Davis: Your Honor, the State would call Dr. Frank Peretti.
Clerk: He needs to be sworn.
The Court: Yeah, you need to raise your right hand. Do you swear to tell the truth, the whole truth, and nothing but the truth in the matter now pending before the Court, so help you God?
Peretti: I do.
The Court: Alright Have a seat.
Direct Examination of Dr. Frank Peretti by Brent Davis
Davis: Dr. Peretti, will you state your full name and occupation to the ladies and gentlemen of the jury?
Peretti: Dr. Frank Joseph Peretti P-E-R-E-T-T-I. I'm an associate medical examiner for the state of Arkansas.
Davis: Okay. And could you briefly explain what an associate medical examiner for the state of Arkansas does?
Peretti: I'm a forensic pathologist and I perform medical, legal autopsies for the state of Arkansas to determine cause and manner of death
Davis: And could you briefly tell us about your education, training, background and experience that qualifies you to be a medical examiner for the state of Arkansas?
Peretti: I graduated from medical school in 1984. I began my training in anatomical pathology at Brown University in Providence, Rhode Island from 1985 to 1988. After completion of my training in anatomical pathology, I went to the office of the Chief Medical Examiner in Baltimore, Maryland where I did a sub-speciality or fellowship training in forensic pathology. I completed that in 1989. Upon completion of my fellowship training, I remained on staff at the office of the Chief Medical Examiner performing medical, legal autopsies for the state of Maryland and I left Maryland in August of 1992 to come to Arkansas.
Davis: And Doctor is one of the primary functions of a medical examiner, and in your position for the state of Arkansas, to perform autopsies on individuals?
Peretti: Yes it is.
Davis: Your Honor, at this time we would submit Dr. Peretti as an expert at the field of forensic pathology.
The Court: Do you want to take him any further on voir dire?
Davis: No, your Honor.
The Court: All right, you may proceed.
Davis: Now Doctor, before I go into the specifics of this case, could you tell the ladies and gentlemen of the jury what your job requires in terms of the findings you make when you perform an autopsy, what you're required to do and what you're looking for when you perform an autopsy?
Peretti: What we do is any body that is brought into the crime lab, we take as-is photographs of the person as they come in and we take the height and weight. After we document the body as it comes into the office, we clean the body up, remove the clothing, any evidence on the body and document it. We then, subsequently, take clean photographs of the body cleaned up. After that's completed and before we begin the external examination, dependent on the type of case we have--for example if it's a gunshot wound case we do a gunshot residue kit, if it's a rape case, we do a rape kit, so we focus in on the type of case it is to get evidence off the body. Then what we do is we do an external examination where we note the general features of the body, the height, the weight, the color of the hair, the color of eyes, any injuries or unusual features situated on external aspects of the body. After that's been completed and documented, we proceed with the internal examination where we examine the structures of the neck, the chest, the abdomen and the head. During that time we look for any evidence of natural disease or injury. We also, at that time, take specimens for toxicology to determine the presence of drugs or alcohol in the body fluids. We take blood, we take bile if it's there, we take urine if it's available and we take the vitreous humorous, that's the fluid behind the eyeball. After that's completed, I issue a death certificate stating the cause and manner of death and I generate an autopsy report for criminal and civil use.
Davis: Now Doctor, when you say that you issue a death certificate that tells the cause and manner of death, when you say cause of death, what do you mean?
Peretti: Well, there are many different causes of death--how that person died. For example, people die of a heart attack or people die of cancer or multiple gunshot wounds, multiple stab wounds or multiple injuries.
Davis: And when you say manner of death, what do you mean by that?
Peretti: Manner of death is the way that person sustained those injuries. For example, is it natural? Is it an accident? Is it a homicide or a suicide or is it undetermined?
Davis: Now Doctor, I'd like to turn your attention back to May 7 of 1993. On that date, did you have an occasion to perform autopsies on the bodies of Michael Moore, Stevie Branch and Christopher Byers?
Peretti: Yes, I did.
Davis: Now did you follow the procedure in that case that you've outlined to the jury as customary?
Peretti: Yes, I did.
Davis: Are there photographs taken when you peform an autopsy and go through these procedures?
Peretti: Yes.
Davis: And what is the reason for taking those photographs?
Peretti: To document the injuries.
Davis: Okay. Now Doctor what I would like to do is show you a number of exhibits that have previously been marked. I'd like to show you photographs, numbers 59A, 62A, 61A, 63A, 64A, 71A, 70A, 67A, 69A, 72A, 73A, 65A and 66A, and ask if you could look at these photographs and identify those for us please?
Peretti: Yes, photographs 59A through 66A are the photographs of--labeled 329 of Michael Moore
Davis: And are those photgraphs that were taken at the crime lab or in your office during the course of the autopsy?
Peretti: Yes they are.
Davis: Would those photographs assist you in explaining what your physical findings were when you performed the autopsy?
Peretti: Yes, they will.
Davis: Did they accurately depict the condition of the body of Michael Moore at the time you performed the autopsy?
Peretti: Yes they do.
Davis: Your Honor, we would ask to move for the introduction of those State's exhibits which had previously been read out which are the photographs of Michael Moore.
Peretti: All right, they may be received subject to the rulings of the court previously.
Davis: Doctor, I would also like to show you what have been marked photographs 71B, 72B, 73B, 70B, 61B, 62B, 63B, 64B, 65B, 59B, 66B, 67B, 68B, 69B and 60B which are photographs, a packet of photographs, and would ask if you could identify them for us please?
Peretti: Yes I can. These are the photographs of Steven Branch.
Davis: And do those photographs accurately depict the condition of the body of Steven Branch on the day you performed the autopsy?
Peretti: Yes they do.
Davis: And would those photographs be beneficial to you and assist you in explaining your findings based on the conducting of that autopsy?
Peretti: Yes they would
Davis: Your Honor, at this time the State would move to the introduction of those photographs which had been previously been identified.
The Court: All right. They'll be received subject to the previous rulings of the court.
Davis: Last Doctor, I have photographs which have been marked as 59C, 64C, 63C, 68C, 67C, 66C, 62C, 71C, 70C, 69C, 61C, 65C and 72C and ask if you could look at those photographs and if you could identify those for us please?
