Dr. G: Medical Examiner - Season 5, Episode 17 - Fatal Twist - Full Episode | Forensic Files

[MUSIC PLAYING] NARRATOR: A young life is tragically cut short. DR. G: I think they're always sad.
The babies are just such innocent, pure, little sweetness. We just hate to autopsy them.
NARRATOR: And Dr. G is forced to consider the worst case scenario. DR. G: It is horrific to think that people
do that to children. And unfortunately, I have seen it happen far too many times.
NARRATOR: Then, a woman dies after being released from the hospital with a simple case of bronchitis.
DR. G: They gave her some antibiotics and sent her on her way. NARRATOR: But an autopsy, Dr. G's findings
reveal an astonishing oversight. DR. G: Nothing trumps that. That's as bad as a bullet through the head.
NARRATOR: Altered lives, baffling medical mysteries, shocking revelations. These are the everyday cases of "Dr. G, Medical Examiner."
It's 8:00 AM at the District 9 morgue in Orlando, Florida. And Dr. G's staff is busy preparing for the day's cases.
This morning, there's a suspected drug overdose, a possible heart attack victim,
and a motor vehicle fatality. But Dr. G's attention is drawn to one case in particular, Carlos Lopez,
a four-month-old baby boy. [MUSIC PLAYING] A lot of sadness in the morgue today.
Unfortunately, we have a four-month-old baby, found unresponsive by his parents.
I've been doing baby autopsies for over 20 years. I think they're always sad. They're always extremely sad.
The babies are just such innocent, pure, little sweetness that we just hate to autopsy.
The story is that the parents, very young parents in a poor, rural area of one of my counties,
put the baby to bed. In the morning, they noticed that the baby is unresponsive.
It doesn't appear to be breathing. Of course, they panic. They don't own a phone.
They rush the baby to the fire station, which isn't too far away. My baby's not breathing.
DR. G: They start CPR. They rush the baby to the nearest pediatric hospital. NARRATOR: There, ER doctors immediately
put the four-month-old on life support, but by then it's too late, Carlos Lopez is already brain dead.
The baby's too far gone. And they eventually take it off the respirator within 24 hours.
NARRATOR: By all accounts, the sudden unexpected loss of their only child comes as a devastating blow
to Carlos young parents, Marco and Isabella. DR. G: They were just absolutely floored that they
have a baby that died. It was just unbelievable to them. NARRATOR: Sadly, Dr. G sees babies
like Carlos all too often. DR. G: Four months old is a very common age for us to see the baby.
The babies get sick really fast when they're very young. They can die from pneumonia, meningitis.
And it's also not an uncommon age to see SIDS, Sudden Infant Death Syndrome, the kids that just
die suddenly and unexpectedly. NARRATOR: But as she combs through the investigator's
report, she finds two potentially troubling clues. Her investigator has noted that Carlos' abdomen appeared
bloated and there seemed to be an area of swelling on the back of his head. These findings lead her to weigh a more disturbing possibility--
child abuse. It is unimaginable hitting a baby, to me, but unfortunately, we see it.
Blows to the abdomen, believe it or not. We see lacerated livers. We see contused bowels, from blows to the belly.
Certainly, one of the more common things we will see in this age group is inflected head trauma.
We get kids here that are murdered and have trauma inflicted on them. NARRATOR: Now Dr. G can't help but wonder if the mounting
pressures of parenthood could have driven Marco and Isabella to do the unthinkable.
DR. G: There's frustration, they're poor. There's probably a lot of pressures on them.
You do worry that maybe they took it out on the baby. So we'll have to do an autopsy and see
really what's wrong with him. [MUSIC PLAYING] Cute, cute kid, though. Yeah. Feel how soft his hair is.
Yeah, soft hair and long eyelashes. Before we start, I think we take a look and appreciate the beauty of the child.
Just as we see a baby out in public, you take a second look and you appreciate what beautiful little creatures they
are. And we do that in the morgue too. We just kind of stare at them and just appreciate how cute they are.
He is a precious little baby boy. I mean he's a cutey bunny. Has he got any teeth there?
I see two lowers, cute. I know with some of the techs, they have a harder time with children.
And some of the detectives won't come in when we do children. Why does everyone hate working on babies.
They can't talk for themselves. We got to talk for them. ASHLEY SHAUGHNESSY: Babies can be difficult.
