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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The Case of Preston Hughes III: Eleven Twenty Five

Now that you understand how freely the blood flows when someone's carotid is severed, you are in a better position to understand that Shandra Charles did not live long after someone severed her carotid in that dark overgrown field. For those of you unfamiliar with the case, you can catch up quickly by reviewing summaries of the previous posts which I've collected at the Preston Hughes Table of Contents. The rest of you can buckle up now. Here we go.

Let's begin by establishing the nature of Shandra's wounds. For that, I'll turn to the testimony of a medical examiner who testified during the trial of Preston Hughes. I would prefer to say the medical examiner, meaning specifically the one who conducted the autopsy. Instead, I say a medical examiner, meaning the one who bothered to read the autopsy notes for the first time on the morning of his testimony, while in his car. I'll discuss this prosecution-friendly witness later. For now, I'll simply accept the description of the wounds provided by the person who performed the autopsy, as related by his autopsy report, as retold by a last minute fill-in medical examiner, as transcribed by a court reporter, as relayed to me by Barbara Lunsford of Mystery Crime Scene fame. It's straight from the horse's mouth, though its gastrointestinal tract, to your ears eyes.

Q. Doctor, moving along to the autopsy report, prepared on the body of the young woman in this case, Shandra Charles. having reviewed that report, do you have a medical opinion as to the cause of death of Shandra Charles? 

A. Yes, sir. 

Q. What is that? 

A. LaShandra Charles died as a result of a stab wound to the neck.

Q. Could you describe more specifically that stab wound to the neck? 

A. Yes, sir. There was a stab wound to the left side of the neck located 2 inches to the left of the midline and 1 inches below the top of the head. The instrument perforated the left jugular vein and the left common carotid artery, two of the large vessels in the neck. 

Q. Is this injury similar to the injury that the child, Marcell Taylor, received? 

A. That is correct. 

Q. In fact the arteries and veins were severed the same as on the child, Marcell Taylor? 

A, That is correct. 

Q. Did you note any other stabbing injuries or wounds on Shandra Chrarles? 

A. There was a stab wound to the chest. 

Q. Could you describe that more specifically to the jury? 

A. Yes, sir. The instrument penetrated the left side of the chest, 1 1/2 inches to the left of the midline and 4 inches below the external notch, which is where the collarbones come together, went into the chest and ended at approximately 4 inches below the entrance; in other words, the instrument penetrated to a depth of 4 inches. 

Q. Does the report indicate the approximate width of the stabbing wound? 

A. Yes, sir. 

Q. What was that? 

A. The wound gaped up to approximately 1/2 an inch in width. 

Q. Does the report indicate a length of the wound? 

A. Yes, sir. Wound measured 1 inch in length. 

Q. And when we say “gaped up to” I believe you said 1/2 inch? 

A. That is correct. 

Q. Does that mean the wound is an inch long but is open, sort of being pushed open an eighth of an inch? I'm sorry? Half an inch or eighth of an inch? 

A. Gaped 1/2 an inch. 

Q. 1/2 inch? 

A. When a sharp instrument enters the skin and subcutaneous tissues, the edges are pulled apart by the little muscular fibers and collagen fibers in the skin. So, it gapes open. 

Q. Did you note any other injuries on -- not you. Did your report note any other injuries on Shandra Charles? 

A. No sir.

As a juror, that is what you would get on this subject. You would hear it once, quickly, and you would be expected to remember the details, along with all the other details of days of testimony. Most jurisdictions do not allow you to take notes. They're afraid it will cause you not to pay attention to the testimony. You also could not, must not, research the subject yourself while acting as a juror. You must rely simply on the testimony, or that portion you can remember, or those portions you mis-remember.

This is one reason, a big reason, why jurors frequently rely heavily on gut feel. The details are too numerous, too convoluted in their delivery, too contradictory, and too far back in time. Screw the details; he's guilty.

I'll give you a much better chance than the Preston Hughes jurors had. I'll summarize the injuries and give you some additional insight from my research.

