ARMED FORCES INSTJTITI'E OF PATHOLOGY
Olflce or tile AJ'IIJed Forea Medical E.umioer
1413 ReseIrdl Blvd., Blda. 102
RDclr.vilJe, MD 20850
301·319-0000

FINAL AUTOPSY REPORT
~ Ala SlINIvwiI
SSAN:Rb)(6)
]
DlI~ of Bitth:'rb)(6) -l,J 982
Date orDeaIb5b){6~200&
DlItelTimc: of Autops)': 09 APR 2008@0900
Dale ofRepon: IS JUL 2008

Name: BTB

(~b~)(6~';;;;~=J

AulOpS)'
NO,t!'
AFIP
No.:'<b){6)

CiViliiii;llCWnee
PJ8CC ofDe8th: Iraq
P~ of Autopsy: ~r Mortuary
Dover AFB, DE

Grade;

Cireum.ltanea of Deatb: This 2S )'«f-o\d detainee. was bema detained in Thealer
InterTunent Faeili!)' (fJF) Camp Bucca. when as reported, he was observed 10 be
vomitina outside or his tent. When qlleStiOllCd. he complained of beina dizzy and
vomiling blood, He was brouaht to !he TIF hospital whcR: Ix: WI! Jistod in serious
coodilion with • possible aneurysm. He was lUlellll)' MEDEVAC'd to the combat
support hospital in Ballld. While in the air. his condition worsened and the aircmt. was
diverted to Al KU1. All rC$llseitative measures were WlSuec:euful.
AUlborizlltioD for Auto~: Office of the Armed Forees Medical EJeaminer,lA W 10

USC 1471.
Ideotiflcatloo: Presumptive Identification via leViewof.U IICCOmpan)'ins paperwotk.
POSI·monem finaerprinlS taken and dental exam performed. Suitabk: specimen for DNA
anaI)'!is obWnod.

CAVSEOF DEATH:

He_n1Ia~oflbe

riclllcerebeJlom

MANNER OF DEATH: Nltural

MEDCOM 1068

ACLU Detainee DeathII ARMY MEDCOM 1068

"NAL AUTOPSY REPORT: (b)(6)

2

BTB Karim. Ala SlInIywir

EXTERNAL EXAMINATION
The body i. that of. _Il~ well·nourished male. The body 1169 K

incha in Ien&th. wcip 21S pounds. and Ippears tomplliblc with the .lIted lie of2S
The body ill cold. Uvldity i.1Ixcd on the poItcriOf swiacc of the body except
in the areu cxpD$Cd 10 pteUIll'e. The head and ncclt ~ IUfI'used. Rip ilresolvin& 10
an equal dcVft In 111 ntremilics. There i. martllinl of the IItln of both Ihouldenl.
The IC&Ip hair i. bladt. On the bIClt of the head ila I·inch linear KIf. Facill
hair consists ofa beard. The irides ~ llIdiainc:l. The comeae ~ cloudy. The
conjunetiYK are pale with no peteehiK. The Kiene are whill:. The lnl cavity, external
nares, UId external auditory c:ana1I ~
of foreign material or abnonnal secmiona.
Thcrc are 110 peteChiae of the oral mllCOlL
The chesl il symmetric. The plllil arc thole ofa circwncbtd adl/II male. The
anus Is atnumatic.
The upper and lower cxtmnities Inll)'mlDetl"ic and widlou! clubbina oredema.
The finaemailllnl intact. On the lateral nihl thiah ill 2 11 I·ineh sur. A 2 11 Y...inch
ICIt il on the left knee. On the riihl knee iJ a I 11 ~inch hcalinaabruion.

)'C&I'I old.

me

CLOTHING AND PERSONAL EFFECQ
The body i. clld in JOCks. AccollIpanyinl the body ~ three syrin;es. two bottles
ofveeuronium. and a bottle ofmlduohun (submitted to 1011lcoIOlY).

MEDICAL um;mlmON
An endotnlCbca1IUbc il in the oral cavity and tl1lCnca. On the ltlterlor torw an:
mulliple EKG lead pId•. A cathder II In the urethra and attached to a catch baa that
contaiN 700 milliliters of yellow urine. Intravenous cathdcn arc In the left &fOin. nihl
wriJl. and left ItItecubil&l fOllL There an: multiple needle P\,lllcture mara of both
clavicles, naJIlltllccubital fo.... and left wrin. Thcrc II galll.C around the left wriSI.

RADIOGRAPHS
A complete SCI of posI-rnorterrI radk\aTaphs I. obtained and rcveal no evldcnec of

on_

~ Is no

EVIDENCE Of INJUn
evidence ohipiflcant extemal or intemal recent injury.

INTERNAL EXAMINAIION
BODY CAVITIES:
The nbs., ltemum. and vcncbnl bodies an: vllibly UId palpably intael. There an: 100
milliliters of JCrOSIIIiIllncoll.l fluid in botJl ehca cavities. No adhesions Ire present in
Ill)' ofthc body cavillcs. The orpnI DCalp)' thclr US\III analOmlc posilions.
HEAD lCENIBAL NERYOUS SVSJEMl and NECK.;

The pica! and IIlbplcai soft !issues oflbc ICIIp~ he orinjury. Tbcfe an: no Iltull
ti1lctutc:s. The ~ mater and fib: CCrtbri Ire intact. The Icptomcninaa an: thin Mel.
delicate. There is 110 epidural Of.ubdunaI tlClIKWTblac. There I. focalsubar-chnoid
hcrnoITtIase ofthc nabl cercbc:lIwn. The brain _i&lui 1270 &rIlN and is cxllTlincd at\cr

MEDCOM 1069

ACLU Detainee DeathII ARMY MEDCOM 1069

FINAL AUTOPSY REPORTJ(b)(6)
BTH Karim, Ala Shnaywir

3

fiKalion. The ecrebnll hemispllelesare symmetrical and the slruc;l1Ires DC tile !lise of the
brain are intaeL The &Yri lI/Id sulci are lIlIl'elI\mble. The surface of the righl
ccn:bellwn is soft. Coronal sections throu&b the ecrebl1.l hemispheres reveal no lesions.
Transyerse sections tIvough!he brain sICm and cerdlellwn reYCl1a 3.0 K 3.0 K 3.0
ccnlimeter area ofhcmorrhaaie. lMlft, and fHable tissue of the right eerebcllwn and
scartered punctuate hemorrhages of the pons.
The anlmor stn.p musles of the neck are homogellOUll and red-brown (by layer-wise
disseetiOll). There is hemotrlv:ge around the pu.neture sites superior to the clavicles. The
thyroid cartilage and hyoid bone are intact. The Imynx is lined by intaet white mllCOSll.
The IOnilUC is free of bite marks, hemorrhage, or other injuries. The thyroid Is symmdJic
and <lark brown, withoutcylllic or nodular chanse. Incision and dissection ofthc
posterior ned: demonsll'ateS no deep paracerYicaI mllSCU1ar injwy and no cervical spinal
colwnn frIctures.

RESpIRATORY symM:
The upper airway is clear ofdebris and foreign material. The mL.llCOSll surfJeos are
smooth, yellow-tan and unrenwbble. The right lUId left lungs weigh 700 and 700
grams, respectively. The pulmonary pumchyma red"JlUl'Ple eKuding moderalC amounts
of blood. The pulmonary arteries are DDI1lllllly developed and palCIII witho\ll. thrombus or
embolus.
CARDIOVASCULAR SYSTEM:
The heart weighs 380 grams and is conmined in III intact pericardial sac. The epicardial
surf_ is $IlIooth, with minimal &t inYCStmellt. The coronary arteries are pl'eSCnt in a
normal distribution, wilb a risbl-dominanl pettem. There is IuMelina ofthc proximal left
Mterior deseendinll coronary artery (0.5 centimeters below the eplcardiwn for 2.0
centimeters). The coronary arteries are widely pMenL The myoeardiwn is bomogeoous..
The yalye leaflets arc thin and mobile. The walls of the left YCnlriclc, interYCntrieular
septum, and ris!rt yentricle are 0.8, 0.8, and 0.2 centimeters, respectively. The risht
YCIItricle is dilated. The IOrta and its major branches arise normally and follow !be usual
course and are unmnarkable. The vena cava and its major tributaries return 10 the bear1
in the usual distribution and are t"ree ofthrornbi.
UyER 4. BILIARy SySTEM:
The 2000 gram liyer bas In inlaCt, smooth eapsuJe and a sharp anterior border. The
parenchyma Ulan-brown with the IUUIIlobular arcllitl:lClure with no focal lesions noted.
The gallbladder contains 5 millilitenl ofdarit-green bile. ~ is dIolesterolosis of the
gall bladder mucosa. The extrahepllic biliary tree is plItent.

SPLEEN:
The 350 gram spleen has. smootb, intICt, red-PLll'pIe capsule. The parenchyma is

maroon with IIJlI'CfTwbblc lymphoid follicles.

MEDCOM 1070

ACLU Detainee DeathII ARMY MEDCOM 1070

•

1

FINAL /t.trrOPSV REPORT:,,(b_"6_'

BT8 Karim, Ala Shnaywit'

-

PANCREAS:

The pancreas is red.tan with alobulaled appeannce. No mass lesions Of olhcr
abnormalities are seen.

s:

APREN,t,J
The riabl and left IdrenaI glands ~ s)'JIllMtric. with mild autolytic changes. No masses
or areas ofhemol'l'Noge are identified.
GENITOURINARY SYSTEM:

gram,.

The ripl and left kidneys _iab 110 and 160
rupecrivcly. The external surfaces
are inlaCt I!II1d smooth. The CUlIurl'aoes are Wl-red and the tol1ex U dell~lcd &om the
medullary pyramicb. The pe.lva are lIIlI'eIlWkablc and the lU'e1el'S are normal in course
and caliber. The bladder contains scant urine. The proslatc and tesleS are IW'CJTIIIt.ablc.
GASTROINTESTINAL IRACf;

'The csophaps is inlaCl and lined by smooth, g:rey-while mucosa. The stomach, small
bowel, tolon, aid appendix are lIlIImWbblc. The stomach contains 20 miUiJilm of
bfOWll Ruid.
MUSCUWSKELETAL:
Muscle developmelU is nonnal. No bone orjoint abnormalities are identified.
MICROSCOPIC EXAMINATION

Cerebellum (Slides I and 2): Pattncbyma htillJOo'TbasC with dilated and Iort\lOU$ blood
vessels. Ex\ellSivc loss of Pwt.inje cells and cells of tile iJ'8Ilular layer. Focal
subarllchDoid hemorrhage.

Pons (Slide 3): Seanered, hyper-eosiniopbilie neurons.

APDmQN6L PROCEDURES
I.

Specimens retaillCd for toxicology lCSting lUldJor DNA Identification are: Blood,
vitreous fluid, bile, w;ne, liver, myocardiwn, lung, kidney, spleen, psoas muscle,

2.

adipose tissue and gastric oomenlS.
The dissected oraans are fOfWaJdod with the body. The bnin is retained for f\u\br:r
p)f.Imjnerion.

3.
4.

Selected portions of orgIJlS are retained in formalin.
Personal effects ~ released wilh the body.

S.

Reeovemi evidence: None.

.......

6.

Skin inl;bions oflhe posterior t~ bullOCks and eXlremitics reveal no evidence of

7.

Documentarv DhotolUUhs arc taken by (bU6)
IUIOPSY is(b}(6}
OAFME).
,
I

kOAFME). Auisting with the

MEDCOM 1071

ACLU Detainee DeathII ARMY MEDCOM 1071

,

FINAL AUTOPSY REPORT/(b)(6)
8TB Kmim, "11 Shnlywir

DNAL AUTOPSY DlAGNQSM
I.

He.orrbqe of the riPt Uftbella.:
A. f'amlehyrna hernotlllll~ of the riaht cetebelhuTI with extensive loa of
P\rtinje tells
8. Focalsublnchnold hemon1wae of!he right cerebellum
C. Puncwe hemorrba&es of the pons (c:onsi1Wll with bcmiation)

IL

Addltionl D.r."" cH1en.:
A. TuMelina ofthc proxirMllell: IIl!eriordesoendinacoronat}' enery

8. CholCllm:llosis

VI.

Toucoaocr (AFIP):
A. VOLATILES: No ethanol detected In the blood and vitreou1 fluid
B. CARBON MONOXIDE: The wboxybemoglobln AWntion in the blood
_4%'
C. CVANIDE: No cyanide deteaed in the blood
D. DRUGS: The folJowina druI' ¥I'Cl'e detee!ed
I. Lidoeaine(urine)
2. Promethazine (wine: DOlle ddccted in the blood)
3. P1eucloephedrine (wine; none detected in the blood)
4. Mldu.ollll'l (urine: none d.nc«d In the blood)
S. AoetIminophen (wiDe)

6. Vccuronium (o.n mWL in the blood) end its metabolite).
OesKelylvee:W'OrIium (blood)
OPINION

This 2S yeu-old del.lin«(b)(61
died ora hmlorrlIlIae oltho ri;ht
cerc:bc:lJum. The IOlIicolol)' _ po$itivc for medication. u.d in re1USCil.ltion (I~
midazollm, end vec:uronlum), anti-na~ metlieatkln (pometbuine) Mel over-thecounter mot6eationl ~ne antIlCetaminop/len). The manner or 6calh is

Nilural.

(b)(6)

(b)(6)

Medical Eumlner

MEDeOM 1072

ACLU Detainee DeathII ARMY MEDCOM 1072

---- - - _.' - ... -- -_..- ...
._.-,_
..
--- -__-- -- -- - -- .
-_.-_.---- __-'-"
--

_...__. -S_

COlT1l',"lI!Of lIUTl1 {O¥t:Il.$EASJ

~--

_ 0 1 ......· -

IIW'I:>O OIKINIC.

BTB Karim, ......,

Civilian
""TOOI' eomo

...."""

OF

-~

(b}(6)

-~-

(b)(6)
~

(b)(6)

Iil

~

98'

~

0

_",aNl

~

•

..........

_T. .T....

~

C"C'MW!

• ,-

0-

...

....... 01' """'OF ""

.

.....~ ' o _

ITJIU'_A

,

aNOO'.-<OOIIl'"

.,•

- . ..."........

...... ....

...

_
.. _-_.- __..
_. --_
-.---_....._,_..
- --

0
GUAlOF
:- .. _
.....'"
_ _ _ ... _

,

,

'100 ... " 09" "' .... ""'" _otoHum

<NRASI 00 CONOI'''' "","",,' ~ TO .....'"

01• • " _

...,.., 00i0lIIT...... _ , ' - T O

... ,.

""""."" ... couse." _. _ _
'0 ........... """'""

-... _., .. _- ...---• .-_
_
.
--- - I
--'...._.. _.-_ ... _---_...
,._
...
__
...
.
......
_...... _.. ..'---.'_._
_---_... _......._...._...--------,_._-... _..
.... _.. _, ..
on... -...... c,"""",,"

•

_ . _ _"0

'""""OI' ..... T~

iii

~.

~-

(b)(6)

(b)(6)

0

....." ' . . . TO~CIQQ

...

•

•

I r:E.- l!J... -

9 April 2008

OUdI/It ....... ~.-

...,.O' .....'"

(b)(6)2006.....· · - ' ...... _ _ _ '" ...'"'c....o.... """'"
(b}(6)

••

"

-~.-----. .T.......

(b)(6)

••

"""OO_...

IHIlICa m> ""'

Medlc.al Examln&r

'''''' ....

<:AUK," l'T.no _ _

•

Dowr AFB, Dover DE
(b)(6)

7/1712008

•

_~.,._

DD·lll'Io 2064

"'O\IoClU ... >c.o _ , _

-_._~--

" ....... >c.o _ " " " . _

MEOCOM 1073

.... _ _...

ACLU Detainee DeathII ARMY MEDCOM 1073

ARMED FORCES INSl1TtJTE OF PATHOLOGY
Oftktfllttle AnIII'd F _ MedIcal t:umllter
1413 Reseattll Blvd" 810:1,,102

.~..

Rockville, MD 20830

JO 1-319-(l()OO

A11fOPSY EXAMINATION REPORT
Name: BTB Ruzaq Abd-AI, J '")'
TMEP:

(~(6)

Mil","

Dale of Blrd{(p)(6) 1986
Dale ofDudJb}@l_i2008
DMeIT1me Alltops)': 09 .... pr 200ll
FlVlIl 1000 to 1200 botII1;

or

AulClplY No.:(bl{6)
AFlP No.:(b)(6)
bnk: Civilian dellllnoee

Place or Deatb: 1nIq
PI_of AutopSy: PorI Monuuy
DAFB, Dova'. DE

Dale of Report.: 02 May 2008
Cralmstalltel O(Dul!l: This civilian deW~ ...... report«Ily round lwIpna in iii' cell by hi'
he made into • IIOOIe.. Durins tIM coune 011111 InlenlJtM:nl,1lIl adrnltled tra\<dllll from
Syria 10 become I .cuic:llle bomber. fwtber. he dlJpIa)'ed IIIIn)' tlT'llk: behavlon .nd Ilanl or I
poniblc 1I>eIl1aI impairment. Print 10 hil death, he wu placed on. U-hour watch clue 10. poulble
thlUl ofielf·harm. The walCh consisted ofcheclu ,,-very IS minutel and his confinement WLl
solitary. The detainee "'II fOll/ld deceased In h~ cell by. membetOflhe US Guard Foroel.
pINS Ibal

"'utboriuticm for AulOp.ly: Nmed fOl'~ Medical Eltlmlllef, per 10 U.S. Code 1471

Idmtltk:atloa: PresIlmpjw idenlifrClllon ~ e&tlblished by the eumjllMlon or.-ecomp.nyin.
paper work.

CAUSE OF J)£ATH: H'llJIn.

MANNER OF DEATH: Suldde

MEDeOM 1074

ACLU Detainee DeathII ARMY MEDCOM 1074

,

AUTOPSY REPORTI{b)(6)
aTB R.azzaq Abd.·AI, Lut.y;;M"~;;;;.'r.c-

EXTERNAL EMMINADON
The body is WI of &nude wcll-developed, _1I·nourished male. 'The body _i&!ls ]12 pounds. is
68 illdu ill lenJlh and appears compaliblc "'ilh the rqlOrIed ~ce of 26 )'fIlS. ~ body iHold..
Rip is pesinl' Lividily is pR$Cnt and fixed on !be posleriorsud-= oflhc body, Cl<ecpI in weas
Cl<pom:IIO
MlIlblilllllf the: skin 01 the left 10'f0ref utremity and left forunn II seen.
ThUll is a !;)iBbI pun disc:oloJ1ltiOll of lho: skin or ~ ri&N lower quadrllll oIlhe abcIomtn.
The normooepbalic head isconSWed, &nd!be sc:alp hair is blOwn, shOfl and curly. FaciBl hair
COllSi$ls 011 slubble beard.. The irides are brown. Thecornelle IICdoudy. "Theconjulldivae Ire
congested witll numuous pelecttiae seen b~atl:rally. Numerous petechiae are Ken on the skin of !be
upper and lollo'er eyelidJ. The IIC~ are white. The ei\lI:mal audilory eanals. Ull:tnalnues and
oral Clvlty are free offoreillllllllterial and abnonnal ~Iions. The earlobes are not pic;roed The
nasal skeleton and muma are palpably illtllCf. The lips IW. .... ithou!: evident injury. Thc.1IX1h are
nalUllll and the left upper cenlra] i~iSOf i. milsinl. The neck Is described in the Evidence or Injury
section below. The chest is unre.markable. No evidence of injury of the ribs or tile lW"num is
evideOt ulemally. The abdomen is unremutable. 'The exlernal ~niraria are those of In aduk",,_
_ ~rcurnciJed male. The posterior lorso and IlItII are wllhoo.Jr-nn1,,-The.filll'lmails IW. inllc:l. U!!>.@.
(b)(6)
1aI1ool@®
. J A no_IIa!(b){6)
iii atllc:lled 10 lite left I!Ikle.
TWOi'iiine IIgs are atllched 10 the left hand. A hospilal ID bnlcclel is .tllChed to tile right wri$l.lIld
is Inscribed witll tile numbers. (b){6)

prus=.

