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INDEX OF EXHIBITS

Muhaymin v City of Phoenix

Case No.: 17-cv-04565-PHX-SMB

Exhibit Description

1 Dr. Bennet Omalu’s Report dated 6/22/2020

2 Dr. Bennet Omalu’s Deposition Transcript dated 10/26/2020

3 Plaintiff’s Sixth Supplemental Mandatory Discovery Responses

4 Maricopa County Office of Medical Examiner Toxicology Report dated 

1/5/2017

5 Dr. Ali Taqi’s Deposition Transcript dated 10/22/2020

6 Terros Record dated 12/12/2016

7 Terros Record dated 11/14/2016

8 Maricopa County Office of Medical Examiner Report dated 1/5/2017

9 Dr. Gary M. Vilke’s Report dated 6/20/2020

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EXHIBIT 1

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Phone: 209-636-2822

Fax: 866-402-6875

bennetomalu@bennetomalu.com

The Fountains

3031 West March Lane, Suite 323, Stockton, CA 95219

Neuropathology

Epidemiology

Medico-Legal Consultations

Autopsy and Anatomic Pathology

Clinical Pathology and Toxicology

Forensic Pathology

Haytham Faraj, Esq. June 22, 2020

Law Offices of Haytham Faraj

1935 West Belmont Avenue

Chicago, IL 60657

Dear Mr. Faraj, 

Re: MUHAMMAD ABDUL MUHAYMIN, DECEASED

MEDICO-LEGAL REPORT

Summary of Education, Training and Experience

I completed medical school in 1990 at the University of Nigeria, Enugu, Nigeria. Upon 

graduating from medical school, I completed a one-year clinical housemanship at the University 

of Nigeria Teaching Hospital in the fields of pediatrics, internal medicine, general surgery, 

obstetrics, and gynecology. After housemanship, I worked as an emergency room physician at a 

university hospital in Nigeria for approximately three years. I sat for and passed my United 

States Medical Licensing Examinations [USMLE] while I worked as an emergency room 

physician. I came to the United States in 1994 through a World Health Organization scholarship

to become a visiting research scholar for eight months at the Department of Epidemiology, 

Graduate School of Public Health, University of Washington, Seattle, Washington. 

In 1995, I proceeded to the College of Physicians and Surgeons of Columbia University, New 

York, New York, at Harlem Hospital Center, to complete residency training in Anatomic 

Pathology and Clinical Pathology. In 1999 I proceeded to the University of Pittsburgh, 

Pittsburgh, Pennsylvania to complete residency training in forensic pathology and 

neuropathology. I hold four board-certifications in Anatomic Pathology, Clinical Pathology, 

Forensic Pathology and Neuropathology. I also hold a Masters in Public Health [MPH] degree in 

Epidemiology from the Graduate School of Public Health, University of Pittsburgh, Pittsburgh, 

Pennsylvania. I also hold a Masters in Business Administration [MBA] degree from the Tepper 

School of Business, Carnegie Mellon University, Pittsburgh, Pennsylvania, one of the leading 

business schools in the world. I am a Certified Physician Executive and an honorary fellow of the 

American Association of Physician Leadership [AAPL]. I also hold a fifth board-certification in 

medical management from the AAPL. I am licensed to practice medicine and surgery in four 

states in the United States namely Hawaii, California, Indiana, and Pennsylvania. 

I am currently the President and Medical Director of Bennet Omalu Pathology [BOP], a 

California medico-legal consulting firm, and a Clinical Professor at the Department of Medical 

Pathology and Laboratory Medicine, University of California, Davis. In my capacity as the 

Medical Director of BOP, I am a consulting forensic pathologist and neuropathologist to many 

hospitals in central California and to several counties in northern California. There are less than 

• 

Bennet Omalu 

PATHOLOGY 

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Muhammad Abdul Muhaymin, Deceased

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a few dozen practicing forensic pathologists-neuropathologists in the United States who are 

board-certified in both forensic pathology and neuropathology. 

For over nineteen years, I have been involved in over nine thousand death and injury 

investigations in my career as a forensic pathologist and neuropathologist, which began in 1999. 

I have personally conducted and performed over eight thousand autopsies and death 

investigations and examined over nine thousand brain tissue specimens. I also perform trauma 

pattern analysis in both living patients and deceased patients to determine causes and 

mechanisms of sustenance of injuries and death. I am also involved in the evaluation of living 

victims of all types of injuries and trauma, including but not limited to victims of assault, 

traumatic falls, industrial and accidental injuries, medical complications and misadventures, 

rape, child abuse and sports-related injuries. I have been consulted and retained as an expert 

witness in one to two thousand cases involving all types of medico-legal cases across all 

jurisdictions in the United States including federal, state, county and municipal courts and 

arbitration panels; in both civil and criminal cases, for the plaintiff, defense, district attorneys 

and public defenders. I have been involved as an expert witness in complex class action and 

industrial lawsuits involving thousands of individuals and major corporations. 

My areas of interest and focus include brain patho-physiology, brain injuries and brain trauma, 

in both living and deceased patients. I identified Chronic Traumatic Encephalopathy [CTE] in a 

retired football player when I performed an autopsy and examined the brain of Mike Webster in 

2002. Subsequently, I identified CTE in other high-impact, high-contact sports athletes and in 

military veterans suffering from Post-Traumatic Stress Disorder [PTSD]. Since 2002 CTE has 

received international attention from the sports industry, sports medicine, and neuroscience. 

My work has been featured extensively in all media platforms across the world. My work and life 

were featured in a major Hollywood film, “Concussion” released in December 2015 by Sony 

Motion Pictures, in which the renowned actor, Will Smith, played me as Dr. Omalu. Several New 

York Times best-selling books have also been published on my life and work including “The 

League of Denial” and “Concussion”. I have published several books including my memoir, 

“Truth Doesn’t Have a Side”, which was published in August 2017. My latest book, “Brain 

Damage in Contact Sports” was published in February 2018. I have published extensively in the 

medical and scientific literature authoring many scientific papers and book chapters. 

I have received three honorary PhD degrees from two universities in the United States, and from 

the Royal College of Surgeons of Ireland in recognition of my work and expertise. I have also 

received numerous awards from across the world in recognition for my work and expertise in 

both living and deceased patients. I have received the “Distinguished Service Award” from the 

American Medical Association [AMA], which is the most prestigious award of the AMA. I have 

been honored by the United States Congress and I have appeared on multiple occasions before 

committees of the United States Congress and committees of State Legislatures across the 

Unites States advising them on matters relating to trauma. In 2019 I was appointed to the 

Traumatic Brain Injury Board of the State of California to advise the state on matters relating to 

traumatic brain injuries. 

Since 1999 I have testified as an expert witness in matters relating to all types of injuries and 

deaths in over 500 court proceedings across the United States. I have attached a copy of my 

curriculum vitae, which enumerates my body of work and experience in greater detail. I have 

also attached my fee schedule. The cases I have testified in, beginning in 2009, are enumerated 

at the end of my curriculum vitae.

Bennet Omalu P \ T II O L O G \ 

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Pursuant upon your request, I have reviewed the following materials in the case of Muhammad 

Abdul Muhaymin, Deceased:

1. Autopsy and Medical Examiner Reports

2. Body Camera Videos

3. Deposition Transcripts and Recorded Interviews

4. Complaints and Other Miscellaneous Legal Documents 

5. Incident Report from the Phoenix Police Department

6. Trip sheet from the Phoenix Fire Department 

Summary of Prevailing Forensic Scenario

At the time of his death on January 4, 2017, Muhammad Abdul Muhaymin [Muhammad] was a 

43-year-old African-American male who was born on He suffered from PostTraumatic Stress Disorder, Claustrophobia and Schizophrenia. He always carried a service dog 

with him to alleviate his mental disabilities and symptoms. The dog was named “Chiquita”. 

Anthony Tarago, the manager of the Maryvale Community Center, called for the police on 

January 4, 2017 at approximately 09:28 a.m. for an assault and for the police to escort 

Muhammad from the center and instruct him never to return. Allegedly Muhammad was at the 

center with his service dog that was off-leash. Muhammad wanted to use the public bathrooms 

to defecate. Mr. Tarago stood in Muhammad’s way and would not permit him to use the 

bathroom because his dog was not restrained. Allegedly an argument ensued, and Muhammad 

and Mr. Tarago bumped into each other without any assault. 

After the police arrived at the center at approximately 09:32 a.m. Muhammad was allowed to 

use the bathroom. Officers discovered that there was a misdemeanor warrant for the arrest of 

Muhammad out of the city of Mesa. The police officers planned to arrest Muhammad after he 

used the bathroom. Officers walked behind Muhammad as he exited the center carrying his dog 

in his right arm. An officer grabbed Muhammad’s left wrist from the back in an attempt to place 

him under arrest. A struggle ensued. Muhammad was taken to the ground by the officers at 

approximately 9:45 a.m. Muhammad clasped his hands together locking them. He did not 

punch or hit any officer. At least three officers were on top of Muhammad or holding him down, 

as they pressed him to the ground while attempting to release his hands and handcuff them. The 

officers placed the weight of their bodies on Muhammad’s head, trunk, arms, and legs. 

Muhammad was heard yelling “Okay!”. Two handcuffs were placed, one on each wrist and were 

linked together behind Muhammad’s back. 

The officers stood Muhammad up after he was detained at approximately 09:47 a.m. and walked 

him to a police vehicle at the parking lot. At the police vehicle, Muhammad’s handcuffed upper 

extremities were lifted from behind above his head to the front, while he screamed. Then 

Muhammad was again taken to the ground by officers at approximately 09:56 a.m. He was 

placed face down on the sidewalk while officers were on top of him pressing him to the ground, 

including an officer who used his entire body and laid perpendicularly across Muhammad’s right 

and left calves to keep his legs from moving. Another office knelt on Muhammad’s trunk 

applying his body weight on Muhammad. Muhammad was heard yelling “I can’t breathe”

several times. A call was made requesting additional officers in order to hold down Muhammad. 

A RIP [leg] restraint was applied to his feet and around his ankles and then attached to the 

handcuffs. The officers placed the weight of their bodies on Muhammad’s head, trunk, arms,

and legs. After Muhammad was re-handcuffed, his body became limp and he began to vomit, 

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and was moved away from the vomit. He stopped breathing and no pulse was detected at 

approximately 10:04 a.m. The RIP restraints were removed from his handcuffs and CPR was 

initiated. Muhammad never struck or kicked any officer. No conducted electrical devices were 

utilized by any officer and no strikes were deployed by any officer. There were at least six officers 

who were on top of Muhammad or pressed Muhamad prone on the sidewalk. 

Muhammad was emergently transported to the Maryvale Hospital and arrived at approximately 

10:23 a.m. Muhammad was unresponsive, had no pulse and was foaming in his mouth. 

Muhammad was pronounced dead at 10:39 a.m.

Autopsy

A full autopsy [17-00095] was performed on the body of Muhammad Abdul Muhaymin on 

January 5, 2017 by Dr. Amanda E. Maskovyak at the Maricopa County Office of the Medical 

Examiner beginning at approximately 10:12 a.m. 

Dr. Maskovyak stated the cause of death to be the following: “Cardiac arrest in the setting of 

coronary artery disease, psychiatric disease, acute methamphetamine intoxication, and physical 

exertion during law enforcement subdual”. The manner of death was stated to be a homicide. 

Under the heading “How Injury Occurred”, Dr. Maskovyak stated the following: “Cardiac arrest 

in the setting of coronary artery disease, psychiatric disease, acute methamphetamine 

intoxication, and physical exertion during law enforcement subdual”. 

The autopsy findings were stated as follows:

I. Cardiac arrest in the setting of coronary artery disease, psychiatric disease, acute 

methamphetamine intoxication, and physical exertion during law enforcement subdual.

A. Coronary artery disease.

1. 40 to 50 percent atheromatous stenosis of left anterior descending artery.

2. lntramyocardial segment, left anterior descending artery (2 cm in length x 

0.1 cm depth).

B. Reported history of schizophrenia and bipolar disorder.

C. Acute methamphetamine intoxication.

1. 0.81 mg/L methamphetamine in iliac blood.

2. 0.24 mg/L amphetamine in iliac blood.

D. History of subdual by law enforcement.

1. Physical exertion/struggle with officers during law enforcement subdual.

2. Placement in prone position with hand, knee, foot, and/or body weight 

force applied by multiple officers to decedent's head, arms, wrists, 

shoulders, torso, and/or legs.

3. Physical restraints applied to decedent while in prone position.

4. Sudden unresponsiveness while in prone position.

5. Blunt force injuries of head, torso, and extremities.

i. Multifocal cutaneous abrasions of face.

ii. Bilateral temporalis muscle contusions (right = 2 cm, left = 0.5 cm).

iii. No internal head or neck injuries are identified.

iv. Intramuscular contusion of left upper back.

v. Subcutaneous hemorrhage of left mid back.

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vi. Mildly hemorrhagic fractures of anterolateral right and left ribs 2 

through 6 and parasternal left ribs 3 through 6 and parasternal right

ribs 2 through 6 (possibly representing perimortem artifact due to 

cardiopulmonary resuscitation with chest compressions).

vii. Multifocal contusions and abrasions of bilateral elbows and wrists.

viii. Subcutaneous and intramuscular hemorrhage of left posterior upper 

arm and left elbow.

ix. Bilateral anterior knee abrasions.

II. Reported history of asthma.

A No significant histologic evidence of acute asthma exacerbation on histologic 

examination of lung tissue.

At autopsy Muhammad weighed 164 pounds and measured 67 inches. Vomitus was noted in his 

nostrils and mouth. The body revealed the following evidence of trauma:

I. Blunt Force Trauma of the Head and Neck:

1. There was a 3 x 1.5 cm orange-pink abrasion of the right lateral frontal scalp. 

2. There was a 0.8 cm thin partial thickness linear laceration of the right forehead, 

just above the right lateral supraorbital ridge. 

3. There were 3 x 1.5 cm and 1.2 x 0.8 cm pink contusion and pink-white abrasion of 

the right lateral supraorbital ridge, respectively. 

4. There were two 0.3 cm shallow abrasions of the right upper middle and lateral 

eyelid. 

5. There were 4 x 3 cm clustered and overlapping pink-orange linear abrasions of the 

right cheek. 

6. There was a 0.5 cm laceration of the medial left nare. 

7. There was a 2 x 1.5 cm irregular brown abrasion of the left frontal scalp at the 

hairline. 

8. There was a 1.5 cm linear abrasion of the right frontal scalp. 

9. There was a 2 x 0.5 cm red-brown abrasion of the left temple. 

10. There was a 7 x 1.5 cm cluster of overlapping pink-tan linear abrasions of the left 

cheek. 

11. There was a 2 cm intramuscular contusion of the right temporalis muscle. 

12. There was a 0.5 cm intramuscular contusion of the left temporalis muscle. 

II. Blunt Force Trauma of the Trunk:

1. There were mildly hemorrhagic fractures of the anterolateral right and left 2nd to 6th

ribs and the parasternal left 3rd to 6th ribs, and right 2nd to 6th ribs. 

2. There was a 2 cm intramuscular contusion of the left paraspinal upper back. 

3. There was a 1.0 cm contusion of the left paraspinal mid back. 

III. Blunt Force Trauma of the Extremities:

1. There was a 2.5 x 2 cm red-brown abrasion of the superior left shoulder. 

2. There was a 2 x 1.5 cm irregular red-pink abrasion of the left elbow. 

3. There was a 2 x 2 cm discontinuous cluster of pink-brown abrasions of the left 

medial elbow. 

4. There was a 2 x 1.5 cm red-brown-pink abrasion of the left posterolateral proximal 

forearm. 

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5. There was a 1.0 x 0.9 cm pink-white abrasion of the left lateral wrist. 

6. There was a 4.5 x 1.5 cm cluster of irregular pink contusions and abrasions of the 

left medial wrist. 

7. There was a 3.5 x 1.5 cm faint pink contusion of the left volar wrist. 

8. There was an 8.0 cm area of ill-defined subcutaneous and intramuscular 

hemorrhage in the left posterior upper arm. 

9. There was a 1.2 x 1 cm red-brown abrasion of the superior right shoulder. 

10. There was a 4 x 3 cm cluster of red-brown punctate abrasions of the right medial 

elbow. 

11. There was a 3 x 2.5 cm discontinuous tan-pink abrasion of the proximal right 

forearm. 

12. There was a 2 x 0.5 cm cluster of red-brown abrasions of the right lateral elbow. 

13. There were three linear abrasions of the right distal and lateral upper arm 

measuring 0.3 cm, 0.5 cm, and 1.5 cm. 

14. There were 9 x 4 cm discontinuous clusters of pink contusions of the right 

dorsolateral proximal to mid forearm situated in a vaguely Y-shaped distribution. 

15. There was a 4.5 x 4 cm area of faint pink contusions of the right lateral wrist. 

16. There was a 3.5 x 3 cm irregular area of pink contusions and abrasions of the right 

medial wrist. 

17. There was a cluster of three irregular abrasions of the proximal medial right 

forearm measuring between 0.2 cm and 0.7 cm. 

18. There were patchy subcutaneous and intramuscular hemorrhages in the right

elbow. 

19. There was a 1.2 x 0.5 cm irregular red-brown abrasion of the left knee.

20. There was a 0.3 cm red-brown abrasion of the medial left knee. 

21. There is a cluster of red-brown abrasions of the right medial and inferior knee 

measuring between 0.2 cm and 0.8 cm. 

The skull revealed no fractures. There were no intracranial hemorrhages. The brain weighed 

1300 grams. the heart weighed 325 grams. The left anterior descending coronary artery revealed 

atherosclerosis with focal 40-50% stenosis. There was tunneling of the left anterior descending 

coronary artery for a distance of 2 cm and a maximum depth of only 0.1 cm. The right and left 

lungs each weigh 475 grams. The liver weighed 1425 grams. 

Toxicologic analysis of iliac blood obtained during the autopsy revealed the presence of 

Methamphetamine [0.81 mg/L] and Amphetamine [0.24 mg/L]. 

Histology Tissue Slides

Seven Hematoxylin and Eosin [H/E] stained tissue histology slides were sent to me from the 

Maricopa County Office of the Medical Examiner. These were the histology slides prepared after 

the autopsy and reported in the autopsy report. Based on my education and experience, these 

seven slides were grossly inadequate and insufficient for accurate pathology diagnoses and 

conclusions. I therefore requested permission to visit the medical examiner’s office and examine 

the archival autopsy stock tissues in order to prepare additional histology tissue slides. Oddly, 

the archival autopsy stock tissues fixed in formalin were sent to my office in California. I 

examined them and made a total of 39 new and additional H/E stained tissue histology slides on 

this case. I examined all the H/E stained tissue slides, a total of 46 histology tissue slides. 

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The following tissue slides were examined:

Maricopa County Slides1: Seven H/E stained slides2 without any numbers.

The slide labeled “LAD” reveals a coronary artery with surrounding epicardial adipose tissues 

and myocardium. The artery shows no significant atherosclerosis with none to minimal 

eccentric fibrous hyperplasia of the tunica intima. The myocardium shows scattered 

myofibrillary hypertrophy with box-car nucleomegaly without any inflammation. There is

multifocal myofiber hypereosinophilia with myofiber waviness. Another slide shows three small 

sections of lung tissue, which show diffuse marked congestion without any bronchial or 

bronchiolar, or alveolar inflammation. There are large amounts of intraluminal aspirated gastric 

contents and foreign matter in bronchioles. Another slide shows a section of the mesial temporal 

lobe and cornu ammonis showing diffuse marked congestion of the arachnoidal and penetrating 

parenchymal blood vessels with perivascular microextravasates in the Virchow Robin spaces. 

There are many pyknotic and amphophilic to eosinophilic pyramidal neurons in the stratum 

pyramidalis especially in the Sommer’s sector and accentuated in the Sommer’s sector. The 

fascia dentata shows many pyknotic, amphophilic to eosinophilic granule neurons. The inferior 

temporal cortex also shows many scattered pyknotic, amphophilic to eosinophilic neurons. 

Another slide shows three small sections of myocardium. The myocardium shows severe 

vascular congestion with multifocal microextravasates. There are few scattered hypertrophic 

myofibers with box-car nucleomegaly. There are multifocal and sparse wavy fibers and 

hypereosinophilic myofibers without any inflammation. Another histology slide shows two small 

sections of the myocardium and the myocardium shows similar findings described above. 

Another histology slide shows a small section of the liver and a small section of the kidney. Both 

sections show diffuse marked parenchymal congestion. The liver section shows no inflammation 

of the portal triads or lobules and no hepatocellular steatosis or necrosis. The kidney sections 

show no glomerulosclerosis, interstitial nephritis, or tubular necrosis. Another histology tissue 

section shows two small sections of lung tissue and both sections reveal diffuse marked 

congestion without any bronchial or bronchiolar, or alveolar inflammation. There are large 

amounts of intraluminal aspirated gastric contents and foreign matter in bronchi and 

bronchioles.

Bennet Omalu Pathology Slides: Thirty-Nine H/E Stained Histology Slides

Slide #1: Two sections of the liver

The liver sections show diffuse parenchymal congestion with no hepatocellular steatosis or 

necrosis. There is no chronic inflammation of the hepatic portal triads or lobules. 

Slide #2: Two sections of the liver

There is focal and sparse lobular hepatocellular infiltration by lymphocytes, Diffuse 

parenchymal congestion is noted, accentuated in lobular zones 3 in a centrilobular fashion. 

Slide #3: Two sections of kidney

There is acute parenchymal congestion with focal micronephrolithiasis in few collecting tubules 

in the medulla. There is no glomerulosclerosis, interstitial nephritis, or tubular necrosis. 

Slide #4: Two sections of kidney

These sections show findings that are similar to what has been described above. 

Slide #5: Two sections of lung

1 The slides were not labeled with any numbers. The inscriptions on all the slides are the following: “17-

0095 SUBPOENA AEM Maricopa County Forensic Science Center”. Only one slide is also labeled LAD. 

2 The staining of the tissue sections is very faint and faded and are suboptimal for diagnosis. 

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There is diffuse marked pulmonary parenchymal congestion with focal and sparse mucosaassociated lymphoid tissue without any significant inflammation. There are large amounts of 

intraluminal aspirated gastric contents in the bronchi and bronchioles. 

Slide #6: Two sections of lung

There is diffuse marked pulmonary parenchymal congestion with focal and sparse mucosaassociated lymphoid tissue without any significant inflammation. There are large amounts of 

intraluminal aspirated gastric contents in the bronchi and bronchioles. Multifocal to patchy to 

diffuse intra-alveolar eosinophilic edema fluid is noted. Multifocal and sparse intra-alveolar 

pigment-laden histiocytes are noted. 

Slide #7: Two sections of lung

These sections reveal findings similar to what have been described above. 

Slide #8: One section of lung; one section of right ventricle

The section of the lung reveals changes, which have been described above. The right ventricle 

reveals scattered hypertrophied myofibers with box-car nucleomegaly. There is multifocal 

myofiber waviness and hypereosinophilia [myocytolysis] without any inflammation. There is 

diffuse congestion of the myocardium. 

Slide #9: Two sections of lung

These sections of lung tissue reveal findings, which have been described above. 

Slide #10: Two sections of left ventricle

These sections of the left ventricle reveal scattered myofiber hypertrophy with box-car 

nucleomegaly. There is multifocal myocytolysis with myofiber waviness and hypereosinophilia, 

with focal contraction band necrosis, without any inflammation. 

Slide #11: Two sections of the left ventricle

These sections reveal findings that are similar to what have been described above. There is no 

inflammation of the endocardium or epicardium. 

Slide #12: One section of left ventricle; one section of right ventricle and one section of aorta

The sections of the right and left ventricles show findings which have been described above. 

Coronary vessels in the epicardium reveal no atherosclerosis. There is no inflammation of the 

epicardium or endocardium. The aorta shows marked adventitial congestion without any 

intimal or medial inflammation or necrosis or sclerosis. 

Slide #13: One section of the spleen; one section of an adrenal gland

The spleen and adrenal gland show diffuse parenchymal congestion. There is no acute splenitis 

or adrenalitis. There are no secondary follicles in the splenic white pulp. The adrenal gland 

shows no hyperplasia or adenoma. There are no adrenocortical or medullary hemorrhages.

Slide #14: One section of pancreas; one section of esophagus and stomach

The pancreas shows early autolysis without any acute or chronic pancreatitis, interstitial 

fibrosis, or lobular atrophy. The esophagus and stomach show no esophagitis or gastritis. 

Slide #15: One section of tongue; one section of cerebellar cortex

The tongue reveals no inflammation and no diffuse myofiber atrophy. The cerebellum reveals 

diffuse congestion of the arachnoidal and penetrating parenchymal blood vessels with multifocal 

perivascular microextravasates. The molecular layer shows no necrosis or infarction. The 

Purkinje neuron layer shows many pyknotic, amphophilic to eosinophilic Purkinje neurons 

without significant neuronal dropout. The internal granule cell layer shows no autolysis. The 

cerebellar white matter shows no necrosis, infarct, or demyelination. 

Slide #16: One section of interventricular septum; one section of cerebellum

The interventricular septum shows focal myocytolysis with many subendocardial myofibers 

showing marked hypereosinophilia, myocytolysis and contraction band necrosis without any 

inflammation. The valvular leaflet attached to the basal interventricular septum shows no 

inflammation. The cerebellum shows findings, which have been described above in addition to 

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many scattered pyknotic, amphophilic to eosinophilic neurons in the subcortical nucleus. There 

is no marked neuronal dropout in the subcortical nucleus. The cerebellar white matter shows 

marked vascular congestion without any focal necrosis, infarct, or demyelination. 

Slide #17: One section of pons; one section of spinal cord:

The section of the spinal cord reveals no inflammation of the meninges or neuropil. The spinal 

funiculi reveal no degeneration, necrosis, or demyelination. The pons is described below. 

Slide #18: One section of pons

The pons is described below. 

Slide #19: One section of pons

The pons reveals congestion of the arachnoidal and penetrating parenchymal blood vessels. The 

basis pontis and pontine nuclei reveal no central myelinolysis. The pontine nuclei reveal 

scattered pyknotic and amphophilic neurons. The tegmental nuclei and locus ceruleus reveal 

scattered pyknotic and amphophilic neurons. There is no dorsolateral hemorrhage or necrosis. 

Slide #20: One section of medulla oblongata; one section of medulla oblongata-spinal medulla 

junction

The medulla oblongata reveals no focal neuropil necrosis or hemorrhage. The inferior olivary nuclei 

reveal mild neuronal dropout with scattered pyknotic and amphophilic neurons. The medullary 

tegmentum reveals scattered pyknotic and amphophilic neurons without neuropil necrosis. The 

medullary pyramids show no atrophy, necrosis, or infarct. 

Slide #21: One section of medulla oblongata; one section of left ventricle

The medulla oblongata reveals findings, which have been described above. The left ventricle 

reveals findings, which have been described above. 

Slide #22: One section of interventricular septum; one section of prostate gland

The interventricular septum reveals findings, which have been described above. The prostate 

gland shows sparse and focal acute and chronic prostatitis with neutrophilic and lymphocytic 

infiltrates. There is no glandular or fibromuscular hyperplasia. 

Slide #23: Four sections of spinal cord

There is congestion of the spinal meninges and neuropil without any inflammation. The white 

matter funiculi, including the anterior and lateral funiculi and the fasciculus cuneatus and 

gracilis, reveal neuropil edema without focal necrosis, inflammation, or demyelination. The 

central gray matter shows no hemorrhage and no necrosis. The spinal neurons show no 

degeneration. The spinal canal is central. 

Slide #24: One section of mesial temporal lobe and hippocampus 

See description below. 

Section #25: One section of neocortex

See description below. 

Slide #26: One section of mesial temporal lobe and hippocampus

The dentate gyrus and cornu ammonis of the hippocampus reveal no focal dysplasia or sclerosis. 

The stratum pyramidalis of the Sommer’s sector (CA1), CA2, CA3 and CA4 regions of the cornu 

ammonis reveal many scattered pyknotic, amphophilic to eosinophilic pyramidal neurons 

especially in the Sommer’s sector. The fascia dentata reveals scattered pyknotic, amphophilic to 

eosinophilic granule neurons. The entorhinal cortex and the alveus reveal no focal neuropil 

necrosis. The choroid plexus is congested. The penetrating vessels of the strata radiatum, 

lacunosum and moleculare reveal mural mineralization. 

Slide #27: One section of neocortex

See description below. 

Slide #28: One section of neocortex

Examination of hematoxylin and eosin stained sections of the neocortex reveals a homogenetic 

cortex with the normal homotypical laminar and columnar organization. There is no cortical 

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disorganization, diffuse or nodular neuronal heterotopia. There is no significant neuronal dropout or astrogliosis. There are many scattered pyknotic, amphophilic to eosinophilic neurons. 

There is diffuse congestion of the arachnoidal and penetrating parenchymal blood vessels with 

multifocal perivascular microextravasates. There is perineuronal vacuolation, accompanied by 

expansion of Virchow Robin spaces and neuropil microspongiosis of both the gray and white 

matter. The arachnoidal mater, pia mater, penetrating vessels and the Virchow Robin’s spaces 

reveal no inflammation. The centrum semiovale reveals neuropil edema and congestion without 

any focal necrosis, infarct, or hemorrhages. There is no gliding contusional hemorrhage. 

Slide #29: Sections of dura mater

See the description below. 

Slide #30: Section of dura mater

The dura mater reveals intradural congestion with intradural microextravasates without any 

inflammation, extradural membranes or pigment-laden histiocytes. 

Slide #31: Section of larynx

The larynx reveals sparse mucosa-associated lymphoid infiltrates. 

Slide #32: One section of larynx; one section of epicardium with coronary artery

The larynx reveals no inflammation. The coronary artery shows eccentric mild fibrous 

hyperplasia of the tunica intima with focal intramural cholesterol deposits and vacuolation. 

Slide #33: One section of epiglottis; one section of trachea

The epiglottis reveals focal and sparse submucosal lymphocytic infiltrates. the trachea does not 

reveal any inflammation. 

Slide #34: One section of adrenal gland; one section of urinary bladder

The adrenal gland shows diffuse congestion without any necrosis or hemorrhage. There is no 

adenoma or hyperplasia and no inflammation. The urinary bladder reveals no cystitis. 

Slide #35:One section of thyroid gland; one section of heart- SA node

The SA node shows no necrosis, dysplasia, fibrosis, or inflammation. The thyroid gland does not 

show any thyroiditis or nodular hyperplasia. 

Slide #36: One section of lung; one section of AV node

The AV node appears unremarkable. The lung section reveals findings, which have been

described above. 

Slide #37: One section of heart; one section of gallbladder; two sections of vermiform appendix

The heart reveals findings, which have been described above. The gallbladder reveals diffuse 

autolysis without any inflammation. The vermiform appendix reveals no inflammation. 

Slide #38: One section of bronchus; one section of vermiform appendix and mesoappendix; one 

section of gallbladder

The gallbladder shows diffuse autolysis without any inflammation. The vermiform appendix 

shows no inflammation. The mesoappendix shows marked vascular congestion. The bronchus 

shows marked diffuse, transmural congestion without any inflammation. 

Slide #39: Four sections of epicardium and myocardium and coronary vessels

The coronary vessels in these sections do not reveal any inflammation. There is none to minimal 

fibrous hyperplasia of the tunica intima. 

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Medico-Legal Questions

1. What were the underlying cause of death, mechanism of death, contributory 

factor to death and manner of death of Muhammad Abdul Muhaymin 

[Muhammad]?

Medicine is a life science, which is evidence based. The practice of medicine is guided by 

established standards and generally accepted principles, which certified physicians must adhere 

to. The specialties and the categories of physicians who are proficiently trained, specialized, and 

competent in the accurate determination of the cause, mechanism and manner of death are the 

forensic pathologists, especially for deaths involving all types of trauma and bodily injury. The 

death of Muhammad involved serious bodily injury. 

The College of American Pathologists [CAP] describes the specialty of forensic pathology as 

follows: “Forensic pathology is the subspecialty of pathology that directs its efforts to the 

examination of living or dead persons in order to provide an opinion concerning the cause, 

mechanism, and manner of disease, injury or death; the identification of persons; the 

significance of biological and physical evidence; the correlation and/or reconstruction of 

wounds, wound patterns, and sequences; and conducting comprehensive medico-legal death 

investigations. Forensic pathology applies techniques of pathology to the needs and protection 

of public health, public safety, quality assurance, education in medicine, research, 

jurisprudence, and the administration of justice. Its highest goal is the development of strategies 

to prevent injury, disease, and death.”

