Medical examiner in Karen Read case could not determine manner of death

Flint McColgan, Boston Herald on May 15, 2025

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DEDHAM, Mass. — The conclusions of the medical examiner who performed John O’Keefe’s autopsy left more questions than answers, which both the prosecution and Karen Read‘s defense team seized on to promote their own theories.

Dr. Irini Scordi-Bello could determine the cause of death “to be blunt impact injuries of head and hypothermia,” but she could not reach a conclusion of the manner of death to a reasonable degree of medical certainty.

The manner of death listed on O’Keefe’s death certificate is listed as “undetermined,” she testified Thursday on the 16th day of Read’s trial, as opposed to options like “accident” or “homicide.” She said a manner is determined by combining the cause of death determined in the autopsy with the context of the death, which is information relayed to the medical examiner by the investigators.

Read, 45, of Mansfield, faces charges including second-degree murder in the death of O’Keefe, a Boston Police officer who she had dated for roughly two years at the time of his death on Jan. 29, 2022. She was tried last year — during which Scordi-Bello presented the same testimony — but that ended in mistrial.

Prosecutors say that Read struck O’Keefe with her Lexus LX570 SUV sometime after midnight and left him to freeze and die on the front lawn of 34 Fairview Road in Canton.

The defense says that no vehicle strike ever occurred and that others killed O’Keefe inside that home, dragged him outside and conspired to pin it all on Read.

The autopsy

Scordi-Bello said that she performed the autopsy on O’Keefe in Cape Cod on Jan. 31, 2022.

The autopsy was observed by two members of law enforcement, which Scordi-Bello said was not unusual, but she cannot remember their names. The photo shown in court shows two men wearing surgical masks and the photo is labeled at the top as featuring Troopers Connor Keefe and Michael Proctor.

Keefe testified earlier in the trial that he attended the autopsy and gave the basic facts of the case to Scordi-Bello. Proctor served as the “case officer” in the investigation and was fired earlier this year primarily due to unprofessional behavior in this case.

Scordi-Bello walked the jurors through diagrams and explicit photos of O’Keefe’s autopsy to point out injuries she observed.

Those included a “small laceration” on his right eyelid, abrasions to the front and left sides of his nose, bleeding under the eyelids that made his eyes appear puffy, defibrillator marks to his chest as well as anterior rib fractures she said are associated with resuscitation efforts, abrasions in a “pattern” formation to his right arm as well as bruises to his hand that she associated with IV lines at a hospital.

She tested his “heart blood” alcohol level to be 0.21 grams per deciliter and the vitreous fluid behind his eyes tested a bit higher at 0.28 g/dL ethanol. His body temperature was recorded at 80.1 degrees at time of death compared to a normal temperature of 98.6.

The defense

Defense attorney Robert Alessi fought against the idea of a vehicle strike on multiple fronts: by contesting hypothermia contributing to O’Keefe’s death and that the injuries to his head were from a fall to the “flat, frozen ground” of the front yard, both of which suggest the primary defense theory that O’Keefe was killed inside the home; and by Scordi-Bello’s confirmation that she found no wounds indicative of a vehicle strike.

Scordi-Bello said she examined O’Keefe’s legs, “as is protocol in any case of suspected impact with a motor vehicle. … I did not see any evidence of an impact site.”

She also confirmed that injuries to O’Keefe’s nose could have been from a punch and that ulcers to O’Keefe’s stomach could have been from excessive alcohol consumption rather than from hypothermia.

This was backed by her grand jury testimony read by Alessi that if the injuries had been suffered in a different, warmer environment then there could have been a different explanation for those gastric and pancreatic hemorrhages.

The prosecution

Special prosecutor Hank Brennan had Scordi-Bello read the rest of that grand jury testimony, which was that she must make her “findings in the context they were presented to me. So in … this particular case, those hemorrhages, the context of a body found in the snow, I believe they were due to hypothermia.”

From there, Brennan used the opportunity to remind the jury through rapid questioning of what the context was based on prior testimony: that first responders allegedly heard Read claim “I hit him” multiple times at the scene, that Read questioned hitting O’Keefe to others, and that taillight material was found.

He also asked if the injuries to O’Keefe’s nose could also be attributed to broken glass or even first aid treatment. Scordi-Bello said, “Anything’s possible.”

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