CLOTHING AND PERSONAL EFfECTS
•

None
~CALINTERYBN010N

•

EDdouac:huI intubation

•
•

Triple llUTlel1 catlleler or tile rl&hllUb<:lavian vein
Two IDIomatic defibrillator pads on tile rillll &nd left t.ides of the dlw
One needle punelure in lho: ripl anleCubitall'ossl and two needle punctures In llIe left
BnleOlbital fossa
Pulse OJ.irneler on IIlI: second di&il of liID left band

•
•

RAJ)J{)(jBAPHS

•
•

Healed rrxture ofllle left d.vjc~
Heavy Ill/1g eonBWkm bilaterally

MEDCOM 1075

ACLU Detainee DeathII ARMY MEDCOM 1075

,

AIJTOPSY REPORT 1(b)(6)

BTB RIUIq Abel-AI, I Jlay Mililift

E\'II)£NCi Of INJURX
There is. 9 ineh brown diKOnUIU.IOUS lipure furrowofthe skinoftbe fron! and left side: of the
neck. The fucrow er.1endli 10 !be left side ohhe ~ofthe neck and is directed obliquely upwards
• an 'fIPl'O-lillllle 20 degree angle.. The liplure IiuTow crosses ,))ave the tllymid eartllqe 9 inches
below the top of the ~ and extends $Uperiorly to the left side of the ncct, passing3-JI4 inc::he$
below the left ClllC:mal auditory I1lW\l5 and 8-m lDehes below the lOp of !he head. The hilhea
point of lhe furrow 15 on the left lillie of the back of lIll: neck located 7 inches below !he top of Ihe
held and 1 J~b 10 the Jell: oflhe po6Ierior midline. The fInTow only utends I im:h 10 the rlghl of

!he anterior midline. The width of the fucrow II 1/4 inch. The O:pIh oflhe furrow Is 118 Inch. The
lItin wimin the fumlw is drie.cllnli abraded. An anterior ned< diJliC.ction shows no injury to !he
IIIlderlylngllOl'I tissua Ol" hernonba&e inlO the w.p m\l$Cles. The h)'Oid bone and thyroid clnilage
.lfC illflel.

There is. 1 Inch eonluSIOll of lhe pocr.c:riorIdislal aspce:t of lhe rig/l( leg.
INfERNAl, EXAMINATION
BODXCAyID@

The bady is opened by the u$u" thonoo;o-a!>dominallncislon and the ehesl plate is "'1IIOYed. The
ribs,litemum, IrId vcnebtaJ bodies an: vlsibl)' IIId palpllbl)' in~t. No Idhesi0n5 or abllOmllll
IXlll«dons of fluid file jlftsen\ In an)' of the body e.vJtio:s. All bod)' orpm an: presenl in IIOITIIIl
anllOIhiC4J ponilion, The $UbcutfWle(lUli fae l.yer ohho: abdominal wall is I-In inches Ihick.
HEAP AND CfljIBAl NERVOUS SY:mM;
lbc brain is retlined for ulmination after fOl'Tllalin fi~ltion. The $CI.Ip ill refleeted. The plcaI and
subp/eII son tissues of!he SCllp an: free ofinjury. ~ an: no skull f/1ll:\UlR. ThecalVJrium of
the Hull 15 removed. The dura mater.nd fal" ocrebsi IIlllntaet, There Is no epidural or subdural
ho:morrh.ge pcaent, The IcpcomcningllS IIllthin and dcIlalle, lbc'" is. 1-314" I inch IWlOle
COlIlll5ion of the left fronlallobe of !he brain .nd • 2" 1/4 inch reTDO\e contusioo of tho: righl fronllli
lobe of !he blain. Clear ectWl'O$piP/ fluid liIIn'Ollncls the 12.S0 gram bn.iJl, whlc:h has unremarkabl~
gyri and suJc~ Coronal $IlCIions through Ihc: eaebNl hemisphert$ ~velll no non-tl$llmatlc ~ions.
TIPliYClSC sccQons Ihrough the brlin $lent and c:erebdJulll_ unl'emartabJe. The: IlJlIllO«Cipillll
joJnl is Mable. The upper cervical ~nal cord is unren1lJtlble.
NECK;

The llIlU::rior slRp mllliCles of llll: neck _ bOll\Oien0u5 and red-brown. witbOUl bc.mor7bage by
layer-wise d;'yaion,. The tllyroid cartilage nnd hyoid booe Ill: i011Ct. The larynx is tined by iOllle\
whim mue::ou.. The \QlIglle is !Tee of bite mllb, ho:rnon!tIge, or OIhcr il\lUries. tnc:lliioll and
diS5llCtion of the posterior neck demoltSlr8lCS no deep paracervieaJ mlL$ellJar lnjul)' and no cervical
spine ftw:turu.

MEDCOM 1076

ACLU Detainee DeathII ARMY MEDCOM 1076

,

AUTOPSY REPOR~}(6}

8TB RIUalI Abd-AJ, l..uay Mistefa
CARDIOVASCULAR SymM;
The 300 erarn heart U oontained in an inlEt perieMdial sac. The ep;eaniial $Ilrface i$ $lllOOIh, wilh
minimal fa! invesfmeJll. The OOllJl'lary ancrics an; pres.e1Il in. nonnaI distribulioll, wilh a righl-

doruinanl panem. Crou sections afthe IeSds shaw wide patency. The myocvdiutrl is
homoaerKlllli. red~wn. and finn. The valve kafleu ~ thin IlId mobile- The wll1ls of the IcJ\
veruricle. iDltrvenlricular seplllm, And riJbt Vl:n1ric1c are 1.0. 1.2 and 0.4 em !hid;. respeclively. The
eIldocardium is $IllOOlh aad glistening. The aorta Jives rise to lhre<!; inlaCl and paleol arclI vessels.
The n:oal and mesenltl1e \'t$SC!Js an; unrelTllfkal>le.
RESP!RATORY SYSTEM;
The uppa airway il clew af debris and fon=ilJllDlltrial; the mucosal swfllC'es ~.mootlt, yellowlaI1 and uJlNlJlUbble. The pleural SUrflO;CA ~ s_h. g1isteninl and IllU"emaricable bUaltraUy.
The puI~ p.tenchylDl is difl\ucly congCAltd and edcma1owi. e~udinl slip 10 modelalt
amounts of blood and frolhy nuld: no focal lesions are llOled. The pulmonary aneries Ill: IIO!fIIIlly
dl:W:1opcd. patenl and wilboul lltrombus 01' embolus. The righl lunl weilbs 640 8"Ims: the left 530

...,..

HEPAIQBnJARY sYSTEM'
The 1630 anm llvu has an intaa iTIIOOth capsuleooverinl datil red-brown. moderalelyCOl'laested
II/I-brown puenehyma with no focal '"ions noled. The lallbladder is empty; the mUOOSl is velvety
and lIllfeIIWbbJe. The exltlhepatlc biliary t= Is pa1enL witbout evideDce ofc:.alculi.

GASIRO!NTf.STINbL SYSTEM;
The esoplulgus is lined by Illy-while. slllOOllllll\lOOSll. The alSlrie mllCOlIa Is amnged in the usual
ruaal folds and the lulllUl contains 5 ml of brown nuid. Thuman and latlle bowels _
unn:martable. The panerellS has a nonnal pink-till lobulated appearllllCC and the ducu lII'C clear.
The appencli~ is present.
GENITOURINARY SY51EM,

The ri,," k.idoey .....ighs IW grams: the left 120 grarJl$. The renal capsules lII'C 1lIIOOlb aM thin,
semi-traruparentlUld Slrip wllh ell5t. from the underlyinl smoolh. red-brown conical sUfface.
The COJtCl< is stwply delineated from the medullary pyramids. whic:h are red-purple to tllll and
"",remUUbJe. 1bo. eal)'l:es, pelves IIId urettn are umenwltable. Wltile bladder mUCO&l O\lffliellll
illUlCt bladder wall. The blldder OOlIlalrlS apprwim.ely 3 ml of tuJf;,id yeJlow urine.. The tesles,
prostltlC gland and seminal vesklC5 lII'C witboo.R 1lOIC.

MEDCOM 1077

ACLU Detainee DeathII ARMY MEDCOM 1077

AUTOPSY

:=J

REPORT~(b){62.-

,

BTB Rauaq Abel-AI, luay Mustafa
LYMPHOBRDCUI.AR SYSTEM:

The 210 awn $pleen tw a&mooch. inttel ClIpsule roverin,g red-purple, moderJ,ldy film
puenebyma; lhc: lymphoid [oWeles are uM;m.hble. Lymp/lllllde3 in the bilar, periaonic LIId ill..e
~&ions are not enluged.

ENOOCRlNE sysTEM:
'Tlw pltlliwy ,glllfld i& unremubble. The thyroid ,gland is symmetric and ~d-brown. wlllloul c)'Slic
or nodular chan,gc.. The ri&!U and leO adrenlllllands IU'C 1)'IlIlllelrlc. with bri&ht ~Ilow COf\icu and
red-bl'own rneOJllae. No masses oc areas o[hcrnorrlIa,ge are idcnlificd.
MUSCULQSKEI RIAL S)'STEM:

/110 non-lf1,lll'tlalic abnormalities o[ muscle or bone are idenlified

ADDmoNAL PROCEDURES
I.. DoculllClllarV lIbolORra[lhs an: laken by OAFME SUlff pholo&f1lp/lerl(b){6)
2J,{b)(6)

IOAFME staff alllOpSy auiSlaII1, ISSisIcd wiih !he IUtopsy.

3. Specimem: retained for IOJicolo,gy leslinJ and/or DNA identlflC8lion are: brain, heart, luna.
Iiva-, spleen, lQcIney, skl:lelal m\ISClc, adipose 1l.uue, blood. urine. gaslric: Q::mtenrs, and
";1rCO\IS n\lid.
4. The dissecled orpns an: rorwiUtlcd willi body.
MlCROSCOl'IC EXAMINATION
Brain (Slide:!: I and 2) _ Dl$Nptcd conex wilh while malter aJiosis

MEDCOM 1078

ACLU Detainee DeathII ARMY MEDCOM 1078

•

AIIT'OPSY REPORT (b)(6)

8T8 R..uq AbfS.AI. t.uay Mllilaf..
fINAL AUTOPSY DIAGNOSES:

m.

H....ar- DiRoadn_lfpbln tlanvw of the ~t UMt Iefl ... of tile ned
Ml80r l!ljurIes: ConltWoa III tbe I1chtlel
Ranou IDj"'" IluIote _t..... ol the len aDd riI"t fr'Olltl.llobes of tbe bnb:I and

IV.

N.bmll.,...., N_

L
lL

V.
VI.
VIL

• bealed rr.ctun of tht Idl dII~1da

MTI'b.. ner1lp,: AI: del.eribelhbove

Pootiawlltm Cb.aaa-: AI: dlSCribid I.bo'IC
....lU)'I., ~rU: At ~ Ibo...,

vlJI. Toxlooklc7IArIP):
A.
B.
C.
D.

VOLATILES: No dbanoIlideteded lnlhe lHood aDd l"t:twuI ftu5d
DRUGS: No Ia'"HnfId drup of.... or IIledIc:Miolg (Ind-'ln& -noq.lMj art
delIded In tIM bklocI
CYANIDE: 'l'bf,1"I." no cyanlde detuted III 0. blood
CARBON MONOXIDE: n.c.11Max11l
'IJobln A1Wnlloa In 0.1aloocI h . .
than

1""
PnNJON

Thll mak "i~lIlan dctainco, 8TB (bW.6)

died of hMgIn,. He .... fcund
llan$in,ln • cdl by his pIlllJ that he IIlI.de InfO .. IlOOK. He WIl$ the onJy OCtUpanl 0( th!: gell. The
c.uboli:)'hcmo&lobln IoIlUralion in the blood it noc dc:vlfcd. ThllIO~io::olllCY _ n II nepriva. l'bc=
IJWIlIeJ of dulh

illuiddc.

(b)(6)

(b}(6)

MEDICAL EXAMINER

MEOCOM 1079

ACLU Detainee DeathII ARMY MEDCOM 1079

_._
....
'
t:---"'--,,-- ..- ~-.... ,.;,--;... -_
......
- -- - - - ------ -._..-_. - -"''''-- - - ...._
.... - -_. __
-- _.- _.-_...- _""-.....
----_
..-_
_
....... _ -"'-------"---"'.-"-,-"
-_
. .... _...
-.
-._----."-._-_
.... __ ...
-._
- --_.-. . . ,......11I01 ....TM/OW.. ll·~

•

~--

8Te RazzlIq, Abel AI,

•

·1l11t

(bj(6i-'--

lurf ........

Ii!

I

.

•

0

~-

c,.c'_

~

• SU.lh'=

.......

...

t:3ii

...

....

... -,..•

,

T

,•

_...............--_-.------- _...
---...-_._--...
... - -.."'--_.
_.. _. __...._---Ii'-_. _-"'
-_.-"'-_
..
. -_
...._._-- _._-. .... _
_.. _
"_......_"-".-.
.... I

iii- = 0=-

=

•

•

(b)(6)

......_no

(b)(6)

I~"2OOlI

•

I....I:E.=

lie.-

(bl(6)

....

b ~~-6

(b)(6)

61'112008

.....
~.
'
DD ,:III'f, 2064

M

.

"'-...

A

----

t'

IDo:: N'B, 0 - DE _

...

iIoelEumll . .

..-

(b}(6)

.

"'--'-

"'

...

.. _ - _ .........._-....

MEDCOM 1080

ACLU Detainee DeathII ARMY MEDCOM 1080

ARMED FORCES INSTITUTE OF PATHOLOGY
om« of the Armed Forcc:s Medical E~ner
1413 Research Blvd" Bldg. 102
Rockville. MD 20850

301-319-0000
AUTOPSY EXAMINATION REPORT
Name: AJ-Saaida. MIIIlammed A.
Delai..- Numberl{lill6)
DaleofBirth·(b)(6} 11965
Dale of Dealhltb}(Sj] 2009
Daletrime of Autopsy: 29 Jill 2009 0 0900
Dale of Rcpon: 21 Sep 2009

rC

Autopsy No.: bf { 6 r - J
AFlP No.: ~b}(6)
~

Rank: De<ai..Place of De.ttl: lnoq
PliICe of Autopsy: Port Mortuary.
Dover Air Force Base. DE

Circu....,t&n«$ of Death: This 44 ycar-old delaincc WB.$ being held in eu.uody i?,lraq,jlr repon.
he Wll! wit~d to collapse hy several OIher detainees at approximately 1600 on{b)(6) 2009.
Resuscitalion was initiatecl and he was !l"lIIl'lfemd to lhe nearest medical facilily. All re5llSCilalive
efforts were uMueee.'ldlil.
Alithorization for Autopsy: Anned Fon.:e:s Medical Examiner. per U.S. Code 10. Section 1471.
Identification: Positive identification by anU-roortIlm and post-mortem fingef)lfinl comparison.

CAUSE OF DEATH:

AtheroscJuodc canilovucliJar di5eaK

MANNER OF DEATH:

Natural

MEDCOM 1081

ACLU Detainee DeathII ARMY MEDCOM 1081

REPORT:~I(b~){~6[)= -J

Aln'OPSY
AI-Saaida, Muhammed A.

,

EXTERNAL EXAMINATION
The bodv is re<:ejyed in a black bodv baR. Attached 10 !he 0II1ermo.u nag are 1111'0 paper lags
jI'he body is undad. P8perJ).~ are D~l on
with !he name.(b){6)
lIw! hands A_oa.....V r.4<> is attached ",,,N. laf,.oowalloe labeled wilh!he name,{b)(6),
_
•
F
-..
'(bl(6)
'-'-"---;
(b){6)
A white lag labeleC__
is placed on the left ankle al inlake by mortuary
affairs.
The body is thsl of a well-developed, _II-nourished male. The body weighs 170-pounds
and measures 67-inches in length. The body is euld. Rigor is presenl to an equal degree in all
extremities. Lividily ill presenl and filled on the posterior surface of lhe body. ellcept in areas
e"posed 10 pressure. There is mild marbling of the upper and lower e,,~mit;es.
Injuries to the: head and neck are described below in "Evidence of injury." The head is
normocephalic, and lhe scalp hair is black-gray and short. Facial hair consisll of a black-gray beard
and mOUSlache. The irides appear brown in color. The corneas are cloudy. 'The conjunctivae are
congeslCd. The sclerlle are OOflge.sted. The extemal audilory canals, external nares and oral cavily
are free of roreign material and abnormal secretions. The earlobes are nol pien:ed. The nasal
skeleton and maxilla are palpably inlaCt. The lips are Wilhoul evident injury. The teeth are natural
and in good condilion. The neck;s straighl, and the trachea is midline and mobile.
The chest ill symmetric with no elltemal evidence of injury 10 !he rib$ or sternum. The
posterior 10rso demonstrates no evidence of trauma. The abdomen is flat with no healed surgical
scatlI present The genitalia are those of a cin::umcised adull male. Pubi" h.air is presenl in a normal
distribulion. The anus is non-traumali". The testes are desc:ended with 00 palpable masses present
Injurie$ to the extremilie$ are desaibed in "Evidence of Injury." The upp« and lower
extremities are symmetric and wilhout clubbirlg. edema, fraaures, lacerations Of deformitles.1lIe
fingernails are inlatl800 lrimmed. The toenails are dystrophic.
Well-healed irregular scars are pre$eIll on both lower extremilies. 1lIere are three st:ar5 on
the medial right thigh. each measuring 't.t x1h-inchr$.11Iere;s a IZ" I·inch irre8"lar Karon the
laleralleft thigh. There is a 3 It I-inch irregular scar and a Y.I" 'h-inch S<;ar on the anterior left thigh.
There is. 3" I·inch s<,;I.J' on the poplileal fossa of the right knee. 1lIere are nW1lerous radio-opaque
foreign bodies idenlified on radiography in bolh lower ex~mltie$ thst are too small to be
re:::overed.

CL011I1NG AND PERSONAL EFFEcrs
The following dathing itenu are received with the body allhe lime of aUlopsy:
• Yellow shirt (tom)
• Yellow swUtpantS
• While boxer shorts
MEDICAL INTERVENTION

•

EKG leads on anterior torso (6)

• DefibrillatOr pads on left upper torso and left upper bacl<
•

Intravascular eatlletef$ in lhe right and left antecubital fossae

• Anlerior right rib fractures of 4-5'" ribs
• Anlerior lefl rib frtll;lure of 4'" rib
RAD'OGRAPHS
A complete se1 of postmortem radiographs is obtained and show no evidence of acute injury.

MEDCOM 1082

ACLU Detainee DeathII ARMY MEDCOM 1082

AUTOPSY

J

REPORT:.~lb_)(~6_)_ _

J

AI-Saaida. Muhammed A.
EylDENCE Of 'NlURY

Minor Injuries:
A \?: x "',inell $uperficial abnuioo is on the anterior surface of the scalp. A II.l x !A-inch
abl1l$;on is on the dotsalsurface arlhe left hand.

INTERNAL EXAMINATION
BODY CAYITWS'
s.,e "Medical Intervention.· No eXCe!lI nuld is in the pleural. pericardial. cw peritoneal
cavities. The organs occupy their I.lS\lal anatomic posiliOl\$. TIle subcutaneous tal layer of the

abdominal wall is . mremarkable.
HEAP (CENTRAL NERyOUS SYSTEM)

and NECK-

See ~Eyidence of Injury." The gaJeal1lld 5ubgaleal soft Iissl.le:5 of the scalp are free of
injll')'. Tnere are Ill) skull fractures. The dura maIer is inlact with no evidef1ce of hemorrhage. The
leptomeninges are Ih;n and delicate. Clearcerebrolpinal nuid surrounds 'the 1383_gram brain. whicll
has unremarkable gyri and sulci. The br1lin was retained and fixed for Neuropathology consultation
(see Appendix A: Neuropathology Consullalion). The allanto-«cipilal joinl is stable. The upper
spinal cord is unremarkable.
The anterior strap muscles of the neck are homogenous and red·brown. withoul hernorTflage.
The lhyroid cartilage and hyoid bolle are tnlaet. The larynx is lined by intact white mucosa. The

thyroid gland is symmelric and red·brown, wilhooJt cyslic or nodular change. The lOngue is free of
bite marks, hemonilage. or other injlU";es. Incision snd dissection of lhe po6tenor neck demonstnltes
110 deep par,ilCenrical muscular injury and 110 cervical spine fraet\lres.
RESPIRATORY SYSTEM:
The airways are clear of debris and foreign material and lhe muco:salsurfac:e:s are smooth,
yellOW-ian. and unremarkable. The righl and lefllungs weigh 680-grams each. The e:ctemal
surfaces are smoolh and deep red-purple. The pYlmonary parenchyma is diffusely congesled VKl

edemalOUS. No mass lesions or areas of coosolidslion are present. The pulmonary arteries are
f101Il1ally developed and patene. The diaphragm is inlact.
CARDIOVASCULAR SYSTEM:

The 480-gram heart is contained in an intact pericanlial sac. The epicardial surface is
smooth, Wilh modenlle fat investmenL The coronary arteries are present in a nonnal distribution.
with aleft-dominanl panern. The proximalldt anterior ~ending coronary anery hili BtUter lhan
90% atherosclerotic narrowing. The mid left anlerior descending coronary artery has a fUIlnel
measuring O.J·cenl;metera in depth and 1.5-<:emtmel:= in length. The cin:umflex artery has SO%
atheroselerolic natTOwing. The righl coronary Ulery Iw 10% athertl.5Clerolic natTOwing. CI'055sectior.s through lhe myocardium show I J-<:entimeter pale area of lhe posterior left venlricle and
po5lefior ventricular septum. The valve leafielS are thin Ind mobile. The WIUS of !he left venlricle,
interventricular seplUm. and right ventricle are 1.3, 1.5. and O.3-centimeters lhick, respectively. The
endocardium is smooth and glistening. The aorta gives rise 10 lhree inlact and patent arch vessels
with mild alhero$Clerotic plaque. The renal. rne<;enteric, and iliac vessels as well as !he venae cavae
are unremarkable.