Sometimes you do get tied into it, and you feel like a gut-wrenching feeling, like how could they do this to this baby, or this poor child.
But at the same time, I try not to let myself get involved or attached in that manner, because you
can't work here if you do that. DR. G: I'm still there to get the answer. And that's what I have to do.
After you get over how cute they are, then you start looking for what you need to look at.
I'm looking for a lot of things. I'm going to have to chart what kind of shape the baby's in, what kind of medical intervention they did.
I'm going to look for rashes. I'm going to look for subtle signs of trauma. I'm going to look for bruises on the skin.
So I'm just looking and seeing what I find. As a first step, Dr. G meticulously records the general state of Carlos' body.
You can see he's obviously been in the hospital. He's got a lot of needle puncture marks
and he's kind of all swollen. But even with that, even with all that medical intervention,
he is a little cutie. NARRATOR: Prompted by her. Investigator's report, Dr. G turns her attention
first to Carlos' head. My investigator first felt, when he saw him in the hospital, he's got this bump or this abnormality
in the scalp. And I'm looking very carefully for that. He does have some cradle cap.
That's just kind of a scaly, oily, flaky skin that's kind of attached to the scalp.
It doesn't mean that he was not well cared for. It's a common finding. NARRATOR: And sure enough, just behind the ear,
she finds an area of swelling. DR. G: I don't know what it is, but I'm worried about some type of inflicted trauma, particularly
inflicted head trauma. NARRATOR: But that's not the only abnormality noted in the investigator's report.
Now, I find a distended abdomen. Well, at this stage, I'm a little worried. Could be from a blow to the belly.
Maybe it's blood in the belly. Huh. I'm anxious to get inside. And I'm really hoping to get answers
when I do the internal exam, because you never know what the autopsy's going to show,
particularly with children. [MUSIC PLAYING] NARRATOR: 4-month-old Carlos Lopez died
late last night in the ICU. And to her dismay, Dr. G has already found two ominous signs
that suggest he may have been the victim of fatal child abuse-- swelling in the head and the abdomen.
It is horrific to think that people do that to children. And unfortunately, I've seen it happen far too many times.
NARRATOR: And based on her experience, Dr. G knows exactly where to start the autopsy.
DR. G: One of the most prominent ways in the infant age group that we see that these children are murdered
is through inflicted head trauma. You got to hold that open and get a picture [INAUDIBLE]
All right. Because there's a little piece right there, NARRATOR: First, Dr. G reflects the infant's scalp,
peeling back the skin to expose the top of Carlos' skull. What's really important was inflicted head trauma is
to see any type of scalp bruising that you may not see externally. Oftentimes, we see that subtle bruising on the inner aspect
without really seeing much on the outer aspect. But with this cute little boy, we don't see anything.
He has no scalp contusions, no bruising on the inner aspect of the scalp. He's got no skull fractures.
NARRATOR: But she still needs to look inside for signs of trauma. To gain access to the brain, morgue technician Brian
Machulski opens the infant's skull, or calvarium, with an oscillating saw. Now a four-month-old, we're still going
to have to saw the calvarium. Their skulls are certainly more pliable. With a really, really young infant, around the age of one
month, we can actually cut between the suture lines, and just kind of, what we call, pedal it
out, just kind of open it up. With a four-month-old, we'll still use the saw. So we'll open that brain just like we would an adult.
It's just much thinner and much more pliable. It's much easier to open. NARRATOR: Here Dr. G will be looking for signs of trauma
or any evidence that suggests Carlos was a victim of abuse. Like slamming them against the mattress,
slamming them against the wall, blows to the head. MARTY ELLINGTON: Children or babies' brains
do not tolerate the same amount of force to the head as an adult would, whether that's actual
shaking or unfortunately the child being thrown, or dropped, or hit. And based on that, they can have brain injury.
NARRATOR: But while there's no immediate sign of blood on the brain surface, Dr. G realizes they have
another problem on their hands. That brain is very, very soft and friable. I already know what that is.
That's respirator brain. This was a telltale sign that Carlos was brain dead on life support.
