By: Dovesblood
September 24th., 2008 was the fourth day of testimony in the murder trial of Nixzmary Brown's mom, Nixzaliz Santiago. First I'll say what happened in a nutshell, then I'll go into detail about the testimony.
HERE'S WHAT HAPPENED IN A NUTSHELL: The prosecution called the Medical Examiner, Dr. Barbara Sampson.
The autopsy photos are shown. No jurors or anyone in the audience visibly crying. Unlike Cesar's trial where jurors were crying and people were literally breaking down in tears and running out of the room, nothing happened this time.
Sampson stated Nixzmary was malnourished, hit on the head on January 8th, and lied on the floor dying for two days. She said she used Nixzmary's body temperature to come to this conclusion.
Defense counsel, Kathleen Mullin points out to jury that Sampson has accepted money for her testimony in the past, applied for expert status in the past when she wasn't an expert, showed Nixzmary was born with a very low birth weight, introduced medical records from birth up until she was approx. 7 years old, shows her weight over the years has gone up and down, and that when it goes down it's down pretty low, that in 2005 she had a full thick head of black hair and people who are starving have thinning hair, that when people are starving their bodies secrete a chemical called "acetone" and acetone was not present in Nixzmary, that she contained fat cells and had no chemical indicative of dehydration. That's what happened in a nutshell.
HERE'S THE TESTIMONY IN DETAIL: In the morning, the chair that Nixzmary was tied to was brought out and placed on the evidence table that's in front of the prosecutor's desk. The female guard also put the duct tape that was used to bind Nixzmary, to the left of the chair along with the bungee cord.
Only Asst. D.A. Anthea Bruffe was in the room.
When everyone arrived, defense lawyers, Sammy Sanchez wore a creme suit and Kathleen M. Mullin wore an eggplant purple skirt suit. Lead D.A., Ama Dwimoh (ja-mo) wore a black skirt suit. Judge Patricia DiMango had a gray pocketbook. Nixzaliz was wearing a tight brown blouse with what appeared to be a floral design going across the blouse's U shaped neckline. She wore brown pants with black shoes and her hair was tied in a bun with a satin brown scrunchie.
The Judge, Patricia DiMango spoke about hospital records that they were in possession of regarding the defendant's children.
Prosecution's first witness was Dr. Barbara Sampson. She' s got short brown hair in a bob, glasses, tall, and wore a black pants suit.
Lead DA Dwimoh did the direct exam. Sampson started listing her credentials. She works for the office of the Chief Medical Examiner for the City of New York. She's the first deputy chief M.E. for the past 3 years. That means she's the second in command only to the Chief Medical Examiner for NY, Dr. Hersch. She has a B.A. from Princeton, a PH.D and MD. She majored in molecular biology. Has been an M.E. for 10 years.
At this point, Nixzmary's stepdad's lawyers, Jeff Schwartz and Barry Deonarine walk in.
Sampson continued listing her credentials. She supervises 30 Medical Examiners and supervises various labs: x-ray labs, toxicology, anthropology etc. Runs 2 training programs and performed 15-1600 autopsies herself. Witnessed 5x that number being as performed and testified 35 times.
Dwimoh asked the judge for Sampson to be declared an expert.
When the judge asked the defense lawyer, Kathleen Mullin if she has objections, Mullin rises and points out that Sampson did not perform the autopsy herself on Nixzmary. Mullin also says that Sampson was not present at Nixzmary's autopsy.
Mullin says some(?) org. isn't aware of forensic NEURO pathology, that they don't recognize it and objects to expert status in forensic neuro pathology.
DiMango grants Dr. Sampson expert status.
Dwimoh asked about records kept at the M.E.'s office.
Sampson said they do take photos of autopsies when warranted.
Dwimoh hands her people's 51, a 28 page autopsy report for Nixzmary Brown. Medical Examiner's recored K06183.
Dwimoh then gives her copies of Nixzmary's autopsy photos and birth certificate, medical records at 5 years old, emergency room records 1 month before she died, and reports from Dr. Wetli and Dr. Sloan. (Wetli was Schwartz's M.E. and Sloan works for the city and inspected the "fetus in the jar"
Sampson said the autopsy was performed by Dr. Guitierez on the morning of Jan.11th 2006.