MEDCOM 1083

ACLU Detainee DeathII ARMY MEDCOM 1083

•

...1JTOPSY REPORT: (b)(6)
AI·Suida. Muharntnal ....

HEP...IOBlblARY SYSTEM;

The 1700-gn.m llv~ has III illlaa. smooch capsule and. st..rp -not border. The
pam'Idlym. is tln-brown.1'ld oonsested, with !heIlAlllIobuJar In:hileClUfe. No mass lesions or
other IbMrmIlities.re seen.. The pllblldderOOMains l().ml11i1i1elS of green-black bile and no
SIOM$. The mUC(lSllllrlaee is green and velvely.
LYMPHQREDCVL\R SySTEM;

The: l60-pm spleen ha$ • smooth. inllCl, red·pwp!eupsule. The: pann:hyma is mlrOOn
and congested. Lymph flOdes in the hilar, perilOr1ic, Illd iliac regions Ire unrmw1r;lble.

ENDOCRINE SYSTEM;
The phultary gl.nd is unremarbble. The thyroid gland has been described (see NECK·
above). The rigll and left Idrenalglarv1s Ire symmetric, with Mglll yellow conias Ifld recI-brown
medullae.. No masses or areas of hel, .... ,h.ge Ire ide<ltil'ied.
QENITOURINARY SYSTEM;

The: right and ~ft kidneys weigh 160-grams elCh. The exlema1 wrfaoes Ire i/Ud. and
in'lOOth. The CUI.urflCellre red-tan and aMlgtlled. with unlfornlly thiek cortices and sharp
conieomeduliary junclioN. The pelves Ite unremarltiible and !he ureters are normal in course and
ealiber. White bladder mucoaa overlies an inllel bladder ....all. The bladder oontains appro~imately
S-millililefS of urine. The prostale is normal in siu, with lobular, yellow-tan p.wmehyma. The
iemln.1 vesicles are unremltbble. The lestes.re freeof mass lesiona. conllSSions, or other
abnormalilies.
QASmOINTESIINAL TRACT:

The esophlllSS Is intiCl and lined by smooth, gr1Iy-whlte mueosa. The slomach contains
approxlm.tely J75-milliliterl of Ian nuid and pani.lly digested food panieles.. The glttric w.1l is
Inlact. The: dUO<lenum, loops of small bowel and oolon are unremar1clble. The panereu is ,ulolyzed
with no mill lesions orOther .bnorm.lities teen. The appendi~ Is present.
MUSCULOSKELETAL SYSTEM;

No IIOn-uaum.tic Ibnorm.lltiu of lhe muscles or bones of [he .ppendicular and ...d.1
skeletons Ire identified. Dissection of the skin of the baclr., upper and lower edremitiet snow 110
evidence of deep tiuue hemorrh.ge. Dissection of !he skin of !he .nkles and wrislil show no
evidence of hemorm.ge.
MICROSCOPIC EXAMINATION
Selected poniolllll of orlllllllire ret.lned in fornl.Jin Wilh preparation of histologic slides.
• 'The liver shows CQngestion and no siJllil'icltll perlponal inflamml110n or portal flbl'Oili.'l. ~
is mUd stealQlil.
• The kidney Showslulolysis of the pro~lmal lubules Wilh relilive Sp&rlngof the glomeruli, disal
tubules. and COIlec:lingsystem. There il occasional g1omerulo.sclerosll. mild-moden.te hyiline
anerioloselerosis. and IeIltered p.tchy chronic InOlmmation.
• The spleen ShoWI congesled ~nehym. with norm.l.ymphoid follicle formllion and lutolytic
change.

MEOCOM 10fl.4

ACLU Detainee DeathII ARMY MEDCOM 1084

AuroPSy REPORT~~(b,,)(6~)
AI·Saaida, Muhammed A.

•
•
•
•
•

•

_

,

The lung shows atelecwis Wilh mullifoeal congestion with no significant intta-alveolaror
inlersliliallnflammalion.
The thyroid shows normal follicles wilh no increased inflammalion Of fibl'Ol5is.
The myocardium shows properly arranged myocyte! thaI are w;lh mild enlargement (~bo~car"
nuclei). 1'here is no significanl increase in fibrosis Of inflammation
The pro~imal left anterior descending coronsry artery shows greater than 90% atherosclerotic
narrowing.
"The mid left anlerior descending COfOflary artery shows lunneling of !he artery inlo!he
myocardium
The poslerior wall of the lefl ventricle shows eXlemive fibrosis willi no significanl aalle or
chronie inflammalion

Slide key;
Slide I; Thyroid, liver
Slide 2; Spleen, kidney
Slide): RighI lung
Slide 4: Left lung
Slide S: Proximal left iUllerior descending coronary attery
Slide 6: Mid left anlerior descending cororw-y artery wilh tunneling
Slide 7; Poslerior left venlricle

I.

Z.
),

4,
5.

ADDITIONAL PROCEDURES AND REMARKS
Documentary phololtflPh!l are,taken by~{b)(6)
tAFMES staff photographer). Assisting
wilh the autopsy b(b)(6}
;(AFMES staff).
Personal effects are released 10 lhe appropriate mortuary operations represenwives.
Specimens retained for IOxiwlogy teslingand/or DNA idenlification are; vilreous fluid, blood.
urine. bile. gastric contents, lung, liver. spleen. kidney. psoas muscle. adipose tissue. and
myocardium.
The dissecled organs are (OIWarded with body.
No evidence is recovered,

MEDCOM 1085

ACLU Detainee DeathII ARMY MEDCOM 1085

AUTOPSY REPORT:[(b)(6)
AI·Saaida. Muhammed A.

1.

II.

~

•

FINAL AlITOpsY QlAGNOSES
Minor abrulolUl:
a. Superficial abrasion on anlerior surface oflhe scalp
b. Superficial abrasion on dorsal $lJrfaceof!he left hand

Natural dlw....:
I. Sev..re coronary atheroscll'lOllia
i. Greater Ihan 90% alhero$cl..rotic narrowing of the proximal left anterior
descending coronary artery
ii. 50% at!}erQ5Clerotic narrowing of lite cio:umnex anery
Ill. 10% atherosclerotic nlllTOwing of the right coronary artery
Iv. RemOl.. infarction of the posterior left ventricle and posterior ventricular
septl/m
b. Tunneling of th.. mid left antel'ior descending coronary artery

Ul.

Medical therapy:
L
EKG leads (6)
b. Defibrillator pada (2)
c. lntlllv8SCl/lar cathelen in right and left antecubital fouae
d. FllIClUres of anll:fior right 4-5'" ribs and anterior l..fl4'" rib, consistent with
cardiopulmonary resl/scitation

IV.

Post·mortem changes:
I. Rigor is present and equal in aU extremitiea
b. Lividity is posterior and fixed excepl in II'e8S exposed to prI'S,lure
c. Th.. body temperature is cold
d. Changes of deaJmposition including maroling of the upper and lower extremities

V.

VI.

Identifying madta:
L
Sca13: multiple scars on both lowerexrremiliea with associated retained mlio-opaque
foreign bodies identified radiograpllically
Toxlcology:
a. Volatilea: No ethanol is detected in the blood
b. Drugs: No screened medications ordruga of abuse are detected in the blood
c, Carbon Monoxide ' : cartloxyllemoglobin aatullIlion in the blood was less than 1%
d. Cyanide: No cyanide is detected in !he blood

MEDCOM 1086

ACLU Detainee DeathII ARMY MEDCOM 1086

AlrrOPSV R.!.PORT: (b){6)

7

Al-Saaida, Mn"lmmtd A. " - - - -

0Pll!IlllI

'died.,.

This drttincc l(b)(6)
re;suJtaf~leroti~ cardiovucuIar
.u-. He had ~ thaD 90% itlIauai«Uti~ IlmOWiIl& of!be pruximIllcft mtcrior... "'ina
C07OMr)' artery, 50% atheroIcI«olie -WIDi of!be cim&IDfIQ utery, ad 10% ~
nM"Owini of tbe right coromry U'lCIy. 1'bcnl_ fibrosla oftbe poMaiot -n of lbe left vanri~~
lIlICI posterior vc:utrieullr xplUlD iDdieMin(. baJ.od iDfIrdioo. The hiItolop: c:hup in the ldd!ley
are consistmt with hyperte:IuiOll. The loU:olagy Jaeetl ill Mp1ive for dhmol, cuboo 1llOlIllxide,
cymide, dr\JaI of ~ uti __ lCd lIIOdicmona. The _
or de8Ih ilIlWUnll.
(b)(6)

---------1'

",~""}(6'--}

(b)(6)

Medical pxun;....".

{b)(6Q~ClII. Enmjllflr

MEDCOM 1087

ACLU Detainee DeathII ARMY MEDCOM 1087

•

AUTOpSY REPORT: (b)(6)
AI·S-alda, Muhlll1med A.
ApDS'ndla: Ai NWIWMbokm C1lIllllIl!lioo
GROSS

D~RIPTION:

Bn.in weight: 1383 mg
The lpeCimen eOf\$istil of the dun. and bn.in of 11\ Idull.
The Intn.eranlal dura is not remal1<able. 'The venous sinuses Ire pllenl.
Due to u.rly lutoly.ls. lhe extem.l features of the Vn.in are slightly dileOlored red-btown
and lhe eul surfleelal'e discolored gray. The brain is ..ell fixed.
The leptomeninges are thin, delleste and lransparent The cerebral gyri hue an ana.tomleally
nQmIals12e. configuration and oonsisleney. TIle peri5ellar. perimesencephalle and
cerebellomedullary dl1ems !lave a normal configuration and sileo
1llere is no sign of hernilliorl or midline shirt. Moderately deep tentorial grooves Indenl
eaeh uncus appro:limately 0.4 em from the medial margins. The cerebellar tonsils have a normal
configul'1lolion. The exlemal.l!lpe<:lS of the bn.inslml md cerebellum are not remarkable. TIle aneries
at the base of lhe bn.in follow a normal distribution and show moderalely severe l1herosclerosis.
There are no aneurismal dilatalions or siles of oecl~iort. 'The idenllfiable eranlal nerve roots are 1101
rnnarkable.
Coronal sections orille ~ reveal no focal or diffuse abnonnalltles in lite eone:<.,
white m.ner or deep nuclear slruelures. Dve to 1IIlO1)'311, the septum pellueidum is .111KlJl
completely dissolved. There is no midline shift. Se<:tionl of the midbnoin. POfI'. medulla and
«rebellum show no diffuse or foesllbnormalitiea. The subsw!lia nigra and Ioe~ eoeruleus sre
well pigm<:nled. E:lcepl as noted, the ventricular SYltem "" an _lornle.lly normal size and
eonfiguralion. The aqueduct of Sylvi~ and the foramina of LuscIU. and M.gendie are patelll. The
choroid ple:<.us is unmnarhble and the ependymalaurfaoea arearnooth and gliStening.
PHOTOGRAPHS: Yes
MICROSCOPIC EXAMINATION:
Blocks of tissue for microseopie e:l.mina1ion are removed from : (I) left frontal lobe. (2) anterior
corpus esflosumleingulate gyri/septum pelh,leidum, (3) left insulalcllustrwnle:<.lemal
espsull!lputamenlglol:lus palliduslintemal elplule, (<I) right dWamusJposterior limb of intemill
capsule, (5) left hj~mfl\1l, (6) lefl oeeipilll lobefoeeipillJ horn of Illem venlriele. (7) right
cerebellum, (8) lefl ponsJmedullalcerebelium (cerebellomedul1lty eistern), (9) du....
Sec:tiorlll frorn e.eh block are mined with H&E. L.F8, Bielsehowsky and iron CPrussian Blue}
teehniques and immunostained for p·amyloid precursor protein ~APP).
MICROSCOPIC FlNDINQS;
The mieroscopie seetions show mildlmodetll1e autolysis of the ependymal surfl'leeS and septum
pellueidum.

MEOCOM 1088

ACLU Detainee DeathII ARMY MEDCOM 1088

,

AlITOPSY REPORT, (b)(6)

AI-Suida, Muhammed A.
lhe seclioo of cerebellom«lullary ci.slem lhal includes midl;rte cefd>ellum and floor of the fourth
ventricle lhere are $maJf foci of acute subarachnoid hemontlage i... the cerebellar folia thaI are
C<)lUi$te1\1 wilh agonal i.scllemia. There is no usociated _lI:SCular anomaly or lumor.
i ... scattered areas of the cerebral cOl1ex and basal ganglia lhere are illdividual modenlllely
et\S;nophiHc neurons $Ulllleslive of early ischemic neul'Oflal i...jury.

11\

DIAGNOSIS:
Brain. autopsy:
1. Early ischemic l'ieuronal injury
2. Mild poslmortem a\ll(llysi.s

~,"b)("'6}-

--

NEUROPATIIOLOGIST
15 Sep 2009

MEDCOM 1089

ACLU Detainee DeathII ARMY MEDCOM 1089

,
_._..__.---... .. -- - _._----"" - -""
- -- - - -- - ..- -.--_.-_.._-- - - -- --_. -_- . -_---....
--..._
..
_--....-_.._-_.-_fO...-. . . - --=-.........--...........
--- -....__-.,
_
......- -_._.... _- ...
-.--_.-_.
_.
.-r"'--_.-- """._'-- -_ _. ...-.'"__..... _--_. - __-_ _CtltfW;ATl! 0# DU<l'M (O\EIlSEA"
/ll'll tI. II

........

_"'_'1(0

~uida.

_"Q.OlnY..-o

MuharmMld. Abel Frarn

(b)(6)

CMIlan

""'

Op

~

""" .....no

-

~i~

I!J

0

-

•

~-

......1\1I

C'"o:'_

~

0 _ _,

-,.

~

~~

-".-~

... ""

....._OOllOl:UoIIO

,-~

~

CIOM<lIfIIl,Ono

_

•

....C_-.:n••

,

•

""""""""" "" .,..,.
., .

~

...

,

,_

,

...... _ . _ . ~ O O

~'

_ _, d . . . . . _

...

_YMI ....... _ . _ _

_ _,d,. __ ...

,

O.... _ ~ C ~

..........

[iJ

~

D~

........... 000_"""""-.

•

•

.,

(b)(6)

~

I

j(b)(6)

""'''<lI'''''''

(b)(6)

"

.....

2009

29 Jyly 2009

1'iJQ'............

• ...

... .

00>

l!l'"

~.-

Camp BIlCClI

._......woo
h o _ .. _ _ ..... _.. ooc....... _

I 0....

"'~.T

_ _ 1HC>OCO-T10

_'''CO' _
•

CN.IIU ",T.1IO _ _

_.... l'b)'6'
-...._..... _.. _-...- .._---_
_.... ---_. _. -.- _....
._

(b){6)

u .......,

N''''

IMedIcaJ Examiner

~(b)(6)

..'T........"'.. "" ..........

Dove." AFB, Dover DE

912112009

,

DD·tin, 2064

....._,"' .......

•......co. "" ''''''' _,_ ,.........""'" _

... ,.,_ ...

......... """'" _-.....

MEDCOM 1090

'~

ACLU Detainee DeathII ARMY MEDCOM 1090

_ _ _ N/tJ ",oI<sl1lr <:oItlI(WOSaucM. CQlIA.InMil1>I<S ISIM)

-~-

(b)(6)

.. _

0 ' ' - - """",.,.

_"'"

_TIDfIOf'YIT.... n .._

"'....

_.

...

.-

~
_
.

-.I\.0I000 _ _

"_V,,",

OOFOlllllOU. ~ 1'"f&llClq

MEDCOM 1091

ACLU Detainee DeathII ARMY MEDCOM 1091

..~.

ARMED FORCES INSTITUTE OF PATHOLOGY
omcc oftbe Anntd Forefl MediCill £umincr
1"13R~hBlvd.,BIdg.I02

Rockville, MD 20850
\·]OJ·]I9-0000

AUTOPSY EXAMINATION REPORT
Name: Fallah (Ismail), Mahmud AI Juburi
Approx Age: do,.vear5 old
Date ofDcalh,(O)(6)

12009

Autopsy Nn.:
AFIP

"(b~).(6"'-==~

NO.!.~(b,,)(~:6~) _ _---'

Rank: Detainee

DatefI'imc ofAutopsy: II JUL 200911300
Dale of Report: 07 OCT 2009

PlaceofDealh: Iraq
Place ofAutopsy: SlAP Monll8lY
SlAP, [mj

Cireunllt.lltei of Detltb: This founS adull malJ(bH6j
Iwas placed
in fJeJt culTs while beini taken into CUSlody by assault forces in Iraq. Investigative
reports indicate INnJl:!)(6)
broke loose from his restraints and attempted to gain

control ofan assault force member's weapon.j<b)(6)
otber members ortlle as.saull fon:e.

]reccived small ann! fire from

AUlboriultloll for Aufopsy: Armed Forees MediClI £Jcaminer, per 10 U.S. Code: 1471
IdcodrKllllan: Presumptive identirlClllion by aceOTnpllJlyina reports, identification tags
and documentation. P05lmortem fingerprinlcxamilll1ion and postmortem DNA samples

are taken for profile PUIJlOSC$ should exemplars bteomes .....iI.ble f~ positi...e
identiIlCIlion.

CAUSE OF DEA11I: Multlplt GUlUbot WOllmb
MANNER OF DEATH: HOlllieide

MEDCOM 1092

ACLU Detainee DeathII ARMY MEDCOM 1092

I

AUTOPSY REPOR1j(b){6)

2

FALLAH (I..ull), Mlh..1Id AI J.bur!
EXTERNAL EMMINATION

Injuries .....ill be described in detail in I separate section. and .,.ill only be brieny Il1l1l1cd
to in lhe ~maindcr of the ~port. for purposes oforientation and completeness. The body
is Ih8t ofl well-developcd, well·nourished appearing, young adull male detainee of
undetennincd lie (approximately 3()"years old). The body is received clad in I blood
and body nuid soaked tan tunic. white sleevelCS! undenhirt, and .....hite boxer shorts. The
~mains are 7G-inthcs in lenath, and .....eigh approximately 123·poundl. Lividity is
present and fixed on lhc posterior sunate of the body except in areas exp;KCd pressure.
Rigor is present 10 an equal degree in all extremities. The lemperalure oflhc body is thaI
oflbe rcfriamuion unil.

The head is normoccphalic:, and lhe sc:alp is coVCT'cd with wavy blac:k hair, in a nonnal
distribution and measuring up 10 2-inchcs in grealCSllcngth. Tbcn: is I trim blN:k
mustache and the remaindcrofthe face is c:lean wven. The irides arc brown. The
corncac are clear. The c:onjunclivllC arc pale. The pupils arc round and equal in
diamcter. The sclerae Ire white and without petechial hcmonhaiC. The external nares
and oral cavity are free of foteign lllIteriat and abnonnaJ secretions. The earlobes arc
unremaJi,;abh:. The nares arc palcnt and the lips arc &traumllic:. The nasal skeleton and
maxillae are peJplIbly intlet. The teeth appear nalunl and in gnod condition. The neck is
waight, and the I1"aChca is midline and mobile.
The c:hest is symmetric:. The abdomen is flal. The genitalil arc those ofa normal adull
c:iTCUmcised mile. The tesles arc dcsundcd and flU ofmllSSCS. Body hair is prescnt in a
normal male distribulion. The buttocks and anus I~ unremarkable.

The IIppcf and lower extremilies arc symmetric: and without clllbbinio edema. '"" nontraumalic: abnormalities. The fmgernails arc intact and the nail beds arc cyanotic:.
No IaIlOOS or surgical scaB arc nOled.
CLOTHING AND PERSONAL EFFECTS

.

