In the sensational Martin MacNeill murder trial, medical expert witness testimony will help to answer the critical question: how did Michele MacNeill die? The mother of 8 was found dead in her bathtub on April 11, 2007 with Valium, Percocet, Phenergan and Ambien in her system. However, her cause of death is “undeterminable.”
Prosecutors have charged Utah doctor MacNeill with first-degree murder and second-degree felony obstruction of justice, claiming that he murdered his wife to be with his (20 year younger) mistress, Gypsy Willis. MacNeill is accused of drowning his wife in the bathtub after she became unconscious from the deadly combination of prescription medications MacNeill fed her during her recovery from a plastic surgery procedure he allegedly pressured her into.
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The details of the Martin MacNeill murder trial make for an especially salacious courtroom drama with MacNeill’s former mistresses and former fellow inmates testifying against him. Willis testified “against her former lover as part of a plea deal with prosecutors from an earlier identity fraud conviction, where she and Martin MacNeill took the identity of one of the MacNeill’s adopted children and altered it.” Anna Walthall, who had a 6-month long affair with MacNeill in 2005, also testified. She revealed that “he had once described how he could induce a heart attack in someone that would appear natural.” Additionally, three federal inmates, who served time alongside MacNeill when he was in jail for three years on fraud charges, testified that MacNeill would never directly answer as to his involvement with his wife’s death. The inmates said MacNeill’s response was that “‘(Expletive) drowned’” and that “there was no evidence he committed murder.”
MacNeill maintains his innocence, contending that his wife died of natural causes associated with a medical condition called myocarditis.
Myocarditis, inflammation of the heart muscle (myocardium), is generally a mild medical condition. However, it may cause heart failure or death. As noted in an article for the American Journal of Epidemiology, there is a lack of scientific knowledge about the disorder. “The incidence of myocarditis has been difficult to study because clinical presentations of disease vary widely and because histopathologic examination of the heart is needed to confirm the diagnosis.”
Related: Doctor Fails to Diagnose Patient with Myocarditis
Expert witnesses have taken the stand to help jurors resolve whether Michele died at the hands of her husband, as Utah prosecutors allege, or from myocarditis, as the defense claims. A cardiology expert witness, a forensic pathologist, and a medical toxicology expert witness testified about their opinions regarding Michele’s death.
Cardiology expert witness, Dr. David Cragun, testified for the prosecution, disputing the defense’s argument that Michele died of myocarditis.
Dr. Cragun argued that Michele’s myocarditis was mild. “In my experience, patients with mild myocarditis have mild problems,” Cragun said. “They don’t normally have serious arrhythmias or life-threatening situations.” He testified that “lack of symptomotology and lab work make it unlikely her myocarditis was severe enough to cause death.”
Dr. Joshua Perper, a forensic pathologist, supports the prosecution’s allegation that MacNeill was drowned, testifying that “[i]t was clear she was inhaling a significant amount of water.” Perper “did not find any evidence of myocarditis in the slides containing small slices of Michele MacNeill’s heart that he analyzed.” Furthermore, he noted that Michele’s “lungs were heavier than normal, and her blood was diluted — indicating that her bloodstream absorbed water that she had inhaled.” Perper testified that “the level of dilution could only be explained by water entering her lungs and crossing through tiny blood vessels and into her bloodstream.”
Ultimately though, Perper “classified Michele MacNeill’s manner of death as ‘undetermined,’ saying there was not enough evidence to conclude without a doubt that a homicide occurred.”
Expert witness Dr. Gary Dawson, a pharmacist and toxicology expert, took the stand at trial to discuss the surprising amount of drugs present in Michele’s system following a standard cosmetic surgery face-lift. Michele did not have extensive prior exposure to the drugs – she was “drug naïve” – and thus “her ability to tolerate drugs and their symptoms would not be as high as someone who frequently used pain killers.” Dawson testified that there was “little chance that Michele MacNeill would have been alert with the dangerous quadruple combination of prescription medications found in her system at the time of her death.” He also noted that the high level of Ambien in her system at midday suggested that “the drug was administered within two hours of when she was found.”
One issue complicating the prosecution’s case in the Martin MacNeill murder trial is the fact that changes were made to Michele’s initial death report. Assistant medical examiner Maurreen Frikee (who sadly died from breast cancer in 2008) had determined that “Michele MacNeill died of cardiovascular disease with hypertension (high blood pressure) and myocarditis (inflammation of the heart).” This was changed, though, in 2010 after the Utah state attorney’s office received information that MacNeill’s affair may have provided motive for Michele’s death. Chief Utah Medical Examiner Todd Grey, who had inherited the case from Frikee, revisited the initial autopsy report. He changed Michele’s cause of death to “undetermined,” amending the report “to include the possibility that ‘drug toxicity’ — or the ‘adverse effect of drugs on the body’ — may have also played a role.”
Yet, evidence suggests that Grey was pressured by investigators to change the report. MacNeill’s defense attorney, Randy Spencer, “read an email Grey initially sent investigators in September 2008, in which he declined to amend Michele MacNeill’s cause of death because there was ‘nothing in the autopsy or toxicology findings that proves her death was from an unnatural cause… the autopsy findings certainly find evidence of natural disease that could explain death.’”
The five-week trial is scheduled to run through November 15.