal in dilllXler. The U.lernal alJditorynnals ~ clenr: lhc CilfS ~
un~rnarkable. The nares ate JNllcnland lhe lips Ilfe atnwmlllic. The nose llIld nw.iUx
au p.a]po:bly Siable. A gray-black rTIO\lSlachc and r...Il beard are present. The reeth are
worn, and a proIilhodonlic applL.nec is approprilldy posiliontd whc~ letrh att missing.
The neck Is Slraight. aoolhc Il1lChea is midline and mobile. The CheSl is
symmeliie'. The abOOlllcn is M'aphoid. An obliqlldy orienled 1·1f2 inch )(:..... 1s nOIe<l on
lhe ~llrfllC'C of lhe rithl lower abdominal qu;U;!rlllll. Addiliol\lllly. grouped petechiae arc
plesenl OVCf lhe rig.hl Icw.·er qlladr.IDl. GI'CIU]lC'd pelcchiat lIK also presenr over lhe b:.o::k
and are aagrcllll.ed into lhrec: larlc gl'llUp5 ranging fro<n 2" I inch lip W 14" 5 inehe!;.
Wilhin lhe JIOOps. pclCChiat VW)' in configunuioo fro<n indivtdulll pllllClllle lesions 10
CQ;lICSCenl foci. The lCnilalia are lhl1<e of a nonnal adull circurnci!>CCl male. The leSld
we descended and f~ of 1na.'I$Cll:. Pubie' hair is "",senl in lhe llMlal tn&Ie di~lJibulion.
The buuocb and anus ~ un~m..,.kable.
The uPf'C:r and Icw.·cr CJ.lremilies are ~ymmelric. PClechiae: DIC prt'scnl in lhc left
anlel."Ubllal fmu. "The'" Ill'C 1M> pollpablc c.:ords in the poplileDJ foss:oe. There is mild
edc:ma oflhc hands and fcci.
CWIIlING AND PERSONAl. EffECTS
The following clurhin, ilcm~.nd pet'SOl'lal cffects lII'C presenl on lhe body 81 the lime of
aUlopsy;
M£P1ql.llflll'R YENIION
Sile~ of EKe; lelld placement shaved
EKG leads approprialcly lkployed o'~r lhc precordium
Inll11venow; accC5.~ ,ilt. donal right IIan<I
Pre.umpl;'·c "enipunclllIC silt ",hi ~nlecllbital fOS\:ll (Iupcd 2" 2 inch I_UK
sponge. right anlCC\loilaJ fOS$il
Hospital idenliflCation balld on lefl wri~l
HOlopilal idenlifh;alion band on ri&hl ankle
Medical chan enlries docuRlCntin; inpatienl and outplllienl ca~. including
chemothernpy
F(N" pain and nausell conlrol agcnl~ idenlirrcd. ~ '''o"icology''
MEOCOM 0657
ACLU Detainee DeathII ARMY MEDCOM 657
4111nPO;;V kEl'OIlTi (b)(6)
(b)(6)
(kAZZAK.Allololl
)
Bc\PIOGBAPIIS
A rompklt w offlOlilmonem radlogJBph$ i.'Iobulined. The resul~
findinp described he~in.
~ con~i~teru
with the
INTERNAL t:XAMINADOS
HEAp:
The g.:llullllld l>IJbgalell lIOfl ,i,;suo. of ,he scalp I~ flU of injury. The calvarium is
;ntlKl. L';5 tbe dun I11lIter benelllh n. The: ce~bnJ blood ves~b are un~nwbble.
Clearcerebmspinll! fluid sU!TOUllds lbc 1324 am bl1lin. ",hich has unremarkable gyri and
wid. Coronal KCIK!n~ dcmon~lrale ~h;updc,"art::U1on belwccn "'hite and grey mallei".
wlthoul hemorrh.:r.~ Of eonu,l.,h·e injllry. The ,·enlrkk.':In of noona!.ize. The bas.oI
gJ.ngJia. btainslem. ~rebeJlllm. IllId anerial 5)'l1lems _ free of injllry 01" Olher
abnotmll!ilies. There art' no .lrull fral;1ul"e$. The allllntO'«Cipilal joint is 5lahle.
liliJ\'
On I_yer·w;lie di.li«lion Oflbe an,erior and pos'erior neck. there i~ no helnormage or
OIbcr evidence of Ir.:lllma. The anterior ~l1lP muscluoflhe neck are homo~nous and
rcd·bro.. n. ThI: lhyroid cartilage and hyoid are inlllCl. The l~ryn~ is lined hy inUIC' whi,e
ml.lC()Nl. The lhyroid i~ symll"oC1ric and red·brovo'n. wilhoul c)"lic or nodular change. The
lon,Uoe " free of bile marks. hernon-Mge. or other injuries..
BODY CA V!IJES:
The ribs. Memllm. and veJ1ebrnl bodies ~ visibly llIM! palpahly miXI. Then: are 40 ee of
Sltllw...::okJred fluid i'llhe nlhl p1eulll! ~pllCe IllId 60 oc in lhe left. In e~ceSli of 600 ce of
nllid is found in the periloneal elvi,y. There is no uceu nuid 15 in,he perieardial 5Il(:.
The orgaru occupy their 115ual anutomie posi,ions.
RESPIRATORY SYSTEM:
Dcn.'iC adhe.ions envelop lhe: lungs and tether 'hem to the pIlnelll pleural surf;ICCS. "The
unl!erlylnglung ,ur(lItt. _ heavily anlhl'llCOIie. The lung, _ markedly c:delnatous
with deep purple congested Clll surfaces: the right lunllwdgh, 1145 gm. and the len lung
wdllh' 782 1m. Nodular dcnsiliu desl:ribe<l K~ being seen in clinical (pre·mortem)
imagin~ r.ludie~ are 110' evidenl &J'OSsly.
CARDIQVASCULAR SYSTEM:
The 270 J:m hean i., conlained in an ;nUII;1 pericardial 'IC. The epicardial surfllCe is
SmOOth. ",il h mini mal rat inve.<tmenl. The coronary arleries are present in a nonnal
distribulion. Wilh a righl·dominanl pauern. Cross !iCClion of the "C!;\oCls shows nelillgible
foo.:al nlhC'rumatou, narrowing. The myocardial CUI surface is uniformly d'lfk brown. The
valve leafkts are thin and mobile. The wall. oflhe left and righ' ventricles 8rc 1.0 and
0.3 em thick, respectively. The endocardium is smooth and gJi~ll~ninl. The liOna give,
ri'IC to lhrce inlacll1l1d patent arch \"essels. The renal and mesenlerie ves!\Cls are
unremarkable.
MEDCOM 0656
ACLU Detainee DeathII ARMY MEDCOM 658
•
AUTOf'SY Rt:POn(b~6)
C....,.MIt.AW..}
(b~6)
LIVER &. BILIARy SySTEM.
The J400 gm lher is markedly discorted by muhiplc JIllY laIInOOular 1l13SSeS. ranSi!\!
from less Ihan 1/16 inch up co 7 indieS in ma~im<l! dimension. The ~.,jdual hepatic
parcnch)'1TlY b foolly <,omp.-essN "Ill illlillCd yellow. Tbr gYllbladdcr rorllains a 50 cc
of ~iKOU. ,IUn·black bil~. Therc are no SlontS. The mucosal surfacr IS l',I'ttn and
''eI,'C'IY. "The ulrailCp;uic biliary tree Is palenl.
$IUEN:
sm
Tbe 108
~plcc:n lias a lhick~ned nbrous capsule ....·i!h foealg/lY lin diseolord'ion of
lhe uwal rcd-pu'1"lc 1.'1lPSlll~. Tbe pan:no:hyma is maroon wid eonge,~led, ....ilh dislinct
r.hlpishian oorpu...clc•.
PANCREAS;
The plIII4ttaS is firm ~nd yellow....·ilh prominent lobulalion .. No mass lesioos or OIher
.bl>Urm.Jili~
arc ,o,e.en.
AQRENAJ.5;
The righl and Idi adrcnal gill/lds un: symmelric.....lIh brighl yeHow conic.:., and gre)'
llIeduH!OC. No muSC>. ,,, 1Q'el<., nr hcmOn"hqc arc identified.
GENITOURINARY SYSTEM:
The righl and left I;jdncys w~igb 120 and 130 gm, re'jlttli\'c1y. The ~xlemaj sulfoces ate
inlllel and >IllOO1h l'ACepl fur. 0.4 cm cunif;.l C)'lil Of,he riShl kidncy. wilh red-tan CUI
surfaces. unifonlll y 'hick con ices and sharp oonicon'edullary junctions. The pelves are
unremarkable and the urclers are normal in course: and caliher. Whi,e bladdcr mucosa
overlies nn ImllCl bladder wall. TIle urinary bladder conl.ins less lhan 200 cc nf clear
amber urine. TIle pro,tnle is 1I0rlllai in .ize.... ilh lobuJIIT. yelloW-Ian parenchyma. The
~min~1 w,ides arc unremarkable. The leS1C5 3rc free of m:'<;I; ICloions. coni usions. or
other allnormuHlil'.,.
GASTROINIESTINAL TRACT:
The csoph&sus i~ inl!IC1 and lined by JnlQOlh. srey·while mucosa. The stomach conlains
in <:Xc':", of IOU cc ofp~lliallydi~sled food. The gawk ...·all is inlaCt. ~ duodenum
lind loops of .• l11ull buwel are unremarhllie. On $eelion orllle n:cto·,ignloid colon. a 1.9
em tumor 11111.'5 is idcmified 00 lhe muc()e<a' surfilCe It!Id gro~sly appears 10 eXlcnd into lhe
'urmunding pericol Ie lissue. and includl'l' a firm 1.4 cm nodular Sll\lClUre grD!:sly
consi-'lem ....ilh alympll node. The remuining coloo Is unremart.able. The appendix
appean; 10 have. betn ~iilily ampulaled in lhe relTlOle pa~1.
MUSCULOSKEI EIAL SYSTEM:
Muscle de"elopment is nnrm.l. No bone or joinl
MEOCOM 0659
.bnoflllalilie~ lITt
noted.
ACLU Detainee DeathII ARMY MEDCOM 659
,
-.Al!l'OPSV REI'ORrt(b}(6)
(b){6)
IRAZUI'. "'Wull
MICROSCQPIC EXAMINATION
CsAIIllI NtQoo\ S"l£m (>Jill."
~
"'- tI):
No sil!nificam hi5lopathologic aJlerauOfl
II:
Me1aslatic adenocarcinoma. moderJte-to-poori y differenlialed
Ww{·,Ii<J~
H;l!IollllOl1iqic- l,ymnbujJ inc! Sn!cgJ (,liJt. ~ ol:. .1):
I.
