J. Scorr Denton, M.D. FORENSIC PATHOLOGIST & ILLINOIS CORONE 104 W. Front Street, BLOOMINGTON, IL. 61702 MO9-RS-MES TOAGS-2836 FAX sdemtonmd® gyal com February 7. 2017 ‘Special Agent Timothy J. Walther Federal Bureau of Investigation Chicago Division. Squad CE-6 Re: Death of CPD Sergeant Donald Markham File No. 184B-CG-2093375 Dear Special Agem Walther, At your request I reviewed the Following submitted materi Sergeant Markham, a $1 year old man who was found deceased in his bed with a gunshot wound of the head: 1. Leticr requesting a review of the materials included on a CD regarding the death of Sergeant Donald Markham dated December 8. 2016. 2. Records from the Chicago Fire Department regarding the death of Sergeant Marieham dated September 2. 2015. 3. Reports from the Chicago Police Department regarding the death of Sergeant Markham dated September 2 through November 13, 2015. 4. Cook County Medical Examiner Investigations Case Report regarding the death of Serycant Markham dated September 2. 2015. 5. Cook County Medical Examiner's Orliee Report of Postmortem Examination regarding Sergeant Markham dated September 7. 2015. 6. Cook County Medical Examiner's Office Toxicology Report regarding the testing of Sergeant Markham’s blood and vitreous humor dated September 16, 2015. ight photographs of the scene of death of Sergeant Markham by the Chicago 1¢ Scene Investigator taken September 2. 2015. 8. Thirty-three photographs of the autopsy of Sergeant Markham taken at the Cook County Medical Examiner s Office on September 2, 2015. Is regarding the death of Afier review of these records. reports. and photographs, and in answer to your specific questions in the consultation review request letter, my opinion is that there are multiple ‘observations and findings that are inconsistent with the ruling of suicide in the death of Sergeant Markham, In the scene investigation photographs taken by the Chieago Police Crime Scene Investigator the gunshot wound on the right side of his head shows (eatwres of a near contact or very close range gunshot wound of entrance. ‘The superior or uppet margin of Mythe entrance wound on the scalp shows soot deposition beneath the hair and within the muzzle abrasion outline. The wound does not show surrounding gunshot stippling or tattooing. The dense blood around the wound obscures other features of the entrance in these scene photos. Mis well known in forensic pathology that a elose range, near contact or conlaet range gunshot wound of the head in and of itself'can be a suicide or homicide. A thorough review of the scene investigation findings and circumstances are critically important to determine the manner of death correctly First, it is clear that Sergeant Markham sustained the gunshot wound of his head while tying in bed within his bedroom at home as reported and documented in the photographs. The wound would have bled immediately and all the blood is on or immediately around his body on the bed and a pillow. ‘The blood flow pattem on his face in the scene photos is inconsistent with the position of his head as shown. ‘The blood Now pattern is flowi anteriorly or towards the front of his Face but his head is Tying sideways on the pillow. It ig also important to note that the blood on the right side of his face is completely dried and actually cracking, which requires a significant period of time to occur, usually a few hours. Therefore his head und body must have been lying sideways an his left side for the blood to flow ta the front of his Face. Also the patch of blood absent from the right side of his chin and clearly transferred to his left hand is consistent with his left hand or his left hand and r jod upward after death, after he sustained the gunshot wound and before the blood dried. The position of his body is not entirely flat with his upper body rotated towards the right. This is consistent with his body being on its le side when the shot was fired. and this left side body and head position would also be consistent with the blood flow on his face being farwards ht arm being Itis very concerning that the right hand and wrist are below and even pattially under the Teft forearm that erosses over his chest. I this were a case of suicide. the gunshot wound of the right side of the head requires that he would use his right hand to hold the gun and pull the trigger. Based upon the internally explos cranium. he would be immediately unconscious and lose all musele tone and movement, His right arm would immediately fall to the right side of his body along with the gun. ‘The position of his right hand below and partially under his left arm is inconsistent with Sergeant Markham shooting himself, as he would have had to volitionally move his right arm below his left arm after sustaining the gunshot wound. I¢ is also very unreasonable to believe that Sergeant Markham was able to shoot himself in the right side of his head and then carry or transport the gun within his right hand to the left side af his body and. cover it with his leftarm, Only in 25% of sel(-inflicted gunshot wounds is the gun still the hand and because almost always because the finger is still within the trigger euard o: 1¢ forces of the wound within his ers showed no the hand did not move after sustaining the gunshot wound. His fit ies or impression from the trigger guard. Neither is tue fox yeant Markham. Mis,Finger is not in the trigger guard and the gun is on the opposite side of his body and away from his head. Also his right hand is rotated outward, [fa person was able shoot himself fr herself and then have their eight hand fall 1 theit left side, the palm surface of the hand would be against the side of the body. His right hand appears rotated outwards and the wrist flexed downwards. with the gun resting in place loosely. This again would require movement of the body after death. Therefore the position of the gun in his right hand that is at the left side of his body below end partially under his left forearm appears Ic hand is to have een manipulated aficr his death. ‘This act of gun placement in the consistent with mavement of the right and left crossed armis upward with the blood contact and transfer mark of the left hand and chin as noted above. Rolling his body towards the right into a more supine position would also allow his right hand t be uncovered and allow placement of the gun in his right hand, Therefore the position of his body. the blood flow pattern on his face. the blood transfer pattern on his chin and left hand under his chin, and the moved and placed appearance of the gun in his right hand. are all consistent