Dr. G: Medical Examiner - Season 1, Episode 2 - Hit and Run - Full Episode | Forensic Files

[EERIE MUSIC] [POLICE SIREN] NARRATOR: The body of a hit-and-run victim arrives at the morgue.
DR. G: Some broken ribs, facial fractures. NARRATOR: Police are looking for answers,
but photos from the crime scene aren't adding up. We're putting a two-inch circle around the body.
NARRATOR: Will a surprise medical finding challenged the police's theory? Then, the routine autopsy of an 88-year-old woman
takes an unexpected turn-- DR. G: She's got a nice bump on the back of her head.
NARRATOR: --when Dr. G finds signs of trauma and must dig deeper. DR. G: How do we know somebody didn't assault her?
NARRATOR: And a man with a rare genetic condition suddenly falls dead at his 35th birthday party.
He just collapsed to the ground. I couldn't believe that he was gone. NARRATOR: The man's brother carries the same rare defect.
Can Dr. G tell whether he will suffer a similar fate? I don't want to lose my other son.
[THEME MUSIC] NARRATOR: Altered lives, baffling medical mysteries, shocking revelations--
these are the everyday cases of Dr. G, medical examiner. [PHONE RINGING] NARRATOR: Late one February night Daniel Barrow
is found lying face down in the parking lot of an Orlando hotel. He is unconscious and covered in bruises.
NARRATOR: When Florida highway patrol arrived at the scene, the circumstances suggest a crime--
Daniel sprawled out with automobile skid marks leading directly to his body. SGT. BLACKWELL: Our dispatchers notified our homicide units.
The Orange County Sheriff's Department had arrived on the scene of an individual who was laying
in the parking lot that appeared to have been run over by a vehicle, and the vehicle had left the scene.
[POLICE SIREN] NARRATOR: EMS workers managed to restart Daniel's heart, but he never regains consciousness.
Two days later, he dies at Orlando county hospital. [AMBULANCE SIREN] Like a thief in the night, hit-and-run incidents
take the lives of 20 people each day in the United States. Designated as homicides, they fall under the jurisdiction
of the medical examiner. In Orange County, Florida, that person is Dr. Jan Garavaglia,
better known as Dr. G. So nothing going on today? What's after school? Just Spanish, right?
Tuesday. All right, so who's picking you up today? You. DR. G: OK. NARRATOR: When death strikes without explanation,
she's the one who must unlock the secrets and answer the questions. When Dr. G gets to the morgue at 7:30 AM,
the bruised and lifeless body of Daniel Barrow has just arrived from the hospital.
DR. G: He was found, basically, in the parking lot, I believe, on the 19th. And I believe he dies two and a half days later.
Pretty much was dead when he got there. They were just keeping him alive, trying to get his heart to come back.
We're going to have to do some research. We're going to have to get some info on what he's
been up to, who saw him last. All we're getting is what the EMS told the hospital, so we need to see if the police
have a written report on it. NARRATOR: Police arrive at the morgue hoping for findings that could help them in their hunt
for the driver of the car. It's got some dirt over here. It doesn't looks like tire, but it's got dirt over here.
SGT. BLACKWELL (VOICEOVER): We brought the evidence that we had, the clothing, all our field sketch, our notes.
SGT. BLACKWELL: This is where the body was, here. NARRATOR: Police inform Dr. G that Daniel Barrow had been
living alone for several months in an efficiency apartment at the Hawthorne Street hotel.
Neighbors hardly knew him, and officers are alarmed by the condition of Daniel's
home, which is littered with empty bottles of vodka. SGT. BLACKWELL: The apartment was very disheveled.
It was a mess. And they were kind of concerned as to whether or not this man might have been--
someone robbed him or something like that. NARRATOR: As questions multiply, detectives manage
to track down Linda, a friend and former co-worker of Daniel's. He was all heart.
He was phenomenal. He could talk just about anything. His lifestyle-- very simply, he worked hard and he played hard.
NARRATOR: According to Linda, Daniel had started a new life in Florida after a painful divorce 10 years earlier.
He soon landed a job as a sales consultant, and trained to run a marathon in his spare time.
But it was no secret that the divorce was hard on Daniel, and that he too often drank his pain away.
LINDA: I would think that it started off gradually. You know, we all drink once in a while,
but then, he just got out of hand. NARRATOR: On first glance, Daniel's history of alcohol abuse may suggest that drinking somehow played
a role in his death, yet hospital tests revealed that he had no alcohol in his blood the night he died.
This new evidence, however, does little to help Dr. G get to the bottom of the hit-and-run homicide.
