". . . LARYNX & TRACHEA UNREMARKABLE THE EPIGLOTTIS HAD FOCAL AREAS OF CONGESTION."
Under Respiratory System page 3 of 5 of the post-mortem report, the M.E. notes,
" The larynx and trachea were unremarkable. The epiglottis had focal areas of congestion."
The epiglottis is the cartilage that covers the windpipe; the lid that keeps food from entering while swallowing.
Examine the diagrams below and note the location the epiglottis above the larynx, (voice box) trachea and the thyroid cartilage.
AllHealthPost: Throat Anatomy
"Epiglottitis is a potentially life-threatening condition that occurs when the epiglottis — a small cartilage "lid" that covers your windpipe — swells, blocking the flow of air into your lungs.
A number of factors can cause the epiglottis to swell — burns from hot liquids, direct injury to your throat and various infections." - Mayo Clinic: Epiglottitis.
The epiglottitis (Chris's epiglottis that ". . .had focal areas of congestion." ) and the unremarkable (normal) larynx and trachea, corresponds with the ligature furrow mark examined on Chris above the thyroid cartilage.
Examine again the sketches I drew of the ligature furrow mark noted on Chris above the thyroid cartilage. *Anatomical diagrams differ from source to source. Internal locations may be slightly off from one another but accurate at best.*
DISPUTES OF ASSISTANT M.E. THEODORE BROWN M.D. OFFICIAL RULING OF SUICIDE: CHRISTOPHER JOHN CORNELL.
350206037-Autopsy-Report-Chris-Cornell
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CONJESTION & FLORID PETECHIAE.
page 1 of 5: Summary & Opinion, paragraph 2:
"The autopsy was most significant for a ligature furrow mark of the neck, congestion of the head and neck above the ligature furrow mark, florid petechiae of the facial skin, and confluent petechiae of the left and right palpebral conjunctivae, all consistent with hanging, partially suspended by the resistance exercise band."
In addition to the uneven ligature pattern, it's also documented that the medical examiner's descriptions of congestion and petechiae noted on Chris specifically, are not at all consistent with a suicide by hanging. Let alone a partial suspension.
LIGATURE STRANGULATION (https://www.mussenhealth.us/carbon-monoxide/ligature-strangulation.html.) WARNING: GRAPHIC IMAGES.
"In ligature strangulation, the pressure on the neck is applied by a constricting band that is tightened by a force other than the body weight. Virtually all cases of ligature strangulation are homicides." (first paragraph)
"Suicides and accidents are rare. The mechanism of death is the same as in hanging — occlusion of the vessels supplying blood and thus oxygen to the brain. With constant compression of the carotid arteries, consciousness is lost in 10-15 sec." (end of first paragraph)
1. ". . . Congestion of the head and neck above the ligature furrow mark. . ."- M.E. Theodore Brown.
According to Ligature Strangulation, "In contrast to hanging deaths, the face and neck above the ligature mark appear markedly congested, . . ." (second paragraph)
2. "Florid petechiae of the facial skin. . ." - M.E. Theodore Brown.
Ligature Strangulation- "In the authors' experience, petechiae are present in 86% of the cases of ligature strangulation."
"The presence of a congested face, petechiae, and scleral hemorrhage in ligature strangulation occurs because, unlike in hanging, there is no complete occlusion of the vasculature. Blood continues to go into the head from the vertebral arteries. It cannot escape, however, because of the compressed venous system. This results in increased intravascular pressure, congestion, and rupture of the vessels." (second paragraph)
However, the presence of florid petechiae on a deceased person doesn’t prove or disprove death by ligature strangulation.
According to EvidenceProf Blog: Under, "The initial important point to note is that" ". . .they are simply a marker of increased cephalic venous pressure. . . "
"Nonetheless, you are very likely to find petechiae in cases of strangulation. Here are some relevant excerpts:"
"From Moulton v. State, 395 S.W.3d 804, 806 (Tex.Crin.App. 2013):" (Under "Evidence of Manner and Means)
“The medical examiner explained that in eighty-five percent of manual strangulation cases, petechiae—small red or purple spots caused by a hemorrhage—are present in the eye.”
3. ". . .confluent petechiae of the left and right palpebral conjunctivae . ."- M.E. Theodore Brown. These are tiny pinpoint red marks on the back of Chris's eyelids (palpebral).
Petechial Hemorrhage: (Petechiae) "If petechial hemorrhages and facial congestion are present, it is a strong indication of asphyxia by strangulation as the cause of death." (first paragraph)
". . . Often they are seen in the conjunctiva of the eyes and also on the eyelids, especially after hanging. . ."
". . . When found in a case of suspect hanging, the presence of petechial hemorrhages strongly suggests the victim was hung when still alive. This helps distinguish hangings staged to make a murder look like a suicidal act." (second paragraph)
Slideshare.net Warning: Graphic Images. (slide 8 of 45) "Absence of petechiae in most hangings is because there is complete obstruction of the arterial system, so there is no pooling of blood in the head, no increased pressure, and therefore, no petechiae."
The presence of petechiae, specifically with Chris, was a strong indication of strangulation
DISPUTES OF ASSISTANT M.E. THEODORE BROWN M.D. OFFICIAL RULING OF SUICIDE: CHRISTOPHER JOHN CORNELL.
