4.Janice Ross — Direct/Cross/Redirect/Recross
592 linesDR. JANICE ROSS, being first duly sworn, testified as follows:
COURT CLERK: Once you're seated, state your full name spelling your last.
JANICE ROSS: Janice Edwards Ross, R-O-S-S.
DIRECT EXAMINATION By Mr. Hubbard:
RICK HUBBARD: Dr. Ross, where are you currently working?
JANICE ROSS: I'm currently in Charleston, South Carolina doing autopsies for the coroner there. Before that I was in Newberry, South Carolina. I'm CEO of Newberry Pathology Associates and was in Newberry until November of last year.
RICK HUBBARD: How many years were you at Newberry?
JANICE ROSS: Eighteen or nineteen.
RICK HUBBARD: Nineteen?
JANICE ROSS: Eighteen, I'm sorry, came in 2000.
RICK HUBBARD: And you mentioned you do autopsies. What is -- what is your job?
JANICE ROSS: I'm a forensic pathologist, which means I've been through four years of college, four years of medical school and at least five years of training in pathology. That field, unlike surgery or pediatrics, we learn how to identify and diagnose diseases by using the microscope and the laboratory in the hospital. We also learn how to do an autopsy. I'm also further trained in forensic pathology, which means I'm trained to identify patterns of injury, document those patterns for the court of law, draw fluids for toxicology and formulate a cause and manner of death.
RICK HUBBARD: When you say manner of death, what types of, what are choices of manner of death?
JANICE ROSS: First of all, the cause of death is just that. What caused the death. The manner of death is how that cause came about, whether it was a natural disease, whether it was accidental, suicidal, homicidal. And sometimes we can't determine, so we say undetermined.
RICK HUBBARD: Doctor, how many autopsies have you performed?
JANICE ROSS: Over 14,000.
RICK HUBBARD: How many times have you had an opportunity to testify as an expert in forensic pathology in a court of law?
JANICE ROSS: Over 200 times.
RICK HUBBARD: Your Honor, at this time I offer Dr. Ross as an expert in forensic pathology.
BOYD YOUNG: No objection.
THE COURT: No objection. And what it means, again, is Dr. Ross is qualified as an expert in the field of forensic pathology and can offer opinions within that realm of field of expertise.
RICK HUBBARD: Dr. Ross, September 11th, 2014 were you asked to perform autopsies on five children, the Jones' children?
JANICE ROSS: Yes, I was.
RICK HUBBARD: Now, initially when you got them, had they been identified as who was who?
JANICE ROSS: Initially they were just labeled J Doe one, two, three, four and five.
RICK HUBBARD: And that was the way they had been found and marked from the scene, bag one, bag two, bag three, four and five?
JANICE ROSS: Correct.
RICK HUBBARD: And you've since found out their identities and you've included that in your reports?
JANICE ROSS: Yes, I have.
RICK HUBBARD: Looking at the first autopsy you did. Initially John Doe number one, Elias Jones?
JANICE ROSS: Yes.
RICK HUBBARD: Can you tell us what you did in your -- do you do an external examination and then do an internal one?
JANICE ROSS: Yes.
RICK HUBBARD: Can you tell us how you received the body of Elias Jones and what you did?
JANICE ROSS: Yes. This patient was in two black body bags that were zip tied with a yellow tag. But the bags themselves had been torn, consistent with animal eating. And so, we opened the bags and saved those for SLED.
RICK HUBBARD: Then examining Elias' body, how tall was he?
JANICE ROSS: He measured 45 inches in height.
RICK HUBBARD: What else did you note in your external examination?
JANICE ROSS: He was clothed in a short-sleeved shirt which had Saxe Gotha Elementary logo on it, a pair of size medium shorts and a pair of Forte white underwear. And he had a lot of decomposition changes, including skin discoloration, the skin gets darker; skin slippage, the surface of the skin starts sloughing off. Some tissue loss, and that could be from animal eating. Some maggot activity, so indicating that flies were able to get to the patient and lay eggs. Then generally there was significant decomposition changes.
RICK HUBBARD: Dr. Ross, about decomposition. If any human body is placed -- a deceased person is placed in a black bag and left out to the elements on hot sunny days for several days, does that expedite that decomposition or does it slow it down, or does it have any effect?
JANICE ROSS: Yes. Temperature is a tremendous influence on decomposition. If you're in the sun, especially in a black bag if it's a sunny day and a hot day, it's going to speed up the process.
RICK HUBBARD: So the condition of the body when originally put in the bag may not be exactly what it was when you see it without a bag?
JANICE ROSS: Correct.
RICK HUBBARD: Now, as far as -- let me ask you this. I'm going to show you State's ID 172. Can you identify this?
JANICE ROSS: Yes. This is a rough sketch, diagram of the patient with my writing to indicate notes of what I'm going to dictate on the case.
RICK HUBBARD: I'd offer this into evidence.
BOYD YOUNG: Without objection.
THE COURT: State's 172?
RICK HUBBARD: Yes, sir.
THE COURT: Without objection?
BOYD YOUNG: Yes, sir.
THE COURT: 172's in. (Whereupon, State's Exhibit number 172 was admitted into evidence.)
RICK HUBBARD: Looking at 172, the diagram, is that a preexisting diagram you use in multiple cases?
JANICE ROSS: Yes.
RICK HUBBARD: And what's the purpose of your notes that you see there?
JANICE ROSS: Just to give me an idea of what to dictate and where certain features were present. For instance, I put down there is light brown hair. The eye color could not be told. The teeth are natural.
RICK HUBBARD: Is that describing right here up at the top on 172?
JANICE ROSS: Yes. And then --
RICK HUBBARD: What is this portion right here, Doctor?
JANICE ROSS: That's an area -- I'm sorry.
RICK HUBBARD: I'm sorry.
JANICE ROSS: An area where there was tissue loss.
RICK HUBBARD: His hand right here. There's a note you have right there?
JANICE ROSS: I'm sure you can't read my writing. Skeletonization. That means that the soft tissue was eaten off the bones, exposing the bones of the hand and wrist.
