Day 8: Prosecutors call medical examiner as last witness in 'shaken baby' murder trial

Defense to begin presenting its case Wednesday
Assistant District Attorney Angie Kemp questions King County Chief Medical Examiner Dr. Richard Harruff on Tuesday during the trial of David J. Paul, 24, for the death of 4-month-old Rian Jambi Orr in August 2010. Dr. Harruff ruled Orr's death a homicide.

The chief medical examiner who conducted the autopsy for a 4-month-old baby who died in 2010, and whose father is presently standing trial for murder and manslaughter in Juneau, testified Tuesday the cause of death was blunt force injury to the head, and the manner of death was homicide.


Dr. Richard Harruff, of the King County, Wash., Medical Examiner Office, also testified, however, that he did not think a video of the defendant demonstrating how he shook the baby was enough to cause the fatal injuries.

“The type of force that had been described to explain this baby’s injuries, I did not feel was sufficient to cause fatal head injuries,” the forensic pathologist said via two-way video conference in Juneau Superior Court on the eighth day of testimony at trial.

Something that would cause fatal injuries in any so-called Shaken Baby Syndrome case would have to be “something far in excess of what someone would normally do to a child,” he said. “I’m not talking about gentle shaking, I’m talking about grabbing a child and flipping its head back and forth and shaking its body.”

Harruff said he examined Rian Jambi Orr the day after she died on Aug. 15, 2010, at Harborview Medical Center in Seattle, which is in King County and under Harruff’s jurisdiction. The infant was flown to Harborview from Bartlett Regional Hospital in Juneau a week prior for treatment of seizures.

The doctor said during the autopsy he observed Orr’s brain injuries, which he said were recent, as well as older injuries, such as three healing rib fractures, a thigh bone fracture and bruises on her chest.

Under questioning from Assistant District Attorney Angie Kemp, Harruff explained that Orr’s subdural hematomas (which means bleeding on both sides of the brain) automatically placed her in the blunt force injury category. The defense attorney for 24-year-old defendant David J. Paul took issue with that categorization under cross-examination, asking why blunt force injury is the “default” prognosis whenever a subdural hematoma is present.

“Subdural hematoma is so specific to blunt force, it almost becomes an equation, as we suggest,” Harruff responded, although conceding that many other things cause hematomas, including the birthing process.

Harruff further stated under cross that he would have expected to see neck injuries and retinal hemorrhaging if Orr had been violently shaken, but she did not have either.

As for the manner of death, Harruff said he ruled the death a homicide, which he says means “death as a result of actions of another person.” It’s not a legal term, he emphasized, which would be up for a jury or court to decide. In a medical sense, homicide is one of the four categories of manners of death, which also includes natural causes, accidents and suicides, he said.

“I base my opinion that the injuries of the head and also the associated injuries provided sufficient evidence that the injury was a result of the actions of another person,” the doctor said when asked by Kemp why he made that finding.

Assistant Public Defender Eric Hedland pointed out under cross that the case came to Harruff as a child abuse case. Harruff confirmed people told him before performing the autopsy that this was a suspicious case, a non-accidental death trauma and that there was an active homicide criminal investigation.

State prosecutors charged Paul, the boyfriend of the baby’s mother, with two counts of second-degree murder and one count of manslaughter nearly a year after Orr died, saying he admitted to accidentally dropping the baby and shook her the morning of Aug. 9, 2010, before she began seizing. The defense says Orr suffered from chronic subdural hematomas and a clotting problem, as evidenced by a bone formation in her brain, that went unnoticed until that morning.

When Kemp asked Harruff if he observed evidence of chronic hematoma or anything that would suggest a coagulation problem, Harruff said no. Under cross-examination, Harruff told Hedland that he observed a bone in the baby’s brain, which is not normal, but that he could not identify it microscopically. He agreed that bones form in the brain when they are trying to fix something, and would probably take weeks to form.

Harruff will resume the witness stand via video conference again Wednesday morning for about 20 minutes to answer follow-up questions from Kemp. Kemp told the judge she expects they will rest their case after that, allowing the defense to present their case.

If convicted, Paul could be facing 99 years for murder, plus another 20 for manslaughter.

• Contact reporter Emily Russo Miller at 523-2263 or at


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