Shandra suffered two stab wounds: one to the left side of her neck and one to the left side of her chest. The stab wound to the neck severed both her common carotid artery and her jugular vein. The state's expert did not mention what damage the stab wound to the chest inflicted, but it sounds to me as if it must have punctured her left lung.

There are actually three carotid arteries in each side of the neck region. Most of the neck is transversed by the common carotid artery, and that is the one that was severed in Shandra's neck. A little higher up, the common carotid splits in two, into the internal and external carotids. If you recall, Richard Zednik had his external carotid severed by an ice skate.

A severed artery is much more serious than a severed vein. Arteries provide blood from the heart. Veins return blood to the heart. Arteries are on the supply side of the world's most amazing pump, and therefore operate under substantially higher pressure than do veins. When severed, arteries spurt and gush. We'll be talking about the significance of blood spurts in an upcoming post. I'm sure you can hardly wait.

Because the common carotid artery carries all the blood carried by both the internal and external carotid artery, a severed common carotid artery is going to spill at even a higher rate than a severed internal or external carotid. In other words, it is reasonable to expect that Shandra spilled her blood even faster than Richard Zednik spilled his.

Humbling.

On to the jugular. There are actually two jugular veins on each side of the neck: external and internal. The larger of the two is the external jugular vein. When people talk about the jugular, they are typically speaking of the external jugular. The external jugular vein and the common carotid artery travel pretty much alongside one another up the side of the neck. It is not unusual for someone suffering a severed carotid to suffer a severed jugular as well, and vice versa.  In Shandra's case, both her common carotid artery and her (probably external) jugular vein were severed, if we are to accept the testimony at face value.

Once again, by way of comparison, Richard Zednik had only his external carotid artery severed. As a reminder, here's the blood trail he left on the ice as he skated towards his trainer, as he skated for his life.

That blood poured out even thought Zednik was attempting to apply pressure with his own hands. That happened in just a few seconds. Because someone severed Shandra's common carotid artery and her external jugular, she would have been losing blood even more rapidly. She also had been stabbed in the chest.

Humbling.

Shandra Charles could not have lived very long without emergency care, and the first responders (as we are now apt to refer to them) offered her none. Let's see how long the prosecution-friendly fill-in medical examiner testified about how long Shandra might have lived.

Q. The injuries sustained by Shandra Charles, is it possible to determine, just from an autopsy report or from performing an autopsy at specifically what time that injury occurred? 

A. Within broad limits, yes. 

Q. Okay. Assuming that the deceased, Shandra Charles, was found at approximately between 11:00 and 11:30, let's say 11:15 in the evening, by the nature of the injuries she had sustained which you have reviewed in your autopsy report, can you make a determination as to approximately how far back from that time she had sustained those injuries if she was conscious at about 11:15 or 11:30 or died shortly thereafter? 

A. Within limits, yes sir. 

Q. Do you know what tine she died? 

A. No sir. The record states that she was pronounced dead. 

Q. Do you know what tine she was pronounced dead? 

A. At 12:58 a.m., on September 27, 1988. 

Q. Does the record indicate she had been transferred from another hospital to Ben Taub? 

A. According to the record, decedent was picked up by ambulance at the scene and taken to Ben Taub General Hospital. 

Q. Okay. Can you make any determination from the information you have available to you in your report and if you assume the facts that the deceased was seen alive at approximately 9:30 or 10:00 without any injuries and was found with the injuries at about, 11:15 or 11:30 and died at that time, is there any way you can determine where in there she was actually stabbed? 

A. No, sir. ... 

Q. Let me ask you this, Doctor. Would it have been possible, based on her injuries, to have been stabbed as early as 8:30 in the evening on September 26th of 1988, if she died of these injuries at 12:58, I believe you said, in the a.m. on the following day? … Can you tell? 

A. Not with any certainty. 

Q. Okay. Is it difficult to pinpoint times of injuries and times of death when cutting and stabbing injuries are involved? 