RICK HUBBARD: Then you have some other notes down here at the bottom of the diagram.
JANICE ROSS: That's generally what I found as far as decomposition goes. Skin discoloration, skin slippage, tissue loss, maggots and malodor.
RICK HUBBARD: Malodor meaning it smelled?
JANICE ROSS: Yes.
RICK HUBBARD: Doing an internal examination what, if anything, did you find?
JANICE ROSS: Well, the internal organs were decomposed -- decomposing also, but you could identify if there's any like congenital heart disease or tumors, which there were not. There was no natural disease. But in the neck we found a fracture of the hyoid bone. The hyoid bone sits above the larynx, the voice box, and it's kind of free floating. It's held -- held on with muscles and tendons. And that's one are where -- one bone where we can see a fracture and is evidence of strangulation. In these kind of cases where there's decomposition we x-ray the whole body. The hyoid bone is so small you can't see it in a major skeletal survey. But we did not see any other fractures, but we did find, in holding it and looking at it directly, a fracture of that bone.
RICK HUBBARD: You made a note that you're looking for also just like congenital defects or other issues that Elias Jones might have had. Did you find any other physical issues with him that might show he was anything other than a healthy boy?
JANICE ROSS: No, I did not.
RICK HUBBARD: So is it your opinion, based on a reasonable degree of medical certainty that prior to his death he was a healthy young boy?
JANICE ROSS: Correct.
RICK HUBBARD: His stomach. Were there any contents in his stomach?
JANICE ROSS: No.
RICK HUBBARD: Did you, with a reasonable degree of medical certainty, determine the cause of death for Elias Jones?
JANICE ROSS: Yes.
RICK HUBBARD: What was that?
JANICE ROSS: That was asphyxia due to strangulation.
RICK HUBBARD: Asphyxia is what, Doctor?
JANICE ROSS: Is lack of oxygen. So it will decrease the blood flow to the brain and cause a lack of oxygenation to the brain.
RICK HUBBARD: Brought on by strangulation?
JANICE ROSS: Yes.
RICK HUBBARD: We talked about the manner of death where you had undetermined accident, natural cause, suicide and homicide, what did you classify this manner of death?
JANICE ROSS: A homicide.
RICK HUBBARD: How about you turn to Merah Jones, Jane Doe number two. Did you do any external on her and report how she was presented to you?
JANICE ROSS: Yes. She was received also in -- well, within four plastic bags, which had yellow ties on them. And those bags were also torn. She was inside a sleeping bag, but she, her body was not clothed.
RICK HUBBARD: She was nude?
JANICE ROSS: Correct.
RICK HUBBARD: You say the bags were torn. Did it look like maybe one of the investigators tore it, or how did it look to you?
JANICE ROSS: It was irregular like animal chewing.
RICK HUBBARD: Looking at her body as it was presented to you, was it consistent with animal activity?
JANICE ROSS: Yes. There was some tissue loss and, again, some maggot activity indicating that the fact that flies could get inside.
RICK HUBBARD: I'm going to show you what's been marked State's 173 for ID and see if you recognize this chart?
JANICE ROSS: Yes. It's a diagram of this -- Merah Jones at the time of autopsy.
RICK HUBBARD: I offer this into evidence, Your Honor, as 173.
BOYD YOUNG: Same as --
RICK HUBBARD: Same diagram.
BOYD YOUNG: No objection.
THE COURT: 173 without objection, a sketch of the autopsy.
RICK HUBBARD: Thank you, Your Honor. (Whereupon, State's Exhibit number 173 was admitted into evidence.)
RICK HUBBARD: Doctor, can you see your sketch on the board, 173?
JANICE ROSS: Yes.
RICK HUBBARD: And again, looking at it. Looking at the front of the face you have a notation on the face. What is that?
JANICE ROSS: That's tissue loss, which --
RICK HUBBARD: And you have notes on the side of that as well. What are those?
JANICE ROSS: She had long brown hair and natural teeth.
RICK HUBBARD: Do you see there's a note right in the middle here. What is that?
JANICE ROSS: That's tissue loss over the sternum.
RICK HUBBARD: The sternum is the area you have marked in the middle of the chest?
JANICE ROSS: Yes.
RICK HUBBARD: Now, looking at, I guess, what would be the left hand, what notations did you make as to the left hand and arm?
JANICE ROSS: The left hand is absent. There's some tissue loss on the left forearm, and in the -- there's tissue loss in the right forearm, lower forearm and the hand.
RICK HUBBARD: The tissue loss on the right hand and arm, tissue loss on the left arm, and then the left hand, the left hand is missing?
JANICE ROSS: Correct.
RICK HUBBARD: And what do we see in your notations down on the legs?
JANICE ROSS: There's tissue loss just above the right knee.
RICK HUBBARD: And what is this?
JANICE ROSS: That's decomp.
RICK HUBBARD: And again, if Merah Jones were placed in a black bag, or any human being, three black bags I think you -- you said four?
JANICE ROSS: Four, yes.
RICK HUBBARD: Four. For several days in the hot sun, would that have increased the level of decomposition?
JANICE ROSS: Yes.
RICK HUBBARD: And in this case there's also animal activity?
JANICE ROSS: Correct.
RICK HUBBARD: On the internal examination, was her stomach full or not?
JANICE ROSS: It was empty.
RICK HUBBARD: As far as the -- I think that is -- I may mispronounce it. Musculoskeletal system?
JANICE ROSS: Yes.
RICK HUBBARD: What finding did you have there?
JANICE ROSS: There was what looked like a blood clot on the surface of the sternum which, because of decomposition, was difficult to identify if there was any pattern or not, so it may or may not represent some kind of blunt force injury there.
RICK HUBBARD: Doctor, on a small child, in a case if you had a strangulation, have you ever seen trauma to the sternum area, even the clavicle area during strangulation?
JANICE ROSS: Well, small children are elastic more than I am, and to cause asphyxiation on a child or a small person it could be pressure around the neck or it can be enough pressure on the chest to hold the person down and not allow breathing to take place so the chest cannot expand. And that can cause asphyxia.