Her first task is to examine and evaluate Daniel's bruises, over 20 of them. DR. G: He's got some bruises around the knees,
pretibial region, and bruises on both hip regions. So this one's a little more lateral,
got some abrasion with it. You can see that's a linear abrasion. That would not be inconsistent with a fall either.
NARRATOR: Daniel even has injuries on his mouth. DR. G: He's got some bruising on the lips, too.
Two little bites to the lip with some bleeding around it, but he also bit his lip-- he bit his tongue pretty bad.
NARRATOR: Dr. G documents all of Daniel's bruises, but her eyes are peeled for a pattern
of injuries that can tell her where the car struck his body. DR. G: Typically, what happens is they get the lower bumper
fractures on the legs, depending on how high the car is, how fast the car is going.
NARRATOR: The force of the impact then throws the body upward. They'll get the bumper fracture on the leg.
It'll toss him up, and he'll hit the hip, impaling on the hood somehow. NARRATOR: Hitting the windshield is often the fatal blow.
A lot of times, they'll hit the windshield with their head. It depends on the speed.
NARRATOR: But Dr. G's findings aren't adding up. For all the bruises on Daniel's body,
he bears none of the tell-tale hit-and-run signs-- no fractures on his skull, hips, or legs.
DR. G: There's no way a car hit him and caused him to go down. He's just got nothing here that's consistent with that.
NARRATOR: But this conclusion raises another important question. Could Daniel have collapsed to the ground
and then have been run over? DR. G: The only thing I was worried about is, hey, he could be down and a car go over him.
That's still a possibility. It's not just blood. NARRATOR: To find the answer, Dr. G turns to police
photos from the scene. Hopefully, another look at them will offer a clue to understanding Daniel's injuries.
This photo shows the tire mark and the outline where Daniel's body was found. Immediately, Dr. G spots something amiss.
We're putting a two-inch circle around the body. How's the tread going over him if it
goes right through the outline? And there's nothing forensically that suggests it.
NARRATOR: If Daniel had been run over by a car, the treadmark would not travel through the outline
of his body. The tire marks at the scene had been burned into the pavement before Daniel fell.
I don't see how the car had any much to do with the whole thing. I don't have any evidence of it.
We don't either. NARRATOR: Suddenly, this open and shut case of hit-and-run has become anything but shut.
If an automobile did not cause Daniel's bruises, what or who did? Could he have been the victim of an assault?
We're going to look, see if there's any signs of a struggle, see if any signs that he's fighting
anybody off, basically. Your hands tell a lot. So we're going to really look for bruises
on his hand, bruises that indicate he may have been in a fight. He definitely has abrasions over the
proximal interphalangeal joint. NARRATOR: It's not just the number of contusions,
but their color, which start to give Dr. G more of the story. DR. G: Two little purple contusions,
a little green contusion-- I'm trying to determine if they're all different ages, if they're all about the same time.
Different ages indicate that he's constantly falling kind of thing. NARRATOR: As a bruise ages, the color changes from red
and purple all the way to yellow, green, and brown. Daniels bruises run the full spectrum.
The range of colors lead Dr. G to believe that Daniel's contusions could not possibly be the result of a single incident
on the night of his death. From the outside, it doesn't seem that he was in a fight at all.
DR. G: But, you know, we've got multiple bruises of various ages on his, you know-- his little-- some
on his buttocks. That's a little odd for a beating. They're not, like, kicks or anything,
just little small bruises-- two green, two blue. You know, we've got bruises around the knees,
abrasions around the knees. Of course, he could have fallen and somebody still beaten him.
I don't know. The only thing-- NARRATOR: But as always, the internal autopsy should
provide a clearer picture. It's time to open Daniel's chest. After a Y-incision is made, pruning shears
are used to gain the leverage needed to cut through the tough bones of Daniel's sternum.
Once inside, Dr. G finds that Daniel has two broken ribs. Could this be evidence of an assault?
--hemorrhage is or the rib fracture is. Do you see any hemorrhage here? I don't either.
Look at this one. A little bit of hemorrhage here. Do you see any hemorrhage on the outside?
Me neither. NARRATOR: If Daniel's ribs had been broken during a fight, the injuries would most likely be
asymmetrical and show hemorrhaging, internal bleeding. Dr. G's experience tells her that Daniel's ribs
were probably broken by the EMS technicians. DR. G: The rib fractures are nothing.
