The professor who received the decomposing body of Valmai Jane Birch still in a wheelie bin before performing an autopsy has told a jury there were four possible causes of death.
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Professor Johan Duflou told jurors in David Bagster's manslaughter trial that Ms Birch's body was given to him to perform an autopsy after she was found deceased and hogtied, face down in a water-filled wheelie bin on March 21, 2011.
The Crown alleges Bagster killed his girlfriend in her Woonona unit sometime after March 9, which was the last day she was seen alive.
Bagster denies he killed Ms Birch and is defending the allegation during his Wollongong District Court trial.
Prof Duflou, who is a consultant forensic pathologist, said there was four possible causes of death: positional asphyxia, drowning, neck compression and overdose, or a combination of two or more.
He explained to the jury the state of decomposition to Ms Bich's body made it difficult to determine an exact cause of death and he estimated she died about 10 to 20 days before she was found.
Prof Duflou said positional asphyxia was a possible cause of death due to the position she was found in - upside down.
He said redness and specific pinpoint hemorrhages were common features in that type of death, however decomposition could mask them.
Prof Duflou indicated Ms Birch may have drowned, which he said was a possible hypothesis due to water being in the bin.
He went on to say there were no physical signs of neck compression to Ms Birch but he could "not rule it out" as a possible cause of death.
A blood test from Ms Birch's body could not be taken due to the level of decomposition, however a tissue sample of her liver was extracted and tested.
The results detected the presence of morphine in her body, Prof Duflou told the court.
He said the level of morphine found in the liver was not necessarily high and caused her death, however there were cases where the level was sufficient to cause death.
"Unfortunately with morphine, either from heroin or the drug morphine itself, it is not possible on the basis of the presence of the drug alone to determine whether it caused an overdose," Dr Dufluo said.
He also noted the level needed for overdose could be affected by the person's tolerance of the drug.
Prof Duflou told the jury there was no way to determine if Ms Birch died from a drug overdose prior to being put in the bin or whilst inside.
The expert pathologist said there were also other possible causes of death such as suffocation, chest compression or other types of asphyxia but he ruled out any natural diseases caused her death.
The trial continues.
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