Thomas Valva coroner describes the stages of fatal hypothermia

Thomas Valva coroner describes the stages of fatal hypothermia

LONG ISLAND, NY — The jury was shown a photo of Thomas Valva’s lifeless, bruised face Wednesday at the trial of Michael Valva, a former New York police officer and father of 8-year-old Thomas, who, froze to death in his father’s garage in 2020 — when the chief medical examiner at the time of the boy’s death in 2020 took the stand.

Valva, along with his then-fiancée Angela Pollina, who will have a separate trial, were arrested on January 24, 2020, and charged with second-degree murder and four counts of endangering the welfare of a child. If convicted, they each face 25 years to life in prison. Both have pleaded not guilty and remain jailed without bail.

Prosecutors have said that Thomas and his brother, who had autism, were forced to sleep in the cold garage when the temperature outside dropped to 19 degrees. When he died, Thomas’s body temperature was 76.1 degrees, 20 degrees lower than it should have been, prosecutors added.

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Dr. Michael Caplan, who was Suffolk’s Chief Medical Examiner on January 17, 2020, the day Thomas died, first discussed how an autopsy is performed.

When Thomas’ body was brought in, Caplan said he also received a medical report from Long Island Community Hospital, as well as one from pediatrician Dr. Zev Gensler, whom Thomas saw in September 2019, when he went to get his back. school visit

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He had been told that Thomas was 8 years old and in cardiac arrest, with injuries to his head and face, Caplan said. “We didn’t know exactly how he died,” he said.

Thomas was brought in with a bag containing two pieces of his clothing, a pair of gray sweatpants, size 5/6, and gray socks with neon orange trim; those clothes were shown in court as evidence.

Caplan, questioned by Assistant District Attorney Kerriann Kelly, said he was initially told that Thomas had been walking to the bus stop when he tripped and fell, suffered head injuries and some bleeding, then became unresponsive, which prompted Valva to call 911.

Later, said Det. Norberto Flores presented new information about “different circumstances,” including that Thomas had been locked in a garage in freezing temperatures.

“Is it fair to say how someone lived can tell you how they died?” Kelly asked Caplan.

“Absolutely,” he replied.

Describing the external autopsy, Caplan said Thomas was a “well-developed” but “thin” boy, weighing 64 pounds and 4 feet, 2 inches tall. His weight was in the 70th percentile and his height in the 50th, he said.

His body mass index was 18, or in the 80th to 84th percentile, Caplan said.

In July, during his pediatric physical, Caplan said Thomas weighed 51 pounds and was 49 or 50 inches tall. His BMI in July was 14.3, he said.

Caplan said that Thomas was “thin or fairly well nourished” and that he was not overweight, but “in between”.

He had brown hair in a “fade” cut, hazel eyes, long eyelashes and a distinctive sack under his chin, Caplan said.

At the school physical, there was concern about Thomas’s alopecia, or patches of hair loss, which he said could have been a “manifestation of chronic stress.”

When asked about his injuries, Caplan said the most conspicuous were injuries to his forehead and face, including two scrapes and bruises on the right side, and one in the middle of his face, with scrapes on the bridge of the nose, one of the front of the nose and the crease, and an abrasion on the right side of the upper lip. He also had a bruise inside his mouth and a small bruise on his cheek, as well as on the mucous membrane above his lower teeth, he said. He also had some scratches on the right side of his chest and some on his rib cage, as well as several bruises and scars on the back of his knees, an older bruise on his right ankle, and a bruise on his upper leg. left. He also had a scratch on his left buttock, he said.

Caplan showed the jury a color photo of Thomas’s face at the autopsy and pointed out the injuries.

The abrasions on his forehead were separated by an area of ​​unbroken skin. “Would they be difficult to explain in one fall?” Kelly asked. “If it fell more than once, would it be consistent?”

“Yes,” Caplan said.

