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Authors: David Klatzow

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An action was brought against the police, and I worked with luminol and the blood stains on the man’s shirt. The police claimed that the criminal they were chasing and had shot was wearing a striped shirt. Yet the man who was killed had been wearing a blue shirt at the time. Even though the shirt had been washed, I was able to show, using luminol, that the shirt worn by the innocent dead man had been covered by his blood.

The defendant’s advocate in the case was Jeanette Traverso, who subsequently went on to become a judge of the Supreme Court and is now Deputy Judge President of the Supreme Court in Cape Town. My testimony was accepted, and the police were forced to pay compensation to the widow.

These were difficult days. As an independent forensic scientist, I always had to be one step ahead of the so-called police experts. This was not always easy, as the techniques and methods they used changed all the time, presenting challenges and frustrations. From a forensic point of view, though, these years were interesting – I was always kept on my toes.

CHAPTER 16
POST-MORTEMS: THE GOOD, THE BAD AND THE TOTALLY INEPT

Disabling Professions

– IVAN ILICH,

Austrian philosopher, book title

Investigating a crime – getting as close to the true sequence of events as possible – is like solving a puzzle. One of the critical steps in this process is the post-mortem. Sadly, in South Africa, the quality of work in this arena is far from ideal. I have been outspoken on this issue over the years, which has not earned me any popularity: it seems we are expected to keep quiet when we see things going wrong. I refuse to do that, and, as such, am often labelled public enemy number one.

In the 1980s, the post-mortem conducted on young activist Ashley Kriel was appalling. It failed to address the issue of whether or not the gunshot that had killed Kriel had been a contact shot. As I mentioned in
Chapter 10
, I am certain that there was a second bullet, the presence of which would have had significant ramifications
at the inquest. Yet the scientist who carried out the postmortem simply never looked for it or did not report on it.

Some post-mortem reports that I have seen have been blatant lies. One such case involved a policeman accused of shooting a suspect who had been running away. I was hired to defend the policeman. At the time, it was considered acceptable behaviour for a policeman to shoot and kill a fleeing suspect, and the pathologist’s report reflected this: there were records showing that the pathologist had opened the body before he examined the bullet wounds in the back. This did not cohere with the report at all, because if he had conducted the post-mortem as he said he had, the organs would have fallen out when he turned the body over to study the bullet wounds! The pathologist had simply not conducted a post-mortem: his report was a patent lie. He was eventually cross-examined and admitted to his dishonesty.

At every crime scene, you, as the forensic investigator, have to start off with a high index of suspicion. If you accept too easily that a death appears to be natural, you fall into the trap that the British police did with Harold Shipman, who murdered old ladies after persuading them to change their wills in his favour. The police in this case had initially failed to find sufficient evidence to bring charges, assuming that the old ladies had died of natural causes. Instead, they had been poisoned by Shipman, their doctor, who had administered lethal doses of diamorphine and then forged their medical records to indicate that they had been in poor health.

A ‘crime’ can be downgraded to a natural cause of death; it is impossible, however, to go back to suspecting a crime if your starting point is that the death occurred as a result of natural causes.

Many people are clothed when they die. A post-mortem should be started with the clothed body in order to understand how the death took place. The clothing needs to be examined in relation to any wounds on the body itself to reveal the context in which the injury occurred. For example, if the hands of a person who
has been shot were above their head when they were killed, their shirt would have moved up. The position of the bullet hole in the shirt would not, therefore, correspond with the position of the actual gunshot wound on the body. So the position of the clothing in relation to the wound is extremely important, as it will provide the forensic pathologist with valuable information about the way in which the shooting took place. In addition, the manner in which blood spills onto the clothing is different depending on whether the victim was sitting, kneeling or lying down.

Another crucial aspect of the post-mortem is that of microscopic investigation. Whenever two objects touch each other, there is a transfer of minute materials – something is always left behind, whether it is skin, hair or clothing fibres. This often requires microscopic research. The position and type of the fibres in relation to the clothing and the wound are also important – there may be a lack of burns on the body, for instance, because there was clothing in place. The wound ultimately has to be interpreted in terms of whether there was clothing on at the time of the shooting.

Ideally, the body should be examined in situ. The hands of the deceased need to be examined, as do the wound, the clothing, and the scene of the killing and its surrounds. In the recent case of Chris Drummond, a high-profile property developer who was pushed off a balcony in Claremont in April 2010, I observed blood on the pillars nearby, so I thought there might have been a fight. When the state mortuary staff arrived to remove the body, they did not have any plastic bags to bag the victim’s hands. I would not allow them to move the body until the hands had been bagged, which I did myself, on the scene. This should have been done by trained, professional mortuary staff, not by me. The hands may have had bruising, material under the fingernails, blood or DNA on them, all of which would be vital evidence.

The current post-mortem procedure in South African mortuaries begins with a person called a prosector, who opens the body, takes
out the organs and lays them out on the slab. The major downside of this is that the body needs to be seen intact first.

