Dr. G: Medical Examiner - Season 5, Episode 9 - Deadly Remedies - Full Episode | Forensic Files

[OMINOUS TONE PLAYING] [MUSIC PLAYING] NARRATOR: A healthy 10-year-old boy is found
dead on his bedroom floor. It was so sad. Oh my goodness, how could this happen?
NARRATOR: But as questions multiply, it quickly turns into a case unlike any Dr.
G has ever faced. DR. G: It's really opened my eyes. I just can't forget it. NARRATOR: Then, a young girl is struck by lightning,
and tragically does not survive. And then the doctor is telling me this is it. You know, I'm sorry Mrs. Chappelle,
Erica's no longer with us. NARRATOR: And suddenly, Dr. G must make a potentially
life saving decision. That's one of the calls we get in the middle of the night:
if you deny those organs, you know, people may die. [MUSIC PLAYING] NARRATOR: Altered lives, baffling medical mysteries,
shocking revelations, these are the everyday cases of Dr. G, medical examiner. [MUSIC PLAYING]
69-year-old, history of heart disease, let's see-- NARRATOR: As chief medical examiner of the District 9
morgue in Orlando, Dr. Jan Garavaglia's days are usually jam packed. This is going to be a mess.
NARRATOR: But if there's one thing she'll always make time for, its consultations with fellow medical examiners,
like her good friend Norma Jean Farley. And it's face down, and it's a strangulation.
Dr. Farley and I practice in different states, but oftentimes, when either one of us
wants to bounce off ideas about a case, we'll just both pick up the phone, and drop what we're doing, and talk to each other.
We-- we think very much alike. I really value her judgment, and she's an excellent pathologist.
NARRATOR: They first met in the 1990s, at the Bexar County medical examiner's office in San Antonio, Texas.
Back then, Dr. Farley was a pathology fellow, working under Dr. G's guidance. During the fellowship, Dr. G was one of my mentors.
I would often consult Dr. G about cases that I may have had in the morgue, any questions or anything I wasn't sure about.
NARRATOR: And in the winter of 1999, Dr. Farley sought Dr. G's advice on a case that
seemed impossible to crack. --at this point. NARRATOR: Little did either know, it would soon become one of the most
confounding and emotionally charged cases of both pathologists' careers. I was just involved somewhat peripherally,
but I just can't forget it. It was a child, and it was so sad and so unexpected,
that it's just never left me. NARRATOR: September, 1999. Danny Evans is 10 years old and living with his parents
in San Antonio, Texas. Like a lot of kids his age, he loves sports and video games,
but he also has a passion for music. In fact, he spent much of the past summer teaching himself
to play electric guitar. This is a happy, happy go lucky child with a nice family.
NARRATOR: But as the school year gets underway, parents Katie and Tom begin to notice a troubling change
in Danny's behavior. He wasn't his normal self. He's a little too hyper, and he was having
a hard time in school sitting still, focusing, and concentrating. NARRATOR: Determined to get a better handle on the problem,
Danny's parents arranged for a consultation with his pediatrician. What they discover next changes their lives forever.
They finally got him diagnosed, and he had ADHD, attention deficit hyperactivity disorder.
And there's certainly different variations of that, but it's basically that these children
have a hard time focusing and concentrating, and are very hyperactive. NARRATOR: The doctor prescribes Ritalin, a drug commonly
used to treat ADHD. The effect on Danny is dramatic. He was finally given the proper medication,
and, I mean, he reached his potential. He was just a go getter, always adventurous.
And, from my understanding, he wanted to be a doctor. And they were just so excited.
DR. G: He went from a special ed kid to a gifted and talented student. So the family was very happy about his progress
with the medication that he was taking. NARRATOR: But their happiness is short lived.
Only three months after his diagnosis, the unthinkable happens. It's a chilly Monday morning and Danny's
running late for school, again. His parents assume he's overslept as usual. But stepping into his bedroom, Katie is startled to find
Danny crumpled on the floor. He wasn't breathing, and he was cold to the touch. They immediately called 911.
NARRATOR: Paramedics arrive within minutes, but they only confirm Katie and Tom's worst fear.
DR. NORMA JEAN FARLEY: They did try CPR, because with children we want to try so hard, you know,
to resuscitate them and bring them back. But it was unsuccessful. No, actually, I don't have an address.
