00:00:03
[DRAMATIC MUSIC]
00:00:16
[THEME MUSIC]
00:00:18
NARRATOR: When a body arrives at the morgue covered
00:00:20
in scratches, Dr. G suspects that the perpetrator
00:00:24
could be man's best friend.
00:00:26
[DOG BARKING]
00:00:27
That dog was just clawing at that man.
00:00:31
NARRATOR: And during his autopsy--
00:00:32
Oh.
00:00:33
NARRATOR: --the case quickly moves from the unusual
00:00:36
to the bizarre.
00:00:37
I've really got to admit, I've never quite seen this before.
00:00:41
NARRATOR: Then tragedy strikes first-time parents
00:00:44
when their baby girl dies suddenly
00:00:46
in the middle of the night.
00:00:48
That was like one of the worst feelings I ever had in my life.
00:00:51
NARRATOR: But after a series of baffling dead ends,
00:00:54
Dr. G worries that she'll be unable to give
00:00:56
the family an explanation.
00:00:58
Nothing's really gelling.
00:01:00
[THEME MUSIC]
00:01:04
NARRATOR: Altered lives, baffling medical mysteries,
00:01:07
shocking revelations.
00:01:09
These are the everyday cases of "Dr. G, Medical Examiner."
00:01:19
[UPBEAT MUSIC]
00:01:25
Every day, Dr. Jan Garavaglia solves
00:01:28
the mysteries of the dead.
00:01:31
What was the circumstances on that?
00:01:33
Does he know what happened?
00:01:34
She just woke up dead?
00:01:35
NARRATOR: But she can't do her job without the help
00:01:38
of her morgue staff.
00:01:39
And one of the most critical players on the team
00:01:42
is that of the medical investigator.
00:01:44
Did you bring in the guy, Carlos?
00:01:47
Here's the deal.
00:01:48
There was no law enforcement involvement in this.
00:01:49
Apparently, they transported him from the Links place.
00:01:51
BILL STRATTON (VOICEOVER): I've been a medical investigator
00:01:53
for 29 years.
00:01:55
My responsibility is to respond to the scene of the death.
00:01:58
[TELEPHONE RINGING]
00:02:00
Medical examiner's office, Bill.
00:02:02
Do you have a last name of the decedent?
00:02:04
BILL STRATTON (VOICEOVER): I'll gather my camera gear
00:02:06
and get my vehicle, respond to the scene,
00:02:10
and get an idea of what type of a death we may have.
00:02:15
JAN GARAVAGLIA: When Bill goes to the scene,
00:02:17
he is to be my eyes and ears, and he
00:02:19
is to take pictures of everything
00:02:22
around that body, the circumstances.
00:02:24
When I get back to the office, I'll
00:02:27
prepare photographs and a report so
00:02:30
that Dr. G can go ahead and review
00:02:32
everything and do the autopsy.
00:02:37
JAN GARAVAGLIA (VOICEOVER): This is a 61-year-old male
00:02:38
of Eastern European descent, who Bill says, he's
00:02:43
never seen anything like it.
00:02:45
I love it when they give me that lead in.
00:02:47
So I'm like, OK, what's this case about?
00:02:51
[DRAMATIC MUSIC]
00:02:57
NARRATOR: It's a sunny Saturday afternoon in late September
00:03:00
and Kissimmee, Florida native Jeanne
00:03:02
Henderson is on her way to visit her neighbor Roy Baranski.
00:03:07
She had spent the night before drinking with him.
00:03:11
So she came in to check on him the next afternoon.
00:03:16
NARRATOR: But as Jeanne approaches Roy's door,
00:03:18
she can tell right away that something isn't right.
00:03:21
Roy?
00:03:22
She called for him outside of the house
00:03:24
and didn't get any response.
00:03:26
Roy?
00:03:27
The door was unlocked, but she didn't want to go in--
00:03:30
[DOG BARKING]
00:03:31
--clearly because of this 80-pound,
00:03:33
kind of aggressive-looking mutt that lives there.
00:03:37
So she gets another neighbor to come in with her.
00:03:40
[KNOCKING ON DOOR, DOG BARKING]
00:03:42
Roy?
00:03:44
NARRATOR: Her friend manages to restrain the dog,
00:03:46
and together, they cautiously enter the apartment.
00:03:49
Roy?
00:03:50
[DOG WHIMPERING]
00:03:51
NARRATOR: But as Jeanne makes her way into the bedroom,
00:03:54
she gets the shock of her life.
00:03:56
Roy!
00:03:58
JAN GARAVAGLIA: She finds him dead on the bed.
00:04:05
NARRATOR: When Bill arrives at the scene,
00:04:07
he immediately begins to gather clues.
