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Amid Lingering Skepticism, A Primer On What Bland's Autopsy Can Tell Us

ARUN RATH, HOST:

As we just heard, questions and public skepticism about the circumstances of Sandra Bland's death have lingered. Yesterday, authorities released the official autopsy report in the case. To break it down for us, we called on forensic pathologist and former medical examiner Dr. Judy Melinek. Now, to be clear, she did not examine the body herself, but she has poured over that written report.

JUDY MELINEK: It appears to be a complete autopsy, including microscopic examination. And most important, there's documentation of healing injuries. Specifically, there are healing parallel horizontal incised wounds - basically, healing cuts of her left forearm. And there is about 25 to 30 of these, and they're parallel to each other, indicating that this was self-inflicted injury. According to the district attorney, it would have been approximately several weeks old, but there's no microscopic sections to support that here.

RATH: Now, what does a medical examiner look for when determining if a death was a suicide?

MELINEK: There's several things that we look for. First of all, we need a scene and a circumstance that is suggestive of self-inflicted injury, meaning that there's no other person who was with them at the time and nobody else could have come in and done anything. So they were alone. They were in a secure place. And all of the injury would have to have been self-inflicted under those circumstances. So that's the setup. Then the autopsy report would be looking for things like defensive injuries or signs of a struggle to indicate that somebody else was involved. If all of the injuries are consistent with the scene and the circumstances and could be self-inflicted, it's most likely a suicide.

RATH: Are there ways that a medical examiner could be fooled or ways that a murder could look like a suicide to a medical examiner?

MELINEK: There are situations - some of them have been publicized - where people have committed murder and tried to cover them up as a suicide. Typically in those cases, medical examiners can figure it out because, number one, the scene isn't secure or, number two, the murderer doesn't really know enough forensics and during the struggle of the murder, they cause injury to the body that's then detected at the autopsy examination, injuries such as a broken hyoid bone. That's a very delicate bone that's in the neck at the base of the tongue, and if you strangle somebody with your hands, you can break it very easily. So to try to cover up a strangulation as a hanging - it's not going to work if the person has defensive injuries or injuries to these very delicate parts of their body.

RATH: Sandra Bland's family has commissioned its own autopsy. How often does that happen, and how often do they come up with different findings?

MELINEK: Second autopsies typically occur when there is a distrust or suspicion that the original assessment was inaccurate. But in most cases, they don't find any additional information.

RATH: So is there anything in this report that gives you reason to question the official story, which is that Sandra Bland took her own life?

MELINEK: The report itself doesn't give me any reason to question that she took her own life. The physical findings in the autopsy report support the fact that this is a self-inflicted injury or a suicide. But that doesn't close the door on questions here because it's not just the report. It's the scene and circumstances that still need to be elucidated. And there are still questions that are being raised by the justification for her arrest. There are still questions legitimately being raised about the jail's violation of their own procedures. There's the intake forms at the jail where she checked off that she had a prior suicide attempt. The jail had protocols with regards to giving people mental health support when they check off the previous suicide attempt box, and that was not provided in this case. And that is a tragedy. So there are still going to be things that are raised by this. The autopsy is not the final word on what happened to Sandra Bland.

RATH: Dr. Judy Melinek is a forensic pathologist and author of "Working Stiff: Two Years, 262 Bodies, And The Making Of A Medical Examiner." Dr. Melinek, thanks so much.

MELINEK: Thank you for inviting me. Transcript provided by NPR, Copyright NPR.

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