I-- NARRATOR: Medical investigator Steve Hansen, who is also working in Texas at the time,
moves quickly to gather as much information as possible about Danny. This was a tragedy.
And I mean, everybody was upset about this. Here's a kid that should be OK, and he died basically
a sudden, unexpected death. DR. G: He's 10 years old when he died. That's a very uncommon age to come into the morgue.
NARRATOR: Danny's case promises to be tough. But when his body arrives at the morgue,
Dr. Farley, on a one year fellowship at the time, volunteers to do the autopsy. As a fellow, I always try to be
in on the most difficult and interesting cases. NARRATOR: Now, as she pores over Danny's medical history,
one detail catches her eye. Looking at the investigative report, I saw the child was taking Ritalin, or methylphenidate,
for his ADHD. NARRATOR: Both Ritalin and its generic version, methylphenidate, are widely used and considered very safe.
As she continues reading Danny's medical history, she discovers an alarming piece of information.
The child had asthma. Asthma as a chronic, lifelong lung disease. Usually a person can live with the chronic part
of the disease, they may have some coughing, but when they have an acute asthma attack,
then that's when it becomes life threatening. The airways constrict, and they get inflamed, and you--
you have a hard time breathing. It can kill you, especially if you don't have a fast acting inhaler near you at the time
of your asthma attack. NARRATOR: But Dr. Farley must also explore the ultimate tragic scenario:
that Danny's untimely death involved no disease at all. You know, we have a child that's dead.
And the sad truth of it is, child abuse is still present in our society. DR. NORMA JEAN FARLEY: Even the happiest family
might be hiding dark secrets. And in our field, we really know this. NARRATOR: As a mother of three children herself,
Dr. Farley understands all too well that the stakes are high, and the answers may be grim.
But I don't let my emotions get in the way. In the end, the family has to be held accountable
if we find something. [MUSIC PLAYING] MAN: [INAUDIBLE] I think we're ready to go.
We look very closely at the outside of the body. We look for any injuries to the body at that point,
and we also look for scars. DR. G: We're going to look for subtle marks, because those marks might help us determine how he was hit,
and what he was hit with. Is there anything that can give us a clue of what happened.
NARRATOR: But soon, a subtle injury catches Dr. Farley's eye. Got a small, blue contusion here on the right chest,
right at the nipple. OK, I got 1.5 centimeters. I wasn't very worried about it. This was a very small contusion, and it really wasn't
suggestive of any foul play. That could just be from cardiopulmonary resuscitation
where they had EKG pads. Looks like they gave him quite a bit of fluids when they
were trying to resuscitate him. Hmm. No other injuries neither to the abdomen or chest.
NARRATOR: But after scouring Danny's body for any hint of injury, Dr. Farley comes up empty handed.
He looked like a well developed, well nourished 10-year-old, and the external really
didn't give us any hints. NARRATOR: Still, if there's one thing Dr. G and her team know,
it's that physical abuse can leave surprisingly little evidence. I will tell you that I've worked many cases where there
is not a mark on the child, and until the autopsy is done, you don't know that the physical trauma is there.
DR. NORMA JEAN FARLEY: Everybody ready? We must rule out child abuse, we must rule out that something
happened to this child. [MUSIC PLAYING] [OMINOUS TONE PLAYING] NARRATOR: At the Bexar County morgue in Texas,
forensic pathology fellow Dr. Norma Jean Farley is determined to find out what, or who,
killed 10-year-old Danny Evans. The police investigating this mysterious surroundings
of the death started suspecting the parents, which were the last people to have seen him.
The parents were in a state of shock. Couldn't even believe that they were actual suspects in this,
you know, the death of their son. It was a nightmare for them. NARRATOR: But when it comes to the unexpected death
of a child, the forensic team has no choice but to explore even the darkest scenarios.
The worst thing we can do is to assume things. We ask what seem to be an awful lot of stupid, basic questions,
but-- but they turn out not to be. Because these are the basic questions that we--
we really need to ask. You really have to finish the internal examination to rule out foul play.
I've been fooled before. [MUSIC PLAYING] So, we start with a y-shaped incision, which
comes across the chest in a v, and then a single line down to the pelvic region.
