Dr. G: Medical Examiner - Season 4, Episode 6 - Deadly Lovers Quarrel - Full Episode | Forensic Files

[OMINOUS MUSIC] [DRAMATIC MUSIC] All you had to do was-- NARRATOR: A lovers' quarrel suddenly turns deadly.
She picks up a butcher knife and stabs him in the arm. NARRATOR: But the evidence isn't adding up.
He has a wound that probably shouldn't have killed him. But somehow, he still ended up dead.
NARRATOR: And then a man turns up dead on the side of the road. That is not something I see every day.
NARRATOR: And Dr. G may have a murder victim on her hands. No wallet was found. He could have been mugged, assaulted.
[DOGS BARK] Who knows? [THEME MUSIC] NARRATOR: Altered lives, baffling medical mysteries,
shocking revelations. These are the everyday cases of "Dr. G-- Medical Examiner."
[PIANO MUSIC] OK, what's this guy? Do we have any history? Ugh, what is this guy?
Alcohol and cigarettes? That's a bad combo. SANDY: Look at me when you say it. JAN GARAVAGLIA: I'm always on Sandy's
case about her bad behavior. Just drinking, I fall on the floor. JAN GARAVAGLIA: I'm worried.
NARRATOR: Dr. G has reason to worry. During her tenure, she has seen hundreds of people who
might have lived longer if they hadn't abused alcohol and tobacco. Dr. G's next autopsy doesn't seem to be an exception.
[OMINOUS MUSIC] It's early evening, and paramedics are rushing to respond to an emergency call from a private residence
in Converse, Texas, about 12 miles from San Antonio. WOMAN: Who's next? NARRATOR: When they arrive, they find a disturbing scene--
a crying woman, and a man bleeding heavily from his arm. The woman is too distraught to be of much help.
But the injured man, Eddie West, immediately explains what happened. He was having an argument with his girlfriend.
And during this argument, she stabs him. [WOMAN SCREAMS] [POLICE SIREN] NARRATOR: Soon police arrive and question
the girlfriend, Julia, who's still too upset to recall any of the details. Meanwhile, paramedics transfer Eddie
to the hospital, where he undergoes surgery to repair the wound. They felt the surgery went well.
NARRATOR: His family breathes a huge sigh of relief. But his stability doesn't last long.
Within days, Eddie inexplicably takes a turn for the worse. And I'm not sure at this point what didn't go well.
But he ends up needing to be intubated. NARRATOR: Doctors fight to improve his condition.
But to the horror of his loved ones, he eventually slips into unconsciousness. Sorry, son.
NARRATOR: And two weeks after entering the hospital, he dies. Eddie's family members are beside themselves.
How could a 34-year-old man go into the hospital with a simple stab wound and never come home?
To find some sense of closure in the wake of this sudden, incomprehensible loss,
they first need to understand exactly what killed him. They strongly suspect the hospital is at fault.
And now they're turning to the autopsy for the evidence. They thought that the doctor possibly
did something wrong or something went wrong with the hospitalization. NARRATOR: As always Dr. G will keep an eye
out in the autopsy for signs of negligence or an egregious error. One possibility is that the wound
developed a deadly infection. An infection, if you let it go, can get into your bloodstream, which can actually be fatal.
NARRATOR: But then, as she reads further into Eddie's file, Dr. G discovers a number of potential threats to his life.
He's got a history of alcohol abuse, drug abuse. He smokes. He's got a lot wrong with him.
All of that plays a role in how well he does during his hospitalization. Maybe he's got, you know, some lung disease already from his,
you know, cigarette smoking. And so that would make it more difficult to him to get over the surgery.
NARRATOR: But there's also another possible explanation for Eddie's untimely death, one with dire consequences.
His death could have been a direct result of the stab wound, in which case, the blame would
fall on his girlfriend, Julia. If you do something to injure somebody that ultimately causes
his death, no matter how frail they are, you're responsible for their death. NARRATOR: Now it's up to Dr. G to untangle the clues
and identify the truth. We have to see if there is maybe some problem with the hospitalization or the surgery
or if his death is all of a result of that stab wound. Or is there some natural disease that's
playing a role that has nothing to do with the stab wound? NARRATOR: Dr. G's findings could determine whether someone--
Eddie's girlfriend or his doctors-- is held responsible for his death. [FUNKY MUSIC]
JAN GARAVAGLIA: Let me get this guy moving. NARRATOR: Dr. G embarks on the external examination.
OK. NARRATOR: Immediately, the gash on his upper left arm commands her attention.
Yeah, I probably need a ruler of that. Otherwise-- NARRATOR: At 4 and 1/2 inches long and more than an inch
wide, the wound seems devastating, even on the arm. But when she examines it with a magnifying glass,
she discovers the original injury is surprisingly small. They have taken a one-inch stab wound
