Defense medical expert believes heart conditions killed Wilson instead of blunt head trauma and swelling of brain

ST. CHARLES, Mo. — A former medical examiner for the city of St. Louis told a jury of six men and six women that he “fundamentally agreed” with the cause of death reported by the Boone County pathologist who recently completed an autopsy on Dusty Wilson.

However, he disagreed with the report from a neuropathologist now living in Colorado that Wilson died because of blunt head trauma and cerebral edema (swelling of the brain).

“There’s no scientific evidence to prove that,” Dr. Michael Graham said Thursday during the fourth day of the Tiara Bonner trial in St. Charles County Circuit Court.

Bonner, 29, has been charged with first-degree assault and second-degree murder for her alleged involvement in the Oct. 9, 2022, bar fight that resulted in the death of Wilson, 49, of Hannibal. Bonner faces 10 to 30 years or a life sentence in the Missouri Department of Corrections if found guilty on either charge, both Class A felonies.

Graham, now a tenured professor of pathology in the medical school at Saint Louis University, said none of the injuries Wilson suffered in the fight outside Rumor Has It Bar and Grill would be expected to kill anyone. He also said there were no injuries to Wilson’s skull, and no hemorrhages or bruising on the brain.

“He got a couple of broken ribs, but they weren’t displaced at all, so there’s no reason why those would lead to death,” Graham said. “He had some scrapes, some bruises superficially, but nothing significant on the inside of the body.”

“What was significant to you about the autopsy report?” Public Defender Chris Terrell asked.

“There were fairly superficial blunt-force injuries,” Graham said. “There was no injury that you would expect someone to die from. Mr. Wilson’s heart was enlarged. He also had a little area (showing an) old stroke in the brain stem, probably related to high blood pressure. It didn’t have any current effect on him. It kind of tells you why his heart was enlarged, at least in part.”

“Would any of (Wilson’) heart conditions — the enlarged heart, the heavier heart, the narrowing of the artery — be enough to cause damage?” Terrell asked.

“The enlarged heart would be,” Graham said. “I wouldn’t expect a 60 percent narrowing of the artery to cause any significant reduction.”

Terrell recalled previous testimony that Wilson (who had a blood-alcohol content of 0.222) was yelling, being pushed away from a crowd, that he was “kind of standing his ground” and that he was fighting and throwing punches.

“Are those the type of actions that are exerting him physically?” Terrell asked.

“Physically and emotionally,” Graham replied.

Terrell asked for Graham’s opinion on Dr. Keith Norton’s findings in the autopsy.

“He attributed death to cardiac arrest related basically to the altercation,” Graham said. “Fundamentally, I pretty much agree with him. I think the reason Mr. Wilson died was primarily was on the basis of his heart disease that was made worse, if you will, by the altercation and alcohol intoxication. Dr. Norton and I both think it was not a particular injury that did (Wilson) in. It fits this whole milieu.”

Terrell asked if Graham had any disagreements with the findings of Dr. Douglas C. Miller, besides the conclusion. “No, his findings were fine,” Graham replied.

However, Graham disagreed with a comment Miller made in his conclusion.

“Dr. Miller attributed the death to brain swelling as a result of the injury and fell into cardiac arrest,” he said. “And I just don’t think there’s any scientific basis to do that.”

Terrell asked what Graham would have expected to see if Wilson had been stomped to death.

“Usually in a lethal stomping, we see a lot of bruising of the scalp, maybe some scraping and tearing,” Graham said. “Usually skull fractures, blood on the surface of the brain and then often bruising on the brain.”

“Were there changes or abnormalities in Mr. Wilson’s brain that you would attribute to something besides a lack of blood and oxygen?” Terrell asked. Graham said no.

Assistant Attorney General Corie Geary asked Graham during cross-examination, “Is it fair to say that all three doctors agree that point A is the assault and point C is the death of Justin Wilson, and point B is the part you can’t agree on, the cause of death?”

“Two of us pretty much agree,” Graham said.

“So from point A to point C, no matter what the cause of death is, the death of Dustin Wilson was still a homicide. Correct?” Geary asked.

“I would certify his homicide for death certification,” Graham said.

The trial’s final witness was Stephanie Jameson, 29, who lived with her husband in a second-floor apartment on the same side of Main Street as Rumor Has It. They got home late on the night of Oct. 8, 2022, after attending a wedding. 

“There was a sudden roar of voices,” she said. “It seemed like 20 people.”

Jameson said she looked out the window in her apartment and saw two groups of people acting like they were fighting each other. 

“This is the example I’ve been giving because it makes the most sense to me, but if you’ve seen the movie ‘The Outsiders,’ it looked like a rumble,” she said. “They were really going at it for some reason, and we were like, ‘Oh, that doesn’t look great.’ So I’m going to go find my phone to go call the cops.”

Jameson said awnings on some of the storefronts and a tree outside her window blocked some of what she hoped to see. 

“Were you able to at least observe some of what was happening down the street from where you’re at?” Public Defender Austin Smith said.

“Not really,” said Jameson, who wore glasses in the courtroom on Thursday. “I mean, I can see shapes, but they’re all moving. Unless somebody’s sitting there, and it’s just a couple of people, you can’t really tell anything.”

At one point, Jameson said she could see one person was on the ground.

When Smith asked what happened to the person on the ground, Jameson replied, “I, for sure, saw his face get kicked in by what I thought was the smallest individual that was there. … It’s hard to tell about the timeline of when it all happened. That’s the part that I don’t really remember.”

During Geary’s cross-examination, Jameson explained she can’t see details “great in the dark.” She admitted she couldn’t tell if the person who kicked the victim was white or black or male or female.”

During follow-up questions with Smith, Jameson said she didn’t see anyone else kick the victim.