Dr. G: Medical Examiner - Season 2, Episode 18 - Deadly Arrest - Full Episode | Forensic Files

[MUSIC PLAYING] NARRATOR: A young father dies in a violent struggle with police.
Did the officers beat him to death? Their actions are definitely going to be under scrutiny.
NARRATOR: Or did he fall victim to something more mysterious? And he starts acting bizarre, running from a police.
NARRATOR: Then, an 18-year-old girl dies suddenly and her parents arms after suffering a seemingly
routine miscarriage. I really tried to save her life. NARRATOR: The truth behind her death shocks Dr. G.
There's no reason you have to die from this. NARRATOR: And later, the countdown continues--
Are you getting nervous yet? NARRATOR: To the big day. Oh, I got lipstick all over you, baby.
NARRATOR: Altered lives, baffling medical mysteries, shocking revelations. These are the everyday cases of Dr. G, medical examiner.
Monday morning, rush hour. It's the beginning of an extra crazy week for Dr. Jan
Garavaglia, chief medical examiner, mother of two, and bride to be. - Hi, sweetie.
How are you? NARRATOR: She and her soon to be husband, Dr. Mark Wallace, only had three and a half weeks
to plan the entire wedding. We're both very, very busy. We've got school schedules, work schedules.
And yet we wanted to be together. Are you getting nervous yet about the wedding?
NARRATOR: The wedding is just six days away. DR. G (VOICEOVER): Billion things I got to do.
Plan the flowers, find shoes to match that dress, final numbers on the dinner. And on top of that, I know I have several cases
in the morgue waiting for me. I just read over the paper. And I'm preparing a talk.
I can't wait til I'm married and it's over. I didn't even drink my coffee. NARRATOR: 8:15 AM, Dr. G begins the day's first autopsy,
a young man who died last night in a violent encounter. According to the investigators' report, it unfolded as follows.
The police are just driving down the street, minding their own business. And this fella jumps out right in front of their car.
NARRATOR: The car stops in time. And the man is not hurt. But the real danger is just beginning.
They could see that he was in trouble. There was something wrong. He starts acting bizarre, running from the police.
They actually tried to spray pepper spray on him. It didn't help. He runs away, dives back into the street.
NARRATOR: Soon, other officers arrive on the scene. The struggle quickly escalates.
He fights back with unexpected strength. It takes their combined force to finally
wrestle the man to the ground and bring him under control. They get him subdued.
They've got him handcuffed. He seems to be OK. NARRATOR: Then, something shocking happens.
The man suddenly falls limp. DR. G (VOICEOVER): As soon as he went unconscious, they called EMS to get there.
They tried. But he was pretty much dead when I got there. NARRATOR: Through fingerprints, police
identify the man is Toby Holmes, a 30-year-old father of two. And now, his family wants to know, how did he die?
And are the police to blame? If someone dies while in police custody, their actions are definitely going to be under scrutiny.
NARRATOR: The officers deny using excessive force. But only forensic evidence can prove or disprove their case.
You worry about some type of police brutality. The police officer that did that would've been prosecuted.
NARRATOR: But Dr. G must also consider a second possible cause of death involving the officers.
Pepper spray, you know, we have to make sure he's not allergic to pepper spray, he didn't have an asthmatic attack
brought on by the pepper spray. Tragedy can occur. People can die even when the police used a force that
wasn't supposed to be lethal. NARRATOR: Considered an illegal weapon in the UK and Canada, pepper spray, or oleoresin capsicum,
is an oil extract from cayenne peppers that's 300 times as strong as jalapenos. A single dose can be fatal if it triggers
a severe asthma attack. But then, Dr. G finds a puzzling detail in the report. After jumping in front of their car,
Toby had yelled, just kill me or go away. Basically, the-- the guy makes a comment that he would like
the police officer to kill him. NARRATOR: More than 31,000 people commit suicide in the US
each year. On rare occasions, they directly involve police officers in a scenario known as suicide by cop.
Suicide by cop is-- is basically when a person is suicidal and they want the cop to kill them.
Typically, what we see as suicide by cop is that'll draw a gun on a police officer.
You draw a gun on a police officer and he's gonna shoot you. That's what he's trained to do.