and extended it for another 3 and 1/2 inches to do surgery on it. MAN: So what are we going to do?
I can tell where the one-inch stab wound was, because it's slightly more irregular
than the scalpel incision. She also notes that the entire laceration has been left wide open.
This may look like a serious oversight that could lead to a deadly infection. But Dr. G recognizes it as a technique known as healing
by secondary intention. Instead of the customary stitches or staples, this allows the wound to heal by natural means.
And it looked pretty good. It didn't look like it was actively infected at all. NARRATOR: But to be sure, she needs to dig deeper,
using her scalpel to check the damage inside the wound itself. Let's open up this first.
NARRATOR: It goes deep, two inches into the arm. It looks like a nice clean in and out.
NARRATOR: But there's no festering infection that she can see. Still, it's clear that this was no ordinary stab wound.
The knife had completely severed Eddie's brachial artery, the largest vessel of the upper arm.
The brachial artery is quite a big artery. One of the main vessels coming off your heart
is your subclavian. And your subclavian, it will go directly, basically, into your arm.
And it changes names. It goes from subclavian to axillary to brachial. So it's-- as it's going into the upper arm,
we call it the brachial artery. It's, you know, a good diameter. And you can lose a lot of blood very quickly.
NARRATOR: But in Eddie's case, the surgical team stopped his bleeding by reattaching
the two ends of the severed artery, and he lived for another two weeks. Clearly, he did not die simply from excessive bleeding.
And the wound, while serious, appears to be well-treated and healing. So far, the findings are good news for Julia
and for Eddie's doctors. But for Dr. G, the mystery of his death is more troubling than ever.
He has a wound that probably shouldn't have killed him with prompt medical attention.
But somehow, he still ended up dead. [OMINOUS MUSIC] NARRATOR: Dr. G cuts down the torso
of 34-year-old Eddie West. Eddie's family believes that for him to die of a simple stab
wound to the arm, hospital doctors must have done something wrong. But Dr. G isn't making any assumptions
until all the facts are in. Peel that, and then you can do your side. NARRATOR: Now, peeling back Eddie's skin,
she can see how two weeks of post-surgical intensive care has affected his body.
And we open up the abdominal cavity, and he's got about a liter of fluid. Now I knew they were giving him a lot of fluids.
They were trying to maintain his blood pressure. NARRATOR: But then she notices something highly abnormal
in the stomach, the kidneys, the pancreas. It's everywhere. Everything has kind of a yellowish appearance.
NARRATOR: Eddie's organs are jaundiced, a symptom of natural disease where a yellow chemical called
bilirubin accumulates in the blood. And when she examines the liver, she quickly identifies
the source of his problem. Hm. It's very cirrhotic. It's very lumpy, bumpy, regenerative nodules.
It's a very sick-looking liver. NARRATOR: Cirrhosis, or the scarring of liver tissue,
can impair the organ's ability to filter bilirubin from the blood. Often, it's the end result of alcohol
abuse, which Dr. G suspects is the case with Eddie. And it looks like he drinks very heavily.
He obviously wasn't taking care of himself. NARRATOR: Over time, cirrhosis can lead
to liver failure and death. I got my-- NARRATOR: But Eddie was clearly active prior to his injury, which means it's unlikely that it suddenly
killed him in the hospital. He was tooling along with his liver disease. And he was able to drink and keep up his alcoholism
when he got the stab wound. NARRATOR: But if he didn't die of liver disease, an infection,
or sheer blood loss, what caused his death, and who is to blame? To find out, Dr. G must persevere in the autopsy.
And her next stop is the chest cavity. MAN: (SINGING) Now this guilty pleasure has taken its toll.
But still my conscience is not sold. I'm your weak endeavor to sever its hold. Half the story goes untold.
It's not that you're right. It's not that I'm wrong. It's just that you got me hanging on.
So keep away. NARRATOR: She removes the chest plate and there detects a possible culprit.
His lungs look terrible right off the bat. NARRATOR: She removes and dissects them.
With every slice, the problem grows more alarming. Eddie's lungs have no trace of the normal spongy texture.
And they're almost solid. They're airless, they're so solid. NARRATOR: Dr. G is certain the condition is not
the result of a smoking habit or inadequate treatment by doctors. It's a natural disease of the lungs called acute respiratory
distress syndrome. Or what we call ARDS. It's something he develops while he's in the hospital being so sick.
NARRATOR: ARDS usually strikes when a patient is very ill, whether from an infection,
injury, or other condition. The lungs' tiny air sacs get inflamed and fill with fluid instead of air,
eventually making it impossible to breathe. When you see them, you cannot believe anybody could