350206037-Autopsy-Report-Chris-Cornell
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NINE FRACTURED RIBS.
page 2 of 5: EVIDENCE OF TREATMENT paragraph 2:
“The soft tissues and muscles of the chest had multiple foci of hemorrhage. The anterior aspects of the right second through six and left second through fifth ribs were fractured. The anterior mediastinal soft tissues were hemorrhagic. The anterior aspects of the right and left lungs had focal areas of hemorrhage.”
The nine fractured ribs along with internal hemorrhaging Chris sustained supposedly from CPR was debatable however, it's unheard-of that nine rib fractures were from life saving protocols given the circumstances. I've personally consulted nurses, EMTs and inquired with my own family doctor.
Not one of those individuals supported the notion that nine fractured ribs are a common result of cardiopulmonary resuscitation.
With the medical studies and the circumstances to follow, it is highly unlikely that Chris received CPR at all on the night of his death. More likely, Chris's internal chest injuries he sustained were from blunt force trauma, inflicted manually or with an object. It's also a possibility that a tremendous amount of weight was applied to his upper body, an attempt to subdue resistance.
BRIEF REVIEW OF MEDICAL DOCUMENTATION: CPR RELATED RIB FRACTURES.
*Before accepting the medical examiner's assertions on Chris's multiple chest injuries and declaring them as "evidence of treatment," rib fractures related to chest compressions must be clearly understood, in addition to the circumstances and timeline that lead up to Chris's death.*
Rib fractures are a common complication in adults as a result of CPR but the risk, especially in the case of Chris Cornell, are quite low.
"Victims who are elderly, small in stature or children have the highest risk of developing rib fracture during chest compressions. Additionally, the chest bone, or sternum, also endures pressure and stress during chest compressions and can fracture as well." - Complications of CPR.
Performing Cardiopulmonary Resuscitation.
The heel of one hand should be placed on the lower part of the sternum, not the very end but mid-low (the bone that connects the two rib cages) and placing the other hand on top, interlocking fingers. The arms are to be kept straight with the shoulders directly over the hands pressing down with the palm, at least 2 inches deep. 100 compressions per minute.
American Red Cross CPR STEPS.
*What is the common number of rib fractures after manual CPR?
CPR-related rib fractures in adults
“It is well-known that rib fractures occur as a consequence of chest compressions during cardiopulmonary resuscitation (CPR), but when a patient dies, how can a pathologist determine whether those rib fractures are due to CPR, or another traumatic event such as an assault?”
Key questions for the pathologist to address In order to assess whether rib fractures in adults were caused by CPR or some other injurious insult, the pathologist can turn to the literature for assistance.
Dr Andrew Davison (Senior Lecturer in Forensic Pathology, Wales Institute of Forensic Medicine, UK) considers the following questions when he finds rib fractures at autopsy, which may have been caused by CPR:
1. Where do CPR-related rib fractures occur (i.e. the rib number and location/ site within a rib)?
2. Are the site and likelihood of fracture related to: age, sex, length of resuscitation attempt, type of resuscitation, and level of life support training of the person(s) carrying out chest compressions?
Under synopsis of the literature, twenty-two case studies documented rib fractures from manual CPR and ADC-CPR, in both men and women.
However, the studies do present problems: absence of information, important factors being rib number fractures, location of the fracture(s), (the site of the fracture on the rib (anterior/posterior) and the following list:
Factors to consider when rib fractures are a result of CPR.
1. Position of the hands
2. Forced used
3. Compression Rate
4. Depth
5. Length of resuscitation
6. Method (manual or mechanical)
7. Qualification of the person
8. Age of the patient
9. Pre-existing medical conditions (osteoporosis, hemophilia, etc.)
In addition to the small number of studies, under reasonable conclusions it states:
8. Lateral fractures i.e. those occurring between the anterior and posterior axillary lines, do occur after standard CPR. If a fracture is noted in rib numbers 10 to 12 or in the posterior third of the bony part of a rib, then non-resuscitation trauma should be suspected.
I personally found CPR-related rib fractures in adults to be informative however, the literature presented does not provide concrete evidence that Chris’s 9 fractured ribs and severe internal injuries was a direct result of CPR.
*The medical examiner only notes where (anterior: front) Chris's rib fractures were. Considering the additional notes of multiple bruising in the chest muscle tissue, internal hemorrhaging in both lungs and the circumstances prior, I believe the injuries Chris sustained in his chest were also lateral. (on the sides)
Reviewed deeper momentarily.*
". . . BONE IS EXTRAORDINARILY STRONG. . . "
From ncbi.nlm.nih.gov, rib fractures as a result of CPR (skeletal chest injuries) under Conclusion:
". . .are much more frequent and that increased compression rate and depth cause more SCI. Since in the period 2011-2013 accompanying severe injuries occurred in only 1.85% of cases, the resuscitation technique has not yet jeopardized patient's safety, but further close monitoring is needed."
The American Association for the SURGERY OF TRAUMA, Scroll down to "General Trauma Information and to ".Rib Fractures" second paragraph: "The most common mechanism causing rib fractures is blunt trauma (i.e. automobile accidents, falls from height, assault, or even severe coughing). Blunt trauma causes rib fractures by exerting direct pressure on the rib causing it to break. Approximately 10% of all patients admitted for blunt chest trauma have one or more rib fractures. Although the injury mechanism itself is an important consideration when discussing rib fractures; patient specific considerations are also important. Patients with advanced age, osteoporosis or osteopenia have an increased risk of number and severity of fractures."