00:04:10
We know he's a painter.
00:04:12
BILL STRATTON (VOICEOVER): Several of the rooms
00:04:14
had a lot of tools and equipment that the decedent
00:04:18
used at his work.
00:04:19
The place is a mess.
00:04:22
He is not quite sure what's going on.
00:04:25
I did notice two empty 1.75-liter
00:04:28
vodka bottles that were just to the right of the bed.
00:04:32
And there were some vials of medications
00:04:35
found on the windowsill.
00:04:38
NARRATOR: But the most telling clues are on the body itself.
00:04:42
JAN GARAVAGLIA: He's found with an incredible amount
00:04:44
of scratch marks on his chest and some bite
00:04:47
marks to his face.
00:04:49
It looks like it's all from his dog.
00:04:50
[DOG BARKING]
00:04:51
BILL STRATTON: This is an aggressive type of an animal
00:04:55
that was rather scary looking.
00:04:57
The crime scene people and Bill are worried
00:05:02
that this dog killed this guy.
00:05:06
You know, I see what dogs do to people.
00:05:09
I have autopsied kids who have been mauled by dogs.
00:05:13
I've autopsied, you know, people who've been eaten by their dogs
00:05:17
after they died.
00:05:19
And I see the bad effects.
00:05:22
NARRATOR: But after interviewing Roy's neighbor on the scene,
00:05:25
Bill begins to suspect that the 61-year-old may have in fact
00:05:29
fallen victim to foul play.
00:05:31
She tells us that there was actually
00:05:33
a verbal altercation with another neighbor
00:05:36
earlier that evening.
00:05:37
[SHOUTING, SIRENS BLARING]
00:05:39
BILL STRATTON: The detectives track him down,
00:05:40
and he claims that the argument was only verbal.
00:05:43
But we have a man that's dead with a lot of trauma.
00:05:47
JAN GARAVAGLIA: What the police want
00:05:48
to know is was it a murder?
00:05:50
Was it a homicide?
00:05:51
And so they're very anxious to figure out why he died.
00:05:56
NARRATOR: But despite the suspicious circumstances,
00:05:59
Dr. G must also consider the possibility
00:06:02
that Roy simply succumbed to some form of natural disease.
00:06:06
I went ahead and reviewed his medical records.
00:06:10
He has high blood pressure, and he's got elevated cholesterol.
00:06:14
He smokes.
00:06:15
And we know that he's a chronic alcohol user.
00:06:18
You know, we just have a whole assortment of things going on.
00:06:21
But about four months ago, he checked himself into
00:06:24
the hospital for alcohol rehab.
00:06:27
It sounded like he was getting better.
00:06:30
But I don't think it took because a lot
00:06:33
of the empty vodka bottles were found in his room.
00:06:37
They also note on those medical records
00:06:39
that he's gone into delirium tremors
00:06:41
before when he doesn't get the alcohol.
00:06:45
NARRATOR: Delirium Tremens, or DTs,
00:06:48
is a severe and often fatal form of alcohol
00:06:50
withdrawal that causes symptoms such as body
00:06:53
tremors and seizures.
00:06:55
JAN GARAVAGLIA: DTs have a high mortality rate.
00:06:58
Did he try to stop drinking again on his own
00:07:01
and he goes into alcohol withdrawal?
00:07:04
Or alcohol poisoning may have gotten him.
00:07:07
Too much alcohol, too little alcohol--
00:07:09
either one of them could kill him at this point.
00:07:12
NARRATOR: But there's one more tragic
00:07:14
possibility on the laundry list of potential killers.
00:07:18
JAN GARAVAGLIA: He also is very depressed over the loss
00:07:21
of his wife several years ago.
00:07:24
He was given some anti-depressants,
00:07:26
but he continued being depressed.
00:07:29
Maybe he overdosed.
00:07:30
I mean, suicide is a possibility.
00:07:34
JAN GARAVAGLIA (VOICEOVER): But I don't know what's going on.
00:07:37
Did the dog kill him?
00:07:38
Did the neighbor kill him?
00:07:39
Did he kill himself?
00:07:41
Did he drink himself to death?
00:07:44
We've got a lot of possibilities on this case.
00:07:50
[DRAMATIC MUSIC]
00:07:56
NARRATOR: Dr. G pulls back the protective sheet
00:07:59
and gets her first good look at Roy Baranski's body.
00:08:02
That is just a shame.
00:08:05
It's really quite remarkable what this man looks like.
00:08:09
Did you see these?
00:08:10
- Oh, jeez. - Gosh.
00:08:11
JAN GARAVAGLIA (VOICEOVER): There
00:08:12
are bite marks to his mouth.
00:08:15
There's even puncture marks to the eyelids.
