Dr. G: Medical Examiner - Season 4, Episode 8 - Twin Terror - Full Episode | Forensic Files

[MUSIC PLAYING] NARRATOR: It's a parent's worst nightmare. A baby girl found dead in her crib.
You know, when we see a baby, it's devastating. NARRATOR: But could it be possible
that the baby died at the hands of her own parents? Infants, unfortunately, are sometimes subjected to abuse.
We still have to rule out that she wasn't murdered. NARRATOR: And then it seems like just
an unfortunate natural death. We have a man in his early 60s who is found dead by his wife
across the bed. NARRATOR: But is there a dark secret that his wife's been keeping?
You just never know. They just don't always tell you the truth. [MUSIC PLAYING] NARRATOR: Altered lives.
Baffling medical mysteries. Shocking revelations. These are the everyday cases of "Dr. G, Medical Examiner".
Up to 50 cases come through the District Nine County Medical Examiner's Office each week.
And Chief Medical Examiner, Dr. Jan Garavaglia is ultimately responsible for all of them.
But not everybody ends up under Dr. G's knife. In addition to her own caseload, Dr. G
oversees a team of four other medical examiners. I have to make sure that the doctors
are doing things correctly. So I, in a way, have a quality assurance duty over all of the cases.
NARRATOR: Her newest hire is Dr. Joshua Stephany. He's been a forensic pathologist for less than a year,
but Dr. Stephany already has a long history with Dr. G. I've known Josh for five years.
He was actually a resident over at the training center at the hospital associated with the morgue.
NARRATOR: In fact Dr. G trained Dr. Stephany during his forensic pathology rotation.
Dr. G is sort of a mentor figure for me. Knowing that I wanted to go into forensics,
she helped me with a lot of the stuff that you can't read in books-- a lot of the things you learn by doing and seeing
more so than reading about. NARRATOR: Although he is now a licensed physician, Dr. Stephany still relies on Dr. G's expertise
on his most difficult cases. My work relation with Dr. G, I think, is a pretty good one.
She's always been helpful in guiding me what to do and, you know, things to look for.
NARRATOR: Every morning, Dr. G and her team meet and assess the cases for the day.
We all review all the cases, we look what came in that day. White male, obese. This is the one where he's snoring loudly
and he took his mother's pills. NARRATOR: Among the new intakes is Melanie Simmons, a baby girl.
Of all their cases, none is more heart wrenching than the death of a child. Babies, you know, obviously, are helpless.
Those kind of hit home a little bit more. NARRATOR: But infant fatalities aren't
just tragic, they're often extremely difficult forensic mysteries. These cases can be anything from natural to homicide.
And you can't really tell just by sometimes looking at the baby or even the circumstances.
NARRATOR: And today, the youngest decedent falls to the youngest member of the staff.
Dr. Stephany ended up with the baby that day. And it was his job to come up with an answer.
[MUSIC PLAYING] NARRATOR: The case began 12 hours earlier in Kissimmee, Florida.
According to the statement Deborah Simmons gave police, she started getting her identical twin daughters,
Morgan and Melanie, ready for bed at 7:30 PM. [MUSIC PLAYING] Here we go. Why don't you lay down?
[MUSIC PLAYING] NARRATOR: After she finishes breastfeeding, she places the babies in the crib
together and rolls them onto their stomachs to sleep. They're both face down on the bedding, pillows,
stuffed animals, heavy quilts. NARRATOR: Then at around 9:30 PM, Deborah finally goes off to bed herself.
[MUSIC PLAYING] It's not until 7:30 the next morning that she hears one of her babies crying.
It's Morgan, who's apparently ready to be fed. The mother got one twin daughter and was taking care of it in the morning.
Like her usual ritual. Put it down and went to look at the other twin. NARRATOR: But when she picks up Melanie,
the baby is cold, unresponsive, and it only takes a few moments for Deborah to realize
her daughter is not breathing. Panicked, she immediately calls 911. [PHONE RINGING]
[SIRENS] [INAUDIBLE] NARRATOR: Paramedics arrived minutes later, but it's clear to them right away Melanie
has been dead for hours. [SCREAMING] [RADIO CHATTER] Deborah Simmons is beside herself with shock and grief.
But when investigators are called to the scene, their first priority is not to comfort her.
When our investigators get there they don't want anyone suspected of foul play near the baby.
So in this case, the mother was not allowed to see the baby or touch the baby after the initial 911 was called.
NARRATOR: When it comes to the death of an infant, abuse is often high on the list of suspects.
So it's essential that Dr. G's investigators leave no stone unturned. You have to do a very thorough or scene investigation.
