Case No.: ME-329-93 Date of Examination: May 7, 1993
Name: MOORE, James Michael
Age: 8 years Race: White Sex: Male
Place of Death: West Memphis, Arkansas County: Crittenden
CAUSE OF DEATH: Multiple Injuries with Drowning.
Ethyl Alcohol: Blood -- <0.01g%
Drug Screen: Blood-- No drugs detected.
Blood Type: A+

Frank J. Peretti, M.D. * William Q. Sturner, M.D.
Assoc. Medical Examiner Chief Medical Examiner
*Pathologist of Record

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NAME: MOORE, James Michael DATE: 5-7-93 NO: ME-329-93EXTERNAL

DESCRIPTION: The body was that of a well developed, well nourished, nude white male, whose hands were bound to the ankles in a "hog-tied" fashion. The body showed multiple injuries which are described further below in greater detail. The body weighed 55 pounds, was 49 1/2 inches in height and appeared compatible with the reported age of 8 years. The body was cold. Rigor was present and fixed to an equal degree in all extremities. Lividity was present, minimal and fixed on the posterior surface of the body except in areas exposed to pressure. The scalp was brown, wavy and blood-soiled. The irides were green. The corneae were clear. The sclerae and conjunctivae were slightly congested with no petechial hemorrhages. Fly larvae were present in the left periorbital region. The teeth were natural and in good condition. The neck, chest, abdomen and extremities were unremarkable except for the injuries to be described below. The hands and feet show washer woman wrinkling. The posterior torso showed injuries as described below. A 1 inch birth mark is present over the left buttocks region.

The body was covered with scattered and focal areas of dried mud and debris. The hands and feet showed washer woman wrinkling. The wrists were bound to the ankles bilaterally with black shoe laces. Removing of the binding showed the abraded and contused furrows present on both right and left ankles and wrists. A strand of "fabric-like" material was clenched in the left hand.

Head Injuries:
Multiple punctate scratches were present over the bridge of the nose. The left ala was abraded. The left side of the cheek was contused and edematous, with an overlaying 1 1/2 inch contusion. The lips were abraded. The mucosal surfaces of the lips were contused, slightly edematous, with multiple superficial lacerations. The frenula were intact. Linear scratches were present on the left mandible region, along with a 3 by 3/4 inch area of abrasion.

Situated on the right frontal scalp was a 2 1/2 by 1/2 inch area of edema and ovoid contusion with overlying multiple small superficial lacerations and a 1/8 inch depressed abraded laceration. On the left forehead was a 1 5/8 inch by 1 1/8 inch abraded laceration. At the superior margin of this wound was a 1/2 inch abrasion. The anterior and posterior surfaces of the right ear were contused, with overlaying linear scratches. The helix of the right ear was abraded.

Situated on the right parietal scalp was an ovoid area of contusion with associated edema, measuring 2 3/4 inch by 1 1/2 inch.

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NAME: Moore, James Michael DATE: 5-7-93 NO. ME-329-93

Situated behind the right ear was an ovoid contusion with edema measuring 1 3/4 inch by 3/4 inch.

Situated behind the right ear were multiple semi-lunar scratches.

Situated on the left parietal scalp was a dove-tail type laceration measuring 3/4 by 1/8 inch. At the inferior margin of the wound was an extension patterned contusion in the form of an upside down "L"; the vertical portion measured 1/2 inch and the horizontal portion measured 1/4 inch.

Situated on the left temporal scalp was an abraded contusion measuring 1 1/8 inch by 1/4 inch.

Situated on the right zygomatic region was a 4 by 3/4 inch contusion with overlying punctate abrasions and a 3/16 by 1/2 inch abrasion. Superior to this wound, extending on the right forehead region were two contusion measuring respectively by 1/4 by 1/2 inch and 1/2 inch by 1/2 inch.

Subsequent autopsy of the head showed multifocal extensive subgaleal contusions and edema. There were also multiple skull fractures which are described as follows:
Situated on the right posterior frontal skull bone was a 1 1/4 semi-lunar fracture. Situated immediately below this fracture was a similar semi-lunar circular fracture measuring 2 inches. Below this on the lateral aspect was a 1 inch fracture. Extending over the temporal scalp were two contiguous fractures; the most superior one measured 1 3/4 inch and the intersecting semi-lunar inferior one measured 1 inch in length. Situated over the midline of the parietal scalp were three semi-lunar fractures, one of which became contiguous with the second with an overall dimension of 2 inches. Inferior to this fracture was a similar semi-lunar fracture measuring 1 3/4 inches.

A _ inch fracture involved the right anterior cranial fossae. A 3 inch fracture extended across the right posterior cranial fossae.

The brain was edematous and showed subarachnoid hemorrhage involving the right cerebellar hemisphere. There were fractures contusions involving the right posterior cerebellar hemispheres.