00:08:17
JAN GARAVAGLIA: Scratches on his face.
00:08:19
I have never seen so many scratch marks on a body.
00:08:26
That dog was just clawing at that man.
00:08:32
It was really disturbing looking.
00:08:34
Oh, boy.
00:08:35
JAN GARAVAGLIA (VOICEOVER): I don't really
00:08:36
know what's going on at this point but to me
00:08:40
that raises a red flag.
00:08:42
Did the dog kill him?
00:08:48
[DRAMATIC MUSIC]
00:09:04
NARRATOR: Dr. G has just discovered that Roy Baranski
00:09:06
whose body is covered in severe scratch and bite marks,
00:09:11
and she believes his pet dog is to blame.
00:09:14
[DOG BARKING]
00:09:15
We've got this horrible 80-pound
00:09:17
aggressive dog that looks like he's mauled his owner.
00:09:21
We need to document his injuries.
00:09:24
That is really bad.
00:09:25
JAN GARAVAGLIA (VOICEOVER): Is this pre-mortem, the injuries,
00:09:27
or are these post-mortem injuries?
00:09:29
I've had cases where dogs have killed people.
00:09:32
And then I've had cases where dogs have eaten
00:09:36
their owners after they died.
00:09:39
And when you look closely, those scratch marks,
00:09:42
some are clearly post-mortem.
00:09:43
But some of them are red and raw,
00:09:46
and it could be just about the time he died.
00:09:50
He's got some bruising on his arm.
00:09:53
He's got some other minor bruising on the body
00:09:57
and bruising of the eyelids.
00:09:59
I'm not sure that's from the dog or if that's
00:10:02
from the altercation, from this angry neighbor.
00:10:10
JAN GARAVAGLIA: Let me see his mouth first.
00:10:11
Hold on.
00:10:13
NARRATOR: Next, Dr. G closely examines the inside
00:10:16
of Roy's mouth, a part of the body that might shed light
00:10:19
on an alcohol-related death.
00:10:20
JAN GARAVAGLIA (VOICEOVER): For us to figure out
00:10:22
if he died from delirium tremors,
00:10:24
I would look for evidence of a seizure.
00:10:26
Oftentimes, they'd bite their tongue.
00:10:29
Is there blood?
00:10:30
Is there trauma?
00:10:32
But there's really none of that.
00:10:36
NARRATOR: But right away, another unusual detail
00:10:38
catches her eye.
00:10:40
Oh, bad-- really bad.
00:10:41
He doesn't have any teeth.
00:10:42
I don't think he's got one in his mouth.
00:10:45
JAN GARAVAGLIA (VOICEOVER): The gums have eroded down.
00:10:47
I mean, there's really little gum tissue or even bone left.
00:10:51
It is not uncommon to see decedents with no teeth.
00:10:54
If you don't take care of them, they're going to fall out.
00:10:56
JAN GARAVAGLIA: Ah, what else have we got going on here?
00:10:58
JAN GARAVAGLIA (VOICEOVER): But there's
00:11:00
really no other clues that would help me narrow down
00:11:04
my hypothesis on why he died.
00:11:07
We still need a cause of death on this guy.
00:11:09
We're not going to know the answer
00:11:11
till I look on the inside.
00:11:14
[DRAMATIC MUSIC]
00:11:19
It's OK.
00:11:24
JAN GARAVAGLIA (VOICEOVER): I do my Y incision,
00:11:25
look at the chest muscles to see if there's
00:11:27
any blows to the chest.
00:11:29
Hmm.
00:11:30
JAN GARAVAGLIA (VOICEOVER): But I don't see any.
00:11:32
I open the abdomen.
00:11:35
I don't see any free blood.
00:11:37
You notice there's no blood in there.
00:11:38
There's nothing in there.
00:11:39
You can pretty much rule out that the dog
00:11:42
did anything to him.
00:11:43
All of those external scratch marks and bites
00:11:47
were most likely post-mortem or at the time that he was dying.
00:11:53
It makes really no sense.
00:11:55
Why he was scratching him so, but it certainly
00:11:59
did not cause his death.
00:12:01
NARRATOR: But while Roy's dog has
00:12:02
been ruled out as a suspect, foul play has not.
00:12:07
JAN GARAVAGLIA (VOICEOVER): Next, we look very carefully
00:12:10
for any other types of trauma.
00:12:13
I don't see a gunshot wound.
00:12:16
I don't see a stab wound.
00:12:17
We don't see any other trauma.
00:12:18
There's no free blood in the belly.
00:12:20
I see no major trauma.
00:12:23
NARRATOR: Next, Dr. G draws fluids to send
00:12:25
to the lab for analysis.