Sometimes we even collect the last formula bottle. Believe it or not, we get babies that are drugged
and they put it in the formula. NARRATOR: In fact, Deborah doesn't even get a chance to hold her daughter before the tiny body
is transported to the county examiner's office and onto Dr. Stephany's table. No medical history of infections or fever.
It appears the baby had pretty much been normal up until she was found dead this morning.
NARRATOR: Dr. Stephany already has his own suspicions on the cause of death based on photos taken
by investigators at the scene. Looks like-- from the pictures, it looks like a pretty big pillow in a crib.
So it's possible suffocation being found face down. NARRATOR: If Dr. Stephany fails to find out
how Melanie died the cause of death will be determined as SIDS. SIDS is an acronym that stands for Sudden
Infant Death Syndrome. Basically, if after the autopsy external examination, internal examination, histology looking
at all the slide of the internal organs, toxicology results, cultures, pretty much ruling
everything out that you can possibly think of, we call it SIDS. Basically, it means we don't know
what caused the baby's death. NARRATOR: SIDS, or Sudden Infant Death Syndrome is the most commonly ruled cause of death
for infants between one month and one-year-old. But for doctors, it's a so-called wastebasket
diagnosis. A ruling made when the autopsy is inconclusive, It really, honestly, is a fancy word for undetermined.
It fits the syndrome of being found dead in bed for no reason. It's probably a natural disease--
it's probably several natural diseases that just aren't detected yet. NARRATOR: Dr. Stephany hopes he won't make a SIDS diagnosis.
He's determined to find the cause of death. And one thing is crystal clear, time is of the essence.
If he finds Melanie died of natural causes it would immediately absolve her parents of any charges
of abuse or negligence. But it could also mean that Melanie's twin sister Morgan is at risk of suffering the same fate.
What you have to worry about is if you have a genetic or a congenital anomaly or defect or disease in one twin.
Especially in identical, you really have to let the parents or let their doctors know about it so they
can monitor the other twin. [MUSIC PLAYING] NARRATOR: Doctor Stephany's first priority
in the external exam is to check Melanie's body for signs of physical abuse. They check for contusions, bruises,
abrasions, lacerations, tears, any signs of trauma. NARRATOR: On the outside, Melanie's body
appears to be in good shape. She has no bruises, cuts, or scarring. But that doesn't mean she was never abused.
Blows to the abdomen may just not show. Blows to the head may not show. You can't always see the bruises.
NARRATOR: As Dr. Stephany moves up the body, he notices lividity or purplish red discoloration of the skin
due to the settling of blood. Lividity occurs after death as gravity causes blood to settle.
So if the baby is on his back the blood will pool to the back. If the baby's on the stomach the blood will pool
to the abdomen or the face. NARRATOR: Lividity is crucial to determining the body's position at death.
And Melanie's lividity pattern provides Dr. Stephany with an important clue. In this case, the blood pulls of the abdomen and the face.
NARRATOR: This proves that Melanie was on her stomach when she died, just like her mother said.
Now, Dr. Stephany is even more convinced that Melanie most likely suffocated while sleeping
in this position. Babies have a hard time lifting up their head and turning their head.
NARRATOR: But as he leans over the baby he notices something else, something that will transform
his thinking about Melanie's last minutes alive and her premature death. [MUSIC PLAYING]
Doctor G's newest Associate Medical Examiner, Dr. Josh Stephany thinks he knows what
killed baby Melanie Simmons. The lividity, or purplish red discoloration on her face and stomach leads him to believe that Melanie's
face down position in the crib prevented her from getting enough oxygen. So automatically you think of possible suffocation.
NARRATOR: But as he examines the baby's face more closely he discovers an important clue.
There was an air of whiteness to the side of the face-- NARRATOR: Dr. Stephany recognizes
the whiteness as a pressure mark on Melanie's face. --meaning that that was the portion that was most
in contact with the pillow. NARRATOR: Judging from the pressure mark, Dr. Stephany now believes that Melanie's cheek was pressed
against a pillow as she slept. The finding is an important clue in Dr. Stephany's investigation.
If Melanie suffocated with a pillow pressed firmly against her nose and mouth, those areas
would be white from the pressure as well. But upon further inspection, it's clear that the area of whiteness is limited to Melanie's cheek.
The area around the nose where she's breathing, had the normal lividity pattern, meaning it was red,