LIVESCIENCE: Brute Force: Humans Can Sure Take a Punch:
". . . Bone is extraordinarily strong — ounce for ounce, bone is stronger than steel, since a bar of steel of comparable size would weigh four or five times as much. A cubic inch of bone can in principle bear a load of 19,000 lbs. (8,626 kg) or more — roughly the weight of five standard pickup trucks — making it about four times as strong as concrete.
Still, whether or not bone actually withstands such loads depends heavily on how quickly force is delivered.
"When you perform CPR, you can give chest compressions and not break any ribs, but if you apply the same amount of force quickly instead of slowly, and you can end up having rib fractures,"
CONSIDERATIONS IN REGARDS TO CHRIS CORNELL'S SUPPOSED CHEST INJURIES FROM CARDIOPULMONARY RESUSCITATION. (CPR)
*Chris was 52-years-old, good physical health, sober for 12 years and with absolute certainty he did not have osteoporosis. Also, Chris's vocal range spanned 4 octaves, so there's no doubt he had a strong core and chest!
ODDITY IN THE TIMELINES, THE ACTUAL 911 CALLS & TIME OF DEATH.
There's a 40 minute gap between Vicky getting of the phone with Chris and supposedly sent Martin Kirsten (bodyguard) to go check on him. Martin reportedly was staying two doors down from Chris's room at the MGM.
"Vicky told police that she spoke with her husband at around 11:35 p.m., and at 12:15 a.m., called Kirsten to ask him to check on Cornell, "to see if he is alright, because he did not sound like he is OK." -ET ONLINE published May, 19/17.
Upon Martin Kirsten's discovery, supposedly at 12:15am or 12:30am, Chris was laying on the bathroom floor "with blood running from his mouth," and a red exercise band around (his) neck,”- THE DETROIT NEWS published May, 19/17.
*Crime Scene Investigation RIVISED: page 3 of 3 states 12:30am after the initial time of 12:15am reported (image below). This would leave a greater time gap of 55 minutes from 11:35am.
*Incident/Investigative report, page 2 of 3.
An MGM Grand Hotel medic, supposedly also does not arrive until 12:56am after Martin Kirsten's reported discovery of Chris at 12:15 am; an additional time gap of 41 minutes.
"MGM medic Dawn Jones arrived at the room at 12:56 a.m., the report said.
“Jones untied the red exercise band from (the) victim’s neck and began CPR on (Cornell, who) was not breathing.”
EMS Unit 42 was at the scene by 1 a.m. An emergency medical technician also unsuccessfully performed CPR on Cornell, according to the report."
*What was going on within a total time gap of 1 hour & 21 minutes?
All before any medical personnel arrived on scene?
REMARKS FROM THE FIRST RESPONDER.
According to the audio clip of a medic’s remarks to 911 dispatch, (Detroit Police scanner) Chris was “cool to the touch” all over; death pronouncement requested.
The audio clip from the scanner strongly indicates the EMT, with crew, to be the actual first responders to the scene. In sync with the actual 911 phone call records linked below.
Mainstream news articles have discredited the remarks, claiming the remarks to be "unverified" and "unreliable." This is due to the entirety of the recording missing from the scanner and instead, the following 911 recording (the call apparently from the front desk of the MGM) was considered.
It's odd that the call to 911 did not come from Chris's hotel room or Chris's bodyguard, Martin Kirsten.
Salvo Zerte
Medic’s Remarks to 911 Dispatch. (Detroit Police scanner)
“I’m on scene with a 53-year old male, 53-year old male pulse [inaudible] on arrival with crew.”
“Unknown downtime, found by a roommate in a hotel at MGM.”
“Patient did have a exercise rubber band around his neck. Suggestions of a possible strangulation, trauma to the back of the head. History of depression. Patient is cool to the touch in all areas at this time. Pulse [inaudible], been on scene for over 30 minutes at this time.”
“Pupils are fixed and dilated. IO in the right knee, ligature marks on his neck, he have established a patent airway, [inaudible] tube.”
“We’re not able to resuscitate at this time, so we’re asking for pronouncement.”
Base04
With the medic's remarks from the audio clip, the gap (1 hour & 21 minutes total) in the reported timeline in addition to the actual Detroit Police Department 911 calls to service Sept 20th/2016 - Present (screenshots of the 911 phone call recorded below) presented by metaldevastationradio.com Phone Records Indicate Chris Cornell Death Timeline Is False? Chris was dead on arrival.
*Note* metaldevastationradio.com is acknowledged here for the explanation of the 911 call record exclusively.
* I've gone to Detroit Police Department 911 calls to service Sept 20th/2016 - Present on Sept,26th/22 to view and acquire a copy the phone records personally, since the screenshots of the records here were not taken by me.
The record of the 911 calls from the MGM (1700 Block of 3RD) as of Sept, 26th/22 do not show in the entirety of the phone records of May, 18th/17. 1:30am was the time indicated on the scanner when the medic made his remarks, but the time of 1:30am isn't captured within the screenshots. So the time of 1:52:09am shown is the only record of a follow up call from the MGM captured via screenshot, assuming only 1:52:09am as the follow up call.*
*FIRST 911 call was made at 2017 May 18 12:59:47 AM. (1700 block of 3RD)
(While in THE DETROIT NEWS published May, 19/17 reports, "MGM medic Dawn Jones arrived at the room at 12:56 a.m., the report said.")
