Medical examiner details skull fractures in Karen Read murder trial testimony

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Investigators take the stand in Karen Read’s retrial

A forensic scientist from the Massachusetts State Police Crime Lab returned to the stand for her second day of testimony Thursday.

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A medical examiner testified she could identify John O’Keefe’s cause of death as a head injury and hypothermia but could not determine whether it was homicide, accidental or any other manner Thursday during the murder trial of Karen Read in the 2022 death of her boyfriend, a 46-year-old Boston police officer.

Dr. Irini Scordi-Bello, a forensic pathologist with Massachusetts’ Office of the Chief Medical Examiner, performed the autopsy on O’Keefe Jan. 31, 2022.

While Scordi-Bello found that O’Keefe had died from head trauma and hypothermia, the manner of death — how he suffered those injuries — was undetermined.

The blunt impact to his head was the primary cause of death, she testified, but hypothermia contributed. He had a deep cut and bruising to the back of his head. Once she looked at it from the inside, she found multiple skull fractures and brain bleeding. And his body temperature when he arrived at the hospital was 80.1 degrees compared to a normal body temperature of 98.6.

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Defendant Karen Read, right, speaks to her attorney, Alan Jackson, before the start of her trial in Norfolk Superior Court Thursday, May 15, 2025, in Dedham, Mass. (AP Photo/Mark Stockwell, Pool)

She discussed the external examination first, saying she found similar injuries to his face, head, hand, arm and knee that other witnesses, including paramedics and police, have already described to the jury.

He had “superficial” scrapes and cuts on his arm, which did not penetrate the skin or expose fat or muscle tissue, she testified. 

Dr. Irini Scordi-Bello, the medical examiner who conducted the autopsy on murder victim John O’Keefe, testifies during the trial of Karen Read in Norfolk Superior Court Thursday, May 15, 2025, in Dedham, Mass.  (AP Photo/Mark Stockwell, Pool)

She also performed an internal examination and looked at additional injuries.

At the back of his skull, she found multiple fractures from a cut on the right side of his head.

That injury is consistent with falling backward and landing with his head on the frozen ground, she testified during cross-examination from defense attorney Robert Alessi, who asked Scordi-Bello if O’Keefe should have sustained a circular wound instead of the linear one found at autopsy.

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Defense attorney Robert Alessis questions Massachusetts State Police forensic scientist Maureen Hartnett during the trial of Karen Read in Norfolk Superior Court Thursday, May 15, 2025, in Dedham, Mass.  (AP Photo/Mark Stockwell, Pool)

“There’s nothing inconsistent with this injury and a fall on someone’s — on the back of the head — with a blunt surface,” she testified.

“A fall backwards where the person impacts the back of their head on flat, frozen ground … would you expect that type of a laceration from that type of a fall?” Alessi followed up. “Not just a general fall backwards, but specifically a fall backwards where the back of the head hits flat, frozen ground. Would you expect that?” 

“I could,” Scordi-Bello said. “Yes.”

However, she also said she found no signs of grass on the back of O’Keefe’s head.

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John O’Keefe pictured in an undated photo. O’Keefe died Jan. 29, 2022. His girlfriend, Karen Read, was charged with hitting him with her Lexus SUV and fleeing.  (Courtesy of Karen Read)

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Alessi also grilled her on the hypothermia finding, asking if internal injuries to O’Keefe’s stomach and pancreas could have been caused by factors other than the freezing temperatures. 

She testified it is possible that his pancreas could have hemorrhaged from a device used to assist paramedics with CPR efforts, but that wouldn’t have damaged his stomach. However, she later testified that the stomach ulcers could have been caused by O’Keefe drinking alcohol without taking his antacid medicine.

The toxicology report found no drugs or prescription medications in his system at the time of his death. He had a .21% blood alcohol level. And he had been prescribed an antacid to prevent gastric ulcers. 

Dr. Irini Scordi-Bello, the medical examiner who conducted the autopsy on murder victim John O’Keefe, explains to the jury the nature of an autopsy during the trial of Karen Read in Norfolk Superior Court Thursday, May 15, 2025, in Dedham, Mass. (AP Photo/Mark Stockwell, Pool)

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Even after an amended death certificate was issued, O’Keefe’s manner of death remained undetermined. Scordi-Bello testified Thursday she stands by her findings as to the cause, head trauma and hypothermia.

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After Judge Beverly Cannone sent jurors home for the day, Alessi argued that new disclosures about expert testimony from Aperture, which conducted reports for the prosecution, would put the “entire defense” at risk if allowed this late in the game.

The disclosure was dated May 8 but was received by the defense May 11, he said.

Karen Read listens to the testimony of Jennifer McCabe during Read’s murder trial in Norfolk Superior Court in Dedham, Mass., Wednesday, April 30, 2025.  (Greg Derr/The Patriot Ledger via AP, Pool)

“I don’t like to use hyperbolic words, but the word has been used against us — ambush, ambush, ambush,” Alessi said. “If there’s ever an example of an ambush, this is it.”

In a heated back and forth, Brennan described the disclosure as evidence of a significant variance between the internal clocks in Read’s Lexus SUV and John O’Keefe’s cellphone data.

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Cannone did not announce a decision before adjourning court for the day.

Read is due back Friday at 9 a.m.

She could face life in prison if convicted of the most serious charge.