RICK HUBBARD: Did you find any broken bones in the neck?
JANICE ROSS: No.
RICK HUBBARD: Now, Doctor, can you have a case of strangulation where there is no broken neck bones?
JANICE ROSS: Yes.
RICK HUBBARD: And in a case where you had advanced decomposition will you always be able to find physical signs of strangulation?
JANICE ROSS: No, I couldn't -- would not.
RICK HUBBARD: But you can't rule it out?
JANICE ROSS: Correct.
RICK HUBBARD: Doctor, let me ask you. I didn't ask you with Elias Jones. When someone is strangled how long does it take?
JANICE ROSS: Strangulation causes lack of blood supply getting to the brain, and also interferes with brain -- with blood draining from the brain. So there's a lot of pressure on the brain, and that causes unconsciousness within seconds. About eight seconds. We witness this directly in films, so we know that for a fact. But you have to maintain that pressure for three to five minutes to cause total brain death.
RICK HUBBARD: Doctor, if somebody passes out in a matter of eight seconds, if you release that pressure, is it possible for that person to revive?
JANICE ROSS: Yes. Within a certain amount of time, yes.
RICK HUBBARD: So in order to kill a person, a child, is it your testimony that somebody has to maintain that pressure for three to five minutes?
JANICE ROSS: Correct.
RICK HUBBARD: Were there any -- well, let me ask you this. To a reasonable degree of medical certainty did you reach a conclusion as to the cause of Merah Jones' death?
JANICE ROSS: Yes.
RICK HUBBARD: What was that?
JANICE ROSS: Some homicidal violence. It was a homicide in some -- by way of some type of violence.
RICK HUBBARD: So violence that brought about a homicide?
JANICE ROSS: Correct.
RICK HUBBARD: The manner of death, what did you conclude?
JANICE ROSS: Homicide.
RICK HUBBARD: Now I want to talk to you about John Doe number three which is Gabriel Jones. Again, can we go through how did he present to you? When he was brought, how was he presented?
JANICE ROSS: He was in three black plastic bags which were open, and I was told they were open at the scene. The bags themselves were not torn.
RICK HUBBARD: So no animal activity?
JANICE ROSS: Correct. He was wrapped in a comforter and a pink sheet. He had on a pair of underwear, which I couldn't see the size on. But loosely in the bag also were an adult sized shirt with partial bleaching appearance. There was also a pair of child's female type underwear with purple trim and a Hello Kitty pink diary. The underwear had purple trim, and there was also a diary or journal that was from Hello Kitty. He was 36 inches in height. He also had -- there was also a wet diaper in the bag, but not on him.
RICK HUBBARD: So this bag had not only Gabriel Jones, but other items were placed in the bag?
JANICE ROSS: Correct.
RICK HUBBARD: The, like girl's underwear and a diary, among other things?
JANICE ROSS: Yes.
RICK HUBBARD: How did he present to you? How did he look on your external examination?
JANICE ROSS: He had decomposition changes. Skin discoloration, slippage. There was no maggot activity. And also, again, because of the decomposition, we did full body x-rays and found no fractures. But on the right side of the neck were -- was an impression that was kind of why, included two parallel lines on it, on the side of the neck.
RICK HUBBARD: I'm going to show you what's been marked State's ID 174 and see if you can identify this diagram.
JANICE ROSS: Yes. That's the diagram I made at the time of autopsy.
RICK HUBBARD: And this is on Gabriel Jones?
JANICE ROSS: Correct.
BOYD YOUNG: No objection.
THE COURT: Without objection. (Whereupon, State's Exhibit number 174 was admitted into evidence.)
RICK HUBBARD: Looking at State's 174, Gabriel Jones. Now, you mentioned something about the neck. What was that?
JANICE ROSS: It was hard to show on the diagram. It was mostly on the right side of the neck underneath the ear and underneath the mandible. The jaw bone. There were two -- two parallel lines there.
RICK HUBBARD: What is that indicative of or consistent with?
JANICE ROSS: It was an impression that could be a type of ligature. Something that was a little bit wide, like a belt or a sash or something.
RICK HUBBARD: I want to show you what's already been placed into evidence. State's 168, a black belt. Would a belt like this be consistent with the ligature marks you see on Gabriel Jones' neck?
JANICE ROSS: Yes, something like that would be consistent.
RICK HUBBARD: And, Doctor, describing the ligature marks, how -- do the lines run together, or how did those lines run?
JANICE ROSS: They were parallel for some distance and then they came together underneath the chin, and then they disappeared.
RICK HUBBARD: This was on the right side?
JANICE ROSS: Correct.
RICK HUBBARD: So did they cross one another?
JANICE ROSS: No.
RICK HUBBARD: Did they run parallel?
JANICE ROSS: Parallel.
RICK HUBBARD: Doctor, if you look at your report, I think you said they weren't parallel.
JANICE ROSS: Oh, they--
RICK HUBBARD: -- on the external examination. I know it's been a long time.
JANICE ROSS: Yeah. They, okay, I'm sorry. Yeah. They do -- they come close and cross underneath the chin, and then widen out. So it came to like a V.
RICK HUBBARD: Which would be consistent with cinching?
JANICE ROSS: Yes.
RICK HUBBARD: Now, as to the lower extremities, do you see anything in your report or did you note anything in your report about how he presented as far as his -- particularly his right leg?
JANICE ROSS: Yes. The right leg was disarticulated at the knee, which means the knee joint was cut into and separated, so that the right calf and foot were separate from the right upper right thigh.
RICK HUBBARD: When you say that, would -- could this be describing the leg going back up towards the body? Up to the torso, where the foot instead of down next to the other foot as you see in the diagram, would it have been facing up towards the face?
JANICE ROSS: Well, when we opened the bag, yes, the patient was face down and you could see the foot coming up underneath his arm basically. So it was not aligned correctly. But the incision in the soft tissue was consistent with a sharp instrument.
RICK HUBBARD: Was his stomach full or not full?
