4.Henry Nields — Direct
382 linesHENRY NIELDS, M.D., duly sworn
COURT CLERK: Have a seat. State your name, spell your last name for the record, keep your voice up and speak into the mic so everyone can hear you.
HENRY NIELDS: So my name is Dr. Henry Nields. My last name is spelled N-I-E-L-D-S.
DIRECT EXAMINATION BY MS. PELLEGRINI:
MS. PELLEGRINI: Good morning, Dr. Nields.
HENRY NIELDS: Good morning.
MS. PELLEGRINI: Can you tell the jury by whom you are employed?
HENRY NIELDS: By the Commonwealth of Massachusetts.
MS. PELLEGRINI: In what capacity?
HENRY NIELDS: Presently as chief medical examiner.
MS. PELLEGRINI: And before we go into what those duties entail, can you give us, please, a brief explanation of your educational background?
HENRY NIELDS: So I went to medical school at Boston University School of Medicine. I did residency training in general pathology at Beth Israel Hospital in Boston and Boston University Medical Center. And I did specialty training in forensic pathology at the Office of the Chief Medical Examiner also in Boston.
MS. PELLEGRINI: And the degrees that you currently hold include what?
HENRY NIELDS: Well, bachelor of science, M.D. and Ph.D.
MS. PELLEGRINI: And with respect to your professional backgrounds, what can you tell us about your licensure and certification?
HENRY NIELDS: I'm licensed -- I have medical licenses in the State of New York and the Commonwealth of Massachusetts. I'm board certified in anatomic and clinical pathology and forensic pathology.
MS. PELLEGRINI: Dr. Nields, as the chief medical examiner, what do your duties entail?
HENRY NIELDS: Well, in addition to the general duties of a medical examiner, I have some administrative responsibilities to oversee the central office in Boston, and we have satellite offices also in Worcester and on the Cape and Holyoke.
MS. PELLEGRINI: And what exactly is the mission of the Office of the Medical Examiner?
HENRY NIELDS: Well, it's to investigate sudden, violent, unexpected deaths that occur in the Commonwealth of Massachusetts.
MS. PELLEGRINI: And with respect to prior employment as either a deputy chief or the chief medical examiner, what employment have you had in that field?
HENRY NIELDS: I was a medical examiner in Massachusetts from 1995 until 1998, then I was a medical examiner in New York City from 1998 until 2006, and then a medical examiner back in Massachusetts since July of 2006.
MS. PELLEGRINI: And over the course of your employment, how many autopsies have you performed?
HENRY NIELDS: I've performed approximately 4,700 autopsies.
MS. PELLEGRINI: And is there a difference between an autopsy and a view?
HENRY NIELDS: Oh, we refer to views -- there are certain postmortem examinations that we feel we can arrive at a reasonable determination of cause and manner of death by performing only an external examination of the body and usually drawing some samples of blood for toxicology testing. So that was what we would refer to as a view.
MS. PELLEGRINI: And with respect to a full autopsy, does that 4,600 [sic] include the full autopsy number?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And have you previously testified as an expert?
HENRY NIELDS: Yes.
MS. PELLEGRINI: In what courts?
HENRY NIELDS: In the courts of New York City, I believe all of the counties in New York City, and multiple counties in Massachusetts.
MS. PELLEGRINI: Have you also testified previously as an expert in federal court?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And where was that?
HENRY NIELDS: New York City and Massachusetts.
MS. PELLEGRINI: And, Dr. Nields, with respect to the protocols regarding an autopsy, we've now heard from several members of your office. And is there a protocol for an autopsy procedure within the Office of the Medical Examiner?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And would it be fair to assume that you also follow those procedures that we've previously heard?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Dr. Nields, in your capacity, did you perform an autopsy on Martin Richard on August 16, 2013?
HENRY NIELDS: On April the 16th.
MS. PELLEGRINI: I'm sorry. April 16, 2013?
HENRY NIELDS: Yes.
MS. PELLEGRINI: You remind me: Do you have your report in front of you?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And with respect to that autopsy -- and before you begin the examination, did you make observations generally of Martin Richard?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And tell us, please, what you observed.
HENRY NIELDS: Well, he was approximately 53 inches tall, approximately 69-and-a-half pounds, he was dressed in clothing.
MS. PELLEGRINI: All right. Did you make observations of the clothing?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And prior to coming into court today, have you had occasion to review and observe the clothing again?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Your Honor, if I may approach.
MS. PELLEGRINI: Dr. Nields, I'm showing you what has been marked as Government Exhibit 1592. Do you recognize this box?
