DR. JOSHUA A. PERPER
having been first duly sworn, was examined and testified as follows.
DIRECT EXAMINATION BY MR. SIPE:
Q.- For the record, please state your name.
A.- Joshua A. Perper, P-e-r-p-e-r.
Q.- And what is your address?
A.- 3546 S. Ocean Boulevard, Palm Beach, Florida.
Q.- What is your occupation?
A.- I am a physician, and my specialty is forensic pathology.
Q.- And where do you practice that specialty?
A.- Currently I am the chief medical examiner for Broward County, that is the Ft. Lauderdale area in Florida.
Q.- Could you give us a brief educational sketch, doctor?
A.- Yes. From 1967 to 1969, I was an associate medical examiner at the Office of the Chief Medical Examiner in Baltimore, Maryland.
From 1969 to 1972, I was the chief forensic pathologist for the Office of the Coroner of Allegheny County, which is Pittsburgh, Pennsylvania.
From 1972 to 1980, I was the acting coroner.
And from 1981 to 1994 I was the coroner of Allegheny County.
From 1994 to the present, I am the chief medical examiner of Broward County, however, obviously I am not testifying in this capacity.
Q.- That's understood. You received your medical degree in what, 1962?
A.- That's correct. I have the following academic degrees. I have a medical degree from the medical school of Hebrew University. I have a law degree from the law school of Hebrew University. And I have a master of science degree in forensic pathology from Johns Hopkins University.
Q.- Have you previously held positions as a teacher?
A.- Yes. During my tenure in Pittsburgh, I was the clinical professor of pathology at the Medical School of the University of Pittsburgh. I was a clinical professor of epidemiology and public health at the School of Public Health at the University of Pittsburgh. I was the clinical professor of psychiatry at the Medical School of the University of Pittsburgh, and for a number of years I was also an adjunct professor of law at the Duquense University, and currently in Broward County, I am a clinical professor of pathology at the University of Miami, and I am a clinical professor of pathology and public health at the University of Miami.
Q.- In addition to those teaching positions, have you also held various editorial positions?
Q.- Have you also held public office?
Q.- Have you also been on and chaired medical committees?
A.- Yes. I was -- in Pennsylvania, I was the chairman of the State Board of Medicine for five years. That is the board which grants licenses to physicians and monitors and disciplines physicians.
Q.- Have you also serves as a consultant?
A.- Yes. I served as a consultant for various organizations including the World Health Organization of the United Nations.
Q.- Are you also board certified?
A.- Yes. I am board certified in anatomic and forensic pathology by the American Boards of Anatomic and Forensic Pathology.
Q.- Do you hold membership in a number of medical societies?
A.- Yes. I am a member of quite a number of medical societies including the American Medical Association, the American Academy of Forensic Sciences, the National Association of Medical Examiners, and I have various positions with those organizations. I am currently the associate editor of the Journal of Forensic Medicine in the field, and the -- of the National Association of Medical Examiners.
Q.- In addition, have you either written or co-written a series of books?
A.- Yes, I did write or co-write eight or nine books in the field of pathology and forensic pathology and legal medicine.
Q.- Would I be correct that you have over 100 articles that have been published in various journals?
A.- That's correct. In the same field of pathology and forensic pathology and legal medicine, I published more than 100 articles in the medical literature.
Q.- Likewise, do you now have at least two manuscripts that have been accepted for publication as well?
A.- That's correct.
Q.- How many autopsies have you performed?
A.- I have performed several thousand autopsies, probably more than 7,000 autopsies and probably supervised more than 15,000 or 20,000.
Q.- Have you had an opportunity -- during the course of those autopsies, are you called on from time to time to determine the time of death?
A.- Yes, that's one of the responsibilities of the medical examiner or the forensic pathologist who is working for the coroner -- is to determine the time of death of an individual who dies under circumstances which makes him or her a case for the medical examiner or the coroner.
Q.- And before I forget, do you have an idea of how many times you have testified before?
A.- I don't have a number - but several hundred times.
Q.- And have you testified in more than one state?
Q.- And when you testify, do you usually testify for the government?
A.- Probably in more than 90 percent of the cases I am called by the government.
Q.- Now, you mentioned forensic pathology. Can you give sort of a layman's description of the difference between forensic pathology and forensic anthropology?
