UPDATE: Prosecutor Questions Defense Pathologist's Methods

Former medical examiner Dr. Elizabeth Laposata did not take photos to back up her findings when examining Camden Fry's body, never examined a bone in the neck she testified about, and did not study all evidence before determining what happened to the young girl.

Prosecutor Stephen Regine pointed out such questions in Laposata's work as he attempted to poke holes in the defense witness' credibility. Laposata, the former chief medical examiner for Rhode Island, performed a private autopsy on Camden's body on Aug. 19, 2009, about a week after her death. She contradicted some of the findings of then-medical examiner Dr. William Cox, who performed the official autopsy two days after her death and testified for the prosecution last week in Kimberly Fry's second-degree murder trial.

Regine questioned Laposata on her methods of examination, pointing out that she does not have her original notes she took while performing the autopsy. Laposata testified she transcribed her notes into a type-written report before destroying the originals, which had been soiled by bodily fluids, she said. She did not provide those notes to the court until last Thursday, Regine noted, failing even to mention them during her grand jury testimony a year ago, Regine noted.

Laposata testified she reviewed all relevent information before determining that Camden Fry died as a result of asphyxiation caused by the combination of compression to the neck, chest and mouth, injuries consistent with the performance of a restraint technique, she said. That contradicts Cox' findings that Camden died as a result of manual strangulation. Regine pointed out that Laposata did not, in fact, review all material, having not seen the entire transcript of father Tim Fry's interview with the . Laposata said she received from defense counsel only 10-12 pages of the interview, which actually totaled more than 140 pages. Tim Fry found his daughter's body.

Earlier, Laposata testified there is no way to determine what ultimately caused the asphyxia that killed Camden. Rather, it was a combination of compression to the neck, chest and mouth that restricted oxygen to the brain, she said. Laposata demonstrated the compression Camden must have experienced on a child-size mannequin Monday, straddling the mannequin's chest with a knee on her right arm, and alternating pressure with her hands to the sides of the neck, the front of the neck and the mouth.

The totality of the injuries — pinpoint bruising to the chest, neck and interior eyelids; hemorrhages to the lungs, the soft tissue in the neck, the jaw and under the collar bone; bruising inside the mouth and a bruise to the inside of her right elbow — all point to an attempt to restrain Camden, Laposata said.

"When you look at all of the injuries as a whole, you can understand exactly how Camden was restrained and how she died as a result," said Laposata, who examined the girl's body about a week after her death. "The injuries are consistent with a restraint death."

But Laposata did not document her findings, Regine noted on cross-examination, specifying the injury Laposata said she found inside Camden's lip, which is the basis of her findings that pressure was applied to the mouth.

Cox made no note of the injury in his autposy and Laposata did not photograph her examination because the batteries in her camera had worn out prior to the autopsy, she said.

Regine also pointed out that Laposata failed to examine the hyoid bone in the neck, which Cox testified last week had been fractured, the result of sustained pressure to the neck. Laposata, noting Cox did not mention the word fracture in his autopsy report, said he erred in assuming the bone was fractured because it was "freely movable." The hyoid bone is made of soft cartilage that should move, she said. However, as Regine noted, Laposata did not inspect the bone because it had been removed in the original autopsy, and no photo exists to show whether the bone was fractured or not.

Camden's mother, Kimberly Fry, is accused of strangling her daughter in the family's North Kingstown home on Aug. 10, 2009 while the young girl threw a temper tantrum over taking a bath. Fry is charged with second-degree murder, which carries the possibility of life in prison if she is convicted. Defense attorney Sarah Wright contends that, while Camden did die at the hands of her mother, her death was the unintentional result of a restraint technique designed to quell the tantrum.

During cross-examination, Laposata testified the compression would have to be constant to at least one of the three areas — the neck, chest or mouth — for up to two minutes before Camden would have lost consciousness, after which she may not have gone quiet. The compression to at least one of the three areas would have had to have been constant for another four to six minutes after loss of consciousness for death to occur, she said.

There is no way of knowing which of the three ultimately caused the death, she said, because Camden's injuries indicate all three occurred simultaneously. She declined to term the compression to the neck as strangulation, saying the hands could have been moved all around the neck in trying to restrain the girl. The few petechial hemorrhages under the eyelids were not as numerous as she typically sees in pure strangulation deaths, Laposata said.

Regine pointed out during cross-examination that placing a hand over the mouth is not taught as a restraint technique and that applying pressure to the chest is a "very dangerous" technique.

Regine also questioned why Kimberly Fry would continue the technique after she lost consciousness. Laposata said that while Camden would have no voluntary movements — like the hitting, kicking and biting Kimberly Fry has said she would face from her daughter — she may have made gurgling noises and continued to move in an involuntary, "seizure-like movement."