HENRY NIELDS: This appears to be the same box that contains Martin Richard's clothing that I examined a couple -- last week, I believe it was.
MS. PELLEGRINI: All right. I'm going to give you some gloves and this piece of paper. And before I move it from the box, I would ask you to look inside and tell me if, in fact, that is the same clothing that you observed Martin Richard wearing before you performed the autopsy in April of 2013?
HENRY NIELDS: Yes. I don't see the sneakers.
MS. PELLEGRINI: They're on the bottom.
HENRY NIELDS: Yes, I do.
MS. PELLEGRINI: All right. Dr. Nields, I'm going to ask you to remain standing, if I might, your Honor. Let me borrow the glove.
And, your Honor, the government would at this time offer Exhibit 1592 and its contents.
MR. BRUCK: No objection.
THE COURT: All right.
(Government Exhibit No. 1592 received into evidence.)
BY MS. PELLEGRINI:
MS. PELLEGRINI: Dr. Nields, I'm going to show you what I've removed from the box. And you're at a taller spot than I am so I'm going to ask you to describe what we're seeing here for the jury.
HENRY NIELDS: This is a long-sleeved jersey that Martin Richard was wearing at the time that I did my examination. It shows some tearing, principally of the left side of the body part of the jersey. And it shows tearing -- pretty significant tearing of the left sleeve of the jersey.
MS. PELLEGRINI: If I may, Doctor, ask you, what are we looking at here?
HENRY NIELDS: This is a T-shirt that Martin Richard was also wearing. You can see also the large defect on the left side of the T-shirt in a similar location to where it was in the long-sleeved jersey, and you can also see more clearly the blood stains on the T-shirt that were also present on the jersey. They're a little bit more difficult to see.
MS. PELLEGRINI: And this item of clothing?
HENRY NIELDS: This was a jacket that he was wearing. Again, it shows a large defect on the left side, and the defect, or shredding, of the left sleeve. And there is also a blood stain as well.
MS. PELLEGRINI: Doctor, I don't think we mentioned, on the green jersey, the discoloration on that, what is that, do you know?
HENRY NIELDS: I think -- well, part of it is the blood stains that I was referring to. Dried blood.
MS. PELLEGRINI: This belt. Do you recall where this was on Martin's body?
HENRY NIELDS: That was around his left arm.
MS. PELLEGRINI: And what was the purpose of that?
HENRY NIELDS: I believe likely it was placed there as a tourniquet.
MS. PELLEGRINI: And then finally, this item?
HENRY NIELDS: This is a pair of -- it was either shorts or pants. It was difficult to say because of all of the melted fabric that occurred, but he was wearing these as well.
MS. PELLEGRINI: Now, you mentioned shoes?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And are these, in fact, the shoes that Martin Richard was wearing that day?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And all of these items were items he was wearing when he came in. Is that correct?
HENRY NIELDS: Yes. Yes.
MS. PELLEGRINI: Dr. Nields, after noting Martin's height and weight, did you, in fact, perform the autopsy?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Starting first with his head and neck, what, if any, were your significant findings?
HENRY NIELDS: Well, he had four abrasions to the left side of his face, including the forehead. He had two abrasions to the right side of his forehead. He had an area of stippling around his left ear and a little bit forwards of his left ear and a little behind his left ear, and there was a skin perforation about 3/16ths of an inch in diameter behind his left ear. And there was another small abrasion on the lower part of the left side of his neck.
MS. PELLEGRINI: So "abrasion" is just another word for?
HENRY NIELDS: For "scrape."
MS. PELLEGRINI: And with respect to the stippling of the face and the scalp that you noted, what can you tell us about that? What do you mean?
HENRY NIELDS: Stippling is something that is caused by essentially pinpoint abrasions to the skin that are caused by the impact of gunpowder particles against the skin.
MS. PELLEGRINI: And with respect to your examination of his torso, what were your significant findings there?
HENRY NIELDS: He had three small abrasions to his right upper chest, and he had an approximately 6-by-6 inch open jagged-edge laceration to the left the side of his abdomen with evisceration of several loops of small intestine.
MS. PELLEGRINI: Doctor, can I stop you there? "Evisceration" means what?
HENRY NIELDS: It means essentially that an organ that is normally within the body is outside of the body.
MS. PELLEGRINI: And what part of Martin Richard was outside his body?
HENRY NIELDS: There were several loops of small intestine.
MS. PELLEGRINI: I'm sorry. I interrupted you. Go ahead.