00:12:28
All right, let's see what kind of tox we're getting.
00:12:30
NARRATOR: The results could reveal
00:12:31
a fatal overdose of medication or an alcohol-related death.
00:12:37
Toxicology can be the key to this case.
00:12:42
NARRATOR: Then she begins looking at his organs,
00:12:44
one by one.
00:12:46
And given his history of chronic alcoholism,
00:12:49
her first stop is the liver.
00:12:51
I'm still waiting for that nice peek of his liver.
00:12:53
Where is it?
00:12:54
A healthy liver is--
00:12:56
have a brownish, almost mahogany look.
00:12:59
So it has a very sharp edge, but his liver is rounded,
00:13:03
and it's fatty.
00:13:04
That is one nasty looking liver.
00:13:09
It is a liver of a chronic alcoholic.
00:13:12
Oh, wow.
00:13:13
That's [INAUDIBLE]
00:13:16
JAN GARAVAGLIA (VOICEOVER): His liver was bad,
00:13:18
but it didn't look really bad enough to kill him.
00:13:22
It probably at this point is not his cause of death.
00:13:27
NARRATOR: No closer to an answer,
00:13:30
Dr. G switches gears to examine the organs
00:13:33
in Roy's chest cavity.
00:13:35
So first I remove the lungs.
00:13:38
Look at that.
00:13:39
That's terrible.
00:13:40
JAN GARAVAGLIA (VOICEOVER): He clearly has emphysema.
00:13:43
JAN GARAVAGLIA: Look at that black in his lungs.
00:13:45
But I don't see anything acute, recent
00:13:48
going on in his lungs.
00:13:50
To my eye, they don't look like they've killed him today.
00:13:54
Now, if he'd have continued smoking, if he'd have lived,
00:13:59
those lungs could have really been his cause of death
00:14:02
down the road.
00:14:04
NARRATOR: Dr. G then turns her attention
00:14:06
to the 61-year-old's heart.
00:14:08
On first glance, it appears healthy.
00:14:12
But she'll have to dissect an exam in each valve and chamber
00:14:15
to find out for sure.
00:14:17
So right off the bat, I caught the heart--
00:14:20
JAN GARAVAGLIA: It's not looking good.
00:14:22
JAN GARAVAGLIA (VOICEOVER): And whoa, lo and behold, I see--
00:14:25
JAN GARAVAGLIA: Oh, my god.
00:14:26
JAN GARAVAGLIA (VOICEOVER): --evidence of a heart attack.
00:14:28
JAN GARAVAGLIA: Whoa, whoa, whoa.
00:14:30
I really think I've got the smoking gun.
00:14:33
But when I cut the heart muscle, it's not acute.
00:14:38
It just didn't happen right before he died.
00:14:42
So this heart attack happened about a week ago.
00:14:46
Some people can have heart attacks,
00:14:48
and they didn't even know they had it.
00:14:51
Although it happened seven to 10 days ago,
00:14:52
it's very critical because that heart is very sensitive.
00:14:57
NARRATOR: In fact, any added stress on Roy's heart
00:14:59
could have caused the fatal arrhythmia at any time.
00:15:03
JAN GARAVAGLIA: He was a ticking time bomb,
00:15:06
and he did have an altercation with that neighbor.
00:15:10
At this point, I think I have my answer.
00:15:13
He probably died from arrhythmia.
00:15:16
NARRATOR: But unlike Roy's minor heart attack,
00:15:18
an arrhythmia leaves no trace evidence in the body.
00:15:22
So Dr. G will first have to rule out everything else,
00:15:27
and there's one last place to look.
00:15:30
So I have to finish the autopsy and look at the neck.
00:15:33
Did that neighbor choke him?
00:15:36
Did he strangle him?
00:15:38
So we reflect the skin up off of those neck muscles.
00:15:44
I'm looking for trauma.
00:15:45
That's what I'm doing in the neck.
00:15:47
JAN GARAVAGLIA (VOICEOVER): And then we, layer by layer,
00:15:50
look at those muscles to see if there's any hemorrhage--
00:15:53
no hemorrhage.
00:15:54
He has no evidence of any kind of strangulation.
00:15:57
NARRATOR: But what she sees next--
00:15:59
JAN GARAVAGLIA: Oh, look at that.
00:16:00
NARRATOR: --takes her completely aback.
00:16:03
I've never seen it before.
00:16:04
It's wet.
00:16:05
Oh, my gosh.
00:16:06
JAN GARAVAGLIA (VOICEOVER): I couldn't even believe my eyes.
00:16:15
[DRAMATIC MUSIC]
00:16:27
I can't even see the-- oh, here's where--
00:16:29
OK.
00:16:31
Look at that.
