EvidenceProf Blog

Editor: Colin Miller
Univ. of South Carolina School of Law

Wednesday, April 22, 2015

Medical Examiner & Pathology Professor Leigh Hlavaty, M.D. on Livor Mortis, Rigor Mortis & Skin Slippage for Hae Min Lee

Last week, I forwarded the autopsy report for Hae Min Lee as well as her autopsy photos to Leigh Hlavaty, M.D., who is (1) the Deputy Chief Medical Examiner for the Wayne County Medical Examiner's Office in Detroit, Michigan; and (2) a Clinical Assistant Professor of Pathology at the University of Michigan. After she reviewed these materials, I asked for her thoughts about the evidence and arguments by the State regarding livor mortis, rigor mortis, and skin slippage at the trial of Adnan Syed for murdering Hae. In this post, I will set forth what I told and asked her, followed by her complete response.

Livor Mortis/Fixed Lividity

As I've noted in prior posts, livor mortis is the settling of blood in the lower (dependent) portions of the body after death, and fixed lividity is the point at which the blood becomes permanently settled. According to Hae's autopsy report, Hae's "body was [discovered] on her right side," and "[l]ividity was present and fixed on the anterior surface of the body, except in areas exposed to pressure." 

Given these findings, I asked Dr. Hlavaty to assess the credibility of the State's claims that (1) Hae was killed by 2:36 P.M. on January 13, 1999 and "pretzeled up" in the trunk of her Nissan Sentra for the next 4-5 hours; and (2) Hae was thereafter buried on her right side in the 7:00 P.M. hour in Leakin Park.

Rigor Mortis

As I noted in a prior post,

When a person is alive, her body produces Adenosine Triphosphate, or ATP, "the gas line that runs the movement of your muscles."  When that person dies, her body stops producing ATP, causing the muscles to start to stiffen about 8-12 hours later, with stiffening taking longer in colder climates. Then, however, about 18-24 hours after death, rigor begins to dissipate, and the decedent's limbs can thereafter easily be moved after it has completely dissipated, or "broken."

According to the Assistant Medical Examiner at Adnan's trial, when Hae's body was disinterred at about 2:00 P.M. on February 9, 1999, her body had "some rigor" that was "easily broken." Moreover, a notation made in connection with a photo of Hae's body right after it was disinterred indicated that "[r]igor appears to be fixed, probably due to temp." The autopsy on Hae was done the next day, and the autopsy report stated that that "[r]igor was broken to an equal degree in all extremities."

Given these findings, I asked Dr. Hlavaty whether it was possible that Hae's body still had "some rigor" on February 9, 1999 if she was in fact killed on January 13, 1999.

Skin Slippage

As I noted in a prior post,

skin slippage is a phenomenon which occurs when a body starts to decompose and the outer layers of the skin, outer epidermal layers separate from the underlying skin. Fluid accumulates underneath the skin surface and the skin breaks and slides off from the underneath layers of the deeper skin.

According to Hae's autopsy report, "[g]eneralized skin slippage was noted...." 

Given this finding, I asked Dr. Hlavaty about my prior post about Hae possibly having two patterns of skin slippage and what it could tell us about the hours/days after her death.

Dr. Hlavaty's Response

To me, the lividity looks fully frontal and fairly symmetrical with regards to areas of pressure.  These B&W photos are not ideal by any means. 

1. Anterior lividity means her body was in a fully anterior position for at least 8-12 hours in a temperate location (neither too hot nor too cold), so neither claim seems plausible.  If she was stored in a hotter environment the time could be less.  She was fully face down for a length of time and then placed in the grave.
2. If there is skin slippage the rigor should have already passed.  Given the temperature on the date she was found I think what is present is artifact from the cold and not actual rigor mortis.  
3. There are not two types of skin slippage and to describe such is trying to make something relatively unscientific more valid but in the end can discredit more than you want.  The skin is sloughing off the body at any point of contact.  Could be contact from being placed in the grave if she was buried at least 24 hours after death, from being buried in general, from being found and dug up, from being transported to the morgue, and from being undressed and photographed. 

The major problem as you know is the burial.  Burial delays the changes after death, the rough rule of thumb is one week exposed to air equals 8 weeks buried in dirt.  Bodies unearthed after several weeks usually look like they have been dead for only a few days.  Plus, you have freezing temperatures that must be considered and ultimately you need a lot of experience in interpreting postmortem changes in order to provide any useful information.
My short form is she was left face down somewhere for at least 8-12 hours and then placed in the grave after livor mortis had set because it and the grave position do not match.  The "rigor" is likely stiffening of the body due to the cold temperatures and not residual rigor, and the skin slippage is nonspecific and is completely what we see in bodies that have been buried.  She was likely buried soon after her lividity fixed as opposed to closer than when she was found, because the body is in such pretty good shape.




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Would you mind providing the specific wording of the questions you asked?

Posted by: theghostoftomlandry | Apr 22, 2015 6:23:14 AM

So we know she was face down for 8-12hrs at least and then moved. How easy would it be to transport a body that was in a state of rigor mortis? If the muscles are stiff, so too are the joints. So is it reasonable to think that she may have been killed in Leakin Park with the killer coming back to bury her OR she would have had to have been transported and buried a day after death when rigor mortis dissipated.

