Ellen Riemer — Direct/Voir Dire
449 linesJUDGE NEWMAN: Thank you. Your next witness.
MR. WATERS: Your Honor, the State calls Dr. Ellen Riemer.
The witness, ELLEN RIEMER, was first duly sworn and testified as follows:
COURT CLERK: Take a seat in the witness stand. Adjust the microphone if you have to. State your name again for the record. Spell your last name.
ELLEN RIEMER: Yes. Hi. My name is Dr. Ellen Riemer, R-i-e-m-e-r.
VOIR DIRE EXAMINATION
BY MR. WATERS:
MR. WATERS: Dr. Riemer, how are you doing today?
ELLEN RIEMER: I'm doing fine, thank you.
MR. WATERS: I'm going to go ahead and get right to it. And, if you would, just tell the jury a little bit about your education that led up to you becoming a physician, please.
ELLEN RIEMER: Yes. Okay. I graduated from medical school in 1997 with a doctor of medicine degree. Following that I did a residency in pathology at New York Presbyterian Hospital, Columbia University Medical Center in the City of New York. Following that I did a forensic pathology fellowship at the Office of the Chief Medical Examiner of the State of Maryland. Following that I did an additional fellowship training year at Johns Hopkins Hospital, Johns Hopkins University School of Medicine, also in Baltimore. And I am board certified in forensic pathology and anatomic pathology. After I completed my -- all of my education and fellowship training, I -- my -- I took my first job at -- as a forensic pathologist at Wake Forest University Baptist Medical Center, Wake Forest School of Medicine in North Carolina, where I remained for almost six years before being recruited by the Medical University of South Carolina in Charleston, where I've been for fourteen years as a forensic pathologist.
MR. WATERS: All right, and at the Medical University of South Carolina, you said you were a forensic pathologist. Do you have any professorship or teaching responsibility there?
ELLEN RIEMER: Yes. So, I have also the title of Professor of Pathology and Laboratory Medicine. And because Medical University of South Carolina is a teaching institution, I am responsible for educating physicians in training, as well as medical students, and that's an integral part of my job. So, a lot of the work I do is observed by students and trainees.
MR. WATERS: And you mentioned you had some board certifications. Can you tell those to the jury, please?
ELLEN RIEMER: Yes. So, you know, in order for somebody -- there is -- the America Board of Pathology is the organization that certifies specialties in different fields. And the America Board of Pathology certifies specialists in pathology and requires them to take very long examinations and demonstrate and pass those examinations. You can't just sit down and take them; you have to have achieved, you know, gotten through your residency training and fellowship training as well. So, I managed to do all of that, and I'm board certified in forensic pathology.
MR. WATERS: All right, and do you have any membership or involvement in any professional societies that are relevant to what we're talking about here?
ELLEN RIEMER: Yes. Well, I'm a member of the America Academy of Forensic Sciences. And I also am responsible for editing journals. I have various academic responsibilities as well.
MR. WATERS: All right, and you mentioned editing certain journals. Have you published in the field of pathology over the years, given your professorships and your educational expertise?
ELLEN RIEMER: Yes. So, because I'm interested in, you know, educating the medical community, I published close to, I don't remember the exact number, but approximately thirty publications in the field of pathology and forensic pathology. And this is also something that's valued at an academic institution, so you're not just practicing but also contributing to the body of knowledge in your field.
MR. WATERS: Over the years with this experience, have you had calls to conduct a number of autopsies?
ELLEN RIEMER: Yes. So, the principal responsibility of my work is to perform autopsies on deceased individuals in order to determine the cause and manner of death. And over the course of my career I have -- I don't keep exact track, but I estimate that I have done approximately 5,500 autopsies.
MR. WATERS: 5,500?
ELLEN RIEMER: Correct.
MR. WATERS: All right. We'll talk more about what an autopsy is in a minute. Over that course of time doing 5,500 autopsies, have you been qualified as an expert and testified in courts of record in the nation?
ELLEN RIEMER: Yes. So, again, I'm not keeping track of every single one, but if I -- a conservative estimate would be approximately once a month for more than twenty years, which would put me in the mid-200. So, about 250, but that's a probably a little bit more than that.
MR. WATERS: And that's times you've been qualified as an expert in forensic pathology?
ELLEN RIEMER: Yes.
MR. WATERS: And is that just in South Carolina or have there been other places?
ELLEN RIEMER: Yeah. The majority have been in South Carolina, but also North Carolina where I practiced for six years prior to moving to South Carolina. And I've also been admitted as an expert witness in forensic pathology in federal court a couple of times where I autopsied individuals who died on tribal lands.
MR. WATERS: Your Honor, at this time the State would move to qualify Dr. Riemer -- Professor Riemer as an expert in forensic pathology.
MR. HARPOOTLIAN: No objection, Your Honor.
JUDGE NEWMAN: She is so qualified.
DIRECT EXAMINATION
BY MR. WATERS:
MR. WATERS: All right, Dr. Riemer, before we get to your specific findings in this case, can you quickly describe to the jury what is pathology and what is an autopsy? What is it that your science and, and being a physician -- what are you trying to do?
ELLEN RIEMER: Yes. So, the purpose of an autopsy is to obtain as much information as I can from examination of the tissues of the body and -- in order to come to a determination of the cause and manner of death. And the autopsy examination is basically a specialized surgical procedure. It starts with an external examination. So, before any cuttings get started, I look from head to toe; I look for anything unusual. If there's injuries, I review them; I look at them carefully and document those findings, as well as establish an opinion on how injuries may have occurred.
MR. WATERS: And obviously -- because in the cases where you have traumatic injury, there's no getting around the fact that it's very graphic, the things that you have to look at, and the things here today that you have to describe to the jury.
ELLEN RIEMER: Yes, that's just part of it.
MR. WATERS: Did you have cause in this particular case to examine the victims of these murders, Paul Murdaugh and Maggie Murdaugh?
ELLEN RIEMER: Yes. I have the name as Margaret Murdaugh. I know she goes by Maggie, but Margaret Murdaugh, as well as Paul Murdaugh. I performed the autopsies on both of these individuals.
MR. WATERS: All right, and do you recall what day that was?
ELLEN RIEMER: I will have to refer to my notes.
MR. WATERS: Please help yourself.
(Break in proceedings.)
ELLEN RIEMER: Both of the autopsies on both Paul and Maggie were performed by me on June 10, 2021.
MR. WATERS: And is it typical when you're conducting an autopsy that you have assistants there that assist you in performing these procedures and that sort of thing?
ELLEN RIEMER: Yes. So, I have assistants to help me with whatever I need. And the autopsies -- I do the autopsy and any assistance I need is done under my direction.
MR. WATERS: Sure, and then is it common that photographs are taken of the various injuries and your various findings as you do the autopsies?
ELLEN RIEMER: Yes.
MR. WATERS: And is any physical evidence that is recovered during that autopsy, is law enforcement present or some official there to take custody of those physical things?
ELLEN RIEMER: Yes. They're not always present, but they -- if they're not present at the day of the autopsy, they'll come back, and I seal all of the evidence up and -- with -- you know, in secure bags. And then those are transferred to the appropriate investigator.
MR. WATERS: Well, let's go ahead and get to it. We're going to talk about Paul Murdaugh first. Okay?
ELLEN RIEMER: Okay.
MR. WATERS: And we also -- do we have some poster boards behind you? And the first one is marked as State's 500. And can you explain very quickly what this is to the jury, please?
ELLEN RIEMER: Okay. So, you may have seen these kinds of diagrams on this -- these are blank body diagrams. And so when I autopsy man, or a male, I start with that diagram, and I -- it's basically a vehicle for me to take notes during the autopsy, so I can incorporate findings into my final autopsy report. But this is not, you know, something that -- this is really for my edification and so I can write things down, and it helps me when I write the autopsy report to make sure I've covered everything.
MR. WATERS: All right, and will this assist you as we -- as you explain to the jury the injuries that the two victims suffered?
ELLEN RIEMER: Yes.
MR. WATERS: Dr. Riemer, let's -- again starting with Paul, if you could very quickly, how many -- did you observe any gunshot wounds to Paul?
ELLEN RIEMER: Well, actually there were two shotgun wounds. So, that's a different than, you know, a handgun, or -- so, a shotgun is where there -- you know, there's basically pellets that are enclosed in a wadding, and the wadding, after it's fired from the shotgun, kind of opens up and allows all of these pellets to be released from the wadding. And so the features of his injuries told me in no uncertain terms that he was shot with a shotgun.