JANICE ROSS: It was empty.
RICK HUBBARD: With a reasonable degree of medical certainty, did you determine a cause of death for Gabriel Jones?
JANICE ROSS: Probable strangulation.
RICK HUBBARD: Homicidal violence with probable strangulation?
JANICE ROSS: Yes.
RICK HUBBARD: Okay. More than likely strangulation?
JANICE ROSS: Strangulation, yes.
RICK HUBBARD: And manner of death?
JANICE ROSS: Homicide.
RICK HUBBARD: And move on to Jane Doe number four, Abigail Jones.
JANICE ROSS: Yes. She was received in two plastic bags which were open at the scene and were not torn. There were two sheets around the body which were blue and with multicolored patterns. There was a piece of paper in there from Kangaroo Express.
RICK HUBBARD: Is that like a receipt?
JANICE ROSS: Yes. It's difficult to read because of the fluid on it. And she was wearing a diaper. She was 30 inches in height.
RICK HUBBARD: I'll show you what's been marked State's 175 for ID. It's another diagram. Do you recognize this?
JANICE ROSS: Yes. That's the diagram from the autopsy, Jane Doe number four.
RICK HUBBARD: I offer this into evidence.
BOYD YOUNG: No objection.
THE COURT: 175 is in evidence with no objection. (Whereupon, State's Exhibit number 175 was admitted into evidence.)
RICK HUBBARD: Dr. Ross, looking at this diagram, 175, of Abigail Jones what, if any, findings do you have or notations did you make on your diagram?
JANICE ROSS: That she had long brown hair. There's a question mark on eyes. In other words, you couldn't see what eye color it was because of the cloudiness. The teeth were natural. And otherwise don't -- on the bottom, generally the decomposition changes, including skin discoloration, skin slippage and malodor. No maggots.
RICK HUBBARD: How tall was she?
JANICE ROSS: Thirty inches.
RICK HUBBARD: Did you do an internal examination as well?
JANICE ROSS: Yes.
RICK HUBBARD: How was her hyoid bone?
JANICE ROSS: It was intact.
RICK HUBBARD: The rest of her organs to the extent that you could tell?
JANICE ROSS: No evident natural disease.
RICK HUBBARD: Her GI tract, stomach?
JANICE ROSS: Her stomach was empty.
RICK HUBBARD: To a reasonable degree of medical certainty did you determine a cause of death?
JANICE ROSS: Yes.
RICK HUBBARD: What was that?
JANICE ROSS: Homicidal by violence.
RICK HUBBARD: And manner of death?
JANICE ROSS: Homicide.
RICK HUBBARD: I'm going to ask you about Abigail Jones. Again, you note the decomposition. Do you see any outward signs of strangulation?
JANICE ROSS: No.
RICK HUBBARD: But you can't rule that out?
JANICE ROSS: Correct.
RICK HUBBARD: And is that why your cause of death is homicidal violence?
JANICE ROSS: Yes.
RICK HUBBARD: Just as it was for Merah Jones?
JANICE ROSS: Correct.
RICK HUBBARD: Now I want you to look at John Doe number five.
JANICE ROSS: Yes.
RICK HUBBARD: Which is Nahtahn Jones. How did he present to you?
JANICE ROSS: He was in -- wrapped in two black plastic bags that were open at the seam but they were not torn. He was covered with a comforter which had a design of Ninja Turtles. He was 43 inches in height.
RICK HUBBARD: Did you determine his hair and eye color?
JANICE ROSS: Yes. He had brown hair. Could not tell what color the eyes were.
RICK HUBBARD: Doctor, decomposition, is it safe to say the eyes sometimes decompose more quickly than other parts of the body?
JANICE ROSS: Well, in decomposition it dehydrates and the fluid in your eyes evaporates basically and the eyes collapse and the -- the cornea, the outside of the eye, becomes cloudy. So it's difficult to identify color.
RICK HUBBARD: And looking at him externally, did you see any other -- make any other findings?
JANICE ROSS: He had some tissue loss also on his left lower thigh area right above the knee and exposing the bone there, and in the bone it looked like a -- what we call an incised wound. A wound made by a sharp instrument consistent with a saw.
RICK HUBBARD: I'll show you what's been marked State's ID 176. Is this the diagram you used with Nahtahn Jones?
JANICE ROSS: Yes.
RICK HUBBARD: I offer this into evidence.
BOYD YOUNG: No objection.
THE COURT: No objection. (Whereupon, State's Exhibit number 176 was admitted into evidence.)
RICK HUBBARD: Doctor, in looking at this diagram, the notations you have around the head area, what -- what do those say?
JANICE ROSS: Brown hair and natural teeth.
RICK HUBBARD: And then looking at -- it looks like his left elbow. What is that--
JANICE ROSS: -- yeah. The back of the left elbow there was some tissue loss there. I couldn't tell from what.
RICK HUBBARD: Could you tell whether it was before he died or after he died?
JANICE ROSS: No.
RICK HUBBARD: Did you make that notation?
JANICE ROSS: Correct.
RICK HUBBARD: The knee. What did you see with the knee?
JANICE ROSS: There's some tissue loss there exposing the underlying bone. Thigh bone. The lower part of it, which showed that incised wound as I described.
RICK HUBBARD: That a sharp instrument had been used?
JANICE ROSS: Yes.
RICK HUBBARD: The notes you have over on the other side of the diagram, what does that say?
JANICE ROSS: That's the, it says, that refers to the wound in the left femur. Incised wound, left femur.
RICK HUBBARD: Doctor, when you do autopsies do you also take photographs?
JANICE ROSS: Yes.
RICK HUBBARD: And document what you're doing?
JANICE ROSS: Yes.
RICK HUBBARD: To document your findings?
JANICE ROSS: Yes.
RICK HUBBARD: I'd like to show you just one photograph. Doctor, State's 177 for ID. What is this?
JANICE ROSS: That's the left knee. It's number five, Nahtahn Jones.
RICK HUBBARD: Nahtahn?
JANICE ROSS: Nahtahn Jones, yes.