I'm going to make a few cuts in the soft tissue, just make sure there's no contusions that we're not seeing,
little bruises that might be hiding. But I didn't see any soft tissue injury at all in this child.
There's no blood in any of the cavities, there's no rib fractures that we can see.
So right now, I'm not seeing anything that worries me that this is trauma. NARRATOR: To completely rule out foul play as a cause of death,
Dr. Farley still needs to examine Danny's head for injuries to his skull and brain.
But for now, she continues her inspection of his internal organs, looking for any sign
of natural disease. DR. NORMA JEAN FARLEY: I want to stay focused on the organs of the chest.
And I was very anxious to do this, because I wanted to take a look at the lungs,
since one of the main clinical clues was the fact that this child had asthma. NARRATOR: Upon opening the chest plate,
Dr. Farley gets her first good look at Danny's lungs. Really, these-- these lungs are
deep within the chest cavity. They feel like they're a little bit heavy, but they're not overexpanded at all.
Not what we typically would expect in a-- an acute asthma attack. So maybe the fact that they were doing CPR
would push some of that air out of the lungs. NARRATOR: If that's the case, asthma
still may be the culprit. To find out, she now extracts the lungs to examine Danny's bronchi, the airway passages
that extend through the organ. DR. G: With asthma, you produce a overabundance of mucus.
You get a lot of mucus mixed with some eosinophils or inflammatory cells. And they plug up all those bronchi,
so you can see that they weren't able to exchange air. NARRATOR: She dissects the organ, inspecting every slice
for mucus plugs that could have robbed him of oxygen. But the search is difficult.
Oh, well, the bronchi do car-- they have a little bit of a green tinge to mucus.
And that's pretty much all I found. Hmm. There really wasn't a lot. There was a little mucus there, but it wasn't
like there was a plug of mucus. Again, I had to remember though, this child had CPR.
And so could some of that mucus been moved out of these smaller airways during the time they
were trying to resuscitate him? So basically, we can't rule in or rule out asthma at this point.
What I'm going to have to do is take microscopic sections of the lungs, and multiple sections in different areas,
and see if I can prove this acute asthma by the microscopic examination of the tissue.
Keep a little bit of this. So maybe microscopics will give us something on this one.
NARRATOR: Dr. Farley prepares the lung samples to send out to a lab, where they'll be chemically
treated, mounted onto slides, and stained for her examination. But the process will take at least a week.
In the meantime, she still has a long way to go on Danny's autopsy. And next up is the heart.
Well, the heart looks normal within the sac. Doesn't look too big. Just to make sure, I'm going to go ahead and take the heart out
to make sure that there's no anomalies to the heart or the great vessels. NARRATOR: Carefully, she removes Danny's
heart from his chest cavity. And as she turns the organ over in her hand, she makes a discovery that's completely unexpected.
DR. NORMA JEAN FARLEY: Hmm. There were some small contusions, little tiny bruises or areas of hemorrhage,
on the surface of the heart. Could be the cause of death of this child. [OMINOUS TONE PLAYING]
NARRATOR: The baffling case of Danny Evans is putting Dr. Farley to the test. So far, she's uncovered two possible causes of death:
an acute asthma attack and foul play. But now, as she inspects the heart, she finds evidence of a third possible killer.
Ah, now right here on the front of the heart, there are scattered little contusions here.
See? It's-- Some tiny ones there, like a myocarditis. Myocarditis is an inflammation of the heart itself,
the tissue in the heart. And it's usually caused by some type of infection, especially
a viral type infection. And so this inflammatory process actually injures and starts eating away at the heart,
and can result in fatal cardiac arrhythmias. That could definitely cause death in a kid this age.
NARRATOR: The symptoms of myocarditis can resemble the flu, with fatigue, fever, and a sore throat.
Oddly, this fits with a minor detail in Danny's medical history. About two weeks before his death,
he was diagnosed with a case of the flu. But if myocarditis is the true culprit,
she can only prove it under the microscope. So I typically put five pieces in different locations.
One more from here. All right. NARRATOR: These samples will go to the lab, along with Danny's
lung tissue, and return as microscopic slides in several days. Only then can Dr. Farley determine
if the young boy died of asthma, myocarditis, or even something else. But the autopsy is still not over.
