John O’Keefe Autopsy: Injuries, Toxicology, and Cause of Death

The autopsy of John O’Keefe, performed on January 31, 2022, found that the 46-year-old Boston police officer died from blunt impact injuries to the head combined with hypothermia, with the head injuries identified as the primary cause. The medical examiner, Dr. Irini Scordi-Bello, classified the manner of death as “undetermined” — a designation that became the central forensic dispute in the two criminal trials of his girlfriend, Karen Read.¹²

O’Keefe’s body was found in the snow on the front lawn of a Canton, Massachusetts home around 6:00 a.m. on January 29, 2022, after a night of heavy snowfall. His body temperature at the hospital was recorded at 80.1 degrees Fahrenheit.²

Who Performed the Autopsy

Dr. Irini Scordi-Bello, a forensic pathologist licensed in Massachusetts and New York, conducted the examination. She holds a medical degree from the Icahn School of Medicine at Mount Sinai, completed her pathology residency there, and did a forensic pathology fellowship at the New York City Office of the Chief Medical Examiner. She is board-certified in anatomic pathology and forensic pathology.³ She testified about her findings at Read’s retrial in May 2025.⁴

Injuries Documented

Head and Face

O’Keefe had a significant laceration on the back right side of his head. Multiple skull fractures radiated from that laceration, and there was bleeding on top of the brain. His face showed a small laceration to the right upper eyelid, a cut above the right eye, abrasions on his nose, and bleeding and swelling around both eyes — a presentation sometimes called “raccoon eyes.”⁵⁶

Arms and Body

Dr. Scordi-Bello documented cuts on O’Keefe’s right arm, two bruises on the back of his right hand, a faint scratch on the back of his left hand, and a small scrape on his right knee. She described the arm wounds as “scrapes or scratches” lacking significant depth, with no exposed fat or muscle. She testified that she had no opinion on how the arm injuries occurred.⁴

Internal Findings

The autopsy revealed rib fractures on both sides near the sternum, which Dr. Scordi-Bello attributed to resuscitation efforts by first responders. She also found hemorrhaging in the pancreas and stomach lining, which she characterized as consistent with hypothermia. She acknowledged it was “possible” the internal hemorrhaging could also have been caused by the LUCAS chest-compression machine used during resuscitation.⁴

Toxicology

O’Keefe’s toxicology screen came back negative for drugs, including prescription medications. His blood alcohol level was 0.21 grams per deciliter. His vitreous humor alcohol level was 0.28 grams per deciliter. Dr. Scordi-Bello explained that the higher vitreous level indicated his blood alcohol had been higher earlier and was trending downward at the time of death. She testified that alcohol intoxication acts as a “negative factor” in hypothermia cases because it inhibits the body’s ability to maintain heat.⁷⁵

Cause of Death and the Undetermined Manner Finding

Dr. Scordi-Bello concluded that the cause of death was “blunt impact injuries to the head and hypothermia,” with the head injuries identified as the primary cause. Hypothermia, she said, “contributed” to the death, though she could not determine whether it would have been fatal on its own without the head injuries.²

She classified the manner of death as “undetermined.” In her testimony she explained that she uses that designation when “the circumstances in a case are not entirely known or clear to us, and the information that we have does not support one manner of death over another.” She said she could not conclude to a reasonable degree of medical certainty whether the death was an accident, a homicide, or something else.⁶

In a typical homicide prosecution, the medical examiner classifies the manner of death as “homicide,” which gives jurors a straightforward forensic conclusion. Here, that conclusion was absent. Dr. Scordi-Bello testified that she was not aware of data from O’Keefe’s cellphone when she filed her report, and defense attorney Robert Alessi pressed her on whether she had been influenced by law enforcement information, particularly from lead investigator Trooper Michael Proctor, who initially framed the case as a “possible person struck by a motor vehicle.” Scordi-Bello maintained that she does not generate “hypothetical scenarios” for how injuries occur and said no one at the medical examiner’s office encouraged her to change her findings.⁶

What the Autopsy Did Not Find

One finding carried outsized weight given the vehicular-homicide theory. Dr. Scordi-Bello testified that she examined O’Keefe’s legs and did not observe any evidence of an “impact site” typically associated with a vehicle striking a pedestrian. She saw no leg fractures, bruising, or bleeding that would suggest a car struck his lower body.⁶

How Prosecution and Defense Experts Read the Same Findings

The autopsy report became a battleground. The same injuries supported two incompatible stories.