RICK HUBBARD: And does this show where the sharp object cut?
JANICE ROSS: Yes.
RICK HUBBARD: Your Honor, I offer this into evidence.
BOYD YOUNG: Subject to previous objections.
THE COURT: Subject to the objection, 177 will be admitted. (Whereupon, State's Exhibit number 177 was admitted into evidence.)
RICK HUBBARD: Your Honor, if I may ask Dr. Ross to step down --
THE COURT: You may.
RICK HUBBARD: -- so I can have you assist me publish this State's 177. (Whereupon, the witness stepped down from the witness stand.)
RICK HUBBARD: Doctor, if we can, if we can work on this half of the jury and then we will walk down to the second half so they can see.
JANICE ROSS: Yes.
RICK HUBBARD: Looking at State's 177, what are we looking at?
JANICE ROSS: Okay. First of all, when I take the photograph at the time of autopsy, I put the number such that the head is above that number. So this indicates, this is the left knee. This is the knee joint itself. This is the exposed thigh bone femor. And right here, this dark area, is just a wound on the surface.
RICK HUBBARD: Is that -- where is the cutting or tool marks you saw?
JANICE ROSS: Right there. (Witness indicated.)
RICK HUBBARD: That dark area?
JANICE ROSS: Yes.
RICK HUBBARD: If we can step down here.
JANICE ROSS: So the number shows the head this way, the foot is this way, the knee joint is right here, this is end, end of the femur.
RICK HUBBARD: Thank you, Doctor. (Whereupon, the witness returned to the witness stand.)
RICK HUBBARD: Doctor, as to Nahtahn Jones, to the extent that you are able, did you determine whether he had any preexisting physical defects or if he was an otherwise healthy six-year-old boy?
JANICE ROSS: He had no evident natural disease.
RICK HUBBARD: So he was an otherwise healthy six-year-old boy?
JANICE ROSS: Yes.
RICK HUBBARD: And you also had the benefit of information from a pediatrician who had seen him?
JANICE ROSS: Yes. From -- records from 2012, I believe.
RICK HUBBARD: In review of that, would you say he was a healthy boy at that time as well?
JANICE ROSS: That was the indication, yes.
RICK HUBBARD: As to his stomach contents, did you find any contents in his stomach?
JANICE ROSS: Yes. He had about 50 CCs, about a cup full of brown food with -- the only thing I could identify maybe is some -- possibly a part of a red cherry.
RICK HUBBARD: Of all the children, he was the only one you found some food substance in the stomach?
JANICE ROSS: Correct.
RICK HUBBARD: Doctor, let me ask you a little bit more, and ask you about physical exertion. Is it possible to kill a young child by physical exertion?
JANICE ROSS: Yes. Children in particular will dehydrate faster than adults because they have a larger body surface than the body mass. So they lose fluid quicker than adults. So, you know, if you're working, exercise and whatever, physical activity for a lengthy period of time, then you can lose enough fluid to become dehydrated.
RICK HUBBARD: Would there be any physical signs to an observer that the child was in danger?
JANICE ROSS: They start to become weak and maybe disoriented and eventually become unconscious.
RICK HUBBARD: Does that happen quickly or is it over time?
JANICE ROSS: It depends on the situation and the history of the patient. But it would take, you know, several minutes. Many minutes, maybe 20, maybe 15, 20, hard to say.
RICK HUBBARD: When a child is just in dire straights?
JANICE ROSS: Yes.
RICK HUBBARD: Now, Doctor, as to Nahtahn, was his state of decomposition, did that impair your ability to determine whether strangulation was a possibility?
JANICE ROSS: Yes, it did.
RICK HUBBARD: Can you rule out strangulation?
JANICE ROSS: No.
RICK HUBBARD: And again, with strangulation, is it possible to strangle a human being, a child, and not break any bones?
JANICE ROSS: Correct, yes.
RICK HUBBARD: And in a case of all these children, the level of decomposition, that made that determination difficult by looking at the skin?
JANICE ROSS: Yes.
RICK HUBBARD: What was your, to a reasonable degree of medical certainty, cause of death for Nahtahn Jones?
JANICE ROSS: Again, homicidal violence.
RICK HUBBARD: So this was not a natural death?
JANICE ROSS: No.
RICK HUBBARD: Manner of death, how did you rate this?
JANICE ROSS: Homicide.
RICK HUBBARD: Doctor, there was testimony of muriatic acid being found in the car, an empty bottle. If that had been placed on a body, would you have been able to tell due to the level of composition?
JANICE ROSS: No. That's quite a weak acid, but still, whether burn skin or not, I wouldn't be able to tell.
RICK HUBBARD: So whether it was used or not, the level the decomposition by the time these children ended up in your presence you would not be able to determine it?
JANICE ROSS: No, I cannot.
RICK HUBBARD: As to Nahtahn Jones, cause of death, homicidal violence, is that the same as your findings for Abigail and Merah Jones as well?
JANICE ROSS: Yes.
RICK HUBBARD: And again, if there was any physical abuse, hitting, spanking, would decomposition make that hard to detect?
JANICE ROSS: Absolutely. I couldn't tell bruises.
RICK HUBBARD: And that's true for all these children?
JANICE ROSS: Yes.
RICK HUBBARD: It's true for Nahtahn Jones?
JANICE ROSS: Yes.
RICK HUBBARD: Your conclusion as to him is homicidal violence?
JANICE ROSS: Yes.
RICK HUBBARD: Doctor, I believe that's all I have at this time. Thank you.
CROSS-EXAMINATION By Mr. Young:
BOYD YOUNG: Good morning, Dr. Ross.
JANICE ROSS: Good morning.
BOYD YOUNG: Dr. Ross, were you able to determine or asked to determine time of death?
JANICE ROSS: No.
BOYD YOUNG: Were you told or was it relayed to you that the probable time of death was around August the 28th?
JANICE ROSS: Yes.
BOYD YOUNG: And was that consistent with the level of decomposition that you observed on September the 11th?