A.  Yes, sir. 

Q.  Is that because, why is that? 

A.  The determination of the time of death is difficult, at best. With cutting and stabbing injuries it is even more difficult because one has to consider the loss of blood and people bleed at different rates from different sharp trauma wounds. One cannot be sure either of the amount of medical support the decedent received in the interval from injury to death. 

Q.  Would it be possible to give an expert medical opinion in this particular case as to either the time the injury occurred without being there personally at the exact time of death? 

A.  No, sir.

Ladies and gentlemen of the jury, you have just been screwed by the people and state of Texas.

The prosecution wants the time of the attack to be as early as 8:30 PM, for reasons we'll discuss later. They  certainly don't want it to be soon before Shandra was found, for reasons we'll discuss later. So they hand-pick a compliant medical examiner to substitute for the person who actually performed the autopsy, because the proper witness happens to be conveniently out of town. (This is also a major issue to be discussed later.) The compliant medical examiner then, after a few leading questions, carefully phrases each answer such that it would be defensible later, but such that the jury is left to believe something that is not so. By the time the compliant, technically honest, but effectively dishonest doctor is done, the jury is left to believe that there is no way any medical expert could narrow the time of the attack any further than somewhere between 8:30 PM and 12:58 AM the next day. That's a 4 hour and 28 minute window.

I have found more than twenty medical experts who will state otherwise. Since I'm certainly not able to pay such experts $400 (or more) per hour, I'll take my chances with the free ones. I found then on Google Scholar. They weren't testifying about Shandra's case in particular. They were testifying about other cases in which a person's carotid had been severed. They were perfectly willing to give an expert medical opinion about how long someone might live after having a carotid severed. Some of them were also willing to give an expert medical opinion about how long someone might remain conscious after having a carotid severed.

Get ready for the money shot of this post.

I'm pretty proud of that plot. I spent 12 hours or so pouring through Google Scholar for the data, and another couple hours organizing the data into a hopefully understandable plot, and I'm several hours into writing this post before I get to insert the plot, so I'm pretty proud of that plot. Allow me to explain it a bit.

The red line plots time before death due to an untreated, severed carotid against the percentage of experts who testified that a person can live no longer. According to my summary of the data, eighty percent of the experts testified that such an injured person could survive sometime equal to or less than 14 minutes. Sixty  percent of of the experts gave a maximum survival time equal to or less than 6 minutes. Forty percent gave a time less than or equal 4 minutes.

In two cases, the victim somehow survived. I don't know if the carotid was barely nicked, or if they received some timely emergency care. There is simply insufficient information in the appellate decision to know. Nonetheless, I found two cases in which the victim survived for some unexplained reason. Those two cases cause the red line to extend all the way to the right rather than top out at 100% somewhere on the plot.

Frequently, but not always, the experts were somewhat vague in their time estimate. While some would say no more than 5 minutes, others would say "several minutes" or "within minutes."  I converted those clearly brief but generalized times into specific times so I could plot them. I plotted "couple minutes" as 2 minutes, and most other brief generalizations as 5 minutes. The single data point at 5 minutes actually represents 9 experts testifying to either 5 minutes explicitly or "several minutes" or something similar.

In summary, I found twenty cases in which an expert was willing to testify as to how long a victim might have lived after having one carotid artery cut. Only one of those was willing to testify that the person could live as long as forty minutes. One was willing to claim thirty minutes. One was willing to claim twenty minutes. The rest testified that a person could survive untreated for no more than 10 minutes, or for only several minutes, or for only a couple minutes.

Now we can estimate when Shandra Charles had her carotid severed. The paramedics arrived at 11:55 PM. I've found no medical expert willing to testify that she could have survived longer than 40 minutes without emergency treatment. That means the attack must have occurred no later than 11:15 PM, but much more likely later. The first police officers arrived sometime shortly after 11:30. The third police officer heard about their discovery at 11:40 and arrived at 11:43. Shandra must have been attacked sometime between 11:15 PM and 11:35 PM.

For convenience, I'll split the difference and call it eleven twenty five.

The End

But wait ... there's more.

