8.Barbara Olson — Direct

BARBARA OLSON: Good afternoon.

BARBARA OLSON: Okay.

BARBARA OLSON: My name is Dr. Barbara Olson, B-A-R-B-A-R-A O-L-S-O-N. I previously practiced under my maiden name, Barbara Vidal, V-I-D-A-L.

BARBARA OLSON: I completed my undergraduate studies at the University of New Mexico. I also completed four years of medical school at the University of New Mexico School of Medicine. Afterwards, I came to Boston to study the field of pathology at Beth Israel Deaconess Medical Center. I completed a four-year residency program there, studying both anatomical pathology and clinical pathology. And after my residency, I did a surgical pathology fellowship, studying the gastrointestinal tract, liver, and pancreas, and I ended my training doing a fellowship of forensic pathology at the Boston office of the Office of the Chief Medical Examiner. I am board certified in anatomical pathology, clinical pathology, and forensic pathology.

BARBARA OLSON: It is essentially the study of causes that... or diseases, disorders, or trauma that results in sudden, unexpected, or non-natural death.

BARBARA OLSON: Yes. I'm a medical examiner at the Cape Cod office of the Office of the Chief Medical Examiner.

BARBARA OLSON: Since 2021.

BARBARA OLSON: I have examined over 1,900 bodies and performed over 800 autopsies.

BARBARA OLSON: Yes. So an autopsy is composed of many parts, the first part being documentation review and the second part being the examination of the body, which is broken up into two parts, the first part being the external examination, where I look for identifying characteristics of a decedent, such as eye color or hair color. I also look for any evidence of natural disease or trauma on the outside of the body. And the second part is the internal examination, where I create a Y-like incision on the chest and abdomen and examine the soft tissues, bones, and organs, looking for any evidence of natural disease and trauma. I also examine the brain.

BARBARA OLSON: Yes.

BARBARA OLSON: Yes.

BARBARA OLSON: Yes.

BARBARA OLSON: Typically I have a preliminary police report to review, as well as either EMS records or records from the emergency department.

BARBARA OLSON: Yes.

BARBARA OLSON: The external examination of Cora, I saw evidence of medical intervention. She was intubated, had various EKG pads and defibrillator pads on her body. She also had a catheter on her right hand and puncture sites on her left hand and her left groin. She had her neck stabilized with a cervical collar, and she had an intraosseous catheter, which is a type of IV they put directly into the bone, on her right lower leg. Her hands, at the time of my external examination, were covered by police evidence bags, and they were secured at the wrist with tape. When I removed those, the fingers showed no evidence of injury, and the fingernails were all of equal length and intact. And then I noted evidence of trauma of the neck, with associated injuries of her head and minor injuries of her right arm and of her legs as well.

BARBARA OLSON: Yes. There were findings of the head that were associated with the trauma of the neck.

BARBARA OLSON: So on her neck, she had a ligature furrow. A ligature is an object used to apply external force to the neck or compress the neck, and a furrow is simply the pattern of injury that develops underneath the site of compression. So for Cora, her ligature furrow consisted of a linear, horizontally oriented area of pallor or paleness around her neck, with distinct superior and inferior edges. On the front part of her neck, the lower half of the ligature furrow was associated with additional red abrasions ranging from one to two millimeters in size. And on a- the back of her neck, the superior and inferior edges of the ligature furrow had developed some linear bruising as well.

BARBARA OLSON: So again, the furrow is... A ligature is when you have external compression by an object on the neck, and a furrow is simply a pattern of injury that occurs beneath it. It can be an imprint, it could be a pattern, or it could be more developed types of injuries, such as bruising or abrasions.

BARBARA OLSON: Yes. I am still under oath.

BARBARA OLSON: Yes. On examination of her face, she showed diffuse petechial hemorrhages of the skin of the face, most prominently around the skin of the eyes. She showed petechial hemorrhages on the inside of her eyelids, as well as the inside of her lips.

BARBARA OLSON: Yes. In this photo, I have the lower lip pulled down, and on the inside of the lower lip, we can see punctate hemorrhages, which are the petechial hemorrhages.

BARBARA OLSON: No.

BARBARA OLSON: Okay.

BARBARA OLSON: Yes.

BARBARA OLSON: Yes.

BARBARA OLSON: Yes.

BARBARA OLSON: So they are pinpoint hemorrhages that occur. And again, they were located on the inside of the eyelids, so I inverted the eyelids, and I lipped open the inside of the lips, and they were also in those locations.

BARBARA OLSON: In this photo, we are looking at the body from the left, and you can see the ligature furrow in this photo. Here is the linear area of pallor with the distinct superior and inferior edge. You can also appreciate in this photo some small punctate hemorrhages or the petechial hemorrhages of the face.