MR. WATERS: All right, and let's -- if I could ask you if, with the Court's permission, if you could stand down. I'm going to hold up this board, and if you could bring a marker with you. I've got a red Sharpie right here if that helps you. And let's talk about the injuries that you observed to Paul Murdaugh. And then if you could, for the jury, if you could illustrate and draw on this board that -- the first gun -- shotgun wound that you observed on Paul.
ELLEN RIEMER: Okay. I'll use my marker, please.
MR. WATERS: All right. Let me put mine up real quick.
ELLEN RIEMER: Okay. So, in order to make things as clear to you as possible, I'm going to use a black marker for entrance wounds and red for exit, okay, so just arbitrarily. Okay. So, Paul had two shotgun wounds. One of them was to the left side of the chest, approximately this location. And the wadding containing the pellets traveled beneath the skin through, like, the soft tissue of the left side of the chest. It didn't actually go into the chest cavity, but traveled beneath the skin and into the muscle and fat before exiting the left axillary. Okay. So, it's kind of a straight kind of left to right -- I'm sorry, right to left shot, and --
MR. WATERS: And just real quick, when you say right to left, you're talking about Paul's right to left.
ELLEN RIEMER: Yeah, that's right. So, I'm always thinking about, like, the patient's right to left. Okay. So, if you look at it, it's from -- you know, would be from left to right, but I'm always -- you always -- for consistency it's always relative to his body.
MR. WATERS: Down here by the hands, could you put an R on one side and an L on the other? Just because I know I get confused.
ELLEN RIEMER: Well, no, it is. And honestly we all do this during autopsies as well because especially you have that and it's very easy to make a mistake.
MR. WATERS: And also just real quick, could you write Paul up at the top there?
ELLEN RIEMER: (Witness complies.)
MR. WATERS: Thank you. All right. All right. So, you were talking about that first shotgun wound to the chest and where it exited.
ELLEN RIEMER: Yes.
MR. WATERS: Were there any other injuries associated with that? Please continue on.
ELLEN RIEMER: Yes. So, the -- remember, we have wadding enclosing pellets. The wadding actually got stuck, you know, didn't completely exit and continue to fly out. It bumps up right underneath the skin of the left side of the chest, like, close to the armpit area. And we have a photograph of that pink wadding that remained in this skin, or the exit wound. From there multiple shotgun pellets started going through, like, the left arm, starting from the underside of the left arm, so the, the, the wadding terminated in the skin, and then pellets kind of went out and went through the left arm. And -- okay. So, this is the left -- remember, this is his left side, his left elbow, his left arm, and then we've got a bunch of exit pellets wounds on the left side of the arm and some a little bit on the back. So, that -- you can see this is going through, and then this is actually on the inside of the arm and the exits are kind of on the left side. So --
MR. WATERS: Was there any stippling associated with this particular wound?
ELLEN RIEMER: Yes. Okay. So, there was stippling, and I'll draw that over here. Okay. So, when the projectile comes out of the barrel of a weapon, be it a shotgun, a handgun, an assault rifle, what propels that projectile -- or we call it, you know, a projectile -- out of the barrel of the gun, it's gunpowder. And gunpowder is basically ignited through the action of the shooter who is holding the gun. And so gunpowder is basically booming and projects the projectile out of the barrel of the gun. A projectile can potentially travel very long distance like, you know, many -- like many feet or, you know, large or long, depending on the projectile, until it hits something, or if it doesn't hit anything it can eventually lose power and hit -- go to the ground. But the gunpowder that leaves the barrel of the weapon can travel not too far, only travels about up to three feet, depending on the weapon. So, in this case we actually have some particles of, like, abrasions from particles of gunpowder, and this is called gunpowder stippling. Okay? So we have stippling, which indicates that this wound was fired at a fairly close range. We can't say exactly, but probably no more than 3 feet because that's our standard. You know, it could be anywhere from 2 to 3 feet. And interestingly enough there was some markings on the edge of this kind of cookie cutter type of defect from the wadding going in that shows that some of the petals of the wadding are beginning to weaken. So, this is very classic for a shotgun entrance wound, and at the autopsy shows that it went, after going through the -- underneath the left side of the chest, it goes through the left arm.
MR. WATERS: All right, and let me ask you this, and before we look at some of the pictures -- which are very graphic. Is that correct?
ELLEN RIEMER: Yes. It's just the nature of the beast.
MR. WATERS: If -- this particular injury, was it immediately fatal?
ELLEN RIEMER: No. Amazingly enough this really -- if that is all he sustained, he would have needed medical attention and some stitches and irrigation of the wound to clean it out and make sure it doesn't get infected, but it actually did not pierce the chest or cause any internal bleeding. It did, however, cause a bruise or contusion of the left arm, and that's because, you know, the -- there's a lot of energy associated with this. It didn't actually go through the ribs but caused a contusion of the left arm. But he would have been expected to be -- continue to be standing after this. It would not have sent him to the ground.
MR. WATERS: All right. If you could, there's a dowel stick over by your witness stand, and I'm going to make sure the jurors down here can see what you're talking about. If you could grab it for me real quick, and then we'll look at some of the pictures here in just a second.
ELLEN RIEMER: Okay. What do you want me to do?
MR. WATERS: Well, I just wanted to show it to these jurors down here, and just make sure they could see what you were doing.
ELLEN RIEMER: Oh, sure, okay.
MR. WATERS: And then if you could just stay standing for me, I'm going to get an exhibit. Just stand by for me real quick, Dr. Riemer.
(Break in proceedings.)
MR. HARPOOTLIAN: No objection.
MR. WATERS: All right, Dr. Riemer, if you would be very careful to keep these pointed this way, if you could. But I'm going to have you just look through State's 478, 479, 480, 481, and 482, and see if you recognize those images.
ELLEN RIEMER: Okay. So, these are photographs --
MR. WATERS: And just real quick, just tell me if you recognize them.
ELLEN RIEMER: Yes. I recognize all of them.
MR. WATERS: All right, and are these images that were taken during the autopsy you conducted of Paul Murdaugh?
ELLEN RIEMER: Yes.
MR. WATERS: And would they assist you in explaining the injuries to the jury?
ELLEN RIEMER: Yes.
MR. WATERS: All right.
MR. WATERS: Your Honor, at this time I would move State's 478, 479, 480, 481, and 482 into evidence.
MR. HARPOOTLIAN: No objection, Your Honor.
JUDGE NEWMAN: They're admitted without objection.
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 478 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 479 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 480 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 481 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 482 WAS RECEIVED INTO EVIDENCE.)
MR. WATERS: All right. Now, Dr. Riemer, if you'll get the dowel stick and come around here to the screen, I'm going to put this first image up on the ELMO, and then if you could -- well, talk a little bit about these injuries and describe them to the jury.
(Break in proceedings.)
ELLEN RIEMER: So, we can see -- it's not great focus here, but this is the entrance of the shotgun wound on the left side of the chest, his left nipple. His left nipple is over here, so the left side of the chest. And there is some stippling over here --
MR. WATERS: And, Dr. Riemer, I apologize, if you can come around and work this way so that all our jurors who are that way can see.
ELLEN RIEMER: Oh, absolutely. Okay. All right. So, the shotgun wound is going in this direction. Remember, it exited that left side of the chest and then continued through the left arm. So, that is a photograph of that wound to -- the shotgun to the chest.
MR. WATERS: All right, and we'll see some more close-up images here in a minute, but this is the entrance wound right here. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: And then we have some injuries right here. Is that where those pellets exited through his arm?
ELLEN RIEMER: Yes. That's where the -- yes. The wadding, which is the plastic piece enclosing the pellets, terminated in the skin. It just didn't manage to get out, but all of those pellets kind of got released from the wadding and went through the left -- the left arm.
MR. WATERS: All right. I'm going to move now to -- that was State's 478 for the record. I'm going to move to State's 479, and what does it image represent?
ELLEN RIEMER: Okay. So, this is a more close-up view of the entrance wound. And you can see it looks like there's little -- like almost squares or pegs sticking out of the edge. And that tells us that the wadding is starting to open because it opens up. It kind of opens up. There's petals, and this is a classic -- I could put it in a book to say that this is consistent with a shotgun entrance wound. Okay, and we can see the dots around here. Those are from pieces of gunpowder that have basically impacted the skin because it was within a distance of 3 feet or so.
