Dr. G: Medical Examiner - Season 6, Episode 3 - Deadly Decent - Full Episode | Forensic Files

[MUSIC PLAYING] NARRATOR: When a routine flight turns deadly, Dr. G is faced with a gruesome challenge.
It's not pretty when you hit the ground at a high rate of speed. NARRATOR: And as the autopsy unfolds,
she begins to wonder if the pilot could have made a deadly mistake. I was a little surprised.
That's probably two things that pilots shouldn't be doing. NARRATOR: Then, a woman is found dead in her home
down in a pool of blood. This could be foul play. NARRATOR: And it looks like the person closest to the victim
could be the chief suspect. The detectives suspect this is a domestic, violent homicide.
[MUSIC PLAYING] NARRATOR: Altered lives, baffling medical mysteries, shocking revelations.
These are the everyday cases of Dr. G, medical examiner. [MUSIC PLAYING] Throughout her 20 year career, Chief Medical Examiner Dr. Jan
Garavaglia has seen her fair share of unusual accidents, from car wrecks and boating deaths,
to train fatalities and even the occasional plane crash. It's probably about every other year, every couple
of years, that a plane crash death will come through your morgue. NARRATOR: And while each accidental death presents
its own unique set of challenges, plane crashes can prove to be especially difficult.
I have had some devastating plane crash, where a plane goes into the side of the mountain
at a high rate of speed. The people are in pieces, and your skin is inside out. I mean, they can be devastating.
NARRATOR: One such case occurred in August 1995, while Dr. G was working at the Bexar County
morgue in San Antonio, Texas. We have a 49-year-old Hispanic male from rural West Texas.
And he was flying an airplane, and nobody knows what happened. It crashed and burned, and that's about as far as we know.
[MUSIC PLAYING] NARRATOR: It's just before 4:00 PM on Thursday afternoon when someone reports a grass fire to the Upton
County Fire Department. [SIRENS] So the volunteer fire department goes out there,
and lo and behold, it's not a grass fire. It's a plane crash. NARRATOR: Firefighters scramble to extinguish
the burning wreckage. And inside, they find the pilot's severely charred body. They quickly ID him as 49-year-old Richard Garcia,
and immediately begin searching the area for clues. Nobody witnessed this plane go down.
NARRATOR: Following standard operating procedure, the fire department turns the investigation
over to the NTSB, or the National Transportation Safety Board. Investigator Hector Casanova is assigned to the case
and his first order of business is to gather more information about this recreational pilot.
The pilot was very experienced. I think he had 14,000, 15,000 hours of total flight time.
So he was extremely familiar. But for some unknown reason, he hits the ground. NARRATOR: Now, it's up to the NTSB
to find out exactly why the plane went down. They're looking, is it something to do with the person?
Is it something to do with machine? Meaning your airplane, or is it something to do with the environment, the weather?
NARRATOR: And is the NTSB prepares to conduct a full inspection of the aircraft,
Richard's body is transferred to the Bexar County morgue, where Dr. G will perform a complete autopsy.
My job is the pilot, that person aspect of the investigation. The NTSB, they want us to give them information
about the pilot that may help them piece together what happened in that cockpit prior to hitting the ground.
Maybe something human has something to do with the accident. But isn't that the way with everything?
How often is it the car that malfunctions, causing the accident? It's usually the person.
OK. So. NARRATOR: As a first step, Dr. g combs through the investigators report, looking for anything that could shed
light on Richard's accident. We know he's married. We know he's 49 years old, Hispanic fellow.
But we don't have direct contact with the family. So we don't know anything about his medical history,
his social history. We don't know anything about him. NARRATOR: Yet despite the lack of background information,
there is one thing that Dr. G does know. By law, all pilots must undergo routine physical exams.
He can be a private pilot. You can be a commercial pilot. Each of them have different medical requirements.
If you are a private pilot, you can be good for one year. NARRATOR: This means that Richard
was given a clean bill of health sometime within the past year. That said, Dr. G still can't rule out the possibility