HENRY NIELDS: There was another approximately 4-1/2 inch by 2-1/4 inch open jagged laceration to the right side of his abdomen that exposed areas of his liver, and two underlying rib fractures of the sixth and seventh ribs. And there were two smaller lacerations just to the right of that, on the right side of the abdomen.
MS. PELLEGRINI: Were there any further observations that you made?
HENRY NIELDS: Yes. Internally there were lacerations of the liver, of the left kidney. There were lacerations of the capsule, or surface of the spleen; there was transection or essentially -- it's just another word for cutting off a piece of the left side of the liver; there was transection of a portion of the tail of the pancreas; there was transection of the left side of the large intestine; there was near complete transection of the abdominal aorta.
MS. PELLEGRINI: Again, can I stop you there and ask you to explain what exactly that means.
HENRY NIELDS: With what, the --
MS. PELLEGRINI: Transection of the abdominal aorta.
HENRY NIELDS: It means that -- the aorta is a major blood vessel that brings blood from the heart to the organs of the body, and the abdominal organ is just the main part of the aorta as it travels through the abdominal cavity. And the near transection again means most of it was cut in half. Not completely cut in half, but most of it was -- was essentially transected. In addition, there was a rupture of the fundus, or body of the stomach. He had shredding of his left adrenal gland; he had partial shredding of the left hemidiaphragm, which is -- the diaphragm is a layer of muscle that separates the abdominal cavity from the chest cavity. He had contusions of the lower lobe of his right lung as well.
MS. PELLEGRINI: Did you make any observations of any thermal injuries to his --
HENRY NIELDS: Actually, I'm sorry. If I could just --
MS. PELLEGRINI: Yes, sir.
HENRY NIELDS: -- add as well that there was also -- there was a perforating injury of his lower thoracic spine. There was a perforation through one of -- the left side of his vertebral body, T-11, which -- and, in turn, perforated through a portion of the underlying spinal cord, thoracic spinal cord. And then that fragment exited his back, just to the left of the midline of his back.
MS. PELLEGRINI: So according to your examination, there was a piece that entered his body and exited?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And could you tell from the autopsy where the entry was?
HENRY NIELDS: It would be difficult to say the exact location given the size of the openings in the abdomen. Most likely, from the left side, but it would be hard to say exactly.
MS. PELLEGRINI: And the exit?
HENRY NIELDS: The exit was in the back, just to the left of the midline.
MS. PELLEGRINI: And you mentioned then the perforation of the -- is it the spine and spinal cord?
HENRY NIELDS: Yeah. Well, with a spine, we generally refer to as the whole -- the vertebral column and the spinal cord. So both of -- one of the bones of the vertebral column -- or vertebral body, T-11, specifically, and the underlying spinal cord that runs within that column were perforated on the left side.
MS. PELLEGRINI: And any further observations with respect to his torso, either front or back?
HENRY NIELDS: Well, on the back there were two relatively small contusions or bruises to the left side of his back. There was an abrasion to the mid lower back, another contusion to the lower right back; there were three abrasions to his left buttock; there were two small thermal injuries to his left buttock and an abraded contusion, which is just essentially an abrasion and a contusion in the same location, also to the right buttock.
MS. PELLEGRINI: And, Dr. Nields, when we say "thermal injuries," what are we talking about in layman's terms?
HENRY NIELDS: A burn.
MS. PELLEGRINI: A burn?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Was there a degree of burn that you were able to ascertain?
HENRY NIELDS: I believe a third-degree burn.
MS. PELLEGRINI: Is that the most severe?
HENRY NIELDS: It's not the most severe. There can be fourth-degree burns. A third-degree burn is a serious burn, however.
MS. PELLEGRINI: And, Dr. Nields, with respect to other observations of any foreign matter in your examination of the torso, what, if anything, did you observe?
HENRY NIELDS: There's a small nail in the right chest cavity, a small metal pellet in the abdominal cavity, and some small fragments of wood also in the right chest cavity.
MS. PELLEGRINI: Before we go on, is there any other observations you made of the torso area that you can recall?
HENRY NIELDS: Not that I can recall, no.
MS. PELLEGRINI: With respect to the extremities, the arms and the legs, what observations did you make?
HENRY NIELDS: There was an abraded contusion to the ventral, or inner part of his right forearm, and a laceration also to the distal part of his forearm and wrist; there were five contusions to the back of his left arm and an abraded contusion to the back of his left arm; there was a near transection of his left forearm; there was a fragment of skin -- a strip of skin approximately -- and soft tissue approximately an inch wide that was connecting the two pieces of the forearm together; there was complete transection of the radius and the ulna, which are the two bones that run through the forearm.