The CAP also describes a forensic pathologist as follows: “A forensic pathologist is a pathologist 

with special training and experience in forensic pathology who is actively engaged in medicolegal autopsies and death investigations. Forensic pathologists shall be board-certified by the 

American Board of Pathology or American Osteopathic Board of Pathology after appropriate 

training and passing a rigorous examination, or a non-USA based pathologist with equivalent 

certification. The practicing forensic pathologist is licensed in one or more states; he/she is 

skilled in conducting death investigations, interpreting injuries in both fatal and non-fatal cases, 

performing medico-legal examinations, determining disease/injury causation to an appropriate 

degree of medical certainty and determining cause and manner of death.”

Trauma pattern recognition, interpretation and analyses are the fundamental methodologies the 

forensic pathologist adopts in the differential diagnoses of causes and mechanisms of injuries 

and/or death. Trauma pattern recognition, translation and analysis are commonly applied to 

forensic differential diagnoses, opinions, and conclusions. It is a generally accepted principle 

and common knowledge in medicine and forensic pathology, that specific traumatic events 

generate predictable, reproducible, and specific patterns of injuries, outcomes, and death. 

The practice of forensic pathology is guided by very well-established and generally accepted 

principles, which board-certified forensic pathologists must adhere to while they routinely 

perform differential diagnoses and determine causes, mechanisms, and manners of death. 

Objective decisions, conclusions and opinions should be made in all types of trauma case 

analyses strictly based on objective interpretations of patterns of injuries, prevailing forensic 

scenarios, and trauma pathophysiology. The prevailing global forensic scenarios, the patterns of 

trauma and the expected outcomes of trauma exhibited by Muhammad are vividly consistent 

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with fatal and homicidal trauma as prescribed by the well-established and generally accepted 

patho-physiology of trauma and disease. 

The determination of cause and manner of death are guided by and must adhere to very wellestablished and generally accepted principles and concepts, standards of practice and common 

knowledge of science and medicine. In order to determine the cause of death of Muhammad 

accurately and competently, we may have to review these generally accepted principles and 

concepts, standards of practice and common knowledge. Forensic pathologists cannot 

determine cause and manner of death at whim outside these principles, concepts, and standards 

when they perform differential diagnoses to determine causes, mechanisms, and manners of 

death. Objective decisions, conclusions and opinions should be made in all types of trauma case 

analysis strictly based on objective interpretations of patterns of injuries and prevailing forensic 

scenarios, which should be based on these well-established and generally accepted principles 

and concepts, standards of practice and common knowledge of science and medicine. 

There are four components of cause of death, viz: underlying cause of death, contributory factor 

to death, mechanism of death and manner of death. 

What is an underlying cause of death?

The underlying cause of death is defined as the single factor, event, or disease, which instigates 

or initiates a terminal chain of events that finally culminates in death. It must not be a single 

disease. An event like compression of the body, a gunshot wound of the head, an assault or a fall 

can be a cause of death, when it initiates the terminal chain of events. The chain of events, which 

occurs between the underlying cause of death and death itself, encompasses the mechanisms of 

death. Mechanisms of death are typically not written on the death certificate. 

An illustration is when an individual is shot in the spine causing quadriplegia. Assuming the 

individual survives for fifteen years after he was shot and develops the known sequelae of 

quadriplegia like recurrent bronchopneumonia, recurrent aspiration pneumonia, recurrent 

urinary tract infections, and decubitus ulcers, and finally develops an overwhelming sepsis and 

dies from sepsis. The underlying cause of death will be the event, gunshot wound of the spine. 

The terminal chain of events and the mechanisms of death would include the recurrent 

infections and the sepsis, which finally preceded death. Although the immediate causes of death 

in this instance are natural diseases, the traumatic gunshot wound of the spine precipitated the 

natural diseases and would supersede the natural diseases. The cause of death in the death 

certificate may be completed as “Gunshot Wound of the Spine”. 

When unnatural events or diseases, like falls from any height, compression of the body or 

fractures, co-occur with natural events or diseases, like cancer or heart disease in the cascade of 

events that precipitate death, the unnatural events or diseases supersede the natural events or 

diseases and assume the cause and manner of death. 

An illustration is a 60-year-old woman who is dying from end-stage cancer and has only several 

months to live. She is admitted into a hospice care center for comfort care only. She got up from 

bed one morning to go to the bathroom, slipped, fell on the ground, and impacted her head on 

the floor. She sustained subdural hemorrhages inside her skull and died several weeks later from 

complications of cancer and surgery to evacuate the subdural hemorrhage. The cause of death in 

this instance would be the traumatic brain injury she suffered because it was an unnatural 

disease or event, although she had suffered advanced cancer for several years and was dying 

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from terminal cancer, which is a natural disease. The manner of death therefore would be an 

accident. 

For a factor or disease to assume the underlying cause of death, there has to be a contiguous 

chain of events between the initial occurrence of that factor or disease and the occurrence of 

death, without any significant breach. The interval between the initiating factor and final demise 

is immaterial and non-contributory to the determination of an underlying cause of death as far 

as a contiguous chain of events can be established and competently linked to the initiating factor 

without any significant breach. 

When there is a pre-existing lethal chain of events from any factor or disease, and a novel factor 

or disease arises, either dependent on, or independent of the pre-existing factor or disease, and 

successfully disrupts and breaches the contiguity of the chain of events of the pre-existing factor 

or disease, while initiating a novel lethal chain of events, which culminates in death, the novel 

factor or disease would assume the underlying cause of death. 

An illustration is the instance of a 55-year-old obese man with severe coronary atherosclerotic 

disease, who has had multiple myocardial infarctions and a triple coronary artery by-pass 

surgery and has developed and is dying from end-stage congestive cardiac failure from ischemic 

cardiomyopathy. If this same man falls backwards at home while opening a chest of drawers, 

which falls on top of him, entraps him and compresses his trunk for about 5 minutes before his 

26-year-old son finds him and moves the chest of drawers off him. Unfortunately, by this time 

he was beginning to lose consciousness. The wife calls 911, paramedics arrive and emergently 

take him to the hospital where he is successfully resuscitated but had suffered asphyxial brain 

injury. He is admitted into the intensive care unit where he dies two days later from 

complications of compression of the trunk and asphyxial brain injury. Although he was suffering 

and dying from severe and advanced heart disease, the compression of his trunk, which he 

suffered was a novel and independent factor which instigated a novel chain of events, which 

successfully interrupted the previously existing chain of events, which culminated in his death. 

Compression of the trunk would therefore assume the underlying cause of death and determine 

the manner of death, which in this instance would be an accident. The asphyxial injury of the 

brain is an unnatural disease and would supersede the natural diseases and assume the cause 

and manner of death. 

For every disease, there are extenuating and aggravating factors, which can either decrease or 

increase the risk of suffering from or dying from a disease. A contemporaneous or co-morbid 

disease or factor that increases the risk of a second disease or factor does not denote causation, 

rather it denotes co-morbidity. Disease or event “A” that is co-morbid with disease or event “B” 

does not mean disease “A” causes disease “B” and vice versa. 

What is a contributory factor to death?

A heading in the death certificate states the following: “Other Conditions Contributing to 

Death”. A contributory factor to death is defined as any factor, disease or event, which occurs 

contemporaneously with the underlying cause of death, possesses an independent capacity to 

cause death, however the lethality of this capacity is inferior to the lethality of that of the 

underlying cause of death. The contributory factor may accentuate or accelerate the lethality of 

the underlying cause of death. 

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An illustration is the instance of a man who suffers from end-stage metastatic lung cancer and 

sustains a fracture of his humerus when he fell in his living room. He is taken to the hospital and 

he undergoes open reduction and internal fixation with intramedullary rods. He unfortunately 

suffers a post-traumatic fat embolism following his surgery and dies from acute respiratory 

failure six days after he sustained his fracture. The underlying cause of death would be acute 

respiratory failure due to traumatic fat embolism due to fracture of the humerus. The 

contributory factor to death will be the metastatic lung cancer. The manner of death would be an 

accident. The lethal capacity of the traumatic fat emboli caused by his fractured humerus is far 

more superior to the lethal capacity of his lung cancer. This is why the fractured bone killed him 

within six days while he had survived lung cancer for three years. Traumatic fat embolism from 

a fractured long bone and metastatic lung cancer independently possess potent lethal capacities, 

however the lethal capacity of traumatic fat embolism is superior to that of lung cancer; and 

traumatic fat embolism is an unnatural disease, while lung cancer is a natural disease. 

Traumatic fat embolism caused by a fracture would therefore become the underlying cause of 

death and assume the manner of death, which will be an accident. The lung cancer will become 

the contributory factor to death. 

A contributory factor to death may become an underlying cause of death, if and when it 

instigates a chain of events, which successfully interrupts the pre-existing chain of events of the 

underlying cause, which has been discussed above. In this instance, the underlying cause of 

death would become the contributory factor. 

What is a manner of death?

The manner of death is a medico-legal terminology, which categorizes the circumstances, which 

surround death sometimes referred to as “the prevailing terminal forensic scenario”. There are 

two broad categories of manners of deaths: 

1. Natural 

2. Un-natural

Natural deaths are deaths caused by known natural diseases as have been published in the 

International Classification of Diseases. Un-natural deaths are classified into four manners of 

death: 

1. Homicide

2. Suicide

3. Accident

4. Undetermined

For this report, only the homicide manner of death will be defined. A death is classified as a 

medical homicide when a person intentionally, knowingly, recklessly, or negligently causes the 

death of another human being. A medical homicide may be deemed as a death that occurs, 

directly or indirectly, as a result of another person’s actions. 

In the determination of manner of death, whenever an un-natural factor plays a role in the 

causation and mechanism of death, no matter how infinitesimal, the unnatural factor 

supersedes the natural factors and assumes the manner of death. 

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The case of Muhammad

On January 4, 2017 Muhammad was a 43-year-old male who was alive and well and was not in 

any imminent death or was dying from any disease before he encountered the police. He 

suffered from the psychological ailments of Post-Traumatic Stress Disorder, Claustrophobia and 

Schizophrenia. His autopsy confirmed that he suffered minimal coronary artery disease, which 

is prevalent in the United States population and was not a disease that was going to kill him. He 

was not dying and was not expected to die. Although he had a history of what was believed to be 

bronchial asthma, autopsy confirmed that he was not suffering from bronchial asthma. 

Muhammad was a member of the community and was at a community center to use a public 

bathroom to answer to a normal physiological call of nature, to pass stool. He did not pose any 

reasonable threat or danger to himself or society, was not wanted for a felony, and was not a 

felon who posed a danger to society, and had not committed a felony that was punishable by the 

death penalty, life imprisonment or a long-term imprisonment. 

Muhammad did not die from Methamphetamine toxicity

Toxicologic analysis of his central blood obtained during his autopsy revealed the presence of 

Methamphetamine [0.81 mg/L] and Amphetamine [0.24 mg/L]. This means that Muhammad 

had consumed Methamphetamine within hours of his death. Every human being who consumes 

Methamphetamine, even on habitual basis, does not die from Methamphetamine overdose. 

Majority of human beings who consume Methamphetamine as a recreational drug do not die 

from Methamphetamine. For example, statistical estimates indicate that about 13 million 

people, 12 years and older, in the United States have reported using Methamphetamine. Only 

about 100 thousand people [0.77%] visit the emergency department for Methamphetamine 

toxicity annually, and only about 3 thousand people [0.02%] die from Methamphetamine 

toxicity annually3. If not for his encounter with the police on January 4, 2017, more likely than 

not, Muhammad would not have died, and was not expected to die on January 4, 2017. 

Methamphetamine was not the underlying cause of death of Muhammad. The presence of a 

drug in the blood of a deceased person does not equate to causation of death. The toxic effects of 

a drug cannot be only or fully deciphered solely based on the level of the drug in the blood. This 

is outside the generally accepted guidelines and standards of practice of clinical pathology and 

interpretative toxicologic analysis for the determination of cause of death4. The toxic effects of a 

drug are multifactorial and are determined by many independent and sometimes mutually 

exclusive factors. However, the level of Amphetamine in Muhammad’s blood was stated to be 

0.24 mg/L which was about the same level with the expected toxic levels of >0.20 mg/L5,6. The 

level of Methamphetamine in the blood of Muhammad was 0.81 mg/L, which was higher than 

the expected toxic level of Methamphetamine which is 0.15 mg/L7,8. This is why a determination 

3 https://drugabuse.com/library/methamphetamine-history-and-statistics/#how-dangerous-is-methamphetamine4 Ferner RE. Post-mortem clinical pharmacology. British Journal of Clinical Pharmacology, 

2008;66(4):430-443. 

5 Schulz M et al. Therapeutic and toxic blood concentrations of nearly 1000 drugs and other xenobiotics. 

Critical Care, 2012;16:R136. 

6 Regenthal R et al. Drug levels: therapeutic and toxic serum/plasma concentrations of common drugs. 

Journal of Clinical Monitoring and Computing, 1999, 15:529-544. 

7 Schulz M et al. Therapeutic and toxic blood concentrations of nearly 1000 drugs and other xenobiotics. 

Critical Care, 2012;16:R136.

8 Regenthal R et al. Drug levels: therapeutic and toxic serum/plasma concentrations of common drugs. 

Journal of Clinical Monitoring and Computing, 1999, 15:529-544.

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of the cause of death of any individual should not be based on only the level of a drug in the 

blood. 

Chronic use of Methamphetamine results in psychologic dependence and tolerance, therefore, 

the effects of Methamphetamine may be modulated by the drug use history of each individual. 

Chronic use and exposure result in chronic drug tolerance and resistance. Muhammad was a 

chronic drug user, and people who use Methamphetamine chronically develop drug tolerance 

and habituation and as time passes would use and need higher levels of drugs to achieve the 

same effects. Therefore, such high levels of Methamphetamine and Amphetamine as 

documented by the autopsy of Muhammad are expected because he was a chronic user of 

Methamphetamine. 

Moreover, following death, high tissue levels of drugs migrate/diffuse into the blood, especially 

in chronic consumers of the drugs, and create artifactually and markedly elevated levels of drugs 

in the blood when measured at autopsy. Methamphetamine exhibits a post-mortem tissue 

redistribution of 0.9 – 2.4 heart/femoral ratios. Amphetamine exhibits a post-mortem tissue

redistribution of 1.2 – 5.6 central/peripheral ratios9. This means that the post-mortem levels of 

Methamphetamine and Amphetamine reported in the autopsy blood sample of Muhammad 

were actually much higher than the pre-mortem levels prior to his death. These ratios may be 

higher in chronic users who have accumulated the drug in their tissues over time. 

Therefore, post-mortem levels of 0.81 mg/L of Methamphetamine and 0.24 mg/L of 

Amphetamine may not be of such a significant forensic consequence as it would have been for 

an individual who has never used Methamphetamine or who has not attained the level of drug 

tolerance Muhammad had attained as a chronic recreational user. This is exemplified by some 

cases reported on page 1320 of the textbook: “Disposition of Toxic Drugs and Chemicals in

Man”, eleventh edition, by Randall C. Baselt, PhD. This page states that “Two women found by 

police asleep in a car had blood Methamphetamine concentrations of 1.7 mg/L and 2.1 mg/L, as 

well as substantial levels of Diazepam. The same book on the same page gives two additional 

examples as follows: [1] Methamphetamine blood concentrations of 1.4 – 13 mg/L [average 5.1 

mg/L] were found post-mortem in nine drug abusers who died of traumatic injury by violent 

means; [2] Blood Methamphetamine concentrations of <0.05 – 2.6 mg/L were observed in 27 

persons arrested for erratic driving.”

The toxic levels and effects of drugs that physicians use and apply to case management and 

analysis are typically related to therapeutic drug levels and toxicities. However, the National 

Highway Traffic Safety Administration reports a non-toxic range of 0.01 to 2.5 mg/L10 in 

individuals who use Methamphetamine for recreational purposes. This further confirms that the 

level of Methamphetamine detected in the blood of Muhammad was of no significant forensic 

consequence, was not expected to kill him and did not kill him. He used Methamphetamine 

recreationally and chronically. 

9 Baselt RC, Disposition of Toxic Drugs and Chemicals in Man, 11th edition, Biomedical Publications, Seal 

Beach, California, 2017.

10 National Highway Traffic Safety Administration. Drugs and Human Performance Fact Sheets. U.S. 

Department of Transportation- Methamphetamine [and Amphetamine] www.nhtsa.dot.gov

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Muhammad did not die from coronary artery disease

In her autopsy report, Dr. Maskovyak concluded that Muhammad died as a result of coronary 

artery disease. This is false and grossly inaccurate and goes against the generally accepted 

principles of cardiology and cardiac pathology. Coronary artery disease causes death through the 

pathophysiological mechanism of ischemic myocardial injury and myocardial infarction, which 

can manifest as cardiac arrhythmia and cardiac arrest. According to the international 

classification of myocardial infarctions11, there are five types of myocardial infarctions, viz: 

Types 1, 2, 3, 4 and 5. 

Type 1 myocardial infarction is precipitated by an atherosclerotic plaque disruption, rupture, or 

erosion. The thrombotic component may lead to distal coronary embolization. Plaque rupture is 

complicated by intraluminal thrombosis and by hemorrhage into the plaque through the 

disrupted surface. Muhammad did not suffer a Type 1 myocardial infarction. 

Type 3 myocardial infarction occurs when a patient presents with myocardial injury or ischemia 

including presumed new ischemic EKG changes or ventricular fibrillation and dies suddenly and 

unexpectedly before it is possible to obtain blood or cardiac biomarker determination. Or the 

patient dies after the onset of symptoms before an elevation of biomarker values has occurred. 

Autopsy does not show any ruptured or disrupted plaque and no intraluminal thrombosis. 

Muhammad did not suffer a Type 3 myocardial infarction. Type 3 myocardial infarction allows 

the separation of fatal myocardial infarction events from the much larger group of sudden death 

episodes that may be cardiac [non-ischemic] or non-cardiac in origin. Muhammad did not die 

from a type 3 myocardial infarction.

Type 4 myocardial infarction occurs as a result of cardiac procedural myocardial injury related 

to percutaneous coronary intervention and revascularization procedures. It may be related to 

the procedure itself, which may reflect periprocedural issues or complications of a device such as 

early or late stent thrombosis or in-stent restenosis. Muhammad did not suffer a Type 4 

myocardial infarction. 

Type 5 myocardial infarction occurs as a result of cardiac procedural myocardial injury related 

to coronary artery bypass grafting procedures. It may be related to the procedure itself, which 

may reflect periprocedural issues or complications, graft occlusion or stenosis. Muhammad did 

not suffer a Type 5 myocardial infarction. 

If Muhammad rightfully died as a result of coronary artery disease, he would have suffered a 

type 2 myocardial infarction. However, it is pertinent to note that Muhammad did not have 

moderate or severe coronary artery disease. As this scientific article states12:

“The pathophysiological mechanism leading to ischemic myocardial injury in the context of a 

mismatch between oxygen supply and demand has been classified as type 2 myocardial 

infarction. By definition, acute atherothrombotic plaque disruption is not a feature of type 2 

myocardial infarction. In patients with stable known or presumed Coronary Atherosclerotic 

Disease, an acute stressor such as an acute gastrointestinal bleed with a precipitous drop in 

11 Thygesen K et al. Fourth universal definition of myocardial infarction [2018]. European Heart Journal, 

2019;40:237-269. 

12 Thygesen K et al. Fourth universal definition of myocardial infarction [2018]. European Heart Journal, 

2019;40:237-269.

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hemoglobin, or a sustained tachyarrhythmia with clinical manifestations of myocardial 

ischemia, may result in myocardial injury and a type 2 myocardial infarction. These effects are 

due to insufficient blood flow to the ischemic myocardium to meet the increased myocardial 

oxygen demand of the stressor. Ischemic thresholds may vary substantially in individual 

patients depending on the magnitude of the stressor, the presence of non-cardiac comorbidities, 

and the extent of underlying Coronary Atherosclerotic Disease and cardiac structural 

abnormalities.”

“The short- and long-term mortality rates for patients with type 2 myocardial infarction are 

generally higher than for type 1 myocardial infarction patients in most but not all studies due to 

an increased prevalence of comorbid conditions. Coronary atherosclerosis is a common finding 

in type 2 myocardial infarction patients selected for coronary angiography.”

“The context and mechanisms of type 2 myocardial infarction should be considered when 

establishing this diagnosis. The myocardial oxygen supply/demand imbalance attributable to 

acute myocardial ischemia may be multifactorial, related either to: reduced myocardial 

perfusion due to fixed coronary atherosclerosis without plaque rupture, coronary artery spasm, 

coronary microvascular dysfunction [which includes endothelial dysfunction, smooth muscle 

cell dysfunction, and the dysregulation of sympathetic innervation], coronary embolism, 

coronary artery dissection with or without intramural hematoma, or other mechanisms that 

reduce oxygen supply such as severe bradyarrhythmia, respiratory failure with severe 

hypoxemia, severe anemia, hypotension/shock; or to increased myocardial oxygen demand due 

to sustained tachyarrhythmia or severe hypertension with or without left ventricular 

hypertrophy”. 

It becomes vividly obvious that if coronary artery disease played a role in the death of 

Muhammad, he would have suffered a Type 2 myocardial infarction instigated by a stressor. The 

stressor in this instance would be mechanical-positional asphyxiation by sustained compression 

of the trunk and body and compressed prone-positioning on the sidewalk. This acute stressor 

instigated a cardiac oxygen demand-supply mismatch, which precipitated ischemic myocardial 

injury. Coronary artery disease, therefore, cannot be a cause of death in this instance of sudden 

traumatic death, but a mechanism of death. A mechanism of death cannot be classified as an 

underlying cause of death and should not be listed on the death certificate. 

A type 2 myocardial infarction does not require coronary atherosclerotic disease to be present to 

occur. The fundamental principle and criterion for a type 2 myocardial infarction is the presence 

of a stressor, which places the heart at an increased demand for oxygen, and when there is a 

mismatch between the supply of oxygen and the metabolic rate of the heart cells, myocardial 

injury and infarction occurs. If coronary artery disease is present, the blood vessels supplying 

the heart may not dilate sufficiently or have luminae that can open wide enough for larger 

amounts of blood to pass per unit time and per unit mass of the heart. So, the presence of 

coronary artery disease is not the underlying cause of a type 2 myocardial infarction but a 

comorbidity that can contribute to the mechanism of injury of myocardial ischemia and 

infarction. 

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Muhammad died as a result of Mechanical-Positional Asphyxiation due to Compression of his 

Trunk and Body

When Muhammad walked out of the community center on January 4, 2017 he was not in any 

form of distress and was not dying. A novel factor or event occurred unexpectedly and suddenly 

in his life at approximately 09:45 a.m. He became unconscious at approximately 10:04 a.m., 19 

minutes later. He was pronounced dead at the hospital at 10:39 a.m. 

Dr. Maskovyak who performed the autopsy stated the following on page 13 of her autopsy 

report: “No significant pathologic abnormalities” seen upon microscopic examination of the only 

section of the brain that she examined, the hippocampus. This is grossly inadequate, insufficient 

and beneath the standards of practice of forensic pathology and forensic neuropathology. I took 

many more topographically targeted and anatomically selective sections of the brain and 

examined them, which I have described above. There is no question whatsoever that 

Muhammad suffered acute asphyxial brain injury [hypoxic-ischemic brain injury] as manifested 

by the following findings and diagnoses in the brain: 

I. Congestive Brain Swelling, Global, with Diffuse Cerebral Parenchymal Edema, Acute

II. Selective Neuronal Excitotoxic Injury with Selective Topographic Vulnerability 

Dr. Maskovyak is not a certified or credentialed neuropathologist and may lack the prerequisite 

knowledge and expertise to competently identify and accurately diagnose Asphyxial Brain Injury 

due to Mechanical-Positional Asphyxiation due to Compression of the Trunk and Body, which 

Muhammad Abdul Muhaymin, a 43-year-old African-American male died from. 

The global evidentiary autopsy findings in this case confirm that Muhammad suffered diffuse 

and global asphyxial brain injury [hypoxic-ischemic brain injury]. The human brain is a postmitotic organ and can only survive on oxygen and glucose, which are supplied by blood that 

come from the heart, primarily in the internal carotid arteries and the vertebral arteries. While 

the brain is only about 2-3% of the body weight, it receives approximately 15% of the cardiac 

output at a rate of 750-900 ml/min of blood. The normal range of perfusion of the brain is about 

50 to 65 ml/100 g/min [80-100 ml/100g/min for the gray matter and 20—25 ml/100g/min for 

the white matter, at a rate of oxygen consumption of 3.5 ml/100 g/min. The normal brain tissue 

partial pressure of oxygen is 35 to 40 mmHg. Brain tissue oxygen levels below 30 mmHg may 

cause brain tissue injury, and at 20 mmHg, the risk of brain damage becomes exponentially 

elevated. The threshold for brain infarction is 10-12 ml/100g/min of blood supply with neuronal 

injury and death beginning in 60 to 180 seconds. 

Being a post-mitotic organ, the human brain does not have any reasonable capacity to 

regenerate itself. This means that when the human brain suffers any type of irreversible injury, 

that injury is permanent and cannot be reversed or cured by the brain or by medical therapy. 

There are so many types of brain injuries. Asphyxial brain injury [hypoxic-ischemic brain injury]

is only one type of brain injury. For the human brain to suffer irreversible hypoxic-ischemic 

brain injury, there has to be impaired supply of oxygen and blood to the brain for a relatively 

long period. The established and generally accepted median or mean reference threshold time 

for irreversible hypoxic-ischemic brain damage to occur is 3 to 5 minutes in cumulative time. 

This means that irreversible brain damage can occur in less than 3 minutes or in more than 5

minutes, but with a mean or median time of close to 3 to 5 minutes. 

The forensic question that arises at this juncture is what caused Muhammad’s diffuse, global 

hypoxic-ischemic brain injury? Any factor that impairs the entire respiratory functioning of the 

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human being can result in the deprivation of oxygen to the brain. Absolute deprivation 

[complete absence of oxygen- anoxia] is not necessary for the brain to suffer brain injury. Any 

factor that impairs the body’s ability to inspire oxygen and expire carbon dioxide, impairs the 

body’s ability to bind oxygen to hemoglobin, impairs the body’s ability to transmit oxygenated 

blood to the brain, impairs the brain’s ability to absorb oxygen from oxygenated blood, impairs 

the brain’s ability to utilize oxygen, and to transmit carbon dioxide to the blood and transport it 

out of the brain tissues can result in hypoxic-ischemic injury to the brain. Diminishing levels of 

oxygen and increasing levels of carbon dioxide in brain tissue impairs the cerebral vascular 

autoregulation, which results in impaired vascular perfusion of the brain, which causes 

combined hypoxic-ischemic injury of the brain. This means that the brain does not have to 

suffer complete lack of oxygen or blood to suffer brain damage. There are multiple metabolic 

factors that can ameliorate or aggravate the risk of brain damage at varying levels of oxygen, 

glucose, and blood supply to the brain. 

Compression of the trunk and body also causes neurological compression injury to vital nerves 

and plexuses in the trunk, head and neck, which decreases respiration and systemic blood 

pressure, which in turn decreases cerebral perfusion pressure, which accentuates the hypoxicischemic injury of the brain. When the motor, sympathetic and parasympathetic innervations 

and systems of the nerves in the trunk and neck, including but not limited to the vagus nerve, 

phrenic nerve, glossopharyngeal nerve, hypoglossal nerve, cervical sympathetic trunks and 

cervical parasympathetic ganglia, undergo sustained compression, there is a combined effect of 

bradycardia, systemic hypotension, cardiac arrest and respiratory arrest. The higher the scale of 

the compression, the more sustained the compression is and the longer the compression lasts 

the greater the risk of attaining irreversible neurological injury and the greater the risk of 

suffering permanent and irreversible end-organ consequences, like we have in the case of 

Muhammad. 

For normal and optimal respiratory activity to occur the thoracic pressure remains at negative 

atmospheric pressure to support intricate homeostatic undulations of intrathoracic pressure 

that allow normal and effortless respiratory movements of the diaphragm, chest, and lungs. 

Compression of the trunk and body as we have in this case undermines this homeostatic balance 

and increases the risk of respiratory failure, asphyxial injury of the brain and sudden death. 

Muhammad was placed prone on the hard floor of a building beginning at approximately 09:45 

a.m. on January 4, 2017. At least three officers were on top of him, held him down and pressed 

him on the hard floor of a building. The officers placed their weights on his head, trunk, and 

extremities for at least 2 minutes. He yelled “Okay!”. The officers placed handcuffs on 

Muhammad and stood him up from the ground beginning at approximately 09:47 a.m. 

Less than ten minutes later, beginning at approximately 09:56 a.m. Muhammad was again 

placed prone on the hard ground of a sidewalk while officers were on top of him. At least six 

officers pressed him down on the ground and placed the weights of their bodies on 

Muhammad’s head, trunk, and extremities. Muhammad yelled “I can’t breathe” several times. 

Muhammad’s gastro-esophageal sphincter collapsed in response to the high traumatic stressor 

levels and he vomited and became unresponsive. The officers observed that he was no longer 

responsive beginning at approximately 10:04 a.m. His body and trunk were mechanically 

compressed for about eight minutes before he vomited and became unresponsive. Microscopic 

examination of all the sections of the lungs shows diffuse and marked occlusion of the bronchial 

and bronchiolar airways by large amounts of aspirated gastric contents. 

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When Muhammad vomited in the prone position in response to the traumatic shock he was 

going into as a result of his asphyxial brain injury, his position and mechanical compression 

enabled and facilitated aspiration of his vomitus, which accentuated the mechanical-positional 

asphyxiation by initiating mechanical obstruction of his airways. The mechanical obstruction of 

his airways contributed and accentuated his spectrum of sustained mechanical-positional 

asphyxiation, and precipitated sudden and unexpected death. 

The prevailing forensic scenario in this case confirms that Muhammad suffered two episodes of 

sustained compression of his trunk and body and mechanical obstruction of his airways within a 

short time. Muhammad suffered mechanical-positional asphyxiation for a cumulative period of 

approximately ten minutes [2 + 8 = 10]. 

The brain is about the only organ in the human body that exhibits the concept of cumulative 

injury, cumulative risk exposure to injury, or repetitive cumulative injury. Being a post-mitotic 

organ, if the brain suffers an injury, and within a relatively short time, suffers a repeat injury, 

the eventual outcome is an exponential and multiplicative combined effect of the two injuries, 

which increase the risk of sudden death. In traumatic brain injury, some refer to this concept as 

the second impact syndrome. This concept does not only apply to injuries suffered within a short 

time. For example, in football players who suffer Chronic Traumatic Encephalopathy [CTE] 

their risk of developing CTE is primarily based on their cumulative exposure to mild and 

seemingly innocuous sub-concussive and concussive blows to the head across time [years]. The 

risk of permanent and irreversible brain injury and death was exponentially increased when

Muhammad suffered two episodes and two variants of asphyxiation within a relatively short 

time. Each episode and each variant possessed an independent and exclusive capacity and risk 

of causing permanent brain damage and death. 

It is also pertinent to note that human beings who are suffering all forms of asphyxial injuries 

can perform phonation functions unless there is a direct early or preceding damage to the vocal 

cords and glottis. Some degrees of phonation may be expected, although impaired, but complete 

loss of phonation is not expected until there is paralysis of the glottis, directly or neurologically. 

In the case of Muhammad, he suffered from Post-Traumatic Stress Disorder, Claustrophobia 

and Schizophrenia, minimal Coronary Artery Disease and Acute Amphetamine Intoxication in 

the morning of January 4, 2017. He was not in imminent death; he was not dying from any 

disease and was not expected to die. However, on January 4, 2017 a novel, independent and 

mutually exclusive, unnatural event occurred which comprised compression of his head, trunk,

and extremities by multiple police officers while he laid prone on the hard ground for a 

cumulative period of 10 minutes. This high-scale traumatic stressor precipitated relaxation of 

his gastro-esophageal sphincter, which precipitated vomiting, which resulted in massive 

aspiration of gastric contents, which aggravated mechanical-positional asphyxiation by 

mechanical obstruction of the airways, which resulted in asphyxial brain injury and sudden 

death. 

