Dr. G: Medical Examiner - Season 5, Episode 15 - Last Gasps - Full Episode | Forensic Files

[INTRO MUSIC] [THEME MUSIC] NARRATOR: A devastated mother finds her baby dead in his crib.
JAN GARAVAGLIA: Four-month-old little boy, has a twin sister. NARRATOR: Can Dr. G solve this heartbreaking case
and save the twin from a similar fate? JAN GARAVAGLIA: There is a chance this child has an undetected congenital abnormality,
and that other twin is in danger, too. NARRATOR: Then, a young father dies under mysterious circumstances.
JAN GARAVAGLIA: They say he's in perfect health. How could he have died? NARRATOR: Now Dr. G must uncover what
took a father from his children in the prime of his life? JAN GARAVAGLIA: Something is going on,
and I don't know what it is. [THEME MUSIC] NARRATOR: Altered lives, baffling medical mysteries,
shocking revelations. These are the everyday cases of Dr. G: Medical Examiner. Despite her 21 years as a medical examiner,
Dr. Jan Garavaglia still find certain autopsies especially difficult. Nobody likes to do babies, but unfortunately, we
do get them in the morgue. Poor thing. Baby. Gosh, how old is he? 15 months old.
This is a true tragedy, a true accident. I can't imagine, as a parent myself, how hard that must be to lose a child.
It would devastate me. NARRATOR: But these cases are not just devastating, they're also some of Dr. G's
most complex medical mysteries. They're difficult cases in that they're subtle changes
that could cause death. We're looking for, sometimes, very minor evidence of trauma.
The belly is a little distended. Very minor changes indicating an infection. NARRATOR: Each year, the District 9 morgue
sees approximately 45 infants who die without warning or a parent cause. Sadly, Dr. G's next case is one of those unfortunate few.
[DRUMROLL] [SUSPENSEFUL MUSIC] NARRATOR: It's 2:00 AM on a quiet Monday morning,
and 21-year-old Sarah Price wakes to the hungry cries of her 4-month-old twins. Half asleep, the young mother nurses
them both, first Charlie, and then his sister Robin. After about a half an hour, she returns them both to their crib
and heads back to bed. Then she woke up at about 7:00 to check on the twins. I'm on my way.
NARRATOR: But as Sarah approaches Charlie's crib, she realizes something is terribly wrong.
Charlie? She heard the twin girl crying and noticed that the little boy was not moving.
Charlie! NARRATOR: Right away, she turns Charlie over on his back, but it's clear that he's not breathing.
Terrified, she calls 911. Paramedics arrive on the scene in minutes. But it's too late.
They try to resuscitate it, and they couldn't. NARRATOR: Now it's up to Dr. G to find out
exactly what caused this seemingly healthy baby to die so suddenly. [SUSPENSEFUL MUSIC]
JAN GARAVAGLIA: So today, we have a baby. It's just died this morning, at least found this morning.
Four-month-old, little boy, has a twin sister. NARRATOR: According to the investigator's report,
Charlie and his sister were born nine weeks premature. JAN GARAVAGLIA: They weighed just
about four pounds, each one of them when they were born. They were hospitalized for an extended period of time.
Hmm. NARRATOR: But looking at the medical records, baby Charlie's health problems appear to have
been a thing of the past. JAN GARAVAGLIA: He's been gaining weight. He's been doing well.
He hasn't had any real problems. NARRATOR: However, Dr. G knows all too well that premature babies like Charlie often
fall victim to infections. MARTY ELLINGTON: Premature infants are more at risk for infection because their immune systems
are immature. Their bodies cannot react to those infections. JAN GARAVAGLIA: Every year, we have several
who die from pneumonia, and every year we have one or two that die from meningitis.
NARRATOR: And Dr. G must also consider another likely culprit, a previously overlooked birth defect.
You know it's always a possibility that this child has an undetected congenital abnormality.
MARTY ELLINGTON: A congenital defect is any other abnormality in the structure of the body.
The most common abnormalities we see usually have to do with, actually, the heart.
The other organs are probably the solid organs of the abdomen, so the kidneys and the liver.
It's actually very important to find whether or not a child has congenital anomalies as early as possible
because often, those defects can be repaired. NARRATOR: But an even more disturbing possibility
is that baby Charlie was the victim of accidental trauma, or worse, abuse. I always suspect foul play or trauma
because there's at least 1% to 10% of these actually turn out to be homicide. There's a lot that this could be.
