Commonwealth v. Read — Trial ArchiveIrini Scordi-Bello
Testimony Impact
Dr. Irini Scordi-Bello is a board-certified forensic and anatomic pathologist employed by Norfolk County who conducted the autopsy of John O'Keefe on January 31, 2022. She testified in both trials as a prosecution witness, presenting her autopsy findings including skull fractures, arm abrasions, hand contusions, and signs of hypothermia. Her official determination — cause of death as blunt impact injuries of head and hypothermia, manner of death undetermined — placed her at the center of the trial's central dispute, as her findings neither confirmed nor excluded the prosecution's vehicle-strike theory.
Challenges & Responses
What attorneys challenged during examination and how the witness responded.
In Trial 1, Elizabeth Little challenged Scordi-Bello on the absence of defensive wounds and whether the injuries were more consistent with an altercation than a vehicle strike. In Trial 2, Robert Alessi mounted a broader methodological attack, questioning her use of investigative information, her approach to alternative explanations and differential diagnosis, and the absence of physical notes documenting her stated considerations. Scordi-Bello testified that she combined autopsy findings with investigative information, considered possible explanations internally, and did not determine the manner of death. Alessi also used her own grand jury testimony — selectively excerpted, then rehabilitated by the prosecution on redirect — to challenge the completeness of her hypothermia analysis.
Trial 1 vs Trial 2
In Trial 1, Elizabeth Little's cross-examination focused primarily on injury patterns, including the absence of lower-body injuries and whether the arm and facial wounds were more consistent with an altercation than a vehicle strike. In Trial 2, Robert Alessi pursued a deeper methodological challenge, questioning Scordi-Bello's use of investigative information, her approach to differential diagnosis, and her documentation of alternative-cause considerations. Scordi-Bello responded that she considered possible injury causes internally, discussed the injuries with colleagues, made no physical notes of those considerations, and did not determine the manner of death. Trial 2 also included disputes over hypothermia terminology and grand jury testimony, followed by redirect rehabilitation that had no equivalent in Trial 1.
Notable Quotes From The Record
“Cause of death was blunt impact injuries of head and hypothermia.”
The official cause of death determination from the medical examiner who performed the autopsy.
“I listed could not be determined.”
The manner of death — the central contested issue at trial — was left undetermined by the medical examiner, meaning she could not distinguish between accident and homicide from the medical evidence alone.
“the skull is a pretty thick bone — it takes a considerable amount of force to fracture the skull — so that was a pretty considerable impact.”
Establishes that O'Keefe's skull fractures required significant force, relevant to evaluating whether a vehicle strike or a fall could have caused the injuries.
“I do believe the injuries — the blunt impact injuries — were sustained first. These are not injuries that are immediately lethal.”
Establishes the prosecution's timeline theory: head injury first, then incapacitation, then hypothermia onset while lying in the snow.
“I didn't see any major signs of what I would call a significant altercation.”
Absence of defensive wounds (intact nails, no knuckle bruising, no hand fractures) is relevant to whether O'Keefe was in a fight before his death.
“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.”
Establishes the medical examiner's independence from law enforcement pressure regarding manner-of-death determination.
“They're not the classic pedestrian injuries that we observe. No.”
Concedes that O'Keefe's injuries don't match the typical pattern seen in pedestrian-vehicle collisions.
“In Mr. O'Keefe's case, I did not see any injuries in the lower extremities. And looking at the car, I did note that it was a much bigger car, with much higher — I would say much higher — tail light, bumper.”
Notes the absence of leg injuries typically caused by bumper impact, and that the SUV's higher profile changes the expected injury pattern.
“I would consider the amount of force to be significant — again, without being able to quantify it.”
Establishes that substantial force was required to produce the skull fractures observed.
“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.”
The ME declines to connect injuries to the alleged vehicle strike, limiting the prosecution's ability to use her testimony for accident reconstruction.
“That's — yes, that's correct.”
Scordi-Bello agreed that bruising on the backs of hands is also consistent with defensive wounds.
“It could be a single impact, but it also could be multiple impacts, correct. It could be, yes.”
Opens the door to the defense theory that O'Keefe sustained facial blows before the fatal head impact.
“It's possible.”
Scordi-Bello concedes it is possible for someone to be punched hard enough to lose consciousness and fall backward — the core of the defense's alternative theory.
“Could be impact during a fall. It could be coming in contact with any blunt object.”
Broadens the explanation for facial injuries beyond the punching theory raised on cross-examination.
“Not typical, but possible.”
Concedes the isolated abrasion near the head laceration is atypical for dragging, supporting that it resulted from impact rather than being moved.
“I would expect to see — or I have seen — multiple bruising to the — again — posterior aspects of the forearms. I have seen cuts, lacerations, depending on how a person might be defending themselves, the position of their arms. And with that, also includes breaks in the fingernails and fractures to the hands.”
Lists typical defensive wound indicators absent from O'Keefe's body, undermining the defense theory that his hand injuries were defensive wounds.
“Again, a single impact with a fall could cause all the injuries that were seen in the brain and the skull.”
Reaffirms that a single fall impact could explain the observed brain and skull injuries, while Scordi-Bello does not identify how the injuries occurred.
“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.
“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 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.
“No, I did not make physical notes of my considerations.”
Establishes that Scordi-Bello testified she made no physical notes of her considerations.
“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.
Key Moments
- Scordi-Bello's manner-of-death determination — 'could not be determined' — became one of the most consequential moments of her testimony in both trials, as it left unresolved whether O'Keefe's death was an accident, homicide, or something else, forcing the jury to draw its own conclusions from the competing theories.
- On direct examination, Scordi-Bello testified that O'Keefe's skull fractures required 'a considerable amount of force,' and that the blunt impact injuries were sustained before hypothermia set in — establishing the prosecution's timeline in which O'Keefe was incapacitated first and then died of exposure.
- Under cross-examination in Trial 1, Scordi-Bello conceded that O'Keefe's injuries were 'not the classic pedestrian injuries' seen in vehicle collisions, and that the absence of lower-extremity bumper-strike injuries was notable, though she noted the SUV's higher profile altered expected injury patterns.
- Scordi-Bello testified that she saw no major signs of a significant altercation — specifically noting intact fingernails, no knuckle bruising, and no hand fractures — offering both prosecution and defense arguments a point of reference for whether a fight or a vehicle impact caused the wounds.
- In Trial 2, defense attorney Alessi confronted Scordi-Bello with her grand jury testimony, challenged her hypothermia diagnosis by questioning whether gastric and pancreatic findings were truly Wischnewski ulcers, and established that the absence of frostbite despite blizzard conditions raised questions about the hypothermia conclusion — a more methodologically focused cross-examination than Trial 1.