Opinion ID: 1940967
Heading Depth: 3
Heading Rank: 2

Heading: Government Expert Witnesses

Text: Dr. Jonathan Arden, who at the time was the Chief Medical Examiner of the District of Columbia, supervised the autopsy of Brianna. An external examination revealed bruising on Brianna's right buttock and her left thigh and hip, as well as a small abrasion in the middle of her back. Additional bruising was visible on the right side of Brianna's face and chin, and there were abrasions on her left cheek. Dr. Arden, using computer-generated graphics, described the three separate areas of bruising that were discovered underneath Brianna's scalp. [14] A subdural hemorrhage [15] covered much of the surface of Brianna's brain. Additional bleeding was discovered in the subarachnoid space, just below the surface of the brain. Hemorrhages were also present around the optic nerves and retinas at the back of Brianna's eyes. Dr. Arden classified Brianna's head injuries as blunt impact injuries and said that the three areas of bruising were discrete and separate impact sites. He concluded that Brianna's head injuries occurred at approximately the same time, fairly shortly before she was presented unconscious and in need of emergency medical treatment, and that the degree of force required to cause the hemorrhaging within her head was somewhere in the medium to extreme range of force, i.e., hard blows or substantial impacts. Dr. Arden's opinion was that the severity of Brianna's head injuries qualified medically as child abuse, meaning that the injuries were deliberately inflicted and were not accidental. [16] He considered it very unlikely that Brianna's injuries could have been caused by falling down stairs, because those injuries could not have been caused by light impacts and were not trivial [or] casual types of injuries. In the doctor's opinion, Brianna's head injuries were consistent with being forcibly struck or slammed into the floor. [17] Dr. Arden said that he would expect Brianna to have become unconscious immediately or shortly after the injuries were suffered. To a reasonable degree of certainty, Dr. Arden concluded that the cause of Brianna's death was blunt impact injuries to her head and that the manner of death was homicide. On cross-examination, Dr. Arden admitted that he could not categorically exclude the possibility that one of the impact sites could have resulted from a fall down the stairs, but in his opinion the totality of Brianna's injuries did not suggest such a fall. He noted that when a person falls down stairs, each impact transmits energy, thereby lessening the force of subsequent impacts. When asked if the three impact sites on the head could have been caused by falling down ten steps, Dr. Arden replied: There may be some possibility in the universe that a fall down ten steps could cause this. Do I think it is likely? Is it my opinion that that scenario did cause this or would cause this? No. I do not find that a reasonable or likely explanation. There is probably some minute chance that a fall down ten steps could cause those injuries, but I emphasize the word minute. When asked the same question with respect to five steps, Dr. Arden responded: It is not my duty, my job, or my practice to ever exclude things with 100 percent certainty.... It is never 100 percent yes or 100 percent no. So, is there some slight, minute, tiny possibility on this earth that a fall down or push down five or six stairs could cause a fatal injury? I have to say there is because I don't categorically exclude things 1000 percent. But is it a reasonable explanation? Does it make sense medically? Does it go with experience? No. THE COURT: The question is whether you have an opinion, to a reasonable degree of medical certainty, as to whether or not that could have caused the injury. THE WITNESS: Phrased that way, Your Honor, it is my opinion with a reasonable degree of medical certainty that a fall down five or six steps would not cause these fatal injuries. Dr. Saami Shaibani, who held a doctoral degree in material physics from Oxford University, was qualified as an expert in injury mechanisms analysis. Dr. Shaibani testified that he examined and measured the carpeted stairway in appellant's home and concluded that, given Brianna's size, the dimensions and constitution of the stairs, and the nature of her injuries, the injuries received by Brianna are not consistent with falling down the stairs when you look at the totality. He could not see any way that Brianna could have received her injuries on the stairs unless she was bodily picked up and thrown down the stairs. You would require such a large force to get not one, not two, but three separate lesions, three separate injuries on [the] head. That's something very, very unusual ... which I don't see associated with the stairs. Dr. Shaibani based this conclusion on (1) the absence of any injury on Brianna's arms and legs, which would be expected in the event of a fall down the stairs based on how the human body articulates; (2) the three separate impact sites on Brianna's head, because, generally speaking, when you would fall down ... only a few stairs... you might hit [your head] once if you're unlucky, but not more than once on a relatively short distance; and (3) the severity of the impact injuries, because one would not expect ... this limited fall ... to be catastrophic. [18] In response to a hypothetical question from the prosecutor positing a scenario where an adult grabs Brianna by the back of the shirt and slams her numerous times into the floor, Dr. Shaibani stated, That's the easiest, most direct, most efficient way to achieve these injuries, because in that situation the energy's got nowhere else to go.