Ultimately I may not find an answer. NARRATOR: And if Dr. G is unable to determine exactly
how Charlie died, his death may end up being ruled as SIDS, or Sudden Infant Death Syndrome.
These are infants under one year of age that after a complete investigation, X-rays,
all the ancillary tests, toxicology, review of the medical records, after all of that,
there is no cause of death. Nobody knows the reason for SIDS. It's probably multi-factorial.
MARTY ELLINGTON: The reality is that we don't know, but it's probably related to brain and cardiovascular system
maturity. NARRATOR: But Dr. G hopes that she won't have to rule this a SIDS death.
All right. There's really no joy in that. We have this nice term, Sudden Infant Death Syndrome,
and it makes everybody feel good because we know. We don't know. We don't know. It's unexplained.
NARRATOR: At this stage, only one thing is certain, time is of the essence. If baby Charlie died from an infection or congenital defect,
there's a strong possibility that his twin sister, Robin, could also be at risk.
The mother is also concerned that whatever killed the little boy is going to kill the little girl,
and so she is really on pins and needles waiting for the results of that autopsy.
[MUSIC PLAYING] [THEME MUSIC] NARRATOR: In Dr. G's morgue, on a cold stainless steel gurney,
the tiny body of four-month-old Charlie Price paints a heartbreaking picture of a life cruelly cut short.
And this autopsy will be particularly difficult for her tech on the case, Brian Machulski.
How I feel about autopsy in babies is I don't particularly like it. Distress tends to be a little bit higher on babies,
and it also depends on the circumstances in which the baby passed. NARRATOR: But neither Brian nor Dr. G
can afford to let the added stress get in the way of their work. Uh, boy. It's just a really sad situation,
but my concern is to get the right answer. [THEME MUSIC] NARRATOR: Dr. G's first step is to scan
the infant's entire body, keeping her eyes peeled for any visible clues. I know he was born 31 weeks, which is premature,
but he's looking good now. He's gained weight. Do you see his hair, how pretty it is?
He looks well-cared for. OK, chest is 50. I want to do very accurate measurements on its length,
on its crown rump, basically the top of its head to its buttocks. Crown rump is 44.
I want to measure the head circumference, the chest circumference, abdominal circumference.
This will help me tell how it's grown since its birth. When I look at the baby's legs, he's got needle marks.
Uh, it's a needle puncture. But he's got needle marks where we'd expect them, so it looks like that's from resuscitation.
Babies are very hard to get intravenous catheters in. They're hard to give them fluid and medicine.
So what they do is they put a needle in, what we call an intraosseous needle, a needle right into the bone, and then give them
medication or fluids that way. So he's got some on the shins, and that's where we'd expect to see them.
NARRATOR: Next, she checks for signs of possible abuse, starting with Charlie's face and head.
JAN GARAVAGLIA: I look very carefully in his oral cavity because when I'm looking for signs of suffocation,
I'm looking for maybe the mouth being pressed down, smothering. After a very thorough examination,
I see no evidence of trauma. Of course, I look at the neck very carefully. And I look in the eye, look for broken blood vessel.
Usually, it means they're somehow trapped or wedged between the bed and the wall, and that certainly
can be a cause of death. Eyes, OK. But he doesn't have any of that. NARRATOR: Still, despite the absence of obvious trauma,
a fatal head injury remains a prime suspect. Just because I don't see trauma doesn't mean there's not trauma on the inside.
NARRATOR: But before she looks inside, there's one more step in the external exam, X-rays.
OK. That's good. JAN GARAVAGLIA: We're looking for subtle fractures to the spine, to the ribs, to the extremities.
NARRATOR: And it isn't long before Dr. G spots something suspicious. What I'm seeing is some possibility
of some rib fractures on the left side, and that's worrisome. Hmm. It just kind of heightens my worry that this
might be an abusive case. NARRATOR: If her suspicions are correct, Charlie's twin sister, Robin, could be in immediate danger.
This is important because if it truly is, we need to get the twin out of there as fast as we can.
Yeah, forceps, I'm ready to go with him. [THEME MUSIC] NARRATOR: Baby Charlie may be the youngest decedent
in the morgue, but his autopsy will unfold much like any other, with some subtle differences.
