1 Friday, 10 November 2000
2 [Open session]
3 [The accused entered court]
4 [The witness entered court]
5 --- Upon commencing at 9.30 a.m.
6 JUDGE MUMBA: Would the registrar please call the case.
7 THE REGISTRAR: [Interpretation] This is case IT-96-23-T and
8 IT-96-23/1-T, the Prosecutor versus Dragoljub Kunarac, Radomir Kovac, and
9 Zoran Vukovic.
10 JUDGE MUMBA: Thank you. I take it the parties are as before. I
11 see the Prosecution and the Defence. This morning we are hearing the
12 evidence of the medical experts after they examined the accused, Zoran
14 We will begin to hear the evidence of Dr. De Grave, simply because
15 he has a tight schedule and he did ask to be released as early as
16 possible. He is an expert for the Tribunal, and after he has given his
17 evidence, the parties -- the Defence first will cross-examine and then the
18 Prosecution, if they wish to.
19 Dr. De Grave, please make your solemn declaration. Please stand
20 up and make your solemn declaration.
21 THE WITNESS: [Interpretation] I solemnly declare that I will speak
22 the truth, the whole truth, and nothing but the truth.
23 [Witness answered through interpreter]
24 WITNESS: IVAN DE GRAVE
25 JUDGE MUMBA: Thank you. Dr. De Grave, keep your microphone on,
1 and I can see that you're speaking French, so can the usher please show
2 him the French channel, please.
3 THE WITNESS: [Interpretation] Yes, I see it. Thank you very much.
4 JUDGE MUMBA: Can the registry please provide the C.V. and all the
5 medical reports with Dr. De Grave's signature to the witness, please.
6 In the meantime, Dr. De Grave, can we have your full name and your
7 residential particulars, please.
8 THE WITNESS: [Interpretation] I'm Dr. De Grave, from Antwerp. As
9 regards where I come from -- are you looking -- is that on my C.V.?
10 JUDGE MUMBA: Yes. We have your particulars. You can see your
11 C.V.? Yes. And I take it all the parties have been given copies.
12 THE WITNESS: [Interpretation] Yes.
13 JUDGE MUMBA: It contains your name, your particulars, your
14 professional qualifications, and your experience to date. Yes?
15 THE WITNESS: [Interpretation] Yes. Everything is correct.
16 JUDGE MUMBA: Can we have the number, please, Madam Registrar?
17 THE REGISTRAR: [Interpretation] The C.V. will be C1, the Chamber's
19 JUDGE MUMBA: It will be admitted into evidence, unless there are
21 Then we'll look at your first report, Dr. De Grave, the one you
22 submitted first after examining the accused. You have it in front of you?
23 THE WITNESS: [Interpretation] Yes.
24 JUDGE MUMBA: What is the date on it?
25 THE WITNESS: [Interpretation] The first report I filed on -- let
1 me find it. It's on page -- on page 10. It was 5th of October of this
2 year. It's a provisional report which was filed urgently at the request
3 of the Court representative.
4 JUDGE MUMBA: Yes. You looked at the provisional report. Do you
5 have the final report of that provisional report?
6 THE WITNESS: [Interpretation] Yes. Yes, it's here. I've got it
7 right in front of me.
8 JUDGE MUMBA: Yes. What is the date?
9 THE WITNESS: [Interpretation] It's signed the 30th of October of
10 this year, that is, the year 2000. [English] October this year.
11 JUDGE MUMBA: Thank you. Can we have the number of the
12 provisional report first and then the final one.
13 THE REGISTRAR: [Interpretation] The provisional report will be C2
14 of the Chamber's exhibits, and the final report will be C3 of the Trial
15 Chamber's exhibits.
16 JUDGE MUMBA: I take it that all the parties have these copies of
17 these reports.
18 Dr. De Grave, after you received the report of the echograph you
19 also made some comments or submissions on it; is that correct?
20 THE WITNESS: [Interpretation] Yes.
21 JUDGE MUMBA: You have your written report on that?
22 THE WITNESS: [Interpretation] Yes.
23 JUDGE MUMBA: And the date?
24 A. Yes. I sent it by fax. It's the 5th of October, 2000.
25 JUDGE MUMBA: Thank you. And do you also have a copy of the
1 echograph report which you received on which you based your findings? Can
2 we find out from the registry, does the witness have that? Or can we have
3 a copy given to him, please.
4 THE REGISTRAR: [Interpretation] The usher has just given him the
5 echograph, has just given Dr. De Grave the echography.
6 JUDGE MUMBA: Can you look at the echograph. Is that the one you
7 received upon which you based your report?
8 A. Yes, that's correct. It was a written report, and the translation
9 into English and French, and in Serbo Croat, and that was the document
10 that I received.
11 JUDGE MUMBA: Can we have it numbered, Madam Registrar, please.
12 Both translations, please.
13 THE REGISTRAR: [Interpretation] The echograph will be C5, and the
14 English copy will be C5A, and the copy in Serbo Croat will be C5B, and the
15 copy in French will be C5C, and these are the Chamber's exhibits.
16 JUDGE MUMBA: Thank you. You have now your report based on the
17 echograph report.
18 A. Yes.
19 JUDGE MUMBA: Yes. And that is all that you submitted upon the
20 report that you received?
21 A. Yes.
22 JUDGE MUMBA: Madam Registrar, can we have the number for the
23 report of Dr. De grave upon the echograph report.
24 THE REGISTRAR: [Interpretation] That will be Exhibit C6 of the
25 Trial Chamber's exhibits.
1 JUDGE MUMBA: Thank you. I take it that all the parties have
2 these copies. I just want to make sure that all the reports are in both
3 English and Serbo Croat. Madam Registrar?
4 THE REGISTRAR: [Interpretation] Yes. All the reports were
5 translated into the Tribunal's official languages as well as in B/C/S.
6 JUDGE MUMBA: Thank you.
7 Dr. De Grave, the Trial Chamber would like to make sure that what
8 you received was the echograph report, not the echograph itself, not the
10 A. No, I never received the echograph. I only received a written
11 text, handwritten in fact, in Dutch, and a translation into French and
12 English. I am not sure, I don't think it was translated into B/C/S.
13 JUDGE MUMBA: Thank you. Any questions, Mr. Jovanovic?
14 MR. JOVANOVIC: [Interpretation] Your Honour, I'm not sure I
15 understood. Did you ask me if I had any questions for the expert witness,
16 or generally?
17 JUDGE MUMBA: Yes, for the expert witness, because we have
18 received all the reports that he worked on. So do you have any questions
19 for the expert witness?
20 MR. JOVANOVIC: [Interpretation] Yes, Your Honour.
21 JUDGE MUMBA: Yes, go ahead.
22 MR. JOVANOVIC: [Interpretation] We do have several questions,
23 thank you.
24 Cross-examined by Mr. Jovanovic:
25 Q. [Interpretation] Good morning, sir. As far as I was able to see
1 from your CV that we have received, you are a specialist in general
2 medicine; is that correct?
3 A. That's correct.
4 Q. Thank you. Mr. De Grave, we just heard all the documents on the
5 basis of which you were able to bring in your findings. I am interested
6 in knowing when you learned of the existence of a poor translation.
7 A. I was asked in urgent -- in urgency to answer a fax, and that's
8 what I did. I noted that these were provisional reflexes, and which was
9 filed in great haste which could be an indication but not as proof.
10 And so I reviewed once again all the documents, and I filed my
11 conclusions in my definitive report, and it was at that point that I
12 realised first of all that the writing of the document in Dutch was
13 dreadful. The handwriting was very, very bad. I can tell you that when I
14 drafted my provisional report, I turned to the English text and to the
15 French text in the second place, and so at the beginning I really hadn't
16 paid attention to the Dutch text.
17 I should also tell you that when I drafted the provisional report,
18 I was a bit surprised and troubled because there was an inconsistency
19 between the -- in the contents. When I drafted the definitive report, I
20 studied the Dutch text, and then I did see that my first reflex had been
21 correct, that there was an inconsistency, and that it was an epididymical
22 cyst and not a epidermic cyst. It didn't make any sense, and it was not
23 compatible with the observations that we made when we examined the victim,
24 because a cyst which is epidermic is something that can be felt with your
25 fingers. And my associate, my Yugoslav associate, extended the skin of
1 the testicle, and we did not see any irregularity or any swelling which
2 would justify an epidermic cyst.
3 Q. Thank you. My next question is the following, and it will help
4 clarify the situation, I hope. I'm not well-versed in medicine, and I
5 apologise in advance if I pronounce some of the Latin terms used wrongly,
6 but what I don't seem to understand is that in the findings that we
7 received from the doctor that conducted the examination, the term
8 mentioned is an epidermic cyst; in your provisional findings we talk about
9 a dermoid cyst; and finally in the final finding which we received, the
10 term used and discussed -- just one moment if I may to find it -- is
11 epididymical cyst. So now we have three concepts, three terms that are
12 being used.
13 A. I don't know, but in the text which is in English, I speak about
14 an epididymical cyst, which was erroneously translated as epidermal. I'm
15 sorry, but in the text itself -- I'm referring now to my English text --
16 I'm speaking about two things: an epidermal cyst which relates to the
17 tissue, the skin tissue and can have skin or dermal elements. I wanted to
18 be sure that an epidermic cyst which was what was found in the first
19 translation is -- shows that cells of the skin that were -- that are
20 projected onto the surface, and in those cysts ordinarily there are traces
21 of skin. And one also can find hairs, parts from pieces of skin, pieces
22 of tooth, or anything that might be on the skin or even places of nails.
23 And an epidermic cyst ordinarily is post-traumatic. It's
24 completely different, and one cannot make a mistake about one or the other
25 and confuse it with an epididymical cyst.
1 And so my definitive notes that is they're talking about internal
2 structure, which is in contact with the spermatozoa, and that is a
3 completely different structure, as well as ontologically different.
4 JUDGE HUNT: Doctor, would you mind spelling, so that we get it
5 correctly on the transcript, the two different terms we're -- or the two
6 different types of cysts that we're talking about? It's obviously
7 difficult for it to go through translations and typing, and to get it
9 A. Epiderm is the skin, Echo, Papa, India, Delta, Echo. That's the
10 first one.
11 JUDGE MUMBA: Can we have -- can we have it spelled, please.
12 A. The second one --
13 JUDGE MUMBA: Can we have it spelled?
14 A. E-p-i-d-e-r, and m is the last letter. The other term is
15 epididymic, e-p-i-d-y-d-i-m, epidydim [As interpreted].
16 JUDGE MUMBA: Thank you.
17 MR. JOVANOVIC: [Interpretation]
18 Q. Sir, I have a further question for you to clarify some other
19 points. Did anybody inform you of the existence of an error in the
20 translation, or did you, on the basis of your own knowledge and
21 experience, come to the conclusion that it had to be a bad translation?
22 A. It was something that I noticed myself, and I was not informed by
24 Q. Thank you. I'd like to discuss your findings now, which has been
25 allotted number C3, and it is your final finding. And the date I have is
1 the 3rd of November, 2000, which was the date that we received it. I see
2 from the document that in fact you compiled it before that date, but it is
3 Exhibit C3, I gather. That is the number that has been accorded to this
4 exhibit; is that correct?
5 A. There's no discussion, because the definitive report contains the
6 answers to the questions. In the provisional report you'll never find the
7 answers to the questions. I cannot answer questions if I don't have all
8 the information. So the final report is the one which contains answers to
9 the questions.
