Department of Pathology

Medical Center Blvd

NC OCME
Winston-Salem, NC 27157
Phone:
NC Office (336)
of the Chief 716-4311
Medical Examiner
Fax: (336) 716-7595

MEDICOLEGAL AUTOPSY REPORT

Pathologist: P. E. Lantz, M.D. Patient Name:: NEVILLE, JOHN E

Resident: W. Harrison, M.D. Medical Record #:
Autopsy Assistant: Hailey Nichole Welborn DOB/Age:: 3/25/1963 (Age: 56)
Service: Race/Gender: B/M
Admitted:
Expired: 12/4/2019
Autopsied: 12/5/2019
Reported: 7/7/2020
Attending Physician: NCBH Path #: A19-2045
Medical P. E. Lantz
Examiner:
Forsyth County Medical Examiner

FINAL AUTOPSY DIAGNOSIS

I. Complications of positional and compressional asphyxia during prone restraint
A. Cardiopulmonary arrest (resuscitated), 12/2/2019
1. Hypoxic-ischemic brain injury
a) Bilateral acute pneumonia, severe
2. Lactic acidosis (medical record)
3. Acute kidney injury (medical record)
B. Abrasions of forehead and left arm, skin and subcutaneous tissue
C. Contusions of back and left arm, skin and subcutaneous tissue
II. Altered mental status, unspecified (acute)
III. Asthma
A. Chronic obstructive pulmonary disease
IV. Hypertensive and atherosclerotic cardiovascular disease
A. Left ventricular hypertrophy, 1.5-1.6 cm
B. Cardiomegaly (500 gm)
C. Coronary arteriosclerosis, focal, mild
D. Fatty streaking of abdominal aorta and femoral arteries
V. Non-organic sleep disorder, unspecified (medical record)
VI. Allergies: shellfish, peanuts, soy (medical record)
VII. Resuscitation-related rib fractures
A. Parasternal (right: 2-4; left: 2-7)
B. Anterolateral (3-4)

***Electronically Signed Out By: P. E. Lantz, M.D.***

sra

Summary of Findings
According to investigative reports, detention center documents, videos, and medical records, on Sunday, December 1, 2019 at
about 3:25 a.m., John Elliott Neville (JEN) [DOB: 3/25/1963] was booked into the Forsyth County Detention Center (FCDC) in
Winston-Salem, NC. He was calm and talkative. His medical intake document indicated he used an inhaler (levalbuterol tartrate)
for asthma (it was last used on December 1, 2019 at 10:43 a.m.) and had an unspecified non-organic sleep disorder (disturbance in
amount, quality, or timing of sleep, or abnormal episodic events occurring during sleep). He had no documented seizure
disorder. Allergies included soy (vomiting), peanuts, and fish derived. Meals at the FCDC on December 1, 2019 did not contain
any foods containing obvious peanuts or fish. He completed the Mental Health and Receiving Screening forms and signed his
name. He told his cellmate that he had been partying the night prior to his arrest. His cellmate stated that JEN told him that prior
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to his arrest he had been drinking and smoked some marijuana. The cellmate said that JEN was eating and drinking during the day
of December 1 without any problems. He said JEN took a few naps during the day and would snore while napping. He described
his snoring as, “like he was trying to catch his breath.” He said JEN never mentioned any medical problems or had any
complaints of illness.

