Continuing with the drowning possibility, intubation of the right main bronchus (versus trachea) at the time of resuscitation might have decompressed some of the water from the right lung but not the left.

Could explain some of the bruising around his neck if he’d been restrained at the neck during waterboarding…

The other question I asked up thread was about blood seen streaming from al-Jamadi’s nose when he was de-hooded after becoming non-responsive in a crucifixion-like stress position. Could this have happened to ME04-309, but have been “cleaned up” with considerable amount of water, perhaps even postmortem at time of death? Again, would probably see some indication here in other body parts besides fluid in lungs.

pdaly (70) – they also said that al-Jamadi had been “frozen” in the mens’ shower area, but what the Abu Ghraib photos all show is his body packed in ice. I suspect similar treatment of ME04-309, so decomposition would be more marked than if he’d been put into an actual freezer.

I was bothered by ‘focal skin slippage of the arms.’
Wasn’t sure how body decomposition would affect delicate organs like the lungs (including their weight) so I ignored the findings as potentially unreliable. I am surprised to see microscopic examination even could be performed on lungs 3 weeks postmortem. If his body was immediately frozen to preserve the tissue, would there be slippage and greening of the abdomen? I don’t know.

LUNGS: The alveolar spaces and small air passages are expanded and contain no significant inflammatory component or edema fluid. The alveolar walls are thin and slightly congested. The arterial and venous vascular systems are normal. The peribronchial lymphatics are unremarkable.

Maybe a typo, but what do you make of his lung weights? 700 right and 900 left. I have seldom seen a left lung heavier than a right lung and never by 200 grams.

If this was simple pulmonary edema at 900 or even 700 grams, I’d expect both lungs to be equal weight and for there to be florid alveolar edema and vascular congestion. The guy has in total 600 cc of extra fluid in his lungs, where is it?

It’s another suggestion to me that he may have been waterboarded, and that head deviation or positioning led to assymetric aspiration of the water…
The extra water may have been in bronchioles and is thus lost to microscopic.

Thoughts?

The periorbital ecchymoses (black eyes) is from bleeding while alive. The blood follows the laws of gravity. It appears he was upright or on his stomach for this pattern to develop.

The rib fractures, including rib 6 after further thought (especially if they are including the cartilage extension of rib 6 to the sternum as their definition of a ‘rib fracture’), are explainable by CPR effort, but as you say, this does not rule out bad faith targeting of those areas for torture.

Lidocaine works rapidly on the heart after injection–seconds to minutes. The time it takes for lidocaine to reach the bladder I don’t know–probably under an hour? I also do not know the amount that needs to accumulate before a urine toxicology screen can detect it in the urine. We’d need a pharmacologist or medical examiner to weigh in on these questions.

However, the liver is the body’s main source of elimination of lidocaine once it is in injected into the blood stream. The liver metabolizes lidocaine to at least two smaller metabolites MEGX and GX. These metabolites are then cleared by the kidneys and end up in the bladder. So in order for 04-309 to have lidocaine in his urine, he has to have a functioning liver, some blood circulation, and functioning kidneys. He was still ‘alive’ when resuscitation efforts began.

Electrical paddle burn and presence of lidocaine in the urine implies 04-309 had a vtach or vfib arrest. Use of these resuscitation options implies 04-309 was hooked up to telemetry at the time. To clarify what I wrote late last night, lidocaine and electric paddles are used for specific heart arrhythmias (vtach & vfib for example) and not for someone who has flatlined.

Of note, someone in a coma would be monitored on telemetry. Such a comatose person might even be described as ’sleeping’ by a nonmedical observer. Brain swelling can lead to malignant heart arrhythmias and require ACLS resuscitation efforts. If 04-309 was in a coma and his telemetry monitor alarmed with vfib, medical personnel would have started the ACLS code to revive him.

This scenario would support drational’s assertion that the brain swelling predates 04-309’s death.

Don’t know if that tells you anything in addition to the indications of lower lid ecchymosis.

The number of badly injured prisoners must far exceed the number of deaths. Which also means that the consequences were well known and were accepted as part of the policy set on high. There isn’t even a fig leaf now separating Mr. Bush and Mr. Cheney from their torturers. They should be aware that “shit happens” is not an adequate defense to committing, authorizing or condoning torture.