reddish-purple. So judging by the pattern, it looked like this baby's nose and mouth was not obstructed by a pillow.
[MUSIC PLAYING] NARRATOR: As he concludes his external examination, now Dr. Stephany believes it's unlikely Melanie
suffocated to death. I've moved possible suffocation further down on my list of possible cause of death.
NARRATOR: But other possibilities remain. Some more frightening than others. Even if the baby looks good externally,
we still have to rule out that they weren't murdered. NARRATOR: The truth behind Melanie Simmon's death
could be hidden deep inside her tiny body. [MUSIC PLAYING] Before the cranial exam begins, the area at the base
of the skull is sterilized. This is one of the processes that is different with babies
that with adults is, we're always thinking about possible infection. NARRATOR: If the cultures and tissue samples
Dr. Stephany is taking become polluted by bacteria it could ruin the chance of an accurate diagnosis.
Dr. Stephany takes his first culture from the sterilized area and extracts a sample of Melania's cerebrospinal fluid
to test for meningitis. Kal, can you give me the scissors, please? [MUSIC PLAYING]
NARRATOR: An infant's cranial exam requires different tools than those used on adults.
An adult skull is hard bone and we need a saw to cut that open. A baby skull is soft, it's malleable.
With a baby you can use scissors to open up the skull. [MUSIC PLAYING] I don't see anything.
NARRATOR: On first glance, Melanie's brain looks healthy. There are no signs of trauma and no discoloration
which would indicate an infection such as meningitis. Take a closer look after I wash it off.
NARRATOR: Next, Dr. Stephany completely removes the brain and washes it carefully.
If this were an adult, he would cut directly into the brain with his scalpel. But with an infant, this is difficult.
Babies' brains are very soft and it's almost the consistency of jello, maybe even softer.
NARRATOR: The brain is then placed in a vat of fixative known as formalin. Over the next few weeks, the formalin
will harden the brain matter and also intensify the color of brain tissues. This will allow doctors to see abnormalities and evidence
of internal brain trauma more easily, including trauma that may have been caused by abuse.
Infants, unfortunately, are sometimes subjected to abuse. And sometimes that abuse doesn't show externally.
NARRATOR: As he heads into the internal exam, Dr. Stephany still has no solid leads on what or possibly
who took Melanie's life. [MUSIC PLAYING] As with an adult, Dr. Stephany begins the infant's exam
with a y-incision. Painstakingly, he examines Melanie's chest muscle and soft rib cage looking for fractures
or any other signs of injury. It all looks normal until Dr. Stephany removes the rib cage
and gets a look at Melanie's thymus gland. The thymus gland was a little enlarged.
NARRATOR: The thymus plays a major role in the body's immune system manufacturing the T cells
that fight off infections. It's a organ that produces inflammatory cells. So if you have an infection throughout the body,
you're thymus gland can enlarge in response to that infection. In this case, the thymus gland was a little enlarged,
but I don't think was outside the normal range. At this point, I'm not really worried about it.
[MUSIC PLAYING] NARRATOR: Dr. Stephany next dissects Melanie's heart looking for signs of congenital defect,
blood clots, or infection. I'm looking at the ventricle walls. They look pink, I don't see anything abnormal.
[MUSIC PLAYING] NARRATOR: The absence of any clues in Melanie's head and heart are troubling.
The number of places left to look for a cause of death are now growing short. [MUSIC PLAYING]
They go into the organs of the abdomen, which include the liver, kidneys, adrenal glands,
spleen, intestines, stomach. NARRATOR: But again, this is a dead end. To the naked eye, Melanie's organs look fine.
But lab work on tissue samples and blood may still reveal whether or not a microscopic source,
like a well hidden infection, might be to blame for her death. Well, in a baby, you know, we still worry very much
about infection because they can die very quickly with an infection. It can overwhelm them much quicker than an adult.
NARRATOR: As Dr. Stephany concludes the autopsy, he's worried that he may ultimately have to rule
this case as inconclusive. Didn't find anything. No tumors, no hemorrhage, no obvious signs
of trauma or anything, any stomach abnormalities. NARRATOR: However, one thing is clear.
So far, it's looking like Melanie's parents had no involvement in their daughter's death.
Dr. Stephany must now contact Deborah Simmons with an update, but it's not going to be easy.
I think it's hard for him sometimes to talk to families, particularly grieving mothers.
And, you know, I made it very clear that in some cases you really got to talk to them.
NARRATOR: And in this case, the call will be even harder because he still has no idea what killed her baby.