MS. PELLEGRINI: That means a complete severing?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Okay.
HENRY NIELDS: There was stippling, again, on the back of his left hand, some abrasions on the back of his left hand and then a contusion on the back of his left hand. And I isolated or retrieved two small nails also from the soft tissue of his left wrist.
MS. PELLEGRINI: Dr. Nields, with respect to his left arm that you just described, is that where you observed the belt being used as a tourniquet?
HENRY NIELDS: Excuse me. Yes. Well, up higher, on the upper arm, yes.
MS. PELLEGRINI: On the arm?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And were there any other observations that you made with respect to the extremities?
HENRY NIELDS: Yes. To the lower extremities, there was an area of stippling on the lateral part, which is the side, outer part, of the left calf and the -- and a portion of the -- the lower portion of the left thigh. And within that broad area there were several other injuries to include a laceration to his left thigh, some abrasions to the left leg, a perforation of the skin of the left calf. There were two lacerations around the left -- the lateral part of the left ankle area; there was an area of charring to the skin also just above the left ankle, and there was fracture of the distal head, or lower part of the left fibula, which is -- it's a bone that is -- it's a smaller bone that runs next to your main shin bone, or tibia. And so -- and associated with that fracture were multiple fragments of this black plastic that was embedded in the soft tissue and in the bone. There was third-degree thermal injury to the lateral part -- and posterior part of his left calf and extending up a portion of the posterior part of his left thigh as well.
MS. PELLEGRINI: And on his hands?
HENRY NIELDS: Again, with regard to the left hand, there was stippling on the back of his left hand, abrasions on the back of his left hand and a contusion to the back of his left hand.
MS. PELLEGRINI: Dr. Nields, with respect to your examination of Martin Richard's head and neck, his torso, front and back, his extremities, arms and legs, front and back, was there any portion of his body that did not have either a contusion, an abrasion or a laceration or a transection or a broken bone?
HENRY NIELDS: Well, all of those areas had injuries.
MS. PELLEGRINI: And with respect to the items that you removed from Martin Richard's body, tell us a little bit more about that. What type of items did you remove?
HENRY NIELDS: Well, there were small nails; there were round, metal -- a pellet; and there were small fragments of wood and there were fragments of black plastic; and there was a fragment of metal but that was actually not in the body, that was in the clothing, or underneath the T-shirt.
MS. PELLEGRINI: And underneath the T-shirt, did that small metal fragment -- was that consistent with the exit wound that you saw on Martin Richard's back?
HENRY NIELDS: Yes.
MS. PELLEGRINI: In shape and in size?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Just for the witness, your Honor, at this time, can we have --
MS. PELLEGRINI: Well, actually, Dr. Nields, did you have photographs taken of the items, the foreign matter that you observed during the course of your autopsy?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And have you had occasion to review those photographs before you came into court today?
HENRY NIELDS: Yes.
MS. PELLEGRINI: All right.
MS. PELLEGRINI: For the witness, please, your Honor, may I have starting with Exhibit 648.
MS. PELLEGRINI: Dr. Nields, do you recognize this photograph, or these items?
HENRY NIELDS: Yes. These are the nails that I was referring to. I'm not sure if these are the ones that came out of the --
MS. PELLEGRINI: I'll get there in just a sec.
HENRY NIELDS: Okay. Sorry.
MS. PELLEGRINI: Okay.
MS. PELLEGRINI: May I have 649 just for the witness again, please?
MS. PELLEGRINI: Do you recognize these items?
HENRY NIELDS: These actually, I believe, are items that were recovered from the body bag at the time of the autopsy.
MS. PELLEGRINI: And 650. Do you recognize this item?
HENRY NIELDS: You know, that's consistent with the metal fragment that I found underneath the T-shirt.
MS. PELLEGRINI: And 651?
HENRY NIELDS: Those are metal pellets also consistent with the ones that were removed from his body. I believe these were more than likely removed from the body bag.
MS. PELLEGRINI: Your Honor, I would offer now Exhibit 648, 649, 650 and 651.
MR. BRUCK: No objection.
THE COURT: Okay.
(Government Exhibit Nos. 648, 649, 650 and 651 received into evidence.)
BY MS. PELLEGRINI:
MS. PELLEGRINI: With respect to Exhibit 648 --
MS. PELLEGRINI: May I have that on the screen, please, Mr. Bruemmer?