MR. WATERS: All right. Moving now to State's 480.
ELLEN RIEMER: Okay. So, usually when I take a photo, I don't want to go too close because then we won't be able to see where it is on the body. But here, this is recognized. This is the nipple, right, his left nipple, and we saw the entrance wound over here. And so here we have the -- this is the -- an exit wound where this pink wadding is basically stuffed right there, and you can see these are the petals on the edge, and that's what gave that unique appearance to the entrance wound. Now, this is basically a cylinder that encloses lots of pellets, and then the pellets here -- we start to actually have some of the pellets coming through the surrounding skin, and then along the left side of the lateral side of the chest.
MR. WATERS: All right. I'm going to show you what's been marked as State's 111 already in evidence at this time. Do you recognize that?
ELLEN RIEMER: Yes. So, that is the wadding that I recovered at autopsy and took a picture of it before I recovered it, and so that's the wadding that was from the Paul's chest.
MR. WATERS: And just, again, just point to where that is in that image, please.
ELLEN RIEMER: Yeah. So, here it is. It's kind of peeking out through this big fold in the left side of the chest.
MR. WATERS: All right. Let me move on to the next exhibit. I'm going to put up on the screen now State's 481, and tell me what this is right here.
ELLEN RIEMER: Okay. So, this is a photograph of the same wadding, but I'm taking it from a different angle. Okay? So, he's lying on an autopsy table, and I've moved his arm up to show the relationship of this wadding. This -- the entrance pellets wounds on the underside -- the underside of the left arm. And interestingly enough, a lot of times pellets just go through the skin but here we have some abrasions around the skin, and it actually corresponds to abrasions. We normally don't have abrasions with an exit wound such as we have here, but the fact that we have abrasions in -- on the underside of the left side of the chest corresponding to the inside of the arm indicates that his arm was down at the time of his injuries.
MR. WATERS: So, let me ask you about that. In your expert opinion, having done 5,500 autopsies, is there any way that Paul's hands were up when he suffered that shotgun wound to the chest that you've been talking about?
ELLEN RIEMER: No. There -- the autopsy answers that question: that his arm was down by his side at the time he sustained this injury.
MR. WATERS: And, again, highlight the specific features that you observed that cause you to come to that expert opinion.
ELLEN RIEMER: Okay. So, if -- let's just say hypothetically if his arm was up, you see all of these abrasions around this exit defect, and the abrasions around these pellet entrances? We wouldn't see that because they -- those are caused by when these pellets and the wadding is pressing up against the skin. The skin is very elastic. So, this is just kind of logic. I think we're all going to get this. It's kind of going to push the skin before it actually exits. The skin is going to stretch a lot, and if it hits up against the other portion of the skin, we have kind of abrasions which become scrapes on the skin around where it exited as well as where it entered. So, these are sometimes called -- like it's a shored exit wound. So, the skin actually struck another area, and, in fact, it corresponds exactly. It's like a reflection. We can see -- this is reflected -- here is -- this is -- this one is reflected over here. So, if -- we can only get that kind of a mark if his arm is down. Now, this is the kind of thing that, you know, it's the logical conclusion, and I'm confident that that was the position of his arm at the time he was shot. And this is based on my training and more than twenty years of experience doing these autopsies.
MR. WATERS: All right. Let me look at the next exhibit, which will be 482 for the record. And tell us what you see here, and also, if you could, how that also supports the conclusions you were just talking about to the jury.
ELLEN RIEMER: Yes. Okay. So, these are exit pellets wounds on the outside of the arm in this area, right, so this is kind of, like, his arm pit here. And we can see these are kind of just -- these pellets -- exit wounds don't have the kind of abrasions around it. This is just kind of finding its way through the skin. And then this one is over here, so -- and the further the pellets travel, it kind of splays out, so after the pellets leave the wadding, the openings, they're spread. So, these are, you know, exit pellet wounds, and we don't have the kind of abrasions to suggest that his arm was pressed up against anything at the time that those pellets exited.
MR. WATERS: All right. One other thing as well as we were talking about his arm being down. Of course, the wadding stopped in that wound and was still in his chest, correct?
ELLEN RIEMER: Yes.
MR. WATERS: Okay. All right. Let me -- let's move on. Just give my one second here to get some other exhibits and show them to defense counsel.
(Break in proceedings.)
MR. WATERS: All right, Dr. Riemer, if I can get you to maybe stand that way just a little bit. I know we're in tight confines and we're trying to be as respectful as we can with these images. I'm going to show you now what's been marked as 483, State's 484, State's 485, 486, and 487. And just quickly tell me if you recognize those, and then I want to go back to the board before we talk about those pictures.
ELLEN RIEMER: Yes, I recognize these.
MR. WATERS: All right, and are those autopsy photographs that you took of Paul Murdaugh?
ELLEN RIEMER: Yes. These are photographs that I took at the autopsy of Paul Murdaugh.
MR. WATERS: And would they assist you in explaining to the jury the injuries that he suffered?
ELLEN RIEMER: Yes.
MR. WATERS: Your Honor, at this time I would move State's 483, 484, 485, 486, and 487 into evidence.
MR. HARPOOTLIAN: No objection, Your Honor.
JUDGE NEWMAN: They are admitted.
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 483 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 484 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 485 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 486 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 487 WAS RECEIVED INTO EVIDENCE.)
MR. HARPOOTLIAN: And, Your Honor, I think all of these exhibits, both he and I, 90 percent of them are introduced will be under seal.
MR. WATERS: Yes, sir. And for the record, these are under seal, and I provided the cover sheets to the court reporter. Every exhibit, except for the poster board that we're doing, the State would request to be under seal because of the graphic nature.
JUDGE NEWMAN: Yes.
MR. WATERS: All right, Dr. Riemer, let's -- that was -- and we'll come back a little bit more to that first injury, but there was a second shotgun injury as well. Is that correct?
ELLEN RIEMER: Correct.
MR. WATERS: All right, and I'm going to go back to State's 500, which is the poster board. And if you could, explain to and draw on this diagram of that second injury, and then we'll look at the pictures.
ELLEN RIEMER: Okay. So, there was a large shotgun wound defect to the top of his left shoulder, and there were a lot of pellets recovered in the left shoulder area. And from there the -- it kind of just went across the top of the left shoulder, and then went into the neck, side of the neck and face. And from there -- his face actually was not destroyed from this, but there is a big exit wound on the top of the right side of the head. So, this wound went from his left toward his right and upward, and made a slight front to back deviation. Now, what does that tell us? We don't really know. It's kind of going toward -- it's sparing his face. It's going behind the face. Now, one thing that makes sense to me, how could that happen? If he was just stand -- not everybody gets shot like standing on these diagrams, right? But if he was shot and his face was forward, it would have taken off a lot of his face.
However, if he was turned toward the shooter, then it's going to go into the face here, and go out towards the right back of the head. So, to me it makes sense that his head is turned to the left, not necessarily completely but partially turned to the left. And what happened here is an extremely severe, immediately fatal injury because what it did was after it went through the left side of the neck and face, it -- our brain is basically held up through the skull, so we have a bone at the top of the skull, but we also the bone that kind of holds up in there. It went through the base of the skull, which is kind of in this area. The brain is up there, and this wound -- actually his brain was ejected out of the top of the right side of his head and actually arrived at the autopsy in a separate bucket. So, this -- the force of this wound actually pushed his brain out of his head. There was only just a small piece of brain remaining, and that's the brain stem that was attached to the spine.
MR. WATERS: All right, and real quickly going back to the first wound to the chest, if Paul was standing when he suffered that, could he have remained standing after suffering that wound?
ELLEN RIEMER: Yes.
MR. WATERS: The second wound, the one that starts in the shoulder and goes in here and then out the top of his head, what would have been the effect of that wound?
ELLEN RIEMER: That would have been immediately, he would not have been standing. He would have just fallen to the ground.
MR. WATERS: All right, and would he have been capable at all of bracing his fall or anything like that with a catastrophic injury like that?
ELLEN RIEMER: No. That's instant, instantaneous death.
MR. WATERS: Did you notice any abrasions on his face or anything like that?
ELLEN RIEMER: Yes. He did have -- and it's depicted in one of photographs. He does have a scrape on his face. And very frequently scrapes on the face that have -- they have a -- it has a slight directionality that's consistent with a terminal collapse. So, if he's hitting the ground with some movement, there's frequently kind of a linear pattern. And, you know, all of this really makes sense when -- once you've seen these things, you can understand that if somebody is going to fall with, like, you know, with force of their body and not their neck, hit their face on the ground, and we get some abrasions that correspond to that.
