Commonwealth v. Read — Trial ArchiveElizabeth Laposata
Testimony Impact
Dr. Elizabeth Laposata served as the defense's forensic pathology expert in Trial 2, offering opinions that O'Keefe's fatal head injuries resulted from a backward fall onto a ridged surface rather than a vehicle strike, and that wounds on his arm were consistent with animal bites. A former Chief Medical Examiner of Rhode Island (1993–2005) board-certified in anatomic and forensic pathology, she testified across Days 29 and 30, covering injury mechanism analysis, coup contrecoup brain trauma, and differential diagnosis methodology. Her testimony was subject to extensive voir dire before she was permitted to testify, and she faced sustained cross-examination from prosecutor Hank Brennan challenging her qualifications, methodology, and independence.
Notable Quotes From The Record
“To determine cause and manner of death, we look at scene investigation, autopsy findings, police and witness statements, and medical history. And using that information, we come up with a differential diagnosis — a list of things that might have happened to that person to cause them to die.”
Establishes the standard forensic pathology methodology she applied in this case
“I was able to come to a definite scientific conclusion.”
States she reached a firm opinion on whether O'Keefe's arm wounds are consistent with dog bites
“No, I'm not a mechanical engineer.”
Concession that forms basis of prosecution's argument against her testifying on vehicle-pedestrian injury mechanisms
“In the back of his head, a little bit to the right-hand side, was a horizontal tearing of the scalp and that's called a laceration, and surrounding that were linear scrapes that were vertical in orientation. So that is an injury pattern, and then you have to think, well, what could cause that injury pattern?”
Establishes the specific wound pattern she identified on O'Keefe's head as the foundation for her analysis.
“The coup contra coup of a falling or being pushed backward has injury patterns where the impact occurred, but then there's also injury patterns 180 degrees opposite from that.”
Explains the mechanism that points to a backward fall rather than a frontal vehicle impact.
“No. It has to be a surface that has some small ridges in it to make those little vertical patterns.”
Rules out a flat surface as the cause of O'Keefe's head wound — the scraping pattern requires a ridged or granular surface, undermining a vehicle strike theory.
“When those delicate bones are broken, there's bleeding, and that bleeding then goes right down into the upper eyelids. So it kind of looks like you have black eyes, but there has not been any punch to the face. It's only come from the skull fracture.”
Explains the raccoon eyes as secondary to skull fractures from the coup contrecoup mechanism, distinguishing them from direct facial trauma.
“A fist is an object.”
Confirms the right eyelid laceration is consistent with a punch, introducing the possibility of an assault separate from the fatal head injury.
“He would be immediately incapacitated with a decreased level of consciousness once he received that impact on the back of the head. He would not be able to make any purposeful movements.”
Establishes that O'Keefe could not have moved or walked after the head injury, relevant to where and how he ended up on the lawn.
“No. There are no ulcers. It's a normal appearance of what we would call a gross specimen.”
Key forensic finding — absence of Wischnewski ulcers, present in 90%+ of hypothermia deaths, supports ruling out hypothermia.
“He did not experience hypothermia.”
Directly contradicts the death certificate's inclusion of hypothermia as a contributing cause of death.
“No, not at all... those injuries are patterned injuries from an animal bite. We have the canines; we have the incisors.”
Expert opinion that arm wounds were caused by an animal, not broken taillight plastic from Karen Read's vehicle — directly challenges prosecution's theory of the case.
“No. The bones were 100% intact. No breaks, fractures, hairline fractures. None of those.”
Absence of any bone injury in the arm undermines the theory that a vehicle struck O'Keefe's arm with enough force to shatter a taillight.
“No. I can't tell you the amount of force. It was significant, because he had the massive skull fractures.”
Establishes Laposata cannot quantify the force involved, undermining the precision of her death timeline opinion.
“It was medium to large.”
When pressed to quantify force, she offers a vague range that Brennan uses to challenge the reliability of her 15-minute death estimate.
“Yeah, both. It could have been both. Sure.”
Laposata concedes the orbital fractures could have been caused by the basilar fracture radiating forward, not just the brain striking the orbital plates as she testified on direct.
“I didn't look at any of that. I'm sorry. I did not look at any DNA.”
Establishes Laposata did not review DNA evidence from the vehicle as part of her analysis.
“It did not hit him. So it was not relevant to my opinion. I could — by looking at the body — I could tell that there was no evidence of impact with a vehicle. So whether the vehicle was going slow or fast is not relevant.”
Reveals Laposata excluded all vehicle evidence from her differential diagnosis because she had already concluded no vehicle impact occurred.
“I do not know what caused it. I can tell you what didn't cause it, but I don't know what did cause it.”
Concession that she cannot identify the source of the eyelid injury she discussed at length on direct
“No, I looked at the photos.”
Admits she never measured or requested measurements of the Lexus spoiler height despite opining it was inconsistent with O'Keefe's injuries
“Sure. They just lie there. They can become hypothermic and die.”
Concession that O'Keefe could have been alive in the cold and lost body temperature before dying, undermining her 15-minute death opinion
“None.”
Direct, unequivocal answer that X-rays showed zero fractures, breaks, or deformities in O'Keefe's right arm
“We see here the two bones of the arm. There's no injury to them. We see the pelvis bone. There's no injury to that bone. They're perfectly normal. And there's no abnormal soft tissue swelling. It's a normal right arm.”
Laposata narrates the X-ray for jurors, emphasizing the complete absence of skeletal or soft tissue injury
“The upper arm bone is totally normal. There's no soft tissue swelling around it. There's no breakage or microfractures.”
Extends the no-injury finding to the upper arm, ruling out damage along the entire right extremity
Key Moments
- Before Laposata could testify on the merits, she faced a full voir dire examination in which prosecutor Brennan pressed her repeatedly on her inability to name any specific class, seminar, or formal training in dog bite wound pattern recognition — a concession that became the prosecution's central argument against her qualifications.
- On direct examination, Laposata identified a horizontal scalp laceration on the back of O'Keefe's head surrounded by a specific scraping pattern she testified required a ridged or granular surface, ruling out a flat vehicle surface and pointing instead to a backward fall.
- Laposata explained the coup contrecoup mechanism — injuries occurring both at the impact site and 180 degrees opposite — as the explanation for O'Keefe's brain injuries and raccoon eyes, framing the injury pattern as consistent with a fall backward rather than a frontal vehicle strike.
- On cross-examination, Brennan established that Laposata had concluded the vehicle did not strike O'Keefe before she reviewed any vehicle data, speed information, or crash reconstruction analysis, suggesting her opinion preceded rather than followed the evidence.
- During redirect, Alan Jackson introduced X-ray exhibits of O'Keefe's right arm showing no fractures or bone injuries, which Laposata used to support her conclusion that the arm wounds were inconsistent with a vehicle impact.