Peretti: Yes, these are the photographs of Christopher Byers
Davis: Okay. And were those photographs taken at the crime lab at the time of his autopsy?
Peretti: Yes, they were.
Davis: And do those photographs accurately depict the condition of the body of Christopher Byers at the time the autopsy was performed?
Peretti: Yes, they do.
Davis: Would they be helpful and beneficial to you in explaining to the jury your findings as a result of that autopsy exam?
Peretti: Yes, they would.
Davis: Your Honor, at this time we would move for the introduction of those previously listed photographs into evidence.
The Court: All right, they may be received subject to the previous rulings of the court.
Davis: Now Doctor, if I could, let me ask you do you have a numbering system that you use in order to ensure that you know the person that you're performing the autopsy on and also to identify your reports and photographs?
Peretti: Yes, I do.
Davis: Okay. And did--was there a number that was assigned to the case of Michael Moore?
Peretti: Yes, there was.
Davis: And what number was that?
Peretti: 329-93.
Davis: And I would like to draw your attention, do you have a copy of your autopsy report from that particular autopsy?
Peretti: Yes, I do.
Davis: Your Honor, if the Doctor may refer to that autopsy report in the course of his testimony?
The Court: Yeah
Davis: Your Honor, at this time, I would ask that Dr. Peretti be allowed to step out of the witness box so that he can, in the course of his explanation of the jury of his findings, that he can be allowed to show the photographs--use the photographs in that explanation.
The Court: All right, that will be permitted.
Davis: Dr. Peretti, could step in front of the jurors please?
Davis: Now Doctor, your autopsy report regarding Michael Moore, does it reflect the size, the height and weight of Michael Moore at the time you peformed this autopsy?
Peretti: Yes it does.
Davis: And what is that height and weight?
Peretti: The body weighed 55lbs and was 49 1/2 in height.
Davis: And was the body bound in a particular fashion at the time you performed the autopsy?
Peretti: Yes.
Davis: And could you describe that for the ladies and gentlemen of the jury?
Peretti: The body was bound in a hog-tied fashion with shoelaces. The wrists were bound to the ankles
bilaterally with black shoelaces on both sides.
Davis: Okay. And when you say "bilaterally" was the right wrist bound to the right ankle and the left wrist bound to the left ankle?
A: Yes, that's correct.
Davis: Okay. Now, if you would start, based on your autopsy report, is the first thing listed there a notation of the general description of the injuries?
Peretti: Yes.
Davis: Okay. Could you describe generally for the jury what injuries you found upon your visual examination of Michael Moore?
Peretti: Well, there were multiple injuries. We have head injuries. We have neck--neck, chest and abdominal injuries. We have lower extremity injuries and back injuries, upper extremity injuries, injuries to the inside of the body plus evidence of submersion. And I have them in order and I'll describe them down--I'll start with the head first.
Davis: Doctor, if you would by using those photographs and if you please would identify them by exhibit number and also you may need to move up and down...
Dr. Peretti: [interrupting] Sure.
Davis:...the jury box so that they can see the photographs but if you would describe what head injuries, and using the photographs, depict those to the jury?
Peretti: Ok. State's exhibit 59A, 62A, 61A, 63A will demonstrate the head injuries and some of the chest injuries. State's exhibit 59A shows a laceration over the left forehead region and also we can see an abrasion. When I talk about abrasions, I'm going to be using the terms--abrasion means a scrape or a scratch and a contusion means a bruise, in layman's terms black and blue. Here we can see, on the left side, we can see the laceration and also we can see an abrasion on the right side of the forehead. State's exhibit 62A is a view of the head showing the left side and here we can see...
Brent Davis: [interrupting] Doctor, excuse me just a second, was the hair shaved back so that could be photographed?
Peretti: Yes. I shaved the hair. Here we can see three impact points on the scalp. We have three separate scalp lacerations surrounded by an abrasion and contusions surrounding the wound. Above the eyebrow, we have an abrasion immediately adjacent to the eyebrow or scrape and also on this photograph, we can see a bruise or contusion noted below the left eye, this dark discoloration here. On State's exhibit 61A, we have two abrasions or scrapes on the top of the head, that ovoid-we have two separate impact sites here.
Davis: Now Doctor, I notice that the injuries depicted in exhibit...what number is that?
Peretti: 61A.
Davis:...61A are different than those that appear in the previous exhibit 62A?
Peretti: That's correct.
Davis: Can you explain to the ladies and gentlemen of the jury, based on your experience and expertise in this field, why we have different type injuries?
Peretti: Well, we have two different instruments--weapons are being used, inflicting these type of injuries.
Davis: And when you say--what type of instrument would you expect to be used or a general description of the type of instrument that would inflict the injury in 61A, I believe?
Peretti: On 61A, we're looking for an object with a broad surface--wide surface area.
Davis: Doctor, would that be consistent with say a log aproximately 2 to 3 or 3 to 4 inches in diameter?
Peretti: An object of that nature is consistent with inflicting these type of injuries.
Davis: Okay. Now the injuries that you see in photograph number 62A, you said it would have been inflicted by a different type weapon. What could have caused that? Or what type of instrument would you expect to cause those injuries?
Peretti: Well, this wound has different characteristics than the previously shown wound. Here we have lacerations, or in laymen's terms cuts, on the scalp that are somewhat irregular. Some are straight, some have a stellate appearance and these type of injuries here indicate an object of a smaller diameter such as, you know, a piece of wood, a 2 by 4, a stick or broom handle are capable of inflicting these type of injuries here.
Davis: So, something about the size of a broom handle?
Peretti: Yes.
Davis: Okay. Doctor, if you could, continue with the next photograph.
Peretti: Okay. State's exhibit 64A is showing some abrasions, contusion or brusing behind the ear and some scattered abrasions that were under the scalp on the left side here. The slight discoloration here is the bruising behind the ear and you can see this little area here, this discoloration here--abrasion or scrape behind the ear. And also, we can see in the hairline that was previously covered with the hair an abrasion or scrape. Okay, State's exhibit 71A is showing a similar abrasion in the back of the neck. State's exhibit 70A is a photograph of the back of the shoulder showing an abrasion, a contusion--bruising. State's exhibit 67A is a photograph of the bindings and the anal region.