MR. WATERS: All right, and let me do this real quick. If you can grab my dowel stick for me, and I want to make sure the jurors down here had a chance to see what you've been drawing.
ELLEN RIEMER: Okay.
MR. WATERS: So, that's the shoulder right there, and then --
ELLEN RIEMER: Yeah. I should have made a red mark here to be consistent. This is the exit wound on the right side of the head, and the brain came out of that exit.
MR. WATERS: All right, and you mentioned a little bit about it being consistent with Paul kind of having his head tilted to one side. If you could use the dowel stick and maybe use me as an example, and show me kind of what you're talking about. You can position me however you want to. So, let's go out here just a little bit if we can.
ELLEN RIEMER: So, to start with, like, a different idea, okay, in order to understand how that's the case -- so, if a shotgun wound is entering the top of the left shoulder, and let's say his head is turned like that. It's going to go right through the face, right? But if his head is turned like that, it's going to spare the face and be able to go behind the face. So, if somebody is just standing, looking straight ahead, this most likely would have done a lot of damage to his face. But the fact that the face has remained intact tells me that his head was, I don't know, up or down, but his head was facing in the direction to where the shotgun was being fired.
MR. WATERS: All right, and then the injury to the shoulder would have been where? If you would just point for the jury.
ELLEN RIEMER: Yes. So, it was kind of on the top of the shoulder. This also did not injure his chest cavity, but it went through a lot of the skin and muscle and the fat of the left shoulder. And there were a lot of pellets that were recovered from the left shoulder area, as well as the head.
MR. WATERS: And I'm going to show you very quickly what's been marked as State's 110. And do you recognize this item already in evidence?
ELLEN RIEMER: Yes. These are the pellets that I recovered from the left shoulder and head area.
MR. WATERS: All right. I'm going to go ahead, and if you could stay on that side so the jurors can see, and I'm going to --
ELLEN RIEMER: This side?
MR. WATERS: Yeah. If we can work on this side so it goes down that end and you can see, and I'm going to bring some of these to the witness.
(Break in proceedings.)
MR. WATERS: All right, and I'm going to show you first what's been marked as State's 483. And can you tell me what is on this particular image, particularly as to some of the things you were just describing as to the abrasion and things like that?
ELLEN RIEMER: Yes. So, we can see, this is basically -- an abrasion is a fancy word for a scrape, so there are scrapes on the right side of his face. And you can see they kind of had -- you can kind of see that there's a little bit of a linearity. So, if he just fell completely flat, we might just get, like, you know, dots, but if there's some movement, we get -- it's kind of he's hitting the ground and then moving a little bit as his face hits, so we get this kind of vertical direction. And this is a very typical type of injury to the face that somebody might suffer from a terminal collapse. So, after they sustain the fatal injury, what they're going to do, they're going to fall to the ground. Now, depending on the surface of, you know, the concrete or, you know, the grass or anything like that -- but this is very typical of -- I don't know what kind of surface it was, but a terminal collapse.
MR. WATERS: Okay. All right. If you would with this image, and this would be State's 484, please explain to the jury using this image some of the concepts you've been describing to them.
ELLEN RIEMER: Okay. So, this is the top of his left shoulder, and this is the continuation of the ammunition through the left side of the lower face, and from there it proceeded behind the face through the base of the skull and exited the right side of the top of the head and shoulder toward the back of the other side of the top.
MR. WATERS: And those two sort of together, they are -- that's kind of what you're describing before when you had positioned my head --
ELLEN RIEMER: Yes.
MR. WATERS: -- in a manner in which you did.
ELLEN RIEMER: Yeah, that's right. So, my feet turned to the left like that. I think that makes the most logical sense, as a forensic pathologist is really logical. So, when we look at these things, we think, well, how could this have happened. And, you know, after the -- it's not always immediately obvious, but, you know, with some thought we can come to these conclusions with confidence.
MR. WATERS: Turning now to State's 485, is this is just another perspective?
ELLEN RIEMER: Yes. So, this is the same entry. This is -- it's formed by a single piece -- a single piece of ammunition here that went through the top of the left shoulder toward -- up, all right, and then went into the left side of his face and neck. And some of these pellets also damaged -- did a lot of damage in the neck because they kind of splay out as they go further. And it went -- some of that went actually through his airway and other structures of the neck, as well as continuing through the base of the skull and propelling the majority of the brain out the right side of the back of the head.
MR. WATERS: All right, and now going to the -- sort of the end of that particular wound, tell us what this image is referencing.
ELLEN RIEMER: So, you know, you can kind of see. It looks like this piece of his head. We're not really seeing the entire thing because his forehead is basically still intact. But you can appreciate at this point that, you know, the contours of his skull are disrupted, and that's because there's a defect at the top of the skull but not involving the forehead, so it's kind of in the back. So, we know it is going -- it started at the shoulder, it's exited the back, so his head may have been like that facing toward the left.
MR. WATERS: For the record that was State's 486.
MR. WATERS: And then finally, State's 487.
ELLEN RIEMER: Okay. Now this is a so this is --
MR. WATERS: And again, it's hard for me to see what I'm doing, but --
ELLEN RIEMER: That's okay. Yeah. So, this is actually a photograph of the right side of -- this is his -- the face area. Okay, and I know that because I'm usually -- when I take a photograph of the number, I usually have it, like, right side up. Okay? So this is the top of his head and --
MR. WATERS: Dr. Riemer, I apologize.
ELLEN RIEMER: No. Yeah.
MR. WATERS: Let me do it like that.
ELLEN RIEMER: Yeah, that's better --
MR. WATERS: It might be a little bit better.
ELLEN RIEMER: -- right. So, now you can sort of see. This is the right side of his head, and it's horrible, I know, and there's a big defect there and we can see the inside of the skull. And, like, you know, the face was spared, so --
MR. WATERS: All right. Dr. Riemer, if you would -- I'm sorry.
(Break in proceedings.)
JUDGE NEWMAN: Ladies and gentlemen, I'll have you go to the jury room for a few moments. Please do not discuss the case.
(The jury left the courtroom.)
JUDGE NEWMAN: We'll take a few minutes break.
MR. WATERS: Thank you, Your Honor.
(A break was taken.)
JUDGE NEWMAN: You may bring the jury.
(The jury returned to the courtroom.)
COURT BAILIFF: The jury is present, sir.
JUDGE NEWMAN: Thank you. You may proceed.
MR. WATERS: Yes, sir, Your Honor. May it please the Court?
JUDGE NEWMAN: Yes.
CONTINUED DIRECT EXAMINATION
BY MR. WATERS:
MR. WATERS: Dr. Riemer, before we took a break, we were obviously discussing the very catastrophic injuries from that second shotgun wound to Paul, and that would have been immediately fatal. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: Let me ask you this very quickly. Do you see any evidence of any defensive wounds on Paul?
ELLEN RIEMER: No, I did not.
MR. WATERS: And can you describe quickly what a defensive wound is, and then explain why you see none in this particular instance for this?
ELLEN RIEMER: Yes. So, a defensive wound is -- you know, sometimes somebody might sustain injuries that suggest that they had their hands or arms up while trying to defend themselves from the -- from what is about to happen. And I don't see anything on his hands that would indicate, you know, he had his hands up to his face in anticipation of the injury that was about to happen, so --
MR. WATERS: And in your expert opinion, and as you described it to the jury, before his arm was down for that first shot, right?
ELLEN RIEMER: Yes. So, that first shot his arm was down, and I don't see any evidence of injury to his hands from the second wound.
MR. WATERS: And then that abrasion on his face is consistent with that second shot and then just having a terminal collapse?
ELLEN RIEMER: Right. So, falling to the ground, hitting his -- the right side of his face on the ground with a little bit of forward movement, so we've got that kind of linearity. And that would be consistent with collapsing to the ground after -- it's very frequently, you know, after sustaining any kinds of disabling injuries, if they're standing up they're going to fall. Just gravity. And so he fell, and he was face down at the time, so he had a scrape on the cheek, which is the surface of his body that impacted the ground.
MR. WATERS: What were the toxicology results on Paul, if any, or --
ELLEN RIEMER: Yeah. So --
MR. WATERS: -- anything that he might have had in his system? Go ahead.