My instruments are pretty much the same. I use smaller scissors and a smaller scale
because the little organs are so small, they don't register on our adult scale. So I have to use a little baby scale that measures in grams.
I have trouble even positioning the baby because my-- what we call the head block that we usually put
under the back is just too big for a baby, so I usually, just a little, roll a towel.
I put on the baby's back to help it put its head back. So some subtle differences.
All right. NARRATOR: Dr. G starts with her standard Y incision. She then peels back the skin to get a closer look
at Charlie's fractured ribs. His left ribs, 3, 4, 5, and 6 are fractured. There is no hemorrhage associated
with those fractures. NARRATOR: And this absence of blood is a vital clue. That means that those fractures are done when
that heart wasn't beating, so that clearly indicates that those fractures occurred with
cardiopulmonary resuscitation. JAN GARAVAGLIA: We OK? Yeah. NARRATOR: Next, she surveys the organs in situ,
looking for trauma, infection, or any congenital abnormalities. Let me look at the spleen.
I make sure that all the organs are in the right place because sometimes with babies, there are some syndromes
where there are not. OK. That looks good. Nothing screams out at us. NARRATOR: Then, she takes samples of baby Charlie's blood
for toxicology and removes his organs one by one for dissection. When I do dissect the heart, I look at the valves,
I look at all the vessels, I look at the heart musculature, make sure there's no holes that shouldn't be there.
The heart looks completely normal to me. NARRATOR: The lungs, liver, and kidneys
all appear normal as well. JAN GARAVAGLIA: Unfortunately, even though I don't really
find anything, I can't rule out a congenital abnormality or infection until I look underneath the microscope.
This is for the kidney? Oh, absolutely. NARRATOR: Dr. G wraps up the internal exam still
puzzled as to what could have caused baby Charlie's sudden death. So I'm still not quite sure why he died,
but I still would like to look at his head. Uh. In this age group, the most common way for them to suffer
abusive injury is to the head. Yeah, go for it. NARRATOR: Another condition she'll
be looking for is bacterial meningitis, an inflammation of the membranes covering
the brain and spinal cord. JAN GARAVAGLIA: The infant meningitis can come on very quickly in this age group.
These children can go from looking good and looking healthy to death within a day.
NARRATOR: And if Charlie did, in fact, die of meningitis, this could spell disaster for his sister, Robin.
There is a chance that if the baby died from meningitis, that, that other twin is in danger, too.
Oh, gosh. OK. Oftentimes, there are things riding on an autopsy. The best I can do is stay objective and cool and try
to do the best job I can. [THEME MUSIC] NARRATOR: Dr. G is about to perform the cranial exam
on 4-month-old Charlie Price. Let's see what's going on here. NARRATOR: She's hoping it will reveal what killed him.
Because in this case, another life might hang in the balance-- that of his twin sister, Robin.
JAN GARAVAGLIA: You might even say that, that second twin's life is at stake if I find trauma or some inherited problem
that that child has had. If it's there, I got to find it. NARRATOR: As a first step, Dr. G cuts across baby Charlie's head
and peels back his scalp. When I reflect that scalp, I'm looking for evidence of contusions.
NARRATOR: But after great scrutiny, she finds no indications of bruising. Hmm. NARRATOR: Then morgue technician,
Brian Machulski carefully slices through the skull using an oscillating saw. The cranial exam is going to be
the same on the baby and the adult. The cranium is a bit different. Certainly, the bones are thinner, more pliable.
It's got a soft spot, meaning that the bones haven't totally fused together. Now if it's a neonate, a very young baby,
we could actually cut those sutures with our scissors and just kind of open up the skull.
Although, at this age, at four months, we'll use the saw. OK. Let's see. And as I immediately remove that skull cap,
I take a look at that brain. Let's see. There is no blood anywhere. There is no evidence of brain swelling.
There is no clear evidence of trauma. NARRATOR: Dr. G immediately informs investigators that she's found no evidence of abuse.
This finding clears Charlie's mother of any wrongdoing. There's always a huge sigh of relief
when I tell the detective that there's no signs of trauma because they do not like investigating baby homicides.
NARRATOR: But the cranial exam is far from over. Next, Dr. G carefully examines the baby's meninges,