He's got one, two rib fractures, minimal bleeding. This guy's probably got them from CPR.
They're very minimal and they're bilateral. I think they're from CPR. NARRATOR: With no internal injuries,
Dr. G is now certain that Daniel was not attacked on the night he died. No hit-and-run, no assault, no crime, but she's
still perplexed by the battered condition of his body. It's beginning to appear as if his injuries may have been
sustained from multiple, unrelated accidents-- falling down or bumping into things.
Dr. G finds her next clue in Daniel's medical records. It turns out that Daniel had been hospitalized just four
months earlier after a strangely similar incident to the one that killed him in the parking lot.
DR. G: And it looks like this admission. He's walking along the parking lot and he
just mysteriously falls-- trips, he says-- falls down, hits his face, and becomes acutely confused.
Goes to the hospital. They work him up, couldn't really figure out why. I guess the confusion passed.
I guess they just contributed to concussion. I'm not sure. NARRATOR: Falling down, disorientation, confusion.
What could cause this strange mix of symptoms? Coming up next, Dr. G finds the clue
that could finally make sense out of Daniel Barrow's death. And later, an accomplished woman,
admired by friends and neighbors, is found dead at the base of a staircase. DR. G: The question is, is there trauma associated with it
or from something natural? NARRATOR: With no witnesses, can Dr. G reconstruct the last moments of her life?
At first, 41-year-old Daniel Barrow, a man found badly bruised and near death in a hotel parking
lot, appeared to be a clear cut case of hit-and-run until he was examined by medical examiner
Dr. G. After proving that his injuries were not caused by an automobile or physical assault,
Dr. G is determined that Daniel was not killed as a result of a crime. But she has discovered that the victim
had an inexplicable propensity for falling down. Could that have something to do with his death?
[MUSIC PLAYING] Inefficient way to-- NARRATOR: After taking samples of Daniel's body fluids
and finding both heart and lungs normal, Dr. G removes his liver. Yeah, his liver looks alcoholic.
NARRATOR: Looking at it, she can tell that Daniel's drinking was more out of control
than even his friend suspected. Oh, this is one big liver. Liver looks bad. This is a stage before the cirrhosis.
This is when your liver gets big, and swollen, and it's full of fat. It has to do with the toxic effects of the alcohol.
NARRATOR: Daniel's liver is in a state of fatty metamorphosis. The damaged liver cannot process fatty substances,
which then accumulate in the cells, causing his liver to balloon to twice its normal size.
This finding explains Daniel's extensive bruising. A diseased liver is less able to produce the factors
needed for blood clotting. As a consequence, bruising occurs more frequently. He had very bad liver disease, and he
would bruise very easily. NARRATOR: The liver is proof positive of Daniel's severe alcoholism.
For Dr. G, it's also a crucial clue that breaks the case wide open. With blood alcohol tests showing an alcohol level of zero
on the night of his death, the discovery that alcohol damaged his liver now enables Dr. G to piece together the cause of death.
The final cause of death was complications of chronic ethanol abuse. Most likely, the mechanism is an alcohol withdrawal seizure.
NARRATOR: Daniel was an alcoholic who died because he had no alcohol in his system.
DR. G: Alcohol withdrawal seizure is a seizure due to the fact that your brain is not
exposed to alcohol anymore, believe it or not. These people are so dependent on the alcohol.
NARRATOR: The seizure not only affects motor coordination, but in severe cases muscles that control vital functions.
This renders the victim unable to breathe or pump blood. With this hypothesis, Dr. G now believes
she can explain what really happened to Daniel Barrow three nights ago in the hotel parking lot.
Daniel Barrow is drying out. He has no more alcohol left to drink. Time passes. Initial symptoms of withdrawal force him out of the building
in search of a drink. As he walks across the parking lot, the seizures begin. Nerve cells in Daniel's brain fire abnormally.
He is unable to control his movements. He falls to the ground, causing more bruising to his already
battered body. His muscles turn rigid and contract violently. Two of his injuries are consistent with this.
They have a bite mark on his tongue and a bite mark on his lip. NARRATOR: The convulsions last anywhere from 30 seconds
to five minutes, during which time his vital functions are failing. As Daniel lies dying on the pavement,
an eyewitness calls 911. SPEAKER (VOICEOVER): 911, what's your emergency? CALLER (VOICOVER): Yes, I'm calling