of a natural death. Just because pilots have to have physicals doesn't mean there's not some silent killer
going on in your body. When we see that, every day in this morgue. They've gone to the doctor.
They've given a clean bill of health. And then they die. NARRATOR: With this in mind, Dr. G
will be on the lookout for any signs of natural disease. I'm worried about a stroke, or maybe a heart attack.
He didn't necessarily have the die of a heart attack. Maybe he's distracted by the severe chest pain.
And that's caused him to lose control of the plane. NARRATOR: Dr. G must also take into consideration
the possibility that Richard's judgment was somehow impaired. We need to know if he's under the influence
of drugs or alcohol. And if that could have affected his decision making. NARRATOR: With a number of theories in hand, and the NTSB
eagerly awaiting the results of the autopsy, Dr. G knows only one thing for sure,
she has her work cut out for her. Many die from blunt impact. Did he have any natural disease that could have contributed?
Was he impaired in some way with drugs or alcohol? So all of those will be that person component.
[MUSIC PLAYING] OK. Let's see. Yeah, let's go for it. Our general appearance is he is intact.
That's the good news. The problem is he is partially charred. He was clearly in a fire.
NARRATOR: The burns and extensive trauma covering Richard's body make him completely unrecognizable.
Because of the condition of the body, we're clearly not going to be able to do a visual ID.
So we're going to try to fingerprint him. Although some of his portions of the hands are burned,
his finger ridges in some of his fingers are still intact. NARRATOR: Dr. G's morgue technician
pulls prints from his undamaged fingers, and sends them off to be analyzed. And it doesn't take long to confirm
that this is indeed the body of 49-year-old Richard Garcia. Dr. G begins with the overwhelming task of
documenting Richard's injuries. He's clearly got trauma. You can see broken extremities that aren't
quite in the right place. His legs and arms aren't going in the right direction.
Oh, gosh. These are broken. His upper arms are fractured. His forearms are fractured.
He's got upper leg fractures. The femurs, lower leg fractures. Fractures by the knees, fractured by the ankles.
His face he's got trauma, a lot of lacerations. His nose is actually kind of torn off.
So a lot of fractures, and dislocation to the bones of the extremities. All right.
NARRATOR: It's a sobering laundry list of injuries, and one that suggests even more extensive trauma on the inside.
If you have broken every single long bone in your body, chances are there's something wrong
with your internal organs, too. NARRATOR: But despite the myriad of burns and fractures,
it's still anyone's guess what actually killed a 49-year-old pilot. And more importantly, why his plane
went down in the first place. So we'll see. You know, we don't know until we open him up.
This is going to be a mess. [MUSIC PLAYING] NARRATOR: The remains of 49-year-old Richard Garcia
have just been pulled from the burning wreckage of a small engine plane. Now, Dr. G is faced with the daunting task
of looking inside the charred and battered body. It's not pretty when you hit the ground
at a high rate of speed. So I don't know exactly what I'm going to find. [MUSIC PLAYING]
Well you know, even though in some areas, the skin is almost completely burnt off,
you'll still do your y incision. I then start looking for trauma, and he had a lot of trauma.
All of his ribs were fractured in the front. All of them were fractured on the side, and all of them
were fractured in the back. NARRATOR: As a first step, Dr. G carefully clears the pieces of broken ribs from Richard's chest cavity.
Then, she surveys the organs in situ. His lungs you have so many lacerations from the edges
of the ribs sticking into him, his pericardial sac is torn open. His heart is multiply lacerated.
Big tears the muscle of the heart. NARRATOR: But while Richard's heart is severely damaged,
Dr. G is still able to collect vital blood for toxicology tests. I certainly will take blood for toxicology.
NARRATOR: She sends the samples off to the lab for a rush analysis. Then turns her attention to Richard's abdominal cavity.
His diaphragm has large tears. See, that's his diaphragm. And his internal organs were just in disarray.
That's not good. NARRATOR: The diaphragm is a thin sheet of muscle that stretches across the bottom of the rib cage,
and separates the organs in the chest cavity from those in the abdominal cavity.