Re~onall}mph node pDiSilin for Mda'llalN: adon""a",inoma, ",odon>t,..toponrly diffol'1'lltialo<!
Splftn: no .'Ifgnillrnnl hisloplltholOl\N: aUrnuion
GI"ntlOI~\I!n.J
1.
2.
(,lido. 1 "'- XI:
Rt<::lo-.lgmold colon (sile 01 primary Inn......): modenlle-Io-poorly
dirrenntiatf(\ "rtolKl('llrrinoma, with ~1'lI:Sion IOIll perkollr adlpo<e tissue
G ...I..... lnl<'Sl1natti.,.lH' nrnolt from prim.ry lum<lr:
a.
No slgnitkant hlslopalholOl:If allorallon
b.
Diff"• • lIlolytit dwnge
lk.1a (,lick J):
No significant histopathologic alleral;on
i.llnl: 1,I~lr
~):
No significant histopathologic aheration
CA:0;N'UflDOO' (1);
No significant llistopathologic alterJlion
lindoM... ()IiJ< 7):
No .i!!.nificanl 1I~"10p.lllologic aheration
ADDrnONALPROCEDURES
I, Documentary pllOlogruphs arc taken by QAFME sUiff phOlograplltr!l.
2. Specimens ~tair.ed for 10J<ioologic lcsling and/or DNA idcnJification Url:: \'ilrl:O\lS
n"id. blood. bile. gastric contcms, uline, bruin, lung. liver, kidney, spleen. ~keletal
muscle and adipose lissue.
4. The disse<:ltd orgalls are forwarded ""ilh body.
S. Personal dfect~ are relea<;<:d 10 the upprop'iale rnonuary upcr:uions rl:prcsenI81;"'CS,
MEDCOM 0660
ACLU Detainee DeathII ARMY MEDCOM 660
6
AUTOPSY DIAGNOSES
I.
Evidence of Multi·system Organ Fallun
A.
Hepatic failun:
1.
Scleral iClel\l.~
2,
Fealllres "fbleeding dial~i§
B.
CirdillC failure
I,
Edema of hand.> and feel
J.
2,
II.
A.
B.
A~ile_~
Bilateral pulmonary effusions
PrImary Colo-rectal Tumor
Tumor: 2.9 em in maJimlll dimension
TUmQr extends through mucosa ;nlO I"'ril"QJiC fal
C.
D.
Evidence of regional lymph node involvement
Stage IV: n. NI. M I (AJCC 6'" edilion)
IU.
A.
B.
Melasllltic Tumor Spread
Multiple liver nodulQ identified al po!'tnl<ll'l"rn u.lIm;nal;OI'I
Clinical (rudiogr..ph~) eyi1k~ of IMlastalic tumor nodules in the lungs
IV.
PTe·existlng medkal Conditions
Multiple den.-.e pleural adhesions. bilateral
V.
E."ideo"e or Medlcallntenention
A.
B.
C.
D.
E.
F.
G.
H,
VI.
Sites of EKG lead plocemenl ~hayed
EKG leads upproprillleJy deployed Over the pn:oordium
Appropriate EKO lead placement
Intra"cnolls aeee.'~ ,ite, dor.;al right hand
Prt.\.umptive venipuncture site right ante<;ubital fosSll
Hospital identification band on left ""riSt
Hospital idemificlllion band on rigtll ankle
Medic:ol chari entries dOCllmeming inpatient and outp~tient care. includin£
ehemothctllpy
Identifying Ftatures
A.
Well healed surgical scar. right lower abdominal quadrant
B.
[)cnwl bridge n:placeI> a:cth 7 - 10
MEDCOM 0661
ACLU Detainee DeathII ARMY MEDCOM 661
.o.lrrnpsv REPORT (b)(6)
IrRA1.7AK.AMUI)
(b)(6)
1
VII.
Toxlrology
A.
Blood IIml vitreous lire neglluve for eth:mol
B.
Urine w~~ ~creened for acctalninophcn. amphelamine.llntidc:pres:s.ant5.
antihistamlnei. barbiturates, ocnzodiazcpines. eannabinoids. chloroquine,
cocaine, dexlmmcthorphan, lidocaine, narcOlic analgesics. opiatc.~,
phencyclidine, phenothiazine.., saticylates, sympathomimetic amines and
vempamil by gas chrom"togr~phy, color test or immunoassay. The
following drugs wen:. detected
I.
llCetluninophen wa~ detected in the urine by immunoassay and
oonlirmed by color test. No acetaminophen was detected in the
blood at a Hmil of quantitation of 5 mgfL using immunoassay.
2.
oxycodone WaS detected in the urine by immunoa~ay and
oonfinncd by gUi chromatography/mllSs speClromc:u)', The blood
contained 0.10 mg/Lof oxycodone as quantitated by gas
chrornalogrophy/mass spectromelry
3.
oxynJOtphone "'lIS detected in the urine hy iml11unOl1Ssay and
confimlCd by gas chromatogt:lphy/mass spectronlCtry, No
oxymorphone was detected in the blood alt limit or quantitalion or
0.05 mg/L usingg:.L\ chromutog..~phy/m:.L~ spectrometry
-I.
mOlphine was detected io the urioe by ilnmunoassay lind
eonfimled by ga' chromalogrilphy/ma.ss spectrornctry. The blood
contained 0.3l'i mg/L or morphine as quantitated by,l',al;
chromlltogIllphy/mass s~trometry
5,
pronlethaT';nc. was detected in the urine by gas chromatOgr.Jphy und
COnfirmed by gas chf'l}matographylmll.~s speclromwy. The hlood
contained 0.25 mg/L or promethazine as quamitaled by ga'
chronullogruphy/mass sp«:tromelry
Vll
Post-mortem Changes
No sis:nificam posUTlOrtem change is noted: mild postmortem changes consist of
ellrly corneal clouding. resolving rigor and postcrior fixed lividily.
MEDCOM 0662
ACLU Detainee DeathII ARMY MEDCOM 662
,
OPINION
[(b){6)
Isuccumbed lU mullisystem urgan failure due to
diSSt:minared careinomal0sis. His liver W~~ llhnosl lwicc: lk ma<;.S e:\pe<:lcd fOT a man his
size. and consisted predominantly of metastatic tumor nodules. Com:spondingly,
features of livcr failure were prominenT at autopsy and consisted of jaundice, ascites and
features of a bleeding diulbesis. Smaller tumor dl:pOSils identified on clinical
roentgenograms ""ere nO! detected at the postmortem exam. His last .O\lnd of
chcmolherupy was on the 13" of December. While it is dimcult (0 8!.SeSS the toxic
poIcmial of lhe decedent's chemOlhcl1lPY regimr::n. it is very clear. both from tile
c~lensi I'e tumor burden and from the critical organ systems affected. that the
uver"hel mingly preponderant causal factor in this lnan'$ <kalli was carcinuma. The
le"cls of analgesic and antiemetic agenu idenlifled 011 toxicologic unal ysis of blood and
urine indicate thaI all rcaoonahle effons ",-ere made to control pain and nausea. Tbe cause
of dealh is muhisyslem organ failure due to carcinomau::'iis. Thc manner of dealh iii
na!Ur~1.
(b)(6)
(b)(6)
]MCdical Examiner
(b){6)
MEDCOM 0663
ACLU Detainee DeathII ARMY MEDCOM 663
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(b}(6)
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MEDCOM 0664
ACLU Detainee DeathII ARMY MEDCOM 664
,
_T'CIiO<lf'_
•
(b)(6)
_
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MEDeOM 0665
ACLU Detainee DeathII ARMY MEDCOM 665
ARr.tED FORCES INSTITUTE OF PATIIOU)GY
Office of the Armed )'OIUll Ml'dkal Examiner
141 J Researcb 81\11.• Bid,. 102
RQI;;hilk. MO 208.50
301·)19·ססOO
AUTOPSY EXAJ\DNATION REPORT
AUlopsy NO.:,(b'"C6CI
~
AFIP No.: ~)®
[)-~le of BII1b (b)(6)
1979
Rank: Civilian delaJI1e'e
O;uc of DeDth:(b)(6)
2007
P18tt of Deatb: ~
[)-~tetri",c: of AUH)P~;Y. 28 OEC 2007 1030 to 1400 P1:lU of Autopsy; Pon Mortuat)'. Dover AFB.
Niln\t: AI Alw"ni, 1lIllir Hamid Khalaf HllS'IlIn
CCN: (b)(6)
Do"CT, DE
D:.tC of Rcpon:
l)
JAN 2008
C!r<ou"""lanc:eli o! t>elllh: This 28·yellr-<lld "h'ih:on iJelDinoe wti reporledly lalled hy ~mllllllfTflS
fire while bcinlf lI1V1~por1ed in D mine rc:,i~tant lImMh prot«'ll'd vcltide. During this If:m~plll1.lhc
ch,liDn lktain« rc:porla1ly Jl1:lbbal an M4 rine: III1d fired one: round below the ~n are" of a
\1urinc:. 11>c Marine .... 0< not struc:k yet rc:,""vcd hi~ 9 mm pi~ol and shot the: ciVIlian dctainc:c. AI
the unM: of b;~ dealh. the cIvililln detainee """; reponedly IkJl l'UlTed in the fronl lond blindfolded.
,\ulhorlutk>n fO( Autopsy: Armed Fon,'es Modical Enminc:r. pcr 10 U.S. Code 1471
ldentinclllkon: Presumptive idcntifKiIlion
""pcr "''Oft..
i~
esutblisbc:d by the eJlwTllnllion of accompanying
CAUSf.; Of.' Of.:A TH: Muillple CunshOl wounds
)tANNEN 0)' DF.A'rH: lIomldde
MEDeOM 0666
ACLU Detainee DeathII ARMY MEDCOM 666
I
AUTOPSY REPORTI(b)(6)
AL ALW ANI. Thair Humi<.l KhulafHa.'<SaJl
2
EXTERNAL EXAMINATION
The body is that of R "'ell-developed, welJ-nouri~hed mate. The body weighs 167 pounds. is 67 y;,
inches in length and appears compatible with the reponed age of 28 )'t'ars. The body is cold. Rigor
is passing in all extremities. Lividi Iy is presenl and fixed on the posterior surface of the body.
eJtcept in area., exposed to pressure. Injuries of the head are de:;cri~d below. The tK-ad i~
nortnOCephalic. and the scalp hair is block. Facial hair consists of a muslllChe and beard. TIle iri<k~
arc: brown. TlIe corlleae are doudy. The ronjunclivae are pale. The sclerae all: white. The eXlCrnal
auditory canals. external nares and oral cavity are free of foreign material and abnonnal secrelions.