May I approach, your Honor? And if I may stand here for a little bit.
MS. PELLEGRINI: Dr. Nields, to make this a little bit easier now, showing you what's been marked for identification as Government Exhibit 648-A, do you recognize this item and the markings?
HENRY NIELDS: Yes. The markings certainly.
MS. PELLEGRINI: They've already been opened prior to coming in today so you can remove them if you wish.
(Pause.)
HENRY NIELDS: These are nails similar to the ones found in the --
MS. PELLEGRINI: You have to speak into the microphone.
HENRY NIELDS: I'm sorry. These are the small nails that -- some of which were embedded in the soft tissue of his left wrist.
MS. PELLEGRINI: All right. And these are -- in fact, the items that are here are very small. And are these, in fact, the same items that appear on the screen in Exhibit 648?
HENRY NIELDS: They certainly appear to be.
MS. PELLEGRINI: And while I'm putting these away, I'm going to ask you to look at --
MS. PELLEGRINI: May I have brought up, please, 649.
MS. PELLEGRINI: And I'm not going to ask you to open that because it's a little bit messy, but I'd ask you from looking at the outside of that if that is, in fact, the items that we see here on the screen.
HENRY NIELDS: It certainly is consistent with that.
MS. PELLEGRINI: Do you need to open it to determine whether or not they are the same as what you removed during the autopsy?
HENRY NIELDS: The way I would identify them as being the same is if they're in these envelopes that I seal myself and label myself. They're actually outside of the envelopes now, so the best I can do is say that they're certainly consistent with that.
MS. PELLEGRINI: Okay. But there are envelopes within here that have the Office of the Medical Examiner notification in there -- or notation in there, correct?
HENRY NIELDS: Yes. Yes.
MS. PELLEGRINI: All right. And what type of items are we looking at here at 649?
HENRY NIELDS: Well, the fragments of wood, the fragments of Styrofoam, some fragments of cloth. I see at least one nail and fragments of what appears to be the black plastic consistent with the same fragments of black plastic that I removed from Martin Richard.
MS. PELLEGRINI: Dr. Nields, this screen is actually interactive if you touch it. So the item that you were just referring to is the items of black plastic. You can draw a circle, you can point an arrow, if you just touch the pad of your finger to the screen.
HENRY NIELDS: I believe it's these.
MS. PELLEGRINI: Yup.
HENRY NIELDS: And these as well.
MS. PELLEGRINI: So you've drawn a -- I can't really call it a circle, but surrounding items slightly to the left of the center that are small grayish in color or black in color. Is that correct?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Dr. Nields, directing your attention to this little item here, do you know what that is?
HENRY NIELDS: I do not.
MS. PELLEGRINI: All right. Do you know where that was recovered from?
HENRY NIELDS: I don't know just from looking at this screen.
MS. PELLEGRINI: All right.
MS. PELLEGRINI: And may I have Exhibit 650, please.
MS. PELLEGRINI: All right. I'm going to show you now what has been marked for identification as Exhibit 650-A, and ask you if you recognize, first, the envelope that is in?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And ask you if you can open that?
HENRY NIELDS: (Witness complies.)
MS. PELLEGRINI: And, Dr. Nields, now that you have removed that from the envelope, which does have the identification of the Office of the Medical Examiner, correct?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Is that, in fact, the same piece that you found within Martin Richard's clothing during the course of the autopsy?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And is this the piece that you indicated was consistent with the exit wound on his back?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And if I may, your Honor, it being very small, and although there's a picture, if I may exhibit this to the jury, I would offer this now as Exhibit 650-A.
MR. BRUCK: No objection.
THE COURT: All right.
(Government Exhibit No. 650A received into evidence.)
(Government Exhibit No. 650A displayed to the jury.)
MS. PELLEGRINI: And may I have Exhibit 651 up, please, Mr. Bruemmer?
BY MS. PELLEGRINI:
MS. PELLEGRINI: And, Dr. Nields, showing you what I've marked for identification as 651-A, which are now out of the little envelope inside, are these, in fact, the same small metal pellets that you observed during the course of the autopsy?
HENRY NIELDS: Yeah, they're certainly consistent with that. Yes.
MS. PELLEGRINI: Your Honor, at this time to the extent I haven't already done so, the government would offer 648-A, 649-A, I think -- I believe I offered 650, and 651-A.
MR. BRUCK: No objection.
THE COURT: All right. Those are admitted.
(Government Exhibit Nos. 648-A, 649-A and 651-A, received into evidence.)