What happens when you're brain dead and they just keep you alive is your brain starts to break down.
And those baby brains are so soft to begin with, that by the time I get them, they're
like jello that's been left out, just really, really soft and friable. But I'm looking past that.
NARRATOR: Carefully, Dr. G removes the fragile organ from the skull and carries it
to the dissecting table. But she knows the brain's delicate state will make the exam extremely challenging.
DR. G: With respirator brains, you have to look quickly, because they're so friable, they almost break up in your hand,
and they're difficult to examine. Dr. G quickly scours the disintegrating organ for signs of injury, such as blood or swelling.
But after a thorough inspection, she can find no evidence whatsoever of internal trauma.
So I really don't have anything positive from that brain that would indicate what his cause of death is.
As for the swelling on the back of Carlos' head, it appears to have simply been the result
of fluids being pumped into his body while on life support. They've given him a lot of fluids
to try to increase his blood pressure and it just kind of goes into his tissues.
You know, just like you get a swelling, a swelling of a joint or swelling of tissue.
By the end of the cranial exam, we have ruled out inflicted head trauma. But I haven't totally ruled out trauma.
I don't like the fact that his abdomen is distended. [MUSIC PLAYING] So then it's time to do the Y incision.
You know, with a baby, you have littler spaces to work. So when I do a baby, some of our instruments are smaller.
I like to use smaller scissors, smaller pickups. But my scapel's still the same.
I go across the chest and I go from the shoulder down. NARRATOR: With one small incision,
Dr. G opens the infant's tiny torso. And right away, something catches her by surprise.
When I get to the abdomen, though, there's trouble. This little belly is so distended, you
don't want to cut that bowel when you open it. I see 50 ccs of turbid, kind of pussy looking fluid.
Something is wrong. I'm going to try to peel that. Something's happened to his abdomen.
This is not a trivial incident that happened to this child. [MUSIC PLAYING] NARRATOR: Dr. G has just made a shocking
discovery in the tiny abdominal cavity of four-month-old Carlos Lopez-- a mixture of pus and fluid.
And this finding raises an ominous red flag. DR. G: Now, I'm immediately worried
that he's got that injury to the small bowel, which we often see with kids with blows to the abdomen.
NARRATOR: To get a closer look, Dr. G empties the fluids from Carlos' belly one ladle at a time.
And it isn't long before she comes face to face with a serious problem. Just as she feared, it's the baby's bowel.
DR. G: It's not looking good. It was swollen, and green, and definitively dead. The bowel looks like that's the cause of death.
NARRATOR: But the question is what could have caused the infant's bowel to fail so catastrophically?
DR. G: Although I have the cause of death, I've really got to figure out what's going on with this bowel.
NARRATOR: And what she discovers next takes her completely by surprise. DR. G: I don't think I'll ever see another one of these again.
NARRATOR: With this finding, Dr. G can now piece together the tragic combination of events that culminated in the death
of four-month-old Carlos Lopez. [MUSIC PLAYING] It's late in the afternoon and four-month-old Carlos Lopez
is crying. His young parents, Marco and Isabella, think he's just being fussy. But they couldn't be more wrong.
Carlos is in the throes of a dire medical crisis and it isn't child abuse. On the contrary, it's the result of an undetected birth defect.
He's got a congenital problem where his right colon was not attached to the bowel wall.
The bowel, in effect, is floating freely in the abdomen when the child is born. NARRATOR: The development of the intestinal tract
begins in utero, as a single central tube. When you're just developing in the uterus,
you got a little straight GI tract. And then, after about fourth week, it really is kind
of cool, it kind of herniates. And that's actually where it starts growing, and twisting, and turning.
And then, after about 10, 12 weeks, it comes back and starts attaching to the abdominal wall.
The intestine has a whole, both the small and the large intestine, probably equal, in a small baby, at least 20 to 30 feet of organ.
And so in order for that organ to fit properly in the abdomen, it needs to be attached in certain places.
NARRATOR: As Carlos' intestines develop, a small section of his large bowel does not attached to the abdominal wall as it should.
