4.Jennifer Hammers — Direct
224 linesJENNIFER HAMMERS, M.D., duly sworn
COURT CLERK: State your name, spell your last name for the record, keep your voice up and speak into the mic.
JENNIFER HAMMERS: Sure. My name is Jennifer Hammers, H-A-M-M-E-R-S.
DIRECT EXAMINATION BY MR. WEINREB:
MR. WEINREB: Good afternoon.
JENNIFER HAMMERS: Good afternoon.
MR. WEINREB: Where do you work?
JENNIFER HAMMERS: I work for the Office of Chief Medical Examiner for the City of New York.
MR. WEINREB: What type of work do you do?
JENNIFER HAMMERS: I'm a forensic pathologist, also known as a medical examiner.
MR. WEINREB: What does a forensic pathologist or medical examiner do?
JENNIFER HAMMERS: So a medical examiner, their duty is to investigate sudden, unexpected or unnatural deaths, to perform autopsies, and utilize that information as well as investigative information to determine why somebody passes away, and to fill out a death certificate indicating the reason that they passed away.
MR. WEINREB: Where did you go to school and tell us about any degrees you earned.
JENNIFER HAMMERS: Sure. So I went to college at Geneva College in Beaver Falls, Pennsylvania, where I earned a bachelor of science. I then went to medical school at Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania, where I got my degree to be a physician. After I finished medical school, I did a residency in anatomic and clinical pathology at Allegheny General Hospital in Pittsburgh, Pennsylvania. I then went to the New York City medical examiner's office where I did my fellowship training in forensic pathology. And I also stayed for a second year of fellowship, specifically in neuropathology and cardiac pathology, which is a specific study of the heart and the brain in forensic-related cases.
MR. WEINREB: What jobs have you held since completing all of that training?
JENNIFER HAMMERS: After I finished my fellowship in New York City, I came to Massachusetts to work for the medical examiner's office for the Commonwealth of Massachusetts. I worked here for just about three years before going back to the medical examiner's office in New York City to work about a year and a half ago.
MR. WEINREB: Approximately how many autopsies have you performed?
JENNIFER HAMMERS: I've performed about 2,000 -- a little over 2,000 autopsies.
MR. WEINREB: Have you ever testified as an expert forensic pathologist before?
JENNIFER HAMMERS: Yes, I have.
MR. WEINREB: How many times?
JENNIFER HAMMERS: About 45 times.
MR. WEINREB: What years did you work at the Massachusetts Office of the Chief Medical Examiner?
JENNIFER HAMMERS: So I worked here in Massachusetts from around September of 2010 to the end of June 2013.
MR. WEINREB: So you were working here during the time of the marathon bombings?
JENNIFER HAMMERS: That is correct.
MR. WEINREB: Was Dr. René Robinson one of your colleagues?
JENNIFER HAMMERS: Yes, she was.
MR. WEINREB: Did you perform autopsies according to the same standards and procedures as she did when she -- as she does at that office?
JENNIFER HAMMERS: Yes, I do -- I did, yes.
MR. WEINREB: On April 16, 2013, did you perform an autopsy on Krystle Marie Campbell?
JENNIFER HAMMERS: Yes, I did.
MR. WEINREB: Did you determine the manner of her death?
JENNIFER HAMMERS: Yes, I did.
MR. WEINREB: What was the manner of death?
JENNIFER HAMMERS: The manner of death that we determined -- that I determined was that she passed away from a homicide.
MR. WEINREB: What was the cause of her death?
JENNIFER HAMMERS: The cause of death was that she passed away from blast injuries to her torso and to her lower extremities.
MR. WEINREB: What are blast injuries?
JENNIFER HAMMERS: So blast injuries are injuries that are caused from some type of explosion force. And typically there are two types of injuries that occur: One is from a wave of energy that can cause injury to the body, typically, to the inside of the body, mostly to organs that have air in them, like the lungs and the gastrointestinal system. The other way that people have injuries, blast injuries, is physical injuries from objects from an explosive device or the surrounding area that can actually cause injuries to the body: injuries to the skin, to the muscle and subcutaneous tissue and to the organs.
MR. WEINREB: How does the shrapnel from a bomb injure your skin, your organs and so on?
JENNIFER HAMMERS: So objects that injure the body typically cause cuts and tears to the body. They can cause bruises or contusions or scrapes or lacerations both to the surface of the body but also deeper into the body.