JANICE ROSS: There's no magic way of telling how long somebody's been dead by looking at decomposition because it's so related to the situation, the temperature. The temperature of the patient before they died, all kind of situations.
BOYD YOUNG: There was nothing inconsistent with what had been reported to you in your findings saying, well, no, it wasn't the 28th, it was the 6th.
JANICE ROSS: Correct, nothing inconsistent.
BOYD YOUNG: You knew that they had -- that it had been reported to you that the bodies of the children had been in a car during the summer driven around the Southeast for about nine days?
JANICE ROSS: Yes.
BOYD YOUNG: And that then they were placed in garbage bags and put out in the woods, right?
JANICE ROSS: Yes.
BOYD YOUNG: At the time of your autopsy you knew that Timothy Jones had reported that he had -- did not know how Nahtahn had died?
JANICE ROSS: Yes.
BOYD YOUNG: That he has exercised him and that he had died?
JANICE ROSS: Correct.
BOYD YOUNG: And your testimony today is that that's possible?
JANICE ROSS: Correct.
BOYD YOUNG: There's nothing inconsistent with what you found and what Tim says happened?
JANICE ROSS: Correct.
BOYD YOUNG: And as a matter of fact, the issue with Nahtahn having food in his digestive tract sort of indicates that he did die at some time before the other four children?
JANICE ROSS: Either then or with exercise or stress sometimes your GI tract, your intestinal tract will slow down and not process food. So it's either -- either he ate later than the other kids or his stress level was such that the stomach -- the food stayed in his stomach.
BOYD YOUNG: And none of the other children had anything in their stomach?
JANICE ROSS: That's correct.
BOYD YOUNG: And that could be because they were killed later?
JANICE ROSS: Could be, yeah.
BOYD YOUNG: You did full body x-rays of all of the children involved?
JANICE ROSS: Yes.
BOYD YOUNG: There were no old fractures, old breaks, old indications that they'd been abused or anything like that?
JANICE ROSS: No, there were not.
BOYD YOUNG: Dr. Ross, I'm going to show you what's been marked as Defendant's Exhibit No. 114 through 118 and ask you if you recognize those.
RICK HUBBARD: Your Honor, for clarification, I need to know if these are her documents or are these somebody else's.
JANICE ROSS: These are the forms -- in this State the coroner signs death certificates. This is a form from the autopsy where we put down what we think should be put. And I think the one on Nahtahn was later amended.
BOYD YOUNG: It was later amended. Is that your signature on these documents?
JANICE ROSS: Yes.
THE COURT: What are they again?
BOYD YOUNG: They're cause of death certificates.
BOYD YOUNG: Is that what these are?
JANICE ROSS: Yes.
BOYD YOUNG: Your Honor, at this time the Defense would offer 114 through 118 into evidence.
RICK HUBBARD: I would object to the one that was later admitted. I have no objection to the, the one that was amended. She said she amended it.
BOYD YOUNG: She can talk about how she amended it later. But this is the one she signed and this is the one that was turned over to us in discovery.
THE COURT: Okay. That is one--
BOYD YOUNG: -- this is the only ones I have. I haven't seen another one that was amended.
RICK HUBBARD: I object to it. If there's an amended one, I think the final one would be --
THE COURT: All right. Let's see if we can find the amended one also.
JANICE ROSS: I don't have -- I don't have a copy of it.
RICK HUBBARD: I tell you what, Your Honor. I'll speed it up. If he wants to put those in, that's fine. I'll just handle it on redirect.
THE COURT: Fair enough. So 114 admitted subject to the one on Nahtahn, whichever one that is, the witness had noted that she recollected it had been amended by her. And that's not a part of these yet. So these are in.
BOYD YOUNG: These are in.
RICK HUBBARD: Yes, sir. (Whereupon, Defendant's Exhibit numbers 114 through 118 were admitted into evidence.)
BOYD YOUNG: Dr. Ross, I have up here Defendant's number 114. Can you see it from there?
JANICE ROSS: Yes.
BOYD YOUNG: Okay. And that's Elias where you said immediate cause of death, asphyxiation, manual strangulation, right?
JANICE ROSS: Yes.
BOYD YOUNG: And that was because he had the broken hyoid and that was consistent with his report that he had strangled Elias, right?
JANICE ROSS: Yes.
BOYD YOUNG: On 115, this is the cause of death for Merah Jones?
JANICE ROSS: Yes.
BOYD YOUNG: In this one you listed possible strangulation, right, as the immediate cause of death?
JANICE ROSS: That should be -- that should be Gabriel.
BOYD YOUNG: Does it say Merah at the top of it?
JANICE ROSS: It does there, but --
BOYD YOUNG: Does it say white female?
JANICE ROSS: I don't have copies of those, but I think those were --
BOYD YOUNG: Well, can you see right here the autopsy number, FA14679?
JANICE ROSS: Correct. That's Merah. But that's -- I think these were all corrected afterwards.
BOYD YOUNG: So that's Merah, right?
JANICE ROSS: These were printed out at the time of autopsy, and then later reviewed and corrected.
BOYD YOUNG: And this is your signature right here, right?
JANICE ROSS: Yes.
BOYD YOUNG: So you signed it?
JANICE ROSS: Yes.
BOYD YOUNG: So it says possible strangulation?
JANICE ROSS: Yes.
BOYD YOUNG: And it has Merah's name?
JANICE ROSS: Yes.
BOYD YOUNG: And this FA14679, that's the number that was used for Merah's autopsy, correct?
JANICE ROSS: Right.
BOYD YOUNG: And at that time you said probably strangulation because it was -- you didn't have any injuries, right? You didn't have any other cause of death?
JANICE ROSS: That's correct.
BOYD YOUNG: Other than what Tim Jones reported to law enforcement that he had strangled them?
JANICE ROSS: Well, at that time I didn't know that, I don't think. I found out afterwards.
BOYD YOUNG: I thought earlier when I was asking you questions you knew that Tim had reported that he had exercised Nahtahn and said that he had fallen down and that he had strangled the other four children?
JANICE ROSS: I can't remember when I heard that.