BARBARA OLSON: In this photo, we are looking at the front of the neck, again focused on the ligature furrow, which is this distinct area, linear area of pallor. And on the front of her neck, the lower half of this ligature furrow had scattered red abrasions associated with it.

BARBARA OLSON: So abrasion occurs when there is sufficient friction against the skin to cause a removal of the superficial layer of the skin.

BARBARA OLSON: Yes.

BARBARA OLSON: This is a close-up photo of the back of the neck. Here is the linear area of pallor with the distinct superior and inferior linear edges. You can appreciate that the linear edges in this photo started to develop linear bruising.

BARBARA OLSON: Yes. She had injuries to her right arm and on her legs.

BARBARA OLSON: This is an up-close photo where we can see a very small faint bruise. All of the bruises on her legs as well as her right arm consisted of small scattered bruises.

BARBARA OLSON: This is an image focused on her right leg. Here, we see three bruises on her knee and two bruises on her left lower leg. This is an ex-site of medical intervention, the intraosseous catheter site where the needle enters the bone.

BARBARA OLSON: This is a photo, a close-up photo of her left leg. Again, we can see a bruise here, as well as a bruise here on her left lower leg.

BARBARA OLSON: In this photo, we can see the bruises I described earlier, as well as the inside of her left ankle, we're seeing two additional bruises.

BARBARA OLSON: This is a image of her left leg, again showing the two bruises close to her left ankle and then additional bruises on her left lower leg.

BARBARA OLSON: This is an image of her right arm extended, and I have the image focused on her right bicep where there was three small bruises.

BARBARA OLSON: No.

BARBARA OLSON: So generally speaking, we can appreciate the color of bruises. So red, blue, purple bruises tend to be bruises that occur more recently, and as they heal over time, they start to take on a yellow or green appearance.

BARBARA OLSON: They all had versions of red appearance to their shapes.

BARBARA OLSON: They occurred recently.

BARBARA OLSON: Correct.

BARBARA OLSON: No, I can only document where they are and their measurements.

BARBARA OLSON: When I see a ligature furrow that is horizontally oriented in association with significant petechial hemorrhages, those findings are consistent with a ligature strangulation.

BARBARA OLSON: Again, a ligature is an object used to apply external force to the neck, and a strangulation is when it is done by someone else.

BARBARA OLSON: So, ligature strangulation results in a category of asphyxial type of deaths. Asphyxia means that the body is deprived of oxygen, and in this case, specifically the brain. So when you have compression on the outside of the neck... Well, blood is how oxygen is delivered to, throughout our body. So the right side of the heart delivers blood to our lungs, where during breathing and respiration, we then put oxygen into our blood. It then moves to the right side of our heart and gets pushed out to our body through blood vessels we call arteries. Once the oxygen is released at its targeted site, it then recirculates to the right side of the heart through blood vessels called veins, and the process starts all over again. It's a continuous circulation. But when you have compression of the neck, first and foremost, your airways reduce. It's compressed. So you can have a reduction in your ability to breathe or complete inhibition in your ability to breathe. When you have compressions of the veins of the neck, there's no... The blood cannot drain from the head, and so then the blood actually has a backwards flow of pressure that meets the arterial blood, and that results in an increase of blood pressure within the blood vessels, as well as an overall increase in intracranial pressure. And with the compression of the artery, there's no oxygenated blood being delivered to the brain.

BARBARA OLSON: Yes. Or like a water pipe as well.

BARBARA OLSON: What normally happens is, first and foremost, the brain just has a reduced ability to take in oxygen. And in the smallest vessels in the face and brain, such as capillaries or venules, they are subject to rupture.

BARBARA OLSON: So, just like our blood vessels run throughout all of our body, there are nerves throughout all of our body as well. And so there is a component of pain present until loss of consciousness occurs.

BARBARA OLSON: I cannot put a specific time on it for the interval. There's multiple variables to consider in a case-by-case basis. The type of ligature used, the force of the ligature used against the neck, as well as the intensity and duration of the altercation. However, in situations where there's complete oxygen deprivation, loss of consciousness can occur as early as 10 to 30 seconds, with brain damage beginning at the one-minute mark, and irreversible brain damage and subsequent death occurring around as early as five minutes. Again, with the caveat that there are variables that might accelerate or decelerate that timeframe.

BARBARA OLSON: I—ultimately, the—once the brain has a critically low level of oxygen, a loss of consciousness will occur. It takes an average of four pounds to compress the veins of the neck and an average of around 10 pounds to compress the arteries of the neck.

BARBARA OLSON: It could occur faster, yes.

BARBARA OLSON: When the body is in a state of stress, you have a stress response that demands an actual increase in oxygen utilization by our body. So in the presence of an increased demand with a decreased amount being delivered to the brain, it can accelerate the timeline to loss of consciousness.

BARBARA OLSON: It would just make it occur faster.