This novel chain of traumatic events successfully interrupted and breached any pre-existing 

chain of events and precipitated sudden death. The underlying cause of death therefore will be 

Mechanical-Positional Asphyxiation. The compression of his head, trunk, and extremities and 

his asphyxial brain injury were directly caused by another person or persons, therefore, the 

manner of death will be a homicide. There was a contiguous chain of events between the onset of 

compression of the trunk and body, and death. 

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In the differential diagnosis of the cause of death of Muhammad, there is no other forensic or 

medical evidence in this case that may suggest or indicate that Muhammad died from any other 

probable disease or cause of death outside Asphyxial Brain Injury due to Mechanical-Positional 

Asphyxiation. 

If Muhammad did not encounter the police on January 4, 2017, he would not have died on 

January 4, 2017 and was not expected to die. The autopsy did not reveal any natural disease that 

was killing him. There is almost no adult who does not suffer from one form of ailment or the 

other. An absolutely normal human being is an anomaly. We all suffer from one ailment or the 

other including drug abuse, which is a disease. However, most of our ailments are treatable and 

manageable and do not expect to kill us at the young age of 43 years old. 

2. Did Muhammad experience conscious pain and suffering before his death?

It is a generally accepted principle and common knowledge in medicine and forensic pathology, 

that specific traumatic events generate predictable, reproducible, and specific patterns of 

traumas and injuries. The patterns of injuries generated by blunt force trauma and asphyxial 

trauma, and the mechanisms of sustenance of these patterns of injuries are very well-established 

in the medical literature and are common knowledge. 

Based on the prevailing forensic scenario, and on the generally accepted principles and common 

knowledge of medicine and science, and based on the global constellation, configurations and 

anatomic conformations of the multimodal and multifaceted traumas sustained by Muhammad, 

Muhammad experienced conscious pain and suffering when he sustained multiple blunt force 

traumas and asphyxial injuries on January 4, 2017 prior to his death. 

Conscious pain and suffering are initiated by widespread free nerve endings situated in the skin, 

soft tissues, and organs. Pain can be elicited by multiple types of stimuli classified into three 

broad categories: mechanical, thermal, and chemical pain stimuli. Nerve endings for pain 

sensations generate electrical action potentials following all forms of tissue damage caused by all 

types of energies including, but not limited to, kinetic and mechanical energy from blunt force 

impacts, chemical and kinetic energy from mechanical compression of the body and obstruction 

of the airways from asphyxiation. 

Action potentials are the sub-cellular physiologic basis for noxious conscious sensations and 

originate from voltage gated sodium and potassium electrolyte membrane pumps in the cell 

membranes of nerve cells, fibers, and synapses. It takes few 10,000th of a second to generate 

action potentials. Action potentials are transmitted through nerve fibers to the brain. They are 

transmitted in peripheral nerves in the Aδ and C fibers for fast and slow pain respectively at 

impulse rates of 5-30 meters per second and 0.5-2 meters per second, respectively. There is 

therefore a double pain sensation, a fast-sharp pain, and a slow pain. The sharp pain apprises 

the person rapidly of imminent danger and prompts the person to react immediately and 

remove himself from the painful stimulus or imminent danger. The slow pain becomes greater 

as time passes resulting in continued intolerable pain and suffering prompting the person to 

continue to try to relieve the cause of the pain and flee from the imminent danger. 

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At autopsy Muhammad measured 67 inches [1.70 meters]. Muhammad felt all types of blunt 

force, asphyxial and chemical pain within milliseconds of contact with an impacting surface, 

compression of the body, aspiration of food and asphyxiation. One millisecond is one second 

divided into 1000 parts. For the slowest nervous mechanisms of pain sensation and 

consciousness, a man like Muhammad felt pain in less than 100 milliseconds. 

Nerve pathways transmitting pain, terminate in the spinal cord. Secondary pathways transmit 

the pain from the spinal cord to the brainstem and thalamus, especially to the reticular 

activating system of the brainstem. From the thalamus tertiary pathways transmit pain to other 

basal ganglia, limbic cortex, and neocortex of the brain. Pain stimuli are transmitted to the 

reticular nuclei of the midbrain, pons, and medulla; to the tectal midbrain and the 

periaqueductal gray matter. These lower regions of the brain, i.e. brainstem, are vital for the 

appreciation of suffering from pain. 

Animals with their brains sectioned above the midbrain, to block any impulse reaching the 

neocortex and cerebral hemispheres, still experience suffering from pain caused by all types of 

trauma. Complete removal of the somatosensory regions of the cerebral hemispheres does not 

preclude an animal’s ability to perceive and experience pain. Pain impulses entering the 

brainstem and lower centers of the human brain can cause conscious perception of pain. Pain 

perception is principally a function of the lower centers of the brain; however, the upper centers 

and cerebral hemispheres are responsible for the interpretation of the quality of pain. 

Blunt force, compression of the body and asphyxiation elicit both the fast and slow pain types. 

Fast pain is felt within milliseconds while slow pain is felt within about one second. Following 

mechanical and chemical tissue damages and asphyxial tissue injury, biochemical tissue 

reactants like bradykinin, serotonin, histamine, prostaglandins, leukotrienes, potassium ions, 

substance P, acetylcholine, acids and proteolytic enzymes are expressed to elicit sustained 

secondary chemical pain in addition to the primary fast pain directly caused by tissue damages. 

The chemical pain elicited by these chemical reactants is a slow type of suffering pain. The 

intensity of pain is closely correlated with the rate of tissue damage. 

The brain is responsible for and sustains consciousness in human beings. The region of the 

brain responsible for consciousness is the brainstem. The center in the brainstem, which is 

responsible for consciousness, is the reticular activating system, which is deeply located in the 

central regions of the brainstem. As long as the reticular activating system remains anatomically 

and electrochemically intact, an individual like Muhammad will remain conscious and will feel 

pain and experience suffering. The sensation of pain induces conscious suffering since pain is a 

noxious sensation, which stimulates the neocortex, limbic cortex, and forebrain to cause mental 

pain, suffering and anguish, and adrenergic fright and fear. All these neural processes occur in 

1000th’s of a second [milliseconds]. The human nervous system is one of the most efficient, 

effective, and optimal operating systems ever known to mankind. After centuries of empirical 

research mankind has not been able to fully decipher and reproduce the operating systems of 

the human brain and nervous system. 

Muhammad’s injury sustenance began when he was encountered by the police, held, pushed, 

tackled and forced to the ground, impacted by blunt force, held on the ground, with weight 

placed over him, vomited and aspirated his vomitus, which mechanically occluded his airways. 

At this time, Muhammad was fully conscious and aware of his surroundings. His reticular 

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activating center was completely intact and functional. As a 43-year-old male he had the mental 

capacity to identify the imminent danger and threat of injury and death. 

The autopsy described at least 36 distinct blunt force injuries of Muhammad’s head, face, trunk,

and extremities. Every blunt force impact his body suffered, every kinetic and mechanical 

energy transferred to his body by the compression of his head, trunk and extremities, and every 

biochemical tissue response he endured from the asphyxial injury, caused biochemical, 

anatomic and pathophysiological tissue disruptions, damages and injuries generated action 

potentials within 10,000th of a second, which were transmitted to the spinal cord and to the 

brain to precipitate cumulative conscious somatic and mental pain, suffering and anguish. The 

multimodal nature of the noxious stimuli resulted in synergistic and cumulative conscious 

experience of very high levels of combined somatic and mental pain, suffering and anguish. The 

primary injuries initiated secondary tissue injuries, systemic and tissue reactive responses, 

which elicited novel chemical pain and accentuated the conscious somatic and mental pain, 

suffering and anguish. 

The brainstem nuclei, the frontal cortex, pre-frontal cortex, basal forebrain and limbic cortex of 

Muhammad’s brain initiated, within milliseconds, the primitive human reflexes of fear, fright,

and flight. This mental awareness of imminent danger initiated the nor-adrenergic and 

adrenergic biochemical neural responses of fear, fright, and flight, when the locus ceruleus of 

the brainstem released large amounts of nor-adrenalin to the cerebral hemispheres. This fear, 

fright and flight response caused high levels of chemical mental pain, suffering and anguish, 

which prompted him to try to flee, struggle, yell, and scream, making noises of intense fright and 

mental anguish. His heart started pumping faster [chronotropic effect] and stronger 

[ionotrophic effect] due to the nor-adrenergic/adrenergic response. His respiratory rate and 

general muscle tonicity increased as well due to the nor-adrenergic/adrenergic response. His 

brain-cells’ demands for oxygen increased causing intense cerebral vasodilation and vascular 

headache. All these patho-physiologic processes culminated in high levels of conscious somatic 

and mental pain, suffering and anguish. 

As Muhammad was in this state of high-scale conscious somatic and mental pain, suffering and 

anguish, he received even more trauma when he vomited and aspirated his vomitus, which 

resulted in mechanical obstruction of his airways and aggravated the pre-existing mechanical 

asphyxiation and accompanying conscious somatic and mental pain and suffering. Additional 

millions of pain action potentials were generated and transmitted to the spinal cord and brain to 

cause even higher levels of conscious somatic and mental pain, suffering and anguish, which 

synergized with the existing somatic and mental pain, suffering and anguish, and even caused 

increasingly higher levels of conscious pain and suffering. Such high levels of conscious somatic 

and mental pain, suffering and anguish can impair the functioning of the limbic system and 

autonomic system of the brain and nervous system to cause an acute confusional and/or 

delirious state, which may have been exhibited by Muhammad. 

As his blood oxygen levels decreased and the carbon dioxide levels increased, while he was on 

the ground, with his body compressed and pressed to the ground, he began to develop acidosis, 

became more confused, and afraid, and struggled more. His primary and secondary injuries 

progressed, more nerve endings in his body, soft tissues and viscerae were recruited, many more 

action potentials were elicited and caused increasingly higher levels of somatic pain and 

suffering, still accompanied by extremely high levels of mental pain, suffering and anguish. He 

gradually and slowly developed hypoxic-ischemic brain injury, which elicited more action 

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potentials from every brain tissue injury and damage, which resulted in more conscious somatic 

and mental pain, suffering and anguish as his sensorium diminished progressively.

As Muhammad’s brain suffered hypoxic-ischemic injury many types of ions, peptides, proteins,

and enzymes were expressed and activated, which enhanced his chemical pain, which synergized 

with his pre-existing pain to cause progressive somatic and mental pain, suffering and anguish. 

Following the attainment of irreversible brain damage, he began to lose consciousness 

progressively passing through the varying broad stages and spectrum of consciousness from 

fully conscious to varying degrees of diminishing sensorium to loss of consciousness and coma. 

Consciousness is a continuum with varying levels of consciousness and depths of 

unconsciousness, which Muhammad passed through before he went into traumatic coma and 

death. 

The autopsy report confirms that Muhammad’s brain and brainstem remained anatomically 

intact without any discernible physical brain damage. These evidentiary autopsy findings 

confirm that his midbrain, pons, and medulla oblongata remained anatomically intact following 

all his traumas until his death. The subcortical ganglia and brainstem nuclei of the cranial 

nerves remained intact. His rostral spinal and cranial reflexes and functioning remained 

anatomically intact. The reticular activating system remained anatomically intact. He continued 

to experience increasingly higher and extreme levels of somatic and mental pain, suffering and 

anguish induced by all his multimodal injuries until he attained irreversible brain injury and lost 

electrophysiological functioning of the brain cells, became unconscious and died. 

It is pertinent to note that the autopsy did not describe any primary anatomic injury of the 

midbrain, pons, medulla oblongata, cerebral or cerebellar hemispheres. Injuries to these regions 

of the brain manifest as follows: primary lacerations, primary contusional hemorrhages and 

necrosis, primary gliding contusional hemorrhages and necrosis, primary concussional 

hemorrhages, primary diffuse traumatic axonal injury hemorrhages and necrosis. None of these 

distinctive evidence of primary anatomic trauma to the vital regions of the brainstem were 

present at autopsy. There was no evidence of instantaneous loss of consciousness at autopsy. 

There were no Adam’s grade III concussional or contusional hemorrhages and necrosis, and no 

hemorrhages or necrosis of the dorsolateral and tegmental midbrain, pons, and medulla. Loss of 

consciousness was therefore sustained and progressed over time. After he lost consciousness 

Muhammad stopped experiencing conscious pain and suffering. 

Loss of consciousness and death in this instance could not have been instantaneous since the 

human brain has an intrinsic ability to survive for a mean of about three to five minutes before 

suffering irreversible brain damage and brain death from any cause. The brain also has a 

metabolic reserve of about 5-10 seconds after suffering complete lack of oxygen and glucose 

before loss of consciousness ensues. Microscopic examination of the H/E stained sections of the 

brain and lungs confirm that Muhammad had enough time after he began suffering asphyxial 

injury for his tissues to develop patho-physiological responses to his injuries before he died. 

Although death is frequently immediate, it is rarely instantaneous since death is a process that 

involves a cascade of patho-physiologic events. The adjective “immediate”, within a forensic 

context, and within the prevailing forensic scenario, in this case, should be interpreted as death 

occurring as a result of mechanical-positional asphyxiation without the intervention of another 

object, cause, or factor. It should not be forensically construed as instantaneous.

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Muhammad experienced conscious pain and suffering for a total composite median duration13 of 

less than 15 minutes before he became unconscious on January 4, 2017 and died. 

3. Did Methamphetamine prevent or preclude Muhammad from experiencing 

conscious pain and suffering?

No, Methamphetamine did not prevent or preclude Muhammad from experiencing conscious 

pain and suffering. The presence of Methamphetamine or Amphetamine at the time he 

sustained his fatal trauma, is of no significant forensic consequence in the differential diagnosis 

of his conscious pain and suffering. 

Amphetamine is a metabolite of Methamphetamine. Methamphetamine or Amphetamine does 

not stimulate or inhibit naked nerve endings, which are the receptors that generate action 

potentials for pain sensation. Methamphetamine does not affect the conduction of action 

potentials in the central nervous system, to and from the spinal medulla and brain and does not 

modulate the experience of consciousness pain in any clinically useful manner. 

Methamphetamine or Amphetamine does not have analgesic properties and is not used as an 

analgesic drug to reduce or control pain. 

The receptors for pain are the free nerve endings. So, the receptors for the mechanisms of 

generation and sensation of pain and suffering are different from the receptors and cellular sites 

for the mechanisms of action of Methamphetamine or Amphetamine. The generation and 

sensation of pain and suffering are complex mechanisms, which involve many different ions, 

peptides, and enzymes, including but not limited to bradykinin, histamine, potassium ions, 

acids, serotonin, acetylcholine, proteolytic enzymes, prostaglandins, and substance P. 

I have provided all my opinions and conclusions with a reasonable degree of medical certainty. 

I reserve the right to amend, supplement, revise and/or modify my opinions and report, up and 

to the time of trial, should additional information become available. 

Thank you. 

Very truly yours, 

13 Medicine is not an absolute science and these estimated ranges should not be interpreted as absolute quantitative 

estimations of time. Quantitative ranges of any measurable index are common practice and are the standard of 

practice in pathology and medicine.

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Bennet I. Omalu, MD, MBA, MPH, CPE, DABP-AP,CP,FP,NP

Clinical Pathologist, Anatomic Pathologist, Forensic Pathologist, Neuropathologist, Epidemiologist

President and Medical Director, Bennet Omalu Pathology

Clinical Professor of Medical Pathology and Laboratory Medicine, University of California, Davis

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DEPOSITION OF BENNET OMALU 

October 26, 2020 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

--o0o--

Mussalina Muhaymin as Personal 

Representative of the Estate of 

Muhammad Abdul Muhaymin Jr. , 

Plaintiff, 

vs . No . 17-cv-04565-PHX-SMB 

City of Phoenix, an Arizona VOLUME I 

Municipal Corporation; Antonio 

Tarango; Officer Oswald Grenier; 

Officer Kevin McGowan; Officer 

Jason Hobe; Officer Renaldo 

Canilao; Officer David Head; 

Officer Susan Heimbinger; 

Officer James Clark ; Officer 

Dennis Lerous; Officer Ryan 

Nielson; Officer Steven Wong; 

and Doe Supervisors 1-5, 

Defendants . ___________________ / 

VIDEO RECORDED DEPOSITION OF BENNET OMALU, MD 

Monday, October 26, 2020 

10 : 17 AM 

Taken in the offices of : 

California Deposition Reporters 

2453 Grand Canal Boulevard, Suite J 

Stockton, California 95207 

REPORTED BY : VICTORIA R . MARTIN, CSR 12322 

CALDEP 

WWW.CALDEP.COM 

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DEPOSITION OF BENNET OMALU 

October 26, 2020 

your professorship with UC Davis? 

A. 

Q. 

A. 

Yes, please. 

What kind of courses do you teach with UC Davis? 

I don ' t -- well, mostly workshops. Case 

sign-outs with medical students. Every now and then I 

give a didactic. Medical students, residents, pathology, 

neurology, neurosurgery, nursing students, physical 

rehabilitation students, and then fellows. And sometimes 

other doctors who want some experience in forensic 

pathology and neuropathology. 

Q. So the focus of these workshops or classes are 

mainly on pathology or neuropathology? 

A. 

Q. 

A. 

Sometimes medical management. 

Medical management of a live patient? 

Yeah, yeah. Medical of a live patient, and also 

medical management of the business of medicine. 

Q. I see . And that 's more recordkeeping and stuff 

like that? 

A. No, no, no. Management of patient care and 

quality control and quality assurance. 

Q. Okay. But in these -- since 1994, do you treat 

living patients? 

A. Oh, so I started in ' 94 since I came to the 

United States -- not on a formal basis, no . Am I involved 

with the treatment of live patients? Yes . Like I had 

CALDEP 36 

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DEPOSITION OF BENNET OMALU 

October 26, 2020 

said earlier, patients with brain tumors, I 'm involved in 

the development of their treatments . 

Q. And that is in the context of examining their 

tissues or determining their --

A. Examining their tissues, making diagnosis, and 

determining the line of treatment . 

,_ Q. 

A. 

But not speaking directly with a patient? 

No, no. Then anot her type of pat ient contact I 

have is in people who have suffered trauma and survived a 

trauma . So I come in to do risk management analysis. I 

meet with the patients. I talk with them to evaluate how 

much damage, permanent damage they have, and to develop 

prognosis. such cases I do many times in litigation 

cases, many times patients who have had brain trauma . So 

I do that direct patient . I talk to them. I ask them 

questions. I monitor them, observe them. So I do that as 

well . 

Q. So you evaluate the extent of any trauma that 

they may have experienced? 

A. 

records . 

Q. 

A. 

Q. 

Yes . Also to confirm what is in the medical 

Okay . So you review t heir medical records? 

Yes . 

And from that meeting, from the review of the 

medical records, you develop is it a medical plan or a 

CALDEP 

WWW.CALDEP.COM 

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DEPOSITION OF BENNET OMALU 

October 26, 2020 

AM, and we're back on the record. 

MS. STILLWELL : Q. Now, Dr . Omalu, we had taken 

a break because you had some slides that had to be 

returned; is that correct? 

A. 

Q. 

Yes, please. 

And you mentioned that those are slides with 

regard to a live patient; correct? 

A. 

Q. 

Yes, please. 

But that is in the context that you had talked 

about before where you review the slides. Is that someone 

who has suffered trauma? 

A. 

Q. 

No. They had a spinal tumor. 

Okay. So that ' s one of the ones where you look 

at the slides and the specimen and then --

A. 

Q. 

patient? 

Look at the specimen . 

But you are not actually treating that live 

18 A. Not directly, no . 

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,-

Q. 

A. 

Q. 

Are you familiar with Arizona POST? 

What? 

Police Officer Standard and Training . Are you 

familiar with that at all? 

A. No. I'm aware of it . Like in California, they 

have something similar to, yes. 

Q. Have you ever attended any training of any kind 

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Q. And so when you are saying "templates," some of 

it is, you know, your analysis of medical stuff --

A. No. 

Q. -- or -- let me just finish the question . or, 

for instance, with your conscious pain and suffering, 

there ' s an opinion in there that you ' ve used in prior 

reports. So is it that background that you are using? 

A. No, no. So the templates are scientific facts 

that I know that I've typed up that do not change . For 

example, that the brain begins to suffer injury after 60 

seconds of asphyxia or that a human brain has a reserve of 

5 to 10 seconds. These are scientific facts that do not 

change. 

So I have paragraphs of such -- or a paragraph 

that explains how the brain is postmitotic organ. So such 

scientific facts that do not change, depending on the type 

of case, I ' ll try and remember, okay, what do I need? 

I ' ll go to that, I'll take that, and I ' ll paste it. 

But when it comes to the analysis of the -- of 

the unique information of the case, that is totally 

generated from scratch. 

Q. Okay . In connection with your work in this case, 

in Muhaymin v . City of Phoenix, did you specifically 

review any medical treatise or publications to gain your 

scientific facts that you relied upon in your opinions? 

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DEPOSITION OF BENNET OMALU 

October 26, 2020 

No . You know, the scientific question at play in 

this case is a very elementary concept of science or of 

neuroscience . 

Q. 

A. 

Okay. 

Like you politely pointed out earlier, I ' ve been 

doing this now for almost 20 years, which is a surprise to 

me because I just feel like I 'm 20 . Okay. So over the 

years I've read hundreds, if not thousands, of published 

articles or books. Okay. Like in my office, I have a 

whole wall lined of books, and my 13-year-old daughter 

will ask me once, "Daddy, have you read every book?" 

I said, "Yes. " 

"Oh, my gosh, Daddy. You are not smart. Because 

if you were smart, you don't need to read all these 

books . " Okay. 

So over the years I ' ve had an accumulated college 

of information and education. So when I get a case like 

this with the very basic elementary topic, I pretty much 

regurgitate what I have learned based on my education, 

training, and experience . 

Now, because I know this is a legal case and some 

attorney may ask me sometimes to provide any published 

article. If you notice in my report, I provided some of 

those references for specific, almost absolute statements 

with specific values of indices, I-N-D-I-C-E-S, of values. 

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thousands of years it doesn ' t change . That asphyxial 

injury can occur without occlusion of the airways is a 

very basic elementary fact we learn in the first year of 

medical school . That has not changed in the past 1,000 

years. 

So the topic in this case is very elementary, 

very fundamental . And in many of my reports I don't even 

provide any citations. I don ' t. Why I provided citations 

in this case? Because I've not done a case from Arizona, 

so I just thought you know what? I don't know how lawyers 

in Arizona behave. Let me just add citations so they 

leave me alone . 

Q. Now, Dr . Omalu, in this instance you didn't 

obviously perform an autopsy of Mr . Muhaymin. You were 

retained three years after the incident; is that right? 

A. That is not right. I did not perform the 

prosection, but I performed a microscopic autopsy . When I 

examined the tissues that were sent to me, I examined them 

on a microscope. Those were not performed before . 

So when you use the word "autopsy," it is 

all-encompassing . But when you use the word "prosection," 

yes, I understand what you mean. I did not cut open the 

body, yes. 

Q. Now, have you performed any surgery on a living 

patient in the United States? 

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Q. 

No . 

DEPOSITION OF BENNET OMALU 

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Did you perform surgeries when you were in 

Nigeria then? 

A. Yes . I did cesarean sections. I did 

appendectomies . I did emergency surgeries like, you know, 

stab wounds . And then basic gallbladder surgery . If 

there 's no surgeon around, rather than watching the 

patient die, I ' ll go and take it out . 

Q. 

then? 

A. 

Q. 

Okay . So the last one would have been in 1994 

Yeah . The last surgery I did was in 1994 . 

When working with lawyers in cases like this, is 

it common for you in performing your analysis to obtain 

the patient ' s medical records? 

A. Is it common? ,-

,_ 

Q. Uh-huh . 

A. No . ,-

Q. Why not? 

A. If an autopsy is performed - - because in the 

gradation of medical evidence, the autopsy is the gold 

standard. Every other evidence is inferior in validity to 

the autopsy . 

So in a case of sudden and unexpected death, the 

death is sudden because the medical records did not expect 

the individual t o die . The death is unexpected because 

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on opinions on the medical findings -- on the autopsy 

findings with or without the medical records . Because 

like when I perform autopsies for hospitals, in all the 

cases the medical records state that the individual died 

from something else . But when I do the autopsy, the 

autopsy is inconsistent with the medical records . 

Q. So what about the prior medical records that 

would show the life of the decedent? 

A. Because death was sudden and unexpected, the life 

of the decedent is immaterial . 

Q. But if a person is a chronic drug user or refused 

medical treatment for a heart condition or what have you, 

wouldn't that be relevant to determining the cause of 

death? 

A. It is irrelevant because not determining the 

cause of death . Determining the autopsy findings . It is 

irrelevant . Why? Because whether the individual was a 

chronic drug user or not, it doesn ' t matter. If the 

autopsy shows -- like the case I did on -- I signed out on 

Sunday, the woman, according to the medical records, had 

end-stage cirrhosis of the liver. I did the autopsy . I 

did not see end-stage cirrhosis of the liver, but I saw 

very high levels of fentanyl . 

So the medical records, no matter what they say, 

is immaterial . The objective of the medical record is to 

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DEPOSITION OF BENNET OMALU 

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treat and manage a living patient . When that patient 

dies, that is the end of the role of the medical records . 

Now, if death wasn ' t sudden or unexpected and an 

autopsy is not performed, okay, an autopsy is not 

performed, it is not a coroner's case. A medical 

examiner's case. Then you go to the medical records, 

document that the cascade of death . 

And again, that is why legally in the State of 

California -- I don't know about other states, but I 

believe is the same for every state in the United 

States -- if death is sudden and unexpected, it must fall 

on that jurisdiction of the coroner to be investigated. 

And it does not state that, no, you have to rely on the 

medical records. 

It's like a man -- a case -- I'll use real-life 

cases. A multimillionaire in Oakland was living with his 

girlfriend. The girlfriend said he woke up. He wasn't 

feeling well . He had heart disease. And he died . Okay. 

I came and I did the autopsy. His ethylene glycol level 

was markedly elevated. This is a real-life case now. I 

could give you the case number. 

So because his death was sudden and unexpected --

even his doctor at Stanford Hospital said, "No, I was not 

expecting him to die." He had no reason to die and to die 

in his sleep, no . So because his death was sudden and 

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unexpected, his medical records was of no significant 

forensic consequence. 

So I did the autopsy and I confirmed that he had 

no reason to die . Toxicology came back ethylene glycol. 

So no matter what the medical records say, it doesn ' t 

matter. It is of no significant forensic consequence 

listen to how I'll qualify this. If death is sudden and 

unexpected and of unnatural mechanisms, medical records 

are of no significant forensic consequence. 

Q. So along those same lines, if medical records 

are, as you say, of no forensic significance, criminal 

records 

A. I didn ' t say, "of no forensic significance ." 

said, "of no significant forensic consequence ." 

Q. So along those same lines, you would feel also 

that any documentation or records regarding the decedent ' s 

life would also be along the same lines. For instance, if 

records demonstrated that a decedent had a violent and 

combative history or a decedent had a history of resisting 

police officers, you are saying none of that would have a 

significant forensic value? 

MR. CHAMI : Object to form. 

THE WITNESS : No . That wasn't what I said . So, 

as part of the autopsy -- remember I told you when you use 

the word "autopsy, " it's all-encompassing, but carving of 

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can review family statements, but you wouldn ' t review 

medical records? 

A. What I said was the medical records are not of 

significant forensic consequence, meaning with or without 

medical records, you rely on the autopsy findings. 

And, in fact, I said in the majority of the over 

600 autopsies I perform every year, I review medical 

records -- and they are available because they are not 

always available -- in only about 20 percent of cases. 

And there has not been any autopsy I ' ve performed whereby 

I made a diagnosis based on medical records. If you do 

that, it ' s only a matter of time you ' ll be sued and maybe 

you lose your license . 

Q. 

A. 

Q. 

A. 

But you certainly review those medical records? 

Not certainly . Not certainly. 

If they are available . 

If they are available and if they are of any 

significant forensic consequence . Let me give you a good 

example . A good example usually applies to natural 

diseases. Okay. 

Somebody has a seizure disorder and dies in his 

or her sleep . Okay. Now I need to establish was this 

individual born with seizure disorder or did this 

individual suffer a motor vehicle accident at the age of 

five and the seizure disorder began after the accident . 

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DEPOSITION OF BENNET OMALU 

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transcripts and recorded interviews, complaints and other 

miscellaneous legal documents, incident report from 

Phoenix Police, and trip sheet from the Phoenix Fire. 

A. 

Q. 

Is that all the materials you listed, sir? 

Yes, sir. Yes, ma'am. Sorry. 

What I don ' t see described though is the prior 

medical records or counseling records . Were you ever 

provided the records from Terros? 

,-

,_ 

,_ 

A. 

Q. 

A. 

From what? 

Terros. 

No, no . So when I -- when I began this case 

like I told you, my duty as a forensic pathologist is to 

establish the prevailing forensic scenario. Okay. So in 

reviewing all the records, the coroner investigation 

reports, the police reports, all the materials in the case 

file, I discovered that he suffered from PTSD. He 

suffered from claustrophobia. He suffered from 

schizophrenia, and he suffered from asthma. 

Q. Okay. Let's break this down. Because I'm really 

trying to figure out what you actually reviewed in this 

case based on this vague description. 

So autopsy and medical examiner reports. We know 

that there was a medical examiner report by Dr. Maskovyak; 

correct? 

A. Yes, please. 

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DEPOSITION OF BENNET OMALU 

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establish a timeline. 

Q. But what you do not reflect in here also is that 

you have the Abrazo, the medical records from Abrazo where 

he was declared deceased. 

A. 

Q. 

A. 

Where he went to the hospital? 

Yes, sir. Do you recall reviewing those records? 

I believe so. I don ' t know . I don't know if I 

reviewed them or not. He was -- he didn ' t receive any 

medical treatment at the hospital. He pretty much was 

dead on arrival. 

Q. Well, the medical records obviously had -- had 

you had them and had you reviewed them, would show you 

what kind of medical treatment, what kind of resuscitative 

efforts they would have made, and the time of death; 

correct? 

A. 

Q. 

A. 

No. 

Why not? 

Because an autopsy was performed. Say, don't 

confuse me. I 'm not a clinician. So the questions you'll 

be asking me are not the questions you ' ll ask a clinician. 

A clinician like a neurologist, a psychiatrist. 

I 'm a forensic pathologist that determines why 

people die . I come in after death . As a forensic 

pathologist, I don't make diagnosis based on medical 

records. The medical record is as important to me as a 

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Q. 

A. 

Q. 

sir? 

Yes . 

DEPOSITION OF BENNET OMALU 

October 26, 2020 

Because she had reviewed those records . 

I don ' t think so . 

Where did she get the information, if you know, 

A. In so many ways. Like I have said, the issue 

here is not about medical records. The issue is about the 

prevailing forensic scenario. So about forensic 

pathologists, you establish the prevailing medical 

scenario through different methods . 

So in her synopsis, she stated that the police 

interviewed the family members and documented a history of 

schizophrenia, bipolar disorder, and I believe asthma. 

Q. And, Mr . Omalu -- I'm sorry. Dr. Omalu, you did 

not review those records prior to preparing your June 22nd 

report; correct? 

A. 

Q. 

A. 

Which records? 

The Terros records . Sorry. 

No. It was not like -- let me state this. I 

said it before . I'm beginning to lose my patience. We 

are going into a cycle here . 

There was a sudden and unexpected death in this 

case from unnatural causes. An autopsy was performed. 

Autopsy findings were generated. A determination of cause 

of death was made. The medical records in a case like 

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DEPOSITION OF BENNET OMALU 

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this is of no significant forensic consequence, period. 

Q. And, Dr . Omalu, I'm trying to narrow down what 

you had reviewed prior to the preparation of your June 

2020 report. Now, earlier we talked about who had 

contacted you, whether it was Mr. Chami or Mr . Faraj, and 

you couldn't recall which one . Had you worked with either 

of them before this case? 

A. 

Q. 

A. 

Q. 

To the best of my recollection, no. 

Do you know how they came into contact with you? 