BOYD YOUNG: So your testimony earlier may have been incorrect --
JANICE ROSS: Correct.
BOYD YOUNG: -- and you didn't know that at the time of the autopsy?
JANICE ROSS: I'm not sure if I did or not.
BOYD YOUNG: Defendant's Exhibit number 116, it says for Gabriel Jones, that his cause of death was probable strangulation, right?
JANICE ROSS: Correct.
BOYD YOUNG: Now, in Gabriel's case you testified that he had some marks on his neck and they were consistent with strangulation, right?
JANICE ROSS: Correct.
BOYD YOUNG: And you also may or may not have known that Tim had reported strangulation?
JANICE ROSS: Correct.
BOYD YOUNG: Defendant's Exhibit 117. This is Abigail Jones and you listed probable strangulation as the cause, correct?
JANICE ROSS: Yes.
BOYD YOUNG: And here again, you didn't have any evidence during the autopsy that it was strangulation other than what Tim Jones had reported to law enforcement, correct?
JANICE ROSS: Correct.
BOYD YOUNG: Now, on Defendant's Exhibit number 118, this is for Nahtahn?
JANICE ROSS: Yes.
BOYD YOUNG: And in this immediate cause you said could not be determined, correct?
JANICE ROSS: Yes. And that was changed to homicidal violence afterwards.
BOYD YOUNG: Changed by you, the coroner?
JANICE ROSS: Both of us.
BOYD YOUNG: And this is your signature on this document?
JANICE ROSS: Yes.
BOYD YOUNG: So at the time that you did the autopsy you said you can't determine it?
JANICE ROSS: Correct.
BOYD YOUNG: And you later changed it to homicidal violence?
JANICE ROSS: Correct.
BOYD YOUNG: I'm going to show you what's been marked as Defendant's Exhibits numbers 113 -- sorry. They're out of order. I'm going to show you what's been marked for ID as Defendant's Exhibit numbers 109 through 1 -- my apologies, 13, and ask you if you recognize those.
JANICE ROSS: Yes.
BOYD YOUNG: Are those pictures that you took during the course of your autopsy?
JANICE ROSS: Yes.
BOYD YOUNG: Is one of the picture's of Elias as he was at the time that you got him for autopsy?
JANICE ROSS: Correct.
BOYD YOUNG: Is one of the pictures of Merah Jones, and that is number 110, I think?
JANICE ROSS: Yes.
BOYD YOUNG: And number 109 is a picture of Merah Jones as she was at the time of the autopsy?
JANICE ROSS: Yes.
BOYD YOUNG: Number 111 is a picture of Gabriel Jones as he was at the time of the autopsy?
JANICE ROSS: 109 is Merah Jones, 679.
BOYD YOUNG: Can you just go through it and identify each one of those?
JANICE ROSS: Okay. 110 is case number 678 which is Elias Jones. Exhibit 109 is case number 679 which is Merah Jones. 112 is our case number 680, Gabriel Jones. 113 is our case number 681, Abigail Jones. And number 111 is 682, Nahtahn Jones.
BOYD YOUNG: Your Honor, at this time I'd offer Defendant's Exhibit numbers 109 through 114 into evidence.
THE COURT: Subject to the in-camera hearing, the Court is not going to allow introduction at this time.
BOYD YOUNG: Beg the Court's indulgence.
BOYD YOUNG: Doctor, I have just a couple more questions about -- and I'm referring back to the autopsy of Gabriel Jones, FA14680.
JANICE ROSS: Yes.
BOYD YOUNG: You had talked about his lower leg being disarticulated --
JANICE ROSS: Yes.
BOYD YOUNG: -- during your direct examination. Did you have -- you have your report in front of you?
JANICE ROSS: Yes.
BOYD YOUNG: At the time you wrote your report you said that both the knees were intact with no evidence of sawing, right?
JANICE ROSS: Correct.
BOYD YOUNG: The soft tissue, much decomposition and it is difficult to identify whether this injury is pre-mortem or post-mortem, is that correct?
JANICE ROSS: Correct.
BOYD YOUNG: Thank you, Dr. Ross. Those are all the questions I have.
RICK HUBBARD: A few follow-up.
REDIRECT EXAMINATION By Mr. Hubbard:
RICK HUBBARD: Defense exhibits 114, 115, 116, 117 and 118. Going through those, did you find some of these are not accurate with your final conclusions?
JANICE ROSS: Yes. Those are printed out at the time of autopsy. And after review, and after review with my colleagues, this situation and how the death certificate should be summarized, since those -- two of them had evidence of probable strangulation. The others didn't have any indication of injury, but a lot of decomposition changes. And the term used by most medical examiners is homicidal violence. That's why homicidal violence was on the subsequent death certificate.
RICK HUBBARD: Well, going through these, 114 is as to Elias where before you had had strangulation. Homicide by strangulation?
JANICE ROSS: Yes.
RICK HUBBARD: Here it has manual strangulation. Did you see any ligature marks?
JANICE ROSS: No.
RICK HUBBARD: Now, looking at 115, which is Merah Jones. Here it says probable strangulation. That wasn't your ultimate conclusion, was it?
JANICE ROSS: No, it was not.
RICK HUBBARD: It was homicidal violence?
JANICE ROSS: Yes.
RICK HUBBARD: As to 116 which is Gabriel Jones, had probable strangulation. Now is it correct you had homicidal violence, probable strangulation?
JANICE ROSS: Yes.
RICK HUBBARD: And he's the child that -- the two-year-old that had the ligature marks on his right neck and jaw?
JANICE ROSS: Correct.
RICK HUBBARD: Abigail, the one-year-old, which is Defendant's Exhibit 117, it says probable strangulation. Did you find any broken bones, hyoid bones or any bruising around the neck for probable strangulation?
JANICE ROSS: Not specifically, but with decomposition couldn't tell if there were contusions, bruises or not.
RICK HUBBARD: So how did you rule her death, the cause?
JANICE ROSS: In the end, homicidal violence.
