Oscar Pistorius repeatedly vomited, retched and sobbed through the sixth day of his murder trial as a forensic pathologist revealed the bullets the Olympian used to shoot his girlfriend were designed to cause “maximum damage” to human tissue.
Professor Gert Saayman, who conducted the autopsy on Ms Steenkamp, told the court the model died as a result of multiple gunshot wounds, with three bullets striking her hip, upper arm and her head.
But while there is expected to be some dispute as to the order in which the bullets struck Ms Steenkamp, the professor said at least two of the three wounds could have proved fatal on their own.
Her right upper arm was shattered, the hip wound could likely have killed her very quickly and the head wound would have incapacitated her immediately, he said.
A lack of blood in her airways indicated Ms Steenkamp had probably only taken a few breaths before she succumbed to the head wound, the pathologist said.
Pistorius loudly retched and his body appeared to shake as Professor Saayman clinically described how a bullet entered Steenkamp’s head, fragmenting and exiting her skull in two places.
Throughout his evidence, the athlete known as the Blade Runner sat doubled over in the dock with his hands covering his ears, fingers laced behind his head.
He sobbed and retched intermittently, prompting trial judge Thokozile Masipa to twice interrupt the evidence, seeking assurances from Pistorius’ barrister Barry Roux that the accused was fit to continue.
“He is very emotional, it is not going to change,” Mr Roux said. He consulted his client, but told the court Pistorius was adamant the evidence “must proceed”.
Pistorius wasn’t the only distraught person in the court on Monday. A close family friend of Ms Steenkamp’s, Desiree Myers, also sat with her head down and was comforted by two others. Reeva’s mother June Steenkamp was not in court.
Professor Saayman said the bullets used by Pistorius are known as Black Talon or Ranger bullets, ammunition designed to “mushroom” and disintegrate on impact with human tissue.
He said even doctors and surgeons were warned to be careful when removing the tiny fragments from a wound because they can cut the skin.
Winchester, who manufactured Black Talon ammunition, ceased all production of the bullets in 2000 but the company's Ranger line is very similar in design. Both are banned in many countries.
In other evidence, Professor Saayman told the court an examination of the deceased’s stomach also indicated she had eaten not long before her death, estimating she ingested some food about two hours prior.
His testimony on that point is not consistent with the version provided by Pistorius, who has claimed the pair went to bed at about 10pm, only to be woken by a noise he believed was a burglar at about 3am.
Mr Roux is likely to query that testimony when his cross-examination begins on Tuesday morning.
The pathologist explained that the model and TV star was wearing grey Nike shorts and a sleeveless black vest at the time of her death.
There was a small, 5mm hole in the shorts, consistent with the bullet wound in her hip.
He also said Ms Steenkamp had some other bruising to her body, but they were a number of other bruises detected on her body but were not a result of the shooting.
Prior to the pathologist’s evidence, he had requested his evidence not be broadcast live given the graphic nature of what he would say.
In an application supported by both prosecutor Gerrie Nel and Mr Roux, Professor Saayman said he believed the deceased’s dignity should be protected by the court, and was concerned “vulnerable” and sensitive people, including children, could inadvertently hear his incredibly graphic evidence.
Judge Masipa granted the application, severing the live television and radio feed and ruling there be no “live tweeting” of the evidence on Twitter.
After much confusion, she later said: “I hope it’s clear - the press can go and do their work, but it's not supposed to be 'live'. You can paraphrase, you can summarise; that is allowed.”
Pistorius has pleaded not guilty to premeditated murder, saying he thought he was shooting an intruder.
The internationally acclaimed athlete, who had his lower legs amputated as a baby, runs on carbon fibre prosthetic blades. He became the first disabled athlete to run against able-bodied competitors, reaching the semi-final of the 400 metres at the London 2012 Olympics.
But if he is found guilty of murder, he faces 25 years behind bars.
Professor Saayman will continue his testimony on Tuesday.
Pistorius had barely left the courtroom when speculation began on social media about how genuine his courtroom reaction had been.
Twitter was rife with claims the athlete was deliberately keeping his head down to ensure cameras did not catch him at an unguarded moment.
Others expressed surprise that he would react to the details in such a way, when he would have know of the autopsy's contents a long time ago.