I don ' t know. 

Did somebody refer them to you? Do you know? 

MR. CHAMI : Object to foundation. 

THE WITNESS : I don't know. 

MS. STILLWELL : Q. Do you advertise your 

services, sir? 

A. No. In the State of California I'm not allowed 

to advertise services, no . 

Q. 

states? 

A. 

Q. 

And you don't advertise your services in other 

No. 

Now, earlier you said Mr. Hobson got it wrong in 

his article that you make way more than the 900,000 per 

year from your business. 

A. Not me. I'm an employee of the corporation. The 

corporation makes more than $900,000 a year. The speeches 

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DEPOSITION OF BENNET OMALU 

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my role as the causation of death expert . 

Q. Now, sir, in the bodycam videos that you did 

review, did you do a breakdown? So did you calculate how 

long each officer was in what position? 

A. Because my duty wasn ' t with the officers, my 

duty -- or my role here was that of causation of death of 

Mr . Muhammad, so I think I did an analysis of the total 

cumulated period he was -- he suffered mechanical 

asphyxia . 

Q. So you took -- was it -- we understand now that 

there are two incidents -- right? 

was on the ground? 

where Mr . Muhaymin 

,_ A. 

Q. 

Yes, please . 

Did you take the time periods from one of those 

incidents or did you combine the time periods of both of 

those incidents together? 

A. on page 21 of the report, second paragraph, 

second paragraph, I did -- I split them into two episodes 

and then added them. So the first episode I estimated a 

duration of 2 minutes and the second episode an 

approximate duration of 8 minutes, giving a total of 10 . 

Q. So you totaled those two episodes together for 10 

minutes without breaking down in what position any officer 

was in or how long that position was held? 

A. No . Because it is immaterial -- again, this is 

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the all -- what is it called? Each and every exposure 

model which doesn ' t apply themselves cumulative exposure . 

So asphyxial injury, you can ' t break it down to each and 

every exposure, meaning how much each officer contributed, 

no . So -- because we cannot do that for brain injury . In 

brain injury you consider the cumulative and total 

exposure . So how much each officer did is immaterial . 

Q. So you understand, Dr . Omalu, that plaintiff's 

experts or I 'm sorry -- plaintiff 's counsel has hired 

additional experts in addition to you; correct? 

I believe so . 

Do you know who those experts are? 

No . 

Scott DeFoe . Are you familiar with him? 

Who? 

Scott DeFoe . He is a police practices expert . 

No . 

A. 

Q. 

A. 

Q. 

A. 

Q. 

A. 

Q. Have you both been an expert on a case before for 

the plaintiff? 

A. 

Q. 

I wouldn ' t know . 

What about Dr . Taki (phonetic)? He is an 

emergency room physician in Michigan. 

A. 

Q. 

A. 

I don ' t know him. 

Did you ever speak with Dr . Taki? 

No . 

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DEPOSITION OF BENNET OMALU 

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No . It ' s a general -- it' s general common 

knowledge . You can find it in different textbooks like 

Guyton's Textbook of Physiology . You could find it in the 

basic textbook of Gray's Anatomy . You could find it in 

any basic textbook of forensic pathology, including Spitz 

and Fisher. Spitz and Fisher, S-P-I-T-Z, Fisher, 

F-I-S-H-E-R . DiMaio DiMaio, D-I-M-A-I-0 . Then 

Neuropathology, a reference textbook, and then 

Greenfield's Neuropathology . It's a very fundamental, 

basic definition . 

And it's in my report I believe - - I will find 

it, the page where I described it . 

Q. Had you ever written - -

A. On page 19 . 

Q. Do you have the reference then? 

A. Page 19, beginning from the last paragraph 

extending into page 20, I defined asphyxia . 

Q. And this definition of asphyxia is from your 

experience --

A. 

Q. 

A. 

Q. 

Yes . 

-- and knowledge; correct? 

Yes . 

It doesn ' t provide any specific reference to any 

particular text then? 

A. No . 

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DEPOSITION OF BENNET OMALU 

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Now, have you personally written any textbook on 

asphyxiation or on forensic pathology? 

A. I ' ve written book chapters . Not asphyxia as the 

primary subject, no . 

Q. Do you recall what those chapters were? 

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primary topic, no . 

Q. 

A. 

Q. 

A. 

What about on forensic pathology? 

Books? 

Yes, sir. 

I don ' t think so . Most books I published have 

been on neuropathology. 

Q. 

A. 

Q. 

That was going to be my next question. 

Not on forensic pathology generally, no. 

What textbooks have you written on 

neuropathology? 

A. 

Q. 

A. 

Book chapters. Book chapters. 

Do you recall the names of those books? 

It's all in my CV. I haven ' t memorized 

obviously. 

Q. 

A. 

We'll do that on the next break again. 

And the books I published, I've published What 

every parent needs to know about traumatic brain injury in 

sports. What else? I published Football Dementia, 

Depression and Death. And then I've published A 

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DEPOSITION OF BENNET OMALU 

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Q. But you can ' t give me a specific location as to a 

particular fact and where you learned it from? 

A. No . If I had done this case like two weeks ago 

or even a month ago, I would have been able to do an 

exact . But I did this -- I did this report six months 

ago . I cannot . 

,_ Q. 

A. 

Okay . And you did this report in June; right? 

Yes . Yes . When I did the report, I sent it to 

the attorneys . I said, "Please check my summary on the 

report to see if there are any factual inconsistencies. " 

Because the case is bigger than me . There ' s other things 

I understand incorrectly . 

So the attorneys reviewed it and said, "Yes, 

Bennet, your facts are correct. " 

Q. And so here we are four months later and one of 

the things you conclude is that Mr . Muhaymin, quote, 

"Always carries a service dog ." So that information you 

would have obtained somewhere else that was verified by 

plaintiff's counsel; correct? 

dog? 

A. 

Q. 

A. 

Q. 

Yes, yes . 

You don ' t know how long Mr . Muhaymin had that 

No, I wouldn't know . 

You don ' t know that he had just been released 

from prison months prior to the incident? 

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evidence . 

DEPOSITION OF BENNET OMALU 

October 26, 2020 

MR . CHAMI : Object . Assumes facts not in 

THE WITNESS : I don ' t know . But -- but -- but if 

you may allow me, such information, whether he came out of 

a jail or not, are immaterial to the determination of 

cause of death . 

MS. STILLWELL : Q. And again, we're just trying 

to determine what information you had, for instance, 

whether the dog was even registered with the county . 

A. 

Q. 

I wouldn't know that . 

Or whether the dog had had any training or had a 

propensity for aggression . 

A. 

Q. 

I wouldn't know that . 

And in the next paragraph you conclude that Mr. 

Tarango called for the police . 

A. 

Q. 

Sorry? 

That Mr . Tarango -- it's in the second paragraph 

in your summary. That Mr . Tarango had called for the 

police on January 4th, 2017 . Now, we already talked about 

how you don't have the CAD report or the 911 call . 

MR. CHAMI : Let her finish the question. 

MS. STILLWELL : Q. And I understand what you are 

about to say . 

A. 

Q. 

No. I thought you were done. Sorry. 

No. I'm not done. But Mr. Tarango had not made 

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exhibiting any violent behavior. Now, this is just what I 

saw on video . I 'm not opining on the standards of 

policing . That is above my pay grade . 

Q. So, Dr . Omalu, in your opinion you add the 2 

minutes in the first instance, plus the 8 minutes to 

render 10 minutes; correct? 

Yes, yes . ,_ A. 

Q. Do you opine, sir, that he was in a prone 

position that full 10 minutes? 

A. No . I didn ' t opine that . He was -- if you read 

my report, I said you cannot break apart the terminal 

events. So the cumulative exposure period and again, 

please, when I say "10 minutes, " don ' t use it as an 

absolute . It ' s an estimate . Using scientific methods, 

you use plus or minus 2 standard deviation, meaning it 

could be more or less. Don ' t mean it ' s absolute values. 

So the cumulative exposure to the terminal injury 

is the time and the year . You don ' t use each and every 

exposure . Just like in asbestos, you can't say one single 

fiber causes asbestos. You say over 30 years his 

cumulative exposure to asbestos. 

Same applies to traumatic brain injury because 

asphyxial brain injury is traumatic brain injury . So his 

cumulative exposure beginning from the moment they had him 

on the ground to the moment he died, including the massive 

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amounts of vomiting, which he aspirated. That was also 

asphyxia . 

Because when I examined his lung sections, the 

specific type of airways we call bronchioles were 

completely occluded . And so you don ' t break it up to each 

and every exposure because even the vomiting is 

asphyxiation . And he vomited and it went down into his 

lungs which also could have caused an acute pulmonary 

hypertension that will increase his likelihood of death . 

MS . STILLWELL : We 're going to take a quick 

break . 

MR . CHAMI : That 's fine . 

THE VIDEOGRAPHER: Counsel, time is now 3:01 PM . 

We are now off the record . 

(Off the record . ) 

THE VIDEOGRAPHER: Counsel, time is 3 : 04 PM . We 

are back on the record . 

MS . STILLWELL : Thank you . We took a quick 

break . I appreciate it. 

Q. Now, Dr . Omalu, we talked briefly about the fact 

that Mr . Muhaymin was not necessarily in a prone position . 

I 'm not holding you to this 10-minute exact mark . You 

understand, of course, in your review of the videos that 

he had been rotated to his side . That he had been up on 

his feet in between the two incidents on the ground; 

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3 Q. Now, you mention in here about Mr . Muhaymin ' s 

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hands coming from behind his back up over his shoulders. 

Do you recall seeing that on the video? 

A. Yes . That was when they were -- this was closer 

to the second episode. 

Q. And in your experience with law enforcement 

agencies, and you've said you ' ve done a few cases, 

officers generally would prefer the arms be in the back 

than in the front; correct? 

MR. CHAMI : Object to form, foundation . outside 

of experts. 

Go ahead. 

THE WITNESS : Yes. But what I saw was his hands 

were in his back were being raised to the level of his 

shoulders. That is not a positioning of the body that is 

compatible with anatomic limitations of the body, and that 

will be very painful. 

MS. STILLWELL : Q. And you recall reading the 

officers' testimony that they went from, you know, lifting 

his hands to search the pockets to try to pull them back 

down because Mr. Muhaymin was moving them on his own. 

A. The video showed that they raise his hand above 

from his back to above the level of his shoulders, 

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extensions, and I wouldn ' t believe that, no . 

Q. You would agree with me that Mr . Muhaymin was 

screaming and yelling and very vocal during his encounter 

with the police officers that day? 

MR . CHAMI : Object to the form, foundation . 

Mischaracterizes the evidence . 

THE WITNESS : I don ' t know why we should use the 

word "very vocal " for a human being who was screaming out 

in pain . He wasn ' t very vocal . He was yelling out . He 

was using the typical primitive reflexive noises human 

beings make when they are in pain . 

MS . STILLWELL : Q. When you are concluding that 

he ' s yelling out, in each of those times he's yelling 

correct? -- that he is yelling in pain, on what basis or 

what research are you relying upon to establish that that 

is similarly a yell in pain? 

A. There were times he said, "I can't breathe, " many 

times . "I can ' t breathe ." And he did say casually, "I 

can ' t breathe, " said it in very high-pitched, high-tone 

voice . There was at the beginning he said -- he was 

yelling out, "Okay, okay ." And when his hand was 

reflexed, he was making the typical reflexive noises human 

beings make when they are in a state of agitation and 

pain. 

Q. When you say that's typical noises, aside from 

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respond to a stimulus. 

So the brain sends signals within 100 to 200 

milliseconds to the blood vessels that supply the heart . 

Given the blood vessels' instructions to dilate, send more 

blood to the heart, but there 's a limit . And because of 

the suddenness, the suddenness of the signaling, the blood 

vessels can go into a spasm. 

Just like human beings, sometimes you are faced 

to speak suddenly, you freeze . So the same happens to the 

blood vessels . They go into a spasm and actually shots of 

blood go into the heart . And then the -- brain asphyxia, 

the brain cells are no longer getting more blood and 

oxygen . The heart is not -- the heart cells cannot pump 

because the blood vessels are in spasm. And what happens? 

2 or 3 minutes passes, the brain dies. 

So having that and that is type 2 myocardial 

injury, outside of five types . So what happens here, an 

individual is exposed to a high state of stress. Autopsy 

showed he had about 40 to 50 percent coronary occlusion, 

which is clinically insignificant . At 40, 50 percent you 

wouldn ' t be having symptoms . 

Q. Why is it clinically insignificant --

A. Because science has established, according to the 

Harrison's Textbook of Medicine, the Harrison ' s, 

Harrison's, H-A-R-R-I-S-S-0-N-S [sic] -- I used to 

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instance was the interaction with the police . 

Somebody could claim: Dr . Omalu, what about the 

amphetamines? Yeah, what about the amphetamines? Before 

he encountered the police, he was a normally functioning 

human being . He was not in any state of duress . He was 

not manifesting any excitotoxicity. And guess what? His 

amphetamine levels were not toxic . 

Remember, amphetamine is a drug used to treat 

attention -- hyperactivity attention deficit disorder. So 

it does not mean that the mere presence of amphetamine is 

lethal . 

Q. Well, that's the amphetamine . But he also had 

methamphetamines in his system which there is no clinical 

value; correct? 

A. Yes . He had methamphetamine . But once you take 

methamphetamine, just like heroin or cocaine, within 

minutes or hours, most times 2 hours in your body, the 

methamphetamine is broken down to amphetamine . So when 

you look at them, they are two different drugs . They are 

two different drugs . 

In fact, it's been very well-studied. Like I 

place in my paper, even the National Highway Traffic 

Safety Administration has clearly stated that the levels 

of amphetamine we found in Muhammad are not lethal, 

especially in people who use amphetamine t o recreate 

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DEPOSITION OF BENNET OMALU 

October 26, 2020 

Q. And is that what led you, sir, to your opinion 

that Mr. Muhaymin, quote, "Did not die from 

methamphetamine toxicity"? 

A. No. That wasn ' t what led me to . What led me was 

multifactorial . Like I said, you consider the entire 

picture. When it comes to the amphetamine if you watch 

the video 

narrative. 

we have a video here, so there's no competing 

When Mr . Muhammad wanted to use the bathroom, he 

had amphetamine in him. He was not in impending death. 

He was not in imminent death. In fact, after he was in 

the bathroom, he was walking away. Because as a chronic 

user of drugs, their body develops resistance and 

tolerance . 

So he was walking away. But the -- immediately 

he interacted and encountered the police physically . It 

was not a coincidence that 10 minutes later he was dead. 

It's not. 

So what it means is without the interaction with 

the police, more likely than not, Mr . Muhammad would not 

have died the day he died . 

Q. So as long as we 're talking about 

methamphetamines, you opined that a majority of human 

beings who consume methamphetamine as a recreational drug, 

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October 26, 2020 

quote, 11 D0 not die from it " ; right? 

A. 

Q. 

Yes . 

And you would agree though, wouldn ' t you, that 

some people who do use it as a recreational drug or who 

use it for the first time or the thousandth time can die 

from it? 

MR . CHAMI : Object to foundation . 

THE WITNESS : Yes . When you perform an autopsy, 

you see the evidence showing that they died from 

methamphetamine toxicity . In this case, even in the 

autopsy report, there was no indication whatsoever that he 

died from methamphetamine toxicity. No . None whatsoever . 

And there was a paper published in 2008 by 

Ferner. It's on page 15 of my report, "Post-mortem 

Clinical Pharmacology ." 

MS . STILLWELL : Q. What is considered a toxic 

level of meth? 

A. That is what you are saying, that you cannot 

determine a toxic level of a drug based on just one single 

measurement at one point in time, especially postmortem. 

That is beneath the standard of practice . Why? Because 

once you die, and also the agony of death affects the 

levels of drugs in human beings. It ' s called postmortem 

redistribution of drugs . 

Q. Well, and t hat ' s why t hey pull blood from 

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October 26, 2020 

statistics, for instance, the National Institute of Health 

and the U.S. Center for Disease Control statistics. They 

represent that approximately 10,000 people or more die 

from methamphetamine intoxication . 

A. It depends on the population base used . 

Generally no matter where you read, it ' s usually less than 

0 . 5 percent . 

Q. 

A. 

How many 

Which is insignificant . I mean, a death rate of 

0 . 05 percent . It ' s epidemiologically insignificant . Not 

that I 'm supporting use of drugs, but our stand now on 

drug abuse is it is a disease that needs to be treated. 

Q. How many living patients do you treat or have you 

treated with who are actively intoxicated on 

methamphetamine? 

A. 

Q. 

I don ' t treat -- I don ' t treat patients, no . 

How many agitated patients, living patients, 

would you have taken care of in the past years? 

A. I don ' t treat . That line of question is not -- I 

don ' t treat patients who need urgent care . 

Q. Can methamphetamines cause a heart attack , for 

lack of a better word? 

,- Sorry? 

,-

A. 

Q. Can methamphetamine -- the use of methamphetamine ,_ 

we agree that you can use methamphetamine and it can 

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DEPOSITION OF BENNET OMALU 

October 26, 2020 

kill you. Can it cause a heart attack or a cardiac 

arrest? 

3 A. It could cause a type 2 myocardial injury. 

4 Can it cause dysrhythmia? 

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A. 

Q. 

A. 

Yes . But there is frequently an instigator. 

And what was that instigator? 

Many times they use -- majority of cases they 

don ' t just use methamphetamine. They use more than 

methamphetamine. They use other drugs . Okay . Probably 

pharmacy. Many times they have an underlying disease. I 

mean, sometimes infections. And many times they have 

severe -- they have severe coronary artery occlusion, 80 

percent or more, and you will see the effects of the drug 

when you do an autopsy. 

So what makes this case different is that an 

autopsy was done . We had the privilege of examining the 

tissues. And everything examining, including in the 

autopsy report, it is speculative to suggest that 

methamphetamine was the underlying cause of death . 

Q. 

A. 

or one of the contributing factors? 

It could be. You could determine is a 

contributory factor, but it does not in any way undermine 

or affect the asphyxiation. 

Q. What can happen with a schizophrenic if they were 

to take methamphetamines? Would it cause psychosis? 

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levels, but both drugs act on the same receptors in the 

human brain. We did an autopsy. Autopsy ruled out any 

other cause of death. 

So although the level of the diazepam and the 

quetiapine, quetiapine, Q-U-E-T-I-A-P-I-N-E, they were in 

therapeutic ranges, the presence of the two at the same 

time in a deceased individual will be a combined acute 

toxicity in spite of the levels in the body. 

Q. Now, Dr . Omalu, I understand you are board 

certified in pathology. 

A. I'm board certified in anatomic pathology. I'm 

board certified in clinical pathology. I'm board 

certified in forensic pathology. I'm board certified in 

neuropathology . 

Q. And I understand that toxicology is a 

component of 

A. 

Q. 

A. 

Q. 

Of clinical pathology. 

clinical pathology. 

Clinical chemistry, yes. 

But you do not have a separate certification, 

board certification in toxicology; correct? 

A. No . 

Q. Now, we talked a little bit about methamphetamine 

intoxication. Given your experience and your board 

certification as a clinical pathologist, can a person 

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October 26, 2020 

it quickly escalated when he was touched. 

Q. Now, on page 17 you touched on it briefly. You 

indicate, "Muhammad did not die from coronary artery 

disease." 

A. 

Q. 

Yes, please. on page what? 

17, sir. And you acknowledge that the prin 

"The fundamental principle and criterion for a type 2 

myocardial infarction is the presence of a stressor, which 

places the heart at an increased demand for oxygen." 

A. 

Q. 

Yes, please. 

Why would methamphetamine not have been the 

stressor in this case? 

A. Because the methamphetamine preceded the 

mechanical asphyxiation . Temporal relationships. So 

before he encountered -- before the video started, he had 

methamphetamine in him. "I 'm coming; I'm coming." He had 

methamphetamine in his body . 

Q. Can I stop you for a second? Do you know when he 

ingested that methamphetamine? 

A. Hours prior. Because the amphetamine level --

the methamphetamine and amphetamine were high . If he had 

just ingested it in the bathroom, you wouldn ' t have such 

high levels of amphetamine because the methamphetamine is 

broken down to amphetamine . And it has to pass first 

through the liver. 

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DEPOSITION OF BENNET OMALU 

October 26, 2020 

So the pharmacokinetics, pharmacokinetics of the 

drugs indicate that he took it much prior. He didn ' t do 

it in the bathroom because I considered that as well . 

Q. And the postmortem level, just so we ' re clear, is 

the 0 . 81 of methamphetamine and the 0.24 of amphetamine; 

correct? 

A. 

Q. 

A. 

Let me see. 

You have it on your page 16 in the middle. 

Yes . So you see, there is still an equilibrium 

conversion. So what this tells you is that he took it not 

5 hours prior. Maybe an hour to 2 hours before his death. 

Okay. or maybe an hour to 2 hours before. He didn ' t take 

it like 6 hours prior, 8 hours prior. No. Okay. 

There was a question I was answering before you 

cut me short . 

Q. Excuse me . Sorry? 

A. There was a question you asked me before you cut 

me short. Did I know the time --

Q. I was trying to clarify it, and that was why 

would methamphetamine not have been the stressor --

A. 

Q. 

A. 

Good, good. 

to precipitate the type 2 myocardial --

So the temporal effect. Okay . So if you read 

the principles of determining cause of death, so prior to 

interaction with police, he had amphetamines. When I say 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

--o0o--

Mussalina Muhaymin as Personal 

Representative of the Estate of 

Muhammad Abdul Muhaymin Jr. , 

Plaintiff, 

vs . No . 17-cv-04565-PHX-SMB 

City of Phoenix, an Arizona VOLUME II 

Municipal Corporation; Antonio 

Tarango; Officer Oswald Grenier; 

Officer Kevin McGowan; Officer 

Jason Hobe; Officer Renaldo 

Canilao; Officer David Head; 

Officer Susan Heimbinger; 

Officer James Clark ; Officer 

Dennis Lerous; Officer Ryan 

Nielson; Officer Steven Wong; 

and Doe Supervisors 1-5, 

Defendants . ___________________ / 

CONTINUED VIDEO RECORDED DEPOSITION OF 

BENNET OMALU, MD 

Friday, October 30, 2020 

7 : 04 AM 

Taken in the offices of : 

Bennet Omalu, MD 

3031 West March Lane, Suite 323 

Stockton, California 95219 

REPORTED BY : VICTORIA R . MARTIN, CSR 12322 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

So like Ferner, F-E-R-N-E-R, Ferner said, you 

cannot base diagnostic decisions just on one isolated 

measurement of blood sample in the human body . 

Q. Now, would the -- the estimates of the 

postmortem, I believe Baselt -- Baselt said that the range 

is 0.09 to 18, and those are the concentrations that can 

cause death from methamphetamines; correct? 

A. 

Q. 

A. 

Any level of methamphetamine can cause death . 

Okay. 

So what you now consider is, is the individual a 

prior user of methamphetamine . For example, a case I just 

signed out before I started this deposition, the 

methamphetamine level was very high, but he died from a 

motor vehicle accident. So the mere presence of high 

levels of methamphetamine does not mean you died from it. 

That is the point I'm making. 

Q. So you would look at the history of 

methamphetamine use; right? 

A. 

Q. 

Yes, please. 

You would look at other stressors or other 

factors to determine whether the methamphetamine had some 

contributing factor to a death; correct? 

A. 

Q. 

Yes, yes. 

Okay. Now, on your letterhead, Dr. Omalu, you 

have Autopsy and Anatomic Pathology. You took the boards 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

separate board for toxicology; correct? 

A. It ' s not -- it ' s not a board that is recognized 

by the American Board of Pathology . It doesn ' t fall under 

the American Board of Pathology . 

Q. So are you saying because you are board 

certified -- because you are board certified in anatomic 

pathology and clinical pathology, you are automatically 

board certified in toxicology? 

A. No, no . That wasn ' t what I said. The board 

certification in toxicology, it' s not under the American 

Board of Pathology . It ' s a separate board given by -- I 

don ' t know who gives it. Because there are many board 

certifications out there that are not recognized by the 

American -- Graduate Medical Education Certification 

Board . 

So there is a PhD -- there are some people with 

PhDs in toxicology . Very recently I started hearing of 

there ' s board certification in toxicology . Anybody can 

get it. So I don ' t know --

Q. I 'm sorry . I didn ' t mean to interrupt you . 

Medical doctors can get board certified in toxicology; 

right? 

A. Yeah . I ' ve seen one or two medical doctors that 

state board certification in toxicology . 

Q. Uh-huh . 

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DEPOSITION OF BENNET OMALU 

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A. Toxicology is not a recognized field of medicine. 

What we have in medicine is pharmacology . 

Q. So -- but medical toxicology is a subspecialty of 

medicine; correct? 

A. Well, medical toxicology, we call it 

pharmacology . Pharmacology, P-H-A-R-M-A-C-0-L-G-Y. 

Because as doctors, we deal with drugs . Drugs are toxins. 

So part of my medical school education, I spent one year 

or six months to one year, I've forgotten, starting 

pharmacology and therapeutics. 

Q. Now, earlier we talked about the fact that you 

don ' t currently treat living patients and you haven ' t 

treated them since Nigeria. But in your CV, it says you 

have hospital privileges. Does that mean that you have 

privileges to treat living patients? I just need a little 

clarification. 

A. I have privileges to make decisions on living 

patients and their medical care and treatment . Like I 

have told you, as a pathologist, I advise clinicians on 

treatments and diagnosis sometimes . I ' m consulted 

directly to help guide the treatment of patients. 

Now, can I treat patients in the State of 

California? Yes, I can . But I've chosen not to do that 

because it's not something I enjoy . 

Q. Okay . Now, earlier when we were talking about 

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DEPOSITION OF BENNET OMALU 

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postmortem redistribution and the factors that you need to 

consider whether methamphetamine toxicity contributed to 

death, you said something about tolerance. Can you give 

me the elements of tolerance? 

A. Okay . The elements of tolerance. To begin with, 

there is what is called pharmaco, pharmacogenetics, 

pharmacogenetics, and what it means is not every human 

being responds to the same drug the same way . 

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A. A good example is like alcohol. I have 

colleagues of mine, they drink one shot of Johnnie Walker 

whiskey, they are so loquacious. They are intoxicated. 

Myself, I drink one shot of Johnnie Walker, I don ' t even 

notice any change. 

So human beings have genetic variations in the 

way they tolerate, they metabolize drugs . That is the 

first thing to begin with . So if you find a high level of 

a drug in an individual, it does not manifest the same way 

as the same level in another individual. 

Two, if your body has been exposed to a drug, 

just like if your body has been exposed to a vaccine in 

the past, the more recent, the greater the effect . If 

your body is exposed to the same drug it has been exposed 

to, your body is no longer naive to that drug . Your body 

is used to that drug, then that drug is more likely to be 

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DEPOSITION OF BENNET OMALU 

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metabolized faster and is less likely to intoxicate you, 

to kill you . And the more exposed you are to that drug 

and the more genetically tolerant you are to that drug, 

the less likely the drug will have adverse effects on you . 

So tolerance is a very broad scientific concept . 

What it simply means -- I go back -- you cannot make a 

diagnostic decision or conclusion just based on the level 

of a drug in a human being. 

Q. Okay . And for the purposes of reliance, is there 

a particular textbook or study that you rely upon for your 

definition of tolerance, as you just told me? 

A. There is a book called the Pharmacological Basis 

of Therapeutics by --

Q. 

A. 

Q. 

A. 

Okay . 

It ' s called -- by Goodman, G-O-O-D-M-A-N . 

Okay . 

It ' s a very basic, primary textbook of 

pharmacology . It's been a while I ' ve read it, but you 

could find the definition -- those definitions are 

provided . 

Q. Do you happen to know the chapter or anything 

like that? 

A. Oh, no . For such a broad topic, there is no one 

single chapter that will address it . So when you go to 

the index, you search, and it will refer you to the 

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DEPOSITION OF BENNET OMALU 

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Neuropathology textbook assist in your opinion? 

A. No . Remember, two days ago -- or say two days 

ago for the first deposition, I said that when I prepared 

this report, I did not rely specifically on any specific 

textbook or paper. I said that . That the concepts we 

are -- the scientific concepts we are concerned with in 

this case are very elementary and basic in medicine . That 

and also very elementary and basic for me as an 

individual. That I simply wrote all these things without 

making any references. But some of the absolute values I 

provided, which I could not memorize, I had to go to the 

specific textbook or reference, lift it out. And when I 

do -- I do that, I will give you the reference so that 

absolute values we have references to. 

But in terms of the scientific principles, I did 

not refer or rely on any specific published book . 

relied on the body of knowledge, experience, and work I 

have done over 20 years. 

Q. So, Dr . Omalu, are you going to follow Mr . 

Chami ' s direction not to provide the chapter on 

Greenfield ' s Neuropathology? 

MR . CHAM! : No . That's not what I said. I just 

said what the rules require . That ' s all . 

MS . STILLWELL : No . Mr . Chami, you said that he 

is not going to provide it. So --

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DEPOSITION OF BENNET OMALU 

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Okay . on page 19, you conclude that Mr . 

Muhaymin, quote, "Died as a result of 

mechanical-positional asphyxiation due to the compression 

of his trunk and body." 

A. 

Q. 

Did I say that correctly? 

Yes, please . 

And you said -- you start out by saying Mr . 

Muhaymin, quote, "Was not in any form of distress. " 

A. 

center" 

Q. 

A. 

I said, "When he walked out of the community 

Okay . 

-- "on January 4, 2017, he was not in any form of 

distress and was not dying." 

Q. How do you make that conclusion in light of the 

fact that he did have methamphetamines in his system and 

he was schizophrenic, and he did have -- although you say 

"clinically insignificant," he did have a blockage in his 

arteries. 

A. No, no. Why I 'm laughing is you said he had a 

blockage in his arteries . 

Q. 

A. 

Yes . 

I sit here and as you sit here too, you and I 

could have blockages of 30 to 40 percent . It is of no 

clinical significance. It becomes clinically significant 

when it is up about 80 . Even with 80 percent, it becomes 

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DEPOSITION OF BENNET OMALU 

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clinically significant if you suffer myofibrillar ischemic 

injury. So the presence of blockage of your vessels does 

not place you in distress. No . One . 

Two, like I have always said earlier, the mere 

presence of the drug in your blood does not mean that drug 

is killing you or that drug is toxic . 

Three, the mere fact that you have schizophrenia 

does not mean you are in distress. It ' s a chronic 

disease . It ' s like saying somebody with high blood 

pressure like myself, that I 'm in distress. No . The mere 

presence of the disease in a human being does not equate 

to distress or impending death . And that is what we have 

here . 

Like I have pugilistic, and I clearly state that 

in my report, that the mere presence of a disease or drug 

in your body does not mean you are dying from the disease 

or drug . The video clearly shows a human being who was 

not in any form of distress or in any form of impending 

death . The autopsy confirmed that . 

(Videographer gone . ) 

MS . STILLWELL : Q. Now, you mentioned in part of 

your review of the slides, the slides you created, sir, 

that you were able to conclude that the slides showed 

brain edema and brain congestion; is that right? 

A. Yes, please . 

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DEPOSITION OF BENNET OMALU 

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You agree with me though that both brain edema 

and brain congestion, that you can also see that following 

a prolonged period of resuscitation efforts? 

A. Yes . But but let 's be very careful . Let ' s 

not start in a wild-goose chase of hypotheticals . 

Anything is possible . It 's possible Dr . Bennet Omalu is a 

woman . Because based on what you see, it is unreasonable 

to assume he ' s woman . 

So in this case an autopsy was done . We have 

confirmed evidential -- prevailing evidentiary values that 

nobody is contesting . And based on the constellation of 

those evidentiary values or indices, we ' ve made a 

conclusion. 

Now, after we've done that and we start 

hypothesizing : Is this possible? Is this possible? 

Based on the out comes, there was no evidence to indicate 

that the changes we saw in his brain were caused by 

cardiopulmonary resuscitation . 

Q. Well, Dr . Omalu, you would agree that there was 

approximately 30 minutes of cardiopulmonary resuscitation 

efforts; right? 

A. Yes . 

MR . CHAMI : Object to foundation . 

