INJURIES
I. STAB WOUND OF THE ANTERIOR LEFT CHEST:
A. STAB WOUND: A vertical, 1 1/2-inch stab wound of the anterior-medial left chest is centered 17 inches below the top of the head and 1 1/2 inches to the left of anterior midline. The wound edge is abraded from 6 to 12 o'clock. The lower end is square and the upper end is sharp.
B. INJURIES: The wound track travels through the skin, subcutaneous and muscle tissues of the left chest and through the left anterior 3rd-4th cartilage adjacent to the sternum.
The wound track continues through a 3.5-centimeter stab wound of the anterior left ventricle and a 7.0-centimeter, diagonal defect of the left ventricle posterior-lateral left ventricle.
The wound track continues through the left lung hilum with transection of the left mainstem bronchus and left main pulmonary artery. The left chest cavity contains 50 milliliters of blood. The left lung is collapsed.
C. DEPTH: Approximately 3-4 inches.
D. DIRECTION: Front to back with minimal vertical or right-to-left deviation.
II. PENETRATING GUNSHOT WOUND OF THE LEFT CHEST:
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A. ENTRANCE: A round, 1/4-inch gunshot entrance wound of the upper left back is centered 13 1/2 inches below the top of the head and 2 3/4 inches to the left of posterior midline. A circumferential edge abrasion measures 1/16 inch.
An eccentric tissue ledge is undermined from10 to 12 o'clock. No soot or powder tattooing is seen.
B. INJURIES: The wound track travels through the skin, subcutaneous and muscle tissues of the upper left back, through the posterior left 5th rib with fracture, through a 3.0-centimeter defect of the posterior left upper lung lobe and then travels through a 4.0-centimeter laceration of the basilar left ventricle and a 3.5-centimeter laceration of the anterior wall of the right ventricle and through the anterior left 5th rib. The left lung is collapsed.
The left chest cavity contains 50 milliliters of blood.
C. EXIT: An irregular, nearly-triangular, 1 1/2-inch gunshot exit wound of the anterior left chest is centered 19 1/2 inches below the top of the head and 2 1/4 inches to the left of anterior midline.
A horizontal, 1/2-inch skin tear is at the 6 o'clock wound edge. One-eighth-inch, horizontal skin tears are at 3 and 9 o'clock.
D. RECOVERY: One large-caliber, deformed, copper-jacketed projectile.
E. DIRECTION: Back to front, left to right and downward.
II. PERFORATING GUNSHOT WOUND OF THE TORSO:
A. ENTRANCE: A diagonal, 1-inch graze gunshot wound of the lateral left chest is centered 15 1/2 inches below the top of the head and 10 inches to the left of anterior midline. The wound edges point posteriorly.
A round, 1 1/2-inch, diagonal gunshot entrance wound of the lateral left chest is centered 17 inches below the top of the head and 8 inches to the left of anterior midline. An irregular edges abrasion extends from 12 to 3 o'clock. No soot or powder tattooing is on the skin.
B. INJURIES: The wound track travels through the skin, subcutaneous and muscle tissues of the lateral left chest and through the left anterior-lateral 5th-6th ribs. The wound track then travels through the left lower lung lobe, through the left diaphragm and through a 7.0-centimeter laceration of the tip of the left liver lobe.
C. EXIT: A 1/4-inch, horizontal, slit-like gunshot exit wound of the right upper quadrant is centered 24 1/4 inches below the top of the head and 3 inches to the right of anterior midline. A 3/8-inch, horizontal abrasion extends from 6 to 12 o'clock.
D. RECOVERY: None.
E. DIRECTION: Back to front, left to right and downward.
III. PERFORATING GUNSHOT WOUND OF THE RIGHT ARM AND CHEST:
A. ENTRANCE: A round, 1/2-inch gunshot exit wound of the right upper chest is centered 15 1/2 inches below the top of the head and 5 1/4 inches to the right of anterior midline. An eccentric edge abrasion is from 5 to 7 o'clock.
B. INJURIES: The wound track travels through the skin, subcutaneous and muscle tissues of the right chest.
C. EXIT: A large, irregular, 1 1/2-inch gunshot exit wound of the lateral right chest is centered 15 inches below the top of the head and 7 3/4 inches to the right of anterior midline. Irregular abrasions measuring up to 1/2 inch are at the 12-1 o'clock edges. A 1/2-inch skin flap is from 5 to 7 o'clock.
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D. RECOVERY: None
E. DIRECTION: Back to front, left to right and downward.
F. RE-ENTRY: An irregular, 1/2-inch, round gunshot re-entry wound of the medial right upper arm is centered 13 inches below the top of the head and 1 3/4 inches medial to the posterior limb midline. An irregular, 1/2-inch abrasion is at the wound edge from 9 to 1 o'clock (widest at 12 o'clock).
G. INJURIES: The wound track travels through the skin, subcutaneous and muscle tissues with a comminuted fracture of the mid-right humerus.
H. EXIT: A round, 1/8-inch gunshot exit wound of the posterior-lateral right arm is centered 19 inches below the top of the head and 1 inch lateral to the posterior limb midline. A diagonal, 1/2-inch abrasion extends from 5 to 10 o'clock. No soot or powder tattooing is on the skin.
I. RECOVERY: None.
J. DIRECTION: Back to front, left to right and downward.
V. ADDITIONAL FIREARM INJURIES: A nearly-horizontal, 2-inch, tear drop-shaped gunshot graze wound of the left hip is centered 30 inches below the top of the head and 8 3/4 inches to the left of anterior midline. The wound edges appear to point posteriorly.
VI. ADDITIONAL TRAUMATIC INJURIES: A horizontal, 1/2-inch abrasion
SUMMARY AND INTERPRETATION
On October 02, 2023 at approximately 2331 hours, Emergency Medical Providers and Dare County Sheriff's deputies were dispatched to the scene of an armed person trespassing on someone's property.
They arrived to find Mr. Sylvester Selby outside of a trailer waving a knife. He was ordered to drop the knife and did not. Deputies began shooting at him. He was pronounced dead at the scene at 23:42 hours.
According to reports, he forced his way into a trailer and the homeowner told him to leave.
Selby refused to leave and the homeowner and stabbed Selby. Selby had a medical history significant for diabetes mellitus, paranoid schizophrenia and substance use (crack and stimulants).
Two knives and 3 shell casings were found at the scene. An autopsy was ordered to investigate his death.
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Significant autopsy findings included a stab wound of the left chest with injuries of the anterior left 3rd-4th ribs adjacent to the sternum, through the left lower lung lobe, through the anterior and posterior-lateral left ventricle, transection of the left mainstem bronchus and main pulmonary artery at the left lung hilum and a left hemopneumothorax.
Additional findings included perforating gunshot wounds of the right upper arm and chest, a perforating gunshot wound of the torso and a penetrating gunshot wound of the left chest.
Injuries due to the gunshot wounds included lacerations of the left anterior-lateral 5th and 6th and left anterior 5th ribs, lacerations of the left upper and lower lung lobes, lacerations of the basilar left ventricle and the left ventricular apex and laceration of the left diaphragm and tip of the left liver lobe.
Additional findings included emphysema of the right lung and acute pulmonary and cerebral edema.
Toxicology of chest blood was positive for alprazolam, amphetamine, benzoylecgonine, cocaine, alcohol and methamphetamine.
Given the investigative, autopsy and toxicological findings, it is my opinion that Mr. Sylvester Selby's cause of death was due to a stab wound of the anterior left chest. Other significant conditions included gunshot wounds (2) of the torso and recent cocaine and methamphetamine use.