My superduper plot also provides a curve of how long someone might remain conscious after having one carotid artery severed. Of the seven cases I found where experts testified to such times, none of them, I repeat NONE of them testified anyone could remain conscious longer than 5 minutes without medical intervention. None of them, I repeat NONE of them, ever mentioned that once someone passed into unconsciousness, they would awaken after bleeding out even more unless they received intensive medical intervention.

So the first two officers arrive sometime after 11:30 PM and find Shandra unconscious. No surprise there. Then the third officer arrives five or so minutes later, after Shandra has bled out even more, and he finds her not only conscious, but sufficiently alert to interview. And with what remains of her blood still flowing from within, she identifies Preston Hughes as her killer.

Houston, we have a problem!


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The Case of Preston Hughes III: Pools of Blood

Last Wednesday, my sister awoke in a pool of her own blood. She was on the kitchen floor. It occurred to her she had been shot. It occurred to her she was going to die.

Assuming the Houston police are honest in their reporting, Shandra Charles long ago awoke in a pool of her own blood. I assume it occurred to her she was going to die.

Less than five months after Shandra's carotid artery had been severed by a knife, Clint Malarcuk found himself looking into a pool of his own blood. His carotid artery had severed by the skate of an opposing hockey player. The video is a must if you want to understand this case.

Malarcuk assumed he was going to die. "All I wanted to do was get off the ice. My mother was watching the game on TV, and I didn't want her to see me die."

Ten years after Shandra's carotid artery had been severed, Richard  Zednik found himself laying in a pool of his own blood. His carotid had also been severed by the skate of a fellow hockey player. Again, the video is a must. Suck it up and watch.

Here's a still shot of the blood trail.

Of the four people just mentioned who found themselves in a pool of their own blood, only one did not survive.

My sister had collapsed because her insulin pump had injected too much insulin. She now remembers seeing her blood sugar level as being 20 something. She remembers nothing after that. Her recording monitor showed that her blood sugar level had dropped to 27. The glass on the kitchen table showed that she saved her own life by reacting quickly. She managed to down a glass of orange juice before she collapsed. The injuries to her face showed that she struck the table as she fell to the floor.

Clint Malarchuk survived because he received immediate and professional first aid.

During a game on March 22, 1989, between the visiting St. Louis Blues and Malarchuk's Buffalo Sabres, Steve Tuttle of the Blues and Uwe Krumpp of the Sabres became entangled while chasing the puck and crashed into Malarchuk's goal. Tuttle's skate caught Malarchuk on the neck, severing his carotid artery. 

With pools of blood collecting on the ice, Malarchuk left the ice on his own feet with the assistance of his team's athletic trainer, Jim Pizzutelli. Many spectators were physically sickened by the sight. Local television cameras covering the game cut away from the sight of Malarchuk bleeding after realizing what had happened. 

Malarchuk, meanwhile, believed he was going to die. "All I wanted to do was get off the ice", said Malarchuk. "My mother was watching the game on TV, and I didn't want her to see me die." Aware that his mother had been watching the game on TV, he had an equipment manager call and tell her he loved her. Then he asked for a priest. 

Malarchuk's life was saved by the team's trainer, Jim Pizzutelli, a former Army medic who had served in Vietnam. He reached into Malarchuk's neck and pinched off the bleeding, not letting go until doctors arrived to begin suturing the wound. Still, Malarchuk came within minutes of becoming only the third fatality to result from an on-ice injury in NHL history after Howie Morenz (1937) and Bill Masterson (1968). It was estimated that if the skate had hit 1/8 inch (3 mm) higher on Malarchuk's carotid, he would have been dead within two minutes. In the dressing room and on the way to the hospital, doctors spent 90 minutes and used over 300 stitches to close the wound. It was also said that had the incident occurred at the other end of the ice, Malarchuk would have died - the Buffalo Memorial Auditorium had the locker room exits at one end of the ice instead of the normal location behind the benches, and he was at that end.

Richard Zednik also survived because of prompt first aid.