Normally, children born with this birth defect don't suffer any long-term problems.
6% to 10% of the population have that and live with it. NARRATOR: But sometime in the days just before his death,
Carlos develops a very rare and deadly complication. His unattached bowel begins to rotate abnormally,
a condition called a volvulus. A volvulus is when part of the intestine has twisted around itself and causes obstruction
to the blood flow to the bowel. NARRATOR: As its blood supply becomes compromised,
the bowel literally begins to die. This causes the bacteria to leak from his bowel, which in turn,
triggers a massive bacterial infection in the baby's abdominal cavity. On the evening of his death, Carlos is critically ill
and in significant pain. Having your bowel strangulated and then having that die off,
it causes a lot of abdominal pain. They'd have terrible abdominal pain, like a burst appendix.
That's how it would feel. You would expect the child to cry and to cry inconsolably and show other signs of distress.
As the disease progresses, you would have further evidence of a very sick infant.
NARRATOR: But Carlos' young and inexperienced parents likely misinterpret his desperate cues.
DR. G: And they probably didn't pick up on signs of him not doing well-- irritability, lethargy, not wanting to eat.
Just couldn't express it in a way that the parents understood it. NARRATOR: Eventually, the bacteria
in the four-month-old's abdomen begins to leak into his bloodstream, unleashing a life threatening
infection known as sepsis. The result is swift and catastrophic. Once that bacteria goes into your blood,
it sets off a cascade of events that cause your blood pressure to drop. And you end up losing your heart rate,
losing your blood pressure, and you stop breathing. By the time his parents saw him in the morning,
he didn't have a pulse, he didn't have a respiration. Even if he lived next to the hospital,
I don't think they could've saved him at that point. [MUSIC PLAYING] NARRATOR: Dr. G meets with Carlos' parents
to explain the tragic and complex circumstances that led to their son's too early passing.
And they're stunned by her conclusions. DR. G: The parents, at that point, were just in shock.
I can guarantee you, though, that they are glad they have a cause of death than no cause of death.
Because ultimately, never knowing why they died is really hard. And also, having that specific cause of death
removes any suspicion that it's trauma from the parents. NARRATOR: For Dr. G, a parent of two
boys herself, the death of the infant serves as a stark lesson. DR. G: I always tell parents, if the baby's starting to look
a little different, and you just don't feel comfortable with the way he's acting, I always
say err on the side of caution, give your pediatrician or your nurse practitioner a call.
[MUSIC PLAYING] NARRATOR: Sadly many of Dr. G's cases involve deaths that could have been avoided.
And for 36-year-old Ellen Walters, a correct diagnosis comes too late. DR. G: Her death could have been totally prevented.
It's just really a shame that it slipped through the cracks. [MUSIC PLAYING] NARRATOR: This morning, Dr. G is starting
her day outside of the morgue. I have to warm up. Working out in general is a wonderful stress reliever.
I really look, actually, forward to and dread these personal training sessions. Because when you're working out by yourself,
you can go at your own pace. When you're working out with a personal trainer, they really push you.
Good deal, let's get started. DR. G: Before I started working with her, I could not do a push up.
It's great. We brought her from where she was a little intimidated. Now she's doing pushups with a ball.
DR. G: When she asked me to do this, I thought this was the craziest thing I'd ever heard.
This squat thing, you notice they're filming from behind. Piece of cake. Down, down, squat, jump, squat.
When I give her a dirty look, she knows it's a good one. And you always like to do an extra.
I concentrate on full body exercises with Dr. G, because you kind of get the most bang for your buck.
You burn the most calories. You're doing lower body as well as upper body. And I also work on external rotations,
help open up the chest, strengthen your rotator cuff muscles. Which, if you're doing a lot of this and moving around, then
hopefully that'll help strengthen and reverse her posture. I think getting in better shape gives you more stamina,
without a doubt. It just makes you feel better. And I think the best part, and was totally unexpected,
is my posture. Don't you think my posture's getting better? Absolutely. DR. G: Furthermore, if you're toned all over,
