Coroner's report - Caitlin Maxwell
Office of the Yoknapatawpha County Coroner |
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DATE and HOUR AUTOPSY PERFORMED: Manish Agarwal, M.D.
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Assistant: Victoria Witte, M.D.
Full Autopsy Performed |
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SUMMARY PRELIMINARY REPORT OF AUTOPSY |
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EXTERNAL EXAMINATION The autopsy is begun at 1:00 p.m. on January 15, 2014. The body is presented in a black body bag. When first viewed, the deceased is clothed in blue jeans, white sweatshirt, light blue long-sleeved shirt, white athletic socks, white bra, blue women's underwear, and white athletic shoes. Soil is visible on all items. Four cuts and tears are observed in the shirt and sweatshirt: (1) one 1-inch slit-like tear on the front lower right; (2) one 1.2-inch slit-like tear on the front lower right; (3) one diagonally-oriented 4-inch on the left upper sleeve; and (4) one 1-inch slit-like tear on the back lower left. The bra has no cuts or tears and has dark stains on the front lower right edge and the back lower left edge. Dark stains are also visible on the jeans and both shoes. The body is that of a well-developed, well-nourished white female measuring 64 inches in length, weighing 106 pounds, and appearing generally consistent with the stated age of 18 years. Rigor mortis is absent. Livor mortis is advanced and detectable on the right cheek, posterior trunk and right shoulder area. The scalp is covered by medium-length, brown hair. The eyes are retracted and opaque. No evidence of conjunctive petechial hemorrhage. The nose and ears are unremarkable. Small, irregular brown abrasions near anterior to the right ear are consistent with ant bites. The upper and lower teeth are natural, there is one amalgam orthodontic filling in the 15th molar consistent with orthodontic records for Caitlin Maxwell. The head is normocephalic and otherwise the face, nose, eyes, neck gums and lips show no evidence of traumatic injury and are unremarkable. The chest is symmetrical, the abdomen is tight and distended. Palpation shows evidence of soft tissue. Multiple sharp force injuries, described below, are observed in the anterior and posterior of the trunk. Laterally, there is a natural skin pigmentation mark transversely oriented, approximating a triangular shape measuring 1.1 cm by .5 cm by 1.3 cm located 9 cm to the right of the midline and 67 cm from the crown on the right lower back, consistent with medical records for Caitlin Maxwell. The external genitalia are unremarkable and show no evidence of injury or trauma. The upper and lower extremities show no deformities. A sharp force injury to the lateral aspect of the left upper arm is described below. There are no scars or signs of surgical treatment. The hands and nails are dirt encrusted with evidence of sharp force injury described below. The medical record is present. There are no additional residual scars, markings or tattoos. EVIDENCE OF TREATMENT N/A INTERNAL EXAMINATION HEAD--CENTRAL NERVOUS SYSTEM: The brain weighs 1,313 grams and is within normal limits. The calvarium and base of the skull are normally configured and have no fractures. The dura is intact, and there is no epidural or subdural hemorrhage. CARDIOVASCULAR SYSTEM: The heart weighs 203 grams, and has a normal size and configuration. No evidence of atherosclerosis or gross ischemic changes of recent or remote origin are present. RESPIRATORY SYSTEM: No injuries are seen and there are no mucosal lesions. The hyoid bone, the thyroid, and the cricoid cartilages are intact. The left and right lungs show basilar atelectasis due to hemothorax caused by sharp force injuries, described below. The visceral pleura are unremarkable. URINARY SYSTEM: The kidneys weigh: left, 107 grams; right, 104 grams. The kidneys are anatomic in size, shape and location and are without lesions. The pelvic calyceal system and ureters are unremarkable. FEMALE GENITAL SYSTEM: The structures are within normal limits. Examination of the pelvic area indicates the victim had not given birth and was not pregnant at the time of death. Vaginal fluid samples are removed for analysis. HEPATOBILIARY SYSTEM: The liver weighs 1,136 grams. The liver on section is uniform and dark brown. No masses are identified. The gallbladder contains 3 cc of thick green viscid bile. The extrahepatic biliary system is unremarkable. GASTROINTESTINAL TRACT: The mucosa and wall of the esophagus are intact and gray-pink without lesions or injuries. The gastric mucosa is intact and pink with no injury. The stomach contains 3 cc of partially digested semisolid food. The mucosa of the duodenum, jejunum, ileum, colon and rectum are intact with no injury. The pancreas, small intestine and colon are unremarkable. MUSCULOSKELETAL SYSTEM: The musculoskeletal system is unremarkable and is within normal limits. TOXICOLOGY: Samples of central and peripheral blood, vitreous humor, gastric contents, urine, liver and bile are submitted for toxicologic analysis. SEROLOGY: A sample of right pleural blood is submitted in the EDTA tube. Routine toxicologic studies were ordered. DESCRIPTION OF INJURIES - SUMMARY
