John O’Keefe Autopsy Photos: Injuries, Prosecution and Defense Theories

The autopsy photos of John O’Keefe, shown to jurors during Karen Read’s 2025 retrial but never released publicly, documented a compound laceration on the back right side of his head with multiple skull fractures, severe swelling and bleeding around both eyes, abrasions along his right arm, bruising on his hands, and no impact injuries to his legs. Those images, and the medical examiner’s testimony explaining them, became the pivot point of the case because the prosecution and the defense drew opposite conclusions from the same wounds.

What the Autopsy Documented

Dr. Irini Scordi-Bello of the Massachusetts Office of the Chief Medical Examiner performed the autopsy on January 31, 2022, two days after O’Keefe was found unresponsive in the snow outside a fellow Boston officer’s home in Canton. Her findings carried through both of Karen Read’s trials.¹

The most significant wounds were to the head. Dr. Scordi-Bello documented a compound laceration on the back right side of the skull with multiple fractures radiating from that area and bleeding on top of the brain. She also noted a small laceration on the right upper eyelid, abrasions on the left side of the nose, and periorbital ecchymosis, commonly called “raccoon eyes,” with swelling and bleeding in both eyelids. She testified the head injury was “consistent with falling backwards on a hard flat surface” and said she found no dirt or grass in the wound.¹

O’Keefe’s right arm carried multiple abrasions of varying lengths, which Dr. Scordi-Bello described as scrapes or scratches without exposed fat or muscle. She testified she had no medical opinion on how those arm injuries occurred.² She also documented two bruises on the back of the right hand that she noted were potentially consistent with IV attempts, a faint scratch on the back of the left hand, and a small abrasion on the outside of the right knee.³

Internally, Dr. Scordi-Bello found hemorrhaging in the stomach lining and pancreas, which she attributed to hypothermia, and rib fractures near the sternum on both sides, which she attributed with medical certainty to resuscitation efforts with a LUCAS compression device. She found no frostbite despite the hours of cold exposure.³

One finding carried outsized weight. Dr. Scordi-Bello testified that she examined O’Keefe’s legs and found no evidence of an impact site: no fractures, no bruising, no significant bleeding in the lower extremities. Pedestrians struck by vehicles typically show injuries there.¹

How the Photos Were Used at Trial

Before the images went up on the courtroom screens during the May 2025 retrial, Judge Beverly Cannone warned jurors that the photos might be “unpleasant or graphic” and instructed them that their verdict could not be influenced by the disturbing nature of the images.²

Dr. Scordi-Bello walked the jury through each major finding on screen: the swollen eyelids, the compound head laceration with its underlying skull fractures, the wounds along the right arm, and the bruises on the hand. One photograph showed a dissected view of the stomach with small dark areas she identified as gastric hemorrhages. Another revealed what she described as a “J”-shaped abrasion on the back of the head.³ The images were displayed inside the courtroom but were not released to the public.⁴

When the defense tried to ask Dr. Scordi-Bello whether the arm wounds were consistent with a dog bite, Judge Cannone sustained the prosecution’s objection and shut down that line of questioning during the medical examiner’s testimony.³

Cause and Manner of Death

Dr. Scordi-Bello determined the cause of death to be blunt impact injuries to the head combined with hypothermia, with the head trauma identified as the primary cause. O’Keefe’s body temperature at the hospital registered 80.1 degrees Fahrenheit, indicating severe hypothermia.³ She classified the manner of death as “undetermined,” testifying that the circumstances were not clear enough to support one manner over another and that there was not enough “compelling” evidence to decide between accident and homicide.⁵

That “undetermined” classification left the fight over what the photos actually showed to be waged by other experts.