NARRATOR: No firearms were involved in Toby Holmes' death. But in speaking with the family, investigators
discover a possible warning sign of suicide, a sudden radical change in behavior.
They've contacted his wife. He's supposedly very-- had been very abusive to her.
But recently, today, for some reason, prior to this incident, had been very nice to her.
NARRATOR: According to his wife, Toby had left the house earlier that day in tears, saying he would
never see his family again. Little did she know, he would be right. Did suicidal intend to play a part in Toby's death?
If so, it could have repercussions for the investigation across the board. Everybody wants those answers.
The family wants those answers. Police executives want those answers. NARRATOR: And they're all counting on Dr. G
to figure out the truth. Dr. G begins by studying Toby's face, which is covered in cuts and bruises.
Let's see. NARRATOR: She's on the lookout for signs of excessive force. He's got a contusion to the middle of his forehand.
He's got some abrasion on the lateral aspect of the right eye. He's got some cheek abrasions.
NARRATOR: The wounds provide a snapshot of Toby's fight with the officers. They certainly subdue them face down.
And his head goes down on the ground. So it's definitely in a struggle. NARRATOR: The external injuries are extensive.
But to prove whether or not police had actually caused his death, Dr. G must go inside Toby's body and head.
A bruise on the face is a bruise on the face until it affects your brain or causes some trauma internally.
NARRATOR: For now, she continues with the external exam, searching for any further injuries,
self-inflicted or otherwise. Some contusions or bruising around the wrist. They were very classic for a struggling against a handcuff.
NARRATOR: And on his forearms, she makes a telling discovery. He has multiple scars running along the major veins.
So what we see are vascular, kind of linear, fibrosis over vessels. He's got a lot of them, a lot of old vascular scars.
NARRATOR: But these scars are not the result of knife wounds sustained in a suicide attempt.
Instead, they are clearly the consequence of drug use, specifically repeated injections of an intravenous narcotic, such as heroin.
People who shoot up drugs will often shoot things into their system that cause this--
the vessels to kind of scar up. One, two, three, four, five, just on the front of that right arm.
So he is really shooting up a lot of drug. That was really quite amazing. NARRATOR: The scars further complicate Toby's case.
They suggest yet another possible cause of death, a drug overdose. But if so, was it accidental or intentional?
Suicide, I don't know how that plays into this. NARRATOR: Then, as Dr. G takes a closer look at the needle
tracks, she discovers one puncture wound on the right hand that commands her attention.
It's a needle puncture mark surrounded by pallor, kind of whitening of the skin, where
there's no blood. And then, ecchymosis, or bleeding, around that area of pallor, which I don't often see.
NARRATOR: It's a half inch forensic clue that could clear the officers names or condemned
them as Toby's killers. Coming up next, was Toby suffering from the mysterious and deadly effects of drug abuse?
Smashing out windows, big dents in your cars with their fists. Oh my gosh. NARRATOR: When "Dr G, Medical Examiner" continues.
Morgue technicians photograph the extensive needle marks on Toby Holmes' arms, looking for clues
to his strange behavior and sudden death. Yesterday, after an abrupt farewell to his family,
the 30-year-old father of two provoked a fierce and fatal fight with police. To explain his demise, Dr. G must untangle a complex web
of theories, including police brutality, a reaction to pepper spray, and a suicidal or accidental drug
overdose. I am just trying to get to the fact of what happened. NARRATOR: And now, she's found a distinctive mark
on his hand that may lead to a stunning revelation. She closely inspects the circular wound.
The defect is not only familiar, but Dr. G knows it could be the key to solving the case.
DR. G (VOICEOVER): It's pale with a central needle puncture mark and then bleeding around it.
He's actually got a classic cocaine needle puncture mark. NARRATOR: Cocaine, a central nervous system stimulant,
is most often inhaled through the nose or smoked in the form of crack. But about 10% of addicts inject the drug into their veins
for a shorter, but more intense high. To Dr. G's expert eye, Toby's puncture wound looks fresh.
He may have injected cocaine just before his death. This discovery sheds a whole new light on this complicated case.
