State board rips ex-coroner in '95 autopsy
By Noam Levey
Mercury News

July 27, 2002

State medical authorities have accused Santa Clara County's former coroner of incompetence and moved to suspend his license in a highly unusual rebuke of a one-time key figure in the local criminal justice system.

The Medical Board of California, which licenses and disciplines physicians, this week filed a formal accusation against Dr. Angelo Ozoa, charging him with failing to perform an adequate examination of a 76-year-old woman who he concluded was a homicide victim.

The 1995 autopsy, which the medical board called an ``extreme departure'' from standard practice, played a central role in the murder trial of her husband. A jury acquitted Nelson Weaver Galbraith, but not until the retired Palo Alto music school owner and insurance salesman had spent more than $300,000 defending himself.

Ozoa denied Friday that he had done anything wrong. ``I believe I examined everything as well as I could,'' he said. ``I did not perform a sloppy autopsy.''

But the medical board's charge is just the latest criticism leveled at Ozoa, who resigned in 1998 amid harsh attacks on his leadership. The board's action could cast doubt on other autopsies performed by the coroner's office during the five years Ozoa headed it.

And it could also boost the Galbraith family's bitter, five-year battle to show that Galbraith was unfairly prosecuted by the Santa Clara County District Attorney's Office.

``This was an egregious example of misuse of power,'' said Galbraith's son Richard, who is coordinating the family's civil suit against the county. Galbraith, 83, is in ill health and receiving treatment at a local veterans hospital.

Ozoa, 77, is retired and lives in Fremont.

1998 grand jury report

But his rocky tenure as chief medical examiner-coroner from 1993 to '98 was punctuated by embarrassing allegations of falsified reports, stolen belongings and racial tension in his office. In 1998, a grand jury issued a blistering critique of his leadership and called for his resignation. Ozoa retired just a few months later after 18 years in the coroner's office.

Ozoa conducted the autopsy of Josephine Galbraith in September 1995 after she was found dead in a guest bedroom of her Palo Alto home with slashes on her arm and a sash tied snugly around her neck.

Ozoa first ruled the death a suicide. But later he changed his conclusion to homicide. He said the knots in the sash were too tight to have been the work of a frail, old woman.

Nearly a year and a half later, Palo Alto police arrested her husband, and the district attorney's office charged him with murder.

The couple's eldest son supported prosecutors. But the other five children rallied around their father and angrily denounced authorities for railroading Galbraith through the courts.

Galbraith's attorney argued vigorously that Galbraith, who suffered from severe arthritis, could not have tied the knots around his wife's neck. He also pointed out there had been many signs that Josephine Galbraith was suicidal, including her depression after being diagnosed with Parkinson's disease.

Jurors took just a few hours to acquit Galbraith of murder on Sept. 3, 1998.

Family files lawsuit

But the verdict did little to assuage the family's anger at the prosecution. Galbraith sued Ozoa and the county for violating his civil rights. And in 1999, Galbraith took the extraordinary step of exhuming his wife's body and having it re-examined.

According to Utah's chief medical examiner, who conducted the second autopsy, Ozoa did not perform basic steps customary in such homicide cases, including dissecting the neck and photographing the procedure.

Those steps and others, according to Dr. Todd Grey, could have provided additional indications that the death was a suicide.

The family's case, which was originally thrown out by a federal judge, is being reviewed by the 9th U.S. Circuit Court of Appeals.

Ozoa's alleged failings form the core of the state medical board's strongly worded accusation against him, which charges that Ozoa's autopsy ``constitutes an overall extreme departure from the standard of care and/or incompetence.''

The medical board, which last fiscal year filed 256 complaints against California physicians, charges that Ozoa did not perform basic examinations, failed to document his work and did not preserve important tissue from the body.

The board also accused Ozoa of failing to do a thorough examination of other parts of the body. Ozoa missed a scar on Josephine Galbraith's abdomen, an oversight that the Galbraith family has contended is evidence of his shoddy work.

Disciplinary actions by the medical board against physicians typically are resolved in settlements between the board and the physician.

Ozoa could lose his license or be placed on some form of probation, although those punishments would be largely symbolic, as Ozoa no longer practices medicine.

Ozoa said Friday he plans to contest the accusations.

Ozoa, who had sometimes clashed with the district attorney's office, insisted he had nothing to do with the decision to prosecute Galbraith, which Galbraith's children have alleged. ``I did not accuse their father of doing anything,'' he said.

Galbraith's son Richard said he sees the medical board's accusations as further evidence that prosecutors should have asked more questions before they sought a murder conviction.

Effects on other cases

Attorney Phil Pennypacker, who defended Galbraith, said he showed prosecutor Linda Condron extensive evidence that there were problems with the autopsy and that Josephine Galbraith's death probably was a suicide. He said Condron wasn't interested.

Condron, now a judge, said Friday she had only a ``vague recollection'' of the case.

But she said the autopsy was never an important part of the prosecution's case, explaining that she had focused instead on Galbraith's suspicious statements to police after his wife's body was found in their Palo Alto home.

``The fact that they may have argued that the autopsy was not well done would not have been my focus,'' Condron said. ``I just don't remember it being an issue for me.''

Pennypacker said the medical board's action and the troubled record of the coroner's office could cause other lawyers to look for similar failings in other autopsies.

``Most cases that come through the coroner's office won't generate questions . . . but lawyers are going to have to be more diligent,'' Pennypacker said. ``This kind of work could well be institutionalized here.''

Contact Noam Levey at or (916) 712-5061.  

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