The nasal skeleton and ma:<illu are palpably iniac\. The li~ are without evident injury. The teeth are
""turd! and in good ~ndiljon. Examination of the neck reveals nO uiden« of injury. A In. x 114
inch scar is on the righl chuk. Injuries of the torso are de.<crihed below. No evidence of injury or
the ribs or tile sternum is evidenl externally. The abdomen is Oal. Healed surgical sea" nrc nol
idcmified. '11>c external genitillia are th<»e or a 'IOrnUll adult circumcised male ..!1te anus is
unremarkable. The e..trcmities show nea\ed >([0" on boIh knee.s (righ\ 112 inch >md lefl I inch). The
fingernails are intacl. No tall00s are identified. Brown p;!p'" bag.~ arc secured Over both hand~ wilh
rubber bands.
nOTHING AND Pl<:RSONAL en'ECTS
"The clothing und pcrsolll,l effects are photographically documented.
WORN:
• Red and white headscarf (lying on the back or the head)
• Olive ooloredj"det (cut)
• l..onl;\ gree~ shin that e~le~ds to the leg:; (cut)
• Blad ~hin (cut)
• While t-~hin (CUll
• Black t·shin (CUl)
• White lank top (CUt)
• White boxers (CUI)
• Gray pauts (CUt)
•
Black soch
•
Brown sandal (right (00l)
ACCO~PA~YING:
•
•
White ncx cuffs
Brown )and,,1
• 11",," .", "'''IIIpl" <10(""" uk"L1fl<'l! <0" ,h. """,I>,,:,,,r. ,I"n, ."d "'''''. Bull.. ,..il'" .$ .... "
",.(,,,", OIl ,I>.: I..,:>.be.. r. No doro"]','" "." d"I"'>" .... "r o"t>uo""d JO""".. * , ;, ...'Cn.
""''''''''ed ""lIh """'" <lr ,hi:
MEDCOM 0667
ACLU Detainee DeathII ARMY MEDCOM 667
AlJTOPSY REPORTI(b){6);-;;",""
AL ALWANI. Thair Hamid Khalaf Hll>san
,
MEDICAl. TJ'I,TERVENTION
•
None
RADIOGRAPHS
A complete set of postmonem •.uliogrdphs i~ obtained. Injuries seen radiog....phieally are
incorporated into Ihe Evidence of Injury section below.
EvrnENCE m' INJURY
The ordering of the following injurieb i~ for descripli"e PuI"JlO!'CS unly. amI is nut intended 10 imply
urder of inflietiun ur ",Iative severity. All wound pmhways are given ",Iath'e to standard anatomic
position.
PERFORAnNG GUNSHOT WOUND OFTHE HEAD:
En1rdncc;
On lhe right ~ide oftllc head. posterior 10 Ille righl ear. is a 1/4 inch circular elltrlllll:e
!lun,hOl ....ound. T1Ic edge~ of lhe ....ound contain multiple fllle IltCeralion.~. TIlere is
all eccenlric marginal abrasion lhal measures lip to I/ll inch on the amerior border aI
the IWO 10 four o'clock posilion. There is aJ50 a 112 inch poorly fonned and faim
abr..sioo extending from the IWO 10 foor o'clock position of the anterior border. The
wound is locmed 3-JI2 inc",",s below the tOP of the head and 3-3/4 inches to the riglll
of the po.\lerior midline. No.-oat or gunpowder stippling i~ iden1ified on lhe
surrounding skin. (A section of this ....OIlnd is submined for histologic examination.
PJca5C .""" the Microscopic EXllrnination section below.!
Injured;
The right lemporopariel.RJ scalp. righl temporoparietal bone~ ( 112 inch defect Wilh
inward be,·ding). righl occipital lobe of the cerebrum. cerebellum. occipil"l booc (I
x 112 inch <Jefeet ""Jih oUlward beveling). and occipital scalp on II>c left side oflhe
head arc injut"Cd.
BlOt:
On Ihe left side of lhe head. posterior tultle left car. is a 112 x 1/4 irlCh 11I(.'erdled exil
gunshot wound iocated 5 inches below lhe lOp of lhe head amI 2 inche~ 10 Ihe left of
lhe poslerior midline.
Recovered:
Two copper colored melal jockel fragments are reoovel"Cd from the head scarf. One
copper colored melal fn.gment and one gmy colnred metal fragment is recovered
from lhe inner tahle ofille lefl.~lde of11le occipital bone, One copper and gray
colored me1al fmgmenl i1 recover«! from the righltemporal !leaJp.
MEDCOM 0668
ACLU Detainee DeathII ARMY MEDCOM 668
AUTOPSY REPORi(b)(O)
]
ALAloW ANI. Thair Hamid Khalaf Hassan
Trajectory;
The bullel lrajeclOry is righl to ief!, slighlly fronllQ back and slightly downward,
Associmed lnjurle~:
As-wciatc<l is diffuse subarachnoid hemorrl1age, ~ubgaleal hemolTllage of the rlght
<U1d left side of tbe $Calp. and linear fractures of the occipital, right tenlporal and
rillllt panetal bonc~.
PERFORATING GUNSHOT WOUND OF THE TORSO (RIGHD:
Ell1r~nce;
On the right side of the cllesl is a 1/4 inch cireular entrome.: gunshOl wound with a
concentric 118 inch marginal ab",,~ion. The wound mnegin appears dmk and dried.
Dnd there is a ~light red-purple dio;coloration of lhe ~kin immediately 5ulTO\lnding llle
wound. No definili,'c SOOl or gunpowder slippling i~ identified on tile ~kin
~urrounding lhe wound. The wound is localed 13·3/4 inches below the top Ofllle
head and 1/2 inch to the right of tbe anterior midline. (A se<:tion of llle wound is
submilled for histological eUminalion. Please sec the Microscopic Eumination
section belo",'.)
Injured:
The skin, .ubcutaneous tiss~s, right serond inlercoslal muscles, middle lube of the
rigbl lung (l/4 incl'llaceraled wound), hilum of the right lung, lower lobe of the righl
lung (I inch la~-erated wound), posterior aspect of the nimh rigl'lt rib, IllId skin of the
right sille oflhc back arc injured.
Exil:
On rile right sidc of the back (superior) is a 1/2 ~ 1/4 Inch laceraled exit wound rhat
h.a.~ an e<:<;cnlric marginal abrasion thatll1CllSlIte!i up 10 JI8 inch on lhe
medial/inferior border in the four to tM o'clock position. Tlle ....·ound is located 17In inches. below the tOP of tile bead and 2·3/4 incl>e.> to the rlghl oflhe poslerior
midline.
Reco~ered:
No e~idence is recovered at autopsy.
Tr-djeclOfY:
TIll.' trajeclOry of the bullet is frolllto bolck and downward with slight left to rigbl
deviation,
A.~socjalcd
lnjunes:
ASSOCluted wilh tbi5 wound is a right hemotoonut (1250 ml),
MEDCOM 0669
ACLU Detainee DeathII ARMY MEDCOM 669
,
,\lJTOPSY REPORTI(b){6)
AL ,\LWANI. Thnir Hamid Khalof Hassan
PERFORATING GUNSHOT WOUND OF THE TORSO (LEFT):
EntrJn~e:
On the left side of the ~hcst is ~n oval 114 ~ 1/8 inch entr<U1<X llunsh01 wound with all
ecccntric marginal abr;o$ion that mca.~ures up to 3/8 in<:h on the lateral border in the
twel> e to four o'c1o<:k position. l1>e wound is located 14-112 in<:hes below the top of
the head and I-In inches 10 the left on the alllerior midline. There i~ no liOO1 Of
gunpowder stippling identified on the surrounding skin. (A section of the wound is
suhm'lled for hi~tological examination. Please:.-ee the Mi<:roseopk Examinalion
secTion below_l
Injured:
TIl<: skin, subcutaneous tissues, second left imen:(»;taJ muscles, pericardium, heal'l
(right "entride - In inch lacerated wound. interventri<:ular ""plUm. tric::u~pid valve,
and right atrium - 112 irn::h lacerated v.-ound), right hemidiaphragm (In in<:h
laceratcd wound), Ii"cr (S illch pulpified wound of the anterior right lobe and 21rn::h
polpificd wound of the posterior right lobe), right hemidiaphmSrIl (1/2 inch Jaccntlcd
wound). ninth right intercostal Inosde and skin or the right side of the back are
injured.
On the riElll ~ide of the b'lCk (inferior) is a 1/4 inch exit wound willt im:gul....
milrgins and all ecrentrK: mnl'llin"l abra.sion that me,ISUre.< 1/8 ioch on the
Interall~uperior border (nine to ~ix o'c1o<:k po>ition), and 114 inch on the
mediaUinferior border (six to "illl'; o'clock position), l1>e ,"ound is locllted J9-3/4
inches below the lOp of the head and 5-3/4 inche.~ to tile right orthe posterior
mil.lline.
Recovered:
No evidence
i~
recovered.
Traje'Ctory:
The trajIXtDry of the bUlitt is left to rig.ht. fronllO back and down .....ards.
Associated Injuries:
"There i~ a htmopcri<:ardium [30 1111). a right hcmothor.v; (J 250 ml" and a
hemoperitoneum (300 ml).
MEDCOM 0670
ACLU Detainee DeathII ARMY MEDCOM 670
,
AlSfOPSY REPORyJ(b)(6)
Al. Al.W ANI.
Th~ir
Hamid Khalaf Hassan
HEALED SUPERFICIAL PENETRAnl'G BLAST FRAGMENTATION INJURY OF1l-IE
HEAD.
Enw.mce:
On Ihc righl cheek is a 112 x 1/4 inch well healed ."Car localed 7 inehes below ,he lop
of lhe head and 4-112 inches 10 lhe righl oflhe anlerior midline.
Injured:
The sk.in. subculaneous lissues and muscle of !he righ, side of lhe face are
Recovered:
One ilT(gular gr~y·rnclal fragmcm
lhe righl zygoma.
inju~.
is recovered from a f,brous ~apsu Ie adjacenl 10
TrajeclOry:
'11lc lrajcclory oflhe mClal fl'llgmt:m is mos, likely righllo Icfl. back. 10 fronl and
up.....ard.
As..<ocialed lnjurie<:
A"so<...iuled wilh lhis wound is fibrosis and scWTing secn on lhe righl side of ,he face.