ELLEN RIEMER: Oh, yes. So, every person that has an autopsy at MUSC and -- everybody gets a full toxicology testing done. And MUSC does not actually perform toxicology, but toxicology -- we send to a toxicology lab that tests for any possible substances that may be in the blood. And the only thing he had in the blood at the time of his death was caffeine.
MR. WATERS: No alcohol or drugs.
ELLEN RIEMER: No alcohol or drugs, was negative.
MR. WATERS: Were you able to reach any conclusion about the order in which Paul suffered these shotgun blasts?
ELLEN RIEMER: Well, in my opinion, based on my education and experience, the first shotgun wound, the initial shot was to the chest, following which he remained standing and sustained the other gunshot wound to the top of the left shoulder and head. If the -- if we think about, well, is it possible that the other wound was first, it just kind of defies logic, right? So, if he got that one first on the left shoulder and through his head, we know that one sent him to the ground. So, he fell to the ground, hit the right side of the face. How is he possibly going to get that one to the front of the chest? So, it's just hard to imagine the scenario in which the shotgun wound to the head was first.
MR. WATERS: Let's move now, if we can, to Maggie Murdaugh. And you did her autopsy as well, as you described to this jury. Is that correct?
ELLEN RIEMER: Yes, I did.
MR. WATERS: All right, and how many gunshot wounds, just very quickly, did you observe on Maggie?
ELLEN RIEMER: So, she sustained a total of five gunshot wounds from a minimum of four shots, so it could have been from four shots with five wounds, or five separate shots, and I will explain once we do that.
MR. WATERS: All right, and I have what's been marked as State's 501. And, again, this is another diagram that would assist you in explaining these injuries to the jury?
ELLEN RIEMER: Yes. So, this is the female, the woman diagram, and so -- and this is what I used to take notes while I perform the autopsy.
MR. WATERS: All right. If you would step down, please, and walk over here, and we'll do the same procedure with Maggie. Start out by writing her name at the top, and then put the left and right on there, too, to aid us in understanding.
ELLEN RIEMER: Okay.
MR. WATERS: All right. Let me do this just very quickly, I apologize. Going back to State's 500, and this is Paul. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: And you had an arrow right here kind of showing the direction of shot number one. Is that right?
ELLEN RIEMER: Yes.
MR. WATERS: Can you do an arrow for shot number two, please?
ELLEN RIEMER: (Witness complies.)
MR. WATERS: And, Your Honor, at this time I would move State's 500 into evidence for demonstrative purposes. Or move it into evidence.
MR. HARPOOTLIAN: Is he going to just use it for demonstrative purposes, or is he moving it into evidence?
MR. WATERS: I'll move it into evidence, Your Honor.
MR. HARPOOTLIAN: No objection.
JUDGE NEWMAN: It's admitted without objection.
(DIAGRAM MARKED AS STATE'S EXHIBIT NUMBER 500 WAS RECEIVED INTO EVIDENCE.)
MR. WATERS: All right, going back to 501, this would be Maggie. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: All right. If you could, start to detail the injuries that you observed to Maggie in -- and what is the most probable order based on your review of the evidence.
ELLEN RIEMER: Okay. Well, first of all this was a different weapon. It's not a shotgun with wadding and pellets. These injuries that Maggie sustained were consistent with an assault rifle, which is a different weapon. And I'm going to go through the five wounds, and then we'll think about -- or I'll try to explain my opinion as to the likely order sort of like we figured out Paul's shotgun wound to the chest came first. I will do the same with her. But she's got a few more wounds so it can be a little bit more -- require a little bit more logical thinking. Okay. So, she had an entrance wound that was right over there. Okay? Kind of right below the rib cage, not far from the middle of her -- midline of her body. And that wound -- okay. Now, we can remember, you know, this is right and left. It's very easy to get the right/left situation confused, but that's going from front to back and downward, and there was an exit wound kind of like that. Okay. So, it entered here. Okay?
So we're in a kind of downward direction. It was actually 10 inches below where it entered, so it's pretty low, you know. Down here was the exit wound. And on the way that projectile, that bullet, went through the abdominal wall. That's like a muscle in the back, and then once it got inside the body it went through mesentery, which is the supportive tissues of our intestines. So, it went through mesentery. It has all the blood vessels and fat, has all that that supports or intestines. The intestines take up a lot of food in there. Now, it's continuing to go toward the back of her body, and through the pancreas, okay, which is kind of toward the back. And then as it's traveling left, it went through the left kidney and left iliac artery, which is a blood vessel that is -- leads off the aorta before exiting the left side of the back.
MR. WATERS: All right, and let's go ahead -- can we do the second wound, and then we'll talk about both of those together in a second, if we could.
ELLEN RIEMER: Okay. So, we've got two that are basically completely to the front of the body, directly to the front. And the other, there's another wound that is kind of on the front inside of the left thigh, like kind of like over there. Okay? And this one is also going from front to back, and toward the left, and downward. So, they -- these two shots follow parallel paths. They're both such -- this is the left, okay, left leg, right? Left thigh. And the exit wound was in the back of the left thigh. And it's -- it actually -- this is a little bit too high. That actually, you know -- but it was lower --
MR. WATERS: Put a X through the wrong one.
ELLEN RIEMER: I'm sorry.
MR. WATERS: All right.
ELLEN RIEMER: Yeah. So, it's traveling in a downward direction, and also we've got kind of a slight right to left. So, I'm going to draw an arrow to indicate the direction. Okay? So, that one is going like that, and then this one is also going in the same direction, downward toward the back.
MR. WATERS: And those you said follow kind of a parallel trajectory.
ELLEN RIEMER: Yes. They had a relatively parallel trajectory. Another feature of each of these wounds is that -- remember we talked about gunpowder stippling when somebody is shot at a relatively close range. Well, both of these wounds had gunpowder stippling around them. Okay?
MR. WATERS: And re -- go ahead. And remind the jury what stippling indicates about probable distance from a firearm.
ELLEN RIEMER: Yes. So, within 3 feet. We don't usually see it any more than 3 feet. Sometimes it's within 2 feet, but depending on the firearm -- I can't say exactly. But it's somewhere in that range.
MR. WATERS: So, fairly close range are parallel trajectories for these two wounds.
ELLEN RIEMER: Right.
MR. WATERS: Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: All right.
ELLEN RIEMER: And they both exited the left side of the body. One was on the -- this is her left. Like, it's really easy to get turned around here. Okay? Left, left thigh. Again, that's on the left side of the lower back. And the one to the left leg actually just went through. It went through the muscle and soft tissue. It didn't actually break a bone.
MR. WATERS: All right. If those two wounds -- let's go ahead and do all of the wounds. Can we go to the next wound that we have? And before we do that, was there a wound to the wrist in this particular instance?
ELLEN RIEMER: Yes. There was a wound to the wrist, and it was on the left wrist. The entrance wound was somewhere around here. And -- okay. So, this is her left rib, and then the exit wound was a little bit higher on the inside of the arm. So, this is the -- kind of the hairy part, this part of the inside of your -- it was an exit wound.
MR. WATERS: And using my left hand, can you kind of point generally to the jury about the location of those?
ELLEN RIEMER: Yeah. So, kind of going in here and out there.
MR. WATERS: All right. So, that's three gunshot injuries at this point. Is that correct?
ELLEN RIEMER: That's correct.
MR. WATERS: All right. Now, tell me about the fourth one, if you would, please.
ELLEN RIEMER: Okay. So, the fourth one is somewhat unusual because it's going in an upward direction through the body. Okay? There was an entrance wound on the underside of the left breast that exited, like, the top of the left breast. Okay? And from there we have some marks on it like bruising on the left side of the chest up here, left clavicle, and that bullet continued through the underside of the left side of the face. Okay? So, there's a wound kind of like over there. Okay? And everything is kind of going up. So, this was an exit, and then we have, like, a re-entrance, okay? So, we have a series of defects. We have -- this is an entrance, an exit, and then the bullet continued through the left side of the face and lower ear area and into her head. Okay. Now, in addition to that --
MR. WATERS: And just real quick. Those first two wounds that you described, the wounds to the abdomen and the wound to the leg -- and those were both to the front of the body. Is that correct?
ELLEN RIEMER: Correct.
MR. WATERS: And they both had a similar parallel trajectory. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: Could those -- either one of those wounds been immediately fatal?
ELLEN RIEMER: No.