from the Hawthorne Street Hotel, and I believe someone just got ran over. NARRATOR: When police arrive on the scene,
the tire tracks adjacent to Daniel's body and his severe bruising lead them to conclude
that he was struck by a car. While EMS workers frantically treat him for injuries they believe are caused by a hit and run driver,
Daniel's organs are failing and his brain is no longer functioning normally. He will never regain consciousness.
Daniel's case is not uncommon. Every year, over 10,000 alcoholics die from complications of long-term alcohol abuse.
In many instances, those who suffer from alcoholism never reach out for help, leaving
behind friends and family who are confused and saddened by senseless loss. LINDA: I couldn't help him because he didn't want help.
He wouldn't share himself. He wouldn't reach out and say, this is what's going on with me.
If there is a moral to this story, if there's anything wrong with you, even if there's not anything wrong with you,
you can't do this life all by yourself. Oh, It's terribly tragic. He was just one of the most delightful individuals
I ever met. NARRATOR: With Daniel Barrow, Dr. G dealt with a complicated case that ended up
with a common cause of death-- alcohol abuse. Sometimes, though, a case that at first may seem routine
is anything but. Sandra Collins was 88 years old, an age fewer than 3% of us live to see.
Early on the morning of March 9, her body is discovered outside of her Orlando area apartment, close to the base of an exterior staircase.
Did her elderly body simply fall prey to a heart attack or stroke, or was this a case of foul play?
Because no one saw her die and her body was found in a public area, these questions
are now in the hands of the Orange County Medical Examiner's Office. And what address are you at?
Where's the scene at? OK. I'll be leaving here in about five minutes and I'll be en route.
NARRATOR: Dr. G's field investigator, Dean Boyd Smith, is sent to retrieve the woman's body and any information
about her death. As Boyd returns from documenting the scene, he offers up the case's first observations.
Another resident at the apartment complex found her. It's kind of a retirement. A lot of older people live there.
Her body conditions would indicate she's been there probably all night. There is no external trauma to the body that I can find.
Photography was done at the scene. The steps were looked at very closely. There's no evidence of hair or blood on the steps anywhere.
NARRATOR: Dr. G reviews the case. At first glance, the circumstances and the woman's age both point towards a natural death--
a sudden heart attack or perhaps a stroke. Now, the next one is an unfortunate woman.
She's 88. You always hate to autopsy people who are 88, but trauma can happen to people 88, too.
NARRATOR: But then, Sandra is not a typical retiree. To Dr. G, her body seems more suited to climbing stairs
than lying lifeless at the bottom of them. Her hair is very long hair-- beautiful hair, actually.
About 22 inches in length. Beautiful nails, beautiful hair, nice teeth. She does seem in very good shape for somebody 88.
I'm sure she took very good care of herself. NARRATOR: Friends and family agree.
They know how full of life Sandra was for her age. To think that she died of natural causes
just doesn't sit right. She promised, actually, that she was going to live until she was 104.
And if you knew her, everyone believed it. It was so shocking because she was a woman who was so determined.
Always did what she said she was going to do. Big old bruise back there. NARRATOR: In the morgue, Dr. G's external exam
quickly uncovers something. Now, she too questions whether Sandra died a natural death.
We've got it here. She's got a nice bump on the back of her head. Oh, yeah. Get a bruise on her back.
NARRATOR: Dr. G doesn't yet know the severity or nature of Sandra's head injury.
But its presence opens up a host of new possibilities. I do feel a bruise back there.
Question is, is there trauma associated with it, or did she fall from something natural and then hit her head?
So we have to sort that out. It was unwitnessed. Heck, I mean, how do we know somebody didn't assault her?
The whole thing's unwitnessed. She's just found outside at the bottom of the step.
NARRATOR: Can Dr. G tell what tragic event took the life of elderly Sandra Collins?
Was she beaten? Did she fall? Only the autopsy will tell. We don't know until we open her.
NARRATOR: And later, to understand the strange and sudden death of a man living in a group home,
Dr. G calls for a second opinion. Do you think doctors know everything all the time?
We are constantly learning. That's the beauty of medicine. You never can learn it all.
NARRATOR: Inside the morgue lies the body of 88-year-old Sandra Collins. At her age, the likelihood that she died from natural causes
might normally rule out an autopsy. But Dr. G suspects a hidden factor may be behind the death