Nixzmary was 36 pounds and 45 inches in length. Less than the 5th percentile for a 7 year old.
Dwimoh shows Sampson a chart of growth curves for girls aged 2-20. Charts made by Center for Disease Control. peoples 65- ht and wt. and 65a which is body mass index.
Mullin at her defense table asks Sampson if she's familiar with the charts. Sampson answered, yes.
The chart, which is on a gigantic easle is placed to the right of the witness box. Sampson walks over to the chart to explain that girl's age in years placed on bottom of chart and along side of chart are weight and height. Curves represent percentiles and an AVERAGE 7 YEAR OLD IS IN 50th PERCENTILE. Sampson marks where Nixzmary would fall and says NIXZMARY WAS IN 5th PERCENTILE, meaning only 5% of 7 year olds would be that wt and 95% would weigh more.
She said looking at Nixzmary, they determined she was malnourished, which means insufficient caloric intake.
At birth, Nixzmary was 7 1/2 pounds and 20 inches long. She said Nixzmary had multiple blunt force trauma to the head, torso and extremeties.
SAMPSON THEN DEFINED CERTAIN TERMS SHE'D BE USING:
CONTUSION: bruise
ABRASION: scrape
LACERATION: tear in the skin
Sampson said Nixzmary had a 3 1/4 inch dried abrasion on her head, dried laceration on right side of face, 1 inch scrape between nostril, cut behind right ear.
Then Dwimoh asked for the lights to be dimmed, she walked over to the projector and started placing the autopsy photos upon projector which projected onto a gigantic screen to the left of courtroom. There were also 2 tv screen at either side of the gallery.
There was one photo of Nixzmary's right eye. Above her eyebrow was a laceration. You could see the stitches. Area had purple bruising underneath. The left side of the bruise looked like a droplet fallin down.
Photo: her eyes and nose and there was a scrape on the tip of her nose.
Photo: Her chin with a gigantic laceration with bruising. This bruise ironically, was heart shaped. It looked like it was a scab.
Photo: her lower lip being pulled back by metal clamps. On the inside of the lower lip was a red bruise in the shape of a submarine. Estimated to be 7 hours old.
Photo: right ear and behind ear gigantic bruising.
Photo: Nixzmary's eyes (almost open a little bit) and her nose. There's a ruler under her nose. She had two black eyes. (This was the saddest photo).
Photo: left hand side of Nixzmary's chin , ear, neck and left shoulder (thin shoulder bone protruding upward) You can see bruising and scraping on the chin, abrasions on her neck in the form of two parrallel lines going around her neck (Sampson said it was a "pattern injury") and her shoulder had bruising and lacerations.
Photo: On her torso there were muliple old abrasions with scabs forming and scarring, 2 1/4 inch abrasions on her shoulder, faint contusion on left side of abdomen, 1 inch contusion on her right hip, contusion on her right buttock, multiple smaller scars on the back of her neck.
Photo: buttocks, contusions and bruising, 2 abrasions on the right side.
Photo: the back of her neck and shoulders. You can see the two parralel lines going around her neck. There was also white flaky material that was consistant with duct tape residue.
Photo: Back, buttocks, back of arms, upper legs. Bruising in the middle of her back that was blue-purple, lower left back: bruises brown and green. There were 6 or more circular shaped bruises on her lower back to the right of photo. Giant bruise on lower back extending towards buttock area. Giant bruising on left buttock..Bruises on elbows and on back of her legs. Bruises on her legs were brown. (variation in color means that they're not sustained at the same time. Sampson suspected hours or days).
Dwimoh passes the photo of Nixzmary's neck with the parrallel lines to the jury. Mullin objects and there's a bench conference.
Sampson said when they took microsections of the skin under the microscope, they saw evidence of healing.
Photo of her legs. On left leg there was an abraision and ligature mark. Bruising was brown. She had bruises on her right knee. Both knees had multiple contusions. On her right lower leg, she had small abrasions. She had a painfully deep ligature mark on area above her left ankle.
Dwimoh holds up the bungee cord and twine used to tie Nixzmary and asked Sampson if these could've caused the ligature mark. Sampson answered, yes.