MR. WEINREB: And you mentioned that the cause of death was injury to Krystle's torso and lower body, her legs, essentially?
JENNIFER HAMMERS: That's correct.
MR. WEINREB: All right. Did she also suffer injuries to her head?
JENNIFER HAMMERS: Yes, she did.
MR. WEINREB: What kind of injuries?
JENNIFER HAMMERS: She suffered injuries that were blast-related to her head. There was singeing of the hair over the back of her head from the heat of the explosion. She had some scrapes or abrasions to her neck; she had a pellet -- it was small, like around the sizes of a BB -- that was embedded into the back of her ear; and she also had some contusions or bruising to both the front of her tongue and the right side of her tongue adjacent to the area of her teeth.
MR. WEINREB: What injuries did she suffer to her body?
JENNIFER HAMMERS: So to her torso, she also suffered blast-related injuries that included thermal injuries, or heat-related injuries. She had a large area of a burn over her back right side and a little bit over the back of the upper right arm near the armpit area. She had evidence of small punctate abrasions and contusions, or scrapes and bruises, over the back side of her body that was consistent with small pellets that I found both outside of her body, inside of her clothes, and also inside of her body. And she had some black powder residue that was particularly over the area of the back of her armpit area. She had some thermal changes, or burns to her clothes, as well as defects consistent with the pellets that I found in some of her clothing, particularly, her shirt and tank top and bra that she was wearing.
MR. WEINREB: Did she have any injuries to her arms and legs?
JENNIFER HAMMERS: Yes, she did.
MR. WEINREB: Can you describe those, please?
JENNIFER HAMMERS: Sure. So on the back of her left hand there was some black powder residue that I noticed, and over the middle finger of her left hand she had a somewhat elongated abrasion or scrape, and around that scrape there were three punctate defects in the skin, again, of a similar size to those that I saw in the clothing, over her back and also in her skin over her back, about the same size as the pellets that I found. Most of her injuries were on the back of her right arm and then to her lower legs. So on the back of the right arm, in addition to what I previously described, there was also a large area over the back of the right arm that had stippling, or very small, fine punctate abrasions or scrapes to the skin over the back of the right arm. On the lower legs, from the upper thighs down to the feet, there were injuries. So there were several very large, gaping injuries to the skin, the subcutaneous tissues and the muscle of both the front and the back of the lower legs. There were also several smaller injuries. So the larger injuries measured up to about ten inches, probably about from, like 5 or 6 inches up to 10 inches, and the smaller injuries were about 1 to 2 inches in greatest dimension each. Many of them were very deep, through the whole surface of the skin, into the muscle. The injuries on the surface of the skin had -- many of them had smoother edges to them and some were slightly irregular. There were -- so they had a sharp aspect to them but also a more blunt, or tearing aspect to them. Some of them had some material that was embedded into the wound itself. So there were three pieces of flat, slightly irregular -- slightly irregular-edged pieces of metal. One I found between the pants and the skin in the area of the right groin, and then two I found actually embedded into the skin and the muscle of the back of the left leg. I also found in some of the wounds some pellets that were similar to what I had found on the outside of the body, and also some clear silicone-type material that had -- some of which had pellets embedded into the material and then some of which I could see that pellets had been embedded into the material but were no longer present. There was a fracture of the femur bone on the left side, which is the bone in the thigh, and there was also a fracture and a laceration, or a tear, to the skin over the area of the bunion in the -- on the left foot.
MR. WEINREB: So her left foot and her femur in that same leg were shattered?
JENNIFER HAMMERS: Well, the femur was broken completely through at the lower aspect of the femur, so closer to the knee than to the hip, and the bone in the foot had multiple small fractures in that area of where the bunion is.
MR. WEINREB: Is that consistent with blast injuries?
JENNIFER HAMMERS: Yes, both of those actually are. Yes.
MR. WEINREB: How does a blast shatter bone?
JENNIFER HAMMERS: So the injury to the foot appeared like -- so the skin had a long, like, laceration or tear to the skin, and it -- what it appeared to be was that something had grazed up against the skin and deep enough to reach the bone of the foot as it was traveling along the foot. The fracture to the leg, to the bone in the thigh, can occur from many types of different injuries, but certainly from a blast type of injury where a force is put onto the body, that can cause a break to the bone.
MR. WEINREB: Is that painful?
JENNIFER HAMMERS: A fracture to the femur?
MR. WEINREB: Yes.
JENNIFER HAMMERS: Yes, that would be very painful.