Talking the mother was difficult because you're dealing with someone who is grieving,
who feels guilty. NARRATOR: But alleviating guilt is not Dr. Stephany's priority.
Melanie's twin, Morgan, could still be in danger. If he can't identify what killed Melanie,
this tragedy could potentially end with the death of not one, but two innocent lives.
[MUSIC PLAYING] Dr. G has a lot of confidence in her rookie Associate Medical Examiner, Dr. Josh Stephany.
I think he'll have a great career in forensic pathology. You know, he's very quiet, but always looking
around, always thinking. [BIRDS CHIRPING] NARRATOR: Two weeks have passed since Dr.
Stephany's inconclusive autopsy of baby Melanie Simmons. The autopsy was essentially negative.
We knew we'd just have to wait for all the tests to be done. NARRATOR: For Melanie's mother, the wait is agonizing.
I spoke to her pretty much almost every day or every other day. She was concerned, she was guilty.
And she just kept wanting answers. NARRATOR: She's also extremely concerned that whatever took Melanie's life could strike twice.
It's natural for all parents to wonder-- if they're a twin, whether or not the other one's in danger.
My personal suspicion at this point is I may have to call it SIDS. NARRATOR: A SIDS, or Sudden Infant Death Syndrome Diagnosis
would leave the real cause of Melania's death a mystery. And leave her parents uncertain about the health
of her identical twin sister, Morgan. The toxicology reports and microscope slides are now their only hope of quelling these fears.
[MUSIC PLAYING] At 100 times magnification, Dr. Stephany can see every detail of the organ tissue he's examining.
And it doesn't take long for him to find something very wrong. Looking at the heart, I see some abnormalities
on a cellular levels. NARRATOR: Melanie's heart cells, called myocytes, look enlarged.
Regular myocytes are nice and pink and a little compact. These cells are a little lighter pink,
they're foamy or granular, and they're more plump. I didn't know quite what it was, but I knew it was abnormal.
NARRATOR: He also knows when it's time to get an expert second opinion. You can do other training in the world,
but you get more by experience and Doctor G's been doing this for a lot longer than I have.
Did you look under in the microscope? Josh knew that something was unusual so he called me
and he asked me to look at it. Once I saw it or the microscope, I go, Oh, wow. I know what this is.
Because I'd had a case like that before in Texas when I was a much younger pathologist.
NARRATOR: Dr. G's case was an infant girl who had died with no warning. Like Melanie, the microscope revealed strange foamy cells
in her heart tissue. I'd read about it in a forensic article that these little infant girls could die suddenly.
And I was able to find one little mention in a cardiology pathology textbook and was able to match up the pictures that, yeah,
that's what that is. She just took a quick look at it and said, oh, yeah this is histiocytoid cardiomyopathy.
NARRATOR: Histiocytoid cardiomyopathy is an extremely rare disorder of the heart.
Less than 100 cases have ever been reported in the literature, but the actual number of cases
is much higher. And most fit a similar profile. It can cause sudden death, mostly little infant girls.
NARRATOR: And like the deaths it causes, the root of the disorder is mysterious.
It is a mutation in DNA. Nobody really knows how it works. NARRATOR: One thing they do know is
that these abnormal cells can prevent the heart from beating properly. This abnormal cell blocks electrical impulses,
it can send irregular rhythms to the rest of the heart. It's a devastating disease because these babies can
die suddenly and unexpectedly. And they may not have any symptoms beforehand. NARRATOR: Now, Dr. Stephany knows
that's exactly how Melanie Simmons died unexpectedly, without warning. [MUSIC PLAYING]
It's 9:00 PM and Deborah Simmons puts her identical twin baby girls, Morgan and Melanie, to bed.
She put them both down in the crib with bedding and a pillow and some quilt, face down.
NARRATOR: On the outside Melanie looks to be peacefully asleep. But inside her heart is struggling.
The complex system that fuels its beat is being thrown off by abnormal cells. These abnormal cells, they either trigger
the abnormal beat or causes the heart to just beat faster and faster. They think they go into a very fast rhythm
and then into a fibrillation where they just fibrillate, and then can't pump. NARRATOR: And then Melanie's heart stops beating completely.
It's most likely that the child died in her sleep and died painlessly. [MUSIC PLAYING]
NARRATOR: Dr. Stephany's diagnosis of what killed Melanie Simmons should wrap up the case.
But instead it takes on a whole new urgency. We had a genetic defect that caused this baby to die,
