A Forensic Pathologist Re-Examines Elliott Smith’s Autopsy Report

I have no doubt Dr. Scheinin who carried out Elliott Smith’s autopsy is a renown professional and did a careful analysis, however the manner of death was left undetermined, and we still don’t know what happened more than 12 years later. I understand that cases are often very specific and that a specialist is never careful enough when it comes to determine the manner of death and decide between suicide and homicide, but a second opinion can’t hurt.

The autopsy report represents the most objective facts we have about this case, and facts can be re-examined. Recently, I contacted an expert in pathological and forensic medicine, and he was kind enough to spend some time reviewing the autopsy report, he also generously allowed me to share his informed opinion. You have to keep in mind that this is someone who wrote scientific articles (about stabbing among other causes of death) published in forensic journals. The only reason he preferred to stay anonymous is because he didn’t want his ‘mailbox be flooded by fans emails’. This is what he wrote to me after reading the autopsy report:

‘I carefully read the autopsy report and give you as requested my opinion on this case. Interpretation of the autopsy findings are difficult, as resuscitation attempts and thoracic surgery added iatrogenic injuries. Concerning the manner of death, some findings are more in favor of homicide :

– Sharp wound in the thorax associated with underlying bone injury.

– Clothing defects in the chest area where are located the two lethal sharp force wounds.

– Absence of hesitation wounds in the vicinity of the two lethal thoracic injuries.

– Two incised wounds on the right arm and left hand, raising the possibility of defensive wounds.

– The axis of the two lethal wounds is near the vertical.

Other elements may point to suicide:

– All the sharp wounds found may be self-inflicted.

– No clothing defect in front of the incised wound of the right arm.

So, finally I am sharing the opinion of the forensic pathologist who carried out the autopsy. Manner of death is undetermined, although autopsy findings are more in favor of homicide.’

Regarding his second point for suicide (‘No clothing defect in front of the incised wound of the right arm’), I told him that Elliott was wearing a short-sleeve shirt when he died, which basically blows up this point: ‘Concerning the clothing defect, I did not take into account a short-sleeve shirt worn by the victim at the time of death. In case of suicide, we can expect no clothing defect in front of the skin incised wound, but this finding is not constant. No clothing defect of a long-sleeve shirt would be more relevant,’ he added.

Despite what he said, his opinion is much more pronounced than Dr. Scheinin’s. When I talked to her a few years ago, she never said that the findings were in favor of one of the manners of death, and stayed very neutral on the subject. This is what she wrote to me a few years before I talked to her, and her discourse didn’t change at all when I met her:

‘In the Smith case, there were certain things — both anatomic findings and circumstances – that were suggestive of suicidal death and pointed down that road, while there were other things that were less consistently associated with suicide and suggested the possibility of homicide.  There was nothing that tipped the scales one way or other.  The mode of Suicide has great psychological impact for those left behind, and carries with it a negative social stigma reflecting on the decedent, so it is not a mode I assign lightly.  If there are elements that cast some doubt on this mode (outside of someone saying “he just wouldn’t have done that”), then I prefer to give the decedent the benefit of that doubt.  I also would not want to assign the mode of Homicide without reasonable cause to do so.  In this case, there was truly no clearcut way to assign the mode of death.’

She was also very cautious to call the small wounds – that Elliott had on his upper right arm and left palm – defense wounds, because Elliott could have done these when mishandling the knife, as she pointed out.

I asked my forensic expert about them and he added: ‘The skin wounds of the right arm and of the left hand are difficult to interpret. If they are fresh, the left hand incised wound may result from an accidental self-inflicted wound when the victim used the knife maybe with clumsiness or hastiness. But its site is also typical for a defensive injury.’

‘Typical of a defense wound’, once again, if it is not a defense wound, the findings in Elliott’s case are going against all the odds.

The wound on the upper right arm wound is particularly bizarre, it is located in an unusual place, between the biceps and triceps muscles, and it is not typical for defense injuries, but also not typical for self-injuries considering Elliott was right handed. The forensic expert thought that it would have been useful to perform histological analysis of these wounds, as the microscopic level can reveal whether these wounds were fresh or not. When I talked to Dr. Scheinin, she, without any hesitation, told me these wounds were fresh and I doubt such analysis were performed. However, the wound on the right arm is particularly strange as ‘the edges of the wound are surrounded by a small margin of contusion’ as he noticed, which ‘may raise the question about the nature of this wound. Is it a true sharp force injury? The possibility of injury secondary to blunt trauma is not excluded’, he added.

If this wound was fresh, as Dr. Scheinin said, if it was not a knife injury as this expert suggests it, Elliott could have hurt himself when he fell on the balcony? Remember, this is what Schultz wrote in ‘Torment Saint’: ‘Elliott then crashed onto the balcony, as if, she believed, he were trying to jump off it somehow. She tackled him there, then quickly climbed off him to call 911, seconds later performing citizen CPR.’

Curiously, Gil Reyes had already suggested this scenario to me, when we talked at W.T. Schultz’s book party at Skylight books: Elliott could have hurt himself on the balcony.

‘The wound of the right arm may result from a blunt trauma (if confirmed by histological analysis), and just one traumatic impact on the edge of the balcony may explain this wound,’ added the forensic expert when I mentioned the balcony story.

However, the reason why Elliott ran away and crashed onto the balcony, has never been explored by the police to my knowledge. But if he was running away from someone and hurt himself there, I guess this wound could also be considered as a defense injury.

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