2.Jeffrey Jentzen — Direct/Cross/Redirect
450 linesMR. GAHN: Thank you, your Honor. The State would call Dr. Jeffrey Jentzen to the stand.
DR. JEFFREY JENTZEN, called as a witness herein, having been first duly sworn, was examined and testified as follows:
COURT CLERK: Please be seated. Please state your name and spell your last name for the record.
JEFFREY JENTZEN: Dr. Jeffrey M. Jentzen, M.D. J-e-f-f-r-e-y J-e-n-t-z-e-n.
DIRECT EXAMINATION BY ATTORNEY GAHN:
JEFFREY JENTZEN: I'm a forensic pathologist employed as a medical examiner for Milwaukee County.
JEFFREY JENTZEN: I am.
JEFFREY JENTZEN: For 20 years.
JEFFREY JENTZEN: I was in Minnesota.
MR. GAHN: Would you please outline, for the jurors, your educational background from residency on?
JEFFREY JENTZEN: I graduated from White State Medical School in Detroit. I, then, did a four year anatomic and clinical pathology residency at Hennepin County Medical Center in Minneapolis.
Following that I did a year of special training in field of forensic pathologist at the Medical Examiner's Office in Minneapolis. I was the assistant medical examiner in Minneapolis for approximately six months before coming to Milwaukee in 1987 as the medical examiner.
JEFFREY JENTZEN: I typically oversee the administrative functions of the office. I supervise other forensic pathologists and trainees. I direct a forensic drug laboratory, supervise other death investigators who go out to crime scenes in the Milwaukee County area. And I perform autopsies and testify in courts.
MR. GAHN: Are you on the staff or are you affiliated with any universities or academic institutions?
JEFFREY JENTZEN: Yes, I'm a professor of pathology at the Medical College of Wisconsin.
JEFFREY JENTZEN: Yes.
JEFFREY JENTZEN: Typically, we have a forensic fellowship program so we teach and train other pathologists to become forensic pathologists. We're one of about 35 training programs in the country. We also teach medical students, pathology residents, and other under graduate -- and other under graduate programs.
JEFFREY JENTZEN: I'm a member of the local State Medical Examiner and Coroner's Association. I'm also the -- on the -- member of the National Association of Medical Examiners where I'm currently the vice president of the organization. And I'm a fellow of the American Academy of Forensic Sciences.
JEFFREY JENTZEN: Yes, forensic pathology.
JEFFREY JENTZEN: Well, pathology in general is the study of disease and injury. And it's broken down into two rather broad categories.
And anatomic pathology has to do with tissues; for example, skin, bone, heart muscle, etcetera. And clinical pathology deals with components of the body's liquids; for example, what's in the blood, the urine, bile, etcetera. And forensic pathology utilizes aspects of both clinical pathology and anatomic pathology as they pertain to general questions of the law.
JEFFREY JENTZEN: Yes.
MR. GAHN: And would you explain -- excuse me -- explain to the jurors the significance of being board certified?
JEFFREY JENTZEN: Board certification indicates that you have taken a prerequisite course of study, you have completed that course of study and taken a standardized examination. And I have -- I am board certified with the American Board of Pathology and Anatomical, Clinical and Forensic Pathology.
JEFFREY JENTZEN: Yes, I have written a number of papers on various topics, in the field of forensic pathology, predominantly. I have also co-authored a book on death scene investigation and training individuals to do death scene examinations, etcetera.
JEFFREY JENTZEN: I -- I have been recognized in some areas, yes.
JEFFREY JENTZEN: I have -- I have developed a child death review team in Milwaukee County for the last 15 years and we have been recognized for that.
We have also developed other testing methods and genetics to determine drug metabolism.
And I have been recognized as in the position of the vice president and president elect as I think an individual who would be a leader in the field.
MR. GAHN: And would you look at, in front of you, I believe there is a document there which has been marked as Exhibit 432?
JEFFREY JENTZEN: Yes.
JEFFREY JENTZEN: Yes, this is a copy of my curriculum vitae. It's roughly around 24 pages and it documents the papers and presentations and other types of academic efforts that I have done over the last 20 years.
JEFFREY JENTZEN: I typically perform, personally, between 250 and 300 autopsies a year. And then I supervise other pathologists and trainees and forensic pathologists in their cases. So I see a number of cases. Our office typically would perform around 1,000 or 1100 autopsies per year.
JEFFREY JENTZEN: I would estimate that probably -- We get a number of subpoenas, but I would estimate that I probably testified once a week for the past 20 years.
JEFFREY JENTZEN: Probably -- I would say probably around 500 or 1,000 times.
JEFFREY JENTZEN: I was contacted by yourself in a telephone conversation and asked if I would assist in the examination of some bone materials.
JEFFREY JENTZEN: I would describe myself as a -- somebody who was brought in as a consultant.
JEFFREY JENTZEN: Yes.
JEFFREY JENTZEN: For example, I was recently in a child death case; I was a consultant. Other cases related to cause and manner of death; interpretation of gunshot wounds; and frequently asked by district attorneys around the State to inquire and make judgment on that. And I also consult with public defenders and other attorneys who might have questions related to injury and disease.
MR. GAHN: How did this -- a case like this, where you are in the role of a consultant, differ from the typical case that you would receive at the Milwaukee County Medical Examiner's Office?
JEFFREY JENTZEN: Well, in our routine business we would go to the scene of sudden and unexpected deaths that occur in the county. I might personally -- If there were a particular type of case, I might personally examine the scene myself and observe materials at the scene, consult with law enforcement personnel at the scene.
And then, basically, process the body myself, examine x-rays and other materials, perform the autopsy, look at the tissues under the microscope with the assistance of a drug analyst. I might interpret drug levels in testing. And then if it were a case in Milwaukee County, I would determine the cause and manner of death and sign the death certificate.