Davis: And Doctor, did you make any findings regarding the examination of the anal area regarding dilation?
Peretti: Yes, there was anal dilatation.
Davis: Okay. And that means a loosening or slackening of the muscles surrounding the anal area?
Peretti: That's correct.
Davis: And was there also the purple--or is there some abrasions in the-on the buttocks in that photograph?
Peretti: You can see some abrasions and scrapes in the post-mortem lividity. This red discoloration here is the post-mortem lividity or the settling of the blood--of the blood vessels after death. State's exhibit 69A is a photograph of the anal orifice. Here we can see abrasions, some focal areas of contusion in the lividity. State's exhibits 72A and 73A show the front and back of the hands showing the--a few abrasions, but what I'm trying to point out here is the washer-woman, the wrinkling of the hands showing that the bodies have been in water. That's the wrinkling.
Davis Now Doctor, and you may need to refer to your report, I'm not sure it's clearly shown in the photographs, did you also find on the hands some defense-what are referred to in your report as defense-type wounds? Think I'm referring to page...
Peretti: .Pg. 5. Yes, on the right thenar eminence, this part of the anatomy here, I found some cuts, a one inch cut. There are also some some very small lacerations measured about 1/8 of an inch each. On the back of the left hand, there was a 3/4 inch scratch and a 1/16 inch abrasion was present on the left thumb.
Davis: Now, when you characterize these as defense-type wounds what--what do you mean by that?
Peretti: Well, it's type of injuries that we normally see when people are trying to defend themselves.
Davis: And do you normally see those injuries to the hand as what you described here?
Peretti: Well, you see them to the hands, you can see them to the forearms, also the legs, also the feet, dependent on the situation
Davis: Okay. And the washer-woman wrinkling that you referred to to the hands. What does that indicate?
Peretti: Well, this indicates that the bodies were in water and there is evidence of submersion.
Davis: Doctor, if you could refer to the next photograph and explain your findings.
Peretti: Okay, the next photographs are State's exhibit 65A and 66A show the mucosal surface of the inner aspects of the lips, the upper lip and the lower lip respectively, and also the nose. Here on the nose, we can see some abrasions or scrapes. Here on the upper lip, we can see some cuts surrounded by contusion and edema or swelling. That's 65A.
Davis: Doctor, does that also reflect some--what you refer to as punctate scratches of the nose?
Peretti: Yes, sir.
Davis: What, what are those?
Peretti: Very--they were enumerable, very small scratches or abrasions situated on the entire nose. State's exhibit 66A is also showing the nose where you can see the abrasions or scrapes and the lower lip where you can see the bruising, that dark discoloration in the photograph is the bruise.
Davis: Doctor, in your experience as a medical examiner when you see injuries to the ears and injuries to the inside surface of the mouth, what does that indicate to you in a person that's eight years old and has died this type of death?
Peretti: Well, there's a number of possibilities but commonly when we see the ears contused on both sides or bruised with all lying fine linear scratches...
Stidham: Your Honor, I'm going to object. May I approach the bench?
The Court: [unintelligible] Well, rephrase your question. I think that is probably overbroad.
Davis: Doctor, let me ask you, have you seen--in your past experenience as a medical examiner, have you seen similar injuries to the ears of children?
Peretti: Yes, I have.
Davis: Okay. And in those cases were they frequently also accompanied by injuries to the child's mouth?
Peretti: Yes, they were.
Davis: Okay. And based on your past experience and expertise and training, do those type injuries indicate to you, based on your expertise and training, a particular type trauma that has occurred to cause those injuries?
Peretti: Well, my practice these type injuries I have seen in children that are held by the ears who are forced to perform oral sex. They can also be due to putting a hand over the mouth to cause the injuries to the mucosal surface of the lips or they could be by grabbing someone by the ear.and just pulling.
Davis: And there were injuries consistent with that found in your autopsy on Michael Moore, is that correct?
Peretti: Yes, that's correct.
Davis: Okay. Now, Doctor, your report at the end has what are called a list--a list of pathologic diagnoses. Is that kind of a general run-down of what you found in your autopsy?
Peretti: Yes, it is a summary of the anatomical findings.
Davis: Could you go over that for us and just explain a rundown of all the injuries and items that you found based on your examination of Michael Moore?
Peretti: Okay. The head injuries consisted of multiple facial abrasions or scrapes and contusions or bruises. We had multiple abrasions and contusions of the lips. We had multiple scalp lacerations and contusions or bruising of the scalp, multi-focal subgaleal contusions and edema of the subgaleal. That's when we do the autopsy, we make an incision and reflect the scalp back, that's the underlying surface of the scalp as seen from the inside out. There we had edema and swelling and we saw multiple contusions or bruising. We also had multiple fractures of the calvarium and base of the skull. A calvarium is the top of the skull and the base of skull or bottom of the skull, are multiple fractures there. Associated with these fractures and injuries--impact sites, we have subarachnoid hemorrhages, that's hemorrhage involving the brain. We had contusions or bruises involving the brain. Those were the head injuries. Then the other injuries, we had the bindings of the wrists and ankles in a hog-tied fashion. We had multiple contusions, abrasions and lacerations of the torso and extremities. We had defense-type injuries to the hands. We had anal dilatation with hyperemia of the anal/rectum mucosa. We had evidence of drowning, which consisted of the washer-woman wrinkling of the hands and feet. We had petechial hemorrhages, small punctate hemorrhages that we normally see on the heart, the lungs and thymus. We had pulmonary edema and congestion, the lungs get full of water and we had water in the sphenoid sinus. There was no evidence of disease present and we found evidence of terminal aspiration of the gastric contents.
Davis: Now Doctor, the items you mentioned--the evidence of drowning, what was the cause of death of Michael Moore?
Peretti: The cause of death of Michael Moore was multiple injuries with drowing.
Davis: Okay. And the head injuries that you describe, the skull fractures, injuries to the brain, would they have caused his death independently of the drowning?
