Thomas Valva's Coroner Describes Stages Of Deadly Hypothermia

LONG ISLAND, NY — The jury was shown a photo of Thomas Valva's lifeless, bruised face Wednesday at the trial of Michael Valva — an ex-NYPD officer and the father of Thomas, 8, who, froze to death in his father's garage in 2020 — as the chief medical examiner at the time of the child's death in 2020 took the stand.

Valva, along with his then-fiancee Angela Pollina, who will have a separate trial, were arrested Jan. 24, 2020, and charged with second-degree murder and four counts of endangering the welfare of a child. If convicted, each faces 25 years to life in prison. Both have pleaded not guilty and remain jailed without bail.

Prosecutors have said Thomas and his brother, who had autism, were forced to sleep in the frigid garage as temperature outside plummeted to 19 degrees. When he died, Thomas' body temperature was 76.1 degrees, 20 degrees lower than it should have been, prosecutors added.

Dr. Michael Caplan, who was Suffolk's chief medical examiner on Jan. 17, 2020, the day Thomas died, first discussed how an autopsy is performed.

When Thomas' body was brought in, Caplan said he also received a medical report from Long Island Community Hospital, as well as one from pediatrician Dr. Zev Gensler, who Thomas saw in September 2019, when he went for his-back-to-school visit.

He'd been told that Thomas was 8 years old and in cardiac arrest, with injuries to his head and face, Caplan said. "We didn't know exactly how he died," he said.

Thomas was brought in with a bag containing two items of his clothing, a pair of gray sweatpants, in size 5/6, and gray socks with orange, neon trim; that clothing was shown in court as evidence.

Caplan, questioned by Assistant District Attorney Kerriann Kelly, said he'd been told initially that Thomas had been walking to the bus stop when he tripped and fell, sustaining head injuries and some bleeding, then became unresponsive, leading to Valva's 911 call.

Later, he said Det. Norberto Flores introduced new information about "different circumstances," including that Thomas had been kept in a garage in frigid temperatures.

"Is it fair to say that how someone lived can tell you how they died?" Kelly asked Caplan.

"Absolutely," he responded.

Describing the external autopsy, Caplan said Thomas was a "well-developed" but "thin" child, 64 pounds and 4-feet, 2-inches tall. His weight was in the 70th percentile and his height, in the 50th, he said.

His body mass index was 18, or in the 80th to 84th percentile, Caplan said.

In July during his pediatric physical, Caplan said Thomas weighed 51 pounds, and was 49 or 50 inches tall. His BMI in July was 14.3, he said.

Caplan said Thomas was "thin, or fairly nourished," and that he wasn't overweight, but instead, "in the middle."

He had brown hair in a "fade" cut, hazel eyes, long eyelashes, and a distinctive sac under his chin, Caplan said.

At his school physical, there had been concern about Thomas' alopecia, or patches of hair loss, that he said may have been a "manifestation of chronic stress."

When asked about his injuries, Caplan said most striking were the injuries to his forehead and face, including two scrapes and bruises on the right side, and one in the middle of his face, with scrapes on the bridge of his nose, one of the front of his nose and the fold, and an abrasion on the right side of his upper lip. He also had a bruise on the inside of his mouth and a small bruise on his cheek, as well as in the mucous membrane over his lower teeth, he said. He also had some scratches on the right side of his chest and some on his rib cage, as well as several bruises and scars on the back of his knees, an older bruise above his right ankle, and a bruise on his upper left leg. There was also a scratch on his left buttock, he said.

Caplan showed the jury a color photo of Thomas' face at the autopsy and pointed out the injuries.

The abrasions on his forehead were separated by an area of uninterrupted skin. "Would they be difficult to explain in a single fall?" Kelly asked. "If he fell more than once would it be consistent?"

"Yes," Caplan said.

Kelly also asked if the injuries on his face and mouth could have been caused by being "slapped in the face" or a "hand over a child's mouth." Caplan said yes, it could have been.

