In today's episode, we talk about the death of an individual.

So if you find that type of thing upsetting, this is not the episode for you.

Welcome and mayhem the more with your host, Doctor Kendall Crown.

Back when I was first starting out, one of the senior pathologists said to me, you know, we don't autopsy in a vacuum.

And I said to him, well, what does that mean, you know, nothing better than a cryptic statement to start your day, And he said, well, you know, the autopsy is not the only part of our investigation.

We can't come to a proper cause and man or death without numerous things, and that includes a thorough death investigation, crime scene photographs, crime scene investigation, medical records, EMS reports, police reports, toxicology findings, microscopic findings.

All these things come together for us to make our final opinion of the cause and manner of death.

And without any of these in just the autopsy, it could be hard to actually get the right conclusions.

And over the years I have learned that that is very true.

So one of my best examples if we don't autopsyne at vacuum is the following case.

The case is that of a middle aged male who worked on a janitorial crew.

On the day of his death, he was working with his crew at a renal dialysis clinic and they were cleaning the cafeteria.

Two of the members of the crew were in the cafeteria with him when one of them witnessed him to drop his mob clutch, his chest, wobble and slump into a chair.

He quickly became unresponsive.

They called emergency medical services and when EMS arrived, they initiated CPR.

They found him to be in ventricular fibrillation, which is an irregular heartbeat.

They shocked him with an external defibrillator, but it didn't work and he quickly deteriorated into pulselessness or a sistily and died.

He was brought to the medical Examiner's office and the next day I was the one that performed the audio topsy, so I started with the external examination.

He was nude, no clothing came in with them.

He was a middle aged male.

No real external evidence of injury except on each side of his chest.

There was one burn mark.

They were kind of circular, not one inch in diameter.

They were the only injuries that were on him.

So I was looking at that and I was like, these burn marks don't make sense, and I asked, was he around electricity, was he a brown something with fire?

Anything to explain these burn marks.

So the death investigators looked into the scene a little bit more.

No, he was in a cafeteria.

He was standing near some big round tables.

Nothing really going on, no electricity, no fire, nothing.

Police reports didn't say anything different.

He did come in unclothed.

I asked about the clothing I was looked into.

The clothing had been cut away at the time he made it to the er and had all been thrown away, so there was no clothing available either.

So I all I had was these two regular birdmarks.

So I did an internal examination.

The burn marks seems superficial, but what he did have was a very enlarged heart.

It was about five hundred grams, which normal heart's around three forty five somewhere in there.

So he had a big heart, thick and left ventricle of the heart or left entry lyropotrophy, which is those two findings are very common with hypertensive carriovascular disease.

He had coordinary atherosclerosis, which is hardening of the arteries.

So these two findings are consistent with athriscrac and hypertensive cardiovaster disease, or in other terms, he had a heart attack.

Using the information I had, I signed him out as athriscrac and hypertensive cardiovasar disease and the manner of death natural.

When I moved on to my next cases and didn't think anything more of it.

A couple weeks went by and one of the other janitors came forward and said that the initial story was a fabrication.

He said, what really happened was one of the janitors was a bully.

The middle aged man that died had learning disabilities, and the bully loved to torment him.

He would push him, he'd hit him, he'd call him names, and one time he even fetish shirt into a paper shredder.

And on this particular day, the bully was playing around with an external defibrillator he found in the dialysis clinic and his pushing buttons, flipping switches, turning dials.

When he finally got it to make this high pitched wine, the other guys and the crew told him, hey, quit messing around with that, and he told him to shut up.

And then he saw the middle aged man, and he said, hey, come here, dummy, come here, And the middle aged man wandered over to him, holding his mop held at both the defibrillator paddles, placed him on the middle aged man's chest and discharged them.

When they discharged, the middle aged man dropped his mop, wobbled and fell into a chair in the cafeteria and became unresponsive.

So part of this story was true.

You know, he dropped his mop, he wobbled, he fell into a chair, and became unresponsive.

But they left out the critical element of he had been shocked with a defibrillator before all this happened.

So with that information now I had an explanation with the burn marks.

The thing about a defibrillator is is when they use it on people in the hospital, it's to shock them out of an irregular rhythm.

So if your heart's gone into an irregular rhythm from a heart attack, the defibrillator can shock it out of that irregular rhythm and save your life.

If your heart's completely stopped, it cannot shock your heart back into operation, which is kind of a misnomber created by TV and movies, etc.

All it can do is take your heart out of an irregular rhythm and try and jump start it back into a normal rhythm, saving your life.

But if your heart's in a normal rhythm like the middle aged man's was, it'll put it in an abnormal rhythm that can result in your death.

And that is what happened here.

So that electricity crossing his heart, causing the two burn marks on either side of his chest, is what caused his death.

So with this new information, I changed the cause of death to electrocution, and of course, since it was intentional harm done by someone onto another, it changed the natural manner of death to homicide, so electrocution homicide.

And how that case ultimately was signed out.

So what happened to the bully.

The bully fully confessed to what he did and he was given a prison sentence.

I don't think it was very long, but I don't know the whole final end of that portion of the story.

But this proved we don't autopsy in a vacuum.

Without that information, it totally changed the cause and manner of death and made it a heart attack and natural.

But with the information it changed it to electrocution and homicide, So we don't autopsy in a vacuum.

We're only as good as the investigation we received that brings us to the end of the episode, and I hope you learned something.

I hope you were entertained until the next time