Thread by @critcrim

Today's sessions of the inquest into the Vancouver police killing of Myles Gray heard revealing testimony from forensic pathologist Dr. Matthew Orde, who performed the autopsy.

It dispelled the police lies and distortions significantly.

#JusticeForMylesGray

Some notes follow

Orde conducted the autopsy of Myles on August 18, 2015.

His report noted multiple blunt force injuries which are detailed.
Multifocal bruising on skin.

A tramline appearance of some bruising. That is 2 linear lines of bruising that indicate he was struck by a rigid object-baton

Bruises on left thigh and right arm.

Black eyes on left and right.
Lacerations with skin totally torn

Fracture of right eye socket. It was blown out.

Nasal bone fracture.
A loose jaw that suggested partial dislocation.

Bleeding around brain.

Upper part of larynx fractured.

Fracture of the third right rib.

Testicular hemorrhaging.

None alone provide an explanation of why he died when he did.

But people who have pressure applied to neck often die. Neck compression process. It is possible that the injury to the larynx and neck bruising suggest

Such a process.

Localized bleeding to brain. Blunt force blow to head is most common cause.

Counter to some attempted insinuations by cops, his heart was not overly large, no contribution of heart disease. No significant lung disease to account for death.

Counsel claims an arm

Went around Myles neck but not in the form of a choke hold. Yet we had previously heard of 2 choke holds (neck restraints, even if police don't like to call them choke holds.

Counsel made no mention of police testimony that the blows from police were given as hard as they could

Orde said that people in law enforcement restraint positions do often die.
He noted a perfect storm to bring about death. Rapid breathing, rapid heart rate, adrenaline release, and compression of neck.

Lateral neck holds. Vascular restraints are often imprecise.

Injury to larynx is explained by the neck holds.

In addition pepper spray irritates airways and contributes to the overall "physiological insult."

Notably Dr. Orde dispelled the notion of excited delirium. Critical analysis of data shows its unlikely the behavior patterns

Lumped together under excited delirium can independently bring about death.

Myle's reported strange behavior could have been an acute behavior disturbance, that only recently came on. It is not excited delirium.

Dr. Orde also stressed that many studies show the effects of

Forcible restraint. Especially in a face down, prone position as police had Myles.

People restrained forcibly in a face down position have a higher likelihood of death.
Because this involves compression of chest and abdomen and compression of heart and blood vessels.

Ventilation and and cardiac output are affected. Diminished.

Being forcibly held in prone position contributed to his death.
Handcuffs behind his back were part of that.

His death was multi-factoral.

Dr. Orde then summarized.

Cardio pulmonary arrest. Law enforcement subdual restraint. Including pepper spray, multiple blunt force injuries, neck compression, dorsal hadcuffing, prone positioning.

Subdual means to subdue someone.

He have little credence to VPD counsel claims

About testosterone or anabolic steroids.

He emphasized that common sense suggests that in *any* position if someone is forcibly restrained it compromises respiration and cardiac.

If you compress chest and abdomen you are compressing the heart and the blood vessels. Cardiac

Output is reduced.

Chest compressed compresses the muscles that allow breathing.
Compromised diaphragmatic movement.
Compression to neck irritated airways. As did oc spray.

Bruising at Myles ankles were described as quite significant injuries. Bleeding deep to skim. Blunt force

This suggests the hobble was applied tightly with some degree of force.

There was also a forehead laceration. Top of forehead, where forehead meets hairline. 25mm around an inch. Jagged, irregular, linear.

Smaller cuts perpendicular to large part.

Caused by blow by blunt edged

Object.

2 injuries to face, external and internal.

Internal findings on neck do show injuries.
Soft tissue in front of neck.
Injuries to muscles in back of neck.
Several muscles injured in front and back.

Dr. Orde said the injury to the head could have been potentially lethal

Officers counsel tried to go back to steroids, manic episodes, cannabis .

Dr. Orde said those are minor issues. The factors he listed are more important.

He said that the longer the restraint and the more force exerted the greater likelihood for a bad outcome.

Deescalation would improve chances.

Here Dr. Orde made a key statement.

Myles would not have died when he did if not for the police interaction on that day.

Behavior disturbance contributed only insomuch as contributing to the position he found himself in that day

And that position was being confronted by police.

#JusticeForMylesGray

A juror asked if anabolic steroids would have made a difference.

Dr. Orde answered that in this case it wouldn't have made a difference.

From a medical viewpoint, cardiac enlargement was not profound in this case and wouldn't have played a role.

He would downplay presence

In this death.

Mental agitation. He's not even sure if that's accepted medically.

But it wouldn't have played a meaningful part in Myles death.

Steroid contribution to death would have been minimal to negligible.

There was no evidence of clotting disorders.

Dr Orde is aware of "road rage" stories but looking at the literature you can't tease out the independent factors of steroids.

Person might have anger issues before medication.
Person might have preexisting rage issues beforehand.

Neither noted in Myles history.

Finally Dr. Orde said the evidence that "excited delirium" causes death is non-existent.

This was cardiac arrest complicated by law enforcement sudual restraint.

#JusticeForMylesGray