Again, if it's argued MGM medic "Dawn Jones" was the first medic to arrive at 12:56am, that still would have been 41 minutes after Martin Kirsten was asked by Vicky at 12:15am to go check on Chris and upon discovery of Chris ". . . on the bathroom floor “with blood running from his mouth. . . "
1700 block of 3RD at 12:59:47am, the first call was made in regards to a suicide.
Under priority code, #1 means “Dead On Arrival”. While under incident is "SUICIDE".
*SECOND 911 call was made at 2017 May 18 01:52:09 AM. (53 minutes later) "REMARKS" indicates a follow up call on a patient's status.
Overall, 01:10am was seemingly the arrival of the first (from the scanner) EMT and the medic's call ("REMARKS") back to dispatch at 01:52:09 AM on Chris's status.
". . . Patient is cool to the touch in all areas at this time. Pulse [inaudible], been on scene for over 30 minutes at this time.”
and after unsuccessfully riving him.
"We’re not able to resuscitate at this time, so we’re asking for pronouncement.”
TIME OF DEATH & ALGOR MORIS: BODY COOLING.
From public record of the 911 calls above, Chris's time of death likely took place before midnight. It's highly unlikely that CPR was performed on Chris who was long deceased (priority code, #1: “Dead On Arrival”) and "cool to the touch" all over.
Chris's likely time of death would've been in the hour of 11:00pm (May 17th/17.) With this estimation, it starts at the end of Soundgarden's last show, a strict curfew at 11:00pm.
(AT HOUR 1)". . . the body begins to cool from its normal temperature of 98.6 F (37 C) until reaching the air temperature around it. Known as algor mortis or the "death chill," body temperature falls at a somewhat steady rate of 1.5 degrees F per hour.
The expected decrease in body temperature during algor mortis can help forensic scientists approximate the time of death, assuming the body hasn't completely cooled or been exposed to extreme environmental temperatures." - What Physically Happens When You Die?
It's a strong possibility within 30 minutes after 11:00pm, Chris died. Specifically and eerily so, I believe he died around 11:36pm. 1 minute after getting of the phone with his wife; Vicky told police that she spoke with her husband at around 11:35 p.m., and at 12:15 a.m., called Kirsten to ask him to check on Cornell, "to see if he is alright, because he did not sound like he is OK." -ET ONLINE published May, 19/17.
The first EMTs (the EMT from the scanner) to arrive on scene may have been around 1:10am, 1hour & 34 minutes from 11:36pm. Chris's body temperature would've dropped 2.25 degrees °F, his body temperature to then be 95.75 degrees °F. All solely from the first EMTs arriving on scene and Chris's body already cool to the touch upon immediate inspection, his hotel room at a normal temperature of ". . . approximately 72 degrees (°F) per thermostat." - MEO Investigator Angela Anderson-Cobb, page 2 of 3 Case Registration Summary.
The remarks of the medic's call back to dispatch at 1:52:09am of, ". . . Patient is cool to the touch in all areas at this time. Pulse [inaudible], been on scene for over 30 minutes at this time.” would be 42 minutes later from the estimated arrival time at 1:10am, Chris's body temperature would then be 94.75 degrees °F.
Additionally, the estimated call back time of 42 minutes, from 1:10am, is in line with the crew "on scene for over 30 minutes."
Also, rigor mortis had appeared in Chris's face, specifically in his jaw. ". . . there is slight rigidity present in the jaw, but the remainder of his body is limp. . . " - MEO Investigator Angela Anderson-Cobb, page 2 of 3 Case Registration Summary.
(At Hours 2 to 6) "Beginning approximately in the third hour after death, chemical changes within the body's cells cause all of the muscles to begin stiffening, known as rigor mortis. With rigor mortis, the first muscles affected will be the eyelids, jaw, and neck." - What Physically Happens When You Die?
Angela's time of arrival to the scene was at 3:53am, 4hours & 17 minutes from 11:36pm. In line with the beginning stages of rigor mortis.
FINAL NOTE: One Handed CPR & Other Oddities.
Lastly, and to further demonstrate the unlikelihood of CPR administered to Chris from all medical personnel involved, I absolutely do not believe Martin Kirsten performed CPR, specifically "one handed CPR." on Chris either.
The alleged first medic, "Dawn Jones", was an MGM Grand hotel medic who arrived 41 minutes later at 12:56am from Martin's "discovery" of Chris at 12:15am.
THE DETROIT NEWS: Reports add details about Cornell’s death, published July,11th/17,
". . . One element many questioned was why it took so long before medical first responders reported finding Cornell, although according to Kirsten, they worked on the rock star for about an hour as he lay in the hotel room bathroom."
“I saw the band around his neck. He was on the floor. I forced the band from wherever it was hanging and attempted (to) loosen the band from around his neck, and began chest compressions with I believe my left hand. “The hotel EMT came in, directed me to stand aside and she began working on him. Other personnel started arriving, hotel security, medical staff and EMTs, and Detroit (police)." - Martin Kirsten.
The question still remains, what was going for 40 minutes after Chris gets of the phone with Vicky after 11:35pm? Vicky afterwards asks Martin to go check on Chris at 12:15am.
Additionally, what was going on within 41 minutes after Martin's "discovery" at 12:15am of Chris ". . . on the floor. . . " , before the alleged MGM medic "Dawn Jones" arrival at 12:56am?
Did Martin administer "one handed CPR" on Chris for 41 minutes? Also, the exercise band was allegedly hanging from the door, so how is Martin lost on ". . . wherever it was hanging. . .." But what's odd most absurd in his claim was to have "attempted (to) loosen the band from around his neck and began chest compressions with I believe my left hand. . . "
He apparently was unable to recall which hand he used also.
