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From the Medical Examiner’s Report:
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Conclusion/Opinion: As often is the case with a skeletonized individual, the exact cause of death cannot be determined with certainty. The manner of death is an opinion based on available information, including circumstances surrounding the death, information from the scene, and examination of the skeletal remains.

The circumstances of death are that this toddler child, with no known medical history, was not reported missing to authorities for approximately 30 days. This child’s remains were eventually found in a wooded, overgrown area, discarded with two trash bags and a laundry bag. Although there is no trauma evident on the skeleton, there is duct tape over the lower facial region still attached to head hair. This duct tape was clearly placed prior to decomposition, keeping the mandible in place.

The clustering of vertebrae at the scene separate from the location of the bags and skull indicate animal activity occurring at this location after decomposition started, but before complete disarticulation of the skeleton. This indicates the body was put in this location prior to complete skeletonization. The roots growing into the vertebrae and bags indicate that the body was placed there months prior to being found. There is nothing inconsistent with the body being placed there soon after the date of being last seen alive.

It is, thus, my opinion that, although the cause of death cannot be determined with certainty, the manner of death is homicide.
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Comments on weaknesses in this examiners conclusion/opinion as far as it’s being used as evidence:

a) Manner of death is described as circumstantial by the conclusion/opinion itself in the first paragraph. People have taken to assuming that the Medical Examiner’s report provided physical evidence of homicide and that all the other evidence in the trial was circumstantial, when, in fact, even the Medical Examiner’s report was circumstantial and the report itself clearly states how it is based on circumstantial evidence in the first paragraph of it’s conclusion/opinion.

b) Also in the first paragraph, it states that the cause of death cannot be determined with certainty, but no possible cause of death is offered anywhere in the report. So saying it cannot be determined with certainty is a misrepresentation which would tend to imply that the cause of death is determined by the report with at least some small amount of certainty. But no cause of death is given in the report - that’s not uncertainty, that’s an unknown. Since no cause of death is offered in this report the conclusion/opinion should simply state that the cause of death cannot be determined in order to be clear to the reader.

c) In the second paragraph, this conclusion/opinion notes that there is no trauma evident on the skeleton. At that age, bones are softer than those of adults and children can often suffer physical trauma without breaking bones. Therefore physical trauma can not be ruled out as a cause of death. For example, a brain injury from a fall is within the realm of possibility, but cannot be supported or ruled out without brain tissue to analyze. However, given that the conclusion/opinion only notes the absence of trauma evident to the skeleton, and does not note that there may have been trauma that is not evident, the conclusion/opinion opens up the possibility that the reader may assume that physical trauma is ruled out as a cause of death. Of course the conclusion/opinion does not rule out ANY cause of death, and, with a careful reading one can see that it technically offers absolutely no cause of death.

d) Also in the second paragraph, the duct tape is noted to have been placed prior to decomposition. One must be careful to note that it does not say that it was placed prior to death. Everyone in this case has argued all along that the duct tape is the murder weapon. But this conclusion/opinion of the Medical Examiner’s report clearly does not go so far as to conclude or speculate that the duct tape was the murder weapon - it only states that it is clear the duct tape was placed prior to decomposition.

e) Referring back to point b), the second paragraph provides an opportunity for the reader to incorrectly infer that suffocation due to the duct tape being placed over the nose and mouth is the cause of death, if they don’t clearly separate the difference between what the paragraph says, “prior to decomposition” and “prior to death”, which the paragraph does not say.

f) In the third paragraph, there is no assertion that the body was placed in the wooded area soon after being last seen alive; it says that there was no evidence inconsistent with that. The third paragraph does state that the body was placed there “months” prior to being found. These statements allow for placement in the woods any time between the second half of June and early October.

General comments:

This report was followed shortly by a homicide charge, as it’s manner of death determination of homicide provided the basis for that charge.

If this report did not offer as it’s conclusion/opinion that the manner of death was homicide, there would be no basis for a murder charge.

The combination of points b) and e) is where this conclusion/opinion is obviously designed to provide a manner of death of homicide based on a cause of death that is implied even though no explicit cause of death is given. Such subtley calls into question the integrity of the Medical Examiner’s office. A few years ago there were very prominent stories circulating in the media about M.E. offices that would give in to pressure from prosecutors to be less than forthright in their investigations in order to get arrests or convictions. One in NY, IIRC, was actually completely shut down.

Medical Examiner’s reports should never imply anything, but should state facts explicitly. M.E.’s must never base their reports on what a prosecuter desires. When an M.E.’s office starts going down this road it sometimes results in wrongful convictions and other times results in charges filed that ultimately become extremely difficult to get a conviction on, thereby wasting millions of dollars.