Cyan. H1 WECHT, M.D.. J.D. Luann. Manama January 11,2012 Dr. Joslrun Greenuerg Re: Ellen Greenherg Deceased Denr Dr, Gleeuherg; Pursuant to your request, Ihave reviewed all the records and materials pertaining to the death uf your daughter. CLINICAL SUMMARY Ms. Ellen Gr-eenberg, 27 yenrs old, was found dead by her fiance, Mr, Samuel Goldberg, in their locked apartment on 26' 2011. Mr. Goldberg reported that he had lefi their apartment for tlre in their apartment building at 16:45 that nner-nonn and returned between 17:15 to 17:30. He stated that he tried to Contact the decedent via text message, telephane and email for approximately one hour in attempting to get back in, but he go! 1m response (confirmed by incoming texts and email in decedent's cell phone between 1732 and 1754). The 911 call was innde at 1833. The solid bar donr- guard was broken (consistent with Mn Goldberg's repon of forcing in tlre door). An apartment secrrtity men was 1ep0rtedly present during Mr. Goldberg's entry. He was briefly instructed to Stan CPR until he noticed is knife in her chest and was instructed to stop. Medics pronounced death at 1840. Tlrere was no evidence struggle Valuables were present and nothing was missing in the apartment. The decedent was found supine in the kitchen, her head and upper body testing against the lower half of the kilchen cabinets, Blood was present on the head. in the hair and on the neck. Multiple chest wounds were observed. A knife was embedded in her 1611 chest. It was a Dr. Joshua Greenherg January 11, 2012 Page 2 single edged serrated blade approximately 12.5 eln in length and 1.5 our wide with a handle approximately l2.5 em in length. The right hand with blood in it was closed in a loose fist. There was no note or anything to indicate suicide on the computers or in the rest of the well kept apartment. The last outgoing call in the decedent's cell phone was for 30 seconds on 1/26/1 at 1433. The recipient of the telephone call was not identified. The decedent was clothed in a 'F--shilt, sweat pants, underwear, a zippered shirt and U66 heats. Blood was present on the head. in the hair. on the front side of the shirts. on the front of her pants and on the top boots. A pair of eyeglasses was on the floor to her right. A while towel was grasped in her lefi hand. it is not known if there was blood on the towel. A hair tie "seninehie" was on her right wrist. The decedent was in a committed relationship with Sam Goldberg. They had been together for 3 years, and were recently engaged. Her parents had no reservations about their relationship. There is no knowledge of airy verbal or physical abuse. No report of a detailed hiterrogation of the fiance is available. (How did the decedent behave before Mr. Goldberg went to tile only 30 minutes earlier? Her mother stated that when she spoke with the decedent that morning, they "had a pleasant conversation She gave no indication that something was imminently Wrong") Her mother knew that her daughter was "struggling with something". Ms. Greenbelg was seeing a Dr. Ellen Berman. Ms. Greenber'g visited the ml 12, 17 and 19. She was upset and stressed about her job as a school teacher for the District of Philadelphia, where she had been employed for three years. She had expressed that she was nveiwhelmed with her classroom work. She had been prescribed Zolnfi first, then switched to a low dose of Xanax. After no success, the doctor prescribed Ambien and Klonopin. on January 17, it was specifically noted by the "she starts thinking about everything else not suicidal." On January 19, Dr. Ber-man noted: "my better". Ms. Greeubcr'g denied airy verbal or physical confrontations with her fiance. Also reviewed is diary-like emailed account Ms, Ellen Greenherg reportedly responded to this close friends text on January 26 about 12 pm saying "yah, yoil are getting out early" (Philadelphia schools were getting out early on account at the snow storm). Ms. Greenberg's response was "Thank Goodness". Dr. Joshua Januaty 11, 2012 Page 3 As published in newspapers on February 1, 201 I, "the Medical Examiner's Ofi'lce ruled the death as a homicide", based on the Philadelphia Police Department's announcement on ianualy ZR. A few days later, the Police Department backed away, making a statement that the case had not been ruled a homicide and was being investigated as "suspicious". However, on February 18, 2011, the police retracted their original ruling, and officially declared that the death ofElleu Greenberg had been ruled a suicide. Philadelphia City Assistant Medical Examiner Marlon Osbourne, M.D., listed "multiple stab wounds" as the cause of death. The manner was ruled to be suicidel There were multiple stab wounds to the chest (8), abdomen (1), back of neck (10) and scalp (1). A knife with a 12.5 cm blade was present in tlle 10 cm. deep chest wound. There were injuries to the sonic arch, the lefi upper lung lobe, Liver and dorsal cervical spinal cord at C2-C3, There were associated bilateral hemothorax and hemopericardium. The wounds were listed as follows: Chest: (8 wounds) Front to hack (0.2 cm deep) midline Front to hack (0.2 cm deep) midline Right to lefl (l .4 cm deep) right chest, front to hack, upward Front in back (2.7 cm right ofmidline. 