Pathologist's work, and cost, raise questions

(adapted from The Times Herald Record, 11/23/97)

By PAULA McMAHON, OLIVER MACKSON and CHRISTOPHER MELE,
Staff Writers

GOSHEN - Orange County taxpayers have paid hundreds of thousands of dollars to a forensic pathologist who makes findings the district attorney says are "incomplete, inadequate or erroneous."

Dr. Louis Roh handles most of the county's important autopsies in cases of suspicious death. For years, he has testified in Orange County in almost every notable homicide trial.

But in a manslaughter trial this week, Chester lawyer Benjamin Ostrer produced a letter, written more than two years ago by Orange County District Attorney Francis D. Phillips II, that severely criticizes Roh's performance.

"We have had substantial problems with (the) quality of the work of Dr. Louis Roh," Phillips wrote in the Aug. 17, 1995, letter to County Coroner Anthony Ingrassia. "In various criminal cases, (Roh's) findings have been either incomplete, inadequate, or erroneous."

"I cannot in good conscience rely upon his findings in cases where the cause of death is more than a simple gunshot wound or stab wound," Phillips' letter continued.

He urged county coroners to replace Roh. Ingrassia said that he did not recall the letter and had no quibble with Roh's work. Roh's work has been challenged - and sometimes contradicted by other pathologists - in recent years. Roh stood by his work and said Phillips' letter stemmed from an unspecified "misunderstanding."

The issue is notable because the work of a forensic pathologist is critical to determining the causes of suspicious deaths. Such determinations are the foundation of criminal prosecutions. Mishandled autopsies or misdiagnosed causes of death undermine the integrity of the criminal justice system. They could result in defendants being wrongly accused or in guilty parties being acquitted.

Among the cases where Roh's work has come under question:
***In 1995, Orange County Court Judge Jeffrey G. Berry found that Roh had performed an incomplete autopsy on Daniel Vassello, 15, and acquitted his parents, Donna and Daniel Vassello, of criminally negligent homicide. Roh ruled the Coldenham youth died of a combination of gas-sniffing and scratches and bruises he suffered after spending most of the night outside his parents' home. But another autopsy by Dr. Barbara Wolf of Albany found the boy died of bacterial meningitis.

The case gave the Vassellos such notoriety that Donna Vassello said they had to find a new home in Pike County, Pa. "I can't sleep, I can't eat. I lost about 100 pounds, I gained about 100 pounds. I have psychotic episodes... This man (Roh) needs to be stopped. There are hints and clues all over the place.'' Phillips wrote the letter to Ingrassia two weeks after Berry tossed out charges against the Vassellos.

***In 1994, Roh ruled that 24-year-old Jason Singleton had died of cocaine intoxication while in the custody of Newburgh city police. A grand jury cleared four officers of any culpability, and found that Singleton had swallowed a lump of rock cocaine to avoid having police find it in his clothing. But the results of the autopsy were challenged, by Wolf and the state Commission of Correction. A second grand jury was convened to hear more evidence. That grand jury cleared the police again, but Singleton's family never accepted the result. They're suing the city.

**Cheryle Branson of Newburgh also questioned Roh's 1994 finding that her perfectly healthy, 28-year- old daughter, Andrea Lanzillotti, had suddenly died of kidney failure. She never had any history of kidney disease. Branson hired another pathologist, Dr. Frederick Zugibe, and he performed a second autopsy and labeled the death suspicious. Another pathologist, Dr. Michael Baden, conducted another autopsy and labeled the cause unknown. "If they (the county) are allowing these mistakes to continue, they're a part of this whole thing," Branson said. "I've been furious about this from the beginning."

In each of these cases, Roh said he stood "absolutely 100 percent" behind his findings. In the Vassello case, he said there was "absolutely no shred of evidence'' of meningitis and that "even medical students'' would have concluded that.

