Dr Timothy R. Killeen

[MrBarnett]

The idea that a larger weapon if available would be used then it would then be switched for a smaller blade for some stabs isn't logical. The idea that a small blade was used until a larger blade was produced is.

My guess would be that the heart wound was last, but there’s nothing in the medical evidence we have to confirm that. And there are logical explanations why the larger weapon might have been used before some or all of the smaller ones:

There may have been more than one killer.

The larger weapon may have proved too cumbersome, so the killer switched to a smaller one.

The killer may have been attempting to divert attention from the larger weapon by stabbing repeatedly in roughly the same area. It clearly didn’t work, but if he had used a sword bayonet and realised that might give away his occupation, stabbing Martha repeatedly in the breast and elsewhere with a smaller weapon wouldn’t have been ‘illogical’. Ineffective, but not illogical in the heat of the moment.

[Michael W Richards]

No, I’m just pointing out that we can’t determine the order of the wounds from Killeen’s evidence. He also states that all the wounds were caused while the victims were alive. How could he have been so sure? It’s unlikely that the whole attack lasted more than a few minutes. I’m no medical expert, but I think wounds caused immediately after death are practically indistinguishable from those caused during life.


Killeen speaks of 39 ‘punctured’ wounds, but the only wound he describes in any detail, the one to Martha’s lower body - three inches long and one inch deep - is not a punctured wound, it’s an incised wound. So what should we understand from that: that the 39 were all punctured wounds and in addition there was one or more incised wounds? Or that there were only 38 punctured wounds and one incised wound?

The idea that a larger weapon if available would be used then it would then be switched for a smaller blade for some stabs isn't logical. The idea that a small blade was used until a larger blade was produced is.

[MrBarnett]

I donīt think there would have been any reason not to list a cause of death in a broader fashion. As has been pointed out, the given reason of death for Polly Nichols was "Syncope from loss of blood from wounds in neck and abdomen", meaning that no decision was taken whether it was the neck wounds or the abdominal ditto that killed her. Llewellyn said that the abdominal wounds came first, and he will have gone with the blood evidence - it the neck had come first, there would reasonaby have been a lot of blood underneath the neck, but there was not. At any rate, the blood loss killed her, and the issue about which wounds supplied the fatal bloodloss was left open.
I donīt see why the same verdict could not have been given for Tabram.
There was "some blood in the pericardium" of the heart, according to the ELO. Would there not have been any blood in the pericardium if Tabram was dead when she received the stab through the heart? And would there have been a lot of blood in the pericardium if she had been very much alive when stabbed there? Is anybody medically versed enough to tell out here?
Any which way, even if Killeen could not say whether the heart stab killed her or whether the 38 stabs did, we do know that he did say that she died from blood loss. Meaning that he could reasonably have stated that Tabram dies from syncope caused by massive bloodloss after having received 39 stabs to her body.

I just donīt see the issue having been a matter of contention to a degree where the coroner decided that no reason at all should be given. And I cannot see, if the medical implications were such so as to suggest that no certainty could be reached, how that would reflect poorly on Dr Killeen. There must have been many deaths where the cause of the demise could not be determined, and as I understand it, that never meant that no medical information was given on the death certificates...?

You may well be right, Fish, but if we are considering Killeen’s involvement in the Tabram case we need all the info we can get. Killeen’s lack of experience, the possibility that he had never performed a PM before that on Tabram and the really strange fact that her death cert doesn’t tell us the medical reason for her death are all of interest.

[MrBarnett]

So your counter argument is that the killer A) used 2 knives at the same time, alternating from large blade back to smaller one, or B) 2 men used 1 knife each?

No, I’m just pointing out that we can’t determine the order of the wounds from Killeen’s evidence. He also states that all the wounds were caused while the victims were alive. How could he have been so sure? It’s unlikely that the whole attack lasted more than a few minutes. I’m no medical expert, but I think wounds caused immediately after death are practically indistinguishable from those caused during life.


Killeen speaks of 39 ‘punctured’ wounds, but the only wound he describes in any detail, the one to Martha’s lower body - three inches long and one inch deep - is not a punctured wound, it’s an incised wound. So what should we understand from that: that the 39 were all punctured wounds and in addition there was one or more incised wounds? Or that there were only 38 punctured wounds and one incised wound?

[Fisherman]

I donīt think there would have been any reason not to list a cause of death in a broader fashion. As has been pointed out, the given reason of death for Polly Nichols was "Syncope from loss of blood from wounds in neck and abdomen", meaning that no decision was taken whether it was the neck wounds or the abdominal ditto that killed her. Llewellyn said that the abdominal wounds came first, and he will have gone with the blood evidence - it the neck had come first, there would reasonaby have been a lot of blood underneath the neck, but there was not. At any rate, the blood loss killed her, and the issue about which wounds supplied the fatal bloodloss was left open.
I donīt see why the same verdict could not have been given for Tabram.
There was "some blood in the pericardium" of the heart, according to the ELO. Would there not have been any blood in the pericardium if Tabram was dead when she received the stab through the heart? And would there have been a lot of blood in the pericardium if she had been very much alive when stabbed there? Is anybody medically versed enough to tell out here?
Any which way, even if Killeen could not say whether the heart stab killed her or whether the 38 stabs did, we do know that he did say that she died from blood loss. Meaning that he could reasonably have stated that Tabram dies from syncope caused by massive bloodloss after having received 39 stabs to her body.