In this case, my role was limited, as a consultant, to look at some material and render an opinion.
MR. GAHN: And is that because the traditional autopsy would not be performed in a case such as this?
JEFFREY JENTZEN: And, yes, that's true, plus -- well, an autopsy is basically an examination of a deceased person. In some cases, you have more material than are -- and tissue than in other cases.
But in this case, it would be that I would not have performed the examinations myself, as far as the autopsy or dissection. And in this case my role is limited to examining small pieces of bone fragments and rendering an opinion.
MR. GAHN: Would you explain to the jury what you did in the course of your investigation in this case?
JEFFREY JENTZEN: I was requested to go to Madison. And at the Dane County Coroner's Office I met with Dr. Leslie Eisenberg, the forensic anthropologist, and some attorneys and other individuals.
And we examined -- I was shown the material that Dr. Eisenberg had previously examined. I reviewed her report and I -- and she showed me some bone fragments. I also examined some x-rays of those bone fragments. And on the basis of those materials, I rendered an opinion.
JEFFREY JENTZEN: Yes, I did. As well as the -- although I wasn't at -- I never went to the scene of this case, I was shown photographs and given laboratory information, looked at the x-rays and the reports.
MR. GAHN: As part of your job as medical examiner, did you have experience with examining burned body parts?
JEFFREY JENTZEN: Yes.
JEFFREY JENTZEN: I would say on a routine basis we would examine probably around 10 charred bodies per year, in our office.
MR. GAHN: And as part of your job as medical examiner, do you have experience with interpreting x-rays?
JEFFREY JENTZEN: Yes, in a general forensic sense, interpreting trauma and injury, yes.
JEFFREY JENTZEN: We typically take x-rays on all pediatric cases, all gunshot wounds, stab wounds, and cases where there's some concern over identification.
MR. GAHN: And as part of your job as medical examiner, do you have experience with bullets and bullet fragments?
JEFFREY JENTZEN: Yes.
MR. GAHN: On an annual basis, approximately how many cases, involving gunshots to the skull, would you see in the Milwaukee County Medical Examiner's Office?
JEFFREY JENTZEN: I would give a rough estimate at probably around 100 to 120.
MR. GAHN: Now, I believe you stated that you met with Dr. Eisenberg and you actually examined bone fragments in this case?
JEFFREY JENTZEN: I did.
MR. GAHN: Could you basically describe to the jurors, what was the condition of these bones that you examined?
JEFFREY JENTZEN: I would describe the bones as fragmented and charred. There was no intact skull fragments. And Dr. Eisenberg had separated out bone fragments from the skull and from other areas and so I was able to look at just small fragments of the bone -- bony material, as well as the x-rays of those areas.
JEFFREY JENTZEN: Yes.
JEFFREY JENTZEN: Yes, on two of the fragments, one fragment Dr. Eisenberg identified to me as the left parietal skull, or a bone from the left parietal skull. And the parietal bone, and I'm pointing to that area just about above my ear, the parietal bone is the -- a rather large flat bone that -- there's one on the right and the left side.
And Dr. Eisenberg identified a fragment of that bone and also there was a fragment that she identified as the left occipital bone. The occipital bone is the bone that's in the back of the skull, in this area. And I'm pointing to that area behind and below my left ear.
MR. GAHN: Was there any particular reason Dr. Eisenberg pointed these two skull fragment pieces out to you?
JEFFREY JENTZEN: Those fragments were noted, by herself and the initial examining pathologist, to have a defect called internal beveling on the fragments and so I paid particular attention to those bones; although, I did make a gross examination of multiple skull bones that she had demonstrated.
MR. GAHN: I'm going to put up on the screen what has previously been marked as Exhibit 390, and has been testified to by Dr. Eisenberg as a left parietal bone area; did you examine this?
JEFFREY JENTZEN: Yes.
JEFFREY JENTZEN: Yes.
MR. GAHN: Could you point out to the jurors this beveling area and maybe amplify a bit on that for the jurors.
JEFFREY JENTZEN: In addition to the beveling area, there was a semi-circular defect that has a shape on it that I would interpret as a portion of a whole. And this area, we're talking about the inside portion of the skull, so this area you can see is fragmented.
And if you would imagine a stone or something striking glass and the way the glass fragments; it's the same thing for a bullet going through the skull. Typically there's an internal beveling that occurs on an entrance wound. And characteristically there's external beveling noted as the bullet exits the skull.
And we use these characteristics to help identify and determine where an entrance or exit wound would be on a skull, if there were two different types of perforation. So it would be my opinion that this is consistent with a perforating entrance gunshot wound -- I'm sorry penetrating entrance gunshot wound.
MR. GAHN: And did you also review an x-ray that would be associated with this particular piece of skull fragment?
JEFFREY JENTZEN: Yes.
MR. GAHN: And I'm going to put up on the large screen what has previously been marked as Exhibit 397. And I'm going to ask you if you could again describe for the jurors what this shows?
JEFFREY JENTZEN: Yes, this is the left parietal bone fragment. Again, you can see the internal beveling and the semi-circular perforation and there's also some small radio dense fragments that I'm pointing to with the pointer. I can see probably about two or three on the picture from here. And those are characteristic of metallic fragments the bullet imparts to the target as the bullet travels through bony material. It's a common finding in certain gunshot wounds to the skull and other bony fragments.
MR. GAHN: And, again, did this support your original conclusion about this being an entrance gunshot wound?
JEFFREY JENTZEN: Yes.
MR. GAHN: I'm going to show you what has been marked as Exhibit 393, and previously testified to by Dr. Eisenberg as a bone fragment from the occipital area, and ask you if you recognize this?