MR. WEINREB: I'd like to show you a photo that has been marked as Exhibit 652 for identification. Do you see that?
JENNIFER HAMMERS: Yes, I see it.
MR. WEINREB: Do you recognize that?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: What is it?
JENNIFER HAMMERS: This is a photograph of Ms. Campbell's body, from approximately her shoulders down to her feet, showing some of the injuries that I've already discussed.
MR. WEINREB: Was that taken during the autopsy?
JENNIFER HAMMERS: Yes, it was.
MR. WEINREB: The government offers 652.
MR. BRUCK: Noting our prior objection.
THE COURT: All right. Admitted. I will display it to the jury.
(Government Exhibit No. 652 received into evidence.)
BY MR. WEINREB:
MR. WEINREB: Can you point out the sites of the injuries that you just described?
JENNIFER HAMMERS: Sure.
MR. WEINREB: And if you like, if you press hard on this screen with your finger, you can circle things and then clear them by pressing in the upper right-hand corner.
JENNIFER HAMMERS: Okay. So on the legs, I had described some of the larger, gaping injuries that went through the skin and also through the subcutaneous tissues, or fat, and into the muscle. You can see one of the larger wounds that I just circled in yellow. There's another here, and then there's another also on the back of the leg here that we can see in this picture. So these wounds show that the edges along the skin have a slightly -- have a somewhat smooth surface to them, and so the object causing these would have somewhat smooth edges, but also deep within the wound in the muscle, you can see that the muscle is actually -- doesn't have a smooth wound through it but, rather, it has more of a lacerated defect, or an irregular tearing of the muscle as opposed to being just from a smooth object. On the right leg, which is closest to the yellow arrow that I circled, you can see that the edges of the wound are slightly more irregular and not quite as smooth as the injury on the left thigh that I just described. So these are three of the wounds that I had previously described. There's one more injury that I did not yet describe, which I'll circle. It's this long, or linear area, of contusion or bruise. This was present on both her right inner thigh and her left inner thigh. It's in the area of the seam of her jeans. And this can occur when the legs are pressed up against each other in a forceful way where the seam actually causes a pattern bruise in the area of the -- on the skin in the area of the seam of the jeans.
MR. WEINREB: Okay.
MR. WEINREB: 655 for the witness, please.
MR. WEINREB: Do you recognize that photo?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: Is that also a photo that was taken during the autopsy?
JENNIFER HAMMERS: Yes, it is.
MR. WEINREB: The government offers 655.
THE COURT: Okay.
(Government Exhibit No. 655 received into evidence.)
MR. BRUCK: As previously noted.
THE COURT: Yes, of course.
BY MR. WEINREB:
MR. WEINREB: What's this a photo of?
JENNIFER HAMMERS: So this is the photo of the back side of Ms. Campbell, showing again her back and the back aspect of her arms and legs from her shoulders down to her feet.
MR. WEINREB: The big red mark on her back, what is that?
JENNIFER HAMMERS: So the large red area on her back is the burn that I had previously described to her skin.
MR. WEINREB: What level of burn is that?
JENNIFER HAMMERS: So this burn appeared to be a third-degree burn.
MR. WEINREB: Is that the most severe kind?
JENNIFER HAMMERS: Essentially, beyond a third-degree burn, there would be charring of the skin or actual burning of the tissue. So without that, yes, this is the most severe.
MR. WEINREB: And the wounds, the big, gaping holes in her legs, were those the wounds you described earlier?
JENNIFER HAMMERS: Yes, they are.
MR. WEINREB: And was it in there that you found shrapnel and metal pieces and the BB-sized objects that you described earlier?
JENNIFER HAMMERS: Yes, that's correct.
MR. WEINREB: Exhibit 654 for identification, please.
MR. WEINREB: Do you recognize that?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: What is that a picture of?
JENNIFER HAMMERS: This is a very close up picture of some of the wounds on the back of her leg that I previously described. And the smaller wound that's to the left side of the screen -- it's in the middle but just to the left -- has a piece of that flat, slightly irregular but slightly sharp metal embedded into the wound that I had described that I had recovered from some of the wounds.
MR. WEINREB: The government offers 654.
THE COURT: All right, with the same conditions, yes.
MR. BRUCK: Thank you.
THE COURT: Published.
(Government Exhibit No. 654 received into evidence.)