the membranes that protect Charlie's brain and spinal cord, for any signs of bacterial meningitis.
I look to see if the meninges are clear. I look to see if the cerebral spinal fluid looks clear.
And they do. All right. If it was meningitis, it looks very cloudy. So nothing that I could pinpoint to his head that would have
killed him. NARRATOR: As the autopsy comes to an end, Dr. G still has no clue as to how baby Charlie died.
Now she realizes that the only hope of finding out what killed him may very well lie outside the morgue.
I need a scene recreation. I need my investigator to go out to the scene. Hey Carol, could you give me the--
I need to see how the baby was put to sleep, how the baby was found, could the baby have gotten
trapped in its crib, could the baby have gotten wedged along a side of an adult mattress,
how is the baby sleeping. NARRATOR: Dr. G dispatches investigator Carol Crosby to Charlie's home, the scene of his death.
What my job is for Dr. G, I'm the eyes and ears when I go out. I go and obtain the information.
When I got there, the mother was very, very Distraught. And the covers-- She just didn't know what she did wrong.
I explained that I would need to take a re-enactment doll in to place the child in the position
that the child had been found. I took pictures of the bedding beforehand, then I placed the baby down, and I took
pictures from different angles. NARRATOR: When Carol returns to the morgue, Dr. G carefully examines the new evidence.
And to her surprise, she spots an important clue. OK. Thanks. Well, with that scene recreation,
that case is starting to make sense. It doesn't mean we have the answer. I still have to rule everything else out.
OK. We still need to look under the microscope, and we need to look at the cultures for the bacteria.
We need to get the toxicology. No answers can be complete until all those pieces are together.
[THEME MUSIC] NARRATOR: Four weeks later, the reports arrive at the District 9 morgue.
The results come trickling in, and there was no evidence of infection in his blood.
I look under the microscope at all as tissues, there was no abnormalities, no other congenital defects.
I'm not finding anything. NARRATOR: And these negative results lead Dr. G to one undeniable conclusion.
Now that we've ruled everything else out, we know what happened. [BABY CRYING] NARRATOR: It's 2:00 AM, and after nursing her hungry twins,
Sarah Price places both infants back in their crib. Little does she know that in doing so,
she may be endangering their lives. JAN GARAVAGLIA: What my investigator find out
is that there is tremendous unsafe sleep practices with these children. NARRATOR: The re-enactment photos
confirm that Charlie was placed face down on his stomach, a known risk factor for sudden death in infants.
But that's not all they show. Not only does the mother put the babies to sleep on their tummies, she puts them to sleep on their tummies,
on a soft, soft pillow. The baby probably liked having that pillow over his face.
NARRATOR: And what the mother thinks is a cozy and comfortable position for the baby,
is actually a deadly one. JAN GARAVAGLIA: If you put the baby on a soft pillow, the baby's going to sleep completely face down
and not move their head about 34%, 35% of the time if they're on a soft surface.
That causes a rebreathing of their own carbon dioxide and not getting enough oxygen.
NARRATOR: This should have triggered Charlie to wake up and turn his head, but instead, the 4-month-old
falls into a deep sleep. And with every breath, his oxygen intake decreases. JAN GARAVAGLIA: His respiratory rates go down.
His heart rate goes down to the point where he ends up dying from lack of oxygen.
NARRATOR: It's a tragic ending that raises a major question. Why couldn't the baby just move its head?
He should have been capable of that. NARRATOR: It's a mystery that may never be solved,
but experts do believe that some infants suffer from an unknown congenital defect
in which low levels of oxygen simply don't rouse them from sleep. There's probably some predisposed problem
with the child. Maybe just has some mild abnormalities in the brain stem or the heart.
Will I ever know what his weakness was, what his vulnerability was? No, I won't.
NARRATOR: But she does know that Charlie's inherent vulnerability, combined with his unsafe sleep position,
ultimately led to his death. So you have to have almost a perfect storm where these overlap, and that's why every kid
doesn't have a problem. In fact, most of them won't. How do we know which kid is vulnerable?