JEFFREY JENTZEN: Yes, that's the bone fragment located, according to Dr. Eisenberg, in the left occipital region.
MR. GAHN: And, again, did you actually see this bone fragment when you were at Dr. Eisenberg's office?
JEFFREY JENTZEN: Yes.
MR. GAHN: And, again, would you take the pointer and just explain to the jurors, again, this beveling process that you have described about -- with the parietal?
JEFFREY JENTZEN: Again, one can see the internal beveling pattern that's prominent here and there is a semi-circular appearance to the edge of the bony fragment.
JEFFREY JENTZEN: It was my opinion that that was consistent with a gunshot wound, entrance gunshot wound.
JEFFREY JENTZEN: I did.
MR. GAHN: And I'm going to show you what has been marked as Exhibit 398? And, again, would you take the laser point and point to any areas of particular interest for the jurors.
JEFFREY JENTZEN: Yes, I'm pointing to the bony fragment on the photograph and, again, on the semi-circular area with the internal beveling. There is a rather localized area of multiple radio dense fragments. And it would be my opinion that these would be consistent with and suggestive of metallic lead type fragments that the bullet delivers to the bone as it's it passing through the bone. Could I expound on that?
JEFFREY JENTZEN: The bone is actually -- the bone in the skull is actually kind of like a wafered cookie. There's -- there's a bony -- a bony surface on the outer portion, a bony surface on the inner portion and the material in the inside is rather porous. It's actually where there's bone marrow and that's how the bone grows.
And so we call the outer table, the outer portion of the skull. And the inner table is the inner table -- is the inner portion of the skull. And the portion between is -- is -- is rather porous. And, then, as you can see in this area, this is predominantly where these small metallic fragments are pushed into or imparted into the bony tissue.
MR. GAHN: Based upon your examination of the skull fragments and the x-rays and all the associated records and reports that you reviewed in this case, do you have an opinion, to a reasonable degree of medical certainty, as to the manner of Teresa Halbach's death?
JEFFREY JENTZEN: Yes, I do.
JEFFREY JENTZEN: It would be my opinion that she died as a result of gunshot wounds to the head and that the manner of her death would be homicide.
MR. GAHN: And based upon your examination of the skull fragments and x-rays and all the associated reports in this case, do you have an opinion, to a reasonable degree of medical certainty, as to the cause of Teresa Halbach's death?
JEFFREY JENTZEN: Yeah, I believe that she -- her -- the cause of her death would be the gunshot wound to the head. And the manner would be the homicidal designation.
THE COURT: Mr. Strang.
CROSS-EXAMINATION BY ATTORNEY STRANG:
MR. STRANG: Dr. Jentzen, about what -- when, I should say, was it that Mr. Gahn first called you to consult on this case?
JEFFREY JENTZEN: I would say it was the early portion of November, or very late portion of October.
MR. STRANG: 2006?
JEFFREY JENTZEN: Yes.
MR. STRANG: Just about a year after you understood that the bones were examined, or the fragments of bones were?
JEFFREY JENTZEN: I would say so, yes.
MR. STRANG: Give or take?
JEFFREY JENTZEN: Yeah.
MR. STRANG: Okay. And it was also well after you knew that Steven Avery had been charged in the homicide of Teresa Halbach?
JEFFREY JENTZEN: I had knowledge of that through the regular media, yes.
MR. STRANG: Sure. Widely reported case?
JEFFREY JENTZEN: Right.
MR. STRANG: You knew of it just from reading the paper, or looking at the internet, or whatever you do?
JEFFREY JENTZEN: Yes.
MR. STRANG: All right. And when you got involved, you come over to Madison, you look at some bone fragments that Dr. Eisenberg has set out for you?
JEFFREY JENTZEN: Yes. Actually we looked at all the bone fragments that she had, yeah.
MR. STRANG: She identified for you the parietal bone fragments?
JEFFREY JENTZEN: Correct.
MR. STRANG: She identified for you the occipital bone fragments?
JEFFREY JENTZEN: Correct.
MR. STRANG: You were not able to identify those bones yourself?
JEFFREY JENTZEN: I could probably identify them as a skull bone fragment, but it would be difficult for me to place them specifically into a left occipital and parietal bone.
MR. STRANG: Okay.
JEFFREY JENTZEN: And that would be in the area of expertise of an anthropologist.
MR. STRANG: Reasonable in your view to rely on Dr. Eisenberg's expertise in telling you where in the skull she thought these bones came from?
JEFFREY JENTZEN: Correct.
MR. STRANG: The meeting that you described with Dr. Eisenberg, you said that there were others there, including some attorneys?
JEFFREY JENTZEN: Correct.
MR. STRANG: Just to be clear, there were not defense attorneys there?
JEFFREY JENTZEN: Correct.
MR. STRANG: The attorneys were both from the State or prosecution?
JEFFREY JENTZEN: The three attorneys at the table, yes.
MR. STRANG: Fair enough. Okay. Now, you, I gather although you were only -- well, you didn't do an autopsy here, as you said?
JEFFREY JENTZEN: Correct.
MR. STRANG: Although you were in a consultant role, you asked for the information you thought might be helpful to forming an opinion?
JEFFREY JENTZEN: Yes. I examined what I would typically examine in a case where I was asked to consult, autopsy protocol laboratory tests, if they were available; scene investigation materials on a -- police reports. It would be consistent with the same type of examination I would do if it was any other kind of forensic examination.
MR. STRANG: You asked for all of the information available that you thought might help you in forming your opinions?
JEFFREY JENTZEN: Specifically, within my area of expertise, yes.
MR. STRANG: I mean, you know, your opinions are within your area of expertise?
JEFFREY JENTZEN: Correct.
