Office of the Chief Medical Examiner CB # 7580 Chapel Hill, NC 27599-7580 Telephone 9199662253 REPORT OF AUTOPSY EXAMINATION DECEDENT Document Identifier B201100793 Autopsy Type ME Autopsy Name Brandon Maurice Bethea Age 24 yrs Race Black Sex M AUTHORIZATION Authorized By Linda M. Robinson MD Received From Harnett ENVIRONMENT Date of Exam 03/16/2011 Time of Exam 9:00 Autopsy Facility Office of the Chief Medical Examiner Persons Present Simmons Mr. Kevin Gerity, Dr. Sam CERTIFICATION Cause of Death Complications of conducted energy device application (see Summary) The facts stated herein are correct to the best of my knowledge and belief. Digitally signed by Jonathan Privette MD Samuel D. Simmons MD DIAGNOSES Conducted energy device application Skin punctures (2) with associated contusions Pulmonary congestion and edema (combined lung weight 1900 grams) Terminal gastric aspiration Pulmonary adhesions Coronary atherosclerosis, moderate Resuscitation-related injuries Sternum fracture Puncture with associated hematoma, neck IDENTIFICATION Body Identified By Papers/ID Tag EXTERNAL DESCRIPTION Length 73 inches Weight 174 pounds Body Condition Intact Rigor 1+ Livor Posterior, fixed Hair Black with beard and mustache Eyes Brown Teeth Natural in good repair Received in a white disaster pouch is the body of a well developed, well nourished adult black male appearing compatible with the reported age. The body is clad in a sock on the right foot, orange pants with the right leg previously cut, white underwear, a white undershirt and an orange shirt. Both shirts have previously been cut. Nothing accompanies the body. Identifying marks and scars consist of multiple well healed scars and tattoos as diagrammed. Page 1 of 5
Evidence of medical intervention includes ID bands, an intraosseous access, a Foley catheter containing clear urine, puncture wounds, single lumen catheters in the bilateral arms, a nasogastric tube and an endotracheal tube. INJURIES Located on the left chest are two puncture wounds with associated circumferential contusion extending to 1/4". One of these puncture wounds is immediately inferior to the left clavicle, the other is inferior to the left nipple. These wounds are consistent with punctures from the darts of a conducted energy device application. The sternum is fractured at the level of ribs #5; this injury is likely related to resuscitation efforts. Located on the left neck is a puncture wound with an underlying hematoma which measures approximately 2" in each dimension; this injury is most consistent with attempted IV line placement during resuscitation efforts. No other significant internal or external injuries are present. DISPOSITION OF CLOTHING AND PERSONAL EFFECTS The following items are released with the body Socks, pants and underwear. The following items are preserved as evidence The following items are collected at autopsy and preserved as evidence. They are released to Tiffany Cohn of the North Carolina State Bureau of Investigation on March 16, 2011. Blood card Shirts (2) INTERNAL EXAMINATION Body Cavities The bilateral pleural and peritoneal cavities contain no significant fluid. No peritoneal adhesions are present. Cardiovascular System Heart Weight 390 grams The pericardial sac is free of significant fluid and adhesions. The coronary arteries arise normally, follow a left sided distribution and exhibit approximately 50% stenosis of the left anterior descending coronary artery. The chambers and valves bear the usual size-position relationships and are unremarkable. The myocardium shows no evidence of acute infarction, scarring or focal lesions. The aorta and its major branches are intact without significant atherosclerosis. Respiratory System Right Lung Weight 900 grams Left Lung Weight 1000 grams Examination of the soft tissues of the neck including the strap muscles and large vessels reveals no abnormalities. The hyoid bone and laryngeal cartilages are intact. The larynx is clear. The lingual mucosa is intact; the underlying musculature is devoid of hemorrhage. The upper airways are free of debris and foreign material. The lower airways contain foreign debris in all lung fields. The lungs are normally formed. The parenchyma of both lungs is extensively congested. The pulmonary arteries are free of thrombi or emboli. There are pulmonary adhesions bilaterally. Gastrointestinal System The GI tract is intact throughout its length and is unremarkable. The stomach contains approximately 100 ml of partially digested food. Liver Liver Weight 1920 grams The capsule is intact and the parenchyma is unremarkable. The gallbladder contains approximately 5 ml of bile and the extrahepatic biliary tree is patent. Spleen Spleen Weight Page 2 of 5 190 grams
The spleen is normally formed; no focal lesions are present. Pancreas Normal size, shape and consistency without focal lesions. Urinary Right Kidney Weight 160 grams Left Kidney Weight 170 grams The kidneys are of normal size and shape. The capsules strip with ease from the underlying smooth cortical surfaces. The renal architecture is intact without focal lesions. The bladder is empty. Reproductive The prostate gland is grossly unremarkable. Endocrine The thyroid gland and bilateral adrenal glands are grossly unremarkable. Neurologic Brain Weight 1350 grams Reflection of the scalp reveals no evidence of injury. There are no skull fractures identified. The leptomeninges are thin, delicate and congested. The cerebral hemispheres are unremarkable. The vasculature at the base of the brain is intact without significant atherosclerosis. Coronal sections reveal normal architecture without focal lesions. Skin Except as noted, grossly unremarkable. Immunologic System Grossly unremarkable. Musculoskeletal System Except as noted, grossly unremarkable. MICROSCOPIC EXAMINATION Cardiovascular Four sections of heart, including the septal and free left ventricle wall are examined and show early autolytic changes without other significant histologic abnormalities. Respiratory Five sections of lung are examined, showing vascular congestion, intra-alveolar eosinophilic fluid and foreign body (food) material with associated bacteria and without adjacent vital reaction. No significant mucus plugging is present. Liver A section of liver shows early autolytic changes. Genitourinary A section of kidney shows early autolytic changes. Neurologic A section of brain shows no significant histologic abnormality. SUMMARY AND INTERPRETATION The decedent was a 24-year-old man with a reported history of schizophrenia and asthma. He was in custody when a conducted energy device was applied; the device was reportedly activated more than once. After falling to the floor in the prone position, he was placed on his back by jail staff and left alone in his cell; there is no report of other physical restraint or handcuffing. Per reports, he was found unresponsive in his cell approximately twenty minutes later, and could not be resuscitated by EMS personnel. Significant findings at autopsy include evidence of a conducted energy device application manifested by skin punctures with associated contusions; pulmonary congestion and edema with terminal gastric aspiration and pulmonary adhesions; moderate coronary artery atherosclerosis; and resuscitation-related injuries manifested by a sternum Page 3 of 5
fracture and puncture with associated hematoma of the left neck. No benzodiazepines, cocaine, ethanol, opiates/opioids, or organic bases are detected on postmortem toxicological analysis of aorta blood. Given the autopsy and investigative findings, it is our opinion that the cause of death in this case is complications of conducted energy device application. DIAGRAMS 1. Adult (front/back) Page 4 of 5
Page 5 of 5