Irini Scordi-Bello

“Cause of death was blunt impact injuries of head and hypothermia.”

States the medical examiner's listed cause of death.

“So in my opinion, I believe the impact, the injury to the head, came first. Mr. O'Keefe was most likely incapacitated or unable to move into a warmer environment and then the hypothermia set in.”

States the witness's opinion about the sequence of injury and hypothermia.

“The two manners of death that remain are accident and homicide.”

Explains the alternatives the witness identified after listing the manner of death as undetermined.

“My response was that I am responsible for what goes on the death certificate, and unless I have enough information — clear and convincing evidence — I cannot determine a manner.”

Explains her stated basis for leaving the manner of death undetermined.

“These are superficial abrasions to the skin. They are not lethal. They're not contributory to the cause of death.”

Distinguishes the arm injuries from the injuries she identified as contributing to death.

“Yes. The cause of death was due to blunt impact injuries of the head and hypothermia.”

States the medical examiner's cause-of-death opinion.

Dr. Scordi-Bello explained that she sought additional investigative information because the death was unwitnessed, but said she did not receive enough information to determine the manner of death.

“I don't know. I am not a reconstruction expert. I'm not a biomechanics expert. I never personally inspected the car, so I can't offer an opinion on that.”

Defines the limits of the pathologist's opinion on the proposed vehicle-impact scenario.

“It could be a single impact, but it also could be multiple impacts, correct. It could be, yes.”

Preserves the witness's qualified testimony about possible mechanisms for the skull fractures.

“That is lividity, yes. Goes all the way down and it's not the result of an injury.”

Distinguishes a photographed postmortem finding from an injury.

“I don't know how they came to be. I described them, and I stated previously that they are consistent with a fall to the back of the head.”

The pathologist distinguished her injury description from an opinion identifying how the injuries actually occurred.

“Again, a single impact with a fall could cause all the injuries that were seen in the brain and the skull.”

She explained that a single fall impact was among the mechanisms consistent with the skull and brain injuries.

“The amended death certificate in this case stated that the cause was blunt impact injuries of head and hypothermia, and the manner was undetermined.”

Confirms the medical examiner classified the manner of death as undetermined; under Scordi-Bello's definition, the available information did not support one manner of death over another.

“I can state to a reasonable degree of medical certainty that that's a bruise, a contusion. But I cannot tell you how it occurred.”

Demonstrates the limits of autopsy findings — the ME can identify injuries but not attribute them to a specific mechanism for most wounds.

“The cause of death was determined to be blunt impact injuries of head and hypothermia.”

States the official cause of death finding.

“Not the primary. It contributed, but the primary cause of death was blunt impact injuries of head.”

Clarifies the hierarchy between the two causes — head trauma was primary, hypothermia contributory.

“I did not have sufficient information that pointed to one manner of death over another manner of death. And therefore I stated that the manner of death was undetermined.”

Reaffirms the ME could not determine manner of death, central to defense argument that homicide was not established

“I don't come up with hypothetical scenarios on how those injuries occur. I tried to state the injuries, describe the injuries, state the cause of death and why that person died.”

Explains that Scordi-Bello does not construct hypothetical injury scenarios; she documents injuries and uses investigative information to assess whether she can determine manner.

“There's nothing inconsistent with this injury and a fall on the back of the head with a blunt surface.”

ME concedes the injury pattern is consistent with a fall, not exclusively a vehicle strike

“I did not see any grass. No, I did not make any determinations.”

Scordi-Bello testifies that she saw no grass and made no determination from it.

“I don't believe a Lucas machine causes hemorrhage to the mucosa of the stomach.”

The quoted answer distinguishes Scordi-Bello's view of gastric mucosal hemorrhage from the possible CPR explanation for pancreatic hemorrhaging; she maintains that the overall findings were consistent with hypothermia.

“I would say somewhere between 10 and 15%.”

Scordi-Bello estimates 10–15 percent gastric-mucosa coverage, while also explaining that hypothermia cases can have fewer spots and retaining her view that the findings were hypothermic signs.

“I did examine his lower extremities. That is protocol in any case of suspected impact with a motor vehicle. So I did examine his legs and I did not see any evidence of an impact site.”

The medical examiner says she found no observed impact site when examining the lower extremities, a limited anatomical observation rather than a conclusion about the overall vehicle mechanism.

“Not from falling backwards and hitting one's head, but that area at some point came in contact with a blunt object or surface.”

Scordi-Bello excludes a backward fall striking the head as the cause of the eyelid laceration and describes contact with a blunt object or surface, without selecting a specific cause.

“The rest of the statement was that I have to take those findings in the context which was presented to me. So in the case of this particular case, those hemorrhages in the context of a body found in the snow, I believe they were due to hypothermia.”

Completes the grand jury statement defense selectively quoted, reaffirming her hypothermia opinion in full context

“I don't believe I knew about Miss McCabe.”

Establishes limits of information available to the medical examiner before filing the death certificate

“No.”

Confirms that no one provided her additional information she had not known, asked her to evaluate it, and asked her to reconsider her finding.

“Most pedestrian fatalities that we see are with impact with the front of the vehicle.”

Contextualizes her earlier testimony about lower-extremity injuries — her frame of reference was frontal impacts, not sideswipe scenarios

“Well, they don't treat them, they prevent them, but that would be a proton pump inhibitor such as omeprazole, right?”

Identifies omeprazole as a proton pump inhibitor; it does not state why it was prescribed to O'Keefe.

“It's possible. Correct.”

Scordi-Bello agrees alcohol-related ulceration is possible, without comparing its likelihood with hypothermia.

“Correct. Correct.”

Confirms she could not determine manner of death even after having Karen Read's incriminating statements, reinforcing that the medical evidence alone is ambiguous.