But Richard's torn diaphragm acts as an open door, allowing his abdominal organs to enter his chest cavity.
His spleen is no longer in his abdomen, because it went through the tear in his left pleural cavity.
And that's in multiple pieces. That's a lot of trauma. Part of his bowels are in his left pleural cavity,
where his lung should sit. His abdomen has multiply torn liver. His aorta is torn.
His back is in two pieces, and one's on top of the other. That's not good. His pelvis, believe it or not, doesn't have any fractures.
That was intact. His bowels are contused. NARRATOR: But despite this damage, Dr. G is still able to spot a subtle clue.
He's got some problems here. He had a lot of blood in the soft tissue, a lot of hemorrhage associated with those fractures.
A lot of hemorrhage in the bowels. What it tells me is his heart was beating, and he was alive when he hit the ground.
NARRATOR: This is a critical finding. It confirms that Richard's death stemmed from injuries sustained
in the crash itself, but it still doesn't explain why the seasoned pilot drove his plane into the ground at over 270 miles per hour.
We've got some answers from the autopsy, but we don't have all the answers. He clearly died from his injuries.
But I don't know if he's incapacitated or using drugs and alcohol. And we're worried about natural disease.
NARRATOR: With that in mind, Dr. G turns her attention to an organ high on her list of suspects.
Using an isolated saw, Dr. G's morgue technician cuts through the skull to expose the brain.
When we do the head exam, we find he's clearly got some devastating trauma which would have been enough to kill him in and of itself.
But not as much trauma, honestly, as the rest of the body. NARRATOR: She removes the organ and carefully
dissects the brain tissue, searching for any abnormalities. See what we have here.
NARRATOR: But she comes up empty handed. No natural disease in his brain, either.
No strokes, no infarcts. Nothing that I could find that would have incapacitated him.
NARRATOR: With the brain ruled out, Dr. G's next stop is Richard's badly damaged heart.
Although it's multiply torn, we can still look at his heart for natural disease.
NARRATOR: Carefully, she dissects the organ, slicing through the tissue and into the coronary arteries.
The heart muscle looked good. It wasn't enlarged. Coronary arteries were fine. Everything looked normal.
So he clearly didn't have a heart attack. NARRATOR: But this search for natural disease
is far from over. Dr. G's next stop is Richard's lungs. When I open his windpipe, his trachea, his bronchi,
there is no evidence of soot. He was not breathing in any smoke. So he's burnt on the outside, but that happened
after he hit the ground. There was no evidence that he was exposed to smoke or soot
prior to the crash. The fire clearly was post-crash. NARRATOR: She slices through the lung tissue,
and it isn't long before something catches her attention. Although I couldn't put my finger on it,
the lungs didn't look quite right to me. They are very dry. Parts of the lungs looked a little over inflated.
NARRATOR: Not exactly sure what this could mean, Dr. G takes samples of the tissue
so she can get a closer look. I needed to look under the microscope. NARRATOR: Then, just as she's wrapping up
the internal autopsy, Dr. G receives crucial new information from the NTSB's investigator.
There appeared to be nothing wrong with the plane, and they really don't have an explanation for the accident
yet. So at that point, they're ruling out mechanical failure. They're ruling out weather.
What's left is the person aspect of this equation. So at the end of the autopsy, we know he died from blunt trauma.
He had no natural disease. And at this point, I don't see any incapacitating problems he could have had.
NARRATOR: Now the investigation is hinging on one thing, Dr. G's lab results. I still have my toxicology to go,
and I still want to look at that lung tissue under the microscope. At this point, the only thing they have left
is anything I can find. [MUSIC PLAYING] It's been three long weeks since the autopsy
of 49-year-old Richard Garcia, who died in a small engine plane crash. So far, the NTSB investigation has
ruled out whether in mechanical failure as the cause of the accident. And Dr. G's autopsy has yet to uncover
why Richard's plane would have taken a sudden nosedive into an open field. I found nothing that would have incapacitated
him prior to the accident. Did drugs or alcohol incapacitate him? I don't know, but the tox may answer those questions for us.