Peretti: Yes, they would have.
Davis: And in this particular circumstance, the drowing contributed to those particular factors?
Peretti: Yes.
Davis: Your Honor, at this time we would asked to be allowed to exhibit these photographs to the jury and give Dr. Peretti an opportunity to get his report on the next [Unintelligible].
The Court: All right, that will be permitted.
Davis: Doctor, while those photographs are going around--let me just ask you, in the instance of each child, did you remove the bindings that they were tied with when you did your autopsy?
Peretti: Yes.
Davis: Okay. And did you forward those items on to other areas of the crime lab for additional analysis?
Peretti: Yes I did.
Davis: Okay. Now, I'd like to show you what has been marked for identification purposes as State's exhibit number 80 and ask if you if that has your name at the bottom indicating those are, in fact, the ligatures that you removed?
Peretti: Yes. That's my signature and initials.
Davis: Okay. Does it indicate which individual?
Peretti: Michael Moore.
Davis: Okay. Your Honor, at this time we would move for the introduction of State's exhibit number 80.
Stidham: No objections, your Honor.
The Court: All right, it may be received without objection.
Davis: Now, I'll show what's marked as State's exhibit number 81 and ask if you could identify that for us?
Peretti: State's exhibit 81 is labeled and circled in blue pen ligature from left and right wrists and legs, initialed by me.
Davis: Okay. And which of the vicitms?
Peretti: Steven Branch.
Davis: Your Honor, we would move for the introduction of State's exhibit number 81.
Stidham: No objections.
The Court: All right, it may be received without objection.
Davis: And what is marked as State's exhibit number 82, I'd ask if you could identify that for us please?
Peretti: State's exhibit 82 is a package labeled ligature from left and right wrist and right and left legs, initialed by me.
Davis: Okay. And this is in regard to Christopher Byers?
Peretti: Yes, sir.
Davis: And all these ligatures have been sent to a another area, section of the crime lab for purposes of further analysis?
Peretti: Yes, sir.
Davis: You Honor, if we could I would move for the introduction of State's exhibit of 82.
Stidham: No objections.
The Court: All right, it may be received without objection.
Davis: Doctor, if you could once again step down in front of the jury. What case number did you assign to your autopsy examination in regard to Stevie Branch?
Peretti: [Unintelligible] 330-93.
Davis: Okay. And Doctor if you could generally describe to the ladies and gentlemen of the jury what injuries you found regarding Mr. Branch?
Peretti: Mr. Branch, we found--we had--we have head injuries, we have chest injuries, we have genital injuries, lower extremity injuries, upper extremity injuries, back injuries and evidence of terminal submersion.
Davis: And if you could, utilizing those photographs, could you start and describe for us the head injuries that you found regarding Stevie Branch?
Peretti: On Stevie Branch, what I found was that the right ear showed multiple confluent contusions or bruises and abrasions. We have multiple scattered abrasions present over the right eye. We have a contusion in the right periorbital region, this area generally right in here or black eye. We have multiple scratches that were present on the right mandible. Also, we have on the right mandible--there's a patterned injury, an injury that has a pattern to it. It was bell-shaped. It was an abrasion. It had a central area of pallor, an abrasion by pallor, an area of clearing and scraping. The lips were abraided. There are multiple--with multiple lacerations or cuts. The inner aspects of the lips showed multiple contusions, lacerations and hemorrhage. The gums were extensively hemorrhagic. Also, above and below the left eyebrow, we have another bell-shaped pattern abrasion with a small 1/4 inch laceration in the immediate vincinity. Also, the left parietal scalp, basically this general area of the head, showed multiple superficial cuts and abrasions. The entire left ear was contused or bruised with overlying linear scratches.
Davis: Doctor, if the photographs would assist you in describing those, please feel free to use the photographs in your description.
Peretti: Okay. Just before I show the photos, I'd just like to explain the injuries and then I can point them out.
Davis: Oh, okay, okay.
Peretti: [Unintelligible] the photos because it would be a lot easier. The entire left side of the face, in an area measuring 5 1/2 by 5 inches showed multiple abrasions or scrapes with multiple gouging type irregular cutting wounds. These wounds went from 1/8 of an inch to 1 and 3/4 of an inch and terminated in the oral cavity. And I'll explain--show you the injuries in the photographs. State's exhibit 71B is a photograph of the face showing the abrasions and the gouging type wounds-cutting wounds. Also, you can note on the top here, we have this patterned abrasion. It looks like a bell. It almost has the appearance of a belt buckle. State's exhibit 72B is a photograph of the face showing the abrasions, the gouging, cutting wounds, and contusion and bruising and the previously described superficial lacerations and abrasions involving the scalp region.
Davis: Now Doctor, when you refer to the-say the multiple gouge wounds, are those caused by an instrument different than the blunt object you described and then the the broom handle sized object you described?
Peretti: Yes.
Davis: So we are now talking about injuries caused by yet a third weapon?
Peretti: Yes sir. And here we can see these large openings in the skin. Those are the gouging wounds, you can notice how irregular they are and the skin has just been pulled away, torn out. The underlying soft tissues have just been pulled away from the cheek. State's exhibit 73B is a close-up of those injuries and here we can also see the depth of some these gouging type injuries, the injuries to the lips and we can see the patterns that I had previously described on the neck. State's exhibit 70B is showing the side of the face, with the black eye as I previously described, some abrasions and injuries to the lips. State's exhibit 61B is a photograph of the back of the scalp showing a similar type injury that I showed you on the previous case of Moore
Davis: Michael Moore.
Peretti:...Michael Moore, on the back of the head, a large abrasion.
Davis: And that's the injury that you indicated in regards to Michael Moore would be consistent with a 3 to 4 inch diamerter club or log.
Peretti: Yes. State's exhibit 62B is showing some of the gouging wounds on the face, showing the left ear--the injuries, the contusions, the scratches on the back of the left ear and some of the superficial lacerations on the scalp.
Peretti: State's Exhibit 63B is a photograph of the ear--the front of the ear, showing the contusions, the scrapes and injuries to that part of the ear.