There's a bench conference and Judge DiMango has the jury take a brief break.
Sampson walks out of the room.
Nixzaliz cuffed and taken into the back.
During break, Sanchez and Mullin walk over to talk to Jeff Schwartz.
Judge DiMango's parents were in the courtroom, sitting in the front row on the left benches.
After the break, the showing of the photos resumed. Photo: On Nixzmary's right lower leg was an abrasion. There was a ruler above it. It was circular shaped and metal clamps were holding the leg.
Photo: back of her left foot by her heel. Deep ligature mark from the bungee cord. It was in the shape of a triangle pointed to the right.
Photo: knee with ruler under it. Contusions on the knee.
Photo of legs: abrasion on left ankle, abrasion on front of the right leg, above ankle area. Abrasion was a straight line.
Photo: legs. left leg closest to camera. Numerous contusions on both thighs, knees and legs. (gigantic bruising on upper thighs).
Photo: back of buttocks and legs. lower right palm seen in the picture. You see the two giant bruises on lower back going into buttock area. Sampson noted that when bruises are brown, it denotes an older injury a week or two old.
Then the crimescene photo of Nixzmary taken lying on the floor of her apt was shown. Her head is closest to camera, to her right is a bed with a blue comforter, in back of her legs is the radiator, and to her left is a children's table (table had a blue top and yellow legs) that has a cup of Jello pudding with the spoon still in it, resting there. Next to the pudding is a purple box. (resembled a kid's crayon box) You can see her hip bone protruding out in this photo. (these crimescene photos are really disturbing. I find them more haunting than the autopsy photos)
Next photo: Nixzmary's lower right hand. Contusions of various colors and swelling of the right hand. There's a bruise from her thumb to her index finger. Another bruise from her ring finger to her pinky and bruise extending downward towards her palm. Bruise across her wrist area.
Photo: crimescene photo. Nlixzmary's lower abdomen. You see her stomach and the red waistband of her red sweatpants. Contusion on lower abdomen. It's large and goes from her left hand side, all the way past her belly button going to her right. The bruise had a point that went past her belly button to her right.
Sampson then started talking about the internal exam. Under the scalp on the right side there was bleeding and hemorraging. Skull opened and the area around the brain was examined.
Membrane around the brain called the dura. She said the subdural Nixzmary sustained was large and caused pressure on brain and that herniation compression on the brain caused damage to important centers of the brain that control breathing and heart rate. She died because of this.
Sampson said the brain was put in a substance called formalin that causes the brain to harden so that slices can be made. Small pieces are taken for microscopic exams. It showed the subdural hematoma was adherant to the dura. Estimated to be 2 days old. Brain not getting enough oxygen.
Sampson said Nixzmary had subscalptulure bleeding (underneath the scalp) and the subdural hematoma on the right side caused by a tearing of vessels. She suffered respiratory depression because her brain wasn't getting enough oxygen.
Sampson said the subdural hematoma could not have occured 6-8 hours prior. She said what was seen under the microscope was consistent with a subdural that was 48 hours old.
She then listed the symptoms of what would happen to the person after the blunt impact to the head: headaches, nausea, vomiting, confusion, sleepy, unconscious, breathing depressed, and then finally the heart would stop. She also said the person would possibly be moaning in pain and gasping for air.
Nixzmary was pronounced dead at 4:38 am.
Sampson then said that there are 4 areas the M.E.'s look at to determine the time of death:
1) Post mortem rigidity
2) Lividity
3) Algor mortis - body temperature
4) Chemical methods
(She used body temperature to determine Nixzmary's time of death).....She then explained all four methods:
1) Rigidity is when your body goes stiff after dying. It's caused by a chain reaction in the muscles of the body. Rigidity peaks 8-12 hrs after death then decreases. After 24 hours, not visible. You have to have good muscle mass to become rigid. Nixzmary had no rigidity.
2) Lividity is the settling of the blood. If a dead person is lying on their back, then the blood will settle on their back and pool there. It's not visible for hours after death but once it occurs it never changes.