The Prosecution Reading

Prosecutors argued that Karen Read struck O’Keefe with her Lexus SUV, causing him to fall backward and hit his head on the frozen ground. Dr. Scordi-Bello herself testified that the lacerations on the back of his head were consistent with falling backward onto a hard, flat surface. When asked about the facial cuts, she said they “could be” consistent with contact with shards of broken glass or plastic, though she lacked firsthand knowledge of how they occurred.⁴

Dr. Aizik Wolf, a neurosurgeon and director of the Miami Neuroscience Center, testified for the prosecution that O’Keefe’s skull fracture was a “nondepressed skull fracture” consistent with a “classic blunt trauma injury.” He said the only way O’Keefe could have sustained the injury was to fall backward onto a hard surface, that the injuries were inconsistent with being struck by a bat or similar object, and that O’Keefe likely lost consciousness quickly but did not die immediately.⁸⁹

Accident reconstruction expert Dr. Judson Welcher of Aperture LLC tied the arm wounds to the SUV. Using a purchased exemplar Lexus of the same model, he conducted a test in which the vehicle backed into his arm at 2 miles per hour, producing paint transfer and an impact pattern he said resembled O’Keefe’s arm injuries. Welcher testified that the cuts on O’Keefe’s arm were consistent with the “geometry and orientation” of the right taillight and that a bruise on the right knee was at a height consistent with the SUV’s bumper.¹⁰

The Defense Reading

Dr. Elizabeth Laposata, a forensic pathologist and former chief medical examiner of Rhode Island, testified that O’Keefe died from blunt force trauma alone. She rejected the hypothermia finding outright: “The body did not have any hypothermia.” She pointed to the absence of ulcers typically associated with death by cold. She also testified that she saw no evidence of impact from a vehicle. She based her conclusions on the autopsy report, a brain examination report, toxicology results, medical records, evidence photos, and more than a hundred autopsy photographs.¹¹¹²

Laposata agreed with Dr. Wolf that O’Keefe suffered a “coup-contrecoup” injury from falling backward, but she disagreed about the surface. She testified that the wound pattern showed “linear scrapes” and a scalp tear consistent with hitting a surface with a “little ridge” and “granularity,” not a perfectly flat surface. She attributed the bruising around O’Keefe’s eyes to the skull fracture itself, which caused blood to seep into the upper eyelids as the brain struck the base of the skull, rather than to any direct blow to the face.¹²

The defense presented the arm injuries as evidence of a dog attack. The judge barred Laposata from explicitly calling the wounds “dog bites” but allowed her to testify that they were “very much” consistent with animal bite or claw marks inflicted before death.¹³ Dr. Marie Russell, an emergency physician who reported treating roughly 500 dog bite wounds over her career, testified that the arm wounds were consistent with a large-dog attack and that people under attack often sustain defensive wounds on the backs of their arms, matching the pattern on O’Keefe.¹⁴ The defense pointed to a 70-pound German shepherd named Chloe, belonging to the homeowners, who was rehomed to a Vermont farm after O’Keefe’s death.¹⁵

Biomechanical expert Daniel Wolfe of ARCCA testified that the damage to the SUV’s taillight and O’Keefe’s clothing was “inconsistent with striking an arm or a body.” Crash reconstruction expert Andrew Rentschler similarly testified that the evidence did not support O’Keefe being hit by a vehicle.¹³

How the Autopsy Figured Into the Verdict

Karen Read’s first trial ended in a mistrial in July 2024 when jurors could not reach a unanimous verdict. Her retrial ran 31 days with 49 witnesses. On June 18, 2025, a Norfolk County jury acquitted Read of second-degree murder, manslaughter, and leaving the scene of a collision resulting in death. She was convicted of operating a vehicle under the influence of alcohol and sentenced to one year of probation, a court-approved alcohol education program, and a license suspension for the program’s duration.¹⁶¹⁷ The autopsy’s finding on cause of death stood, but its silence on manner was never filled in by the jury’s homicide verdict.

1
CBS News. Karen Read Trial Timeline
2
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Doximity. Irini Scordi-Bello, MD
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CBS News. Karen Read Trial Day 16
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WHDH. Medical Examiner Outlines Findings From John O’Keefe Autopsy
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Boston.com. Karen Read Murder Trial Livestream Thursday May 15
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MassLive. Karen Read Trial Live Updates Testimony Resumes on Thursday
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WPRI. Brain Surgeon Explains Boston Officer’s Head Injury in Karen Read Trial
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Boston 25 News. Miami Brain Surgeon Testifies O’Keefe’s Brain Injury Came From Fall
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MassLive. Karen Read Retrial Biggest Takeaways From Week 6
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WPRI. Former RI Medical Examiner: O’Keefe Did Not Die From Hypothermia
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Boston.com. Karen Read Murder Trial Livestream Monday June 9
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USA Today. Dog at the Heart of the Karen Read Trial
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