The following
clothing items and pe~na1 effects arc present on or aec:ompany the body
.
the lIme oflulopsy:

It

•
•

•

White boxer shorts
Tan tunic
While sleeveless undershirt
MEDICAL INTERVENTION

NoevidellCC of medicil intervention is in place al the lime ofalltopsy.

MEDCOM 1093

ACLU Detainee DeathII ARMY MEDCOM 1093

ALn'OPSY REPORT (bK6)
'ALLAH (limall). Mabmlld AI J.burl

l

BAPIOGRAPHS

A complete set of poJltlIOtIem Bdiol11phs is obtained IU\d dcmonstlllteS lhe rollowina:
•
No relaincd bulk!. mlJMllU in the he.d.nd dJe:sl
•
Multiple non-dc:p CIJ e~ lItull rlXluteS W Nlterior P'lC'ImoceplWus
•
Transvene Md oblique rl1lCl.uta orthe ri&lu ~I Md bil.leraI froolal bones
•
Transverse fronloedvnoicbllladUfe willlli1lctures of the Iionlallllld ethmoid
sinuses lind aibrifonn plllle
•
BillllC:fJll U)'lM'IC:Iric luna CMJOlidllion, riaJu paler than leA
•
Pne:umome:diaslinum and ~ium
•
No frK1uru'diJl~ of the 19i~ orutmnitie:s
•
SoA tissue ukifiation in the medilJ Je:l\ prolimalllliah
EYIDENCE OF INJURY
The orderinl of the foUowina injuries iJ for de:seripdve: purposes onl)', and is not
intended 10 impl)' order of innietion or rellllive sevenI}'. All wound palllWII)'S are: ;jVUl
relJtive 10 sland.o _tomit position.
A.

Multiple aunshot wounds:
GWlSbos WOund gftbe ""ttl;
A Sunshot en1rlntC wound Is on the undmide: of the jaw 10C:fIte:d 9-inche:s below
the: lOp of Ihe: head Nl~ 3/4-inche:s 10 thc leA of thc &/lterior midli~. The:
clrculll' wound mel5ll1U 311·inches In diamtttr. No soot or stipplina is prC:SC:l1t
within the: wound or on the sutTOOndina skin. The wound path pe:rforatell skin.,
b&$i!u skull (predominanll)'!he: sphenoid bone), riJht cerebnrol hemisphere,
saaitWsuture &I the vertex of the C:lIJVIIl'ium, and nihl pariellli sealp. The: bullet
exilS the vertex of the head II2·inclles to the riJht of the: Ulterior midline: via an
obliquelY oriented (alona the 5 to II o'elock axis) I 112 x 3/4·inch IllCeraled
wound with uttllsion laee:nltions me:asurina up to 3/4-inches. No bullet or
build fraamenlt arc re:co't'Cftd. The wound path is directed sHahtl)' front 10
back. sJiahtl)' IcA to npt, and upwardL Associaled witli thc wound path is
b1eec1inSlnto the: wound trICI. comminuted fractures of the: basilar skull
(disruption of both &/lterior and both middle cranial fossae), 1i~ar fractures o(
the ftontal and left pariettl bones, diaslatic frr.cNrcs along the: coronal and
salillal sulUl'CS, puJpif)'ing lacerations of both frontallobe:s o( the: bnin, diff1lSC:
su~hnoid hemonMae. bil'tenl periorbital ecchymosis, aV\llsivc lOll o(the:
pIlUiwy allnd. Jnd disNpdon of the: circle: o(WiIIiL
11. Ounsbg! WOund 9(IM Ired;
A lunshol en1rlntC wound is on the riiht te:mpllral sealp 1000te:O 3 114·1nches
below the top the: head and 4-inchcs to the rithl of!he: anterior midline. The
circu1ar wound me:asurcs 1/4-inches with Ul e:ccc:ntric marginalabrlllion .lonS
the: 6 to 12 o'clock martin me:asurina up 10 III-inches al the: 9 o'clock position.
Tlw:re Is a cone of 6e:nse lunpowde:r SllpPIillJ C:lCte:ndina from the 12106 o'clock
margin 2·inche:t onto the: right side: o(the (orehead. The: wound pIIth pe:rfOI'll1C:$
the: riallltemporaJ .ICIIlp, the: ritht side: of the a1varium III the: pterion, both

I.

MEOCOM 109<1

ACLU Detainee DeathII ARMY MEDCOM 1094

AUTOPSY Rl:PORTll"b,W'6"'-FALLAH (I...all), Mahmud AI J'buri

•

EYidepce Dr Iplua (eonlli

JI. Gunsbo! wound of the bead (com):
fron..1lobe! of the brain, ~Il. temponll bone, IIld lell. tempOi'll! se.lp. The bullel
exits the left lemponll sc.lp villa II2·inch IacenIled exit wound localed
13f4-inches below the top Ihc: head and 3 5II-inches 10 Ute left of the anterior
midline. No bullet or bullet rnla.mcnts are M<:overed. The wound path is
diM<:led righllo leI\, slightly beck 10 rront, aM slightly upward. Associllted
wilh the wound path is bleedina inlO lhe wound tract, comminuled frw;tures of
the basilar skull (disruption of bolh 1Il1erior and both middle crlOial rQUlle),
linear fractures of lhe frontal and lell. parietal bones, dilSlltic rractures along the
coronal and 5aaittal sutures, pulpiCyinalaeetations or both frontal lobes ofw
brain, diffuse su~hnoid hemormaae, subaale«l hemorrhaae over1ying
rnlClUreS ofboth temporal bones IIId lhe occJpillll bone, and bil.tCflllI periorbital
c:a:hymosis.
1II. Gwishot wound oCthe chg!;
On the rightlllterior chest is a glJlUbol enuanc:e wOllnd. 10000ed 6-inches below
the lop the shoWder and S II2·inches 10 the right orl/te Interior midline ofw
10150. The hori~ntally oriented ovoid wound measures 3J8 x l/4-inches wilh
III eccentric maraiMl.bruion .10lti the lalCflllI mqin ortlle wound measuring
up to 112-inches.l the 9 Q'clock posilion. F.int gunpowder stippling exlcnds
fmm lhe 1.ICnlI margin of!hc abnded enlrance wound measuring up to I-inch
.1 the 9 o'clock posilion. On the latcnll righl arm is. 3/4 x 112·lnch IrU of rlinl
slippling. The wound path perforates skin, musclc, 1Il1eriot righl third rib, soil.
tis:sues of the IIllCrior media5tinum, left Interior 4th intercostal space, musc~,
IIId skin. The bullet exits the left Inlerior chest .Iong the IlIIterior axilllly line
via a II2-inch lllterated exh wound with eeeeniric marginal abrasion along!llc:
12 to 6 o'chx:k I1\Illin measurill& up to 1f8-inch at the 3 o'clock position lIIat is
10000ted i-inches below l/'le lOp the lhoulder- and i·inches 10 t/'le left or l/'le
anterior midline. No build Of bullet fnlgmcnlS are recovered. The WO\IIId path
is direcled front to back, right to left. Ind slighlly downward. Associated with
the wwnd plIth is bleedina into the wound 1r8(:t. IlOn q1llOtiliable hcmonhalle
inlO the lIIIterior mediastInum, fractures of the anterior aspe<:ts of the. 2nd
through 4th ribs bilaterally, fl1lC1un: of tile Slemum at the level of!he Jrd ribs.
and (:Ontusions or the upper lobes or both lunp.
IV. Gunshot wound orlM leO laD:
On the Intcrior left arm is a ilDlShol entlVlCC wound located 8·inches below the
lop of the shoulder and in the midlinc of the upper extremity in the II'IItomie
posilion. The cin:ular wound meuures 3f8-inches in diametCf and hallll
lKIjftCCtlt vercically oriented discontinuous 2 x 3/8-inch contU$ed .brasion. No
soot or gun powder stippling IR al present within the wound oron the
SllmIundins skin. The WOIlnd pith perforates skin, subcullncous liuues,
muscle, subcutaneous !issues, and skin. The bullet exits the posteriOf ~O arm
via a 114-inch dillmcter htccrated exit wound 10clIted i·inc~ below the lOp or
the shoulder and in the posteriOf midline or!hc upper cxttemily in the II'IItornic
position. No bullec or blllld fragments are ~~red. The wound pith is

MEDCOM 1095

ACLU Detainee DeathII ARMY MEDCOM 1095

,

AUTOPSY REPORT (b)(6)

FALLAH (IImaU). M,lII.11d AI Jlb.rt

£yId,," ,(Jglln 'soalli
dirccled nihtto leA, front to blck, and without vertiCIl devi.tion. Associated
with lhe wound palh is bleedinl imo the wound trat1.
B. Addillona1.utoplY flndinp
I. Ifliuries 10 the Head and Nccl::
Abo~ lhe Illenol riaIM eydwow IIIlhe f"'""11 lIlIirline is a J'4 x Ill-inch
supcd'lCial,bnasion. Blood drailll frvrn both the exlcmal.uditoty cllllls.
II. Injuries 10 the tono:
On tlw leA IIIkrior clJesl approximaldy 4 inches below lhe leA nipple is Ul
obIiql.lCly oriented (.Ionl the S 10 II o'clodt axis) Jf4 x " ..inch SuperfICial
.bruion. In the left lowerql.drant o(the abdomen are 2 discontinuous
horiUlft..l1y oriented curvilinear abnsions spkCd flPPfOlIirnltely I Ill-inches
apan and measurina up to 4 I'''inches in J,reIlcsl dimension. Aboyc the left
iliac eres! is. Jf4 x Ill-inch superfici.1 abrasion. AIonI the leA inauinal crease
and Interior IIpper thiahs is a 4 x 2 Ill-inch clllSter of disconlinuous SUpcr1ltial
abrulons ITlCIS\Irina III' to 2·inches in.,etlest dimension.
1II. ifliurics to lhc eXlmnitics:
On the l.teraI dorsallSpCCl o(the diSl.ll riabt forearm il' horizontllly oriented
film 2 1/4 x III-inch contllSion withoul inj\ll')' to the undcrlyina 10ft tissues. On
the distal left forearm is a circumfc:mllial III-inch superficial contusion without
injury 10 the undcrlylnllOA lissuel.
On the Ulterior leA thigh is a 7 x S·inch cluster of ..ucmcd (paired markinlll
willi 1/1 .pproximate I II2-inch IpKinJ) superlicial eomminJIed Ibruions and
supcrfkill pul'lCtlm WO'lncb lnCIS\IIinl up 10 I-inch in &,reatCSl dimcnsk>n.
Similar clllSters ofsuperfici.l abnlsions and superflCi.1 puntiUR wounds
rneasurinillp 10 I-inch in J1C!IIClI dimcnlion are noted on the left knee,
proximal mcdiallcA lea. left p<l9lilcal (ossa, and leA proximal posterior lea.
Reflection orthe slcin IlId .IIIbcullncOuS lissues of the back, buttocks, and
txtremitics with incilion of the lInckriyinl muscles dcmonltnlCl no evidence of
sipilicant blunt fOfU injuries.
INTERNAL £XAMINATION
'The (onowinl descriptions pauin 10 uninj~ liSJIICs. Sec "Evidence oflnjwy" scelion
fot additiOhllI inforTTUItion.
BODY CAyITIES;
(Sec "Evidence ofll\iury")
'The body is opened by the uslllltltclrKo-4bdominal incision and the chell pille is
ranovcd. The vtTtcbral bodies '-": visibly Uld palpably inlact. No adhesions or
.bllOrmal collections of nllid It'C presc:nt in the pleural, pericardi.al, or periloneal Clvlties.
All body orpns are prtlCflt in lheir normalltlllomic: positions. Theft is no inlernal
evidence ofblunl fon::e or penetrltina injury 10 lhe thoraco-.bdominal rcaion.
The subcu!lnCOus flll.yer of the .bdominal WIll is II2-inches thick.

MEDCOM 1096

ACLU Detainee DeathII ARMY MEDCOM 1096

AUTOPSY REPORT (b){6)

6

FALLAH (lImlll), Mlbmud AI Jab.r1
HEAD AND CENTRAL NERyOUS SYSTEM;
(See above "Evidence of Injury")

The sealp is reneelcd. No epidurlJ or subdural hemorrbages are nolcd. The
leplomeninges are litin and delic:ate.lhc brain ~iglu 1420-grams. Where uninjWtil, the
cerebral hemispberts are symmetritaJ with WU'elNll'bble IIYri and sulet The SlJ'Uctures
at the base of lite blain, includinc cranial lXrves and blood vessels, hive no non·ltIUmalie
abnormalities.
COfOI'\lII stelions oflhe uninjWtillissuc:s Qemonstllte sIwp c1elfW'Cltion beI~n white
and grey maller, withoul hemorrhage or contusive injury. 'The ventlides are ofno11l'lal
size:. 'The bull ganglia, btlinstem, cerebellum, and lII1eria! systems are Iiee of nonltllumatic aboorrnalilies. The al!anto-oecipita! joint is stable.

NECK:
The anterior $trap muscles of the neck are homogeneous and red-bro\o\ll'l, without
hemorrhage. The lityroid cartilage and hyoid bone are intaet The: larynx is lined by
intacl while mucosa. The long\>t is !Tee of bite marks. hemol'l"hage, or other injuries.
Incision and dissection of l!'Ie posterior ned: demonstrates no deep pat1IIcervic:l1 muscular
injury and no eervieal spine ftllclul'eS.
RESPIRATORY SYSTEM;
(See above "Evidence of Injury")
The upper airway is elear ofclebris and foreian nUllmal; lite mucosal surfaces ate
smooth, yellow-tan and urtrernalkable. The pleW1l1 surfllCeS ate smooth, SlistenillJ and
IIIlI'emIlrltable bilalenllJy. The puJmorwy parenehyma,1Il'I'Iere uninjured, is SIlmon pink,
diffusely congested and edemalous, exuding sllshtlo moderate amounts of blood and
frothy fluid. No mass lesions or areas ofconsolidation are present. The righl and left
lunss weigh 710 and SOO-SrlffiS, respectively.
CARDIOVASCULAR SYSTEM;
(See above ~Evidence oflnjury~)
The pericardial surfaces are SITIOOth, eJistenins and unrel'lWicabJe. The 31 O-~ heart is

contained in an intaet pericardial SIll: me ofsignifiCll1t fluid or adhesions. The .:pieartlial
sur(a.;e is smooLlt, wilh minimal fl\ investment. The eoronlUY aneries arise norTTUllly,
follow the llSI.IIIl distribution in a right dominant plltem, III"e widely patmt, and without
evidc:nee oflhrombosis or sianificant Ilheroselerosis. The myoeardium is homo&eneous.
red-brown, finn and unretnllliuble; the:
and ventricular seplae are inIaC\. The walls
oft!'le left and right ventricles are 1.0 and 0.3-eentimeltn lhiek, respectively. The valve
lealkts lII'e thin and mobile. The lIOl1a and it! major branches arise norTTUllly, follow the
USUlI eoune and ate free ofsignirlc:ant abnormalities. There is mild atherosderotie
streaking in lhe lhoracie aorta. The venae eavae and their major lributAries return 10 lhe
helII1 in the usual distribution and are Iiee of thrombi. The renal and mesenterie veSStI$
are WU"emarlt.able.

mal

MEDCOM 1097

ACLU Detainee DeathII ARMY MEDCOM 1097

I

AUTOPSY REPORt1(b){6)
FALLAH (bll1llll), Mahmud AI Jubllrl

7

HEPAIOBILIARY SYSTEM:
The hepatic capsule is smooth. glistening and inlllCl, covering dark red-brown,
moderately congested parenchyma. No mass lesions or other abnormalities are nOled.
The p1lblaclder contains 5·millilltet'S ofgreen-brown mucoid bile; the mucosa is velvety
and \IIV'CI1Wbble. The ex\Jlhepalic biliary tree is pIltent and without evidence ofcakuli.
The liver weighs 1690-gnms.
GASTROINTESTINAL TRACT;
The esophafllll is mJa(:t and lined by smooth, gray-white mllCosa. The ~rie wall is
intact and the stomKh conlains approximately lO-milliliters of thin WI nuid. The gllSlric
mllCO$I il arranged in \hr; uSllllI rupl folds. The dl.lOdenum, loops ohmall bowel and
colon lie unremarkable. The appendix is present.
GENITQURJNARY syrnMj
The ript and left kidneys _igh 120 and Ilo.JrIITIlI, respectively. The renal capsules are

smooth and thin, semi·transparentllld strip with ease fmm \hr; underiyins smooth. redbrown conical surf.:e. The cut surf~ are red-tan and congested, with lIl\ifonnly thick
col1ien and sharp col1ieomedullary junctions. The pelves and arolyces are unremarkable.
me ureter1 are normal in COlllSe and caliber. White bladder mucosa overlies an intllCl
blllllder wall. The urinary bladder is emply. The preslatc is normal in size, ...ith lobular.
~llow-WI ~nchyma. The seminal vaicles are UIlI'aTIIJkabIe. The testes arc free of
mass lesions, conlUSions, or other abnorm.aJities.
LYMPHORETICULAR SYSTEM:
The 170·grvn spleen has a smooth, inJa(:t c:apsuIc covetins maroon, modcnllely finn
parenchyma; the lymphoid follicles are IIIU"tlIlIIbblc. L.ymph nodes in the hilar.
perilOl1ic, and iliac: rqions are not enlarsed.
ENDOCRINE SYSTEM:
(See above "Evidence oflnjury")
The thyroid gland issymmeuic and red-bmwn, without cystic or nodular chanse. The
pancreas is finn and ycllow'lan, witlt the UIIlIllobular archite<:ture. No mass lesions or
other abnormalities are noted. The risht and Icft lIdmv.l glands arc symmetric, with

blisht ~lIow cortices and grey medullae. No masses or areas ofhemorrilage are
identified.
MI'SCULOSKELETAL SYSTEM;
Muscle development appcan normal. No non·traumatic bone Of joint abnormalities are

"""".

MEDCOM 1098

ACLU Detainee DeathII ARMY MEDCOM 1098

AUTOPSY REPORT (b)(6)

FALLAH (II.,II), M,bm.d AI J.b,,"

•

ADP.IDONAJ"fB2C EPUBES
I. Documenllly pllotoanoplu In liken b) (b){6)
OAFME slaffphotOlfllphef.
2. Specimens retlined for IOldeolOJ)' IeSlinl MdIor DNA identifJealion ue: Blood,
yitreowl fluid, psllie contenll, bile, hean, splem, IiYer,lung, kidney, min,-.dipose
tiuue, Mel ste\elll mllscle.
3. Full body ndiopphs aft obtained IIICI demonstnte the.bow findings.
4. Seleaed portioI'Ll of 0fI1lIJ ue retlined in fOl1llllin.
5. The diSStded orpns _ forwmled with the body.
6. PetSOl'III etrcclS In released to the mortlW)'ltrlin I"CPfUC'IlIliYeS.

MICROSCOpICEXAMINADON
Sdetled ponions of 0fIIN Ire re\Iined in formalin, without preparation ofhistoloJic
slides.

MEDeOM \099

ACLU Detainee DeathII ARMY MEDCOM 1099

AUTOPSY REPORT(b)(6)
FALLAH (....Il), M'._lad AI J,blari

,

FINAL AUTOPSY DIAGNOSES:
I.