Posted by: Anonynon | Apr 22, 2015 6:49:40 AM

EP, can you clarify what information the expert has for grave body position when she makes this statement, "it and the grave position do not match."

Is it simply the statement "on her right side" or does she have more? For example, photos etc.

Posted by: monstimal | Apr 22, 2015 7:46:10 AM


1. The prosecution’s claim is that the victim was killed by 2:36 P.M. on January 13, 1999, pretzeled up in the trunk of her Nissan Sentra for the next 4-5 hours, and then buried on her right side in Leakin Park that same day in the 7:00 P.M. hour. Given that the victim solely had anterior lividity, is either of these claims plausible? In other words, under the trunk scenario, wouldn’t we expect an initial lividity pattern on the side (because lividity starts fixing a few hours after death), and, under the 7:00 hour burial scenario, wouldn’t we also expect side lividity because lividity doesn’t become fully fixed until roughly 8-12 (or at least 6) hours after death?

2. The body was disinterred on February 9, 1999, at which point it was noted that the body still had “some rigor” that was “easily broken.” The autopsy was done the next day, and, according to the autopsy report, rigor had broken. Is it in any way possible that the victim died on January 13th and still had “some rigor” on February 9th? Or is the likely conclusion that the body was somewhat frozen due to cold weather, which was mistaken for rigor?

3. Following up on point 2, another expert I consulted concluded that the amount of skin slippage was consistent with the victim being dead for weeks before discovery. She also said there were two distinct patterns of skin slippage: one pattern on the front/center of the body, and one (more extensive) pattern on the back, with left to right slippage. Her conclusion was that the frontal skin slippage occurred when the body was face down after death during and after the period when lividity became fixed and that the back slippage reflects a back/right burial, with the victim’s left should being pushed up by something (due to the patch of skin on the left shoulder without slippage. What do you think about the skin slippage?

Posted by: Colin Miller | Apr 22, 2015 8:44:24 AM

Anonynon: From what I understand, it would be tough to move the body in that state of rigor.

monstimal: All we have is the description in the autopsy report. The first photo of Hae is the one of her on the tarp after she has been disinterred.

Posted by: Colin Miller | Apr 22, 2015 8:46:18 AM

To follow up on monstimal's question: on Ep. 3 of "Serial" Sarah Koenig mentions examining the crime scene photos that were taken prior to the disinterment of Hae's body, "I didn’t understand how camouflaged the body was until I saw photos of the crime scene, the way Mr. S found it, before they removed the body. I was in the State’s Attorney’s office in Baltimore. [...] We opened a packet of photos together. […] There was one where you could make out a bit of black hair amid dirt and leaves."

Do you, Rabia, Susan, or anyone else have plans to gain access to these photos to allow your consulting experts to better assess the burial position and give a more informed opinion on the lividity issue?

Posted by: Jodi | Apr 22, 2015 9:32:49 AM

Jodi: That's interesting. I had forgotten that portion from Episode 3. I haven't seen those photos. I will check into whether I can get access to them.

Posted by: Colin Miller | Apr 22, 2015 9:35:38 AM

I do thank your for finally bringing in an expert, but I must ask, why did you not just send her the autopsy and autopsy photos and ask for her opinion, before you asked, "show me how the prosecution was wrong"? Secondly, If we had pictures of the actual burial, I would take the absolute side burial we are all assuming much more seriously.

Posted by: jlpsquared | Apr 22, 2015 10:34:38 AM

jlpsquared: That's what I did. Dr. Hlavaty hadn't listened to Serial, and I initially just sent her the autopsy photos and autopsy report. Then, after she reviewed those materials, I sent her my three questions.

By the way, for those wondering about the photo(s) taken before Hae's disinterment, we don't have copies of those files. The Serial team got them from a FOIA request and hasn't turned them over. We have our own FOIA request out, and, when it's fulfilled we should have them and can determine more about body position.

Posted by: Colin Miller | Apr 22, 2015 1:03:58 PM

Hi Professor,

Thanks for doing these follow ups to Undisclosed; it's always helpful to see the method behind the madness. (Not! meant as an insult.)

Re lividity: I found something that stood out to me in CG's closing statements when she states that HML's body was "face down" in the trunk of the car. It struck me that we had not heard that before. That the body was face down. Maybe we did and I missed it.

Posted by: Badger | Apr 22, 2015 3:06:34 PM

Isn't it a big coincidence that based on what you have said here, the burial time seems to be around midnight - which is what Jay now claims to be in his interview.

Posted by: Neelam Jain | Apr 23, 2015 7:54:43 AM

What about livor mortis in the legs? If the body was stretched out and face down until livor was completely fixed, wouldn't there be at least some livor on the anterior of the legs?

Posted by: Cobinja | Apr 23, 2015 9:06:56 AM

Hi Evidence Prof, I would really like to get an expert opinion as to the 'no observable lividity in the limbs' in the autopsy photos as stated by Susan Simpson.