She has one place left to look for evidence of foul play: Danny's head. We start this, of course, by reflecting the scalp,
and looking, again, for any soft tissue hemorrhages that may not have made it to the skin surface.
And there weren't any. We also look at the skull itself. All right. And no skull fractures.
You see the suture lines, because this is a child, and his head's still growing.
So they're all open, but no fractures at all. Totally clean. And there's no blood here, so there's
no signs of any kind of trauma. I continued, and we removed the brain as well, and I didn't see any abnormalities to the brain.
There was no evidence of any type of meningitis, or inflammation to the membrane around the brain.
The brain is totally normal at this point. We're not finding anything unusual. NARRATOR: With the cranial exam complete,
the entire autopsy comes to a close. And looking back, only one thing is clear to Dr. Farley.
I have now totally ruled out foul play, which I will relate to the investigative officer
on the case. [MUSIC PLAYING] NARRATOR: But for Danny's parents, being proved innocent of child abuse
is small relief, compared to the agony of losing their only son. They were just in a state of confusion.
They wanted to find out what happened. I was hoping with a microscopic examination,
I would be able to give the family some type of answer, some type of closure. NARRATOR: A long week after Danny's autopsy,
Dr. Farley gets the microscopic slides back from the lab. So I do have two possibilities at this point: asthma,
or it may be some type of inflammatory process in the heart itself that caused a fatal, abnormal arrhythmia
that caused the child to die. OK. I began by looking at the heart, and looking for the inflammation that I was hoping
would be there and prove myocarditis. And I didn't see this. Hmm. And the heart looked totally healthy and normal.
NARRATOR: Dr. Farley now knows that myocarditis did not cause his death. She immediately looks at another slide, this time
of Danny's lung tissue. Mostly what I'm looking for is increased numbers of white blood cells, especially eosinophils, which
is a type of white blood cell that we often see and associate with asthma. NARRATOR: Asthma is similar to allergies
in that an attack triggers a flood of inflammatory white blood cells. If Danny died from an acute asthma attack,
she would find a large number of inflammatory cells, specifically eosinophils, saturating his lung tissue.
Slowly, she turns the dial, bringing every cell into sharp focus. And I did see some inflammation, mild to moderate
chronic inflammatory cells. NARRATOR: Danny Evans clearly had asthma, but Dr. Farley isn't certain if her findings prove he
suffered a fatal asthma attack. I then went through the other tissues, looked at the liver,
looked at the kidney, looked at the adrenal glands, the pancreas. I didn't see anything wrong with any of those tissues.
I then went to the brain, and looked at the brain, thinking, you know, maybe I didn't see a subtle meningitis.
But there was nothing wrong with the sections of the brain, either. So after the microscopic examinations,
I'm still at a dead end. I may never have the answers for this boy's family. [OMINOUS TONE PLAYING]
I just dictated this case, could you download it for me? And let me know when it gets back, OK?
Sure. Thanks. NARRATOR: At the Bexar County morgue in Texas, Dr. Farley has hit a brick wall in her search for what
killed 10-year-old Danny Evans. After the microscopic examinations, I still don't have a cause of death in this child.
NARRATOR: Weighing heavily on her mind are Danny's parents, Katie and Tom, whose anguish is growing each day as they wait for answers.
They just couldn't take the pressure. It was a emotional strain on them of just unbelievable proportions.
NARRATOR: For their sake, and as a professional, giving up is not an option. Only twice since I've been a forensic pathologist
I've had to say this-- a death was undetermined, and I really don't like to do that.
NARRATOR: She did find hints of asthma in Danny's lung tissue, which leaves the possibility, however slim, that asthma caused his death.
But as Dr. G's pathology fellow, she knows when it's time to get a second expert opinion.
So at this point I decided to go up to Dr. G's office and have her just quickly take a look at the slides,
and in particularly the lung slides, and just make sure I wasn't missing anything in my diagnosis.
At the time of this case, she's clearly the fellow, I'm clearly the staff, and I have to help teach her.
But it was more than that, because we had hit it off. I think we just had a mutual like of each other,
and whenever she had a question, she- she would-- she'd often come to me. With Dr. G, I always felt comfortable that I
wasn't interrupting something. She always made time to discuss the cases with me.