OlliER INJURIES:
'fh(,re is 11)(2 x 1/4 inch abl'3ded contusion on lhe right side oflhe forehead aool'e ,he medial aspecl
uF lhe figh, eyebro"·. On Ihe second finger of lhe IeFI hand h a 1/4 inch linear abrasion.
INTERNAL EXAMINATION
BOpy CAVITIES;
The body is opened by the u.suallhoroco-abdominal incision and lhe chesl plale is removed. The
s!emum and "cncbI'31 bodies MC visibly and palpably inlacl. TI1e right posterior ninlh rib is
rractu~. No ~dhcsions arc pre",nl in lilly of lhe body cavities. One lhousand lWO hundred and fifty
milliiiters of blood is idenlified in lhe rlghl pleural cav;ly. 30 ml of blood is identified in lhe
pericardium. und )00 ml of blood is illenlified in lhe periloneum. All body organs we presenl in
IIOrmal anutomical po,ilion. 'Ibc subcu,aneous fal layer of lhe abdominal "'aU is I n inch ,hick.
MEDCOM 0671
ACLU Detainee DeathII ARMY MEDCOM 671
,
AUTOPSY REPORTf®{6)
AL ALW ANI. Thair Hamid Khalaf HlI.~~an
HEAD AND CENTRAL NERVOUS SySTEM:
Plea~ see Evidence of Injury. Injuries of the Sl:~lp. skull and b... in are described above. The scalp
is reflected. TIl(; calvarium of lhe skull is removed. There is no epidurul or subdural hemorrhage
presenl. Where uninjured, the leplomeninge~ are thin and delicate. Blood tinged cerebrospinal
nuid surrounds Ill<: injured brdin IIihich weighs \ 270 grams, When: uninjured. the gyri and ~ulci are
unremarbble. Coronal section~ through the cerebral hemispheres n:veal no non'll'Uumutic lesions.
Transverse seclion.~ through the brain stem = unremarkable. The atlanto·occipital joint is stable.
The ~pinal cord i< unremarknble.
NECIS.;
The: anterior Slrap muscles of the neck are homogenous and red-brown, without hemorrMge by
l"yer-wise di'section. The thyroid cartilage and hyoid bone are intact TIle laryn~ is lined by ;nt""'t
while mucosa. The tonj;ue is free of bite mill'ks. hc:JTlQrrhage. ur OIlier injuries. Incision and
di.sec\ion of thc p<»tcrior neck demOnstrates no deep p;1J'acervic~1 mu.<cular injury and no cervical
spine frueture~.
CARDIOVASCULAR SYSTEM:
See EVl(let>l.'C of Injury, The injured hean weighs 310 grams. Where uninjured, the epicardial
...,rf;l<:e i~ smooth. and there is minimal fat inveSlmenl. The coronary aneries are present in a
normal distrihul ion. with a right·doln'nant panern. Cross seclion~ or the vessels show wiele pltIcncy.
Where uninjured. the myocurdium i.< homogcnous. red-brown. and Jim1. and the valve lea nets an:
thill :lim mooile. The walls of tM \en ventricle. lnter',enlric\llur :;eplum. and rigll\ ven\lick: ~1'C I,0,
1.1. and O.3-'nl thiek. re.\pect'vcly. Where uninjun:d, the endocardium i.< .<mooth and glistening.
The aonu B:i~e.< riS/:: to three illlllCt and patem areb vcssels. The ren~J and mesemeric ,'.,.sse)" arc
unrem~rkable.
RESPIRATORY SYSTEM:
Plea~e see Evidence of Injury. TIle upper airway j, clear of debris ~nd roreign malerilll; the
mucosal surfaces are smooth. yellOW-Ian and unremarkable. The pleural.<urfaces are smooth.
glistening and unremarkable bilalentJly. Where uninjured. the pulmonary parenchyma is diffu~ly
coligested and edematous. exuding slight to modenlle amounts of blood and fJ'Olhy nuid; no focal
non-trallmatic lesion, a.rl: naled. The polmonary aneri~ are normally developed. patem and
.... ithOUt thrOlllbu~ or embolus, The injured right lung ....eighs 300 gran,s. The left lung weighs 290
gmlTl.\.
MEDCOM 0672
ACLU Detainee DeathII ARMY MEDCOM 672
AUTOPSY REPORT (b)(6)
AL ALWANI. Th.:Iir Hamid Khalaf H:LUlIn
•
HEPtJOBILlARY symM;
P1ellSC!Itt Evidence of InJIlr)'. TI1e 1480 cram liver h&.~ a smooth capsule coverlnll d~d; red-brown.
mollcraLd)' .'Olll~led p;lR:nch)'ma Wilh 110 foal non lrullrTl3tic lesions OOIed. 'The gallbllldder
OOIIt.ins 10 ml of g«n·brown. ,nueoid bile; Lhe mllCOSll i, vel vel)' and 1I1U'e1lllld;able. The
euruhepatic bililll)' Uff is JIIlteni. wilhout evidence of calclIll.
GASJRQIl\"IESTINAL SySTEM:
The esophaj:~ is lined by gray.while. S1noolh ITlUC05I. The gasLric mUC05/l i' lIlTllnged in lhe usual
ru,al fold. and the lumen con..tin, 20 ml ofpllnially digeslal food. 1lle"malllUld large bowel' are
unrell\llrkahle. The p;lncrea~ has a nonnal pink-tan lobuJaled appemsnce lUld the dvcU are dear.
The appendb is presen!.
GENITOURINARY SYSTEM:
The right kidne)' weigbs 90 grams; the left 90 &rIm~. l1lII: renal capsules lite I.lll()(lIh and Ih.n. semi·
IllIlIspout.nl and stnp lI.. ith ease from.he lJJlderl)ing St1lOOlh. red-brown conical slInace. 'The conu
I, sharply deline;oted from the mccillllary pyramid>;..... hich are red,pulple 10 IlIn and unremarkable..
'The tal yee,. pelves and lIfeIefl< Ire unremarkable. While bladder mUCO\oa ()\·crlie.~ an il\laet bladdff
wall. The bl:Mkler conla;l\l; appl'Ollimalcl)' SO ml of tic'" yellow urine. The le~. proslatc gllllKl ;uK!
scm,"ul '"Clooclc::s are will\olrt IlOIC.
LYMPHQRETICULAR
SYSTE.Y:
The 170 grwn <pkCD hmi I SffiOO(h. intaef capsule OO'o'ering red·purple. modenold)' linn
p;trenchyma: the lympliGld follicles are IInrem:ut.able. Lymph nodes in the hilar, periaonic;l/l(j Hille
regioo, Ill'C IlOI enlarged.
ENDOCRINE SYSTEM:
The plll1iwy &land ii e~BmiQed il'l )ilullnd;$ unremarltablt. TIlt thyroid gland is symmt1ric and
red-brown. WilhoUl cystic or noduli' chlnre. l1x: righl WKIleft adrenl1ll:1ands;m: syrnmctric, willi
brighl )'ellow conices Ind reO·b!'Ovo·n meOulillt. No ma.. .'les or areas ofhernormBge ~ identirltd.
MuscuLQSKEbETALSySTEM;
/110 non·tr,wmBIK: Ilbnormalnies of mUliele or bone lift idenufitO.
MEDCOM 0673
ACLU Detainee DeathII ARMY MEDCOM 673
AUTOPSY REPORTr(b){6)
]
Al ALWANI, Thair Hamid KhaiafHas.un
9
RECOVERED EVJQENCE;
•
Left hund swab in swab box
• RiShl hand swab In -,,"ab box
• Brown paper bag, rubber barn! and fingernail clippings from len hand
• BlOwn p:iJll'r bag. rubber band and fingernail clippings from right had
• ""Illjo" case fingcrprints
• O~ white COlton tllllk top
• One black I-shin
• One white I-shin
• Black Ivnl!: ske"cd <w~at5hin
• T(IJI striped calf_length blood soaked I-shin
• Black/bmwn rel'et"llibJe corduro~ jacket
• Brown leather ,;andal.
• One gn~ pair of pants
• One pairof white boxcr shon~
• Onc pair ofbliid socks
• Metal hulkt fragments from head (:ree Evidence of Injury section abo\'cj
• Metal bulle! fragmenTs from ,."I/v.·hile scarf (s« Evidence of Injury !>eCtion above)
• Metal hullc! fragmenlS frO\1' righl jaw (see Evidence of Injury 5«llon abo\'e)
• White cut Oexi-curf
• Red anti white patterned scarf
ADDITIONAL 1'Il,OCEI>URl}S
I. Documenlar~ phQ10graphs arc taken bYI(bj(6J~ OAFME.J;!lIffohOllnl1lOher.
2. Pcn:onal effecl-< lind evidence are releaw.lto Special Agcntl(b)(6)
NelS· HQ •
Washinglon DC.
3. Specimens rctainc-d for 10J(icolog~ tnling art; bnUn. heart. lung. Ii vcr. ~pJc<:n. kidney. skeletal
lllus<;le. adipo$C .issue, blood. viucous fluid. bile. urine and gastric COnt"'1I5.
4. The di".ectoo or.llans are forwarded Wilh body.
5. Spial .... gcnH~(6)
,attended the autopsy in its emitety.
6U~>-@L
J OAFME staff uutopsy 1•.';siSlanl. a~.<i~led wilh .he autopsy.
MICROSCOP(C RX,\MINATION
•
•
•
Enll1lnce gunshot wound thead\ No definilive SOOt deposition is ,;cen
Enln>ncc gunshot wound (right chcsll No defillilive ~ deposition is $Cen
Entrarn:c gummot wound (len C~t) No defmith'C soot deposil;Qn is seen
MEDCOM 0674
ACLU Detainee DeathII ARMY MEDCOM 674
AlJTOPSY REPORJI(b)(6)
Ai. Ai.WANt, Thair Hamid KhalafHusan
10
r1I'\iAL AUTOPSY DIAGNOSES:
I.
Perfontill' KUlUbol wound oflhe hfad
A.
rnlnll~' On the ri&bt.ide oflhf bud, posleriorlo Ihe rilbt ur, is 1114 illcb
citc"ullr ellirallce Kunshol "'oulld; Ibe", Ia In eccellirle IIlI'linal Ibrasioll; Ihue
is I poorly fOrllled flinl abrasion utrndinK from Ibe two 10 four o'dock
posilion; 110 toOl or KUllpowdu Illppllol il identified
B.
Injured, Tbe lulp. rilbl temporal/plrielll bone, rerebrum, cerebellum,
oceipilll bone Ind ,,"ipilll sulp
C.