and there is a twin. We have to alert the family. If ever there was a case in forensic pathology
that you have to talk to the family with, this would be this case. NARRATOR: Dr. Stephany now has to tell Deborah Simmons that
what killed one of her babies could potentially kill the other. Hi. May I speak speaking Ms. Simmons, please?
I let her know that her other daughter could be at risk for this same entity. So I wanted her to get in contact
with a pediatrician and a pediatric cardiologist as soon as possible. NARRATOR: Moving forward, doctors
will need to regularly monitor Morgan's heart for arrhythmia, a crucial indicator for the disease.
She could have the mutation but she may still not show any problems with it. And she could maybe not have the mutation at all,
believe it or not. She may have not inherited it. If it's discovered or diagnosed
that the other twin does have the same disorder and that she is getting help, it makes us feel that we're doing,
you know, our job. I was able to tell the parents that there's nothing they could have done that would
have prevented the death. I'm not sure relief is a good word, but I think closure is a good word for them.
[MUSIC PLAYING] NARRATOR: Dr. Stephany is glad that he didn't have to diagnose Melanie's cause of death
as Sudden Infant Death Syndrome. The fact that we found a diagnosis-- a concrete diagnosis and didn't sign it as a SIDS,
it's kind of not so much a relief, but as helpful to have a solid diagnosis for me and for the family.
We know we have a concrete diagnosis, we can tell the family why the child died.
NARRATOR: Dr. Stephany also knows how important Dr. G's guidance was in getting Melanie's parents
the answers they needed. She pretty much gave me my diagnosis. I just saved him a step.
He'd have figured it out. I have never heard of this disease entity, and it's rare.
It doesn't mean I'm not going to be looking for it again. And I can guarantee you, I'll never miss it in the future.
I think to be a really great forensic pathologist, the more experience you have, the better you get.
You know what? And the beauty of this field is, you never see it all. There's always going to be something new out there.
[MUSIC PLAYING] NARRATOR: But even Dr. G couldn't have been fully prepared for the truth behind what
killed her next dissident. He looks like a guy in his early 60s who could be your grandfather.
I just didn't expect it. [MUSIC PLAYING] DR G: You know, it's hard for most people
to stomach the thought of food after what we do all day. But for my team and me, grabbing lunch
is always a welcome break. [LAUGHTER] Yeah. When I thought-- I ran about 3 miles on--
- Did you? - --Sunday night. And I went to gym my Friday night. [INTERPOSING VOICES]
I go every day for about two and a half or three hours. All I can tell you, don't get married.
Yeah, forget that. That's going to go by the wayside. [LAUGHTER] He's thinks he's gone to the gym for two to three hours a day.
Forget it, he'd be divorced within-- [INTERPOSING VOICES] --like two months. MAN: [INAUDIBLE]
Well, we're trying to get-- Ashley's getting married. MAN: --to get married. I will not have a groom.
He will be gone. He will not-- DR G: It'd be cheaper to-- We could probably arrange for a hearse to drive him in.
Oh, a hearse? There you go. Hop in back. This was a very short time offer because once we start bringing bodies in there, forget it.
We can't do it anymore. Would you do it? What would you do it if your groom was--
If you got me drunk enough I would. Really? [LAUGHTER] DR G: Being able to laugh together
can sometimes help us deal with what we see in the morgue every day. Because truly our cases are never a laughing matter.
NARRATOR: The body Dr. G will autopsy next was transferred to the morgue yesterday.
A seemingly healthy man named Vincent Morehouse. We have a man in his early 60s who is found dead by his wife.
[MUSIC PLAYING] NARRATOR: According to the investigators report, Vincent and his wife, Audrey slept in late yesterday
morning-- a Sunday. When Audrey wakes up first everything seems fine. So she decides to let Vincent sleep while she takes
care of some household chores. She saw him at about 11 o'clock that morning, and then about four hours-- five hours later, she goes to check
on him and he's unresponsive. And she calls 911. [MUSIC PLAYING] They get there and pronounced him, he's really quite dead.
NARRATOR: For Vincent's wife, Audrey, the death is devastating. The couple had been married for 28 years
and had recently begun planning his early retirement. And compounding her sudden loss is
an overwhelming sense of guilt. She did have some guilt worrying and wondering if maybe she had gone and really tried to wake him up
and realized something was wrong he would have had a chance to live. NARRATOR: Dr. G looks over the case file
and considers the circumstances. By all accounts, Vincent seemed perfectly healthy for his age