BARBARA OLSON: Yes, for loss of consciousness.

BARBARA OLSON: Again, there's multiple variables. So the force of the ligature against the neck, the actual ligature itself, and the intensity and duration of the altercation.

BARBARA OLSON: No. So, if there's no intervention, the brain continues to have a lack of oxygen. And so until the brain cells start to die, there, it's irreversible injury to the brain. The person is alive until the body can no longer sustain the lack of oxygen.

BARBARA OLSON: Without intervention, it is very unlikely.

BARBARA OLSON: No. Once the brain is subject to oxygen deprivation and brain cells start to die, there, it's irreversible. And so it will continue to progress towards death if there's no intervention.

BARBARA OLSON: Resuscitative efforts, if somebody tried to give CPR.

BARBARA OLSON: If—

BARBARA OLSON: I said that in this presence of complete oxygen deprivation, there is a general timeframe. And so 30 seconds, I cannot give a specific number to that. Once strangulation occurs, again, the brain starts to be subjected to a lack of oxygen. So whether the ligature is present or whether the ligature is not present, those, the oxygen deprivation and irreversible brain damage is already occurring.

BARBARA OLSON: Not without intervention. It's very unlikely. Again, the brain cannot heal those cells.

BARBARA OLSON: Yes.

BARBARA OLSON: Asphyxia.

BARBARA OLSON: By strangulation.

BARBARA OLSON: Yes.

BARBARA OLSON: Yes.

BARBARA OLSON: January 25th.

BARBARA OLSON: I did observe injuries to Dawson. He had trauma to his neck with associated injuries of the head, as well as minor injuries to his left arm and his legs.

BARBARA OLSON: This photo is a picture of the lower lip of Dawson being pulled down, and we can see, again, similar to Cora, these petechial hemorrhages on the inside of the mouth.

BARBARA OLSON: You can see periorbital petechial hemorrhages, so the skin around the eye.

BARBARA OLSON: Yes.

BARBARA OLSON: Dawson, on his neck, similar to Cora, had a linear, horizontally oriented ligature furrow consisting of a area of pallor around the neck. He had distinct superior and inferior edges to his furrow as well. This is on the backside of the neck where we can also appreciate abrasions that are in line or parallel with the inferior and superior edges of the furrow.

BARBARA OLSON: In this photograph, we can appreciate the distinct area of pallor here on the neck, again representing the ligature furrow with diffuse petechial hemorrhages of the skin of the face.

BARBARA OLSON: This is just some dried body fluid.

BARBARA OLSON: This is a similar photograph to the one just shown. Here, where you can see the distinct area of pallor representing the ligature furrow with superior and inferior edges, and again, the diffuse petechial hemorrhages of the face.

BARBARA OLSON: They appear more prominent in Dawson than in Cora, yes.

BARBARA OLSON: Again, petechial hemorrhages occur as a result of rupturing of small vessels in the skin. And so the fact that there are more present in Dawson is indicative that there were moments where some blood did reach, or push through the furrow or the ligature, in little spikes or peaks, which would just result in momentary increases in blood pressure that would result in more petechial hemorrhages.

BARBARA OLSON: Any movement against the carotid arteries. The carotid arteries are thicker and more muscular than the veins, so they're more likely to push through with the blood. So that could be movement of the ligature or movement of the person handling the ligature or movement of Dawson himself.

BARBARA OLSON: Yes, changes in the pressure of the ligature.

BARBARA OLSON: This is the back of his left forearm. It is a little pale with the light, but there were three small bruises on the back of his left forearm.

BARBARA OLSON: This is a picture of us, so at this point, position, Dawson is face down, so we're looking at the side of his right leg, and we can see a small faint bruise here.

BARBARA OLSON: This is an up-close photograph, but I can appreciate that there are small bruises in the center of the image.

BARBARA OLSON: In this photograph, we're looking at the back of the legs. The one closest to us is the left leg. The one farthest from us is the right. You can see bruises here, here, and here, as well as the inside of the right knee.

BARBARA OLSON: Of the left upper leg.

BARBARA OLSON: This is an up-close photo of his hands.

BARBARA OLSON: I would not have called these necessarily blue or cyanotic. That would be more of the discoloration of his face. There is some subtle blueness to the nail beds, which is again a sign of cyanosis, which is just reflective of a decrease in oxygen in the body.

BARBARA OLSON: In this image, Dawson is face up, and we can see his left, right, and left legs. Here on his right lower leg, we see small bruises. On his right knee, we're seeing... or left knee, we are seeing a bruise, and here is a site of medical intervention, the intraosseous catheter site.

BARBARA OLSON: They are all red and purple in appearance, so they were more recent.

BARBARA OLSON: Yes.

BARBARA OLSON: Yes.

BARBARA OLSON: Asphyxia.

BARBARA OLSON: Thank you, Your Honor.