The cellmate stated they went to sleep the night of the December 1 with JEN sleeping on the top bunk (height: 51 ¾ inches;
mattress thickness: 4 inches) and the cellmate on the bottom bunk. During the night, the cellmate heard a loud bang in the cell.
He first thought he was dreaming, but he saw JEN on the cell floor, shaking (cell flooring: concrete with epoxy covering). He said
it appeared that JEN was having a seizure. He pressed the emergency button in the cell and FCDC staff escorted him out and
into a nearby cell. At 3:26 a.m., FCDC personnel found JEN on his cell floor with vomitus on his clothing, sweating, and blood
around his mouth, initially having seizure-like activity. His eyes had a glazed appearance. FCDC staff rolled up bedding or
clothing and placed it under his head. He did not respond to verbal commands, but would groan. The nurse described him lying
on his right side, snoring, and unresponsive; his pupils were reactive to light. The nurse applied a sternal rub (application of
painful stimulus by knuckles of closed fist to center of a patient’s chest who is unresponsive and does not respond to verbal
stimuli) to JEN. His eyelids opened, and after regaining consciousness he was incoherent, seemed confused, uncooperative, and
became aggressive – he tried to sit up, kick, and swing his arms. FCDC staff told him he was not in trouble but was having a
medical emergency and needed to calm down and stop resisting. Special Response Team (SRT) members restrained JEN on his
back with his arms and legs held down. No one exerted pressure to his chest or on his neck. He yelled but his speech pattern
was incoherent. JEN became unresponsive again and the nurse again applied a sternal rub; he regained consciousness but was still
incoherent and aggressive, trying to kick, jerk his arms away, and thrash his body side to side. JEN mumbled incoherently, but
said, “Let me go,” “Help me up,” and “Mama” plus a few other disconnected phrases. He did not respond to questions from the
nurse. FCDC staff covered his head with a spit mask after he tried to bite SRT member(s). The nurse attempted to obtain his
blood pressure but was unable to get a reading due to his resistance and movements. After metal restraints secured his ankles,
SRT members rolled him onto his stomach to handcuff his wrists. He uttered, “I can’t breathe” once while on his stomach. FCDC
staff helped him to his feet and he walked with assistance to a restraint chair. After sitting in the chair, straps secured him to the
chair and his hands were handcuffed behind his back and metal restraints on his ankles. During transport to a multi-purpose room
on a different floor, FCDC staff noticed he had fecal incontinence. In the multi-purpose room, the nurse tried to obtain his blood
pressure. During transport, he seemed confused and said, “Help me.” He occasionally calmed down but then resumed writhing
about, moving his torso forwards and twisting.

FCDC staff moved him to a single cell to facilitate observation. After removal of the chair restraint straps, he followed
instructions getting out of the restraint chair, walked with assistance into the cell, kneeled down, and was lowered down prone
(face down on stomach) onto a mattress that had been removed from the bunk and placed on the floor of the cell. He continued
writhing, moving his torso and tensing his arms and legs. His hands were handcuffed behind his back and his legs were in metal
restraints. FCDC personnel restrained him by holding his shoulders, arms (handcuffed behind him), and legs. No direct pressure
was placed on his neck or back; a chokehold was never used. Following removal of his ankle restraints, his legs were flexed into a
trifold position with his heels near his buttocks. Coherent phrases he made while restrained prone included, “Please,” “I can’t
breathe,” “Help me,” and “Let me go.” During the initial attempt at removing the handcuffs, the handcuff key broke off in the left
handcuff keyhole about 2½ minutes after he was placed prone. Another handcuff key was unable to unlock the handcuff. The
last intelligible phrase he made was around 3½ minutes after placed prone on the mattress. About 4 minutes after placed prone
FCDC staff straightened his legs and restrained them. A set of bolt cutters malfunctioned and would not cut through the
handcuff (about 5 minutes after placed prone). JEN stopped moving and verbalizing comprehensible words. Another set of bolt
cutters cut the left handcuff allowing removal of the handcuffs about 12 minutes after he was placed prone. FCDC staff removed
his blue jumpsuit. The nurse checked him and they exited the cell with JEN lying prone on the mattress. FCDC staff closed the
cell door. The nurse indicated she could not see him breathing or moving so FCDC personnel re-entered the cell, rolled him
supine (onto his back) and secured his arms and legs. Unable to obtain a pulse, external chest compressions were given, then
about 19 minutes after placed prone, cardiopulmonary resuscitation (CPR) was begun after a CPR mask was placed over his
mouth [external chest compressions x30; breaths x2 with CPR mask]. An automated external defibrillator applied to his chest
indicated: “no shock advised” on three assessments. Forsyth County Fire Department and Emergency Medical Services (EMS)
personnel arrived and requested moving him to the Day Area (multi-purpose room) just outside of the cell. They continued CPR
and Advanced Cardiovascular Life Support (ACLS) procedures until a return of spontaneous of circulation (ROSC) occurred at
4:35 a.m. He received 10-15 minutes CPR/ACLS prior to ROSC. During CPR and ACLS, FCDC personnel restrained his arms
and legs.