of this active retiree who was found dead at the bottom of a staircase. We've got it here.
NARRATOR: To start with, there is a good sized bump on the back of her head. Trauma can happen to people at 88, too.
Makes me want to think, though. My mom lives alone, and I didn't call her last night.
So I better call her tonight. NARRATOR: The hit on the head Sandra suffered leaves
Dr. G with two questions. Did the injury kill her, and if so how did it happen? Dr. G believes the answer lies beneath Sandra's scalp
and skull. So that's where she begins her internal autopsy. Her assistant removes the upper portion of the skull,
exposing the woman's brain. She's got blood. You can see all the blood that was on top of her brain.
She's definitely got a subdural hematoma. NARRATOR: A subdural hematoma occurs when a damaged vessel
leaks blood between the surface of the brain and its outermost membrane, the dura.
Dr. G also sees Sandra's skull is fractured and her brain is badly swollen. In severe cases like Sandra's, the subdural hematoma
and the brain swelling constrict the brain, cutting off vital functions. Dr. G now knows one thing for certain.
This woman did not die of a heart attack or a stroke. Sandra's head injury was lethal.
She died from the craniocerebral injuries, a skull fracture causing the contusions to the brain
with subdural hematoma. So that was definitely trauma to the head that she died from.
NARRATOR: But what caused the blow? She's got some compression. NARRATOR: Did she simply fall down the steps,
or was she the possible victim of an assault? As Dr. G examined Sandra's brain more closely,
the injury itself gives her the answer. She's got one bruise to the back of her head,
right around the hat brim area, on the right posterior aspect. So we know that's the impact site.
No other bruise is present. But yet, underneath that bruise, we don't see a whole lot of trauma.
NARRATOR: Inside Sandra's skull, directly under the fracture site, on the heads right side, Dr. G sees only
a small bruise on the brain. But the subdural hematoma and the fatal contusion is opposite on the front left side of Sandra's brain.
So the exact opposite would be the front part of the brain on the left side. And on there, she had very extensive bruising.
NARRATOR: The bruising on the side opposite to where her head was impacted is known as a contrecoup injury.
It forms when the brain is slapped hard against the far side of the skull, opposite from where an impact occurred.
So the contrecoup contusion is opposite. That's what contra means, opposite-- supposedly in French--
to the trauma. NARRATOR: This type of injury tells Dr. G that Sandra's head was moving quickly,
when it came to a sudden, violent stop. In other words, Sandra died because her head
smacked against something, not because something smacked against it. A blow to the skull would have produced a much
different injury pattern. So everything is consistent with a fall. NARRATOR: Dr. G can now clearly state the cause of death.
Sandra fell down a flight of steps and suffered a fatal head injury. But Dr. G doesn't consider the case closed.
There is still a fundamental question left unanswered. Why did Sandra Collins fall?
DR. G: She isn't in perfect health. She could've just fall and hit her head and tripped.
You just don't know. NARRATOR: Dr. G reaches out to Sandra's friends and loved ones.
Hi. This is Dr. Garavaglia at the Medical Examiner's office in Orlando. NARRATOR: She tells them what she knows about how Sandra died
and probes for clues. I automatically expected that the medical examiner I was going to talk to was going to be a man.
I don't know why. So I got on the phone with this woman, who was extremely friendly and warm.
At the beginning, they thought it was probably a natural disease, that maybe she'd had a heart attack
and just kind of collapsed down the stairs. I was really shocked when the medical examiner
told me that her death had occurred as a result of the trauma. And then something happened that was funny.
She said, "I know that you are the one that is supposed to ask questions to me, but I have to ask you.
I have a feeling about this woman." I don't know what it was, but I was taken by the fact
that I know I would have liked her when she was alive. I was so excited to share with the doctor
the things that I knew and loved about her. NARRATOR: As Marilyn shares what she knows about her old friend,
she reveals a surprising detail about Sandra's last days. For Dr. G, it is the missing link.
Now, we didn't get this in our medical records, but from what her friends said, she
had had some type of a laser procedure that didn't go well. NARRATOR: According to her friends,
Sandra recently had unsuccessful laser eye surgery, leaving her nearly blind. It was a bit of a revelation, though,
when they told me that she had gone blind. NARRATOR: Now Dr. G can see the full picture
