Medical Examiner’s Report in Alex Nieto Case Details 10+ Gunshot Wounds, Mental Health History, Taser Discharge


After a long and disgraceful delay, the San Francisco Medical Examiner’s office finally released its report on the March 21 officer-involved shooting death of Bernal resident Alex Nieto on Bernal Hill.  Yet in the style of a politician or corporate bigwig who seeks to disclose information while blunting its impact, the medical examiner’s report in the Nieto case was released on Friday — just as San Francisco headed into the low-attention weekend.

So now, on a paying-attention Tuesday, let’s consider what the report says, and what it might tell us about the case of Neighbor Alex Nieto.

If you’re a primary-source kind of person who wants to read the medical examiner’s report in unfiltered form, you can find the full text of the report right here (courtesy of KQED).

If you want the digest, we’ll share the SF Appeal’s version, which highlights both Nieto’s injuries and the section of the report detailing his mental-health history:

The San Francisco medical examiner’s office released a full autopsy report Friday for 28-year-old Alejandro “Alex” Nieto that confirmed he was struck by at least ten bullets when he was fatally shot by police at Bernal Heights Park in March.

Nieto, a San Francisco native who lived on Cortland Avenue in the Bernal Heights neighborhood, was a security guard who attended City College of San Francisco. He had aspirations of being a probation officer.

Nieto was killed on March 21 by San Francisco police officers and the autopsy report indicates that Nieto suffered as many as 15 gunshot wounds from as few as ten bullets.

The Nieto family’s lawyer, civil rights attorney John Burris, said Friday that he has never seen an autopsy report that released so much information about the deceased’s alleged history regarding mental health problems and police contact.

The medical examiner’s office notes numerous details in the autopsy report, such as an incident in 2011 in which Nieto was not taking his medication and received 72-hours of involuntary psychiatric treatment after allegedly “attempting to burn his parents’ house down.”

Burris said he was surprised to see that the medical examiner’s office included medical records from San Francisco General Hospital that, according to the autopsy, “revealed a history of aggressive and bizarre behavior, auditory hallucinations,” as well as Nieto’s noncompliance to prescriptions for two atypical anti-psychotic drugs.

The medical examiner’s office reported traces of cannabinoids in Nieto’s system at his time of death and no trace of anti-psychotic medications.

The other item of note in the report is the assertion that Nieto’s pistol-shaped Taser had been discharged at some point during his confrontation with the SFPD. Here’s how that section reads in the report’s case history:


Justice for Alex Nieto, the committee formed by Alex’s family and friends in response to his death, has published a lengthy response to the medical examiner’s report that seeks to refute many of its key assertions. Here’s an excerpt:

There is no reason or authority for the Medical Examiner to act as a police detective investigating any possible rationale for anything that happened on Bernal Heights on Friday, March 21. Their job is simply to conduct an examination of the body and notify the public of the medical examination concerning the cause of death. The San Francisco Medical Examiner is not a detective agency; if they were, then they should also be investigating the background and disciplinary records of the police officers who killed Alex Nieto, yet we still do not even have those officers’ names. The San Francisco Medical Examiner is supposed to be unbiased and transparent in safeguarding the public good, yet here they are obviously attempting to besmirch the character of Alex Nieto, even though that is not their job.

The report also claims that Alex brandished his taser, yet it is not the medical examiner’s job to make any determinations on possible brandishing of tasers. In an unbiased manner, they are simply supposed to determine cause of death. Their statement about brandishing obviously shows that they are using the police account as fact, which is not part of the medical examiner’s job.

The long-awaited release of the medical examiner’s report is an important milestone in the Nieto case, because it’s first time in almost six months that new information about the shooting has been officially released. Moreover, the medical examiner’s report plays an important role in the parallel (but opaque) investigations underway to ascertain if officers acted legally when Nieto was shot on March 21.

The investigation process as a whole is slow, cumbersome, secretive, and far from ideal. Unfortunately, it’s also the only process we currently have.

