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The autopsy

Medical examiner explains unusual findings in an inconclusive death

-Daily Freeman-Journal photo by Elijah Decious Dr. Michelle Catellier, state medical examiner, outlines different parts of the throat in explaining her autopsy of victim Andrea Sokolowski.

After testimony from state witnesses narrated the signs of domestic violence leading up to Andrea Sokolowski’s death in September 2018, Wednesday’s testimony in Zackery Bassett’s trial examined the post mortem signs left on her body.

State medical examiner Dr. Michelle Catellier walked the jury through photos of the victim’s body showing numerous points of hemorrhaging referenced earlier by the state.

Bassett is charged with first-degree murder in Sokolowski’s death after she was reported unresponsive in September 2018.

The pinpoint hemorrhages, known as petechiae, were scattered like freckles around the victim’s eyes, cheeks, forehead, inner eyelids and inner lip.

“These (pinpoints) are significant enough that they’re beginning to coalesce and cause larger hemorrhages as well as the pinpoint ones,” Catellier said in front of an autopsy photograph.

-Daily Freeman-Journal photo by Elijah Decious Aaron Sokolowski, victim Andrea Sokolowski's ex-husband, points to Andrea in a photo during his testimony Wednesday.

But what was more concerning, she said, were the ones in Sokolowski’s mouth.

“(Seeing them in the mouth) is described in literature, but not often seen,” the 15-year medical examiner said. “I can’t say that I remember seeing it in the upper lip before.”

The presence in the mouth was a concern she said made her more seriously suspect external trauma, though she ruled the victim’s manner of death as “undetermined” rather than a homicide — a finding defense attorneys highlighted. The victim’s cause of death was ruled as “consistent with asphyxia,” which can be caused by strangulation.

“I think people think of (strangulation) as blocking the airway,” she said. “Though that can be part of the process … it’s possible to strangle someone and have them keep breathing.”

Strangulation that leads to death, she said, requires pressure to be applied to the carotid artery in the neck with enough force and enough time to deprive the brain of oxygenated blood. Loss of consciousness takes about 10 seconds with properly applied pressure during strangulation. Brain damage can occur after about three minutes; death a few minutes later.

Letting go of someone after they lose consciousness but before the point of death usually allows them to regain consciousness, Catellier said — information that could help the jury clinch the necessary element of intent to return a first-degree murder verdict, rather than a lesser form of homicide.

Signs left on the body after being strangled are simply a matter of blood finding an outlet when it has no other place to go.

“If blood is backed up and there’s increased pressure in the veins, the little tiny capillaries can’t maintain their pressure and we get a hemorrhage,” Catellier said. “It’s not terribly unusual to see some petechiae, but it’s unusual to see what we see (here with) florid petechiae, which are essentially covering the part of the face that includes the eyelids, forehead, and in this case went all the way to the ears.”

The more numerous the marks, the more concerned a medical examiner becomes about external causes of death. Catellier said she saw no plausible explanations for suicide, accidental death or natural causes, such as a heart attack, in her examination. Though she “strongly suspected homicide,” she said she didn’t have enough personal confirmed information to allow her to confidently classify the incident as such.

Her full autopsy report, which the defense successfully argued contained inadmissible hearsay regarding domestic abuse history from law enforcement, was excluded from the jury’s consideration.

Exploiting that status, defense attorney Paul Rounds again brought up the issue of cricoid pressure applied by paramedics during resuscitation efforts. Catellier replied that properly applied cricoid pressure, used to help open the airway to intubate a patient, would not cause the type of hemorrhaging seen with Sokolowski’s face.

Rounds also surfaced positional asphyxia, caused in positions such as being upside down, as a potential possibility, though the witness’ responses did not enthusiastically entertain it as a genuine possibility with Sokolowski’s death. The medical examiner noted that one particular symptom present with her — an empty bladder accompanied by saturated pants — is something that happens in cases of strangulation but not with other forms of asphyxiation, such as hanging.

Testimony from the victim’s ex-husband, Aaron Sokolowski, returned the state’s case to Andrea’s life as seen and heard through others who knew her well.

Though a ruling Wednesday morning by District Court Judge Amy Moore denied admittance of certain voicemails he received from the victim, a photo of her swollen face sent through a text message that read “he beat me up for the last time,” and explanations of what caused injuries he saw on her, she allowed the victim’s ex-husband to testify to the types of injuries he saw and her state of mind before her death.

“She said on several occasions that she was scared (Bassett) was going to kill her if she didn’t get away from him,” he told the jury.

After Andrea Sokolowski died, he said the defendant said in a conversation that he was upset, sobbing, horrified and “scared.”

“That statement (being scared) struck me as strange,” he said.

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