Again, before the release of Chris's autopsy/toxicology report, (Fri, June 2nd 2017) THE DETROIT NEWS, published May, 19/17, when the news of Chris's death was first published, specifically states that the alleged MGM medic "Dawn Jones" "untied the red exercise band from (the) victim’s neck and began CPR on (Cornell, who) was not breathing."
Why is it that the alleged MGM medic had to untie the exercise band from around Chris's neck? Martin claims to have loosened the band from around Chris's neck but oddly leaves the band on? Then Martin supposedly gave Chris chest compressions with only his left hand? The reason being, supposedly, Martin was on the phone with Vicky at the same time.
Bodyguards, certainly for the most part, are trained in the proper procedure to administer CPR. Especially a bodyguard for a high profile musician.
A basic life saving protocol anyone could acquire.
Performing Cardiopulmonary Resuscitation
The heel of one hand should be placed on the lower part of the sternum, not the very end but mid-low, (the bone that connects the two rib cages) and placing the other hand on top, interlocking fingers. The arms are to be kept straight with the shoulders directly over the hands pressing down with the palm, at least 2 inches deep. 100 compressions per minute.
American Red Cross CPR STEPS.
To reiterate, besides Martin Kirsten's claim of "one handed" chest compressions and the "loosening" of the band around Chris's neck to be highly suspect, CPR was not administered to Chris, whom was long deceased upon the arrival of the first EMTs (from the scanner), in accordance to the 911 public records and the 1 hour & 21 minute total time gap before
the arrival of additional medical personnel and police notified.
It would be an excessive of amount CPR given to a victim who long passed.
DISPUTES OF ASSISTANT M.E. THEODORE BROWN M.D. OFFICIAL RULING OF SUICIDE: CHRISTOPHER JOHN CORNELL.
350206037-Autopsy-Report-Chris-Cornell
.pdf
Download PDF • 56KB
NINE FRACTURED RIBS. (CONTINUED)
page 2 of 5: EVIDENCE OF TREATMENT paragraph 2
“The soft tissues and muscles of the chest had multiple foci of hemorrhage. The anterior aspects of the right second through six and left second through fifth ribs were fractured. The anterior mediastinal soft tissues were hemorrhagic. The anterior aspects of the right and left lungs had focal areas of hemorrhage.”
1.“The soft tissues and muscles of the chest had multiple foci of hemorrhage."
"Foci," plural to "focus" in pathology is "the primary center from which a disease develops or in which it localizes." - Dictionary.com
The medical examiner describes the tissues and muscles of Chris's chest having multiple centers of hemorrhages. (Bleeding)
That's the first problem under Evidence of Treatment; multiple centers of hemorrhages on Chris's chest. One area of the chest, the sternal area (central) in particular, should only have bruising if CPR had been performed vigorously. Minor or major bruising may be a result of CPR, but it's important to consider the circumstances surrounding Chris's death and his physical condition prior.
In my opinion, the multiple hemorrhagic centers of the soft tissues and muscles on Chris's chest, were likely of an assault. Not CPR.
2. "The anterior aspects of the right second through six and left second through fifth ribs were fractured. "
The nine fractured ribs noted by Brown as a result of "post acute cardiopulmonary resuscitation", is a strong unlikelihood, considering the circumstances around Chris's death, the medical literature covering CPR related rib fractures and Chris's physical condition prior. “The soft tissues and muscles of the chest had multiple foci of hemorrhage. . . " externally syncs with Chris's multiple rib fractures internally.
The alleged MGM Grand hotel medic Dawn Jones, Martin Kirsten, who I strongly do not believe administered "one handed CPR" on Chris and other medical personnel involved, should have adequate training for delivering proper chest compressions.
Nine ribs fractures as a result of manual or mechanical CPR in any case, is an excessive amount of damage administered by trained medical professionals.
Additionally, the medical examiner doesn't note fractures on the sternum. Shouldn't the sternum likely be fractured as well? Especially if nine ribs were fractured do to vigorous CPR? The sternal bone, I assume, is stronger than the ribs themselves however, would having sternal fractures be a high indicator for resuscitation attempts over an assault?
Within the literature of CPR related chest injuries, there are cases of sternal fractures as positioning of the palms are to be placed on the sternum (mid-low) for proper chest compressions.
Examine the rib and sternum diagrams below. I've circled the locations where I believe the site of the fractures on the ribs may have reached, aside from the noted rib fractures from the medical examiner to be anterior (front).
*How were the ribs fractured exclusively from the sternum? Especially the 6th rib on the right and 5th rib on the left away from proper, centralized chest compressions mid-low on the sternum?*
Human Rib Cage Diagram: HUMAN BODY ANATOMY.CO
Seemingly, the area of "compressions" performed on Chris had been placed on the ribs themselves away from the sternum.
Either an excessive amount of pressure or rapidly repeated force was inflicted exclusively on the ribs themselves; suspect of an assault.
Here's an exclusive look of the sternum. Circled is where the fractured ribs were.
Sternal Angle: EARTHSLAB
The medical examiner only notes the location of the fractured ribs (anterior/front) on Chris. Again, in the rib cage diagram above, I've circled to where I believe the site of the fractures on the ribs may have been.
This is suspect due to Chris having multiple centers of hemorrhages on his chest. “The soft tissues and muscles of the chest had multiple foci of hemorrhage. . ."