MR. STRANG: So you were interested in information that might bear on the opinion you hoped to form?
JEFFREY JENTZEN: Correct.
MR. STRANG: None of the information you requested was withheld from you, was it?
JEFFREY JENTZEN: Not to my recollection, no.
MR. STRANG: You got what you thought you needed?
JEFFREY JENTZEN: Yes.
MR. STRANG: Here, as in any other case involving a charge of a homicide, you understand that the personal stakes are high for the family of the victim?
JEFFREY JENTZEN: Yes.
MR. STRANG: The family of the defendant?
JEFFREY JENTZEN: Yes.
MR. STRANG: The defendant himself?
JEFFREY JENTZEN: Yes.
MR. STRANG: It's a serious case when the allegation is homicide, obviously?
JEFFREY JENTZEN: Yes, as I mentioned, I probably testify on probably 50 to 100 homicide type cases a year.
MR. STRANG: Right. And you're -- because you're a forensic pathologist, every time you testify, to some extent your own reputation is -- is at stake?
JEFFREY JENTZEN: I make opinions based on the evidence that I'm given and use my background experience in training and education to make opinion statements, correct.
MR. STRANG: Sure. And you want those opinions to be expressions that you can stand behind confidently?
JEFFREY JENTZEN: To the best of my ability, yes.
MR. STRANG: Stake your reputation to?
JEFFREY JENTZEN: Yes.
MR. STRANG: And, of course, any time you testify, just as today, you are testifying under oath?
JEFFREY JENTZEN: Yes.
MR. STRANG: You came here, as I understand it, offering two specific opinions: One, the more general, would be manner of death; am I correct?
JEFFREY JENTZEN: Correct.
MR. STRANG: And then, the second, and more specific in a sense, would be cause of death?
JEFFREY JENTZEN: Correct.
MR. STRANG: All right. Let's start with the more general, manner of death. We have heard a little bit about this, but not from a pathologist or medical examiner. In your work, we could say that there are four determined manners of death; is that right?
JEFFREY JENTZEN: Typically five.
MR. STRANG: All right. One would be accidental?
JEFFREY JENTZEN: Correct.
MR. STRANG: No special order here, but one of these is accidental, another is natural?
JEFFREY JENTZEN: Yes.
MR. STRANG: A third would be suicide?
JEFFREY JENTZEN: Yes.
MR. STRANG: And fourth, homicide?
JEFFREY JENTZEN: Yes. Fifth is undetermined.
MR. STRANG: Very good. That's the one we didn't hear about yesterday. Unexplained or undetermined is your term of choice?
JEFFREY JENTZEN: Undetermined, yes.
MR. STRANG: All right. We'll use undetermined. So that would be the fifth manner of death, which is different than the other four in the sense that it's -- it's what you say when you don't know?
JEFFREY JENTZEN: It's what we say when we can't definitively determine between, or distinguish between, for example, an accident and a suicide, or a homicide and an accident, yes.
MR. STRANG: Sure. Okay. And then, if we descend to the specific cause of death, there is as many as there are the ways that people die in some sense. I mean, this would be a gunshot in one case, it would be a drug overdose in another, you would try to identify the drug, if you could --
JEFFREY JENTZEN: Correct.
MR. STRANG: -- in that instance?
JEFFREY JENTZEN: Correct.
MR. STRANG: It may be just any -- any of a number of ways that can cause people to die?
JEFFREY JENTZEN: Yes.
MR. STRANG: All right. And what you do in establishing cause of death, if you can, is be as specific as possible?
JEFFREY JENTZEN: Yes. And I would say, based on the materials and evidence that's present, we make an opinion on that, yes.
MR. STRANG: All right. And by specific as possible, let's, since you are talking today about gunshots, let's use a gunshot case. When you get a full course or, you know, most of the course, you may find multiple gunshot wounds in evidence at autopsy?
JEFFREY JENTZEN: Yes.
MR. STRANG: When that happens, you make an effort, to the extent medically possible, to determine which of the gunshot wounds would have led to death?
JEFFREY JENTZEN: Yes. And in some cases there are multiple wounds and others I would describe as non-lethal and others are potentially lethal.
MR. STRANG: Sure.
JEFFREY JENTZEN: Others are definitely lethal.
MR. STRANG: Sure. So -- And, again, just by way of example, if someone has five gunshot wounds, you may be able to say, for example, that two of these definitely would have been lethal; two definitely would not have been lethal in the ordinary course of medical care; and maybe the fifth, possibly lethal?
JEFFREY JENTZEN: Correct.
MR. STRANG: Something like that. And just as an example.
JEFFREY JENTZEN: Yes.
MR. STRANG: All right. Now, here you saw evidence of two gunshot entrance wounds?
JEFFREY JENTZEN: Yes.
MR. STRANG: To bones that you could identify, personally, as probably being from a human skull?
JEFFREY JENTZEN: Correct.
MR. STRANG: And as to which you had more specific locations from Dr. Eisenberg?
JEFFREY JENTZEN: Yes.
MR. STRANG: You saw no bones displaying anything you viewed as an exit wound?
JEFFREY JENTZEN: Correct.
MR. STRANG: A bullet leaving the body.
JEFFREY JENTZEN: Correct.
MR. STRANG: You, therefore, were not able to draw any conclusions about what we might call wound track?
JEFFREY JENTZEN: Correct.
MR. STRANG: The direction or angle at which a bullet penetrates the body?
JEFFREY JENTZEN: I would say, based on the material that I had, I wasn't able to do that, correct. In some cases, when you have more intact specimens, you can certainly render more definitive --
MR. STRANG: Sure?
JEFFREY JENTZEN: -- opinions as to wound track, direction of fire, that type thing.
MR. STRANG: But those were not opinions you were able to form or render here?