It's now possible that Toby was suffering from one of the worst effects of cocaine abuse, not a basic overdose,
but a dangerous condition called excited delirium. Typically, these are chronic cocaine users, where
this last episode puts them over the edge and they start having delusional, excited
thoughts and behavior. NARRATOR: While the physiological phenomenon of excited delirium is not fully understood,
researchers believe excited delirium is caused by a chemical reaction in the body
that triggers violent actions. These are the type of people that are smashing out windows,
plate glass windows with their hands, putting big dents in your cars with their fists.
I would run the other way. They would scare me to death. NARRATOR: But police cannot just run away.
It's their job to bring the violent person under control. Unfortunately, in some cases, the subject dies.
There are two possible explanations for excited delirium deaths. The first is that the excited delirium triggered
an arrhythmia, an irregular heartbeat that prevented blood flow to Toby's major organs.
This would have killed him, regardless of any injuries sustained in the scuffle.
But Dr. G can only make this ruling after eliminating all other options, because arrhythmias leave no tangible proof
after they occur. DR. G (VOICEOVER): It's a cardiac arrhythmia. The electrical component, the heart,
isn't causing a uniform beat. So we're not gonna see anything. NARRATOR: The second possible cause of death, however,
would leave hard evidence. If the excited delirium had turned Toby so violent that the officers reacted with extreme force
above and beyond what they needed to restrain him. Was the intervention and the use of force necessary?
Was the amount of force justifiable? Was it reasonable? In the heat of the moment, maybe
he got a nice blow to the head that I can't see with the hair. I don't know. NARRATOR: For answers, Dr. G must
now turn to the internal exam. So we're ready to go, right? Ready to go. NARRATOR: Dr. G makes the standard Y
incision from the shoulders through the torso. She's in search of hard evidence that can pinpoint Toby's killer
among many suspects, Pepper spray, a drug overdose, arrhythmia from excited delirium, or trauma.
First, she checks the abdominal cavity for excess blood that may have resulted from a beating.
Because blood really is the trail to the trauma. Is there blood collected in his abdominal cavity?
Could there have been a blow to to the liver? NARRATOR: Seeing no pools of blood, however,
she proceeded to examine the ribs. A blow to Toby's chest or the weight of officers fighting
to subdue him may have broken a rib bone, causing fatal internal injuries. Sometimes a kick can cause a displaced rib to go into a lung
or or even a heart sometimes. NARRATOR: But all the ribs appear intact. And the lungs are clear of puncture wounds.
We're also looking for evidence of maybe an allergic reaction, possibly from the pepper spray.
His bronchi looked fine. They were all patent. The air could go through them. So that ruled that out.
NARRATOR: So far, she's found no evidence of any internal trauma inflicted by the police.
But the internal search for clues to Toby's sudden death is not over. While her assistant takes blood and urine samples for a tox
screen, Dr. G continues exploring the possibility of police brutality, inside his head.
We're looking for evidence of him having a skull fracture and a blow to the head or something that happened
to him that shouldn't have. NARRATOR: And her thorough examination reveals no injuries.
There was no skull fractures. There was no bleeding in the brain. No skull fractures at the base of the skull.
So I really-- there was no trauma to the brain. NARRATOR: The negative findings add up to one conclusion.
The officers are not responsible for killing Toby Holmes with excessive force. There's no proof of that.
Nothing. Nada. NARRATOR: With the autopsy now over, Dr. G can finally eliminate a few theories
about Toby's sudden death. He certainly didn't die from trauma. He didn't die from the police beating him up.
He didn't have an allergic reaction to the pepper spray. NARRATOR: But that still leaves two possibilities remaining,
a suicidal overdose or heart arrhythmia brought on by excited delirium. And we have nothing anatomically
that we can find at autopsy. So that means it's gonna be toxicology. NARRATOR: Coming up next, a critical discovery
may help Dr. G solve the case of Toby Holmes. Very few things cause you to go from walk, talking one
minute to flatline the next. NARRATOR: When "Dr. G, Medical Examiner" continues.