[MUSIC PLAYING] When we get the toxicology report, I was a little surprised. He has a little bit of alcohol, at about a six
grams per deciliter. So he clearly probably had a beer at lunch. I don't know if you can drive a plane with a 0.06,
but I don't think I'd want my pilot with any alcohol. NARRATOR: But Richard's alcohol level
isn't high enough to convince Dr. G that it's to blame for the crash. And as she continues to scan the report,
she spots something else that raises a red flag. He had a little bit of diphenhydramine on board.
That's the kind of antihistamine that kind of puts people to sleep. It would take a boatload of diphenhydramine
to incapacitate you, but it can make you sleepy at high enough levels. But his level really wasn't that high.
I don't know why he took it, but maybe he was having seasonal allergies. Maybe he was having some type of allergic feeling.
NARRATOR: Although the level is low, it's possible that this, along with the alcohol
made for a deadly combination. He had a beer, and he was taking some diphenhydramine, probably two things
that pilots shouldn't be doing. NARRATOR: But for Dr. G, the pieces of this puzzle
aren't quite fitting together. And there's only one tool left in her arsenal, the microscopics.
We still need to look at that lung tissue. [MUSIC PLAYING] NARRATOR: Dr. G places the slide of Richard's lungs
under the microscope. And adjusts the dial to bring the image into focus. When I look at the lung tissue under the microscope,
I was really surprised. I'll get that again. It really all points to one thing. NARRATOR: And in an instant, Dr. G
knows exactly what caused the plane crash that killed Richard Garcia. That microscope doesn't lie.
[MUSIC PLAYING] NARRATOR: It's Thursday afternoon, and pilot Richard Garcia is about to indulge
in his favorite pastime. But before he takes to the skies, he grabs a quick lunch.
I think he probably had a beer at lunch. After eating lunch, I don't know if he was having
problems with a dry cough, or what he thought were seasonal allergies. But he takes a diphenhydramine, an antihistamine.
NARRATOR: Richard then boards his small engine plane and prepares for takeoff. He gets in that plane, probably
with some mild symptomatology of a dry cough. Maybe somebody thought was seasonal allergies.
While he's flying at 500 feet, he probably starts to get shortness of breath. NARRATOR: But Richard isn't only suffering
from seasonal allergies, instead microscopic results confirm he's in the midst of an asthma attack.
He was clearly having acute asthma at the time of the incident. The airways in his lungs were clogged
with mucus, the characteristic that we see with asthma. Asthma is a reactive airway disease of the small vessels
that contracts the airways. And mucus starts coming out of the lining of the airway,
and it blocks those airways. As those airways start contracting he's having difficulty breathing.
He can't get oxygen to his blood, and he's feeling like he's short of breath. NARRATOR: As Richard gasps for air,
he focuses all of his attention on his next breath. And it isn't long before his plane begins
to careen toward the ground. He hits that ground so hard that it breaks every long bone in his body.
It tears his diaphragm. It tears his heart, fractures all his ribs. A fire ensues, and he gets partially burned before they
can put out the fire. NARRATOR: With this, Dr. G closes the case on Richard Garcia, and report your findings to the National
Transportation Safety Board. I don't think he died from asthma. But if you get distracted with shortness of breath
from an asthma attack, it's not a stretch of the imagination that that was a contributing factor, if not
the cause for that accident. So the blunt trauma is the cause of death, but really the initiating problem was the asthma.
NARRATOR: This information allows the NTSB to complete their investigation and rule the pilot at fault.
The cause of the accident was the pilot's failure to maintain clearance with terrain.
NARRATOR: Then Dr. G, reaches out to local authorities to deliver the information to the family.
I give the information to the justice of the peace, and they relay that to the family.
I would think that the reaction would be surprised, considering that most likely
nobody knew he had asthma. But maybe it helps them at least understand it wasn't a failure in decision, or failure in something
he necessarily did. I just don't think he knew he had it, and clearly this may have been one of his worst attacks.
A lot of people think that asthma is just for children, but a lot of adults get asthma.