MS . STILLWELL : Q. We started talking before on 

Monday and I asked you if you could tell me how much body 

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DEPOSITION OF BENNET OMALU 

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weight was placed on Mr . Muhaymin and by which officer, 

and I think you had told me that you can ' t quantify that; 

is that correct? 

A. Yes . It ' s the same -- it is tantamount to the 

all or non-principle, which I ' ll explain . That you cannot 

specify each and every exposure . No . Rather, it is a 

spectrum of cumulative exposure . And that is why the 

diagnosis we raise -- everybody just say, "mechanical 

asphyxia ." We say, "mechanical-positional ." 

Because first in positional, a human being thrown 

on the ground with his chest and abdomen compressed on the 

ground, inability of the diaphragm to move up and down, so 

the cumulative exposure with him on the ground and with 

him even crying out, "I cannot breathe ." You need to put 

the entirety of the exposure to injury together, not each 

and every . 

And that was what -- I clearly state that in my 

report, that this is -- this is about the concept of 

cumulative exposure . We are dealing with brain injury. 

Q. Okay . Would you agree with me, Dr . Omalu, that 

the officers ' placement was changing? 

A. 

Q. 

Sorry? 

That the officers changed positions in 

placement --

MR . CHAM! : Objection to form and foundation . 

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Chami? 

DEPOSITION OF BENNET OMALU 

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MS . STILLWELL : Can I finish the question, Mr . 

MR . CHAMI : That was a question . I didn ' t know 

you weren ' t done . 

Q. 

A. 

MS . STILLWELL : I 'm not done . 

-- during the encounters with Mr . Muhaymin? 

MR . CHAMI : Object to form and foundation . 

MS . STILLWELL : Q. Go ahead, Doctor. 

My answer to that is yes . But not unique to this 

case . I was not paying to attention to that . When there 

is compression of a human being, it ' s not a static, static 

phenomenon . It ' s a dynamic phenomenon . So I expect 

positioning to change, including the body of Muhammad . So 

my answer to that is yes . 

Q. 

A. 

Yes, they were changing? 

Not -- my answer is general -- a general answer . 

I did not pay attention to it in this case because it is 

of no significant forensic consequence . You expect their 

bodies to change, yes . 

Q. Does the person ' s weight on someone ' s legs impact 

the ability to ventilate? 

A. 

Q. 

I don ' t understand the question . Sorry. 

Sure . If a person is holding someone ' s legs, 

does that impact their ventilation, their ability to 

breathe? 

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DEPOSITION OF BENNET OMALU 

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So the answer to that is yes . But you have to 

consider the entirety of the event, not just holding the 

person ' s legs . Holding somebody ' s leg -- if I 'm sitting 

down now and my son is holding my leg, it ' s not going to 

affect me because I 'm sitting down . My chest can move up 

and down . 

So like I have said earlier, we cannot break it 

up into different parts. If he was holding his leg, what 

was the other things going on at that moment . Were his 

legs -- his knees being flexed, and were his hips being 

flexed with the legs? 

So the totality of the exposure to injury 

compromise his aspiratory functioning including the 

aspiration of his vomitus . 

Q. So the same -- your opinion would be the same on 

whether an officer had weight on buttocks or on arms --

A. 

Q. 

A. 

Q. 

A. 

Yes . 

-- or hands? 

Yes . 

Correct? 

Because it is a concept of cumulative exposure . 

We cannot engage in each and every, which medically is not 

acceptable . And even legally, based on my experience, you 

can ' t propound each and every exposure concept . It is 

accumulative exposure . 

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DEPOSITION OF BENNET OMALU 

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So your opinion, sir, on cumulated exposure, a 

cumulated sustained mechanical compression I think is 

another phrase you had used . Can you cite to any 

textbooks or articles that support that concept? 

(Videographer returned . ) 

THE WITNESS : Concept of what? Can you help me 

understand? 

MS . STILLWELL : Q. Sure . You had indicated 

cumulated exposure or pressure and not breaking it down 

per officer or per event, but the cumulated -- everybody, 

regardless of what they were holding or what they were 

doing . Is there a textbook or an article or a study that 

supports that concept? 

A. Every basic textbook of medicine will address the 

issue of cumulated injury to the human brain . There is no 

basic textbook of brain disease or brain injury. This is 

a very basic and elementary concept, honestly . It does 

certain things -- certain generally accepted principles of 

medicine . Like a man has XX sex chromosomes . We don ' t 

need a reference for that . It ' s a fact of medicine . 

(Mr . Faraj joins the depo . ) 

THE WITNESS : Every basic textbook of medicine 

you should consider. 

MS . STILLWELL : Q. Dr . Omalu, you've said 

"basic " and "elementary" quite a few times. If it's so 

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DEPOSITION OF BENNET OMALU 

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So when we talk about contemporaneous other 

factors, we can talk about, you know, how much weight was 

applied or for how long; correct? 

A. Yes . But not just the weight, per se, like I 

have said . Because I think we are divergent -- excuse me . 

You 're focusing on the weight as a mutually exclusive 

factor, and I 'm telling you, no, you cannot do that . It 

is a totality, a cumulation of multiple contemporaneous 

factors, including the vomiting . Because we keep on 

staying away from it. Including the vomi t us, which -- the 

vomiting, which occluded all his airways . 

Q. We ' ll get to the vomiting, Dr . Omalu, but you 

brought up something that reminded me from the Monday . on 

Monday you said it wasn ' t just the weight, and it sounds 

like right now it doesn ' t matter how much weight or where 

it was applied . But you said on Monday about the knee 

compression in a vital plexus. Do you recall that? 

A. 

Q. 

A. 

The what plexus? 

I think you said "vital " plexus. 

No, no, no, no . I said in the neck and chest . 

They are vital plexuses, plexuses, P-L-U-X-E-S [sic] , 

plexuses of nerves and ganglia that are very sensitive to 

compression . 

Q. Where are -- I don ' t mean to interrupt you, 

Doctor. I 'm sorry . Where are those nerves that you are 

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DEPOSITION OF BENNET OMALU 

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did not list it. So if you ask me maybe it was in there, 

I don ' t know . But I could check the autopsy report if you 

will let me . 

Q. Dr . Omalu, if you just want to check the autopsy 

report really quick to see if it - -

A. Yes . Thank you . It says there were no petechia 

in the eyes. 

Q. Okay . Thank you, Doctor. Do you recall -- well, 

you told me you don ' t know exactly when his heart stopped . 

Is that you true that you don ' t know also when he stopped 

breathing? Can you tell that from the video, sir? 

A. I did not watch out for that because it was of no 

forensic value, so I wasn ' t watching the video to identifY. 

specifically when he stopped breathing . All I know is my 

review during the asphyxial event, during the second 

officer the officers noted he was nonresponsive after 

he said he could not breathe . I didn ' t go to find out 

exactly the time, no . 

Q. Okay . Now, Dr . Omalu, if a person is struggling 

or resisting, can that increase the amount of lactic acid 

that they are producing? 

A. It is not t he struggle that is producing the 

lactic acid . It is the metabolic injury which was 

instigated by the asphyxial injury. The struggle is a 

consequence of t he asphyxial injury . 

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evidence? 

A. 

to --

DEPOSITION OF BENNET OMALU 

October 30, 2020 

But they show the encounter. They are the best 

Yes, ma ' am . 

MR . FARAJ: I'm going to -- I 'm going to object 

MS . STILLWELL : Go ahead, Mr . Faraj . 

MR . FARAJ: I'm going to object to lack of 

foundation . Dr . Omalu's opinion as to the best evidence 

is not relevant . That's a legal question . 

Go ahead though . 

THE WITNESS : I'm sorry. I don 't - - I will -- my 

opinion is not the best evidence . My opinion is the video 

speaks for itself. I did not -- I was not using the word 

"best." 

MR . FARAJ: I didn ' t say you did, Dr . Omalu . 

MS . STILLWELL : I did . 

MR . FARAJ: It ' s a question and response, and I 

wanted to make sure I 'm objecting to the suggestion that 

that ' s the best evidence . 

Faraj? 

Q. 

MS . STILLWELL : So did you have any more, Mr . 

MR . FARAJ: No, I didn't . 

MS . STILLWELL : I didn't mean to interrupt you . 

Now, Dr . Omalu, I 'm very curious about this 

concept of primitive response and that he was acting out 

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DEPOSITION OF BENNET OMALU 

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of fear and not resistance, and then he was acting out of 

asphyxiation and not continued resistance . With that 

concept -- where did that concept come from? Is there a 

textbook? Is there a study or an article that supports 

this idea of the primitive responses? 

A. Every basic textbook of medicine . Again, I give 

you Guyton ' s Textbook of Physiology, G-U-Y-T-0-N-S . Any 

basic psychiatry textbook . Every basic textbook of human 

behavior or -- it ' s like I said, it ' s a very basic, 

elementary generally accepted common knowledge of 

medicine . 

Q. Now, Dr . Omalu, a few things. No . 1, you are not 

a psychologist; correct? 

1-

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Q. 

A. 

I 'm not a psychologist, no . 

And you are not a psychiatrist? 

As a physician, I 'm trained in psychiatry, but 

I 'm not board certified in psychiatry. 

Q. And you ' ve never provided mental health treatment 

to a living patient; correct? 

A. I have; I have . Your question is I have never, 

and the answer to that is that is not true . I have . When 

I was in Nigeria, I worked for how many years? -- five, 

six years as a physician, and I worked as a general 

practitioner. A general practitioner, you provide every 

spectrum of care . Like cesarean sections. I performed 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

Okay . Dr . Omalu, let ' s switch gears. You 

mentioned before the oxygenation . And actually on page 24 

of your report you opine, "As his blood oxygen levels 

decreased and the carbon dioxide levels increased, while 

he was on the ground, he began to develop acidosis, became 

more confused and afraid and struggled more ." 

Do you know, Dr . Omalu, what his oxygen 

saturation level was when he was walking to the police 

car? 

A. No . That was why I did not put it in my report 

because it's a misnomer . It doesn ' t matter what his 

oxygen saturation level was there. What matters is that 

he died and an autopsy was performed which showed he 

suffered an asphyxial injury. The medical examiner who 

performed this autopsy ruled it a homicide. She ruled it 

a homicide. 

Q. So, Dr. Omalu, you just indicated about the blood 

oxygen levels. Because you don't know the oxygen 

saturation, obviously he wasn ' t wearing a pulse oximeter, 

so there was no monitoring device to conclude that his 

blood oxygen levels decreased and the carbon dioxide 

levels increased . So I 'm trying to find out how did you 

make that opinion. What was it based upon other than your 

final conclusion? 

A. Because the brain cells, which I examined --

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Muhaymin; is that correct? 

A. 

Q. 

Yes, please . 

And do you know, as you sit here, Dr . Omalu, what 

he was cognitively experiencing during any part of his 

encounter with law enforcement officers? 

A. 

Q. 

Could you repeat the question? 

Yes . Do you know, Dr . Omalu, as you sit here 

today, what Mr . Muhaymin was cognitively experiencing 

during his encounter with the law enforcement officers? 

A. He was experiencing mental pain and anguish . He 

was experiencing somatic pain . He was experiencing 

chemical pain . 

Q. Can you base that, sir, off of your review? 

Obviously you can ' t interject yourself into Mr . Muhaymin ' s 

box or brain that day; correct? 

A. No . I base that on the prevailing avenues and on 

established scientific principles beginning with the fact 

that Mr . Muhaymin is a human being and human beings are 

known to behave and to manifest and exhibit specific types 

of behaviors which are predictable, predictable in 

specific circumstances. 

Q. And you said they were on scientific methods . 

Can you tell me which ones? 

A. Scientific methods : observing the video 

watching him as a human being, and then what is 

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established about the human being ' s experience of pain and 

suffering . 

Q. So, Dr . Omalu, you agree though if an individual 

is feeling pain, they would generally modify their 

behavior to relieve that pain; correct? 

A. 

reflex. 

Q. 

1-

That is what I have always said is the primitive 

Right . 

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you 're sitting on a hot surface, the moment you experience 

the heat, you stand up immediately . That is a primitive 

reflex. 

Q. Given that example . I'm just trying to figure 

out, sir, in this instance you just said it's the 

primitive response to struggle against the officers. But 

how is it not a primitive response 

MR . FARAJ: Misstates the testimony . 

MS . STILLWELL : Well, I'm not done with my 

question . 

Q. How is it not a primitive response to modify his 

behavior according to the -- provided? 

A. I missed you for like a second . It went blank . 

Could you repeat it, please? 

Q. Sure . I'll try to repeat it word-for-word, but I 

most likely won't . 

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nothing in this case that may indicate or suggest that 

Muhammad was in an active psychotic state . There is no 

evidence whatsoever . 

Q. So, Dr . Omalu, then you don ' t believe based on 

your review that he was in an acute mental crisis? 

A. No . There's no evidence whatsoever . As a 

physician, as somebody who has suffered I've struggled 

with depression in my life, if you read my book . I frown 

upon anyone painting mental illness in dark light . 

His schizophrenia was controlled. He wasn ' t in a 

severe advanced state of schizophrenia that makes him a 

vegetative human being . He was adequately functioning . 

And t hat morning, as the video clearly shows, he was not 

suffering from an acute form of schizophrenia . 

Q. So, sir, how do you quantify the conscious pain 

and suffering that you ' ve opined that Mr . Muhaymin had? 

A. Like I have said, how you quantify it is first 

performing a differential diagnosis, which is a general 

accepted methodology physicians use . How did I apply the 

forensic diagnosis? Watching the video . Reviewing -- I 'm 

answering your question . 

Q. 

A. 

Go ahead . I 'm sorry . 

Reviewing the autopsy findings, the toxicology, 

and applying the established principles of medicine, 

putting everything together. Okay . 

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DEPOSITION OF BENNET OMALU 

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Then I said, given the totality of the evidence, 

he experience high-scale -- if you notice, I stayed away 

from one, two, three, four. I did not quantify it 

absolutely. No. I said he suffered high scales or high 

levels of conscious pain and suffering . Why do I use high 

levels? Because it is established that the agony of 

death, especially violent death, causes high levels of 

conscious pain and suffering. 

And also his heart showed what we call a 

catecholaminergic, catecholaminergic -- I spelled it on 

Monday -- catecholaminergic event . So on the totality of 

the case and under proven and established scientific 

findings, scientific principles. 

Now, every human being in terms of response to 

pain, we all respond to pain the same way. It is not 

something we have control over. It ' s primitive reflex. 

Now, if you are a normal human being, our cognitive 

interpretation of pain may vary based on learning 

behavior. But cognitive interpretation of pain is not the 

came as conscious pain and suffering . Each individual 

experiences conscious pain and suffering . Your response 

to the conscious pain and suffering does not in any way 

nullify the experience of the pain. 

Q. And, Dr . Omalu, I don ' t -- I don ' t mean this 

offensively, but when was t he last time you treated a 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

--o0o--

Mussalina Muhaymin as Personal 

Representative of the Estate of 

Muhammad Abdul Muhaymin Jr. , 

Plaintiff, 

vs . No . 17-cv-04565-PHX-SMB 

City of Phoenix, an Arizona VOLUME II 

Municipal Corporation; Antonio 

Tarango; Officer Oswald Grenier; 

Officer Kevin McGowan; Officer 

Jason Hobe; Officer Renaldo 

Canilao; Officer David Head; 

Officer Susan Heimbinger; 

Officer James Clark ; Officer 

Dennis Lerous; Officer Ryan 

Nielson; Officer Steven Wong; 

and Doe Supervisors 1-5, 

Defendants . ___________________ / 

CONTINUED VIDEO RECORDED DEPOSITION OF 

BENNET OMALU, MD 

Friday, October 30, 2020 

7 : 04 AM 

Taken in the offices of : 

Bennet Omalu, MD 

3031 West March Lane, Suite 323 

Stockton, California 95219 

REPORTED BY : VICTORIA R . MARTIN, CSR 12322 

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DEPOSITION OF BENNET OMALU 

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So like Ferner, F-E-R-N-E-R, Ferner said, you 

cannot base diagnostic decisions just on one isolated 

measurement of blood sample in the human body . 

Q. Now, would the -- the estimates of the 

postmortem, I believe Baselt -- Baselt said that the range 

is 0.09 to 18, and those are the concentrations that can 

cause death from methamphetamines; correct? 

A. 

Q. 

A. 

Any level of methamphetamine can cause death . 

Okay. 

So what you now consider is, is the individual a 

prior user of methamphetamine . For example, a case I just 

signed out before I started this deposition, the 

methamphetamine level was very high, but he died from a 

motor vehicle accident. So the mere presence of high 

levels of methamphetamine does not mean you died from it. 

That is the point I'm making. 

Q. So you would look at the history of 

methamphetamine use; right? 

A. 

Q. 

Yes, please. 

You would look at other stressors or other 

factors to determine whether the methamphetamine had some 

contributing factor to a death; correct? 

A. 

Q. 

Yes, yes. 

Okay. Now, on your letterhead, Dr. Omalu, you 

have Autopsy and Anatomic Pathology. You took the boards 

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DEPOSITION OF BENNET OMALU 

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separate board for toxicology; correct? 

A. It ' s not -- it ' s not a board that is recognized 

by the American Board of Pathology . It doesn ' t fall under 

the American Board of Pathology . 

Q. So are you saying because you are board 

certified -- because you are board certified in anatomic 

pathology and clinical pathology, you are automatically 

board certified in toxicology? 

A. No, no . That wasn ' t what I said. The board 

certification in toxicology, it' s not under the American 

Board of Pathology . It ' s a separate board given by -- I 

don ' t know who gives it. Because there are many board 

certifications out there that are not recognized by the 

American -- Graduate Medical Education Certification 

Board . 

So there is a PhD -- there are some people with 

PhDs in toxicology . Very recently I started hearing of 

there ' s board certification in toxicology . Anybody can 

get it. So I don ' t know --

Q. I 'm sorry . I didn ' t mean to interrupt you . 

Medical doctors can get board certified in toxicology; 

right? 

A. Yeah . I ' ve seen one or two medical doctors that 

state board certification in toxicology . 

Q. Uh-huh . 

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DEPOSITION OF BENNET OMALU 

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A. Toxicology is not a recognized field of medicine. 

What we have in medicine is pharmacology . 

Q. So -- but medical toxicology is a subspecialty of 

medicine; correct? 

A. Well, medical toxicology, we call it 

pharmacology . Pharmacology, P-H-A-R-M-A-C-0-L-G-Y. 

Because as doctors, we deal with drugs . Drugs are toxins. 

So part of my medical school education, I spent one year 

or six months to one year, I've forgotten, starting 

pharmacology and therapeutics. 

Q. Now, earlier we talked about the fact that you 

don ' t currently treat living patients and you haven ' t 

treated them since Nigeria. But in your CV, it says you 

have hospital privileges. Does that mean that you have 

privileges to treat living patients? I just need a little 

clarification. 

A. I have privileges to make decisions on living 

patients and their medical care and treatment . Like I 

have told you, as a pathologist, I advise clinicians on 

treatments and diagnosis sometimes . I ' m consulted 

directly to help guide the treatment of patients. 

Now, can I treat patients in the State of 

California? Yes, I can . But I've chosen not to do that 

because it's not something I enjoy . 

Q. Okay . Now, earlier when we were talking about 

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DEPOSITION OF BENNET OMALU 

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postmortem redistribution and the factors that you need to 

consider whether methamphetamine toxicity contributed to 

death, you said something about tolerance. Can you give 

me the elements of tolerance? 

A. Okay . The elements of tolerance. To begin with, 

there is what is called pharmaco, pharmacogenetics, 

pharmacogenetics, and what it means is not every human 

being responds to the same drug the same way . 

9 Q. ,- Uh-huh. 

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A. A good example is like alcohol. I have 

colleagues of mine, they drink one shot of Johnnie Walker 

whiskey, they are so loquacious. They are intoxicated. 

Myself, I drink one shot of Johnnie Walker, I don ' t even 

notice any change. 

So human beings have genetic variations in the 

way they tolerate, they metabolize drugs . That is the 

first thing to begin with . So if you find a high level of 

a drug in an individual, it does not manifest the same way 

as the same level in another individual. 

Two, if your body has been exposed to a drug, 

just like if your body has been exposed to a vaccine in 

the past, the more recent, the greater the effect . If 

your body is exposed to the same drug it has been exposed 

to, your body is no longer naive to that drug . Your body 

is used to that drug, then that drug is more likely to be 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

metabolized faster and is less likely to intoxicate you, 

to kill you . And the more exposed you are to that drug 

and the more genetically tolerant you are to that drug, 

the less likely the drug will have adverse effects on you . 

So tolerance is a very broad scientific concept . 

What it simply means -- I go back -- you cannot make a 

diagnostic decision or conclusion just based on the level 

of a drug in a human being . 

Q. Okay . And for the purposes of reliance, is there 

a particular textbook or study that you rely upon for your 

definition of tolerance, as you just told me? 

A. There is a book called the Pharmacological Basis 

of Therapeutics by --

Q. 

A. 

Q. 

A. 

Okay . 

It ' s called -- by Goodman, G-O-O-D-M-A-N . 

Okay . 

It ' s a very basic, primary textbook of 

pharmacology . It's been a while I ' ve read it, but you 

could find the definition -- those definitions are 

provided . 

Q. Do you happen to know the chapter or anything 

like that? 

A. Oh, no . For such a broad topic, there is no one 

single chapter that will address it . So when you go to 

the index, you search, and it will refer you to the 

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DEPOSITION OF BENNET OMALU 

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Neuropathology textbook assist in your opinion? 

A. No . Remember, two days ago -- or say two days 

ago for the first deposition, I said that when I prepared 

this report, I did not rely specifically on any specific 

textbook or paper. I said that . That the concepts we 

are -- the scientific concepts we are concerned with in 

this case are very elementary and basic in medicine . That 

and also very elementary and basic for me as an 

individual. That I simply wrote all these things without 

making any references. But some of the absolute values I 

provided, which I could not memorize, I had to go to the 

specific textbook or reference, lift it out. And when I 

do -- I do that, I will give you the reference so that 

absolute values we have references to. 

But in terms of the scientific principles, I did 

not refer or rely on any specific published book . 

relied on the body of knowledge, experience, and work I 

have done over 20 years. 

Q. So, Dr . Omalu, are you going to follow Mr . 

Chami ' s direction not to provide the chapter on 

Greenfield ' s Neuropathology? 

MR . CHAM! : No . That's not what I said. I just 

said what the rules require . That ' s all . 

MS . STILLWELL : No . Mr . Chami, you said that he 

is not going to provide it. So --

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

Okay . on page 19, you conclude that Mr . 

Muhaymin, quote, "Died as a result of 

mechanical-positional asphyxiation due to the compression 

of his trunk and body ." 

A. 

Q. 

Did I say that correctly? 

Yes, please . 

And you said -- you start out by saying Mr . 

Muhaymin, quote, "Was not in any form of distress." 

A. 

center " 

Q. 

A. 

I said, "When he walked out of the community 

Okay . 

-- "on January 4, 2017, he was not in any form of 

distress and was not dying ." 

Q. How do you make that conclusion in light of the 

fact that he did have methamphetamines in his system and 

he was schizophrenic, and he did have -- although you say 

"clinically insignificant, " he did have a blockage in his 

arteries. 

A. No, no . Why I 'm laughing is you said he had a 

blockage in his arteries . 

Q. 

A. 

Yes . 

I sit here and as you sit here too, you and I 

could have blockages of 30 to 40 percent . It is of no 

clinical significance . It becomes clinically significant 

when it is up about 80 . Even with 80 percent, it becomes 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

clinically significant if you suffer myofibrillar ischemic 

injury. So the presence of blockage of your vessels does 

not place you in distress. No . One . 

Two, like I have always said earlier, the mere 

presence of the drug in your blood does not mean that drug 

is killing you or that drug is toxic . 

Three, the mere fact that you have schizophrenia 

does not mean you are in distress. It ' s a chronic 

disease . It ' s like saying somebody with high blood 

pressure like myself, that I 'm in distress. No . The mere 

presence of the disease in a human being does not equate 

to distress or impending death . And that is what we have 

here . 

Like I have pugilistic, and I clearly state that 

in my report, that the mere presence of a disease or drug 

in your body does not mean you are dying from the disease 

or drug . The video clearly shows a human being who was 

not in any form of distress or in any form of impending 

death . The autopsy confirmed that . 

(Videographer gone . ) 

MS . STILLWELL : Q. Now, you mentioned in part of 

your review of the slides, the slides you created, sir, 

that you were able to conclude that the slides showed 

brain edema and brain congestion; is that right? 

A. Yes, please . 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

You agree with me though that both brain edema 

and brain congestion, that you can also see that following 

a prolonged period of resuscitation efforts? 

A. Yes . But but let 's be very careful . Let ' s 

not start in a wild-goose chase of hypotheticals . 

Anything is possible . It 's possible Dr . Bennet Omalu is a 

woman . Because based on what you see, it is unreasonable 

to assume he ' s woman . 

So in this case an autopsy was done . We have 

confirmed evidential -- prevailing evidentiary values that 

nobody is contesting . And based on the constellation of 

those evidentiary values or indices, we ' ve made a 

conclusion. 

Now, after we've done that and we start 

hypothesizing : Is this possible? Is this possible? 

Based on the out comes, there was no evidence to indicate 

that the changes we saw in his brain were caused by 

cardiopulmonary resuscitation . 

Q. Well, Dr . Omalu, you would agree that there was 

approximately 30 minutes of cardiopulmonary resuscitation 

efforts; right? 

A. Yes . 

MR . CHAMI : Object to foundation . 

MS . STILLWELL : Q. We started talking before on 

Monday and I asked you if you could tell me how much body 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

weight was placed on Mr . Muhaymin and by which officer, 

and I think you had told me that you can ' t quantify that; 

is that correct? 

A. Yes . It ' s the same -- it is tantamount to the 

all or non-principle, which I ' ll explain . That you cannot 

specify each and every exposure . No . Rather, it is a 

spectrum of cumulative exposure . And that is why the 

diagnosis we raise -- everybody just say, "mechanical 

asphyxia ." We say, "mechanical-positional ." 

Because first in positional, a human being thrown 

on the ground with his chest and abdomen compressed on the 

ground, inability of the diaphragm to move up and down, so 

the cumulative exposure with him on the ground and with 

him even crying out, "I cannot breathe ." You need to put 

the entirety of the exposure to injury together, not each 

and every . 

And that was what -- I clearly state that in my 

report, that this is -- this is about the concept of 

cumulative exposure . We are dealing with brain injury. 

Q. Okay . Would you agree with me, Dr . Omalu, that 

the officers ' placement was changing? 

A. 

Q. 

Sorry? 

That the officers changed positions in 

placement --

MR . CHAM! : Objection to form and foundation . 

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Chami? 

DEPOSITION OF BENNET OMALU 

October 30, 2020 

MS . STILLWELL : Can I finish the question, Mr . 

MR . CHAMI : That was a question . I didn ' t know 

you weren ' t done . 

Q. 

A. 

MS . STILLWELL : I 'm not done . 

-- during the encounters with Mr . Muhaymin? 

MR . CHAMI : Object to form and foundation . 

MS . STILLWELL : Q. Go ahead, Doctor. 

My answer to that is yes . But not unique to this 

case . I was not paying to attention to that . When there 

is compression of a human being, it ' s not a static, static 

phenomenon . It ' s a dynamic phenomenon . So I expect 

positioning to change, including the body of Muhammad . So 

my answer to that is yes . 

Q. 

A. 

Yes, they were changing? 

Not -- my answer is general -- a general answer . 

I did not pay attention to it in this case because it is 

of no significant forensic consequence . You expect their 

bodies to change, yes . 

Q. Does the person ' s weight on someone ' s legs impact 

the ability to ventilate? 

A. 

Q. 

I don ' t understand the question . Sorry. 

Sure . If a person is holding someone ' s legs, 

does that impact their ventilation, their ability to 

breathe? 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

So the answer to that is yes. But you have to 

consider the entirety of the event, not just holding the 

person's legs . Holding somebody's leg -- if I'm sitting 

down now and my son is holding my leg, it's not going to 

affect me because I'm sitting down . My chest can move up 

and down. 

So like I have said earlier, we cannot break it 

up into different parts. If he was holding his leg, what 

was the other things going on at that moment . Were his 

legs -- his knees being flexed, and were his hips being 

flexed with the legs? 

So the totality of the exposure to injury 

compromise his aspiratory functioning including the 

aspiration of his vomitus . 

Q. So the same -- your opinion would be the same on 

whether an officer had weight on buttocks or on arms --

A. 

Q. 

A. 

Q. 

A. 

Yes . 

-- or hands? 

Yes . 

Correct? 

Because it is a concept of cumulative exposure . 

We cannot engage in each and every, which medically is not 

acceptable. And even legally, based on my experience, you 

can ' t propound each and every exposure concept . It is 

accumulative exposure. 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

So your opinion, sir, on cumulated exposure, a 

cumulated sustained mechanical compression I think is 

another phrase you had used . Can you cite to any 

textbooks or articles that support that concept? 

(Videographer returned . ) 

THE WITNESS : Concept of what? Can you help me 

understand? 

MS . STILLWELL : Q. Sure . You had indicated 

cumulated exposure or pressure and not breaking it down 

per officer or per event, but the cumulated -- everybody, 

regardless of what they were holding or what they were 

doing . Is there a textbook or an article or a study that 

supports that concept? 

A. Every basic textbook of medicine will address the 

issue of cumulated injury to the human brain . There is no 

basic textbook of brain disease or brain injury. This is 

a very basic and elementary concept, honestly . It does 

certain things -- certain generally accepted principles of 

medicine . Like a man has XX sex chromosomes . We don ' t 

need a reference for that . It ' s a fact of medicine . 

(Mr . Faraj joins the depo . ) 

THE WITNESS : Every basic textbook of medicine 

you should consider. 

MS . STILLWELL : Q. Dr . Omalu, you've said 

"basic " and "elementary" quite a few times. If it's so 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

So when we talk about contemporaneous other 

factors, we can talk about, you know, how much weight was 

applied or for how long; correct? 

A. Yes . But not just the weight, per se, like I 

have said . Because I think we are divergent -- excuse me . 

You 're focusing on the weight as a mutually exclusive 

factor, and I 'm telling you, no, you cannot do that . It 

is a totality, a cumulation of multiple contemporaneous 

factors, including the vomiting . Because we keep on 

staying away from it. Including the vomi t us, which -- the 

vomiting, which occluded all his airways . 

Q. We ' ll get to the vomiting, Dr . Omalu, but you 

brought up something that reminded me from the Monday . on 

Monday you said it wasn ' t just the weight, and it sounds 

like right now it doesn ' t matter how much weight or where 

it was applied . But you said on Monday about the knee 

compression in a vital plexus. Do you recall that? 

A. 

Q. 

A. 

The what plexus? 

I think you said "vital " plexus. 

No, no, no, no . I said in the neck and chest . 

They are vital plexuses, plexuses, P-L-U-X-E-S [sic] , 

plexuses of nerves and ganglia that are very sensitive to 

compression . 

Q. Where are -- I don ' t mean to interrupt you, 

Doctor. I 'm sorry . Where are those nerves that you are 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

did not list it. So if you ask me maybe it was in there, 

I don ' t know . But I could check the autopsy report if you 

will let me . 

Q. Dr . Omalu, if you just want to check the autopsy 

report really quick to see if it - -

A. Yes . Thank you . It says there were no petechia 

in the eyes. 

Q. Okay . Thank you, Doctor. Do you recall -- well, 

you told me you don ' t know exactly when his heart stopped . 

Is that you true that you don ' t know also when he stopped 

breathing? Can you tell that from the video, sir? 

A. I did not watch out for that because it was of no 

forensic value, so I wasn ' t watching the video to identifY. 

specifically when he stopped breathing . All I know is my 

review during the asphyxial event, during the second 

officer the officers noted he was nonresponsive after 

he said he could not breathe . I didn ' t go to find out 

exactly the time, no . 

Q. Okay . Now, Dr . Omalu, if a person is struggling 

or resisting, can that increase the amount of lactic acid 

that they are producing? 

A. It is not t he struggle that is producing the 

lactic acid . It is the metabolic injury which was 

instigated by the asphyxial injury. The struggle is a 

consequence of t he asphyxial injury . 

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evidence? 

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to --

DEPOSITION OF BENNET OMALU 

October 30, 2020 

But they show the encounter. They are the best 

Yes, ma ' am . 