BY MR. WEINREB:
MR. WEINREB: Can you please indicate -- just by tapping the screen it will leave an arrow -- where you found that metal shard?
JENNIFER HAMMERS: Sure. So the piece of metal is in the wound that the arrow is pointing to. It's sort of on end, so that in the photograph you're seeing the thin aspect of it.
MR. WEINREB: May I have Exhibit 656 for the witness, please.
MR. WEINREB: Do you recognize that?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: And just I'm going to show you two more.
MR. WEINREB: 659 for the witness, please.
MR. WEINREB: Do you recognize those?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: And 651 for the witness.
MR. WEINREB: Do you recognize those?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: What are they?
JENNIFER HAMMERS: So they're three photographs of the material that I've previously described that I collected from the wounds in the body.
MR. WEINREB: These are FBI laboratory photos, not your own photos. Is that right?
JENNIFER HAMMERS: I believe the second two are. The first one may be as well.
MR. WEINREB: But you had an opportunity to review them and compare them to your notes and to the evidence, and these are accurate photos of the items you removed from Krystle's body?
JENNIFER HAMMERS: Yes, they are.
MR. WEINREB: The government offers those three exhibits.
THE COURT: All right.
(Government Exhibit Nos. 651, 656 and 659 received into evidence.)
MR. WEINREB: If we could have Exhibit 656, please.
BY MR. WEINREB:
MR. WEINREB: So could you describe where you found that item?
JENNIFER HAMMERS: Yes. So this is one of the flat pieces of metal.
THE COURT: Just one second. I have to resend it.
JENNIFER HAMMERS: Oh, I'm sorry.
THE COURT: Did you get it?
JUROR: No.
THE COURT: Okay. Go ahead.
BY MR. WEINREB:
MR. WEINREB: Go ahead.
JENNIFER HAMMERS: Okay. So this is one of the flat pieces of metal taken from one of the wounds in the back of the leg that has slightly sharp, but also slightly irregular, margins.
MR. WEINREB: I'm going to hand you what's been marked as several exhibits. While I do, do you want to put on some gloves?
JENNIFER HAMMERS: Sure.
MR. WEINREB: We've marked these as 660-A, 659-A, 658-A, 657-A, and 661-A for identification. I'm going to ask you to open those and tell me if you recognize the objects inside, if you don't mind.
JENNIFER HAMMERS: Sure. Do you have a particular order you want me to do it in?
MR. WEINREB: No, you can do it in any order.
JENNIFER HAMMERS: Okay.
(Pause.)
JENNIFER HAMMERS: This is 658-A.
MR. WEINREB: Just continue.
JENNIFER HAMMERS: Oh, sure.
(Pause.)
JENNIFER HAMMERS: Would you like me to pull all of these out?
MR. WEINREB: Yes, please.
(Pause.)
JENNIFER HAMMERS: I think I have them all open.
MR. WEINREB: All right. Dr. Hammers, do you recognize those items?
JENNIFER HAMMERS: I do.
MR. WEINREB: What are they?
JENNIFER HAMMERS: They're multiple envelopes that contain swabs/foreign material that I collected at the time that I did the autopsy on Ms. Campbell.
MR. WEINREB: Okay. And what's pictured in 656, is that one of the items that you removed from her body?
JENNIFER HAMMERS: It is -- so in the photograph, that is an item that I took from her body at the time of autopsy, yes.
MR. WEINREB: And can we have 659 on the screen, please.
MR. WEINREB: Do you recognize those items?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: What are they?
JENNIFER HAMMERS: These are the three larger flat pieces of metal that I recovered at the time of the autopsy.
MR. WEINREB: And 661, please. Do you recognize that?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: What's that?
JENNIFER HAMMERS: This is one of the envelopes -- the contents of an envelope that I collected at the time of the autopsy. It shows multiple pellets and the white silicone-type material both that contains some pellets but also contains imprints of where pellets used to be.
MR. WEINREB: Okay. So you said earlier that the cause of death was blast injuries, but how does that actually cause someone to die? How did it cause Krystle Campbell to die?
JENNIFER HAMMERS: So Ms. Campbell passed away because she received injuries not only to the surface of her skin and her muscle, but also in the process of those injuries occurring, blood vessels in her lower legs were cut or transected which caused bleeding. So the reason that she passed away is because she lost a significant amount of blood in a short enough period of time that her body couldn't make more blood in order for her to survive.
MR. WEINREB: And based on the nature of the injuries that you observed during the autopsy, can you estimate how long it took her to bleed out, how long she lived?
