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

[JudgeJudi]

That may be but Perumal testified in the Rohde trial he retrieved it.

Thanks Tortoise. I didn't hear that.

 

[JudgeJudi]

Perumal is back in the witness box. He tells the court he is giving his interpretation of the facts he has observed.

The private pathologist points out that he is not testifying as individual but bringing years of training, experience.

Van Der Spuy wants Perumal to explain concepts of typical and atypical hanging.

Perumal says a typical hanging is when the noose is behind neck. Atypical is anything else.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

Perumal: "Most common ligature position is left or right of neck". A total hanging is where full mass is held by cord.

A partial hanging is where part of someone's mass is taken away from suspension point because of contact with something.

VDS tells Perumal that Jason testified his wife's feet were on the floor, thus a partial hanging.

Perumal: Position of body upon discovery is not necessarily reflective of original position.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

VDS asks forensic pathologist how easy it is for someone to hang themself.

Perumal: Suicide is common and because hanging is most common, I can extrapolate and say it is relatively easy.

Perumal: Within 8 seconds, unconsciousness sets in. Once there, you can't reverse the process.

Perumal says he has seen a lot of cases of police cell hangings where strips of blankets are used.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

Perumal: All that is needed is enough pressure with weight of head and point of suspension.

Perumal: All that is needed is enough pressure with weight of head and point of suspension.

VDS is reading out details about Susan's body at point of discovery at the crime scene.

VDS says Coetzee-Khan examined Susan's body and said lividity indicated she died in supine, not hanging position.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

Perumal talks about drainage of blood to the lower body. He says Coetzee-Khan made a "rookie mistake" because hypostasis, lividity does not tell you position in which they died.

Perumal: If somebody hung themselves and was removed and placed on ground, then lividity he described is entirely consistent with that scenario. But textbook warns against using lividity being used to make his finding.

Perumal: All literature will say that the best you can do is say that this is an important sign that death has taken place. It's not a reliable sign to be used as indicator to put into formula for determining time of death.

VDS says that because of skin pallor, allegation is that Susan was smothered. Perumal replies: "I cannot see that the use of pallor of the nose, lips is an objective indicator of smothering". Speculation unless finding underlying tissues bruises there.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

Coetzee-Khan said in his report after visiting scene that he recommended police seize Jason's passports. Perumal has a lot to say about this action by his "junior colleague".

Perumal: "This recommendation for passports to be seized of suspect in forensic pathology, is serious overreach. It is not the function of the doctor to engage in this."

Perumal: "It is an SAPS responsibility to be looking at suspects fleeing. Without doing the autopsy and getting in better environment and getting idea of what happened, to make this comment at the scene, is serious overreach on behalf of the practitioner."

Perumal turns to lung bruises/injuries. He says these are typically seen in high velocity blunt force trauma cases, like car accidents, and CPR cases where rib and sternum fractures press onto lung.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

Perumal says his opinion is that the lung contusions were caused by the trauma of CPR.

VDS asks whether in the case of an electric cord with smooth surface, would it always be expected to have leathery parchment skin. Perumal says not always. Sometimes might just find blanching.

Perumal: When resuscitation takes place, one extends jaw [especially lower jaw] to keep airway open. He looks at post-mortem photos and says Susan's bruising is in that same area.

Perumal: One expects to see bruising in manual strangulation in area of larynx, which is why you often get hyoid bone and thyroid cartilage fractured. Not excluding it but points out that most injuries are higher than that.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

Perumal says manual strangulation is unlikely because associated bruising is not in typical place.

VDS points out external scratch marks. "You cannot totally exclude correlation between these marks and manual strangulation, however, these are more likely associated with resuscitation attempts?" Perumal corrects: "resuscitation attempts with hanging"

VDS says that looking at videos of people hanging, some have a change of heart and try to stop process. Perumal: "I don't think there was that attempt to grab at the ligature once it was placed."

VDS says he is not sure of State's case with cause of death. "The indictment refers to manual strangulation but this was not put to Jason during cross-exam. Then smothering was introduced and put to Jason."

Sounding like a gripping TV series, Van der Spuy says he will ask question on cause of death "after the break".

Short tea adjournment.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[Tortoise]

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[JudgeJudi]

We are back. Perumal is reading out literature on partial hanging and how the required downward force is reduced depending on what body part touches the floor.

VDS points out to court that Perumal is speaking in his dual capacity as head of forensic pathology services in Mpumalanga and as a practitioner with limited private practice.

VDS is reading through Perumal's report and stopping at sections to ask whether he wants to add anything.