EJiil: 0 .. Ihf lei'! Ilde of Ihe hud. pl»lerior to the left ur, i, I 112 Ii 1/4111ch
Ilu..led u:il gunlholwound
D.
Rero\"CrW: ,...·0 rop"",r rolored mellol jlcl(et fngmell,", froDl Ihe head Klrf;
Olle «lPpU rolorlMl melll fnpenllnd one eny rolored melll fr1lgmtat from
Ibe inlier table of Ihe left ,ide of Ihe ocrip;lal bone Ind Olle «lpper Ind ooe eny
COlored mdll f..penl from Ihe richl remponllulp
E.
T ..j«lory: Riebl to lefl. Ililbl/r front 10 bark alld ,Ii&hlly dO,..IIward
F.
Auodlled injurlet: DirfuM' ,ublncllnold htQIorrltlle, 'llblaiul hemorrhale,
Ind lillrlr fnrturu of Illr ,,"ipilll nlhl Iemporatand ripl plrielal bollH
II.
PtrforallllC gUlls hoi "'OIlnd of the tOtlO (richl)
A.
Enlranu: Oa Ihe rlchilide af the rllest III 1141ncb circular enlnnce cunsbol
woulld with I ron~lIlric 118 Inch mafilnallbrasio,,; no delio;I"'e SOOI or
cunpowder stipp'illl Is K1tatined Oil lhe suttOulldillllldn
8.
IIIjured: The ,kill. ,ubentllltoUS lisslle, riChl st«IIId lIIlertollal ",ulClts, right
IUIIC, pO~lerior "p'CI of Ibe ..lolh right rih Illd lkill of the righl side of the bad,
C.
Edt: Oa Ihe ricbllide of the back (superior) ts I 112 I IJ4 illch laceraled uit
wouod
D.
Reco\'ered: NOilltnl
E.
Tnjeclory: The Injecto.,. oflhe bullei il frool to blck alld dO"'IIwanlwitb
IliCh1 Itft 10 right de,-iat;Oll
f.
Anociated injuria: ",noclaled ..-ilb Ihis wouad Is a rilbl hemOlhon); (1250
ml)
III.
Perfollli"g Ituuhol WOUlld of the torso (lefl)
A.
Enlnnu: On tht le£lslde of the chat ill all oval 114 I" 1/8 inch ",trallulua.hol
wound with III eculltnc marclnlllbns;oll; tbere is n" lOOt "r IlInpo..'der
stippllog Idelilified on Ihe nrroulldlnl skin
B.
Illjurtd: The skin, subeullneous IUS lie, I""IId lef! illICrton,,1 mllfCle:s,
pericardium, beal1, nlht htmKlllphragm, liver, nioth tilhl illICrtOlul mUKln
Ind skill of tht ricbtsldt of tbe back
C.
EIliI: On the righlside of Iht back (Inferior) is a If4 iorh exil wound with
llunttt! ml'1lnS
D.
Rtoeovertd, NOlhinC
£.
TnJeclory: Left to righi, fronll" blck and dllWnwlni
f.
Auotilted Injuries' There is I hemopericardium (30 IIll), I righl btmOlhoru
(1250 ml' Ind I btm"penloneum (JGO ml)
IV.
Hultd .uperlitilll penetral;n& blast fragmtntlnJury "fthe hud
A.
Entrallcf' On the righl cheek It In!( 1/4 inch Kar
B.
Inj ured: Sli;n, ,ubelltantolls lilI,ue and muscle
MEDCOM 0675
ACLU Detainee DeathII ARMY MEDCOM 675
I
AUTOPSY REPORT'(bf(6)
AL ALWANI. Thair Hamid Khalaf Hassan
"
C.
Reco\'eI"ed: One irrt'gular gra)' metal fraglMnt Is r«on,red from .librous
capsule adjacenllo the righl ~ygolTUl
D.
Trajeclory: Moslllkely right 10 ltfl, back 10 fronl, and upward
E.
Associated il\Jurles: fibrosis and scarring of the right side of the face
\'.
Other Injuries:
Abraded colltusion of the right side of the forehead
A.
B.
Unesr abrasion of the~ond linger of the len hand
VI.
Natul1ll Disease: None Identl~ wilhln Ihe Ilmlt,o; nf the elUlmlnalion
VII. Medica' Therap)': None
VIII. Postmortem Changl'll: As described al>o\~
IX.
Identifying Markli: A" dl\!icrlbed abol't
X.
Toxicology (AHP):
A.
VOLATII.ES: No ethanol is deleded in Ihe blood and vltreousnuld
B.
DRUGS: No screened drugs of abuse or medicalions are detected in the urine
C.
CARBON MOl'\OXIDE: The carboxyhcmoglobin saturalion in Ihe blood l\ les.'
than 1%
O.
CYANIDE: No cyanide 1.\ detected In the hlood
OPINION
This 211-ye3r·old civilian llcmioeclb}(6}
~icd of muliiple gunshot
wOlJnds. The delainee surfered a perforal;ng gun,hot wound of lhe head. The entrance was on 111<:
righl ~ide of thc head posterior lQ the righl eur.lIIld tl1<:re wus no evidenee of close range di!.Charge
ofa fireann SUITQ,onding lhe wound, The scalp. skull and brain were injured. The e.~it wound was
localed On the left ,ide of the head posterior to Ihe left ear. Multiple bullet rragmcnls were
recovered frolll a headscarf which wa.~ silualed hehind the deceased head. lhe ""alp. and the inner
labk orthl: occipilal bone. The lrajttlory of Ihis bullet wn> righlto lefl. slighlly fronllO back and
~lig:htly downWard. A.~sociated injuries indu<kd bleeding inlo tile subarachnoid space of I~ brain.
subgalea\ hemorrhage. and fraclures of the occipital, righllemporal. and righl panelal bones. A
,ecund gun,hol wound was to the right side of the chest. The enlrance WaS localed on the: riglll side
of lhe che,1 ano.lthere was no evidence of dUM: runge dil;Chargc from a firearm on the ,kin
surrounding Ihe wound. The skin. subculaneous lis!NCS. riglll second intercostal muscles. righl
lung. the posterior a.<peel of the ninth right rib. and lhe skin of tile right side orthe back are injured.
An exit Wi., located on Ihe righl side of the bllCk (superior). No evidcrn:e WaS recovered in
as;;()Ciation wilh lhis wOllnd. The tllljectory of Ihe bullel Wll.S front to b;ick and downward with
slighl left 10 righl deviation. Associated with this wound w"!; a right hcnt(ll.horax. There waS also a
perforating gunshot wound of Ihe left side of the chest. n,e enll'llnce WllS localcd OIIlhe left ,ide of
the che:st and lhen: was no evideOC<' of dose range dischlUge of a firearm sUrT(lunding lhe wound.
TIle skin. subcutaneous lis,ues. second lefl intercostal muscles, pericardium, heart. righl
hemldiaphragm. Ii '·cr. aud skin of Ihe right side of the back were injured. There was an ""il wound
011 the right .<ide of lhe hack. No evidence was recovered in a'SOCiation with Ihis wound. The
trJjc<:lory of the bullet was left 10 righl and front to bad: and downward. Associaled wilh Ihis
woalld were II hemopericardium. II righl hemothOl'a.~.1lIld a hemoperitoneum. An lldditionaJ injury
disc(wered al autopsy was a healed superficial penetraling blaM fragmentatiOn mjury of the head.
The entrance was evidenced by II scar on 111<: light cheek. The blul fra{'JllCnt injured Ihe skin •
.I ubcutanwu.' tissues and muscle of the righl side of thl: face. One irregular gray metal fragmenl
MEDCOM 0676
ACLU Detainee DeathII ARMY MEDCOM 676
AvrOPSy RePORT(b)(6)
12
AI.. ALW ANI. Thair Hamid Khalaf Hassilrl
"'a.~
n:<:overed frQlll a fibrous ClI~ulc lIdjacent to the filllt l)'CQIlla. 1lIe. IrajeclOry of the melal
rl'lllment W!OS IOOSl likel)' ",hI 10 left. ~k to front and upwlll'd. lnjurie. 1ISliOl:i.ued willi Ihis
,"'tJU11ti "'e~ ftbrosi. and >(amnll which was >(Cn OIllhe nght side OCllle C~. Addilional minor
injuric$ disco"eled at aulops), were an:lbraded COOIU~ on the right Jide or lhe rCfthead llnd a
line~rl.br..~ion OIllhe \eCond fin,erofthe left hand. '1lIc 10xicoloU K~n i~ Mgati~ roreyanidl:,
\'ol<ltile~;md liCn:ened medic,u;oo. and drugs or abuK. The ellt'I)'hemoglobin salur.u.ion in lhe
bloud w... nul elevated. The manllerof <kIth j~ humiddc.
(bK6)
(bK6)
MEDICAI..EXAMINER
MEDCOM 0677
ACLU Detainee DeathII ARMY MEDCOM 677
_.---_.- .----- -- -' -- --- --_... - --.
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.""-"-MEDCOM 0678
ACLU Detainee DeathII ARMY MEDCOM 678
~
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I
I
(b)(6)
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MEDCOM 0679
ACLU Detainee DeathII ARMY MEDCOM 679
~
.y
ARMED FORC&S INSTITUTE OF PATHOLOGY
om" ,11M AnDtd Fortel Medial! Esualner
1413 Research Blvd.., BJda.. 102
Rockville. MD 20lSO
301·]19-0000
AUTOPSY EXAMINATION REPORT
Nune: DNAHI, AI Amirl HUSItl HUSlyn
AIlIOpSy No.l(b)(6)
ISN (b)(e)
APIP No.'(bl(6j
o.Ieo(Birth: IJ..k_ _
DucorDcath:(b)(6) 2007
JUnk: CivillanlDetainee
j
P1tc:e or Dcalh: lnq
DmlTime of AillOpS}': 21 DEC 2oo7@0900hn
Dale o(Rcpof1: II MAR 2008
Place of Autopsy: Pon Mortuary Dover AFB.
DE
Circuesta_ of Ontll: Thb Operal.ion IfWJI Freedom ~e, as ~pol1eCl, was vomiting bklod
and was lnrIJpOrted to !he suraieaJ opctllina room (or Il/lell'leraenc:y I~)'. IMina the
pl'OCedure,lhe dtcedml hid unc:onltOlllblc pstric: bJcedinl/IIW tb: pstro-esop/lllgcal junction.
The pIIietl1 died. despile .II Mten\PU to control his leute blood loss.
A8diortutlOll for Autopsy: Armed Forta Medical ExamiDel. perU.S. Code 10, Seetion 1471
Jdmriftalt\Oa: Presumptive idenli(ltwon perCIO investiption.