10 Q. Yes, I understand, and that is precisely what I wanted to
12 May we start from the end, and the last page of your finding, when
13 we come to the conclusions and answers, and it is section C, paragraph C
14 of answers on the questions. And the sentence begins, "We pass comment on
15 the statement of Mr. Zoran Vukovic." Could you explain whether that is
16 your joint opinion, that by Dr. Dunjic and your own, or is it only your
17 opinion presented in this findings? Because the sentence begins in
18 paragraph C with "We pass comment." Who is the "we," you or the two of
20 A. Well, I always use the plural -- well, the royal "we." It's a
21 personal opinion. I think that it's clear in the text as I wrote it.
22 It's not the opinion of my colleague. I can't speak for my colleague.
23 Q. Thank you. Moving on now. After the first examination that you
24 and Mr. Dunjic conducted, you proposed jointly that there be an additional
25 examination, another one, did you not?
1 A. Yes.
2 Q. And that additional examination, as far as I was able to
3 understand, consisted of two examinations in actual fact. One examination
4 was of the scrotum and the second part of the examination was to determine
5 the flow and certain other elements which you requested. Am I wrong in
6 saying that?
7 A. I asked for an examination of the structures. And so that there
8 be no doubts, I determined that first one had to take into consideration
9 the contents of the testicles and then the urethra. That is a structure
10 which is different from the first. In addition, there's yet another thing
11 in respect of my questions, the questions which I submitted in Dutch and
12 in English, that was transmitted to someone else, but I was right. First
13 of all, I drafted my request in Dutch to be sure that that technician
14 would not make any mistakes. I added the English translation so that
15 everybody could understand what I had asked for.
16 In my request I did determine what had to be looked for, that is,
17 the traces that could have a relationship with trauma in the past. And to
18 be sure, I mentioned three elements that -- to look for the cyst
19 structures and to see whether or not those -- there were structures of
20 calcifications. And third, to look for fibrous structures. And that was
21 the same thing for the urethra. One didn't have to repeat myself.
22 I wanted to explain to the Tribunal the reason for those three
23 different facts, elements. We've already taken into consideration the
24 first when we were talking about epidermic cysts. Those are
25 post-traumatic elements. But it is possible there is something else as
1 well, but we don't know, and so we've got to look for the structures of
2 the cysts. And if so, there is one, then I have to find out where it is
3 and, if possible, to explain what is the origin of those cysts. That was
4 the first thing.
5 The second, to know whether there was any cysts or anatomic
6 or -- structures that one can see. The second has to do with
7 calcifications. That was first of all an area which corresponds to some
8 extent to the capability of -- the technician's ability to interpret
9 things, to see whether or not there were calcifying structures. If so,
10 they would have to be -- make one think that they might have had
12 The third, which also can be seen with the eye, is the
13 irregularity of the structures. If I have a stick, I can see whether the
14 stick is straight or whether it's broken. These are -- it's a question of
15 what one can observe. These were the elements that I asked for. And
16 likewise, for the urethra. And so I've explained to you what it is that I
17 asked the technician to do.
18 Now I'm going to answer a question which was not asked but what
19 I'm going to be asked, and so I have to answer. An echograph is an
20 examination for which interpretation is reserved to the technician. We
21 did not give the echograph to my colleague or to -- or it wasn't given to
22 me, either, and the Tribunal might wonder whether that's logical, that is,
23 to interpret the results of an examination without seeing it. But I was
24 just going to say, we are not the ones who are going to do the
25 interpretation, it's rather the technician who interprets it. And I have
1 never met any serious experts who is capable of interpreting that
2 examination, and so that's reserved for those people. And if I never saw
3 the echograph, it's not surprising. It might surprise everybody in this
4 courtroom, but it's absolutely a natural thing.
5 Q. According to you, then, is the examination which was conducted by
6 the doctor or technician and the echo examination was done correctly and
7 according to the rules of the medical profession?
8 A. To some point I can't really answer because it wasn't done while I
9 was there. I trust the quality, that is, the professional quality of the
10 technician who performed the examination. I think that I can trust that
11 person. And as everything else goes, all he has to do is prepare the
12 examination, and then to tell us what the results are.
13 In the answer that the technician provided, I cannot see answers
14 to my question as to whether there was calcifications, but the fact that
15 there is no reference made to that, that is, to the calcification, doesn't
16 really surprise me because he's not going to answer and say it's not this,
17 this, or that. If it's not there, well, he just doesn't speak about it.
18 And that is a rather -- an attitude which is rather familiar in this type
19 of examination. If there's no specific question raised or there's no
20 calcifications, one just doesn't say anything.
21 That's the difference between my question and the answer. I asked
22 the questions, and he has to take into consideration what my question is.
23 It would have been much easier and much more agreeable if that technician
24 had first answered our questions and then prepared a report for which the
25 handwriting would be easier to read, or typed what his answers were. I'm
1 not sure if you understand what I mean.
2 Q. Yes, thank you. I should like to go back now to my previous
3 question about the cyst. We at present are talking about the epididymical
4 cyst; is that correct? Am I correct in saying that?
5 A. Yes.
6 Q. Thank you. And now may I go back to your finding. In the
7 discussion where you discuss your findings, and it is the fourth paragraph
8 and the sentence begins, "The absence of traumatic change in cystic
9 formations, the presence of a medium-size epididymical cyst is a normal
10 finding in over a third of the testes."
11 What I am interested in knowing is, does that mean when you say in
12 one-third, that one-third of the male population has an epididymical cyst
13 of some kind, or does it mean that one-third of the occurrences are
14 congenital and exist?
15 A. One could say, it might be surprising, but there are quite a few
16 other illnesses. And if one were to just make an overall examination, a
17 blind test if you like, if one were to take people here in this courtroom,
18 and if we take them to examine the people here, at least one-third of the
19 cases one would find cysts, so this is something which one finds
20 commonly. And if one looks for it, if we look to the nature or the type
21 of cyst that is in 66 per cent of the cases, it's the result of an
22 infection, and in 33 per cent, it's the follow-up of a congenital
23 deformation. So it's very common. And the reason why, it goes back to
25 Q. Are you telling me now that an epididymical cyst can only appear
13 Blank page inserted to ensure pagination corresponds between the English
14 and French transcripts.
1 in these two ways, occur in these two ways, either through a disease of
2 some kind or that it can be congenital, through birth?
3 A. You must not forget that an epididymical cyst is deep and behind
4 the testicle, and first one has to break the testicle in order to find the
5 epidermis. It's inside. There is the testicle, there is the surface
6 which one can see or feel under the skin and in the middle. Well, there
7 are two testicles. If you were to take them into one's hand this way, the
8 epididymic -- the skin on one side, we sort of got to go vertically upward
9 from below in order to encounter problems.
10 And I have to say that Mr. Zoran Vukovic was telling us that he
11 had fainted, and the trauma that you're looking for, for an epididymis
12 hurts, but it doesn't hurt that much, but a trauma to the testicles it
13 makes a person lose consciousness. Do you understand what I mean? In
14 order to cause trauma to the epididymis, in fact it's like spaghetti, it
15 moves around if you touch it; it shifts.
16 Q. Sir, am I getting your meaning, that you said to begin with that
17 in addition to disease, the hereditary factor, there is a possibility of
18 an epididymical cyst occurring through trauma, a traumatic experience; is
19 that so?
20 A. I've never encountered it in any literature. It's not spoken
21 about. It's just a possibility that one finds in old literature, but not
22 in modern, in modern literature.
23 Q. For example, in the 1970s or 1980s with the advancement of
24 science, would be that old literature, the literature of the 1970s and
1 A. Well, I don't want to criticise anything that's being said, but I
2 think we're going beyond the purpose of this hearing.
3 Q. I'm not here to enter into polemics about -- with you with respect
4 to medical literature, of course, but I should just like to ask you the
5 following: Do you happen to know the works of Mr. Anderson, the head of
6 the pathology department of the University in Miami and the director of
7 pathology of the Jackson Memorial Hospital laboratory, also in Miami? Are
8 you acquainted with his work or --
9 A. I've got this document. Anderson, is that the name you gave?
10 Q. Yes, yes.
11 A. What's your question?
12 Q. As far as I was able to follow, in that portion, it is volume 2,
13 published in St. Louis, 1971, Mr. Anderson, talking about the subject and
14 the existence of cysts and what causes cysts, says that there are three
15 main causes for the occurrence of a cyst as a medical problem: hereditary,
16 for a hereditary factor, through disease, and through trauma.
17 A. I've got the text that you are referring to, "Inflammatory or
18 infectious origin or congenital."
19 Q. We'll come back to that. Just give me a few moments to find the
20 translation, please.
21 Let's go back to where we left off. So according to you, an
22 epididymical cyst cannot be caused by a traumatic experience?
23 A. I'm sorry to say this, but we're not discussing a theoretical
24 element with respect to an error that a technician may have made, but I
25 think cysts or anything else have to be looked at within the history of
1 the -- within the context of the history that was shown to us, the case
3 If Mr. Vukovic tells us that he was walking around in the woods,
4 that he slipped, and that he bumped probably into some stones, he doesn't
5 remember, and then after that there was a trauma to the right testicle
6 which was swollen to the size of a woman's breast or a big melon, if a
7 testicle with a trauma swells that much, there would be other traces and
8 other signs afterwards. And now we're simply spending time looking at an
9 error regarding a cyst which is on the other side of the trauma. I'm
10 sorry, but we could keep on going on and on discussing this, but I can't
11 cooperate with that. I object to that. We have to see what we're talking
12 about because we can talk about anything forever and ever.
13 The case history is here, we've got the elements, and we've had
14 discussions. I was expecting that we could -- that we wouldn't go on and
15 on about errors that were not our mistakes, but I don't really want to
16 talk about that any more because it's not my right because I -- or if you
17 insist, I suppose we can go on.
18 JUDGE MUMBA: Mr. Jovanovic, you understand the point the expert
19 is making? There is a case in point upon which these reports are based,
20 and that is the case of your client whom the expert examined and whom the
21 expert listened to as to how he says he came across the injury.
22 MR. JOVANOVIC: [Interpretation] Yes, Your Honour. I just tried to
23 find a shortcut, and that is why I asked the question. Is it possible
24 that that cyst is caused through that specific injury? If the answer is
25 "no," then I have no further questions for the doctor. If the doctor
1 says "yes," were he to have said "yes," then I could have gone into a
2 deeper analysis of the findings and the discussion.
3 JUDGE HUNT: Speaking for myself, I would be interested in an
4 answer to that particular question. I think the doctor has impliedly
5 answered it to say yes, but there was no sign of such a cyst here. But I
6 myself would be interested. Can this particular type of cyst be caused by
7 trauma? Can you say that, Doctor, yes or no?
8 A. I would say no because if it were to trauma, we would have found
9 something else along with the cyst, this so-called trauma. For instance,
10 if you would have a seat in your car which had been turned upside down
11 after a collision, after a road accident, there would be no traces in
12 front or behind, and you would say that the seat had gone out of the car
13 through an accident -- as if there was no accident. That's the same thing
14 as a cyst. If you want to accept the theory of a post-trauma in respect
15 of the cyst, there's got to be other signs, but these other signs are
16 completely not there at all.