OK. So we have peripheral blood, bile, little bit of urine. Oh. NARRATOR: Dr. G orders a full toxicology screen
on Toby Holmes' fluid samples. I got to see what his levels are. NARRATOR: Through a negative autopsy,
she's determined that this young father was not a victim of police brutality or a pepper spray mishap.
But whether he died of a suicidal overdose or suffered from excited delirium depends on the type and amount of drugs he'd taken that day.
DR. G (VOICEOVER): We just don't look for one thing. We don't have a hypothesis and say that this is cocaine.
No. We're looking for everything. You know, what really happened? Let the toxicology speak to me.
NARRATOR: A few weeks later, the final lab reports arrive. As expected, Toby's blood and urine show the presence
of an illicit stimulant. Cocaine. And the level is not that of a suicidal overdose.
He's got cocaine, a pretty hefty amount, but not like super hefty, like we'd see with a massive overdose of cocaine.
If this man was truly trying to kill himself, he wasn't very efficient at it. NARRATOR: For Dr. G, these tox results, together
with the negative autopsy findings, leave only one logical explanation for his sudden death.
So what we have is a man who died very suddenly after bizarre behavior, who has recently used cocaine.
Well, that's a setup for that excited delirium. NARRATOR: And the actual mechanism of his death
may lie in the organ most vulnerable during excited delirium. DR. G (VOICEOVER): One minute he's kicking and thrashing.
And the second later, he is limp. Very few things cause you to go from walking, talking one
minute to flatline the next. And that really indicates it's his heart. Now, why would his heart do that?
Cocaine can do this to you. He's clearly dying from a sudden cardiac arrhythmia brought on by that cocaine.
NARRATOR: Now, Dr. G can finally explain the strange circumstances of Toby's untimely death.
After leaving his family, Toby Holmes spends his last hours on earth injecting cocaine.
But he's far from committing suicide with an overdose. Instead, he takes just enough to fuel his addiction.
As a drug abuser, Toby's cocaine intoxication is nothing new. Except this time, his body reacts in a shocking way.
He begins experiencing excited delirium, a condition often associated with chronic cocaine use.
Why this time it puts him over the edge, I can't give you that answer. But ultimately, what's happening is
it starts causing him to get excited. It starts causing him to have some delusional thought.
And his heart's beating harder and harder. NARRATOR: Wandering down the street, he suddenly jumps in front of a police
car, not to commit suicide by cop, but driven by excited delirium. The police officer ends up chasing him.
The guy's acting bizarre. NARRATOR: In his drug-induced state, Toby resists arrest with tremendous strength.
The officers struggled to restrain him, increasing his agitation. But when they finally managed to handcuff him--
His heart's beating harder and harder. And eventually, his heart starts to quiver.
It doesn't beat anymore. It just quivers. NARRATOR: The quivering, or arrhythmia,
prevents the heart from pumping any blood. With no blood circulating in his system,
Toby suddenly collapses and dies in the arms of the officers. We need EMS, ASAP.
And then, in conclusion and in consideration of the circumstances surround the death--
NARRATOR: Dr. G files the autopsy report as a case of excited delirium. No officers are charged with his death.
For his family, the findings are not easy to accept. Some of them just don't understand
this whole phenomena. Some of them cannot believe that trauma didn't kill their loved ones.
They had-- the police had to have done something wrong. NARRATOR: Coming up next, Dr. G discovers shocking evidence
in the case of a young girl who died after a miscarriage. If she had been diagnosed properly, she'd be alive.
NARRATOR: And later, wedding plans come down to the wire. Talking to the next of kin one second
and then they'd be talking about flowers. Flower girl, my niece. NARRATOR: When "Dr. G, Medical Examiner" continues.
DR. G (VOICEOVER): Donna, this is Dr. Garavaglia, Garavaglia-Wallace wedding this Saturday.
NARRATOR: As chief medical examiner, and a bride to be, Dr. G's lunch break isn't about lunch.
It's about juggling two worlds. Planning that wedding and having those phone calls come
in and you'd be talking to the deceased's next of kin one second and then the phone would ring
and they'd be talking about flowers. And so if you could arrange for some rose petals--
You know, and then, I'd put it down and I'd be talking to a detective one second.