JEFFREY JENTZEN: Correct.
MR. STRANG: Now, tell the -- I mean, in your opinion, the cause of death here was one or two gunshot wounds?
JEFFREY JENTZEN: Yes.
MR. STRANG: To the head?
JEFFREY JENTZEN: Correct.
MR. STRANG: All right. Tell, the ladies and the gentlemen of the jury all of the information you have in this case that allows you to conclude that either of the two bullets here first struck skull bone while the victim was alive?
JEFFREY JENTZEN: Okay. Could you repeat that question.
MR. STRANG: Sure. I would like you to simply tell the ladies and gentlemen of the jury what information you have here that allows you to conclude that either of these gunshot wounds occurred while the victim was alive, that is, bullet struck bone, while that person was alive?
JEFFREY JENTZEN: I don't specifically think that there's any one piece of information that would say that the person was alive, with a beating heart, or an intact brain. There's material and I was given information that there was a spent bullet recovered at the scene that contained the blood specimens of the decedent.
And that would be indicative to me that the bullet had passed through the brain at a time, whether it was liquified blood, or that it wasn't going through specifically bone fragments. And I would think that that would be the predominant -- that would be information that I think would be helpful in making that type of opinion.
MR. STRANG: All right. We have certainly had testimony that Teresa Halbach's DNA was found on a bullet fragment?
JEFFREY JENTZEN: Right.
MR. STRANG: I, at least, recall no testimony that Teresa Halbach's blood was found on a bullet fragment, but the jury will decide in the end, that. And in a sense it doesn't matter.
Is there any way to distinguish the bullet you -- hole you saw, either one, from a gunshot that was fired into the head of an intact corpse, from a gunshot that was fired into the head of a living person?
JEFFREY JENTZEN: I don't think I could make a definitive determination based on whether the individual was in a peri-mortem time frame or whether the individual was skeletonized. It would be my opinion that the wounds showed an intact, robust bone that is consistent with what I would say non-skeletonized material, meaning that these look like -- typically like an entrance wound through a bone of a person who is not a skeleton.
And the way -- the reason I described that and I would make that -- that clarity is that in a skeletonized bone, where you have got dried bone material, as the bullet passes through it, I would suspect that there would be a different kind of fracturing and that it wouldn't get the same type of gunshot wound, particularly in the parietal bone fragment that I can see. That would just be my opinion on that.
MR. STRANG: Okay. So, you know, I'm trying to track you here, but as I understand, you think these bullet holes were made before the body was in a purely skeletal condition?
JEFFREY JENTZEN: Yes.
MR. STRANG: All right. Let's go back to the question I asked. The gunshot wounds to the bones you observed, would be indistinguishable if the bullet had hit the bone 30 minutes after the person had expired or 3 seconds before the person expired?
JEFFREY JENTZEN: I would agree with that, yes.
MR. STRANG: You would. And if the person was 30 minutes expired when the bullet hits bone for the first time, then the gunshot did not cause the death, true?
JEFFREY JENTZEN: If the individual was dead before the gunshot -- sustained the gunshot wound to the head, then the bullet would not have caused the death.
MR. STRANG: The bullet wounds you saw are as consistent with a bullet striking a non-skeletal body after death, as they are with a bullet striking the skull before death?
JEFFREY JENTZEN: I would say so, yes.
MR. STRANG: If death occurred before the first bullet struck bone here, then there was another cause of death entirely, as a matter of logic, wasn't there?
JEFFREY JENTZEN: I would agree with that, yes.
MR. STRANG: And as to -- In that situation, as to cause of death, you cannot give an opinion?
JEFFREY JENTZEN: Are you talking about specifically in this case or are you talking about if I have got a skull with two bullet holes in it without any other information?
MR. STRANG: Well, let's start without any other information.
JEFFREY JENTZEN: I would say that the two gunshot wounds to the head are highly suspicious for a non-intentional, or the individual would not have done it themselves, because of the multiple nature of the injury.
MR. STRANG: Sure.
JEFFREY JENTZEN: And with the caveat that, you know, whether it was done before or after the person died.
MR. STRANG: Okay. So, let's -- let's unpack that. If we have two gunshots to the head, we're highly doubtful that this is suicide?
JEFFREY JENTZEN: I would say so, yes.
MR. STRANG: Right. Most suicides --
JEFFREY JENTZEN: Assuming that these were the ones that caused her death --
MR. STRANG: Sure.
JEFFREY JENTZEN: -- yes.
MR. STRANG: Most suicides don't get off a second shot?
JEFFREY JENTZEN: Correct.
MR. STRANG: All right. You would suspect homicide?
JEFFREY JENTZEN: Correct.
MR. STRANG: But you also would have to suspect accidental death if you had gunshot holes in a skull, absent other information.
JEFFREY JENTZEN: I wouldn't suspect that there would be two perforations with a accidental type -- or two entrance wounds with an accidental type death, unless it was a multiple missiles; for example, like a buck shot injury, or something along those lines.
MR. STRANG: Sure. And in that instance it would be relevant information if the deceased was found dressed in blaze orange in shrubbery, in the middle of the woods in the third week of November. That's information that might be relevant to determining whether two gunshot wounds to the head were accidental or homicidal?
JEFFREY JENTZEN: I would say that would be helpful information yes.
MR. STRANG: Sure. You would need more information, in any event?
JEFFREY JENTZEN: Yes.
MR. STRANG: By homicide, if we back up on manner of death, we didn't explain that here, but this, in your argot, homicide would mean the intentional causation of another persons death?
JEFFREY JENTZEN: That a homicide in my, would be that the death was caused by another person, correct.
MR. STRANG: Correct. And it does not necessarily connote legal liability, homicide in that sense?