and had no recent illnesses. He'd voiced no complaints a shortness of breath, no complaints of chest pain, no complaints of dizziness,
vocalize a headaches. NARRATOR: According to his wife, Vincent's only medical issue
was that he had high blood pressure, but he was taking medication to control it.
He's been feeling good. He does smoke. He socially drinks beer, but that's about it.
When we do the autopsy, you know, anything's fair game here. I mean, I don't really have a good hypothesis.
And we'll see then what the external tells us. [MUSIC PLAYING] Why don't we do his face first before we turn him?
NARRATOR: Dr. G examines Vincent's body. Outwardly, he looks healthy. Just as his wife indicated.
No trauma on him. He looked in pretty good shape. NARRATOR: But she does notice something
that his wife didn't mention. A distended belly and a large hernia bulging from his navel.
He's got an umbilical hernia. Some of his bowels look like they've kind of protrude
into this out pocketing right at the umbilicus or belly button. It's at least three or four inches in length.
So it's a pretty good sized hernia, quite noticeable. NARRATOR: A hernia occurs when the intestines
push through a weak spot in the abdominal muscles. In some cases, hernias can cause significant complications
such as incarceration or trapping of the intestines in the hernia. When I see the hernia, I mean, other things then start
running through your mind. You know, could this hernia have anything to do with his death?
I do worry about that the bowel got incarcerated in there. If the bowel gets incarcerated in there it loses
its blood supply, it dies. You can-- you can die from that. I'll be there in a second.
NARRATOR: But within moments, she discovers that a hernia isn't the only cause for concern.
Another is Vincent's legs. He's got some edema to his lower extremities. NARRATOR: The edema, or swelling due to fluid accumulation,
is in Vincent's lower legs and feet. This could be a sign of heart trouble. When the amount of blood that the heart pumps out is low,
the body is fooled into thinking it needs to retain fluid. A pooling of blood in the veins can
also lead to an accumulation of fluid in the surrounding tissues. I'm a little worried, maybe he's had
a little bit of heart failure. NARRATOR: Heart disease, a deadly complication from a hernia.
Suddenly the external exam of Vincent Morehouse is suggesting that he wasn't as healthy as his wife described.
Now, Dr. G wonders, what other secrets might Vincent's body reveal? You cannot judge a book by its cover.
And that's why we always have to probe. [MUSIC PLAYING] Yeah. I think he's-- All right, once I open him, I can tell in a minute
if I'm going to need that blood culture. NARRATOR: Dr. G is ready to open the body of 60-year-old Vincent
Morehouse, who died yesterday morning while his wife thought he was sleeping. She thinks he's sleeping and she goes about her chores.
And she goes back and checks on him and, unfortunately, he's dead. [MUSIC PLAYING]
NARRATOR: Dr. G opens the body with a y-incision where she will get her first look
at Vincent's umbilical hernia. Maybe some of his bowel got stuck in there and then twist
and now it can't get the blood to the bowel. NARRATOR: Carefully, she exposes the abdominal organs.
But after a thorough examination, it's clear that the bowel is not trapped in the hernia
and that the hernia was not fatal. It's just there and he never got it repaired.
So it's hard to say what that's telling me at this point. Where are the clippers?
NARRATOR: But then she sees something else that might be fatal. I can see that he's got a pretty gnarly liver.
So far his liver's peeking out at us, and it looks terrible. Normally, it's a nice uniform brown that's very pretty,
but when it really looks gnarly, it's like lumpy, bumpy kind of yellowish will all this fibrosis going through it and very hard.
This is chronic alcoholism. It has this nice micro nodule or small nodules. And that's how alcohol slowly kills your liver.
NARRATOR: Liver disease, including cirrhosis, is one of the top 10 causes of death in the United States.
This finding reveals something vital and unexpected about Vincent's health. Now, I was not told he had cirrhosis of the liver.
His family makes him seem like he's a pretty healthy guy. And then my first look when I open up to his body
is, he's got pretty bad cirrhosis of the liver. So now that I see this cirrhosis,
I'm wondering what's going on. And B, you know, maybe alcohol plays a role here.
[MUSIC PLAYING] NARRATOR: But if Vincent's liver was indeed already failing, Dr. G would expect to see telltale signs.
He does look like he's dying from liver failure because he's not jaundice, not yellow.
But it does lead me to think maybe he died from some complication of alcohol, whether it be acute alcohol intoxication.
Whether it be from falling intoxicated and hitting his head. NARRATOR: To determine the level of alcohol in Vincent system
