REPORT OF INVESTIGATION BY MEDICAL EXAMINER

Transcription

1 Central Office 901 N. Stonewall Oklahoma City, Oklahoma (405) Fax (405) BOARD OF MEDICOLEGAL INVESTIGATIONS OFFICE OF THE CHIEF MEDICAL EXAMINER Eastern Division 1115 West 17th Tulsa, Oklahoma (918) Fax (918) REPORT OF INVESTIGATION BY MEDICAL EXAMINER Re OFFICE USE ONLY Co I hereby certify that this is a true and correct copy of the original document. Valid only when copy bears imprint of the office seal. By Date DECEDENT First-Middle-Last Names (Please avoid use of initials) Age Birth Date Race Sex DESMOND L CAMPBELL 30 12/6/1983 BLACK M HOME ADDRESS - No. - Street, City, State 946 EAST 61 STREET APT 12 X,, OK EXAMINER NOTIFIED BY - NAME - TITLE (AGENCY, INSTITUTION, OR ADDRESS) DATE TIME ST. FRANCIS HOSPITAL ICU 7/8/ :34 INJURED OR BECAME ILL AT (ADDRESS) INTERSTATE 44 AND EAST 41ST STREET CITY COUNTY TYPE OF PREMISES ROADWAY DATE 6/29/2014 TIME 5:54 LOCATION OF DEATH ST. FRANCIS ICU CITY COUNTY TYPE OF PREMISES HOSPITAL DATE 7/8/2014 TIME 11:23 BODY VIEWED BY MEDICAL EXAMINER CITY COUNTY TYPE OF PREMISES DATE TIME 1115 W 17TH ST MORGUE 7/10/ :04 IF MOTOR VEHICLE ACCIDENT: DRIVER PASSENGER PEDESTRIAN TYPE OF VEHICLE: AUTOMOBILE LIGHT TRUCK HEAVY TRUCK BICYCLE MOTORCYCLE OTHER: DESCRIPTION OF BODY RIGOR LIVOR EXTERNAL OBSERVATION NOSE MOUTH EARS EXTERNAL PHYSICAL EXAMINATION Jaw Neck Arms Legs Complete Absent Passing Passed Color PURPLE Lateral Posterior Anterior Beard BLACK Hair BLACK Eyes: Color BROWN Mustache BLACK Opacities Pupils: R 4MM L 4MM BLOOD OTHER Decomposed Regional Body Length 66 INCHES Body Weight 133 LBS Significant observations and injury documentations - (Please use space below) **SEE AUTOPSY PROTOCOL** Probable Cause of Death: COMPLICATIONS OF TRAUMATIC BRAIN INJURY BLUNT FORCE TRAUMA OF HEAD Due To: Other Significant Medical Conditions: Manner of Death: Natural Accident Suicide Homicide Unknown Pending Case disposition: Autopsy YES Authorized by JOSHUA LANTER M.D. Pathologist JOSHUA LANTER M.D. Not a medical examiner case MEDICAL EXAMINER: Name, Address and Telephone No. JOSHUA LANTER M.D. I hereby state that, after receiving notice of the death described herein, I conducted an investigation as to the cause and manner of death, as required by law, and that the facts contained herein regarding such death are true and correct to the best of my knowledge W. 17TH, OK Date Signed Signature of Medical Examiner Computer generated report JOSHUA LANTER M.D /10/2014 Date Generated CME-1 (REV 7-98)