(1) Stab wound to left side of back, 23 inches from the crown of the head, 41 inches from the soles, 6 inches from the midline. The wound is vertically oriented, and after approximation of the edges, measures 7/8-inch in length. Both the inferior and superior ends of the wound are blunt, and squared measuring 1/32-inch in length superiorly and 1/16-inch inferiorly. The wound shows non-abraded clean, sharp margins with no evidence of contusion at the edges. Internal examination shows the track to be deeper than the width, with a back to front and slightly downward path. The wound path is through the skin, subcutaneous tissue and through the left 7th rib. The rib is totally incised. The path continues through the left pleural cavity and lateral base of the left lung and subjacent hemorrhagic parenchyma at the base of the lobe. There is overlying bruising in the intercostal musculature. The pleural wound is approximately 1/2-inch. The estimated length of the total wound path is 4 inches. The path of the wound shows hemorrhage and bruising. Opinion: This is a fatal injury. (2) Stab wound to the right side of the chest, 22 inches from the crown of the head, approximately 42 inches from the soles, 4 inches from the midline. The wound is diagonally oriented, and after approximation of the edges, it measures 5/8-inch in length. The inferior end is blunt and squared measuring 1/32-inch in length. The superior end is tapered. The wound shows non-abraded, sharp margins with no evidence of contusion at the edges. Internal examination shows the path of the wound from front to back and slightly downward. The path is through the skin, subcutaneous tissue and through the intercostal musculature penetrating into the pleural cavity through the 8th right intercostal space without striking rib. The pathway passes through the pleura and subjacent hemorrhagic parenchyma at the base of the right lower lung. The pleural cut measures approximately 1/2-inch, the estimated length of the total wound path is 3.75 inches. The path of the wound shows hemorrhage and bruising with overlying bruising in the intercostal musculature. Opinion: This is a fatal injury. (3) Stab wound to the right side of the chest, 21 inches from the crown of the head, approximately 43 inches from the soles, 5 inches from the midline. The wound is vertically oriented, and after approximation of the edges, measures 1 inch in length. Both the inferior and superior ends of the wound are blunt and squared measuring 1/32-inch in length superiorly and 1/16-inch inferiorly. The edges of the wound are non-abraded, non-contused and clean. The path of the wound is front to back with little deviation. The path is through the skin, subcutaneous tissue and through the intercostal musculature incising the 7th rib and penetrating into the pleural cavity. The pathway passes through the pleura and subjacent hemorrhagic parenchyma, 1/2-inch and 5/8-inch pleural cuts are found anteriorly and posteriorly respectively. Opinion: This is a fatal injury. (4) Incised or cutting wound to the lateral outer aspect of the left upper arm, located 3 inches below the shoulder joint. The path of the wound is back to front, through the skin and subcutaneous tissue, evidencing a small amount of dermal hemorrhage. The track is diagonal extending for 3.25 inches. Opinion: This is a non-fatal perimortem injury. (5) Incised or cutting wound to the distal portion of inner aspect of right forearm. This wound is transversely oriented 3 inches from the wrist, measuring 1.5 inches in length. The wound is through the skin and subcutaneous tissue. Opinion: This is a non-fatal perimortem injury compatible with a defense wound. (6) Incised or cutting wound to the distal portion of inner aspect of left forearm. This wound is diagonally oriented 2 inches from the wrist, measuring 1.25 inches in length. The wound is through the skin and subcutaneous tissue. Opinion: This is a non-fatal perimortem injury compatible with a defense wound. (4) Incised injury of palmar region right hand extending from the base of the little finger diagonally toward the thumb, terminating at approximately the index finger. The wound is 2.75 inches in length and approximately 3/8-inch in depth with hemorrhage at the margins. Opinion: This is a non-fatal perimortem injury compatible with a defense wound. LABORATORY DATA Cerebrospinal fluid culture and sensitivity: Gram stain: Unremarkable Cerebrospinal fluid bacterial antigens: Hemophilus influenza B: Negative Drug Screen Results: Urine screen {Immunoassay}:
Ethanol: .00 gm/dl, Blood (Heart) Ethanol: .00 gm/dl, Vitreous Millicent Schmid, Ph.D. EVIDENCE COLLECTED 1. One (1) pair women's blue jeans 2. One (1) women's turtleneck shirt, light blue, long-sleeved 3. One (1) women's sweatshirt, white, long-sleeved 4. One (1) brassiere, white 5. One (1) pair women's underwear, blue 6. One (1) pair women's athletic socks, white 7. One (1) pair women's athletic shoes, white 8. Samples of Hair, Blood (type A+), Bile, and Tissue (heart, lung, brain, kidney, liver, spleen). 9. Seventeen (17) autopsy photographs. 10. One postmortem CT scan. 11. One postmortem MRI. Clothing, hair sample, and blood sample transferred to Crime Lab for further analysis and comparison. OPINION Time of Death: Autopsy findings and entomological evidence approximate the time of death between January 2, 2014 and January 4, 2014. Immediate Cause of Death: Exsanguination due to multiple perforating stab wounds of the chest. Manner of Death: Homicide //Manish Agarwal, M.D.
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