TACOMA, Wash. — On the witness stand Thursday, former Pierce County Medical Examiner Dr. Thomas Clark, who performed the autopsy on Manuel Ellis’ body, explained to the jury how and why he came to his conclusions about Ellis’ death.
Clark ultimately cited Ellis’ cause of death as hypoxia due to restraint, with significant contributing factors of meth intoxication and cardiomyopathy (an enlarged heart).
Ellis, a 33-year-old Black man, died in Tacoma police custody on the night of March 3, 2020, following a confrontation with officers.
Officers Christopher Burbank and Matthew Collins are charged with second-degree murder and first-degree manslaughter in Ellis’ death. Officer Timothy Rankine is charged with first-degree manslaughter.
Clark explained on Thursday that the ruling of homicide as the manner of death is a neutral term and means external force is willfully applied by one human against another that results in a death. However, his job is only to determine and explain cause and manner of death, said Clark, who retired in late 2020.
“I have tried very hard not to remember the names of officers in association with actions,” Clark said. “That’s not part of my job and I don’t want that knowledge when I’m making decisions. … I don’t have an opinion on which human directed that external force or exactly why.”
Weighing three 'unpredictable factors'
Clark noted that when coming to his final conclusion for the reason for Manuel Ellis’ death, he was tasked with weighing three “unpredictable factors” he could cite as the ultimate cause: meth intoxication, an enlarged heart and hypoxia due to restraint.
Toxicology reports reflected that Ellis had what could potentially be a fatal amount of methamphetamine in his system – however, Clark said, people have been known to survive higher doses, and there is no one level of meth intoxication that has proven to be fatal every time.
Ellis’ heart also didn’t exhibit signs of ventricular fibrillation; the type of heart attack that would be induced by a stimulant like meth.
Clark said that the second potential cause, the enlargement of Ellis’ heart, is also something people routinely survive. Ellis’ heart weighed in at 480 grams, which is enlarged but not especially so, and people can survive with hearts that are much larger for years at a time.
This brought Clark to the third potential cause of death: oxygen depravation induced by police restraints. In his examination of Ellis’ body, Clark said it was evident that Ellis had been restrained, and that his face, arms and knees were pressed against the pavement. He was aware that Ellis had been placed into handcuffs and hobbled, with the restraints on his wrists and legs connected, and that there was a spit mask placed over Ellis’ face.
Clark said medical literature about police restraints is split on whether or not they can cause someone’s death – the restraint methods are variable and often inconsistent in how long they are used. However, a pre-hospital report provided by medics who treated Ellis at the scene pointed to more evidence that oxygen deprivation resulting from the restraints was the ultimate cause of death.
In the report of Lt. Nicholas Wilson, a Tacoma Fire Department paramedic who previously testified, Clark read that Ellis’ pupils were dilated and did not respond to light, that Ellis was not breathing and he had a weak and slowing pulse. This signaled to him that Ellis was already brain-dead when paramedics arrived on scene.
“He was brain dead because he had insufficient oxygen … he may have had a pulse at the time he became brain dead, probably did, but the blood wasn’t carrying enough oxygen at the time to support his brain,” Clark said.
Clark said the pupils of someone with brain function will always respond to light because it is an involuntary neurological response, even in people who are under the influence. Although Ellis was likely brain dead, he did register a pulse on an EKG that should have been able to sustain life.
Having ruled out meth and heart complications as Ellis’ cause of death, Clark said he felt “reasonably confident” that it was hypoxia due to restraints.
Clark said he later was given additional information about that night which reinforced his conclusion. Clark later learned that police had sat or kneeled on Ellis back, pressing him into the pavement, which is something he was not aware of at the time he made his initial ruling. He was also able to speak to first responders who treated Ellis at the scene and dispute an unverified report that Ellis had been speaking when they got there.
“It was not part of the report, it was not given to me by the police investigation and I don’t think I knew it,” Clark said about the officer on Ellis’ back.
However, Clark was not able to come to a specific conclusion about whether a single restraint method was more responsible for Ellis’ death, instead attributing it to the “constellation of factors.”
Determining factors in manner of death rulings
During cross-examination, defense attorneys brought up two prior cases that Clark performed the autopsies on which involved similar police restraint methods and methamphetamine levels, though less than what was found in Ellis' system; both previous cases were ruled accidental deaths.
The March 2017 case involved a man named Randy Steele, who created a disturbance in a convenience store and police responded, a defense attorney recounted in court on Thursday. Police placed Steele in a lateral neck restraint until he collapsed on the ground, and then put handcuffs on him. Steele became unresponsive and died shortly after.
