Dr. G: Medical Examiner - Season 5, Episode 1 - Under The Knife - Full Episode | Forensic Files

[SUSPENSEFUL MUSIC] [THEME MUSIC] NARRATOR: A strange man staggers up to a woman's front door,
dazed and bloody. He just stared, and then he walked away. NARRATOR: Hours later, a passerby
finds him in the woods dead. JAN GARAVAGLIA: And I looked, and I-- woo, that looks bad.
I mean, what is going on here? NARRATOR: And then, a seemingly healthy mother of two
dies without warning. JAN GARAVAGLIA: The kids are devastated. The husband is devastated.
She's now in my morgue, and we don't know why she died. [THEME MUSIC] NARRATOR: Altered lives, baffling medical mysteries,
shocking revelations. These are the everyday cases of Dr. G, Medical Examiner. [THEME MUSIC]
[MUSIC PLAYING] NARRATOR: It's 8:00 AM at the District 9 Orange/Osceola County Medical Examiner's Office,
but Dr. Jan Garavaglia is already hard at work. Oh, did my investigators have it?
He does have an enlarged heart. Yeah, the cause of death is pending. No. Might be, you know, weeks and sometimes, you know, months.
I've got families calling, wanting answers. I don't know why some of the micros are late.
I'm going to have to go to cut more tissue. You know, there's people to call. Just thinking about what else I could do.
And multiply that by numerous cases. New ones coming in every day. NARRATOR: Today's newest body arrives
under suspicious circumstances, even by morgue standards. And although Dr. G is extremely busy,
this case demands her immediate attention. Wow. NARRATOR: It's almost noon, and Deer Park,
Florida resident Debbie Balcombe is busy fixing lunch when she hears a knock at the front door.
She assumes it's just one of the neighbors dropping by for a visit, but what she sees on her front stoop
comes as a complete shock-- a disoriented, disheveled, and bleeding young man. Must have been scary, because he had blood on his shirt.
It looks like he's been beaten up. He just stared at her, and then he walked away.
NARRATOR: Shaken by the encounter, Debbie quickly locks the door. But neither she nor anyone else in the apartment complex
crosses paths with the man again. In fact, he seems to disappear entirely until a few hours
later when recently retired Jim Weisberg goes out for his afternoon walk. As he passes through the woods beside Debbie's home,
he gets the shock of his life. The body of a man on the ground, dead. Jim calls 911, and within minutes
the police arrive on the scene. JAN GARAVAGLIA: It's unclear what's going on here.
The detectives are very suspicious that there's foul play. NARRATOR: The homicide unit's first step
is to locate the man's wallet. His name is Gregory Flynn, and a background check reveals
another more curious fact. JAN GARAVAGLIA: He doesn't live anywhere in these houses.
He doesn't live in the apartment complex. NARRATOR: And a few minutes later, police make another discovery.
JAN GARAVAGLIA: The investigators looked around. They found his-- what appears to be his car
in a ditch in this wooded area. This wooded area separates these houses from an apartment complex.
NARRATOR: Looking for possible witnesses to Gregory Flynn's death, detectives begin
knocking on apartment doors. JAN GARAVAGLIA: Canvassing the area, they found out that he was seen driving
about four hours earlier. NARRATOR: And it isn't long before the detectives find Debbie Balcombe.
She views Greg Flynn's body and identifies him as the man who came to her door hours earlier.
Meanwhile Medical Investigator Jack Cuccia of the District 9 morgue arrives on the scene.
He takes photographs of the body for Dr. G and prepares it for transport to the morgue.
But the detectives need more information. At that point, they really didn't know what they were dealing with until we
were able to see if there was any traumatic injury to him. NARRATOR: The detectives want permission
to examine Greg's body for chest and face wounds on the scene. JACK CUCCIA: The law enforcement agencies, they do not
have the authority to examine the body, remove the clothing, without making contact
with the medical examiner because we don't want to lose any trace evidence or disturb the wound in any way
until the doctor has seen that firsthand. NARRATOR: Jack Cuccia calls Dr. G. Dr. G?
NARRATOR: He explains the situation and asks for permission to inspect the body.
OK, Dr. G. Thank you. And I said, fine, you know, examine him at the scene. NARRATOR: Turning over the body, they reveal quite a sight.
Greg Flynn's right eye looks swollen, and his face is bloody. There's also a large amount of blood on his shirt.
So I said, just go ahead and bring him in. We'll X-ray him and look for the wounds.