And then, you know, I'd still have to be-- you know, reminders that I hadn't picked the menu yet.
Allergic to the nuts and the dairy. I can't believe how you remember everything.
It was kind of tipping me over the edge there. It's just too much. All right. Thank you very much.
I'll-- we'll meet on Saturday morning. NARRATOR: But before long, Dr. G's lunch break is over.
And it's time to direct her attention to another case. Thank you very much. You've been great.
Bye bye. All right. We got two more. NARRATOR: Back in full work mode, Dr. G reads the investigators' report for her next autopsy.
So we have a sad case today. Dad. Come on. Get that out of here. The decedent is Isabel Foster, an 18-year-old
just out of high school. an independent spirit and avid dancer, Isabel had her heart set on studying musical theater when
she got to college in the fall. At the time of her death, however, she was still living at home with her parents,
recovering from one of the most traumatic events in her life. Seven days earlier, she'd gone to the hospital,
complaining of unusual vaginal bleeding. And they found out she was pregnant. NARRATOR: After taking a sonogram of her uterus,
the doctor tells Isabel that her bleeding is from an early miscarriage and that the embryo,
just seven weeks old, would soon pass naturally. DR. G (VOICEOVER): A couple of days.
They were just gonna treat it conservatively, just watching her. NARRATOR: Shaken by the experience, Isabel goes home.
After two more follow-up visits, her ordeal seems to be over. The doctor finds no evidence of the embryo.
Then, just a day and a half later-- She's watching TV on the couch. She falls asleep.
The family thinks she's just taking a nap. NARRATOR: But when they try to wake her up,
she doesn't respond. Something is terribly wrong. Isabel's father immediately calls 911.
And paramedics rush her to the emergency room. But it's too late. And she's basically dead on arrival to the hospital.
NARRATOR: Isabel's sudden death stuns her parents and fills Dr. G's mind with questions.
We have a young girl, a late teens that's dead on the couch. I mean, what could it be?
Does it relate to the miscarriage at all? NARRATOR: Miscarriages occur in up to 20% of pregnancies
and are often the body's natural mechanism of aborting an unhealthy baby. In most cases, hormonal changes prompt the uterus
to shed its lining along with the embryo, causing bleeding and severe cramping. While often emotionally traumatic,
miscarriages usually cause no physical problems. But on rare occasions, there are at least
two complications that can be fatal and may have killed Isabel. One is if the bleeding doesn't stop.
If the pregnancy does not completely miscarry, if she has not completed the process, the patient
can lose a significant amount of blood, and that tends to be the most common complication that we'll see.
NARRATOR: Another danger is if an infection takes hold and sends toxic bacteria into a woman's blood.
You always do have a small risk of infection, because you have exposure of the organisms that are
in the vagina to the uterus. NARRATOR: Isabel's full medical records could shed more light on the mystery.
But they're held up at the hospital. All we're getting is what the EMS told the hospital.
NARRATOR: Did Isabel die as a result of a complication from the miscarriage? Could the death have been prevented?
They are counting on Dr. G for answers. As Dr. G starts the external exam, she learns from the investigators' report
that paramedics had made every effort to revive Isabel. She has a lot of medical intervention.
They really tried to save her life. NARRATOR: Her first task is to catalog and inspect
each item of Isabel's clothing. As we normally do in forensic, you know, sometimes clothing can give us hints of what's going on.
NARRATOR: If Isabelle had continued to hemorrhage due to her miscarriage, Dr. G would
expect to find bloodstains on Isabel's underwear or sanitary pad. But she finds nothing.
It appears Isabel was not bleeding vaginally when she died. So maybe the miscarriage, did we get the right story?
Because I don't have her medical records yet. And-- or maybe she's over the miscarriage?
But she certainly did have any blood in her panties. NARRATOR: Next, Dr. G checks Isabel's airways
for a possible drug overdose. Occasionally, from drug abuse, we'll see foam in the nose and the mouth.
But we don't always see that. That's just kind of a little telltale sign. It doesn't give us the answer.
Oftentimes, we see drug overdoses with nothing in the nose or mouth. NARRATOR: Isabel's nose and mouth are clear.