17 JUDGE HUNT: That is the way I understood you to be putting it,
18 but is that not a statement, in effect, that it can be caused by trauma,
19 but there was no sign that it had been caused by trauma in this particular
20 case? You are dealing with the practical one; you're being asked a
21 theoretical question. Theoretically, it could be caused by a trauma such
22 as a car accident. If it had, you say there would be signs of it, and
23 there were no signs of it here. Is that stating your opinion?
24 A. Yes.
25 JUDGE HUNT: I think you've got your answer now, Mr. Jovanovic.
1 It doesn't help you, but I think you've got an answer to it.
2 MR. JOVANOVIC: [Interpretation] Yes, Your Honour. Thank you, Your
4 Q. My next question for you, sir, is the following: We have an
5 injury of some kind. We have a cyst. Let's take it that we have a cyst,
6 which can be, which could be, I underline, to a certain percentage, the
7 result of trauma. Now, in addition to that cyst, must there be other
8 signs, other parameters, or anything else, as you have just described?
9 Because we're talking about a period of eight years ago. Now, at this
10 point in time, would you be able to detect them and should you be able to
11 detect them and must you be able to detect them, or is the cyst just is a
12 sign that something occurred at some point in time previously?
13 A. We examined Mr. Zoran Vukovic, and the purpose was to look for
14 traces so that we could answer the questions that had -- as to whether --
15 question as to whether there had been an accident. It's just as I said to
16 you before, as if there was a collision with a car, but there was no trace
17 of anything else or -- in the car. We found no traces of any injuries.
18 Nonetheless, Mr. Zoran Vukovic showed scars at other places, scars which
19 had been caused by vaccination when he was young, and those scars were
20 very visible. The other scars were easy to see as well, and in the
21 perineum area between the testicles and the two legs, there, between the
22 testes and the anus, there was no trace that would tell us that there
23 might have been any type of injury, not a knife injury or a hammer or
24 anything. It was absolutely perfect structure. As one often says when
25 kind of laughing, we're talking about the family jewels there. I can tell
1 you that I've seen family jewels. When I looked at them, they were
2 absolutely fabulously beautiful family jewels. One could be envious of
3 them. Perhaps my way of stressing myself is a little odd and it is not
4 quite what one ordinarily hears, but I wanted to be very clear about this.
5 Q. You have been quite clear, Doctor, and you made a good parallel
6 with the car and the seat, the car seat. Could we draw the same kind of
7 parallel and say that I can have a trauma today, that is to say, that I
8 could fracture my arm underneath my clothing, and eight years later on the
9 skin there are no signs of that; that is to say, when the arm was broken,
10 the skin was intact, and eight years later, looking at the skin -- that is
11 to say, you can only say that there was a fracture of the bone, but that
12 you can note nothing on the soft tissue. Is that the same case? Because
13 he was injured through his clothing, and there were no external injuries.
14 But does the possibility exist of internal injuries without the skin or
15 the soft tissue being disturbed, injured?
16 A. It's possible, and so I have to say yes to that question. But
17 you're speaking about an accident or a trauma, and here we're talking
18 about a haematoma which is the size of a grapefruit. I'm sorry. I must
19 not be concerned with theory, but limit myself to a very concrete,
20 specific case. So the concrete and specific case is that there was a
21 large haematoma that we explained -- described, rather, which caused some
22 itching for months or even years. And you're talking also about a cyst
23 which may have been caused by a trauma. I'm saying yes, but here there is
24 no congruence. Either there is a mistake in the case history or something
25 else is wrong, but the two things don't go together. Therefore, my answer
1 to your question is yes, it is possible, but in the case which is of
2 interest to us, there is no compatibility between the two case histories.
3 Q. Does that mean that you could now detect some external injuries if
4 there had been such an injury eight years ago?
5 A. Yes. Yes. It's like with your arm. There's a major trauma, so
6 with skin which is not perfect, you can find that, in the tendons and on
7 the bone. And even if the bone were completely intact, nature restores
8 things. I'm not going to go into explanations about that here, but we can
9 see that. So in order to avoid an erroneous interpretation, I suggested,
10 and my colleague agreed, that we should have an echograph in order to try
11 to find the traces, as with the case -- that was the case in that
12 fracture. And so we found a cyst that was post-traumatic, and in any
13 case, in most cases, about 66 per cent of the cases those are infections,
14 result of infections.
15 Q. All right. Let me try to be as precise as I can. I hope I'll
16 manage. Is it possible that there should be a cyst at this moment, a
17 detected one, without the existence of any other parameters, external
18 scars, et cetera, and that this cyst is a consequence of a trauma? I mean
19 a shock. I don't mean lesion or rupture. I mean, could it be a
20 consequence of a shock?
21 A. Do I have to answer that, that question? For almost a half hour
22 we're talking about a trauma. I would wonder about what kind of trauma
23 could cause a one-centimetre-diameter cyst. What type of trauma could
24 cause cysts that are that size? It does post-traumatically happen to
25 bicycle -- to cyclists or to cyclists in the Tour de France. In fact,
1 that's a well-known illness. And those are people who have been sitting
2 for a long time in a very narrow saddle, and the pressure of the saddle
3 can cause a break in the epididymis, which takes the form of a cyst.
4 There's another one which is familiar. Little boy who, while playing, is
5 kicked behind his buttocks, and you can find a cyst there.
6 What is the epididymis? Because I've been asked questions about
7 post-traumatic cysts. The epididymis is, as I said, is like a spaghetti.
8 The difference between the testicle is that the testicle is a very solid
9 structure, it is not elastic, and there's no possibility of enlarging it.
10 It's like a room which is made out of concrete. And the concrete room is
11 where it produces immature spermatozoa. And the production is continual.
12 It has to ripen and be stocked. And so it comes out of this concrete room
13 into a tunnel, which can be compared -- [English] Channel 6, I think.
14 Okay. [Interpretation] So this epididymis can be compared to a tunnel
15 which is made out of cloth, like something that would be set up for a
16 dance or when you come out of a hotel, like a marquee, which would be made
17 out of cloth. So it's --
18 Q. Excuse me.
19 A. It's movable. It's elastic. It's a structure which can swell or
20 can shrink, depending upon the quantity of spermatozoa that's in it. So
21 it's a room where one can rest, where one can be trained. As I was
22 saying, it's like spaghetti. It's very supple. If it begins to shrink,
23 it's firm, it creates kind of partitions, and creates new entrances and
24 exits in other places. This facility is also the source of problems when
25 you want to study the issue, in sterilisation cases. In fact, there's a
1 ribbon around the epididymis --
2 Q. Excuse me, sir.
3 A. After a certain amount of time the ribbon is no longer valid
4 because there's another structure which sets itself into place, and so
5 there is an obstruction. The part -- one of the parts can be turned
6 into -- can turn into a cyst.
7 Q. Thank you. I must confess, I wasn't able to follow you entirely.
8 My knowledge of medicine does not allow me to do that. I'm very sorry.
9 But could you possibly answer my question very briefly: Is this cyst
10 which exists today, without those other accompanying external signs, could
11 it be a consequence of a trauma?
12 A. It could be the consequence of a trauma in a distant past, but not
13 the consequence of the trauma that we're interested in, talking about.
14 Q. What would be the other consequences which are not present in this
15 case and which should be present where it -- a consequence of an event in
16 the period we're interested in? What does medicine expect to find in such
17 a case in an examination?
18 JUDGE HUNT: You'd have to limit that, would you not, to the type
19 of incident that has been put in issue here, that is, a fall, but not a
20 car accident or something like that. And in any event, Mr. Jovanovic,
21 we're not interested in possibilities. Almost anything is possible.
22 We're interested in whether it is a reasonably possible explanation. So
23 it's got to be a reasonable possibility. But you will have to, I think,
24 limit it to the type of event which has been put forward in this case.
25 MR. JOVANOVIC: [Interpretation] Absolutely, Your Honour. I will
1 do my best to make this as short and as expedient as possible. I just
2 thought that I had to provide the doctor with a basis on which I would ask
3 him a question so that we can start from somewhere.
4 Q. So distinguished doctor, my last question was: What does medicine
5 expect to find in an examination eight years later in addition to what has
6 been found here?
7 A. I didn't understand that question.
8 Q. My question was: An examination eight years later was done,
9 noting the presence of an epididymical cyst. What else would doctor a
10 expect to find to confirm that such an event indeed took place, had taken
11 place? You said that you have not found -- I shall quote you: "No
12 physical injuries in the lower part, no injury in the perineum or
13 elsewhere." In other words, there are no scars. We saw that scars do not
14 necessarily have to exist, so what else should have been found in this
16 A. That's a question I'm not going to answer, because now you're
17 asking me to imagine things. I don't want to speak about things that
18 might be.
19 Q. Perhaps it is my mistake. I did not formulate my question
20 precisely enough. I did not wish to embarrass you with my question in any
21 way; I only wanted to ask what your science, the science of medicine,
22 thinks about this. What elements are missing? That was nothing personal
23 addressed to you.
24 A. No, don't worry. Don't worry. It's a regular question. I'm used
25 to it. I can't answer it. One conducts an examination and one makes
1 observations. What you're asking me is to describe all kinds of crashes
2 that I could imagine that a car could be involved in, in respect to the
3 perineum, all signs that might be there. There's an infinite number, and
4 I'm not going to describe something which isn't there, which doesn't
5 exist, which is not there.
6 Q. Thank you very much. I understand. Somewhere towards the end of
7 your findings -- let us turn back to the document marked as C3, which is
8 your final report. Your conclusions and answers to the question,
9 paragraph B, the last sentence says, at least in my translation: "There
10 were no indications of temporary impotence, inability or incapacity in the
11 past in the critical period." We shall not dwell on the injury as a
12 possible cause of the epididymical cyst. I wish to ask you something
13 different. You said it could be caused by a disease. Am I correct?
14 A. Yes.
15 Q. Would I be correct in saying that this disease has an acute period
16 lasting -- well, I really don't know, perhaps seven days. So there are
17 diseases which lead to the occurrence of an epididymical cyst. That would
18 be an acute disease, would it?
19 A. I don't know where -- what we're driving at. We started talking
20 about traumas, accidents, and now I'm being asked questions about
21 illnesses. One could continue to ask questions and wonder about all kinds
22 of things, but I want to keep things simple.
23 What's the history here as it was presented to us? At an
24 unspecified date, Mr. Zoran Vukovic was the victim of a trauma or an
25 infection, you can choose as you like. He lost consciousness. He went to
1 see a physician in the area, in Foca. He was sent to the military
3 Q. Sir, excuse me, I'm very sorry to interrupt you, but in a
4 concerted effort, we could perhaps move along more quickly. We have all
5 this in writing.
6 My question was the following, and that's why I asked you about
7 the disease: In the acute period of the disease when an epididymical cyst
8 occurs, you will correct me if I'm wrong, that implies a swelling, pain,
9 and high temperature. In that period, according to the rules of medicine,
10 could there occur temporary impotence or inability?
11 A. In cases of illnesses, one could ordinarily say that that
12 inability never lasts longer than three days. That's a surprising answer,
13 perhaps. Every human being has three missions fundamentally. The first is
14 to guarantee the species, the second is to protect life, and the third is
15 to make life easy or facilitate life. The first is the most important,
16 and nature does everything so that the living being is in a position to
17 respond to that goal, that objective of guaranteeing reproduction.