it's just easier moving the bodies around and, just standing on your feet. NARRATOR: Having the necessary strength
and endurance to get through long days in the morgue is essential. But equally important to Dr. G is
her ability to maintain a heightened level of concentration. That's the beauty, actually, of doing an autopsy,
is I don't think about what's for dinner. I don't think about the problems with my kids.
All I think about is trying to find the answer. You tune out the rest of the world and you focus.
I haven't done anything on her yet, so-- Athletes call it in the zone, so I think
I can call it in the zone. This morning we have a 36-year-old Caucasian female who is supposedly having a seizure on the bus.
Pretty much, by the time she gets to the hospital, she's dead, and is now in my morgue.
[MUSIC PLAYING] NARRATOR: It's a typical summer morning in Orlando, hot and muggy.
Braving the heat, 36-year-old housekeeper Ellen Walters is waiting for the 9:35 bus which will drop her off
just a few blocks away from the home she'll be cleaning that day. She was going to work on the bus.
The bus driver said he could see something was wrong. Alarmed, the driver quickly pulls his bus
to the side of the road. He sees her have a seizure. He calls 911. NARRATOR: Paramedics arrive within minutes.
PARAMEDICS: Anybody here know anything about her? NARRATOR: And rush Allen to the hospital.
DR. G: But by the time they get there, she's dead. She's dead on arrival. [MUSIC PLAYING]
NARRATOR: As a first step, Dr. G begins reading through the investigator's report.
And right away, she spots a red flag. It appears Ellen had gone to the hospital the night before she died.
DR. G: She goes into the emergency room, complaining of feeling lightheaded and some chest
pain. The emergency room does an X-ray. They give her an exam. The chest X-ray was normal.
They heard some wheezing. And they thought she had some bronchitis. NARRATOR: Bronchitis is an inflammation
in the lungs' airways, that's extremely common and usually harmless. That's certainly not going to be what killed her.
But I'm worried that she goes to the ER just the night before with complaints of chest
pain and difficulty breathing. I don't like coincidences. NARRATOR: Now Dr. G wonders if Ellen's symptoms were
actually signaling a far more serious ailment, like a heart attack. It's certainly something we see in the morgue.
NARRATOR: But then, something else in the report catches her attention. DR. G: Looking into her history a little bit,
it's kind of interesting. She's got a mental disability. Now, of course, with her disability,
we don't know really what type of disability she has. They don't have a diagnosis for her.
NARRATOR: According to the investigator, Ellen lived in a group home for adults with disabilities.
And now, her sister Deborah believes the home's caretakers may be responsible for her death.
DR. G: The sister, she's pretty upset. She thinks the group home is to blame. They let her take care of her medication on her own.
NARRATOR: Without proper supervision, Ellen could have easily taken too much of her prescription drugs and died
of an accidental overdose. They'd just given her a couple new medications when she went to the emergency room.
She already takes some medications for behavioral problems. So maybe if she's unsupervised and is
not used to taking her own medication, maybe she took too much. She'd taken that medication unsupervised about
45 minutes before she dies. NARRATOR: But Dr. G knows she must also consider an even
more disturbing scenario. When a person dies in a group home setting or in any type of institutional setting,
it's very important for the medical examiner to get involved, because there's always a question of how
they're being treated, if there's any type of abuse, or neglect, or if possibly there's unrecognized trauma.
She doesn't communicate as well. And so maybe something happened that she's not telling.
NARRATOR: And it's now her job to coax the truth from Ellen's body. DR. G: So we have a whole host of problems.
But we're not going to know for sure until we do the autopsy. [MUSIC PLAYING] OK, so when I start the autopsy, I just
do a general over appearance. I look for anything that'll give me clues. NARRATOR: And it isn't long before Dr.
G spots something slightly odd. DR. G: Hey what is that? Now her legs were a little asymmetric.
OK, let's see. Her right leg was a little bigger than her left. It wasn't that big of a difference.
It could mean a deep venous thrombosis, or a blood clot developing in the vein of a lower leg.
NARRATOR: Blood clots in the legs can be dangerous if they break off and travel through the body