of Sandra Colins's death. The night she dies, Sandra leaves her second floor apartment.
She nears the stairs, but with poor eyesight, she can't find her way. Sandra loses her footing and falls
back, striking the right side of her head hard against the steps. Inside her head, Sandra's brain is whipped forward, slapping
against the front of her skull. This slap creates her fatal contrecoup injury, which swells, constricting
blood flow to the brain. With the brain starved of oxygen, Sandra dies. Her body is found the next morning.
I felt that her life had been cut short because of a surgery that she probably shouldn't have had.
She still died too young. I will miss her forever, and I'll always remember her.
NARRATOR: Coming up, a man dies suddenly at his 35th birthday party. He was actually very happy yesterday.
It was his birthday. He was smiling, and then he just collapses. NARRATOR: What could have caused such
a strange and abrupt death? And why does Dr. G not want to perform an autopsy? James Sadaikis is celebrating his 35th birthday.
He's surrounded by good friends and good food. By all accounts, the party is a success.
RUBY: He was very happy that day. They never seen him so mild, so calm, so kind.
NARRATOR: James lives in a group home for the mentally handicapped. He suffers from Laurence-Moon-Biedl syndrome,
a rare genetic disorder that caused his brain to function at the level of a nine-year-old.
He also has a long, strange history of violent outbursts. Moments after the birthday cake arrives, excitement
turns to horror and confusion. James, trembling, leaps up from the table, charges at a nurse,
and grabs hold of her shirt. He just stretched out his arms, grabbed onto her blouse,
and held on for dear life. And just looked at her and couldn't speak. NARRATOR: James releases his grip
and collapses to the ground. He is never revived. Due to the unusual circumstances of his death,
James is referred to the Orlando Medical Examiner's office. DR. G: This is a 35-year-old man.
Looks like he's got a mental retardation. He's got a IQ of about 59, knowledge of about a nine
to 10-year-old. He lives in a group home. He was actually very happy yesterday. It was his birthday.
He was smiling. And then all of a sudden, he became unable to speak, and then collapsed, and then died.
NARRATOR: But after reading through his medical records, Dr. G isn't so sure James needs an autopsy.
His medical history is actually quite revealing, in that he had a brain tumor. And this brain tumor was known back in November,
several months ago. NARRATOR: But doctors felt that the tumor was inoperable, too deeply embedded in his brain
to be removed safely. Rather than subject him to a painful operation with uncertain results, he would instead live out
his remaining days in comfort. They've decided to just let him live with this as long as he could.
And what a nice thing. And he lived. In his last day, he was happy and smiling. It was his birthday, and then he just collapses and dies.
So it was probably the right decision. NARRATOR: Dr. G is certain the brain tumor caused James's death and decides not to do an autopsy.
I know, right from the beginning, that he has a history of genetic disease. And I know he has a brain tumor.
It didn't seem to be a mystery. NARRATOR: She makes a call to James's mother to let her know the brain tumor caused her son's death.
Hi. This is Dr. Garavaglia at the Medical Examiner's office. I believe I have your son, James, here.
She's a very nice woman. Very upset over her son's death. Her son is 35 years old.
She speaks as if he's still a young boy. NARRATOR: Despite Dr. G's findings on the cause of death,
James's mother, Ruby, pleads for an autopsy. She told me nothing could have been done.
But I had questions for her myself. NARRATOR: As a mother, she's haunted by two lingering questions.
First, Ruby hopes to find a reason for the violent outbursts that James had suffered from since childhood.
RUBY: He would get aggressive and take it out on other children or other people.
Maybe go over and just hit them. Something clicked in his mind, and he would just go for it.
We couldn't figure out why. NARRATOR: Since 50% of people diagnosed with brain tumors
exhibit mental changes, it's possible that James's tumor could have played a hand in his strange behavior.
Ruby wants to know, could James's tumor have been there since childhood. DR. G: She really wanted to know,
how long the tumor was growing. Because he'd had some very violent behavior since a very young age.
NARRATOR: Ruby also has another, more desperate reason for an autopsy. Her younger son who still lives at home
has Laurence-Moon-Biedl like his brother. While his case is less severe, he too is mentally challenged.
Does having the same genetic condition mean he is likely to develop the same type of fatal tumor?
I was worried if it was hereditary, it would-- of course, I was scared to death.
