Dr. G: Medical Examiner - Season 2, Episode 20 - Old Wounds Run Deep - Full Episode | Forensic Files

NARRATOR: An elderly man who lives alone dies under suspicious circumstances during a brutal winter storm.
There's all sorts of trauma on his face, on his hands, on his arm. I see blood on the screen door, blood
mixed with mud on his face. NARRATOR: Who or what led to his tragic death? He was a nice guy.
Everybody's saying he was a nice guy. He had lots of friends. Why would somebody just go in there
and beat him up and throw him in the backyard? NARRATOR: And then-- [GUNSHOT] --a gunshot victim is paralyzed from the waist down.
But 30 years after the shooting, he dies unexpectedly at a clinic. Just dead right there in the waiting room.
NARRATOR: The question is, what actually killed him-- complications from his paralysis or natural disease?
That's the big question. Because if the paralysis killed him, it's a homicide. There's not going to be a statute
of limitations on murder. NARRATOR: Altered lives, baffling medical mysteries, shocking revelations--
these are the everyday cases of "Dr. G, Medical Examiner." [THEME MUSIC] As chief medical examiner in Orlando, Florida,
Dr. G has had a number of fatalities attributed to weather conditions. It has been very hot here in Orlando.
I know it's, you know, considered paradise for some, but it's been a little bit hot.
NARRATOR: But one of her most troubling weather related deaths occurred in 2003, when
she was a medical examiner at the Bear County morgue in San Antonio, Texas. During that winter, a brutal ice storm swept into the area.
Temperature in the 20s, which was very unusual for Texas, and everything was frozen over.
It was all over. It was cold. It was icy. It was raining. It was sleeting. NARRATOR: In the storm's wake, Investigator Steve Hanson
is dispatched to investigate the deaths of several victims. One of them is a 92-year-old man who
was discovered dead in his yard the morning after the storm. OK, Steve, you were at the scene.
Yeah, the-- What's going on here? NARRATOR: Investigator Hanson briefs Dr. G on what he's learned so far about the decedent.
His name is Richard Adler. He's a 92-year-old widower and decorated former military officer.
Stubbornly independent, he lived alone with the help of part-time care, despite his advanced age
and a diagnosis of dementia. Seems like an independent, dynamic guy with a really good life.
He was doing OK. He wasn't wheelchair bound. He wasn't stuck with a walker. You know, he's an ex-military officer.
You know, he's old school, and he was tough. And you know, just that whole fact of him wanting to live alone--
I mean, this was a man with dementia, but he still wanted to live alone and try to take care
of himself as much as he could. NARRATOR: Which is why the circumstances surrounding
his death are so disturbing. According to Investigator Hanson, earlier that morning,
Mr. Adler's caregiver Suzanne arrives at his residence at 9:00 AM as usual. But she finds the front door wide open
and no sign of Mr Adler inside the cold house. And I thought, well, it's kind of early for him
to be out this morning, leave that door open. Keep in mind, it's in the 20s. Not too many people should keep their front door open.
NARRATOR: Worried, Suzanne searches outside for Mr. Adler, who routinely went out to check for the mail every day.
JAN GARAVAGLIA: She's looking all around for him, cannot find him. He's not in the house.
He's not in the front yard. She's very worried about him. NARRATOR: As she approaches the backyard,
she notices the fence gate ajar. And then she sees him. Mr. Adler is sprawled face down on the frozen ground
at the foot of a cement patio. His body is bloody, bruised, and he is clearly no longer alive.
It scared me real, real bad. NARRATOR: Investigator Hanson and the police are dispatched to the scene.
Here we find this guy laying in the backyard, and there's all sorts of trauma on his face, on his hands,
on his arm. NARRATOR: In addition, the back screen door is ripped and there is blood in several locations.
You see blood on the screen door, blood mixed with mud on his face. His glasses were here.
There was a little blood on the lenses. NARRATOR: The death of the independent 92-year-old man
is immediately suspect. Investigators' chief concern is that he may have been victimized in a home invasion.
And they have good reason to be suspicious. While robberies have decreased overall in the US,
at the time of Mr. Adler's death, home invasion robberies, which typically target the elderly,