18 Let me here take the extreme example of scorpions where the female
19 kills the male after she's been fertilised. In my practice, I have seen
20 that even people who are almost dying are able to have sexual relations.
21 And nature makes it so that even in cases of trauma, as quickly as
22 possible, the individual is recovered and then can have sexual relations.
23 There is a second infection -- or other situation in nature with
24 human beings, and this has to do with sight. Even in the case of sight,
25 within 24 hours the illness is cured. So we're not speaking about -- when
1 you talk about infections, as you mentioned, it has a very, very short
2 amount of time.
3 Now, what type of infection, because you haven't asked me that
4 question, but that perhaps it's not separate from the question that you --
5 that is having to do with prostate problems.
6 Q. Thank you very much for your answer. I didn't even -- I hadn't
7 meant to go that far.
8 I would further be interested in finding out if such temporary
9 inability or impotence occurs as a result of a disease, could it also
10 occur as a result of a trauma, of an injury within a certain period of
11 time that medicine has this defined? I don't ask you precisely to
12 determine how long this period is, I'm just asking how --
13 A. It's possible, yes.
14 Q. I therefore assume that not every kind of injury can lead to the
15 problems we're discussing here. It has to be a stronger impact or a
16 graver injury; am I right? I mean, regular, everyday injuries do not lead
17 to this kind of consequence. Am I wrong?
18 A. I think -- well, that's, once again, a question which makes no
19 sense. If once again you're calling on my fantasies, then I just can't
20 answer you. I'm not here to talk about fantasies.
21 I have no information here. I believe -- well, one asks
22 questions, one asks what happened. The history is negative, and he had
23 all the time necessary for him to say, "I had this and this and that." If
24 it's really important, I think that we would be told that in that case
25 history because I've got my reflexes about that.
13 Blank page inserted to ensure pagination corresponds between the English
14 and French transcripts.
1 This is an incomplete story. There's information missing. So if
2 there was trauma, a small trauma with an inflammation which would make one
3 temporarily impotent, I think we would have been told that; but no one
4 said that to us.
5 Q. I understand that you worked with partial and incomplete
6 information that had been given to you.
7 A. I'm not saying that. If somebody asked, What are you suffering
8 from? And that was -- and we examined that. We had -- there was time to
9 tell us, and to tell us later again.
10 I'm sorry for saying this, but in this case, I saw the gentleman
11 was put into detention -- has been in detention for almost a year. I
12 believe that there was time to think about things. I would. And when I
13 am asked questions, I could also tell -- I would also tell you what
14 happened. I asked questions almost after a year of his being in
15 detention, and I don't get the case file. What do you expect me to answer
16 here? How can I answer your questions?
17 Q. Yes, but you made conclusions. You did not have the input
18 information, but you nevertheless drew conclusions. Your conclusion is
19 that there were no temporary impotence or inability in the past, and now
20 you're telling me you had no information about it. Then how did you
21 conclude this?
22 A. No, no. What I said is that in the file, there's information. If
23 you look at Internet, you can read that in four languages.
24 Q. Distinguished sir, your findings dated -- wait a minute, please,
25 let me find the date -- 3rd November, chapter 6, "Answers to the
1 questions," paragraph B, is text of about a dozen lines which I will not
2 read out in full, but it seems to me that this says everything that the
3 accused Zoran Vukovic could have possibly told you about this injury: The
4 time it occurred, how it occurred, what happened to him at that moment,
5 and what happened to him later. And I'm looking at your own finding. We
6 had no other information, and all that we knew we did tell you, that is
7 also included in your report.
8 A. I saw the text that -- it was on Internet. If it's put on
9 Internet, I think that's available to everybody, and I can read it like
10 everybody else. If I'm asked to perform an examination, I would act like
11 everybody else. I would look to see what I could find on Internet about
12 the subject, about the case.
13 Q. You're absolutely right. I adore hanging out on the Internet
14 also, but believe me, neither my client nor I had the opportunity to put
15 that information up on the Internet.
16 And my last question, in view of the fact that we have been
17 discussing for almost an hour, do you still stand by your claim that the
18 statement of Mr. Vukovic is fundamentally incompatible and even deceptive
19 with what you found? I would say that that is a premature conclusion, and
20 I'm stating my opinion only.
21 A. Would you repeat that question, please, the question that you're
22 asking me?
23 Q. Yes, sir. My question was, after this entire discussion, do you
24 still maintain that the statement by Mr. Vukovic as regards the reasons
25 and the circumstances of his injury is incompatible with the findings and
1 even "apocryphal," deceptive? It is my opinion that it is a premature --
2 A. Where, where did I say that? There was an accident in the forest;
3 there was itching in the sexual area; he was taken on a stretcher to Foca;
4 he was seen by a doctor. The doctor allegedly sent him to a hospital.
5 Q. Excuse me, sir, but I do have to interrupt you, I'm very -- I
6 regret that very much. But we are talking about things of which I have
7 completely different information, or at least I'm receiving a different
9 For the second time running, I'm hearing that Mr. Vukovic had an
10 itching due to which he was transferred to the hospital. It says in your
11 findings he fell on his backside, continued sliding, hit with his back
12 something that could have been two bigger stones, and lost consciousness.
13 It does not specify whether that was due to the impact. He felt two
14 shocks, and the next thing he remembers is somebody washing his face with
15 a damp cloth.
16 From this description of events, I cannot conclude that it was a
17 case of itching. I could conclude that it was a very strong pain which
18 led to -- the man to lose consciousness.
19 A. I'm sorry for the words I'm using. It was an injury. If there is
20 a trauma, if there's an injury to the testicles which would cause such
21 swelling, every doctor knows that he can't just leave it like that, that
22 it has to be operated on. It's got -- you've got to go in there and get
23 rid of the haematoma. If you don't do that, it would be absolute torture.
24 And you can't tell me that the doctors in Foca --
25 Q. Doctor, we are discussing year 1992, Foca and the war. I know
1 what the medical science assumes should have been done.
2 MR. JOVANOVIC: [Interpretation] But in any case, Your Honour I
3 shall have no further questions. Thank you.
4 JUDGE MUMBA: Any questions from the Prosecution?
5 MS. KUO: No, Your Honour.
6 JUDGE MUMBA: No questions.
7 Questioned by the Court:
8 JUDGE HUNT: Doctor, have you seen the report which has been
9 supplied by the expert witness to be called on behalf of Mr. Vukovic,
10 Dr. Dusan Dunjic?
11 A. Yes, I read it.
12 JUDGE HUNT: I hope that I have read it correctly when I say that
13 his conclusion is that the investigation is still too incomplete to reach
14 any proper conclusion. What do you want to say about his view?
15 A. Well, my colleague's reflexes are right, and the only thing that I
16 can say, it's like everybody, he really based himself on the mistake in
17 translation which was the mistake between epiderm and epididym. So the
18 reflexes that were his are the right ones if there hadn't been an error.
19 JUDGE HUNT: But do you agree that the investigation is still
20 incomplete or sufficiently complete to reach any proper conclusion now
21 that the correction has been made to the error?
22 A. One could say yes; one could also say no.
23 A few minutes ago I said that it was a technical examination which
24 shows or confirms or doesn't confirm, and so I asked specific questions
25 asking that certain information be obtained or looked for. There were
1 negative results from that search; that is, it does not speak about or it
2 doesn't -- there was no finding there.
3 If the examination was an additional one in order to try to find
4 out more information which could contradict us, there was no information
5 to contradict us.
6 JUDGE HUNT: Well, is it correct to say, then, that there is
7 nothing that has been shown which would support the version which
8 Mr. Vukovic has put forward; there's nothing medically that has been
10 A. There's no information that would support the explanation given by
11 Mr. Zoran Vukovic in his statements. I have to this point not been able
12 to finish my thoughts. I began twice.
13 JUDGE HUNT: Do you wish to add something, then?
14 A. Yes. In order to go back to whether this was a true -- what he
15 said was true, there are situations, which as the Defence has said, where
16 one might find -- that when one was in a war, and that medical
17 possibilities are not the same as in peacetime. That's what you said.
18 One must not forget that a haematoma as described by Mr. Zoran
19 Vukovic, and not only a haematoma, but which is a black one with the skin,
20 the back -- the buttock and everything around it becomes black, it's
21 dreadful. And people who had that kind of experience, that's the very
22 first thing they tell us. That information which is not there, which is
23 not in the story which was presented to us, and I could continue by
24 telling you that we were told that there was a loss of consciousness, that
25 he was transported. But what I needed and what I didn't have, and I'm
1 sorry I'm allowing myself to say, that at that point I had some thoughts,
2 I asked myself the following question: Is it -- isn't it possible that he
3 saw that on another person who had been hit between the testicles and had
4 a haematoma, and then this person collapsed and suffered horribly? But
5 when you see a person who is dressed, and you see a person at that moment
6 but not several days later, but on seeing that person a few days later,
7 then one can see that the haematoma which has gotten black. [As
9 There was other information in that story which was missing,
10 elements I didn't have, and that's why I added, among other things, this
11 sentence, sentence C, in my conclusion.
12 JUDGE HUNT: Thank you very much.
13 JUDGE MUMBA: Mr. Jovanovic, you had finished your questions and
14 the Prosecution did and then the Bench, unless you want to ask as a result
15 of the answers to the Bench; not to continue, but as a result of answers
16 given to the Bench, do you wish to ask questions?
17 MR. JOVANOVIC: [Interpretation] Yes, Your Honour. I will be
18 extremely brief. I omitted something because I had not consulted my
19 client, and now I had a message from him. I would ask you for your leave
20 for just a minute longer. Thank you.
21 JUDGE MUMBA: Yes, please go ahead.
22 MR. JOVANOVIC: [Interpretation] Thank you, Your Honour. No
23 further questions.
24 JUDGE MUMBA: Thank you very much, Dr. De Grave, for giving
25 evidence to the Tribunal. You are now free. You can go.
1 [The witness withdrew]
2 It's 11.00 and we go for our break until 11.30.
3 --- Recess taken at 11.03 a.m.
4 --- On resuming at 11.35 a.m.
5 JUDGE MUMBA: The proceedings will continue under Rule 15 bis
6 because Judge Pocar is unable to sit with us due to urgent personal
8 Before we begin with the witness, the registrar has to give us the
9 correct numbering of the documents. And the confidentiality under which
10 the documents were filed is now lifted, so that all the documents, the
11 medical reports and everything that we are dealing with now, will be in
12 the public domain.
13 Madam Registrar, please.
14 THE REGISTRAR: [Interpretation] The C.V. of Dr. De Grave is marked
15 C1, Chamber Exhibit C1. Dr. De Grave's report from the 5th of October,
16 2000 will be marked Trial Chamber C2, Trial Chamber Exhibit C2. The final
17 reports of Dr. De Grave, dated 30th of October, 2000, will be marked C3,
18 Trial Chamber Exhibit C3. The provisional reports of Dr. Grave following
19 the echograph will be marked C4. And the report about the echograph will
20 be marked C5, Trial Chamber Exhibit C5. The original document is C5 in
21 Dutch, the translation into English is C5A, and the translation into
22 B/C/S, C5B.
23 JUDGE MUMBA: Yes. Can the witness make a solemn declaration,
25 THE WITNESS: [Interpretation] I solemnly declare that I will speak
1 the truth, the whole truth, and nothing but the truth.