A.- Yes. Pathology is the branch of medicine which studies the causes and changes produced by disease in the human body. Forensic pathology is the sub-specialty of pathology which deals with the findings in sudden, unexpected, suspicious or violent death. In other words, an individual could die suddenly while in very good health or die as a result of accident, suicide or homicide.
forensic anthropology is forensic science in which the individual develops skills and have training in what is basically in the vast majority of cases, and most exclusively, the examination of human bones in order to determine the age, the sex, the race, and usually forensic pathologists use forensic anthropologists when they have bones which are particularly difficult to diagnose as to race, sex, age and so on. The forensic pathologist also has more experience in determining the type and pattern of injuries even in bones. So, forensic anthropologist never basically acts independently.
Most of the time or most invariably he is assisting the medical examiner when the medical examiner or the coroner has a problem examining bones.
Q.- Doctor, you were asked obviously to come here and testify, is that correct?
A.- That's correct.
Q.- And you are being paid for your services, are you not?
A.- That's correct.
Q.- Have you been paid for your testimony, that is, have you been bought by the defense to come here and tell a story?
A.- I am paid in order to express my opinion. I'm not selling my testimony to anyone.
Q.- You were asked to review certain items, were you not?
Q.- And I believe you made a shorthand list of those. Can you tell the ladies and gentlemen of the jury the items that you received prior to coming here to testify?
A.- Yes. I received the autopsy report by Dr. Lee Lehman of October 2, 1996; the police reports, which included the report of the investigation, photographs -- photographs and their description, crime scene investigation trace evidence collection, receipts of findings from Thomas A. Fuller, a forensic scientist, contact report with the toxicology coroner's office in reference to drug information, narrative supplement to weather conditions, crime scene sketches, and then quite a number -- I think 122 photographs of scenes and photographs of the deceased and xeroxed x-ray copy of a report of Thomas Fuller, a forensic scientist.
Q.- Were you asked to determine the time of death?
A.- Yes, I was.
Q.- And is this something that you do on a regular basis?
Q.- And can you tell the ladies and gentlemen of the jury the things that you were looking for as you were attempting to determine the time of death?
A.- Basically, the determination of the time of death is based on the evaluation of what we call postmortem changes.
Those postmortem changes are used as a clock, which indicates how long it took from the -- prior to time of the discovery of the deceased that the individual was alive.
The postmortem changes include the cooling of the body, stiffness of the body, which is called postmortem rigidity or rigor, which is related to chemical changes in the muscle of the individual.
Liver mortis, that's a peculiar discoloration, which is due to the movement of the blood in the lower gravity areas of the body. So, if an individual is lying on his back, the discoloration is going to be present on the back.
This is one set of changes. Some of those changes are not helpful once the individual is dead for a longer period of time.
The post mortem rigidity eventually disappears within 48 hours or so.
The additional changes which permit us to say -- evaluate a longer period of time are changes which are related basically to changes pertinent to the breakdown of the body tissues, and there are two types of those.
One is what is called decomposition; in other words, the body breaks down because it has chemical enzymes which break the tissue down.
And second is the process which you call putrefaction, and this is due to the action of bacteria which everybody has in the intestines, and they break down the tissue as well.
So, those are the two types of changes. Now, once the -- again, those changes depend on temperature and environment. After about two days - one or two days - there are changes of decomposition, and those changes include swelling of the face, darkening of the face as result of postmortem changes, greenish discoloration of the face.
Then we can see on the skin what we call marbling. Those are blood vessels, which is the result of the bacterial action. They engorge. And we don't see them usually under the skin, but we see them on the the skin as veins in a marbling. That's what they are called -- marbling. The skin is then peeling.
And those changes which are seen on the outside of the body are also accompanied by changes inside. There are certain organs in the body which break down much more rapidly. For example, there is an organ which is called the pancreas. It has a lot of chemical or enzyme, so this organ breaks down very rapidly.
So, based on the appearance of those changes and considering the other circumstances, forensic pathologists arrive at certain conclusions as to the time which occurred from the death to the time of the finding of the body.
Q.- Doctor, I want to hand you a series of photographs -- and for purposes of the record, they will begin with Defendant's Exhibit #7 and go through #20. I want you to look first at #7. Can you tell us what that is?
A.- This is a photograph of the left side of the face of the deceased, and it shows some reddish discoloration around the eyelids, which is related to the gunshot wound of the head which this individual sustained.
Q.- Is there evidence of marbling?
A.- There is no evidence of marbling.
Q.- Is there evidence of slippage?
A.- There is no evidence of slippage other than -- on the on the photograph. On the video there was some slight slippage.
Q.- Was there evidence of swelling of the face?
A.- There is no evidence of swelling of the face, and there is no evidence of black discoloration of the face. There is no evidence of bloating of the face.
