South Africa - Susan Rohde, 47, murdered, Stellenbosch, 24 July 2016

[JudgeJudi]

Van der Spuy says Khan did not pick up rib fracturing on left side or sternum and only some fractures on right side. Perumal agrees.

Perumal says a procedure called "spare rib slices" is used to pick up fractures in that area. "It isn't a criticism but it wasn't done in the first autopsy".

Perumal: The fractures with hemorrhages indicate some degree of circulation at time they occurred. Those without mean no circulation at the time.

Defence asks if circulation only occurs when heart is beating or if CPR too. Perumal says circulation can be caused by blunt force injury or by CPR. Chest is CPR site.

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[JudgeJudi]

Perumal says the rule with CPR is to do aggressive, decent compressions, even if you break bones. He says it is not uncommon to find fractures as a result of CPR.

Perumal talks about two different types of hemorrhages on Susan's lungs. "For many years in forensic pathology, they looked for certain signs to confirm someone died from asphyxia. We no longer place emphasis on these classic signs".

Perumal: All the lungs show me is congestion and oedema (build up of fluid).

Van der Spuy says Dr Abrahams alleged that Susan suffered from such severe lung pathology that she could not offer any resistance to attack or assault. Says Susan swore and commented on mistress. Asks Perumal about this given his findings of right lung.

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[JudgeJudi]

Perumal warns he has a long response. "I didn't see the contusions on the lung, either macro or microscopically. If fractures of rib and sternum were before death, that person would be in significant amount of pain with disability. Every breath would hurt."

Perumal: The fractures would have seriously hurt Mrs Rohde. He believes they were caused peri or post-mortem.

Perumal talks about blood in the nostrils. His opinion is that there was an injury to the nose and the blood was then swallowed and ended up in stomach. Two episodes of bleeding because blood also found in small bowel.

Perumal says there was just under a cup of blood. "It is virtually impossible to have that amount of blood emanating from pulmonary contusions. You have got to have vascular injury for the blood to pour out from lungs."

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[JudgeJudi]

Perumal: When blood is found in stomach, it is important to find source. It is negligent to take fluid from body and pour it back into body. When reconstructed, body has to be as dry as possible.

We are taking another short break until 13:15. The court will then sit until 14:30.

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[Dora in the field]

So, Susan was alive when she swallowed the blood that was found in her stomach. Jason denies that he hit her in the face during the physical altercation. When was Susan hurt then?

 

[Tortoise]

Good afternoon all, or evening depending on where you are. I've just had a look at Nick van der Leek's tweets and he is in court so I will post them.

 

[Tortoise]

Nick van der Leek (@HiRezLife) | Twitter

Looks like things are about to start. Judge being summoned. #Rohde had a few words with me when I came in. Tell you more later.

Dr. Perumal, the pathologist, due to continue testifying today. Yesterday he basically introduced his cv. #Rohde Glad I missed that.

Do you have any experience with hanging as a cause of death? "Most certainly, my Lady." Reckons he's done 100/a few hundred autopsies

Perumal faces the Judge. Slightly away from Van der Spuy. Today is all about 1 pathologist expert vs another

Khan based in the Cale. [Cape?] Autopsy in Joburg. Perimal based in Durban. Khan didn't attend 2nd autopsy on August 1st.

"What special investigations did you perform in terms of the hyoid bone?" Perumal said he found a spot of blood on inside.

Hyoid is u-shaped bone made of 5 bones. Google it and orient yourself where it is in neck and throat.

Wow. Perumal removed Susan's hyoid bone and took it with him...as an exhibit. Had it X-rayed. Entirely intact. No fractures.

Judge taking meticulous notes. Perumal speaking slow in order for her to transcribe each word.

Perumal has kept the hyoid bone as an exhibit. Crucial piece.

#Rohde watching his expert from opposite of room with a confident expression. Between Perumal & accused the door lies on its side on floor.