to the heart and lungs, stopping vital blood flow. But they're usually associated with risk factors,
such as immobility, heavy smoking, and recent surgery, none of which appear anywhere in Ellen's history.
It could be just asymmetry of her lower extremities that some people have, because they tend to favor
one leg over the other. A lot of people will have one calf bigger than the other.
NARRATOR: She makes note of the measurements and then begins looking for any signs that
could suggest Ellen had been neglected, or worse, beaten by her caretakers. Well, certainly, for abuse what I'm looking for
is evidence of any type of bruising, trauma. I'm looking to see how clean she is, whether she's well taken
care of, clean nails, clean hair, not lice in her hair, no sores anywhere. You just want to do the whole overall?
She appears to be well cared for, well nourished. In fact, she's overweight, but not badly so.
No evidence of trauma. So overall, the external examination didn't tell me a lot.
NARRATOR: But years of experience do tell Dr. G that it's far too early to dismiss
the specter of abuse. DR. G: Even though she didn't have any external evidence of trauma, she's certainly still could
have delayed effects of trauma, particularly a delayed head injury. So until we get into her head, we won't know for sure.
[MUSIC PLAYING] NARRATOR: Dr. G's morgue techs Brian Machulski saws through the calvarium of 36-year-old
Ellen Walters, a mentally disabled woman who lived in a group home. DR. G: When there's any type of institutional setting
or a group home setting, there's always suspicion on that group home that something happened.
NARRATOR: Dr. G is now exploring the possibility that Ellen was assaulted by her caretakers and sustained
a fatal blow to the head. This could easily explain the seizure she suffered just before she died.
I take the calvarium off. I certainly don't see any fractures. I'm looking for accumulations of blood.
I'm looking for maybe swelling, asymmetric swelling of the brain, anything that's abnormal.
NARRATOR: But after a careful examination, she can find no evidence of an injury.
There's also no sign of natural disease that could explain Ellen's seizure. DR. G: Her brain looks normal.
OK, well I don't see anything. So at this point, now that I've done the brain exam,
I suspect that that seizure may be due to something else going on inside her body.
I have my suspicions, but no one thing is pointing more than the other. I'd like the autopsy to speak to me on this one.
[MUSIC PLAYING] All righty-- NARRATOR: Dr. G draws her blade from Ellen's shoulders
to her sternum and down her abdomen. First and foremost, she'll be on the lookout for any damage
to the organs that could signal abuse. DR. G: Do you remember, the night before, she
was a little lightheaded. Maybe she's even losing blood internally somewhere. Sometime we get a delayed effect from a spleen rupture
or blow to the spleen. NARRATOR: Peeling back the skin and fat, she gets her first look at Ellen's abdominal cavity.
And it doesn't take long to rule out another potential culprit. DR. G: I certainly didn't find any trauma.
She doesn't have any trauma. Her abdomen looks normal inside too. Liver looks of normal color, size.
Her spleen's OK. Her bowels are intact. They don't have anything wrong with them.
Her appendix is fine. She doesn't have any accumulation of blood. She hasn't ruptured a spleen or a lacerated any liver.
NARRATOR: And upon closer examination, the only abnormality she detects is a mild aberration
in the uterus. DR. G: Her uterus, though, is misshapen. It's a relatively small uterus, but with a rather lumpy,
bumpy appearance, I call it. And she's got some large leiomyomas. Leiomyomas are smooth muscle tumors which are benign.
They're usually as a result of people who are still producing estrogens. They're estrogen sensitive.
So they tend to be enlarged in this age group if you have them. And usually post-menopause, they go away.
For the most part, a lot of women don't have any problems with them. And you certainly aren't expecting to die from them.
NARRATOR: Now Dr. G is convinced of one thing. Ellen did not suffer any physical abuse
at her group home. But that doesn't exonerate the staff. They could still be held responsible for her death
if they failed to supervise her medications properly. We're still worried about some of the medication she's taking.
So it's very important at this point that I take my toxicology, because that may be the answer.
NARRATOR: Dr. G collects samples of Ellen's blood and urine and sends them off to the lab for a full analysis.
Then she turns her attention to the heart. We've got the night before, with the chest