She was kind of on the fence whether it was enough asthma or not, because she really wanted
to give the family the answer. It was getting close to Christmas, she really wanted to just put this to rest
and have some closure for the family. NARRATOR: Now Dr. G carefully scans Danny's lung tissue
for inflammatory cells and diffuse bronchial plugging, which indicate an acute asthma attack.
I really wanted her to be able to find the acute asthma I didn't see on those slides.
But when I looked at the slides, there wasn't-- there wasn't near enough acute changes.
So, unfortunately, I had to tell her that she just did not have enough on that slide under the microscope
to say that's his cause of death. It-- clearly, his cause of death was not asthma.
NARRATOR: Doctor G's analysis is a huge blow to Dr. Farley, and she's beginning to fear she may never find
closure for Danny's parents. And I'm wondering where else I can go. NARRATOR: But then, Dr. G offers one last ray of hope.
What she told me was, Norma, wait for the toxicology, it could have all the answers.
NARRATOR: The chances are extremely small. But there is the slight possibility that a large overdose of Ritalin could have triggered
a fatal arrhythmia, a cause of death that would have been impossible to detect in autopsy.
[MUSIC PLAYING] Unfortunately, toxicology at that time took about three months to come back,
so it meant that the family was going to have to wait before I'd have that result.
It was hard on the family. They were just overwhelmed with the whole process. I mean, the mother was in really bad shape.
But, we want the right answer, not the fast answer. I just want to give them some type of closure.
So now I'm even more anxious to get these toxicology results back. NARRATOR: A grueling month goes by, followed by another.
Finally, on a cloudy Friday afternoon in March, the toxicology report on Danny Evans arrives.
Finally, I get the toxicology results and I'm very anxious to see if there's anything that could help me determine the cause of death.
And I'm expecting to see Ritalin, because the child is on this for the attention
deficit hyperactive disorder. But when the tox came back, it was a surprise to us all.
It was a shock. [MUSIC PLAYING] [OMINOUS TONE PLAYING] NARRATOR: At the Bexar County morgue in Texas,
a bomb shell has just been dropped on the case of 10-year-old Danny Evans. This was a child with ADHD, who was on Ritalin.
And so I'm expecting to see Ritalin in these toxicology results. But, when we got the tox back, it
was a shock, because the toxicology showed no Ritalin whatsoever. DR. NORMA JEAN FARLEY: Instead, I find
a drug I'm not even expecting. I'm finding the drug methadone. NARRATOR: Methadone is a powerful central nervous system
depressant, a synthetic drug strictly monitored by the FDA. It's almost inconceivable that the 10-year-old would have
access to it, because the drug's primary use is to treat heroin addiction and chronic severe pain.
But Dr. Farley is startled to find he not only had methadone in his system, he'd ingested a huge amount.
The methadone level in this child was 0.44 milligrams per liter. That's not only lethal in a child,
but that's lethal in an adult. So at this point, I do have a cause of death: it's an acute methadone
intoxication. NARRATOR: Her discovery sends shock waves through the morgue, and immediately sparks a barrage of questions.
How did he get the methadone? What could possibly be the ways this child could have gotten methadone?
Is he trading his Ritalin, which is a stimulant, for the methadone, which is more
of a downer or a depressant? You know, it's-- it's certainly-- methadone is certainly becoming a very common drug of abuse.
But we mostly see it in teenagers, I've never seen it in one so young. 10 years old is pretty young to be using
methadone as a drug of abuse. But maybe he didn't know what he was trading his Ritalin for.
Or is there someone in the family, the mother or the father, maybe on the medication?
NARRATOR: Dr. Farley and Dr. G call the entire investigative team back into action,
launching an exhaustive search for the origin of the dangerous pills that killed Danny.
All of a sudden, we get a call saying, we need to go back and we need to find out why this kid had methadone.
Go back to the family and see if anybody in the family was on methadone. And there was no one.
Go back to the school and see, what kind of student was this child, was he drug seeking in any ways.
DR. G: But he's not the type of kid. Everybody at school is baffled, and his family's baffled.
Nobody seems to know. DR. NORMA JEAN FARLEY: So, and then I started thinking, where
else would he get methadone? Well, you know, one of the things we finally thought about
is, well, how about those pills that he is supposed to be taking, has anybody checked those?