During the autopsy, it was found Steele had a 2,000 nanograms per liter of meth in his body and his death was ruled an accidental death from methamphetamine poisoning, Clark confirmed. Ellis was found to have methamphetamine levels of 2,400 nanograms per liter in his system.
In the report of Steele's death, Clark said he put a sentence in the report that Steele could’ve been excited and delirious in response to questions from various investigative agencies about the cause of death being excited delirium (Clark said he does not believe excited delirium is a credible cause of death).
“I was getting all sorts of requests from them to try to prove it was excited delirium,” he said.
Referring to Steele’s case, Clark said “it was called methamphetamine because at that time, I didn’t have any other conflicting potential causes of death. That’s really the bigger issue than whether or not the concentration is more or less than Mr. Ellis.”
Clark said before Ellis’ case, he was more trusting of information provided to him by law enforcement agencies.
“However, looking at a case like this makes me worry there was something I didn’t know, such as there was on Mr. Ellis’ case,” Clark said.
Was the spit hood the ‘most important factor’ in Ellis death?
In cross-examination, attorney Brett Purtzer, defense for officer Burbank, turned to a portion of Clark’s initial and supplemental autopsy reports that seemed to single out the spit hood as having played a larger role in Ellis’ death than the other restraint methods.
In response, Clark said he could not say that definitively and, in his report, meant that it could have been the most important factor but there was no true way to tell. Clark noted that the spit hood was covered with blood and secretions, which could have completely cut off Ellis’ breathing, while the other restraint methods would have contributed to the asphyxia but did not have the ability to cause it completely.
As has been previously discussed over the course of the trial, none of the defendants were the one to place the spit mask on Ellis’ head. The prosecution initially argued that the officers violated their duty of care by not intervening when the spit mask was placed over Ellis’ head, but the judge ruled that they could not be held responsible for the impact of that particular form of restraint.
Purtzer then turned to a discrepancy with Clark’s understanding of Lt. Wilson’s report on the night Ellis died. Clark, and other medical experts to appear on the stand, initially believed that Wilson did not register a heartbeat on Ellis. However, Wilson said he did in fact feel a pulse.
Purtzer attempted to assert that Ellis couldn’t have been truly brain dead if he had a pulse, but Clark disputed that, saying the heart can continue beating even after brain death. Purtzer then called into question if Ellis’ cardiac arrest occurred in the manner that Clark and other medical experts assumed that it had if Ellis did actually have a pulse when medics got to the scene.
In response, Clark said he had reservations about whether or not paramedics truly did feel a heartbeat that night, but regardless, it did not change his conclusion about Ellis’ death. Whether Ellis’ heart was not beating when paramedics got there, or if it was beating and then slowed continuously until he experienced cardiac arrest, that would not change Clark’s conclusion about what caused it, he said.
“I would’ve come to the same conclusion either way,” Clark said on Thursday afternoon.
How do jurors decide which experts to believe?
At the end of the case, jurors will be responsible for deciding which expert testimony to factor into their final decision - a difficult task when multiple medical experts are expected to contradict each other on the stand.
Retired Pierce County Superior Court Judge Brian Tollefson told KING 5 that jurors will be instructed by the judge on how to weigh the opinions of experts at the end of the case.
"The first thing they're going to be told is they're not bound by any opinion that any expert gives them," Tollefson said.
Jury members will then be given a list of factors to consider to help them weigh the different opinions they heard over the course of the trial, including the expert's education, training and experience, among other factors.
Background on the case
On March 3, 2020, Ellis was walking home when he stopped to speak with Tacoma Police Officers Burbank and Collins, who were in their patrol car, according to probable cause documents.
Witnesses said Ellis turned to walk away, but the officers got out of their car and knocked Ellis to his knees. All witnesses told investigators they did not see Ellis strike the officers.
Other responding officers told investigators that Burbank and Collins reported Ellis was “goin’ after a car” in the intersection and punched the patrol car's windows.
Witness video shows officers repeatedly hitting Ellis. Collins put Ellis into a neck restraint, and Burbank tasered Ellis’ chest, according to prosecutors.
Home security camera footage captured Ellis saying, “Can’t breathe, sir. Can’t breathe."
Rankine, who was the first backup officer to arrive, applied pressure to Ellis' back and held him in place while Ellis was "hogtied" with a hobble, according to documents.
When the fire department arrived, Ellis was “unconscious and unresponsive,” according to documents.
KING 5 will stream gavel-to-gavel coverage of the trial from opening to closing statements. Follow live coverage and watch videos on demand on king5.com, KING 5+ and the KING 5 YouTube channel.