This was highlighted in a recent case I worked on, in which a man died as a result of a suture that had occluded his internal mammary artery, which was the main blood supply to the heart. Although a mammary is not normally a supply to the heart, in bypass surgery it is often used in this way, as was the case here. The man was eighty-two years old and was undergoing the surgery to replace his heart valve. The final metal suture – to pull the sternum together – was to be located close to the mammary artery. Normally, the surgeon would place a metal plate between the internal mammary artery and the sternum, but in this instance the surgeon did not use a plate, as the patient had scarring from a previous triple-bypass operation. The surgeon took a chance and put the suture right through the mammary artery, killing the patient on the operating table. The post-mortem did not reflect this fact, as the whole sternal plate was removed at the post-mortem and no one looked at it. The surgeon knew what he had done, though.

Examining a body in its entirety to determine how the person died is a major part of forensic pathology: it should be done by a pathologist, not a policeman with little or no training, as is often the case. Frequently, crimes are taken at face value, with very little actual detailed investigation taking place. This simply does not serve justice, as I have witnessed time after time.

When examining the scene of death in cases of suicide by hanging, the noose should not be removed from the body, as this evidence has to be compared to the marks on the structure from which the noose was hung, as well as the marks on the skin. It may be possible that the person was hanged after they died, for example. If you disturb the noose and the evidence, the exact cause of death will be difficult to determine.

Part of the problem with post-mortems is that families who wish to be present at these sessions find it very difficult to do so. Family
representation should be encouraged, in my view. People like Jurie Nel, the chief forensic pathologist at Stellenbosch University, would always insist on the family obtaining magisterial approval, despite the fact that he could decide who attended the post-mortem on his own authority. The pathologists have also always tried to keep me out on the basis that I am not medically qualified. Even when I represent families, it is almost impossible for me to observe the post-mortem; in the past I have been allowed to examine the body only when the pathologist was finished with it.

The most important thing for a forensic pathologist to remember is that he is a man of science. If this critical piece of investigation is done badly, it leaves wiggle room, in my opinion – and the state pathologists like to have wiggle room.

The blatant laziness in performing proper post-mortems was illustrated vividly by the death of Isaac Miggels, a young boy who supposedly drowned in 2004. A story appeared in the press about this boy, whose body had been found in the Faure Dam in the Western Cape. Miggels, who was eight years old at the time, had been out with friends when he died, and the pathologist from Swellendam found that he had died as a result of drowning.

Miggels’s father, to his credit, was unhappy with the post-mortem report, which resulted in a second post-mortem, in which it was found that Miggels had a fractured skull, as well as a fractured hyoid bone. I was approached by the press for comment, and I had less than complimentary things to say about the pathologist who had conducted the post-mortem. I found it very difficult to believe that the pathologist had missed the fractured hyoid bone during the initial post-mortem, as the first step in a medical examination is to open the body, and the neck, in particular.

The hyoid bone is part of the larynx, in the neck. Where there is strangulation or any manual pressure, this bone normally breaks. A fractured hyoid is almost always an indication of pressure brought to the neck. Thanks to the work done by the late Professor Okkie
Gordon, it is now possible to carry out a bloodless dissection of the neck to examine the hyoid bone. Previously, there would have been blood all over the place, making it extremely difficult to see if the bone was fractured. Clearly, the pathologist had not opened Miggels’s neck when she had conducted the first post-mortem.

The second thing the pathologist should have done was to look at the boy’s skull to examine the brain and the base of the skull. It is very easy to see if there has been a fracture of the skull: the skull is sawed open and a scalpel is used to cut the attachments that fix the brain to the base of the skull. The brain is then lifted out by hand. The pathologist is left with an empty skull lined with transparent membranes. The brain is inspected, and the membranes are then peeled back – they come away from the skull bone quite easily – leaving the white inside of the bone of the skull. If any fractures have occurred, they would have caused bleeding against the white inside of the skull, which shows up tiny blood lines.

My first experience with post-mortems was when I was seventeen years old, when I assisted the local district surgeon. I would open up the bodies in his presence so that he could perform the post-mortem. I remember the body of a young woman who had been beaten to death by her husband. He had hit her very hard on the jaw, causing multiple fractures to the jawbone. The woman had a ring fracture around the foramen magnum, which is the large opening to the spinal cord. The fracture was clearly visible at the base of the skull. In the case of Isaac Miggels, no such examination was carried out the first time round – that was clear.

Poor and inaccurate post-mortems are of critical importance in legal proceedings. In the case of Miggels, not only had the postmortem not been properly conducted the first time round, but when the pathologist redid it, she came up with a completely different finding – an utterly ridiculous situation!

After the media asked me for an opinion on the quality of the
pathology as I saw it and I had responded – I was very outspoken, and will continue to fight this battle until they do things correctly – my comments were challenged by a man called J.J. Dempers, a junior forensic pathologist at Tygerberg Hospital. He wrote a letter to the
Cape Argus
in 2004, in which he referred to the 567 CapeTalk radio interview I had given on the matter. He defended the postmortem, commenting that I was caught up in the past and should familiarise myself with current developments in forensic science.

I immediately wrote a letter to the
Cape Argus
in response, saying that anyone who does a post-mortem should follow the basic principles, and that the Steve Biko inquest in our recent history is a glaring example of where rules are made as people go along. I also addressed the issue that family representations at post-mortems are discouraged, with which I do not agree. I ended my letter by pointing out that those who do not know history are condemned to repeat it.

As a result of the second post-mortem report, there was a full investigation into the death of Isaac Miggels, and a murder inquiry. His friends later admitted that they had hit him against the head and in the face, as he had been swearing at them. They had taken his unconscious body and dropped it into the dam, where he died.

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