00:16:32
NARRATOR: Dr. G has just uncovered
00:16:34
one of the strangest findings of her over-20-year career.
00:16:38
Lo and behold, I'm shocked.
00:16:43
Oh.
00:16:44
I've never seen that.
00:16:46
NARRATOR: Deep inside the larynx of 61-year-old
00:16:48
Roy Baranski is something that doesn't belong there--
00:16:53
dentures.
00:16:55
JAN GARAVAGLIA: There in his larynx.
00:16:58
All right.
00:16:59
His dentures are impacting on the vocal cords
00:17:02
and partially going through them.
00:17:04
I was totally surprised.
00:17:06
I didn't know the guy had dentures.
00:17:08
His gums are just-- they must have been so loose.
00:17:12
So I know a lot about this case, but I don't
00:17:15
think I have the answer yet.
00:17:17
We know he's got a very bad heart that could
00:17:20
have killed him at any time.
00:17:21
But we also know that he has got dentures down in his larynx.
00:17:27
NARRATOR: And the unusual finding notwithstanding, it's
00:17:29
still unclear if the dentures played a role in Roy's death
00:17:33
or how they got three inches down his throat
00:17:36
in the first place.
00:17:38
JAN GARAVAGLIA (VOICEOVER): I don't know what's going on.
00:17:40
So I think tox is going to play a key role here.
00:17:48
[DRAMATIC MUSIC]
00:17:55
NARRATOR: Three weeks later, the report finally arrives
00:17:58
from Wusthof Toxicology Lab.
00:18:01
I'm hoping I have an answer.
00:18:03
NARRATOR: And as her eyes scan down the page,
00:18:05
one unexpected detail jumps out at her.
00:18:09
I was actually very surprised.
00:18:11
NARRATOR: And with this last clue in hand,
00:18:14
Dr. G can finally replay the chain of events
00:18:17
that led to Roy's sudden death.
00:18:19
JAN GARAVAGLIA (VOICEOVER): So I think that puts all the pieces
00:18:21
of the puzzle together.
00:18:23
I think we know what killed him.
00:18:28
[DRAMATIC MUSIC]
00:18:35
NARRATOR: Roy Baranski has had a tough couple of years
00:18:37
since the death of his wife.
00:18:39
He's suffering from severe depression,
00:18:42
and his chronic alcoholism has been spiraling out of control.
00:18:46
I think depression plays a huge part
00:18:49
in many alcoholics and people who just stopped
00:18:53
taking care of themselves.
00:18:56
NARRATOR: Recently, the 61-year-old's been trying
00:18:58
to get his life back on track.
00:19:01
JAN GARAVAGLIA: He said he wanted to get off of alcohol.
00:19:03
He spent about three weeks in rehab.
00:19:07
He was detoxed.
00:19:09
NARRATOR: But Roy isn't able to stay sober for long,
00:19:13
and eventually he slides back into old habits.
00:19:18
On a Friday evening, several neighbors gather at his house
00:19:21
for a night of hard drinking.
00:19:23
[CHATTER]
00:19:24
JAN GARAVAGLIA: There's a lot of drinking.
00:19:26
These guys are extremely drunk.
00:19:30
NARRATOR: Roy and one of his neighbors begin arguing,
00:19:33
and the party soon breaks up, but Roy doesn't stop drinking.
00:19:38
I was actually very surprised just how drunk he was.
00:19:43
His level was just about a 0.5.
00:19:47
Most people would die in and of itself with a 0.5.
00:19:54
But for drinkers that have been going at it for years and years
00:19:56
and years, it's not uncommon, but you're
00:19:59
on that edge of death.
00:20:01
NARRATOR: With his blood alcohol rising,
00:20:03
it isn't long before Roy passes out on the bed.
00:20:07
While he's intoxicated, his denture becomes too loose
00:20:11
because his bone is eroded.
00:20:14
The dentures are old.
00:20:15
They didn't fit well at all, and they slip off,
00:20:19
and they slip down into his throat.
00:20:24
Normally, we would have a gag reflex.
00:20:26
We would try to cough that up immediately.
00:20:29
He doesn't have that.
00:20:30
That is all blunted because of the alcohol.
00:20:33
You've decreased your central nervous system
00:20:36
to the point where you can't even
00:20:39
coordinate your swallowing.
00:20:41
That's why people choke.
00:20:43
That's what makes it easy for him to aspirate.
00:20:46
He's choking on his dentures.
00:20:51
They occlude his airway.
00:20:53
He's probably having difficulty breathing.
00:20:56
He already had lower lung capacity
00:20:58
because of his emphysema.
00:21:00
NARRATOR: And with a heart already
00:21:01
damaged by a recent coronary, the scenario
00:21:04
is a recipe for disaster.