are on the rise. Well, the first thing that comes to mind is there's something wrong.
Here's a guy that shouldn't be in the backyard. He should be-- you know, he's 90 some odd years old.
And he's got trauma all over him. Well, obviously, the first thing you do is stop and think.
Whoa, this has possibility of being a homicide. So let's take it from there. JAN GARAVAGLIA: It was definitely
an ominous story at that point. NARRATOR: But based on photos taken at the scene,
Investigator Hanson points out that Mr. Adler may have simply fallen off of the cement patio, which could have easily
contributed to his death. This raised patio area right here, you can see this is icy.
Oh. And you can see that his feet are-- NARRATOR: Moreover, he finds marks on the ground near the victim's feet,
which suggests that Mr. Adler was still alive after the fall. So you can see at the scene, it looks like he
was moving around a little bit. NARRATOR: But whatever the ultimate cause of his death
may have been, it seems Mr. Adler met a dreadful fate. When authorities informed the family of his death,
they are distraught over what he might have endured in the hours he was alone at his home.
The main concern of his family is how long was he out there? How long did he have to suffer?
Did he die right away? He was a nice guy. Everybody is saying he was a nice guy.
He had lots of friends. Why would somebody just go in there and beat him up and throw him in the backyard?
NARRATOR: Like any unexplained fatality, the death of Richard Adler will require a full autopsy.
Thank you, Steve. Yeah, I'll let you know what I find. Poor guy. NARRATOR: Dr. G takes her first look at the elderly man's body.
It is muddy and covered with debris. And as investigator Hanson noted, it looks as if Mr. Adler struggled while on the ground.
His hands, too, show signs of a struggle. Really crawling, really grabbing at something in that mud.
You can see it's just caked on there with the blood. NARRATOR: Dr. G collects forensic evidence
from Mr. Adler's fingernails in the event he was attacked. Then to get a better look at his injuries,
the morgue technician strips the body and washes it of debris. Once the body is cleaned, the trauma is evident.
But back of his hands really bruised, over the knuckles bruised. He's got a lot of dried blood, so he's clearly bleeding.
He also has bruising about his elbows, some abrasion, and even a superficial small laceration
on that left elbow, bruise on the back of that left hand. NARRATOR: And on the back of his right hand,
Dr. G finds a deep tear. JAN GARAVAGLIA: He tore that skin. It's almost eight-inch tear with a flap.
And so it's a bad tear and exposes the ligaments in his hand. NARRATOR: The tear is so deep it would
have required extensive surgery to repair it had Mr. Adler survived. JAN GARAVAGLIA: You know, this would have needed a skin graft.
We're down to his ligaments there. NARRATOR: The severity of the trauma just adds to the burning question.
What did this man endure before he died? It could be that he's in, you know, some kind of fight, some type of altercation.
You know, it wouldn't take much with this older fellow. NARRATOR: The external exam is coming to a close.
And Dr. G has made several key findings-- bruising, trauma, signs of a struggle.
But how Mr. Adler died, how he was injured, and by whom remains a mystery. Solving this case will now fall to the internal examination.
We really have to see what kind of internal injuries he has. NARRATOR: Coming up next, Dr. G opens Mr. Adler's body
and discovers his injuries are not just external. We've got trauma. NARRATOR: When "Dr. G, Medical Examiner" continues.
Dr. G prepares to examine 92-year-old Richard Adler internally. The elderly man was found dead outside of his home
after a brutal winter storm. The police are concerned about the possibility of a robbery
and assault. And his family fears that he may have suffered through the night outside
in freezing temperatures. But Dr. G still needs to perform the internal exam to determine the exact cause of Mr Adler's death.
You don't know for sure until you finish the autopsy. You never know. You can have all the hypotheses in the world.
But what are the forensic evidence that point to it or not point to it? NARRATOR: Dr. G opens Mr. Adler's frail, thin body
with a Y incision and examines his organs in situ, meaning in their natural position
within the body. JAN GARAVAGLIA: The difference between a hospital autopsy, usually, and a forensic autopsy or medical legal autopsy
is here with the forensic autopsy, we have to look at everything in situ, where-- how it lies in the body.