be alive with these lungs. NARRATOR: For Dr. G, this severe lung disease trumps cirrhosis
as the final death blow. It's a very, very severe disease. Clearly, he must have died ultimately from the ARDS
with these airless lungs. NARRATOR: Now she knows exactly how Eddie's life ended.
The discovery would bring most autopsies to a close. But in this case, finding a mechanism of death
doesn't satisfy Dr. G. The mechanism of death isn't always the cause of death. The mechanism is just the end piece.
The cause of death is what started the chain of events that ultimately caused him not to be able to aerate.
NARRATOR: To rule the cause and manner of death, she must determine what caused Eddie's ARDS
and triggered his downward spiral. What got him to those airless lungs? What got him there?
NARRATOR: If the hospital is found to be at fault, they still could be held responsible.
Or if the inciting incident turns out to be the stab wound, Eddie's girlfriend Julia still could be charged with homicide.
290. NARRATOR: But so far, Dr. G only has sporadic links in the chain between the stab wound
and ARDS. And after dissecting the heart and brain, she can find nothing to complete the picture.
Where I cut his brain, there's a little edematous, which we see with someone kind of slowly dying.
But overall, his brain looks normal. NARRATOR: At the end of the autopsy, she still lacks the evidence to rule
a cause and manner of death. Yeah, I have a lot of the facts of what his organs look like.
I have, you know, a wound that's been surgically manipulated. And I can see that he's been very sick.
I've got a mechanism of death, that he died from respiratory failure because his lungs were
so damaged. But I really still need to know how he got to that from a simple stab wound to the arm.
NARRATOR: Now there's only one place where she might still find clues that wouldn't show up in autopsy--
Eddie's complete files from the hospital. I may not have all the notes. So I need to look at those medical records very carefully
and put that with what I found at autopsy. NARRATOR: The truth may exonerate Julia
and the hospital or finally give Eddie's family a chance at justice. [OMINOUS MUSIC]
How much is it for the unstained? How much are they charging? WOMAN: Stain slides are $11.
NARRATOR: Sometimes the most creative part of Dr. G's job happens outside the autopsy room.
You need a quiet place to read the chart more carefully. You have to kind of think about what you've found.
And you need the police report, the autopsy findings, your microscopic slides. And usually, you do that in your office.
NARRATOR: The full medical records of Eddie West have finally arrived. And Dr. G puts everything else aside to pore over them.
She's certain that the 34-year-old died from a respiratory disease in the hospital--
Pay the bill? NARRATOR: --two weeks after his girlfriend Julia stabbed him in the arm.
But without knowing why Eddie became so ill, she can't determine who should be held responsible-- his doctors, Julia
herself, or nobody at all. If you're going to punish somebody for something, you just want to make sure that the T's are crossed
and the I's are dotted. NARRATOR: Now she carefully examines the hospital report, which describes every aspect
of his medical care. The details are astounding. So when I review the chart, I see all of his problems
he had during his hospitalization. NARRATOR: One problem in particular stands out.
She discovers that before and even after the surgery, he had needed massive blood transfusions for two reasons--
his severed artery and his sick liver. When the liver doesn't work well, you bleed much more easily.
So if a patient has liver disease and they have trauma in addition to that, their blood loss is amplified, accentuated,
three, four, five times. NARRATOR: But while replenishing the blood supply in patients
like Eddie is paramount to keeping them alive, it can sometimes trigger unexpected side effects.
We all can be allergic to different proteins, like a bee sting or, you know, certain foods we eat.
Well, there's proteins in some of the blood products they give. So some people can have allergic reactions to proteins.
NARRATOR: This type of response is uncommon and almost impossible for a surgical team
to protect against. A reaction occurs in about one in 500 patients. But life-threatening cases like Eddie's are even rarer.
Because of them giving him so many blood products, he ends up having a transfusion reaction
to some of the products that he was given, most likely some of the protein or the white cells.
NARRATOR: Eddie's allergic-like reaction to blood products caused fluid to leak into the lungs,
making it difficult for him to breathe on his own. This could explain why doctors put him on a ventilator.
But Dr. G suspects that, at this point, he still could have recovered. Although he has a bad reaction,
if the cards are right and things go well, yeah, he should have survived it. NARRATOR: But Eddie's cards were stacked against him.