The hemorrhages noted on Chris were not local to one area.
If the ". . .right second through six and left second through fifth ribs were fractured," I highly suspect that the site of the fractures on the ribs were away from the sternum, through the costal cartilage and reached the curves of the ribs. Lateral (on both sides) passed the costochondral joints.
3. "The anterior mediastinal soft tissues were hemorrhagic."
Madiastinum- a space in the thorax that contains a group of non-delineated organs and their surrounding connective tissue. It lies in the midline of the chest between the pleura of each lung and extends from the sternum(FRONT) to the vertebral column.(BACK) - RADIOPAEDIA
The anterior madiastinum is the portion of the mediastinum anterior to the pericardium and below the thoracic plane. It forms the anterior part of the inferior mediastinum, and contains the thymus, lymph nodes, and may contain the portions of a retrosternal thyroid. - RADIOPAEDIA
Internal bleeding of the anterior mediastinum (BLUE AREA) connective tissues which falls behind the sternum, Chris's sternum not mentioned anywhere to be fractured in the post-mortem report.
From: Cardiovascular and Thoracic Anatomy
4. "The anterior aspects of the right and left lungs had focal areas of hemorrhage.”
Focal (PATHOLOGY) ". . .limited to one specific area and may be either microscopic (seen through a microscope) or macroscopic (seen with the naked eye). Focal is an adjective and is not a synonym for focus." - SEER Training definitions
I strongly assume the medical examiner indicated more than one specific area of hemorrhaging; "focal areas of hemorrhaging."
Had vigorous chest compressions resulted in 9 rib fractures revived Chris, he would've ultimately asphyxiated on his own blood. Punctured lungs do to acute pulmonary resuscitation is a serious complication for any patient to endure; breathing would be excruciating.
Examine the diagram below, and again, circled is the cite of the ribs where I strongly believe the fractures also may have been.
This is based on the medical examiner's notes of "multiple foci of hemorrhage" on the soft tissues and muscles noted on Chris's chest and "the anterior mediastinal soft tissues were hemorrhagic." , ( the soft tissues behind the sternum) along with both of Chris's lungs with ". . .focal areas of hemorrhage."
HUMAN BODY ANATOMY.CO
RESPIRATORY SYSTEM.
On page 3 of 5 in the post mortem report, Under Respiratory System the medical examiner states, "The parenchyma was red-dark red and congested."
"The lung parenchyma is the portion of the lung involved in gas transfer - the alveoli, alveolar ductsand respiratory bronchioles."- RADIOPAEDIA
Injuries involving only the lungs are relatively rare; generally they are a combination of thoracic and pulmonary trauma - INJURY TO TO THE LUNG PARENCHYMA
Lastly, it's noted that "No pulmonary emboli were identified."
Meaning, Chris had no blood clots. ". . . a blood clot gets caught in one of the arteries that go from the heart to the lungs, it’s called a pulmonary embolism (PE). The clot blocks the normal flow of blood." - What Is a Pulmonary Embolism?
ANATOMIC DIAGNOSES: PULMONARY CONJESTION.
Additionally, the medical examiner notes Pulmonary Congestion, page 4 of 5 in the post mortem report under Anatomic Diagnoses.
Primarily known as Pulmonary Edema which "is a condition caused by too much fluid in the lungs. This fluid collects in the many air sacs in the lungs, making it difficult to breathe."
"In most cases, heart problems cause pulmonary edema. But fluid can collect in the lungs for other reasons. These include pneumonia, contact with certain toxins, medications, trauma to the chest wall, and traveling to or exercising at high elevations. . . "
. . .The causes of pulmonary edema vary. Pulmonary edema falls into two categories, depending on where the problem starts.
-If a heart problem causes the pulmonary edema, it's called cardiogenic pulmonary edema. Most often, the fluid buildup in the lungs is due to a heart condition.
-If pulmonary edema is not heart related, it's called noncardiogenic pulmonary edema.
Sometimes, pulmonary edema can be caused by both a heart problem and a nonheart problem.
". . . Pulmonary edema that is not caused by increased pressures in the heart is called noncardiogenic pulmonary edema.
Causes of noncardiogenic pulmonary edema include:
. . . -Nervous system conditions or surgeries. A type of pulmonary edema called neurogenic pulmonary edema can occur after a head injury, seizure or brain surgery. . . " - MAYOCLINIC
In Chris's case, the pulmonary congestion was non-cardiogenic, meaning he did not have congestive heart failure, a chronic progressive condition and the common cause of pulmonary edema.
Strangulation is one of the neurogenic causes of non-cardiogenic pulmonary edema,
Homicidal Strangulation: Uncommon Cause of Noncardiogenic Pulmonary Oedema
Under Discussion, paragraph 1:
"Strangulation is a recognized cause of noncardiogenic pulmonary oedema."
HEAD INJURY: AN ADDITIONAL CAUSE OF PULMONARY EDEMA.
Lastly, head trauma is considered another neurogenic cause of pulmonary edema, which goes back to Chris's head injury. How severe was the trauma to the back of Chris's head before and after his death?
The DMCare patient care report states that there was "100ml -500ml of blood loss, trauma noted to back of skull, minor bleeding noted upon crew arrival" as seen in images and concert footage.
The medic via Detroit Police scanner". . . trauma to the back of the head.. . ."
