Sunday, April 8, 2012

Cases Involving Severed Carotid Arteries

While working my way slowly through the case of Preston Hughes III, it became important that I understand how long one might survive (or remain conscious) after having a carotid artery severed. I searched through Google Scholar for cases involving a severed carotid and mentioning testimony about how long the victim might have lived or remained conscious. From those cases, I constructed the following plot.


I excluded cases in which carotids were severed on both sides of the neck. I excluded cases in which the person may have died even more rapidly due to another wound, such as a severed aorta, with an exception. I did include cases where the medical expert specifically said that the person would have died within a certain time based on the severed carotid only.

I excluded cases of choke holds, where the carotids on each side of the neck were compressed. Losing flow from both carotids is clearly even more serious than losing flow from one side only.

I excluded cases where the person received prompt and professional care. I did include in the reference list (but not in the plot) one case in which the person survived because someone promptly provided pressure to the wound.

I did not exclude cases in which a person suffered other wounds, even many other woulds, if those wounds were not the proximate cause of death.

I did include both knife and gunshot wounds that severed one carotid artery. I did include cases where both the carotid artery and a jugular vein were severed. 

I translated generic times such as "a couple of minutes" into 2 minutes and "several minutes" into 5 minutes. I'll note in the references below the actual minutes I used for the plot.

I categorize the cases into those which relate to survivability, those which discuss time of consciousness, those in which the person survived, and (as an added bonus) those which mentioned blood spurting, spraying, or gushing. I'll have use for that last category soon. Some cases appear in more than one category.

I don't claim by any means that this is a comprehensive list of cases involving severed carotids. I claim only that these are all the relevant ones I could locate on Google Scholar after a dozen or so hours of searching and recording.

I offer these cases as a starting point for anyone who may benefit by understanding the issue of how long a person may remain conscious and survive after having a carotid artery severed. For those of you who want a visual perspective of how serious a severed carotid is, check out the two videos at my post Pools of Blood.

CASES MENTIONING SURVIVAL TIME

Commonwealth v. Lambert, 2000, PA – 5 minutes
Dr. Larson also offered an opinion that the left carotid artery on [the victim] was severed. … His opinion, in essence, was that [the victim] would have died within a few minutes of receiving her wounds. He felt she would have had to lose consciousness within three minutes and suffer brain death within two minutes after that. If her left carotid was severed, she would have lost consciousness within a minute or so.

Cooper v. Brown, 2007, CA – a couple of minutes [2 minutes]
Jessica suffered a stab wound to her neck. The wound resulted in massive bleeding. Unconsciousness from the wound would have occurred in as little as thirty to sixty seconds, and would have been fatal in a couple of minutes.

Edmonds v. Commonwealth, 1985, VA – 5 minutes
The "most serious injury ... was a cutting wound to the right side of the neck". A sharp instrument had been inserted in "a vertical direction" into "the muscles of the neck", and "there was some twisting motion of the object" as it moved "upward in ... a left to right direction." Bleeding from this wound, which cut the carotid artery, was "rapid and massive". Although the victim expired in less than five minutes, he remained able to talk because the larynx was intact. The pumping of the heart caused blood from the neck wound to "spurt" and collect on the lower part of a refrigerator located near the spot where the body was found. In the examiner's opinion, the pattern of blood indicated that the victim was not standing erect when the wound was inflicted. He also agreed that if the assailant and the victim had been facing each other in a standing position when the artery was severed, the assailant "would have been hit with a spurt of blood.”

Elliott v. State, 1983, IN – within minutes [5 minutes]
The coroner who examined Sheryl's body determined she died as the result of a bullet fired at close range which severed the carotid artery in her neck. It was determined the bullet entered the left side of the neck and exited on the right side. It was also determined death would have occurred within minutes after the infliction of the wound.

Jefferson v.State, 1984, AL – several minutes plus several minutes [10 minutes]
The victim died from an excessive loss of blood due to the fact that both of the jugular veins and the right carotid artery had been severed during the attack by Jefferson. … Jefferson cut the victim's throat numerous times, and cut all around the throat and neck (front, back and sides) severing three major blood vessels. The extensive loss of blood caused the victim to loose consciousness after several minutes, and to die several minutes thereafter.

Mickens v. Commonwealth, 1996, VA – 40 minutes
The fatal wounds included a stab wound to the right neck that severed the carotid artery and the jugular vein, four paired stab wounds that punctured the right lung, three stab wounds that punctured the left lung, seven stab wounds to the skull that penetrated the brain, a stab wound to the forehead that also penetrated the brain, and one pair of stab wounds that perforated the liver. The medical examiner opined that the fatal wounds may not have caused instant death, and she estimated that the victim could have survived for as long as 30 to 40 minutes after the last wound had been inflicted.