CAUSE OF DEATH:
HEMORRHACE DUE TO PEPTIC ULCER DISEASE
MANNER OF D£ATH:
NATURAL
MEDCOM 0580
ACLU Detainee DeathII ARMY MEDCOM 680
AUTOPSY REPORt(b)(6>'-DHAHl, AI Amiri Hassan Husayn
PIlJC 2 oC1
EXTERNAL EXAMINATION
The body is that of a wt'll-developed. wt'JI-nourished male. The body weigJu 144 pounds and is 61
~ inehc:s in Icngtb. The body is eold. Rigor is presml to an equal degree in all exlMmitics. Lividity
is present and fixed on the posterior surface of the body, except in Il=S exposed to pl"CSSlR.
The head is llOnDOeephalic, and the scalp h4lr is black. Fll:w hair consists ofmLl5lldle and exlends
into a full blacklgn.y beard. The irides are hazel. The c:ome.e are cloudy. The conjunctivllC and
sclerae an: lIlII'mlartable. The cxlemll auditory canals and oral cavity are me of foreign rnalenal
and abnonnaI sec:retions. The naris hils dried blood present. The nual skeleton and maxilla are
palpably inUlet. The lips are withoUl evident i!1iury. The teeth are natunI.I and in good condition.
Examination of tile neck reveals no evidence ofinjury.
Thc chesl: is wtrernartable. No evidence ofinjury of the ribs or the stmIwn is evident externally.
The abdomen is fiat. The Clttema! &CJlitalia are those ofa nonnal e6ult cirewneilCld male. The anus
is unremarkable.
The fingemails are inla<:L Thm= are two well healed scatS on the dorsal sutface of \be right fOOl
meuming up to I inch in llWIimwn dimcnsion. Thete ill one well bealed seMon the dolSlJ surface
of the left foot measuring up to I inch in rnuimum dimension. Thete are no wtoos ~ O!l lite
body. ThCfe is a skin tag measuring V. inch in maximum dimension on the left bIlek. The majority
of the posu:riortono has multiple vitiligo petehe:s.
CLOTHING AND PERSONAL Et'FECIS
None identified.
MEDICAL INTERVENTION
A six inch verti<:a1, stqical staple line ill above the umbilieus. TheTe is a puncture mark on \be left
anlDcubital fossa.
RADIOGRAPHS
A complete set of postmortem rlIdiograpbs is obtained and dc:moruJllaIes only a slU'gieal suple line
from T-II to U.
EVIDENCE Of INJURY
None identified.
MEDCOM 0681
ACLU Detainee DeathII ARMY MEDCOM 681
AUTOPSY REPORT(b)(6)
DHAHt. Al Amiri Hauan Huayn
Page 3 of7
INDRNAL EXAMINADON
BODY cAymES:
ri"".
The
sternum, and Yertebml bodiQ life visibly IIld pllpably iIltItl:t. The peri\Olle:ll has 200
millili\l:l'S of bloody fluid. All body orpns life present in nonnaI aII.ItOmie.1 position. The
lUbcuwleous fat l-rcr of 1M abdominal wallis y.. iIlch thiek.
HEAP AND NECK:
The llaleaJ and subpJealson lissues of 1M sealp IIle liee of injllf)'. There life no stull frItrures.. The
dura mller and falx cerebri Iln: inlaCt. Theft is no epidural or subdunl hemofrha&e present.. The
leptomminaes are thin and dclieate. The caeblal bemispbaQ are symmdrieal. The slnIeI\lrU at
the hue of the brt.in, indudinll ~ nerves and blood. _ I s Iln: intKL
The brain weishs 1270 srams. which has unremarkable Il)'ri and JUlei. CotonaIlOCtions through the
cerftlntI hemispheres reveal no lesions. Transvene xcUClllI thmush the linin _
and caebdlum
IIle unmnubble. The "1an!<H>CCipital joint is $Wble.
The anterior Slnp musclQ of the neck lIl'l: ~mogeno\lS and red-brown, wilbout bernonhqe by
llyer-wise diS5Clctioo. The thyroid can.ilage and hyoid bone U'e Intact. The larynx Is lined by inuet
IIIl mucosa. The l(mllue is free of bite marks, hemorT!IaIle. or other injwiQ.
CARDIOVASCULAR SYSTEM:
The bear! weighs 320 grams ~ surrounded by 1III ill~ pericardia! sac. The epiearllial surtiee Is
smooth, with millim&l fat inYeSlment. The ool'OlW)' arteries are present in a normal distribution,
with I ristn-dominanl pattern. Crosa sections oflhe _ I s Ibow no .isruflcanl atherosclerotic
luminal $UIlOSis present. The myocardium is homosa'lOUJ. red.-brown, and finn. The Ylllve leaflets
are Ibm and mobile. The walls of the left venlricle.lnlerYelllricular Jqllum, lIIId rij.ht ventricle are
I.•, I.•, and 0.3 OI:IIlimeten thIe;.k. respectively. The mdoeanIiW'll is smooth and s1lstcning.
The lIOlU!lives rix 10 Ihrec intact and P*'td areh _Is. The renal and mesenterie vessels_
w",,,"'..,,,
Rf$P!RATORy SYSTEM;
The upper Ii.......y Is cle.r ofdcbris and foreisn materill: the ml.lCOSlJ surfllCel are smooth, yellowtan and unrernarbble. The rilhl pleund ufllU IIa Idhesions; but the len pleural surfIee hu I
IITIOOdt. a1i$1enilll and unranarbble appeanDCL The pullT101WY puenchyma is lIlIMnwtablc, il
exudes a IUshl &rIlOWlt ofbklod lIIId. rtothy nuid; DO foc:allaiODl are noted.
The puhnonary Irttries ~ normally developed, pa1eI'lI.lIld withoUIlhromblls orembolus. The rishl
lUlli weip)6O pvns; the Ieft))O pms.
MEOCOM 0682
ACLU Detainee DeathII ARMY MEDCOM 682
AUTOPSY REPORTIS(b~)(~')==--,
DHAHI, AI Amiri Hassan HUSllyn
Page 4 of7
HErAIQBILIARY SYSTEM;
The liverwr:iahs 1050 snms has an intact smooth eapsulc covering modenUt;ly congested tanbfown patellCbyma wiltlllO focal lesions noted.
The gallbladder contains I milliliter ofgreen-brown, mllCOid bile; the mucosa is vclvef)' and
~. The extrahepatic biliary lJ'ee is plIlen\, wilhout evidence of calculi.
GASTRO!NJESTINAL SYSTEM:
The csoptwgus is lined by gray-while. smooth mlIOOIL The gastric m _ is lImIl\iCd in !he Il$U.l/
rupI folds and shows a 7 x 5 centimeler defecl near the greater curvature. Located I centimeter
from the gastrie-csophqealjunelion lite two gastric ulcenl meaJWing 0.7 and 1.0 centimeters in
maximum dimension. Boltl ulcers are SlIfI'OWlded by a 5.S x S centimeter area ofmueosal
erythema. A bJaet suraiea.l SUIIIM is localed befWCeD these IWO lesions.
The small and large bowels conraln bloody semi-liquid and fccal maner, I'e$pCCtively. The pancreas
is slightly deeomposed with a tan lobulaled appearance and the duclS are clear. The appendix is
p"""'GENITOURINARY SYSIEM:
The rialll kidney weighs 90 grams; the left kidney weighs 110 grMIS. The renal capsules are smooth
and thin, semi-transparent and strip with ease from the underlying smooth, red-brown cortical
surface. The cortices are sharply delineated from the medullary pyramids, which are red-putple to
tan and unmnarkable. The calyc~ pelves and ~ters an: wvernatbble.
Tan bladder mucosa overlies an intICt bladder wall. The bladder contains no urine. The testes.
prostate gland and seminal vesicles are unremarbble.
LYMPHOREl1CULAR SysTEM:
The splcen weighs 170 Sram5 has a smooth. intact capsule covering red_purple. rnodcrately firm
parenchyma; the lymphoid follicles Ire unmnarbble.
Lymph nodes in the hilar. periaortic and iliac regions are 1101 enlarged.
ENDOCRINE SVS"IEM:
The pituitary gland jsleft in :tllu and is unrenwtable. Tbc thyroid g1"'li is symmetric and redbrown, withou.t C)'$lie or nodular change. The right and left adrenal glands aresymmetric. with
bright yellow oortices lIIId red-brown medullae.. No masses or areas ofbemorrhage are identified.
MEDCOM 0683
ACLU Detainee DeathII ARMY MEDCOM 683
AUTOPSY REPORT(b)(6)
~Sof7
DHAHI. Al Amiri Hassan H_)'ll
MUSCULOSKfl £TAL SYSTEM;
No non-traumllic Ibnormalities of mutele Of bone _ identified..
MICROSCOPIC EXAMINATION
Sclceled ponlons oforpns are reWnecl in formalin, wWllftllU8lion ofhislology slides o(the
sp\ecft pcndillJ.
ADDnnONALPRQCEDURES
I. Documentlry photoar-Pht IlrC taken by OAFME.
2. Pmona! effects are reJ~ to the 'fiPiOjiliate mortuary opullliOll5 representatives.
3. SperimenJ retained (or toxleolOjY lestina and/o( DNA identifieatiorlll'l!: vil/ClOus fluid,
blood. bile. spl«lI, liver, l~ kidney, bnlIn, myoeanlium, .cIipose tissue: and skeletal
muscle.
4. The diuected orplIlIlI'I! forwarded with body.
MEOCOM ()68.4
ACLU Detainee DeathII ARMY MEDCOM 684
AUTOPSY REPORTt(b}(6)
DHAHI, Al Anlin Hassan HUSlIyn
r..se6of1
FINAL AUTOpsY DIAGNOSES
I.
Gastric U1cen, Multiple, Nnr the G..I~Esop"eealJllactioll
11.
Natun.1 dunsa or pfe-el.iltlDJ coadhloas:
A. Vitiligo of the posterior torso
B. Splenomegaly, 810 grams
m.
E"k1"te of Me4~lISlIrpeal Then.".:
A. A 1" j centimeter dcf~ near !he greateI CIltV.lure of the Slomach
B. Black lutuM ptCIentllCar the site of gulrie blce:ling
C. A vertie.l sutiieal staple line above the umbilicus
D. Puncture- mark on the lel\ AlIttalbital fossa
IV.
Post·Morttal C....llla: Described above
V.
ldeatifybll, Body Marb: None identified
VI.