Kelly also asked if the injuries to her face and mouth could have been caused by “a slap to the face” or a “hand over a child’s mouth.” Caplan said yes, it could have been.

Caplan also said that red blood cells that showed up when examining the injuries indicated that they were fresh.

During the afternoon session, Caplan discussed the internal autopsy. Thomas, he said, had Wischnewsky spots, blackish lesions typically associated with death from hypothermia, on his stomach, as well as a very small thymus. The normal size of the thymus is 43 grams and Thomas’s was 9 grams, he said. When asked what would make a scam so small, Caplan replied, “chronic stress.” The con of him, he added, was “wafer thin”.

In addition, Thomas had “chronic inflammation of the kidneys, he said.” and infection, she said.

The spots on the stomach could have been caused by hypothermia, Caplan said; Ninety percent of fatally hypothermic people had the same spots, he said.

When asked what his determination was regarding Thomas’s cause of death, Caplan said, “In my opinion, Thomas Valva’s cause of death was hypothermia.”

Caplan said he had ruled out any possible illness and that his head and other injuries were not the cause of his death.

Thomas’s core temperature in the ER was 76.1 degrees F, he said, leading to the determination of hypothermia.

Caplan then discussed hypothermia, which can begin when body temperature drops below 95 degrees F. Healthy humans can regulate their body temperature to 98.6, he said. Heat loss can be caused by direct body contact with a cold surface, airflow, evaporation, and other factors.

The main way the body minimizes heat loss is through basal constriction and shivering, he said.

Asked by Kelly if sleeping on a freezing garage floor or going outside and spraying it with cold water in January temperatures could cause hypothermia, Caplan said yes.

He then discussed the four stages of hypothermia. In Stage 1, body temperature drops to between 90 and 95 degrees F, but the body can still compensate, she said. Heart rate, blood pressure and breathing all increase, she said.

Stage 2 involves a drop in body temperature between 82 and 90 degrees; a person loses the ability to tremble. “The state of mind will change,” Caplan said. “You’re not that alert or awake.” Below 90 degrees, a person can go into cardiac arrest, he said.

“Is it possible that you fall repeatedly?” Kelly asked.

“Yes, it is,” Caplan said.

In Stage 3, body temperature ranges from 77 to 82 degrees, and a person becomes “even more seriously ill,” Caplan said. A person’s heart rate would be low and they could possibly lose consciousness. “They are barely alive,” he said, adding that all vital functions are severely affected.

And, at Stage 4, with a body temperature of 77 degrees or lower, which was Thomas’s, the “person would appear dead, with no vital signs,” although it would still be possible to resuscitate them, he said. “They have no signs of life.”

Asked by Kelly if a person could speak at that point, Caplan said, “Not in my opinion. There can be moans and groans…involuntary agonizing noises.” In Stage 4, the heart stops, the person becomes unconscious, and cardiac arrest occurs, she said.

Kelly also showed Caplan a photo of Thomas, smiling and wearing a football sweatshirt, giving a thumbs up with very red hands, which Caplan was consistent with being out in the cold.

Kelly asked if a hand over the mouth, when a patient was hypothermic, would be an additional risk factor, and Caplan said yes.

Speaking of how a person dies, Caplan said there are involuntary bodily responses like urinating and having a bowel movement. When the blood stops flowing, the blood settles and rigor mortis sets in.

When asked about a conversation he had with Valva after Thomas’s death, Caplan said that Valva asked if Thomas had had an aneurysm or a seizure; he said no. He then inquired about funeral arrangements, and Caplan told Valva that unless both biological parents agreed to a funeral home, he could not release the boy’s body.

Defense attorney Anthony La Pinta then began cross-examination, asking Caplan if he had written articles or books, or spoken about hypothermia; Caplan said no.

“Would you agree that cases of hypothermia as a forensic pathologist are not common?” La Pinta asked. Caplan said no.

Testimony will continue Thursday in Riverhead.

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