RICK HUBBARD: Homicidal violence. And Nahtahn, which is 118, which said could not be determined, you did make a conclusion on that. You just talked with your colleagues and you all looked at this one hard, correct?
JANICE ROSS: Yes.
RICK HUBBARD: You had other factors to consider like physical exertion and things that were presented to you as possibilities that might lead to death?
JANICE ROSS: Yes.
RICK HUBBARD: But is it fair to say no matter what, you had to look at a child that was in a heavy state of decomposition?
JANICE ROSS: Correct.
RICK HUBBARD: So your conclusion was homicidal violence?
JANICE ROSS: Yes.
RICK HUBBARD: So Nahtahn Jones, Abigail Jones and Merah Jones all had the same conclusion, homicidal violence?
JANICE ROSS: That's correct.
RICK HUBBARD: And as for manner of death you had homicide for each one?
JANICE ROSS: Yes.
RICK HUBBARD: Specifically as to Nahtahn, the issue about accident, did you project accident as to Nahtahn Jones and determine his manner of death?
BOYD YOUNG: Objection,--
THE COURT: She's a forensic pathologist expert. She is an expert, she can answer, opinion. Rephrase it, please.
RICK HUBBARD: You had as a possible choice for manner of death, accident, for Nahtahn Jones. Did you accept that or reject that?
JANICE ROSS: No. The definition of homicide, to me, is the death of a person at the activity or inactivity of another.
RICK HUBBARD: So somebody subjecting somebody with either trauma or not giving them help after they've been put in trauma by that person, that's homicide?
JANICE ROSS: Yes.
RICK HUBBARD: So as far as manner of death, you saw no accident with Nahtahn Jones?
JANICE ROSS: Correct.
RICK HUBBARD: Thank you.
RECROSS-EXAMINATION By Mr. Young:
BOYD YOUNG: Everything that you observed during your autopsy -- autopsies was consistent with what you had been told Tim Jones had told law enforcement, correct?
JANICE ROSS: Well, again, I don't remember when I heard what he stated, but I think I probably did hear that he strangled -- but other than that, we look for evidence of strangulation versus something else.
BOYD YOUNG: Right. And as far as Nahtahn goes, the evidence was consistent with him saying he exercised him until he got exhausted and then checked on him and found him deceased?
JANICE ROSS: That's consistent, yes.
BOYD YOUNG: And as far as Elias and Merah, Gabriel, and Abigail or Elaine, he reported to law enforcement that he had strangled them, right?
JANICE ROSS: Yes.
BOYD YOUNG: Two with his hands and two with a belt, right?
JANICE ROSS: I didn't hear that exactly.
BOYD YOUNG: Okay. But the evidence in your autopsy was consistent with what he had reported to law enforcement, correct?
JANICE ROSS: Yes.
BOYD YOUNG: Including the one cut on Nahthan's leg?
JANICE ROSS: Correct.
RICK HUBBARD: One just for clarification.
THE COURT: All right.
REDIRECT EXAMINATION By Mr. Hubbard:
RICK HUBBARD: As to Nahtahn, did you also determine--
BOYD YOUNG: One second. Thank you.
RICK HUBBARD: But it is also your testimony you can't rule out strangulation for all five children?
JANICE ROSS: Correct.
RICK HUBBARD: Including Nahtahn?
JANICE ROSS: Right.
RICK HUBBARD: Thank you.
THE COURT: You may step down.
BOYD YOUNG: Your Honor.
THE COURT: Yes.
BOYD YOUNG: We need to put some stuff on the record outside the presence of the jury.
THE COURT: Okay. It's time for a break anyway. That will work. You may step down. (Whereupon, the witness stepped down from the witness stand.)
THE COURT: Let's take a short break. You all step in the jury room and then we'll get you back in here and have lunch. Don't talk about the case. We'll have you back in here in a couple of minutes.
(Whereupon, the jury was excused from open court.)
BOYD YOUNG: Your Honor, and I apologize. It's my understanding that we just need to go through those pictures that the Defense wants to offer and make those a Court's exhibit. I don't know if we need Dr. Ross to continue to testify. I think she's identified them enough.
THE COURT: You've got them marked for identification as your Exhibit numbers, 109 through 114.
RICK HUBBARD: And I think she identified them on the stand when I showed them to her.
BOYD YOUNG: I think she did too.
RICK HUBBARD: She did.
THE COURT: She did?
RICK HUBBARD: Yes.
THE COURT: They were actually 109 through 113 for ID only.
RICK HUBBARD: She actually identified the name of the child.
THE COURT: Which one by number.
RICK HUBBARD: Yes, sir.
BOYD YOUNG: I just need to make one 114 -- I think 109 through 114 as a Court exhibit for the record.
THE COURT: No, no, no. 109 through 113 are the five photos. 114 is in, those are starting at 114, 115, 116, 117 and 118 are the death certificates and those got in.
BOYD YOUNG: Okay.
THE COURT: It's 109 through 113 for ID.
COURT REPORTER: ID for the Defense.
RICK HUBBARD: Your Honor, if they want to make Court's Exhibits as well so that--
THE COURT: I think they were identified in the in-camera hearing as well as on the record for the jury, both times. Those group of pictures, 109 through 113.
BOYD YOUNG: Judge, you tell me I'm protected, I'm going to trust you on that.
THE COURT: We've said it twice. I don't think I would miss it twice. (Whereupon, Defendant's Exhibit number 109 through 113 were marked for identification only.)
THE COURT: I'm ready for a break. I mean, you good for a break?
RICK HUBBARD: Yes, sir.
THE COURT: Okay. We'll take about 10 minutes and we'll get them back in here. We have another witness that's not going to be lengthy next?
SUZANNE MAYES: Short witness.
THE COURT: Okay, that will be good. That will get us close to 12:30, time for lunch.
SUZANNE MAYES: Yes, sir.
(Whereupon, a short break was taken.)
THE COURT: Let's get them in. (Whereupon, the jury came into open court at approximately 12:59 p.m.)
THE COURT: Call your witness, please.
SHAWN GRAHAM: Shelby Derrick.