How do we know? We don't, and we just have to assume all kids are vulnerable, and we don't put them in these unsafe sleep practices.
NARRATOR: Finally, Dr. G can close the case on Charlie Price. She rules his cause of death as SUID,
Sudden Unexpected Infant Death. In this classification, there's a known external factor
that contributes to the death. In Charlie's case, his sleep position. Now the only thing left is the difficult task
of reporting her findings to Charlie's mother, Sarah. JAN GARAVAGLIA: She's shocked.
She said this is the way her mother taught her to put the babies to sleep. And you know what, we've progressed since then.
Unfortunately, not everybody puts the kids on their back even in the United States.
At least 13% to 15%, 20% still put the babies on their tummies because the babies like it that way, they sleep better.
Well, that's just the problem. They maybe sleep too good. NARRATOR: As sad as this story is,
Dr. G takes comfort in the knowledge that her work may have helped save an innocent life.
Although we can't do anything for this baby, and it's a tragedy, at least, we can do something for the twin.
We know that the unsafe sleep practice probably played a role in this death, but that's something
we can correct for this baby and possibly, save it from the same fate. [THEME MUSIC]
NARRATOR: It's all too often that Dr. G sees families devastated by the loss of a child,
but similarly tragic are the countless cases in which a young parent dies, leaving their children behind.
JAN GARAVAGLIA: A typical healthy 23-year-old guy collapsed suddenly in front of the four-year-old.
It's going to be traumatic for the kid. [THEME MUSIC] NARRATOR: At the busy District 9 morgue in Orlando,
Florida, approximately 35 new cases come through the doors each week. JAN GARAVAGLIA: So we've got that, we've got that,
shall we take this off now? NARRATOR: Most of these are routine. JAN GARAVAGLIA: Yeah, this guy is not looking good.
It's clear why he died. NARRATOR: But Dr. G always welcomes a challenging case. OK, wait, I'm not doing anything
till we figure this out. That's the part of forensics I love. Look at that. When you can go a little bit deeper for the answer,
and particularly, when it means something for somebody, [THEME MUSIC] [MUSIC PLAYING]
NARRATOR: It's 3:00 PM on an unseasonably, chilly October afternoon in Kissimmee, Florida.
23-year-old Roman Glabinski is busy spending some quality time with his kids. I got some bananas.
NARRATOR: Victor, aged four, and Maruska, aged two. The mom went out shopping, and left him with the two kids.
NARRATOR: But when Anita returns home, she's stunned to find her husband collapsed on the living
room floor unresponsive. She calls the EMS, and they come and take him to the hospital.
They tried to shock him, but they could not get him back, and he died in the emergency room.
I think it's got to be fairly traumatic for the kids to have seen their dad collapse, but the wife's devastated also.
NARRATOR: Dr. G begins by reviewing the investigator's report. Well, we have a 23-year-old male with no prior
medical history, and doesn't go to the doctor, takes no medications. I mean, there's really not much to sink your teeth on here,
except that it appears he died suddenly. NARRATOR: But Dr. G does take note of one seemingly minor
detail in the medical history. Hmm. His wife said that as a child, they had told him
that he'd had a heart murmur. A heart murmur is basically when the doctor listens
to your heart with a stethoscope, and he hears more of a swish sound instead of the beep, beep, beep sound.
And basically, all that tells him is that the blood is not going the way it usually does.
NARRATOR: It's considered a dangerous symptom for an adult. But for a child, it's a fairly standard finding.
THOMAS CARSON: Heart murmurs are quite common in children. About 70% to 75% of all children at some point
get told that they have a heart murmur, and the vast majority of them have what we call innocent murmurs, where the physician
is just hearing the sound of blood as it flows through the heart. Most of the ones in pediatrics,
it really doesn't indicate anything. NARRATOR: The heart murmur on first glance would seem an unlikely suspect.
You want me to clean [INAUDIBLE]?? JAN GARAVAGLIA: You know, in your 20s is not a common age for sudden death.
NARRATOR: But Roman does indulge in a risky habit shared by over 26.2 million men in the United States, smoking.
He does smoke one pack of cigarette a day. NARRATOR: But Dr. G doesn't think this habit
caused Roman's death. JAN GARAVAGLIA: I don't expect to see changes that are severe enough to cause death at the age of 23