Q.- If you would look at Defendant's #8, would you tell us what that is?
A.- Which one?
A.- The next one?
Q.- Yes, we are moving on.
A.- The next one is a photograph of the deceased, which is dressed, lying on the right side of her body, and photograph shows the arm of the deceased and part of her left loin or left side of the body.
Q.- Is there evidence of marbling?
A.- There is no evidence of marbling whatsoever.
A.- No. As a matter of fact, the consistency of the skin appears to be normal consistency.
Q.- Doctor, I am going to hold up for you State Exhibit P65. Can you see that?
A.- Yes, sir.
Q.- And what does that appear to depict?
A.- This depicts, again, the arm of the individual who is -- of the deceased who is clothed.
You can see part of the forearm, the crook of the elbow and part of the arm, and if -- and there is no marbling. If there would have been marbling, you would have seen thick bands, vertical bands, which are basically the veins, like a mesh of, or network of veins, and there is none there.
Q.- If you would look now at Defendant's Exhibit #9.
A.- Exhibit #9 basically is a similar picture, just a close up of the former one.
Q.- Of the former one -- that being number 7?
Q.- Again, do you see marbling? Do you see slippage or peeling?
A.- There is no marbling and there is no peeling. As a matter of fact, again the consistency is the consistency of a normal arm from the photograph. The person has postmortem lividity, which is present, and this indicates a longer period of time.
Q.- Number 10, Defendant's #10?
A.- Number 10 is a picture which depicts the back of the deceased, and on the back of the deceased there are a number of what appears to be abrasions or scratches, which would be consistent with dragging marks.
Q.- Did you note those in the autopsy?
A.- No, the autopsy report mentions that the back is unremarkable and, obviously, it is not unremarkable, it is very clearly remarkable.
Q.- And again, on the back -- do you see evidence of marbling?
A.- There is no evidence of marbling whatsoever.
Q.- Or slippage?
A.- There is no evidence of slippage.
Q.- And the next number I believe is -- are we up to #11?
A.- #11 is a picture of the deceased, which is done from the right side of the deceased. It shows that she is still dressed in pants, the upper part of the body has a blouse which has been pulled up. The right arm and forearm are showing, and also the very low chest -- front chest and part of the abdomen and part of the right side of the body are shown. The hand is bagged with a bag, and there is no evidence of marbling.
Q.- All right. Number 13?
A.- #13 is a close up of the area of the right side of the body and abdomen, in which there is no marbling. There is some evidence of postmortem lividity, reddish hemorrhagic discoloration, and there is also some greenish discoloration of the skin of the abdomen, which is also a sign of postmortem change.
A.- #14 is just a more distant view basically of the same photograph except that it shows also the right side of the face of the deceased and her right arm. And the right side of the face of the deceased shows, again, reddish hemorrhagic discoloration around the eyes related to the gunshot wound.
Q.- And, doctor, can you tell from #14 whether or not this photograph appears to be from the scene or does this appear to be from the autopsy room?
A.- This photograph is clearly from the autopsy room because under the deceased, you can see that the deceased is lying on a classical, typical autopsy table.
Q.- #14, I am sorry.
A.- #14 is, again, a photograph of the entire body of the deceased see primarily from the right side without some parts of the left side of the body, left side of the leg are observed, and it shows anteriorly and on the right the postmortem lividity. Again, there is no evidence of marbling.
Q.- And the next one is? What number is that?
A.- This is #15. Again, a photograph of the entire body which is without clothing and photographed from the area of the knee upwards and. again, with no evidence of marbling. Now, there is evidence of postmortem lividity. And there is no evidence -- not here, not in the previous one, there is no evidence of skin slippage.
Q.- The next number?
A.- Next number is Exhibit #16, and is a photograph of the back of the deceased, the entire back. Clearly in the area of the upper back, there are those kinds of patterns and lines of scratches, which in my opinion are indicative of dragging. There is no evidence of slippage, and there is no evidence of marbling.
Q.- Next number?
A.- Next number is #17, and this is a photograph of the legs of the deceased with part of the foot, just part of it, the upper part of the foot, and it shows a transverse and horizontal band of bruising, which would be consistent with some type of ligature in this particular area.
In the upper portion of the left leg shows some faint greenish discoloration, which is an indication of postmortem change again.
Q.- And again, did you find evidence in that picture of marbling?
A.- There is no evidence of marbling and there is no evidence of slippage. As a matter of fact, the pattern of the skin is clearly visible.