But nevertheless, Dr. G will continue exploring the possibility of an overdose later in the autopsy.
Next, as with all autopsies she performs, Dr. G examines Isabel's body from head to toe,
searching for clues. We didn't really expect to find anything. You know, she looks like a normal young woman.
NARRATOR: But then, she notices something very subtle. Isabel's stomach feels slightly distended to the touch.
Could this be some kind of fluid from an injury or undetected disease? It could even just be changes in post-- in postmortem.
So it really is hard to tell what that little rounded abdomen is from. NARRATOR: The answers will have to wait
until she opens Isabel's body. OK. You did you take her ID pictures? OK. So she's ready to go?
NARRATOR: First Dr. G makes the standard Y incision. When she folds back the skin and subcutaneous fat,
she immediately sees what made Isabel's belly soft. And it's not just any fluid.
There's a major pool of blood in the abdominal cavity. Depending on size, the average human body
contains about four liters of blood, which flows through the cardiovascular system,
delivering oxygen to the vital organs. If more than 30% of Isabel's blood, about 1.2 liters,
had drained into her abdomen, it would have been fatal. And you're in shock, because you just don't have
enough blood in the vessels. It's all accumulating into your abdomen. And you die.
Your heart doesn't get enough blood and your brain doesn't get enough blood. Measure this blood.
NARRATOR: To see how much blood Isabel has lost, Dr. G methodically removes it from her body.
We ladle it out with the soup ladle that we use, collect that, and measure it. But I can't look at where it's coming from,
til it's all out of there. NARRATOR: The total amount is shocking. A full two leaders had drained out of Isabel's
cardiovascular system. OK. Dr. G now knows what killed Isabel. The young girl bled to death, internally.
That's clearly why she died. Now, we've got to figure out why that's there. NARRATOR: Coming up next, could Isabel's killer
be a common procedure used to treat her miscarriage? It can result in disastrous consequences.
NARRATOR: When "Dr. G, Medical Examiner" continues. A week after doctors told Isabel Foster she had suffered
a miscarriage, the 18-year-old's parents found her unconscious on the couch, never to wake again.
This would not be something we would expect. We see blood where it's not supposed to be here.
NARRATOR: Dr. G now surveys Isabel's internal organs in situ, or in place. She's just blood into her abdominal cavity.
Organs like her brain, her lungs, everything looks real pale. NARRATOR: Dr. G has discovered that Isabel lost half her blood
through internal bleeding. But how? Often, internal bleeding is caused by an injury to a major organ, such as the liver or spleen,
or when blood vessels are disease or torn by broken bones. But in Isabelle's case, Dr. G suspects
the hemorrhage could be related to the reported miscarriage. The girl may have suffered complications
from a follow-up procedure called a D&C, or dilation and curettage. It's a common follow-up to a miscarriage to make
sure all the products of conception are out of the uterine cavity. NARRATOR: In a D&C, the doctor scrapes
out the lining of the uterus. Examining this lining can reveal why the miscarriage occurred.
As minor as it is, however, a D&C is a surgical procedure. And up to 10% of cases result in complications
ranging from infections to trauma from the sharp instruments. The most common risks with a D&C
are perforation of the uterus. You could have injury to organs around the uterus,
such as the ovaries, the tubes, the intestines. So it can result in disastrous consequences,
even in the best of hands. NARRATOR: Without the full medical records, Dr. G can't know for sure whether Isabel had had
a D&C. If she had, her massive blood loss could be from a serious puncture wound.
To determine this, Dr. G hones in on Isabel's reproductive organs. And you just gently lift up some of the small intestines
and you can expose the uterus. NARRATOR: But the uterus appears intact. No perforations from a D&C. Instead, she finds the culprit
just inches from the uterus. Lo and behold, you can see, quite readily, where that bleeding is from.
Clearly we had about a 1.8 centimeter defect, a hole right in the middle of the fallopian tube.
NARRATOR: Fallopian tubes are thin conduits that carry a woman's eggs from her ovaries to her uterus.
Somehow, Isabel's left tube has been torn open. OK. Oh, she's OK. Hold on. NARRATOR: Dr. G immediately realizes
what must have caused the hole in Isabel's fallopian tube, an ectopic pregnancy.