2 WITNESS: DUSAN DUNJIC
3 [Witness answered through interpreter]
4 JUDGE MUMBA: Thank you. Please sit down.
5 Yes, Mr. Jovanovic.
6 MR. JOVANOVIC: [Interpretation] Thank you, Your Honour.
7 Examined by Mr. Jovanovic:
8 Q. Professor Dunjic, when you were here last, you gave us your C.V.
9 with all the particulars. Have there been any changes since then in your
10 professional status?
11 A. Yes. In the meantime, I have become full professor at the faculty
12 of medicine of the university in Belgrade, and at the same time, from the
13 20th of November onwards, I was director of the forensic institute in
15 MR. JOVANOVIC: [Interpretation] Thank you. Let us get back to
16 business now. I have before me, and I assume that we all have a copy of
17 the medical expertise of the 21st of September, 2000, the medical report.
18 No, I'm sorry. That is another one. I've got the wrong report.
19 JUDGE MUMBA: If you could please deal with the reports
20 chronologically. It's easier that way. The first one up to the last
22 MR. JOVANOVIC: [Interpretation] Yes, Your Honour.
23 Q. I have in front of me two of your findings. The first finding is
24 dated the 21st of September, 2000, and I assume that that is the report
25 after your examination of the accused Zoran Vukovic. Is that correct?
1 A. Yes.
2 Q. After that you have a second report and finding, dated the 31st of
3 October, 2000, on the basis of the documents that you received in the
4 meantime; is that correct?
5 A. Yes.
6 MR. JOVANOVIC: [Interpretation] Your Honour, may we receive
7 numbers for the two reports? Although I think the first report by
8 Dr. Dunjic has been entered into evidence. I'm not quite sure. But can
9 we have numbers?
10 JUDGE MUMBA: They were just filed. Madam Registrar, can --
11 You want them both entered into evidence?
12 MR. JOVANOVIC: [Interpretation] Yes, Your Honour.
13 JUDGE MUMBA: Any objection from the Prosecution?
14 MS. KUO: No, Your Honour, except just to clarify that the first
15 report mentioned with the date 21st September appears actually to be dated
16 and signed 9th October 2000, so there's no confusion.
17 JUDGE MUMBA: Okay. Can we have the numbers, Madam Registrar,
19 THE REGISTRAR: [Interpretation] The first report of Dr. Dunjic
20 will be marked D173, Defence Exhibit 173. The second report of Dr. Dunjic
21 will be marked D174.
22 JUDGE MUMBA: Thank you. You can proceed.
23 MR. JOVANOVIC: [Interpretation] Thank you, Your Honour.
24 Q. On the basis of which documents presented to you -- that is to
25 say, your second report of the 31st of October was based on some other
1 documents. Which ones?
2 A. My findings of the 31st of October are based on the documents that
3 I received, and they are a typewritten report, in Dutch, on the
4 echographic findings. And next, the same report translated into English,
5 a report that my colleague, Dr. De Grave, sent as a preliminary report,
6 after an echographic examination, and based on his basic findings, that is
7 to say, the initial findings, which incorporated all the facts that I had
8 at my disposal, including the finding that I arrived at when I examined
9 Mr. Vukovic.
10 MR. JOVANOVIC: [Interpretation] Thank you.
11 JUDGE HUNT: Mr. Jovanovic, we've got all this in the report. We
12 don't want it repeated. We've read the report, and what the doctor just
13 told us is all stated in the report. If you want to ask him any questions
14 beyond what he's already said in the report, you go ahead, but we don't
15 want him now just to give us the content of what he's already put in
17 MR. JOVANOVIC: [Interpretation] Yes, Your Honour. I have
18 understood your instructions. My question was in another direction, and I
19 think my next question will show you why I have raised the matter.
20 Q. As I said to Mr. De Grave, I asked him a question with respect to
21 some unclarities which arose from the translation, and diagnosis, because
22 we have three different cysts that appear in the findings: We have an
23 epidermal cyst, we have the epididymal cyst, and the third was the -- just
24 one moment to refresh myself -- the dermoid cyst. That's right. Thank
25 you for helping me out there. Your findings were compiled on the basis of
1 the documents that you have just mentioned, and in all of them cysts
2 occurred as -- what cysts occurred, in fact? Could you tell us the cysts
3 that you found?
4 A. When I wrote my findings, I had two diagnoses. The first basic
5 diagnosis upon which I based my opinion was the diagnosis by the doctor
6 conducting the echography of the scrotum, and in Dutch and in English it
7 states that it is an epidermal cyst. In Dr. De Grave's interpretation,
8 preliminary, he mentions a dermoid cyst for that same cystic change that
9 took place. He mentions the dermoid cyst. So I had to comment in my
10 findings both types of changes observed on the basis of the echographic
12 Q. When you finally learnt that it was none of these two cysts but
13 indeed a third type of cyst that I discussed here with Mr. De Grave,
14 epididymal cyst, what do you have to say to that?
15 A. Well, it was only when I received those findings by Mr. De Grave,
16 a day or two I was due to leave for the Hague, actually before I arrived
17 in The Hague. That was the first time I heard about that third type. And
18 so through force of circumstance, my colleague, Dr. De Grave, showed me
19 the document and the text that was handwritten in Dutch. With the
20 enlarged section where the word has been interpreted as an epididymical
21 cyst, which is a third type of the same change that was noted on the
22 echographic examination.
23 Q. Do I understand you correctly in saying that your opinion and
24 findings were, to the best of your knowledge, on the basis of the findings
25 of an epidermal cyst and the provisional opinions and findings of
1 Dr. De Grave where he speaks about a dermoid cyst?
2 A. Yes, and that's what I wrote in my findings. And I commented -- I
3 had to comment on both types of cyst, that is to say, their appearance and
4 everything that stems from that kind of diagnosis, so the aetiological
5 factors which influence the occurrence of both types of cystic change.
6 And my findings, the second findings, are based in fact on the documents
7 that I had at my disposal at the time. Up until then, in fact.
8 Q. So to all intents and purposes, this opinion of yours, these
9 findings, cannot help us a great deal, cannot help the Trial Chamber?
10 A. Well, I apologise for saying so, but I think they can be of
11 assistance for the simple reason that we have cleared up some forms that
12 changes of this kind can take.
13 The epididymical cyst as such which occurs in the text now, in
14 view of my profession and the fact that I'm a forensic expert, and I -- is
15 based on pathology, this development is based on pathology, on the
16 development of an organ, enables me now to differentiate and make a
17 diagnostic differentiation between these changes, cystic changes.
18 Q. So in other words, we're going to get from you now a forensic
19 expert opinion as to precisely the subject we're interested in, which is
20 the epididymical cyst, because we have ascertained after all that that in
21 fact we are dealing with the epididymical cyst; is that right?
22 A. Let me state at the outset that I would like to explain certain
23 points first, that is to say, how cysts occur in the body.
24 Q. Professor Dunjic, let us take this step by step. We'll get to
25 that, but may I ask you a few preliminary questions first, and may I draw
1 your attention to the fact, and don't get me wrong, but can we ask you not
2 to flood us with a whole lot of medical terms because none of us is
3 qualified enough to be able to follow you as, indeed, Dr. De Grave as
5 A. I'll do my best. And I want my expert report and expert finding
6 to be just that and to incorporate everything that an expert report
7 should, that is to say, to use medical terms and facts and all the other
8 elements which I had at my disposal, and the basic -- my basic findings on
9 the 4th of October this year when I conducted an examination of
10 Mr. Vukovic, and all the other facts that I had to take into account. So
11 I'm going to try and present all this in the form of an expert opinion, to
12 incorporate it all.
13 Q. Thank you. My basic question is the following: Could you tell us
14 the mechanisms or the reasons for which an epididymical cyst can occur in
15 the human body?
16 A. Let me try first of all to make a medical distinction first.
17 There are changes that take place in the body which are called cysts, that
18 is to say, empty spaces, which occur in all parts of the body and in all
19 the body's organs. Their basic division is into what a cyst actually is,
20 a form, a creation, and the spaces, the hollows, which are not in fact
21 cystic formations, the cavities.
22 What occurs in the form of cavities or the cyst, we usually say a
23 cystic phenomenon, they either occur because different fluid is retained
24 in the organs or parts of organs, or they occur after certain changes have
25 taken place in the body. Those changes in the body can be the result of,
13 Blank page inserted to ensure pagination corresponds between the English
14 and French transcripts.
1 and to put it simply, a disease of some kind or trauma. Trauma, if there
2 has been bleeding or fluid, the formation of fluid, then this blood or
3 this -- the fluid in an organ or tissue or their capsules is -- the fluid
4 is closed off, encapsulated; and later on, that liquid content is
5 reabsorbed gradually. It is gradually reabsorbed and remains -- and as a
6 consequence of this, a cavity remains. That is what we call reabsorption
8 There are retention cysts as well where the fluid is retained in
9 those cavities which gradually get -- become -- take on a membrane, and
10 those formations are also referred to as cysts. Pathologically speaking,
11 they are not in fact cysts; but the clinical picture which is significant
12 and with respect to their localisation, they behave in that same way and
13 can lead to certain changes in the organism, depending on where they have
14 been localised.
15 Let me now go back for a moment to the previous finding.
16 Q. I'll have to interrupt there, Professor Dunjic, at this point, and
17 I think we'll have to move forward a bit.
18 Trying to make a list of the questions that I am going to ask you,
19 I have done a bit of reading, and I read somewhere that those changes in
20 the organism that we refer to as cysts medicine says can be -- can occur
21 in three ways: Either they're congenital, either they are the result of
22 disease and infection, or the result of trauma. Would you agree with me
24 A. Yes, those are the three possible ways in which cysts or cystic
25 formations in the body occur. However, allow me to state that each of
1 these types of cyst has its characteristics, and depending on how they
2 occurred and what led them to be formed and where they have been
3 localised, they give a certain clinical picture.
4 If we go back to the initial finding, and let me state that in the
5 preliminary opinion given by Dr. De Grave, on the dermoid cyst, the
6 dermoid cyst occurs most frequent congenitally, that is to say, it's
7 inborn, and it has its specificities, histological, pathological,
8 clinical, it's specific features; and usually they are on the forehead,
9 the face, and so on, and they're different in structure. So we are able
10 to differentiate this from the epidermal cyst, and that is why I made the
12 Epidermal cysts can occur congenitally or after certain diseases
13 which can occur in a particular area of the body and are usually the
14 result of trauma, a consequence of trauma. And it is even stated that it
15 is possible that cysts of this kind occur at the place where -- after an
16 insect bite. That is why I make the distinction between the dermoid and
17 the epidermal cyst.
18 And finally this brings us to the epididymical cyst, which is a
19 hollow formation, a cavity, and only if you tell me that there has been an
20 error in the transcript, then I will go on to comment on that. It is a
21 cystic formation which can be noted on the epididymis, that is to say, on
22 a particular structure joining onto the testis. Now, that cystic
23 formation can be also congenital. A third of them are usually congenital
24 and can be found in a third of all males. It can result from disease, but
25 it can also result from trauma, just like the epidermal cyst.
1 The appearance of the cyst is essential here. And starting out
2 from the facts, the aetiological occurrence of those cysts, I'm able to
3 give my expert opinion, including everything that I have done, I did
4 beforehand; that is to say, the examination, the physical medical
5 examination of Mr. Vukovic that I conducted; second, the analysis of the
6 case history, his case history; third the clinical aspect, the clinical
7 picture that can attend a trauma or a disease, for example.