JEFFREY JENTZEN: I don't make those determinations.
MR. STRANG: Right. So if something later proves to be, let's say a justified shooting in self defense, it's still a homicide in your world because it's one person causing the death of another?
JEFFREY JENTZEN: Correct.
MR. STRANG: All right. Now, back closer, I guess to this case, you can't tell whether these bullet holes in the skull were made before death or after death. You can -- You can tell only that they are made before the remains are skeletal?
JEFFREY JENTZEN: Correct.
MR. STRANG: All right. And if the bullet wounds were made after death, then necessarily something else is the cause of death?
JEFFREY JENTZEN: I would agree with that.
MR. STRANG: And as to what that might be, there's almost nothing you could rule out, based on the information you had?
JEFFREY JENTZEN: Based on the evidence that I have, yes.
MR. STRANG: So --
JEFFREY JENTZEN: There could be other -- There could be other, for example, drugs or something along those lines --
MR. STRANG: Sure.
JEFFREY JENTZEN: -- that I don't have access to.
MR. STRANG: And we could sit here all a day on that, but someone could have been strangled and then shot after -- after they --
JEFFREY JENTZEN: Certainly is possible.
MR. STRANG: -- expired.
JEFFREY JENTZEN: Yes.
MR. STRANG: Beaten, shot after they expired.
JEFFREY JENTZEN: Correct.
MR. STRANG: Drugs, as you say, a drug overdose, shot after they had died of the drug overdose?
JEFFREY JENTZEN: Correct.
MR. STRANG: And I won't go on but, in other words, there's nothing that you can say about opining on cause of death, if the gunshot wounds occurred after death?
JEFFREY JENTZEN: On the cause of death, yeah, I would say so.
MR. STRANG: And then, likewise, once -- once we don't have a cause of death, it's similarly difficult to assign a manner of death?
JEFFREY JENTZEN: Well, medical examiners and forensic pathologists don't make determinations on manner of death in a vacuum. We utilize, as I mentioned, evidence from the scene. And if we can go to the scene, personally, we use that information. Or if we can't, then we use photographs and other people's reports to use that information.
We use laboratory data. We use evidence that's recovered. And we -- we put that together and we render our opinion as to what the manner of death is. We don't do it in a vacuum with a single piece of information, in isolation from all others.
MR. STRANG: Of course not. Of course not. And in a cause of death, for example, you cited to these jurors, your understanding that a bullet or bullet fragment was found with what you thought was blood of the victim on it. And that, initially, factored into your opinion on cause of death?
JEFFREY JENTZEN: That was one of the things, yes.
MR. STRANG: Sure. You now acknowledge, that as long as the remains weren't skeletal, blood or DNA could have been left on that bullet, passing through the skull of a dead person?
JEFFREY JENTZEN: Correct.
MR. STRANG: Likewise, with manner of death you, of course, consider all the information you have, that's almost obvious, isn't it?
JEFFREY JENTZEN: Correct.
MR. STRANG: And some of the information you have here is that the bone fragments you saw were burned?
JEFFREY JENTZEN: Correct.
MR. STRANG: Badly burned?
JEFFREY JENTZEN: Correct.
MR. STRANG: Burned to the point that they had fragmented and fallen apart?
JEFFREY JENTZEN: Yes.
MR. STRANG: That suggested to you, in your line of work, some effort to conceal the body or disguise the body?
JEFFREY JENTZEN: Exactly.
MR. STRANG: And you said to yourself, now, with that information, why would someone want to conceal the fact of death. Well, one obvious reason would be that the death itself, you know, the fact that the person died, might be incriminating or awkward in some way.
JEFFREY JENTZEN: That would be information that would be valuable, yes.
MR. STRANG: Sure. And an effort to conceal death is something you see frequently, or at least not infrequently, in homicide cases?
JEFFREY JENTZEN: Correct.
MR. STRANG: It's also something you will see less frequently, but it's happened in your experience, you will see this in accidental deaths, on occasion?
JEFFREY JENTZEN: I would say it would be pretty rare, yes.
MR. STRANG: Well, let's -- let's offer some paradigms and see if you have had these kinds of cases in your experience. None of them -- And I'm not suggesting any of these paradigms bear any similarity to this case, but I want to explore the relation between an unknown cause of death and the manner of death.
JEFFREY JENTZEN: Sure.
MR. STRANG: Okay? A young teenager who's become pregnant out of wedlock, feels a great deal of shame about that, conceals the pregnancy, ultimately gives birth by herself, the baby dies for want of medical care and an effort is made to conceal the newborn.
JEFFREY JENTZEN: And you are giving that as an example of what --
MR. STRANG: Concealment.
JEFFREY JENTZEN: -- manner of death?
MR. STRANG: Concealment in connection with an accidental manner of death.
JEFFREY JENTZEN: I don't know if I would attribute that to an accidental manner of death; it would depend upon the totality of the information that's available.
MR. STRANG: Sure.
JEFFREY JENTZEN: Resuscitation efforts, evidence of trauma and injury on the child, age, etcetera. So, again, you can't take a specific issue and look at it in isolation. You need all the information.
MR. STRANG: Understood. And sometimes in the sort of paradigm that I have explained, sometimes, unfortunately, the young mother will smother the infant or do something active to cause the infant's death, other times it simply the lack of medical care, the infant can't thrive or survive?
JEFFREY JENTZEN: Correct.
MR. STRANG: Dies of, in a sense, a natural cause or an accidental cause, for want of medical care at the time of birth?
JEFFREY JENTZEN: Again, I don't know if we're talking about an accident or ...
MR. STRANG: Right.
JEFFREY JENTZEN: -- or another type of injury, that you are talking about.
MR. STRANG: Yes.