Multiple IUftShoI wowds
A. Gunshot wound of the tad
l. Entnneo: On the underside oflhe jaw, 10 !he leR of the arueriot midline. No
evidence of clox n.nae disc:~ of. firearm.
2. Injured: Skin, basiial' sbill (ptedominlntly the sphenoid bone), riab! cerebral
hemisphere. sqinal suture.lhc vctWl of the ealvarium,llld riPI pIrietII SCIlp
). Exit: Vatu oftN head, to the riih! of the midline
... R.cccvered: No bullet or bullet rraamenu are r«Gwrc<I
S. DiK'dion: SJiptly &oratlO blck...lipJy left 10 nihl, Illd upwards
6. AUoc~led injwies: Bleedina into the wound tntl, comminuled frxturc:s oflhe
builv skull (disnIpCton of both llI1crior and both middle Cl'Illial. foss.).lincar
flllCturcS of the Ii'ol'I1aI. Illd 'eft pIrietaI bones, dilSlltK I'nlcturcs Ilona the
COIOfllIlllld lljittll sutures., pulpifYlna llCa'ltions of both Ii'ol'I1aI. lobes of the
nil, dilTuse subuleMoid 1Iemon!ll&c, bi\.ueral periorbilll ecchymosis,
'V\llsiw loss of the pituilar)' &IIlld,1tId disruplion orthe eittle of Willis
B. Gumhot wound oflJle head
I. EnIr&nCe: R1&h1 temporal scalp. Denx stipp/illl on the mil oflbe forclleld
adjacent to Ibe WOlmd.
2. lnjurcd: Riiht temporal -ealp, Ibe nabt side of the a1variwn 1.1 the plerion, both
frontal lobes ofthc brain, leR temponl bone.llld left lemporal ICIIp
3. Exit: leI' Icmporall.Cllp
... R.cccvcrcd: No bullet or bullet (rqmcnlJ _ m:overed
S. DitecUon: R.iihtlO /eft, .Hahtly beet 10 ftont. and .liptJy Iapward
6. Auoeilted iJljunes: B1ccclina into lhe wound IIKt, commil'llllcd fndura of the
balil... tkull (disruption ofboth lllteriof and both middle cnnill fO$Sl.C),linar
Ii'Idure:I oflJle fi'oolll and left parietal bones, diastatic frxturcs aklni the
coronal and JllaitW sutures., pulpifyillllac:eJalions of both l'ronll.l lobes oflhe
brain, diffuse subanchnoid hemonhaae. subal1eal hemOlThI.&e overlyini
fntcturcs of both temporll bones and the oecipill.l bone,and bilatCTll periorbilll
eechymosil
C. GIlIIShol wound oftbc chetl
I. Entnneo: R1ihtlflteriorchelt. Stippllna on the riahtilleral edie of the wound
IIld on the lalet'l.l ript arm
2. htjlll'Od: Skin. muscle, anterior rilJbt third rib, 10ft tissues of Ibe anterior
mcdil.Slinurn, left Inlerior 4lh in\Cft!OSll.l splICe, muscle,.oo skin
J. Exit: Left anterlOf d\esl11011j the I.IIterior llIi11ary line
... Recovered: No bullet or bullet fnI&me111S Il'C rcco~
S. Direclion: Front 10 back, ri&hl 10 len,w sllihlly downWlf'd
6. Associated injwies: Bleedina into !be wound tnel, non quantifiable ll1e,,~e
InlO the anterior mcdil.Slillum, fractura of lhe anterior aspects of Inc 2nd throuah
..th ribs bilaterally, fnctu~ of the sternum Illbe level of the: )rd ribs. I.Ild
conllUiONI oflbe upper lobes ofbolh lunas.

MEOCOM 1100

ACLU Detainee DeathII ARMY MEDCOM 1100

Atn"OPSY REPORTi(b)(6)~

FALLAH (lima I!), M~blll.lia AI ~ri

10

D. Gunshol wound ortlle left arm
1. Enuanc:e: Anterior leA arm. No evidmcc ofclose range discharge ofa firearm
2. Injured: Skin, subcUWltOUS tissues, muscle, subcullMOUS tissues, and skin
3. Exit: PosteriOT left aml
4. Recovered: No bullet or bul~ mr.&ments are ~vered
5. Dittclion: Righi 10 left, ffOl\l to bal:k and wilholll significant ve:nicallleviation
6. Associated injwies: Bleeding inlo!he wound II1lCI
Il. Additional injuries
A. SuperfICial abrasion orthe race
B. Superli.ciaJ pllttemed abl'&!lions and superficial puncture wounds of tile tono and
left lower eJllremity
C. Superficial contusions ofbolh forearms without underlying soft lissue injury
III. Evidence ofnalUl'llI disease consists of mild atherosclerotic streaking of the thonEic
IV.

V.

....

No evMknee or medical Intervention is In pI_ lIllie lime of autopsy
Postmortem changes
A.

Lividity is fixed on the posterior surface orille body except in llJelS exposed to
",,",,'

B. Rillllr is preseniiO 11II equal degree in all extranities
VI. Toxicology ~lul\S
A. VolflliJes: The blood and viueous fluid were (lCamine<! for the pre!eIIOC of
ethanol.t IclllOffof20 mlldL. No elMnolwu detel:tcd.
B. Drugs: The blood was Sl:reened for .cet.minophen. IllTIphel4miM,
anlidepressarnlJ, antihistamines, b.rbilunlles, beJu:odiazepines, canllllbinoids,
chloroquine, me8oquine, cocline, Iklltromethorphan, lidocline, lIUCOIic
MUIIlgesics, opiales, phencyclidine. phenothiuines, salicylatet, s)'lTlpathomimetic
amines, and \/el1lpamil by plI chromatoaraphy, color lest or immunoassay. The
following dlUgs were Iklected: None detected.
C. Carbon Monoxide: The carboxyhemoglobin SAlUtation in the blood was 6% III
delermined by 5pl!cuopholometny with a limit ofquanlitalion of 1%.
Carboxyhemoglobin SAlurations of0-3% 1m expected for non-5ll'lOkeers and 310% for smoke~ Sllul1ItionJ abollC 10% an:: considered ele.... ted and are
confirmed by gas ChronUllDgl'llphy.
D. Cyanide: There was no cyllnide detected in !he blood. The limit ofqlllll'1titatlon
for cyanide is 0.25 maIL.

MEDCOM 1101

ACLU Detainee DeathII ARMY MEDCOM 1101

AUTOPSY REPORTI{b)(6)

~

"

FALLAH (blD.II), M.hmud AI Jubun
OPINION

POSlmOl1em _lysis oflhe body nuld5 WlIS neptive for the presence of etMnoI, cubon
monoxide, cyanide, sereened medications lind sc~ illicit dnip of lbuse.
The mlMerofdealh;s
(b)(6)

~

clllSSifled lIS homicide.

j
(b)(6)

MEDCOM 1102

ACLU Detainee DeathII ARMY MEDCOM 1102

- "'-- _. ""
.

_d'_(~

"""""":IE""""" _

~

_
-

CEImFICATI! OF DEA1lt (O'o£ItSEAS/

"'-.- I
AFIPl(b)(6}

CIVilian

BTB Fallah (Ismail), Mahmud AI Juburi,

...""" '"

"'TlI "" IOITH

~

-

•

_.......

-""-'''''...

_-

_

u

-"'--"-

-,

....1.110. _

e-o ... ....'"
""""""

--'". -

~~
.
CHSa
_ _'"

... _
1 -....- ......1

,

- ... _---.. ..... --_
... ,..... _."
--_... ....._...
.-- ' -....- ...
. . . . . (Ill

,

0 0 _ ~'l.l.'ON<Ito ....'"

_00tC>IT...... ""'" w.ooo:; TO

-~
....,....woo""'-'"f." _, ""'""' ....

t" •.

TO HI....,. ""'"""

_.-- -

•.,.llOf_'H

,

--

_..

,

(b}(6)

_.

l(b){6)

I 0- "" I!J""'-

"",-Of_'" ....... _

1(b}(6'}"'!oo9""""---'

Iraq

.-""""",ru>_._....

'h._too
..."' ........0 _
__
_
""".
_
OCO_"AT"..
....
_ 'OlCEAtOO
"__
.. _'"
_
...
_.__

"......

"""'"

(b)(6)i

--

"""'"
""'-,oUt>_
e.uwa
Cio
_ .... _ _
.....

-.

_"__

!(b)(6}.........-...n<......

0""'-

[ilm ...

•

- ...- - - - - om......"""'''''''''''''''..

,,~

.. _

..

CAIJSE.....
ITAruI ..........
_

MedIcal Ex"';.min&r
_

.. _

Dover AFB, [)oo;Elr DE

_...._.... _-,_---"
_. '__....__,,_
-..... -_ _.. _,-.... _.. _

1112312009

,

.

l{b)(6)

.

....

DD •.:w"n 2064 """""'.,.._-'_.. m:'O~'{:f<r.t._ ............_ .........

ACLU Detainee DeathII ARMY MEDCOM 1103

i
:

-

~
'

.

ARMED FORCES INSTITIrrE OF PATHOLOGY

.. ~

!

.

OfTln of Ihle Armrd ForclIS Medical EUlminfr
141J Rest'a~h Blvd., Bldg. 102
RlXkvillc. MD Z08.~1

:

\.301.]19-‫סס‬oo

(FAX '·301-J19·l,I6J.'il

FINAL AlITOPSY REPORT
Name: AI H;nashi. Muhammad Ahmad A.S.AuIOJ!:'Y No.,I(b)(6)

lD N1db){6)

AFIP No~(b)(6)

I

Oile of Binh: Unknown
Dale of Dealh:{b)(S) 2009
Dale of Autopsy: OJ JUN 2009. 1]00 hours
Date or R~"art: 23 JUN 2009
COUll ........,...... "f

n.... 'h,c,

Rank: Ch,man tDetalned
Place of Dealll: Gllanlanamo Bay
PlilCC of AUlop$y: US NaYal H()5pil~1
Glllntlnamo Bay. Cuba

_

l(b){6)
]. ciYi'il" detainox', wu found uIlresponsi,'C" iln a
ligawre (claslic band) .rourd his n«k in his cdl ~111M: Bellaviar Hcahh Unit (BHUI,
Joint Task Force Guanlanlrno Bay. Cuba at IIppro~im"lely ZlOO hours onl(b){6) 2009,
The ligailire WIS CUI and resuscilation dfons W(f~ Slarled ;mm~'CIlately in the cell and
~ominued al lhe locil mediCilllrealm~'fl1 faeilily. All eHorlS fail~d lO revin him. He ""u
pronounced dead It 2259 hO\lfli.

Imedical r~'Cords rc.-cal a long hi$tory of adju$lmenl disorder. ani i-social
personality diMlrder and WCSSOfli of confinement. He h3.' a history or suicide ideations
geslurt'S and mull ipl~ failed suicide auemplS. H~ WI$ on hunger slri~c since Jlnuary
2009 Ind ""as emeraly fed. The case is under investillalion by Ihc Naval Cri'ninll
In,,e$'igalil'c Se..... ice (NCIS).

[(b}(6)

Author17.l1';on for AUlopsy; Office of lhe Armed Forces Medicil Examiner. lAW Till...
IU US Code 1471
Idenlincat;on:
~®
is ;denlified by visual ret:ognllion and his
detainee idenl ificalions lags. Flngerprinl$ Ire obtained by NCIS Ind I ,ISSllC !iilmple is
~ollected for DNA ldentifica, ion. if OCt.'CIed.
CAUSE OF DEATH:
Asphy~ ia due 10 liga,ure strangulll ion
MANNER OF DEATH:
Sui~idc

MEDCOM \\04

ACLU Detainee DeathII ARMY MEDCOM 1104

AUTOPSY REPORTlb)(6)
AL HANASHI, Muhammad Ahmad A. S.

2

Nqs P8P.I.IMI(iABY INYf.STJGAD0(i
AOCOfdinalO pmiminlry NCIS inve:slia.tion, while IIIe shift guards were perfonning
periodic checlu on lhe delllineu.t the BHU, the decedem wu viewed through tile cell
window and no&ed 10 I'Ol be Ilulthinll. He was seen Ot'Ilhe floor of his cell, on his righl
side in the fetll posilion.(b)(6)
w., reponed 10 hive bem covered Wilh I
bllOket with his hinds Ind (~eJtpoMd. He WIS f.,ina tile 'iahl cell wan with head
Ilightly lilled. 'The guartb entered tile cell and secured the decedent'l hands Ind feet
prior to pIlCin. him on his back. The pards noticed I ligature consistin. of an efutic
bind ti.htly ""ripped" leat twice '1'01I00 lhe neck and twisted on the left side. The
liBlwre wlS wrlpped lightly and had to be cut (lllhe mo&ltwisted pIrI) from lhe
decedent'l neck. It was removed in two pieces. No pulse (Y spontaneous brealhing wu
noted. CPR was immedillely 11lIned. Passive vomiting oa:urred during CPR.
AI approximltely 2120 hot.rrs the decedetll l'CqUested 10 spe.... 10 a nurse and asked for a
sleeping.iei. He wu IwkllOwn lIive IpproJIimately 10-15 minutel5 l.ter ""hen he asked
the Buatd to close his "bean hole cover
sign tNI he WIS reldy 10 10 10 sleep. He
.ppeared, to the suarOs, in "good spirit" and did not appear upset. He wu dilCOvered
unresponsive I few minuteS liter II tpprOltimately 2155 houl'$.
M

,'

MEDICAL RECORDS REylEW

The ,vlilable mental ht.lth records.re Klt'Clled by the prosector Ind the ovsenrillJ
civilian medical eJtaminef prior to the lllt0p5y: see: -P05trnonan EltamiMtion
M

•

Screening of the menllli health records rev"'" psychi.tric history of IdjUSfmetlI
di$Order, antisoci.1 per:son.ality disorder Ind stresson of confinement. The decedenl has.
history of wicide idations, suicide gestures and multiple luicide allemptl by hanJin,.
neck ligature, $elf inflicted shlrp fon::e injuries and f'eqIICflt blum fon:e uauma 10 the
htad. On January 2009 he Matted I hunger IUiIce Ind has been fed enleTaly. He hu been
on. suicide watch Illhe BHU, wllere lie ilseen daily by lhe medicll stiff. He had five
suicide atlemptJ in May 2009.

LIGATURE
The lil"ure is cofl«:led as evidence by NCIS Illhe scene Ind examined by the prosector
and lhe observin. civilian medical euminerprior to llle aUlopsy.

The lilliure is lImo&11denllclllo lhe elulic: bind of a white brief, medium liu 34-36issued to thedetlinees II the detention facility. The ligalu~ COl\5i5l5 of two segmer111.
with. COrtlbined Iweglle Ienilh of approxlmalely 2J VI- Ind width of approltimltely
1 The smaller of the two seaments mellura 6 Y," in lenlth. The ligature fibmi Ire
M

,

MEOCOM 1105

ACLU Detainee DeathII ARMY MEDCOM 1105

AUTOPSY REPORT (b}(6)

J

AL HANASHI. MII.I\anI....cI Ahmad A. S.
elongated and dislOl"led II tile junction of lhe IWO CIll: edIt'S c/w the hiSiory 01 cuning the
llplllte _ lhe lwisled pan. TMre Ire no blood silins noIed on lhe lipblre.

POSTMORTEM EXAMINATION
The postl'l'lOrtem elllminaliorl. (b}(6)
01 (b)(6)
is perfc.med ~!he
US Nlval Hospila! (USNH). QUlllWlamo Bay, Cu~ or,{b)(6) 2009. saning II
IpproJlimllely 1300 hoIJt1. Full ~ lJdiolQRiCiI sllldies Ire obIalned IIlhe USNH.
Ptlotopphs Ire obuolned by (b}(6)
O~Vo1E Photognpher. Anend~ lhe
lulopsy .. rneclleoIepi observers are(b){6)
(b)(6)
and Specill A&enlSlb)(6)

Medicl.l Enminer~{b~)"~)_~
from lhe NCIS. .

EXTERNAL EXAMINATION
The body Is thlt of I well-de¥e1oped. weil-ncurisMd Caucasian mlIe dad in khaki shirt Ind
~ wilhotllunderprments: _
"Ciolhing and P~I EffflClS~. The feet Inl held
IOgether with white plUlk flu.i cuffs and the hands Ire held topther with bllcl: p1lS1ic neJli
cuffs. The f1ui culls wete CUI open 10 flCitillle lhe completion of the rwtiologic.ll Rudies.
The hinds are (Xlvered in brown paper~p..telCurcd by adhesive tape; ICe "Evidr:rw;e". A
blue colored p1lS1ic idenliflCllion band encircles the riaht wriSl.

The M1gh1 WId wei"" noted on the ~if~lIion wriSi band are68" and 120 Ib,
respeclively. The body Ippean c:onslSlMl with the reported heiJhlIn:l wei&hL Rip is
pre:senllO 111 equal degree in all eJlllemities. Lividity is prese:nI and fixed on the poSIerior
sulfloCl! of the body, except in Ileas expolCd 10 PRSS~e. Body temperature is cold due 10
refriaeration.

The 1C.lp Mlr is blICk, long. Wo'er1l1le blCk of the neck tnd il maned. Vom;t is noIed on
lhe lOfIancl btclt of the he-d. The facial hair CClI\SISIS of bllCk mustlChe Ind beard. 'The
forehead revelladlrk IITIIIt niHdletiont; see "Evidence oIll1jurles". The eyes.e
unternarktble. The Irides are brown. 'Theeomcae Il'e sHalll'y cloudy. The eonjllnClivae
Ippur injected with no sl&nifielnl petedllae. ThesclerlC are white with no pelechiae. The
extemtlludltory etnIls. extemtll11l1lllln:1 onl Clvily are free of roreii1' materitlllld
tbnormtJ tecre!;on.. The IIUII skeleton Is palptbly intael. The lOngue ;lu~le.
The lipll.re withoul evident injury. The frmulae are unremtrbble. The teeth Ire lIIIunl
and unl'ernllhble. Eumillllion of the neek re~u.ls I broad patterned impression 0l'I the
II1lerior neclt tnd dirt colored impreasionon the poslerior neck; see "Evidence oIlojury".
The cllestls unrtrnlrbble. No injury of the ribs or stemum Is evident eXlemtlly. The
abdomen Is ul'U'etnllrtible Wilh noevldenee of major wIJictl SCI~. The posterior lorso Is
ull1emlrtlble with no evide1lce of lnum•. A hetlina -loI J[ VI" 1I1eerof unknown diololJ' is

MEDCOM 1106

ACLU Detainee DeathII ARMY MEDCOM 1106

REPORT(~b)~"~):;~"

•

Alfl'OPSY
AL HANASHl, Muhammad Ah"..d A. S.
noted on the right lower back, immediately below the waisl.
of a nonnal adult circumcised male.

Thee~temaI

genitalia are those

'n1e «tremities are llfll'emIfltable with no evidence of recent lnluma. Linear broad
impressions are IlOIed on the right wrist and llI'lkles, consistent with the history of use of the
f1exi cuff ties.
Multiple well healed setrlI are noted on the right anterior neck. scalp, right arm. right
shoI.Jlder, left JtlIicubital fossa, left thumb, both k~, left shin and the dorsal surface of the
left fOOl: pbotograp/'led for documentation. No wtoos. other major surgial SCII1 or
identifying malb are noted.

EVIDENCE OF INJURY
Neck Trauma:
EJttemal e~amination of the neck reveals a ligature impression lITOUnd the neck. A broad
reddish discoloration is noted (ll'1the skin of the Interior neck, overlying the lhyroid
certillge measuring 1 1f2~ in it maximum width on the midline. The ligature marie tw I
maximum width of 1 11,( It the anterior midline. is sUghtly upwardly angled towards the
posterior neclc. The ligature impression on the right side of the neck is tlpered into I
triangular shape with its apell below the angle of the mandible and is associated with nonpltterned fainl contusions. see ·Opinion". 'The liglture impres.sion is incomplete and
fades Ind disappears below the ears. A small superficialabrasiOfl is noted below the right
ear, see "Opinion~. A thin dlril; linear disc:ololation is noted on !he posterior neck: see
"Opinion~.

Dissection Ind e~amlnllionof the Slnlp muscles of the neck revells loaoliud hemorJtJage
on !he right side of the sterno-hyoid muscle, underlying the above noted ligature
impression and contusion on the right side of the neck. No other tllluma is noted. The
hyoid bone and thyroid cartilage are intact.
Qther Injurig:

E;lIImillltion of the forehead reveals a small cluster of dark raised lesions. on the midline.
in an area measuring '!4 It v.t~ with underlying mild s.ubcutaneoull hemonhage and no
underlying skull fractures: see ~Opinion~.
A fracture of the anterior right 5th rib is noted with minimal surrounding herrool'\'tlage:

see

~Opinion".

MEDCOM 1107

ACLU Detainee DeathII ARMY MEDCOM 1107

AUTOPSY REPORTI(bl(6l

I

5

AL HANASHI. Muhunmad Ahmad A. S.
A well heated scar overlies a malunion fracture of the right humenlS is noted. consistent
with remote unrelated trauma (firearm injury in 2002 per medical records). There is a
superficial healing abrasion 01\ the left shin. No Other significant injuries are noted,
Serial incisions on the baclc and upper and lowerutremities reveal no evidence of
trauma. The incisiOns are ptlotognphed for documentation.

CUlI'HING aDd PERSONAL EFFECTS
The deceated is clad in khaki shin and pants. general issue of tile detention center. No
persona' effeclli are II(Ited on the body. The clothing is photognphed and collected by
NelS present during autopsy.

MEDICAL INTERVENTiON
Evidence of active medical intervention is noted IS follows:
An endotracheal tube.
Central venous line
Mulliple intravenous puncture sitts on right arm and anticubitat
EJetemat automatic defibrillator palb 01\ the chest.

fossa.

