Medical Examiner Perper: Casey the Likely Killer, Jett's Autopsy Flawed

Broward County Medical Examiner Dr. Joshua Perper became a familiar sight on TV after the death of Anna Nicole Smith two years ago, when he was the man overseeing her autopsy.  These days, he's been popping up regularly on Nancy Grace to talk about the death of toddler Caylee Anthony, despite the fact the case is not being handled by his office.

Juice gave Perper a call to discuss his side gig, and during our chat, he dished on Jett Travolta, Nancy Grace, and fear of death. The interview after the jump.

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Can you tell us about how you became a commentator on Nancy Grace?
She just asked. I am I am not paid for that, it's voluntary. Occasionally, she asks me to come in the evening to the local CNN station in Plantation.

What do you think of Nancy?
Well, she's an attorney, too. I am an attorney, too, in addition to being a physician. I think she is very intelligent and inquisitive -- reporters have to be. And she usually doesn't stand for nonsense! What I find commendable is that she is basically inviting a whole array of people with a different way of life and from different investigative services to be on the show.

You mean, because she invites psychics to discuss what might have happened to Caylee?
Yes. That makes for more generalized and less biased opinions. I think [Grace] is very concerned about the welfare and well-being of children and she succeeds in making the program very interesting. She really is able to probe [the case] quite extensively and I think her audience is very responsive to that. [Her show] can bring attention to domestic abuse of women and children and the elderly, pointing out how really inappropriate it is to treat other people in such terrible fashion.

Do you think the mom, Casey Anthony, murdered Caylee?
I think I said this already. Look -- it was a much more circumstantial case before they found the skeleton. The tape placed on the child's mouth is an indication of homicide. And the behavior of the mother -- she didn't notify anyone for a month! And she went out dancing! A mother doesn't go out dancing immediately after [her child has gone missing]!  And they found the car in her possession with the smell of decomposition; tests show the decomposition comes from humans. The presence of chloroform in the car, which they detected, the inquest on the internet about chloroform. There's a mountain of evidence, but the tape in my opinion was the centerpiece. It was obviously placed there before the death of the child, not after the child was dead, which is indicative of assault.  

Did the medical examiner in Orlando rule that she died because of the tape being put on her mouth?
Perper: He has not said it was from asphyxiation. I would have said that. That medical examiner was more cautious. If there hadn't been tape on the mouth, [Casey Anthony] could have said, 'Oh, it was an accident, she died so suddenly and I was afraid somebody would accuse me so I put the body in the bag and hid the bag' -- but the tape contradicts that.  I don't see how the defense can overcome the evidence.

But you never examined the body, correct?
No. But there was really no body -- just a skeleton. And the skeleton didn't have any injuries.

How come no one ever talks about the biological father? Isn't it still a mystery who Caylee's biological father was?  (Casey Anthony has told friends he was a short-term relationship and that he died in a car crash, but friends have suspected that may be a lie.)
It's irrelevant because they never substantiated that any other person had Caylee in their custody.

Do you have any comment about the death of Jett Travolta?
It's unfortunate that autopsy was not done under different circumstances. The doctor in the Bahamas is quite good but he certainly would have enjoyed the assistance of a more experienced physician. The only other person present was a general practitioner who had been caring for the child, not the kind of person who would be able to offer significant professional input in the process. Secondly, they say the child died of epilepsy, but you cannot make a determination of that at autopsy. A large percentage of epileptics have no pathology in the brain. It should be kept for several weeks. And if he was 16 years old, they should not release immediately the final opinion because unfortunately people can die of drugs. Or even if he doesn't die of drugs, if he had in his blood any anti-epilepsy meds --- epileptics who have no anti-epilepsy drugs or a sub-therapeutic level of drugs can die suddenly and unexpectedly.

So you're saying a determination was made before they would have had time to carry out those kinds of tests?
Yes.

What about the possibility that he had autism?
Autism is a pshycological/behavioral condition. To my knowledge it doesn't have any proven organic counterpart. And there's no connection between autism and seizures, or epilepsy -- they can occur independently of each other. Besides, autistics don't die suddenly.

You became rather famous because of the Anna Nicole Smith case, right?
It's very unfortunate -- people have to die for us to gain some unusual public attention. I would prefer these people to be alive.  I never sought publicity, but as medical examiner I feel I have an obligation to when called upon to explain to the public these things that I am familiar with.

Are there any local cases that should be getting attention, but aren't?
We in this country suffer from a disease -- it's called celebrities. If you are a celebrity, then everyone gets very interested in why they die, or their relatives or so on. So [the fact that we don't have any] in Broward, that's fortunate -- we want to keep people away from our office.

What do you want to do with your career from here? Any more books coming out?
I just completed a book -- it comes out in July.  It's called When Doctors Kill. It's about all kinds of situations -- accidental death, malpractice... Nazis... Che Guevara.

Is it true that you have a lump on your head because you were dropped as a baby?
Yes, that's true. Although I used to like to say I have so much brains, it pushes out one side.

Are you scared of dying?
No, because life is a fatal disease, a fatal condition. Being afraid doesn't help. In life we have to do our best to add a little bit to the world, to what much better people have done before us.

Well said. And, since Nancy Grace has gotten you curious about psychics, any chance that you will bring some into the medical examiner's office to help you?
No, investigations are done by police and I am very wary of psychics. But I've also learned that I don't know everything, and things I don't believe in sometimes prove true.    
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