NARRATOR: Danny's bottle of prescribed Ritalin had been brought to the morgue with his body,
and left untouched ever since. Looking at the label on the bottle, I noticed right away that the name is correct,
but instead of Ritalin, which is what I was told he was on, which is a brand name,
he was on the generic. And that generic was methylphenidate. NARRATOR: Ritalin and methylphenidate,
both drugs are identical. And it's common for doctors to allow a brand name prescription to be filled with the cheaper
generic counterpart. But in this case, Dr. Farley has a strong hunch that this seemingly benign switch
triggered a deadly mix up. If she's right, she'll be able to close the three-month-old case for good, and replay for Danny's
parents the exact chain of events that led to his tragic death. It's 6 PM on a Tuesday, time for Danny to take
his evening dose of Ritalin. Over the past few months, the medication has transformed
his struggle with ADHD. After being properly diagnosed and given the proper medication, he went from being
in special ed classes to being an honor roll student. A gifted and talented little boy.
NARRATOR: His parents, Katie and Tom, couldn't be happier. But recently, they've been dealing with an entirely
new health concern. He was not himself. He was always drowsy, and he would start getting the cold sweats.
NARRATOR: Alarmed by these new and perplexing symptoms, they take Danny to the doctor.
He reassures them that it's only the flu. But the diagnosis couldn't be more wrong.
Unbeknownst to anyone, Danny is actually feeling the effects of a powerful narcotic--
methadone. And Dr. Farley think she knows how it got into his system. She immediately heads to the poison control office
with the contents of the pill bottle. I pass the pill over to the poison control,
and within about 15 minutes, they were able to tell me what the medication was, and it was methadone.
The methadone had been filled, most likely, incorrectly at the pharmacy. I could see how it might happen, methylphenidate,
methadone, both Ms, maybe sitting by each other on the shelf. And inadvertently you pick up the wrong one,
and you fill it in the prescription bottle. When they refilled his prescription three weeks
before he died, they had switched it from the brand name to the generic of methylphenidate.
And the person who filled that prescription inadvertently gave him methadone instead of methylphenidate.
Now, the family didn't pick up on the fact that it was a different-appearing pill,
because they just thought, well, this is the generic, it's a different shaped pill, a different color pill,
as it often is. And the depressant effect of methadone started almost immediately.
DR. NORMA JEAN FARLEY: He's drowsy, they can't wake him up, he seems always tired.
NARRATOR: The symptoms grow worse each day, because methadone has what's known as a long half life.
And basically, a half life just means the time it takes to get half of the drug that you've ingested out of your system.
So the more he takes, the more methadone he's accumulating in his system. NARRATOR: Frightened by his worsening condition,
Danny's parents rush him to the ER. But again, an opportunity to identify this tragic mistake
falls through the cracks. DR. NORMA JEAN FARLEY: They even do a urine drug screen.
But most likely, the urine drug screen that they preformed only looked for five or six different medications.
DR. G: It's totally different in forensics. The drug tests we do are confirmatory,
and they're the gold standard, and they're done in your blood. The drug screen that you get in the emergency room
is very limited. It's only designed to pick up the common drugs of abuse. And methadone has to be looked at and asked for specifically.
And in this case, the drug screen panel did not pick up methadone. In the meantime, Katie and Tom continue
to follow the advice of Danny's doctor, cutting the medication to half the original dose.
But, you know, he's been on methadone now almost a month, so it's accumulating in his system
this whole time. And on this night, it becomes too much for his small body, and he has too high of a level of methadone.
He's breathing slower and slower, until he stops breathing, and dies. [AMBULANCE SIREN]
NARRATOR: Dr. Farley has put together almost all the pieces, except one. She calls the Texas State Board of Pharmacies
to confirm this tragic chain of events. DR. NORMA JEAN FARLEY: Methadone and methylphenidate
are both controlled substances. So we kind of keep a good eye on them. In fact, they do counts on this type of medication
to make sure no one's abusing the medications. In this case, we did find out that they were short
on the methadone the exact number that they prescribed to this child. So it was clearly a pharmacy error.
Although they didn't do it on purpose, they mixed up the name of methadone and methylphenidate.
Just a-- just a really bad, unfortunate circumstance. Nobody wanted this to happen.
NARRATOR: The State Board issues a fine and suspension, and the case is settled out of court with the family.