JEFFREY JENTZEN: But I think it would be very rare to call a death like that an accident.
MR. STRANG: All right.
JEFFREY JENTZEN: There -- I mean, there might be other examples.
MR. STRANG: Another example would be, something you may have run across, two people involved in an adulterous affair or liaison and one drops dead of a heart attack. Some effort may be made under those circumstances to conceal the fact, or at least the timing or place of death.
THE COURT: Mr. Strang.
MR. STRANG: I'm simply trying to establish that there are instances in which accidental death, as a manner, will be matched with concealment.
THE COURT: Is that in dispute?
MR. STRANG: Is that in dispute?
THE COURT: Do you acknowledge that such circumstances can exist?
JEFFREY JENTZEN: I would acknowledge that there's concealment in some cases, your Honor, but examples that are given here, I don't think I would agree with. Could I expound on that?
THE COURT: Go ahead.
MR. STRANG: Sure.
JEFFREY JENTZEN: I have never seen a individual burned in an attempt to conceal an adulterous affair and somebody who dies suddenly during an act of intercourse. On occasion, we will see individuals who die from drug overdoses that would be dumped at a different location, but it would be very uncommon or rare to see any mutilation or other types of bodily disruption to hide that kind of death.
MR. STRANG: Okay. Fair enough.
JEFFREY JENTZEN: And so the type of burning and charring that I would see in this case would be, in my opinion and my experience, most consistent with homicidal type of manners of death and extremely rare in others.
MR. STRANG: Fair enough. Okay. You simply, you think this is most consistent, you can't rule out other possibilities?
JEFFREY JENTZEN: I can't rule out other possibilities beyond -- beyond the impossible, correct.
MR. STRANG: Well, and one of the problems we have here is that we're dealing -- we're in a forensic setting, the intersection of the pathology with law, correct?
JEFFREY JENTZEN: Yes.
MR. STRANG: And you know that there is both a first degree intentional homicide charge that these folks will have to decide and a mutilating a corpse charge they will have to decide, correct?
JEFFREY JENTZEN: I'm not aware of what the -- of what the legal standards are being used here as far as --
MR. STRANG: Or what the charges are?
JEFFREY JENTZEN: And what the charges are.
MR. STRANG: You are familiar with the fact that Wisconsin has a crime for mutilating or concealing a corpse?
JEFFREY JENTZEN: I am, yes.
MR. STRANG: All right. And you are familiar that Wisconsin has a crime of first degree intentional homicide?
JEFFREY JENTZEN: I am aware of that, yes.
MR. STRANG: All right. And you are not -- Your field of expertise does not allow you to render an opinion on who fired a shot, or shots, into this skull?
JEFFREY JENTZEN: No. I don't have that information, no.
MR. STRANG: Your area of expertise does not allow you to render an opinion on who caused the burning or charring of the bone fragments you saw?
JEFFREY JENTZEN: That's correct.
MR. STRANG: And whether one or more, two, three, four, however many people are involved, in one or the other of those alleged crimes, you are not able to say?
JEFFREY JENTZEN: In this case I can't, no.
MR. STRANG: Right. And whether one person is involved in one offense, but not in the other, you are not able to say?
JEFFREY JENTZEN: Correct.
MR. STRANG: All right. So these are the reasons for my questions and I guess in the end, what you are telling us is that your opinion on manner of death rests in part on the fact that you see gunshot entrance wounds?
JEFFREY JENTZEN: Correct.
MR. STRANG: And then rests on the burning or charring that you saw here, of the skeleton?
JEFFREY JENTZEN: Correct. Could I expound on that?
MR. STRANG: Well, I don't want to -- if you have useful information --
JEFFREY JENTZEN: There may be other issues.
MR. STRANG: -- you can answer that question.
JEFFREY JENTZEN: There may be other issues related to the determination of manner of death, in addition to simply the evidence of gunshot wounds and the evidence of concealment.
MR. STRANG: And are there other specific issues here that you rely upon in offering the opinion that homicide is the manner of death here?
JEFFREY JENTZEN: I would have other information, yes.
MR. STRANG: Do you have other information in this case?
JEFFREY JENTZEN: Yes.
MR. STRANG: That came from the police?
JEFFREY JENTZEN: It came from the investigators, yes.
MR. STRANG: All right. Your opinion, in any event, is that homicide was the manner of death?
JEFFREY JENTZEN: Correct.
MR. STRANG: You did not view this as unexplained?
JEFFREY JENTZEN: Correct.
MR. STRANG: Not withstanding the fact that you cannot here, as I understand you, assign a cause of death other than by assuming that the bullet holes were made, at least one of them was made, while the person was alive?
JEFFREY JENTZEN: Correct.
MR. STRANG: Just to be perfectly clear here, in the end, as you sit here today, you can't tell this jury whether one or both of these gunshots were made while the person was alive?
JEFFREY JENTZEN: That would be correct, yes.
MR. STRANG: If they were made after death, they did not cause the death?
JEFFREY JENTZEN: That would be true, also.
MR. STRANG: But your opinion remains that gunshot is the cause of death?
JEFFREY JENTZEN: Correct.
MR. STRANG: That's all I have.
THE COURT: Mr. Gahn.
REDIRECT EXAMINATION BY ATTORNEY GAHN:
MR. GAHN: Dr. Jentzen, you talked about, as a medical examiner, not viewing one particular piece of information in a vacuum and you talked about having helpful information and looking at the totality of the circumstances; would you explain what all of that means, to the jurors, in the context of this case.
JEFFREY JENTZEN: Well, on a daily basis, the medical examiner, I mean, for example, I would investigate hundreds of deaths a year. And that investigation entails seeing information: History, medical history of the individual, habits and social habits of the individual, past medical history, and then, finally, the appearance of the body. Possibly the position of the body in some cases, at the scene, may determine whether the death is an accident or a natural death, based simply on the position and other artifacts that we would see on the body.