FC EMS transported him unrestrained to Wake Forest Baptist Medical Center (WFBMC) Emergency Department (ED) [arrival:
12/2/2019 @ 0502]. In the ED, he was unresponsive with a blood pressure of 220/200. He became bradycardic (low heart rate)
and hypotensive (low blood pressure) and then became pulseless. Restoration of ROSC occurred following 6 minutes of CPR
along with administration of epinephrine and sodium bicarbonate. He became pulseless a second time and received about 3
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minutes of CPR plus epinephrine and sodium bicarbonate before ROSC was again restored. A portable chest radiograph (CXR)
on 12/2/2019 showed no acute cardiac or pulmonary abnormalities. Initial laboratory results and arterial blood gas (ABG)
revealed a pH of 6.8 (normal: 7.35-7.45), pCO2: 109.7 mmHg (normal: 35.0-45.0), lactic acid: 24.5 mmol/L (normal: 0.5-2.0),
prothrombin time (PT): 14.6 seconds (normal: 8.9-12.1), partial thromboplastin time (PTT): 30.2 seconds (normal: < 30),
creatinine: 1.96 mg/dL (normal: 0.5-1.5), aspartate aminotransferase (AST): 94 IU/L (normal: 5-40 ), alanine aminotransferase
(ALT): 56 IU/L (normal: 5-50), blood glucose: 154 mg/dL (normal: 70-99), troponin I: 0.022 ng/mL (normal: 0.000-0.040). A
urine drug screen was positive for tetrahydrocannabinol (marijuana) and negative for amphetamines, benzodiazepines, cocaine,
opiates, and methadone. He was admitted to the medical intensive care unit (MICU) with a Glasgow Coma Scale (scoring system
to describe level of consciousness of a person) of 3. Physical examination described his head as normocephalic and atraumatic,
and his skin with no obvious lesions or abnormalities. A computed tomographic (CT) scan of his head revealed diffuse loss of
gray-white differentiation and effacement of the sulci, basal cisterns, and Sylvian fissures consistent with global hypoxic-ischemic
injury and scattered hyperdensities that likely represented pseudo-subarachnoid hemorrhages. His condition continued to
deteriorate with multi-system organ failure reflected by increasingly abnormal laboratory results - creatinine: 5.65 mg/dL,
troponin I: 18.935 ng/mL, AST: 869 IU/L, ALT: 513 IU/L, PT: 23.9 seconds, PTT: 104.8 seconds. A CXR on 12/4/2019 detected
lower lobe opacifications suggestive of atelectasis or aspiration; a tracheal aspirate grew Staphylococcus aureus and Escherichia
coli. His time of death by neurological criteria was at 0922 on 12/4/2019.

Major findings at autopsy included bilateral pneumonia and hypoxic-ischemic brain injury, which occurred following resuscitation
from his cardiopulmonary arrest precipitated by positional and compressional asphyxia. A few abrasions were on his forehead
and left arm and scattered contusions (bruises) were on his back and left upper arm. Natural disease processes included asthma,
chronic obstructive lung disease (emphysema), mild cardiomegaly (enlarged heart), and mild coronary artery stenosis (narrowing
of the arteries of the heart). Toxicological testing of antemortem blood from 12/2/2109 detected desloratadine (an antihistamine),
but no other drugs (analysis does not screen for THC or its metabolites) or ethanol. He did not have sickle cell trait; his hemoglobin
(Hgb) electrophoresis revealed Hgb A2/Hgb F. The cause of his acute altered mental status remains unexplained after review of
his medical records, autopsy findings, and toxicological analysis.