But to the pharmacists, it isn't about the money. Oh, it's sad. You know, it was just a small mom and pop type of pharmacy,
they'd been in business for, you know, 40 years. And he was devastated that his business
caused the death of this child. He was grieving just like the-- you know, the family was grieving.
And he lost his business. He-- he sold it. NARRATOR: For Danny's parents, the wounds cut even deeper.
DR. G: Although the family was angry that these mistakes were made, the pharmacy mix-up, the fact that it wasn't picked up
on the drug screen, the fact that no doctor could figure out what was going on, ultimately they were very upset
that what caused his death was what they were giving him to take. It was through their hands that what
they gave him caused his death. Each one of those pills had been cut in half, just
as the parents were told to. They were following the directions given to them by the doctor.
They wanted to do right. And by continually giving those pills that they thought he
needed, they were killing him. [DOOR OPENS] NARRATOR: The impact of Danny's death
runs deep for both Dr. G and Dr. Farley. This is one of those cases you walk away from
and you take with you the rest of your life. When my children get prescriptions now, or my husband, or myself, I actually do look at the pills.
I usually do it on every medication that we get in the family, from-- just because of this case.
DR. G: I've been a medical examiner for over 20 years. I've worked on thousands of cases, well over 6,000.
Why this case stands out, why this case is one that I can't forget, is that it was a surprising ending to me,
and a tragic involvement of the mother who loved him so much. I'm a mom, and you want to do nothing
but good for your children. [MUSIC PLAYING] NARRATOR: The loss of a child is always tragic.
But Dr. G's next case gives her an opportunity to turn tragedy into hope. It's a beautiful case of a tragedy
that this family was able to turn around into something very positive for other people.
[OMINOUS TONE PLAYING] [MUSIC PLAYING] NARRATOR: In her career as a medical examiner,
Dr. G encounters astonishing stories every day. And many of these stories stay with her forever.
This case actually very much stands out my memory, because, you know, this shows you
how our lives turn on a dime, and how precious life is, how fast it can be taken away from us.
[MUSIC PLAYING] NARRATOR: It's August 25, 2004, and fourth grader Erica Chappelle is on her way home from school.
Erica Chappelle was just a healthy, beautiful 10-year-old girl that was having an ordinary day.
NARRATOR: Her mother Bianca still remembers the rainy afternoon as if it were yesterday.
Erica and three other children had gotten off of the school bus. And my daughter Erica was taller than the rest
of the kids in her class. And so she asked them, could she hold the umbrella and everybody come under the umbrella with her.
They heard a crack. [THUNDER STRIKES] She directly got struck by lightning. NARRATOR: Rescue workers arrived just
minutes later to find that Erica has no pulse and is not breathing. CPR is done on her for about 20 minutes
before her heart rate returns, but unfortunately, during that time her brain wasn't getting enough oxygen.
NARRATOR: When Erica arrives at the hospital, she's in a coma. Her chances of survival are slim,
but doctors refuse to give up hope. BIANCA CHAPPELLE: They were trying to regulate her vitals
and figure out how-- where we were going to go from there. Really didn't have a lot of answers,
other than keeping her stable, monitoring her heartbeat, and her respiratory, and all of that.
[MUSIC PLAYING] NARRATOR: Hours pass, then a day, then two. Still, Erica shows no sign of improvement.
To see your child in that kind of state and feel so helpless, you know, not knowing what I was-- what the outcome.
I just didn't really know how to act, other than the fact that I knew I needed to be strong for Erica,
and I needed to be strong for my family. [MUSIC PLAYING] On the third day was when they came to us and said,
we have a test that we have to run on her. And after that we'll be able to tell you whether or not
she's brain dead. It was on August the 28th when the doctor ran the last test. And then the doctor is telling me, this is it.
You know, I'm sorry, Mrs. Chappelle, Erica is no longer with us. NARRATOR: Devastated at their loss, Bianca Chappelle
and her husband are now confronted with one of the biggest decisions of their lives.
They came to us within probably 30 minutes of her passing, and they told me her organs could be donated.
That part was hard. But my husband and I, at that moment, together, looked at each other and went, yeah.
We think that that is going to be a wonderful legacy to her, to save someone else's life.