Davis: And Doctor, were the injuries to the ears of Steven Branch, were they of the same nature and type as the kind you described in regard to Michael Moore?
Peretti: Yes, they were.
Davis: Okay. And were there also injuries to the mouth and the lips regarding Steven Branch?
Peretti: Yes.
Davis: And would these be consistent, as you indicated earlier based on your experience and opinion--would that be consistent with, in past cases that you have observed where...
Crow: [interrupting] I'm going to object again, your Honor.
The Court: I'll sustain the objection. Rephrase your question. It might have been a little bit broad.
Davis: Can you draw any findings from the injuries or can you give us an opinion as to the cause of the injuries when you have injuries to the ears and injuries to the mouth and to the lips?
Crow: Your Honor, I'm going to object if he's going to speak in the alternative as to what it could be. I don't think he can be certain.
The Court: Okay. Doctor, do you have an opinion as to the cause of those injuries and if so, is that opinion based upon a reasonable degree of medical certainty in your experience and training in your field?
Peretti: Yes, I do have an opinion.
The Court: All right. And is that opinion based upon your training and education in your field?
Peretti: Yes.
Crow: Your Honor, I understand his testimony before was that he offered alternate sources.
The Court: I'm sorry?
Crow: I understand in his testimony before there were alternate possibilities.
The Court: Well, I'm going to allow him testify as to what his opinion is. All right, you may proceed.
Perettti: The injuries noted to the ears and the lips can be caused by holding the ears, pulling the ears. The injuries involving the lips could be having an object, any object, inserted inside the mouth or hand placed over the mouth or firm object placed over the mouth. It could also be from being a punch also, or a hit with a rock, for example. That's how you sustain those type of injuries.
Davis: Doctor, using the next photographs, if you could describe what additional injuries you found?
Peretti: There are injuries to the penis and the anus. The anus was--the anus showed dilatation and hyperemia of the anal mucosa. The penis...
Davis: [interrupting] When you say hyperemia, Doctor, what do you mean by that?
Peretti: Redness of the muscosa. It's red. It's not the normal coloration it should be.
Davis: And dilation would be enlargement?
Peretti: Of the orifice? Yes.
Davis: And in regard, if you could refer to exhibit number to explain these additional injuries?
Peretti: Okay, um. Exhibits number 64B and 65B are photographs of the penis. 65B shows the midshaft of the penis and the head of the penis with contusion, bruising and overlying scratches. This injury is--you can see there's a well--area of demarcation between the involved area and the uninvolved area. This is--all this discoloration here is bruising. There are fine scratches overlying the head of the penis along with other focal areas of bruising. Also, State's Exhibit 64B is the back of the penis showing the similar injuries and the line of demarcation between the uninvolved and non-involved area.
Davis: Doctor, do you have an opinion as to what type of instrument or what could have caused the bruising, lacerations and injury that you indicated there to the penis?
Peretti: Well, these injuries could be from oral sex. They could be from--also from a squeeze, a very tight squeeze but also with the clear band of demarcation between the uninvolved and involved surfaces it could have been that an object could have been placed around the penis and tightened very fastly. State's Exhibit 59B is an injury that was on the thigh, a linear band. You have two linear bands here with an area of pallor and abrasion right here. State's Exhibit 66B is a photograph of the arm showing some bruising inside the arm and some scratches.
Davis Doctor, in these autopies, are you able to tell the difference between a wound that was inflicted before death and a wound that was inflicted after death?
Peretti: Some of the injuries we're able to tell.
Davis: Okay. And could you tell, in regard to any of these three children, whether wounds were--there were some wounds that were inflicted even after death?
Peretti: There, there--some wounds have the appearance of being inflicted perimortem, around the time of death and postmortem, after death.
Davis: Doctor, using the remaining photographs, if you could explain your findings?
Peretti: [unintelligible] contusions, abrasions and lacerations of the torso and extremities and we had evidence of drowning consisting of the wrinkling of the hands and feet, aspiration of water into the sinuses, pulmonary edema or congestion. There was no evidence of any natural disease that could have contributed to the death and there was evidence of terminal aspiration of the gastric contents.
Davis: Doctor, what is your opinion based on your experience and expertise, regarding the cause of death in this particular situation?
Peretti: That Mr. Branch, Stevie Branch, died of multiple injuries with drowning.
Davis: Okay. Your Honor, at this time I would ask to be allowed to exhibit these photographs to the jury and allow the Doctor to get his [unintelligible].
The Court: Yes, you may submit to the jury and after they review those, I'm going to take a court recess.
RETURN TO OPEN COURT
Davis: If you could, in reference to Steve Branch could you tell us how tall he was and how much he weighed?
Peretti: He weighed 65 pounds and was 50 inches in height.
Davis: Four foot two and how much did he weigh?
Peretti: 65 pounds.
Davis: If you would, would you find your autopsy report on Chris Byers?
Peretti: Yes, sir.
Davis: What number did you assign to that particular case?
Peretti: 331-93
Davis: Could you step down from the witness box and with those photographs that have previously been introduced -- could you explain your findings regarding the autopsy?
Peretti: Here we have head injuries, neck injuries, genital and anal injuries, injuries to the right leg, injuries to the left leg, back injuries, injuries to the right arm and injuries to the left arm
His body was received nude, covered with dry mud and leaves. There was wrinkling of the hands and feet also. The hands were bound to the ankles behind the back in a hog-tied fashion. Strands of hair-like material were found on the left posterior thigs, on the back of the left thigh, and under the bindings of the left ankle. The right wrist was bound to the right ankle with a black shoelace. And the left wrist was bound to the left ankle with a white shoelace.