8 So on the basis of all these parameters, I am now able or, at
9 least, I'm attempting to explain everything. But the starting point is
10 what type of cyst it actually is. What type of cyst has actually been
11 diagnosed for you to be able better to understand the aetiological
12 development of a cyst, whether it is congenital or the other types, and
13 then having said that, I can elaborate.
14 Q. Before I ask you questions specifically linked to this case, and I
15 asked Dr. De Grave something similar, do you consider that the echography
16 that was conducted was conducted sufficiently well for both you and
17 Mr. De Grave to have all the necessary information on the basis of which
18 you can make a diagnosis and give an opinion which will be beyond all
19 reasonable doubt, that is, to convince us of your opinion and what you're
21 A. I received the finding and on the basis -- and it is in four
22 points. It has been written in four sections, four points, by the doctor
23 who conducted the examination.
24 For all practical purposes, it is a diagnosis of what he saw, that
25 is to say, the conclusions, what he saw. I haven't -- do not have his
1 findings, I just have his conclusions, and these conclusions are -- I must
2 say, I must tell the Trial Chamber, that they are insufficient or lacking.
3 They are lacking.
4 The question that now arises is where are they lacking? And we're
5 talking about the echography: Where is it lacking? From point one of
6 that finding, we see that the right testis appears to be normal.
7 Cordially [as interpreted], the cyst on the epidermis is one centimetre in
8 size. A trace of fluid has been recorded.
9 And now I'm going to talk about those first three sentences. From
10 the finding, I cannot see whether an examination of the overall scrotum
11 area has been conducted. It just refers to the right testicle.
12 Second, from this, we do not see whether and what the other
13 structures around the right testicle are like, the capsules, the areas
14 around, and that is a very important area, significant.
15 Next, mention is made of the epidermis, an epidermal cystic
16 formation without saying on the basis of what they were able to conclude
17 that it is an epidermal formation, an epidermal cyst. And let me also say
18 that even if -- were it to say that it was an epididymical cyst, and if we
19 accept that that is so, then that same cystic formation has not been
20 described except by giving the size of it, and that implies the appearance
21 of that cystic formation. It is not the same if something is round and
22 smooth, equal, or if the surface is rough and if the internal walls of the
23 cavity are also rough, and that is what gives us the possibility to
24 conclude what type of cyst we are in fact dealing with.
25 Furthermore, it says "a trace of fluid" in the finding. Let me
1 tell the Trial Chamber that between the testicle, the scrotum, that is to
2 say, the skin, there are capsules normally containing fluid. Now, whether
3 a trace -- when it says "a trace of fluid," whether that refers to that
4 normal composition or to the fluid contained in the cyst, in the actual
5 cavity, that is unclear.
6 It says furthermore, and I quote: "No post-traumatic changes."
7 That is a conclusion from which I cannot now see on the basis of which
8 that conclusion has been made, what was looked for, what was studied for
9 that conclusion to have been made. I must state at this point that there
10 are no scars, there is no thickening of the shell, there is no atrophy of
11 the testicle, there are no cavities in the testicle, in the capsules,
12 there is no calcification, and so on and so forth. So I would have to
13 say -- to make a list of all the things I did not find, to draw a line,
14 and to summarise, and on the basis of that, to make a diagnosis, and that
15 is something that is lacking here. So what we have is a conclusion, we
16 have a diagnosis, without seeing what was done to lead up to that
17 conclusion and diagnosis, and that is why I say it is lacking.
18 Next it states, and I quote: "No indication of hernia." As a
19 doctor, I know what he was looking for; I can say what he was looking
20 for. But once again, we have an opinion, his opinion, and his conclusion
21 as a diagnosis of something without seeing the whole process that led him
22 to make that conclusion and diagnosis.
23 And this brings us to point 3, and I quote: "The urethra cannot
24 be examined echographically." Suggestion for this query: Why urethra?
25 Because in traumas of the scrotal area, scrotum, the urethra can also be
1 injured, and this too would have a definite symptomatology. Once again,
2 that is lacking.
3 What is important for me, as a physician and an expert witness, is
4 point 4, where the doctor conducting the medical examination gives his
5 advice. He says that the examined person Zoran Vukovic should be referred
6 to a doctor, a urologist, a specialist for that type of ailment.
7 I, as a physician and as an expert witness, am able to conclude
8 that that advice was made on the basis of his findings. Therefore, the
9 change that has been noted -- let us say an epididymal cyst or epidermal
10 cyst. We have concluded the dermoid cyst. It does not exist for this
11 purpose, although the term "dermoid cyst" was mentioned in Dr. De Grave's
12 preliminary finding. So this particular position considers that it is a
13 change which merits reference to a urologist who should follow on the
14 patient's condition. Why? Because the possibility exists that this
15 change undergoes further change, that is to say, that it can be expanded
16 and that the other structures are compressed or that it changes and
17 becomes malignant. In either of these two changes, this advice is very
18 good, and I consider it completely justified on the basis of the findings
19 as they have been given. I assume that he could have written many other
20 things as well, points as well, indicative points, but that he considered
21 this to be sufficient.
22 I have a general criticism to make, if it is a criticism -- I'm a
23 forensic expert myself, so I am able to say that -- is that nowhere in the
24 finding do we see that a complete examination of the scrotum has been
25 made. What about the left-hand side of the scrotum? What about the left
1 testicle? What about the left testicle and left epididymis of the left
2 testicle? Nowhere is that apparent.
3 I do apologise. May I make just one point more? If it is
4 congenital, if the cyst of the epididymis is congenital, then it is
5 logical and frequently seen that changes of this kind occur on the
6 left-hand side as well. If there is inflammation, if it is the cause of
7 inflammation or trauma, then they are more frequently unilateral. I say
8 more frequently, not exclusively, but usually, which means that they can
9 be both. And that is why I consider this finding that I have been
10 presented with lacking in those points.
11 Q. We understood all your remarks and objections to this report, but
12 it's the only one we have, and we will work with what we have. Let us
13 come back to the question which was asked before your comment on the
14 report. My question in that area was -- referred to the way of occurrence
15 of epididymal cysts. You said there are three possible causes.
16 A. Yes.
17 Q. Is that your opinion, or can you refer us to an author or any
18 other person to support that opinion, I mean an authority in that field?
19 A. I have submitted to the Trial Chamber in my report some
20 photocopies of the literature which has been used. This is a small part
21 of such literature, in view of the fact that we had to make a
22 differentiation between an epidermal and an epididymal cyst. So I
23 submitted a photocopy of a textbook on pathology by Anderson. I have
24 brought for you a photocopy from the original textbook, which means the
25 English original, whereas I had earlier submitted the B/C/S translation.
1 I have also managed to collect a lot of literature, including General
2 Pathology, 4th Edition, Walter, Israel, published in 1974, also dealing
3 with these type of cysts, their origin, and about epidermal cysts. I also
4 have our authors of textbooks on pathology, George Murphy. Speaking about
5 injuries of urogenital organs, by academician Caba Petkovic.
6 Histopathological changes on the Skin, by David Elder, also on these types
7 of changes. Just a second.
8 Among the photocopies that have been submitted to you, these
9 authors deal with cystic changes in the scrotal region. Among other
10 things, there is a photocopy of the medical encyclopaedia, where the
11 origins of these real cysts and the four cysts, including the resorption
12 cysts and also the epididymal cysts, including etiology, hereditary,
13 morbid, and trauma-related.
14 Q. Excuse me.
15 A. I am a professor, so I take the liberty of taking my time.
16 Q. Yes, but you are in Court.
17 JUDGE HUNT: Professor, you may be able to do that in an academic
18 institution, but we are not here just to listen to lectures. Please try
19 and keep to the point, would you.
20 THE WITNESS: [Interpretation] I accept, and thank you very much.
21 I apologise.
22 MR. JOVANOVIC: [Interpretation]
23 Q. I have just asked a similar question of Dr. De Grave, and he
24 explained that the reason that you mentioned -- trauma-related changes
25 used to be explained this way, and that is an older opinion, superceded by
1 modern medicine, which now omits this particular type of origin. Do you
2 agree with this?
3 A. No. I must say at the outset that I disagree, for the simple
4 reason that this literature is about pathology, by Anderson, although this
5 is a 1974 edition or a reprint. It does not exclude trauma as a possible
6 cause of cystic changes, whereas urological literature, that is, clinical
7 literature, absolutely confirms this. And the literature available to my
8 profession definitely accepts this, and regardless of the advances made in
9 technology, which help us make distinctions in making diagnoses, we cannot
10 exclude this type of cause. So this particular change can be caused
11 either by disease or by trauma.
12 Q. My next question to you, Professor Dunjic, would be as follows:
13 You have read, and you know what the accused Zoran Vukovic had stated
14 about the way he incurred this injury.
15 A. Yes. I am familiar with that, with both what I've read and what
16 Mr. Vukovic himself told us while we were doing the examination.
17 Q. In this way of incurring the injury, when he fell on a rock or a
18 stump while he was dressed in a uniform, could there be any scars,
19 deformities, or is it possible that such an injury would not lead to
20 external injuries, only internal ones, if I put it precisely enough?
21 A. Yes. An injury to the scrotal region could involve open injuries
22 and different ones, and then on the skin of the scrotum we could see scars
23 or other changes, such as wounds, if there had been wounds. We would see
24 scars even after an extended period of time. If there are no scars, that
25 doesn't mean that there had been no injury, because there are dull
1 injuries through clothing, et cetera. Then occur injuries to internal
2 structures without changes in the skin. A simplest example, if I should
3 now hurt my arm through the clothing, I would get a haematoma without any
4 external changes on the skin. There would be no external injury. The
5 same goes for the scrotal region, and an impact, especially through
6 clothing, would cause a haematoma and an increased amount of liquid,
7 et cetera, without leaving any trace on the skin. That means that a
8 negative finding on the skin of the scrotal region can absolutely not rule
9 out a blunt blow.
10 Q. My next question: For an epididymal cyst to be developed through
11 a trauma, would it be necessary for a strong blow to be suffered?
12 A. If we proceed from the premise that the epididymal cyst occurred
13 in this area, we can only guess as to the intensity of the impact, meaning
14 that if the impact was stronger and there was a great outflow of liquid in
15 the structures of the scrotum, then the probability is higher that such
16 changes would leave residue in the form of cystic changes, that is, the
17 intensity of the impact or force and the injured structures of the scrotum
18 are the factors which condition the consequences, either in the form of
19 inflammation or any other changes .
20 Q. What I would like to know is whether the description of events, as
21 given by the accused, Zoran Vukovic, fall, pain, loss of consciousness,
22 would that be consistent in the most general terms with the medical
23 picture of development of such a cyst?
24 A. I must here behave as a forensic expert and a physician, which
25 means that when I hear a statement, regardless of the source, and when I
1 hear in that statement certain parts referring to a clinical picture, I
2 have to think about it. I heard that there had been an injury. That can
3 be accepted or not. But one part of the statement which refers to
4 fainting, loss of consciousness, awakening after a certain time, which the
5 person cannot determine, that part of the statement can be given only by a
6 person who has suffered this himself or who is very familiar with it. It
7 cannot be read or studied. Because such injuries of the scrotal area are
8 injuries, and this has been described in literature, can lead to strong
9 pain, shock, and there have even been described cases where reflexive
10 heart arrests occurred.