2 Board of Medicolegal Investigations Office of the Chief Medical Examiner 1115 West 17 th Street Tulsa, Oklahoma Voice Fax CERTIFICATION I hereby certify that this document is a true and correct copy of the original document. Valid only when copy bears imprint of the office seal. By Date REPORT OF AUTOPSY Decedent Age Birth Date Race Sex Case No DESMOND L CAMPBELL 30 12/6/1983 BL M Type of Death ID By Authority for Autopsy VIOLENT, UNUSUAL OR UNNATURAL VISUAL RECOGNITION JOSHUA LANTER, M.D. Present at Autopsy BRITTANY CRASE, SARAH CAMPBELL, JOSHUA LANTER, M.D. PATHOLOGIC DIAGNOSES I. Blunt force trauma of head A. Partially healed abrasions, lacerations, and contusions of forehead, nose, lips, scalp B. Medical history of extensive facial bone fractures, bilateral maxillary wall fractures, bilateral pterygoid fractures, nasal bone fractures, left orbital bone fractures (CT, Saint Francis Hospital, 06/29/2014) C. Subdural and subarachnoid hemorrhages covering bilateral cerebral hemispheres D. Cerebral contusions involving bilateral cerebral hemispheres, pons E. Diffuse cerebral edema F. Status post external ventricular drain and ICP monitor placement (Saint Francis Hospital, 06/29/2014) and repair of lip laceration, nasal and forehead lacerations (Saint Francis Hospital, 06/29/2014) II. Other blunt force injuries A. Partially healed abrasions and lacerations of chest and extremities B. Medical history of bilateral pulmonary contusions and open dislocation of right knee (CT of chest and x-ray of right knee, 06/29/2014) C. Status post incision-drainage of right knee, repair of patellar tendon, patellar ligament avulsion, repair of lateral and medial reticulum, and applications of external fixators (Saint Francis Hospital, 06/29/2014) III. Postmortem organ procurement CAUSE OF DEATH: MANNER OF DEATH: COMPLICATIONS OF TRAUMATIC BRAIN INJURY DUE TO BLUNT FORCE TRAUMA OF HEAD ACCIDENT The facts stated herein are true and correct to the best of my knowledge and belief. OCME, Eastern Division 7/10/2014 1:04 PM JOSHUA LANTER, M.D. Forensic Pathologist Location of Autopsy Date and Time of Autopsy CME-2 Page 1

3 MEDICOLEGAL INVESTIGATION I. CIRCUMSTANCES OF DEATH: This 30 year old male (DOB: 12/6/1983) reportedly became unresponsive after a motor vehicle accident that occurred on 6/29/2014. II. AUTHORIZATION: The postmortem examination is performed under the authorization of the Office of the Chief Medical Examiner, Eastern Division, Tulsa, Oklahoma. III. IDENTIFICATION: The body is identified by hospital staff. Digital photographs of the deceased are taken. POSTMORTEM EXAMINATION I. CIRCUMSTANCES OF THE EXAMINATION: The postmortem examination of Desmond L. Campbell is performed at the Office of the Chief Medical Examiner, Eastern Division, Tulsa, Oklahoma, on 7/10/2014 commencing at 1304 hours. Assisting in the examination are Brittany Crase and Sarah Campbell. II. CLOTHING AND PERSONAL EFFECTS: None III. EXTERNAL EVIDENCE OF RECENT MEDICAL THERAPY: 1. Intracranial pressure monitor of right frontal scalp 2. Intracranial pressure monitor bolt of right frontal scalp cm sutured incision of right frontal scalp 4. Tape covering left and right eyes 5. Orogastric tube within mouth, esophagus 6. Endotracheal tube within mouth, larynx cm sutured vertical incision of anterior torso covered by a white bandage 8. Intravascular access of left supraclavicular chest 9. Cardiac monitor pad of right upper back 10. Bandage of midline lower back labeled 7/3 10:00 BS 11. Metal orthopedic external fixators of right distal leg 12. Intravascular access of left anterior wrist cm sutured incision of right leg extending from knee to anterior distal leg 14. Bandages covering left and right heels 15. White hospital band labeled Campbell, Desmond of the right wrist CME-2 Page 2