MR. WATERS: All right. The wound you just described -- how about the wound to the wrist? Would that have been immediately fatal?
ELLEN RIEMER: No.
MR. WATERS: What about the wound that you just described that went in near the breast and then went into the head?
ELLEN RIEMER: Yes. That would have been immediately fatal because when it entered the left side of the face, it basically destroyed the brain.
MR. WATERS: And was there another gunshot injury, traumatic gunshot injury aside from that one?
ELLEN RIEMER: Yes. But I'm going to -- before I continue, I did want to mention that there was, like, scratch -- an abrasion, kind of a scrape below that, below her left breast. So, it indicates before it actually went through the left breast. It kind of scraped along the abdomen as it was going upward before it went into her head.
MR. WATERS: On the injury -- the gunshot wound, the rifle -- assault rifle wound to the abdomen and the assault rifle wound to the legs, you said there was stippling there. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: Did you --
ELLEN RIEMER: The other wounds did not have any stippling.
MR. WATERS: So they --
ELLEN RIEMER: They were from further back.
MR. WATERS: The wrist wound had no stippling?
ELLEN RIEMER: Yes.
MR. WATERS: And that wound that you just described going up into Maggie's head, that did not have any stippling either.
ELLEN RIEMER: Correct.
MR. WATERS: You mentioned there was one more as well to her head. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: All right. Describe that to the jury using this chart, please, or this diagram.
ELLEN RIEMER: Okay. So, there was an entrance wound to the back of the head, okay, that was kind of going right over there, okay, and kind of near the base of her skull, and that was going downward. Okay. Now, this is -- this is an automatic rifle, you know. It's a rifle. So, it's a kind of single, you know, cylindrical projectile that remains intact. With these rifles, the projectiles fragment as they go through the body. That's one of the mechanisms by which they do, you know, enormous damage. Okay. Now, this wound was going in a downward direction, and then you have lots of exit wounds on the right side of her upper back where all of those fragmented projectile fragments exited. And this wound, it's in a clearly downward direction. It was -- it entered the back of her head, went through the back of the skull, and through the brain stem, and so the -- so this is -- these are vital portions of the very bottom of the brain. But it did not enter into her chest.
It continued just scraping along the top of that. So, we know this is going downward. So, how do we reconcile? How do we make sense of a wound that's going upward and then another wound that's going downward? Okay. You'll recall, this wound that went through her left breast and into the left side of her face injured her brain, right? She's not going to be standing anymore. Now, how would this even go upward, okay? The -- those first two shots, right -- the one to her -- say the one to the right side of her abdomen, that went, remember, through her pancreas and the left kidney. Kidney pain is some very -- it's usually very painful. We can imagine this did not immediately cause death, but she may have been bent over, bent over straight, and that puts her in a position, if someone is bending over, leaning over, to get a gunshot wound that goes along.
So, when we look at the body in an upright position and she's got a gunshot wound going upward, we know it's going upward because it ended in her head, probably her body was bent over, and it may have been that she just sustained this very painful wound to her abdomen, in addition to her thigh, and she was most likely, in my opinion, bent over, or even possibly on the ground, but not completely lying flat, you know, at the time, because then it would never have been able to go through the front -- the -- you know, have to, like, skip the areas here. So, if she's bent over, we have some skin fold. We're going to get a skip. Plus it went through the underside of left breast, exited the top of the left breast, so that would indicate that her breast may have been sort of, you know, like, pointed downward.
MR. WATERS: So, do you have that dowel stick anywhere? And let's, if you would, again, use me, and if you could just describe some of the concepts you're talking about. And let's start with those first two shots to the abdomen, and then just kind of position me as we move on to the shots from there.
ELLEN RIEMER: All right. So, one wound --
MR. WATERS: Stand over here, if you would, so the jury can see.
ELLEN RIEMER: Absolutely.
MR. WATERS: Okay.
ELLEN RIEMER: Well, now I have to kind of -- I will have to -- yeah, I can't show this -- yeah. The entrance would be about there at the top of the abdomen, and it went through the body exiting on the left side of the lower back. And while it was in the body, it went through the pancreas and the left kidney and the blood vessel nearby.
MR. WATERS: All right, and the wound to the thigh?
ELLEN RIEMER: Okay. The thigh was kind of on the front, but a little bit toward the inside area, and that exited going down on the left thigh in the back of the leg.
MR. WATERS: And the one to the abdomen, would that have been very painful?
ELLEN RIEMER: Yes. I mean, you know, kidney -- if you ever knew anybody who had a kidney stone, kidney stones are some of the worst pain. And I understand people who are getting kidney stones are on very high doses of morphine just to control the pain. Well, she had a -- you know, projectiles, ammunition going through her left kidney. You can imagine that was a very painful wound and may have caused her to, like, fold over in pain.
MR. WATERS: So, something like this?
ELLEN RIEMER: Yes.
MR. WATERS: All right, and could it even have been that she went to the ground, and she's on her hands and knees, something like this?
ELLEN RIEMER: Yes, that's also possible. And she could have had her head bent down, like, sort of touching the ground at that point as well.
MR. WATERS: This shot, this one right here that you described right there, is there any way at that point in time she could have been completely prone, flat on the ground like this?
ELLEN RIEMER: No, because then how -- the bullet is going to go up. So, she has to at least have been -- can't say for sure, but it makes sense that after receiving those first two shots, she's going to be bent over at least -- or possibly, you know, even lower to the ground, enabling her to get a wound of --
MR. WATERS: Now, again, bent over like this.
ELLEN RIEMER: That's perfect. Okay. Going through the front of the left side of the chest. And if your head is bent over even further, you can imagine it's going to go into the head. Okay, and so when, you know, I first look at this, I'm, like, what? It takes a little -- but in retrospect, now that I've made sense of this, it all comes together. So --
MR. WATERS: So far at this point in time, we've talked about the abdomen and the thigh wound. In your opinion, are those two shots the first two shots she suffered?
ELLEN RIEMER: Yes. I think she was standing upright at the time, and then she only could have gotten the wound to the left side of -- you know, to the left side of the front into her head if she's horizontal but not completely on the ground, and -- but after sustaining that wound, okay --
MR. WATERS: She could have been down on her hands and knees, too.
ELLEN RIEMER: Yeah. Could have been down on her hands and knees or just bent over. Like it went into her brain, she's going to fall to the ground completely, and that puts her in a position to get the gunshot wound to the back of the head. I can't really -- you know, you might not -- you're too far away.
MR. WATERS: All right. I'm going to go over here, but show me that last wound, if you would.
ELLEN RIEMER: Okay. So, the last wound was going in a downward direction, entered here. It's kind of, you know, enough to fracture the skull and go through the back of the brain just like a brain stem, and then have just a bunch of exit wounds there. So, that's, you know, that's actually in kind of a downward direction. So, we've got something going upward, we have something going downward, and it only makes sense that the one to the left side of the front occurred first because if she -- let's see, the one to the back of the head was -- she basically was already -- had injury to the brain sufficient to have killed her. The one to the back of the head that went down was, you know, an additional wound. But the one to the -- that went into the left side of the brain was more than sufficient to have killed her.
MR. WATERS: If she had not suffered this wound right here, the one where she's hunched over or on her hands and knees, if she had not suffered that one, would this one to the back of head also been immediately fatal to her?
ELLEN RIEMER: Yes. Either one of them would have been immediately fatal. That one went through the brain stem and sort -- that -- those sections of the brain, their whole job is to keep us alive, to keep us breathing, and set the cardiac rhythm. Without that, none of us would be here.
MR. WATERS: But in your opinion, abdomen and thigh is first. This one that went through her breast into her head is after that?
ELLEN RIEMER: Right.
MR. WATERS: And then this one is when she's prone on the ground to the back of the head.
ELLEN RIEMER: Yes.
MR. WATERS: This is the last one.
ELLEN RIEMER: So, I do think -- this isn't something that I, you know, immediately, like, realized. But after thinking about it, how -- you know, just gunshot wounds to one person, how do I make sense of this? And this is the most likely logical sequence of shots that she sustained. I also want to mention, remember we had this wound to the -- so, we had four we know about, right? We've got right side of the abdomen, left thigh, like, left -- you know, the left side of the head in the front, you have breast first, and then we have this last wound while she was prone on the ground, okay, to the back of the head. We also have this additional wound to the left wrist that exited a little bit higher. Now, is it possible that her arm was just somewhere and got shot? Yes. But remember, I -- we know that she must have been in a lot of pain in her abdomen, from that shot that went through the abdomen, and if she's bent over, where would her arm and hand likely be? You know, it makes sense she was likely bent over with her hand right there, and so if her hand -- if her hand is bent, she's got her hand on her belly, the wound entering the left wrist could exit there before actually going up. So, she's got her hand on her belly. I don't know if that's actually happened, but that's why I described five individual gunshot wounds, but it could -- it could cause -- the left wrist could have moved. It could have happened before another one.