11 Please leave the literature aside. I just wanted to mention that
12 it is very important to know that this set of symptoms, this clinical
13 picture, is absolutely consistent with the previous description, statement
14 about the injuries. It had to be an injury, that is, an injury to the
15 testes. Of what intensity and how it occurred is a different matter, but
16 what is important is that this set of symptoms is consistent with an
18 Q. My next question would be, if you conduct an examination eight
19 years later and you receive the report of an echography noting the
20 presence of an epididymical cyst, is it possible for us to expect with a
21 great degree of certainty that in addition to that cyst, there are certain
22 other changes on the testicles, the scrotum, or it can exist in itself and
23 testified to the fact that something had occurred after a number of years?
24 A. Even a cyst does not necessarily remain after such an injury.
25 Nothing may be found at all. So if we have a cystic change in the
1 epidermis or the epididymis that indirectly points to a possible previous
2 trauma, those other consequences which occur immediately after the injury
3 such as the increased outflow of serous liquid or blood disappear in time
4 and may leave no trace at all, unless there had been serious blood clots.
5 That is also optional, but they are usually caused by some other
6 reabsorption cysts. That's why I had mentioned the way those cysts
8 Q. I must now ask you to give us your comment. A little while ago
9 while Dr. De Grave was giving us his explanations, he said that the person
10 who had suffered such an injury, he said that such an injury is terrible
11 to see and that there is black swelling covering the entire area, the
12 bottom, the back side of the thighs. Could you give us your comment to
14 A. This black colouring, and I suppose that my colleague Dr. De Grave
15 meant a haemorrhage, can exist in that area if it has been injured as
16 well. That means that if in addition to the scrotum the area surrounding
17 the scrotum, the inner part of the thighs, the perineum, and even the rear
18 area, the seat, had been injured as well, then this can be the case. But
19 if only the scrotal part is injured, the haematoma will not spread to the
20 backside or the thighs. It will only spread along those areas which are
21 accessible to it which is the groin, in the upper part of the scrotum, for
22 instance, and the epididymis.
23 Q. I just wish to say that the accused Zoran Vukovic had not stated
24 that -- I just wish to clarify that Mr. Vukovic did not claim he injured
25 any other part except the scrotum.
1 A. No.
2 Q. I asked Dr. De Grave one question which I will ask of you as well,
3 and I will ask for your comment. It refers to a part of the final
4 conclusion by Dr. De Grave, paragraph D, and I will read it, it's only one
5 sentence, where he says that, "There are no indication of temporary
6 inability or impotence in the past."
7 I would be grateful for your comment, first of all, as to whether
8 it is possible for the medical science to determine the existence of a
9 temporary impotence or inability eight years ago, that would be my first
10 question; so, is it possible as well. And when you answer that, I would
11 ask you another question.
12 A. I cannot say anything precise or definitive in answer to your
13 question. The point is that medicine may or may not be able to answer a
14 question regarding temporary impotence.
15 Q. Excuse me, I wish to make my question more precise. Based on the
16 information available to you and Dr. De Grave, were you able to conclude
17 whether or not this temporary impotence existed just on the basis of the
18 information you had?
19 A. No, I wasn't able to.
20 Q. And that leads me to my next question which I had also asked of
21 Dr. De Grave, and he agreed with me that there are three possible causes
22 of cystic changes. If there is a disease which eventually causes an
23 epididymical cyst, my question would be in that acute period, which I
24 really don't know how long it can take, can the disease and can these
25 changes lead to temporary impotence?
13 Blank page inserted to ensure pagination corresponds between the English
14 and French transcripts.
1 A. I must say that this is absolutely the case. In other words, it
2 is absolutely possible, regardless of the origin and cause of a cyst, be
3 it an inflammation or an injury.
4 Let's start with an inflammation. The changes in the case of an
5 inflammation of an epididymis are such, and they are never isolated or
6 strictly localised, they extend to all structures. And since there is a
7 knot of nerves there and very good vascularisation, changes are diffusive
8 and spread to the entire area, and that's why they are very painful, just
9 as in a case of trauma. Therefore, any erection is impossible due to pain
10 because pain itself through another mechanism paralyses desire, even if
11 desire exists, and makes erection is impossible. That is, that pain is
12 due to inflammation and the swelling no matter what the cause of the
13 swelling is because all these structures are involved.
14 Q. And finally, I would appreciate your opinion and comment on the
15 segment of Dr. De Grave's report, we are discussing the same part of his
16 report as before, where he says that the statement of Mr. Vukovic about
17 the way the injury had occurred is fundamentally inconsistent or
18 incompatible and even fictitious. Can you comment on that?
19 JUDGE MUMBA: No, you cannot comment on that. That is [transcript
20 read in error is "not"] the opinion of Dr. De Grave.
21 JUDGE HUNT: You can ask him whether it was his opinion, but not
22 whether or not it was open to Dr. De Grave.
23 MR. JOVANOVIC: [Interpretation] I truly apologise. I formulated
24 my question in a completely wrong way.
25 Q. Please tell us your opinion. Is the statement of the accused
1 Vukovic about the circumstances of his injury and the consequences
2 inconsistent and even fictitious?
3 A. I cannot accept that this injury had never occurred. In other
4 words, what I have heard is one thing. What I have found, and that is
5 increased painful sensitivity in the area of the right testicle as well as
6 the cystic formation which could be -- could have been caused by a trauma,
7 and the most important part of Mr. Vukovic's statement, the one I had
8 quoted, and that is a layman cannot know these -- this set of symptoms
9 unless he had indeed suffered from them. So I don't think it's
10 fictitious; I don't think this injury had never occurred. Those are four
11 factors which I as a forensic expert absolutely must take into account,
12 and that is why in my latest report I mentioned precisely those four
14 What I am sure of, at least what I know with a great degree of
15 certainty, is that there is a cystic change, and it is related to that
16 trauma. And there is only one element missing, and that regards the
17 period when he arrived at the hospital. That's what's missing, what I
18 would like to know as a forensic expert. But that missing part would have
19 been the link between what I know about the injury and what I have
20 detected myself.
21 His statement referring to the clinical picture and the part which
22 I found through examination of only one testicle and the segment which
23 says that there has -- that there is a symptom which could have been
24 caused by injury, all of this led me to write that trauma cannot be ruled
25 out as the cause of the cyst.
1 Q. Thank you, Professor Dunjic.
2 JUDGE MUMBA: In my intervention, I didn't say that "is not" the
3 opinion, I said that "is" the opinion of Dr. De Grave, so I just wanted to
4 correct it on the script.
5 You can proceed.
6 MR. JOVANOVIC: [Interpretation] Thank you, Your Honour. Those
7 were all my questions. If you allow me just a minute to consult with my
9 Thank you, Your Honour. We have -- the Defence has completed its
10 questioning of this witness.
11 JUDGE MUMBA: Any questions by the Prosecution?
12 MS. KUO: Yes, Your Honour.
13 Cross-examined by Ms. Kuo:
14 Q. Good afternoon, Dr. Dunjic.
15 A. Good afternoon.
16 Q. At the end of your testimony you mentioned that there were four
17 factors that led you to believe that the trauma to Zoran Vukovic could
18 have occurred in the way he described. You said there were four, right?
19 A. Yes.
20 Q. I may have misheard. I counted three, and I believe that they
21 were the existence of the epididymical cyst, the increased painful
22 sensitivity to the right testicle, and the description of the fainting.
23 What is the fourth one? I perhaps missed it.
24 A. I mentioned those three. The case history as the whole --
25 surrounding the whole event as the fourth segment, the finding, and the
1 continuation of the symptoms that occurred. I did not wish to elaborate
2 on the continuation of the symptoms, the continuity that indicate an
3 injury, symptoms from that, let us call it, critical event up until the
4 medical examination itself; in the course of the examination, what was
5 said about the stabbing pains that were experienced, pain in the scrotal
6 region, and the inability to have normal sexual intercourse from time to
7 time. So those are the case histories, the symptoms, the clinical
8 picture, the echography, my own findings, et cetera. All that together.
9 Q. Very well, Dr. Dunjic, let's take those four items. First of all,
10 the case history that you mentioned, that is completely dependent on the
11 truthfulness or untruthfulness of the person giving you the description,
12 isn't that right? And you cannot comment on that, can you, as a doctor?
13 A. Quite so. As an expert witness, I have to look at the anamnestic
14 data, the whole of them, and I use this data as a pointer, which direction
15 to take. But as an expert witness and as a physician as well, they allow
16 me to evaluate and assess whether the individual that has been examined is
17 telling the truth or not.
18 And I should like to ask you if you remember the previous trial
19 that I attended. As an expert witness at the time, I gave my opinion and
20 I presented the doctrinaire position of forensic medicine in the world,
21 and that is that in all situations the like this one in rape crimes, that
22 the victim be examined and the perpetrator be examined as well. And it is
23 one of the tasks of us forensic experts is that in that realm, that is to
24 say, to establish and to see whether the case history and anamnestic data
25 are truthful or not. I have to have them at the back of my mind
1 somewhere. They don't have to be in the forefront. But if the symptoms
2 fit into place, fit into a general picture, then I must accept them. If
3 he says that there was severe pain and that he lost consciousness, then
4 that is capital piece of information for me as a forensic expert. Now, I
5 have to see whether there are changes consistent with that or not, and it
6 is within the frameworks of those factors that I arrive at my opinion and
7 state it.
8 Q. Dr. Dunjic, if the person telling you or giving the description of
9 what occurred were lying -- I'm just posing that to you
10 hypothetically -- if the person were lying, then that piece of information
11 is not scientific proof of your conclusion; right? Then that basis for
12 your conclusion contains a flaw; correct? I'm not asking you to comment
13 in this particular case; I'm posing it to you hypothetically. Isn't that
15 A. Absolutely. And let me tell you the following, in very precise
16 terms. He says there was an injury, an injury to the hand, he had
17 such-and-such symptoms, someone, some hypothetical person. The symptoms
18 were a series of them. When giving my opinion after an examination, I
19 will state the following: There are no characteristics of an injury, and
20 by writing down that sentence which represents my opinion, I have
21 overridden what he has said, and in that way I refute a false anamnesis or
22 case history. And on the basis of what he says, of the symptoms he gives,
23 I see whether they correspond to that particular injury or not, and that's
24 what we do in our work. So I don't say whether he's telling the truth or
25 not. In my opinion, I -- in fact, I conceive my opinion on the basis of
1 the factual situation. And I say there are -- those symptoms don't
2 exist. He says, "I can't feel the fingers of my hand," "My hand goes
3 numb." We test him and see whether his hand is in fact numb and we say it
4 does exist or does not exist. But of course it is up to you, the Court,
5 to interpret it in the correct fashion.
6 Q. Thank you, Dr. Dunjic. Let's take another one of your four bases,
7 and that is the increased painful sensitivity in the right testicle. Now,
8 pain is a subjective matter; right? If someone feels pain, you only know
9 it if the person tells you he feels pain?
