Samuel White of Brentwood is led out of the Third...

Samuel White of Brentwood is led out of the Third Precinct in Bay Shore for arraignment in Central Islip on May 26, 2016. Credit: James Carbone

A Bay Shore man who died after a fistfight he initiated in Huntington was killed by blows to his head and neck, Suffolk's chief deputy medical examiner testified Wednesday in Riverhead.

In addition to breaking several bones in Edwin Rivera's face, the blows were likely to have caused the collapse of Rivera's airway and caused him to breathe in his own blood, eventually leading to cardiac arrest, Dr. Odette Hall testified at the manslaughter trial of Samuel White, 35, of Brentwood.

White and Rivera had fought in the street outside a bar in the early hours of May 25, 2016, after Rivera, 39, went looking for his ex-girlfriend, who had texted and called him numerous times that night to tell him she was out with another man.

 On Tuesday, jurors saw a video of White emotionally explaining what happened. He said Rivera was angry and intent on a fight, which White said he never wanted to happen.

During questioning by Assistant District Attorney Daryl Levy, Hall said Rivera  stood 6 feet 1 inch and weighed 261 pounds. White told detectives he himself was 5 feet 11 and about 180 pounds.

Autopsy photos showed Rivera suffered severe injuries to his face, which was covered in blood and bruises. White looked away from the screen showing the photos.

Hall said a fractured bone and cartilage in Rivera's neck  probably caused his airway to collapse, making it even harder for him to cope with blood that he was aspirating from his broken nose and having a tooth knocked out. The breathing difficulties  probably caused his heart to stop, Hall said.

During cross-examination, defense attorney Christopher Gioe suggested other factors played a role in Rivera's death. Hall agreed that Rivera had an enlarged heart, and that he was intoxicated, both by cocaine and alcohol, which she said magnifies the effects of cocaine. Those effects can include a faster and irregular heartbeat, Hall said.

But she said Rivera had managed to live with his enlarged heart and cocaine and alcohol intoxication until the fight. "The only new player I have is the blunt force trauma to his head and neck," she said.

Hall also discounted  the fact police officers did not treat Rivera for nine minutes while he lay in the street until an ambulance arrived.

Earlier Wednesday, during cross-examination by Gioe, Homicide Det. Michael Milau said it was unusual that White showed up on his own, after the fight, to tell police what happened.

"Sammy walked into the Third Precinct [in Bay Shore] and waived all his rights, correct?" Gioe asked.

"Correct," Milau said. "It doesn't happen very often."

Milau said he took no steps to investigate White's claim that he was defending himself from the larger, aggressive Rivera. Milau conceded that a surveillance video of the fight, which took less than a minute, showed "aggressive behavior" by Rivera as he advanced on White.

Gioe asked Milau to put himself in White's shoes. "When would you have drawn your gun, if that was you?" Gioe asked.

State Supreme Court Justice William Condon sustained an objection by Levy, so Milau did not answer that question.

Closing arguments are expected Thursday.

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