The injuries, we have similar injuries. The right ear was contused and abraded also. On the bridge of the nose there were multiple abrasions. Situated between the upper lip and bridge of the nose was a semi-lunar pattern abrasion. Abrasions were present on the lips, the mucosal surfaces of the lower lip showed a 5/16 of an inch laceration. The frenulum, that's the piece of soft tissue that when you lift up your lips it's right in the midline, that was bruised and surrounded by a bruise measuring 1/2 inch and there were multiple bite marks present on the mucosal surfaces of both right and left sides of the cheeks, in other words, inside your mouth. Also, internally--also, the left ear was contused with multiple scratches. On the left parietal scalp region, this general region, there was a 1 and 1/4 inch laceration. When we did the autopsy and reflect the scalp, there was edema, swelling and multiple bruising of the scalp. The calvarium or the top of the skull was not fractured, however, the base of the skull was extensively fractured like an eggshell and also, on the left posterior medial cranial fossa--the base of the brain is divided up into the regions, we have the anterior region where the eyes are, the middle region generally where your ears are and the posterior in the back and on the back of the base of the skull on the left side, we had a 1/4 inch ovoid--a round, a roundish fracture, that was punched out into the brain, going into the brain. Okay, the brain also showed multi-focal hemorrhage and there were associated fracture contusions. State's Exhibit...
Davis: [interrupting] Doctor, before you get started, how tall and how much did Chris Byers weigh at the time of this autopsy examination?
Peretti: Chris weighed 52 pounds and was 48 inches in height.
Davis: Okay. If you could, using those photographs, explain your findings to the jury please?
Peretti: State's Exhibit 59C is a close-up of the face. Here we can some contusions or black eyes, the abrasions on the nose and here, we can see, there's a pattern type injury here. State's Exhibit 64C shows the ear with the bruising and the [unintelligible] scratches.
Court Reporter: I'm sorry, I didn't hear the last part.
Peretti: Overlying scratches. Excuse me.
Court Reporter: Thank you.
Davis: Doctor, would those scratches over the bruising, would that be consistent with fingernail scratches?
Peretti: Fingernails will cause these type of scratches, yes. Here, we can see the side of the face with scratching and bruising of the ears, bruising of the eye. Here, we have on the back of the scalp, the laceration which is similar in appearance of the other two boys, linear.
Davis: And Doctor, that laceration would be more consistent with the broom handle type weapon you referred to rather than--rather than the large 4 inch club of some sorts?
Peretti: Or a piece of 2 by 4, piece of wood. Here, we have State's Exhibit 67C and 66C, these are the mucosal surface of the lips. Here's the frenulum, we can see where it's con, um, bruised and we can see the laceration on the lower lip. State's Exhibit 62C, here we can see on the face we have these other patterns, they're round and circular and they indented the skin.
Davis: Doctor, comparatively speaking, can you rate the severity of the head injuries of Chris Byers? How did they compare with the severity of the injuries to the other two boys?
Peretti: Well, I think they are all equal in degree. Some may have a little more injury than the others but basically the same types of injuries.
Davis: Okay.
Peretti: Okay. State's Exhibit 71C is the buttock region and here--there was evidence of genital mutilation. This is the back, here's the anal orifice. There are multiple cutting wounds here around the anal orifice and the perineum area, the piece--the area between the um, below the anal orifice.
Davis: Doctor, did you also make a finding that the anal and rectal mucosa were hyperemic and injected?
Peretti: Yes, I did.
Davis: Can you explain what that means?
Peretti: Well, it means that it was red and injected, there was some capillary dilatation there.
Davis: And there were signs of physical trauma as far as abrasions and lacerations to the buttocks area and the area immediately surrounding the anus? Is that correct?
Peretti: There's cutting wounds and abrasions, yes. And State's Exhibit 70C is a close-up of the genital mutilation. Here, we have multiple gouging type injuries where the skin has just been pulled out. The skin overlying the shaft of the penis was carved off. What you see here, the part--this red part that's in the photograph, that's the shaft of the penis after the skin has been removed and you can see above the scrotal sac and testes are all missing. The whole genital area is missing except for the internal aspects of the shaft of the penis and around this area you can see the multiple gouging type wounds, stab wounds and cutting wounds.
Davis: Doctor, the gouge wounds and cutting wounds you referred to around the genital area, how did those, in your opinion, how would those wounds have been inflicted? What type of manner would those have been inflicted in?
Peretti: Well, it could be when you see these type of irregular cutting wounds, gouging wounds, not knowing the instrument, you can get these type of wounds from a knife, piece of glass, usually the knife or the object is being twisted and the victim is moving to get those irregular edges. State's Exhibit 69C is a photograph showing the legs, the area of genital mutilation and you can also see the binding injuries of the left wrist but also here, we can note in the um, on the thighs, on the top of the thighs and inner aspects of the thighs, we have multiple contusions or bruising inside the thighs and you can see that here.
Davis: Doctor, what would cause that type of bruising and that type of injury?
Peretti: Well, these type of injuries we normally see in a--female rape victims when they're trying to spread the legs to, for penetration or it may be hit with an object also, that's a possibility. Okay, I'll take these a little out of order here, State's Exhibit 65C is a close-up of the bruises inside the thigh. State's Exhibit 72C is a photograph showing the back of the anal region, the thighs and the bruising situated on the thighs and also, on the backs of the legs, the lower legs and here you can see all the bruising. There's some sort of pattern here, you've got these two linear bands of contusion and in between here, you have this space which is called pallor which is uninvolved so that indicates in this part an object such as a piece of wood, a large object was inflicted there to cause--struck there to cause this type of injury. Also, you can see on the back of the legs what we would classify as defense wounds too or bruising to the back of the legs. State's Exhibit 61C just shows a small abrasion to the back of the neck.
Davis: Now Doctor, in regard to Chris Byers, did you find on your autopsy regarding him injuries to the mouth and to the ears similar to what you found with the other two?
Peretti: Yes, I did.
Davis: And would your opinion as to a cause of those injuries be the same regarding this particular case.
Crow: Your Honor, I make the same objection.
The Court: As to the general, broad nature, is that what you're...rephrase the question.
Davis: Doctor, based on your experience, background and training, do you have an opinion as to the cause of the injuries where you have ear injuries as you've described and the injuries to the mouth as you've described?
Peretti: Yes, I do.
Davis: And what is that opinion?
Peretti: Well, those injuries you normally see in areas of--children who are forced to perform oral sex. You can get those type of injuries from an object placed over the mouth, a firm object or the hand over the mouth or some of the injuries, the contusions to the lips, the bruising may be due to a punch.