MR. WATERS: And what you just described there with her wrist kind of close to her stomach after suffering that abdominal and thigh wound, that is consistent with the evidence what you just described, is that correct, that having her hand right there --
ELLEN RIEMER: Yeah.
MR. WATERS: -- like next to the ground?
ELLEN RIEMER: That -- it would be consistent. I can't say 100 percent that that's how it happened. But, you know, that is a gunshot wound to the left wrist, and it may have been sustained while she had her hand on her abdomen possibly.
MR. WATERS: All right. Give me one second.
(Break in proceedings.)
MR. WATERS: All right, Dr. Riemer, I'm going to show you some images. If you could, just stand back that way just so we can, again, try to protect these as much as we can. These, again, are very graphic. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: I'm going to show you, if we could, and I'm going to kind of give them to you this way: State's 488, 489, 490, 491, 492, 493, 495, 498, and 499. And do you generally recognize those images?
ELLEN RIEMER: Yes.
MR. WATERS: All right, and are those autopsy photos you took of Maggie Murdaugh?
ELLEN RIEMER: Yes. These are photographs that I took of Maggie Murdaugh's wounds.
MR. WATERS: All right, and would those assist you in explaining these injuries to the jury?
ELLEN RIEMER: Yes.
MR. WATERS: All right, Your Honor, at this time I would move into evidence State's 488, 489, 490, 491, 492, 493, 495, 498, and 499.
MR. HARPOOTLIAN: No objection, Your Honor.
MR. WATERS: They're admitted.
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 488 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 489 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 490 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 491 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 492 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 493 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 495 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 498 WAS RECEIVED INTO EVIDENCE.)
(PHOTO MARKED AS STATE'S EXHIBIT NUMBER 499 WAS RECEIVED INTO EVIDENCE.)
MR. WATERS: All right. Dr. Riemer, if you could grab a dowel stick and come on down here, and we'll try to move through those as expeditiously as I can. Starting with 488. If you could tell the jury --
ELLEN RIEMER: I'm just going to move this because I can't see.
JUDGE NEWMAN: Just a moment.
MR. HARPOOTLIAN: These folks can't see.
MR. WATERS: If you can stand on this side real quick so that --
ELLEN RIEMER: Yeah. Okay. That's good. All right. So, this is a photo of her left thigh, and this is the knee area. And we can see this is kind of on the inside area of the front of the left thigh, and we do have the stippling around it, which tells us it was shot within a relatively close range.
MR. WATERS: Okay, and we have the stippling, as you described. Moving onto State's 489, what is this right here?
ELLEN RIEMER: All right. So, we can kind of appreciate, this is, like, the curve of her knees. This is the back of the left thigh where we have an exit wound.
MR. WATERS: All right. Going on now to State's 490, what is this?
ELLEN RIEMER: Okay. So, this is the entrance wound on the right side of the front of the abdomen below the rib cage close to the midline, and we do have stippling here. It's a little sparser and a little further this way. So, that was also close enough, within 3 or so feet, to deposit the stippling probably a little further back than the one to the left thigh because there's a closer -- there's more tightness of the stippling on the thigh. So, if you think of it as kind of going outward, it covers a wider area and it's more sparse on the right side of the abdomen.
MR. WATERS: All right. Going down to the next one, what is this right here?
ELLEN RIEMER: Okay. So, this is the exit wound to the left side of the lower back.
MR. WATERS: Just very quickly, you mentioned that there's stippling on both the abdomen and the thigh, but there is a little bit of difference in distance between the two. Is that correct?
ELLEN RIEMER: Yes, a small amount. You know, there is stippling on both, but the wound to the thigh is a more tighter, more closely packed bunch of stippling and doesn't appear as further away from the actual defect. So, that is a little bit closer than to -- the barrel of the gun was a little closer to her body than the one to the right side of the abdomen, but both of them were aimed within 3 feet.
MR. WATERS: All right, and those were the only two wounds that you observed with stippling of the ones that you described. Is that correct?
ELLEN RIEMER: Yes.
MR. WATERS: All right. Going on now to this next, 492, tell us what this is, if you would, please.
ELLEN RIEMER: Okay. So, this is a wound to the left wrist. And we can see this is her left thumb, so it's kind of right over there. And it's going through the left wrist, exiting on the soft side of her left forearm.
MR. WATERS: All right, and moving now to 493, what does that reflect?
ELLEN RIEMER: Yes. So, there it is, that's the exit wound. So, she had the entrance wound to the -- this -- the part of her wrist near her thumb, and it's going through the left forearm area exiting at an angle, right? That we know it's kind of exiting as an angle because this is a -- this defect is agonal, right? If it's going straight across, we would just have a hole -- a hole, right? But if something is exiting at an angle, we have more of an agonal exit.
MR. WATERS: All right. Moving on to the next one. And, again, this is graphic, but --
ELLEN RIEMER: Yeah. I'm sorry, but --
MR. WATERS: -- tell me what this is. And I'm going to move the picture down as you describe it, please.
ELLEN RIEMER: Okay. So, this -- here is belly button just to give you a reference point. And this is that entrance wound on the right side of the abdomen. This is another injury that kind of grazed, kind of abraded the left side of the abdomen before going to her left breast.
MR. WATERS: All right, and then moving down --
ELLEN RIEMER: Yeah.
MR. WATERS: Is that stippling? I can't really see.
ELLEN RIEMER: Yeah. So, this is -- it's fine, okay? This is a very large, destructive hole on the left side of her face, including parts of her left ear. And this makes sense to be a continuation of the one through the left breast. I was confident that this was all the result of a single bullet, single fired shot. And what we see over here is basically the bruise from the -- it didn't actually go into the left shoulder, but as it's coursing upward through the breast before it kind of go -- and if she's bent over, then it's going to bruise this clavicle area, right -- that's the bone right here -- before going into the left side of her lower face.
MR. WATERS: All right. Moving on. Now I'm going to go out of order just a bit. I'm at 499. And can you explain --
ELLEN RIEMER: All right. I'm having trouble seeing this -- oh, yeah. Okay. Yeah. So, at the time I did the autopsy, and I have a wound to the left wrist and through the forearm, and a wound that's going along the left side of the abdomen. I can't be certain, I can't say with an absolute certainty that her hand was up against her abdomen at the time that the gunshot wound to her torso was going upward. But if her hand was on her abdomen, which she may have had there after getting shot through the abdomen and bending over, this would be a perfect line through the -- like, through the wrist, coming out the left forearm, and, like, continuing in an upward direction before fatally entering the left side of her head.
MR. WATERS: Is than an explanation for how the wrist and that gunshot could have been related?
ELLEN RIEMER: Yes. So, I took a photo of the wrist and the scrape along the left side of her abdomen together because it occurred to me, based on my experience over decades, that this may have represented a single inflicted shot. Maybe it was -- maybe the one to the wrist was a separate shot. And in my autopsy report I described it as separate because unless I'm absolutely certain that it's from the same shot, I'm going to describe them separately. But I'm able to tell you -- so, we have four wounds to the body, and it may -- you know, five wounds but -- if we count the left wrist as separate. But if the lift wrist was connected to the other one -- to one of the others, then it's a -- there's only four shots to her.
MR. WATERS: And then finally State's 498.
ELLEN RIEMER: Okay. So, this is also a very oblique shot, and this is the back of her head. And what I -- as a routine matter, she has -- she had hair there, but I shaved -- it wasn't apparent what kind of a wound she had back there. There was blood, but I'll shave -- cut away the hair and -- to display the entrance wound. And you can see how long it is. It's long. It's not just a hole going from back to front. It's going in a downward direction like that. And this ammunition breaks up into fragments, and we have, like, these fragments basically coursing along the top of her back going to the skin and going -- like fatty tissue being in her upper back. So -- and this one, before it actually hit the back, it went through the skull, the right side of the back of her head, as well as the brain stem and cerebrum.