CAUSE OF DEATH: Complications of hypoxic ischemic brain injury due to

Cardiopulmonary arrest (resuscitated) due to
Positional and compressional asphyxia during prone restraint

Other significant conditions: Acute altered mental status (unspecified); asthma

EXTERNAL EXAMINATION

Body Weight: 178 lb Representatives for the Forsyth County Sheriff's Office and North
Body Length: 68 in Carolina State Bureau of Investigations are present during the autopsy.
BMI: 27.1
The body is that of a well-developed, well-nourished, adult African
American man, who appears compatible with the stated age. Body
identification includes a bracelet on the right wrist and a tag on the right
great toe, both of which bear the decedent’s name. The body bag is not
sealed.

The body is received clothed in a hospital gown. No personal effects

accompany the body.

The body has been refrigerated. Rigor is fully fixed in the extremities
and jaw. Diffuse, fixed livor extends over the posterior surfaces of the
body, except in areas subject to pressure. Numerous Tardieu spots are
on the back.

The scalp hair is gray-white and measures up to 1/16 inch in length over
the crown with frontotemporal balding. The irides appear brown; the
pupils are symmetrical. The corneae are cloudy. The sclerae and
conjunctivae are pale. No petechiae are on the palpebral or bulbar
conjunctivae (two postmortem punctate episcleral hemorrhages
temporal to the limbus occurred following vitreous fluid removal). The
nose and ears are not unusual and the nasal septum is intact. The lips
and gums are pale. No obvious trauma involves the buccal mucosa. The
teeth are in adequate condition. Facial hair consists of stubble on the
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EVIDENCE OF INJURY
HEAD AND NECK
CHEST AND ABDOMEN
UPPER EXTREMITIES
LOWER EXTREMITIES
INTERNAL EXAMINATION
BODY CAVITIES
Panniculus adiposus: 3.0 cm
NEVILLE, JOHN E
Autopsy Report
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NC Office of the Chief Medical Examiner
chin and neck. The neck is without masses and the larynx is in the
midline.
The thorax is symmetrical and the abdomen is flat. The external
genitalia are those of an adult male; the testes are descended within the
scrotum. The anus and back have no unusual features except as noted.
The upper and lower extremities are well-developed and symmetrical
without absence of digits.
Identifying marks and scars consist of multiple irregular hyperpigmented
scars ranging from 1/8 x 1/8 inch to 3/4 x 1/2 inch on the central
abdomen; a 1 ½ inch vertically oriented linear hyperpigmented scar on
the superior right back; a 4 inch curvilinear hyperpigmented scar on the
inferior left back.
Evidence of emergency resuscitation and/or medical therapy consists of
an endotracheal tube secured at the mouth; a triple-lumen intravascular
catheter in the left neck; a single-lumen intravascular catheter in the
right antecubital fossa; a single-lumen intravascular catheter in the
posterior right hand; a single-lumen intravascular catheter in the right
groin; a Foley catheter. Left ribs 2-7 have parasternal fractures, right ribs
2-4 have parasternal fractures, and right ribs 3 and 4 have anterolateral
fractures, consistent with cardiopulmonary resuscitative efforts.
Evidence turned over to the representative from the North Carolina
State Bureau of Investigations during the autopsy includes a blood spot
card.
BLUNT TRAUMA:
Three irregular abrasions, ranging from 1/4 x 1/8 inch to 3/4 x 1/2 inch,
are on the lateral right forehead, approximately 1 inch superior and
lateral to the right brow.
BLUNT TRAUMA:
A posterior back dissection reveals a 1 x 1/4 inch contusion within the
right medial paravertebral muscle, approximately 10 inches from the top
of the head, and a 1/4 x 1/4 inch subcutaneous contusion on the left
back, approximately 10 inches from the top of the head.
BLUNT TRAUMA:
On the posterior left wrist is a 1 inch linear abrasion. On the posterior
hand is a 1/2 x 1/2 inch irregular abrasion.
Dissection of the soft tissues of the upper and lower extremities reveals
a 3/4 x 3/4 inch subcutaneous contusion of the anterior left wrist,
approximately 11 inches below the elbow, and a 4 x 1/2 inch
subcutaneous contusion in the posterior left arm, approximately 14
inches from the top of the shoulder.
NONE
The pleural and abdominal cavities contain no abnormal quantities of
fluid and no fibrous adhesions. All body organs are present in normal
and anatomical position.
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CENTRAL NERVOUS SYSTEM
Brain weight: 1400 gm No subscalpular contusions or skull fractures are present. The dura
mater and falx cerebri are intact without adherent blood. The superior
sagittal sinus is patent. The leptomeninges are thin and translucent and
with no areas of extravasated blood or exudates. The cerebral
hemispheres are symmetrical with diffuse flattening of the gyral crests.
The structures at the base of the brain, including cranial nerves and
blood vessels, are intact and free of abnormality. The arteries of the
Circle of Willis are in the usual anatomical configuration and are patent.
Sections through the markedly softened cerebral hemispheres reveal no
focal lesions within the cortex, subcortical white matter, or deep
parenchyma of either hemisphere. The cortex is continuous and of
uniform thickness. The basal ganglia and thalami have no unusual
features. The bilateral hippocampi are markedly disrupted secondary to
autolysis. The cerebral ventricles are mildly compressed. Sections
through the brain stem and cerebellum reveal no lesions. The substantia
nigra and locus ceruleus have age appropriate pigmentation. The
cerebral aqueduct is patent and the fourth ventricle is not dilated.