PHOTO: Telstar Logistics

20 thoughts on “Medical Examiner’s Report in Alex Nieto Case Details 10+ Gunshot Wounds, Mental Health History, Taser Discharge

  1. “The San Francisco Medical Examiner is not a detective agency”

    Nonsense. The medical examiner *investigates* causes of death, it does not simply report the cause of death.

  2. “The report also claims that Alex brandished his taser”

    Is makes no such claim. It simply says there were *reports* that Nieto brandished a taser.

    “The subject reportedly brandished and discharged…”

  3. From the police perspective: (1) They went to the scene because the dispatcher said that there were reports of a man threatening people with a gun; (2) when they arrived at the scene people said that there was a man with a gun and pointed out where he was; (3) the police likely didn’t know him or his history, but they were required to stop him from using the gun. (4) Given the distance they didn’t know that he was waving a taser, given that the taser looked like a gun from the distance. (5) TV shows are not reality. It is extremely difficult to shoot someone in the leg or arm from a distance; they have to aim for the torso, so every shooting by police is de facto a “shoot to kill”. Forget the days of the Lone Ranger when the TV production code required that the Lone Ranger hit the bad guy in the hand in order to prevent the bad guy from firing. That’s TV; real life doesn’t work that way. (6) If they HAD aimed for a limb instead of his torso, they likely would have missed and angered him enough that he would be inclined to return fire and kill a police officer.

    And remember that there are accounts that the police told him to drop the gun, but he didn’t.

    There is nothing else the police could have done.

      • Danny,
        Defensive firearm training provides for two rounds to the thoracic cavity (chest- center of mass) and if the threat is not subdued one round to the ocular cranial cavity (under forehead and above cheek). If as the allegations provide that Alex did in fact light up the responding officers with a red dot laser which looks like a pistol, no one in their right mind would pussy foot around and waste their own life even contemplating a hand, arm or leg shot but to imediately neutralize the threat.

      • robmokry – While your use of technical language is impressive albeit unnerving, it’s totally irrelevant, except to point out maybe that they shot him too many times? 10 shots like that is irresponsible panic when someone is brandishing a yellow taser. And the only way a cop is sitting around “contemplating” a shot is if he’s a poor shooter and hasn’t learned how to manage fear.

      • Yep, and what they conveniently don’t show you in that photo is that on that model there’s a yellow piece of plastic on the front of the “barrel” where the probe discharges. Even if they were staring straight on at the “barrel” of the taser, they would still be seeing yellow.

    • The dispatcher did not say that Alex was “threatening people with a gun.” She reported a code 211, which means “person with a gun.” “He’s got a gun at his hip and is pacing back and forth on the north side of the park near a chain-link fence.” That’s the only behavioral description the dispatcher gives, before she gives a quick physical description.

      There have been reports that Alex pointed his Taser at a dog that startled him, but the dispatcher didn’t mention that, and I don’t see how the police could have known about that within seconds of arriving at the park.

      That said, it’s plausible that Alex’s behavior convinced the police that he was a deadly threat. I think I’d need to see, at minimum, the police and witness statements that were collected that night, before I’d be convinced.

  4. Forget, for a moment, about whether Alex behaved in an unwise manner or not, and what may have caused him to do so. The fact remains that the SFPD killed a man who wasn’t actually carrying a gun, and who wasn’t in a position to kill. Why can’t less lethal but temporarily incapacitating weapons – e.g. plastic bullets – be the first line of defense in more ambiguous situations? There were multiple officers present, and even if he was rightly perceived as threatening, I’m not convinced it was necessary for them all to respond with a storm of lead.

    Individuals who are mentally ill, or even just temporarily emotionally distraught, act out in the presence of police all the time. If we aren’t asking about how we might reform police processes and try to resolve these situations without fatalities, we are failing.

    • Please attend a funeral for a slain police officer and during a quiet moment afterward casually mention your position to some of the officers attending.

      Anyway Nieto was off his meds. How someone with that psych history gets a job where he carries a taser (can be lethal too as the anti-police SJW’s will hesitate to remind us only in this particular case) is probably the biggest question here. Were people so overjoyed to see him land any job at all that they didn’t warn the employer of the risks? Such optimism killed him.