NARRATOR: Once Greg Flynn's body is on its way to the morgue, detectives make contact with his ex-wife, Rosanna.
Hello? JAN GARAVAGLIA: According to his ex-wife, he didn't suffer from any major diseases
or chronic health problems. NARRATOR: Next an officer calls Greg Flynn's brother, Sean.
And as soon as they inform him of Greg's death, Sean levels a stunning accusation.
The brother believes that the ex-wife had something to do with his death. NARRATOR: The detectives don't know
if Sean is right about Greg's ex-wife, but they do suspect foul play. Detectives are highly suspicious that this
was a homicide. They're really waiting for me to give them an answer. NARRATOR: But Dr. G has questions of her own
about his death. JAN GARAVAGLIA: Why was he acting so strange? Why did he go up to that apartment and just stare?
It's just very odd. NARRATOR: Dr. G wonders if someone ran him off the road. The car had only minor damage, but it's
possible that Greg sustained injuries in the crash. JAN GARAVAGLIA: Did he have a head injury?
Maybe he hit something when he stopped suddenly. NARRATOR: It's possible that the crash was an accident.
But at this stage, one thing is clear-- all clues point to murder. JAN GARAVAGLIA: Knife wound, gunshot wound,
blows to the head, and that's what we're really looking for right now in the external examination.
[MUSIC PLAYING] NARRATOR: The first thing Dr. G notices about Greg Flynn is how well dressed he is, but Greg's button down Oxford shirt
is heavily stained with blood. Oh, Lord. The one pattern was odd. It was on front of his shirt only
and at the ends of his sleeves. The other odd thing is that his clothes were also wet.
There is a small wet creek in those woods, but how did he get wet? NARRATOR: But the strangest thing about Greg Flynn
isn't his clothes. It's his skin. It's slipping off. He's already starting to show signs of early decomposition.
That's very odd. NARRATOR: Greg's been dead less than 10 hours. But when it comes to the stages of death,
he's way ahead of the curve. Skin slippage normally doesn't appear until 48 hours post-mortem.
JAN GARAVAGLIA: When we see somebody decomposing that quickly, we really worry that maybe he
had an infection or an elevated body temperature prior to death. NARRATOR: But that wouldn't explain
the blood soaking Greg Flynn's shirtfront or his battered face. He's got a huge bruise over here.
It looks bad. He's got dried blood. He's got this kind of big, swollen eyelid with a lot of, like, little abrasions.
NARRATOR: He looks like he's been in a fight, and this makes Dr. G even more suspicious
of possible foul play. But as she looks closer, Dr. G recognizes what did this to him, and it wasn't human.
When you look closely, you see small rodent scratches and excoriations. NARRATOR: But on Greg's face, the damage done by the animal
activity is mainly superficial. And I still can't explain this blood on his shirt.
NARRATOR: Dr. G suspects it might have come from a nosebleed or mouth wound. So she carefully checks both potential sources.
There's really no blood in his nose, and I don't see a blood in his mouth. I don't know where that blood is coming from.
NARRATOR: As Dr. G moves down the body, looking for a major wound, she notices dozens of tiny cuts criss-crossing
Greg's forearms and hands. He really was scratched up quite badly. NARRATOR: Was Greg running away from someone?
And if so, who? And where did the blood soaking his shirt come from? The answers to these questions may lie under his clothes.
JAN GARAVAGLIA: A little 22 can kill you, and my investigator may not see that, particularly
if there is a lot of blood. May have a small stab wound. At this point, it can be anything.
[MUSIC PLAYING] [SUSPENSEFUL MUSIC] NARRATOR: During the external exam of Gregory Flynn's body,
Dr. G found scratches that suggest he may have been running from someone before he died.
Greg's brother believes he was murdered, and now Dr. G is looking for the source of the blood
soaking Greg's shirt. JAN GARAVAGLIA: And I'm taking his clothes off, and I'm examining inch by inch.
Where could this blood be coming from? NARRATOR: She searches the entire body for a small bullet or knife wound,
but what she finds surprises her. I don't see any wounds that are accounting for all that blood.
At this point, I don't know how he died. It's very odd. I'm hoping I find something internally.
All righty? MAN: All righty. NARRATOR: Dr. G opens Greg Flynn's chest with a y incision
and begins searching for evidence of trauma. JAN GARAVAGLIA: I'm looking for evidence of contusion
to his chest, maybe internal trauma to the organs. NARRATOR: As a first step, she removes Greg's chest plate
looking for free blood and other signs of injury, but she doesn't find anything of significance