00:21:07
JAN GARAVAGLIA: He's not getting enough oxygen into his lungs
00:21:11
and with a heart that's already so sick
00:21:13
that any kind of decrease in oxygenation
00:21:16
would have put it over the edge.
00:21:17
NARRATOR: The 61-year-old's heart
00:21:19
begins to beat erratically.
00:21:21
And within seconds, Roy Baranski dies.
00:21:32
Dr. G can now officially rule on a cause of death.
00:21:38
But one question remains--
00:21:40
what about the dog scratches?
00:21:43
He was just furiously scratching at his master.
00:21:48
Why was the dog doing this?
00:21:56
[DRAMATIC MUSIC]
00:22:07
NARRATOR: Dr. G has just closed the bizarre case
00:22:09
of Roy Baranski.
00:22:11
JAN GARAVAGLIA: In my years as a medical examiner,
00:22:13
I have seen people aspirate boluses of food,
00:22:16
pieces of steak, even a wad of paper towel,
00:22:21
but I've never seen anybody aspirate their own dentures.
00:22:24
NARRATOR: But there's still one piece of the puzzle
00:22:26
that's been left unsolved.
00:22:29
Why was Roy's body covered in dog scratches and bites?
00:22:33
Why was the dog doing this?
00:22:36
NARRATOR: It's a perplexing question.
00:22:38
But after re-examining all the findings,
00:22:40
Dr. G comes to another surprising conclusion.
00:22:45
I actually was dead wrong from the beginning.
00:22:49
I really thought that dog might have played
00:22:53
a role in his death, or at the very least
00:22:56
was trying to eat that fellow.
00:23:00
I was wrong.
00:23:01
I really think that dog was trying to save his life.
00:23:06
I think the dog saw that he was in distress.
00:23:09
Animals are very keen to what's
00:23:11
going on in their environment.
00:23:13
He's probably scratching at his master to try to help him out.
00:23:19
I guess he's doing doggie CPR.
00:23:21
My view of that dog has changed.
00:23:24
I guess he's not the bad dog that I thought he was.
00:23:27
[DOG WHIMPERING]
00:23:29
Maybe dogs aren't all bad.
00:23:34
I personally take a lot away from this case.
00:23:37
So lesson is it may appear to be one thing at the scene,
00:23:41
but you never know until Dr. G completes the autopsy
00:23:45
and gives us the full, final answer.
00:23:49
[UPBEAT MUSIC]
00:23:53
NARRATOR: Dr. G is always excited about solving
00:23:56
a mystery.
00:23:57
And while her next case promises to be just that,
00:24:01
it's one that she'd just as soon never see in the morgue.
00:24:08
I have to deal with many infant deaths.
00:24:11
This is a little baby--
00:24:12
gosh, how old?
00:24:15
JAN GARAVAGLIA (VOICEOVER): It's a really difficult autopsy.
00:24:19
We wish we could bring the baby back.
00:24:21
We can't.
00:24:22
We can just diagnose.
00:24:24
So that's why you have to do an autopsy.
00:24:27
As with all baby cases, this is a sad one.
00:24:30
This is a 4-month-old.
00:24:31
JAN GARAVAGLIA (VOICEOVER): It's our job
00:24:32
then to figure out what happened and give the family answers.
00:24:39
[DRAMATIC MUSIC]
00:24:44
NARRATOR: It's late September in Orlando, Florida.
00:24:47
Peek-a-boo.
00:24:48
NARRATOR: And Whytnea Matthews is enjoying an evening at home
00:24:51
with her daughter Laniya.
00:24:53
I had a little routine that I did for her every night.
00:24:55
I played with her a few hours before she went to bed.
00:24:59
I'd put that CD on with the classical music,
00:25:02
and I'd rock her a little bit.
00:25:03
And once her eyes start to close, I'd lay her down.
00:25:09
And then I laid down myself around 11:00, 11:30.
00:25:12
NARRATOR: But Whytnea could have never imagined
00:25:14
that within just a few hours her seemingly
00:25:17
ordinary day would turn into a mother's worst nightmare.
00:25:20
I woke up close to 3 o'clock in the morning,
00:25:23
came back to check on her, and I noticed she wasn't breathing.
00:25:28
I was like, maybe the dark us playing tricks on my eyes.
00:25:32
[SOBBING]
00:25:33
NARRATOR: Panicked, Whytnea immediately dials 9-1-1.
00:25:35
(FRANTIC) Something is wrong with my baby.
00:25:37
NARRATOR: Her next call is to the baby's father, Jefferson.
00:25:41
JEFFERSON DELVA: So I rushed over,
00:25:42
and we just was trying to do CPR,
00:25:44
trying to just do anything possible.