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NAME: MOORE, James Michael DATE: 5-7-93 NO: ME-329-93

Neck, Chest, and Abdominal Injuries:
In an area measuring 3 inches by 3/4 inch, situated over the right side of the neck and scapula region, was an area of contusion with an overlying 1 1/4 by 1/2 inch abrasion. Situated medial to this contusion, extending onto the left side of the neck, was a 1 by 3/4 inch contusion.

Situated on the right shoulder were three scattered contusions measuring about 1/4 to 1/2 inch. Adjacent to this was an area of focal red-purple contusion. Below this contusion an area measuring 2 1/4 by 1/4 inch were multiple linear, diagonally oriented abrasions surrounded by contusions. These abrasions were interspaced by a distance of 1/8 to 1/4 inch. Situated on the lower right side of the chest were two 3/4 inch contusions. Below this contusion were two parallel oriented abrasions which measured about 3/4 inch each and were interspaced by a distance of 1/8 inch.

Situated over the lower left side of the abdomen were a group of linear abrasions which were interspaced by a distance of 1/16 by 1/8 inch.

Anal/Genital Region:
The penis was circumcised and showed no injuries. The anus was dilated and showed no external evidence of injury. Mud and debris was present in the anal orifice. Subsequent autopsy demonstrated no internal injuries noted to the scrotum or testes. The mucosal surfaces of the rectum were slightly hyperemic and showed no evidence of injury.

Lower Extremities:
A 1/4 inch ovoid contusion is present over the left knee. Binding abrasions were present on the ankles bilaterally. Situated above and below these binding abrasions were faint red-purple contusions.

Back Injuries:
A 1 inch contusion was present on the back of the forearm. Situated over the right upper back were two diagonally oriented interrupted abrasions, each measuring about 4 1/2 inches. They were interspaced by a distance of 1/2 inch. Situated below this abrasion and on the left side was a 4 by 2 inch area of contusion. Below this contusion, extending to the right mid back were two linear diagonally oriented abrasions which were interspaced by a distance of 2/16 inch.

Situated over the right buttocks were multiple linear scratches measuring from 1/2 inch to 3/8 inch. Punctate linear scratches were present on the inferior aspect of the left buttocks region.

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NAME: MOORE, James Michael DATE: 5-7-93 NO: ME-329-93

Upper Extremity Injuries:
The wrists showed binding abrasions. Situated around these abrasions were contusions.
Situated on the left antecubital fossa was 1/8 inch abrasion. Below this were linear abrasions measuring from 1/16 inch to 1/2 inch.

Situated in the right thenar eminence was a 1 inch cut. Situated on the left thenar eminence was a 1/8 inch superficial laceration. Situated on the back of the left hand was a 3/4 inch scratch and a 1/16 inch abrasion which was present on the anterior surface of the left thumb. The hands showed bilaterally washer woman wrinkling.

Internal Evidence of Injury of the Neck, Chest, and Abdomen:
There were multiple bite marks present on the lateral margins and tip of the tongue. There was no hemorrhage noted in the muscles of the neck. The hyoid bone and larynx were intact. No petechial hemorrhages were present on the larynx or epiglottis. There were no penetrating or perforating injuries noted to the chest, abdomen, or pelvis.

Evidence of Drowning:
The hands and feet showed washer woman wrinkling. The sphenoid sinus contained 2 ml. of bloody fluid. Petechial hemorrhages were present on the epicardium, pleura, and thymus. The lungs were edematous and extruded abundant amounts of frothy material.

BODY CAVITIES: The body was opened by the usual thoraco-abdominal incision and the chest plate was removed. No adhesions or abnormal collections of fluid were present in any of the body cavities. All body organs were present in normal anatomical position and showed moderate pallor. The subcutaneous fat layer of the abdominal wall was 1/2 inch thick. There was no internal evidence of blunt force or penetrating injury to the thoraco-abdominal region.

Right lung—180
Left lung—150
Right kidney—50
Left kidney—50

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NAME: MOORE, James Michael DATE: 5-7-93 NO: ME-329-93

HEAD: (CENTRAL NERVOUS SYSTEM) Injuries of the head were previously described. Sections through the cerebral hemispheres, brain stem and cerebellum, revealed no nontraumatic lesions.

NECK: Examination of the soft tissues of the neck, including strap muscles, thyroid gland and large vessels, revealed no abnormalities. The hyoid bone and larynx were intact with no evidence of injury.

CARDIOVASCULAR SYSTEM: The pericardial surfaces were smooth, glistening and unremarkable; the pericardial sac was free of significant fluid or adhesions. The coronary arteries arose normally, followed the usual distribution and were widely patent, without evidence of significant atherosclerosis or thrombosis. The chambers and valves exhibited the usual size-position relationship were unremarkable. The myocardium was dark red-brown, firm and unremarkable; the atrial and ventricular septa were intact. The aorta and its major branches arose normally, followed the usual course and were widely patent, free of significant atherosclerosis and other abnormality. The vena cava and its major tributaries returned to the heart in the usual distribution and were free of thrombi.

