Theories About Inmate's Death Put to the Test

Nevertheless, they did not rule out a hanging or the possibility that a medical examiner could break the bone in the course of an autopsy. One of the doctors said it is possible to break the hyoid while performing CPR if the head is tilted forcefully.

When the examiner opens up a body, "you do not see a big 'S' for 'suicide,' " said Werner Spitz, who formerly worked in Detroit. "The truth is, you look inside, you find [the hyoid] broken, and that's the way the investigation starts."

The day White died, an official at Prince George's Hospital Center confirmed that there was no sign of trauma on the body or any visible cause of death. The official, who was not authorized to release information, spoke anonymously.

The five doctors interviewed by The Post disagreed on the likelihood that officials would have noticed bruising or other signs of trauma. Specifically, they were torn on the subject of petechiae, red marks left by burst blood vessels in the eyes and face.

Vincent DiMaio, retired chief medical examiner of San Antonio, and Dimitri L. Contostavlos, retired medical examiner of Delaware County, Pa., said petechiae were more likely in strangling and often absent in hanging. Harry Bonnell, former chief deputy medical examiner of San Diego, and William Manion, assistant medical examiner of Burlington County, N.J., said they could be found in both types of death.

In a news conference the day White died, Col. Gregory O. Harris, deputy director of operations for the county's Corrections Department, did not rule out suicide. But he said White had passed a medical and psychological evaluation and showed no suicidal tendencies when admitted to the jail. He also said White had not been allowed to have any cloth or ropelike material that could be used to hang himself.

Detectives, however, found that White had a bedsheet in his cell, the sources said.

At least four inmates have committed suicide in the Upper Marlboro facility since it opened in 1987, including Alejandro Grant, who hanged himself in 1998 in a maximum-security cell similar to the one in which White was being held.

Vicki D. Duncan, a spokeswoman for the county Department of Corrections, said suicides are rare but not impossible. Grant had been in the jail for months. "He used his sheet, and it was extremely difficult to do," Duncan said. "He had to get himself in exactly the right position."

Investigators have also discovered that officers working inside the unit could have used metal keys to let people in without leaving electronic records of the visits, said one of the sources familiar with the investigation and two former jail employees. The employees also said someone could have gained access to the unit through a second-floor maintenance entrance with keys from a shift commander's office.