00:25:46
[SIRENS BLARING]
00:25:48
NARRATOR: Paramedics arrived just seconds behind him
00:25:51
and attempt to resuscitate the 4-month-old.
00:25:54
JEFFERSON DELVA: Just like a lot of emotion
00:25:55
going through your head.
00:25:56
The baby's not breathing.
00:25:57
JEFFERSON DELVA: They're trying to save
00:25:58
my child's life right now.
00:26:01
NARRATOR: They performed CPR for over an hour,
00:26:05
but it's too late.
00:26:08
JEFFERSON DELVA: There was nothing more they could do.
00:26:11
That was like one of the worst feelings I ever had in my life.
00:26:14
NARRATOR: In just the blink of an eye,
00:26:15
Laniya's life is cut tragically short.
00:26:18
And her heartbroken parents are left struggling
00:26:20
to make sense of the loss.
00:26:22
You go into having a child thinking,
00:26:24
you know, you're going to watch this person, mold this person
00:26:26
into an adult, and then in a split second,
00:26:29
you get it taken away from you.
00:26:31
WHYTNEA MATTHEWS: Laniya was a happy baby,
00:26:32
laughing and smiling.
00:26:35
She was very happy.
00:26:37
It was hard to accept that she passed on.
00:26:40
It was unexpected.
00:26:42
There weren't any warning signs.
00:26:50
[DRAMATIC MUSIC]
00:27:04
So the story is--
00:27:05
NARRATOR: The District 9 morgue has just received the tiny body
00:27:08
of baby Laniya Delva.
00:27:11
JAN GARAVAGLIA: This is a four-month-old baby that
00:27:13
died suddenly and unexpectedly.
00:27:16
It's really devastating for the family,
00:27:19
for the mom and the dad.
00:27:20
You know it was just so, like, out of the blue.
00:27:24
It was hard to accept that she was no longer with us.
00:27:27
JEFFERSON DELVA: We just wanted to know what really happened.
00:27:30
JAN GARAVAGLIA: I really have to figure out
00:27:32
what killed this child so I can at least
00:27:34
kind of help the family along to help understand this.
00:27:40
NARRATOR: Dr. G begins by reviewing
00:27:41
Laniya's medical history, hoping to glean
00:27:44
any information that could shed light
00:27:46
on the infant's sudden death.
00:27:48
The medical history is that the baby's
00:27:50
had a cold the past couple days, but nothing
00:27:53
major, kind of sniffles.
00:27:55
JAN GARAVAGLIA (VOICEOVER): If that plays a role, I doubt it.
00:27:57
But I'm really not too worried about it.
00:28:00
NARRATOR: However, reading further,
00:28:01
she does spot something of note.
00:28:05
Laniya was born with sickle cell disease.
00:28:08
Sickle cell disease affects 70,000 people in the United
00:28:12
States and millions worldwide.
00:28:15
NARRATOR: Sickle cell disease is a genetic abnormality
00:28:18
of the body's red blood cells.
00:28:20
It causes just a slight variation in the hemoglobin
00:28:24
molecule, the molecule inside the red blood cells
00:28:27
that carry the oxygen. Normally a red cell looks
00:28:33
almost like a donut or disk.
00:28:35
But when these cells get stressed,
00:28:38
this abnormal hemoglobin causes the red blood cell
00:28:41
to change shape, and it looks like a little-- kind
00:28:43
of a half-moon sickle.
00:28:45
NARRATOR: But while the disease can sometimes
00:28:47
lead to fatal complications, Dr. G doesn't believe it's
00:28:50
to blame in Laniya's death.
00:28:52
Only four months old--
00:28:54
usually they don't start having trouble until about six months.
00:28:57
It's unusual to find a baby in this age group die suddenly
00:29:02
and unexpectedly from sickle cell disease.
00:29:06
Higher on my list, I'd worry about the typical things
00:29:10
we would see in this age group, and that
00:29:12
would be congenital abnormalities that
00:29:14
didn't get picked up at birth.
00:29:17
Mostly, it would be heart abnormalities.
00:29:19
That's something I'll keep in my mind.
00:29:22
But while Dr. G isn't overly concerned
00:29:24
about the sickle cell, it isn't long
00:29:26
before she comes across troubling evidence
00:29:29
of a completely different sort.
00:29:31
My investigator said she's got a contusion,
00:29:34
or bruise, on her forehead.
00:29:36
That's a little worrisome.
00:29:39
NARRATOR: And although Whytnea and Jefferson seem like loving
00:29:42
parents, Dr. G can't help but consider
00:29:45
the worst possible scenario.
00:29:47
JAN GARAVAGLIA (VOICEOVER): This could be child abuse.
