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EVIDENCE OF TREATMENT
N/A
EXTERNAL EXAMINATION - SUMMARY
The autopsy is begun at 1:45 P.M. on March 16,
2005. The body is presented in a black body bag admixed with
fragments of collapsed and burnt construction debris and body
tissues.
The body is that of a charred remains of an adult white female measuring
63 inches (residual) and weighing 117 pounds (residual). There is
extensive charring with burning of flesh and massive heat-related
bony fractures. Right side of face, neck and chest, however, are
spared. Focally burnt, blackened and fragmented clothing items
include: shirt, skirt, bra, and underpants. In addition, a yellow
metal ring was recovered from the left hand.
The head is collapsed and fragmented and consists mainly of portions
of posterior left and right parietal, left and right temporal,
frontal left zygomatic and sphenoid. Debris submitted in body bag
contained fragments of calvarium which were subsequently
reconstructed. Reconstructed calvarium revealed presence of two
gunshot defects, described in detail below.
The neck is intact and markedly rigid. Chest is symmetric and
presents extensive charring of right upper chest extending to flank
area. There is sparing of the left chest as noted above. Abdominal
surface is extensively charred with total destruction of lower
abdominal wall and herniation of loops of small bowel.
Upper extremities are fully articulated and present extensive heat
damage with massive charring of the left shoulder, left arm and
elbow as well as dorsal surface of entire right arm and forearm.
There are heat-related fracture dislocation of both left and right
elbow joints and distal left radius and ulna. Lower extremities are
burned and charred but largely intact except for the distal
phalanges of the feet. Charred female
external genitalia are present. Back presents global charring.
INTERNAL EXAMINATION - SUMMARY
CENTRAL NERVOUS SYSTEM: Soft tissues of the
scalp are generally absent There is extensive destruction of the
calvarial vault over the frontal temporal and anterior parietal
areas. Despite extensive destruction of the skull by charring, there
is no evidence of notable heat fracture. Rather there are traumatic
fractures associated with a gunshot injury described below.
Fractures radiating from the mid sphenoid body
into the right and left cavernous sinuses and to the left jugular
foramen, then into the left posterior cranial fossa where the
delicate fossa floor is fractured and disrupted. Fractures radiate
from the exit defect in the mid occiput into the parietal,
inferiorly to and along the lambdoid suture and into the left
posterior cranial fossa inferiorly, adjoining the fracture from the
entry wound described above. There are no notable projectile
fragments recovered within the cranial cavity.
The brain is markedly heat altered with
destruction of the superior and anterior cerebral cortices. The
residual brain approximates 400 grams. Minimal residual hemorrhage
is visible along the autolyzed wound track.
CARDIOVASCULAR SYSTEM: The heart weighs
139
grams, and has a normal size and configuration. The heart is firm,
moderately dessicated and pale due to cooking. Cardiac valves and
coronary ostia are anatomic and unremarkable. No evidence of
atherosclerosis or gross ischemic changes of recent or remote origin
are present.
RESPIRATORY SYSTEM: Neck present an intact
hyoid bone and thyroid cartilage. Larynx appears normal. Trachea and
spine are in the midline and devoid of trauma. The lungs weigh: left,
316
grams; right 203 grams. Tracheobronchial tree contains a notable
amount of hemorrhagic fluid.
GASTROINTESTINAL SYSTEM: Esophagus and GE
junction appear unremarkable without erosions or varices. Stomach is intact
and devoid of food particles. Loops of small and large bowel reveal
prominent but patchy areas of charring. Appendix is absent
consistent with surgical amputation of remote origin. Rectum is
charred.
URINARY SYSTEM: The kidneys weigh: left,
48
grams; right, 41 grams. The kidneys are anatomic in size, shape and
location and are without lesions. The pelvic calyceal system and
ureters are unremarkable. The bladder is devoid of urine.
FEMALE GENITAL SYSTEM: External genitalia are
charred. Internal genitalia reveal a non-gravid uterus with
unremarkable fallopian tubes and ovaries.