in the abdominal or chest cavity. The source of all that blood is becoming more mysterious by the moment.
All Dr. G can do now is continue searching for clues within his internal organs.
[MUSIC PLAYING] SINGER: Clinging to the trees. NARRATOR: Next, she extracts the heart
and prepares to dissect it. But right away, she notices a striking abnormality. He had a significant narrowing to his right coronary artery.
It was at least an 80% narrowing. Odd for someone at a relatively young age. NARRATOR: This narrowing could have caused a heart attack,
which could explain why Greg drove his car into a ditch-- but not his behavior afterwards.
JAN GARAVAGLIA: I would not expect him to be acting odd like that, just because he's
got the heart disease. He still has enough energy to go running through the woods.
I wouldn't really expect him to be doing that with a coronary event. So it's not making sense.
NARRATOR: Other than signs of decomposition, the rest of Greg's heart looks normal.
Dr. G's next stop is the lungs, and what she sees here is disturbing. JAN GARAVAGLIA: You can also see that they
were starting to decompose. NARRATOR: In addition to Greg's lungs, his other organs are clearly beginning to decay.
JAN GARAVAGLIA: His spleen is soft and friable. His bowels are starting to turn green.
These are all early signs of decomp. NARRATOR: Greg's accelerated decomposition is extremely unusual.
It could be a sign that he was sick with a severe infection right before he died.
People who are infected and have high fevers can start having early decomposition.
NARRATOR: To confirm an infection, Dr. G takes blood samples to be tested for the presence of bacteria.
And as standard practice, Greg's blood will also be screened for drugs and alcohol
at a toxicology lab. By the end of the internal exam, Dr. G still has no idea how Greg Flynn died.
The chest and abdomen just didn't tell us too much. NARRATOR: And as she readies her scalpel for the cranial exam,
she's hoping the brain and skull will yield the clues she's been looking for. I am hoping that the brain gives me the answer.
[SUSPENSEFUL MUSIC] NARRATOR: Dr. G and the Orlando homicide unit both believe that 34-year-old Gregory
Flynn may have been murdered. There's blood on his shirt. He's faced down in kind of a dark area in the dirt.
NARRATOR: So far, she's found no evidence of foul play, but she's yet to examine Greg's skull and brain.
Head trauma could indicate that Greg was the victim of a fatal assault. Dr. G will also look for signs of natural disease.
JAN GARAVAGLIA: Maybe he's got a ruptured aneurysm or stroke, something else going on that caused him to kind
of act odd and lose control. I don't know. NARRATOR: Dr. G reflects Gregory's scalp,
looking for any sign of a fracture or wound. Going on in here, no impact site, no wound, no small gunshot wound that I missed, nothing.
NARRATOR: But she can't entirely rule out trauma yet. A blow to the head could fatally injure the brain
without fracturing the skull. There's no skull fracture, but that doesn't mean there's
no bleeding in the brain. NARRATOR: Next, morgue technician Brian Machulski cuts through the skull with an oscillating saw.
And Dr. G performs a thorough examination of the brain itself. I don't see any blood.
The brain looked good. I was disappointed. I was hoping for something. There is no trauma anywhere on his body.
I'm sorry we have to rule out trauma. I mean, we have a lot of things it isn't. We just don't have what it is.
NARRATOR: By the end of the autopsy, big questions still remain. There is no drama, but he's got blood all over him.
I'm still suspicious that it's from his nose. I just don't see any residual blood in his nostrils.
I told the detectives if it's homicide, I don't know what kind of homicide it is besides a poisoning, because there
is no trauma there. NARRATOR: The police accept Dr. G's initial findings, but Greg's brother, Sean, finds it more difficult.
I am getting multiple phone calls from his brother. He is sure his ex-wife murdered him.
NARRATOR: Sean now thinks Greg's ex-wife, Rosanna, must have poisoned him. This could explain why he ran his car into the ditch
and stumbled around in a state of delirium in the hours before his death. But the only way Dr. G can prove it was murder
is with the results of microscopic and toxicology tests. [MUSIC PLAYING] NARRATOR: It takes two weeks to get Greg Flynn's processed
tissue samples back from microscopic evaluation, but only moments to find a significant abnormality
in his heart tissue. He's got a lot more fibrosis in his heart than I'd expect. When you look at cells and a normal heart,
you see the pink muscle cell. But with him, instead of nice pink cells, we see scar tissue replacing those cells.
