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MacNeill Trial Day 10: The Cardiologist and the Pathologist - CourtJunkie

MacNeill Trial Day 10: The Cardiologist and the Pathologist

November 1, 2013

Today’s testimony in the Martin MacNeill trial was very technical. A cardiologist and a forensic pathologist took the stand to testify about Michele’s cause and manner of death.

State’s Witness: Dr. David Cragun, Cardiologist

Cragun

Dr. David Cragun is an interventional cardiologist, who has been in practice for 6 years. He’s an expert in clinical cardiology and is an active practitioner, treating and managing patients. Below are highlights from his testimony.

  • Dr. Cragun never examined Michele, but looked over her all of her medical records.
  • He says that myocarditis can be “patchy,” meaning that it might be in one part of the heart but not the other.
  • Dr. Cragun says that patients with mild myocarditis like Michele don’t usually have life-threatening complications. He says it would be “very rare.”
  • Michele’s lab work shows she had more liver damage when she died than heart damage.
  • Dr. Cragun says there was a protein in Michele’s blood that indicates there was heart damage, but it was low. Likely due to long CPR effort rather than myocarditis. The lack of symptoms and lab work make it unlikely that Michele died from myocarditis.
  • Dr. Cragun says he believes Michele died of drowning but says the drugs in her system could have played a role in her death.
Cross Examination

On cross examination, the Defense asked if he would be uncomfortable administering Promethezine to a patient in Michele’s condition and he said “no.”

State’s Witness: Dr. Joshua Perper, Pathologist & Forensic Pathologist

Perper

Dr. Joshua Perper was asked by investigators to review Michele’s file, including the autopsy. Below are highlights from his testimony.

  • Slides of Michele’s heart tissues are shown in court on the overhead. Dr. Perper says that he sees “no evidence of myocarditis” in Michele’s heart.
  • Dr. Perper says myocarditis is easy to misdiagnose in a clinical setting but that pathology will show myocarditis, In Michele’s case, it doesn’t.
  • Dr. Perper believes Michele drowned.
  • Dr. Perper says that in comparison to the previous labs, Michele’s blood was diluted on the day she died. The dilution levels didn’t match how much fluid Michele was given via the IV. This means that the extra water came from water that seeped into the blood stream from the lungs, which is why he thinks she drowned. The dilution would also impact the drug levels.
  • Dr. Perper says he can’t say if arrhythmia was a mechanism of Michele’s death, because you have to have a beating heart in order to diagnose arrhythmia.
  • Dr. Perper says he ruled that Michele’s manner of death is undetermined because he hasn’t seen evidence to conclude otherwise.
  • Dr. Perper says that Michele died sometime between 8:45 and 11:30 AM but can’t tell exactly when.
  • He says the water temperature Michele was in would make a big difference in her drop in body temperature, but that body temperature isn’t a great way to determine time of death.
Cross Examination
  • Dr. Perper was hired by prosecutors in 2011 to evaluate the medical examiners reports.
  • Dr. Perper was on the Nancy Grace show in December 2010 to discuss the Martin MacNeill case.
  • Dr. Perper says that based on initial information he had, he told Nancy Grace that he thought Michele had drowned.
  • Dr. Perper told Nancy that when someone drowns and you administer CPR, water pours out of their mouth and nose.
  • Dr. Perper says he’s been paid $10,000 – $14,000 for his testimony in this case.
  • Dr. Perper says he doesn’t believe drugs killed Michele.
  • Dr. Perper says that he assumes he was given the same slides of Michele’s heart that Dr. Fricke reviewed, but he isn’t sure. If the slides are different, then his opinion about her not having myocarditis could be wrong.
  • Dr. Perper says that Michele had lividity at the hospital, and that “under no circumstances happens within half an hour or under an hour.”
  • Dr. Perper admits that he wrote an article stating that lividity could occur in as little as 25 minutes after death.
Jury Questions

The jury only had one question for Dr. Perper, which is paraphrased below.

  • “Would the use of CNS depressants raise or lower body temperature?” Answer: It would depend.

Jailhouse inmates who were housed with MacNeill are supposed to testify on Tuesday.

Background of the case:

Dr. Martin MacNeill is on trial for allegedly drugging and drowning his wife Michele, who was found dead in their bathtub. The first medical examiner ruled that her death was an accident due to heart problems. The second medical examiner changed the manner of death to “undetermined,” which led the way for the murder charges against MacNeill. Within weeks of Michele’s death, MacNeill moved his mistress, Gypsy Willis, into the family home. Gypsy took on the identity of Jillian MacNeill, although she and Martin never officially married. This is mostly a circumstantial case, with no direct evidence proving that Michele died as the result of a murder, or that MacNeill killed her.

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