Dr. Cyril Wecht, under questioning by defense attorney John Momot, testified that Ted Binion did not die of suffocation. (Court TV)

By Laura Barandes
Court TV

Ted Binion died of a drug overdose, not as the result of suffocation, the defense's star witness testified Wednesday. And with his testimony, jurors heard yet another theory for the cause of death.

"In my opinion, to a reasonable degree of medical certainty, the cause of death was what I would call acute combined drug toxicity," said Dr. Cyril Wecht, a famed forensic pathologist who worked on the JFK assassination, the death of Elvis and even performed the autopsy on Waco's David Koresh.

Read Dr. Cyril Wecht's Complete Pathology Report

"I would leave it as undetermined just from the autopsy," said Wecht, but based on information about Binion's "business life, personal life, emotional status...I would opt for suicide."

Prosecutors have argued that Sandy Murphy, Binion's live-in girlfriend, and her lover, Rick Tabish, forced a potent mixture of heroin and Xanax down the millionaire's throat and then suffocated him when the gardener arrived at the house unexpectedly. According to the state, the pair killed Binion for his money and to free Murphy from her relationship with him.

The defense has maintained that Binion, a heroin addict for 20 years, simply succumbed to his long-standing drug habit, either accidentally or by a deliberate act of suicide. They point out that Binion himself bought 12 balloons of potent tar heroin and filled a prescription for Xanax the day before he died.

Beginning with the top of Binion's body and working his way down, Wecht testified that he saw no signs of suffocation in his examination of the evidence.

Pointing to enlarged photographs of Binion's eyes, Wecht told the jury, "I do not see petechiael hemorrhaging." That type of injury, characterized by red dots the size of pin's head, could be indicative of a sudden oxygen deprivation or a significant rise in blood pressure.

Wecht's observation contradicts that of the state's star pathologist, Dr. Michael Baden. The latter expert, who claims Binion died of suffocation, testified he saw petechiael hemorrhages in his examination of the autopsy photographs.

Wecht then turned his attention to the area of redness around Binion's mouth. The prosecution contends this redness is evidence of trauma to the mouth, inflicted by Murphy and Tabish as they tried to suffocate Binion with a hand or pillow.

However, Wecht testified that the redness in no way implied foul play. Echoing the testimony of other defense experts, Wecht said "it looks to me like an area of mild irritation...the kind many men get from shaving" and "it's more accentuated by the post-mortem drying." Wecht also noted that there was no evidence of trauma to Binion's external neck area or trachea, which might have suggested strangulation or suffocation.

Sandy Murphy and Rick Tabish sat quietly through another day of straight medical testimony — Murphy barely stifled a yawn when Dr. Wecht was on the stand. (Court TV)

One of Wecht's most significant opinions involved the circular marks on the center of Binion's chest. Both sides seem to agree that the marks were made by the buttons on Binion's shirt, but they have disagreed about what specific pressure caused them and when.

Prosecutors argue the marks show that one of the defendants sat on or put a knee into Binion's chest to keep his lungs deflated, a method known as "Burkeing." Defense attorneys contend that the marks were caused by a sternal rub, a vigorous rubbing of the chest used by paramedics trying to revive patients.

Unlike Baden, who said the marks were made before Binion died, Wecht testified that "these markings were produced after death...anywhere from several minutes to several hours," based on their coloring. Also, said Wecht, "Burkeing" would have caused a blue-hued congestion in the head area from the low-oxygen blood trapped above the lungs.

Wecht testified that he was also impressed by the missing signs of struggle. "The man shows no defensive wounds of any kind," said Wecht, which is inconsistent with suffocation. "The need to breath is basic. You will fight to do it." However, the prosecution countered that no struggle took place because Binion was drugged into a stupor.

Wecht admitted he could not say whether the scrapes on Binion's wrists were made before or after death, but he disputed the prosecution's claim that they are evidence of restraint. Wecht testified that these scrapes and the bruise on Binion's leg have no impact on his opinion that the millionaire died at his own hand.

"Oh no," said Wecht, "they have no meaning at all with regard to cause of death." With Binion, who was often high on drugs, "you get a bump here, a scrape there," said Wecht. The witness noted that the autopsy evidence did not include samples of tissue from the wrist injuries, which might have given a better indication of when they happened in relation to Binion's death.

Wecht testified that Dr. Lary Simms, the Clark County medical examiner who performed Binion's autopsy, also neglected to take several important measurements which could have helped pinpoint the time of death.

First, Simms did not take a reading of Binion's core body temperature at the scene of death. According to Wecht, by taking that and successive readings, one can calculate the rate of cooling to estimate when death occurred.

Second, Simms neglected to extract fluid from the back of Binion's eye in order to measure the level of potassium. As in the case of temperature, the potassium level changes at a certain rate after death and can be used as another indicator of when death took place.

Third, Wecht said Simms did not examine Binion's small intestine, "where almost all of the absorption takes place." Said Wecht, "it would have shed a lot of light" on how much of the drugs were ingested and at what point in time.

Lead prosecutor David Roger made no objections during the direct examination of defense expert Dr. Wecht. (Court TV)

However, based on all of the evidence he examined, Wecht said that in his opinion, Binion died of an overdose. The levels of heroin, Xanax and Valium in Binion's blood, though none of the drugs individually was at a lethal level, acted synergistically to cause his death. Wecht testified that he based his particular opinion of suicide on information he learned about Binion's drug use and his life experience.

The prosecution scored its best point against Wecht when they asked if he had formed his opinion of suicide based only on transcripts he received from defense attorneys. Wecht admitted that if he were presented with other information that Binion was "happy and planning for the future...I might back away completely from suicide."

Many prosecution witnesses testified that Binion was indeed in good spirits and spoke of future investments and travel in the days leading up to his death. The defense, Wecht said, did not supply him with those pieces of testimony.

But Wecht stressed that suicide is the manner of death and "it still doesn't change my opinion as to the mechanism of death," which remains drug overdose, not suffocation.

On Monday, another forensic pathologist, who has practiced for 60 years, testified that the original cause of death in Binion's autopsy was correct: undetermined. According to Dr. Robert Bucklin, "there's not anywhere near enough information to call it a homicide."

And regarding the prosecution theory of suffocation, specifically, Buckling testified that it was "highly improbable based on the lack of findings."

Jurors in the Ted Binion murder case have now heard three theories of how Binion died: homicide by suffocation, suicide by overdose and undetermined. In the end, this "battle of the experts" may just be confusing enough to create reasonable doubt.