I don't want to lose my other son. I only have one other son left, and that's all I've got.
And that's a very good reason to do an autopsy. If that'll give you some peace of mind,
I'll be more than happy to do it, then. NARRATOR: Can Dr. G prevent one death by exploring
the mysteries of another? She feels that Ruby's questions are reason enough to go above and beyond the call of duty
and perform the autopsy even though she knows the cause of death. But before Dr. G begins, she must know more
about James's genetic disease. Could it have caused his tumor? I just wanted to know a little bit of background.
I don't have any books on congenital abnormalities in my office, but I had my husband.
NARRATOR: Over the phone, Dr. G's husband, a pediatric trauma surgeon of 25 years,
gives her a quick tutorial. I told you I'd call you back. He had a congenital syndrome that
is called Laurence-Moon-Biedl. I didn't know really anything about it. He's a pediatrician.
He did. NARRATOR: Laurence-Moon-Biedl syndrome is a disease passed through recessive genes.
The syndrome is very rare in the United States. It wasn't until 1993 that scientists even discovered
the gene that causes it. The neurologists had diagnosed him back when he was about two years old.
Back then, they'd never even heard of that syndrome. In fact, they asked me if he could
be in the historical books for medical discovery. NARRATOR: Dr. G's husband also gives her
a rundown of the strange symptoms of Laurence-Moon-Biedl syndrome. It's common for them to be obese.
It's common for them to have mental retardation. It's common for them to have the polydactyly,
like he had the multiple fingers, the extra fingers, extra toes. NARRATOR: Polydactyly, having more than the normal numbers
of fingers and toes-- it's one of the most distinctive indicators of the disorder.
Armed with new information about Laurence-Moon-Biedl syndrome, Dr. G begins the autopsy.
She quickly sees the first abnormality linked to James's genetic disorder. One, two, three, four, five, six toes on that side.
One, two, three, four, five, six toes on that side. NARRATOR: But other than the superficial effects
of his syndrome, Dr. G notes nothing remarkable about James's body. So we're probably expecting everything to be negative
until we get to the brain. NARRATOR: Will the brain give Dr. G the answer she needs?
Was this tumor somehow related to the syndrome of Laurence-Moon-Biedl? NARRATOR: If so, could the brother die
from the same type of tumor? And was the tumor the cause of James's violent outbursts?
A worried mother waits for her dead son's diagnosis-- a diagnosis that can only come from Dr. G's autopsy.
[MUSIC PLAYING] Dr. G is about to open the head of James Sadaikis, a man with a rare genetic condition who died suddenly
at his own birthday party. But she's not looking for a cause of death. He was almost certainly killed by an inoperable brain
tumor diagnosed months earlier. What she is looking for is evidence that could answer
a mother's lingering questions. Could his fatal brain tumor have been growing long enough to help explain a lifelong history
of violent outbursts? And could the tumor be linked to his genetic condition, Laurence-Moon-Biedl syndrome, a condition
that his younger brother also has? My other son has medical problems, too. And I was so worried if he were to have this kind of tumor
also. I was scared to death. This one's fresh, right? ASSISTANT: Yes. Gee, thanks.
Do you want me to cut this? Yeah, go ahead and cut it. Jean is going to go ahead and open his head up.
I don't know what kind of tumor it is. Maybe it's even bled into the brain. I don't know.
I have to see it. NARRATOR: Once the brain is exposed, Dr. G spots the tumor immediately.
It's huge, and we're not even seeing a lot of it. A lot of it's gone into the base of the skull.
NARRATOR: The tumor is enormous, about the size of a baseball. And just as his doctors predicted,
it would have been impossible to remove without killing James. So we've got it at least 5.3 centimeters by 3 and 1/2.
All this is tumor. You can see it's caused the compression here. That's usually not like that.
Tumor is just pressing on the brain. NARRATOR: When she sees the massive growth,
Dr. G has no doubt that it caused James's death, and she now knows how it killed him.
Growing for some time, the tumor eventually began to press into the centers of the brain
that regulate the body's heart and respiratory systems. At the time of his party, pressure
was so great that his vital functions failed. His brain was effectively cut off from his body
and could no longer tell his heart to pump. He died as if someone had thrown a switch.
But now the real challenge begins-- answering questions about the tumor itself. Did it affect James's behavior?
Was it caused by his genetic syndrome? And will his brother develop the same tumor?