BY MS. PELLEGRINI:
MS. PELLEGRINI: Dr. Nields, as a result of your autopsy, did you make a -- did you come to a conclusion regarding the cause and the manner of death of Martin Richard?
HENRY NIELDS: Yes.
MS. PELLEGRINI: What were they?
HENRY NIELDS: Cause of death was blast injuries of torso and extremities, the manner of death was homicide.
MS. PELLEGRINI: Now, when you say the cause of death was blast injuries, how did Martin Richard die?
HENRY NIELDS: Essentially from hypo- -- principally from hypovolemic shock, or loss of blood.
MS. PELLEGRINI: Loss of blood?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And with respect to the transection of the abdominal aorta that you mentioned, would that have been a cause of the loss of blood?
HENRY NIELDS: Yes.
MS. PELLEGRINI: With respect to the transection of the pancreas and the perforation of the spine and spinal cord and the transection of the large bowel, would that have been a cause of death?
HENRY NIELDS: That certainly was part of the overall cause of death.
MS. PELLEGRINI: Dr. Nields, starting first with some of the injuries that you have explained to us, for example, the rupture of the stomach and the transection of the large bowel, would that be painful?
HENRY NIELDS: I believe that overall the injuries would have been painful. The injury to the stomach and the intestine are a little harder because the pain receptors in those organs are a little different from other organs. But I would say that overall the injuries to his body would have been painful.
MS. PELLEGRINI: With respect to the thermal burns and the contusions and the lacerations, would those have been painful?
HENRY NIELDS: Yes.
MS. PELLEGRINI: The fractured ribs, would those have been painful?
HENRY NIELDS: Yes.
MS. PELLEGRINI: The injury to his left arm and the transection of the bones there, would that have been painful?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Dr. Nields, during the course of the autopsy did you, in fact, take photographs of the injuries that you have just told us about here today?
HENRY NIELDS: Photographs were taken.
MS. PELLEGRINI: I would ask that the screens be --
THE COURT: All right. We'll prepare the screens.
(Pause.)
MS. PELLEGRINI: Just for the witness.
BY MS. PELLEGRINI:
MS. PELLEGRINI: Dr. Nields, have you had occasion to review the photographs -- some of the photographs of the autopsy prior to your testifying this morning?
HENRY NIELDS: Yes.
MS. PELLEGRINI: May I please have for the witness only Exhibit 639 marked for identification.
MS. PELLEGRINI: Dr. Nields, do you recognize this photo?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And what are we seeing here, just generally, please, first?
HENRY NIELDS: It's a photograph of Martin Richard at the time of autopsy.
MS. PELLEGRINI: May I also have Exhibit 638 for the witness only.
MS. PELLEGRINI: And this second photo, what does it show us?
HENRY NIELDS: This is also a picture of Martin Richard at the time of the autopsy.
MS. PELLEGRINI: Now, 639 shows you from the front. Is that correct?
HENRY NIELDS: The previous one was from the front, yes. This is from the back.
MS. PELLEGRINI: This is from the back? And do both of these photographs fairly and accurately depict the condition of Martin Richard's body at the time of autopsy?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Your Honor, the government would move these in and ask to publish them to the jury starting with Exhibit 638 first.
MR. BRUCK: Your Honor --
THE COURT: Subject to prior rulings, admitted.
(Government Exhibit Nos. 638 and 639 received into evidence.)
THE COURT: Starting with 638?
MS. PELLEGRINI: Yes, please.
And, your Honor, if I may approach because I find this difficult to see at an angle.
BY MS. PELLEGRINI:
MS. PELLEGRINI: Dr. Nields, with respect to the photograph that we see here now, can you tell us what we're looking at with respect to the injuries that you observed on Martin Richard?
HENRY NIELDS: Well, looking at his back -- shall I point to any of them?
MS. PELLEGRINI: You can point and you can -- again, you can touch the screen.
HENRY NIELDS: This here...
MS. PELLEGRINI: The pad of the finger is best.
HENRY NIELDS: Sorry. I just circled, that's the perforation of the metal fragment as it came out of his back on the left side. These -- this area here on the back of his left leg is the area of third-degree burn or thermal injury that I observed. There's another area that's a little harder to make out because it was more lateral, but this is also in the area of thermal injury on the back of the right -- of his right leg. We have two contusions to his left -- whoops. I just -- I'm sorry -- the left side of his back here and there. There's an abrasion there, another small contusion here. This is the abraded contusion to his right buttock here, this is one of the thermal injuries to his left buttock there. The abrasions to his left buttock are small.