Morrisette v. Commonwealth, 2002, VA – within minutes [5 minutes]
The autopsy documented that White had suffered a slash wound across her throat, which totally severed her trachea, the right carotid artery, the jugular vein, and certain muscles in her neck; the wound partially severed the esophagus. White had also sustained a stab wound to her neck; three stab wounds to her chest, one of which penetrated her heart; and stab wounds to her abdomen and flank, for a total of eight stab wounds. Additional defensive wounds on her hands and legs indicated that White had attempted to ward away the knife blows. Several of the wounds individually could have caused White's death, but the slash wound to her throat was "fatal within minutes."

People v. Brown, 1984, MI – a very few minutes [5 minutes]
The pathologist testified that Day was stabbed in a small space between the lower jaw bone and the styloid process of the skull which contains three major blood vessels, the external carotid artery, the internal carotid artery, and the internal jugular vein. These three vessels pass through such a confined space that it is inconceivable that a stabbing there could miss all three. According to the pathologist, if one of the arteries in that space were severed, death would result in a very few minutes unless the victim received immediate medical treatment. If only the vein was severed, death would result within 20 or 30 minutes.

People v. Cowan, 2010, CA – 10 minutes
A large slashing incised wound on the right side of the neck from the midline to the back had severed the sternocleidomastoid muscle, jugular vein, carotid sheath and artery, and everything down to the spine, trachea, and larynx. There was also a superficial incised wound on the left side of the neck. Russell died from exsanguination—he bled to death. The wound to his neck probably rendered him unconsciousness almost immediately, and he died in less than 10 minutes.

People v. Davenport, 1985, CA – 20 minutes
The autopsy pathologist, Dr. Walter Fischer, testified that the cause of death was the loss of blood from the carotid artery … Dr. Fischer testified that the neck and hand wounds had probably occurred before the penetration of the stake. He testified that the victim could have lived from 5 to 20 minutes after the artery was severed. He could not offer a medical opinion that the victim was or was not conscious when the stake was inserted.

People v. Gomez, 2011, IL – 2 minutes
Dr. John Scott Denton testified that he performed Ralson's autopsy. He stated that she died from a stab wound to her neck which severed her jugular vein and cut the carotid artery in half. … Dr. Denton stated that Ralson would have only lived for one or two minutes after the knife went through her jugular vein and artery. He also noted that active bleeding stops when the heart stops beating.

People v. Hurst, 2009, CA – several minutes [5 minutes]
He sustained six stab wounds, primarily to his neck, including one severing the carotid artery, which would have resulted in death within one or several minutes.

People v. Flores, 2012, CA – 2 minutes
The wounds were consistent with being inflicted by the large knife found on the fold-out bed. It would have taken two or three minutes for someone to inflict all the knife wounds on Jackie. One cut hit the carotid artery, and she would have died within one to two minutes.

Petty v. State, 1955, OK – few minutes [5 minutes]
There was a superior wound which was approximately five inches long through the entire structure of the right neck, including the jugular vein, the right Carotid Artery and into, through and into the Trachea, the inferior wound was a little longer, approximately seven inches separating the clavicle from the sternum, cutting the right sub-clavian artery and penetrated the chest wall." … There is sufficient competent proof to clearly show the decedent, a cripple, was brutally assaulted, without warning, with a knife by the defendant, and as a result thereof, Rains died in a few minutes thereafter.

Reeves v. State, 2000, AL – few minutes [5 minutes]
An autopsy revealed that Johnson had died from a shotgun wound to his neck that severed the carotid artery, causing him to bleed to death over a period of several minutes. … There is sufficient competent proof to clearly show the decedent, a cripple, was brutally assaulted, without warning, with a knife by the defendant, and as a result thereof, Rains died in a few minutes thereafter.

State v. Suttles, 2000, TN – 10 minutes
The immediate cause of death according to Dr. Elkins was bleeding from the jugular vein and external carotid artery, which were cut by the slash wound to the right neck. The other major wounds would have also potentially caused death given enough time and no medical treatment. Dr. Elkins also opined that the victim was alive when the wounds were inflicted, that she remained able to speak, because the injury to her larynx from the slash wound to the right side of her neck did not damage her vocal cords, that she would have fallen unconscious in about five to six minutes, and that she would have bled to death within ten minutes as a result of the slash wound to the right side of her neck. However, Dr. Elkins opined that application of pressure to the wound on the right side of the victim's neck may have extended consciousness and delayed the time of death by five minutes.