Davis: Now, the injuries that were around the genital area, those were inflicted by some sharp object such as a knife, would that be correct?
Peretti: Yes, a sharp object, yes.
Davis: Okay. And the injuries to the head of Chris Byers, were those injuries inflicted by different type weapons?
Peretti: Yes.
Davis: And which injury by what type of weapon?
Peretti: Well, the injuries to the head were probably inflicted by an object maybe such as a piece of wood. It could be even a large stone. The injuries to the genital, um, injuries, were inflicted by an object such as a knife or a piece of glass.
Davis: Okay, the laceration injury to his head or the elongated injury, was that different than the injury to the back of the skull?
Peretti: Yes, that was different.
Davis: Okay, so would it be fair to say that, at least three different weapons caused--one causing injury to the top of the head, one to the back and one to the genital area?
Peretti: Yes.
Davis: Now Doctor, regarding Christopher Byers, what was your opinion, based on your examination, your experience and training, as to the cause of death of Christopher Byers?
Peretti: That he died of multiple injuries.
Davis: And those multiple injuries being what?
Peretti: They consisted of the multiple facial contusions, abrasions and lacerations. The contusion and abrasions of the ears, the left parietal scalp laceration, the fracturing of the base the skull, the subarachnoid hemorrhage and contusions of the brain, the abrasions that were situated on the front of the neck. Then we have the genital mutilation with absence of the scrotal sac, testes, skin and head of the penis with surrounding gouging--with multiple surrounding gouging and cutting wounds. We also have a dilated anus, the bindings of the ankles behind the back in a hog-tied fashion, the multiple contusions, abrasions and laceration of the torso and extremities, the terminal aspiration of gastric contents and there was no evidence of any disease which would have contributed to his death.
Davis: Any evidence, regarding Chris Byers, as to drowning?
Peretti: There was no evidence of drowning in Chris Byers.
Davis: Now, let me ask you some questions regarding who receives this information that you put in your report after an autopsy is performed. Where does your autopsy report go and who did you send it to after May 7th of 1993 when you performed this autopsy?
Peretti: Okay, what happens after we perform any autopsy at the office, we send to the investigating agencies and the coroner, a cause of death form so that they know exactly what we found at the time of autopsy 'cause a lot of times, they may not--the investigating agency may not have the time to call us so we communicate with them in written response. We do that with all cases. What I normally do is if it's a gunshot wound case or an automobile accident or even a suicide, I would outline generalities--the type of injuries, if it's a gunshot wound I would say, you know, where the bullet was found, if there’s evidence of [unintelligible] on the skin or not. But on this case here because of the intense media coverage and phone calls, I issued a press statement and what I did was, I elected to send out the cause of death form just putting the causes of death. I did not list any of the injuries on the initial forms that I sent to the investigating agencies. I sent these to--the cause of death forms went to Mr. Kent Hale, the coroner; Brent Davis, the prosecuting attorney because all the prosecuting attorneys, regardless if it's a natural--will get a cause of death form so he knows what's going on in his jurisdiction and the West Memphis Police Department.
Davis: And that, the initial sheet that you sent out is a one page sheet just listing the cause of death?
Peretti: Yes.
Davis: Okay. And so, in an effort to not reveal the specifics of the injuries, you made sure you didn't put those specifics in that information, correct?
Peretti: I felt that the nature of the case and the publicity that it was receiving, it was best not to divulge those injuries to the media or even the prosecuting attorney.
Davis: And the reason, with an ongoing investigation, why would that be important?
Peretti: Well, it would be important so it wouldn't be common knowledge, so people won't have something to talk about. You know people, in my experience, tend to spread rumors about certain types of cases so that--on this particular case here, these cases here, that would eliminate that and I thought it would be beneficial just to keep the communication with um, subsequently with the West Memphis Police Department and the um, Brent Davis and the prosecuting attorney's office and not give any information out to anyone else at that time and then as subsequently as the investigation took place, I had meetings with the police, the prosecuting attorney and the defense counsels.
Davis: And Doctor would that also be for the purpose that only those people who were there when the bodies were retrieved and those who performed an autopsy in the crime lab and those who received the autopsy report would know the specific nature...
Crow: [interrupting] Objection to leading, your Honor.
The Court: Avoid leading.
Davis: I'll pass the witness, your Honor.
Cross-Examination of Dr. Frank Peretti by Dan Stidham
Stidham: Dr. Peretti, you don't have to be a pathologist or medical examiner to look at the bodies when they were recovered and determine that there were head injuries, there were injuries to their faces, there were injuries to their, other parts of their body including the genital mutilation. You don't have to be a pathologist to see those things do you?
Peretti: No, sir.
Stidham: So those are obvious...
Peretti: Obvious.
Stidham: Sounds like a silly question but it would be obvious to anyone who was standing there and had seen it?
Peretti: That's correct.
Stidham: Okay. The injuries that you were describing to the victims' ears, you laid out some possibilities about how that could have been caused, is there any evidence to suggest that it was definitely caused by oral sex?
Peretti: I found no evidence of semen in the oral cavities.
Stidham: Okay. Dr. Peretti, you talked about the victims' anal orifices being dilated, isn't it true that that could be caused by the fact that the bodies were in water?
Peretti: That's correct.
Stidham: Was there any evidence, whatsoever, to indicate that these victims were sodomized or raped anally?
Peretti: I found--no semen was detected in the anal orifices and canals.
Stidham: Was there any evidence of trauma or lacerations or anything of that nature?
Peretti: There were no injuries noted to the anal orifice or the anal mucosa. The only thing I saw was the hyperemia or reddening of the mucosa.
Stidham: Isn't it true Dr. Peretti, that if someone were sodomized or raped, especially if they’re a young child, that you would expect to find these types of injuries?
Peretti: My experience, dealing with many children of rape, I've found anal trauma.
Stidham: So you would expect to find that if the victim had been sodomized?
Peretti: Yes.
Stidham: Was there any indication Dr. Peretti, that any of the victims were choked?
Peretti: There were no--although there were some abrasions or scrapes on the neck region, there was no evidence of any type of strangulation.