He said Daniel Vassello had ingested anti-freeze at levels greater than the fatal dosage. He said he did microscopic studies of the boy's brain and that there was "not a drop of pus'' indicating meningitis. He said, likewise, that Singleton had traces of cocaine at five to 10 times above lethal dosage. Roh said Wolf had disregarded this finding, which he called "disconcerting."

Roh said autopsies are not a simple procedure and require "interpretation." With 27 years of experience in pathology, Roh said he has the most extensive background and testified more than anyone else in the region. Phillips' letter about Roh may not be an issue in the case being tried this week. Ostrer's effort to get the letter introduced as evidence in the manslaughter trial of Michael Maragh failed because Roh said he hadn't seen the letter until he was confronted with it on the witness-stand. But it could be used in future trials - now that Roh knows about it - to question why he still does autopsies and testifies as an expert witness when the county's chief law enforcement officer has little confidence in his work. Perhaps more importantly, Phillips said in an interview this week, crime victims and their families should be able to have confidence that the most professional services are available to investigate suspicious deaths in their county.

Roh works full-time as Westchester County's deputy chief medical examiner. Orange County hires Roh as a consultant. He has been a licensed doctor in New York for 25 years after graduating in 1967 from medical school in South Korea. He is board certified in anatomic, clinical and forensic pathology. Roh said that he had never seen or heard of the Phillips' letter until Ostrer gave it to him on the witness-stand Monday.

Roh said he was "surprised" by the letter's contents and Phillips' opinion of him. "That (letter) was not correct," Roh said. "I think it was (an) unfair letter. As far as I know, I'm doing a satisfactory job. The coroners are all happy."

Orange County has paid Roh $471,190 from 1992 through 1997, county figures show. Phillips said Roh gets $2,000 per day for testimony as an expert witness.
Orange County's four coroners select pathologists, such as Roh, to carry out autopsies.

"I have no say. The coroners designate all the doctors. They got my input and it was ignored," Phillips said.

Phillips said he does not believe that Roh has caused prosecutors to lose any cases. In the Maragh case, he noted that his office retained two other pathologists who agreed with Roh's findings. But a third pathologist, Dr. Mark Taff, who was hired by Ostrer to testify for Maragh's defense, also criticized Roh's work when he testified.Taff said Roh did an improper autopsy which could have missed a rare but natural cause of death.

By the time a second autopsy was done by another pathologist for the prosecution, there would no longer be evidence of the possible natural cause, Taff said.

"Anatomical landmarks have already been disturbed," Taff told the jury. "(Other pathologists) had to depend on Dr. Roh's eyes and ears." DA Phillips also criticized the existing system which has coroners decide whether an autopsy is warranted. "It's left to the discretion of the coroner to decide if it's a (potential homicide)," he said. "Here are guys who are funeral directors making calls that would be difficult for a forensic pathologist to make."

Sullivan County District Attorney Stephen F. Lungen said he's called Roh as an expert witness about four or five times. Roh was "just excellent'' and his testimony was "terrific," Lungen said. In one shaken-baby case, Roh's testimony helped clinch a guilty verdict, Lungen said. "No doctor has testified more clearly than that,'' Lungen said. "The jury was so impressed, they convicted (the defendant) right away."

Ulster County District Attorney Michael Kavanagh said his county has a good working "hybrid" system that relies on coroners and pathologists, but he supported Phillips' demand for accountability. "The DA, quite frankly, should be the one to make that call,'' Kavanagh said. "If your coroner is not employing the pathologist the DA wants, he should be fired. If Frank is the one encountering a problem, he is the one to make the call, because he's the one to live with the results."The chief difference between a coroner and medical examiner system is one of approach.

A coroner system can consist of lay persons, such as funeral directors or former police officers, or medical doctors. They can declare a person dead and investigate death scenes, but must rely on qualified pathologists to perform autopsies and rule on causes of death.

A medical examiner's office can consist of medical doctors or a board-certified forensic pathologist who could conduct autopsies and make determinations of death.

Full-fledged medical examiners' offices consist of a staff of investigators, office workers and a lab.