3) Algormortis is the cooling of the body: body temperature. Normal temp =98.6. You lose quite a bit in the first hour or two after death. as time increases, temp. continues to fall until it reaches room temperature. Obese people and heavily clothed people or someone lying on a cold floor, will cool slower. Body temp. drops a degree and a half and hour. M.E. arrived at 8:30 am, Nixzmary was 82 degrees F. The ambient (room temp) was 78 degrees. She died 12 hours prior to the ME getting there.
4) Chemical tests Post mortem potassium is measured by the fluid in the eye. As soon as you start dying, potassium starts coming out of your cells. Not a practice used in forensic pathology.
Defense counsel, Mullin, objects and tells Sampson to cite the literature.
Sampson said the best thing they had to go on was Nixzmary's body temp.
Sampson said the 2 black eyes would be consistent with a throw to the floor and that they could not have been self inflicted.
She said, Nixzmary went into respiratory depression because of the size of her subdural. After respiratory depression that leads to cardiac arrest. She said the signs of respiratory depresssion are: breathing labored, gasping for breath, then you stop breathing.
She said if the person was in a bathtub then by a radiator, it could raise body temp.
She said Nixzmary had focal bronchial pneumonia caused by the respiratory depression. It develops in people not able to breathe properly and clear their airways.
Sampson listed Nixzmary's cause of death as: Child Abuse Syndrome with the subdural hematoma. Child abuse syndrome is a constellation of symptoms indicative of abuse: multiple abraisons, contusions, lacerations, malnourished, bound. What killed her is the subdural hematoma. Sampson said what physically caused Nixzmary's death was a herniation of the brain that suppressed breathing centers of the brain. They might moan in pain or gasp for air. Sampson said the death process would be slow, over the course of hours. She stated if a person receives prompt medical attention, they might be able to survive.
Dwimoh shows Sampson notes from the M.E. for a different case k06194. (the miscarried fetus that Nixzaliz put into a jar) The item examined was a jar with clear liquid, a blood clot, tan tissue. 110 milliliters of clear liquid. tan tissue was 5 by 2 by 1 centimeter. Blood clot was 5 by 2 by 3 centimeters. Tissue was smaller than a matchblade.
(I've noticed both sides (prosecution and defense) refer to what was in the jar as "not a baby". This really goes to the heart of the pro-life movement, that LIFE STARTS AT CONCEPTION, and not when the unborn child is out of the mother's womb. To the prolife movement as well as those who believe life begins at conception, a baby is still a baby regardless of whether it is fully formed, has a head, arms or a torso. It is still a human life. I guess what I'm trying to say, is that even though alot of people see the substance in the jar as tissue and a blood clot, and junk that should have been thrown away, to someone who believes that life starts at conception, what was in that jar WAS a baby and should not have been dumped in the garbage. Maybe she shouldn't have kept it on her dresser, but it could've been buried. There are plenty of people who have miscarriages in the first 20 weeks that choose to bury even though what they're burying might not have been fully formed)
(The defense is trying to portray Santiago as "crazy" so I understand why they're claiming that it's not a baby. To the average person on the street, they'd see the substance in the jar as just tissue and WOULD think that anyone who thinks it's a baby is crazy. Nevermind the fact that if you ask them what religion they are, they'd probably say, "Christian". Well here's a little news flash: Christians believe life begins at conception! So what they're saying goes against their own religion!)
(I could never understand why the prosecution would keep saying that the fetus in the jar is not a baby. Every time they say that, it only helps the defense because they're basically agreeing that Santiago is crazy for believing it was a baby. They should've taken my position, that it WAS in fact, a child and that Santiago is NOT crazy for believing so.)
(Santiago was pro-life, because when she got pregnant with Nixzmary and told Nixmary's biological father, Abdrurrahman Mian, he wanted her to have an abortion. She refused telling him she doesn't believe in abortion, and she doesn't believe in killing children and hurting children and that she would rather give birth to them than abort them. Aftrerwards, he offered to give her money to help out with the baby but she would have nothing more to do with him after he suggested abortion)
Before the court breaks for lunch, Judge DiMango tells the jury to tell the court officers when they need time off for religious holidays.
After the lunch hour when we returned to the room, the chair that Nixzmary was tied to was still standing atop the evidence table.