NARRATOR: The fibrosis or scar tissue tells Dr. G that Greg's heart has been damaged
over a long period of time, though she doesn't think it could have killed him suddenly.
Seeing it gives her a crucial clue. She now thinks she knows how Greg Flynn died,
but she can't prove it without the results of the toxicology. [SUSPENSEFUL MUSIC]
NARRATOR: Back in her office, Dr. G digs into the lab reports-- and it isn't long before they confirm her suspicions.
It turns out that the theory that Greg was poisoned was partially correct. JAN GARAVAGLIA: He was poisoned, all right.
He poisoned himself. He was high on cocaine. Extremely high on cocaine. NARRATOR: Cocaine overdoses are hard to prove because drug
levels fall after death. But even though his blood sample was taken 10 hours after his death, Greg Flynn's blood
still had an extremely high level of cocaine. Now the entire chain of events is beginning to make sense.
The side effects caused by cocaine use can explain many of the curious details of Greg Flynn's final hours.
JAN GARAVAGLIA: Sometimes we see excited delirium with excited, kind of bizarre behavior, which
looked like he was having. It's a marker that he's having a bad reaction to the cocaine,
and you can get this elevated body temperature. NARRATOR: Dying with an abnormally high body
temperature causes accelerated decomposition. This explains why Dr. G observed advanced decay
in Greg Flynn's body. And cocaine even answers the question about the blood on Greg's shirt.
JAN GARAVAGLIA: Cocaine is a stimulant, making the heart beat faster, making your blood pressure go up.
The bloody nose was probably associated with the high blood pressure from the cocaine.
NARRATOR: Dr. G now believes prolonged use of cocaine probably caused the fibrosis and coronary artery
disease she found in his heart. And I think he's probably a chronic cocaine user.
NARRATOR: But what ultimately killed him was a straightforward narcotic overdose, most likely triggering a fatal seizure
or heart attack. When the blood pressure goes up, the heart beats harder, the coronaries constrict.
The terminal of it is usually the heart arrhythmia. NARRATOR: An arrhythmia with the heart's normal rhythm
is disrupted can often result in a heart attack. And although this is a common effect of cocaine overdose,
Gregory could have also succumbed to a fatal brain seizure. Just like it can disrupt the electrical component
of your heart, it disrupts the electrical aspect of your brain and precipitate seizures,
and you can die that way, also. There are many ways that cocaine can kill you. NARRATOR: But all it takes is one.
Dr. G can now piece together the bizarre series of clues and describe step by step the last moments
of Gregory Flynn's life. [SUSPENSEFUL MUSIC] [MUSIC PLAYING] NARRATOR: On a cool September night,
chronic cocaine abuser Gregory Flynn goes on yet another binge, snorting cocaine for hours,
but this time is different. By the next morning, he's awake and high. And although he's a frequent user, he begins to feel ill.
The cocaine was starting to affect his brain, and his blood pressure was going up.
NARRATOR: Greg is disoriented, and his heart is pounding. His high blood pressure most likely
triggers a severe nosebleed as he's driving, so he steers his car into the parking
lot of an apartment complex. He makes a u-turn, his car goes into a ditch, then gets out of the car.
NARRATOR: By now, Greg's face is covered in blood from the nosebleed. Looking for help, he knocks on Debbie
Balcombe's apartment door. At this point the cocaine is beginning to affect his thinking process, possibly inducing delirium
and paranoia, and his body temperature is getting dangerously high. He's getting disoriented, confused.
NARRATOR: Unable to speak, Greg panics and runs into the patch of woods bordering the complex.
At some point, he likely uses his shirt to stop his nosebleed, soaking up the blood.
He probably jumps into a nearby creek in an attempt to cool off, which gets his clothing wet
and also clears his nostrils of blood. Delirious, Greg races on through the woods, hitting branches
and razor-sharp grass along the way, which scratched his arms. And then he collapses.
He collapses either from the seizure or from the heart arrhythmia, and then dies in that field.
[MUSIC PLAYING] NARRATOR: Dr. G immediately contacts the investigators to report her findings.
Hi, this is Dr. Garavaglia from the Medical Examiner's Office. NARRATOR: She then calls Greg's brother, Sean,
and breaks the news. He, at first, refused to believe it. But I think over time, he's accepting it.
NARRATOR: Sean's brother, Gregory, kept his addiction well-hidden from everyone in life.