VDS; When Jason placed his wife on ground to perform CPR, he noticed trickle of saliva, wiped it away and later noticed blood from nose and mouth that was wiped away with tissue. Perumal says this is blood stained fluid

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

VDS turns to Susan's blood alcohol levels. Perumal says no matter what degree of tolerance, an average of 0.14g/100ml at around 2am would influence anyone. "It will affect the central nervous system of a vast majority of individuals".

Perumal apparently compiled a list of all the mistakes that the state pathologists made. But he is going through his documents and can't find it now. Puts it down to "gremlins".

Perumal has found his list and Judge Salie-Hlophe asked if the gremlins returned it to him. Public laughs. He is reading it out now. I will take a screenshot in a while.

Perumal: The practice of medicine is a science. In every day life you deal with formulas. Error made in terms of calculations of time of death could have had far-reaching outcomes, adverse outcome that could be deemed negligence.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

As promised, here is Perumal's list of errors that he believed Coetzee-Khan made when doing the first post-mortem on Susan Rohde.



VDS brings out a whole lot of medical literature and asks Perumal to explain why a dribble of saliva from Susan's mouth was a sure sign of ante-mortem (before death) hanging.

Perumal reads out different authorities to reinforce that saliva dribble is suggestive of ante-mortem hanging.

VDS goes to conclusions stated in Perumal's report. Asks to comment on Coetzee-Khan referring to external airway obstruction. Perumal: "I assume that refers to blockage of nose and mouth".

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

Perumal found that Susan's injuries were consistent with ligature strangulation i.e. hanging. He cautions that he can make conclusion on what death is consistent with but not to the exclusion of other pathology.

Perumal: "At the time of the autopsy, we don’t have the whole picture. We only have what injuries are presenting. I would not limit myself as being categorical, adamant in terms of cause of death."

Perumal: "I am saying to the court that I can say it's consistent with hanging but I can’t be categorical or adamant about this finding. It is the role of the court, which has far more access to the information. I think any pathologist should not be adamant."

VDS asks if there's a difference between manual strangulation and manual throttling. Perumal says in both, the hand is used to inflict pressure on the neck.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

Perumal is still reading excerpts from different medical authorities to back up his testimony. Jason listens while resting his hand on his mouth.

Perumal says soft tissue and skeletal injuries occur with high frequency in hangings. "The presence of these injuries does not necessarily mean it was manual strangulation."

Perumal reads an article that says while CPR is potentially life-saving it also causes a variety of injuries. Injuries occur in 93.7% of CPR cases, it states, most to organs and structures in the chest region

Perumal reads another article on CPR and injuries. Potential injuries when reclining neck to open airways and for intubation.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[JudgeJudi]

VDS refers to state pathologist Dr Abrahams saying Perumal cannot be trusted because he is a "hired gun".

Perumal responds: "Respectfully, Dr Abrahams seems to be living in quite a small, isolated world as it seems she doesn't understand what the role and value of a second autopsy is."

Perumal: He said that her comments are "most ridiculous and outrageous". Says that all documents come before court and under scrutiny. "I won't sacrifice my independence and credibility for any person or institution".

VDS indicates that Perumal will return at a later stage for cross-examination.

Court is adjourned until 9.30am on Monday for the defence to call a psychiatrist.

Jenna Etheridge (@JennaEtheridge) | Twitter

 

[Tortoise]

Thank you JJ.

I think I understood it that the defence will hear the next witness on Monday and possibly revert to Perumal on Tuesday to finish his evidence in chief before handing him over to the prosecutor. At the rate this court moves I'm not banking on it.

Strangely enough van der Spuy is the first defence advocate that I have been able to stomach.

 

[Estelle]

I find that van der Spuy's accent is more palatable to my ear and he is less aggressive than others I have heard.

 

[JudgeJudi]

Strangely enough van der Spuy is the first defence advocate that I have been able to stomach.

I agree. And strangely enough Perumal is one of a defence team's major witnesses that I've been able to stomach. I find him extremely articulate and a very impressive witness.

I found Khan very aggressive and rather unprofessional towards a colleague, even if they are on opposite sides of the fence.

I've heard very little of his testimony. Copying the tweets really plays havoc with digesting what is being said and tweets are definitely not a substitute for that. I'm always having to play catch-up the next morning.

 

[Dora in the field]

Dr. Perumal was an excellent witness for the defence. He has vast experience in his field, and like he pointed out, no professional is willing to lose their credibility just for one case/client. Let's see how the state responds.