RESPIRATORY SYSTEM: The upper and lower airways contained bloody, frothy material mixed with brown vomitus. The mucosal surfaces were smooth, yellow-tan and unremarkable. The pleural surfaces were smooth, glistening with petechial hemorrhages. The pulmonary parenchyma was salmon pink, exuding moderate amounts of blood and frothy fluid. No focal lesions or injuries were noted. The pulmonary arteries were normally developed, patent and without thrombus or embolus.

LIVER AND BILIARY SYSTEM: The hepatic capsule was smooth, glistening and intact, covering dark red-brown, moderately congested parenchyma with no focal lesion noted. The gallbladder contained 9 ml. of green, mucoid bile. The mucosa was velvety and unremarkable. The extrahepatic biliary tree was patent, without evidence of calculi.

ALIMENTARY TRACT: The tongue showed evidence of injury as described above. The esophagus was lined by gray-white, smooth mucosa. The gastric mucosa was arranged in the usual rugal folds and the lumen contained 2 ounces of brown fluid. The small and large bowel were unremarkable. The pancreas had a normal pink-tan lobulated appearance and the ducts were patent. The appendix was present.

GENITOURINARY SYSTEM: The renal capsules were smooth and thin, semi-transparent and stripped with ease from the underlying smooth, red-brown cortical surface. The cortex was slightly congested and sharply delineated from the medullary pyramids, which were red-purple to tan and unremarkable. The calyces, pelves and ureters were unremarkable. The urinary bladder contained 1 ml. of clear yellow urine. The mucosa was gray-tan and smooth. Testes, prostate and seminal vesicles were unremarkable.

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NAME: MOORE, James Michael DATE: 5-7-93 NO: ME-329-93

RETICULOENDOTHELIAL SYSTEM: The spleen had a smooth, intact capsule covering red-purple, moderately firm parenchyma; the lymphoid follicles were unremarkable. The regional lymph nodes appeared normal.

ENDOCRINE SYSTEM: The pituitary, thyroid and adrenal glands were unremarkable.

MUSCULOSKELETAL SYSTEM: Muscle development was normal. No atraumatic bone or joint abnormalities were noted.

Skin—right wrist—intact epithelium. No hemorrhage.
Skin—right ankle—intact epithelium. Subcutaneous hemorrhage.
Skin—left ankle—intact epithelium. Subcutaneous hemorrhage.
Skin—left wrist—disruption of epithelium with dermal hemorrhage.
Anus and Rectum—no hemorrhage.
Testis—no hemorrhage.

I. Multiple injuries with drowning.
a. Head injuries—multiple facial abrasions and contusions.
b. Multiple abrasions and contusions of lips.
c. Multiple scalp lacerations and contusions.
d. Multifocal subgaleal contusions and edema.
e. Multiple fractures of calvarium and base of skull.
e. Subarachnoid hemorrhage and contusions involving the cerebrum and cerebellar hemispheres.
II. Binding of wrists and ankles in "hog-tied" fashion.
III. Multiple contusions, abrasions and lacerations of torso and extremities.
IV. Defense type injuries of hands.
V. Anal dilatation with hyperemia of anal/rectal mucosa.
VI. Evidence of drowning—washerwoman wrinkling on hands and feet.
a. Washer woman wrinkling on hands and feet.
b. Petechial hemorrhages of heart, lungs and thymus.
c. Pulmonary edema and congestion.
d. Aspiration of water into sphenoid sinus.
VII. No evidence of disease.
VIII. Terminal aspiration.

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NAME: MOORE, James Michael DATE: 5-7-93 NO: ME-329-93

Ethyl Alcohol: Blood-- <0.01g%
Drug Screen: Blood—No drugs detected.
Blood Type: A +

This 8 year old white male, James Michael Moore, died of multiple injuries with drowning.
Investigation of the circumstances of death revealed that the decedent was one of three children (see related cases MEA-330-93 and MEA-331-93) that were found in a ditch which contained approximately 2 to 2 _ feet of water, approximately 150 yards southwest of Blue Beacon Truck Wash on the south service of road at Interstate 40 and 55, West Memphis, Arkansas. The decadent was reported missing at approximately 6:00 PM on May 5, 1993 and his nude body was found the afternoon of May 6, 1993. When found the body was nude and the wrists were bound to the ankles bilaterally.

Autopsy showed that the decadent’s hands were bound to his feet in a "hog-tied" fashion. There were multiple traumatic injuries consisting of contusions, abrasions, and lacerations involving the head, torso, and extremities. The skull showed multiple fractures with associated brain injury. Defense type injuries consisting of cuts were present on the hands. The anus was dilated and contained mud. Spermatoza were not detected in the oral and anal smears. In addition, there was evidence of drowning, which included "washerwoman" wrinkling of the hands, pulmonary edema and congestion, aspiration of water into the sphenoid sinus and petechial hemorrhages involving the heart, lung and thymus. The alcohol detected is probably the result of decomposition. No drugs were identified in the body fluids.


Frank J. Peretti, M.D. William Q. Sturner, M.D.
Assoc. Medical Examiner Chief Medical Examiner
*Pathologist of Record

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