We are looking for trauma. We're not looking for just medical problems. We're looking sometimes at the chest wall.
We're looking at the abdominal wall. NARRATOR: And as she examines the body, what is immediately clear is Mr. Adler's poor state of health.
His lungs show signs of emphysema, a chronic and sometimes fatal pulmonary disease that is caused
by smoking in 80% of all cases. His lung tissue is destroyed. They are over inflated as if like it's
a balloon with trapped air. NARRATOR: And his heart is weakened from years of accumulating plaque or atherosclerosis
in the coronary arteries. Mr. Adler's diseased lungs and heart are troublesome. If the circumstances of the scene were different,
Dr. G might conclude that Mr. Adler died from a heart attack. JAN GARAVAGLIA: If he was just found dead in bed,
it would've been clearly a result of that heart with that lungs. But that's why you have to take everything in context.
NARRATOR: In this case, the scene suggests that Mr. Adler did not simply die from natural disease, but that his death was due
to trauma, perhaps from an assault, and that he died while lying on the ground during the frigid ice storm.
JAN GARAVAGLIA: We really have to just see what kind of internal injuries he has, and is
it consistent or not consistent with somebody beating him? OK. NARRATOR: Next, she removes each and every organ from the body
so that she can inspect the inside of the empty abdominal cavity for any internal injuries.
And there, she finds something unusual. Mr. Adler has six broken ribs along his back.
I couldn't see it with the lungs in there, is that he had some rib fractures that he broke.
We've got trauma. We've got rib fractures on the left side in kind of the posterior aspect of 6, 7, 8, 9, 10, and 11.
NARRATOR: But the fractures are very unusual. The six ribs are broken in a clean distinct line
which stretches to the spine. And it's one after another in a line, very sharp. And the ribs are slightly displaced.
And then the back is broken at T10. NARRATOR: There is only one way that an injury like this
can occur. The fractures are clearly not from a blow with a fist or an object, but rather from an impact against a hard edge,
such as the lip of a cement patio. You can almost see the line where he hit, really sharp,
and then it ends at the broken back. So as he's going down, he hits against the side of that patio.
It'd would be very painful. All of this would be very, very painful and caused him to just lie there right there on the ground.
NARRATOR: In a young person, a fall like this might result in minor injury. But in a 92-year-old, the fall is devastating.
Elderly, they're more-- falls are more dangerous for elderly because they have more brittle bone.
Over time, both men and women lose the strength of their bones. They lose calcium out of their bone,
and they more easily break. NARRATOR: Dr. G now believes that Mr. Adler died from the trauma of the impact.
But based on the significant natural disease discovered earlier, she concludes that Mr. Adler's heart and lungs
were most likely a contributing factor in his death after all. If he breaks a bone, there's a lot of stress.
There's a lot of pain. And it's cold, all of which is coming down on him to the point
where his heart doesn't have a lot of reserve. So we definitely have an answer that trauma was involved
in his death, most likely from what we-- it appears here that he's fallen. OK. NARRATOR: But if Mr. Adler died in a fall,
this explains only one part of the bizarre and troubling death scene. Still unknown is what he was doing in the backyard
in the first place, why he fell, and whether the fall occurred during an assault.
So we're sitting here going, OK, we've got trauma. But why is he out here? Why's the front door open?
So this is when we started trying to rebuild what this guy was doing. NARRATOR: Though she's determined the cause of Mr.
Adler's death, Dr. G wonders if his body might still hold the clues to understanding this complex and puzzling case.
Coming up next, Dr. G opens Mr. Adler's brain, searching for anything that might clarify the unusual circumstances
of his death. And she finally finds what she's looking for. He's got actual loss of tissue of the portions of his brain.
NARRATOR: And in Dr. G's next case, it's one of the worst infections this medical examiner has ever
seen. This man's got a black leg where the flies have laid eggs in the dead tissue, and the maggots have hatched,
and they're eating it. NARRATOR: When "Dr. G, Medical Examiner" continues. Dr. G's morgue assistant opens the skull