And a lot of them don't have it diagnosed, because they must take their symptomatology of asthma
for something else. It just goes to show that oftentimes, the autopsy may not show anything important.
Sometimes it plays a small piece of the puzzle. But sometimes it's key. NARRATOR: And in Dr. G's next case,
the autopsy proves to be the missing link in a homicide investigation. The detective was very worried that this woman was murdered.
Now, it's my responsibility of truly prove why she died. [MUSIC PLAYING] NARRATOR: Sunny skies and world class attractions.
Together, they draw more than 30 million visitors a year toward Orlando, Florida.
But inside the District 9 morgue, Dr. G is witness to the darker side of this lively city.
Even though it's a wonderful city, there's a lot more violence in Orlando than you would think.
There's stabbings, and shootings, and things going on that I see on a daily basis.
Overall, about 10% of our cases are homicides. But actually, everybody that comes through our office
is a potential homicide until proven otherwise. Just don't throw anything away yet until we
figure out what that is. [MUSIC PLAYING] NARRATOR: It's a muggy Sunday evening in Orlando
and [INAUDIBLE] has just returned home after a weekend away with friends. He gets home about 5 o'clock in the evening,
he finds that the kitchen door is unlocked. Rosie? DR. JAN GARAVAGLIA: And as soon as
he walks in he sees a struggle. BEN: Rosie! NARRATOR: Ben's girlfriend, Rosie [INAUDIBLE]
is lying face down and emotionless on the floor. He's obviously startled. He calls the police, who come and pronounce her dead.
NARRATOR: And as police examine the scene, a gruesome scenario begins to emerge.
There's some blood pooled around her face. And she's got kind of a black eye. This could be foul play.
NARRATOR: Although Ben seems genuinely shaken, police can't help but wonder if he may have
played a role in Rosie's death. The detective is very worried that this woman was murdered.
Keep in mind, 30% of women that are murdered are murdered by an intimate partner, by their boyfriend,
by their husbands, by their ex-husband. The boyfriend is clearly upset, but is it an act, or is it not?
Did he have something to do with her, or did he not? The police are very suspicious of him.
NARRATOR: But there's one problem, without physical evidence linking Ben to Rosie's death,
police have their hands tied. They left a law enforcement officer at the scene to guard the crime scene until my determination at autopsy.
So I do want to make sure that I get this case done as quick as I can. So I can either tell them it is a homicide,
or tell them it isn't a homicide. [MUSIC PLAYING] NARRATOR: Rosie's body arrives at the District 9 morgue,
and as a first step Dr. G reached through the investigators report. We have a 44-year-old African-American
woman that the police are suspicious might be a homicide. NARRATOR: But Dr. G knows better than to jump to conclusions.
Just because the police thinks it's homicide, doesn't mean I have to think it's a homicide.
There's another possibilities. It could be an accident. She could have collapsed from natural disease.
We don't know. NARRATOR: And right away, she spots a few details in Rosie's medical records that raise a red flag.
She's not just overweight, she's obese. And there's a lot of problems with obesity.
You certainly have more heart disease. It's certainly going to predispose you to high blood pressure.
She smokes. There's no good reason in the world to smoke, and it's going to affect your heart.
It's going to affect your lungs. And she drinks heavily. She could have been drinking and fell very suddenly
and hit her head. NARRATOR: She also wonders if Rosie may have indulged in another dangerous habit, one often
associated with sudden death. She already smokes, she drinks. Her boyfriend's out partying and drinking.
Who knows what else she's doing? It could even be drugs. It could be a homicide.
It could be an accident. It could be natural. I'm keeping all of my options open.
[MUSIC PLAYING] Did you see that nice shiner she's getting? So when I start my external, the detective is there with me,
giving me more information, and just waiting for me to tell him what I found. It's really actually very important
that when I'm doing a suspicious death, that the detective who's investigating, or one of his partners is there at the autopsy.
But you guys have to give me information. Oh, that too. NARRATOR: Dr. G's first order of business