JENNIFER HAMMERS: I can in a general kind of way.
MR. WEINREB: What's the estimate?
MR. BRUCK: I'd like to be heard, your Honor.
THE COURT: You want to be heard, is that it?
MR. BRUCK: Yes.
THE COURT: All right. I'll see you at the side.
(Discussion at sidebar and out of the hearing of the jury:)
MR. BRUCK: The only expert opinion that was provided in discovery under Rule 16 was that her death would not have been instantaneous. There is no estimate of the period of time. We would like to know what the estimate is and see if we would object to it. I don't think we've been provided notice.
THE COURT: What do you expect her answer to be?
MR. WEINREB: I expect her answer to be up to one minute. And given the nature of the particular injuries in this case, it was probably closer to the one-minute side than the zero side.
However, I would like to state that first, the indictment in this case is not something that the defendant murdered people, it was that he actually committed a terrorist act. He terrorized the entire population, and causing people to die in a particular manner, a manner that caused them to bleed to death, to suffer pain while they were dying. And that the disclosure that the death was not instantaneous subsumes the idea that she was alive at least some seconds after the -- I mean, we're not going to say that she lived for days or for hours or something that will obviously require --
THE COURT: Okay.
MR. WEINREB: -- more elaborate disclosure.
THE COURT: Okay. I think "up to a minute" is consistent with "not instantaneous."
MR. BRUCK: Well, we then further object to the speculation that it was probably more closer to one minute than closer to -- we don't think that that's -- there's any likely basis for it.
There's also -- it's speculative because there's no telling how soon she would have passed out for other reasons having to do with blast injuries. It's just complete guesswork and it's inflammatory. There's nothing to base it on.
MR. WEINREB: That's what cross-examination is for.
THE COURT: Your objection is noted, but I'll allow it.
MR. BRUCK: Okay.
(In open court:)
BY MR. WEINREB:
MR. WEINREB: So, Dr. Hammers, do you remember the question?
JENNIFER HAMMERS: Yes, I do.
MR. WEINREB: Okay. So what's your estimate of how long Ms. Campbell likely lived?
JENNIFER HAMMERS: So Ms. Campbell would have been able to survive for a period of time from seconds up to even approximately a minute or so after she sustained the injuries.
MR. WEINREB: And is there anything about the nature of the injuries that allows you to offer a medical opinion on whether it was closer to seconds or closer to a minute?
JENNIFER HAMMERS: Yes.
MR. WEINREB: What is that?
JENNIFER HAMMERS: So people who pass away from blood loss, they have to live for a period of time in order for their heart to keep pumping for them to continue to bleed. So people who have injuries to smaller blood vessels take a longer period of time to lose a sufficient amount of blood. They need to lose about half of their blood volume quickly. So if there's injuries to smaller blood vessels as opposed to larger blood vessels, a person would be able to survive for a longer period of time, closer to the minute mark, as opposed to closer to the few seconds mark.
MR. WEINREB: And in Ms. Campbell's case, what injuries did you observe?
JENNIFER HAMMERS: So in Ms. Campbell's case, she had injuries to both the arteries and the veins in her lower extremities. So while these certainly aren't extremely small vessels, they aren't some of the largest blood vessels in the body.
MR. WEINREB: And so based on the nature of those injuries, you would estimate that she could have lived for up to a minute?
JENNIFER HAMMERS: That's correct.
MR. WEINREB: No further questions.
MR. BRUCK: Thank you, Dr. Hammers. We have no questions.
THE COURT: No examination?
All right, Doctor. Thank you. You may step down.
MR. WEINREB: Your Honor, if I neglected to offer the exhibits that I listed earlier, then I offer them at this time.
THE COURT: The A exhibits?
MR. WEINREB: The A exhibits.
THE COURT: Yes, all right. You did not but they'll be admitted.
(Government Exhibit Nos. 657-A, 658-A, 659-A, 660-A and 661-A received into evidence.)
THE COURT: That's as far as we'll go today, jurors. It's Thursday. You have the next three days to yourself. I hope you enjoy them.
Again, please avoid any discussion of the case, any interaction with people in person or on the Internet or whatever, and avoid news accounts as much as you can. We'll resume on Monday morning with the evidence in the case.
COURT CLERK: All rise for the Court and the jury. The Court will be in recess.
(The Court and jury exit the courtroom and the proceedings adjourned at 4:02 p.m.)