ToJ.leoiocY (AFlP)
A. VOI...A.T1LES: No ethanol detected in the blood aDd vitreous fluid
B. DRUGS: Midazolatn was detected in the blood
C. CYANIDE: There was no eyan.ide detected in the blood
MEDCOM 0685
ACLU Detainee DeathII ARMY MEDCOM 685
AUTOPSY REPORl1{b)(6)
~
Page70f7
OHAHI, Al Amiri H _ AlWyn
OPINION
The cause of death for thb binec(b)(6)
lis due to acute: blood loss
from two b1ceding gastrie uleeJ5. The7"XS centimeter aerect near ttiC grealtt curvature oflhe
stomlleh was produced by the surgeon to find the site: ofblccdingduring \be emergency lap8l'lllomy.
The 10kicology screen was po,itivc for micb:zotam. an intravenous generallU\Clltbctie used on
SVJ'lleIY paticnb. The puncture marie on the left lUl!eCubital fossa wu the likely 'ite of
administration forthi' anesthetic during the dccedcrll', emelllency operation. Vitiligo is. benign
condition that rcsuhs in depigmentation ofllle skin. The manner ofdCllth is natural.
Hi5lology ,lidcsofllte splCCl'l are pending. If there i' ,igniritanl information identified from these
slklcs fn addendum repon will be gcncnted.
(b)(6)
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Mcdieal Ekamin«
MEDCOM 0686
ACLU Detainee DeathII ARMY MEDCOM 686
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MEDCOM 0687
ACLU Detainee DeathII ARMY MEDCOM 687
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MEDCOM 068B
ACLU Detainee DeathII ARMY MEDCOM 688
.~.
.....RM£D FORCES INSTITUTE OF PATHOLOGV
om« of tile AnDed Forea MedlC1l1 [ ...lau
1413
R~1l Blvd., Bldg. 102
Rockville, MD 20fl50
301-319-0000
AUTOPSY EXAMINATION REPORT
No·;1(b~,(i(6~'
==1
Name: {BTBl MOSHIN. b'ld Sa'ad,
ISNITMEP~)(6}
_I
DIIll:ofOirth:Jb)(61JAN 1987
-
AFIP No.i(b){6)
Rank: Civilian Detllinec
Dele or~th:{b)(6)
,
Place of Death: Baghdad, lraq
2007
Autopsy
DeteITime of Autopsy: 20 DEC 2007@0930
Place of Autopsy: Port Mortuary, Dover APB, DE
Date ofRcpon; 01 JUl. 2008
Ornmataocel of Delt.ll: This Civilian Detainee was admitted to the ),- CSH inlen$ive ~ UIlit
at Camp Cropper, Baghllad, Iraq on 12 DEC 2007 due to complications of end stage liYff disease of
an unknmvn etiolo&Y. He first came to the attention orthe medical saff at Camp Croppc:t in
October 2001 with complroinlS oflWl5Q and fatigue, and.",.., diagnosed with viral syndrome. His
past medical hislofy was sianifieanl only for adcrmJlitis for which he used IOP~ medications and
ocasional oral prednisone. He developed prolreuive weighlloss andj.undi« wilh rising
bilirubin., liver cmymes and ammoni.lcvcls in NoVftl1beT2007. He denied exposure 10 chemicals,
medications., akohol or herbal prepat1tions. Viral markers for hepatitis A, B, C and HIV were
M~ti~. His condition prog.rcssively deteriorated 10 mulli-orpn s)'Stem failutC Ilnd he eltpircd on
(b){6LJ2007.
Al:llboriutioll for AlIlojH)': Anncd Forcc$ Medical ExaminCf. per U.S. CoOt 10. &ction 1471
IdnUifinllon: Prallmptive Identification is made based upon identification bnlccleu on the body.
Positive identification the ISN is confirmed by the comparison ofan antemortem DNA reference
IllId a postmortem DNA 511mple. FinacrprinUi ~ taken foroomparison 10 an eumplar if one
becomes available.
CAUSE OF DEATH:
LIVER FAILURE DUE TO CRYPTOGENIC HEPATITIS
MANNER OF DEATH:
NATURAL
MEDCOM 0689
ACLU Detainee DeathII ARMY MEDCOM 689
AUTOPSY REPORT(b)(6}
(BTB) MOSHIN. Ra'ad Sl'ad
Page 20f1
ExtERNAL EXAMINATION
The body is thai of. well-dcvelopc:d. well·nourished C&ue&SOid mfJe receiYCd unc:11Id and Vl'TlIIpped
in two sheets. The body weiahs 18J·powxls, is 66-inches in length and Ippear1 older than the
reponed age of2o-yean. The body is cold. Rigor is passiroa 10., equal degree: in all extmnilies.
Lividity is present and fixed on the posterior SUffICe oflhe body, exccpt in lII'ellS exposed 10
~. The body isjlundieed and alIas&n:ic, witlt 4+ pining edema over the entin: torso and fJl
eXlrC:ITIities. The skin Bppw1 pale and cUy with flaking. most notably on the scalp. Lerae bullae
are pn:sent on the skin, mostly on the del'ClIderll portions oflhe body. Some skin sliPP'ie is
""",,,
The he.d is nonnocepltalic, and the scalp hair is spuse, short and brown. Facial hair consists oh
bellRl Bnd ntOllSlIChe. The irides an: brown, the cornelle are cloudy, and the eonjuncuvac lie
edemalous and otherwise unrmwtable. The selerae lII'e icteric. The extemliluditory canals,
n:tcmaI nItCS and oral cavily are free of foreign material and abnonnal secretions. The earlobc:s an:
IWlt pierud. The nasal $keleton Bnd rnu.iJlun: palpably intact The lips an: witholll evidenl injury.
The teelh an: I'Illrural and in good condition. Eumil'llliion oflhe neck reveals no evidence of injury.
$pane
The ckest is unremarkable. No evidence ofinjury of the ribs or the stemwn is evident ClIterlllllly.
The abdomen is nwtedly protubel8llt with striae and an obvious fluid wave. The ClItcmal genitalil
are those ofa normal aduh circumcised male. The anus is withoul note. There is a parti,l thicltness
decubilis ulcer in the natal cleft on the left buuodt dUll
SC&r'!I an: not TIOted 01'1 the torso.
measuJel
Ii II; l/g·in.m. Healed sllr&ical
The cxttemitics show the presence ofa few Itealed SC&rS on the shin and I few bruises, but no
evidcnr.enrht:nll'et..looeenolinn.. N dern""il;S-'The fincretTllils are trimmed and intact. A tanoo is
noted l(b)(6)
An irregular scar is TIOted 01'1 the
mcdialleft llrlkIe region lIIat II'IeBS\Il'eS 1 ~ II; Y..inch. There arc numerous pustuks lSSOCialed with
hair follicles on the eXlremities in various stages orhealing.
CyYrHING AND rERSQNAL J;FFECIS
No clotltillg or pmonaI elTecu are received with the body.
MEDICAL INTERVENTION
•
ITllrlvenollS line inserted in
the right subclavian region
•
Uril\l\l)' bladder CBlheter
•
•
NISOSutric Nbe inserted into the left Mris. properly 10000ted
Medical dressing on decubiti! ulCCT, left bullock
MEDCOM 0690
ACLU Detainee DeathII ARMY MEDCOM 690
AUTOPSY REPOR~(b)(6)
(aTB) MOSHIN, Ra'ad Sa'ad
Page) of7
RADIOGRAPHS
A complete set of postmCH'lem radiograplu and CT ima,es Ale obtained atId demonstnltes the
following:
•
Meclieal therapy
•
•
•
Bilateral pleun.l effusions
No old or =nt fractures of the skull, axial skeleton or extremities
No mclallie foreign bodies
EVIDENCE Of lNJUBY
There is no evidence of old or reeeTtt ilijury.
INUBNAL EMMINAllQN
BODY CAVITIES:
The body is opened by the usuaIlJ1oraco.4bdominal intision and the chest plate is _ - t . The
ribs:, sternum, and vertebral bodies IlR visibly and palpably intact. No adhesions are present in any
of the body cevitie!. Both pleural cavities contain JOO-milliliter! of5efOSlllg\linotu fluid. The
pericardial $I(: contains 80'millilitcD of serosanguinous fluid, and the abdominal cavity contains
3,4lJO.millilitel'll of yellow serous fluid. All body organs are present in normal anatomical pos:ition.
The subcutaneous fat layer of the abdominal wall is I-inch thii:k ac the UlJIbilicus.
HEAp AND CENTRAL NERVOUS SYSTEM:
The scalp is reflected. The gslealand subgaleal soft tissues of the saolp IlR heofinjury. There are
no JJc.uU fractures. The calvarium oftbe JJc.u11 is mno-t. The dura mater and falx eaebri arc intllCt.
There is 110 epidunll or subdural hemonhage ~1. The leptomeninges IlR thin and delii:ak. The:
c:m:braJ hemispheres are symmetrical. The stt\ICtlll'eS at the bllse of the brain, includingcranial
l'IefVes and blood v_Is arc intaCt.
Clear oerebn»pinal fluid surrounds the 1,590-gram brain, which has untell\lJkable gyri and suk:l.
Coronal sections through the cerebral hemispheres reveal no lesions. Transverseseo:tions through.
the brain stem and om:bellum are unremalbble. The a\llllltO-OOCipilaljoint is stable.
NECK:
The anterior sttap muscles of the neck are homogenous and red-brown. witrout hetnon'hagc: by
layer-wiK dissection. The thyroid eartilage is soft and the hyoid bone is intllCt and unfused. The
luynx is lined by intact white mucosa. The lOngue is free of bile marks. hemotTbage, or other
injwies.
CARDIOVASCULAR SYSIEM:
The lJO-gram heart is contained in an intact pericardia' sac. "The epicardial surface is smooth, with
minimal fat investment. The coronary arteries are present in a oonnal distribution, with a right.
MEDCOM 0691
ACLU Detainee DeathII ARMY MEDCOM 691
AUTOPSY REPORT '(&)(6) ,---_]
Page40f7
(8TB) MOSHIN, RJ'ad Sa'ad
dominant plIllem. Cro~ se<:tions of!he vessels show 110 luminal narrowina and an: widely plllent.
The myocudium is bomoaenous, red-brown, and finn. 'The valve leaflets are thin and mobile. The
walls of!he left ventricle, inler·vmtricular septum, and right ventricle llI'e 1.0, 0.1 and l.l}.
centimeters thiclr:, ~tively. The endocardium is smooth and glistening.
11Ie aora gives rise to thm: intact and patent areh vessels; mild atherosclerosis (fatty slteaks) is
noted. The rtnaI and mesenteric vessels are unrertlal"kable.
