Three of the seven rounds fired by Seattle police that struck Charleena Lyles were fired from behind her, including one that tore through a major vein in her chest and likely caused her death within minutes, according to medical testimony Tuesday at the King County inquest.

Meanwhile, the Seattle Office of Police Accountability said it will review an incident last week when Seattle Police Department SWAT members responded to the site of the inquest as a “precaution” following a verbal exchange between Lyles’ family members and one of the officers who shot her.

Several of Lyles’ family members groaned audibly Tuesday while others left the conference room in tears during the testimony of King County Associate Medical Examiner Dr. Brian Mazrim, who described in detail the wounds suffered by Lyles when SPD Officers Jason Anderson and Steven McNew shot her in her apartment on July 18, 2017, after, they say, she lunged at them with a kitchen paring knife. Lyles, 30, died at the scene while officers rushed three of her four children from her apartment near Magnuson Park.

In King County, an inquest jury is to be convened for every death caused by law enforcement. The Lyles inquest is the second of at least 56 pending inquests into police-related deaths in the county. The process is a public inquiry convened to explore the facts around Lyles’ death, whether police followed proper procedures and if “criminality” was involved.

SPD has cleared the officers of wrongdoing. Both remain with the department.

Mazrim’s testimony Tuesday included graphic autopsy photographs depicting Lyles’ injuries.

Mazrim said two of the seven gunshots would have been quickly fatal: One bullet went through her back and passed through her chest cavity, tearing the vena cava — the major vein that returns blood to the heart — before exiting her chest. Another bullet wound in her abdomen severed her deep femoral artery. That round also struck her uterus, resulting in a rupture that forced her 16-week-old fetus out of the womb, killing it.

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The other five wounds were serious, but likely not immediately fatal, Mazrim said. One struck Lyles in the belly, grazed her uterus and would have caused significant bleeding; another was a grazing wound to her side, traveling back to front; another struck her in the right hip, penetrating the bone; another bullet entered her left back but did not hit any vital organ, and another bullet hit her in the upper right arm, traveling from front to back.

Mazrim said it could not be determined which shot was fired first.

Mazrim said the gunshot wound that struck her in the back and tore through the vena cava would have been “rapidly lethal,” and Lyles would have lost consciousness almost immediately. Combined with the injury to the femoral artery, Lyles — who was 5-foot-3 and weighed 110 pounds — likely would have bled to death within minutes.

In fact, he said, the officers at the scene who performed CPR were actually pushing blood out of her circulatory system through the chest wound and would have had no way of knowing that.

“She probably would have fallen unconscious very quickly … due to massive blood loss,” he said. “I find it unlikely that she would have survived if this injury had occurred on the sidewalk in front of Harborview” Medical Center.

Lyles had reported a burglary and Anderson and McNew had responded to the 911 call — a two-officer response due to a previous incident during which Lyles had threatened officers with a pair of shears.

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According to the officers’ statements, Lyles was conversant and acting normal when she suddenly produced a small knife from her pocket. McNew was to one side, in the kitchen of the small apartment, and Anderson was directly in front of Lyles when he said she lunged at him.

Both officers drew their 9 mm Glock handguns and fired. Lyles collapsed in a short hallway off the kitchen. Three children were in the home. One reportedly crawled on top of Lyles as she lay dying.

Jurors hearing testimony at the inquest were told that Anderson was disciplined for failing to carry his stun gun, which he had left in his locker because its battery had died. SPD tactics officer Leroy Outlaw was challenged by Lyles’ family Tuesday attorneys when he questioned whether a less-lethal stun gun would have been effective, given the close quarters of the confrontation and the fact that Lyles was wearing a parka when she was shot.

SPD Lt. Dan Nelson testified Tuesday that the officers acted properly and in line with the department’s crisis-intervention policies, but that the suddenness of Lyles’ attack and the confined space in the apartment narrowed their options to use distance, cover and time to de-escalate the situation.

On Monday, Inquest Administrator Michael Spearman expressed concerns when he learned that SPD had sent members of its Special Weapons and Tactics team to the Judge Patricia Clark Children and Family Justice Center, where the coroner’s inquest is being held, after members of Lyles’ family verbally confronted McNew, calling him a “coward,” and other pejorative terms, as he walked through a gathering of family members, including Lyles’ father, outside the center June 22. The day’s testimony had involved wrenching testimony that included photos of her body and a video of her children crying and upset.

McNew reportedly called his sergeant after the verbal confrontation and two days later members of SPD’s SWAT team showed up to inspect the center — which is operated by King County and secured by sheriff’s deputies — as a “precaution.”

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Spearman called the response “excessive,” and admonished participants for further escalating an already tense situation, with family members sitting within yards of the officers who killed Lyles.

Tuesday morning, there were fewer family members present and their attorney, Karen Koehler, told Spearman several of the older women who had been attending the hearing were afraid of a SWAT turnout.

“They do not feel safe,” Koehler told Spearman, a former Washington Court of Appeals judge.

Spearman said he could “not guarantee” SWAT would not show up, but said he had made it clear SPD was supposed to coordinate with the Sheriff’s Office and center security.

The family members, Spearman said, “do not risk any physical harm coming to these proceedings.”

Katie Wieliczkiewicz, the interim assistant director of operations at OPA, confirmed the incident is under review and has been assigned an OPA case number. OPA has 30 days to determine whether further investigation is warranted, she said.