at the time of his death, Dr. G's tech, Arden Monroe draws samples for toxicology.
Well this is good peripheral blood. I certainly am going to check to see how much alcohol he has.
And I'm certainly going to check all his drugs to see if there's any illicit or even prescription
drugs present. We didn't get quite the truth about the alcohol. We don't know any-- everything's up for grabs now.
[MUSIC PLAYING] A lot of men in their early 60s that come through my office or alcoholics.
So, you know, it's not that surprising. And a lot of people with alcohol, they kind of downplay how much they drink.
So it's really not that unusual. They may not be, you know, trying to lie to us.
It's just that they downplay it. He may try to hide it from his wife. He may be somewhat of a closet drinker.
NARRATOR: Next, Dr. G begins to remove and examine the rest of the internal organs one by one.
He's not as healthy as it comes off, either by his family or his external appearance.
NARRATOR: Vincent's spleen is enlarged. His kidneys are congested. His lungs are heavy with fluid.
But it's his heart that troubles Dr. G the most. It looks a little bit big. I take the heart out, I weigh it.
It is big. It looks like it's got some effects of high blood pressure. Normally his heart would be maybe 350, 360.
His is up to almost 500 grams. NARRATOR: But Vincent's heart isn't only enlarged,
it's dilated as well. Blood had clearly begun to back up into the organ causing it to expand and to weaken.
The heart starting to fail. NARRATOR: Moreover, Dr. G finds evidence of coronary artery
disease as well. He did have a significant 80% narrowing in the coronary artery.
That's a very significant narrowing. It could have caused him some problems. NARRATOR: But while Vincent's heart is severely diseased,
Dr. G finds nothing acute. The arteries have no blood clots and there's no visible damage
to the heart muscle. From the heart, nothing tells me acutely what happened. Did it cause his death or did it not cause his death?
I'm not sure yet. NARRATOR: With nothing near a smoking gun, Dr. G must first rule everything else out before she can
even consider the heart theory. I don't really know at this point. Things are quite making sense.
[MUSIC PLAYING] See it? When you push and it goes away. I do need to-- keep his bowel out though, I want to look at.
NARRATOR: Dr. G's discovered that Vincent Morehouse wasn't nearly as healthy as his family said he was.
A lot of people argue with me that there is no way their loved ones has heart disease.
If I'm looking at your heart and you have heart disease, I've got the truth-- I've got the facts.
The body tells me otherwise. NARRATOR: But despite these findings, Dr. G still doesn't have a definite cause of death.
So she must continue to hunt for the culprit. Her next stop, the brain. [MUSIC PLAYING]
[SAWING] NARRATOR: Morgue assistant, Brian Mikulski saws open Vincent's skull. Then Dr. G gently removes the skullcap
and gets her first look at the organ. I take the calvarium off, and then I know there's trouble.
It is a mess. And I can see that the brain is swollen and it's asymmetric. One hemispheres a lot bigger than the other,
and that's not normal. Now I know there's something going on in his brain. NARRATOR: Dr. G removes the brain from the skull
and weighs it. Then she methodically begins to dissect the organ in an effort to determine
the cause of the swelling. And deep inside, she finds it. He's got a large intracerebral hemorrhage.
Cerebral, the brain. Intra is inside the brain tissue. He's got a hemorrhagic stroke.
It's very large. It's several inches in length, it occupies a large portion of it.
And that's clearly why he died. He had an intercerebral hemorrhage. NARRATOR: And Dr. G believes she knows
why Vincent's brain started to bleed in the first place. The vast majority of intracerebral hemorrhages,
particularly in that location, from high blood pressure. Blood pressure blew the vessel in his brain.
NARRATOR: And that massive hemorrhage led to a deadly stroke. [MUSIC PLAYING] Everything kind of makes sense.
60-year-old guy, history of high blood pressure, dead in bed. And I find that intracerebral hemorrhage,
all consistent with chronic hypertension. There's other things that can cause these hemorrhagic strokes
but you don't-- in a 60-year-old guy with high blood pressure, it's high blood pressure that caused it.
NARRATOR: The autopsy of Vincent Morehouse is now complete. And Dr. G is ready to close the case
with the manner of death determined as natural on the death certificate. But to be absolutely certain, her final step
is to review the toxicology report and any possible revelations it may on earth about Vincent's
last moments alive. [MUSIC PLAYING] When the lab results finally arrive at the morgue,
they reveal a secret that even Dr. G couldn't predict. I'm certainly shocked when I see that toxicology.