RESPIRATORY SYSTEM:
The upper airway is clear ofdcbris and foreign fIlIrmal: the mucosal swfaces llI'e smoodI, yellow.
tan and utm'markable. The parietal pleural surfaces llI'e smooth, glistening and unrenwtable
biialefllily.
The pulmorwy pIftflChyma is diffusely congesled and edematous, eltuding modetlte to large
amounts of blood and frothy fluid; no foeallesions III'e IIOted. The viS«fII1 pleW'8J surfaces are
smooth, glistening and unn:marltable blla~lly.
The pulmorwy arteries an: normally developed, paten! and without thrombus or embolus. The right
lung weighs 8OI).gra.ms; the left 790-gmms.
HEPATOBIl.lARY symM:
The 2,J4lJ.grarn liver has an inlaCl smooth CIpSllle covering very soft, yellow to tan parenchyma
with no foeallcsions noled. The exp«ted liver weight forbody weight Is 2,3ISograms.
The gallbJadder contains 2l}.milliliters of ~-bro\.vn, mucoid bile; the m~ is velvety and
unremarbble. The extrahepatic biliary tree is petent. without evidence ofealcllli.
GASIRQ!NJESTINAL SYSTEM:
The esophagus is lined by gray-white, SIllOOIh mllOOS8; no varices are noted. The gastric mUCOM is
ImllIged in the usualruaal folds uti the lwncn eontains 6O-milliliters of lin, semi-solid material.
The small and l~ bowels are unremarkable. The pancreas is soft and autolyzed and the duclS are
clear. The appendix is present.
GENITOURINARy SYSTEM:
The right kidney weighs l2(l.grams: the left IIl}.grams. The I'CIIIlI eapsules an: smooth and thin,
semj.transpatml and strip with ease from l!le underlyina smooth, dusky red·brown conical surface.
The conex is sh1llJlly delineated from the medullary pynmids, which
l1IIl'm1oIlkabJe. l'lte calyces, pelves and llIetetS &Ill unremarkable.
&Ill
red-purple to 1111 and
White bllltkler mllCOSI with foea.l hemol'Tbage overlies an intact bladder waJI. The bladder contains
approximately IO-milliliters of cloudy yellow urlTIC. The testes. prostate aland and seminal vesicles
&Ill without1lOte.
MEDCOM 0692
ACLU Detainee DeathII ARMY MEDCOM 692
AUTOPSY REPORT(b)(6)
(DTB) MOSHIN, Ra'ad SII'ad
LYMPHOR£DCULAR SYSTEM:
1M 21G-iJVII spleen has. smooth, intaet capsule coverina red-purple, moderatelyliOT\ eonae~ed
parenchyma; the lymphoid follicles llnl unremarkable.
Lymph nodes in the 1I1Iar, periaortic and iliac regions llnlllOl enlaraed.
EHOOCRiNE SYSTEM:
The pituitary Jland is left In !l11l and is VOSSly unremarkable. Tbe Ihyroid lland is symmetric and
red-brown, wilhol,ll cystic or nodular thange. The rig.ht and left tdrenailiandt are sliahtly .utolyzed
IIld symmetrit, with brillht yellow cor1ices and red-browrI mcdlll!ae. No maues or NeaJ of
l'lemomIaae are idenlified.
MUSCULOSKEI'ETAL SYSTEM:
No non-lftumatic IbllOnnalilics ofmllJCle or bone are identified. Skin incisions with uodenninina
subcuW\eOUJ diJJOd;on in IIIUS of ecch)'lToOS1s are negative: for t1Wllmatic i'lillf)'.
SLIDE KEY AND MICROSCOPIC EMMJN4DQN
Selecled por1Jons ofOtPnJ an: rctlIlned in fonnalin, with preparaliOlt orhiseoJoay slides.
I. Luna:} {Vo:ular COftJestion and desquanl1lion ofpnuemoc}'les inlO tile alveolar
2. Luna:} {spaces. There il no evidence or lICIll.e infoction..
l. Kidney: Autolysis.
4. Kidney: Autolysis.
$. Spleen: Con&estiolt, otherwise unranarUble.
6. Liver. SeYfft m-::rosteatohepltids., bridaina fibrosis, bile swls and biliuy hyperplasia,
with renwbbly lillie inflammation.
1. PmlCfU1: Autolysis.,
I. Hellt (Left Ventriclc): No pMholoaic diaanosis.
9. Heart: (Septum and IUatn VCfttricle): No patIlolo&lc dili/101is.
10. Adrmal Glands: AUIOlysis.
II. Brain (Hippoeampus): Hypo..ic chlnaes oflhe neurons in the CA-! resion.
12. Brain (Cmbc:l1um): No pMiloloaic diqllOlis.
13. BBin (Pons): Hypoxic cllanJCS oftbe fICUtOns in the peri.qucducl1l &nlY maner.
14. Spinal Cord: No pWIolo&lc diaposls.
15. Lymph Node: No pMholoaic di.iJlOSis.
16. Thyroid Glands: No pathologic diagnosis.
ADDITJONALPRQCEDU Bf
5
I. Doc\llTlCnwy photographs &Ie taken by AFMES sttffphotoaraPher.
2. PerRIn&! effceu are released 10 the Ipplopliale mortlI1Iy operations rcprescnwiva.
3. Specimens rctlIined (or lo.. icoloiY tcstinlllf1dfor DNA idenlitiCllion Ire: vitreous nuid,
blood, urine, bile. pstrit conlenlJ, spleen. liver, hma. kidney. brain, myocanlium. tdipose
tissue llltd slceleW musclc.
4. The dissmed orpns ~ forwalded with body.
MEDCOM 0693
ACLU Detainee DeathII ARMY MEDCOM 693
1
Page 6 on
AUTOPSY REPORT {b)(6)
(BTB) MOSHIN, Ra'ad Sa'ad
S. Hislolosical seclions of the li~r ~ submitted \(l the Deparlmetll ofHcpetic Pa1hDlogy,
AAP for open COl\SUltaljon. The results arc described abD~ (sec KSlide Key and
Microscopic Examination" (6. Livu).
6. Body fluids and tissue is $lIbmitted 10 the Department of Environmental and lnfectiOIlS
Disease Sciences, AFIP for ~avy mctaI analysis.. The results ate described below (see
''To)[icolo8)'").
FINAL AUTOpsY DIAGNOSES
L
Nalunll Diseue
A. AIIII$lUClI
B. Pulmonary edrma and congestion. bilateral
C. Pleural effusions, bilaleral
D. Pericartlial cffusion
E. Ascites
F. Hepatomegaly and seVCI'l:: macrosteatohepe.titis with bridging fibrosis, bile swis and
biliary hyperplasia
G. Decubitis ulea, left buttock
H. Iclerus and jaundi«
II.
Tlten Is IlO evldnee of phy.kalabllse.
III.
!vldl!lleeofMedlealTllerapy
A. Intravenous line inserted in the right subclavian I'l::lIion
8. Urinary b1adderCllt~ter
C. Nasopslric lube: inserted into the left naris
IV,
Posl·Monelll ella_gea
A. Rigor is absent and equal in all extremities
B. Lividily is poslCrior and fixed except in areas exposed to pressure
C. The body lemperalure is cold 10 lOud!
D. Skin slippage
V.
IdCl:ltlfyla1 Body.Marks
A. Tanoo(b)(6}
c
_
B. Scar on the medial left ankle lqion
VI.
Tukolol)'
A. The blood islested for earbon monoxide and lhc earboxyhemoglobin salunltion is less
than 1%.
B. The blood is tested for cyanide and none i$ detected.
C. The blood and vltrcou.s fluid ate tested for volatile compounds including ethanol and
none are fowld..
D. The urine is S(:reened for medicalions and drugs of abuse and the followill8 mcdicaliOlU
are found:
,. Lidocaine (an anti-arm)'lhmic medieuion) is ple$Cnt in the urine but IlOlquantitated.
MEDCOM 0694
ACLU Detainee DeathII ARMY MEDCOM 694
AUTOPSY REPORT (b)(6)
(BTB) MOSHIN. Ra'ad SI'ld
Page 70r7
2. Morphine (I nlJ'eOtic lIllalaesic medieatlon) is present in the urine llJId is quantitated
in the blood It • level or 0.57 mitlil?;!Mts per liter.
3. PromelhllZine (1IlIllti<metic medielliOll) is present in the urine IIld is quantitlted in
lhe blood It I level orO.16 ml1lilf1lJllS per liter.
E. The liver, kidney, urine. blood Ind bile arc tested ror heavy me1lls including aluminum
(AI), Intimony (Sb).uscnic (As). eadmiUl'll (Cd). cllromium (Cr), cobalt (Co). copper
(Cu), leid (Pb), manptIC$C (Mn), mercury (Hg), molybdenum (Mo), nickel (Ni).
thallium (TI). lin (Sn),litlJ'lium (Ti), W'IIliwn (U), vlJlldium (V), tungsten (W) utd zinc
(Zn) Ind the following IIl't de1tt:ted:
I. The liver Ind kidney did not collUlin elevlltd levels of any tested rnetals.
2. The blood contained elevlted levels ofeldmium (Cd), IJWIiInCSt (Mn) Ind IIIngsteTI
(W). See lhe Ittached toxicology report for details.
OPINION
Thb 20-yeu-old mile civilian deuince, (believed 10 bc)(b)(6)
,died of liver fllilute.
The liver failW't pro~sed to multi-orpn s)'Stem flilure over I pmocfohpproximately 2 months.
The allSt oflhe liver railure is unknown; virallt'llltm were neptive (by ~viewofthe medical
leCOrds) lAd by history the de<:eased denied chemical ordrog exJlO5Un. Routine toxi«Jlogical
testing forethlnollllld screened drop oflbuse was neptive. Carbon monoxide Ind c)'lllide were
not cletceted in the bIoocl. The mediClltions morphine IIld prometJw:ine were present in the blood at
therapeutic levels, consistent with hospitaliutiolL Extended toxioologiClltesting for IleIvy metaJ
exposure WlI5 inconclusive. Atthouih elevated levels ofeldmium (Cd). manganese(Mn) lIIld
tungarn (W) were present in the blood,they were: not present in lhe liver lIIId lticlne)' tissues tested
and likely represent posI-monem rc:-distribution orlftiflll:l The microscopic Ipparante oflbe
liver tiss~ is a gmeral panero IIIld III etioloay of the liver flilure cannot be detmnined with
certainty. Based on the cummt investigation, laboratory studies- and aulOpsy findings. the manner of
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Medial Examiner
MEDCOM 0695
ACLU Detainee DeathII ARMY MEDCOM 695
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