Day 9

February 5th, 2010
Case 1
Caucasian M, approx 55 YO
MVA
Deceased was rear-ended by an unknown driver, got out of car to check damage, was then hit by unknown driver and dragged approx 350 yds.
Two tubes in mouth, one in trachea, one in esophagus, bent upwards onto itself.
Multiple abrasive lacerations, both ears gone due to skidding.
Multiple fractures of ribs, fractured L humerus.
Hinge fracture of base of skull.
COD blunt force trauma/devastating head trauma

Case 2
Caucasian M, approx 80 YO
Medical misadventure
Deceased was undergoing a medical procedure when an artery was nicked.
Damage to artery could not be found, it is assumed that the nick healed in the interval.
COD exsanguination

Case 3
Caucasian M, approx 50 YO
Probable OD
Vietnam vet
Hx of PTSD, depression, ethanol abuse, prescription drug abuse, cocaine use, marijuana use, heroin use.
Hepatitis C +
Deceased was found surrounded by pills, etc, some pills were crushed in hair.
Deceased had vomited.
COD OD (pr. unintentional)

Case 4
Caucasian M, approx 80 YO
MVA
Deceased was driver in collision w/ tree, was found conscious and responsive, report of injury to abd. organs, brace on healing fracture of R shin, sutured cut from repair to hip fracture, abd was open, taped over, packed w/ 3 blk sponges, 5 wht, foley catheter, copious other signs of therapy.
Deceased was hospitalized for 3 weeks.
When opened up, found to have massive peritonitis w/ necrotic tissue on duodenum, peritoneum, etc.
COD massive septic shock

Greg 2 untaped the abdominal opening and immediately, milky brownish fluid dribbled in a thin stream from the lowermost point. He took out the soaked sponges, the white ones now brown and spotted, and the flow increased, though the peritoneum was firmly sutured shut. We could see dark, loose splotches on the pinkish surface, necrotic tissue, and it did not bode well for the condition of the man’s internal organs.

When the Y was made and the stitches cut, the abdominal incision immediately overflowed hideously with the brownish exudate, at least 1000 milliliters of it in all, and the organs were pale and peeling wetly, mottled and slimy with necrosis, all grown together. The autopsy was hideously difficult, the organs foul and connected indescribably, and more and more brown fluid kept welling from somewhere, fecal and rotten and swirling, the table and body and sink and us all beslobbered and befouled with it. The body’s scrotum was grossly swollen with the liquid, the penis almost inverted on itself, hidden in that swollen balloon of thin, goose-pimpled skin.

The gall bladder was the worst part, somehow, for when Dr. Gr. nicked it with his scalpel, the bile did not flow out easily and slightly glutinously as usual, it was not that dark yellowy green that dilutes into brilliant yellow with water—it welled up in the incision, sure enough, but it was the blackest thing I had ever seen, grainy and sludgy, a heavy, necrotic, asphalt, and it would not wash away, so concentrated it was.