Death of Michigan referee raises medical questions

LIVONIA, Mich. (AP) A well-respected veteran soccer referee's life was cut short by a punch delivered during a Detroit-area men's league game.

John Bieniewicz, 44, died on July 1, two days after a player struck him at a community park in Livonia.

Baseel Abdul-Amir Saad is charged with second-degree murder, a charge that carries a penalty of up to life in prison.

Saad, a 36-year-old auto mechanic and father of two daughters, had no prior criminal history. Bieniewicz, married with two young sons, was a soccer enthusiast who had refereed games for years.

The circumstances seem unusual, but someone dying from a single blow - dubbed a ''one-punch homicide'' by a documentary filmmaker - is not without precedent.

Here are some questions and answers about the phenomenon.

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Q: What happened in this case?

A: Bieniewicz reached into his pocket and was pulling out a red card when the player he intended to eject punched him, according to witnesses, including Scott Herkes, who plays for and manages the Metro Rangers, one of the teams playing. Herkes said Bieniewicz fell to the ground and was attended to by a player on the opposing team who had medical training. He later was declared dead at a hospital. During Saad's arraignment in Livonia District Court on Thursday, assistant county prosecutor Raj Prasad said the final medical examiner's report would not be completed for two weeks. But the initial finding announced July 3 was that Bieniewicz's death was the result of blunt force trauma to the neck.

Q: How can a single punch inflict so much damage?

A: Because of the head's physical makeup, said Dr. Howie Zheng, a neurologist at Mercy Medical Center in Baltimore. The brain is in a closed space and there is little room for expansion within the skull, making it susceptible to intracranial bleeding, brain swelling, hydrocephalus (excess fluid on the brain) and herniation, Zheng said. A fist traveling upward at 25 mph and delivering a force of hundreds of pounds, Zheng said, could ''result in severe and potentially fatal consequences - even with one blow.'' Unexpected blows also can be fatal, said Dr. David Fowler, Maryland's chief medical examiner. One-punch killings can occur when victims ''take an impact that they were not expecting or haven't steeled themselves for,'' he said.

Q: How often does something like this happen?

A: Not very, said Fowler, who has seen more fatal cases in which the victim is punched once and then suffers a second blow as a result of going down. ''An unprotected fall ... is potentially very dangerous,'' said Fowler, citing the twisting of the head as it strikes the ground. People die after receiving a single blow ''with far greater frequency than most people would imagine,'' said Steve Kokette, a Madison, Wisconsin-based documentary filmmaker whose ''One Punch Homicide'' came out this year. Kokette read about two such incidents that happened near his hometown five years ago. ''I thought it might make a great documentary and decided to go online and see if I could find other one-punch homicides. In no time I found 20 such incidents. Now I've found over 300,'' he said.

Q: What is the result?

A: Pain for all involved. A funeral service for Bieniewicz was held Thursday in front of a ''packed house'' of mourners in Redford Township, Michigan, said Jim Acho, a friend and former high school classmate. An hour earlier, family and friends filed in to see Saad make an initial appearance in his murder case. Saad has ''substantial family support as evidenced by'' the many people in the gallery, defense lawyer Ali Hammoud told Judge Kathleen McCann in arguing for a lower bond. McCann called the case ''a horrendous tragedy.'' These situations can be avoided, said Dr. Jennifer Pilgrim, a forensic pharmacologist and toxicologist at Australia's Monash University who has studied the impact of drugs and alcohol in sudden, unexpected deaths.

''Violence is never the answer. A single punch can kill in any circumstance - we know this, it has been well-publicized,'' she said. ''It is no longer an excuse for an individual to say that they didn't know a single punch could kill.''