MR . FARAJ: I'm going to -- I 'm going to object 

MS . STILLWELL : Go ahead, Mr . Faraj . 

MR . FARAJ: I'm going to object to lack of 

foundation . Dr . Omalu's opinion as to the best evidence 

is not relevant . That's a legal question . 

Go ahead though . 

THE WITNESS : I'm sorry. I don 't - - I will -- my 

opinion is not the best evidence . My opinion is the video 

speaks for itself. I did not -- I was not using the word 

"best." 

MR . FARAJ: I didn ' t say you did, Dr . Omalu . 

MS . STILLWELL : I did . 

MR . FARAJ: It ' s a question and response, and I 

wanted to make sure I 'm objecting to the suggestion that 

that ' s the best evidence . 

Faraj? 

Q. 

MS . STILLWELL : So did you have any more, Mr . 

MR . FARAJ: No, I didn't . 

MS . STILLWELL : I didn't mean to interrupt you . 

Now, Dr . Omalu, I 'm very curious about this 

concept of primitive response and that he was acting out 

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October 30, 2020 

of fear and not resistance, and then he was acting out of 

asphyxiation and not continued resistance . With that 

concept -- where did that concept come from? Is there a 

textbook? Is there a study or an article that supports 

this idea of the primitive responses? 

A. Every basic textbook of medicine . Again, I give 

you Guyton ' s Textbook of Physiology, G-U-Y-T-0-N-S . Any 

basic psychiatry textbook . Every basic textbook of human 

behavior or -- it ' s like I said, it ' s a very basic, 

elementary generally accepted common knowledge of 

medicine . 

Q. Now, Dr . Omalu, a few things. No . 1, you are not 

a psychologist; correct? 

1-

,-

,_ 

A. 

Q. 

A. 

I 'm not a psychologist, no . 

And you are not a psychiatrist? 

As a physician, I 'm trained in psychiatry, but 

I 'm not board certified in psychiatry. 

Q. And you ' ve never provided mental health treatment 

to a living patient; correct? 

A. I have; I have . Your question is I have never, 

and the answer to that is that is not true . I have . When 

I was in Nigeria, I worked for how many years? -- five, 

six years as a physician, and I worked as a general 

practitioner. A general practitioner, you provide every 

spectrum of care . Like cesarean sections. I performed 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

Okay . Dr . Omalu, let ' s switch gears. You 

mentioned before the oxygenation . And actually on page 24 

of your report you opine, "As his blood oxygen levels 

decreased and the carbon dioxide levels increased, while 

he was on the ground, he began to develop acidosis, became 

more confused and afraid and struggled more ." 

Do you know, Dr . Omalu, what his oxygen 

saturation level was when he was walking to the police 

car? 

A. No . That was why I did not put it in my report 

because it's a misnomer . It doesn ' t matter what his 

oxygen saturation level was there. What matters is that 

he died and an autopsy was performed which showed he 

suffered an asphyxial injury. The medical examiner who 

performed this autopsy ruled it a homicide. She ruled it 

a homicide. 

Q. So, Dr. Omalu, you just indicated about the blood 

oxygen levels. Because you don't know the oxygen 

saturation, obviously he wasn ' t wearing a pulse oximeter, 

so there was no monitoring device to conclude that his 

blood oxygen levels decreased and the carbon dioxide 

levels increased . So I 'm trying to find out how did you 

make that opinion. What was it based upon other than your 

final conclusion? 

A. Because the brain cells, which I examined --

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

Muhaymin; is that correct? 

A. 

Q. 

Yes, please . 

And do you know, as you sit here, Dr . Omalu, what 

he was cognitively experiencing during any part of his 

encounter with law enforcement officers? 

A. 

Q. 

Could you repeat the question? 

Yes . Do you know, Dr. Omalu, as you sit here 

today, what Mr . Muhaymin was cognitively experiencing 

during his encounter with the law enforcement officers? 

A. He was experiencing mental pain and anguish. He 

was experiencing somatic pain . He was experiencing 

chemical pain . 

Q. Can you base that, sir, off of your review? 

Obviously you can't interject yourself into Mr . Muhaymin ' s 

box or brain that day; correct? 

A. No . I base that on the prevailing avenues and on 

established scientific principles beginning with the fact 

that Mr . Muhaymin is a human being and human beings are 

known to behave and to manifest and exhibit specific types 

of behaviors which are predictable, predictable in 

specific circumstances. 

Q. And you said they were on scientific methods . 

Can you tell me which ones? 

A. Scientific methods : observing the video 

watching him as a human being, and then what is 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

established about the human being ' s experience of pain and 

suffering . 

Q. So, Dr . Omalu, you agree though if an individual 

is feeling pain, they would generally modify their 

behavior to relieve that pain; correct? 

A. 

reflex. 

Q. 

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That is what I have always said is the primitive 

Right . 

9 A. A good example, if your hand touches fire or 

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you 're sitting on a hot surface, the moment you experience 

the heat, you stand up immediately . That is a primitive 

reflex. 

Q. Given that example . I'm just trying to figure 

out, sir, in this instance you just said it's the 

primitive response to struggle against the officers. But 

how is it not a primitive response 

MR . FARAJ: Misstates the testimony . 

MS . STILLWELL : Well, I'm not done with my 

question . 

Q. How is it not a primitive response to modify his 

behavior according to the -- provided? 

A. I missed you for like a second . It went blank . 

Could you repeat it, please? 

Q. Sure . I'll try to repeat it word-for-word, but I 

most likely won't . 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

nothing in this case that may indicate or suggest that 

Muhammad was in an active psychotic state . There is no 

evidence whatsoever . 

Q. So, Dr . Omalu, then you don ' t believe based on 

your review that he was in an acute mental crisis? 

A. No . There's no evidence whatsoever . As a 

physician, as somebody who has suffered I've struggled 

with depression in my life, if you read my book . I frown 

upon anyone painting mental illness in dark light . 

His schizophrenia was controlled. He wasn ' t in a 

severe advanced state of schizophrenia that makes him a 

vegetative human being . He was adequately functioning . 

And t hat morning, as the video clearly shows, he was not 

suffering from an acute form of schizophrenia . 

Q. So, sir, how do you quantify the conscious pain 

and suffering that you ' ve opined that Mr . Muhaymin had? 

A. Like I have said, how you quantify it is first 

performing a differential diagnosis, which is a general 

accepted methodology physicians use . How did I apply the 

forensic diagnosis? Watching the video . Reviewing -- I 'm 

answering your question . 

Q. 

A. 

Go ahead . I 'm sorry . 

Reviewing the autopsy findings, the toxicology, 

and applying the established principles of medicine, 

putting everything together. Okay . 

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DEPOSITION OF BENNET OMALU 

October 30, 2020 

Then I said, given the totality of the evidence, 

he experience high-scale -- if you notice, I stayed away 

from one, two, three, four. I did not quantify it 

absolutely. No. I said he suffered high scales or high 

levels of conscious pain and suffering . Why do I use high 

levels? Because it is established that the agony of 

death, especially violent death, causes high levels of 

conscious pain and suffering. 

And also his heart showed what we call a 

catecholaminergic, catecholaminergic -- I spelled it on 

Monday -- catecholaminergic event . So on the totality of 

the case and under proven and established scientific 

findings, scientific principles. 

Now, every human being in terms of response to 

pain, we all respond to pain the same way. It is not 

something we have control over. It ' s primitive reflex. 

Now, if you are a normal human being, our cognitive 

interpretation of pain may vary based on learning 

behavior. But cognitive interpretation of pain is not the 

came as conscious pain and suffering . Each individual 

experiences conscious pain and suffering . Your response 

to the conscious pain and suffering does not in any way 

nullify the experience of the pain. 

Q. And, Dr . Omalu, I don't -- I don't mean this 

offensively, but when was t he last time you treated a 

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Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 112 of 165
EXHIBIT 3

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 113 of 165
PLAINTIFF’S SIXTH SUPPLEMENTAL MANDATORY DISCOVERY RESPONSES

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David A. Chami, AZ #027585

PRICE LAW GROUP, APC

8245 N. 85th Way

Scottsdale, AZ 85258

T: (818) 600-5515

F: (818) 600-5415

david@pricelawgroup.com

Haytham Faraj

LAW OFFICES OF HAYTHAM FARAJ

1935 W Belmont Ave.

Chicago, IL 60657

T: (312) 635-0800

F: (202) 280-1039

haytham@farajlaw.com

Attorneys for Plaintiff

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Mussalina Muhaymin as Personal 

Representative of the Estate of 

Muhammad Abdul Muhaymin Jr., 

Plaintiff,

v.

City of Phoenix, an Arizona Municipal 

Corporation, et al.,

Defendants.

Case No.: CV-17-04565-PHX-SMB

PLAINTIFF’S SIXTH

SUPPLEMENTAL MANDATORY 

DISCOVERY RESPONSES

Plaintiff Mussalina Muhaymin as Personal Representative of the Estate of Muhammad 

Abdul Muhaymin Jr. (“Plaintiff” or “Muhaymin”), hereby makes the following sixth

supplemental disclosure while reserving the right to seasonably supplement this disclosure 

statement as additional relevant information becomes available.

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 114 of 165
PLAINTIFF’S SIXTH SUPPLEMENTAL MANDATORY DISCOVERY RESPONSES

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as well as the statutory and common law rights as guaranteed by the law and Constitution of 

the State of Arizona and of the United States.

D. Computation of damages claimed by disclosing party.

Plaintiff is entitled to compensatory damages recoverable under A.R.S. §§ 12-611, et seq., 

and 14-311 in an amount of not less than Ten Million Dollars ($10,000,000) or such other 

amount as may be deemed fair and just by the trier of fact. The compensatory damages include 

but are not limited to: special damages including, but not limited to, loss of income and services, 

medical fees and expenses, and funeral and burial expenses, all incurred on behalf of Muhaymin;

and general damages include, but are not limited to, loss of consortium, pain and suffering, loss 

of enjoyment of life, and wrongful death. Plaintiff is also entitled to punitive damages against

the individual Defendants in an amount to be determined by the trier of fact. Plaintiff is entitled 

to pre-judgment and post-judgment interest. Plaintiff is also entitled to attorneys’ fees and costs 

pursuant to 42 U.S.C. § 1988; and for such other and further relief as the Court deems just and 

proper.

E. Insurance Agreement

Plaintiff is not aware of any insurance that is relevant to this matter. 

Plaintiff provides the above disclosures based on the information currently available. 

Plaintiff reserves the right to supplement or amend this disclosure statement.

F. Experts 

1. Mr. Scott A. DeFoe

c/o David Chami

Scott Defoe is an expert on police practices and activities throughout the United States, 

as well as an expert on the use of deadly or excessive force. Scott DeFoe will provide his expert 

opinions and testimony consistent with the information contained in his report.

2. Dr. Bennet Omalu

c/o David Chami

Dr. Omalu is a Forensic Pathologist, which focuses on forensic and hospital autopsies, 

causes, mechanisms and manners of death. Dr. Omalu will provide his expert opinions and 

testimony consistent with the information contained in his report.

///

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 115 of 165
EXHIBIT 4 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 116 of 165
COP 003370

MARICOPA COUNTY 

OFFICE OF THE MEDICAL EXAMINER 

701 W. Jefferson Street 

Phoenix, AZ 85007 

TOXICOLOGICAL EXAMINATION REPORT 

DECEDENT: MUHAMMAD ABDUL MUHAYMIN CASE: 17-00095 

DATE OF EXAM: 01/05/2017 

MEDICAL EXAMINER: AMANDA MASKOVYAK, MD 

Specimens Collected: . GROSS TISSUE, VITREOUS, HISTOLOGY, BLOT/FILTER 

PAPER, BILE, URINE, ILIAC BLOOD, CARDIAC BLOOD, GASTRIC, LIVER 

RESULTS*: 

Vitreous: 

Iliac Blood: 

None detected for ethanol, methanol, isopropanol and acetone 

Positive for: 

Methamphetamine 0.81 mg/L 

Amphetamine 0.24 mg/L 

None detected for ethanol, methanoC isopropanol, acetone, 

phencyclidine, cocaine, benzoylecgonine, methadone, morphine, 

codeine, oxycodone/oxymorphone, benzodiazepines, barbiturates, 

fentanyl, antihistamines, phenothiazines, antidepressants, other 

basic drugs, and acid neutral drugs 

*If results are not listed for any specirnen(s), that/those specirnen(s) is/are deemed to be on "HOLD" 

~d-l/ /1 

Date Signed 

Jurisdictional Agency: PHOENIX PD 

/jk 

Toxicology Supervisor 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 117 of 165
EXHIBIT 5 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 118 of 165
Ali Taqi, D.O.

October 22, 2020

586-468-2411

Carroll Court Reporting and Video

Page 1

 IN THE UNITED STATES DISTRICT COURT 

 FOR THE DISTRICT OF ARIZONA

 Mussalina Muhaymin as Personal

 Representative of the Estate of

 Muhammad Abdul Muhaymin Jr.,

 Plaintiff,

 vs. Case No. 17-cv-04565-PHX-SMB

 Honorable Susan M. Brnovich

 City of Phoenix, an Arizona Municipal

 Corporation; Antonio Tarango; Officer

 Oswald Grenier; Officer Kevin

 McGowan; Officer Jason Hobe; Officer

 Ronaldo Canilao; Officer David Head;

 Officer Susan Heimbinger; Officer James

 Clark; Officer Dennis Lerous; Officer

 Ryan Nielson; Officer Steven Wong; and

 Doe Supervisors 1-5,

 

 Defendants. 

 /

 CONFIDENTIAL - SUBJECT TO PROTECTIVE ORDER 

 

 VIDEO DEPOSITION OF ALI TAQI, DO,

 

 Taken at Carroll Court Reporting and Video,

 

 1861 East Maple Road, Troy, Michigan,

 on Thursday, October 22, 2020, 

 commencing at or about 10:08 a.m. 

 

 APPEARANCES:

 For the Plaintiff:

 MR. HAYTHAM FARAJ 

 Law Offices of Haytham Faraj

 1935 West Belmont Avenue

 Chicago, Illinois 60657

 (312) 635-0800

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 119 of 165
Ali Taqi, D.O.

October 22, 2020

586-468-2411

Carroll Court Reporting and Video

Page 69

1 A Correct. 

2 Q And do you consider yourself an expert in the area of 

3 toxicology? 

4 A I consider myself an expert in patients' drug use and 

5 treating patients with drug abuse problems. I see patients 

6 with methamphetamine use, cocaine, and heroin every day. So 

7 I'm an expert in treating patients with drug use disorder; 

8 correct. 

9 Q And do you know what has been determined to be the toxic 

10 level for meth? 

11 A That is not my expertise. 

12 Q But you recall reviewing that level from pathologist reports 

13 -- Dr. Omalu's, for example; correct? 

14 A Correct. Both -- both the ME and Omalu's report had mention 

15 of methamphetamine use. 

16 Q And I'm referring specifically to what the experts have 

17 determined to be a toxic level. 

18 A Correct. 

19 Q Okay. And that's .15 milligrams per liter; correct? 

20 A If that's in the report, then yes. 

21 Q Okay. And what -- what does -- do you know what "toxic 

22 level" means? 

23 A The toxic level in the blood refers to the amount of drug 

24 that will cause an adverse outcome in the patient. "Adverse 

25 event" meaning can lead to death, arrhythmia, or another bad 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 120 of 165
Ali Taqi, D.O.

October 22, 2020

586-468-2411

Carroll Court Reporting and Video

Page 70

1 outcome. 

2 Q Okay. So -- 

3 A What we call morbidity or mortality. 

4 Q Okay. So "toxic level" means it can lead to death; correct? 

5 A It can cause harm; correct. 

6 Q And it's a potentially fatal amount of the drug in a person's 

7 system; correct? 

8 A Correct. 

9 Q And do you know the level of methamphetamine that 

10 Mr. Muhaymin had in his system according to the toxicology 

11 report that was prepared at the autopsy? 

12 A I would have to refer to the report. 

13 Q Okay. You can do that if you want, but I'll tell you 

14 it's .81 milligrams per liter according to the toxicology 

15 report. If you want to confirm that, you're welcome to. 

16 A I don't have the ME report with me. 

17 Q Okay. Assuming it's .81 milligrams per liter that was 

18 determined as the level of methamphetamine in Mr. Muhaymin's 

19 -- with -- in Mr. Muhaymin at the toxicology report at the 

20 autopsy, that -- that would be an amount that's more than 

21 five times the toxic level; correct? 

22 MR. FARAJ: Incomplete hypothetical. Assumes fact. 

23 Go ahead and answer. 

24 THE WITNESS: I'm sure -- .5 -- .15 to .8; correct. 

25 BY MR. HILL, CONTINUING:

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 121 of 165
Ali Taqi, D.O.

October 22, 2020

586-468-2411

Carroll Court Reporting and Video

Page 110

1 Q Would you agree that his heart was strained because of the 

2 meth intoxication? 

3 A I would agree with that. 

4 Q Okay. Because, again, we are talking about five times the 

5 toxic level; correct? 

6 A The number you mentioned was five times; correct. About five 

7 times. 

8 Q On the first -- first page of your report you say his death 

9 was multifactorial. And you've mentioned, you know, that 

10 phrase, I think, a couple of times throughout the deposition 

11 today. What do you mean by "multifactorial"? 

12 A There were many complications that caused his death. So, in 

13 my opinion, it was a respiratory issue or lack of respiration 

14 that led to the cardiac issue, cardiac arrest, and all that. 

15 So there's, like, an incidental cause and then the sequelae 

16 of that so . . . 

17 Q So basically a number of factors in combination resulted in 

18 the death. 

19 A Correct. 

20 Q Are you -- do you think you're able to determine what 

21 percentage you would assign to each factor? 

22 A The main factor, in my opinion, was he was not able to 

23 breathe and that led to all these other issues. 

24 Q Okay. 

25 A So that's my -- the opinion that I have. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 122 of 165
EXHIBIT 6 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 123 of 165
PA;L\RT E: i\.NNUAL BEHAVIORAL HEALTH l TPDA 1"1E AND RE\1

IEW SUMMARY 

Nrune Muhammad Muhaymin Date of Birth Client CIS ID# 1101103099 

i\..ccompan)i.ng 'a1nily l\1en1ber/Signitica11t Ot.her (Not.e relatio11ship to person): see generated copy 

Dat.e of Current Assessment/Review 12/12/2016 Date of Iirltial Assess111e11t./Last Revie.w 12/12/2016 

Initial and or Change in Diagnosis 

Modified ])ate: 12/05/2016 10:50 l\M -

""""""""""""""""""""""""""""""""""""""""""""""""""""""""' _______________ """""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" _________ _ 

Primary Billin.g Diagnosis: AXIS I: 295.10 - Schizophrenia Disorganized Type 

Axis I - DSl\1 -IV DSI\1-V 

s ··- ipec1 ier: 

295.10 Schizophrenia Disorganized Type F20.9 Schizophrenia i .. 

305.20 c:annibus 1\buse Fl2.10 Cannabis use disorder~ J\1ild i 

I .. 

.. 

Axis II: 

I V71. 09 __________ l No diagnosis ~~-~~:-~--~---------------------------------------------J ________________ J_ _______________________________________________________________________________________________ L ____________________ j 

Axis Ill: 30 Chronic Puln1onary Disorders 

;\xis IV: Problen1s llith/related to housing, 

Sig1lificant recent losses as of 09/22/2016: 

1\xis V: 45 

Modified. by: Lilliam Villalobos fvID 

~Date: 12/05/2016 

Client:; Muhammad Muhaymin 

Client ID: 1101103099 

Date of Log: 12/12/2016 

Current Provider: 

Terros 

Medication Log 

Date of Birth: 

Active Meds 

COP 015243 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 124 of 165
COP 015244

Inactive Meds 

Allergies 

Client Name: Muhammad Muhaymin 

*Reminder: Please copy and paste most current diagnosis and medication log from generated documents in Next Gen directly 

onto generated assessment.* 

Date, start and stop time and location of interview: 

Cm sat down with Muhammad and his step mother Annie Davis to update his assessment and ISP goals on 11/14/16, cm sat down with 

Muhammad at 2:30pm, cm did get the permission of Muhammad guardian Mussallina (sister). Mussallina is his guardian and sister, 

Annie Davis is Muhammad step mother and will be helping him attend his appointments. Cm completed Muhammad assessment at 

Maryva!e Park at 9:30am, cm ended the interview at 10:55am. 

Presenting Issues/Concerns/mental status assessment: 

Muhammad said he wanted help with everything had to offered, Muhammad presented okay he was talking and answering questions 

the best he could. Muhammad is wanting help with housing, medications management, case management. 

History of present illness (progress in recovery over last year): 

Muhammad reports his symptoms are using hand gestures, feeling like he is being followed, talking incoheant about the birds, and 

people when he was little he would think the adults are telling him to be bad or seeing little girls being bad. Muhammad step mother 

(Annie} said it could be a!! day and all night the longest it ever went for was a week. Muhammad reports never being in the hospital 

Muhammad step mother Annie report they would take him to jail instead of the hospital. Muhammad reports no current SI/HI. 

Muhammad reports no current stressor at this time. Muhammad report over the last year he has done better he has not been to jail 

and is getting more help now. 

Past Psychiatric History: 

Muhammad reports his first diagnosed was at the age of 33 after his father death. Muhammad has never been to the hospital for 

psychiatric only when he got arrested. Muhammad reports past symptoms are hand gestures, not wanting to be inside (i.e. home or 

apartment) hearing voices, Annie informed cm that Muhammad will talk with the child and see them when there is no children there. 

Annie informed reported Muhammad said the adults are the ones that make him do bad things. 

Medical History (include PCP contact info, labs ordered): 

Muhammad reports last year when he was in jail they took blood for routine blood work. Muhammad report no current health issues at 

this time. Muhammad is new to the system and has a PCP but has not seen him at this time. Muhammad reports no barriers to going to 

the PCP once he knows who he/she is. Muhammad is current going to go to Dr. Allen who can be reached at 602-797-7760 and is 

located at 3864 N. 27th Ave. 

Cultural Preferences for Treatment: 

Muhammad reports his culture and religion preference is important in his treatment planning, Monotheist Muha mad primary language 

is English preferred language is English according to guardian, an interpreter is not needed at Muhammad treatment planning or 

appointments. English is the preferred language. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 125 of 165
COP 015245

Special Assistance assessment {include contact info for Guardian/Advocate if applicable) 

Muhammad has a guardian his sister Mussal!ina Muhaymin who can be reached at 678-920-0786 Mussallina will also be Muhammad 

payee when Muhammad receives his benefits. Muhammad was assessed for special assistance, and it was determined that he did need 

it and the form was filled out with his sister and is waiting on permeant guardianship. Therefore, temporary form was filled out. 

Muhammad is unable to understand the G&A process. Muhammad fully participated in his treatment plan along with his guardian 

Mussallina, and reported that did want his sister (Mussallina) and step mother (Annie Ruth Davis) involved in his treatment planning 

and appointments. Mussallina Muhaymin is Muhammad temporary guardianship until she is able to get permeant guardianship, 

Mussallina can be reached at 678-920-0786. 

Involvement with other agencies: 

Muhammad is not involved in another agencies at this time, Muhammad is signed up for supportive housing and is on the waiting list. 

Muhammad is not on Adult probation, not involved in DCS, DD, or another BH providers at this time. Muhammad is not involved in 

counseling services at this time. 

Family status/history: 

Muhammad reports his relationship with his family is distance, Muhammad guardian reports Muhammad has 2 cousin that is verified 

with mental illness, one has Schiophinaic and the other is unknown but Muhammad and his guardian. Muhammad reports no sexually 

/physical abuse he wants to talk about right now. Muhammad reports he feels is has affected his family relationship worse, he fells his 

family aunt got time to help him. Muhammad reports he does not want his family to deal with his mental illness. Muhammad reports 

he does have a family mentor his unde, Muhammad feel he could benefit from community support. Muhammad reports his natural 

support is his sister Mussa!lina, and step mother Annie Ruth Davis. 

Educational status/history: 

Muhammad is not currently involved in any learning activities, Muhammad reports the highest grade he complete he completed was 

college where he got his Associate Degree worked toward earning a Bachelor's but need more credit. Muhammad reports 

transportation, stable, medications is a factor as well. 

Employment status/history: 

Muhammad is not currently employed at this time, Muhammad is not stable and is living in Maryvale Park, Muhammad is currently not 

taking any medications, Muhammad reports the barriers to not working is stability, medication, not eating right. 

Housing or living environment status/history: 

Muhammad currently lives in Maryvale Park with his dog, Muhammad is waiting on the MM!C housing list. Muhammad does not have 

income at this time and is not working. Muhammad is not stable on medications. Muhammad does not get SS!/ S501 and does receives 

$19.00 in foods stamps. Muhammad lives in Maryvale Park. 

Social status/history: 

Muhammad reports his social lives involves his friends at the Park, Muhammad reports his dog helps him mentally, and his sister and 

step mother will come around to see how he is doing. Muhammad reports he stays at the park and helps his friends around there with 

food, Muhammad reports they help each other. Muhammad is homeless and stays in Maryvale Park, Muhammad report his hobbies is 

art and crafts, sewing, cooking, hand drawing, studying, wiping shoes, keeping his area dean. 

Legal status/history !include COT and Criminal Justice involvement): 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 126 of 165
COP 015246

Muhammad reports no legal or pending litigation at this time. Muhammad reports no custody concerns, Muhammad is not a sex 

offender, no probation, DCS involvement, Muhammad is not on COT/ COE at this time. Muhammad has no history of COT/COE at this 

time. 

Substance use status/history: 

Muhammad reports his does use substance; Muhammad reports his drug of choice is meth, Muhammad reports he has used alcohol 

and marijuana social, Muhammad as reports he used all types of substance and is not ready to say what he has used. Muhammad 

reports he is still researching his substance use. Muhammad reports he has used synthetic drug. Muhammad reports his longest 

sobriety was 2 months. Muhammad reports be involved in a drug treatment program, about a decade ago in and out of treatment. 

Muhammad is not currently involved in any substance abuse treatment program or counseling. Muhammad reports his barriers for not 

stopping is the privacy act and the right to bear arms (which he means bear his arms). 

Risk Assessment: 

Muhammad is not SI/HI/PAD/GD at this time, Muhammad is at risk of withdrawal or overdose/toxic use. Muhammad nutrition is not 

good due to his homelessness, Muhammad is at risk to exposure to the elements, exploitation, abuse or neglect due to his substance 

use and his current homelessness. 

Brief summary/areas of need to be addressed in ISP (what will the ISP goals be addressing?): 

Living Goal: I want own apartment/ Muhammad needs to keep in touch with cm and guardian for updates on his housing. 

Learning/Working Goal: I want to work part-time to earn money/ Muhammad will meet with RS for supportive employment 

Socia! Goal: I want attend community groups/ Muhammad will meet with RS to community support services. 

Health Goal: I want to visit with PCP yearly for routine check-up/ Muhammad meet with the PCP for intake. 

Strength's 

Muhammad has work history 

Muhammad has the support of his family 

Muhammad has the support of the clinical team 

Muhammad will attend his appointments 

Muhammad can cook and clean 

Muhammad utilize the transit system 

Muhammad has support from his dog 

Muhammad does get food stamps 

Muhammad car drive 

Muhammad has Associate's Degree 

Clinical Team Recommendations: 

Case Management: activities may include assisting, maintaining1 and monitoring covered services, finding necessary resources 

to meet basic needs, coordinating care with family and other agencies involved, outreach and follow up1 and other activities as 

needed, 

BHMP Services: Services may include ongoing medication management involving the review of effects, side effects, and 

adjustment of medications to prevent, stabilize, or ameliorate symptoms of a behavioral health condition. 

RN Services: as needed through activities that may include the measurement of vital signs, assessment and monitoring of 

physical/medical status, review of the effects and side effects of medications and administration of medications. 

Clinical Coordinator recommends she attend all MD and RN appointments, take all medications as prescribed, counseling 

referral as needed, engage with RS and FM to increase daily meaningful activity and enhance natural supports, Ensure follow up 

with PCP and other medical specialists as indicated. CC recommends individual counseling. 

TRANSPORTATION: CM or ACT specialist will support by assisting in coordinating, arranging, or providing clinically necessary 

transportation for medically necessary behavioral health services. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 127 of 165
COP 015247

Rehab Specialist: Rehab Specialist services may include assessment of level of assistance he/she requires to create, plan, and 

successfully work towards accomplishing his/her employment/learning and social engagement goals. 

Peer/Family Mentor: Services may include group teaching independent living, social, and communications skills to persons 

and/or their families in order to maximize the person's ability to live and participate in the community and function 

independently. 

Electronically signed by Kimberly Bryant BHT Is/ 

Kilnberly Bryant BlfT - Provider 

Behavioral Health Professional Reviewer Name (print)/ Signature 

Terros 

Agency 

1211212016 

Date 

Date 

REMINDER: All demographic data reported to ADHS!DBHS rnust be revlev,1ed during annual update. Based on this revie,v: 

At a n1initn1m1 the following dernographic/clinical data fields rnust be reported to A.DHS/DBHS regardless of whether they have changed since the 

last data subrriittal: Axis t II and V and GAF/CGAS, behavioral health category, ernployrnent and educational status, priniary residence, nUinber of 

arrests since the last data update and prin1ary and secondary substance use; and/or 

All other demographic infonnation that has changed (e.g., other agency involve1nent, income for non-Title XIX/XXI eligibles). 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 128 of 165
EXHIBIT 7 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 129 of 165
lrupilli~ Change 

fo'l Ufe 

Psychiatric Progress Note 

Encounter Date: 11/14/2016 

Provider: 

Patient Name: 

Submitted Code(s): 

Lilliam Villalobos MD 

Muhammad Muhaymin 

Start Time: 02:00 PM End Time: 02:30 PM 

EM Code: 99214 Unit: 1 

Reason for Treatment: 

Presenting issues/Chief Complaint: I am as ok as I can be. 

Age: 43 Years 

Patient came accompanied by Stepmother, she brought some paperwork for the Guardianship, we 

discussed that her daughter was given the same paperwork filled out last appt, patient remains homelessJ 

presented casually dressed, clean, had his dog with him, responded questions when asked, disorganized, 

moderate FOi , LOA, when asked if he was sleeping he said •earthn, appetite ok, denied any S/H ideations, 

questionable hall, did not answer accordingly. Drug use hx, drug of choice cannabis. 

Recommendations: 

Pian reviewed: 11114/2016 

Schedule appt for a Psych Eval. 

CSPMP reviewed. No opiates rx'ed. 

Once Psych Eval completed I will consider rx meds. 

Continue to provide Supportive Therapy. 

Contact Case Manager with any concerns. 

Practice Sleep Hygiene. 

Continue compliance with Clinical Team recommendations. 

Encourage proper hydration, nutrition and exercise. Regular Diet. 

Risk factor reduction: Avoid stressful situations; contact Clinical Team with any concerns. 

Contact the Crisis Line if he becomes DTO/DTS. 

Follow up with PCP for Medical Concerns. Denied any now. 

RTC with Psychiatrist in 4 wks or as needed. 

RTC with RN for labs or as needed for triage. 

Psychosocial stressors: Housing stressors are severe. 

Review of Systems: 

Reviewed, NO changes 

Ears, Nose, Throat: Negative 

Page 1 of 4 

Nrune: Muhan1mad ~1uhayin1n CI.S ID: 1101 l 03099 

COP 015324 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 130 of 165
Constitutiona I: 

Cardiovascular: 

Endocrine: 

Gastrointestinal: 

Genitourinary: 

H ematolog ica I: 

I mm u no logic: 

M uscu los keletal: 

Respiratory: 

Skin/ Breast: 

Eyes: 

Neu rologica I: 

Negative 

Negative 

Negative 

Negative 

Negative 

Negative 

Negative 

Negative 

Negative 

Negative 

Negative 

Negative 

Psychiatric: Positive Additional Deta i I: psychotic 

Histories: 

Reviewed with NO Changes 

Past Medical History 

Past Medication: Has not taken meds in a long time. Treated while in jail but does not remember name. 

Developmental History: Normal 

History of injury, illness. and seizures: Denied. 