because he smokes one pack a day. That doesn't mean you should smoke one pack a day
because it's going to catch up with you sooner or later. I just doubt that it caught up with him at 23.
OK. Let's see. NARRATOR: But when someone this age dies with no apparent cause, there's
one unfortunate possibility that does come to mind. JAN GARAVAGLIA: Somebody this young,
we always worry about drugs. His wife said that he does smoke marijuana, but she says, as far as she knows,
he doesn't use other illicit drugs. But sometimes, they'll admit to the marijuana,
but they won't to admit to the other things. So that is definitely going to be a possibility.
Tom, could you hand me a male chart, please, and an internal. NARRATOR: But Dr. G knows that there's only one way
to get the truth from Roman. I will certainly figure out the cause once I do my autopsy.
[THEME MUSIC] NARRATOR: Dr. G begins the external exam by carefully noting the appearance of Roman's body.
First thing I notice is he's overweight. Hm. He's only about 5'5", but he's about 200 pounds.
Write it. Oh, well. At 23, you don't get that belly as you do as you get older. But he was just kind of a big guy.
It looked like he was not particularly out of shape. I mean, he still kind of looked muscular,
but he clearly was carrying too much weight. NARRATOR: Obesity is linked to numerous life-threatening
conditions, such as high blood pressure, blood clots in the lungs, and cardiovascular disease.
We've got three really deadly things here, any three of which could be possibly lethal.
NARRATOR: For now, Dr. G continues scanning Roman's body for more clues. Yeah, a little bit of a scar here.
He's definitely got evidence of resuscitation. They've clearly worked on him. He's got some resuscitation burn over a sternum.
He's got intravenous catheters in, trying to give him fluid, EKG pads. Scar here.
NARRATOR: Given that an overdose is a prime suspect, she keeps an eye out for the telltale signs of drug use.
I'm looking for a needle puncture marks. NARRATOR: And scanning Roman's arms, Dr. G does spot some recent marks that may have
been left behind by needles. Here, there. NARRATOR: But she can tell right away that they are not
the result of illicit drug use. JAN GARAVAGLIA: All of his needle puncture marks
have gauze over them, indicating to me that the hospital was attempting to draw blood or start IVs.
NARRATOR: She continues her search for evidence of drug use. JAN GARAVAGLIA: I'm looking for a septum
that may be perforated from chronic sniffing of cocaine. He doesn't have any of that.
See what else we got. NARRATOR: But Roman's face holds a clue that raises her suspicions,
JAN GARAVAGLIA: He has some frothy fluid in his oral cavity and a little bit in his nose.
That's worrisome. Oftentimes, we will see that with drug overdoses. That's not good.
NARRATOR: As she concludes her external investigation, Dr. G is more concerned than ever
that her findings could spell bad news for Roman's grieving family. JAN GARAVAGLIA: It's a guy that I think is using drugs,
but we'll see when we get in there. [THEME MUSIC] NARRATOR: Dr. G sinks her scalpel
into the skin of 23-year-old Roman Glabinski's chest and abdomen, creating a Y incision.
Let's see what we got going on in here. NARRATOR: She's now worried that what she'll find inside his body will confirm her darkest suspicions.
Hm. Yes, sudden death, 23-year-old, while the wife's gone. Maybe he was using drugs.
It certainly would be high on my list. NARRATOR: Dr. G carefully peels back the skin to expose the front of Roman's chest cavity.
There, I do find rib fractures, ribs 4, 5 and 6 on both sides, and very minimal hemorrhage surrounding it.
So it doesn't appear to be from trauma. It appears to be from CPR. Hold that for me like that.
NARRATOR: Immediately, she collects blood and fluid samples to send to the lab for drug testing.
JAN GARAVAGLIA: What is important is that I remove my toxicology. Because at this point, I'm worried that that is probably
going to be the answer. If you can't see it, I'm going to [INAUDIBLE] NARRATOR: But while she waits for the results,
Dr. G must exhaust all other options. She begins by examining the abdominal organs one at a time.
Anything interesting around here? The liver looked fine. The spleen looked fine.
The bowels all looked normal. Pancreas doesn't look so bad. There is nothing wrong with the kidneys.
There doesn't appear to be anything acute going on in the abdomen that would have caused his death.
NARRATOR: Next, Dr. G removes the chest plate to get a closer look at Roman's heart and lungs.
I remove his lungs first because of possibilities that he has a pulmonary embolist.
