Dr. Aazam's report on Zahra Kazemi:

Dr. Shahram Aazam, Staff Physician of Security forces, in December 28,2002 was referred to work in Baghiatolah hospital as an Emergency physician. (ref # k/612/80/216/23). I started to work on January 21,2003.

In the first night of Ms. Zahra Kazemi hospitalization, I was the emergency night doctor on duty. My presence that night is documented in the nursing report dated  July 26, 2003.
and numbered J-00-D-75. 

In view of Ms. Zahra Kazemi’s inhuman treatment and considering the Islamic Republic  authorities’ efforts to swiftly bury her to conceal the evidence of torturing her and considering that I had been the staff doctor on duty resident physician on June 26, 2003  and that  I was her examining physician at the hospital, I consider it my moral and human duty to give  testimony and pronounce my observations to international human rights organisations in regards to  injuries inflicted on her due to torture, assault and battery and, in this regard, play a small role in  exposing the inhuman nature and rapacity of the Islamic regime. Therefore, I implore all free-thinkers who are active in connection with Ms. Ziba Kazemi to  assist me in presenting my testimony and keeping this case alive until it reaches the desirable  conclusion, which is the condemnation of the suppressive regime of the Islamic Republic.  Therefore, I submit a summary of Ms. Zahra Kazemi’s clinical file including her clinical assessment when hospitalized and the medical treatment she received during the seven hours of  her first night of hospitalization.

Clinical report

The patient is a 54 year old female.
C.C : The main complaint is vomiting blood following nose bleed. 
P.I. : according to those accompanying the patient and the referral sheet from the prison’s clinic, patient  vomited following a nose bleed and has had altered level of consciousness for some hours.
clinical examination:  patient is in a coma and responds only to painful stimulation.
head and neck: Ecchymosis  in the right frontal and temporal areas resulting from blow.   left occipital*  inflammation and fluctuating hematoma.
The Nose Bone is fractured. Ecchmosis around the nostril bone and Orbital rim. Watery  Bloody discharges from nostril. Evidence of Epistaxis (nose bleed).

eyes: pupils in normal state with normal reflex to light. In funduscopic [opthalmoscopic]  examination edema is observed due to rise of cerebral spinal fluid pressure.

ears: Ecchymosis in the area of temporal extending to the ear canal, causing the narrowing of the  canal during examination as well as difficulties when examining the tympanum  [eardrum] The  left tympanum is normal but the right tympanum in the upper section is completely  fragmented/crushed. The small bones are exposed.
neck: deep parallel linear abrasions, three lines observed in the back of the neck.   In examination of the neck vertebra no injuries are seen.

Chest:  expansion of lungs is asymmetric. Ecchymosis and crepitation [crackling] of the joints of/in the  chondro-ribal in the area of the fifth and seventh ribs   may indicate possibility of fracture.  Ecchymosis and several linear strip-like wounds in the back.   In listening to the lungs no pathological injuries are observed.   In listening to the heart, rhythm is sinusoidal and there is no soufflé [murmur] or extra sounds.

abdomen: in examination, abdomen is soft and there is no mass.  liver is felt 2.5 cm below the edge of the ribs.   Ecchymosis in the left lower quarter.

pelvic and genitals: in the pubic area extensive ecchymosis spreading to the thigh and groin.   when the nurse did the Catheterization trauma in genitals was reported.

in the back, in the area of the buttocks and sacrum ecchymosis measuring 7.5 cm diagonally.

extremities: in the upper extremities extensive ecchymosis in the back of the right arm up to the  near of the shoulder,  fractured second and third phalanges of the right little and middle fingers.
ecchymosis of the back of the left forearm up to the wrist                                                                                                                                                              
the last phalange of the left middle finger is fractured.   broken nails of the left index finger and thumb.

lower extremities: Ecchymosis is present on the groin of the left thigh extending to the anterior  of the thigh.  Swelling of the right knee-joint and ecchymosis behind the knee.  crushed and fractured right big toe and nail   left third and fourth toes and nails are fractured  ecchymosis of both soles of the feet
ecchymosis and linear wounds measuring 7-9 cms in length in the back of the forelegs (right  three lines and left five lines)
neurological examination:  intensified tendon reflexes

prescribed treatment:   NGT  placement for stomach cleaning was difficult due to the fractured nose.   The aspirate contained no blood probably indicating that the bloody vomit was due to the blood  swallowed from the epistaxis.

at 2:30 patient was moved to the relevant unit to be scanned. The obtained scan showed a  fracture of the skull as well as a severe right temporal cerebral hemaetoma, contusion and  swelling resulting in ventricular compression of the right side.

consultation with neurosurgeon: Mr. Ahmad Sadidi visited the patient at 3:25. Based on the  neurosurgeon's diagnosis sub-arachnoid hemorrhage with severe brain edema caused by trauma.  Dexsamethasone  for injection and Mannitol serum was  prescribed. 

At the end of my shift at 6:45 the patient's general condition was the same but coma was  deepened and patient was not at all responding to painful stimulation.

at 10:30 of June 27 2003  patient had a pulmonary arrest and required the aid of a life support  and therefore was transferred to the intensive care unit.

At 13:00  brain death was confirmed.
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A hematoma, or haematoma, is a collection of blood generally result of hemorrhage, hematomas exist as bruises  (ecchymosis), but can also develop in organs.

A nosebleed, medically known as epistaxis, is a relatively common affliction wherein there is hemorrhage from the  nose usually noticed when it drains out through the nostrils.

naso-gastric tube is a plastic tube, inserted into a nostril through the nose, into the throat, down the oesophagus and  into the stomach.

The occipital bone is a bone situated at the back and lower part of the cranium