Fixed Lividity/Livor Mortis: The Experts Weigh in on a Side Burial in the 7:00 Hour

This is my fifth in a series of posts about livor mortis/fixed lividity (first post; second post; third post; fourth post). I've made two claims: (1) it is unlikely that a body could be on its side for about five hours after death and exhibit solely anterior (frontal) lividity with no lateral (side) lividity; and (2) it is unlikely that a body could be buried on its side about five hours after death and exhibit solely anterior (frontal) lividity with no lateral (side) lividity.

These claims have particular relevance for the case discussed in the Serial Podcast: the death of Hae Min Lee. The State's contention was that the 5'8" Lee was strangled by Adnan Syed, placed in the trunk of her 1998 Nissan Sentra for about five hours, and then buried in Leakin Park. The State's key witness said on at least one occasion that Lee was "pretzeled up" in the trunk (ostensibly on her side), which would seem to have to be the case because the trunk of the Sentra was probably about 52 inches wide. When Lee's body was discovered in Leakin Park weeks later, it was on its right side and had fixed frontal lividity, which was also consistent with the key witness's testimony on at least one occasion that Lee was buried on her right side.

Yesterday, I posted information about the Assistant Medical Examiner who performed the autopsy on Lee, which I thought tended to show that she would have supported both of my claims. Today, I have information from (1) pathology residents who have completed extensive rotations in forensics; and (2) a former forensic medical investigator. I think that both sources of information tend to corroborate my claims.

Residents

Let's start with the generalities. According to the residents, lividity can start about 2.5-3 hours after death and usually continues fixing up to 10 hours after death, depending on "external conditions." Put another way, some bodies can be fixed in 8-10 hours, and some can take 24 hours to become fixed, depending on "environmental conditions."  If a victim is moved before lividity starts becoming fixed, there would still be small areas of blood movement, but not a lot.  Lividity is used to determine if a body was moved before lividity was fixed, but it can only be used to estimate time of death based on fixation if the body is found within a relatively short period of time after death.

Now, let's move to the specifics of the death of Lee. According to the residents, if Lee was on her side for about five hours after death without movement, you would see a good portion of lividity on her side. Meanwhile, if she was on her stomach and face down for about five hours after death, you would see a good amount of lividity developing on the frontal region. Now, assume that Lee was on her stomach and face down for about five hours before being buried on her right side. In this case, there would be lateral lividity, but it wouldn't be as much as frontal lividity because the greater area of lividity is usually the indicator of where the body was positioned in the hours after death. Of course, if you believe the new timeline created by Serial in which Lee died closer to 3:00, it was closer to four hours before Lee was buried (if you believe the cell tower pings), creating the possibility of a more mixed distribution of lividity. 

If Lee was in the car and there was lividity on the front of her body and also areas of the back of her body, this could be indicative of her being bounced around in the car, if she was pushed up against anything, etc.

Forensic Medical Investigator

According to the forensic medical investigator, if Lee was in the trunk on her side for five hours or more, she would have a good deal of lividity indicating that she was on her side. Because the autopsy report showed that the primary lividity was frontal, she would have needed to be face down. If she was on her side for about five hours after death, she would have less lividity in the front, and they would have been able to say that she was moved from side to frontal exposure. Again, if the change in position was closer to four hours after death, the lividity could be more mixed. Finally, even if it took twelve hours for Lee's lividity to become fixed, her lividity was all frontal, and this could not have happened in the trunk of a car unless she was somehow in a position that was consistent with solely frontal lividity.

Closing Thoughts

What I found interesting about this information was that it generally corroborated my claims but also cut against some of my thinking. My thought was that the body's position in hours 5-12 after death would be most consistent with the pattern of lividity. According to the information I was given, most of the lividity would actually be consistent with the body's position in hours 0-5 after death. That said, everyone seemed consistent that a move from a side to a front position (or vice versa) after about 5 hours absolutely should produce a "mixed" pattern of lividity that would be noted in an autopsy and that would allow the medical examiner to conclude that the body had been moved before lividity became fixed. 

I haven't seen Lee's autopsy photos, but Susan Simpson has, and she says that 

The only visible lividity is on the chest and neck. It is a bit irregular in shape, but symmetrical in coverage area and prominence on the left and right sides. No visible lividity in the limbs; there are no differences in appearance between the right arm and left arm, or right upper leg and left upper leg. No photos of lower legs to compare.

This description is consistent with Lee's autopsy report, which states that, despite Lee's body being found "on her right side," (1) "[l]ividity was present and fixed on the anterior [front] surface of the body, except in areas exposed to pressure;" and (2) "livor mortis was prominently seen on the anterior-upper chest and face." 

Finally, I have a couple of leads on medical examiners who might be willing to share their opinions on the case. If they come through, I will do a new post with the information that they provide.

-CM