Stidham: Your Honor, may I approach the witness?
The Court: Yes.
Stidham: Dr. Peretti, if you were told that one of the victims was choked, specifically the victim Byers was choked with a big old stick, would you expect to find some evidence, some abrasions, bruising, a line of demarcation, something indicating choking?
Peretti: I would expect to find a pattern or injury on the neck and the underlying neck muscles.
Stidham: Did you find any such patterns?
Peretti: No.
Stidham: Did you find any such patterns on the victim, Byers, specifically?
Peretti: No.
Stidham: Was there any abrasions or injury to the strap muscles of the neck?
Peretti: No.
Stidham: Were there any fractures of the larynx or the...how do you say that?
Peretti: Hyoid bone. No.
Stidham: Would you expect to find those had a victim been choked?
Peretti: Well, you may not find fractures of the hyoid bone because in young children it's very difficult to fracture it but I would expect to find hemorrhage.
Stidham: So does it appear be any--does there appear to be any evidence of sodomy or choking on any of these victims?
Peretti: Um, no.
Stidham: Pass the witness.
Crow: Excuse me, one second. Can I have a moment, your Honor?
The Court: Yes, sir.
Stidham: Dr. Peretti....may I address the witness from here, your Honor?
The Court: Yes.
Stidham: The most likely source of the dilation of the anuses of the victims was probably the water?
Peretti: Well, you get dilatation from being in the water--postmortem relaxation or if a small object may have been--such as a finger may have been inserted into the anus but more so decomposition.
Stidham: Thank you. No further questions.
Davis: Couple of questions, your Honor.
Re-Direct of Dr. Peretti by Brent Davis
Davis: Doctor, when you indicate that there was no sign of semen in the anal or oral cavities, all that indicates to you is that there was no ejaculation if there was a sexual assault, correct?
Peretti: That's correct.
Davis: Okay: There can be a sexual assault, no semen and that evidence does not counter-indicate...
Crow: [interrupting] Objection to leading, your Honor.
Davis: I'll rephrase.
The Court: Rephrase it.
Davis: The absence of semen does not rule out sexual assault?
Peretti: It indicates there was no ejaculation.
Davis: Okay. And, in this case if you would refer to your autopsy report on Christopher Byers, page 4 of that report I believe, at the very top of the page, did you indicate in that report that the anal orifice was markedly dilated?
Peretti: Yes, on Christopher Byers, it was markedly dilated.
Davis: Okay: When you say "markedly" how is that different from the other ones where you said it was dilated?
Peretti: Well, it was dilated more than the others.
Davis: Okay. And you also indicate that the examination of the rectal/anal mucosa showed to be diffusely hyperemic?
Peretti: Yes.
Davis: Okay: And injected, correct?
Peretti: That's correct.
Davis: Okay. And what does "diffusely" mean?
Peretti: I mean all over--involving the entire mucosal surface.
Davis: Okay. And about five or four paragraphs down, right before you get to the injuries of the right leg, did you indicate that there was scattered linear abrasions present about the anal orifice?
Peretti: Yes.
Davis: Okay. And that would be abrasions around the area of the anal opening?
Peretti: Yes.
Davis: Okay. And you indicated, I believe, on cross-exam of Mr. Stidham, that there--you found no tears or anything in the anal orifice itself. Is that correct?
Peretti: That's correct.
Davis: And would whether or not there was trauma of that nature, would that depend on number one, if there was penetration?
Peretti: That would depend on if there was penetration.
Davis: Okay. If there was an attempt at sodomizing an individual but no penetration, would you expect to find tears or lacerations?
Peretti: Well, if the penis, you know, enters into the canal because the canal is tight, I would expect to find lacer - - tearing and bruising and abrasions of the opening.
Davis: Okay. But with no penetration, would you expect to find the injuries to be to the outer portion of the buttocks?
Peretti: Well, without penetrating--if there was forcible penetration you would have some injuries around the external aspects of the orifice.
Davis: Okay. And here we had some injuries?
Peretti: We had some abrasions.
Davis: Okay. And also, the size of the object penetrating would determine if there was any laceration or tears, correct?
Peretti: That's correct.
Davis: Pass the witness, your Honor.
Re-Cross of Dr. Frank Peretti by Dan Stidham
Stidham: If there was a witness to these homicides and that witness purported to say that these victims were sodomized, would you expect to find tears or trauma to their anal orifices, Dr. Peretti?
Peretti: If there was forceful penetration into the orifice and into the rectum, I would expect to find injuries.
Stidham: In the absence of those injuries, you would expect that sodomy didn't occur? Is that correct?
Peretti: Well, I would expect that there was no penetration into the canal with ejaculation of semen.
Stidham: Thank you very much, Doctor.
Fogleman: Your Honor, can we have just a minute?
Davis: Your Honor, we'll pass the witness.
The Court: All right, you want to excuse him? Is he free to go?
Davis: Yes, your Honor.
Stidham: Your Honor, we have no further questions.
The Court: All right Doctor, you're free to return to Little Rock.
Peretti: Thank you.
The Court: Thank you, sir. All right ladies and gentlemen, we're going to take our noon recess at this time, and with the usual admonition not to discuss the case with anyone you may stand in recess until 15 minutes past 1.
RETURN TO OPEN COURT
The Court: You're back again?
Peretti: Back again.
Davis: Judge, I just have one additional question.
The Court: You want to wait for Fogleman or you wanna go ahead?
Davis: [unintelligible]
The Court: Here he is anyway. Go ahead.
Re-Direct of Dr. Frank Peretti by Brent Davis (cont.)
Davis: Dr. Peretti, I've just got one additional question for you. Are you familiar with medical literature that indicates there can be sodomy to young children without evidence of tears or lacerations?
Peretti: There is published medical literature on that--on those facts, yes.
Davis: Okay. Thank you very much.
Re-Cross of Dr. Peretti by Dan Stidham
Stidham: Dr. Peretti, more times than not, there will be trauma if that occurred?
Peretti: Well, in my experience and the cases that I've dealt with, I've always seen trauma.
Stidham: Always seen trauma?
Peretti: The cases that I've previously autopsied.