". . . Stains of suspected blood are present on his face and on the floor next to and beneath his head. . . " - Angela Anderson-Cobb, Case Registration Summary page 2 of 3.
Though the severity of Chris's head injury that night is unclear, he may have endured more trauma to the back of his head during his final moments alive.
THE BLOOD ON SCENE.
The amount of blood that was present from Chris's supposed hanging death is extremely questionable. Personally, I sought and found images, through a macabre curiosity, of victims of suicidal hangings.
Within the pictorial archives of several cases in hanging deaths, there was absolutely no blood near or on the decedents. If not faint at heart, observe images from medical/investigative documentation of victims post hanging death for confirmation.
That fact of the matter is, Chris endured:
- a head injury: trauma to the back of the head
- trauma to the neck
- trauma to the chest
The blood present on scene was a direct result of one or all of the above three injuries
“It’s very unlikely such large amount of blood found in a case of hanging,” Dinesh Rao, a forensic pathologist who has conducted more than 12,000 autopsies, told International Business Times in an email.
“…I would like to state at this moment that in partial hangings or [in] incomplete hangings, signs of congestion are common and sometimes we see ruptures of blood vessels as a reason for hemorrhage,” the doctor explained. “This needs to [be] confirmed during [an] autopsy by ruling out trauma as the source.” - From INTERNATIONAL BUSINESS TIMES. Published July,14th/17.
THE BLOOD SPLATTER: AN ALTERCATION.
It is important to understand that Bloodstain Pattern Analysis is one component of a crime scene investigation. The analysis of the bloodstains need to considered in the context of the scene and its associated evidence. - BLOODSTAIN PATTERN ANALYSIS
With certainty, Chris at one point endured blunt force trauma while in a likely altercation of ligature strangulation. As evident from the photographs of blood splatter on the side of the tub, the drag mark of blood on the bathroom floor, blood drops at the entrance of the bathroom, blood outside on the bathroom door, the documented evidence of his head injury, his noted chest injuries to his torn t-shirt; all when he was found dead.
*The specifics on Chris's torn t-shirt explained later in this post.
The appearance of the scene with bloodstain pattern analysis and considering the full circumferential ligature mark noted on Chris's neck, the bathroom is likely where the possible altercation primarily took place and the bedroom is where Chris's death may have actually ended up. *Explained further momentarily.
The bedroom, where the altercation may have started, Chris was strangled from behind, sustained his chest injuries either in the bedroom or in the bathroom and possibly endured additional trauma to the back of his head, all while heavily sedated to easily over power him, most likely by butalbital (5.1 mcg/ml in Chris's system) administered to him prior without his knowledge.
The butalbital would be an intoxicating combination with the dosage of "Ativan"/Lorazepam in Chris's system. (41 ng/ml)
Chris had no prescription for butalbital: The Detroit News May, 15th/18
* Considering the 40 minute time gap between 11:35pm and 12:15am, before the bodyguard's "discovery" of Chris at 12:15am, the possible altercation could've lasted 5 to 10 minutes, with Chris then to have lost consciousness from ligature strangulation, (". . . It can take about 4.4 psi for 10-30 seconds to strangle someone into unconsciousness if they have blocked off the jugular vein,. . . while it takes 11 psi for 10-20 seconds to block the carotid arteries and cause someone to fall unconscious."- Training Institute of Strangulation Prevention) to the set up and story of the incident. The scene to appear as if an apparatus for a suicidal hanging was used. A carabiner clip, the door anchor, the exercise band and the notch on top of the door seemingly caused from band alone.*
"PSI definition: PSI is a unit of pressure expressed in pounds of force per square inch of area. It stands for Pounds per Square Inch.
1 PSI = 6894 Pascals = 0.070 atmospheres = 51.715 torr" - ThoughtCo.
BOODSTAIN PATTERN ANALYIS
Analysis:
When properly documented, bloodstain patterns found at the crime scene, or on a
particular person's clothing, can be used to:
1. Confirm or refute the position of a victim, witness, suspect, or defendant
2. Determine if there is evidence of a struggle, or if the assault is "one
sided. . .
SPATTER. . .
. . . Spatters are produced when a source of liquid
blood is acted upon by an external force. The
blood droplets, created by the force, travel
through the air before landing on a target
surface.
SPATTERS
Spatters = Force
-In order for spatters to be produced, an external force must be applied to a source of liquid blood.
-The force must be great enough to overcome the surface tension of the blood
-Blood will not break up unless it is acted upon by force.
-As a general rule; the greater the amount of force applied to the source of liquid blood, the smaller the resulting blood splatters. . .
Observing the blood splatter on the side of the bathtub, Chris's face likely made strong impact to the tile floor, the bloodshed either from his nose or mouth. With this likely scenario, the position of his body was prostrate. (facing down)
This coincides with the RIVISED Crime Scene Investigation report, page 3 of 4 of Chris's face ". . . covered with blood splatter ."
Was the ". . . blood running from his mouth. . . " from internal hemorrhaging Chris sustained in his lungs or from the act of ligature strangulation? Or both?
- Incident/Investigation Report page 2 of 3.
Coughing Up Blood Causes: MAYO CLINIC - " . . . Trauma to the chest."
ScienceDirect under Forensic Medicine/Causes of Death, Mechanism: ". . . As in strangulation by ligature, the typical findings are congestion of the head with (at least temporary) cyanosis, petechial hemorrhages, and sometimes bleeding from the mouth, nose, or ears."