is to try to piece together the chain of events leading up to Rosie's death. She's already starting to get some very early
days, compositional changes. She's been there over 24 hours. So we at least know whatever happened was
closer to the Saturday morning. The boyfriend leaves Saturday morning, comes back Sunday night.
NARRATOR: Given the timeline, it's possible that Ben killed Rosie before he left on his trip.
So we certainly haven't ruled out the boyfriend. NARRATOR: Next, Dr. G inspects Rosie's skin inch by inch,
searching for forensic evidence. I look very carefully for any kind of trace on her body
itself. Hairs, fibers, anything strange. But I didn't find any trace evidence. NARRATOR: She also checks for needle marks
on the arms and legs that could tell her if drugs somehow played a role. We don't see any evidence of drug use.
But I may not see that, if she does it orally, or she sniffs it, or she smokes it.
So I can't rule out drugs. NARRATOR: Then Dr. G turns her full attention to Rosie's bloody head.
Oh, gosh. She's a mess. Her face is still matted in blood. So I can't really see what's going on.
NARRATOR: Morgue technician Brian Machulski is assigned the gruesome task of cleaning her head.
Slowly, the veil of blood over Rosie's face falls away. And what lies underneath takes Dr. G by surprise.
There is no laceration, or tearing of the skin. I don't see where this blood is coming from.
NARRATOR: But while Dr. G can't pinpoint the source of the blood, she does spark another clue.
She's got a lot of ecchymosis. That's blood which is gone into the delicate tissues
of the upper and lower eyelid. Maybe she fell. Maybe it's a blow to the eye, or maybe it's due to the fact
that she's just face down, and she's starting to decompose. At this point, I can't really tell you why she died.
It could very well be a homicide. [MUSIC PLAYING] NARRATOR: Dr. G is investigating the mysterious death
of 44-year-old Rosie [INAUDIBLE] who was found lifeless in a pool of blood just a few hours earlier.
This is a case at right off the bat came in as suspicious. NARRATOR: And police can't help but wonder
if the victim's live in boyfriend, Ben [INAUDIBLE] may have been involved. He's worried that this is a domestic, violent homicide.
NARRATOR: So far, the external exam has raised many questions but yielded few answers.
And with no proof of murder, the police investigation remains at square one. The hunt for the culprit must now
continue inside Rosie's body. We have to see what the internal findings are. [MUSIC PLAYING]
NARRATOR: Dr. G slides her scalpel across Rosie's torso in a Y-shaped incision. People always think the Y incision is at the beginning
of the autopsy. The beginning of the autopsy starts when I first look at the body.
So by the time I finally get to the y incision, the body is cleaned, I've documented
everything I could find. At least an hour and a half has gone by. I'm looking specifically for any trauma underneath the skin.
I'm looking for bruising. I'm looking for rib fractures. I'm looking for maybe blood in her abdomen.
She doesn't have any. So we don't see any other trauma. There's no free blood in the belly.
Yeah. NARRATOR: Next, she takes blood and urine samples to send out for toxicology tests.
The tox is important with her because she died suddenly and unexpectedly. When anybody has a sudden death, we will check toxicology
to see if drugs played a role. Good. NARRATOR: Moving deeper into the chest cavity,
she cracks open the rib cage and removes the lungs. Her lungs are not in that bad a condition,
considering her habits of smoking. At 44, she still had a long way to go before those cigarettes
would get to her. NARRATOR: Then, Dr. G turns her attention to the heart, and immediately she spots an alarming clue.
Oh, something here. We have a big heart. The first thing I noticed, it's enlarged,
and it's much heavier than it should be. 800. That's a big heart. What is it that's causing her heart to be like that?
NARRATOR: To find out, Dr. G begins a careful dissection of the organ. And it isn't long before she gets her answer.
Oh, what's this? But when I cut the heart muscle, her heart muscle was thickened.
And in her case, that indicated high blood pressure. NARRATOR: High blood pressure forces
the heart muscle to work harder, causing it to grow abnormally thick. The heart muscle passed a pump against that elevated pressure.
And over time, the muscle thickens. Well, suddenly the large heart is severe enough
to have given her a sudden cardiac arrhythmia, but did that kill her? I don't know.