Meds Reported at Intake: 

FamilY, Histor~ 

Mental illness in family: Cousin : Schizophrenia 

Substance abuse in family : Unknown 

Suicide attempts in family ~ Unknown 

Violence in family : Denied 

Medical problems in family : Mother died of Al DS 

Father died in Surgery 

other comments: 

Social History 

Client is homeless. Living situation is stressful. 

Mental Status: 

Client is a 43 year old l ma le. Dressed appropriately. Appears age and normal weight. Client is 

well ... groomed. Oriented to situation, place, person. Level of alertness is normal. Eye contact is good. 

Speech quantity is diminished with slow rate and diminished amplitude. Client has no mannerisms of 

note .. Thought processes: tangential. Associations: very loose. Stream of thought is tangential. Reports 

no delusions.. No hallucinations reported. 

Client is not DTS. Client is not OTO. Sleep: fair. Appetite: good. Mood: congruent Affect: flat. Fund of 

knowledge: fair. Memory: fair. Insight: poor. Judgement: poor. Concentration: poor. 

Observed Gait : Steady. Muscle Strength and Tone appears: Normal. 

Client did not report danger to otJ1ers (DTO). 

Client did n.ot report danger to self (DrfS). 

Page 2 of4 

Nrune: Muhan1mad ~1uhayin1n CI.S ID: 1101 l 03099 

COP 015325 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 131 of 165
Medication Effectiveness and Side Effects: Client or Guardian reports experiencing no side effects to 

meds. 

Medical Data: 

No accidents, injuries or serious illnesses reported. 

Substance Use: 

Admitted to smoking cannabis 

Current Meds: 

Axis I - DSl\'1 -I,i 

295.90 

Axis II: 

V71.09 

Axis III: 

Axis Ill: 

Axis IV: 

Axis V: 

Schizophrenia Undifferentiated Type 

NONE 

NONE 

No diagnosis on Axis TI. 

Problems with/ related to housing, 

NONE 

DSM -V 

F20.9 Schizophrenia 

Treatment Plan: No progress with Tx plan. Medications were not changed. 

The following were discussed with the client: Client or guardian understood and made an informed 

decision. 

Cit to be seen in 4 weeks. 

MOM - Problem Points 

Problem 

Di so rga n i zed 

Problem 

Disorganized 

Pian Desc Problem Deta ii 

No Plan New to Examiner 

Chonic Acute Workup 

Chronic No Additjonal Workup 

Medical Decision Making (data points): 

NatureDesc 

Worsened 

Notes 

Needs psych eval 

_x Obtained history from someone other than the patient OR made decision to obtain records 

_25 Reviewed and summarized records and obtained records and or had a discussion with another health care provider 

Risk: Moderate Risk 

Electronicall)l Signed B~: Lilliam Villalobos MD 

Document generated and completed 11/14/2016 02:36 PM 

Page 3 of4 

Nrune: Muhan1mad ~1uhayin1n CI.S ID: 1101 l 03099 

COP 015326 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 132 of 165
EXHIBIT 8 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 133 of 165
COP 003356

MARICOPA COUNTY 

OFFICE OF THE MEDICAL EXAMINER 

701 W. Jefferson Street 

Phoenix, AZ 85007 

MEDICAL EXAMINER REPORT 

DECEDENT: Muhammad Abdul M.uhaymin 

DATE OF EXAMINATION: 01/05/2017 

PERSONS PRESENT AT EXAMINATION: 

Phoenix Police Department: Detective Anthony Winter #7952 

CAUSE OF DEATH: 

CASE: 17-00095 

TIME: 1012 Hours 

Cardiac arrest in the setting of coronary artery disease, psychiatric disease, acute 

methamphetamine intoxication, and physical exertion during law enforcement subdual 

MANNER OF DEATH: 

Homicide 

HOW INJURY OCCURRED: 

Cardiac arrest in the setting of coronary artery disease, psychiatric disease, acute 

methamphetamine intoxication, and physical exertion during law enforcement subdual 

Date Signed AMANDA E.~ ASKOVY ~6 

MEDICAL EXAMINER 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 134 of 165
COP 003357

MUHAMMAD ABDUL MUHAYMIN 17-00095 

FINDINGS 

I. Cardiac arrest in the setting of coronary artery disease, psychiatric disease, 

acute methamphetamine intoxication, and physical exertion during law 

enforcement subdual. 

A. Coronary artery disease. 

1. 40 to 50 percent atheromatous stenosis of left anterior descending 

artery. 

2. lntramyocardial segment, left anterior descending artery (2 cm in 

length x 0.1 cm depth). 

B. Reported history of schizophrenia and bipolar disorder. 

C. Acute methamphetamine intoxication. 

1. 0.81 mg/L methamphetamine in iliac blood. 

2. 0.24 mg/L amphetamine in iliac blood. 

D. History of subdual by la"'.V enforcement. 

1. Physical exertion/struggle with officers during law enforcement 

subdual. 

2. Placement in prone position with hand, knee, foot, and/or body 

weight force applied by multiple officers to decedent's head, arms, 

wrists, shoulders, torso, and/or legs. 

3. 

4. 

5. 

i. 

ii. 

iii. 

iv. 

V. 

vi. 

Physical restraints applied to decedent while in prone position. 

Sudden unresponsiveness while in prone position. 

Blunt force injuries of head, torso, and extremities. 

Multifocal cutaneous abrasions of face. 

Bilateral temporalis muscle contusions (right = 2 cm, left = 0.5 

cm). 

No internal head or neck injuries are identified. 

Intramuscular contusion of left upper back. 

Subcutaneous hemorrhage of left mid back. 

Mildly hemorrhagic fractures of anterolateral right and left ribs 2 

through 6 and parasternal left ribs 3 through 6 and parasternal 

right ribs 2 through 6 (possibly representing perimortem artifact 

due to cardiopulmonary resuscitation with chest compressions). 

vii. Multifocal contusions and abrasions of bilateral elbows and 

wrists. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 135 of 165
COP 003358

MUHAMMAD ABDUL MUHAYMIN 17-00095 

viii. Subcutaneous and intramuscular hemorrhage of left posterior 

upper arm and left elbow. 

ix. Bilateral anterior knee abrasions. 

II. Reported history of asthma. 

A. No significant histologic evidence of acute asthma exacerbation on 

histologic examination of lung tissue. 

SUMMARY AND OPINION 

REPORTED CIRCUMSTANCES OF DEATH: 

The decedent was a 43-year-old male who became unresponsive following a physical 

struggle during law enforcement subdual on 1/4/2017. He was transported to a local 

emergency department and pronounced dead shortly after arrival. 

REVIEW OF LAW ENFORCEMENT INCIDENT REPORTS: 

Individual officer interviews conducted by law enforcement were reviewed and 

summarized below: 

On January 4, 2017 multiple officers responded to a call at the Maryvale Community 

Center. On arrival the officers contacted the manager of the community center who 

reported he was arguing with the decedent, Muhammad Muhaymin, about trespassing 

and Muhammad letting his dog ·run around without a leash. Officers observed 

Muhammad to be 11talking incoherently" to the manager when they initially arrived and 

he continued to be incoherent during the subsequent interactions with officers. Officers 

attempted to verbally engage Muhammad and asked for his information. Muhammad 

initially. refused to supply his name, but eventually did so. He was then allowed to use 

the restroom and during this time, officers ran his information and discovered an 

outstanding warrant for Muhammad's arrest. When Muhammad exited the restroom 

they escorted him out of the building and told him he was under arrest. An officer asked 

Muhammad to set down the dog, but Muhammad refused. Officers took Muhammad's 

left wrist and brought it behind his back. They were unable to bring Muhammad's right 

wrist behind his back because Muhammad was still holding_ the dog. Muhammad was 

placed against a wall while officers used a baton under Muhammad's right arm for 

leverage to "knock Muhammad,s hand free". Officers· were able to free Muhammad's 

right arm. · 

During the struggle, one officer described using a single "elbow strike" to Muhammad's 

right shoulder. Officers state Muhammad was "thrashing back and forth and pulling all 

over the place" and would "tense up repeatedly". Officers struggled to get Muhammad 

to the ground. Officers continued to tell Muhammad to "stop resisting" and "give us your 

arms". 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 136 of 165
COP 003359

MUHAMMAD ABDUL MUHAYMIN 17-00095 

Once on the ground, Muhammad was face down with one officer on each side of him 

and another "on top of him". Officers then were able to restrain Muhammad1

s wrists 

behind his back using two sets of handcuffs connected to each other. Officers helped 

Muhammad to his feet when Muhammad started talking about his "sensei" and "was not 

acting his normal self". While officers escorted Muhammad to the patrol car he 

continued to pull and struggle, yell, push back on his feet, and drop into a squatting 

position, causing officers to "hoist him back up11

• Officers state that while walking 

Muhammad to the patrol car they did raise his arms towards his head in a l[pain 

compliance maneuver''. 

Once at the patrol car, officers placed Muhammad against the patrol car and began to 

search Muhammad. Officers state Muhammad was "kicking, pulling, yelling, and 

causing. a commotion11

• Officers pulled Muhammad's arms up level to his shoulders to 

search his pockets when Muhammad was able to pull his arms from over his head down 

to his front. Muhammad then used his arms and body to push back against the officers. 

Officers and Muhammad then went to the ground. Officers state they may have tripped 

on the way down. Muhammad was initiariy face down but was "fighting to get on his 

back11

• One officer controlled Muhammad's legs, another used his waist over 

Muhammad's waist, and one officer was on each shoulder. Officers state they were 

"huffing and puffing11 and requested additional units. While waiting for backup, 

Muhammad was on his left side. 

Officers state that Muhammad alternated between periods of calm and active resistance 

during this time. Officers also stated Muhammad1

s dog was running around and yipping 

and barking at the officers. One officer stated he pulled the trigger on his 

e(ectromechanica·1 device to scare the dog but did not physically make contact with or 

deploy the weapon on the dog or Muhammad. · 

Additional units arrived and helped to control Muhammad. Various officers indicated that 

some amount of weight or pressure was used to control Muhammad during the ensuing 

subdual. This included body weight over Muhammad1

s legs and body weight on 

Muhammad's waist. Officers also used hands, knees, and/or feet to control 

Muhammad's shoulders, arms, upper back, torso1 and head. (Comment: No officers 

indicated the amount of weight or pressure applied or the duration of the application). 

One officer observed Muhammad llrubbing his head on the ground11 and held 

Muhammad's hair back to try to prevent Muhammad from hurting himself. 

Officers were able to disconnect the pairs of handcuffs that were around Muhammad1

s 

wrists. Other officers placed restraints around Muhammad's ankles. Officers state they 

struggled to bring Muhammad1

s hands behind his back, but once they did, he was rehandcuffed and the handcuffs were connected to the ankle restraints by a length of 

rope. An officer described the position of Muhammad's legs at this time as "slightly past 

90 degrees". Officers then stood up and noticed Muhammad "went limp" and began to 

vomit. They removed the rope and ankle restraints and turned Muhammad onto his 

back. Officers could not feel a pulse so they began chest compressions and requested 

medical support. During compressions an officer stated he could possibly feel a faint 

D,,rir. A r..f '1 ".l \X(,{/{J'-

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 137 of 165
COP 003360

• 1 .. 

MUHAMMAD ABDUL MUHAYMIN 17-00095 

pulse. Muhammad's wrist handcuffs were removed and chest compressions were 

continued until Fire and Rescue arrived. 

When emergency personnel arrived Muhammad was in asystole. Emergency personnel 

noted vomitus in Muhammad airway. They described his skin as cool and pale. No body 

temperature was taken. Muhammad was intubated and transported to a local 

emergency department where he was pronounced dead shortly after arrival. 

Throughout the struggle officers continued to give commands to Muhammad to 11 stop 

fighting" and "stop resisting". One officer who had prior encounters with Muhammad 

stated Muhammad was previously compliant and never acted like this before. Multiple 

officers commented on Muhammad's apparent strength. According to all interviewed 

officers, no other punches, kicks, bites, slaps, pepper spray, or electrical restraint 

devices were used against Muhammad by officers aside from the single elbow strike 

described above. Officers further state that Muhammad did not attempt to kick, bite, 

slap or otherwise harm the officers but that he was "passive aggressive" and resisting 

arrest. 

Additional witness interviews conducted by law enforcement were reviewed and 

summarized below: 

The manager of the community center stated Muhammad would raise and lower his 

voice as he went on tangents about the human race, human needs, and aliens, and was 

refusing to comply with requests to leave the premises. He stated at one point later on 

he could hear Muhammad 11squeal" but did not observe what was happening at that 

time. 

Other witnesses observed Muhammad becoming "aggressive and verbaln with the 

manager prior to officer's arrival and refusing to leave the premises. Muhammad was 

. observed to be "fighting hard'1 against the officers and appeared to be "on something1

'. 

One witness stated she observed Muhammad being "dragged" to and "slammed 

againsf the patrol car. One witness heard Muhammad yell "I can't breathe" to which an 

officer replied "then stop resisting". She then stated officers appeared to have 

Muhammad under control. While they walked away they could still hear Muhammad yell 

and then saw officers begin chest compressions. Another witness also heard 

Muhammad make the statement that he couldn't breathe and then witnessed an officer 

appear to release pressure from Muhammad's back. 

Family members interviewed by law enforcement stated that Muhammad suffered from 

asthma, bipolar disorder, and schizophrenia. They stated he was prescribed 

medications but did not know if he was taking them. They further state he has been a 

transient and has been deteriorating mentally and emotionally since his fathers' death in 

2006. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 138 of 165
COP 003361

MUHAMMAD ABDUL MUHAYMIN 17-00095 

REVIEW OF VIDEO FOOTAGE FROM LAW ENFORCEMENT OFFICERS (BODY 

CAMERAS): 

Multiple (12) body camera videos are reviewed which provide multiple perspectives of 

the above described incident. The videos are identified by numbers only. Some of the 

videos appear to be a single video recording broken into twQ parts. Timestamps are 

visible in each video but do not appear consistent across the multiple video recordings. 

Muhammad's behavior initially appears to be relatively calm while talking with the 

manager, however he is not following requests to leave the premises or place his dog 

on a leash. After a few minutes of verbal engagement with the manager Muhammad 

becomes more agitated, raises his voice, and begins to talk tangentially. 

Once outside the building Muhammad does refuse to follow officer's commands to place 

the dog down and bring his hands behind his back. He argues with officers and asks 

them to "call his sensei". An officer can be seen using his baton under Muhammad's 

right arm as described above. Once on the ground one officer's knee can be seen on 

the back of Muhammad's right leg, one officer's knee is on Muhammad's right temple, 

and another officer can be seen above and parallel with Muhammad's back, but it is 

unclear if the officer laying on Muhammad or just leaning over him. 

During the struggle between Muhammad and officers on the ground by the patrol car 

the positions of the officers relative to Muhammad is only shown intermittently on any 

given video recording. It cannot be determined how long each of the following positions 

are held, nor is it possible to tell how many of the following positions were simultaneous1 

if any. A sound resembling an electromechanical weapon can be heard but is not visible 

on screen in any video. Muhammad can be heard yelling once that he cannot breathe in 

at least two videos. The body positions of Muhammad or officers are not visible in any 

videos during this statement. Muhammad can be head continuing to yell intermittently 

after this time. No one video shows the entire encounter, so an accurate length of time 

over which the event occurred cannot be determined. 

The numbers below refer to individual video recording file numbers. 

7012: Hands can be seen on Muhammad's torso and near his head. Later a knee 

appears to be on Muhammad1

s head which is turned to his side. Later one knee can be 

seen on Muhammad's upper back while he is face down. 

6119: While Muhammad is being taken to the ground an officer can be seen using his 

elbow to strike Muhammad's right shoulder region. Once on the ground officer's hands 

can be seen on Muhammad's torso and a knee is on the right side of Muhammad's 

waist. Later while Muhammad is on his left side, an officer's knee is against 

Muhammad's upper back, an officer's hands are controlling Muhammad's arms, which 

are stretched out in front of him, and one officer's hand is on Muhammad's right waist. 

r. r. A I"\ 1\./H rJ\_ 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 139 of 165
COP 003362

MUHAMMAD ABDUL MUHAYMIN 17-00095 

6778: While Muhammad is face down one officer can be seen laying over Muhammad's 

feet, one officer has a hand on the back of Muhammad's right thigh, and one officer has 

a knee on Muhammad's buttocks region. 

8028: While Muhammad is on his side an officer's knee can be seen on Muhammad's 

left temple region and an officer's hand is gripping Muhammad's left sleeve. Later, an 

officer's foot can be seen on Muhammad's right wrist. Still further in the video an 

officer's hand can be seen on the back ·of Muhammad's neck. It is unclear if 

Muhammad's ne.ck is being gripped or if pressure is being applied. Another officer can 

be seen gripping Muhammad's hair. 

POSTMORTEM EXAMINATION 

Postmortem examination (autopsy) showed a well-developed adult male. External 

trauma consisted of cutaneous contusions and abrasions of the face, elbows, wrists, 

and knees. Internally there werE? focal intramuscular and/or subcutaneous hemorrhages 

of both temporalis muscles, the left mid and upper paraspinal back muscles, the left 

posterior arm, and surrounding the left elbow. Bilateral minimally hemorrhagic and nondisplaced anterolateral rib fractures were identified (may be secondary to 

cardiopulmonary resuscitation or prone positioning with compression of the torso). 

Other findings at autopsy consisted of focal 40 to 50 percent atheromatous stenosis of 

the left anterior descending artery and an incidental intramyocardial segment of the left 

anterior descending artery. There was congestion ·and edema of the lungs and mild 

global edema of the brain. There was no significant histologic evidence of asthma. 

Toxicologic analysis was performed and revealed methamphetamine and its metabolite 

in iliac blood. Postmortem analysis of vitreous fluid was not further contributory. The 

decedent has reported diagnoses of schizophrenia and bipolar disorder. 

In summary, based on the above findings, reported circumstances of death, and all 

other investigative information received to date and as available to me, my Dpinion is 

that Muhammad Abdul Muhaymin, a 43-year-old male, died as a result of cardiac arrest 

in the setting of coronary artery disease, psychiatric disease, acute methamphetamine 

intoxication, and physical exertion during law enforcement subdual. 

The decedent had multiple preexisting risk factors for cardiac arrest including coronary 

artery disease and acute methamphetamine intoxication. Physical exertion during law 

enforcement subdual further contributed to the deyelopment of a fatal cardiac arrythmia. 

Given all of the above, in my opinion, the manner of death is most appropriately 

designated as homicide. 

As with all death investigations, opinions expressed herein are amenable to change should new, reliable, 

and pertinent information come to light. 

The Maricopa County Medical Examiners Office is required by statute (A.R.S. § 11-594(A) (2) and (4)) to 

certify the cause and manner of death following completion of the death investigation of each case over 

which it assumes jurisdiction and to promptly execute a death certificate, on a form provided by the state 

registrar of vital statistics, indicating the cause and manner of death. The form provided by the state 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 140 of 165
COP 003363

MUHAMMAD ABDUL MUHAYMIN 17-00095 

registrar of vital statistics includes five manners of death: homicide, suicide, accident, natural, and 

undetermined. The determination of manner of death is a forensic determination by the pathologist 

predicated upori the totality of all then-known forensic evidence and other circumstances surrounding the 

cause of death; it is not a legal determination of criminal or civil responsibility of any person(s) for the 

death. 

POSTMORTEM EXAMINATION 

The body is in a plastic body pouch secured by a seal bearing the number 0001418. 

The hands are received within brown paper evidence bags. 

Clothing and personal effects 

The body is received clad in a gray and red t-shirt previously cut by emergency 

personnel, black sweatpants, cargo pants with a canvas belt, and undershorts. A sock 

is on the right foot, and a black cloth necklace with a white metal charm is around the 

neck (see also separate property inventory list). The bottom of the sweatpants are 

secured with hair ties. A ring is on the left 5th digit (separately photographed). A black 

nylon strap is loosely around the torso running diagonally from the right shoulder to the 

waist. 

Evidence of medical intervention 

An endotracheal tube is in the mouth secured around the head with medical tape. An 

orogastric tube is in the oral cavity, defibrillator pads are affixed to the right anterior 

chest and left lateral thorax, three electrocardiogram electrode leads are affixed to the 

left anterior axilla, three are affixed to the left anterolateral lower abdomen, and two are 

affixed to the right lateral chest, an intravascular catheter is in the right antecubital fossa 

attached to a clear plastic bag labeled with "0.9% sodium chloride'\ a pulse oximeter is 

taped to the distal right 2nd digit1 an intravascular catheter is in the right dorsal forearm, 

and a hospital-issued patient identification band with the decedent's name and medical 

record number encircles the left wrist. 

General external examination 

The body is that of a 67 inch, 164 pound, well-developed, well-nourished adult African 

American male who appears compatible with the reported age of 43 years. 

The scalp is covered by curly black-brown hair with bifrontal alopecia, short on top, and 

then arranged in braids and loosely arranged in a ponytail. Facial hair consists of a sole 

black-gray mustache and goatee. The eyes have brown irides with symmetric pupils. 

The conjunctivae are free of petechiae. The external ears show no acute injury. The 

facial bones are intact to palpation. A small amount of vomitus is in and about the_ nares, 

mouth, and beard. The nasal septum is without perforation. The oral cavity has no 

visible lesions or foreign objects. The frenula are intact. The teeth are natural and in 

fair repair. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 141 of 165
COP 003364

MUHAMMAD ABDUL MUHAYMIN 17-00095 

The neck is unremarkable. The thorax and breasts are symmetrical wit~out palpable 

masses. The abdomen is rounded and firm. The back, buttocks, and anus are 

unremarkable. The atraumatic external genitalia are those of an adult male. The 

extremities are well-developed and symmetric without visible deformities or palpable 

fractures. All digits are present. The intact fingernails are short, irregular, and soiled. 

The intact toenails are thickened, irregular, and discolored. Multiple 0.1 to 0.3 cm 

slightly raised, velvety appearing dark brown-black skin lesions are within the folds of 

the neck 

Postmortem changes 

Rigor mortis is well-developed and symmetric. There is fixed posterior red-purple 

lividity. The body is cold secondary to refrigeration. 

Identifying marks and scars 

A 9 cm curvilinear scar is over the right anterior upper arm. A 2 cm ovoid scar is over 

the left posterior shoulder. A monochromatic tattoo of the word "Peace" is just above 

the right elbow. A faint monochromatic tattoo of apparent lettering extends from the right 

elbow to the medial wrist. A monochromatic tattoo of a crown, sun, and a black graphic 

design is over the midline lumbar back. A monochromatic tattoo of the phrase "War" is 

just above the left elbow. A monochromatic tattoo of a foreign lettering is over the left 

proximal volar forearm. A multicolored tattoo of two stars and the letters "A, H, L, L, A" is 

left forearm. Monochromatic tattoos of helmets are over both dorsal hands. A 3 cm 

irregular scar is over the right posterior calf. A 1 0 cm horizontal scar is over the 

posterior neck. · 

EVIDENCE OF INJURY 

Head and Neck: 

i. 3 x 1.5 cm orange-pink abrasion, right lateral frontal scalp. 

ii. 0.8 cm thin partial thickness linear laceration, just above right lateral supraorbital 

ridge. 

iii. 3 x 1.5 cm pink contusion with a 1.2 x 0.8 cm pink-white abrasion, right lateral 

supraorbital ridge. 

iv. Two 0.3 cm shallow abrasions, right upper middle and lateral eyelid. 

v. 4 x 3 cm cluster of overlapping pink-orange linear abrasions, right cheek. 

vi. 0.5 cm laceration, medial left nare. 

vii. 2 x 1.5 cm irregular red-brown abrasion, left frontal scalp at the hairline. 

viii. 1.5 cm linear abrasion, right frontal scalp. 

ix. 2 x 0.5 cm red-brown abrasion, left temple. 

x. 7 x 1.5 cm cluster of overlapping pink-tan linear abrasion, left cheek. 

xi. 2 cm intramuscular contusion, right temporalis muscle. 

xii. 0.5 cm intramuscular contusion, left·temporalis muscle. 

xiii. Anterior and posterior neck dissections are negativ~ for injuries. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 142 of 165
COP 003365

MUHAMMAD ABDUL MUHAYMIN 17-00095 

Torso: 

i. Mildly hemorrhagic fractures of the anterolateral aspect of right and left ribs 2 

through 6 and the parasternal aspect of left ribs 3 through 6 and right ribs 2 

through 6. 

ii. 2 cm intramuscular contusion, in the left paraspinal upper back. 

iii. 1 cm contusion, left paraspinal mid back. 

Extremities: 

Left upper extremity: 

i. 2.5 x 2 cm red-brown abrasion, superior left shoulder. 

ii. 2 x 1.5 cm irregular red-pink abrasion, left elbow. 

iii. 2 x 2 cm discontinuous cluster of pink-brown abrasions, left medial elbow. 

iv. 2 x 1.5 cm red-brown-pink abrasion, left posterolateral proximal forearm. 

v. 1 x 0.9 cm pink-white abrasion, left lateral wrist. 

vi. 4.5 x 1.5 cm cluster of irregular pink contusions and overlying red-brown 

abrasions, left medial wrist. 

vii. 3.5 x 1.5 cm area of faint pink contusion, left volar wrist. 

viii. 8 cm area of ill-defined subcutaneous and intramuscular hemorrhage, left 

posterior upper arm. 

Right upper extremity: 

i. 1.2 x 1 cm red-brown abrasion, superior right shoulder. 

ii. 3 x 4 cm cluster of red-brown punctate abrasions, right medial elbow. 

iii. 2.5 x 3 cm discontinuous tan-pink abrasion, proximal right forearm. 

iv. 2 x 0.5 cm cluster of red-brown abrasions, right lateral elbow. 

v. Three linear abrasions measuring 0.3, 0.5, and 1.5, right distal lateral upper 

arm. 

vi. 9 x 4 cm discontinuous cluster of pink contusions in a vaguely Y-shaped 

distribution, right dorsolateral proximal to mid forearm. 

vii. 4 x 4.5 cm area of faint pink contusion, right lateral wrist. 

viii. 3.5 x 3 cm irregular area of pink contusion with overlying red-brown 

abrasions, right medial wrist. 

ix. Cluster of three irregular abrasions measuring between 0.2 and 0.7 cm, 

proximal medial right forearm. 

x. Patchy subcutaneous and intramuscular hemorrhage, right elbow. 

Left lower extremity: 

i. 1.2 x 0.5 cm irregular red-brown abrasion, left knee. 

ii. 0.3 cm red-brown abrasion, medial left knee. 

Right lower extremity: 

iiL Cluster of red-brown abrasions measuring between 0.2 and 0.8 cm, right 

medial/inferior knee. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 143 of 165
COP 003366

MUHAMMAD ABDUL MUHAYMIN 

The above injuries, having once been described, will not be referred to below. 

INTERNAL EXAMINATION 

BODY CAVITIES 

17-00095 

The organs of the thoracic and abdominal cavities are normally situated. There are no 

abnormal fluid collections in the pleural, pericardia!, or abdominal cavities. There are no 

pleural, peritoneal, or pelvic adhesions. The subcutaneous fat at the level of the 

umbilicus measures up to 2 cm in thickness. 

HEAD 

The scalp and subscalp tissues are free of injury. There are no skull fractures. The dura 

is intact. There is no epidural, subdural, or subarachnoid hemorrhage. The 

leptomeninges are thin and delicate. The 1300-g brain has symmetric cerebral 

hemispheres with a normal gyral pattern with mild global edema. The roots of the 

cranial nerves are unremarkable. The cerebral vasculature shows no significant 

atherosclerosis or other lesions. There is no evidence of herniation. The cerebral 

cortical ribbon is well-demarcated from the grossly normal underlying white matter. The 

deep nuclei, mammillary bodies, and hippocampi are unremarkable. The ventricular 

system is symmetric and of normal configuration. The substantia nigra is normally 

pigmented. The pons, medulla, upper cervical cord, and cerebellum are unremarkable. 

The base of the skull does not demonstrate any fractures. 

NECK 

The anterior cervical strap muscles are symmetric and free of hemorrhage. The tongue 

is atraumatic. The hyoid bone and laryngeal cartilages are intact. The larynx and 

trachea are lined with tan-pink mucosa, have a normal caliber, and are patent. The 

cervical spine is intact. 

CARDIOVASCULAR SYSTEM 

The pericardium, epicardium, and endocardium are smooth and glistening with a usual 

amount and distribution of epicardial fat. The 325-g heart is normal in configuration. 

The coronary arteries arise from normally situated ostia and show right dominance. The 

left anterior descending artery shows focal 40 to 50 percent stenosis by soft, yelloworange atheromatous plaque. Additionally, in the midpoint of the left anterior descending 

artery, there is an area of tunneling measuring 2 cm in greatest length x 0.1 cm in 

maximum depth. The left circumflex and right coronary arteries are patent without 

evidence of acute thrombosis. The cardiac valves leaflets are thin and delicate. Valve 

circumferences are as follows: tricuspid valve = 11.5 cm, pulmonic valve = 6.5 cm, 

mitral valve = 10.5 cm, aortic valve = 6 cm. The myocardium is uniformly dark redbrown and firm. There are no septa! defects. The left and right ventricular free walls and 

septum measure 1.4 cm, 0.3 cm, and 1.2 cm thick, respectively. 

The aorta and its major branches are normally distributed without stenosis. The intimal 

surfaces show minimal' atherosclerosis. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 144 of 165
COP 003367

MUHAMMAD ABDUL MUHAYMIN 17-00095 

RESPIRATORY SYSTEM 

The lungs are 475 g each and have normal lobation. The pleural surfaces are smooth 

and glistening with scattered anthracotic pigment deposition. The major bronchi are free 

of obstruction. The lungs are well-expanded with dependent congestion. The cut 

surfaces exude a small amount of pink-tan frothy fluid. The pulmonary arteries are free 

of thromboemboli. 

HEPATOBILIARY SYSTEM 

The 1425-g liver has a smooth and intact capsule. The liver configuration is normal. 

The parenchyma is dark red-brown and homogeneous. The gallbladder is normally 

situated and contains green-brown viscous bile without calculi. The wall is thin and the 

mucosa is unremarkable. 

L YMPHORETICULAR SYSTEM 

The 50-g spleen has a smooth, purple-grey, and intact· capsule. The parenchyma is 

dark maroon-red and of normal consistency. No abnormal lymph nodes are 

encountered. 

GASTROINTESTINAL SYSTEM 

The esophagus is lined by intact smooth white-tan mucosa. The gastroesophageal 

junction is unremarkable. The stomach contains approximately 20 ml of brown fluid. 

The gastric mucosa is thrown into rugal folds. There are no areas of ulceration in the 

stomach or proximal duodenum. The remainder of the small bowel and the colon are 

opened and the contents are examined and are negative for foreign objects. The 

appendix is externally unremarkable. The pancreas is normally lobulated and the 

parenchyma is firm, tan, and without focal lesions. 

GENITOURINARY SYSTEM 

The kidneys are 100 g and symmetric. The subcapsular surfaces are smooth and 

slightly lo bated. The cortices are of. normal thickness and the corticomedullary junction 

is distinct. The medullae, pelvicalyceal systems, and ureters are unremarkable. The 

urinary bladder is of normal configuration. The mucosa is tan and smooth. There is 

approximately 70 ml of clear yellow urine. 

The prostate gland is of normal configuration with firm tan-pink parenchyma. The testes 

and seminal vesicles are unremarkable. 

ENDOCRINE SYSTEM 

The thyroid gland is homogenous red-brown and firm, without nodules or cysts. The 

parathyroid glands are inconspicuous. The adrenal glands are normally located. The 

cortices are thin and golden yellow. The underlying medulla is well-demarcated and tangrey. The pituitary gland is unremarkable. 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 145 of 165
COP 003368

MUHAMMAD ABDUL MUHAYMIN 17-00095 

MUSCULOSKELETALSYSTEM 

The clavicles1 sternum, pelvis, and vertebral column have no fractures. There are 

scattered vertebral osteophytes. The skeletal musculature is normally distributed and 

dark red. The diaphragm is intact. 

ANCILLARY STUDIES 

Full body postmortem radiographs are obtained prior to examination. 

Toxicology 

Samples of cardiac blood 1 iliac blood, vitreous fluid1 bile, gastric contents, urine, and 

liver tissue are collected and submitted for analysis (see also separate toxicology 

report). 