On February 10, 2008, in a game between the Florida Panthers and the Buffalo Sabres, teammate Olli Jokinen, while tripping over the leg of Sabres forward Clarke MacArthur, cut Zedník's external carotid artery with his right skate blade. Zedník immediately skated to the Florida bench, leaving a trail of blood on the ice. He was immediately attended to by Florida trainer Dave Zenobi (along with all medical personnel in the arena) who took him to the locker room for treatment until emergency medical personnel arrived at HSBC Arena. Zedník underwent surgery that night starting at 9:00, his status being published as stable after leaving the arena. The game was delayed for more than 20 minutes as the zamboni was needed to help clean the blood from the ice.

Shandra Charles received no first aid. Instead, the first two officers on the scene gave CPR to Marcell Taylor, who was already dead. The next officer elected to interview her rather than save her. After interviewing her, he simply sat beside her and awaited the ambulance. An unknown individual stood nearby and sipped a beverage.

As I have now said twice before, there is little about this case that is not heartbreaking sad.

I came across the hockey videos as I researched the chances of surviving a severed carotid. I've spent perhaps six hours today with that research. I'll provide details in my next post. The information will allow us to narrow the time of the attack, and Marcell's time of death. That will bring us one step closer to understanding this case.

For now I'll leave you with a summary. A person can survive a severed carotid artery if that person receives timely first aid. Otherwise, the person will die quickly, in a pool of their own blood.


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The Case of Preston Hughes III: Shandra's Trail

Fifteen-year-old Shandra Charles and her 3-year-old cousin Marcell Taylor were brutally murdered at night in an overgrown field in Houston, Texas. The police claim Shandra lived long enough to identify her attacker as "Preston." The police located Preston Hughes in a nearby apartment complex. Hughes confessed not just once, but twice. He was convicted and sentenced to death. He has been on death row for more than two decades. Nonetheless, I have little doubt he is innocent.

For  complete listing of all previous posts for this case, see the Table of Contents I have created for this lengthy series.

In this post, I will walk with you along the trail taken by Shandra and Marcell the night they were killed. This geographic and temporal transport is made possible by the photographs recently provided by Barbara Lunsford. Once again, I thank her.

Two voices will narrate the walk. The first, of course, will be mine. That's a given since there is no way I could remain silent for so long as this walk will take. The second voice will be the one in your head, that of a Jack Webb like character reading from the police reports of Homicide Sergeant D.J. Gafford and Crime Scene Unit Officer F.L. Hale.

I'll begin. Jack can wait a bit. Using the police reports and Google maps, I previously reconstructed the overhead view of the crime scene in my post Geography.  Here's the image I presented when I knew no better.

I cautioned in my post that I had the most confidence in constructing the trail with the two white dots, representing the approximate location of the bodies. I had less confidence in the trail to the south, and no particular confidence whatsoever in the other trails. Here's what I had to go on. Take it away, Jack.

There are numerous trails through these tall weeds but there are two main footpaths that run generally east-west. The main trail, the one with the most traffic, appears to be the one on the south side of the large burned out building in the center of the lot, directly behind the restaurant. There is another well used trail to the north of the burned out building that lead from the back of the restaurant to the rear of two apartment complexes on east side of the vacant lot. The complex to the south is called the Lakewood Village apts and they carry an address of 11770 Westheimer. The complex on the north is the Lakehurst Apartments. ... There were numerous side trails leading off the two main trails in the lot.

I knew also that Drew Hartley and his wife had been walking through the field to get to the Stop N' Go and that they apparently entered and/or exited the field at the car wash.

Now I offer the first of several overhead photographs of the area taken sometime before the murder. It's clear they were taken well before the murder because the car wash has yet to be constructed. Here's the first overhead, and an enlargement of the trail area.

You're in a helicopter. You're looking down and west. Fuddrucker's is near the top of the image. The Lakehurst Apartments, where Preston lived, are at the lower right. The Lakewood Village Apartments are at the lower left.