He's got cocaine in his system. He's got a lot of cocaine in his system. He's got not just the breakdown products,
he's under the influence of cocaine when he has that intracerebral hemorrhage. He looks like a guy in his early 60s
who could be your grandfather. I mean, what's he doing using cocaine? NARRATOR: Based on these shocking lab reports,
Dr. G was now amend the death certificate. Because he is acutely intoxicated with cocaine
at the time he has that hemorrhage, I can't ignore that because it's well-documented
fact that cocaine can precipitate these hemorrhages. So it clearly played a role in my view.
And so I amend the death certificate in two ways. He still died from intracerebral hemorrhage
of hypertensive type, but in a contributing factor is acute cocaine intoxication.
And what else changes, since I do believe the cocaine contributed to his death, I changed the manner of death from natural to accident.
NARRATOR: With the stunning toxicology results in hand, Dr. G can now officially closed the death investigation
and describe the events leading to Vincent Morehouse's untimely death in the report of autopsy.
[MUSIC PLAYING] It's late at night and 60-year-old Vincent Morehouse, an alcoholic and drug user who has
a history of high blood pressure, is craving a hit of cocaine. [MUSIC PLAYING] He's probably using it, you know,
more than once that evening. And then decides maybe to go to bed. He probably is feeling good.
He probably didn't have any ill effect from it at the time. NARRATOR: He might not be feeling it,
but as he sleeps next to his wife, Vincent's body is reaching its breaking point.
The cocaine pulses through his blood vessels, elevating his already high blood pressure even further.
When I talk about, you know, cocaine increasing your blood pressure, you know, it's any stimulant.
Amphetamines, methamphetamine, cocaine they all increase our blood pressure. NARRATOR: Finally, the pressure grows
too great for a delicate cerebral vessel deep in the left hemisphere of his brain and it explodes.
It burst and it started bleeding. The brain is damaged by the blood, it starts to swell just like it reacts to an injury.
And eventually, the swelling and the pressure puts pressure on the respiratory center.
NARRATOR: Vincent quickly slips into a coma. As the pressure builds in his brain,
his breathing grows labored, thin. His wife thinks he's sleeping, but in reality,
Vincent is dying. He's probably in a coma for a while. Unconscious to the point then his heart and
his respiratory centers stop. And he dies in bed. NARRATOR: Because of the unusual circumstances involved
in the death, Dr. G calls Vincent's wife, Audrey, to inform her of the findings and the amendment
to Vincent's death certificate. Yes this is Dr. Garavaglia at the medical examiner's office.
NARRATOR: But she's worried as to how Audrey will take the shocking news. When I do something like that and it's out of the blue, I--
I tend to try to contact the family because I'm never sure how much they knew or not new.
And if they get angry with me, they usually probably didn't know anything. If they said, oh, OK.
That means they probably knew. In this case, I got more of an oh, OK. So I think they knew more than they told.
[MUSIC PLAYING] (SINGING) I try and try, but I just don't know what to do. You just never know.
I mean, you know, you try to get a history and they just don't always tell you the truth.
That's why I still do toxicology on people who are in their 60s, some of whom are still using illicit drugs.
[MUSIC PLAYING] (SINGING) Help me, I can't even help myself. In the end, the body is not going to lie.
The body will tell us the truth. [MUSIC PLAYING] VOICE: Atlas.

Paramedics respond to a mother in distress: one of her infant twin girls hasn’t woken up. By the time help arrives, it’s too late. But there is no apparent cause of death.

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

Brief Summary

Dr. G investigates the deaths of baby Melanie Simmons and Vincent Morehouse, revealing rare heart disease and cocaine-related complications.

Key points

A Baby's Tragic Death. A baby girl is found dead in her crib, raising suspicions of foul play.
Dr. Stephany's Investigation. Dr. Stephany examines the case of baby Melanie, determined to find the cause of death.
A Rare Heart Disorder. Dr. Stephany discovers a rare heart condition that caused Melanie's unexpected death.
The Cause of Death. Dr. G determines Vincent died from a hemorrhagic stroke due to high blood pressure.
A Shocking Discovery. Vincent Morehouse's autopsy reveals unexpected cocaine use contributing to his death.

Episode highlights

Episode quotes

It's a parent's worst nightmare.

NARRATOR introduces the tragic situation.

0:18WatchJun 10, 2021

Tension

75/ 100High tension

More from True Crime Files

Solve the Crime

Read a real case one clue at a time, then see how your call held up against the investigators.