pain and the lightheadedness. Then we've got the witnessed seizure and she's dead.
So it could be a result of a lack of oxygen to your brain, maybe because of something wrong with her heart.
Now, we don't know really what type of disability she has, but sometimes these disabilities are associated
with other problems, strictly in the heart and other congenital problems. We don't have that history with her.
So again, we'll be looking for any kind of congenital abnormalities also. NARRATOR: But as Dr. G cracks open Ellen's rib cage
and gets her first look at the organ, she's surprised by what she sees, or doesn't see.
DR. G: Her heart, I take it out and it looks normal. So many of the hearts I see are enlarged
from high blood pressure. Her's was not. It was of normal weight. I look at where the fat's accumulated.
I look at the surface, is it nice and shiny? The overall shape. The overall shape appeared normal.
What else we got going on here? NARRATOR: But appearances can be deceiving. So she dissects the tissue inch by inch, looking for anything
out of the ordinary. DR. G: I look at coronary arteries. Do they have atherosclerosis?
In this case, normal, normal coronary arteries. Coronaries looked great. I then look at the muscle of the heart.
I look at the blood, how the blood flows to the heart. I look at the valves. What's wrong with her?
She has a completely normal appearing heart. Both externally, and internally, including
the muscle, the cornea arteries, the valves, all appear normal. NARRATOR: With not a shred of evidence
so far pointing to a cause of death, Dr. G is now beginning to wonder if Deborah's suspicions
may prove true after all. Well, her sister really feels that somehow it's the group home's fault. And at this point,
we're running out of organs to blame her death on. I'm worried about that. [MUSIC PLAYING]
NARRATOR: 36-year-old Ellen Walters died yesterday on a city bus. And her sister, Deborah, believes that her caretakers
may be to blame. She thinks that it might have been a result of them letting her take the medication or too
much of it. NARRATOR: Toxicology tests will help determine the truth, but the results won't be in for weeks.
And for now, Dr. G still has one place left to look-- the lungs. Based on Ellen's diagnosis at the hospital the night
before she died, Dr. G expects to find nothing more than evidence of bronchitis.
So to take the lungs out, I lift them up. I do notice a discoloration, some kind of reddish,
firmness on the back of the lower lobe of one of her lungs. NARRATOR: Dr. G then begins a careful dissection
of the pulmonary arteries. And what she finds is a far cry from bronchitis. Nothing trumps that.
That's incompatible with life. That's as bad as a bullet through the head. OK. [MUSIC PLAYING]
NARRATOR: It's a steamy Thursday night in Orlando. And Ellen Walters is having no fun at all.
Feeling short of breath and lightheaded, she's rushed to the ER, where doctors conduct a thorough examination.
They do a chest X-ray. They can't find anything. They listen to her lungs. They really don't hear much, maybe some wheezing.
They give her a diagnosis of bronchitis and send her on her way. NARRATOR: Little do they know, something much more serious
is going on inside Ellen's body. DR. G: At some point, she developed a blood clot in the veins of her leg, most likely her right leg.
It probably explains the asymmetry of the legs. NARRATOR: However, these clots are usually harmless.
DR. G: Your blood is clotting all the time. And so your body's always making little blood clots.
And then it breaks down the little blood clots, and it makes little blood clots, and it breaks
down the little blood clots. And that's just-- you know, it's in balance. And that's what it should do.
NARRATOR: But unfortunately, for Ellen that's not the case. For reasons unknown, there's an imbalance in her blood clotting
mechanism. And what started as a small clot in her leg is now growing at an alarming rate.
Unfortunately, she was a ticking time bomb. Some small pieces of the blood clot were breaking loose and traveling her vessels
and getting caught into her lungs. NARRATOR: And it's only a matter of time before these breakaway clots, known as pulmonary emboli,
begin to impede the flow of blood and oxygen within the lungs. DR. G: That probably was causing her to get short of breath
and having some chest pain and probably is what really precipitated her going to the emergency room.
Unfortunately, they didn't pick up on it in the ER. And that's not uncommon. Between 100,000 and 200,000 people
die every year with misdiagnosed or undiagnosed pulmonary emboli. It's because it's a great pretender.