And in the hospital report, she soon spies another blow to his chances, something impossible to detect in autopsy.
In the days after his surgery, Eddie had suffered a severe form of alcohol withdrawal known
as delirium tremens, or DTs. It really has to do with the brain receptors no longer being exposed to the alcohol
like they normally are. And you actually get seizures. You can also get hypotension.
Even with proper treatment, you can have a 5% to 10% mortality just by going through alcohol withdrawal.
NARRATOR: The withdrawal symptoms would have taxed a number of vital organs, including his damaged lungs, ultimately
enough for him to develop ARDS. For Dr. G, these details from the hospital records coupled
with her autopsy results finally complete the chain of events leading up to Eddie's death.
Besides him already having liver disease, the bleeding, the transfusion reaction, all of those are insults to his lungs.
He needs more and more oxygen to maintain him having oxygen in his blood. And at some point, they can no longer then oxygenate
his lungs, and he dies. NARRATOR: Now Dr. G can explain to Eddie's family exactly what cut the 34-year-old's life
so tragically short. [OMINOUS MUSIC] It's a beautiful Saturday afternoon. But for Eddie and his girlfriend Julia,
there's trouble in the air. Can't find anything-- NARRATOR: Something sparks a fight.
And soon, their argument spirals completely out of control. ACTOR AS EDDIE WEST: Stupid!
And I just still-- I don't know why he's arguing. But she stabbed him. [SCREAMS]
NARRATOR: The knife impales his upper arm, severing the brachial artery. Oh my God.
They know it's severe, calls 911. They go to the hospital. They immediately take him into surgery.
NARRATOR: But Eddie's liver, ravaged by alcohol, prevents his blood from clotting,
and he continues to bleed. To combat this new problem, his doctors ply him with transfusions.
But to their alarm, their efforts backfire. He has a bad reaction to some of the blood products.
But it was unforeseen. There is no way you could have tested for it. NARRATOR: To help Eddie breathe, doctors immediately
put him on a ventilator. But then he takes another devastating hit, this time from alcohol withdrawal.
Doctors face this all the time. People come into the hospital not healthy, or, you know, one bad complication
happens after another. NARRATOR: Eddie's condition quickly spirals downward. His lungs weaken drastically, further exacerbating
his respiratory distress. And they just can't maintain any oxygen in him, 'cause his lungs are getting worse and worse.
NARRATOR: Finally, despite his doctors' best efforts, Eddie's oxygen-starved organs begin to shut down one by one.
And two weeks after entering the hospital, he dies. Based on these findings, Dr. G concludes
that the medical team was not at fault for Eddie's death. But someone is-- his girlfriend Julia.
Although the mechanism of death is really complicated with all of these chain of events
happening and the ultimate lung failure, the cause of death actually is very simple, and it's a simple, single stab
wound to the arm. So ultimately, although some of the problems were his in that he had liver failure,
and some of the problems were just a bad consequences reaction to the blood, all those things
were set in motion because of the stab wound. NARRATOR: And with the stab wound as the definitive cause of death,
Dr. G must make a disquieting ruling. The manner of death is homicide. That's more of a forensic term.
Homicide doesn't imply intent. It doesn't imply that it's premeditated. It doesn't imply it's a murder.
Homicide means that his death is a direct result of an act of another on him. And that's what I call it, and that's
what it gets-- how it gets sent for the judicial system to decide what they do with it.
[PEACEFUL ACOUSTIC MUSIC] NARRATOR: The police immediately arrest Julia. She pleads guilty to aggravated assault. Her sentence,
12 years probation. For Eddie's family, it provides some measure of justice. But whether it brings them peace, only time will tell.
They see that quite clearly with the autopsy and the death certificate that, yes, he did die from the stab wound,
and yes, it was his girlfriend that ultimately put him in there. In a totally healthy person, would
this have been a fatal injury? It's possible. It depends how much blood you lose at the time.
It depends that everything went well with the transfusions. But sometimes things don't go well.
So one of the reasons we want to be in good shape is if we ever do have to go to the hospital,
the chances of surviving anything are better. [ENERGETIC MUSIC] NARRATOR: Coming up, as Dr. G closes one homicide case,
another finds its way to the District Nine Morgue. It's always a red flag if you're found just dead outside.
He could have been mugged, assaulted by anyone. Who knows? [OMINOUS MUSIC] [RELAXED ACOUSTIC MUSIC]
JAN GARAVAGLIA: As the medical examiner, I might be the one holding the scalpel.
But a morgue runs on teamwork. MAN IN BLACK: That, too. But I-- I don't think I have the ER sheet.
