David "D.J." Creato Jr. is accused of killing his son, Brendan, 3, in 2015.
CAMDEN -- The medical examiner who performed the first of three autopsies on 3-year-old Brendan Creato testified Wednesday that the boy's body had no fresh signs of trauma but several signs of oxygen deprivation.
The boy's father, David "D.J." Creato Jr. is on trial, accused of murdering his son so he could continue dating a teenager who testified that she did not want his child around.
His son was found dead on a rock in a stream in a park about three-quarters of a mile from Creato's apartment in Haddon Township Oct. 13, 2015. Creato had called 911 a few hours earlier to report he woke up to find his son missing.
Dr. Gerald "Buck" Feigin and two other medical examiners who examined the body were unable to say exactly what killed Brendan. They did conclude, however, that he died of "homicidal violence of undetermined etiology."
On the stand Wednesday during the sixth day of Creato's trial, Feigin testified that the cause of death could have been drowning, asphyxiation and blunt-force trauma to the neck, possibly including strangulation.
Medical Examiner Gerald "Buck" Feigin testifies in Camden Superior Court May 3, 2017. Also pictured is Judge John T. Kelley and Assistant Prosecutor Christine Shah.He noted in his autopsy report that because Brendan's socks were clean it is clear he "had not gone there of his own power" and was put there.
No trauma was visible on his body, he said, other than a pair of bruises on the boy's chest near his clavicle.
The signs of oxygen deprivation included edema or swelling in the lungs, and swelling and a darkening of the gray matter in the brain. He said the lung edema is consistent with drowning or suffocation, and the signs in the brain could be from oxygen deprivation or some other "slow death."
He also noted that the boy's sinuses contained a small amount of liquid that appeared to be water. That would occur if a person's head was submerged in water, even after death, he said.
Under fire
Creato's attorney, Richard J. Fuschino Jr., pulled no punches in his cross-examination of Feigin.
In the past, he and several other forensic scientists have questioned why Feigin did not go to the crime scene himself and take control of the collection of evidence. Feigin began working as a medical examiner in South Jersey in 1998, after working in Massachusetts.
Fuschino made sure to point out that Feigin's medical investigators -- which he trusted to go to the scene in his place -- have recently taken heat for leaving a severed hand behind at a fatal accident scene for the family to discover two days later.
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Fuschino also pointed out that Feigin's cause of death conclusion was a "determination of exclusion" and based largely on the circumstances of how Brendan's body was found, rather than findings during the autopsy.
"You can't actually say what happened just because of other things you think didn't happen, it seems like the only explanation, right?" Fuschino said.
"Yes," Feigin answered.
Feigin later said that if Brendan had been found at home, the cause of death would likely be undetermined or perhaps "presumed cardiac arrhythmia."
Fuschino also questioned Feigin about all the things he didn't examine closely or test.
The medical examiner said he never swabbed to see if there was evidence of a sexual assault because he saw no physical signs of an assault. He said he didn't look for DNA on the boy, including under his fingernails, and ran a limited toxicology test instead of one described as comprehensive.
Fuschino also hammered Feigin, who had described himself as "detail-oriented," for failing to notice that the copy of Brendan's autopsy report that the medical examiner brought to court also included a page from a different report from a different death. Feigin said it was a simple mistake.
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Fuschino didn't limit his questions to Creato's case, but also asked him about two cases in Massachusetts -- including one that Fuschino suggested was the reason he resigned his job there before coming to Gloucester County.
As reported by PhillyVoice, Feigin performed the autopsy in the so-called Boston Nanny case in 1997, in which an au pair was charged with murdering a baby in her care. After Feigin changed his testimony about the death of a baby between the grand jury hearing and trial, a judge changed the jury's verdict from murder to manslaughter.
Another case in 1997 involved a man who died from a seizure, which he only began having after allegedly being kicked in the head by a student, according to PhillyVoice. Feigin ruled the death a homicide.
The murder charge against the student was later dropped after Feigin's boss changed the manner of death to 'undetermined.' PhillyVoice reported the change and Feigin's resignation from the job were due to Feigin's failure to inspect the man's heart.
Feigin said on the stand Wednesday that it was changed to protect a doctor from a possible malpractice suit related to the man's seizure medication.
The trial is expected to continue until the end of May.
Rebecca Everett may be reached at reverett@njadvancemedia.com. Follow her on Twitter @rebeccajeverett. Find NJ.com on Facebook.