By Rennie Whang
The New Paper
Sunday, May 19, 2013
SINGAPORE - The pathologist had examined Dr Shane Todd's body, and concluded he had "no doubt" it was a case of asphyxia due to hanging - of which he's seen about 800 cases.
Rarer are cases of strangulation - he recalled seeing one in 2009 and another last year. On Thursday, he and a psychiatrist who had seen Dr Todd, shed light on the US researcher's living and postmortem circumstances.
The coroner's inquiry into the death of Dr Todd, who was found hanged in his Spottiswoode Park apartment last year, continued on Friday.
They discussed the following on Thursday.
1. Could he have been strangled?
Dr Wee Keng Poh, senior consultant forensic pathologist who supervised Dr Todd's post-mortem, said that ligature marks found on him pointed to hanging.
The marks ran below the chin towards the back of the neck, in an inverted V shape 38cm-long. At the back of his neck was a 4cm stretch of unmarked skin.
On the other hand, marks in strangulation cases would usually be horizontal, and run completely around the neck, he said.
A dissection of Dr Todd's neck also revealed no haemorrhaging or fractures.
Two independent experts, Dr David Fowler and Dr Valerie Rao, respective Chief Medical Examiners of the State of Maryland and that of District 4 and part of District 3, Jacksonville, Florida, US, affirmed that haemorrhaging or fractures of underlying structures were usually seen in manual strangulation cases.
Dr Wee had added in his autopsy: "In ligature strangulation, there is often a struggle for life, one can often expect to find fingernail scratches on the front and side of neck."
These would be as the victim usually fights to relieve the strangulation. But there were no scratches on his neck, he said.
Nor had there been ruptured capillaries in Dr Todd's eyes. Strangulation would increase the blood pressure in the capillaries, predisposing the capillaries rupturing in the eyes, he said.
Dr Fowler and Dr Rao agreed that broken blood capillaries around the eyes or face would have been unusual in suicidal hangings, and there had been none.
2. What caused the injuries?
What of bruises on Dr Todd's palms and near his wrist, which a Deputy Medical Examiner in Boone County and Callaway County, US, had described as "multiple blunt trauma injuries"?
These, said Dr Edward Adelstein, a pathologist engaged by the Todd family in the US, were "very visible at the time of funeral".
Dr Todd's funeral was on July 5 last year, about two weeks after his body was found.
Dr Wee said they were not bruises, but hypostasis or postmortem lividity - blood circulating passively after a person dies, resulting in purple colouration of dependent parts.
They had not been present at the time of post-mortem, he said.
When showed photos taken on July 4 last year of scratch marks on Dr Todd's neck, he said these hadn't been around during the post-mortem as well.
"I really do not know how these marks arose," Dr Wee said. But he said they were due to hypostasis, and not likely due to injuries.
Asked by lawyer Steven Lam, who represents the family, if any DNA testing had been done on Dr Todd's fingernails, Dr Wee said: "Not that I know of."
Dr Adelstein had also found suspicious the fact that Dr Todd's lungs were "normal" in weight at the time of the autopsy.
This he thought did not point to a case of suicide by hanging, and that this was evidence Dr Todd died rapidly, and was unconscious 20 to 30 seconds after the ligature was applied.
But Dr Wee said he disagreed, and Dr Fowler had said that comment was "not in any literature he was aware of".
3. Was Dr Todd depressed?
Dr Nelson Lee, a psychiatrist at The Psychological Wellness Centre, said he saw Dr Todd on April 4 last year.
Dr Todd had indicated his main problem was his "struggles with stress, anxiety and depression due to work and life-related issues".
Dr Lee said Dr Todd reported suffering tremors and palpitations, though he said he hadn't noticed Dr Todd's hands trembling.
He diagnosed Dr Todd with moderate depression, with a significant component of anxiety.
He prescribed the anti-depressant Lexapro, and asked Dr Todd to return for a review three weeks later. But Dr Todd did not contact the clinic again.
Dr Lee said in a medical report: "(Dr Todd) did not feel that life had no meaning, nor were there any suicidal ideations expressed."
And Mr Lam said that Dr Todd had reasons to be upbeat - he had been offered a US$15,000 ($18,760) job in the US on June 21 last year, and had been packing to fly home in a week.
"That's unusual (for a person going to commit suicide)," Dr Lee said.
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