An ectopic pregnancy is a pregnancy that has developed outside the uterus, outside its normal location.
NARRATOR: A healthy pregnancy takes place in the uterus, where the baby has plenty of room to grow.
But in up to 1 in 40 pregnancies, a fertilized egg on its way to the uterus gets stuck in the fallopian tube,
either because it is too narrow or because of previous scarring from surgery or a sexually
transmitted disease. There, the embryo implants itself, digging deeper into the tube as it grows,
until the walls can no longer sustain the pregnancy and they rupture. Now, a fallopian tube's very little.
It does not have the capacity to expand or hold a baby, like a uterus. And it just basically erodes right through it.
Fallopian tubes can never hold a baby. They're doomed. Let me know if it's enough.
NARRATOR: Despite the risk of fetal rupture, however, ectopic pregnancies don't often end in death.
It's rare. We don't see these anymore. NARRATOR: That's because doctors can typically
remove the embryo surgically to prevent the fallopian tube from bursting. But the hospital never diagnosed Isabel's ectopic pregnancy.
Instead, they had supposedly observed and treated her for a normal uterine pregnancy and miscarriage.
It's a puzzling contradiction. When she cuts open the organ, Dr. G makes a shocking discovery.
The lining is still there. And there is no sign that an embryo was ever implanted.
You don't see anything to suggest a pregnancy. NARRATOR: The intact lining is proof that Isabel was not
killed by a complication from a miscarriage, because she never had one. It also confirms that she never had a D&C, the follow-up
procedure that would've warned doctors of her abnormal pregnancy. I mean, if she had been diagnosed properly,
she'd be alive. NARRATOR: Suddenly, explosive questions arise from this revelation.
How could the hospital have made such an egregious error? This is what killed her.
NARRATOR: Coming up next, the forensic clues add up to devastating answers and plenty of frustration.
I don't understand how this happened, in this day and age. NARRATOR: Then, the big day finally arrives.
Are you crying? Yeah. NARRATOR: When "Dr. G, Medical Examiner" continues. Dr. G wraps up Isabel Foster's autopsy, her mind
already analyzing the findings. There's no doubt that the 18-year-old girl bled to death from a ruptured ectopic pregnancy.
There's a hole right in the middle of the fallopian tube. NARRATOR: But just a week ago, she had been diagnosed
with a normal miscarriage. She'd gone to the hospital complaining of some unusual virginal bleeding.
NARRATOR: So why didn't they catch her ectopic pregnancy? Did we get the right story?
NARRATOR: The intact uterus, the two liters of blood, the silent death. Now, after adding up all the clues from her investigation,
Dr. G reconstructs what she believes were the likely events leading up to Isabel Foster's death.
About a week before she dies, Isabel begins experiencing heavy abdominal cramps and vaginal bleeding.
Concerned, she goes to the hospital, where an ultrasound shows no baby in her womb.
Then, instead of exploring the possibility of an ectopic pregnancy, the doctor diagnoses a miscarriage.
I think what happened is they didn't find any u-- any evidence of pregnancy in the uterus
and assumed she was having a miscarriage because of the bleeding. You know, that is one of the problems that this can mimic.
It's not unusual for these women to bleed a little bit, like a miscarriage. NARRATOR: The doctor's assumption
is a crucial mistake. Convinced that Isabel is having a normal miscarriage, she apparently fails to conduct some critical tests,
such as tracking hormone levels. We want to know now, what is the level of pregnancy hormone?
When is this a normally positioned pregnancy or an ectopic pregnancy? NARRATOR: In addition, for unknown reasons,
the doctor also decides against doing a D&C. Without this follow-up, she doesn't realize
that the pregnancy was never in the uterus and Isabel's condition remains misdiagnosed.
Within a few days, the cramping and bleeding subside and Isabel believes her miscarriage is over.
But in fact, the embryo is still there, inside her fallopian tube. It's been growing now for seven weeks,
stretching the tube beyond capacity. When the tube expands, there may be some temporary relief
of pain, which sometimes can be misinterpreted by the patient as everything getting better.
NARRATOR: Instead, the danger only gets worse, until, finally, the walls of the tube give way.
Then, she bleeds out. And she bleeds out through the fallopian tube. NARRATOR: Half a liter, one liter, a liter and a half.