The obvious feature of the photograph, particularly in the enlargement, is the "large burned out building in the center of the lot." The south trail is to the left. It is clearly larger than the north trail, barely visible at the lower right of the burned out building. There's a big difference between those two trails. The northern trail, the one less traveled, the one taken by Shandra and Marcell that night, is clearly going to be more obscured and darker than the southern trail.

I don't see any trails heading north or south (left or right) in this photo or in any of the nine other overhead shots. I don't see any other east-west trails either. The only two trails that I can see are those shown in the picture, and one of them is barely visible.

Now if you will just have the helicopter pilot swing around to the south of that area, you will see this shot, looking north. My previous recreation should match this photo. It doesn't.

What I find interesting, very interesting in fact, is that the wide south trail forks. One branch continues nearly straight and must serve the fine folks of the Lakewood Village apartment complex. There must be a hole in the fence just north of that red car. The other branch veers north, and seemingly serves the fine folks of the Lakehurst Apartments. If so, it would join the narrow northern trail and empty at the hole in the fence by the power pole.

In either case, I find the northern fork interesting indeed. If it does not lead to the Lakehurst Apartment complex, why is it as well traveled as the southern fork? If it does lead to the Lakehurst Apartment complex, why would Shandra have elected to take the more narrow, the more heavily covered, the darker northern trail? In either case, there is mystery here.

Now back to Jack.

There is a wooden fence that runs east and west that separates the two complexes. This fence ends at the vacant lot and there is a utility pole at that location. ... There is a hole in the fence that provides free access to the apartment complex.

Here's a picture showing the hole in the fence looking from within the Lakehurst Apartment complex.

That is one world-class hole in a fence. The scofflaws didn't just tear out five-foot worth of fence. They built a privacy wall. Possibly the people in the apartment complex didn't want those people at the fence opening to see into the complex. More likely, the people transacting business at the fence opening did not care to be viewed by the security guards at the apartment complex. Either way, all parties seem to have agreed on the value of the privacy wall. It had been there for a while. It's visible in the overhead shots already presented, and those shots were taken before construction had even begun on the nearby car wash.

Notice that it's dark out there past that hole in the fence. It's pretty dark on this side of the fence as well, when not being illuminated for photography. Let's step through the opening and take a peek back into the apartment complex. You'll see how dark it was in there that night.

What did I tell you?  Now let's swing around and take a look into the field we're going to walk through.

Whoa! It must have been really dark out there. In fact, it was even darker out there than suggested by these pictures. These pictures were taken sometime past midnight, when the moon was high in the sky. When Shandra and Marcell were attacked, the moon was much lower in the sky. Check out the image below to understand my point.

I obtained the moon path data from WolframAlpha, the mathematical search engine. If you wish to do so yourself, go to WolframAlpha.com, enter Moon Houston September 26 1988 in the search field, and click the equal sign.

When the police investigators were out there past midnight, the moon was higher than 60 degrees above the horizon. Given that the moon was nearly full and the night was clear, the moon would have provided a reasonable amount of light, assuming you were standing in the open. Let's hear what the police had to say about the lighting that night. Take it away, Jack.

The weather was clear and warm. ... In the vacant lot, there were no lights but there was still enough light to be able to see where one was going. Visibility was assisted by officers flashlights and a video flood light.

That raises an interesting issue. No flashlight was found on or near Shandra or Marcell. Nor was a video flood light found nearby. Shandra apparently picked the darkest path possible even though she had no flashlight to help her find her way.

Compared to the police, Shandra and Marcell were at a further, substantial disadvantage in seeing. Not only did they have neither flashlight nor flood light, the moon was lower in the sky when they entered the trail.

The attack occurred no later than 11:30 PM. At that point, the moon would have been 45 degrees above the horizon, in the east, behind us as we walk to Fuddrucker's. If you look again at the first overhead shot, which was taken from the east, you will see that there is but a short segment of this path that might have been lit by the moon. If that helicopter dropped lower such that it was looking from a 45 degree angle, it seems as if none of the path may have been directly illuminated by the moon.