4 IV. COLLECTIONS A scalp hair sample, facial hair sample, pubic hair sample, oral swab, rectal, swab, fingernail swabs of the left and right hands and a blood DNA card were procured and introduced as evidence. EXTERNAL EXAMINATION The body is sealed in blue body bag with lock tag # intact. The body is that of an unembalmed, well developed, well-nourished male appearing consistent with the recorded age of 30 years. The body weight is measured at 133 pounds. The body length is measured at 66 inches. The state of preservation is good in this unembalmed body. Rigor mortis is moderately advanced in the arms, legs, and jaw. Lividity is purple and is faint and is noted in the posterior arms, legs, and back and is fixed. The chest and back are symmetrical with normal conformation. The neck is symmetrical and without masses or unusual mobility. Bilateral petal edema is noted. External fixators are noted of the right lower leg. The head, neck, and shoulders are not congested. There is no peripheral edema present. Personal hygiene is good. No unusual odor is detected as the body is examined. The hair is black and worn to a short length. It represents the apparent natural color. There is facial hair composed of a black beard and mustache. The body hair is of normal male distribution. The pupils are round, regular, equal, and somewhat dilated. The sclerae are normal in color. The conjunctival surfaces are not remarkable. The irides are brown in color. No petechiae are noted. The teeth are in a fair state of repair. The gums are normal in appearance. The oral cavity is normal. The nose is symmetrical and the air passages are open. The external ears are normal in appearance and without injury. The male breasts are normal. Examination of the skin reveals various tattoo designs of the right arm, left arm, chest, left leg and right leg; tattoos labeled Nicole are noted of the left neck, East Side of the back, Tammy of the left upper arm, Deborah of the left lower arm, Playa of the left posterior hand and Young of the right posterior hand. Various scars are noted of the left anterior distal leg which range in size from 0.2 to 0.9 cm. A 4.1 x 2.9 cm hyperpigmented spot is noted of the right posterior upper thigh. Examination shows no significant external lymphadenopathy. There are multiple blunt force injuries. INJURIES Multiple partially healed abrasions which range in size from 0.2 to 0.3 cm are noted of the left forehead above the left eyebrow. Bilateral periorbital ecchymosis is noted. There is a 1.0 cm linear partially healed scar and a 2.0 cm linear partially healed scar of the nose. There is a 9.0 x 5.5 cm purple subgaleal contusion covering a 7.0 x 8.0 cm purple periosteal contusion of the right temporal aspect at the vertex of the head. Examination of the brain shows a thin subdural blood clot (dark red and measuring less than 0.3 cm in thickness) covering the right cerebral hemisphere; the cot is lightly adhered to the overlying dura. There are scattered areas of subarachnoid hemorrhage covering the left and right frontal lobes and right temporal lobe. Sectioning of the brain shows numerous intraparenchymal hemorrhagic contusions involving the CME-2 Page 3

5 white and grey matter, which range in size from 0.4 to 1.9 cm. The largest intraparenchymal hemorrhagic contusion is noted of the right temporal lobe and it measures up to 5.8 cm. A 2.5 x 1.0 cm partially healed abrasion is noted of the right supraclavicular region of the chest. A 0.6 x 0.5 cm partially healed abrasion is noted of the left chest above the left nipple. A 2.0 x 1.0 cm region of skin excoriation is noted of the lower back. A 4.0 cm linear partially healed abrasion is noted of the left anterior upper arm. Multiple small 0.2 cm partially healed abrasions are noted of the left anterior forearm. Multiple horizontal and linear partially healed abrasions are noted of the left posterior forearm which range in size from 0.5 to 4.1 cm. A 1.0 x 0.4 cm partially healed abrasion is noted of the right posterior upper arm. Multiple partially healed abrasions which range in size from 0.2 to 0.7 cm are noted of the right posterior hand. There are multiple partially healed abrasions of the right anterior medial leg which range in size from 0.2 to 3.9 cm. Multiple partially healed abrasions which range in size from 0.2 to 6.1 cm are noted of the right anterior leg at the knee. There are multiple partially healed abrasions of the right anterior distal leg which range in size from 0.2 to 1.6 cm and there is a 1.0 x 1.0 cm partially healed ulcer/abrasion of the right medial ankle. Multiple partially healed abrasions which range in size from 0.2 to 8.9 cm are noted of the left anterior leg at the knee and left anterior distal leg. BODY CAVITIES The body is opened through the customary Y shaped incision. Subcutaneous fat is normally distributed, moist, and bright yellow. The musculature through the chest and abdomen is rubbery, maroon, and shows no gross abnormality. There is a previous sternotomy (secondary to postmortem organ procurement); otherwise the sternum is removed in the customary fashion. PARIETAL PLEURA: There is approximately 500 ml of liquid blood in the left and right pleural cavities. PERICARDIUM: Pericardial sac and heart have been removed secondary to postmortem organ procurement. PERITONEUM: Is smooth, glistening membrane in both the abdominal and pelvic cavities. The peritoneal cavity contains no abnormal fluid or adhesions. CME-2 Page 4

