A Second Opinion On Elliott Smith’s Autopsy Report

A few days ago, I got in contact with a licensed nurse who has been working for 11 years, nine years in Southern California in L.A. County and, for the past two years in the Pacific Northwest. She was recently made aware of Mr. Smith’s case by someone, who gave me her contact. We exchanged a few emails and she very kindly accepted to interpret the 27 pages of the autopsy report I sent to her. It is possible that other documents exist and are still in the possession of the L.A.P.D.

Nothing really came up from my interview with Dr. Scheinin, who performed Mr. Smith’s autopsy. She at first appeared to be somewhat nervous and maintained a very neutral position throughout the entire interview, stating she could not determine whether it was a suicide or a homicide based on the forensic evidence.

I had always wanted to get another opinion from someone who wasn’t directly involved in this case, who is not an elected official, and doesn’t work for L.A. County. As opposed to Scheinin, who necessarily had to choose her words very carefully, this person (let’s call her L.) had more freedom to share her informed opinion without fear of possible consequences.

So after evaluating the autopsy report, L. had to say a lot and I have tried to regroup the most salient points. She first discussed this particular form of suicide and the oddities presented by Mr. Smith’s case:

‘Suicide by stabbing is very rare and when it does occur, there are nearly always what are called hesitation wounds or marks. These are superficial cuts and scratches. It’s psychologically difficult to stab yourself, let alone stab yourself in the chest. And suicides tend to stab in soft tissue, like the abdomen or neck, not a bony structure like the chest wall.’

The autopsy specifies a lack of hesitation marks surrounding the wounds and L.’s first reaction is ‘that in and of itself demands closer scrutiny.’

In his book ‘Torment Saint’, W. T. Schultz tried to prove that the lack of hesitation wounds was not a big deal as ‘the person might simply ‘obliterate the mark’, stabbing himself clear through any small hesitation puncture.’ I wanted L.’s opinion about this. ‘Yes, this is possible but hesitation marks tend to be close by the stab wound. Suicides are not marksmen and are not aiming at hesitation marks as if they were a target at an indoor shooting range. To Mr. Schultz I say, are we expected to believe a man distraught enough to attempt suicide, depressed enough to attempt suicide, and, after arguing for hours, was emotional enough to attempt suicide yet took the time to aim carefully enough to obliterate hesitation marks??  Stab wound #1 was approx. 7/8 of an inch long.  Stab wound #2 was approx. 1-1/4 inches long.  This wasn’t a butcher knife, after all.  To be fair, hesitation marks may be so close to the actual wound that they are partially obscured by the wound or the swelling around it. They’re usually very superficial, and therefore are not consistent with a wound inflicted by another person in a homicidal attack, unless there was a struggle with the knife poised over the victim.’

The wounds were around an inch long each, and effectively Mr. Smith would have had to aim exactly at the same place to obliterate the hesitation marks. ‘Dr. Scheinin was neutral as to the manner of death as I would expect any clinician in her position to be when handling a post mortem with compelling evidence both for and against suicide ’, added L.  ‘I have not read Mr. Schultz’s entire account but it may be he was very selective about which of her remarks, or which parts, he chose to use.’

According to the autopsy, ‘a small slight laceration is noted to the palm of the left & right hand and another slight laceration is noted under the upper right arm as well.’

‘These sound like defense wounds’, wrote L., ‘the kind of superficial lacerations you’d see in someone fighting off a sudden attack. You hold up your hands and arms to shield yourself. Although Dr. Scheinin stated a defense wound at the bicep (upper arm) is unusual, it is not outside the realm of possibility. A victim turning away from an attacker with arms held up in front to shield could sustain such a wound in such a location. The combination of the presence of defense wounds and a lack of hesitation marks is very persuasive.’

And L. had more to say about the wounds: ‘Stab #1: At the 5th intercostal space. The apex of the heart is its lowest point and in most people that would be found at the 5th intercostal space (the space below the 5th rib). Someone knew where to hit. Stab #2: At the left border of the sternum. This stab wound was slightly downward. And while it’s true that homicide stabs tend to be vertical or nearly so, it’s possible that Jennifer, if she’s shorter than Mr. Smith was, would have a slightly downward motion.’ Although I can’t be certain of her height, I have seen her standing next to Mr. Smith and she seemed only slightly shorter than him.

It was reported that Mr. Smith walked once stabbed and Robin Peringer even told ‘the harrowing story of cleaning up the blood throughout Mr. Smith’s house after the suicide’ (Filter Magazine 02-01-2008). I have always found this odd to say the least and once again L. agrees with me: ‘It seems odd to me that a suicide would trail blood throughout the house after stabbing himself. It makes perfect sense that a man stabbed by his girlfriend would trail blood while trying to escape. Ms. Chiba could not have administered CPR while Smith was trailing blood, therefore one would hope she was busy contacting EMS.’

Very early, it was reported that Jennifer Chiba removed the knife while Elliott was still standing. L. had this to say about this part: ‘If what Jennifer says is true, and that she exited the bathroom and Mr. Smith was standing with a knife in his chest, then it was, in my opinion, a poor decision on her part to pull it out. At this point, the precise nature and extent of Mr. Smith’s injuries were unknown, so a penetrating object, such as the knife, should have been left in place and removed by emergency department personnel. 

 ‘One thing I think threw a spanner in the works is Ms. Chiba’s removing the knife,’ she wrote later. ‘There’s the suicide/instability evidence on one side: history of molestation, history of depression, history of drug and alcohol abuse, and history of self-mutilation. On the other side, there’s the history of loud fights, presence of defense wounds, lack of hesitation marks, and possibly the angle of the stab wounds. 

But L. is ready to give the benefit of the doubt: ‘Let’s assume for the moment Ms. Chiba’s hands are squeaky clean. As a licensed art therapist, Ms. Chiba was required by her employer to be BCLS certified, as anyone who works with patients and children is required. Another job requirement may have been to be certified in basic first aid and considering her client base this would have been likely. I am a health care provider and I think most health care providers (nurses, Nurse Practitioners, physicians and physician assistants) would not have removed the knife. Neither would any surgical technician. Stabilize it, yes, but remove it? No. But Ms. Chiba didn’t work in an ED. She didn’t work in a Surgical Unit, ICU, Acute Care, or even Sub-Acute Care. There’s really no reason to expect that she would be thinking this way. It would not be second nature for her. Her first impulse might be to remove the offending object from this man she loved. Still and all, I think most people’s response would be to run to a phone to call 9-1-1 and not touch the knife for fear of making things worse. Now let’s assume Ms. Chiba is dirty, dirty, dirty. Then she would unthinkingly remove the knife after her second stab. I don’t think the knife is left in place 99.9999% of the time in a homicide. She realizes she needs to make herself look innocent so she wipes down the knife and if any of her prints are still lifted, she’s already told police she touched it.’

L. didn’t know anything about Mr. Smith before reading his autopsy report, but she gets him right at the end of our short conversation: ‘So far, I see a man who in all likelihood was depressed and he self-mutilated, in a limited way, to alleviate the stress he felt. This also a man who allegedly committed suicide in an unlikely way yet had defense marks at the places you would expect them to be.’

She continues: ‘Stabbing is a very painful way to kill yourself. Those who commit suicide by knife tend to have very deep personality disturbances. And it is more difficult to stab oneself through clothing, requires a lot of strength to do that to yourself (unless the clothing is a thin T-shirt). Being very depressed won’t make it any less painful. There WILL be hesitation marks. And then you have the lack of hesitation marks, those defense wounds, the stabbing through clothing, Ms. Chiba “removes the knife” .

I will let you draw your own conclusion.