Some readers have suggested Shandra might have been attacked soon after 9:30 PM. They argue she could have left the Lakehurst Apartments soon after Evelyn left, sometime after 9:30, and walked to Fuddrucker's for the last fifteen minutes of its opening. At 9:30, the moon was but a little more than 20 degrees above the horizon. There's no way it would have illuminated the northern trail.

I still wonder what Shandra was doing there with Marcell that night. Whatever it was, it cost her own life and that of her young cousin.

As we continue to walk from east to west, from the apartments to Fuddrucker's, we come across Marcell's body. That's Marcell out there, to our right.

Tragic.

Preston Hughes did not kill that young man. To convince others of that, I'll be writing about this case for a while. I intend to proceed carefully and deliberately. I want this young man's killer to be identified. I want Preston Hughes to walk free. I suspect I'll be found wanting. At this point I'll simply take it a step at a time.

And so must we, as we continue to walk that trail on which Shandra and Marcell were murdered that night. Up ahead is another point of interest. It's the Busch beer can the killer may have left in the weeds. There it is, just ahead, again on our right.

I turn it over to Jack for a description.

Between ... where the [victims] were was an empty Busch beer can, which appeared to be fresh. The beer can was clean and had a small amount of condensation on the outside. This beer can was resting in the tall grass.

That beer can is one of the few pieces of evidence retained to this day. It has not been tested for DNA. I repeat, it has not yet been tested for DNA. For now, I'll leave it at that.

Up ahead is where they found Shandra. If it seems suddenly light outside, it's because we don't have a nighttime photograph of this shot. You wouldn't have been able to see the items of interest in any case. You'll just have to pretend it's dark, and the moonlight can't penetrate the trees behind you, and you have no flashlight.

Those items on the trail just ahead indicate where the paramedics treated Shandra as she lay bleeding out on the trail. You can see that she was attacked at a point just before the trail once again disappeared under the trees. That assumes, of course, that she was walking east to west.

Just a few steps more, and we'll have a better view of the scene, assuming we have a flashlight.

That appears to be medical waste laying on the trail. That appears to be Shandra's blood soaking into the earth. That appears to be a lot of blood.

There's more blood just to the right of the trail, lower in the photo, and that's interesting. If Sgt. Hamilton merely rolled Shandra over to speak with her, how did Shandra spill so much blood in two regions so remote, but not much in between?

Also disturbing is the large drink cup beyond and to the right of the medical waste. It's there, neatly tucked into the weeds.

What the hell is that doing there? Is it evidence? Should it have been bagged and tested for prints? Should it have been preserved? Could we have found DNA on the straw today if it had been preserved?

Perhaps it's not evidence. Perhaps instead it was left there by a police officer who sipped a nice cool beverage as he watched the life flow from Shandra. Perhaps that officer was more concerned about quenching his thirst than he was about applying first aid or preserving the crime scene. Instead of helping, he stood by sipping. Instead of preserving the crime scene, he contaminated it.

As I said before, there is little about this case that is not heartbreaking sad.

Let's continue. Not too much further.

As soon as we enter the trees, we come across the northern side of that large burned out building.

I don't know about you, but it seems creepy to me. Especially if it's late at night. And I don't have a flashlight. And there is no way the moon is going to illuminate it very well. Just enough to make it eerie.

Perhaps my imagination is getting away from me when I think that such a place might be occupied by drug addicts, or cut-rate prostitutes, or their clients, or zombies, or orks, or other ne'er do wells. In any case, I don't believe I would like my 15 year old daughter or my 3 year old son walking along this trail, so late at night, alone, without a flashlight. Even if there was an off chance for a nice, juicy burger at the end.

Let's get the hell out of here. There's the end of the trail now.

I know that the parking lot was described as well lit in the police report, but I'm tempted to disagree. Sure looks dark to me. The overhead shots show precious few lamp posts in the area. The few lights that are there seem to be towards the street.

Finally, we're at Fuddrucker's. Unfortunately, it's closed.

So much for the burger.

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