But in death, nothing can hide from Dr. G. Greg Flynn's death is a sad irony. Although it originally seemed tangled in mystery, in the end,
it was tragically predictable. It's just another one of our drug deaths down here.
It's epidemic. It's epidemic. NARRATOR: Some days for Dr. G, it seems like every death is an accident
that could have been avoided. But her next case stands out in the morgue as a truly unforeseen tragedy.
JAN GARAVAGLIA: It is devastating that those two children are left without a mom.
[SUSPENSEFUL MUSIC] NARRATOR: For Dr. G, juggling multiple cases at once is just part of the job.
But when it comes time to perform an autopsy, it's critical that she focus solely on the task at hand.
The autopsy itself is beautiful because although I have hundreds of cases upstairs
that I have to think about, when I'm doing the autopsy I'm just doing one, and I'm only thinking about that one case,
and nothing else in the world matters. NARRATOR: But for Dr. G, cases aren't an escape.
They're a challenge. He should have some scars around his face, too. Yeah, see it?
I always prefer cases that are more of a challenge. I love unusual cases. You know, I get enough heart attacks down here
that I don't need another one. When a really unusual case comes in, those are really the best.
NARRATOR: And her latest case definitely qualifies as unusual. This morning, we have a 42-year-old woman that just
had abdominoplasty surgery. She's got two kids. She's married, and she dies suddenly.
Two days after the procedure. [MUSIC PLAYING] NARRATOR: Michelle Rohn's tragic story actually started
three years earlier, shortly after the birth of her first child. It was then that her battle with obesity began.
By the time she had her second, the stay-at-home mom was over 200 pounds. At that point, Michelle decided she'd had enough.
[UPBEAT MUSIC] She committed to a strict diet and exercise regimen, and lost more than 50 pounds.
She felt great, except when she looked in the mirror. If someone's been overweight or obese for a long time
and then they lose weight, then the skin will hang over in various areas. The most common place is the lower belly.
NARRATOR: Michelle is clearly unhappy with the excess skin around her middle. And after talking it over with her husband, Kevin,
she decides to go ahead and schedule an abdominoplasty, or tummy tuck. This is to remove some of that skin,
tighten, those abdominal muscles, remove some of that excess fat. 200,000 people will lose a tremendous amount of weight
over this next year, and probably 75% will seek a plastic surgeon to help them contour their body
because of this excess skin. This is clearly an elective procedure for her, partly doing it to please her husband, partly
doing it to please herself. NARRATOR: By all accounts, the operation goes according to plan.
And after three hours in surgery, the procedure is pronounced a success. The next day, her doctors send her home with a prescription
for painkillers. But despite the powerful medication, the pain becomes so intense that Michelle is unable to get
out of bed for 24 hours. Still, it seems like a relatively routine recovery from major surgery.
Nothing unusual, until 3:00 AM the following morning. She goes and takes some medication,
and as she's going back to bed, she collapsed suddenly. NARRATOR: Kevin scrambles out of bed
and attempts to revive her-- Michelle! NARRATOR: But to his horror, he realizes that she stopped breathing.
Frantic, he dials 911. My wife had surgery. NARRATOR: Paramedics arrive within minutes.
They rush her to the emergency room, where doctors work on her for almost a full hour.
And they tried to resuscitate her, but she was dead. They never could revive her.
At this point, her husband and family is devastated. They can barely even talk, and I'm sure they
just want to know why she died. Just like, you know, any of us would. NARRATOR: It's now up to Dr. G to provide Michelle's
family with some answers. Given the circumstances of her death, she suspects that complications from the surgery
could have killed Michelle. Wow. NARRATOR: 10% to 20% of patients develop complications during or after cosmetic surgery.
Most are not serious, but abdominoplasty is one of the most invasive cosmetic procedures.
Abdominoplasty is not an operation that should be taken lightly. What you're doing is you're making a large incision
across your lower abdomen. You're removing part of your skin. CHRISTINE REN-FIELDING: Essentially, the underlying
fat plus the skin is removed. Sometimes the muscle underneath is then tightened by an extra stitch,
almost like a baseball stitch, sort of corsetting you together. And then the skin is sewn together.
NARRATOR: And the list of potentially adverse outcomes is long. For one, Michelle could have contracted
