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Office of the Yoknapatawpha County Coroner

DATE and HOUR AUTOPSY PERFORMED:
11/23/2013, 8:30 a.m. by

Manish Agarwal, M.D.
555 Jackson Avenue
Oxford, MS 38655
662-234-XXXX (FAX 662-234-XXXX)

 

Assistant:

Victoria Witte, M.D.

 

Full Autopsy Performed

SUMMARY PRELIMINARY REPORT OF AUTOPSY

Name:
 COATES, Diane Crenshaw

Coroner's Case #:
 2013-142

Date of Birth:
 06/13/1965

Age:
 48

Race:
 White

Sex:
 Female

Date of Death:
 11/22/2013

Body Identified by:
 Rupert Coates, husband

Case #
003709-22K-2013

Investigative Agency:
 Yoknapatawpha County Sheriff's Department

EXTERNAL EXAMINATION

The autopsy is begun at 8:30 a.m. on November 23, 2013. 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 45-50 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.

The scalp is covered by brown hair with a maximal length of 43 cm. 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 body hair is female and average.

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

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. No evidence of sexual intercourse, forced or consensual, is noted.  Vaginal fluid samples are removed for analysis.

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: 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

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}:

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   NEG

Ethanol: .05 gm/dl, Blood (Heart)

Ethanol: .03 gm/dl, Vitreous

Millicent Schmid, Ph.D.
Chief Toxicologist
December 12, 2013

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 vaginal fluid

8. Samples of Hair, Blood (type A+), Bile, and Tissue (heart, lung, brain, kidney, liver, spleen).

9. Nine (9) 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: Dr. Rebecca Kelleher pronounced death at 6:28 p.m. on December 22, 2013, at Baptist Memorial Hospital following unsuccessful resuscitation efforts.

Immediate Cause of Death: Massive internal bleeding resulting in catastrophic multiple organ failures.

Manner of Death: Pending investigation

Notes: Medical records indicate the subject's warfarin treatment regimen had been terminated at the subject's request due to "intolerable side effects" five (5) months prior to death. The positive finding of warfarin at autopsy makes the death suspicious, and therefore, it requires further investigation.

 

//Manish Agarwal, M.D.
Yoknapatawpha County Coroner's Office
December 13, 2013

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People in this conversation

  • Just as I thought and, massive internal bleeding resulting in catastrophic multiple organ failures and warfarin found in her system.
    Until I read both Diane's doctor and pharmacist's statements there was no real evidence of foul play or anybody to point the finger at.
    But after reading both of those interviews one person started to stand out.
    If we were given a poll I would click the name of Landon Talley.
    Two of the clues were in his BIO.
    The first one, was that he had lived in Atlanta, and the man who picked up the warfarin tablets in July was wearing an Atlanta Braves baseball cap.
    At the very bottom of his bio Landon say's that Diane had began to remind him of his wife Genevieve both of whom were shrill and confining and he needed to get rid of one of them from his life permanently.
    In his interview he didn't want his wife to find out about his affair with Diane. So it was obvious that he was prepared to stay with his wife, but Diane was the one who had to go. Diane was good at threatening so I don't doubt that Diane had threatened Landon.
    The second hint, was the man who did pick up the prescription of the warfarin wearing the old style Atlanta Braves baseball cap, fitted the description of Landon.
    The request for the prescription was made over the phone.
    Diane had refused to take the warfarin and, her doctor told her to take the aspirin.
    And Diane's cause of death is exactly what warfarin can do if not taken properly.

  • yes i doubted it its not a foul play ....

  • Hello Poppy,
    Diane told her doctor that she did not want to take the warfarin anymore, because one of the side affects was, it made her mouth sore. So he prescribed her 300mg of the aspirin instead.
    And when he last saw Diane on November the 8th she said, "Boy! I'm glad I'm off that warfarin stuff. I'd hate to give up kissing.!" Then gave the doc a wink.
    So I believe that Diane has been given the warfarin in smaller amounts, so as not to make her mouth sore again, so she was not aware of being given the warfarin. But these smaller amounts and her quite heavy drinking were a deadly cocktail.

  • yeah and it was also her fault .. now she's dead no more kissing ever

  • I think it's intresting to note that the coreners reports states:


    This confirmed that some warfarin was still within her system, although someone has already noted she was now taking aspirin, due to the side effects of warfarin..

    After doing some light research on the internet, I've notice that taking aspirin as well as warfarin can lead to bleeding. One question that should be asked is 'If ms.coates was prescribed aspirin why did she ask Moss, for some? You would have thought that if you suffered from a serious illness or had common pains, you'd carry some with you?'

    In addition we already no from Ms. Coates was under stress and suffered from alcoholism. It's very unlikely that alcohol did not have some role in here death. Although not certain yet (Newcomer to Crimescene.com) the mixture of both Aspirin, Warfirin and alcohol might be the sole reason for unfortunate death? I believe that the high levels of internal bleeding would be impossible to take effect within a few hours. I believe this mixture could have been over a long period of time or the result of foul play possible the tampering of the drugs. I will investigate further :)

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