MS. PELLEGRINI: Before I clear -- and I'd just like to have this for the record, so when you were talking first -- the first circle that you drew was around -- what almost looks to be like a crescent-shaped area of -- towards the middle of the back?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Is that correct?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And then you have four areas below that which you indicate were abrasions?
HENRY NIELDS: These two on the left -- the two on the left were small contusions --
MS. PELLEGRINI: Contusions?
HENRY NIELDS: -- the one that's smaller to the middle is an abrasion, and the one on his lower right back was a small contusion.
MS. PELLEGRINI: And again for the record, with the larger circle that you drew on the leg, that is what area again?
HENRY NIELDS: That's the back of his left leg including much of the calf, back of the knee and a portion of the back of his left thigh.
MS. PELLEGRINI: All right. And I'm just going to clear this for the moment. Dr. Nields, with respect to what we see here -- I've made a circle here -- what are we looking at? I've made a circle on the left side, the body being on the side. And right underneath, what are we looking at here?
HENRY NIELDS: Well, within that circle you can see the two small contusions to the left side of his back, and underneath the arrow is where the abrasion is to his mid-back.
MS. PELLEGRINI: Okay. And right above what appears to be the ruler, this portion of the body?
HENRY NIELDS: Those are small -- loops of small intestine that were extruding from that open laceration on the left side of his abdomen.
MS. PELLEGRINI: And moving down on the leg, these darker areas that appear just above the ankle, little arrows here, what are those?
HENRY NIELDS: It's difficult to see on the back. He had -- he had perforations to the back or the medial aspect of his right calf. It's just a little difficult to see in this posterior photograph exactly which is which.
MS. PELLEGRINI: And, Dr. Nields, I want to go back to -- I'll clear this again -- back to the perforation in the middle of the back to indicate it was consistent with the metal fragment?
HENRY NIELDS: Yes.
MS. PELLEGRINI: All right. And you said you couldn't tell because of the nature of the wounds to the front, basically an entry wound?
HENRY NIELDS: Right.
MS. PELLEGRINI: Could you tell a path of travel?
HENRY NIELDS: Well, only that it passed through the lateral part of his lower vertebral column through the lateral part of vertebral body T-11 through the spinal -- unaligned spinal cord within that spinal canal, that level, and then, of course, exited the back where you see there.
MS. PELLEGRINI: So that metal piece, 650, would have been responsible for the transection of the spinal cord?
HENRY NIELDS: It was actually a partial transection of the spinal cord.
MS. PELLEGRINI: Partial?
HENRY NIELDS: Yes.
MS. PELLEGRINI: But that path of travel would have traveled across the spinal cord?
HENRY NIELDS: Yes.
MS. PELLEGRINI: Okay.
MS. PELLEGRINI: May we have Exhibit 639, please.
MS. PELLEGRINI: Dr. Nields, can you explain to the jury what we are looking at here?
HENRY NIELDS: You can see the jagged laceration to the left side of his abdomen here. The soft tissue protruding from that open laceration is the loops of small bowel that I referred to previously. The other open laceration, the 4-1/2-by-2-1/4 inch laceration, to the right side is what I just circled there. And you can't make out the -- you can almost make out one of the small lacerations just lateral to that. There are two that are lateral to that laceration on the right side. This is the near transection of his left forearm, and this here is that --
MS. PELLEGRINI: Actually, I'm going to --
HENRY NIELDS: I don't know how to make an arrow but essentially --
MS. PELLEGRINI: I'm going to ask Mr. Bruemmer if he can --
MS. PELLEGRINI: With the section that Dr. Nields has circled on the arm, Mr. Bruemmer, are you able to enlarge that section, please?
MS. PELLEGRINI: What are we looking at here, Dr. Nields?
HENRY NIELDS: So this is a near transection of his left forearm. And you can see the strip of skin and soft tissue to which I referred to earlier, that it is essentially holding the two sections together. You can see little dots on the back of his left hand which are the areas of stippling, and there are abrasions, or scrapes as well, and a single contusion also to the back of his left hand.
MS. PELLEGRINI: And the tourniquet that you described that the belt was used for, where would that have been with respect to his injury?
HENRY NIELDS: It's approximately up here. It's in the upper part of his arm, above the elbow.
MS. PELLEGRINI: And you're indicating that the strip of skin that basically is holding these two pieces together is approximately how big?
HENRY NIELDS: It's approximately an inch wide.
MS. PELLEGRINI: And what are we looking at here, this section that I am now trying to circle?