of 92-year-old Richard Adler. During the internal exam, Dr. G has concluded that the elderly man died from trauma in a fall,
combined with a diseased heart and lungs. But the cause of his death still doesn't explain
exactly what happened to him. Why was Mr. Adler in his backyard? Why was the front door ajar and the back door damaged?
Who or what caused his trauma? Dr. G wonders if findings in Mr. Adler's brain might help explain the troubling circumstances.
First, she inspects the top of Mr Adler's skull to make sure he did not suffer any blow to the head
when he fell. However, she finds nothing abnormal. JAN GARAVAGLIA: When I reflect the scalp,
I don't see any contusion or bruise. NARRATOR: Then she begins to examine the brain itself.
And here she does find an abnormality, but it's not trauma. It's brain atrophy. Mr. Adler's brain has shrunken.
There are wide open abnormal gaps between the gyri, the coral-like folds of the brain.
It appears that Mr. Adler's dementia was more significant than previously thought.
He's got actual loss of tissue of his brain, which is typical of what we would see in advanced stage dementia.
NARRATOR: Dementia is a disorder caused by the death or impairment of nerve cells in the brain.
There are many kinds of dementia, but the most common in people aged 65 and older
is Alzheimer's disease, which typically causes memory loss, confusion, agitation, and even depression.
It could be Alzheimer's. I can't say by just looking, but most likely. NARRATOR: For Dr. G, the forensic evidence
of dementia in Mr. Adler's brain is critical to the case. She believes that the finding of impaired brain function,
along with crucial information provided by Investigator Hanson, finally provides answers to many
of the perplexing questions that surrounded Mr. Adler's death-- why he was outside, why the screen was torn,
how he was injured. And more importantly, at the end of the autopsy, Dr. G can now surmise how long Mr. Adler suffered while lying
alone on the ground. Based on Investigator Hanson's report, Dr. G knows that Mr. Adler's caregiver
left his home at approximately 2:30 in the afternoon, as she usually does. Dr. G believes that sometime in the late afternoon,
Mr. Adler is drawn outside. But it's not due to an intruder. He most likely just goes to check the mail
and leaves the door ajar. If you go and check the mail sometimes, you don't bother closing the door
because you're just going in and out. NARRATOR: Despite the cold, Mr. Adler does not wear a jacket
or take his cane. Here we've got a gentleman who's pretty mobile. He can take care of himself.
But his dementia is starting to catch up with him a little bit, and sometimes he forgets stuff.
NARRATOR: But the day's mail has not arrived yet. And it's perhaps at that moment that the elderly man suffering
from advanced dementia, as discovered in the autopsy, suddenly becomes confused.
Rather than return inside through the wide open front door, he walks around to the backdoor.
But it is locked, and Mr. Adler, once confused, now becomes agitated. He's panicking.
He's trying to get into the house. He's trying the door and cuts himself on the back screen.
He's got blood in different areas. He's trying the glass door, the screen doors.
He takes his glasses off that has a little blood on it. So now he's not seeing as well.
NARRATOR: Confused, blinded, bleeding from the hands and knuckles, and cold, Mr. Adler
walks across the cement patio which is covered with a patch of ice. With his glasses off, he probably
does not even notice the surface is slick until it's too late. He slips on the ice on the edge of the patio.
As he's falling down, he very sharply on the edge of that concrete breaks ribs 6, 7, 8, 9,
10, and 11 and breaks his back. He gets on the ground. He's still alive. NARRATOR: Mr. Adler is not paralyzed,
but the pain from his injuries is debilitating. He's in a tremendous amount of pain.
He's not going to be able to breathe as well. His lungs are already diseased, and the broken ribs
is causing him not to expand his lungs fully. The stress of that situation would
put even more stress on his heart, causing it to pump faster and harder. NARRATOR: The trauma exacts a fatal toll on the elderly man.
He struggles to breathe. His heart, weakened by disease and the stress of the trauma
and cold, falls into a deadly arrhythmia and then ceases to beat. Evidence from the autopsy and the scene
support the events that Dr. G believes led to Mr. Adler's death. This case definitely hinged on those findings at the scene.