The Prosecution’s Reading: Vehicle Impact

Prosecutors argued that Read struck O’Keefe with her Lexus SUV while backing up outside 34 Fairview Road, knocking him down and leaving him in the snow to die. They pointed to broken taillight pieces found at the scene and on O’Keefe’s clothing, with DNA on the fragments matching O’Keefe, and to digital data showing the SUV was placed in reverse within seconds of O’Keefe’s phone recording its last activity at 12:32 a.m.⁶

Biomechanical engineer Judson Welcher testified that O’Keefe’s arm and head injuries were consistent with being clipped or sideswiped by a vehicle identical to Read’s Lexus. Using a replica SUV, laser scanners, and 3D modeling, he told jurors a scuff mark below the taillight corresponded to O’Keefe’s hip and that the laceration above O’Keefe’s eye matched a protruding fin above the rear hatch.⁷ Judge Cannone limited his testimony, ruling that while he could say O’Keefe’s injuries were consistent with being struck by a Lexus, he could not testify that Read’s specific vehicle was the one that hit O’Keefe.⁸

On cross-examination, Welcher conceded he had performed his paint-transfer demonstration at only 2 miles per hour rather than the 20 mph he theorized the SUV was traveling, saying he was not willing to be struck at that speed. He also acknowledged he did not know the exact point of impact and had not performed a formal force analysis. His firm, Aperture, had been paid $325,000 by the Norfolk County District Attorney’s Office.⁹

The Defense’s Reading: Backward Fall and Dog Bites

The defense argued O’Keefe entered the Albert home after midnight, was beaten inside, attacked by Brian Albert’s 70-pound German Shepherd, Chloe, and then left outside in the snow.¹⁰

Neurosurgeon Dr. Aizik Wolf testified that the head laceration was “classic blunt trauma” consistent with falling backward and striking a hard surface, a common pattern for intoxicated people who fall on ice. He described the skull fracture as a “classic linear basilar skull fracture” and the brain injury as a “coup contre coup” pattern, in which the brain is thrust forward after the back of the skull hits the ground. He pointed to the absence of a depressed skull fracture, which he said would be more typical of an attack with a weapon, and testified that O’Keefe likely did not die immediately but succumbed to a combination of brain swelling and hypothermia.¹¹

Dr. Marie Russell, a retired emergency room physician and forensic pathologist, testified that the arm injuries were “the result of dog bites and/or claw marks” to a reasonable degree of medical certainty. She identified linear abrasions and arch-like structures she said were consistent with a dog’s front teeth, along with holes in O’Keefe’s sweatshirt that she attributed to a canine tooth. She said the wounds showed a “vital reaction,” meaning inflammation indicating they were sustained before death, and were “inconsistent” with injuries typically seen in vehicle collisions.¹² Prosecutors challenged her credentials, noting she had never previously testified as a dog-bite expert and that no canine DNA was found on O’Keefe’s clothing.⁵

Defense accident reconstruction expert Daniel Wolfe of ARCCA ran crash-test simulations at speeds from 15 to 29 mph using a replica of Read’s SUV and an anthropomorphic test dummy. He testified that none of the tests produced damage to the dummy’s clothing consistent with the holes and tears on O’Keefe’s sweatshirt, which he attributed instead to “road rash.” He said the taillight damage in his tests did not match the damage on Read’s vehicle, and that a direct head impact with the taillight would not have generated enough force to cause the skull fractures.¹³

How the Jury Resolved It

The retrial jury sided with the defense’s interpretation of the physical evidence. On June 18, 2025, jurors acquitted Read of second-degree murder, manslaughter, and leaving the scene of an accident resulting in death. She was found guilty only of operating a vehicle under the influence of alcohol, and Judge Cannone sentenced her to one year of probation.¹⁴

1
WHDH. Medical Examiner Outlines Findings From John OKeefe Autopsy on the Stand in Karen Read Murder Retrial
2
CBS News Boston. Karen Read Trial Live Day 16
3
Boston.com. Karen Read Murder Trial Livestream Video Thursday May 15
4
Boston 25 News. Live Court Video Updates Day 17 Witness Testimony Karen Reads Retrial
5
CNN. Karen Read Retrial Key Testimony
6
CBS News Boston. Karen Read Trial Timeline John OKeefe
7
WCVB. Karen Read Retrial Live Updates May 27
8
MassLive. Karen Read Trial Live Updates Testimony From Crash Expert Resumes on Wednesday
9
Boston Globe. Karen Read Retrial Live Updates
10
USA Today. Dog at the Heart of the Karen Read Trial
11
Boston.com. Karen Read Murder Trial Livestream Video Wednesday May 21
12
Boston.com. Karen Read Murder Trial Livestream Video Monday June 2
13
Boston.com. Karen Read Murder Trial Livestream Video Friday June 6
14
NPR. Karen Read Acquitted Trial Verdict Not Guilty