Very little alcohol in Susan's blood. Not none, but negligible. O.05%. Khan got different amount.

Dr Perumal took the autopsy photos. I'm wondering whether that's typical. I'll find out.

Khan said of Perumal "What kind of autopsy is this?" Called Perumal a hired gun. Perimal responds by quoting a French author.

On that note, a reminder that Perumal was called to testify in #OscarPistorius and #VanBreda cases as well. Not a hired gun?

 

[Tortoise]

Nick van der Leek (@HiRezLife) | Twitter

"I heard those comments...I'm not going to reduce myself to personal comments."

Van der Spuy going to bring in a model and have pathologist draw ligatures on her neck with a black koki.

Perumal weighs in at length that he's simply giving facts, not opinions. Loses his voice. Clears throat. Alrighty then.

As Van der Spuy questions his expert, who is turned away from him slightly, he glances at me quite often. Kinda disconcerting.

Autopsy is usually same day or next day. Perumal in his pinstripes is a doctor - an expert - on death.

Perumal invokes his expertise in #OscarPistorius trial. And yet he was never called to testify ne.

Thomas Mollett is sitting opposite me. He wrote a book on #OscarPistorius.Will ask him his thoughts on this aspect of testimony after

Perumal holds up an autopsy wound - photo 6 - to the Judge to show sutures. Judge looks, nods, winces slightly, scribbles a note.

Thomas cranes his head to see picture. #Rohde glances at it. I can't see from where I'm sitting. Refers to "ligature imprints..."

Perumal explains jargon. Blanched refers to diffuse bruises. Is bruising from fingers or a cord?

Perumal is quite a wordsmith. Refers to wounds as "insults". He's articulate, likes words. Almost like a stage actor.

Perumal says our insights into autopsies comes most from rats and dogs. Refers to new trend of people filming themselves hanging.

Setting up the model during the adjournment. Arrived in a coffin-sized box filled with styrofoam.

We're back. During the break I had a look through defence exhibits. Many images seen for first time. Very disturbing.

 

[Tortoise]

Nick van der Leek (@HiRezLife) | Twitter

The bruise on Susan's inner thigh is massive. About the size of two bricks or about six hand palms. Roughly shape of a rectangle.

That very slight black mark is meant to suggest ligature to the neck Nick van der Leek on Instagram: “That very slight black mark is meant to suggest ligature to the neck #Rohde”

Susan sustained 2 small cuts onto the tops of her toes. How do you cut the tops of your toes?

Van der Spuy now asks Perumal to demo ligatures on this model with black marker.

Nick van der Leek on Instagram: “While Perumal demonstrates the ligature on the mannequin's neck, murder accused #Rohde takes a swig of water.”


The hyoid bone floats in the throat. Unique configuration. It's actually a hybrid of bone and cartilage. So it's flexible.

Judge asks "Are we done with this?" Perumal says he's done. Judge points to mannequin. Says it's obstructing her view. Ironic.

Perumal refers to small injuries on knuckles and a bruise on Susan's wrists. #Rohde scatches his face.

Perumal describes bruise on Susan's thigh as a "healing bruise". The huge black bruise didn't appear healing.

Perumal has done this a lot. Is able to hold court for lengths without Van der Spuy asking him anything.

This is gross. Perumal describes removing face flap to check hidden areas behind face skin "mask" to check bruising/bleeding

Same examination was done on Reeva Steenkamp.Perumal says it's always done on women. It's routine because smothering so stereotypical

Perumal shoots defense case badly in the foot. Van der Spuy impatiently: "Let's move on."

Susan's tongue was bruised too. God.

Interesting that state presented this evidence by projecting them onto the wall. Allows media to see them. Defence using paper.

"I don't know why...but everything in pathology refers to food." Refers to rib procedure as spare rib slices. Ag nee man.

Perumal says Susan even had rib fractures. Suggests they were caused by CPR. Sorry but that's nuts.

