Whether JonBenet was strangled first and then struck on the head or the other way around is a matter of debate. As is whether or not she had been previously molested.
Another point of view:
Pathologist: No doubt of JonBenet sex assault
Girl was hit on head before she was strangled, expert says
[font=arial,helvetica]By Charlie Brennan [/font]
%%byline%%By Charlie Brennan
Rocky Mountain News Staff Writer
BOULDER -- JonBenet Ramsey was sexually assaulted, suffered a tremendous blow to the head and was strangled as much as an hour later, a respected forensic pathologist said Tuesday.
Dr. Ronald Wright, director of the forensic pathology department at the University of Miami School of Medicine, reviewed JonBenet's autopsy report Tuesday at the request of the Rocky Mountain News.
''She's been sexually assaulted,'' said Wright, who served as the medical examiner in Broward County, Fla., 13 years.
"She's had vaginal penetration.''
Wright -- who has done consulting for the FBI and worked on the Elvis Presley autopsy -- joined a growing chorus of out-of-town experts who see sexual assault as part of the unsolved Christmas night murder.
"I think there's some kind of sexual assault,'' said Dr. Robert Kirschner, formerly deputy chief medical examiner in Cook County, Ill. He is now a clinical associate in department of pathology and pediatrics at the University of Chicago.
"There is evidence of acute injury'' in the vaginal area, Kirschner said.
Wright, whose best-known case as Broward Medical Examiner was the unsolved abduction and murder of 6-year-old Adam Walsh in Hollywood, Fla., was surprised to hear some experts are uncertain whether Boulder's slain beauty princess was sexually assaulted.
"Somebody's injured her vagina,'' said Wright. "And she's tied up. Doesn't that make it involuntary sexual battery?''
Wright said the presence of a small amount of food in JonBenet's small intestine -- possibly pineapple fragments -- indicates she died well after her final meal, most likely late at night or early in the morning.
The blow to her head -- which Wright is convinced was not from a golf club but more likely a blunt object such as a baseball bat or heavy flashlight -- came first, Wright said.
"She was whopped on the head a long time before she was strangled,'' said Wright. "That might or might not have rendered her unconscious. But this is not anything that kills her right away.''
He said 20 to 60 minutes elapsed between the skull fracture and the strangulation.
The reason he's so sure, said Wright, is that details revealed about the brain injury, "the swelling, the bleeding here and there, they take a while to happen.''
And that wouldn't have happened, he said, if she was already dead.
"I think, probably, the head injury came first, because the strangulation resulted in petechial (pinpoint) hemorrhages'' in areas such as the eyelids, Kirschner said.
"I think she died when she was strangled. The cerebral hemorrhaging and bruising of the brain did occur first. But she was still alive when strangled.''
Wright noted that the presence of "birefringent (shiny) foreign material'' in JonBenet's vaginal tract could be consistent with someone penetrating her while wearing rubber gloves.
That, combined with prior disclosures that someone appeared to wipe down the body, is inconsistent with a typical child sex offender.
"It's not the typical pattern of somebody who decides they like having sex with young girls,'' said Wright.
"This looks like something different. If you're into having sex with kids, it's usually not so subtle.''
Wright was particularly intrigued by the girl's empty bladder. Evacuation of the bladder often occurs at the time of death, he said, but it's usually only partial.
Complete emptying of the bladder, he said, would be consistent with her having done so intentionally while awake, near the time of the crime, or a bed-wetting.