I just donīt see the issue having been a matter of contention to a degree where the coroner decided that no reason at all should be given. And I cannot see, if the medical implications were such so as to suggest that no certainty could be reached, how that would reflect poorly on Dr Killeen. There must have been many deaths where the cause of the demise could not be determined, and as I understand it, that never meant that no medical information was given on the death certificates...?

[Michael W Richards]

Killeen didn’t say the heart wound had
been fatal, only that it ‘would be sufficient to cause death’ (Times).

He certainly didn’t say that it would have been instantly fatal - for all we know it may have taken several minutes for the blood leaking from such a wound to stop the heart.

As it stands we have no official cause of death. Unusually, the coroner (presumably) chose not to record one on the death cert.

So your counter argument is that the killer A) used 2 knives at the same time, alternating from large blade back to smaller one, or B) 2 men used 1 knife each?

[harry]

A description of a wound caused by weapon claimed to be a penknife.
An incised wound 5 inches long inside the abdominal cavity,with the stomach transversed and portion of the small intestines protruding.Could such a weapon have caused the injuries to Nichols?

[MrBarnett]

Well, if she was alive for the 38 stabs by what is described as a pen-knife and once, fatal on its own, by a larger blade, then the large stab was last.

Killeen didn’t say the heart wound had
been fatal, only that it ‘would be sufficient to cause death’ (Times).

He certainly didn’t say that it would have been instantly fatal - for all we know it may have taken several minutes for the blood leaking from such a wound to stop the heart.

As it stands we have no official cause of death. Unusually, the coroner (presumably) chose not to record one on the death cert.

[Michael W Richards]

The breadth of the wound and the depth of penetration would have been 2 primary factors he used to make his conclusions, and in physical data and logical terms, one man didn't stab her 38 times with a pocket knife then change to a dagger like blade for one last stab. That it was a larger blade is established, and it would seem the evidence says it was last. Consistent with a soldier mate finding the killer over the woman, who is still alive but very badly wounded, and either handing the larger blade to him to finish the poor woman off, or he does it for him.

[Michael W Richards]

It means we have no idea of the order of the wounds.

Well, if she was alive for the 38 stabs by what is described as a pen-knife and once, fatal on its own, by a larger blade, then the large stab was last.

[MrBarnett]

Right so. Reading the reports it's easy to assume the heart wound caused death, quickly if not instantly, and the other wounds were inflicted post mortem. Helps explain the lack of noise and resistance. But the 'lesser' wounds hit internal organs, and Martha was a stout woman, so they're not minor pen knife cuts but inflicted with force.

Killeen's post mortem in the infanticide case kindly posted above suggests that despite being young and recently in practice, he paid attention in class. Had he closely examined stab wounds or handled a murder case? We don't know, but if that's the only comparable data right now then it seems plausible he was working scientifically or at least was thorough.

Killeen’s opinion was that all 39 wounds had been inflicted while Tabram was alive. Some have taken his assessment that the heart wound would have been fatal to mean it was therefore the last inflicted.

Killeen clearly knew the PM procedure, but something overturned the inquest jury’s verdict.

[Al Bundy's Eyes]

It means we have no idea of the order of the wounds.

Right so. Reading the reports it's easy to assume the heart wound caused death, quickly if not instantly, and the other wounds were inflicted post mortem. Helps explain the lack of noise and resistance. But the 'lesser' wounds hit internal organs, and Martha was a stout woman, so they're not minor pen knife cuts but inflicted with force.

Killeen's post mortem in the infanticide case kindly posted above suggests that despite being young and recently in practice, he paid attention in class. Had he closely examined stab wounds or handled a murder case? We don't know, but if that's the only comparable data right now then it seems plausible he was working scientifically or at least was thorough.

[MrBarnett]

Goes to show how hard it can be to conclude what was really said! One would think that a penetration of the heart would always cause death, but no. This is from a medical study of the matter:
"Thirty-one patients were admitted with a penetrating cardiac injury. Fourteen patients survived (45 %). Four out of 8 patients (50 %) with gunshot wounds survived compared to 10 out of 23 (44 %) with stab wounds." (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4451723/)

I can’t believe the ELO made up the stuff about there being some blood in the pericardium, so the Times account would seem not to be complete.

[MrBarnett]

No single stab wound anywhere would kill "instantly". So not sure what relevance this has.

It means we have no idea of the order of the wounds.

[Fisherman]

The differences between the Times, ELO and ELA versions of Killeen’s description of the heart wound are interesting.




ELO

The heart was rather fatty, and was penetrated in one place, but there was otherwise nothing in the heart to cause death, although there was some blood in the pericardium.

Times:

The heart, which was rather fatty, was penetrated in one place, and that would be sufficient to cause death.

ELA

The heart was rather fatty and it was penetrated in one place, but otherwise it was healthy. There was nothing in it likely to cause death.



None of them says the heart wound would have caused death instantly.

Goes to show how hard it can be to conclude what was really said! One would think that a penetration of the heart would always cause death, but no. This is from a medical study of the matter:
"Thirty-one patients were admitted with a penetrating cardiac injury. Fourteen patients survived (45 %). Four out of 8 patients (50 %) with gunshot wounds survived compared to 10 out of 23 (44 %) with stab wounds." (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4451723/)