EXTERNAL EXAMINATION - SUMMARY
The autopsy is begun 9:00 A.M.
on June 7, 2008. The body is presented in a black body bag. When
first viewed the deceased is clothed in black pants and jacket,
maroon shirt, and black leather shoes.
The body is that of a normally
developed white female who appears 40-45 years of age and is of
average nutritional status measuring 64 inches and weighing 178
pounds. Preservation is fair on the unembalmed body. The body is
cold to the touch following refrigeration.
There is brown hair with
a maximal length of 17 inches. The eyes are closed. The irises are
brown. The sclerae are clear. The pupils measure 0.4 cm. The scalp
is unremarkable. Teeth are natural and in fair repair.
The neck
is unremarkable. The chest is unremarkable as are the breasts. The
abdomen is unremarkable. Limbs are equal and symmetrically developed.
The back is unremarkable.
The medical record is present.
There are
no residual scars, markings or tattoos.
EVIDENCE OF TREATMENT
An orotracheal tube is in place.
Intravenous puncture sites are present in the right antecubital
fossa and an intravenous line is present in the left antecubital
fossa. EKG pasties are present on the upper torso. On the dorsal
aspect of the left wrist, an intravenous line is present. AED pads
are present on the sternum and left apex regions.
INTERNAL EXAMINATION - SUMMARY
CAVITIES: Right and left pleural cavities are suffused with blood.
CARDIOVASCULAR SYSTEM: The 235-gram heart has a dominant right
coronary artery. The coronary vessels show focal mild artherosclerosis.
Specifically absent are areas of discoloration with softening
and fibrosis.
RESPIRATORY SYSTEM: The lungs are unremarkable. The visceral
pleura are unremarkable. The bronchial tree contains blood-stained
fluid. Laryngeal and tracheal cartilages are intact and their
mucosae contain blood-stained fluid.
CENTRAL NERVOUS SYSTEM: The 1385-gram brain has unremarkable
meninges. The vasculature of the basilar and cerebral arterial
circulatory systems are unremarkable. With the dura removed, the
base of the skull is free of fractures.
URINARY SYSTEM: The 121-gram left kidney and 120-gram right kidney
are similar. The pelvic calyceal system and ureters are unremarkable.
The bladder contains 12 cc of urine. With this removed, the bladder
wall is unremarkable. Microscopic hematuria is present.
GENITAL SYSTEM: Fallopian tubes and ovaries are unremarkable. There
is evidence of a previous subtotal hysterectomy. All organs are within
normal limits. No underlying pathological disease conditions or
congenital anomalies were observed. Examination of the pelvic
area indicates the subject had not given birth. Subject was not
pregnant at the time of death. No evidence of sexual intercourse,
forced or consenual, is noted.
HEPATOBILIARY SYSTEM: The 1265-gram liver has an unremarkable
capsule. The liver on section is uniform and dark brown. No masses
are identified. The gallbladder contains 7 cc of thick green viscid
bile. The extrahepatic biliary system is unremarkable.
GASTROINTESTINAL TRACT: The esophagus is unremarkable. The stomach
contains 6 cc of red liquid. The pancreas on section is uniform,
gray-pink and moderately firm. The opened duodenum has neither
food, ulcers nor masses. Externally the small intestine, appendix
and colon are unremarkable.
LYMPHOPROLIFERATIVE SYSTEM: The 59-gram spleen has an unremarkable
capsule. The parenchyma is moderately softened and dark red-brown.
Abdominal and thoracic lymph nodes are unremarkable.
MUSCULOSKELETAL SYSTEM: It is unremarkable.
DESCRIPTION OF INJURIES - SUMMARY
HEAD AND NECK: The nasal bone is intact. Crusted blood is present
at the nares. Crusted brown dried material is present within the
mouth, on the lips.
EXTREMITIES: A hematoma is present over the palmar and distal
portion of the left arm of 5.3 X 4.2 cm. A blue-green/brown
area of discoloration consistent with old hematoma is present
on the proximal aspect of the right thigh, measuring 6.5 X 8.1
cm.
TRUNCAL: The right suprailiac area there is a 4.3 X 8.2 cm hematoma.
LABORATORY DATA
Cerebrospinal fluid culture and sensitivity:
Gram stain: Unremarkable
Culture: No growth after 72 hours
Cerebrospinal fluid bacterial antigens:
Hemophilus influenza B: Negative
Streptococcus pneumoniae: Negative
N. Meningitidis: Negative
Neiserria meningitidis B/E. Coli K1: Negative
Vitreous sodium: 180 mmol/l
Vitreous potassium: 13.9 mmol/l
Vitreous urea nitrogen: 300 mg/dl
Vitreous creatinine: 2.6 mg/dl
Vitreous glucose: 15 mg/dl
Vitreous chloride: 161 mmol/l
Vitreous specific gravity: 1.337
Drug Screen Results:
Urine screen {TLC-Basic} was positive for warfarin, which was
later confirmed using GC-MS
Urine screen {Immunoassay} was NEGATIVE.
Ethanol: .05 gm/dl, Blood (Heart)
Ethanol: .03 gm/dl, Vitreous
Millicent Schmid, Ph.D.
Chief Toxicologist
June 17, 2008
EVIDENCE COLLECTED
1. One (1) women's blouse, maroon,
short-sleeved
2. One (1) women's jacket, black,
long-sleeved
3. One (1) pair women's black pants
4. One (1) pair women's shoes, black
5. One (1) pair women's underpants, black
6. One (1) brassiere, black
7. Samples of Hair, Blood (type A+), Bile, and
Tissue (heart, lung, brain, kidney, liver, spleen).
8. Nine (9) autopsy photographs.
9. One postmortem CT scan.
10. One postmortem MRI.
Clothing, hair sample, and blood sample transferred to Crime Lab for further
analysis and comparison.
OPINION
Time of Death: Dr.
Rebecca Kelleher pronounced death at 6:08
P.M.
on June 6, 2008, at Baptist Memorial Hospital following unsuccessful resuscitation efforts.
Immediate Cause of Death: Massive internal bleeding resulting
in catastrophic multiple organ failures.
Manner of Death: Homicide
//Manish Agarwal, M.D.
Yoknapatawpha County Coroner's Office
June 18, 2008 |