We'll have to go ahead and try and figure it out. JAN GARAVAGLIA: And when the team isn't
clicking on all cylinders-- - Medical examiners. Carol. JAN GARAVAGLIA: --it can make this job a whole lot harder.
OK, who's his next of kin? JAN GARAVAGLIA: This was definitely the case for a recent autopsy of a 67-year-old man
named Gene Andrews. [OMINOUS MUSIC] NARRATOR: 8:00 AM. Dr. G arrives at the morgue, where it's strangely quiet.
Oh, my. We got problems today. We got-- you know, Steve's out on vacation. Two of my investigators call in sick.
We're trying to get one in who worked pretty much all day, till, like, midnight last night.
He says he'll come in. It's going to take a little bit. NARRATOR: Meanwhile, there are bodies waiting to be autopsied.
The first file she picks up is that of a man found lying on a street corner in nearby St. Cloud, Florida.
According to the report, a local flower shop owner and his manager were walking to their van
when something caught their eye. And they see this poor gentleman pretty much on the curb, not looking good.
NARRATOR: At first, they assume it's a homeless man just drunk or asleep. But on closer inspection, they're shaken when they
realize he's not breathing. They immediately call 911. NARRATOR: Paramedics arrive within minutes.
EMS tries to resuscitate him. PARAMEDIC: One, two, three. NARRATOR: But it's too late.
They can't get a pulse, and he dies right there on the pavement. No one recognizes the man.
But fortunately, the paramedics are able to get a quick lead on his identity. They found a card--
his driver's license or ID card-- in his pocket. NARRATOR: His name is Gene Andrews, his age, 67.
Now, while the police look for Gene's family, his body is immediately transferred
to the District Nine Morgue and into Dr. G's hands. So we're going to have to figure out what went on.
NARRATOR: Already, she has a major concern about his cause and manner of death because of where they found him.
It's always for us a red flag if you're found just dead outside. The location kind of gives us a hint of how you're dying.
Usually, on the toilet, we're thinking, you know, hypertensive or a rhythmic type death.
Just dead in your sleep, you know, that tells us more of a heart. In this case, he's found on the side of the curb.
NARRATOR: Nobody actually saw Gene fall to the ground, which means that an attack of some sort
is a likely possibility. No wallet was found. He could have been mugged, assaulted by anyone.
Who knows? [GUNSHOT] NARRATOR: At worst, he could have been shot. A small-caliber bullet can lead to heavy internal bleeding
that's hard to detect externally. The blood stays in his chest. You know, we oftentimes can see that.
NARRATOR: If Dr. G finds any evidence of trauma, police will need to launch an immediate manhunt
for the offender before the trail grows cold. Given Gene's age, however, death from natural causes
is also a prime candidate. Unfortunately, she's got no medical records to work with.
And I have nobody in my office to, like, check all the local hospitals to see if he had any medical history, any admissions.
But I don't think this is going to get done. NARRATOR: The longer she waits for information,
the harder it will be for police if they need to start tracking down murder suspects.
So I have to proceed. We've got to put extra care and really prove that no traumas occurred.
NARRATOR: Dr. G begins the external examination with a search of Gene's clothing.
His clean appearance suggests he's not homeless. But the contents of his pockets could be even more telling.
All righty. Let's see. When you go through the decedent's pockets, you never know what you're going to find.
A lot of it will build the picture of who they are. Some guys are really neat, you know?
They have their money in the clip. A lot of guys, though, uh-uh. They just got things wadded up in here, old gum wrappers,
you know, just all sorts of little odds and ends. NARRATOR: A good clue can be priceless.
Sometimes you find lots of money, you know, thousands upon thousands of dollars.
But sometimes you can find syringes, sometimes the photographs. We had one where he was in an automobile accident,
and I had his cell phone. And you could see the pictures on his cell phone were at a party, and he was obviously drunk.
So it's very helpful to help you build the picture. MAN: Puts on three, four pounds--
NARRATOR: Gene's belongings look trivial at first. And he's got, you know, the typical lighter.
I don't find any cigarettes. Ooh, let's see. NARRATOR: But then she spies something extremely valuable.
Lo and behold in there, I did get a hint. And what I got was a slip-- a prescription for him to get a CAT scan.
NARRATOR: A CAT scan, or computed axial tomography, is used to diagnose a multitude of problems,
from cancers to blood clots. Given that the prescription was still in Gene's pocket,
Dr. G suspects he never used it. But the clinic where the CAT scan was prescribed
may have vital information about his health, and in turn, his death. Normally, she could follow a clue like this