      • “Please attend a funeral for a slain police officer and during a quiet moment afterward casually mention your position to some of the officers attending.”

        Spare me the non sequiturs, please. No officer actually faced serious threat to their life here – and, given just a brief moment to better assess the situation, that could very well have been recognized. This was a failure of protocol, and it’s allowed to happen because of blind appeals to emotion like that.

      • “No officer actually faced serious threat to their life here”

        20/20 hindsight

        “just a brief moment to better assess the situation, that could very well have been recognized”

        20/20 hindsight, during a moment of reflection an innocent person may have been shot (a person brandishing a taser is not “innocent”)

      • “20/20 hindsight”

        The whole point is that a temporarily incapacitating weapon could offer better _foresight_, minus the “death” component.

      • Nothing works with the certainty and speed of bullets. And the police use a lot of them quickly when threatened to gain that certainty. You’re not going to be able to convince them to put their lives on the line betting that someone threatening them won’t succeed in hurting or killing them because there’s a chance it was all an accident. It should be and is a certainty that if you physically threaten the police you’re committing suicide. If you are too mentally unhealthy to survive under those conditions measures should be taken by those who care for you to protect you from yourself.

        If you don’t like that BP, you can be the change you want to see, and apply to the force. Don’t want to deal with all that? Neither do I, and so I’m not telling them how much more dangerous they should make their jobs for the benefit of a couple hundred mental cases a year.

        This is tied into the ridiculous “militarization of the police” complaint. If you give police armor, they are *less* likely to feel a need for lethal force. So if the cops in this case had approached Nieto in a tank, they don’t particularly care if he pulls a weapon on them (as long as it isn’t an antitank weapon…don’t laugh, you can get them at gunshows). But the antipolice SJW is adamantly insisting the police give up tanks after seeing those scurrrrry things on TV a month ago. Same with long guns…who’s going to try anything other than a wannabe martyr?

        People become single-issue whiners when they narcissistically lack the capability of putting themselves in someone else’s shoes and thinking through the parameters of a situation. The SJW algorithm for any situation is to identify who is a member of a demographic perceived as advantaged and to unconditionally support anyone with any complaint against them. It’s tired and tiresome. The police have actually been very good at denying the SJW a truly worthy martyr. Meanwhile it’s the police that are the ones risking their lives to protect members of disadvantaged groups more than anyone.

    • SFPD cannot carry less-than-lethal weapons. Last year they gave up trying to get Tasers. Why? Because the usual San Francisco suspect argued that, if police had tasers, they would be using them principally on homeless, people of color etc etc. These ‘community activists’ proposed a list of restrictions so long that they were practically useless (could not be used on ‘people in crisis’ for instance). So the police gave up.


      So the same community activists complaining about the apparently justified – though sad and unfortunate – killing of this individual are the ones who prevented police from having other tools to potentially resolve these or similar situations without death. Very San Francisco

  5. The movie analogy goes both ways. How many SFPD have been injured on the job in recent years? Killed? Shot at? Tasered? Bah, how many have encountered a suspect with a gun here?

    The answer is very very few, in fact the most recent case on 25th and Florida was friendly fire. These statistics are even relatively low in Oakland. So all of these pseudo justifications about police-shoot-to-kill and suicide-by-cop are misguided – that is not the world we live in (and stop watching so much overstimulation media).

    In fact, it is firefighters who risk their lives and suffer more. And are considerably more heroic and courageous. We cant even get SF police to do foot or even bike patrols here.

    And what is the story with the dog? The owner was presumably there so there should be a good account. Unfortunately dogs here can be a problem. People forget that they are wild animals at heart and often can’t be compeletly controlled. In fact, often the owners seem to have no issue with their pet being a wild animal momentarily – I mean they’re only a DOG after all. How many people get injured by dogs? Many more than police injured in the line of duty. I’ve witnessed many compeletly unprovoked bite victims at local ERs and then there was the kid on the block last week. Those dogs are still around as if nothing has happened… An apology doesn’t really cut it if you’re getting stitches and a rabies shots. And for a kid this could mean a lifetime fear of the hounds …

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