0,2 cm deep) front to back to right, from to back and downward (horizontal, lo cm deep left Ics, sharp end 3:00, blunt and 9:00 supet'iormediastinum, sonic arch, lefl upper lung lobe, 600 cc left pleural hemothomx, 500 cc right pleural helnothol'ax, l20 cc hemopericardium From to hack (0.2 cm deep) Front to back (0.2 cm) Front to back, left to right (4 cm deep, vertical blunt and 12:00, sharp end 5:00 lhmugh right ICS Form Abdomen (1) I. Front to back, lefl to right (6 cm deep) Head (1) Dr. Joshua Greenberg January 11, 2012 Page 4 Right occipital scalp (8 cm above right external auditory meatus Neck (10 wounds) Back to front, left to right (0.3 cm deep) vertical Back to front, left to right (0.2 cm deep) vertical . Back to front (0.3 cm deep) vertical Back to front (8 cm deep) through occipital triangle into ligamentum nuchae, small vessels overlying cerebellum, subaraclmoid over vermis, caudal right cerebellar hemisphere Back to front (3 cm deep), horizontal right to left Back to front, (2.1 cm deep), vertical right to left Back to front (2 cm deep) vertical, left to right Back to front (1.9 cm deep), vertical left to right Back to front (2.1 cm deep) vertical left of midline left to right Back to front (7 cm deep) horizontal between and 3rd cervical vertebrae, incising dura over spinal cord right to left 4.5 cm right of midline no defect in spinal cord Heapsp Multiple contusions ?in various stages of resolution? were present on the upper and lower extremities: right upper arm, right forearm (3), right lower abdomen, right thigh (round contusions in a vertical row) and above the right knee (3). 223 color photographs at the scene and at autopsy have been submitted. No toxicology reports are found in the materials submitted. (Reportedly, the tests were negative.) Ms. Greenberg had seen Dr. Ellen Berman. Her handwritten notes from three patient visits have been reviewed. There had not been any summary of a detailed interrogation of the ?ance. MEDICOLEGAL QUESTION What was the most likely manner of death? Suicidal stab wounds can rarely be multiple. Suicides by stabbing are becoming less frequent, with simpler choices being drugs, hanging, or gunshot. Cutting of the wrist and throat. is often associated with suicide, whereas stab wounds to the back are unlikely to be suicide. A murder usually involves multiple stab wounds to the side, back or stomach. In a suicide, there may be additional cuts across the wrist, or tentative stabbings to see if it will hurt, or to work up courage. Then there will usually only be one wound and most likely in the chest. Dr. Joshua Greenberg January 11, 2012 Page 5 The multiple stab wounds to the back of the upper neck and lower head found at autopsy were unlikely suicidal stab wounds especially the different directions that K, L, Q, and with vertical direction left to right, straight vertical of M, and T, and, right to left horizontal, and vertical P. The locations of the stab wounds high up the back of neck and lower back of head are also unlikely for self-in?icted wounds. A suicide victim will ?'equently leave a note. There was none. There was also no indication that. the decedent was suicidal from the standpoint of her own family, friends, professional associates and the who had evaluated her. There had not been any indication that she had the intention to commit suicide, or was depressed during the day she was found dead. She seemed her usual self in the morning when she had a telephone conversation with her mother, and later at mid-day during her texting with a friend at approximately noon. It would be important to ?nd out from the ?ance how she behaved barely half an hour before, when he left their apartment as he claimed. A suicide victim will rarely stab herself through her clothing. Instead, she will open her shirt to expose the skin. Stabbing through clothing may indicate homicide. It is not known if ?ngerprints on the knife were taken and examined. OPINION Following the review of all submitted documents, the results of the autopsy and the accounts from the investigation, based upon reasonable degree of medical certainty, it is my professional opinion that the manner of the death of Ellen Greenberg is strongly of homicide. Very truly yours, ,6 if} Cyril H. M.D., .D. CHW/srw