NARRATOR: A pulmonary embolist is a lethal condition that occurs when a blood clot blocks the pulmonary artery that
carries blood to the lungs. Roman's obesity puts him at risk for developing these types of blood clots.
When I cut the lungs off and look at the pulmonary artery going into the lungs, there are no pulmonary emboli.
They looked completely fine. Wow, no PE. I can definitely eliminate pulmonary emboli.
NARRATOR: But she does spot an abnormality. Right lung is going to be heavy. Ooh, 990.
There is definitely an increased amount of fluid in the lungs. NARRATOR: This fluid buildup, known as pulmonary edema,
supports her theory on how Roman died. JAN GARAVAGLIA: When we say edema in the lung
when somebody dies suddenly, I think of a drug overdose. NARRATOR: But she can't be sure until she
gets the toxicology report. In the meantime, there's one organ left to examine, the heart.
And there, the case takes a shocking left turn. Oh, my gosh. When I open up the pericardial sac,
you can see this large globe of a heart. Ooh, that's a big heart. MAN: Yeah, it s a big--
His heart should only weigh, at most, 375 grams. His heart weighs 800 grams, more than twice what
it should weigh. An 800-gram heart in a 23-year-old young man is really unusual, and it's really remarkable.
The heart is clearly the cause of death. NARRATOR: Not only is she sure that Roman's heart was
responsible for his death, she's now convinced that drugs probably had nothing to do with it.
This investigation's going in a different direction. We don't have all the answers just because we
have an enlarged heart. What is it that's causing his heart to be like that? NARRATOR: Dr. G begins with a careful dissection
of the organ. She examines the coronary arteries, the vessels which bring blood to the heart.
JAN GARAVAGLIA: He's got about 75% narrowing, which is significant, in one of his coronary arteries,
with the rest of him completely normal. NARRATOR: The extent of Roman's coronary artery disease
is more than she would expect to find for someone his age, but it wouldn't have made his heart expand
to twice its normal size. Something else must have caused the organ to enlarge. There's clearly a lot of work I still have to do.
NARRATOR: One chamber at a time, she inspects the heart valves. The valves all look normal.
NARRATOR: Next, she slices into the thick heart muscle itself. And here, she discovers a subtle abnormality.
JAN GARAVAGLIA: Hmm. When I look at the heart muscle, it looks asymmetric, meaning it's not the same width all the way
around that left ventricle. This is a terribly ill heart. We've got a-- oh, boy.
NARRATOR: So ill, in fact, it looks like it's been deteriorating for years. It's an important finding.
All right. NARRATOR: But unfortunately, this makes it even more difficult to ascertain exactly what's
behind Roman's heart problems. JAN GARAVAGLIA: Now you think, what difference does it make,
it's a heart disease, it's-- let's leave it at that and go home. But there's a lot of questions to be answered, some of which
has some definite implications for those kids that he has and left behind. NARRATOR: If Roman's heart was the result of a genetic defect,
his kids could have inherited the deadly condition. JAN GARAVAGLIA: They clearly are at risk for sudden death also.
So it's definitely something we need to answer for that family. [THEME MUSIC] NARRATOR: 23-year-old Roman Glabinski fell victim
to a heart condition he didn't even know he had, and now it's crucial that Dr. G figure out what caused it.
All right. MAN: It's from the heart? Yeah. He's got two kids. And is it something that they could have inherited?
What I really need to find out is some more history. So I called the wife. She tells me that she thought he was perfectly healthy.
Uh-huh. I want more information. NARRATOR: Dr. G asks medical investigator, Carol Crosby,
to contact Roman's parents. JAN GARAVAGLIA: The problem is that she has a very hard time
communicating with his family because they're Eastern European, and they don't speak English.
NARRATOR: But with the help of an interpreter, Carol is able to glean some valuable information.
What she got from the family is that as a young child, about 7, 8, he was being worked up for something wrong with his heart
that they wanted to operate. And the father refused to let the operation occur, and they just never took him back to those doctors.
Now that just piqued my interest. Hey, Carol, could you give me-- So I asked, where was he treated?
NARRATOR: Carol learns that Roman received treatment at a hospital in Boston, but his parents can't recall which one.