State v. Tucker, 1994, NJ – 30 minutes
She also indicated that the victim's external injuries included "multiple throat slashings ... a deep stab wound to the left side of the neck ... scraping on the right side of her forehead[,] ... abrasions on her midchest[,] ... a superficial stab wound [in the chest area] ... [and] linear ... abrasions on the right wrist." The stab wound on the neck was one to two inches deep, cutting "through the skin, subcutaneous tissues ... the internal jugular vein and a branch of the carotid artery...." According to the medical examiner, a person inflicted with these injuries could survive only twenty or thirty minutes.

State v. Helton, 1954, WY – 3 minutes
The wound through the head was described as entering the left cheek near the left corner of the mouth, passing rightward and backward, breaking off the second molar tooth, entering the roof of the mouth on the right side, passing through the bone of the palate, and rupturing a major branch or possibly several branches of the right artery. This would bleed somewhat profusely — both internally and externally — and although it was a fatal wound, … as the witness otherwise testified, "I would expect that to be fatal within a period of three minutes at the most, two to three minutes."

State v. Rollins, 2006, TN – 4 minutes
An autopsy disclosed that the victim had sustained twenty-seven and possibly twenty-eight knife wounds and had bled to death from these wounds. While most of these injuries would not have been immediately fatal, a deep six-inch cutting wound that began near the victim's left ear and extended across his neck had sliced through his left common carotid artery and jugular vein and would have rendered the victim immediately unconscious and led to his death within four minutes.

CASES INVOLVING TIME OF CONSCIOUSNESS

Commonwealth v. Lambert, 2000, PA – 3 minutes
Dr. Larson also offered an opinion that the left carotid artery on [the victim] was severed. … His opinion, in essence, was that [the victim] would have died within a few minutes of receiving her wounds. He felt she would have had to lose consciousness within three minutes and suffer brain death within two minutes after that. If her left carotid was severed, she would have lost consciousness within a minute or so.

Cooper v. Brown, 2007, CA – unconscious within 60 seconds
Jessica suffered a stab wound to her neck. The wound resulted in massive bleeding. Unconsciousness from the wound would have occurred in as little as thirty to sixty seconds, and would have been fatal in a couple of minutes.

Jefferson v. State, 1984, AL – several plus several minutes
The victim died from an excessive loss of blood due to the fact that both of the jugular veins and the right carotid artery had been severed during the attack by Jefferson. … Jefferson cut the victim's throat numerous times, and cut all around the throat and neck (front, back and sides) severing three major blood vessels. The extensive loss of blood caused the victim to loose consciousness after several minutes, and to die several minutes thereafter. Tucker came down the stairs and saw the body and the blood.

People v. De Sarno, 1986, NY – 60 seconds
The defendant, a parolee, fired six shots at Police Officer Cecil Sledge during a traffic stop at a busy intersection. One bullet struck Officer Sledge's bullet-proof vest, fracturing a rib. Another bullet penetrated Officer Sledge's face, fractured his jawbone, severed the left common carotid artery and the jugular vein, and became lodged in the centrum, the heavy bone protecting the spinal cord. … According to these experts, an individual who sustained wounds similar to those caused by the bullet which penetrated Officer Sledge's face and lodged in the centrum may be capable of performing voluntary acts for 30 to 60 seconds after the bullet's impact and before losing consciousness.

State v. Bonds, 2010, TN – a few minutes [5 minutes]
The neck wounds severed both the carotid artery and the jugular vein and punctured the victim's right lung. The victim bled to death, but could have remained conscious for a few minutes after she was stabbed.

People v. Mayfield, 1997, CA – immediate loss of consciousness [0.5 minutes]
Sergeant Wolfley was taken from the scene of the shooting to a hospital where he was pronounced dead at 3:10 a.m. The cause of death was a single gunshot wound to the face, the bullet shattering the left side of the jaw at the angle and completely severing the external carotid artery, causing profuse bleeding, immediate loss of consciousness, and a rapid decline in blood pressure. Apart from the gunshot wound, Sergeant Wolfley suffered minor cuts and scrapes on his face and knees consistent with collapsing and falling face forward onto an asphalt or concrete surface after being shot.

State v. Henretta, 2009, TN – 30 seconds
An autopsy of the victim's body, performed by Doctor Fenton Scruggs, revealed three stab wounds to the victim's neck, two on the left side and one on the right side. A three-inch wound to the top left side of the neck severed her jugular vein. A one-inch wound to the bottom left side of the neck did not cut any major veins or arteries. A wound immediately below the right ear, which Doctor Scruggs described as "particularly damaging," severed the carotid artery and the jugular vein and extended so deep that it severed the ligaments holding the backbone vertebra together, exposing the spinal cord. Doctor Scruggs testified that this most severe wound, which was the first such wound that he had seen, resulted from "great force" and would have rendered the victim unconscious within approximately 30 seconds. The autopsy report reflected that the victim ultimately died of the loss of blood resulting from the stab wounds to her neck.