MR. WATERS: All right. Thank you, Dr. Riemer. We're almost done. If you could, have a seat real quick and we'll conclude the examination.
MR. WATERS: Your Honor, also at this time I would move into evidence State's 501, which is the diagram that Dr. Riemer did of the injuries to Maggie.
JUDGE NEWMAN: What says the defense?
MR. HARPOOTLIAN: No objection.
JUDGE NEWMAN: They're admitted.
(DIAGRAM MARKED AS STATE'S EXHIBIT NUMBER 501 WAS RECEIVED INTO EVIDENCE.)
MR. WATERS: Dr. Riemer, you mentioned that there was a slight difference, or a difference in the stippling between the abdominal and the thigh wound. And which one had -- seemed to be a little bit farther away according to your review of the evidence?
ELLEN RIEMER: Yes. The gunshot wound to the abdomen was slightly further away than the gunshot wound to the left thigh.
MR. WATERS: And that could be consistent with Maggie and the shooter changing their positions in relation to one another.
ELLEN RIEMER: Yeah. Nobody -- people aren't completely just standing still. They're -- it could be that the shooter was moving closer toward her or moving a little bit back at the -- or she could have been moving, or a combination of the two. So, I don't know what happened there. But I do know that the barrel of the gun was closer at the time it struck her left thigh because the stippling is more tight concentrically and doesn't cover as wide an area as the one to the right side of the abdomen.
MR. WATERS: You described the injuries to the front, and then the injury to the breast and to the head, and then this final injury to the back of the head. Could that be consistent with the shooter circling his victim?
ELLEN RIEMER: Yeah. I think that only makes sense if there's some movement on the part of the shooter. We know one -- the gunshot wound to the front of the body that's going up, if Maggie was bent over either in air or on the ground, the shot would have been fired from behind her, right? From behind her. That's the only way it's going to go up and through the base of the -- like the chin area into her head, right? She's bent over. That's the way that it logically makes sense. Nobody is sitting on the floor and you couldn't do that. And after that shot was sustained, the wound that went through the front side, the vertical one, okay, it's vertical through her body, but most likely occurred while she was bent over, or -- then that's going to be an incapacitating shot because it went through her brain and caused her to fall to the ground. She's bent over, she gets a shot, she's going to fall face down. And then the last shot to the back of her head is going in the other direction, so that's going downward. So, we have one going -- so, that only can occur if the wound to the left side of the front is somebody shooting from behind her, and then the gunshot wound to the top -- to the back of the head is going downward while she's on the ground, indicating somebody is standing at, like, you know, at the top of her.
MR. WATERS: Was there a lot of blood accumulated in Maggie's abdomen?
ELLEN RIEMER: Not that much. The thing about these wounds is there's so much tissue destruction that blood is just basically in all of the tissues. So, it's not like -- sometimes with like a -- even like a small caliber bullet, you know, there's a single, clearly defined wound path, and there's -- I can take out blood from the abdomen. But in this case there was so much tissue destruction, there was a lot of blood in the soft tissues, but not necessarily something I can scoop out and measure.
MR. WATERS: Did the lack of a lot of blood in the abdomen tell you about how rapidly it all occurred together?
ELLEN RIEMER: Yeah. So, if the wound stopped there to the abdomen and somebody walked away, you know, she had -- she would have had more bleeding out of those tissues in the abdominal cavity.
MR. WATERS: Did both Maggie and Paul, did you make any observations about their stomach contents?
ELLEN RIEMER: Yes. So part of the autopsy, I'm not just looking at the wounds. I'm examining all of the internal organs, and when I -- this is how I knew it went through the pancreas and the kidney. Because, remember, I'm not just looking outside of the body. I have to -- I do everything, look at all of the internal organs and dissect each one. And it -- when examining the stomach it's -- I will document the contents of the stomach, and they each had a lot of recently digested food fragments. So, you know, there was a -- they had a full stomach of food.
MR. WATERS: And were those stomach contents consistent with one another?
ELLEN RIEMER: Yeah, they looked identical to each other. They were kind of gray/tan, you know. I couldn't tell exactly what it was, but it may have included meat. I didn't see any corn or, you know, green beans or anything like that. But whatever it was, they were identical to each other. And I believe she had 600 MLs, which is, like, it's -- 450 MLs is a pound, so it's like almost one and a half pounds of food. And he had 500 MLs, which is a little bit more than a pound. But they looked similar like they may have shared a meal together.
MR. WATERS: You testified that there was no defensive wounds on Paul. Did you observe any defensive wounds on Maggie?
ELLEN RIEMER: Nothing that would indicate any kind of a defensive wound.
MR. WATERS: Did you observe any damage to her fingernails or anything that indicated that she had been in a fight with her attacker?
ELLEN RIEMER: No. That's also part of the autopsy. In addition to collecting clippings from the fingernails, I look carefully to see -- sometimes there's a fingernail broken, sometimes there is obvious tissue or blood underneath fingernails. And she didn't have any evidence of, you know, material visually evident underneath her fingernails.
MR. WATERS: What about her toxicology? Did she have anything in her system, any drugs or alcohol?
ELLEN RIEMER: She had caffeine only, the same as Paul. And no other alcohol -- no alcohol or other drugs other than caffeine.
MR. WATERS: Dr. Riemer, in your professional expert opinion, what was the cause of death to a reasonable degree of medical certainty for Paul Murdaugh?
ELLEN RIEMER: For Paul Murdaugh, shotgun wounds -- let me see what exactly I said. I said shotgun wounds to head and chest. Shotgun wounds of head and chest.
MR. WATERS: And what was the manner of death?
ELLEN RIEMER: Manner of death is homicide, which means death at the hands of another.
MR. WATERS: And, Dr. Riemer, in your expert opinion, what was, to a reasonable degree of medical certainty, the cause of death for Maggie Murdaugh?
ELLEN RIEMER: Maggie Murdaugh died of multiple gunshot wounds.
MR. WATERS: And what was the manner of death?
ELLEN RIEMER: Manner of death is homicide, death at the hands of another.
MR. WATERS: Death at the hands of another. One final question. Did you recover any fragments from Maggie Murdaugh during your autopsy?
ELLEN RIEMER: Yes. So, this kind of ammunition breaks up into fragments. That's how it's -- that's the nature of that ammunition, and so I recovered multiple fragments of projectiles.
MR. WATERS: And I'm going to show you what's been admitted into evidence as State's 112. And do you recognize that?
ELLEN RIEMER: Yes. So, those are fragments I've recovered from Maggie's autopsy.
MR. WATERS: Thank you, Dr. Riemer. Nothing further, Your Honor.
JUDGE NEWMAN: Cross-examination?
MR. HARPOOTLIAN: Your Honor, I'm going to have an extensive cross-examination. Do you want to begin that tonight or the first thing in the morning?
JUDGE NEWMAN: If -- you want to begin it in the morning?
MR. HARPOOTLIAN: I think -- I mean, it's quarter til 6:00. It could go easily to 7:00, and I don't think the jury at this point would like to stay here. I don't, but --
JUDGE NEWMAN: All right. Ladies and gentlemen, we will recess for the evening and start at 9:30 tomorrow morning. Please do not discuss the case.
(The jury left the courtroom.)
JUDGE NEWMAN: And, Doctor, you may step down. Please do not discuss your testimony with anyone. As we -- If everyone will be seated. As we anticipate other witnesses tomorrow, are there any matters that the Court needs to consider overnight regarding any matters of controversy, or any controversy, or outstanding issues regarding any witness?
MR. HARPOOTLIAN: Not that we know, Your Honor, not on the part of the defense.
MR. WATERS: Not on the part of the State. The new information from GM we addressed this morning, and obviously the defense has that, and both sides are analyzing that, but I'm not -- aside from that, right now I'm not aware of any specific issues the Court needs to address.
MR. HARPOOTLIAN: The only query I will have, because we're, again, trying to arrange for people to fly in, and Monday is not going to be a court day, is does the Attorney General have any prognostication on when he might finish this case? I think that the GM material is somewhat -- I just don't know how much.
MR. WATERS: Your Honor, we're still on target for Wednesday. That GM material is just confirmatory of the timeline that both sides have had, and it's being incorporated into testimony. We have a custodian coming, which I don't imagine will be an extensive witness. We're still on target for Wednesday, Your Honor.
JUDGE NEWMAN: Okay. We'll be in recess until 9:30.
(Whereupon, the case was at ease.)