with his body having been moved after death from its position lying more on his left side and the gun then placed looscly in his right hand after death. ‘The autopsy photographs from the Cook County Medical Examiner's Office show the previously described soot on the scalp above the gunshot wound indicating a very close or near contact range gunshot wound of entrance. ‘The distance of the muzzle of the gun from the scatp is consistent with the muzzle less than one inch from the scalp. held just above the skin when it was fired. A full or tight contact range wound would show a mote pronounced abraded laceration matching the muzzle of the gun and absence of the surrounding soot. A gunshot fired {rom a few inches away would leave a greater dispersal pattern of soot on the scalp around the wound and a ring of stippling within the soot. ‘The most accurate method af determining the exact range of firing would be to test fire the same weapon with the same ammunition at different close range distances to duplicate the soot pattern shown above the wound, The distance or range of firing: certainly closer than one inch based upon my experience and the forensic pathol literature. The Medical Examiner's photographs also show flecks of dried blood on the skin of the car and forehead. witieh do not appear as gunshot stippling, and were not present in the scene photographs. Therefore they eame to be there as the body was r scene and are not gunshot stippling. Blood smears are also an different parts of his body hot seen in the scene photographs consistent with heing placed within a body bag and transported to the Medical Examiner's Office, The dryi cracking is noted in the autopsy photographs. It is disappointing that the entrance wound ‘was not cleaned free of obscuring blood and the hair around the wound shaved away. Which are standard pracedures for examination of'a gunshot wound at autopsy. liven moved from the 1g of the blood with morewithout these procedures. the wound still shows the concentric rings anteriorly from the cnirance defect due to the muzzle striking the skin os the scalp is elevated or blown outwards from the skull by the expanding gases of the cartridge. Dark gray soot is seen at the entrance defect margin and reportedly within the wound, The skull shows extensive comminuted or displaced and radiating fractures consistent with the explosive discharged gasses entering the skull eausi insion. The flattened and expanded ‘metal jackeied medium caliber bullet did not exit and was recovered from within the left side of the head. 1Lis unclear from the photographs where the bullet exactly terminated or struck the opposite left side of the skull, but the gunshot wound is generally deseribed 4s being right to lef in the autopsy report. Sergeant Markham’s right hand and index finger also show no abrasions or lacerations that can be seen after firing and handgun. Finally, there are ther areas of concern in determining Sergeant Markham’s death a suicide, Sergeant Markham had no history or indication that he was depressed or ever expressed an indication that he wanted to commit suicide. ‘There was no history that Sergeant Markham was prescribed anti-depressant or other psychoactive medivations. In regards to when his gunshot wound was sustained. the police investigation report stated that he returned home around 100 a.m. but the incident was reported around 3:00 am, There was also information indicating a domestic argument had occurred priot to the gunshot wound at home. [t is also difficult to understand how no one inside the house heard the gunshot wound unless an object muffled the sound of the gunshot. The toxicology report from the MLE, testing of his postmortem blood indicates a blood alechol concentration of 123 mg/dl and a vitreous humor eye Fluid concentration of 153 mg/dl. These values indicate that Sergeant had a significant concentration of blood alcohol, and that the higher vitreous humor alcohol concentration indicates that he had stopped drinking alcohol for at least an hour hefare he died from the gunshot. ‘The Chicago Police report indicates that the investigating detective arrived at the Medical Examinet’s Office to continue investigating the death after the autopsy had already been completed. It is important for the forensic pathologist to consider any i information and scene investigation photographs hefore beginning the autopsy so that any concerns o questions can be addressed and any additional evidence collected. if requested. [tis also a matter of potential bias in the determination of manner of death that the scene investigation photographer's placard! and initial investigation reports all indicate that Sergeant Markham’s death was a suicide before a critical evaluation af the circumstances of his death was performed. In my experience. once a determination is established quickly at the scene it is difficult to change course and start an investigation over from the begi ing without a preconceived and a continued confirmation hias, even alter the autopsy and further investigation, The autopsy report was completed and certified as a suicide five days after the autopsy was performed. and likely the death certificate was certified as such the day of the autopsy. A forensic pathologist whobelicves zoing into an autopsy that a death is an unquestioned suicide as opposed to one in which there is a possibility that it may be homicide or that there are eoneerns it is not a suicide will creat each of those autopsy situations differently. and again may be subject to continued confirmation bias. In summary, based upon a carefil review of the submitted informatian noted ahove, my ‘opinions ate that the cause of death for Sergeant Donald Markham is @ elose range near ‘contact range gunshot wound of the head. and the manner of death is best certified as a homicide, or death at the hands of another. His death should not he certified as suicide The findings and observations at the scene of his death are inconsistent with a self inflicted gunshot wound. as noted above. This review and opinions are reasonable degree of medical certainty, based upon the current provided information listed above. and my training, experience and knowledge as a Board Centitied Forensic. Anatomic and Clinical Pathologist in an active forensic pathology practice. I reserve the right to amend any of these opinions if further information becames available. 1. Seott Denton. M.D. Forensic Pathologist & IL Coroners’ Physician Bloomington, IL Clinical Associate Professor. Department of Pathology. University of Hlitois College of Medicine at Peoria iven to