As Perumal refers to #Rohde not having training in CPR, I glance over to him. Eyes still doing excessive twitching. Nervous twitch.

 

[Tortoise]

Nick van der Leek (@HiRezLife) | Twitter

Petichial haemorages is a tough one. Sometimes this tiny bursting of fine capillaries caused by trauma. Sometimes by asphixia.

Van der Spuy asked to link back context of injuries.Mentions Susan using expletives. Judge asks how linked. "I thought it was clear."

Van der Spuy mentions Susan swallowing blood, coughing it up. Same thing happened in the murder of Meredith Kercher. Horrible exit.

Perumal refers to "every breath" hurting with a rib injury. He glances at #Rhode BLINK...BLINK-BLINK...

Perumal refers to nose being distorted/abbreviated. Remember #Rohde mentioning he elbowed wife in face?

 

[JudgeJudi]

Court is back in session. Perumal says a negative finding in forensic pathology is just as important as a positive finding. There should be photos even for negative findings.

Perumal says that it is almost impossible for a neck block (used during an autopsy) to cause an injury to the back of the neck.

Perumal: I am not at all convinced that this is a post-mortem artifact and the characteristic of this mark, I cannot see how it is caused by a neck block. Without being disrespectful, it is an observer error.

Team News24 (@TeamNews24) | Twitter

 

[Tortoise]

Did they look for or find a trail of blood outside from Susan's toe injuries I wonder.

 

[Christelle]

The guy could very well be innocent of her murder. But, i highly doubt it. Too many cases of this nature in SA to think otherwise.

 

[Tortoise]

Welcome to WS Christelle.

 

[JudgeJudi]

Van der Spuy turns to time of death. State pathologist's final report and testimony says death occurred at 5:40am on Sunday 24 July 2016 and 95% probability it occurred at that time.

Defence pointed out to State pathologist that he hadn't measured temperature on the floor, possibility of sunlight in bathroom, temperature in bedroom and had taken ear, not anal temperature.

VDS: After cross-examination, he conceded he made error and that he had repeated it with 50 other scene examinations.

VDS refers to a 1995-edition forensic pathology book. Perumal says that "forensic 101" is looking at circumstances leading up to death and determining time of death.

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[Christelle]

Welcome to WS Christelle.

Ah, thank you. Been a long time lurker.

 

[Tortoise]

Live link

 

[JudgeJudi]

Perumal: In this case, you cannot say that the time of death is 05:40.

Perumal says at best, you can say death happened between 2:50 and 8:30am "but still 5% chance that it occurred out of that". Stating an absolute time like in crime series, "stays with TV. It is not applicable scientifically".

Perumal: "The challenge in forensic pathology is to make proper observations. The bigger challenge is interpreting observations."

Perumal confirms that three authors of the forensic pathology textbook that VDS is reading from are internationally recognised. "I personally do not see anyone else having any more authority than these three writers".

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[JudgeJudi]

VDS: Is the presence of a fracture of a hyoid bone diagnostic of any type of death? Perumal: "The skeletal structures in neck, which include hyoid and thyroid cartilage can be injured, fractured in both manual strangulation and hanging.

Perumal: We are beginning to see more studies that show these fractures are much higher in hanging. Presence of skeletal injuries do not support or prove either way.

Perumal: Beyond discussion that the hyoid bone is not fractured. What it shows is hemorrhage on inner side. When deceased had convulsions, there is movement and likely related to this, not external trauma.

VDS: So when it comes to thyroid cartilage and alleged fracture of one superior horn, your interpretation is that it was an injury caused during dissection process? But even if incorrect, this is most common skeletal injury with hanging? Perumal: Correct.

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[JudgeJudi]

Perumal acknowledges that he knows about Jason's version of events that night. VDS asks if he found injuries to rule that out. "No there is nothing I can specifically say that is totally inconsistent with the version he has put before this court.

Court adjourns for the day. Dr Perumal will continue with his testimony at 9:30 on Thursday morning.

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