6 HEART: The heart has been removed secondary to postmortem organ procurement. The thoracic aorta, (extending from the distal aortic arch to the abdominal aorta) is free of abnormality. NECK ORGANS: There are multiple areas of hemorrhage of the left anterior neck which extend from the percutaneous intravascular access point of the left supraclavicular region. The musculature is otherwise normal, rubbery, maroon, and the organs are freely movable in a midline position. The tongue is intact and normally papillated, without evidence of tumor or hemorrhage. The hyoid bone is intact. The cartilaginous structures forming the larynx are intact and without abnormality. The thyroid gland is symmetric, rubbery, light tan to maroon, and in its normal position without evidence of neoplasm. The epiglottis is a characteristic plate-like structure which shows no evidence of edema, trauma, or other gross pathology. The larynx is comprised of unremarkable vocal cords and folds, is widely patent without foreign material, and is lined by a smooth, glistening membrane. There are no petechiae of the epiglottis, laryngeal mucosa, or thyroid capsule. THYMUS: No significant tissue is identified grossly. LUNGS: The right and left lungs have been removed secondary to postmortem organ procurement. G.I. TRACT: The esophagus shows an unremarkable mucosa, a patent lumen, and no evidence of gross pathology. The esophagogastric junction is unremarkable. The stomach is of normal configuration, is lined by a smooth, glistening, intact mucosa, has an unremarkable wall and serosa, and contains approximately 100 ml of a brown homogenate which has passed to the duodenum. The proximal duodenum has been removed secondary to postmortem procurement. Jejunum and ileum are unremarkable and contain soft brown fecal material. There is no Meckel s diverticulum. The ileocecal valve is intact and unremarkable. The appendix is not identified. The colon is examined segmentally and shows no evidence of neoplasm or trauma. There are no diverticula. Anus and rectum are unremarkable. LIVER: The liver has been removed secondary to postmortem organ procurement. CME-2 Page 5

7 GALLBLADDER: The gallbladder has been removed secondary to postmortem organ procurement. PANCREAS: The pancreas has been removed secondary to postmortem organ procurement. SPLEEN: The spleen has been removed secondary to postmortem organ procurement. ADRENALS: The adrenals have been removed secondary to postmortem organ procurement. KIDNEYS: The left and right kidneys have been removed secondary to postmortem organ procurement. URINARY BLADDER: The urinary bladder is empty. Its serosa and mucosa are unremarkable. MALE GENITALIA: The prostate is symmetric, rubbery, gray-tan, and of normal size. The seminal vesicles are unremarkable. The prostatic urethra is unremarkable. The testes are bilaterally present and show no evidence of tumor, trauma, or inflammation. The investing membranes are unremarkable as is the epididymis. BRAIN AND MENINGES: Injuries to the scalp and brain are described in the Injuries section above. The scalp is opened through the customary intermastoid incision. The calvarium is removed through the use of an oscillating saw and is intact without evidence of osseous disease. The brain weighs 1350 gm. Aside from the previously described injuries, diffuse cerebral edema is noted and multiple serial sections of cerebral hemispheres, midbrain, pons, medulla, and cerebellum show no gross pathological change apart from moderate congestion. The ventricular system is also symmetric and unremarkable. The base of the skull is intact without osseous abnormality. RIBS: Intact. CME-2 Page 6

8 PELVIS: Intact. VERTEBRAE: Scoliosis is identified involving the distal thoracic vertebra. BONE MARROW: Moist and dark red. Unremarkable. TOXICOLOGY See attached report. MICROSCOPIC EXAMINATION Brain: Sections show subarachnoid hemorrhage, intraparenchymal contusions and diffuse cerebral edema. OPINION The cause of death is complications of traumatic brain injury due to blunt force trauma of head. The manner of death is ruled an accident. CME-2 Page 7

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