a fatal infection either during surgery or while recovering. The CDC estimates probably about
88,000 to 90,000 deaths from hospital-acquired infections each year. Whenver you open the skin with surgery,
you are decreasing your skin barrier from infection and increasing your risk of infection.
NARRATOR: Another possibility is that Michelle developed blood clots in her legs
at some point during her recovery. They conform after long periods of immobility,
then travel through the blood vessels to the heart, lungs, and brain, cutting off blood supply with deadly results.
But because Michelle underwent liposuction, she's also at risk for fatal fat emboli,
a problem specific to the procedure. JAN GARAVAGLIA: The liposuction, you're breaking up the fat when
they're trying to suck it out. Then you can cause damage to some of the small veins.
These fat molecules and globules get into your vascular system, and then could go to any organ.
NARRATOR: And with the fat emboli displacing blood supply, the body cannot absorb the oxygen it needs to survive.
However, there's a chance that the culprit had been developing undetected in Michelle's body for years.
Could just be natural disease, and that the surgery had nothing to do with it. NARRATOR: Although Michelle was no longer obese,
her past weight gain could have triggered heart problems. If someone is obese or overweight,
their heart has to pump much harder to carry that extra weight, and that can affect its health.
NARRATOR: Dr. G also can't ignore another potential scenario-- Michelle may have overdosed on her powerful pain medication.
JAN GARAVAGLIA: She's given some potent narcotics, and possibly, she's taken too much.
NARRATOR: And there's one even more tragic possibility. If Michelle did overdose on painkillers,
it may not have been an accident. JAN GARAVAGLIA: There is clearly a syndrome of depression
after these body-contouring surgeries. After the surgery, you're in pain. Things are looking bad down there.
You kind of get this depressive effect because stress hormones go down. NARRATOR: Could Michelle have succumbed
to a post-surgical depression and taken her own life? Michelle's family is desperate for answers.
But with no immediate clues, only a full autopsy can solve the mystery of her sudden death.
There's a lot of possibilities here. It'll be interesting to see what we find. [SUSPENSEFUL MUSIC]
OK. We're just gonna go. NARRATOR: The first thing Dr. G notices as she begins the external exam is how hard doctors
worked to save Michelle's life. They have lines in both arms. They have a line in her neck, and they tried very,
very hard to resuscitate her. NARRATOR: It's a sad reminder of what a tremendous loss
this was for Michelle's family. She's got two kids, four and two, which is just devastating to die and leave two children.
NARRATOR: But she has no time to dwell on the tragedy. As Dr. G begins examining Michelle's skin,
she keeps an eye out for small, reddish, purple dots called petechiae. They occur when fat clots travel through the bloodstream
and congest the small capillaries near the skin surface. Petechiae could indicate the presence
of deadly fat emboli, one of Dr. G's leading suspects. I don't see any of the petechiae,
but that doesn't mean she doesn't have fat emboli. It's still a possibility. NARRATOR: The only way to rule out fat emboli for sure
is to examine tissue samples of Michelle's heart, lungs, and brain under the microscope.
Another thing that Dr. G is hoping to find in the external exam is evidence of blood clots.
These often form in the legs, causing one leg to swell up larger than the other.
Brian, could you lift the leg up for me when I measure? Her legs don't look asymmetric.
There's no pulmonary embolism that has obviously developed in her lower extremities.
NARRATOR: In fact, as she works her way up the entire body, Dr. G doesn't see any red flags at all.
She looks like she's lost weight recently. But overall, she looks pretty good. The only thing that really doesn't look good
is that incision across her abdomen. Whoa, whoa, whoa. That looks painful NARRATOR: Dr. G carefully examines
the 18-inch incision for telltale signs of infection. Now, the one thing, though, when you look at the scar
is that it doesn't look infected. NARRATOR: There's also no swelling under the wound.
Blood or serum can clot there, but I don't see any hematoma or large amount of blood.
NARRATOR: Still, Michelle's surgical site looks extremely painful, and this moves one of Dr. G's initial theories
to the forefront. Just by looking at it, I'm thinking, oh, she must have overdosed on medication.
[SUSPENSEFUL MUSIC] NARRATOR: Although Dr. G now suspects that Michelle Rohn may
have overdosed on painkillers following a tummy tuck operation, she still hasn't ruled