Medical examiners and coroners do this on a routine basis and looking at individual cases. And to take one specific area or one single piece of information and to say that this is an accident, or a homicide, or a undetermined case, I think is not real consistent with how medical examiners and coroners function in evaluating and investigating deaths.
On a daily basis, we make determinations as to cause and manner of death, based on evidence, information, scene investigation, medical history.
JEFFREY JENTZEN: This is my 21st year as a medical examiner for Milwaukee.
MR. GAHN: And did you state that annually you will look at maybe 100 cases involving gunshot wounds to the skull?
JEFFREY JENTZEN: Typically our office would investigate between, I would say, roughly 100 to 120 or 30 homicides and probably 100 to 130 or 40 suicides. And 60 to 70 percent of those are gunshot wounds. And the vast majority of those are to the head and upper torso areas. Many times there's multiple wounds, there's different types of ammunition.
And in addition, that we attend lectures and other educational programs to expand our understanding of both the -- the bodies, and the projectiles and weapons, and the circumstances, and we render opinions, legally bound -- binding that determine cause and manner of death where there is a lot at stake.
MR. STRANG: Your Honor, I object to the reference to a legally binding determination of this witness, that's entirely out of place and the jury should be told that there is no legally binding determination by this witness.
THE COURT: Well, I agree, I guess it depends on your definition of legally binding, but to the extent, certainly, it invades the province of the jury, the Court agrees very strongly, that's the jury's determination in this case. And I will instruct the jury to that affect. I'm not sure of the context in which it was used.
MR. GAHN: I took it to mean that he just gives opinions in cases that other people make decisions on. That's what I took the context in.
THE COURT: Anything else?
MR. GAHN: (By Attorney Gahn)~ Doctor, do you believe that you had sufficient information in this case to render an opinion as to manner of death and cause of death?
JEFFREY JENTZEN: Yes.
JEFFREY JENTZEN: Correct.
MR. GAHN: If this case had happened in Milwaukee County and with all the information that you know in this case, would you have rendered an opinion as to manner and cause of death, if this were your case in the Milwaukee County Medical Examiner's Office?
JEFFREY JENTZEN: I would have rendered the same opinion.
MR. GAHN: And is that opinion -- And, again, what is your opinion as to the manner of death of Teresa Halbach?
JEFFREY JENTZEN: It would be my opinion that she died as a result of gunshot wounds to the head and the manner of her death is homicide.
THE COURT: Anything else, Mr. Strang?
MR. STRANG: No, thank you.
THE COURT: All right. The witness is excused. Members of the jury, that is all the evidence that we're going to hear today. At this time I'm going to excuse you for the rest of the day. I will let you know in a minute, because of the order of things, why. Before I do that, since we are adjourning for the weekend, at this point I want to read to you the warning that you have heard before, but it's still very important.
The Court's decision not to sequester the jury during the trial in this case is dependent on the jurors not listening to, watching, or reading any news accounts of the case, nor discussing it with anyone, including members of your family or other jurors.
For these reasons it is vital that you do not listen to any conversation about this case. Do not read any newspaper or internet reports or listen to any news reports on radio or television about this case.
To assure that you are not exposed to any improper media coverage, the Court has ordered that, for the duration of the trial, you do not watch the local news on television, do not listen to the local news on radio, and do not read the newspaper unless you first have someone remove any articles about the case. In addition, you are not to visit any internet websites or web logs which may include any information about the case.
Since we are breaking for the weekend, I understand that some of you may be working at places of employment. Do not discuss the case with any employers, employees, or patrons, do not volunteer your status as a juror to anyone.
If anyone attempts to discuss the case with you, politely but firmly notify them that you are prohibited from discussing the case. If you're involuntarily exposed to any information about the case from any source, take steps to immediately avoid any further exposure.
Should you be exposed to any reports or communications from any source concerning the case during the trial, or should you become aware of anything you believe may affect your ability to serve as a juror, you should not discuss your concerns with any other jurors but should report any concerns to the jury bailiff.
Now, I have also told you, previously, that occasionally during the trial there will be times when the Court has to take up matters with the attorneys, outside the presence of the jury. There is going to be one such occasion on Monday. And because it is a matter which may take the greater part of the day, rather than have you sitting around and waiting until we're finished, I'm not going to have the jury report for duty on Monday. I'm going to have you report for duty on Tuesday at the normal time.
Because of the fact that you are not going to be here on Monday and it's a weekday, I want to make especially sure that you pay attention to the warning I just read, that is, make sure you don't discuss it with anyone, avoid any exposure to the case.
But it is necessary for the Court to hear information outside your presence on Monday and for that reason you will not be reporting on Monday but reporting on Tuesday morning, at the normal time. With that, I will excuse you for the weekend at this time.
MR. STRANG: No objection.
THE COURT: All right. That exhibit is admitted.
(Jury not present.)
THE COURT: You may be seated. Appears the jury is not disappointed that we'll be going home early. All right. Then, on Monday, we'll report back to this courtroom at the normal time. Correct, counsel?
MR. STRANG: Yes, sir.
THE COURT: All right. I will see you then.
MR. FALLON: Your Honor, could we have an accounting on the exhibits; there's a number of exhibits that may not have been moved in that we would like to move into evidence at this time. And then if the Clerk would check her score cards.
COURT CLERK: Sure.
THE COURT: I have to address another matter at this time. Let me suggest this, why don't the attorneys meet with the clerk first thing Monday morning. If you discover there is action that needs to be taken with respect to any of the exhibits, we'll do it at that time.
MR. FALLON: All right. Thank you.
(Proceedings concluded.)