without leaving the room. I'll give it to my investigator, and I'll, you know, have him call
while I'm doing the autopsy. In this case, I didn't have any investigators. NARRATOR: But the clock is ticking.
I'm, like, really wondering what's going on with the fellow. So I thought, well, I'll try calling the doctor myself.
[OMINOUS MUSIC] NARRATOR: Dr. G steps out of the morgue for a moment, leaving Gene Andrews' body on the gurney.
I just postponed the autopsy for a few minutes to see if I could get some more information on him.
NARRATOR: With a skeleton staff, it's the only way to find out why the 67-year-old had a prescription
for a CAT scan in his pocket. Hi, this is Dr. Garavaglia at the medical examiner's office.
Now you just can't call a doctor's office, usually, and get information about anyone.
But, you know, they know the medical examiner's office. In this state, we can get their medical information
to help us with the cause and manner of death. NARRATOR: At first, it takes a moment
for the clinic's administrative nurse to track down the records. That little piece of paper actually
was written about three months earlier. NARRATOR: But the effort pays off. She's telling me that he was in there.
He had some history of previous strokes and recent right-sided weakness. NARRATOR: Concerned that Gene's weakness
was the classic sign of a stroke, the doctor prescribed a diagnostic CAT scan. Gene took the prescription, but apparently
never went for the test and never returned to the clinic. He never finished his workup for this right-sided weakness.
Now I find it interesting. After three months, he still has the prescription in his pocket.
Maybe he's just a typical man. He's going to get to it. Maybe the right-sided weakness went away,
and he figured he didn't have to do anything about it. NARRATOR: Yet Dr. G can't ignore Gene's history.
Strokes are the number three cause of death among Americans his age. If he truly has a history of stroke,
you know, maybe he's had another huge stroke. [OMINOUS MUSIC] NARRATOR: Dr. G delves into the external exam,
first focusing on the possibility that Gene was the victim of a mugger's attack.
Now I'm still having to worry about trauma. I look for a skin, for any evidence of bruising, even,
you know, grabbing his wrist, certainly looking for, in the abdominal area, anything abnormal, any abnormal--
even, you know, a gunshot wound with very little blood. NARRATOR: But she finds no indications
of an assault or even illness. He looks maybe even a little better than 67. And I really don't see anything on him.
NARRATOR: In fact, for someone with a possible history of strokes, he shows none of the muscular degeneration
often seen in stroke victims. They said he had a history of a previous stroke. They said he had this new onset of right-sided weakness.
But when you look at the guy, he doesn't show any signs of stroke. I mean, his muscles look, you know, bilateral.
They look symmetrical. He's obviously walking down the street. NARRATOR: But about 10% of patients
make a full recovery with no loss of mobility. Either Gene was one of those lucky few,
or what he thought were strokes were something else. Yet based on the known circumstances,
Dr. G still wonders if Gene's sudden death was from stroke or head trauma. And there's only one way to find out.
[OMINOUS MUSIC] Slicing from ear to ear, Dr. G peels back the scalp and at first spots no injuries.
I look at the skull, the calvarium, and I certainly don't see any fractures. [DRILL WHIRRING]
NARRATOR: But then, as soon as she extracts the brain, she sees trouble. There is a portion of his right cerebral hemisphere,
there's almost 2 and 1/2 centimeters by about two centimeters that is dead. NARRATOR: This is clearly not trauma from an attack.
Instead, she recognizes the condition as an infarction, or the aftermath of a stroke.
When I see a brain, it's usually got the consistency of a nice, kind of a firm Jell-O. And in this case,
you have the normal kind of gray soft brain, and then you have a place that's indented.
That part of the brain, almost a wedge shape, has lost blood supply, and it died,
and it doesn't get replaced. And that's clearly an ischemic stroke. NARRATOR: Ischemic strokes are those
caused by clots or other obstructions in a blood vessel in the brain. If untreated, the victim can incur serious brain
damage and even death. But oddly, for Gene, that's not the case. If it was fresh stroke, you know, the tissue
would still be there. But it'd be soft, and it would show that it was starting to die.
Now this-- the body's already kind of repaired it. It almost looks kind of shriveled up,
and it's clearly an old stroke. I know that's not what caused his death. NARRATOR: As she continues the dissection of the brain,
she's surprised to discover that it's actually riddled with strokes, and all of them
are old except one. I do find a little blood clot in one of the vessels. NARRATOR: The finding suggests that all of his strokes
are ischemic, caused by blood clots. And this little one is the newest. So eventually, these blood clots get reabsorbed.