" . . . Bleeding when coughing (hemoptysis), vomiting (hematemesis) or from the nose (epistaxis) indicates the most likely source of the bleed – the respiratory passages, gastrointestinal tract or nasal cavities respectively. Many of the causes of bleeding in these cases may also be responsible for bleeding from the mouth (stomatorrhagia).
In order to identify the most likely cause, it is important to take preceding events into consideration. Finding blood in the mouth is expected but nevertheless worrying and possibly serious after these conditions :
. . . - after trauma to the head and neck ."- Blood in Mouth and Saliva – Causes of Bleeding from the Mouth
A Study of Gross Postmortem Findings in Cases of Hanging and Ligature Strangulation
.pdf
Download PDF • 283KB
Under OBSERVATION, paragraph 2:
". . . Dribbling of saliva was present in 38.37% cases of hanging but not present in any cases of ligature strangulation. Bleeding from mouth and nose found in all cases of ligature strangulation but only in 1 case (1.16%) of hanging."
Under CONCLUSION:
"Dribbling of saliva present in case of hanging while rarely [10] in case of ligature strangulation. Post mortem findings like bleeding from mouth and nose, cyanosis, involuntary discharge of urine, fecal matter, semen on glans penis, periligature injuries, fracture of hyoid bone, thyroid cartilage, larynx and trachea in cases of hanging and strangulation are nonspecific and variable depending upon composition of ligature material, force applied on neck and its duration. However either singly or in combination these findings helpful when ligature mark creates element of doubt in cases of hanging and ligature strangulation. It can be concluded that presence of other bodily injuries suggest only manner of death not about hanging or ligature strangulation. In doubtful cases final opinion will be made depending upon circumstantial evidence, crime scene investigation and autopsy findings."
THE DRAG MARK OF BLOOD.
Following the impact causing the blood splatter, blood pooled next to the splatter, evident with the blood darker on the right from the drag mark to the left.
- RIVISED Crime Scene Investigation report, page 3 of 4.
The drag mark of blood indicates a transfer (Transfers occur when a blood source comes
in direct contact with a target surface area. - Bloodstain Pattern Analysis) of Chris from the right to the left, while Chris possibly continued to endure strangulation, the loop of the exercise band evident of smears of blood and strands of hair.
Additionally, the band had smears of grey residue, likely so by the band with " . . . the opposite end of the band across the top of the entry door." With that, the band alone was pulled from the outside the bathroom door (observe closely the downward damage at the top of the door in the image below) into notch, paint from the door smeared on the band as a result.
*View of the top of the door from outside of the bathroom.
"Further investigation of the bathroom indicated (a) small notch in the top of the bathroom door. This notch appears to be indicative as to where the resistance band was positioned when used as a tool for hanging."
- RIVISED Crime Scene Investigation report, page 3 of 4.
*Smears of grey residue on the band initially mentioned in a blog post, again brought to my attention, by Glen Hetfield.
However, this does not indicate that the band was used as a mechanism for Chris to hang, analyzed and dismissed in part 1 in regards to the ligature furrow mark and the location of livor mortis on Chris's body. It's highly suspect the scene was staged with the clip, door anchor and the band giving an impression of an apparatus supposedly used by Chris for a suicidal hanging.
This also presents and confirms that the carabiner clip and the door anchor were never used to begin with. They seemingly were only used for taking photographs.
The handle looped around the band and the "noose" created indicates the band was manipulated for that manner, not how the band came to be after the supposed hanging.
Chris was never "found" laying on the floor in the bathroom with exercise band around his neck shown here.
Observe the distance between where the exercise band was laying and the bathroom door.
*Visualize the bathroom door closed with the band around Chris's neck in the alleged manner of a partial suspension. This is with the band supposedly over the top of door with the door, according to Martin Kirsten, partially opened.
The blood splatter and the drag mark of blood indicates where Chris's face was.
Again, Chris was not "found" on the floor with his neck in the loop of the band shown here.
Observing the photo above, Chris was either removed from the bathroom after death, or continued in the possible struggle while being strangled from behind, landed in the bedroom and died long before medical crew/police arrived.
The band afterwards removed from Chris's neck, taken back into the bathroom, manipulated and placed over the blood. “Patient did have a exercise rubber band around his neck. . . " - First Responder via Detroit Police Scanner.
During that time, Chris had been ". . . cool to the touch in all areas at this time." - Frist Responder via Detroit Police Scanner, while he lay in the bedroom supine. (facing up)
MGM Medic "Dawn Jones" continues to appear to be a fabrication, as it was never mentioned who precisely removed Chris from the bathroom upon discovery ( 41 minute gap from Martin's "discovery" of Chris deceased in the bathroom) in addition to who specifically removed the band from Chris's neck.
MEO investigator Angela Anderson-Cobb mentions that medical crew (not the first responder from the Detroit police scanner) removed the band from Chris's neck to facilitate resuscitation as it appeared to her upon her arrival at 3:53am.
Case Registration Summary, page 1 of 3
THE DRIP STAINS OF BLOOD.
The blood on the outside of the bathroom door and the blood drops on the bathroom floor at the entrance, suggest Chris was bleeding, either from the nose or mouth, while he struggled in reduced mobility to escape the possible altercation.
DRIP STAINS
- Blood drop that falls at the speed/force of normal gravity
- These drops usually fall from an open wound, or from a surface that is saturated with blood
- Blood forms a spherical shape (perfect circular shape)immediately upon separating from the blood source. - Bloodstain Pattern Analysis