out other causes of death, such as an infection or a botched surgery. I won't know for sure until I open that incision up.
[MUSIC PLAYING] NARRATOR: Because of Michelle's recent surgery, Dr. G does not begin the internal exam
with a typical y incision. In this case, I actually open up the incision-- the 18-inch incision, it goes around her lower abdomen,
because I want to see what that one looks like. NARRATOR: Dr. G carefully cuts through Michelle's stitches
and reflects the skin. It looked painful. Where are those things coming from? But it didn't look infectious.
All right. NARRATOR: Finding nothing suspicious at the surgery site, Dr. G uses her scalpel to make a y incision, opening up
the torso from each of Michelle's shoulders through her chest, all the way to the pelvic bone.
First, she'll check the organs for any sign of accidental injury from the surgery.
[MUSIC PLAYING] JAN GARAVAGLIA: Her liver looks normal. Her spleen looks normal.
There's no free blood, no pus in her abdominal cavity. There's no perforation in her bowel.
NARRATOR: With no evidence of infection or surgical injury to Michelle's organs,
it's looking like the surgery itself had absolutely nothing to do with her death.
You know, I'm still wondering, maybe she took an overdose. NARRATOR: An overdose of painkillers
could have been accidental-- or not. Some patients have been known to suffer psychologically
after plastic surgery. There's some serious depression that can occur post body contouring surgery.
They were feeling good before surgery. They're feeling terrible after surgery. They have these horrible scars.
They're in a lot of pain. And they second-guess their decision. NARRATOR: Dr. G slices open Michelle's stomach, looking
for evidence of an overdose. There's really nothing in her stomach. I don't see any pills or pill fragments, or a bunch of pills
that I would expect with an overdose. NARRATOR: But there's only one way to tell for sure,
and that's by drawing blood from Michelle's body for toxicology testing. JAN GARAVAGLIA: So if this autopsy is negative at the end,
I'm hoping that toxicology ends up positive. NARRATOR: But toxicology aside, there's
still critical work to be done. Dr. G must push on with the autopsy. Michelle's body has yet to reveal what killed her,
and the possibilities are dwindling. Maybe it's just some natural disease process.
Maybe she's got a bad heart. Maybe she's got something else going on that we don't know about.
NARRATOR: In the meantime, Michelle's husband and two young children anxiously wait for any information
that may help them begin to come to terms with this tragic loss. I just hope we find a cause of death.
There's nothing worse than a middle-aged woman that dies suddenly with no cause of death.
[SUSPENSEFUL MUSIC] NARRATOR: So far, Dr. G hasn't found any evidence to suggest that 42-year-old Michelle Rohn died
from her recent tummy tuck. But Michelle's sudden collapse does point to a likely culprit--
the painkillers she took minutes before. We see prescription drug, narcotic overdoses
all the time in this office. Some of them are intentional. Some of them are unintentional.
NARRATOR: But it will take weeks to get the toxicology results back from the lab.
In the meantime, Dr. G continues the autopsy, looking for any clue as to what might have caused
Michelle to die so suddenly. Based on the circumstances of her death, I'm going to really still look for natural disease.
I'll look at her heart. That's really going to be where the money is for dying suddenly.
NARRATOR: Dr. G opens Michelle's rib cage and removes the heart. She then meticulously dissects every chamber
and artery in the organ. JAN GARAVAGLIA: There's no evidence of scar tissue, any evidence of longstanding high blood
pressure. Hair looks good. NARRATOR: Next, Dr. G turns her attention to Michelle's lungs.
At first glance they look healthy, judging by their size and color. You can't just look at the external aspect of a lung
and figure out what went on. You gotta take it out and cut it. NARRATOR: Carefully, she lifts the lungs up and uses
her scalpel to detach them. She then begins dissecting the delicate tissue, and at that moment, she sees something horribly wrong.
She's got bilateral pulmonary thromboemboli. Blood clots that formed and are occluding
the main pulmonary arteries. The lung can't get anymore blood from the heart, and it's incompatible with life.
This is what killed her. NARRATOR: But Dr. G's work isn't over yet. Even though I have the cause of death,
I am curious what caused it. I need to know, where did she get these bilateral pulmonary emboli?
You know, inquiring minds still want to know. NARRATOR: The prime suspect, Michelle's legs, where blood