NARRATOR: An arrhythmia leaves no physical evidence in the body. So the only way to know if Rosie's heart is to blame
is to first rule out every other possible cause of death. When you do an autopsy, it's a process for elimination.
I would have to rule out everything else before I could make that determination.
All righty. But unless I find something else to trump that, that very well may be her cause of death.
NARRATOR: Now Dr. G must finish your examination of Rosie's abdominal organs. And given the 44-year-old's history of alcohol abuse,
she begins with the liver. Her liver is slightly enlarged. It appears to be a fatty.
This could be partly due to her drinking, and it could be partly due to her obesity.
But it doesn't look bad enough that it would have killed her. NARRATOR: She then examines another organ that's
often destroyed by alcohol. DR. JAN GARAVAGLIA: We look at her pancreas. A pancreas is that organ that helps regulate your glucose.
It also provides a lot of digestive juices into your small intestine. That will be affected in some people
with chronic alcohol use. But again, her pancreas looked pretty good. NARRATOR: Dr. G's next stop, the kidneys.
Look at that. NARRATOR: And there, she spots something odd. I notice that her kidneys have a lot of a granularity
to its surface. That indicated years of high blood pressure. NARRATOR: And there's more.
Just above the kidneys or the adrenal glands, tiny organs that produce hormones crucial to the regulation of bodily functions.
In Rosie, these glands are strangely misshapen, and with Dr. G cuts them open, she can see why.
She has adrenal adenomas. So what an adenoma is, it's a small tumor. And that tumor could be cancer, or could be benign.
NARRATOR: Dr. G doesn't believe the tumors directly caused Rosie's death, but it is possible they contributed
to her high blood pressure. And in some circumstances, those adenomas can be a cause
for high blood pressure. But most of these little tumors are just incidental findings.
They don't mean anything. All right. So let me think what I still need to do. OK.
NARRATOR: As the abdominal exam comes to an end, the spectre of foul play still looms large.
Why does she have the blood around her? I still can't rule out foul play. At this point, they're not holding the boyfriend.
They're not interrogating him until they know it's a homicide, and I can give them some specific information.
NARRATOR: And she has one last place to look for the final piece of the puzzle. At this point in the game, I'm hoping the answer
is going to be in the head. [MUSIC PLAYING] NARRATOR: Dr. G and her team are preparing for the cranial exam
of 44-year-old Rosie [INAUDIBLE] who died under mysterious and highly suspicious circumstances.
On the one side, I have a possible cause of death. Her big heart could have caused her
to go down suddenly and unexpectedly with an arrhythmia. On the other side, I still have to contend with this blood
around her head. I still can't rule out foul play. I'm hoping but the final piece of this puzzle
is going to be in her brain. [DRILLING SOUND] [MUSIC PLAYING] So when I go to the head, I'm looking
for any kind of bruising. She didn't have that, and I don't see any skull fracture
to the calvarium, the skullcap. NARRATOR: But in some cases, fatal trauma is only
evident on the brain itself. Morgue Technician Brian Machulski ski saws open Rosie's skull.
Then Dr. G steps in for a closer look. Let's see. NARRATOR: And just beneath the dura,
the outer covering of the brain, she spots an alarming clue. I see a little bit of blood.
Something's going on here. NARRATOR: Carefully, Dr. G extracts the organ and dissects it.
And deep within the tissue, she finds her answer. She has bleeding into the deep structures of the brain.
And of course, swelling of the brain. The questions are over. This trumps anything else I found.
[MUSIC PLAYING] NARRATOR: It's Saturday morning and Rosie's boyfriend, Ben has just gone off on a trip with friends,
leaving Rosie to enjoy a quiet weekend at home. So what we thought was a homicide,
and what we thought was his bogus alibi, turns out to be really what happened. And Meanwhile, this poor woman is enjoying
the weekend by herself. Probably starts getting a headache. NARRATOR: Little does she know that inside her head,
a ticking time bomb is about to go off. In this case, everything pointed to high blood pressure.
NARRATOR: Over the years, Rosie's untreated high blood pressure has wreaked havoc on her body.
Beat by beat, the increased pressure strains the heart, causing it to enlarge. You get a thickened heart from it having to pump so hard