HENRY NIELDS: Well, you're looking at fragments of soft tissue. And this is actually the end of one of the bones. I'm not 100 percent sure if that's the radius -- particularly in this view, if that's the radius or the ulna, but it's one of the bones that was transected.
MS. PELLEGRINI: Can we go back, Mr. Bruemmer? And can we have a focus on the left side, please, on the leg.
MS. PELLEGRINI: And can you describe for us what we're looking at here?
HENRY NIELDS: Well, you can see these -- the little -- some are red and some are black dots, small pinpoint abrasions. That's the stippling. Here I'm circling -- what I'm circling now is what was within that stippling, was the laceration to his thigh. I mean, it also -- that circle also encompasses some of the abrasions that were also present. And this here, I'm circling now, is just the area -- includes that area of third-degree burn to the lateral part of his calf, and actually, the side of his knee as well.
MS. PELLEGRINI: And his other leg?
HENRY NIELDS: On the other leg, again, you'll see some red/some black pinpoint abrasions, or the stippling. That's the stippling on the calf. Then you'll also see larger -- I'll just draw a circle around some of them. There are some larger and some -- I'm sorry for not using this correctly. Some of the larger and more irregular defects in the skin. Those were -- there were at least nine I counted in the calf of these skin -- perforations of the skin. And there, again, were multiple fragments of black plastic that were removed from the soft tissue of his calf as well.
MS. PELLEGRINI: Thank you, Dr. Nields. Dr. Nields, did you also have occasion to review photographs of the Boylston Street scene after the bombing?
HENRY NIELDS: Yes.
MS. PELLEGRINI: All right.
MS. PELLEGRINI: This can go back up, your Honor, because I'm going to ask that Exhibit 24, already in evidence, be shown.
(Pause.)
MS. PELLEGRINI: Dr. Nields, looking at the image on the screen in front of you --
THE COURT: I just want to be sure we're all set.
(Pause.)
THE COURT: All right. Exhibit 24 is now exhibited.
HENRY NIELDS: It's not on my screen but -- oh, there we go.
BY MS. PELLEGRINI:
MS. PELLEGRINI: All right. Dr. Nields, looking at this exhibit, and particularly the area --
MS. PELLEGRINI: Actually, can we go back, Mr. Bruemmer, to the large area?
MS. PELLEGRINI: -- that I'm enlarging here, do you see the debris on the sidewalk and the street?
HENRY NIELDS: Yes.
MS. PELLEGRINI: And do you also see a tree to the right-hand side of the screen?
HENRY NIELDS: Yes.
MS. PELLEGRINI: All right. And with respect to the items that you located and recovered during the autopsy of Martin Richard, is this scene consistent with what you observed during the course of your autopsy?
HENRY NIELDS: It would be consistent with that.
MS. PELLEGRINI: Thank you. Dr. Nields, during the course of an autopsy, do you obtain other identifying information about the individual upon whom you're performing the autopsy?
HENRY NIELDS: I'm not sure what you mean.
MS. PELLEGRINI: Do you obtain the age of the individual?
HENRY NIELDS: Yes.
MS. PELLEGRINI: How old was Martin Richard at the time you performed the autopsy?
HENRY NIELDS: He was eight years old.
MS. PELLEGRINI: I'm sorry?
HENRY NIELDS: He was eight years old.
MS. PELLEGRINI: May I have a minute?
(Counsel confer off the record.)
MS. PELLEGRINI: I have nothing further, Dr. Nields. Thank you very much.
MR. BRUCK: Thank you, Dr. Nields. We have no questions.
THE COURT: All right. Thank you, sir. You may step down.
HENRY NIELDS: Thank you.
(The witness is excused.)
MR. WEINREB: The government rests.
THE COURT: Mr. Weinreb's announcement that the government rests completes the government's presentation of evidence in this part of the case. We'll take a short recess.
Let me just emphasize for you again, as I have repeatedly, that you are not to discuss any of the evidence in the case or make up your mind about any of the issues until you've heard all the evidence in the case and until you've heard my instructions about the principles of law. And there may be, obviously, some temptation to talk about things, but we ask you to please resist it. The time will come and it is not now, okay? We'll take a short recess.
COURT CLERK: All rise for the Court and the jury. The Court will take a short recess.
(The Court and jury exit the courtroom and there is a recess in the proceedings at 12:06 p.m.)
COURT CLERK: All rise for the Court.
(The Court enters the courtroom at 12:27 p.m.)
COURT CLERK: Be seated.
THE COURT: Let me see counsel briefly at the side.