INTERNAL EXAMINATION
BODY cAymES:
Bilateral adhesions are noted in both pleural cavities. No abnoonal collections of fluid are
present in any of the body cavities. All body organs are present in the normal Ulltomical
position. The $lJbculaneous fll layer of the abdominal wall is unmnarkable. There is no
interTIIl evi6ence of blunt Of sharp force injury to the thol"llC(Hl)dominal region.
HEAp; (CENTRAL NERVOUS SYSTEM)

See ~Eviderlceorlnju:ryN
The dura miller and falx cerebri are intact. 1lIere is no epidural or subdural neoiion'hage
present. The leptomeninges Ire thin and delicate. The cerebral hemispheres Ire
symmetrical. The SltIlCIures It the base of !hemin, including cranial ner.oe5 and blood
vessels. are intact. Coronal itCIions thmugh!he cerebral hemispheres reveal no lesions.
Transverse itCIions thmugh the brain stem and cerebellum are unrematllable. The min
weighs 1300 grams. Serial sectioning of the brain reveals unremarkable parenchyma and 110
evidence ortrauma.

MEDCOM 1100

ACLU Detainee DeathII ARMY MEDCOM 1108

AUTOPSY REPORT {bItS}

6

AL HANASHI, M\I~ Ahmad A. S.
NECKj

See ~Eyidenceof Injury".
Examinatioo of the soft tissues of the nedc irch.dina Sltap mLISCIes. thyroid gllll'ld and I.rge
vessels tre unremtrbble and ....ithoullnlumttic tbnormalilies. The hyoid bone and thyroid
~i1age are inact.
CARP10VASCW,AR SfSTEMj
The pericardi.1 swflCe:.' tre smooth. g1islenillll and unmnarbble; the peril:*tdi.l.sac is free
of significanl fluid and w:l!lesiollS. The COtOfI8ry trteries arise normally. follow !he usutl
distribution and are ... idely patent ... ith 110 alherosclerolic changes. Theepicardium is
slTlOOlh and unremarkllble. The myocardium is dtrlc. red-brown. finn and grossly

unremarkable. The v.lve$ exhibit the us\llll.siu, le.llture IlIld position relalionsh.ip IlIld are
unrem.rklble. The IOftlIIlIld i15 majorbrlnches arise normally. fol\o"'lhe usull course and
are ... idely patent. fTeeof signlflCIInlatherosclero5is and other llbnomalily. The venae
c.vae and their major uibutaries relum to the heart in !he us\llli distribution IlIld ~ free of
thrombi. The heIn ...eishs 280 grams.

RRffiMBAIQRYSYSTEMj
The upper airw.y is clear of debris and fomgn material: the mllC05al surfaces are Sl"IlOOIh.
yel\o...·tan and unmnll'kable. The pleulalsurfaces revell jliese"..e ofbil.teral w:lhesions.
more pronounced on lhe posleOor and latei'll swf-=:e:s. The pulmonary parenchyma is red·
purple and exudes I modenlte amount ofbloody fluid ith no foc:alle:sions identified. The
pulmotlary arteries are l'IOm1ally developed, patent and ilhoul!hrombus orembolus. The
right and lefllung weigh 650 grams and llOO gmns. respectively.
LIVER" BILIARy SYUEMi
The hepatic Clpsule is smoodi, glistening IlIld intacl. ..oyering dark red·bro.....n, modenItely
coogested pm:nc:hyml ..... ilh no focal lesions noted. The glIl1blldder containsgreen·bro....n,
muooid bile: (he mllCOU. is velvely and wvemarkable. Theexlrahepatic biliary ~ is
palenl. ..... ilhout evidence of Cllculi. The liver ....eighs 1300 grams.
ALIMENTARY TMCTj
The esophagus is lined by gJ1IIy·..... hile, smooIh mUCOSl. The 8'!1ric mucosa is arranged in
(he usual ruB'1 folds and is unremarkable. The stomach is distended ..... ith partially digesled
food ..... ith no evidence of muc:osal or vascular injury. 'The smlH and large bowels are
unrelTllrltlble. The panaus Ills llIOffnIl pil\k-{lI'Ilobullted appearance and lhe ducla lte
patenl. The appendix is ~I and untemIOOIble.
GENIIOUNNARX SYSTEMi
The renll Clpsules lite smooIh and Ihin, semi-tra'lSpatenl and strip ....ilh ease from the
lD'derlying SITIOOIh. red-bro....n conical surfaces. The conices Ire slwplydelinWed frotrl
lhe medullary pytamids, which lIl'e red·purple to tan and unremarklble. 'The Cllyces. pelves
Ind Urelen> tre ulll'efTllltable. The ....inary bladder is unl'elTllll1table and contains
yello..... urine. The right and left kidne)'ll weigh 100 gmns exh.

"ear

MEDCOM 1109

ACLU Detainee DeathII ARMY MEDCOM 1109

AUTOPSY REPORT(b){6)

7

AL HANASH.I. Muhammad Ahmad A. S.
The e;ctemal genitalia are those of a circumcised adult male wilh bitllendly descended
unremarkable tesleS.

RWCULOENPOTHELIAL SYSTEM;
The spleen has allTlOOlh. intlCl capsule covering red-pu'll~. moDel1llely firm parench)'llla;
the lymphoid follicles are unremarbble. The regional l)'Illph nodeI .ppear nonnal. The
spleen weighs 120 gmTliI.
ENDOCRINE SySTEM;
The pituilary. thyroid and adrenal glands are

unremarhb~.

MYSCULOSKEurrAL SYSTEM;
See MEviden« of Injury".
Muscle del'elopnem is norm.1. NOOlher bone or joint8bnol'malities ~ lW)Ied.
EyIDENCE
The clothing, plastic f1ui cuffs and the brown bags around the hands are collected and
submilted to the NCIS agenu attending the autopsy. 1be ligature is uamined and
relained by NCIS.
(Note; An inlaCt white brief simllu to !he one issued to the decedent is provided by NCIS
for e)lamination and comparison to the ligature. The ligature is identical to the elastic
band of the e)lamined brief)

RADIOLOGICAL STUDIES
Radiogtllphs reveal no recent skele\lll fractures or abnormalities. A temOle healed
(malunion) ffICtu~ right humerus is noted.

MICROSCOPIC EXAMJt!AIJON
Representative sectiOll5 of the major orgall5are retained wilhout prepal1ltion of
histolo!ic.1 slides.

TOXICOLOGY
Carbon Monoxide;
ClUbo;cyhemoglbin Sltul1ltion in blood is less than 1% (e;cptete<! normallimiu)
Cyanide:
Not delected
Volatiles (Blood and VilteOus fluid):
No ethanol is detec!ed.

MEDCOM 1110

ACLU Detainee DeathII ARMY MEDCOM 1110

AUTOPSY REPORTi(b)(6)

AL HANASHI. Muhammad

I
Ah~ A.

8
S.

Screened medication and drugs of abuse:
Screened in lIrine and confinned in blood:
Po$ilive Acetaminophen 5mgll.. (0.5 rog %)
Positive Beruodiuepine: Lorazepam 0.025 mgll.. (OJ)()3 mg 9t»
Positive Benrodiaupine: 7-Aminoclonazepam 0.03 mgIL (0.003 mg 9t»
Positive Sympathomimetic amine: PseI>doephedrine 0.3 mgll. (0.03 mg%)

ADDITIONAL PBOCEDURF$
I. IDo<.lInWUMV o/lo(ographs are taken by OAFME pIKMographerJ(bffSj
(b)(6)

I

2. Full body radiogBphs are obtained by Department of Radiology, Nav,l Hospital
(jllilltanamo Bly. ClIba.
3. Specimens retained for toJticologicalandlor DNA identification are: Blood
(heart). vitreous flllid. bile. lIrine. Solomach contents. and tissue samples from liver.
11Ing, kidney, spleen, brain, psoas and hean mu.scle and adipose tissue.
<4. Representative seclions of o<gllls are retained in formalin without pnparation of
histological slides.
5. Cloching and other evidence are photographed for Oocllmentation Ind submit~
to NCIS agents Itlending the 11ItOpsY.

fiNAL AlITOrsX DIAGNOSIS

I. Aaphyda by llaalure RranaulatiDn:
A. L.igatll!'e mark partially encircling lhe neck with possible twist on the right side.
B. No evidence of ocher ned; traumaor frKtllI'U.
C. No evidence of significant lfIlImatic injlllies.

11. Evidence:
- Collected evidence submitted 10 NCIS.

m. To:dcolOJY:
A. Volatiles (Blood and Vitreous fluid): No ethanol is found.

B. Screened drugs of abu.se and medicltiOf\S (Blood):
Positive for: Acetaminophen. Benrodiazepine and its metabolites and
Pseudoephedrine.

MEDCOM 1111

ACLU Detainee DeathII ARMY MEDCOM 1111

AuroPSy REPORTI"(b){6"---~
AL HANASHI, Muhammad Ahmad A, S.

9

QPINION
la civilian dminee of unknown ag~,
died from asphy~il due 10 ligalure stnn&\llllion by lighl1y wnlppinglhe elaslic baM of
hia underwear mulliple limes al'O\lnd the neck arod apparenlly securing it wilh I twist 01\
lhe righlaide of the neck Ind a head lill. AUlopsy reveals no evidence of other
significant IRuma or evidence of mllLreatmenl.

flb)(6)

The raised lesions I'IOled on lhe forehead Ire consislenl with repcKted hislOry of wilnessed
repealed self-infje.::ted hillinglbanging of lhe head on !he detenlion facilily Wills. 'The
contllSions noled on the righl side of the neck may be associlled wilh the ligalure lwisl or
by the guarUs' iniTiallllemplS 10 manually remove the ligalure. The non.displllCed right
S· rib fraclure I'IOted during examinaTion is consistent Wilh CPR Ind resua<:ilalion ~ffOlU,
Tolticologkal sludies posilive for A~tamioophen, Benwdiu~pine and ilS metabolile and
Pse1ldoephedrine. 'The posiliv~ medialions Ire wilhin their therapeullc level and are
nolKOOtrib\l1Ory 10 the cause of dealh.
Review oflhe decedenl'S medical records rlNeals multiple stresllOl'S, multiple suicide
ideal ions and gestUl'e$ and multiple suicide aliempU by mulliple modalilies as early as
2003, The decedent WIIS on hunger slrike since January 2009 and hid five suicide
attempts in May 2009,
[(b)(6)

Based upon the aVlilable

informaljon,Jhe_ma.nnet_o'-dealbjs~Sujclde"·

(b)(6)

(b}(6)

-i

- -Fic.aJ E~amillef

MEDCOM 1112

ACLU Detainee DeathII ARMY MEDCOM 1112

_.. __.-

---

_oo"«'t·...

--- --- -_.00'_"""'" .......'-... . -- _.-,-

cunn<;_1"I! OF DEO.Tl\

.....

-.

toYERSlA'J

I,"",,,,,"''''"'''''''''-''

- - - --,.-.
..
""'
----,- _._,__-- - - ...._"'''"''
- ... -_..__....-...
---_
.
...._
-,_
_
...
...
_............ _-----~

AI Harlashl. MlAl.mmer:I Ahmad.

S.

lb}(6)

Civilian

_"

-,~

~

"'"'.,. ",Tl<

I!l
0

_T" " ' _

•

C·

CNCo_

~-

,~

0__

.........' . .T

~

•

~

...

_0'00'''' ...

"

."",

-,

C"Y COt T""'" "".,,,,

...............-HT

....... "'

..
...............

'"

,

-...

---~

...........

~_IOUg-...~

_ .. "" _ON.-en. ,""""" ."_,,,
,
N _ .. _ _ . _

•

---_. - ....
-.--- ---..
..........
_.--- - • - --....-_...--- -- • •• ....,- ....
......
--- _. ... _--rt~~-_.
._-_
_._..._......__.........- ..._._--....
-_._.._-.... _. -...
......... _ " " , , , _.lVOt«> '"

'~T

_ _....... _u
.....-

'0"'-"''''''''

--,"""'-'.

...-_.......

,

""""'

Gl-

~--

~

0

""'''' .... '" D _ .......

•

(b)(6)
_Mll(b)(6)

l[}u

3 June 2009

"'. . 01' . . .'"

(b)(6)

1......... ~"'"1:li<. .. -

-.'-

JoInt Task Face Guanlan.amo Bay
"'CI·...,_....."'OCO'-". ,

2009 (b)(6)

1 " _ .. _ _ .... ,.,.,.
_ . _ _ .. _
;;:;r._hc...-...

_

Cuba

~

00--

oou•• or.,.,,_

... _ . _ _"""""TOO
••, .. _
_ _
'''''''_
,.,.,. ..._ _

""~tlWt

(b)(6)

Medical Examiner

1""''''''''''''''''-''--''']'D~(b)(61
oY&r AFB. Dover Of

(b)(6)

~

.

_

_

................-.._,,_.._ _...........,._''''''''-<It.
~

•

MEOCOM 1113

ACLU Detainee DeathII ARMY MEDCOM 1113

ADPW FORCES INm'ITVrE OF PATHOLOGY
QftkIc of die AnDcd FoT'CCll MedkaI EIUlminc:r
1413 Research Blvd., Bldg. 102

Rodtville. MD 20850
301-319-0000
AUTOPSY EXAMINAnON REPORT
Nan'Ie: tBTBl HAMID, Adrwl Naif
ISN: (b){6)

Autopsy Nt> .--,(b)@_~

TMEP{b)(6)

Rank: Civilian Detainee
Place of Dealh: Iraq

AFIP No.: l(b)(6) ~

DaJeofBlrth: (BTBJ{b)(~)~I966
Dale of Death: (b}(~2009
o.wrimeof Aueop.y: 19 MAY 2009 01130
PI_ of Autopsy: Pon Mortuary. Dover AFB, DE
D.te of Repoft: 07 JUL 2009

Cln:u~ otDeuh: Thu 43-yur-okllnqi CiviliM tlecainee, who hid. mediul hi.scofy
signifiQlll for aneml. and lIiOl,obocywpmi.. begllllCi eJlperienee acute distras which rasulled in
death despite .ggreuive reslll(:itatiOil efforts.

Alittiorizadon f~ Au~: Armed Forces Medkal Eumioer, per U.S. Code 10, Sec:l:1on 1471.

IdmtUlcatloo: PQ4itive JdentlficMiOIl is e$lablished by comP'rison of posunonem f1npprinl
utminuion and U1temortem fingerprinl records. A postI,Mtem DNA sample is obtained.

CAUSE OF DEATH:

PULMONAllY EMBOUSM

MANNER OF DEATH:

NATURAL

MEDCOM 1114

ACLU Detainee DeathII ARMY MEDCOM 1114

AUTOPSY REPORT{b)(6)

Paae 2 of 7

HAMID, Adnan N.

EXTERNAL EXAMINATION
The body Is that of, well-developed, well-1IOIIriJhed Ca'''''oId rMIe m:ei¥ed unclad. The body
weighs 167-pound$, il64-illdles in len,sm lI'Id apptlR compIlible with die ~ ,se of 33yun. The body il cold. Rip Is pauin& f t P'aenl1O WI cqUll dearee In .J18lltnmili•.
VioillCeOU5lividily It pteSenI Utd fixed on the posleriof
of the body. elleepl in &real 8Ilposed
10 Pi fIS'~. The body I. uncmbalmed.

.Iri_

The head i. ~ i c , flIld!he.caJp hlir ilIpy-tllack Uld up 10 I ~1nen.1n lenp"- Faci.J
IWrconsisu of, gray-tllaa mouslllCbc and beard slubble. 'The irides IrC bm1\'n,!he pupils ar-e
round Utd equ.J in .i1e,!he COli
are cloudy. the conjunalv. arellftl'CrlWbble, and the Kienle
are white. 'The exlcmll auditory c:cW', exlcmll rwee lI'Id or.J c.vity an free of foreign maccrial
and abnonnIJ secrctlonl. The earlobes IrIl noI pierced. The naAI.keleton and maxilla are plipably
il'lllet. 'The lip' and oral ml.lCOUl membrva an wilhoul ....ldenI injul')'. The teMh are nalURllnII in
good condilion. Eurninlllion of !he neck revul. no cvidence of injwy: the IrKhea I. P'iP'bly In !he
midline of !he neck. Evidence of mediClllIMnpy Is preHfIl, _ below.
en

The cheal: is Iyrnmclric with nonn.Jly formed male brcull tha! are free of ftIUSCI. No evidence of
injury of the ribll or the aemurn i. evident exICml1ly. £videnceof medical therapy It puent,_
belo.... 'The Ilbdomcn is flat without rt:«IU nurna. Healed swglc:al scan are not IIOICd on the 1OfSO.
Tbe exteml1 genllalla an thole of a nol'TTllll adull circumcised malc. and !he pubic hair Is In U'I .
lpp,opriate distribulion. The posttlrior lOBO and U'lUl are withou!~.
Tbe extremitiel are .ymmetric and normally formed wilhollt evidence 0' .IJftlfieant teeerlt trauma.
A Vi; xlh-inch.tlruion i. on lhe right knee repon. The finSemail. arelrimmed and infaCt. 'The
lOenlil. are UNMllrbblc. TIItOOS IJ'C I'lOI noIed on !he extremllia.

cumtlNQ AND PERSONAL EPFlcn
•

A g;reen penonaI effects bas aooompU'llea!he body which contains U'I ldentifK:llion band

•

which matches the ~ name and ISN of the decedent.
No ~~ or ~ penonaI effcclll auonlpU'lilll the rem.li",.

MEDICAL INTI'yENTlON
•
•
•

........

A 1hcnpeuIic: noedl. stick-marl!; on the rlg;hl.ide of the neck iI covered by medical puze

Defibrillator bumlabruion on the centnl chell
'tbenpeutic: ~1"1k:k.-rrwb in both U'IUICUbilai f _

RADIOGRAPHS
A ccmp1ele lei of poaanorum rwlio~ and CT imep .... obtained and demonaInIee die
followIng;:
•

No rec:cnt tracrura

•

No meuJllc foreign bodies

MEDCOM t tt5

ACLU Detainee DeathII ARMY MEDCOM 1115

AlTTOPSY REPORT (b)(6)
HAMID. Adnan N.

PageJ of7

EVIDENCE Of lNJllBY

BODY CAy[JJf;S:
The body is opelled by lhe tlII.III thoneo-lbdomiNil ineilion and the cheat plile .. removed. The
ItunulTland verutnl boda are vWbly and palpably illllCt. No ldheJions at abnonnal colleelions
of fluid are pllUIi in MJ of tha body CIIviriet. All body or.- _ preaenI j" norrnaI
pocidon. The IUlU:riof Z - S- rilht ri.. WllI the Ieh 2"" - ""leh Ii.. are frKtwed 1Il'itto &SIOCl&lOd
klft eu- .. ,lOf'. ....

.womical

The I\IbcuWleOUl fa! l.yerof the abdornlnal1ll'all ts M-inehc:l dlic*:.