Caplan also said the red blood cells that appeared when examining the injuries indicated that they were recent.

During the afternoon session, Caplan discussed the internal autopsy. Thomas, he said, had Wischnewsky Spots — blackish lesions typically associated with hypothermic death — on his stomach, as well as a very small thymus. The normal thymus size is 43 grams and Thomas' was 9 grams, he said. When asked what would cause a thymus to be that small, Caplan responded, "chronic stress." His thymus, he added, was "wafer thin."

In addition, Thomas had "chronic inflammation of his kidneys, he said. "You could see it had been going on for awhile," and was likely caused by stasis, of urine sitting and not being drained, making it susceptible to colonization by bacteria and infection, he said.

The spots on the stomach could have been caused by hypothermia, Caplan said; 90 percent of those with fatal hypothermia had the same spots, he said.

When asked what his determination was, in regard to the cause of Thomas' death, Caplan said, "In my opinion the cause of Thomas Valva's death was hypothermia."

Caplan said he'd ruled out any possible diseases, and his head and other injuries were not the cause of his death.

Thomas' core temperature in the emergency room was 76.1 degrees F, he said, leading to the hypothermia determination.

Caplan then discussed hypothermia, which can commence when body temperature drops below 95 degrees F. Healthy humans can regulate their body temperature at 98.6, he said. Heat loss can be caused by direct contact of the body with a cold surface, flowing air, evaporation, and other factors.

The main way the body minimizes heat loss is through basal constriction and shivering, he said.

When asked by Kelly if sleeping on a frigid garage floor or going outside and being doused with cold water in January temperatures could cause hypothermia, Caplan said it could.

He then discussed the four stages of hypothermia. In Stage 1, the body temperature drops to between 90 and 95 degrees F, but the body is still able to compensate, he said. Heart rate, blood pressure and breathing increase, he said.

Stage 2 involves a drop in body temperature to between 82 and 90 degrees; a person loses the ability to shiver. "The mental status will change," Caplan said. "You're not as alert or awake." Below 90 degrees, a person can go into cardiac arrest, he said.

"Is it possible you would fall repeatedly?" Kelly asked.

"Yes, it is," Caplan said.

At Stage 3, body temperature ranges from 77 to 82 degrees, and a person becomes "even more critically ill," Caplan said. A person's heart rate would be down and they could possibly lose consciousness. "They are barely alive," he said, adding that all vital functions are critically impaired.

And, at Stage 4, with a body temperature of 77 degrees or below, which Thomas' was, the "person would appear like dead, with no vital signs," although it would still be possible to resuscitate them, he said. "They have no signs of life."

When asked by Kelly if a person could talk at that point, Caplan said: "Not in my opinion. There might be moans, and groans . . agonal, involuntary noises." At Stage 4, the heart stops, a person is unconscious, and there is cardiac arrest, he said.

Kelly also showed Caplan a photo of Thomas, smiling, and wearing a football sweatshirt, giving a thumbs' up with very red hands, which Caplan was consistent with being exposed to the cold.

Kelly asked whether a hand over a mouth, when a patient was hypothermic, would be an additional risk factor — and Caplan said it would.

Discussing how a person dies, Caplan said there are involuntary bodily responses such as urination, and defecation. When the blood stops flowing, the blood will settle and rigor mortis sets in.

Asked about a conversation he had with Valva after Thomas' death, Caplan said Valva asked if Thomas had had an aneurysm or a seizure; he said no. He then asked about funeral arrangements and Caplan told Valva unless both biological parents agreed on a funeral home, he could not release the boy's body.

Defense attorney Anthony La Pinta then began cross-examination, asking Caplan about whether he'd written articles or books, or spoke about hypothermia; Caplan said no.

"Would you agree hypothermia cases as a forensic pathologist are not common?" La Pinta asked. Caplan said they were not.

Testimony will continue Thursday in Riverhead.