And you don't necessarily see them in the vessels. I'm actually surprised I could actually find even
this tiny one, this fresh one. NARRATOR: But Dr. G is confident that the clot is too small
to have cause Gene's death. Though there's no doubt he was prone to strokes for some reason, she finds nothing that
indicates he died from one. And if a stroke didn't kill him, it's more likely than ever
that he suffered a deadly assault. I'm still having to worry about trauma. MAN: Can you get this side off for me?
JAN GARAVAGLIA: Yeah, feel free. NARRATOR: Dr. G makes the standard Y incision on Gene Andrews from the shoulders to the sternum
and down the abdomen. If he died from a fatal injury, she would expect to find internal hemorrhaging
from a damaged organ or vessel. Well, don't have blood there. My first answer is, he doesn't have any free blood
in the abdominal cavity. And then I also look to make sure there's no rib fractures, any evidence of blood,
evidence of blows to the chest. And there is none. So I've ruled out trauma in the head,
I've ruled out trauma in the abdomen, and I've ruled out trauma in his chest. Trauma is ruled out.
NARRATOR: Now she can alert authorities that Gene's death is not a homicide. But if neither trauma nor a stroke killed him, what did?
We're ready, then? NARRATOR: To find out, she turns up the heat, checking every organ for any signs of an acute illness.
So I open the chest cavity. I cut up the anterior ribs on both sides, take that chest plate off.
NARRATOR: But then, as she removes Gene's abdominal organs, she uncovers something far more alarming--
kidney damage. Nice, healthy kidney has, you know, just as you heard, the typical kidney-shaped bean.
They call them kidney-shaped beans for a reason. They look like just what the real kidneys look like.
They have a nice, smooth surface. Now his kidneys, you can see immediately there's something wrong.
You have nice, normal tissue. And then you lose tissue. You know, it kind of bumps down, and then some normal tissue,
and then it bumps down. And these are-- there's old infarcts in his kidney, multiple small infarcts, giving these kidneys this kind
of lumpy, bumpy pattern. The right kidney is going to be 125. NARRATOR: Much like in the brain, the infarctions
in Gene's kidneys indicate areas where tissue lost blood supply and died because of the clots.
Yet amazingly, Dr. G believes Gene may not have even felt the damage, much less died from it.
The beauty is, you have two kidneys. And you really have to harm a lot of kidney tissue
before it starts truly affecting you. Just the outer-- NARRATOR: Still, she's troubled by the condition
of Gene's kidneys. Why is he having infarcts in his brain and his kidneys? That is not something I see every day.
Even more baffling, she can't figure out how they could possibly relate to his death, if at all.
And she has only one major organ left to examine. OK, let's see. I've still got the major cause of death
that comes through my office, and that's heart. And I still need to look at that heart.
[OMINOUS MUSIC] NARRATOR: Dr. G extracts 67-year-old Gene Andrew's heart, and it looks quite bizarre.
Just like his kidneys were lumpy-bumpy, his heart wasn't normal-shaped either. My, my, my.
I can clearly see part of the heart had died. NARRATOR: Dr. G immediately recognizes
this as a classic sign of a heart attack. To find out what caused it, she begins slicing into the organ.
JAN GARAVAGLIA: Let's see. NARRATOR: And there, in the coronary arteries, she finds the culprit.
He's got bad atherosclerosis, the buildup of fatty plaque. NARRATOR: She believes the plaque impeded blood flow
in Gene's heart, causing his heart attack and killing part of the heart wall. So classic old heart attack that I see.
The wall is dead already. It's been replaced by fibrous tissue. This is not something acute.
This has been there for months. NARRATOR: But then, attached to the inside of the heart wall,
she finds something that intrigues her even more-- a large, old blood clot. These blood clots on the inner aspect
of the walls with major heart attacks are very common. And in this case, it's, you know,
a pretty big blood clot in there, and it's pretty thick. And it's well-attached.
You can tell it's been there a long time. But it's somewhat friable. It easily breaks apart, and the edges are a little bit loose.
NARRATOR: Suddenly, she realizes this finding in the heart could actually solve the mystery of Gene's
strokes and kidney damage. I think I have it all figured out. What happens is that he has a heart attack that
kills off the front part of the heart muscle in the left ventricle. That's replaced by scar tissue, and a clot had formed.
And occasionally, a big enough piece breaks off that it kills part of the tissue where it lodges.
And it's obviously lodged a lot in the kidneys, and it's lodged in the brain. NARRATOR: Now Dr. G has a perfect explanation
for Gene's numerous infarcts. In the wake of a heart attack, a massive clot in the left ventricle was simply depositing bits and pieces