Undetected, the hemorrhage becomes fatal. And the blood is spilling out from the hole.
You're not getting enough blood to the brain. And eventually, you pass out. NARRATOR: Right there on the couch, Isabel slips into shock.
By the time her parents realize something is wrong, it's too late. She's lost too much blood and she dies.
Despite what appears to be a series of errors, Isabel's parents never bring charges against the doctor
or the hospital. But for Dr. G, the bottom line is clear. If you're diagnosed prior to it breaking open,
there's no reason you have to die from this. They have good ways to treat this. I don't understand how this happened, in this day and age.
It's really not my job to put the blame, but on this one, she sure fell through the cracks with medical science.
I wish somebody would've picked up on this. NARRATOR: Another case, another workday is over.
And now, it's finally time for Dr. G to leave the dead and celebrate life with her loved ones.
I'm always very happy to be in the morgue. There's no question about that. I'm very thankful that I live in a world that shows
me how important living is. But once in a while, I'd like to feel thankful not because I'm
standing next to a dead man with multiple gunshot wounds, that I'm thankful that I'm looking over a beautiful scene
at the ocean. Are you gonna cry you think? Yeah. Just don't go [WIPING]. I was very, very worried coming up to the wedding.
There is no question I wanted to marry Mark. He's the love of my life. But I love my boys and my older boy
was having a very hard time that I had divorced his father and now I'm marrying somebody different
and bringing somebody different in their lives. And he pretty much told me he wasn't going to accept it.
And-- and I had to respect that. But he's such a beautiful kid. I mean, at first, he was not gonna
come to the wedding at all. And then, at the last minute, as I'm walking out to the ceremony, I saw him sitting there.
And that meant a lot to me. My younger one, you know, you always worry how they're accepting it, but he's very, very loving.
And he's the one that walked me down the aisle. I have enough love for all of us.
And once they see that I'm not gonna lessen their love just by loving Mark, I think they're--
they're accepting more that we could be a family unit. Mark, I've never felt as happy and in love as I am with you.
I really believe our love's a gift from God. I vow to love you with all my heart, until the day I die.
He asked me to marry him approximately 28 years ago. And you know, I said no. And I had regretted it the rest of my life.
I vow to be faithful and honest and true to you and myself. I was thinking with my mind instead of my heart.
I was a scientist. That's what I was trained to do. I thought that was the way to do it.
That's how you planned your life. But sometimes, I guess I'm proven wrong that, you know,
the matters of love don't necessarily-- are something you should do with your mind.
Sometimes you have to follow your heart. You may kiss your wife. Thank you, Alex.
Give me a little Dr. G. Dr. G. DR. G (VOICEOVER): There is something outside besides this morgue.
There's something else in life besides my kids and my morgue-- and the morgue. That is just wonderful.
They want the U incision, not the Y. Any wishes for Dr. Mark? Good luck. Just kidding.

Police are driving down the street when a man suddenly jumps in front of their car. They screech to a halt and avoid hitting him, but the man is highly agitated.

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

Brief Summary

Dr. G investigates a father’s death in police custody and a girl’s fatal ectopic pregnancy after a miscarriage misdiagnosis.

Key points

A Young Father's Tragic Death. A young father dies in a violent struggle with police, raising questions about accountability.
The Mystery of Toby Holmes. Dr. G investigates the death of Toby Holmes, uncovering layers of complexity.
Final Findings on Toby's Death. Dr. G concludes that Toby's death was caused by excited delirium, not police brutality.
The Countdown to the Wedding. Dr. G balances her demanding job with wedding planning just days away.
Excited Delirium Explained. Dr. G uncovers the dangerous effects of excited delirium in drug users.
Tragic Misdiagnosis. Isabel was misdiagnosed with a miscarriage, leading to her untimely death.

Episode highlights

Episode quotes

I can't wait til I'm married and it's over.

Dr. G expresses wedding planning stress.

2:06WatchJun 1, 2021

Tension

75/ 100High tension

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