10 A. Yes. Pain is a subjective factor. That is a fact. That is so.
11 However, there are ways and means of studying and testing that, and those
12 ways and means of investigation and testing I apply during my
13 examination. That is to say, the person being examined shows certain
14 signs of painful sensitivity. I know that the testicles are very
15 sensitive and can be painful to the touch, and everybody knows that. But
16 if this is done in an interval of time and in the way in which I performed
17 this examination, with pauses in between -- and of course the patient is
18 not aware of this. He is not aware of what I am actually doing during the
19 examination -- I can clearly see that in a segment when -- that it is
20 either sensitive to the touch and that this is expressed in a grimace on
21 the face or in a body convulsion. So that when I touch a particular area
22 and I note that there is pain, then I noted this down. And I asked
23 Dr. De Grave, and he agreed that it was necessary to undertake the
24 echography as a test after that type of clinical finding.
25 Q. And therefore, as a result of your testing of the pain, the pain
1 that Zoran Vukovic was indicating to you, that was not conclusive and you
2 required a further test; right? Before I move on --
3 A. Yes.
4 Q. -- to the echography, I'd like to ask you about the fainting.
5 Isn't it true that if someone faints and you see that person faint, that
6 is an observable symptom? You can see somebody faint; right?
7 A. Yes. Yes, that's right. Yes.
8 Q. So if someone --
9 A. But -- and I do apologise for interrupting. I have just
10 remembered one thing. You lose consciousness. A man loses consciousness
11 and he says, for example -- the person who has lost consciousness says, "I
12 don't know what happened. I just remember being slapped in the face or
13 water poured over me, people standing over me." If the person says that,
14 then that is a form of amnesia for a certain period of time, and that in
15 fact confirms that he did actually lose consciousness, because he doesn't
16 know that. I am able to say that, but an ordinary man won't say that. He
17 knows what happened before and he knows what happens after, but doesn't
18 know what happened in between, and cannot say when he actually lost
19 consciousness, when it took place. He can say, "Well, it can happen two
20 hours ago," and that is amnesia, and we deduce from that that the
21 individual really did lose consciousness. And with injuries to the body
22 or the extremities, people can lose consciousness for a shorter or longer
23 period of time.
24 Q. Let's shift the focus in that situation away from the person
25 actually losing consciousness to an observer. Somebody who watches
1 another person fall down, have this very traumatic injury and lose
2 consciousness, would be able to describe to you the accident and the fact
3 that that person lost consciousness, wouldn't he? These are clearly
4 observable actions?
5 A. Yes, yes.
6 Q. Now let me move on to the echography. Can you describe exactly
7 what the echography does? As a layperson, I'm not completely sure. It's
8 an instrument that is measuring or allowing a technician to observe
9 things, internal injuries or symptoms; right?
10 A. Yes. It is a special device with a probe. It has a probe, and
11 you move the probe over a certain part of the body, and you have a screen
12 on which you can follow the structure that exists in that part of the
13 body. And on the basis of the structure, that is to say, the picture you
14 get on the screen, you are able to see whether changes have occurred and
15 what kind of changes, where they are localised, and so on and so forth.
16 Q. So the probe is actually applied to the outside of the body, to
17 the skin; right?
18 A. Yes. It is passed across certain areas of the body, depending on
19 what you're examining. A substance is placed on the skin so that the
20 probe can adhere better to the skin and to give you a clearer picture on
21 the screen.
22 Q. Now, one of your criticisms of the echography report was that it
23 failed to examine the scrotum; right? The report simply says "testes,"
24 but not "scrotum," and you think therefore it is incomplete?
25 A. My criticism referred to the fact that there had been no
1 examination of the overall region of the scrotum: both testes, all the
2 outer layers, the epididymis, left and right. That is to say, in what has
3 been written, I cannot see that that was done, that that was what was
4 done, and my criticism refers to that. If the report had stated "the left
5 testis normal, right testis normal, the over layers or epididymis is
6 normal, left and right," then I would be able to make my conclusions. The
7 doctor who wrote the findings wrote the conclusions, the diagnosis, from
8 which you can see that the other part of the job has not been done and
9 that attention has not been paid to the other elements that can be seen in
10 an echography.
11 Q. So your criticism is not that the scrotum itself was not examined,
12 because in fact the scrotum is the outer layer, the skin that encloses the
13 testicle, but your criticism is the left-hand side was not examined and
14 only the right-hand side; is that right?
15 A. Well, it relates to the whole region, all its segments, not only
16 the left testicle, but all the structures on the left side as well as all
17 the structures on the right-hand side. He describes the right testis and
18 the cyst. Let us say epididymal. But he says nothing about the structure
19 of the outer layer of the right testis. And the fluid that is mentioned
20 is not -- he does not describe where it is located, whether it is the
21 normal fluid in between the testis and epididymis or in the cystic
22 formation which he detected. And my criticism is that he did not describe
23 those points. Even the cyst has not been described according to the
24 rules, that is to say, how it should be described. It just gives its
25 size. Apart from size, it states nothing. So those are all my criticisms
1 with respect to the finding.
2 Q. Whether or not there was liquid in the cyst doesn't make a
3 difference, does it, in this kind of cyst?
4 A. It does. It makes a great difference, because depending on the
5 contents in the cyst, we are able to arrive at the conclusion indirectly
6 of its origin.
7 Q. And if there were liquid inside the cyst, what could you say about
8 its origin?
9 A. What kind of liquid? Is it a serous content or haemorrhagic, that
10 is to say, blood? Or inflammatory, that is to say, pus.
11 Q. And what if this trace of fluid were actually the residue of
12 inactive spermatozoa?
13 A. Spermatozoa. Well, I don't know that. I don't know whether they
14 exist, because they have not been described. They can exist in the outer
15 layers, in the capsules, or in the cystic formation, but I don't know
16 where they are, where they're located. This does not exclude a trauma
17 origin or a disease origin, the presence of that particular fluid.
18 Q. The person who prepares this echography report is really a
19 technician, a person who is simply observing what he or she sees and then
20 relaying it to the doctors, you and Dr. De Grave, to make the medical
21 conclusions; isn't that right? This is really like an eyewitness giving
22 you his or her testimony of what he or she sees; isn't that right?
23 A. That is why I am all the more surprised, absolutely surprised,
24 because then the technician has given himself the right to make medical
25 diagnoses which are incompatible with his profession of technician. And
1 if he says there are no post-traumatic injuries, he has made a
2 medical -- a diagnosis, and in my opinion, it is not up to him to do
4 I insisted being present when that was done. I insisted that it
5 be undertaken by a physician, because in our country it is doctors who do
6 the echography and interpret the findings, and I thought that I would be
7 there on that particular day, on the 4th of October. I thought that
8 everything had been organised in that way, and I was extremely surprised
9 that I was just called upon to perform the medical examination and not the
10 echography, because I wanted to take the finding and to consult people
11 whose job it is to do that. And in my country it is only physicians who
12 are allowed to do echographies. I am astounded that a technician does it
13 here and is able to make a finding of this kind. So I don't want to
14 comment at all, because then the question arises as to the truthfulness of
15 everything, the whole procedure.
16 Q. Are you questioning the truthfulness of the technician who
17 produced that report? Is that what you're saying?
18 A. Well, you've taken me by surprise now with what you have just
19 said, with the statement you have just made. I really have to give the
20 matter a lot of thought. As a physician, as a physician and expert called
21 upon to give my opinion, I have to see who is finding this, and I don't
22 know whether Dr. De Grave was aware of the fact that a technician had done
23 the work. I doubt that my colleague, Dr. De Grave, would have made any
24 comment had he known that the echography had been performed by a
25 technician. Let me tell you that in my country a technician takes x-rays
1 and gives the findings to the doctor to comment. This is a very dangerous
2 situation and is incompatible with the work to be done. In my country it
3 is unheard of, if you want to ascertain the truth.
4 MS. KUO: Your Honours, I see it's 1.00. I have only one more
5 question. I don't know if we wish to take a break or --
6 JUDGE MUMBA: I see Mr. Jovanovic on his feet.
7 MR. JOVANOVIC: [Interpretation] Yes, Your Honour, if I may be of
8 assistance. I have made some investigations, and according to what I've
9 been told, the person that carried out this echography is a physician and
10 was not just a technician trained to work with the device, just to assist
11 you in this discussion.
12 As far as I know, that individual is indeed a physician attached
13 to the hospital, attached to the detention centre in The Hague. He is an
15 JUDGE MUMBA: Thank you.
16 [Trial Chamber confers with registrar]
17 JUDGE MUMBA: I understand there's information from the registrar
18 who is responsible for supervising the whole thing as to who conducted the
19 echo tests.
20 THE REGISTRAR: [Interpretation] It was confirmed to the registry
21 by the head of the detention centre that the echography was conducted by a
22 doctor, Dr. Aarts, A-a-r-t-s.
23 JUDGE MUMBA: Thank you. I just want to find out from the
24 interpreters. I hear we have one question. Let me ask the interpreters,
25 can we maybe have five, ten minutes?
1 THE INTERPRETER: Yes, Your Honour.
2 JUDGE MUMBA: Thank you.
3 You can proceed.
4 MS. KUO:
5 Q. Dr. Dunjic, you have not -- you do not have scientific evidence
6 that would prove to a reasonable degree of scientific certainty, do you,
7 that in fact the injury which Zoran Vukovic claims occurred to him in fact
8 did occur to him in the way he describes it? There is no scientific
9 evidence that proves definitively that that happened; right?
10 A. There is, there is. Scientific evidence is the echography
11 finding, and now we hear that it was indeed an M.D. who performed it,
12 which means that a cyst did exist. That is scientific evidence.
13 Scientific evidence is that I am a professor and that I conducted the
14 examination and noted sensitivity to pain. That is scientific evidence as
15 well. Scientific evidence is the literature which explains how cysts
16 occur and the types of cysts that exist. That is scientific evidence
18 Now, whether you're going to accept my opinion or not, that is
19 quite another matter. But I must base my opinion on those facts, and they
20 are undoubtedly scientifically established, and that is what science today
21 knows. Cyst, what type of cyst? Painful sensitivity, how that is tested,
22 that exists, too. Echography conducted, accepted in medicine as a
23 diagnostic instrument to indicate whether something or not exists. That
24 is scientific again.
25 Q. I'm sorry to ask a follow-up question to this, but the best that
1 you can do with the evidence you have before you is to say you cannot
2 exclude the possibility that it occurred, but you cannot affirmatively,
3 positively say in fact that this occurred, can you, based on the
4 scientific evidence?
5 A. On the basis of everything that I have said so far, I cannot say
6 with absolute certainty that there was an injury. But I, on the basis of
7 everything that has been said and that has been found, absolutely cannot
8 exclude the fact that trauma did not exist.
9 Q. Thank you.
10 MS. KUO: That's all my questions.
11 JUDGE MUMBA: Any re-examination?
12 MR. JOVANOVIC: [Interpretation] No, Your Honour. Thank you.
13 JUDGE MUMBA: Thank you very much, Dr. Dunjic. You've been very
14 helpful for giving evidence to the Tribunal. Thank you.
15 THE WITNESS: [Interpretation] I thank you, too, and I apologise
16 if I was a little lengthy.
17 JUDGE MUMBA: I think it was necessary. We adjourn until the --
18 let me check, yes, the 20th of November, I think, when we shall have the
19 closing arguments.
20 --- Whereupon the hearing adjourned at 1:03 p.m., to
21 be reconvened on Monday, the 20th day of November,
22 2000, at 9:30 a.m.
13 Blank page inserted to ensure pagination corresponds between the English
14 and French transcripts.