NARRATOR: But before Erica's organs can be donated, the organ procurement agency must get approval
from one more person: Dr. G. [MUSIC PLAYING] They have to call my office, because she
is an unnatural death, it's a traumatic death, an accidental death, and I have to investigate that death.
NARRATOR: She must decide if she can perform a successful investigation without many
of Erica's vital organs. It's an urgent situation, and every second counts. With Erica's case, we have to make a quick decision,
so they can quickly get her into an operating room and recover the organs before they're damaged any further.
NARRATOR: She quickly runs through all the information she has: hospital records, police reports, and accounts
from her medical investigators. There didn't seem to be any question about why she died.
It was witnessed, she'd already had a CAT scan of her brain, so there was really no questions left.
NARRATOR: Dr. G is always eager to help save a life by facilitating organ donation.
Occasionally, we have to put restrictions on it. We may not let them open up the chest, let's say,
because that's where the injuries are. We may not want them to open up the abdominal cavity.
A couple of times I've had to restrict them from not taking the heart for heart valves, and restrict
them not to take the skin, because I need to look at the bruises. So I will occasionally have to put restrictions on them, if it
looks like there's foul play involved that I am still trying to figure out what happened.
NARRATOR: This time, the decision is easy. Once the hospital gets the official sign off from Dr. G,
the usable organs and tissues are removed from Erica's body, and she's transferred to the District 9 morgue.
[MUSIC PLAYING] She has an incision all the way down her chest and her abdomen, which they
made to get her organs out. But when I see her, she's still a beautiful young girl.
Pretty, dark brown eyes. She still has clear injuries and burns from the lightning.
46. NARRATOR: And she anticipated, Dr. G is able to quickly confirm Erica's cause of death.
It's clear she was a victim of a lightning injury. The way people die from lightning
is usually an electrical event. It harms the nervous system, and guess what keeps your heart pumping?
It's that electrical component of the heart, and so when that electricity splash comes over you,
it can stop your heart. It was a cardiac arrest, and her brain didn't get enough oxygen.
DR. G: [INAUDIBLE] NARRATOR: Dr. G's brief autopsy is now complete. She records the cause of death as cardiac arrest as a result
of lightning strike. But Erica's story is far from over. They were able to use kid--
kidneys, liver, that the valves of her heart were able to be used, that the corneas of her eyes
were able to be used. So she saved three lives. We got a letter from a 17-year-old girl who
lives in Tallahassee who said that she had received Erica's kidney, and if she had not gotten Erica's kidney,
she would have died. And she told us that she loved us, and that she was my daughter because she had
a part of my daughter in her. And that just really, really-- it-- it made it all worth the while.
Erika was a person who I know all through her life loved people. She always had the attitude where she wanted to help.
So that's basically what keeps me going. [WATER RUNNING] NARRATOR: To this day, the strength
of the Chappelle family is a continuous source of inspiration for Dr. G. You know, donating organs of a loved one
is a very personal decision. And it takes a really special family, really special people,
to turn their own grief and tragedy around to try to help somebody else. [MUSIC PLAYING]
(SINGING) Though you're desperate to the believe [INAUDIBLE] ANNOUNCER: (WHISPERED) Atlas.

Dr. G must decide if she can perform a successful autopsy without the deceased's organs. As she ponders the decision, we are given a rare glimpse into a different side of Dr. G’s job.

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

Brief Summary

Danny Evans dies from a medication mix-up; Erica Chappelle's organs save lives after a lightning strike.

Key points

A Tragic Discovery. A 10-year-old boy is found dead in his bedroom, leaving his family devastated.
A Life-Saving Decision. Dr. G faces a critical choice regarding organ donation after a young girl's tragic death.
The Mystery of Danny Evans. Dr. Farley investigates the sudden death of Danny Evans, a seemingly healthy child.
Unraveling the Cause. Dr. Farley discovers possible causes of death, including asthma and myocarditis.
Toxicology Report Shock. The toxicology report reveals no Ritalin, but a lethal amount of methadone instead.
A Tragic Pharmacy Error. A mix-up at the pharmacy led to a child's death, devastating the family.

Episode highlights

Episode quotes

I just can't forget it.

0:38WatchJun 15, 2021

Tension

85/ 100High tension

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