We can never do an autopsy in the vacuum. Sometimes the findings of the scene tell us more than what the autopsy does.
NARRATOR: The findings also tell Dr. G how long Mr. Adler suffered in the cold, a pressing question
for his family. JAN GARAVAGLIA: The main concern of his family is how long he was out there, did he suffer.
NARRATOR: Based on the devastating extent of his injuries and his poor health, Dr. G believes that the frail, elderly man
likely succumbed quickly. JAN GARAVAGLIA: They were very relieved to know that he didn't spend the night out in the cold suffering
and that it was-- you know, I can't say that he died, you know, instantaneously.
I have to tell the truth. And he was probably in a lot of pain, but the pain didn't last long.
It was probably just a few minutes. NARRATOR: For Dr. G, the death of Richard Adler
is especially poignant. It shows the difficult struggle that the elderly face to maintain their independence as they age.
It's an issue that Dr. G has encountered with her own mother, who, like Mr. Adler, lives alone.
JAN GARAVAGLIA: And I clearly worry that she's going to fall and nobody's going to be there.
But that's her decision. She doesn't want to lose her independence. She likes being in her own house,
and she has a right to make her own decision. And I would just know I have to accept that.
I would rather have her fall and not be able to get up than put her in a place that I know she's safe
but she's miserable. So you know, you weigh it. And every family makes a different decision.
NARRATOR: Coming up next, a 55-year-old man dies unexpectedly in an outpatient clinic.
He had terrible lesions on his legs. NARRATOR: But the cause of his gruesome death
may not be as obvious as it seems. He has a clearly diseased heart. NARRATOR: When "Dr. G, Medical Examiner" continues.
For any forensic pathologist, working a murder case is always a challenge, especially when the crime took
place nearly 30 years earlier, such as Dr. G's next case, Dennis Folton. The body of 55-year-old Dennis Folton
arrived at the morgue yesterday afternoon. We got a call yesterday from the nurse from the VA clinic.
And this unfortunate fellow was brought in by his family for mental status changes.
And they didn't-- the VA really didn't know much about him then. NARRATOR: As a first step, Dr. G reviews the investigator's
report to learn what information has been gathered about the victim so far. The report states that the decedent had been a paraplegic
for 30 years, the result of a gunshot wounds suffered in his 20s. [GUN SHOT] Dennis managed his paralysis well for many years,
but his medical records indicate that in the past few months, his health had begun to deteriorate.
Three weeks ago, Dennis was hospitalized due to infection, chronic high blood pressure, and advanced coronary artery
disease. He has a lot of problems with his paralysis, as oftentimes they do. He had recurrent urinary tract infections and very bad
bedsores that he was being treated for. They also know he had a bad heart. NARRATOR: But as she reads further into the case file,
Dr. G learns that Dennis left the hospital only a few days after his admission, before his treatment was completed.
JAN GARAVAGLIA: He left that hospital not because he was cured, but because he wanted to leave.
He just kind of went out on a pass and never returned, so they decided he was discharged
I guess against medical advice. NARRATOR: Then, only 20 days after leaving the hospital,
Dennis is beset by illness. He loses consciousness and his family cannot wake him.
JAN GARAVAGLIA: He wasn't acting right. He was looking really sick. Basically, he was unable to be aroused.
NARRATOR: His wife immediately rushes him to a nearby clinic for care, but it is too late.
Dennis is already dead. JAN GARAVAGLIA: Just dead right there in the waiting room.
NARRATOR: The case leaves Dr. G with several possibilities. First, she considers Dennis' 30-year history of paralysis.
JAN GARAVAGLIA: They're doing wonderful things with people who are paralyzed now,
and they have a lot more to offer them. Their lifespan used to be fairly short. It still is not as long as we'd like it to be.
There are many, many complications. And even living 20 years out can sometimes be
a struggle, and 30 years out. And if you're not taking care of yourself-- you have to be really motivated to take care of yourself.
NARRATOR: She also weighs Dennis' history of heart disease. During his hospitalization three weeks earlier, doctors
found that Dennis suffered from ischemic cardiomyopathy, a critical reduction in blood supply