against that high pressure. NARRATOR: But the fallout from this chronic condition
is not confined to Rosie's heart. It also affects her entire vascular system. High blood pressure has effects on your brain.
It has effects on your heart. It damages the kidneys. It affects all your blood vessels.
NARRATOR: And on this fateful Saturday morning, the pressure becomes too great inside a blood vessel
deep within Rosie's brain. She probably had a horrible headache. NARRATOR: Then suddenly, the vessel burst.
DR. JAN GARAVAGLIA: That causes bleeding inside her brain causing it to swell. NARRATOR: The swelling puts unbearable pressure
on the organ depriving it of vital oxygen. Soon, her brain can no longer function, and she collapses.
Tragically, almost two days pass before Rosie's boyfriend returns from his trip and finds her body
decaying in a pool of blood. That blood around her face is caused by her being face down,
starting to decompose. And then, the delicate blood vessels of the nose are breaking down, and the blood is just oozing out.
NARRATOR: Finally, with all the pieces in place, Dr. G's ready to share her findings with the police.
I know this isn't a homicide. So the boyfriend's off the hook. We've got the killer, and the killer was high blood pressure.
Anyway, well you already knew some. The detective is like all smiles. You mean, because that made his day.
He is not spending the rest of his day interviewing the boyfriend. He's not spending the rest of the day looking
for a perpetrator, because her perpetrator was their high blood pressure. NARRATOR: It's possible that the tumors Dr. G found
on Rosie's adrenal glands could have caused her elevated blood pressure. The adrenal glands may or may not have been the cause
of their high blood pressure. NARRATOR: Special tests do exist that could have identified the adenomas as the source
of Rosie's high blood pressure. But unfortunately, she never sought medical attention.
It would be interesting to find out, but now there's nothing I can do about it. If she was alive, that would be wonderful.
If you're alive with high blood pressure, and they find the cause for high blood pressure, and something
like taking out that tumor to get rid of your high blood pressure, that would by all means,
be worth it. But she's already dead. When we run a medical examiner's office, we have to kind of allocate our resources
on what's important to find out, and what's not. And unfortunately, that's the reality of the situation.
And those are the kind of calls I have to make. NARRATOR: And although Dr. G takes comfort in the fact
that Rosie wasn't murdered, this case is yet another example of an unfortunate and premature
death. She could have prevented her death by stopping smoking, and losing weight.
NARRATOR: There are also effective medical treatments for high blood pressure. We have good medications to control high blood pressure.
And if one doesn't work, they try another. Some cases are just sadder than others.
High blood pressure can be a silent killer. That is why knowing your blood pressure
is one of those essential numbers you need to know, if you want to live to old age.
Anyway, so not a bad today. Just tragedy. There is no excuse for you to have high blood pressure,
and not treat that aggressively, unless you don't want to live. [MUSIC PLAYING]

It’s up to Dr. G, along with the National Transportation Safety Board, to piece together how and why a plane crashed, leaving the pilot dead.

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

Brief Summary

Dr. G investigates a pilot's fatal crash and a woman's suspicious death, revealing asthma and high blood pressure as key factors in both cases.

Key points

A Deadly Flight. When a routine flight turns deadly, Dr. G faces a gruesome challenge.
The Investigation Begins. The NTSB investigates the crash of Richard Garcia's plane, looking for answers.
The Cause of Death. Dr. G discovers that Richard's asthma attack may have contributed to the crash.
The Mysterious Death of Rosie. Rosie is found dead in her home, raising suspicions about her boyfriend Ben.
The Autopsy Begins. Dr. G starts the autopsy, searching for clues to Rosie's sudden death.
The True Cause Revealed. Dr. G discovers that high blood pressure was the cause of Rosie's death.

Episode highlights

Episode quotes

It's not pretty when you hit the ground at a high rate of speed.

NARRATOR describing the impact of a plane crash

0:21WatchJun 22, 2021

Tension

75/ 100High tension

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