When everyone returned, defense lawyer, Sammy Sanchez who was sitting at the table, pulled out a metal container of mints and started popping them in his mouth. He offers some to Mullin and she stretches out her hand and he taps the container with his index finger so the mints fall out into her palm.
Jeff Schwartz is back in the room.
Defense counsel, Mullin does the cross exam. Mullin was like a barracuda released into the water. The barracuda swam straight over to Sampson, ready to rip her to shreds and devour her.
Mullin started out by getting Sampson to admit that she sometimes accepts money for her testimony.
Then Mullin brought up that Sampson was a paid consultant in a case in Ohio called Taser vs. City of Akron. Taser company sued Dr. Lisa Kohler for claiming that someone's death was caused by a taser. Kohler hired Sampson to be an M.E. that would testify on her behalf that the taser did cause the death. Mullin pointed out that Sampson had no knowledge of taser related deaths nor had she ever done a single autopsy on a taser victim. Sampson also admitted that she had no knowledge of how tasers even work. Mullin pointed out that Sampson applied for expert status but was denied that expert status on whether tasers contributed to death.
The young girls who accompanied Sampson to court who were sitting in the gallery, looked mad that Mullin was slinging the dirt on Sampson. When I looked over at them, sitting on the left hand side of the room, they were making faces and crinkling up their faces when Mullin exposed Sampson.
Dwimoh, of course, objected.
The reason Mullin brought this up, I think, is to show the jury that Sampson is not above accepting money for her testimony and has applied for expert status in the past when she clearly wasn't an expert. (and got denied)
Mullin defined the meaning of the word "autopsy" saying that it comes from the word: autopsia, meaning "to see with your own eyes".
Mullin pointed out that there were 3 medical examiners present during Nixzmary's autopsy, and Sampson wasn't one of them and wasn't even in the room.
Dr. Guitierez was the one who performed the autopsy and has been an M.E. for 2 1/2 decades, which is longer than Sampson. Mullin also points out that Sampson, being Guitierez's boss could've permitted him to come here today. She also said Guitierez gave sworn testimony 3 times in relation to this case.
There's a bench conference.
Juror 3 asks for some water and starts chuckling afterwards. Everday jurors 2 and 3 (two young black females) start talking to each other and laughing during testimony. Juror 2 likes to make faces when testimony is being given.
Mullin asked Sampson if she discussed her conclusions regarding Nixzmary's case with Guitierez. Sampson said no because the conclusion was the same so there was nothing to discuss. When Mullin kept asking Sampson about conversations she had with Guitierez, and if both their conclusions were the same, the implication to the jury is THAT DR. GUITIEREZ, WHO DID THE AUTOPSY, MIGHT HAVE A DIFFERENT OPINION THAN DR. SAMPSON, WHO DIDN'T DO THE AUTOPSY.
Mullin then focuses on the starvation aspect of the case.
Mullin offers into evidence, Nixzmary's birth records from St.Mary's hospital.
Mullin then drew Sampson's attention to the chart entered into evidence by the prosecution. Sampson previously stated she was familiar with the chart. It's a growth chart for girls from birth to 36 months. Mullin points out that THE BOX THAT ASKS FOR THE MOTHER AND FATHER'S STATURE IS LEFT BLANK!.
Then Mullin drops
a bomb!
She confronts Sampson that THE BASIS FOR THE CHART IS WHITE CHILDREN!!! This is big because Nixzmary wasn't white, she was half Hispanic and half Pakistani. The chart being used to judge her is for white children! Mullin then points out to Sampson that there are other charts for children of different races. Sampson claims she didn't know this.Mullin then hands Sampson Nixzmary's "well baby doctor visits" from birth up until 2005, so they can see what Nixzmary's weight was throughout the years.
Mullin asks Sampson to get up and go to the chart and mark with a marker the different points that correspond to what percentile Nixzmary's weight corresponds to.
Mullin wanted it to be on the record that it was Nixzaliz who took Nixzmary to all of these doctor visits but Sampson, looking at the signature, couldn't make out that it was Nixzaliz's. Judge DiMango looked at the signature and also agreed that the signature couldn't be made out. Mullin pointed out that there was no one else to take Nixzmary to the hospital but Nixzaliz. When DiMango suggested the grandmother, Mullin pointed out that the grandmother was in Puerto Rico. DiMango refused to allow that it was Nixzaliz's signature on the medical records.