I'm like, oh, brother. Poor Carol, who-- having call every hospital in Boston, try to go the extra mile to get those records for me
to see if we can piece it together. I'll be back. JAN GARAVAGLIA: Meanwhile, because this
has been taking months, I didn't think I'd ever get these records. But I really, on my own, couldn't
come up with the cause. At some point, I felt like just quitting, but you know what, the answer has implications for the kids
and their future health. NARRATOR: Thankfully, the team's diligence eventually pays off.
I was thinking, oh, Hallelujah. NARRATOR: Carol locates Roman's old hospital records.
And as Dr. G expected, they provide a critical final piece of the puzzle. This is why I'm in forensics.
A, the answer means something to somebody. B, I had to do a lot of detective work
to try to put it all together. NARRATOR: On the day of his death, 23-year-old Roman Glabinski is at home with his two
young children, but little does he know that inside his chest, his heart has deteriorated and ballooned to more
than twice its normal size. In fact, the organ has been diseased since the day he was born.
I get the medical records, and it appears that he had the asymmetry from the very beginning.
He was born with a primary hypertrophic cardiomyopathy. NARRATOR: It's a genetic defect that
triggers abnormal growth in the cells of the heart muscle. Most likely. The heart murmur that Roman's doctor
detected when he was a child was an early sign of this defect. Maybe this benign heart murmur wasn't so benign.
NARRATOR: When Roman was eight years old, his doctors recommended heart surgery.
And it would have helped his heart. NARRATOR: But convinced the procedure would be too dangerous, Roman's father declines.
And as the years pass, his son's heart grows larger and larger. JAN GARAVAGLIA: Unfortunately, hypertrophic cardiomyopathy
is a silent killer, meaning no symptoms until death. NARRATOR: Roman may feel fine, but on that ordinary October
morning, he's already in big trouble. His heart is failing and dying. NARRATOR: As the heart dilates, the muscle weakens, and becomes
less and less capable of pumping blood, until finally, it gives out. JAN GARAVAGLIA: The heart muscle could no longer pump,
and the pressure is starting to build up in his heart, so the fluid starts going into his lungs.
NARRATOR: It's the same frothy fluid that Dr. G found in Roman's mouth and in his lungs
during the autopsy. The final coup de grâce came on very suddenly for him in a sudden collapse.
That must have been very scary for the children. NARRATOR: But even scarier for Roman's kids
is what he left behind. The problem is hypertrophic cardiomyopathy is usually genetic.
There's a 50% chance that they would have inherited this. NARRATOR: It's frightening news for the children,
but also critical information. Fortunately, medical knowledge has improved since Roman was
a child, and now, his kids can undergo genetic testing to see if they've inherited the condition.
JAN GARAVAGLIA: I think the wife was so thankful that I put the extra effort in to get the diagnosis
for her and her kids. [MUSIC PLAYING] JAN GARAVAGLIA: They may not have inherited it,
and they may have. But at least, they can do something about it now instead of just dying suddenly and unexpectedly.
Maybe he died as a message to have his kids checked, and his death saved his children.

A mother of infant twins notices that her son is not breathing. EMTs attempt to revive him, but it's too late. Now, Dr. G must work fast to determine if the other twin's life is in danger.

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

Brief Summary

Dr. G investigates the deaths of a baby and a father, revealing unsafe sleep practices and a genetic heart condition.

Key points

A Mother's Heartbreak. A mother finds her baby unresponsive in the crib, leading to a tragic investigation.
The Mystery of Sudden Infant Death. Dr. G explores the complexities surrounding the sudden death of a seemingly healthy baby.
The Danger of Unsafe Sleep Practices. Dr. G uncovers that unsafe sleeping positions contributed to the baby's death.
The Tragic Collapse. A young father suddenly collapses, leaving his children and wife in shock.
The Heart of the Matter. An autopsy reveals a shocking cause of death: an enlarged heart.
Genetic Implications. The investigation uncovers a genetic heart condition that could affect the children.

Episode highlights

Episode quotes

There's probably some predisposed problem with the child.

Dr. G discusses potential congenital defects that could affect the baby.

24:53WatchJun 17, 2021

Tension

75/ 100High tension

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