COLUMBIA, S.C. — Before dawn on a steamy July day in 2015, Hampton County coroner Ernie Washington was called to an area of pine trees and cornfields, where a young man’s body was sprawled in the middle of the road.
He suffered blunt force trauma to the right side of his head but few other apparent injuries. His loosely tied shoes were still on his feet, his iPhone and keys tucked in the pocket of his khaki shorts.
Washington, a funeral home owner who had been coroner for four years, surmised this was no hit-and-run. He showed Highway Patrol officers and others arriving on the scene the spot where he believed a bullet had entered the young man’s head.
But seven hours later, Dr. Erin Presnell, now director of the pathology department at the Medical University of South Carolina in Charleston, came to a very different conclusion.
Nineteen-year-old Stephen Smith was not shot, but hit by a vehicle, her autopsy showed.
Presnell’s conclusion set off a dispute that lingers to this day as the investigation moved among various law enforcement agencies — Hampton County Sheriff, coroner, South Carolina Law Enforcement Division, Highway Patrol and its Multidisciplinary Accident Investigation Team and now back to SLED, which says unequivocally they are investigating a homicide.
SLED Chief Mark Keel takes it a step further. He believes Smith was murdered.
—The Pathologist
If an arrest is made and a suspect tried, Presnell’s interpretation of Smith’s injuries will be crucial, perhaps mostly to a defense team wanting to advance the idea that it was a hit-and-run, maybe an accident.
Two state agencies have criticized her findings, but Presnell has been silent. She did not respond to The State’s request for comment. But a pathologist who she helped train did.
Dr. Eric Eason said pathologists simply do not talk publicly about cases, unless in court, because it is the job of coroners to do so.
Presnell, a Clemson University graduate, has been associated with MUSC for her entire career, from medical school on.
She has performed autopsies on some of South Carolina’s biggest recent cases, including the nine parishioners shot to death by a white supremacist at Charleston’s Emanuel African Methodist Episcopal Church in 2015.
Presnell worked four days, including through the weekend, to complete the autopsies. Not surprising to anyone who knows her. She also worked the morning she got married in the early 2000s.
Coincidentally the Emanuel probe was just three weeks before Smith’s body was found.
Presnell had two key findings in Smith’s death: that his brain stem had separated from his spinal cord and his skull had been fractured, which led her to rule the death was the result of a pedestrian vs. vehicle crash.
Such injuries can only be caused by a vehicle hitting a pedestrian at a high rate of speed, said Eason, a pathologist who has spent most of his career at the Georgia Bureau of Investigation and Cook County (Chicago) Medical Examiner’s Office. He returned to Charleston to work as a consultant at the height of the COVID-19 pandemic.
“The head gets whipped backward,” he said, “The impact has to be really severe.”
That would rule out being hit by a baseball bat, as some have speculated.
Eason said determining that Smith was hit by a vehicle does not rule out that he was intentionally killed. He has pushed back on people who have questioned Presnell’s findings, calling her a doctor with great integrity who would not be swayed by anyone or anything other than what she sees at autopsy.
“She would not risk her medical license,” he said.
Another doctor who The State reached out to for her opinion on the autopsy report, disagreed with Eason’s assessment. Dr. Erin Kimmerle, a pathologist and associate professor at the University of South Florida, said, “a brain stem injury may occur in high-speed accidents, falls or other forms of blunt injuries. They can also be misdiagnosed when damage occurs to the brain stem during the removal of the brain at autopsy.”
She said to determine with certainty how Smith died would require reconstructing the cranial fractures to see the point of impact, the shape of the object that hit him and the number of injuries.
That is the work of a forensic anthropologist, she said.
—A second autopsy
Smith’s mother, Sandy, has raised more than $125,000 for a second autopsy, which was recently completed. She wanted to avoid anyone from or associated with MUSC, she wrote on her gofundme page.
Her lawyers, Eric Bland and Ronnie Richter, assembled a team to take another look, led by Dr. Dan Schultz, president and chief pathologist for a private company in Tampa called Final Diagnosis.
Also on the team were Dr. D’Michelle DuPre, a retired forensic pathologist in Columbia who was the medical examiner in Miami and also a professor, and Dr. Heather Walsh-Haney, a forensic anthropologist at Florida Gulf Coast University in Fort Myers, Florida.
The team also includes a noted witness from the Alex Murdaugh trial, Kenny Kinsey, who worked as an investigator for the Orangeburg Sheriff’s Office. He told Court TV he is considering four or five scenarios about how Smith died, including a hit-and-run scenario, but did not offer specifics. He also said he is counting on the new autopsy to help lead him to a conclusion.
Smith’s body was exhumed the previous weekend, driven to Florida, autopsied and returned for reburial at Gooding Cemetery in Crocketville near Hampton last Sunday. His mother posted on social media a photo of her at the grave.
DuPre told Court TV that the doctors were able to perform a full autopsy and got the information they had hoped to find. She would not say specifically what was uncovered at the request of SLED.
—The Highway Patrol
Highway Patrol investigators have said that they suspected from the beginning that Smith was murdered and perhaps killed elsewhere. They point to the fact that there were no pieces of a vehicle or broken glass at the scene and that Smith’s shoes were still on his feet, uncommon in situations where someone is hit by a car or truck.
Eason said he has seen both shoes on and shoes off when someone is hit by a vehicle.
Smith’s mother Sandy has also said it was highly unlikely that her son would be walking down a dark highway in the middle of the night. He would have been afraid.
Also his car, which was out of gas, was about 2 miles away with his wallet inside.
Todd Proctor, the lead investigator for the Highway Patrol in the Smith case, wrote in his report that he went to MUSC to talk to Presnell about her findings in August 2015 but was met with a “negative tone.” She was busy and he didn’t have an appointment.
“She asked why we did not think it was a vehicle strike and I explained to her that we had no evidence of this individual being struck by a vehicle. I asked her if someone with a baseball bat could do that and she stated “no.” When I probed further saying what about someone in a moving car, with a bat she stated “well I guess it’s possible.”
Eason said he knows how busy the MUSC pathology lab can get. More than 1,000 autopsies are done there each year by a handful of pathologists.
In his report, Proctor wrote that the coroner agreed it was not a hit-and-run, but later he said he would go along with Presnell’s opinion. Washington could not be reached for comment.
Proctor also wrote in his report something puzzling: “The coroner stated that he had made contact with the pathologist, Dr. Presnell, and she stated that she would be willing to change her report to read however he wanted.”
None of the three could be reached for comment so it’s unclear what the statement means.
Eason suggested it’s likely a reference to the coroner’s personal preference of the wording of the medical terminology used in the autopsy report. Coroners sign death certificates in South Carolina, and have the final say on what is included.
—The second autopsy
The investigation team assembled by Smith’s lawyers hope the additional information from the autopsy will put pressure on whoever is responsible for Smith’s death. Any number of people have been accused on social media, but SLED has been mum. The 2015 Highway Patrol report lists a number of names, including Buster Murdaugh, whose father was convicted of murdering his mother and brother and sentenced to life in prison last month.
Buster Murdaugh released a statement denying any involvement. He was a high school classmate of Smith.
Eason said he believes the confusion over the first autopsy began when coroner Washington said emphatically it was a gunshot wound. More typically a coroner’s information to the pathologist would be more vague — that the body was found in the road, possibly a hit-and-run, possibly a gunshot victim.
“That’s where the chaos began,” he said.
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