I'm definitely going to have to bring in an expert on this. NARRATOR: The tumor will have to be dissected and analyzed
by a neuropathologist, a specialist in the field of forensic brain pathology. I thought I'd get the neuropathologist,
because you know what? If it's my son, that's what I want, too. NARRATOR: The brain is placed in a fixative,
and a section of the tumor is kept for examination. That examination will be performed
by Dr. Gary Pearl, the ME office's neuropathologist. We took a piece of the tumor and made
microscopic slides from it. And if you take a look at some of his tumor cells, you can see that they are massive
compared to what a normal cell would be and very abnormal in shape. NARRATOR: From these findings, Dr. Pearl
feels he can positively identify the type of tumor in James's brain. This is what's called a chondrosarcoma,
a malignant tumor derived from cartilage. And this is growing out of the base of his skull.
NARRATOR: Though the tumor grew into James's brain, Dr. Pearl discovers that it isn't a brain tumor at all.
Surprisingly, it's a tumor derived from mutated cartilage cells, not nerve cells.
Chondro is cartilage, sarcoma is a connective tissue tumor. So it's a basically cartilage kind of tumor.
It makes cartilage. NARRATOR: Dr. Pearl's examination brings one more discovery--
the tumor's growth rate. If you look at them, there's a low grade, intermediate,
and high grade, which tells you, more or less, how fast they grow, how aggressive they are.
This is a chondrosarcoma of intermediate grade. NARRATOR: From this, Dr. Pearl concludes
that the tumor has only been growing for a few years-- not nearly long enough to have Jame's violent behavior,
which started when he was a child. Did the tumor cause that behavior? No. We can say that for sure.
NARRATOR: Dr. G can finally start to give James's mother conclusive answers about her son's life.
She believes, two to three years, maybe it was there, and then it just grew very rapidly.
Nothing could have been done now. NARRATOR: While Ruby may never know exactly what contributed
to James's violent behavior, she can at least rule out the condition that ultimately killed him.
This leaves just one final question to answer. Is the chondrosarcoma associated with
Laurence-Moon-Biedl syndrome? So we've looked in the literature-- both Dr. Pearl
and I looked in separate searches-- and we couldn't find anything relating the two.
So it's just one of those freaky things. NARRATOR: James's tumor was not connected to his syndrome.
It was simply a very rare bone tumor that grew into his brain. That James suffered from both these extremely rare conditions
is, in the end, only an incredible coincidence. Keep in mind, this isn't a typical tumor in the brain.
These are usually on bones. NARRATOR: And without a genetic link, Dr. G can now ease the fear of James's mother, Ruby.
The chances of her younger son getting the same kind of tumor are extremely remote.
When she found out what kind of tumor it was, she ruled it out that it was hereditary.
It was very rare. It was nothing to worry about with his brother. I was glad to hear that.
NARRATOR: A mother is given hope, and a human connection is made. Dr. G considers the day a success.
But tomorrow is guaranteed to present its own set of new challenges. DR. G: Do you think doctors know everything all the time?
We are constantly learning, even the good doctors. And the great doctors, they still have to look things up.
You don't know everything. So you learn. That's the beauty of medicine. You never can learn it all.
[OUTRO MUSIC PLAYING]

Dr. G preforms an autopsy on an alleged hit-and-run victim but finds no evidence of vehicular injury on the 41-year-old man's body. Could his alcoholism have had a role in his death?

A Florida medical examiner takes viewers through puzzling cases while explaining procedures and conclusions.

Brief Summary

Dr. G investigates three deaths: a hit-and-run victim, an elderly woman with a head injury, and a man who died from a brain tumor.

Key points

The Mystery of Daniel Barrow. Daniel Barrow's death appears to be a hit-and-run, but the evidence tells a different story.
Sandra Collins: A Life Cut Short. The unexpected death of 88-year-old Sandra Collins raises questions of foul play versus natural causes.
The Mystery of Sandra's Death. An autopsy reveals Sandra Collins died from a fatal head injury, but what caused her fall?
James's Sudden Collapse. James Sadaikis dies unexpectedly at his 35th birthday party, leaving friends and family in shock.
The Tumor's True Nature. Dr. G discovers James's tumor is a chondrosarcoma, not a brain tumor, easing family fears.

Episode highlights

Episode quotes

I don't want to lose my other son.

A brother's fear for his sibling's health.

1:08WatchMay 13, 2021

Tension

75/ 100High tension

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