I find it hard to believe there was NO lividity in the limbs but if there was so little that it was not observable in the photos then that surely implies that the legs must have been considerably higher than the face and chest for so much of the blood to pool there and virtually none to pool in the legs.

I know that to explain the lividity pattern it has been suggested that the body might have been placed face down with the legs draped over a log and in this way therefore slightly higher than the upper body. But I find this explanation most unsatisfactory as if this was the case I feel sure there would have been SOME lividity on the thighs apart from pressure areas where the thighs were in contact with the log. But this lividity pattern was not observed. The lividity pattern that was observed was so markedly in the face and upper chest it surely must indicate that the upper body was significantly higher than the hips and legs. An obvious position that comes to mind is the one in which the hips and legs were on the front seat of the car and the head and shoulders pushed down on the floor in front. Can you get your experts to discuss this please? Or at least come up with an explanation as to why there was 'no observable lividity in the limbs'? Thanks

Posted by: samarkandy | Apr 23, 2015 9:59:36 PM

A follow up to my previous query - people might think I am going on a bit about Hae’s body being left in the front seat of the car and maybe I am (I have posted about it before). But I see it as the best explanation for the lividity pattern and if I am correct about this and she WAS left in that position for 12 hours then by that time rigor mortis would have set in. Very likely her body in full rigor would have become wedged in that space and therefore immovable for another 12 hours or so until the rigor had dissipated. This would mean there was at least 24 hours before even the trunk pop became possible, let alone the burial. If this kind of scenario could be established as the one most likely to explain the autopsy findings it would make complete nonsense of Jay’s stories.

Posted by: samarkandy | Apr 23, 2015 10:20:14 PM

Also - lividity was absent 'in areas exposed to pressure'. Can you please tell us exactly where those areas were?

Posted by: samarkandy | Apr 23, 2015 10:24:09 PM

Colin, Fair enough. Thanks for responding. Here is the thing, if those photos come back and she was on her side 100%, than I will admit, my doubts about that trial will seriously be increased. Would you agree that if it turns out her head and legs were turned, but her body was essentially flat, than the states theory may in fact be correct?

Posted by: jlpsquared | Apr 24, 2015 10:17:09 PM

samarkandy: I'll check into it.

jlpsquared: I'll rely on my experts. If they say the burial position is inconsistent with lividity, that will be my take as well. If they say the burial position is consistent with lividity. that will be my take as well.

Posted by: Colin Miller | Apr 25, 2015 4:20:31 AM

Shouldn't there have been traces of body fluids in the trunk if a body had been there?

Posted by: Nancy Moreland | May 31, 2015 8:55:24 AM

I have a number of queries that, if you think they are relevant, I would appreciate you asking your contacts.
If Hae was not buried but simply had leaf litter flung over her, I feel sure that the stench of the decomposition of her body and fluids would be noticeable. We know she had skin slippage and associated fluid build up. I do badger watching and even in early winter the stench of a decaying badger corpse is strong and lasts weeks. I'm not sure about Jan/Feb but Hae's body is much larger than a badger's so I assume the smell would be much worse. Yet none of the witnesses refers to the smell of death. This makes me think that Hae's body was buried.
I also query the theory that Hae was only covered by a sprinkling of soil and leaf litter in a hollow next to the tree. In his first interview, Jay described digging a grave a foot deep and a shin deep. I simply believe it is physically impossible for a woman to be placed on her side in such a shallow grave without her shoulder being exposed. I have measured the width of my shoulders and iirc they are 15 inches and I am slightly smaller than Hae. This would suggest that Hae's right shoulder was either above ground or the grave was deeper than 6-12 inches. Iirc your expert noted that there was some slippage on Hae's back with a right to left pattern but I don't think there is any sign of uneven decomposition on her body so I think Hae was below ground. Dr Rodriguez, in his testimony, says that the grave was "very well camouflaged" (Trial 2, p182, line 5). In fact it completely blended in with the surroundings to the extent that the State's Surveyor, Buddemeyer, missed the body when he arrived to take measurements. Sarah K and her fellow reporter, when looking at the photos of the burial site also commented on how they would have had trouble spotting the grave. All they could see when they looked closely was a tiny bit of hair which made them query how Mr S had spotted Hae. To my mind all this suggests that Hae was fully buried.
I also want to challenge the notion that Hae was placed parrallel to the tree in the dip formed by the gully which ran under the tree which has been shown in various photos. If Hae had been placed in the gully along the side of the tree it would be obvious something was awry. The gully would be blocked under the tree for no apparent reason. The ground level where her body was would not match the surrounding soil in the curve of the gully. Hae's body would be at strange angles at both ends as her body lost its rigor and collapsed into the gully. And if she had not been buried but simply had soil and leaf litter thrown over her then her body would have probably collapsed as it lost its rigor especially under the weight of the large rocks and the pull of gravity in the dip. The only reason I can imagine a body not collapsing would be because the body was held in place by compacted soil on both sides of her body (which again would suggest that Hae was placed in a dug out grave.)
I am speculating here but it would be nice to know what an expert thinks of my ideas. Thanks.

Posted by: liz | Sep 13, 2015 2:51:39 AM

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