HEAD AND CENDAL NERyOUS SYSTEM:
The tcalp" refI~. The p1eal and aubgaleallOh IiIIuet of the ~p are flee 01 injury. Then: are
no lkull fraetura. The CIIIvarium of die skull ia removed. The dur1. miller and falx celebti are inlaet.
There ia no epidural. aubdural or subarxhnold hemonhase PJ-lL The leptomminges are dlin and
ddiCllle. The ceRbraI hemiapheres are.ymrnetrieaI with an unremarkable pauem of Irri and luki.
The blood veneb &I the bue of the min are intlc:t and IymmetriCIIl without signirlCll1l
MheroeclCll'Olli•• The cnniall'lel'Vei are 11k_iN ')'Jl'IJIlCiaical u.I intad.
The brain 1Il'eigtu: 1.300-snrr-. CoronJI UCliOru IhrouJh the cerebral hemiJphaaJ reveal 110
laiona. The VUlcriclel: of the min are of normal lite and COtIWn clear ......btosp;ntl fluid.
TranlVtne IeCtlons Ihroug. the brain stem and cerebellum are unmnarbble: u il the upper spinal

lXll"d. The Ill1l111O-OeCipitll joinl is stable.
NECK:
The ~ Itrap mUJ(:l~ of the neck are homosenous and ro:l-brtl1tm. withoul hmlorrlvolle by
layer.wi.. diqeetion. The dlyroid CIIltiI,se and hyoid bone are inClll;:I. The larynx is lined by inlad
1Il'hile mllCOlli. The tonp il ~ of bite martJ. hemorttIase, Of" ocheI' il\iuriell.
CABplOv6SCUL\B SYSTEM:
The 420-pm hMrt II eonlIlned In an lnlKl perieatdial Ai:- The epieardiallWfaee illmoodt.. with
minimal fal inveelmenL The coronary arUlries triM nomIaIly and are prasel'Il in a normal
diltl'lbullon. with • rishl-dol'nilWll pauem. Cro5.I NlClI(lf\$ of the major coronary arteries
6emonItraIe the followina: me leh anlerior clelcendlns eoronuy anery has mullifoeal luminal
narrowing IfUlet' thin 7~ by calcified &fhemIe1erotic plMlue. The mid-portion of the left
circurnnu coronary artery has 509b foea! luminal lWTOW'ing. and dle right coronary l1lery hu
mwlifocal h.ninalnarrowl", sreater!han 75lJ1' narT'O'IlIinll by ,thero8elerotle plMllle.
The myee.dium ill homogenoua. red-bfown. and farm without foea! IOftening. dileo/oration or
fibrosts. 'The valve leafleu are ttlln and mobile. 'The ,...lIs of the leh ventricle. irur-venlrieular
ac:plUm. Md riglll verllricle are 1.8. 1.9. and O.6-eeIIlirneterl thick. raspeelively. n. chambers of !he

MEOCOM 1116

ACLU Detainee DeathII ARMY MEDCOM 1116

AUTOPSY REPOR1jlb)(6)

Page4of7

HAMID, AdrIan N.
heart anlllOI dil.led, and the endocardium is Ill'IOOth and sli.ten!n&-

The IoOttI his moderate calcified I1herosclerosls, predominanlly in the abdominal region, and gives
rise to three intIC:t and patent Irt:h vessels. The renaJ and mcsenIeric veuels are IInremllklble.
RF:jPIRAIQRY SYSTEM:
1be u.pper litway is clear of debris and foteign matetial: the mUOOSII SwflCeS are smooch. yello1¥WI and IInremarkable. 1be p.nelll pleural .lIrflCeS .... SITlOOIh, s1iSWlinS and unremlrltLble
biltten1ly.
The rip luna weisba 960-JI'II1llI: the left S80-1JtI1IS. The pulmonary parenchyma is diffusely
eonsesled and edematous. exlldlnl sllghl 10 modenle IlJlOUlIU of blood and fn:llhy fluid: no foeaI
lesions are TIOIfd. The vllceral pleural SUTfICell are smooIh and gli.mning with IlIlhnoosis
bllatenlly.

1be pulmonary IrIeries arc normally developed and pIIlenL The Iwnens of the right and left
pvImorwy anerles .... oc.::lllded by mll.lllple fragmenu of thrombi. The emboli have .!Jilllons,
tribulaly easIlI and valve m-itinp and are of. caliber OOIVIistent with a venous origin. Emboli are
found extefldlngll'fO me peripheral bnnche:s of the pulmonary aneries in the Illng parme!lymL'
tmPATOBUJARY SYSTEM::

The 1,640-snm liver hal III inlacl .mooch capsule covering moderaIely congested lan-brown
parenchym. 1¥ith no foeaI lesiQllJ 1lOled.

The pllblaOder conllim ll).milJililerl of green,bro'llm. mucoid bile: the mucosa is velvety and
wwemarkable. The extnhepllle biliary tree ia pIIeIlI. 1¥lthoul evklenee of ealevli.

OASIROINTFSTINAI. SYSTEM:
The esopNguI is lined by gny-1¥hiw. amooch m~. The patrie mllCCa i. arranged in the lllval
rugal folds and the lwnen contains 2OO-milliliten ofbrown flllid 1¥ith food.
The amall and luI'" bo1¥e1S are II.nre",wbble. The pmc:l'ell hll • normal pink-llll lobulated
~. The appendix Is present.

OF.!'tITOURINAJI,y SYSTEM:
The right k'dney 1¥eighs l30-grvns: the left 140-,""",. The renal ClpSlIles are IITIOOIh IJld thin,
3tmi-1raIISpIteIll and $lTip "ith eat from the underIylnS smooth. red-brown cortical IIIrf_.

The conices

ani sharply delinewd from the medlllllt}' pyramid!. which ani red-purple 10 tin and
IlIVe1T111kLble. The cortex of the left kidney his a 0.8 x 0.5-oentimeur 1¥edp-shaped region of
henlOi,h.ge,.,jth eentraI calcification. Thecal),ee5. pelva and ~ Iltl wnmarbble.

White bllldder

m~

overlies

~

;ntaet bladder wall. The bladder eontailll .pproxlnwely 5proswe gland and aemlnl.1 vesicles are 1¥ithout now.

milliliters 0' cloudy urine.. The testes.

MEDCOM 1117

ACLU Detainee DeathII ARMY MEDCOM 1117

AUTOPSY REPORT',"(b~)(''''-----­

Page 50f7

HAMID. Adnan N.
[,YMFHORBTICULAR SYSmM:
The thymus is small, flU)' ailCI otherwise unremaritable. 'nMl 320-pvn spl6ell has a amooth, intact
c~ule covering red-purple, lJIOdcnicIy filTT1 parenchyma: the lymphoid follicles are unremarkable.

Lymph node.! in the hi/v, peri.artic and i1i~ regiollS are nor mllJged. The hiler lymph nodes
demonsrraae mild anthrac05l1, bul are Olherwlse unremarkable.

ENDOCRINE SYSTEM:
The pituitary gland is .:nrnin¢ i" situ and is JfOSSly unremarkable. The thyroid gland is symmetric
and recH:lrown. 'frfithlNt c}'lllic or nodullJ change. The parathyroid g1ancb are not identified. The
right and left adrenal glands are symmetric.....ith bright yello'frf cortices and nd-brown medullae; no

1'1I_ or areas of hemorrhage are idenlirl«L
MUSCULOSKELETAL SYSTEM;
No abnonnalities of rnU5Cle or bone are identified.

SuperfICial po,sierior incisions fail 10 demonstrate any iniuric:s of the posterior torso; extended
dWeet!orl around the ankle aM .... rist ~Ions tall 10 demonstme any evidence of binding or
ph}'llical restrainL
.
.
DissectiollS of the deep ven of both posteriOf" leaa fail to demonstrate thrornbo&ia.

MICROSCOPIC EXAMINATION
Selected ponions of organs are rellJined In formalin, 'frfithlNl preparation of histology slides.

TOXICOLOGY
yOVJU fS: 'The blood and vitreous nuid are examined for the presmce of volalile compounds
including ettIanoI at a cutoff of 2O-miJligrwna per deciliter. No ethanol is cleW1ed.
DRUGS: The blood IslCl'eened for rnedlcations and dn.ip of .buse il'lcJuding acetaminophen.
amphellJntirle, anlidepc lunts, antihistamines. barbilUnteS, benwdiazepines, cannabinoid5.
chloroquine, rnefJoquine. cocaine. dexllOmelhorphan. lidocaine. rwcorie analgesiea. opilleS,
phencyclidine. phenochiuines, ulicylltes, .ympathomirnetic amines and veraparnil by gas
chromaloaraphy. color test or immunoassay. The foltowina drop are ddecIed:

.

Poohjve J j"ar'ine: UdocailMl is detected in the blood by gas chrom.uognphy and
C()fIrJ..mled by gas chromatography/rnusspecbOl"ecry.
CARBON MONOXIDE: The C&Iboxyhemoilobin salUration in the blood it: lUI than 1% as
determined by spectrophocomelry with alirnit of quantitation of 19&. Saturations above 109& are
considered elevated and are confirmed by gas chromatography.

CVhNJD£: The blood Is tested for cyanide with a limit of quantitation of O.Z5-mHligams per liler.
No eyan\de Is delecled.

MEDCOM 1118

ACLU Detainee DeathII ARMY MEDCOM 1118

Page6of7

....UTOPSY REPORT (b)(6)

HAMID, A.dnan N.

ADDITIONAL 'IOCIID"'M

AFMESSUlff~.
A.FMES autop&y uaistam.
J. The Criminallnyalilllive Diyision (CID) replllcnwiye MUndiro.lhe lUlOplIIy u Specid

t. OocumenwyphotoJrlPNanlW....... 1b}(6)

2. ....ulOpIy _iSUInCe II P'Oykjed bj(b)(6)

"lent (b)(6)

,«

... Spec:ilMlW retUned
IOlIicoI01Y wrinJ and/or DNA i6erllifleation are yitreol&ll fluid,
blood, urine, bile, ,Ulrie eonlfntl, tPlcen. Jiver.lurlJ, kidney. bnin. myocardium. adipose
I. . and skeletll mll5Cl..
S. The \II'let'I\boIImed body and di"M1ed «a- are renlmed 10 the point 01 origin by Mortuary

OperatIoN pelWlldld.
fINAL AllIOPSX DIAGNOSES
I.

P'Ial-.aI}' EmbolII:m
A. Both pulmonary Il1eI"- are occ:luded by fl\Ultiple fragmenu of thttanbolle emboli wtl.idl
WC:tld inlo the deep parenehymal bnrlc:heI
B. Theemboli baye JtriI!lons. tribuWy aIU and yalve rrwtlnp. conJiIlenI: with. deep
YUlOUll tIwombol:le ori,m
C. Associaled pilmonary COtli_ion, bilaunl
D. Deap yenous ~ _ noc iderlrified within"1ha limildliona of ttU. t!JI:cnirwion
(theoriJin of the lhrornbocic emboli is not ~flCd)

D.

HJPCitawl"~Ca.ldlu._IarD.f_.
A. Mild e.rdlomeply (hqn: welghl It -420-pmr, the expeeted rnulmal heaft weigl'll: is
J34-pnt f«body weiJhI,l wid! c:Gl ......,ble ldl yentricular hn>allop/.y
B. Sevt!tt! IIterioIeIMltIe dl_all tIRe major c.oronary dI"leriel
C. ModenIe cak:lflfld dIhermcl_is in the abdominal aorta
D. Probable anbolle Intara of the left kidney

m.

SpJc_ I ply bploal"aht. 320-JI""UM: the. 'I leacd mn'_1 ~ wdaht b 134..... for body wa,M)

IV.

No nkImft or dbUM or pbytlcal rwtraInt Ia Sdmdncd.

V.

EvIdena: of Medk&I Therapy
A. Thenpeutle !-tIe ttk:k·marQ on the righl tide of the neek and bo!h antecubital tO$Sle
B. Defibrillator bunv'abnalon on the untnLl chest
C. Fr.ctura of the anterior r1,gbt anci left ribli Wtemp!ed resuacitallon reldIfId)

VI.

PoIt·MCN1enl CbM&a
..... Rip is peuing and equai In all uuemitia
B. UyidilY is posaerior and filled except in area upoaod 10 prullII'e
C. '"'- body temparattmlla eold

MEDCOM 1119

ACLU Detainee DeathII ARMY MEDCOM 1119

AtrrOPSY REPORT(b)(6)

Pap 70t7

HAMID. Adnan N.

YD.

l6eatltyflia Body Mat:b: NOM DOted

YDL T<>""'*'fy
A. No ethanol is 6etected in the blood and vitreoIAI fluid.
8. No ~lM 4rugs of abuse Ill't detected in the blood..
C. LidoCiine (a rned~ion lIQOC:ia!Od witt! f'llSUI(:itation efforu) i. pt' II II ill dw btood
D. The cubDxyhemoglobin saturation illlhe blood b: lea than I".
E. No cyanide ill decected in the blood.
OPINION

Thil 43-year-old Inqi civilian dsaiNl!lb)(6}
died of a pulmonary ernboilim. The
IOUrCe 01 the embolic Ihrombi..-ere not idmtifl«l, but bued on the -weannee otthll MlboIi. they
ITlOSt likely oriiinMed from !be deep veillli of !he lei ClI. ~i1Uf1l to identify this.ile .. the origin of
the emboli by dislection of die lep does not precll.lde this c:onc:hllion. S-V. . hwen-ive
arteriOsclerotic card.iovQ(:u\u dileue 'Will &1110 pacnl, as denuiiUued by k1a zued heart 'Weipt,
llletUled dliekneu of the left venll'iele of die heart, I1tleroIderoI:Ic dlseue of the ~ and severe
narrowina of a111hroe major QOfOf\oW)' arterieI of the heert.. The embolic infU'CCKJn of the lefz .
kidney likely orlgineud fTom the .lhefosc;lerodc d i _ IN II: II in me IlOfU. An enIqed spleen
wu a110 idllntWed III: autoply. No l!vicknc:e of phylical ebuIe ot ph}'IicaJ restrailll wu idelltitio:lat
alltOply. Tollicolo,ic:alle5l.ill' 'Will lllIptive fot cdwlal, JaClllllM «up of IIbuIe, devued
CIftlo1ytlemoaJobln or cyan~ In the blood. A medicatKln associl1ed with l'lIS'Iac:iWion
Q.;doc.airw) Will d-"Ud in Ihc blood. The IllIfV'IeI" of dealh is natunII..
(b)(6)

(b)(6)

MediCI! Examlller

MEDCOM 1120

ACLU Detainee DeathII ARMY MEDCOM 1120•

------'-

--.-''''

-_...- .._.,_-

evlTlflCO,Tf: Of' DUoTtt IO_$EA$)

........

_..

_ O ' ....' ... e

eTe Hamid. AdrIan. N

(ll'O.<Or. III ~

OIWC. o< .. ova

-

(b)(6)

Cr.-man

"'T""' ..

Dop

IIOC.....""""" . . . - .

~

__

"".. ,", . .no

-"
---.--_.- -_.._-- -- -- - --_. __-,_ftl__.._ _
... -_
.. _--_ .... --_.
-_
.
.-• '"

-=

_UOUTU.,..

......-lOlllUOIfo

..... T"""'....

CIT"f,-_""I<TA"

......

_O"","T"'"

--~

~

~

.

~

couoo ... _
"""""'"
....'"_ _ _ .. _

_ " " ~ o...CIl>iV<NHO TO""';,"

oT_I_

""'TIS,....

_sr.-.

••

_

•

..........

,

e·

lEI
0

....T....,"""T.

,

" " •. - '0

e - _ , .... _ _ ...

__.,.....

-~

CAuSr,~_.

__

IO ............ CAUOI

e:..-_,",,' _ _ ...
-~

-. - .. _.........
_.-_.• ---- _._poI ,

"",",,_~C<K\O''''

-"' .......

1iI

~

"S

•

0

-- --_...._-. """"' . . . I O P _ ~S

co,

~

_<>orA

_.--

~

(b)(6)
--jb)Ce)

"'It"" """... ........ _to

t)(6l

2009

_... __ ....._I Camp Tajl

".,

I 0 .... ""

..
1iJ--

I"

0ClICA.'' ' ' ' '''''''' '..
••
Medical Examiner

...."m>_

r
._
__
_ t~_lCIA'
.. _ . __ _
_ ... _ _ _~
__
, ......
- ....
._
_ . :_....
" _ " " __ ......W'
_ ........
TOOl

--

_or ........."'.""

!,b)(6L
(b)(e)

-~19 May 2009

---_._..--....-. _...

. .'Ol... ...,..""~

00Yef AFe, 00Yef DE

_. .... _.... _....-"""""
,--_

(b){6)

,-.-".-".-~""-".-,,
.....-. .. _ _ t _ , , _ .. " " " ' _.......
MEOCOM 1121

~

_ _ _ ...-....

ACLU Detainee DeathII ARMY MEDCOM 1121

AroMED FORCES INsnTUTE OF PATHOLOGY
om....f Ib, ArmecI Ferra Mecll.,.1 E. . .lur

.~.

1413 Rcxareh BIYd., Bid.. 102
R.odcvilk, MO 208SO
301·319-0000
AUTOPSY EXAMINATION REPORT

Name: 8TB IbrMIm. Ahmad A-.d

Autopsy No.: (b)(6)

ISN: (b)(6)

AFIP No.:(b)(6)

r;;

o.le or Birth: BT8 (b)(6) 1917
OIlc ofDealh:(b)(6) 12009

o.telT'lIIlCof Autopsy: 22 Jan 2009@ 1000
~ ofRepoct: 07 APR 2009

Rank: Civililrl Detainc:e
P_ of ee.h: 1""1
Pl_ of Autopsy: Port Mortuary,
Do~rAFB,DE

Clrcum.lInea .f Datb: This 21-year-old 1""11 Civilian was • 6eta.inee It Camp Buc:a, IfIq
wbea be repor1CdIy.1Wke with shortneu oflnaih and c1utchilll hi. cbest. He lost consciousness

and was In!IlIpon.ed 10 the auard by other de\a.i.nca. Medical personnel we~ dbpllehed and
brou&b1 him to the medical facility....tlm: all nsuxiative efforts were Ull$UCcnsful.
Alilborlul~1I

r.r Alilopsy: Anned Forcu Mcdk::aJ Examiner, per u.s. Code 10. Section 1471

Idtlltlf1efllioll: Presumptive identifICation is established by mortuary ldcntlrlCltion lap.
Finlerprin~and. DNA sample life taken forCOl'llpari50n to an a:empt.c if one becomeJ IYlIilablc.

CAVSt OP DEATH:

L,.,.pboeytlc My_rdllb

MANNER OF DEATII:

Nahl,.1

MEOCOM 1122

ACLU Detainee DeathII ARMY MEDCOM 1122

AUTOPSY REPORT~b}(6) _ _
BTB fbl'llhi/!l, Ahmad AWWlId

Paae20 fll

EXTERNAL EXAMINATION
The body is that ofl

_lI-de~loped,well-nouriahe:lunelld

male. The body weighs

In polllllb, is

73 irlclles in ICllilh IIId Ippean; compatible with I/le reported 1ge of21 yws. The body is cold.
Rigor is Ib$enI in III Clttrem.ities. Lividil)' is pleSCntlllld fIXed 011 the posterior SIiIfal:e ofthc body,
There is slight marbling of the torso and both lollr'er

Cll.cept in areas exposed to pressure.

extremities.
The hcIId is norma<:ephalic. and the scalp hair il short black. FEill hair consists of bllCk burd aDd

moUSllChe stubble. The irides are brown. The COI'llCIIC; are cloudy. The conjunetivle are congested.
The sclerae are whitt. The extemalluditory CIllIls, exlemalllafeS and oral CIvil)' are free of foreign

materiallnd Ibnonnal seen:tiolllll. The 1IIl!lI1 skeleton and maxilJl are palp1bly int.et. There is I 318
x 1/8 inch dried Ibmion on the fell; side of tile forehClld.. On the Iell; temple is 13/4 x 112 inch
11nsi0ll. On the bridge of the nose is I 1/4 x 1116 inch abrasion. The Hps Ire withoul evident
injury. The teeth are iWural and in good condition. Eu.milllltion of the IIC(:k reveals no evidence of
injury; the IrIC:Iletl is palp1b1y in the midline ohlle nedc.
The chest il symmetric with nonnally formed mille bream thtlt are free ofnusses. There is I 4 J[ 3iDeh plttemed burn I Inion on the riaht side of the chest. On the litem left side of the ChCSl is I

3-112 x 3-112 plInemecl bwn Ilbration. The Ibdomen is flit wilbout recentlllluma. Healed surgical
SClI/'lIlI/'C not noted on !be totSO. The external genilllilll/'C those ofl cirewncised Idult male, Md
the pubie IlIir is in IrIlpproprilte distribution. There is mild folliculilis 011 the po51.erior tono Bnd
the IrIl1l1 is without note.