Mullin then directs Sampson's attention to Nixzmary's weight at different ages.
2 months old = 9 pds. 6 1/2 oz. (bet. 10-25 percentile)
4 months old = 12 pds. (close to 25 percentile), 9 months = 16 pds. 1 1/2 oz. (10th percentile--a drop from her 4 month well baby visit)
12 months old = weight can't be read on chart
17 months= 21 pds. 4 3/4 oz. (over the 75th percentile)
Mullin points out that FROM BIRTH TO 15 MONTHS, "THERE'S A CONSIDERABLE INCREASE IN WEIGHT" and that "SOMEBODY HAS BEEN FEEDING THIS BABY".
"OBJECTION"! said the D.A.
Dr. visit for the year 2000, no weight listed.
2 years old= 24 pds. ht. 32 inches. (weight fell a little bit over the 75th percentile)
Mullin points out that Nixzmary starts out life low on the percentile, then goes up, then goes down.
5 yrs old= 35 pds.(25 th percentile - a significant downturn in weight)
6 3/4 yrs old= 37 pds, 45 inches. ( a little above the 10th percentile.) Nixzmary is again moving down.
Nixzmary's weight at the time of autopsy was the same as her weight in 2005 at a pediatrician's visit.
The point of all of this was to show that Nixzmary was born with a very low birth weight and her weight throughout the years has gone up and down and when it goes down, it goes down pretty low. She was always an extremely very thin girl.
Mullin points out that at a 2005 pediatricians visit (with Dr. Jose Simpao), it was noted that Nixzmary had a full head of thick black hair. Mullin pointed out that people who are starving have thinning hair and have baldness. Nixzmary didn't fit the profile for starvation.
Sampson stated Nixzmary became unconscious sometime on the 8th or 9th . (this contradicts Cesar's trial because I think she said at that trial Nixzmary became unconscious between 2:30--3 pm Jan.10th)
Sampson said it would've been possible for her to eat or drink the next day
Mullin said there's no chemical test to determine if a person is starving but the closest thing that we do have is to check for a chemical called acetone. ACETONE APPEARS WHEN A PERSON IS DEPRIVED OF FOOD AND IS BEING STARVED----THERE WAS NO ACETONE IN NIXZMARY'S BLOOD. When the body has no food to break down, it develops acetone. Mullin said that the presence of acetone is not proof positive but is strongly suggestive of starvation and that it was not present in Nixzmary.
Mullin pointed out that NIXZMARY HAD SUBCUTANEOUS FAT (fat below the cells of the skin) Then she said that she's not saying that Nixzmary was fat but the test reveals that she did have fat cells. If a person had an episode of starvation, that the cells would show that. Mullin referenced something called serosatrophy: a protein that remains in fat cells.
I didn't pick up on the rest of what Mullin said.
Sampson said the only time you'd see cellular changes in fat cells is during the end stage of starvation.
Mullin then summed up that:
1) there was NO ACETONE in Nixzmary's blood meaning she was not being starved
2) NO EVIDENCE HER FAT CELLS WERE BREAKING DOWN, TRYING TO NOURISH THE BODY.
Sampson also pointed out there were slides made of Nixzmary's heart. (listening to that really disturbed me. Why did they have to cut up her beautiful heart?)
3)Nixzmary's blood and cells were all normal.
4)Mullin pointed out that vitrious fluid in the eye was tested for youreanitrogen. and her levels were all normal. THIS IS A CLASSIC MARKER FOR DEHYDRATION AND HER LEVELS WERE NORMAL.(that also disturbed me, hearing how those ghouls at the M.E.'s office were taking fluid from her beautiful eyes)
5)Mullin also pointed out that her creatine and
6)sodium levels were normal.
Sampson said post mortem values go up.
7)Mullin also said Nixzmary's chloride levels were normal and she didn't have a single chemical of dehydration.
Testimony ends. Sampson must come back the next day because the cross examination is not finished.
At the bench, DiMango is again refusing to allow that it was Nixzaliz who brought Nixzmary to her doctor visits because the signature is illegible. DiMango said someone could've been representing themselves as her. Court ended.
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