It can mimic other things. A lot of people come in with just some shortness of breath,
because they have a viral infection, and it's hard to pick up. it's hard to test far.
It's hard to find on your scans, on your X-rays. But now a days, they do have better tests.
Certainly, the CT angiogram is much better now at picking up these pulmonary emboli.
NARRATOR: But in Ellen's case, doctors had no reason to suspect pulmonary embolism,
and hence, didn't run any of the potentially lifesaving tests. As a result, her condition goes undiagnosed.
And by the next morning, her symptoms have diminished, just enough to provide a false impression of recovery.
She had breakfast. She was in good spirits. She wanted to go to work. NARRATOR: But moments after Ellen boards the bus,
her condition takes a catastrophic turn, when several massive pieces of the clot
break off and travel to her lungs. They look like worms. They look like-- they can be as big as your finger.
NARRATOR: Swept along in the blood stream, these larger clots bombard the arteries
that connect the heart and lungs, until eventually they get stuck. It just clogs the plumbing.
It clogs the big pipes going into her lung. No blood ends up going into her lungs.
No blood's getting back to her heart either. She's not getting enough blood to her brain.
So in the process of dying, she has a seizure. And by the time she gets to the emergency room, she's dead.
And it's just really a shame that it slipped through the cracks in the emergency room.
It just wasn't on their radar. NARRATOR: Unfortunately, Dr. G will never know what caused these deadly cloths to form
in the first place, because Ellen didn't have any of the common risk factors for pulmonary embolism.
We don't have any history of mobility. Works as a maid, she's walking around. She's certainly not pregnant.
She's not on any kind of estrogen. She hasn't had any kind of long trip. It could certainly be one of the congenital abnormalities,
where she has a problem with some over the proteins that help clot the blood. Some people, their blood becomes hypercoagulate,
more apt to clot. So why her system got out of whack, of the clotting, and the unclotting, and keeping it balanced,
the balance that we all have, why her's got out of whack, we'll never know. [MUSIC PLAYING]
NARRATOR: A few weeks later, toxicology results arrive and confirm that drugs had nothing
to do with Ellen's death. With the case finally closed, Dr. G can now deliver her findings directly
to Ellen's sister, Deborah. Well, what we found is-- I think her sister was surprised.
She was really blaming the group home for not monitoring her medication. And the other interesting thing we found--
But I don't think the group home is responsible. --we'll take it out of that-- And I suggested for her to watch out for blood clots too.
Since her sister was at a young age-- 36-- to die from that, and so that might be something that she should look out for.
All right, bye-bye. [MUSIC PLAYING] (SINGING) Farewell, but soon I'll have to go.
You know, your life is on such a balance, isn't it? [MUSIC PLAYING] (SINGING) --but you are what I'll miss the most.
It's just that slight imbalance caused just that cascade of events that caused her death.
[MUSIC PLAYING] (SINGING) --will get me through. I mean we're just all so lucky to be alive because there's so
many things that can go wrong. [MUSIC PLAYING]

When an infant dies under mysterious circumstances, the young parents are prime suspects. Dr. G discovers several clues that bolster the child abuse theory, but the case is not clear cut.

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

Brief Summary

Dr. G investigates the deaths of a baby from a congenital defect and a woman from misdiagnosed pulmonary emboli.

Key points

The Tragic Case of Carlos Lopez. A four-month-old baby dies unexpectedly, leading to a shocking autopsy revelation.
The Discovery of a Birth Defect. Dr. G uncovers a congenital issue that led to Carlos' tragic death.
Ellen's Mysterious Death. Ellen Walters dies suddenly, leading to an investigation into her medical history and care.
The Shocking Autopsy Findings. Dr. G discovers unexpected issues during Ellen's autopsy that suggest a serious underlying condition.
The Cause of Death Revealed. Toxicology results show drugs weren't a factor, leading to a shocking conclusion about Ellen's death.

Episode highlights

Episode quotes

The parents... were just absolutely floored that they have a baby that died.

Dr. G describes the reaction of Carlos' parents.

3:59WatchJun 17, 2021

Tension

75/ 100High tension

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