DESCRIPTION OF INJURIES
(1) Entry gunshot wound of mouth
(posterior pharynx) (GSW #1)
Description: Evidence of gunshot injury is
found in the base of the skull and posterior palate. There is a
pyramidal shaped defect of the palate beginning 2/3 of the
distance between the alveolare and the posterior edge of the
bony palate. Due to extensive heat disruption of the nasal
cavity, there is little additional residual wound track visible
through the posterior pharynx.
A perforating defect is found through the
sphenoid body which is internally beveled and soiled by soot
more notably along the left and inferior margins than along the
right. The track is then traced from anterior to posterior,
inferior to superior through the regions occupied by the rostral
pons, posterior corpus callosum and cerebellar vermis as well as
the medial occipital lobes of the brain, impacting the skull in
the upper occipital area at the juncture of the sagittal and
lambdoid sutures. The bone fragment from the right parietal bone
is absent; there is no charring along the margins of the absent
bone. There is notable external beveling of this bony defect,
consistent with a projectile exit.
Fractures extend left and inferior, right
inferior along the lamboid suture and superiorly along the
sagittal suture. Fractures radiate from the entry defect into
the sphenoid body and sinus, cavernous sinuses bilaterally and
there are "blow out" fractures of the right middle and left
posterior cranial fossae. An additional fracture radiates from
the entry defect along the inferior edge of the left petrous
temple ridge to the jugular foramen and then into the posterior
cranial fossa. There are no projectile fragments recovered at
autopsy.
Opinion: This is a fatal injury.
(2) Exit gunshot wound of mid-occipital
skull (GSW #2)
Description: Wound is localized to the
occipital bone 3 centimeters superior to opisthion and very
slightly right of the mid-sagittal line. The defect is circular,
larger than the entry defect and measures 1.4 centimeters along
the inner table and 4.7 centimeters along the outer table.
Characteristic beveling of the outer table is present. There is
focal charring along the left, superior and right margins of the
defect. There is no overlying scalp. The wound is consistent
with gunshot wound of exit.
Opinion: This is a fatal injury.
(3) Global charring with extensive body
mutilation
Opinion: This is a postmortem injury.
(4) Minimal inhalation of carbon monoxide
Opinion: This is a non-fatal injury.
LABORATORY DATA
Toxicology Test Results:
| BLOOD |
|
ETHANOL |
|
POS |
| BLOOD |
|
CANNABINOIDS-ETS |
|
NEG |
| BLOOD |
|
COCAINE-ETS |
|
NEG |
| BLOOD |
|
OPIATES-ETS |
|
NEG |
| BLOOD |
|
AMPHETAMINE-ETS |
|
NEG |
| BLOOD |
|
BARBITURATE -ETS |
|
NEG |
| BLOOD |
|
BENZODIAZEPINE-ETS |
|
NEG |
| BLOOD |
|
METHADONE-ETS |
|
NEG |
| BLOOD |
|
PCP-ETS |
|
NEG |
| BLOOD |
|
CARBON MONOXIDE |
|
POS |
Further analyses to establish toxin levels are
in progress.
Millicent Schmid, Ph.D.
Chief Toxicologist
March 23, 2005
EVIDENCE COLLECTED
1. Samples of Blood, Bile, and
Tissue (brain, lung, kidney, liver, spleen).
2. Thirteen (13) autopsy photographs.
3. Residual clothing for trace evidence
analysis
OPINION
Cause of Death: Craniocerebral trauma due to gunshot wound of head
Manner of Death: Suicide
COMMENTS
Autopsy was performed on a rush basis at
the request of the Yoknapatawpha County Sheriff's Department and
the Yoknapatawpha County District Attorney. Findings presented
here are preliminary and subject to revision at a later date,
particularly concerning toxicological analysis. Some analysis
results were not available as of this date as more time is
required to complete the analyses.
//Manish Agarwal, M.D.
Yoknapatawpha County Coroner's Office
March 24, 2005
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