By Mauro Whiteman

WASHINGTON — The Supreme Court turned down an appeal Monday of an Arizona death-penalty case in which an autopsy report was entered as evidence without the medical examiner who wrote it.

Attorneys for Efren Medina argued that the inability to cross-examine the medical examiner violated his Sixth Amendment right to confront his accusers in the 1993 murder of a Phoenix man.

The high court’s refusal to hear the appeal lets stand an Arizona Supreme Court ruling that upheld Medina’s conviction and death sentence, the latest legal turn in his two-decade-old case.

But attorneys involved in the case predicted it will not be the last legal turn. They said they believe Medina “has other avenues that he’ll pursue” to appeal his death sentence.

According to court documents, Medina and a friend, Ernest Aro, were “high on paint fumes” on Sept. 30, 1993, when they “set out in Phoenix, Arizona, to steal a car.”

Medina, who was 18 at the time, pulled Carle Otis Hodge from his car, beat the 71-year-old man in the street and tried to take his car, but was unable to start it. Medina then tried to steal the car’s radio before leaving the scene in a second car.

Hodge was left lying in the street, where Medina and Aro returned shortly and ran over him with their car, killing him, according to court documents.

At trial, witnesses gave different testimony on the number of times Hodge was run over, with one eyewitness saying it was only once and another witness testifying that Medina said he ran over the body three times. The autopsy said Hodge’s body showed signs of being run over more than once, which was repeated by a medical examiner during trial.

But that was not the same medical examiner who prepared the autopsy, which violated Medina’s “right to confront witnesses against them,” said Jeffrey Fisher, co-director of Stanford Law School’s Supreme Court Litigation Clinic and a co-counsel for Medina.

The Arizona Supreme Court ruled in August that the autopsy was non-testimony evidence, and therefore it did not violate the confrontation clause.

The U.S. Supreme Court’s decision not to hear the appeal is the first of “several layers of review” for Medina’s case, Fisher said.

”Death penalty cases have several layers of review given their incredible importance,” he said. “Even though this case has been around for a while, this is really the end of only the first round.”

Fisher said he believes future appeals will be based on the same arguments raised to the U.S. Supreme Court, “because, as we’ve said, we think the Arizona Supreme Court decision is flatly inconsistent with Supreme Court precedent in this area, so he’d have a strong federal claim if he needs to make it down the line.”

Elizabeth B. Wydra, chief counsel with the Constitutional Accountability Center, agreed that Medina’s case will likely have more appeals in the future.

”Obviously, we’re disappointed that the court decided not to hear the case, which we see as a clear violation of the Constitution’s confrontation clause,” said Wydra, adding that she thinks Medina will eventually end up before the U.S. Supreme Court.

But John Pressley Todd, special assistant attorney general for the Arizona Attorney General’s Capital Litigation Section, said in an email that there is “no compelling reason” for the U.S. Supreme Court to second-guess the Arizona Supreme Court’s ruling on the 20-year-old “brutal murder.”