to the heart due to coronary artery disease. JAN GARAVAGLIA: We know he's got ischemic cardiomyopathy,
meaning the heart muscles are damaged. Maybe he's just going into heart failure and not getting enough blood into the brain.
NARRATOR: Was it natural disease or a complication of his paralysis that took Dennis' life so unexpectedly?
We have to look at what's going to cause you to be slowly unarousable. Could it be a lack of blood flow to the brain?
Could his heart be failing? What is wrong with him that he can't be aroused? NARRATOR: The only way to find the answers
is through a full autopsy, beginning with the external exam. When Dr. G gets her first look at Dennis Folton's body,
she cannot believe its poor condition. Basically, when you see him, these are bedsores--
the worst I've ever seen. They start on his hip, especially on the right. And his entire leg is necrotic and dying.
There is exposed bone. The bone joint has been somewhat eroded from it. It's obviously infected.
There's obvious gangrene. And some of it's black. Some of it's green. He's got just a whole infected right leg.
It's partly necrotic and black and areas of-- some of it's dry gangrene. Some of it looks wet gangrene.
NARRATOR: From hospital records, Dr. G knows that Dennis was treated for infected bedsores, also
known as decubitus ulcers, which are a common complication of paralysis. But Dennis' bedsores had clearly worsened
since he left the hospital. His flesh has actually begun to decompose, and it is infested with maggots.
JAN GARAVAGLIA: There's actually even maggots that have gotten into it. I mean, flies have laid eggs and hatched in this wound.
And they're feasting on this dead tissue. NARRATOR: The infection is so severe, it could have actually caused Dennis' death.
This possibility adds a new twist to the case. If Dennis died as a result of his infected bedsores,
it would mean his death was caused by a complication of his paralysis. And because his paraplegia was the result
of a shooting decades earlier, his death could ultimately be ruled a homicide. JAN GARAVAGLIA: Even 30 years later,
what caused him to get in a wheelchair is going to be his cause of death if he died from the bedsores.
NARRATOR: But with stakes this high, hunches aren't enough. Before Dr. G turns this case over to the district attorney
as a potential homicide, she must verify whether or not it was an infection that killed Dennis Folton.
The nut that we have to crack in each case-- and especially a very old one-- is did that criminal act cause this death,
even if it was much later? NARRATOR: To find out, Dr. G needs to complete the autopsy.
Coming up next, Dr. G opens Dennis' body and discovers another possible cause of death.
I mean, it would be heart disease that would kill most people. NARRATOR: But did it kill Dennis Folton?
When "Dr. G, Medical Examiner" continues. Dr. G's morgue technician, Arden Monroe,
prepares the body of Dennis Folton for the internal examination. The 55-year-old paraplegic man died yesterday afternoon
in a local clinic. During the external exam, Dr. G found that the victim's legs were massively
infected from bedsores. It starts at his hip. It goes down the back of his leg, even into his calf
is all black. NARRATOR: If she determines that the infected bed sores from his paralysis actually killed him,
then the ultimate manner of Dennis Folton's death could be homicide. JAN GARAVAGLIA: Whatever trauma caused him to be paralyzed,
that was the initiating event that caused him to have bedsores. And then we can relate the cause of death
back to the initiating event. But we have to prove that the bedsores are what killed him.
NARRATOR: Before the body of Dennis Folton is opened, Arden Monroe washes the maggots off of the body.
Once the body is cleaned, Dr. G opens Dennis' torso from the shoulder blades to the pelvis.
Immediately, she encounters scar tissue in his chest cavity. It is undoubtedly from the gunshot wound that
paralyzed him 30 years earlier. JAN GARAVAGLIA: When I opened him up, you know, normally your lungs sit nice and loose
in your lung cavity. Your heart sits nice and loose in your pericardial sac so it can beat.
And your lungs sit nice and loose in the lung cavity so they can move. Well, in his case, he's got a lot of adhesions,
or fibrous tissue, between the surface of the lung and the surface of the pleural cavity,
which is where the lung sits, and between the surface of the heart and the pericardial sac,
which is where the heart sits. Which tells me that he's had trauma in that area.