NECK
A layered anterior neck dissection reveals intramuscular and soft tissue
extravasated blood associated with the intravascular catheter of the left
neck. The remaining soft tissues of the neck, including strap muscles,
and large vessels, have no additional abnormalities. The hyoid bone and
laryngeal structures are intact and the adjacent musculature has no
areas of extravasated blood. The lingual mucosa is intact; the underlying
firm red-brown musculature is devoid of hemorrhage.

CARDIOVASCULAR SYSTEM
Heart weight: 500 gm The pericardial surfaces are smooth and glistening; the pericardial sac
contains 50 mL of serous fluid. The coronary arteries arise normally and
follow the usual distribution of a right-dominant pattern with the proximal
left anterior descending coronary artery having mild (about 25%)
eccentric luminal stenosis. The diagonal branches, left circumflex,
obtuse marginal branches, right coronary artery, and posterior
descending coronary artery are widely patent. The chambers and valves
bear the usual size-position relationships. The circumference of the
valves is as follows: tricuspid, 12.0 cm; pulmonic, 8.0 cm; mitral, 10.0
cm; aortic, 7.5 cm. The myocardium is dark red-brown and firm; the
atrial and ventricular septa are intact. The thicknesses of the ventricular
walls are: left ventricle 1.5 cm; interventricular septum 1.6 cm; right
ventricle 0.5 cm. The aorta and its major branches arise normally, follow
the usual course and demonstrate mild fatty streaking within the
abdominal aorta and femoral arteries. The vena cava and its major
tributaries return to the heart in the usual distribution and are free of
thrombi.

RESPIRATORY SYSTEM
Right lung weight: 810 gm The upper airway is clear of debris and foreign material; the mucosal
Left lung weight: 930 gm surfaces are smooth and yellow-tan to mildly hyperemic. The pleural
surfaces are smooth and glistening with moderate anthracotic
pigmentation. Lobar divisions are of the usual configuration. The
pulmonary parenchyma is dark red-purple with moderate
emphysematous change, exuding large amounts of blood and frothy
fluid. The lower lobes are consolidated. The pulmonary arteries are
normally developed, patent, and without thrombus or embolus.

LIVER AND BILIARY SYSTEM

Liver weight: 1640 gm The hepatic capsule is smooth, glistening and intact, covering red-brown
Bile volume: 5 mL parenchyma with no focal lesions. The gallbladder contains green,
slightly mucoid bile; the mucosa is velvety. The extrahepatic biliary tree
contains no calculi. The portal vein and its tributaries are patent.

ALIMENTARY TRACT
The esophagus is lined by gray-white, smooth mucosa. The gastric
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mucosa is arranged in the usual rugal folds, and the lumen has less
than 20 mL of gray chyme. The serosa of the small and large bowel is
smooth and glistening. The appendix is present. The pancreas has a
gray-tan, lobulated appearance and the ducts are unobstructed.