of itself throughout his body. And this may even point to a cause of death, because after a heart attack, the resulting scar tissue
leaves the heart vulnerable to dangerous interruptions to the heartbeat. With that major of heart attack,
it sets up an arrhythmia. And so he is at high risk for sudden death. [GUNSHOT] NARRATOR: But as she wraps up the autopsy,
she's not convinced she has all the answers. She wonders why, after surviving for months
with a damaged heart, brain, and kidneys, Gene collapsed on that particular day.
He was going along fine with it. Why does it kill him today? I do have this nagging worry of what else is going on with him.
Ah, I can't figure it out. NARRATOR: Dr. G's last hope for resolving Gene's puzzling death is toxicology.
Perhaps a secret remains hidden deep within his blood. JAN GARAVAGLIA: Okey-dokey.
NARRATOR: Dr. G sends Gene Andrews' fluid samples to the toxicology lab. But what comes back is nothing short of shocking.
It is amazing what you find in toxicology. Surprisingly, even at the age of 67, even with previous strokes,
even with this previous heart attack, this guy is using cocaine. [CHIME MUSIC] NARRATOR: Specifically, the chemicals
found in his blood show that he had used cocaine within an hour or two of his death.
I mean, it is just unbelievable that a 67-year-old man is still doing crack cocaine out on the street.
NARRATOR: But in retrospect, it fits perfectly with all the clues from the autopsy.
He's got a lighter in his pocket, but he didn't have any cigarettes. Even his lungs-- very gray, a lot of anthracotic pigment.
So I suspect he has been smoking crack cocaine for a long time. NARRATOR: This also explains her unexpected findings
in the heart. Cocaine is known to cause heart disease. His heart attack, his atherosclerosis
can all be associated with cocaine. NARRATOR: But most importantly, cocaine is also associated with arrhythmias, a disruption
to the heartbeat that can be fatal. With all the evidence in hand, Dr. G is now certain that Gene was ultimately
killed by a cocaine-induced arrhythmia. His body is set up to have a cardiac arrhythmia.
He has been cheating death for a long time. [OMINOUS MUSIC] [DOGS BARKING] NARRATOR: At 67, Gene Andrews has
a habit he just can't break. And today is no exception. He's smoking crack cocaine.
He's out on the street doing what he wants. NARRATOR: He probably doesn't realize what a dangerous chain
reaction cocaine had triggered in his body, starting with heart disease, then leading to a heart
attack and a large clot, which then slowly chipped away, causing his strokes and kidney damage.
But amazingly, Gene survived all of this. There are many things that could have caused his death along the way.
And I think he's lucky to have lived as long as he did. NARRATOR: But finally, his luck is beginning to run out.
As he smokes his usual dose of cocaine, Gene's heart struggles to pump. It's a stimulant.
It causes increased heart rate, increased blood pressure. NARRATOR: The drug also acts as an irritant,
causing his heart vessels to spasm. And this heart then starts to quiver. NARRATOR: He makes his way to the street,
perhaps to call for help. But it's too late. Gene is having a cardiac arrhythmia.
His heart can no longer keep beating. And he dies on the curb, not from natural disease
or an assault, but as a victim of his own vice. MAN: Hello? Sir? [PEACEFUL MUSIC]
Do you have a pen I could borrow, though? NARRATOR: Dr. G rules the death an accident,
because although Gene may have soon died from another heart attack or stroke, he died on this particular day
from the unpredictable effects of cocaine. It's Russian roulette. You never know when it's going to affect you and can kill you.
NARRATOR: But for Dr. G, the most unpredictable part of the case is human behavior.
He's 67. I really didn't suspect it. And you know, it just goes to show, you just never know.
Oh, we got three today. [FUTURISTIC MUSIC] ANNOUNCER: Atlas.

Dr. G must figure out if a man died as a result of his infected stab wound or if his history of drug abuse was the culprit.

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

Brief Summary

Eddie West's death from a stab wound leads to homicide charges against his girlfriend, while Gene Andrews dies from cocaine-induced cardiac arrhythmia.

Key points

A Lovers' Quarrel Turns Deadly. A heated argument leads to a shocking stabbing incident.
The Mystery of Eddie's Death. Eddie goes to the hospital after a stab wound, but complications arise.
Dr. G's Investigation. Dr. G uncovers the truth behind Eddie's unexpected death.
Homicide Ruling. Dr. G determines the manner of death as homicide, leading to Julia's arrest.
A Mysterious Death. Dr. G investigates the death of Gene Andrews, found dead on the street.
Uncovering Clues. Dr. G examines Gene's belongings, leading to vital health insights.

Episode highlights

Episode quotes

Just drinking, I fall on the floor.

Sandy reflects on her behavior.

1:28WatchJun 10, 2021

Tension

75/ 100High tension

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