The ex~miliCJ are symmetric lind normally formed witbOIlt evidence ofsignifieBlll recent trauma.
There is I 2 x r iDeh contusion on the dorul surr.ce of the left hand, There are ~ abrasions elCh
measuring Iii lr. Iii-inch on the dorsal 5litfaee o.hbe lell hand. The finRC(lIIiIS_&r:.e_lrirnmed Bnd~
I~\n)' The loelllil.s.ll'e unremBtIr:lple. A lBll«W!'~(6'L}_ _

1

CLOTHING AND PERSONAL Etnrn

•
•

PCfSOna! etT~ (conllined in I ~en pcl"SOnlll etTccts bag lUIIChed 10 the Jell; wrist) Ire
removed by Port MortlWy personnel prior to autopsy
Ae«lmplrlying tile body Ire yellow boxer shorts (Clll). yellow pants (cui), and yellow swell
pants (cut)
MEDICAL IrmiRVENTlQN

• EKG petch on the lell lower quedfllnt oflbe abdomen
• Multiple needfe slicu on the chest. bilateral illItecubitalll'ClS, and right inguinal area
• Intc~us cltlleter is nOied in the IrIlCriot rightle@;
• Bum Ibrasions on the chert from the defibrillator peds

MEDCOM 1123

ACLU Detainee DeathII ARMY MEDCOM 1123

AUTOPSY REPORT,{b)(6)
BTB Ibnhlm, Ahmad AIIl'WlId

Pagel o( I I

RADIOGRAPHS
A complele XI o(poslmortem radiogBphs and CT lmega are obtained and demonstrates the:
following:
Multipte bilatmJI anlerior rib fraclures (CPR relaled)
No skull, vertebral, or lona bone fraclUrtS
No metallic (oreign bodies are noled
EVIDENCE OF INJURY

There is no evidenee o(~entsignifieanl injury.
INTERNAL EXAMINAtiON
BODy CAymES:

The body is opened by the usual tholllCO-abdominal incision and the ehdt plate is mn<JYed. The
ribs, sternum, and vertebm bodies lite visibly and palpably iniac\. There are bilatem p1eURI
adhesions with areas oflo<:ulated elear fluid in !he pleural spao::e. There are atlhe5ions between the
diapmilll and the right lobe oftlle liver. There are no .bnonnal eoJle~ions o(f!l,lid in thc:
petieardial or peritoneal eavities. All body organs art present in normaIlUII.tomical position.
HEAD ANp CENTRAL NERVOUS SYSIEM:

TIle sealp 15 renO::lcd. The larcal and subgaleal !Oft tissues o( the Kalp are tree of injW)'. There are
no skull ~. The calvarium o(thc: skull is removed. The dura mater and (a1x =dlri art intacl.
There is no epidural, subdllllll or subuaehnoid hemOlrllaae present. 'The leptomenilt&o:s art thin and
delicate. The c:erebnIJ hemispheres are symmetrical. The blood vessels atlhe base o(the bnlin are
inlael and synunetrlo:.al without sipiflCllll athet'oselerosls. The eranial nerves are likewi3e
symrnetrieal and intal:t.
The bnin weighs 1,436-gnuns and is fixed prior to further ellamination and submission (or expert
c:onsultatiOl\. Set' Addendum A (or eomplcte det.ils.
NECK:

The anterior strap muscles o( the neek art homo~nousand red-brown. without hemol'l'bqe. The
thyroid cartilage and hyoid bone are intld. The larynx Is lined by intKt wttite m\lt{lSl. The tonaue
is free o(bite marir.s, hemorthage, or other injuria.
CARDIOVASCULAR SYSTEM:
The 460-gram helll'l is eontalncd In an inlael periwdlal

The epicardial surfa<:e is smooth, with
minlmalltt investment. Theeoronary arteries arise nonnally and are present in a nonnal
51(:.

distribulion, with a rlght-dominant paltem. Cross sections ofl.be major eoronaJ)' arteries
demonJlme no luminal narrowing.. 'The heart is lTxed prior to further examination and submission
(or expert consultation. See Addendum B for romplete details.

MEDCOM 1124

ACLU Detainee DeathII ARMY MEDCOM 1124

AUTOPSY REPORTllb}(6}
BTB lbnhim, Ahmed Awwad
The aortll is without atherosclerosis and. gives rise to three inw:t and pltent an:h vessels. The renal

and. mesenteric vessels are ~markable.
RESPIRATORY SysTEM:
The upper airway is dear ofdebris and. forcilJll material; the mucosal swfaees are smooth, yellowtan and l1I'Il'eI'MIbble. The parle..... pleural surfllCCS hive extensive adhesioll5 bilaterally.
The right lW1g wcishs l,nG-grams; the left 1,0000grams. The pulmonary parenchyma is diffu.scly
congested and o:cIelNllDUS, exuding copious amouol.S of blood aDd frothy nuid; no focal lesiollll an:
noted. The visceral pleural swfaccs hive exlensive adhesions bilaterally.
The pulmonary arteries are normally developed, pfltml and withoutlhrombus orembolus.

HEPAIOBU.lARY SYSTEM:

lhc 1,760-8JlIIIlIiver has an intact smoolh capsule covering moderately congested tan-broWII
parenchyma wilh no focal lesions noIed.
extending 10 !he diaphragm.

~ are .cIhesions over the

righllobe oflhe liVCT

The gallbladder contains I-milliliter ofgreen-brown. mucoid bile; the mucosa is velvety and

wumwbble. The extrahepatie biliary 1m: is pltent, without evidence of calculi.
GASTROINTESTINAL SYSTEM:
The esophagus is lined by &ray-white, smooth mucosa. The gastric mucosa is ananged in the usllll.l
f\lpI folds and the lwnen contains 4QO-milliliters ofbrown granular n\lid.
The small and tqe bowels are UN'emarkabre. The pancreas has a normal pink-tan lobulated
appearance. The appendix Is ~nt.

GOOTOURINARY SYSTEM:
The right kidney weighs l60-grarns; the left 140-grams. The renal capsules are mlooth and thin,
semi-lJ'aJ'I.sparent and strip with ease from !he wxlerlyingsmooth. red-brown cortical surfaces.
'The conices are shaqlly deliMIted from the medullary pyramids, which are rm-pwple 10 Ian and
unremarkable. The calyces, pelves and ureters are unremarlcable.

White b1ac\lkr mucosa overlies an intact bladder wall. The bladder contains approximately Smilliliters ofcloudy yellow urine. The testes, prmtate gland and scmillll vesicles are without note.
LYMPHQRETICULAR SWEM:
The thymus is small, falty and otherwise unremartable. The 2&O-pm spleen has. smooth. intact
capsule: covering m1-purple. mcderately firm pam>chyml; the lymphoid follicles are unremarkable.

Lymph nOOcs in !he hilar, periaortic and ililC regions ~ no! enlarged.

MEDCOM 1125

ACLU Detainee DeathII ARMY MEDCOM 1125

AUTOPSY REPORT (b)(6)
8TB JbBhim, A!lINd A-.d

Page $ or II

EHQOCRINE SYSTEM:

The pituil&ry Pnd is examined I" situ and Is ps.sly umemarbble. The thyroid &land is I)'Tt\Il\CIl'k:
IIld reG-bro'WII. without cystic or noduJarcllan&c. The parJothyroid &lands are not IdcnrJfled. The

riahllrld left Idrenal &lands are Iymmcllic, with bri&bl yellow cortices and rM-brown mtdullao: no
masses or ~ ofhcmorrllllJ'C are Identified.
MUSCULOSKELETAL SYSTEM:
Superficial posicrior skin incisions are ncplive for In\IIIWlc injuries. SuperfIcial incisions of nch
anklc and wrisI region show no evidence of I11IumI or binding. No non.u.umatic Ibnonna1itics of
mlllCle or bone are identified.
SLIDE

KEY AND MICROSCOPIC EXAMINATION

I. Kidney - UnrClTllatbblc alomcrull with POSiITlOl1Cm IUlOly.is of the tubules.
Uver- Normal heplllic archltcclll1e with conccslion and mild ehronic peri.portaI
inflammilion.
Splcen -Conaestion with IUlolysllllld no focallcsions.
2. Luna (Ill five lobeli) - PulmolW)' ~nawion with CKlnVl$lltcd
alveolar spaces and pulmonary edema.

~

blood ccU.In!he

YOJucoWGX
The blood and Vilmous fluid are examined ror the prcscncc ofvoillilc ~mpounds IncludJna ethanol
II I cUioffof2o.milliaranu perdceHiter. No cUlll'1Ol i. detected..

The blood i. screened for medicaliOfll IDd druas of lbuse incllJdina acetaminophen, ampbCllmine,
lUllidcpreuanll, lUlllhllllmines, barbilUr.ICS, betu:odlueplnes, CIMIbinolda, chloroquine,
mefloqulnc, coealnc, deKlJometlJofPhan., Ildoeaine, IIItCOI.1c llIalSCIics, oplltes, pbencyclldine,
phcnothiazinc:s, lIIieylates, sympethomirnellc amines and vcl'lpamil by III chromltoll'lPhY, color
test or immWlOll$lY. The followina drup WCfCdetcclcd:
po"llive Lidocaine: Udocline WII detected in !he blood by pi chn:mlatoaraphy and
confinned by &II ehrolJ\l\Ogl'lphyJmus spectrometry.
The ca:boKyhClllO&lobin SltIil'Mion in the blood was ICIlI !han I" IS c1c\Crmincd by
'pcdrophotomclry wim I limit of qulllililion of 1%.

There wu no cyanide cktected in the blood, The limit ofquaniwion for cylnKle is 0.25·mUliarams
per Ilter.

ApDITIONAL PROCEpV8!:j$
I. Documtntary photopplu; Ire liken b)(b)[6)
OAFME IIIfI'photoppbcr.
2. Penonal dfocts an relcued 10 the sppropri.te mortllBl')' DpeTlllons ~~nlltive:s.
3. Specimens mainod (or IOKicolol)' testing lIllVor DNA Idcndfication Ire: yjll'COllJ fluid,
blood, bile, p.stric contents, heart, spleen, liver, tung, kidney, myocardium,ldipo,c: tissue
anclskclctal mlllCle.

MEOCOM t 126

ACLU Detainee DeathII ARMY MEDCOM 1126

AUTOPSY REPORT~b){6)
BTB Ibrahim. Ahmad Awwad

Plle60fll

4. The dissected orpns arc fo~ with body except for the heart and bnlin.
S. The beart is sent for Cardiovascular Pathology wnsuJwlon.
6. The brain is sent for Neuropalhology oonsultation.

FINAL AlITQPSY DIAGNOSES
I.

C.rdiovurulllr SysleM (1ft Addendum B)
A. Lymphocyti<: Myocarditis
B. Right ventricular dilatlltion, mild

II.

N.ta....1 dlnues OJ" pre..ubll'l ~ndlllollS Identlned:
A. Pulmonary congesllon, edema, and ~hesions
B. Hcpatosplenomegaly

C.
III.

C~bfaI

edema

Evidenee otMcdic'll The... py:
A.
B.
C.
O.

EKG patch on left lower q1Wlranl of the abdomen
Multiple lhmpeulic needle sticks
Interosseous catheter in !he right IlIterior lq
8wn abruions on the chest from the defibrillator pads

IV.

Posl-MorleM Ch'lIla:
A. Rigor is abxnt in all exlmttlties
B. Lividity is posterior and fixed CJl.a:pl in IIleIS nposed 10 pressure
C. There is marblinl of the torso and both 1_l:lI.ttemities
O. The body tempenllun: Is cold to touch

v.

IdellUf'yia1 Body M.rb:
A. Tattod{b)(6)

VI.

Tilen It 110 evidence oU.... um. OJ" phYJlealabllte.

VII.

ToJi~Io&Y:

A.
B.
C.
D.

J

No etlwJolwas defected in lite blood and vi~ fluid
Lidocaine is detected in the blood
No carbon monoxide WII.S dctected in the blood
No cyanide wu detected in the blood

MEDCOM 1127

ACLU Detainee DeathII ARMY MEDCOM 1127

AUTOPSY REPOR1(b)(6)

Plie70fll

BTS Ibnhim, Ahmad AWWId
opiNION

i

Thh 21-~1d. 8TB b)(6)
died orlymphoeytie myoanlilis. Per
InYe$\ipdOl\(b}(6)
was found by othcrdetaine:es eompllining ofshortness of breath
and elulChlng his chest. While the other detainees were bri~inlz him 10 the 2IWd he lost
conscloIIsncss. Medic:al pmonne:l _
dispatched JIll! 1OO~(b){6)
to the medieal
facUlty whm= resuscitative: elTON were ~M. At autopsy, he had extensive: adhcslons
around both hillunp as well as on the righlllpper lobe: of the liver. His hclll1 showed mild richl
ventriculardi1aWion with histological evidcnc:coflympbocytic myocarditis. Thc~ is no evidence
oftrawna or foul play. A review ofthc Limited medical re«lrds available wu non-eonlributory.
TIle lOXicoiop saecn for ethanol, «rbon monoxide, eyanide. and illicit drup ohbux are
Ilt&ative. The toxicological screen for medications was positive for lidocaine: which if~ than
likely from musc:itative elTons.
Myocarditis is defined as infWrunalory changes in the heart muscle and is eharacterized by
myoc)'lc (individual tart muscle cells) nec:rosilI {death}. The causes ofmyocardilis are nllTl\CTOllI
and CID be rouahIy divided into illfeetious, loxic, Md immunologic etiologies. with viral etiologiC!
most common. Couackicvtrus B is the most common viral elllSC ofmyoearditis but other viruses
implicated in tall!ling myocditis include in!luenz.a vinas, ee.hovirus, herpes simplex virus,
hepatitb. Epslein-BarT virus, and e)'lOmeploviNS. Nonviral illfecliouselUle! Include diphtheria,
Chps discuc, Stn:ptoeoecal species. S.y1ocOCC'I species. Bartonella, 8nK:c11a, ~ira, and
SalrnclnellalpC'CJcs. Toxic myocarditis ~ be caused by mcdlcalions such .. penicillin,
doxotUbieill, zidovudine (AZT) or environmentaltoxbu such as I~, arsenic, and insect!linp
(sc:orpion Of spidm). lmmWlOlotic etiologies of myocwditis C1'ICOmpasll a number of clinical
syndromes JIll! include systemic lupwt crthcmatosll$, rheumatoid arthritis, sdetOdclu", Kawasaki
dixuc, !8I'COido!il., and giant cell ancritis.l l J. 'The decedent hi! no history or toxie exposure and
there is 110 eviden« of bacterial or s)'$ltmic dita!e. The hiltolOlieal ftnding in thia cue ora
lymphocytic infillnlc within the heart muscle is sugacslive ora viral c:a\IIC of his myocarditill.
The ll'WIna"ofdeath is NlIIunJ.
(b)(6)

(b}(6)

IMedical EumillC1"

'o.boonl.. C, Darin MI, 800lh sc, Io1ck_ W: OWIoctlo 8 ........ - ' !MIn-.

hflttWlOlI,,7;22J:Jl·'2.

.

.

Medical Examlncr(b}(6)

'*'" d~. e-

rqo /.I/o.~ ~ ,

IFrIdrnu AIo1, McNllMnl D: lo1)'1l'Wdltl.. Ii u.,I J Uf<J 2110O: :H1: I111-139•.
'Wcins<e"'C, F....lIoJJ: Myocn~1t. H_ ,~1ftJI \917; 1I:'ll"tL
'''1_ 8J: Io1cdlul pI'OIJUJ: SucIrlen dnih I~ )'OU"I1lh1cla, Ii bill J UN 2OOJ; )(9:1064-101'.

MEDCOM 1126

ACLU Detainee DeathII ARMY MEDCOM 1128

AUTOPSY REPORT](b}(6} ~
BTB Ibrahim, Ahmad A_ad

Pegc 8 of II

ADDWDUM Ai Nnmp.lholou CopsP'tldoP Report

ARMED FORCES INSTITUTE OF PArnOLOGY
NEUROPAnJOLOGY_REPOR'L...,

CASENUMB~6)

I

PA11ENTNAME~(b}(6}

DAlE OF EXAMINATION: 02119109
GROSS DESCRIPTION:
Brain weight: 14368m

The specimen consista of the brain ofan adult.
The brain ill diffusely swollen with widened &)'ri. narrowed sulci, effaced basilar

cisterns, swOllen cerebellar tonsils and an effaced cerebellomedtilllU')' cistern. Modmlely
deep tentorial grooves indent each uncus approximately 0.6 cm from the medial margins.
There is no associated visible unca'I cortical or cerebellar tonsil cortical injury.
The leptomeninges are thin. delicate and transparenl Except as noted, the cerebral
gyri have nonnal configuration and consiSlency.
There is no sign of midline shift. Except as noted. the external aspects ofthe
bJainslem and cerebellum are not remukable. The arteries at the base of the brain follow
a normal distribution and are free of atherosclerosis. There,are no aneurysmal dilatati.ons
or sites ofocclusion. The Identifiable cranial nerve roots arc not remarkable.
Coronal sections of the certbrum revea1 dissolution of the septum pellucidum due
to edema and early autolysis. The demarcation ~ cerebral gray and white matte! is
blurred due to swelling and edema. There are no focal lesions in the cortex, white matter
or deep nuclear structures. There is DO midline shift. Sections oCme midbrain. pons.
medulla and cerebellwn show no focal abnormalities. The substantia niJra and locus
COeIU1eus are well pigmented.
The ventricular system and aqueduct of Sylvius are patenl. The third ventricle is
compressed due to brain S\W:1ling. The ventricular system is otherwise unremarkable with
an anatomically normal configuration. The choroid plexus is wuemarkable and the
epmdymaJ surfaces are smooth and glistening.

MEDCOM 1129

ACLU Detainee DeathII ARMY MEDCOM 1129

AUTOPSY R£I'ORT (b){6)

]

Plge90fll

BTBltKahim, Ahm..t A-.d

PHOTOGRAPHS: Yes
MICROSCOPIC BXAMINAnON:
Blocks oftissue for microscopic examination are removed from: (l) right frontal lobe, (2)
anterior corpus callosumlcingul.te gyri/septum. pellucidum, (3) right mid frontallobc, (4)
left UIlCUJ, (S) left. insulalclausuwnlputamewBlobus pal1iduslantcrior limb of inltmlll
capsule, (6) left th..hunu.Vsubs!anti. nigra/red nucleus/posterior limb ofintcmal capsule,
(7) right hippocampus/!.teral. gcoicul.te nuc:leusltemporal hom ofJ.teraJ ventridcl
choroid plexus. (B) mid corpu.s caIlO$umIeingul.1C gyriIcaudate nuclcusflDtemal ClpSt1Ie,
(9) right calearine cortex/occipital hom ofJateral ventricle, (10) cerebellum, (II)
midbrain. (12) pons and (13) mtdt1lla.
Sections from each block are stained with HolE and LFBIBodian t«.hniques and
immun05taincd foe ~yloid pm:ursor protein (P.APP).

COMMENT:
Microscopic sections show diffuse edema Ind widespread eosinophilic neurons (acute
isc:bemic neuronal injury) in the froDtal, dnguhuc gym, hippocampal (subiculum),
occipital,lnd basal ga.ogIia gray matter.

There is no evidence of inflllIIl1I1.llion or trauma.
(b)(6)

NEUROPAlHOLOOIST

MEDCOM 1130

ACLU Detainee DeathII ARMY MEDCOM 1130

AlITOPSY REPORl{~)(6)

~

Pace: 10 or II

BTB Ibrahim, Ahmad Awwad
ADDENDUM Hj Cardloyueullr lithology ComultltiO!! Report
OEPARTMENTOF DEFENSE
ARMED FlMtCU INlJTTTUT1! OF PAntOLOGy

WAllINGTON, DC _ _

Am Interdepartmental CODSllltal:lon Report
SEOVeiCE NO.

F.'No

l{b)(6lj

~)(6)

J

AFIP:(b}(6)

14131t.esearcb Blvd.
Bldg. 102
Rocmlle, MD 208S0
DlAGNOSIS:,(b)(6)
!Heaort.autoPJY:
-Lymphocytic myoeardlds
-MUd rtlbt venrr:lellilu dUatal:lop
History: 21 ycarold Iraqi male; height 18S em, weight 80 Ir.g; awoke with shortness of breath,
coll.pscd, and oouId not be resuscitated; autopsy showed plcunll adhesions
Heart: 460 8 (per conbibutor) (predicted oonnal value 341 g, upper limit 481 g for 184 cm
JllIle); closed forJ,mcn ov.le; mild right ventricular dil.tatlon; left ventriculI! cavity dilIIlelcr 27
mm,left. ventricular free waUlbickneu 13 min, anlerior ventJ'ieuJ.r septum thickness 12 mm,
posterior ventricular septum thickDeas 17 mm, right venbiculM Clvity diameter from acute angle
to septum 43 mm, pos[crior right ventricle thickness 4 mm; valves grossly UIll'emarbble; aortic
root diameter 17 mm, pulmonlf)' tnl1lk dilJTletcr IS mm; focal IlIterior and I.tcrallcfl VCJltricullr
white discoloration; histologic sections demonstrate lymphocytic infiltntcs primarily involving
the subepicardial region ofthe left vcnbiclc with patchy infiltratca in the subendocardialllld mid
myocardial regions and in the righl ventricle with associated myocyte necrosis and belling areas
with granulalioD tissue aod fibrosi.
Coronary arteries: Normal ostia; right domioaocc; DO gross albCfOlClerosis

MEDCOM 1131

ACLU Detainee DeathII ARMY MEDCOM 1131

AUTOPSY REPORT(b)(6}

Page II of II

BTB Ibrahim, Ahmad Awwad
ElP..ACCESSION~O--.SEOUENCE_N°·l
(b}(6)

SSN:

blt6}
(b}(6)

February 17, 2009

'"

7'

li\

!!l

Lymphocytic myocarditis ill the left ventricle (left) with myocyte necrosis (rigbl)

A copy of this report his been faxed to you

al~
(b){6)

Department ofCardiovascular Patbo""-Iogy=-----'

MEDCOM 1132

ACLU Detainee DeathII ARMY MEDCOM 1132