GENITOURINARY TRACT
Right kidney: 130 gm
Left kidney: 150 gm
Urine volume: < 1 mL
The renal capsules are mildly adherent, and strip with ease from the
underlying mildly granular cortical surface. The cortex is sharply
delineated from the medullary pyramids, which are red-purple to tan.
The calyces, pelves, and ureters are not dilated. The relationships at the
trigone are arranged in the usual anatomical configuration. The mucosa
of the urinary bladder is gray-tan and slightly trabeculated. The prostate
and seminal vesicles have no abnormal findings.

RETICULOENDOTHELIAL SYSTEM
Spleen weight: 80 gm The spleen has a smooth, intact capsule covering red-purple, firm
parenchyma; the lymphoid follicles are indistinct. The regional lymph
nodes appear age-appropriate. The bone marrow is red-purple and
homogeneous, without focal abnormality.

ENDOCRINE SYSTEM
The pituitary, thyroid, and adrenal glands contain no lesions.

MUSCULOSKELETAL SYSTEM
Except as noted in the "Evidence of Injury" section, the bony framework,
supporting musculature, and soft tissues are not unusual.

Block Summary:

1. Heart, left ventricle

2. Heart, interventricular septum
3. Heart, interventricular septum; right ventricle
4. Heart, right ventricle
5. Heart, right ventricle
6. Heart, sino-atrial node
7. Heart, right atrium; Left anterior descending coronary artery
8. Heart, atrio-ventricular node and conduction system
9. Heart, atrio-ventricular node and conduction system
10. Heart, atrio-ventricular node and conduction system
11. Left lung, upper lobe
12. Left lung, upper lobe
13. Left lung, upper lobe
14. Left lung, lower lobe
15. Left lung, lower lobe
16. Left lung, lower lobe
17. Right lung, upper lobe
18. Right lung, upper lobe
19. Right lung, middle lobe
20. Right lung, middle lobe
21. Right lung, lower lobe
22. Right lung, lower lobe
23. Trachea; Spleen; Skin (anterior left wrist)
24. Liver; Pancreas
25. Kidney
26. Brain, left frontal lobe
27. Brain, left temporal lobe
28. Brain, pons
29. Brain, medulla
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Microscopic Description:

Sections of frontal and temporal neocortex show diffuse neuronal pyknosis and pericellular edema. Scattered perivascular
karyorrhectic debris and inflammatory cells are present. The pontine nuclei shows groups with pyknotic neurons and cytoplasmic
hypereosinophilia. No gliosis, meningitis or encephalitis is present. The medulla has no histopathological abnormalities.

The lungs exhibit bronchocentric pneumonia with intra-alveolar neutrophilic infiltrate, which is more severe in the lower lobes. The
acute inflammatory infiltrate is admixed with fibrin, extravasated blood, and scattered bacterial colonies. In some areas the alveoli
also contain eosinophilic acellular material that represent early hyaline membranes. The alveolar capillaries are engorged. The
lung tissue relatively uninvolved with acute inflammation demonstrates patchy alveolar expansion with loss of the alveolar walls
and alveolar septal clubbing. The arterioles have medial hypertrophy. Within the alveoli are numerous pigment laden
macrophages. Foci of interstitial fibrosis and bronchiolar squamous metaplasia are present. Within the interstitium are numerous
pigment laden macrophages and scattered lymphocytic aggregates. No polarizable material is seen. The larger bronchioles have
thickened basement membranes, mural muscular hypertrophy, and increased numbers of chronic inflammatory cells, scattered
eosinophils, and slightly prominent mucus glands. Occasional bronchioles have markedly engorged submucosal blood vessels and
lumens containing mucus, epithelial cells, and inflammatory cells.

The trachea shows a moderate mononuclear infiltrate within the lamina propria and partially denuded epithelium, but no significant
acute inflammation is present.

