In the trial of the two alleged killers of Ted Binion, the battle of the medical experts is now fully engaged.
Defense lawyers on Monday called to the witness stand their own medical experts who said the millionaire casino figure died from a drug overdose.
Suffolk County Chief Medical Examiner Dr. Charles Wetli, from New York, and Bexar County Chief Medical Examiner Dr. Vincent DiMaio from San Antonio, Texas, said they had examined the same reports as the prosecution's chief medical witness, Dr. Michael Baden.
Baden previously testified that injuries found on Binion were consistent with a type of suffocation known as "burking" -- "where the mouth and nose are obstructed and someone sits on the chest to prevent the diaphragm from moving up and down." He said it is usually done "to leave as little injury to the body as possible."
DiMaio disagreed.
"There is absolutely no object evidence, physical evidence, nothing to say this man (Binion) has been burked or suffocated," DiMaio said.
He said the only "compelling evidence" found in the case was the "lethal combination" of heroin, Xanax and Valium found in Binion's blood.
Baden had testified the additional evidence included the variety of injuries Binion suffered -- abrasions found on his chest, upper lip, on the side of his mouth, bruises found on his upper and lower back and broken blood vessels in his eyes. Baden said they all occurred near the time of Binion's death and were consistent with what would be seen in a case of burking.
Baden, who is co-director of the forensics unit for the New York State Police Department, has performed more than 20,000 autopsies in his 38 years in the field.
DiMaio said that in 35 years he has performed close to 9,000 autopsies.
Wetli, the defense's other main medical expert to testify Monday, has conducted roughly 700 autopsies and supervised a few thousand more. He said there was no "evidence of injury" to suggest another cause of death. He said there was nothing remarkable about the discolorations found around Binion's nose, lips or mouth. He also said he believed all of the markings occurred after Binion's death.
Most of Wetli's time on the witness stand was spent challenging Baden's theory that the two marks found on Binion's chest were the result of button marks left from someone applying pressure to Binion's chest during the alleged suffocation.
Wetli said both chest marks indicated "a loss of epidermis," which isn't consistent with markings of a button on the skin caused by pressure.
DiMaio agreed saying a "button mark would have left a stamp" on Binion's chest and also the marks were too big to be consistent with those found on most men's shirts.
Wetli said it is possible the marks were the result of cigarette burns since Binion was known to smoke two to four packs a day. He also noted that heroin users often get "drowsy, and go on the nod" while smoking and burn themselves.
DiMaio didn't second Wetli's cigarette burn theory and wouldn't say that the marks were the result of dermatitis, but he said he was "certain they (the marks) weren't left by buttons."
"I can say what it's not, but I can't say what it is," DiMaio said.
As for "scratches" found on Binion's right wrist, DiMaio said they weren't consistent with restraint and also could have happened anywhere from two hours before his death to a day before his death.
The defense's medical examiners also disagreed with Baden's conclusion that Binion's eyes indicated he was suffocated. Wetli said there was no "rupture of the capillaries" in Binion's eyes as Baden has suggested, but instead they were simply bloodshot, which was "normal."
Both DiMaio and Wetli also rejected Baden's assessment of the drug levels found in Binion's blood, finding themselves in agreement with Dr. Lary Simms, Clark County's chief medical examiner.
Simms testified that lethal doses of heroin and Xanax were found in Binion's blood, as was a therapeutic level of Valium. He said the presence of all three drugs collectively increased their volatility and led to Binion's death.
Baden had testified that after reviewing Binion's toxicology report and researching his heroin addiction, he was able to deduce that the amount of heroin in Binion's system was "typical for a recreational user" who was well versed in his abuse of the drug -- as Binion had been.
DiMaio, however, said it wasn't simply the heroin, but the combination of the Xanax and Valium found in Binion that caused his demise saying it was like "piling on the boxes on the mule's back, it breaks."
Although DiMaio and Wetli shared many points during their respective testimony they did differ on Binion's time of death. Wetli placed the time of death between 10:00 a.m. and 2:00 p.m., while DiMaio said between it occurred between 1:00 p.m. amd 4:00 p.m.
Baden and Simms have testified that Binion died between 8:30 a.m. and 1 p.m on that day, but said the most likely time of death was between 8:30 a.m. and 10:30 a.m.
The prosecution, using Baden's medical findings, alleges Sandy Murphy and Rick Tabish suffocated Binion and tried to make it look like an overdose.
Tabish and Murphy had been lovers at the time of Binion's death, even though Murphy was living with Binion. In 2000 Tabish and Murphy were convicted of murdering Binion and were sentenced to life in prison, but the Nevada Supreme Court later overturned the convictions.
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