NARRATOR: But also evident in the victim's body cavity are visible signs of a raging infection.
JAN GARAVAGLIA: You get an overall sense that his tissues are kind of softened. The tissues don't have the same nice healthy color to them.
A lot of it's because with the infection, they have a lower and lower blood pressure.
And so he didn't look well on the inside, just like he didn't look well on the outside.
NARRATOR: But is the infection that ravaged Dennis both externally and internally what killed him?
The answer can only be found under the microscope. If there is an increase in white cells in Dennis'
internal organs, it would be a telltale sign of a deadly infection. But at this point, even without microscopic evidence,
Dr. G believes Dennis' cause of death is obvious. You know, it's looking like this
is going to be complications of the paralysis due to that gunshot wound. NARRATOR: However, when she begins
to examine Dennis' heart, the course of the autopsy suddenly shifts. He has a clearly diseased heart.
It was enlarged, thickened. He has diseased vessels to the heart. The coronary arteries or blood vessels
that supply blood and oxygen in the heart were narrowed. NARRATOR: One coronary artery is 80% blocked
with atherosclerotic plaque. Another, 95%, and yet another is 98% blocked. See this one.
You can see where the blood is supposed to be. And then if you go down, see where it--
there's not much left where the blood is supposed to be. ARDEN MONROE: OK. Do you see it?
The only hole is right down there. ARDEN MONROE: It's tiny. Tiny little hole left.
And all the blood is supposed to go through there? Well, it can't. NARRATOR: It's evident that the blockage
has chronically reduced the flow of blood to Dennis' heart. Dr. G now wonders if he simply succumbed to a massive heart
attack and not the infection. JAN GARAVAGLIA: It would be heart disease that was bad enough, certainly, to have caused him to die suddenly
and unexpectedly at any time. In a normal man in the right circumstances, I'd have said he died from his heart.
NARRATOR: However, Dennis Folton is anything but a normal man. His legs are black and gangrenous with infection.
So which caused his death-- an infection linked to his paralysis and gunshot wound,
which would lead to a homicide charge, or did he die from unrelated heart disease, a natural death?
There's only one way to know for sure. Dr. G must scrutinize the samples taken from Dennis' organs, including
his heart, microscopically. Coming up next, slides are back from the lab, and Dr. G faces a difficult ruling.
On that heart, I was particularly concerned that there was nothing acute. NARRATOR: When "Dr. G, Medical Examiner" continues.
Dr. G has just received slides of tissue samples she took a few days before while performing the autopsy
of 55-year-old Dennis Folton. During the examination, Dr. G discovered massively infected bedsores, a complication
of the victim's paraplegia from being shot 30 years earlier. However, she also found significant heart disease.
The question is, which actually killed him? And that's the big question. Because if the paralysis killed him, it's a homicide.
It's complications of that gunshot wound. NARRATOR: Dr. G examines the slides of Dennis Folton's
heart tissue and other organs. Under magnification, she finds no necrotic or dying
tissue that would indicate he suffered a fatal heart attack. But in his liver and spleen are the unmistakable signs of
a life threatening infection. JAN GARAVAGLIA: He had a tremendous amount of white cells throughout his body, a collection
of them in his spleen. So he does have evidence that he had an overwhelming infection.
NARRATOR: The forensic evidence points to a death from infection, not a heart attack,
and so do the circumstances of the scene. Dr. G's conclusion-- Dennis Folton's death is directly
linked to the shooting that paralyzed him 30 years ago. This case has become a homicide investigation.
Once I decide that this man died from infection, which was initiated from him being paralyzed,
I then have to contact homicide because it is a homicide. His death is the result of the actions
of another, although delayed. We don't get a lot of 30-year-old cases, but the tragedy of homicide, the tragedy of assault,
battery, sex assault, it's always the same. In the original crime, someone was injured.
Society was injured. And it doesn't matter that time has passed. We still have our duty to do.
I think we should not give people a pass on killing someone, just because time has passed.
NARRATOR: However, the investigation into the shooting of Dennis Folton is short-lived.