The heart exhibits diffuse cardiomyocyte enlargement with mild interstitial and perivascular fibrosis. A few foci of myofiber
disarray are in sections of left and right ventricle, but this occupies < 5% of the sampled myocardium. A Masson trichrome stain
highlights the fibrosis. Myocarditis and myocyte necrosis are not present; however, scattered areas of fragmented,
hypereosinophilic myofibers are present. The left descending coronary artery exhibits mild stenosis due to fibro-intimal
proliferation with scattered mononuclear cells and calcific deposits. Sections of the sino-atrial and atrio-ventricular nodes show no
inflammation, abnormal fibrosis or vasculopathy.

The spleen has well delineated red pulp and white pulp without atypical architecture or lymphocyte morphology.

The section of skin shows diffuse blood extravasation within the dermis and subcutis plus a vital reaction of mild mixed
inflammation.

The liver is organized into plates of hepatocytes 1-2 cell layers thick with acute centrilobular sinusoidal congestion. No steatosis
or significant inflammation is identified. The portal tracts contain an appropriate number of bile ducts and blood vessels without
inflammation or fibrosis. The central veins are patent without thrombosis.

The pancreas has well-formed acinar structures and islets without atypia. No significant inflammation or fibrosis is present.

A section of kidney shows an appropriate number of glomeruli without significant sclerosis. The proximal convoluted tubules show
diffuse vacuolation of the cytoplasm with relative preservation of the nuclei. Several arteries and arterioles show mild intimal
proliferation. No polarizable material is seen.

Remaining sections exhibit no significant histopathological abnormalities.

TOXICOLOGY
Toxicology Folder: T201911463
Case Folder: F201912615
Date of Report: 21-jan-2020

Status of Report: Approved

Report Electronically Approved By: Justin Brower, PhD
===============================================================================
SPECIMENS received from Patrick E. Lantz on 16-dec-2019

S190035296: 1.0 ml Blood CONDITION: Antemortem

SOURCE: Peripheral OBTAINED: 02-dec-2019

Specimen drawn on 12/02/2019 @ 05:40 hrs.

Ethanol --------------------- None Detected 01/21/2020

_______________________________________________________________________________

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S190035297: 1.5 ml Blood CONDITION: Antemortem
SOURCE: Peripheral OBTAINED: 02-dec-2019

Specimen drawn on 12/02/2019 @ 05:40 hrs.

_______________________________________________________________________________

S190035298: 1.0 ml Blood CONDITION: Antemortem

SOURCE: Peripheral OBTAINED: 02-dec-2019

Specimen drawn on 12/02/2019 @ 05:40 hrs.

_______________________________________________________________________________

S190035299: 0.0 ml Serum CONDITION: Antemortem

SOURCE: Peripheral OBTAINED: 02-dec-2019

Specimen drawn on 12/02/2019 @ 05:40 hrs.

_______________________________________________________________________________

S190035300: 5.0 ml Urine CONDITION: Antemortem

SOURCE: Urinary Bladder OBTAINED: 02-dec-2019

Specimen drawn on 12/02/2019 @ 06:49 hrs.

Benzodiazepines ------------- None Detected LCMS 01/21/2020

Cocaine metabolite ---------- None Detected LCMS 01/21/2020
Desloratadine --------------------- Present 01/21/2020
Gabapentin/Pregabalin ------- None Detected LCMS 01/21/2020
Opiates/Opioids ------------- None Detected LCMS 01/21/2020
Other Organic Bases --------- None Detected 01/21/2020
_______________________________________________________________________________

S190035301: 19.0 ml Blood CONDITION: Postmortem

SOURCE: Aorta OBTAINED: 05-dec-2019
_______________________________________________________________________________

S190035302: 12.0 ml Blood CONDITION: Postmortem

SOURCE: Femoral Vessel OBTAINED: 05-dec-2019
_______________________________________________________________________________

S190035303: 5.0 ml Vitreous Humor CONDITION: Postmortem

SOURCE: Eye OBTAINED: 05-dec-2019
_______________________________________________________________________________

S190035304: Liver CONDITION: Postmortem

SOURCE: Liver OBTAINED: 05-dec-2019
_______________________________________________________________________________

Accredited by the American Board of Forensic Toxicology, Inc.

012120 16:06 ***END OF REPORT***

COPY TO:
P. E. Lantz, M.D.

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