State v. Penley, 2003, TN – within seconds [0.5 minutes]
Dr. Harlan determined that the cause of death was "an incised wound, meaning a cut, to the neck transecting the right internal carotid artery." She explained that the cutting of the carotid artery caused a loss of blood and lack of blood supply to the victim's brain. Dr. Harlan testified that once the artery was cut, "unconsciousness would have occurred . . . within just a matter of seconds. And then [the victim] would have been unable to move or do anything else." The lack of blood would have induced a massive stroke. She stated that once the wound was inflicted, the victim would not have recognized his surroundings or his assailants.

CASES IN WHICH THE VICTIMS SURVIVED

Cromartie v. State, 1999, GA – survived
Cromartie entered the Madison Street Deli in Thomasville and shot the clerk, Dan Wilson, in the face. … Wilson survived despite a severed carotid artery.

People v. Gilbert, 1992, IL – survived
Defendant Marietta Gilbert was charged by indictment with attempted murder, armed violence and two counts of aggravated battery. … Defendant made a stabbing gesture towards Bell and blood began to gush all over the floor. … Dr. Paul Norris testified that the knife wound suffered by Bell severed his jugular vein and almost completely cut through his left carotid artery. Due to blood loss to the brain Bell. suffered a massive stroke resulting in paralysis of the right side of his body.

People v. Miller, 2012, CA – survived
Without speaking a word, the man swung his arm and struck McLeod in the neck. McLeod felt a sharp pain, looked behind him, and saw defendant. McLeod felt blood coming out of his neck. He put his hand on the wound to put pressure on it and ran back into the bar. While inside, he removed his hand, causing blood to gush from the wound. A nurse got McLeod to lie on the ground. She recognized that McLeod's artery had been punctured and she used towels to maintain pressure on the wound until paramedics arrived.

CASES MENTIONING BLOOD SPURT, SPRAY, OR GUSH

Eguia v. State, 2008, TX – blood spray
Appellant contends there is no evidence of blood splatter on the red shirt that Marron initially saw him wearing, which investigators located in appellant's wife's car. Appellant asserts the bloodstain pattern on it was inconsistent with the arterial spurt pattern that complainant's severed carotid artery sprayed onto a wall in the apartment. Although no arterial spray appeared on the red shirt, the jury could have reasonably determined that appellant positioned himself out of the way of the spray to avoid the spray, which then hit the wall of the apartment.

Landrum v. Mitchell, 2010, OH – blood spurt
The neck wound, five inches in length, extended to the spine itself; the right carotid artery, windpipe, neck muscles and veins were all severed. … Landrum's trial counsel brought out the fact that little or no blood was found on Landrum's clothes, in spite of the pathologist's testimony that the victim's fatal injuries would have spurted blood.

McCray v. Alabama, 2010, AL – blood spurt
One of the deep stab wounds on the right side of the neck actually cut Bachelder's artery, which would have caused blood to "spurt" in all directions.

People v. Gilbert, 1992, IL – blood gush
Defendant Marietta Gilbert was charged by indictment with attempted murder, armed violence and two counts of aggravated battery. … Defendant made a stabbing gesture towards Bell and blood began to gush all over the floor. … Dr. Paul Norris testified that the knife wound suffered by Bell severed his jugular vein and almost completely cut through his left carotid artery. Due to blood loss to the brain Bell. suffered a massive stroke resulting in paralysis of the right side of his body. Norris stated that the wound was one inch long and two inches deep and, in his opinion, it was a puncture wound rather than a slash wound.

People v. Miller, 2012, CA – blood gush
Without speaking a word, the man swung his arm and struck McLeod in the neck. McLeod felt a sharp pain, looked behind him, and saw defendant. McLeod felt blood coming out of his neck. He put his hand on the wound to put pressure on it and ran back into the bar. While inside, he removed his hand, causing blood to gush from the wound. A nurse got McLeod to lie on the ground. She recognized that McLeod's artery had been punctured and she used towels to maintain pressure on the wound until paramedics arrived.

People v. Taylor, 1961, CA – covered in blood
Torres died as a result of a hemorrhage caused by an incised wound over the carotid artery and the jugular vein on the left side of his neck. This single wound was three-fourths of an inch in length, three-eights of an inch wide, and the depth of the penetration was one and three-fourths inches at an approximate downward angle of 45 degrees. The police were informed that a man covered with blood had entered the Apex Hotel which was around the corner from the Jamal Hotel where the homicide took place.

ADDENDUM (6/18/2012)
For more information involving time to death or unconsciousness following a severed carotid, see my later posts Silence of the Lambs, Where's Willis?, and Shime-Waza.

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1 comment:

Anonymous said...

Very interesting, i thank you for writing this, it has inspired me greatly. The vigilantes of the new world order will be born.

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