Vitreous electrolytes 

Sodium = 164 mmol/L 

Potassium = 12 mmol/L 

Chloride = 127 mmol/L 

Urea nitrogen = 17 mg/dl 

Creatinine = 0.7 mg/dl 

Glucose = 14 mg/dl 

Microscopic descriptions 

• HEART: Section of left anterior descending artery shows overlying incomplete 

myocardial bridge and eccentric atheromatous plaque formation. Myocytes show patchy 

enlarged boxy nuclei and hyper-eosinophilia. Multiple sections of both ventricles show 

capillary congestion, slightly thickened arteri0Jes1 areas of interstitial expansion by loose 

fibrous tissue, and perivascular fibrosis. · 

LUNGS: Multiple sections show perivascular and peribrohchial deposits of dark black 

granular material (anthracosis), polarizable debris in alveolar spaces; aspirated gastric 

contents without inflammatory reaction, vascular congestion with extravasation of red 

blood cells into alveolar spaces, multifocal peribronchial hemorrhage, patchy 

atelectasis, and scattered thickened alveolar septae. 

LIVER: Sinusoidal congestion and rare portal tract showing increased chronic 

inflammation. 

KIDNEY: Thickened small vessels, vascular congestion, and proximal tubules showing 

eosinophilia and loss of nuclear detail. 

HIPPOCAMPUS: No significant pathologic abnormalities. 

AEM/jk 

D: 01/05/2017; T: 01/19/2017 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 146 of 165
COP 003369

Maricopa County Office of the Medical Examiner 

Forensic Science. Center 

701 W. Jefferson St - Phoenix, AZ 85007 - (602) 506-3322 

Hair Color: Eye Color: 

Teeth: Beard (YIN) 

Weight: £ C L/- Mustache (YIN) 

Height: Clothing: 

Rigor: 

Livor: Seal No.: 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 147 of 165
EXHIBIT 9 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 148 of 165
Gary M. Vilke, M.D., FACEP, FAAEM

11582 Normanton Way

San Diego, California 92131

(619) 666-8643

June 20, 2020 

Karen J. Stillwell

O’Connor & Dyet

7955 South Priest Drive 

Tempe, Arizona 85284 

RE: Mussalina Muhaymin v. City of Phoenix, et al.

Case No: CV-17-04565-PHX-SPL

 

Introduction

I am a board-certified emergency department physician with substantial experience in 

cardiac arrest and sudden death. I am also an independent researcher on the physiologic effects of 

restraint, weight force and body position. My specific qualifications will be outlined in more detail 

at the end of this report. 

I have been retained as an expert to review relevant materials and provide expert opinion on 

this matter on whether the actions of the police officers caused or contributed to the cardiac arrest 

and death of Mr. Muhammad Muhaymin Jr. when the officers encountered him on January 4, 2017. 

After careful review, it is my opinion to a reasonable degree of medical certainty that Mr. 

Muhaymin’s cardiac arrest and death was not caused by the actions of the officers but rather was 

caused by the toxic effects of methamphetamine and continued exertion and resistance causing 

physiologic stress on his abnormal heart resulting in cardiac arrest. This opinion and related 

opinions are set forth in the expert report. 

CONFIDENTIAL COP 015475

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 149 of 165
- 2 -

Materials Reviewed

I have reviewed extensive materials pertaining to the above referenced case. This includes, 

but is not limited to:

A. Medical and Scientific Literature

Chan TC, Vilke GM, Neuman T, Clausen JL: Restraint position and positional asphyxia. Ann 

Emerg Med 1997;30(5):578-586. 

Chan TC, Vilke GM, Neuman T: Reexamination of custody restraint position and positional 

asphyxia. Am J Forensic Med Pathol 1998;19(3):201-205. 

Vilke GM, Chan TC, Neuman T, Clausen JL: Spirometry in normal subjects in sitting, prone, and 

supine positions. Respir Care 2000;45(4):407-410. 

Chan TC, Vilke GM, Clausen J, Clark RF, Schmidt P, Snowden T, Neuman T: The effect of 

oleoresin capsicum “pepper” spray inhalation on respiratory function. J Forensic Sci 2002; 

47(2):299-304. 

Chan TC, Neuman T, Clausen J, Eisele J, Vilke GM: Weight force during prone restraint and 

respiratory function. Am J Forensic Med Pathol 2004;25(3):185-189. 

Michalewicz BA, Chan TC, Vilke GM, Levy SS, Neuman TS, Kolkhorst FW. Ventilatory and 

metabolic demands during aggressive physical restraint in healthy adults. J Forensic Sci 

2007;52(1):171-175. 

Reay DT, Howard JD, Fligner CL, Ward RJ. Effects of positional restraint on oxygen saturation 

and heart rate following exercise. Am J Forensic Med Pathol. 1988 Mar;9(1):16-8. 

Schmidt P, Snowden T. The effects of positional restraint on heart rate and oxygen saturation. J 

Emerg Med 1999;17:777-782. 

Vilke GM, Sloane C, Castillo EM, Kolkhorst FW, Neuman TS, Chan TC. Evaluation of the 

Ventilatory Effects of a Restraint Chair on Human Subjects.. J Emerg Med. 2011;40(6):714-8. 

Epub 2010 Jan 13. 

Savaser DJ, Campbell C, Castillo EM, Vilke GM, Sloane C, Neuman T, Hansen AV, Shah S, Chan 

TC. The effect of the prone maximal restrained position with and without weight force on cardiac 

output and other hemodynamic measures. J Forens Leg Med. 2013 Nov;20(8):991-5. Epub 2013 

Aug 30. 

Sloane C, Chan TC, Kolkhorst F, Neuman T, Castillo EM, Vilke GM. Evaluation of the 

Ventilatory Effects of the Prone Maximum Restraint Position (PMR) on Obese Human Subjects. 

Forens Sci Int 2014;237:86-9. Epub 2014;46(6):865-72. Epub 2014 Feb 14. 

CONFIDENTIAL COP 015476

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 150 of 165
- 3 -

Ho JD, Dawes DM, Moore JC, Caroon LV, Miner JR: Effect of position and weight force on 

inferior vena cava diameter--implications for arrest-related death. Forensic Sci Int. 2011 Oct 

10;212(1-3):256-9. 

Kroll MW, Still GK, Neuman TS, Graham MA, Griffin LV. Acute forces required for fatal 

compression asphyxia: A biomechanical model and historical comparisons. Med Sci and the Law. 

2017 Jan 1:25802417695711. [Epub ahead of print] 

Kroll MW, Brave MA, Kleist SR, Ritter MB, Ross DL, Karch SB. Applied Force During Prone 

Restraint: Is Officer Weight a Factor? Am J Forensic Med Pathol. 2018 [Epub ahead of print] 

B. Case-Specific Materials

01. Order re Stipulated Protective Order 

02. Confidentiality Agreement 

PLEADINGS

01. Plaintiff’s First Amended Complaint 

02. Defendants’ Motion to Dismiss

03. Plaintiff’s response to Motion to Dismiss

04. Defendants’ Reply in Support of Motion to Dismiss 

05. Court’s Ruling on Motion to Dismiss 

06. Defendants’ Answer to First Amended Complaint 

07. Plaintiff’s response to Non-Uniform Interrogatories

08. Plaintiff’s response to Request for Production 

09. Plaintiff’s Motion to Amend Complaint w/ exhibits

10. Defendant City of Phoenix’ response to Request for Production 

11. Defendant Canilao’s response to Non-Uniform Interrogatories 

12. Defendant Clark’s response to Non-Uniform Interrogatories 

13. Defendant Grenier’s response to Non-Uniform Interrogatories 

14. Defendant Head’s response to Non-Uniform Interrogatories 

15. Defendant Heimbigner’s response to Non-Uniform Interrogatories 

16. Defendant Hobel’s response to Non-Uniform Interrogatories 

17. Defendant Leroux’ response to Non-Uniform Interrogatories 

18. Defendant McGowan’s response to Non-Uniform Interrogatories 

19. Defendant Nielsen’s response to Non-Uniform Interrogatories 

20. Defendant Tarango’s response to Non-Uniform Interrogatories 

21. Defendant Tarango’s amended response to Non-Uniform Interrogatories 

22. Defendant Wong’s responses to Non-Uniform Interrogatories

CONFIDENTIAL COP 015477

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 151 of 165
DOCUMENTS AND VIDEOS 

BATES NUMBERS DOCUMENTS 

COP 000001 Body Camera Video of Officer Grenier 

COP 000002 Body Camera Video of Officer Hobel 

COP 000003 Body Camera Video of Officer Hobel 

COP 000004 Body Camera Video of Officer Canilao 

COP 000005 Body Camera Video of Officer Head 

COP 000006 Body Camera Video of Officer Head 

COP 000007 Body Camera Video of Officer McGowan 

COP 000008 Body Camera Video of Officer Nielsen 

COP 000009 Body Camera Video of Officer Nielsen 

COP 000010 Body Camera Video of Officer Nielsen 

COP 000011 Body Camera Video of Officer Acker 

COP 000012 Body Camera Video of Officer Clark 

COP 000013 Body Camera Video of Officer Miller 

COP 000014-000238 Phoenix Police Department Incident Repo1t No. 201700019424 with 

supplemental notes/diagrams/ documents 

COP 000239 911 call at 0928 

COP 000251 Recorded inte1view of Anthony Tarango 

COP 000252 Recorded inte1view of Anthony Williamson 

COP 000253 Recorded inte1view of Arizona Sinith 

COP 000254 Recorded inte1view of David Head 

COP 000255 Recorded inte1view of Dennis Leroux 

COP 000256 Recorded inte1view of Dennis Leroux 

COP 000257 Recorded inte1view of Everett Baeza 

COP 000258 Recorded inte1view of Hanna Glemba 

COP 000259 Recorded inte1view of Jason Hobel 

COP 000260 Recorded inte1view of Jimmy Yee 

COP 000261 Recorded inte1view of Juan Lara 

COP 000262 Recorded inte1view of James Clark 

COP 000263 Recorded inte1view of Kevin McGowan 

CON FI E>'ENTIAL COP 015478 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 152 of 165
BATES NUMBERS DOCUMENTS 

COP 000264 Recorded inte1view of Mark Acker 

COP 000265 Recorded inte1view ofMmrny Williamson 

COP 000266 Recorded inte1view of Oswald Grenier 

COP 000267 Recorded inte1view ofRonaldo Canilao 

COP 000268 Recorded inte1view of Ryan Nielsen 

COP 000269 Recorded inte1view of Steven Wong 

COP 000270 Recorded inte1view of Susan Heimbigner 

COP 000271 Recorded inte1view of Tonya Davis 

COP 000272 Recorded inte1view of Tonya Davis 

COP 000273 Recorded inte1view of Tonya Davis 

COP 000886-000926 41 photos taken of items received at autopsy - taken by Phoenix Police Dept. 

COP 000927-001274 348 photos taken of autopsy and scene by Phoenix Police Dept. 

COP 001275-002277 Incident Rep01ts pe1taining to Mr. Muhaymin 

COP 002278-002319 An est and Booking Records pe1taining to Mr. Muhaymin 

COP 002320-002334 Booking Photos for Mr. Muhaymin 

COP 002335-002747 Arizona Dept of Con ection File pe1taining to Mr. Muhaymin 

COP 002748-003355 Criminal Comt Records pe1taining to Mr. Muhaymin 

COP 003356-003370 Medical Examiner Repo1t and Toxicology Rep01t 

COP 003371 Letter from Maricopa County Attorney 

COP 003372-003376 Plaintiffs Notice of Claim 

COP 003377 X-Rays taken by medical exruniner during autopsy 

COP 003378-003525 148 photos taken by medical examiner during autopsy 

COP 010809-011021 PSB17-0004 - final as of 11/02/2018 -COP 010501.1 (re Grenier UOF boru·d) 

COP 011239-011246 Incident Rep01t with attachments prepru·ed by Antonio T ru·ango 

COP 011445-011448 Ce1tified copy of pleadings from Mesa Municipal Comt , 2016068065 

Muhaymin 0001-0038 Documents produced by Plaintiff in response to Request for Production 

TRANSCRIPTS OF PREVIOUSLY PROVIDED RECORDED INTERVIEWS 

01. Anthony Williamson 's inte1view on 01/05/2017 (COP 012054-012076) 

CON Fll:>ENTIAL COP 015479 

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 153 of 165
- 6 -

02. Antonio Tarango’s interview on 01/04/2017 (COP 012077-012156) 

03. Arizona Smith’s interview on 01/05/2017 (COP 012157-012183) 

04. David Head’s interview on 01/04/2017 (COP 012184-012206) 

05. David Head’s interview on 01/11/2017 (COP 012207-012271) 

06. Dennis Leroux’ interview on 01/04/2017 (COP 012272-012278 and COP 012279-012295) 

07. Dennis Leroux’ interview on 01/12/2017 (COP 012996-012234) 

08. Everett Baeza’s interview on 01/18/2017 (COP 012335-012350) 

09. Hannah Glemba’s interview on 01/04/2017 (COP 012351-012387) 

10. James Clark’s interview on 01/04/2017 (COP 012388-012407) 

11. James Clark’s interview on 01/11/2017 (COP 012408-012444) 

12. Jason Hobel’s interview on 01/04/2017 (COP 012445-012481) 

13. Jason Hobel’s interview on 01/11/2017 (COP 012482-012540) 

14. Jimmy Yee’s interview on 01/04/2017 (COP 012541-012572) 

15. Juan Lara’s interview on 01/04/2017 (COP 012573-012603) 

16. Kevin McGowan’s interview on 01/04/2017 (COP 012604-012622) 

17. Kevin McGowan’s interview on 01/27/2017 (COP 012623-012670) 

18. Mark Aker’s interview on 01/04/2017 (COP 012671-012695) 

19. Matt Murray’s interview on 01/04/2017 (COP 012696-012709) 

20. Oswald Grenier’s interview on 01/04/2017 (COP 012710-012751) 

21. Oswald Grenier’s interview on 01/11/2017 (COP 012752-012816) 

22. Ronaldo Canilao’s interview on 01/04/2017 (COP 012817-012872) 

23. Ronaldo Canilao’s interview on 01/11/2017 (COP 012873-012950) 

24. Ryan Nielsen’s interview on 01/04/2017 (COP 012951-012967) 

25. Ryan Nielsen’s interview on 01/13/2017 (COP 012968-013024) 

26. Steven Wong’s interview on 01/04/2017 (COP 013025-013065) 

27. Steven Wong’s interview on 01/10/2017 (COP 013066-013114) 

28. Susan Heimbigner’s interview on 01/04/2017 (COP 013115-013131) 

29. Susan Heimbigner’s interview on 01/13/2017 (COP 013132-013188) 

30. Tonya Davis’ interview on 01/04/2017 (COP 013189-013219) 

31. Tonya Davis’ interview on 01/24/2017 (COP 013220-013225) 

32. Tonya Davis’ interview on 01/24/2017 (COP 013226-013236) 

DEPOSITIONS

01. Defendant Antonio Tarango 

02. Defendant Officer Oswald Grenier

03. Defendant Officer Ronaldo Canilao

04. Defendant Officer James Clark

05. Defendant Officer Ryan Nielsen

06. Defendant Officer Susan Heimbigner 

07. Witness Jimmy Yee

08. Witness Arizona Smith

09. Witness Andy Damiano 

CONFIDENTIAL COP 015480

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 154 of 165
- 7 -

10. Defendant Officer Jason Hobel

11. Defendant Officer David Head

12. Defendant Sgt. Steven Wong 

13. Medical Examiner 

14. Sgt. James Ward

15. Detective Jemima Schmidt 

MEDICAL RECORDS 

01. Records from Maricopa County Correctional Health Services (COP 11932-12022) 

02. Records from Phoenix Fire Department (COP 13882-13892) 

03. Records from Community Bridges Integrated Medical Group (COP 13893-13918) 

04. Records from Terros (COP 14724-15221) 

05. Records from Abrazo Community Health Network (COP 14724-15221) 

Overview of Opinions

(all opinions within this report are to a reasonable

degree of medical or scientific probability)

An overview of my opinions is as follows with more description of each below: 

1. Mr. Muhaymin’s cardiac arrest was most likely caused by his underlying coronary artery 

disease coupled with an intramuscular left anterior descending coronary artery, 

methamphetamine use and his agitation.

2. The actions of the officers to control and restrain Mr. Muhaymin did not cause or 

contribute to his cardiac arrest and death. 

Analysis 

After reviewing the above listed materials, it appears that in the morning of January 4, 2017, 

Mr. Muhaymin attempted to use the men’s restroom facilities at the Maryvale Community Center 

with his dog, Chiquita. Mr. Muhaymin was 43 years old, weighed 164 lbs. and was 5’ 7’ at the time. 

Phoenix Police received a call regarding an assault at the Maryvale Community Center and 

CONFIDENTIAL COP 015481

Case 2:17-cv-04565-DLR Document 382-11 Filed 12/01/21 Page 155 of 165
- 8 -

responded. While Mr. Muhaymin was using the restroom, officers learned that he had a warrant for 

his arrest. After Mr. Muhaymin used the restroom, the officers walked him outside and told him he 

was under arrest for this outstanding warrant. Mr. Muhaymin refused to put his hands behind his 

back as instructed and then there was a struggle for a brief period and Mr. Muhaymin was 

ultimately placed into two sets of interlocking handcuffs with hands behind his back. 

The officers were walking Mr. Muhaymin to the parking lot towards one of the police 

vehicles. When Mr. Muhaymin was at the front of the police vehicle, he brought his double cuffed 

hands up over his head then in front of his body. Mr. Muhaymin and officers went to the ground. 

Other officers arrived to assist getting Mr. Muhaymin re-handcuffed with his hands behind his back. 

Mr. Muhaymin continued to physically resist. As the officers were getting the handcuffs secured, 

Mr. Muhaymin vomited. EMS was called. Then officers assessed Mr. Muhaymin and then started 

CPR. Paramedics attempted resuscitation and transported him to the hospital however Mr. 

Muhaymin never regained consciousness and was pronounced dead. 

The medical examiner performed an autopsy and determined the cause of death was cardiac 

arrest in the setting of coronary artery disease, psychiatric disease, acute methamphetamine 

intoxication, and physical exertion during law enforcement subdual. 

Given this history, there are several issues that need to be addressed in more detail below. 

All opinions given are to a reasonable, or higher, degree of medical probability based on the 

information currently available. 

Detailed discussion and basis of opinions

1. Mr. Muhaymin’s cardiac arrest was most likely caused by his underlying coronary artery 

disease coupled with an intramuscular left anterior descending coronary artery, 

methamphetamine use and his agitation.

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Mr. Muhaymin was noted to have an atheromatous plaque in the left anterior descending 

(LAD) coronary artery. The plaque causes a stenosis of 40-50% of the LAD, limiting blood flow 

through this artery. This blockage of the heart artery in and of itself can place an individual at 

increased risk for sudden cardiac arrest and death from an irregular heartbeat. 

On top of this blockage of the LAD, Mr. Muhaymin also had an abnormality of an 

intramuscular LAD coronary artery that involved a 2 cm portion at the midpoint of its distribution. 

This is significant. Normally the coronary arteries, the blood vessels that supply the heart muscle 

with oxygen and other nutrients, travel on the surface of the heart as depicted in the image below. 

In the case of Mr. Muhaymin, a 2 cm portion at the midpoint of the LAD coronary artery 

tunneled down and was embedded into the cardiac muscle. The problem with this anatomic 

anomaly is that when the artery is embedded in the muscle, as the heart muscle contracts, it limits 

blood flow through that artery and thus limits oxygenation to the heart muscle supplied by that 

coronary artery. And in the case of Mr. Muhaymin, the LAD was already narrowed and limited in 

how much blood could flow by the 40-50% blockage. It should be noted that the LAD is one of the 

CONFIDENTIAL COP 015483

Right coronary 

artery 

~:'a~g~ marginal 

l't~J'/r 'lo..11L-- Diagonat branch 

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major coronary arteries, so important that it is nicknamed “the widow maker” because blockage of 

this vessel will typically result in cardiac arrest and sudden death. 

So, Mr. Muhaymin, unbeknownst to him or the officers on scene, had two life threatening 

cardiac conditions both impacting one of the most important coronary arteries, each with an 

increased risk for sudden cardiac arrest. When combined, they are even more dangerous. This 

creates cardiac stress and significantly increases the risk of sudden cardiac arrest. 

 In addition to this combined cardiac risk, Mr. Muhaymin added methamphetamine to his 

system. Methamphetamine is an often-unpredictable stimulant that, regardless of the amount 

ingested, increases the work of the heart. It increases the heart rate and contraction strength of the 

cardiac muscles. The increased heart rate will increase oxygen demand throughout the body as well

as the heart muscle. However, the increased heart rate and contraction strength only compresses the 

intramuscular LAD more and more, at a time when the heart muscle needs more oxygen than ever. 

This becomes a vicious cycle. Additionally, methamphetamine will cause the blood to be more 

acidic, caused by a metabolic acidosis. This increased acidosis (lower pH of the blood) is irritating 

to the cardiac muscle, increasing the risk of an irregular heartbeat (dysrhythmia) and sudden cardiac 

arrest. 

 And finally, Mr. Muhaymin became agitated and resisted physically and exerted himself. 

This is an additional physiologic stressor on top of the methamphetamine and anatomic anomalies 

that increases lactic acid production of muscles and demands more oxygen. The lactic acid 

production is additive to the metabolic acidosis from the methamphetamine use and worsens the 

irritability of the cardiac muscle, increasing the risk of sudden cardiac arrest. 

It should be noted that in the video Mr. Muhaymin could be heard stating loudly “I can’t 

breathe.” At face value, one might think this statement means that Mr. Muhaymin could not breathe 

or ventilate. However, when evaluating the video, Mr. Muhaymin was clearly moving air in and out 

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of his lungs very well, yelling loudly, and having no clinical evidence of ventilatory restriction at 

the time he was making this statement. What was likely happening is that Mr. Muhaymin was 

having a cardiac event not a pulmonary event. Patients who come to the emergency department in 

the process of having a heart attack often describe the feeling of an elephant sitting on their chest or 

feeling like they can’t breathe. This is because the heart is not getting enough blood flow and the 

symptoms feel like loss of breath. In these cardiac patients, their ventilations are fine, and the 

oxygenation level is normal. The underlying issue is that the heart is not getting enough blood flow. 

So, when Mr. Muhaymin was reporting about not being able to breathe, it is likely that his 

heart was becoming ischemic by not getting enough blood flow which then led to the sudden 

cardiac arrest soon after. There was nothing that the officers could have done to prevent the cardiac 

arrest. Changing positions or removing the modest amount of weight placed was not going to 

change the blood flow issues to Mr. Muhaymin’s diseased heart that was being aggravated by the 

methamphetamine and severe acidosis caused by his exertion and continued resistance. 

 In summary, Mr. Muhaymin had a heart that was significantly abnormal and at increased 

risk to go into cardiac arrest. Added to this increased risk was the methamphetamine he ingested

and the physical exertion and resistance which made the heart more volatile and worsened all 

physiologic parameters. It was this combination of events that increased the oxygen demand of the 

heart that was limited in how much blood could flow through the intramuscular “widow maker” and 

more likely than not, this was the cause of Mr. Muhaymin’s sudden cardiac arrest and death.

2. The actions of the officers to control and restrain Mr. Muhaymin did not cause or 

contribute to his cardiac arrest and death. 

During the period that officers were repositioning Mr. Muhaymin’s handcuffs from his front 

to his back, he was maintained at times on his side or in a prone position with officers repositioning 

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and distributing some weight in response to Mr. Muhaymin’s physical resistance. During this time, 

based on the reports by officers and my review of the body worn camera videos, Mr. Muhaymin 

was continuing to physically resist and yell. 

Based on the review of the video, the approximate timing and weight used on Mr. 

Muhaymin was as follows: Officer Grenier was holding Mr. Muhaymin’s head and hair to prevent 

Mr. Muhaymin from pressing his head against the ground and injuring himself. He reported he had 

his knee or shin on Mr. Muhaymin’s shoulder and neck for a brief period of time. The position was

intended to be the shoulder but would slip and move as Mr. Muhaymin moved and continued to 

physically resist. Officer Grenier moved away and then Officer Leroux placed his knee onto Mr. 

Muhaymin’s right upper shoulder for a short period of time. Then Sgt. Wong replaced Officer 

Leroux and placed his knee on Mr. Muhaymin’s upper torso to assist with removing the wrist band 

from Mr. Muhaymin’s wrist so that the cuffing could be completed. Officer Canilao was holding 

Mr. Muhaymin’s arms. Officer Hobel had his hands-on Mr. Muhaymin’s hips with his knees on the 

ground to keep Mr. Muhaymin from flipping over. Officer Heimbigner had her hands on Mr. 

Muhaymin’s lower back to keep him from getting up. Officer Clark had his knee on Mr. 

Muhaymin’s lower back very briefly. Officer Nielsen had his hands on Mr. Muhaymin’s hair and 

Officer Head was holding Mr. Muhaymin’s legs. The image below from Officer’s Nielsen’s body 

worn camera demonstrates some of the positioning, though with Mr. Muhaymin’s continued 

physical resistance, this was a dynamic situation with several intermittent shifting of positions. 

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For over 2 1⁄2 minutes after the arrival of Officer Nielsen, Mr. Muhaymin could be heard on 

the video yelling and moaning. He was heard grunting and keening, demonstrating that he was 

moving air in and out of his lungs. This demonstrated that his ventilation was intact. About 30 

seconds later, the re-handcuffing was completed and seconds later, Mr. Muhaymin vomits. Shortly 

thereafter Mr. Muhaymin was noted to be in cardiac arrest. 

The majority of the body weight was not even on Mr. Muhaymin in such a position that 

would have created the potential to limit ventilation. The limited period of time that weight was 

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placed intermittently on the upper back during the re-handcuffing would not significantly limit 

ventilations enough to cause asphyxiation. This was evidenced by Mr. Muhaymin’s ability to 

continue to speak, grunt and breathe very regularly. As research shows, the limited and 

intermittent time periods in which any body weight was applied to Mr. Muhaymin’s upper back and 

neck would not cause clinically significant physiologic changes that could cause asphyxiation or 

significantly limit ventilations. 

The weight of the officers holding Mr. Muhaymin’s legs, lower back, arms, head, neck and 

hair would not have had any impact on breathing or the ability for Mr. Muhaymin to ventilate 

effectively. 

Mr. Muhaymin was yelling, grunting, breathing and physically resisting throughout the 

encounter until less than one minute before he vomits. If the officers’ application of weight had 

impacted Mr. Muhaymin’s ability to ventilate to the point of causing a cardiac arrest and sudden 

death by asphyxiation, the ventilations would have had to be restricted long enough to where blood 

oxygen levels would drop because there was not enough oxygen getting into Mr. Muhaymin’s 

lungs. When this occurs, the low blood oxygen levels will cause the heart to become irritable and 

eventually slow and then stop causing the subject to go into cardiac arrest. This takes time and 

essentially a complete blockage of air movement in and out of the lungs. There was no evidence 

that the short periods of weight applied to Mr. Muhaymin caused the cascade of physiologic 

changes from asphyxia to result in a cardiac arrest. The weight was simply not enough to 

significantly restrict ventilations. In summary, there is no evidence that position, restraint or body 

weight caused or contributed to Mr. Muhaymin’s cardiac arrest and death. 

Background

My background is that I am a full-time faculty member in the department of emergency 

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medicine at the University of California, San Diego Medical Center. I am residency trained and 

board certified in Emergency Medicine. I work full time as a practicing clinician in the Emergency 

Department of a busy urban hospital and serve as the clinical operations chief for our two 

emergency departments with a combined annual census of approximately 75,000 visits. I currently 

serve as the Medical Director for Risk Management for UC San Diego Health. I also serve as the 

UCSD Medical Center’s Medical Risk Management Committee Chair and Allocation Committee 

Co-Chair, as well as previously having served as the Chair of the Patient Care and Peer Review 

Committee, each of which are charged with the task of reviewing medical records and making 

determinations of standard of care. I am also the former Chief of Staff for UC San Diego Health.

As a physician working at an urban based emergency department at a Level 1 trauma center, 

I have evaluated hundreds of patients over the last 25 years who have been in cardiac arrest and 

thousands who have been under the influence of methamphetamine. 

I am knowledgeable of peer-reviewed medical and scientific research on the physiological 

effects of positional restraint and positional asphyxia conducted by others. I have also performed 

extensive clinical research on human subjects who have been restrained in various positions and 

with various amounts of weight being placed (articles included in my curriculum vitae) which 

includes having directly been involved with hundreds of subjects being restrained and studied, 

hundreds of patients restrained during my work in the emergency department and have personally 

been restrained with weights placed on me as well. I have been invited to lecture nationally and 

internationally on this subject. Given my own interests in this area, I regularly perform a complete 

review of the literature regarding restraints and in custody death. 

I am knowledgeable of peer-reviewed medical and scientific research for cardiac arrest and 

CPR practices. I was the Principle Investigator for San Diego’s Resuscitative Outcomes 

Consortium (ROC) site, a National Institute of Health (NIH) funded study for ten years that 

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involved over 200,000 cardiac arrest patients to evaluate treatment options for out of-hospital 

cardiac arrest and severe traumatic injury. I have published many peer-reviewed papers on the topic 

of cardiac arrest and cardiac resuscitation, including publications in the New England Journal of 

Medicine, JAMA, and Circulation. I also served as the Medical Director of the American Heart 

Association Training Center at the University of California, San Diego Center for Resuscitation 

Science almost ten years, teaching Advanced Cardiac Life Support (ACLS) both locally and being 

asked to give lectures on cardiac arrest internationally. I had been an ACLS instructor for over 20 

years. I also work at a busy urban comprehensive emergency department where I care for patients 

in cardiac arrest on a regular basis. 

My Emergency Medical Services (EMS)/prehospital background and experience includes 

having been a flight physician with Lifeflight of San Diego and with Mercy Air, taking care of 

acutely injured patients at the scene. My EMS administrative roles include having been the Base 

Station Medical Director for UCSD, the Medical Director for the Palomar and Southwestern 

Paramedic College Training Programs, and the former Medical Director for the County of San 

Diego Emergency Medical Services (EMS) one of the largest EMS systems in the nation. In this 

role, I was responsible for protocols and quality assurance of over 1000 paramedics and 4000 

EMT’s. I started the UCSD EMS/Disaster Medicine Fellowship Training Program and was the first

Fellowship Director and currently serve as the associate Director of the EMS/Disaster Medicine 

Division in the UCSD Department of Emergency Medicine and as the Medical Director for the 

North County Fire Protection District. I have been a paramedic base hospital physician in San 

Diego County for over 25 years. Other previous EMS roles include having been the Medical 

Director for the Chula Vista Fire Department, the Carlsbad Fire Department, and the Aeromedevac, 

Aviamedix and AirLink USA Air Ambulance Services. I was also the Medical Director for the San 

Diego County Metropolitan Medical Strike Team (MMST) and the UCSD Base Hospital Medical 

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Director, and I also served as EMS medical back up for many SWAT operations. I have written 

numerous peer reviewed papers on prehospital medicine and operations as well as many book 

chapters and have lectured nationally and internationally on prehospital care. I was also the 

Principal Investigator for San Diego’s Resuscitative Outcomes Consortium (ROC) site, a National 

Institute of Health (NIH) funded study consortium that evaluated treatment options for out ofhospital cardiac arrest and severe traumatic injury for over a decade. 

As per Rule 26 formatting, Appendix A is a copy of my current Curriculum Vitae, which 

includes a list of all publications authored by me. Appendix B is a list of all cases in which I have 

testified as an expert in trial or deposition within the preceding four years. Appendix C is my fee 

schedule. The knowledge base that I utilize has been developed over time from my years of 

clinical practice and experience, reading and training as well as research. Under penalty of perjury, 

I hereby swear that the opinions stated above are true and correct within a reasonable degree of 

medical probability based on the information currently available to me. The opinions may be 

updated as additional information is provided for review.

Respectfully submitted,

Gary M. Vilke, M.D., FACEP, FAAEM 

Professor of Clinical Emergency Medicine 

Vice-Chair, Clinical Operations Emergency Medicine

Medical Director, Risk Management, UC San Diego Health System

Medical Director, North County Dispatch JPA

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