clots are most likely to form. So we dissect the legs, and they don't have any residual clot in those legs.
No, I can't see. It's just all blood here. I don't see any clots. NARRATOR: Determined to locate the source,
Dr. G slowly moves upward on Michelle's body-- and soon finds her culprit. But not in the usual spot.
I find some residual clots still in her pelvic vessels. NARRATOR: Although blood clots usually form in the legs,
in Michelle's body they formed in her pelvic area, then broke free and traveled through her bloodstream
before lodging in the lungs' pulmonary arteries. A blood clot forming in the pelvic vein
is more dangerous than a blood clot forming in the calf vein. The reason being is that the vein in the pelvis
is much larger than the vein in the calf. So when a blood clot breaks off, if it breaks off
from the pelvis, it's a larger blood clot, and then can be much more fatal. NARRATOR: This is the smoking gun she's been looking for.
And finally, Dr. G can explain exactly how Michelle Rohn's tummy tuck turned tragic.
[MUSIC PLAYING] NARRATOR: After an uneventful abdominoplasty and liposuction, 42-year-old mom Michelle Rohn is recovering at home.
She's bed-bound and in pain. Still, on the outside, everything appears normal. But inside her body, it's a completely different story.
The tissue destruction from the surgery and liposuction causes blood to clot more readily,
and her immobility during recovery makes it more sluggish. JAN GARAVAGLIA: And that can lead to pulmonary emboli
forming in the pelvic region. NARRATOR: At around 3:30 AM, Michelle's pain wakes her up.
She crawls out of bed and makes her way to the bathroom for another dose of painkillers.
But unbeknownst to her, the movement's likely caused several blood clots to break
free from her pelvic region. JAN GARAVAGLIA: They go through her vascular system
and flog up the pulmonary arteries going to the lung. NARRATOR: As Michelle tries to get back into bed,
her body, deprived of oxygen, suddenly begins to fail. She collapses, and within minutes, she's dead.
That's one of the few things that you're walking, talking one minute, and you're dead on the floor
the next. NARRATOR: Michelle's sudden death has left her grieving husband, Kevin, desperate for answers.
Now Dr. G calls him with her findings. This is Dr. Garavaglia at the Medical Examiner's Office.
Yes. He just got the cause of death and hardly said a word. He certainly didn't want to talk to anybody about it.
Oh, I would imagine that there was some tremendous guilt. NARRATOR: It's unlikely that Kevin Rohn ever
thought his wife could die from the consequences of such a common procedure. The dangers for cosmetic surgery are minor,
but they're real. Having pulmonary emboli, the complication of that is little less than 1%.
About a 0.08%, but it's real. If she doesn't have anything that is going to put her
at increased risk for the surgery, she's one of those unfortunate people that had a bad complication.
NARRATOR: For Dr. G, Michele's death is a powerful cautionary tale when it comes
to elective plastic surgery. As long as you know the risks and the complications,
and it's still worth it for you, you know, go for it. And especially if it makes you feel better.
But the people she devastated the most with it are her children. You can't ever substitute for mommy.
[MUSIC PLAYING] SINGER: I miss you, I miss you. I love you, la la, bah, bah, bah.
And the smell of your-- [MUSIC PLAYING] MALE SPEAKER: Atlas.

A hiker stumbles across a man's dead body in the woods. The victim's brother is convinced he was murdered. Dr. G must get to the bottom of this case. Was foul play really involved?

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

Brief Summary

Dr. G investigates Gregory Flynn's cocaine overdose and Michelle Rohn's fatal complications after surgery, revealing tragic outcomes in both cases.

Key points

The Disappearance of Gregory Flynn. A strange man appears at a woman's door, only to vanish hours later—dead in the woods.
A Mysterious Death. A seemingly healthy mother dies unexpectedly, leaving her family devastated. "The kids are devastated."
The Shocking Cause of Death. Dr. G discovers that Gregory Flynn's death was due to a cocaine overdose.
Michelle Rohn's Tragic Story. A young mother dies unexpectedly after a routine tummy tuck surgery, leaving her family devastated.
The Cause of Death Revealed. Dr. G discovers that Michelle died from pulmonary emboli caused by blood clots.

Episode highlights

Episode quotes

I don’t know where that blood is coming from.

Dr. G's confusion over the blood on Greg's shirt.

1:01WatchJun 15, 2021

Tension

75/ 100High tension

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