Detectives soon discover that the man who shot Dennis 30 years ago has since passed away.
JAN GARAVAGLIA: I remember the homicide detective coming in and telling me that, you know, it's not going to go
anywhere and that the fellow that shot him had actually done time and has since died.
NARRATOR: At the conclusion of the homicide investigation, Dr. G has the information she needs to describe
the circumstances leading to the death of Dennis Folton, events that spanned over 30 years.
At age 25, Dennis Folton is shot in an altercation. [GUNSHOT] He survives the attack, but is paralyzed from the waist down
and confined to a wheelchair for 30 years. JAN GARAVAGLIA: You could see the damage.
You could see the area where the bullet went through, but the bullet was no longer there.
NARRATOR: By age 55, the effects of his long term paralysis are catching up with him.
Dennis suffers from numerous health conditions, including heart disease and chronic infections.
He gets chronic urinary tract infections, not an uncommon problem. And he has these terrible bedsores.
NARRATOR: Three weeks prior to his death, Dennis is hospitalized due to infected bedsores
and other medical disorders. But before his treatment is over, he leaves the hospital without doctor consent.
JAN GARAVAGLIA: He goes out on a pass while he's hospitalized and never returns,
so they in absentia discharge him. NARRATOR: Without proper medical care, over the next three
weeks, the infection festers and invades the bones of Dennis' legs. You could see the bone.
It looked he had, you know, an infection of his bone, an infection of his tissues.
NARRATOR: Lured by the decay of rotting tissue, common house flies lay eggs in his flesh.
Soon, the infection in Dennis' legs spreads into the bloodstream, causing a massive system wide infection of the blood, known as sepsis.
JAN GARAVAGLIA: And that sets off a cascade of events, where your body can't maintain its blood pressure
anymore because of the effects of the bacteria inside your blood. NARRATOR: As his blood pressure plummets,
Dennis loses consciousness and falls into a coma. By the time his wife takes him to the clinic for treatment,
his legs are teeming with fly larva, and his vital organs are on the verge of shutting down completely.
Within moments, his heart finally gives out, and Dennis dies in the waiting room.
But by this time, the infection is so extensive, it's likely nothing could have saved him.
Just like the death of 92-year-old Richard Adler, the case of Dennis Folton demonstrates the importance
of both forensic findings and knowing the circumstances of a death during an autopsy.
JAN GARAVAGLIA: When you see that he's got necrotic wounds, you see that he kind of slowly slipped
into a coma because he wasn't-- and previously not feeling well, feeling sick. That's not consistent with dying from your heart.
It's consistent with, he's dying from the infection. You always have to put it all together.
That's why you always have to know the circumstances. You always have to know how are they feeling.
You know, a doctor has to take a history, just like I have to take the circumstances
surrounding the death. And basically, what that is, is your medical history of what
happened right before you died. Honestly, these kind of cases are why I exist. There are so many unanswered questions at the beginning,
and you just pick through it. You just find out the answers one by one, and things fall into place.
OK. MAN: Atlas.

A retired military officer is found dead in his own backyard during a freak ice storm in San Antonio, Texas.

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

Brief Summary

Richard Adler's suspicious death and Dennis Folton's infection raise questions about aging and health complications after trauma.

Key points

Mysterious Death of Richard Adler. A 92-year-old man is found dead outside after a brutal storm, raising suspicions of foul play.
Dr. G's Autopsy Insights. Dr. G discovers severe trauma and health issues that complicate the case of Mr. Adler's death.
The Struggle for Independence. Dr. G reflects on the challenges the elderly face in maintaining independence.
A Gruesome Discovery. Dr. G uncovers the shocking condition of Dennis Folton's body during the autopsy.
A Homicide Investigation. Dr. G concludes that Dennis Folton's death is linked to a shooting from 30 years ago.

Episode highlights

Episode quotes

It scared me real, real bad.

Caregiver's reaction upon finding the body.

4:30WatchJun 1, 2021

Tension

75/ 100High tension

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