00:29:50
And unfortunately, I have to be suspicious,
00:29:53
and I'm going to look for that.
00:29:54
NARRATOR: But the most frustrating possibility of all
00:29:57
is that she might never know what
00:29:59
caused the baby's sudden death.
00:30:01
It always bothers me when I can't find the answer.
00:30:04
But with children, a lot of times when there's nothing
00:30:07
wrong with them either at autopsy
00:30:09
or under the microscope, and ultimately if I can't figure
00:30:13
out why this baby died, we rule it
00:30:16
sudden infant death syndrome.
00:30:19
We're not going to know until we start the autopsy.
00:30:25
[DRAMATIC MUSIC]
00:30:31
JAN GARAVAGLIA (VOICEOVER): When I approach
00:30:32
the gurney on a baby, you would think my emotion
00:30:36
would be, oh, how sad.
00:30:38
That lasts for maybe a second.
00:30:42
Pretty eyes too.
00:30:43
JAN GARAVAGLIA (VOICEOVER): But what goes through your mind
00:30:45
is I have my work cut off for me because we have
00:30:49
to rule out a lot of things, and some of those things
00:30:52
are quite subtle.
00:30:54
I start out looking--
00:30:56
does the baby look well cared for?
00:30:58
Does it have any really bad rashes
00:31:01
or diaper rash or things that look like it's been neglected?
00:31:06
And she looks pretty good.
00:31:08
Her height, her weight all are normal.
00:31:12
And then, of course, I will be looking for any signs of trauma
00:31:19
there was a little scar on the scalp
00:31:21
that my investigator noticed.
00:31:24
It looks completely healed at this point,
00:31:27
but that doesn't mean that there's
00:31:29
still not trauma internally.
00:31:32
I don't--
00:31:34
NARRATOR: Now, Dr G must dig deeper for answers,
00:31:36
and she knows just where to start.
00:31:39
JAN GARAVAGLIA: You've got to make sure
00:31:41
that head is fine because that's where most of the child abuse
00:31:45
is.
00:31:51
JAN GARAVAGLIA (VOICEOVER): This is
00:31:52
the part of the autopsy where you take a deep breath
00:31:56
and you reflect the scalp.
00:32:00
Then we remove the calvarium to look at the brain.
00:32:04
And that moment that we take that calvarium off
00:32:08
is very important because with abusive head trauma in this age
00:32:11
group, you may see just a tiny little bit
00:32:13
of subdural blood and some cerebral swelling,
00:32:17
and that might be all we see.
00:32:20
So it's a big moment--
00:32:21
the difference between a natural or a homicide.
00:32:26
This could be child abuse.
00:32:28
It is unimaginable to me, but unfortunately we see it.
00:32:37
[DRAMATIC MUSIC]
00:32:51
NARRATOR: Dr. G is examining the brain
00:32:53
of four-month-old Laniya Delva on the hunt for any signs
00:32:57
of a fatal injury.
00:32:59
JAN GARAVAGLIA (VOICEOVER): You have
00:33:00
to make sure it's not some kind of abusive or even accidental
00:33:03
trauma that causes her death.
00:33:06
Autopsying babies, the stress is very high
00:33:09
and everybody everybody's concerned
00:33:10
and fixated on that child.
00:33:13
Charges may be pending against parents, so the stress is high.
00:33:19
NARRATOR: She carefully removes the brain,
00:33:21
her eyes peeled for subtle signs of swelling or bleeding.
00:33:25
JAN GARAVAGLIA: It looks normal.
00:33:27
I don't see any evidence of any kind of trauma,
00:33:31
but I can't rule out trauma at this point.
00:33:33
So I'll wait till I see what I can get inside.
00:33:45
NARRATOR: To begin, Dr. G makes a standard Y-shaped incision
00:33:48
from the shoulders to pelvis, just as she
00:33:51
would with a full-grown adult.
00:33:54
JAN GARAVAGLIA (VOICEOVER): When I reflect the skin off the rib
00:33:57
cage, it's very important to look for rib fractures
00:34:01
because with babies, it'll usually indicate some kind
00:34:04
of violence and squeezing.
00:34:06
I don't see any on her, thank goodness.
00:34:09
So there is no trauma on this baby.
00:34:12
JAN GARAVAGLIA (VOICEOVER): So at this point, I go ahead,
00:34:14
take the chest plate off.
00:34:16
JAN GARAVAGLIA: I'm having a hard time getting blood now.
00:34:18
NARRATOR: On the lookout for any congenital abnormalities,
00:34:21
she heads straight to an organ high on her list of suspects--
00:34:25
the heart.
00:34:28
JAN GARAVAGLIA: I look at all the vessels
00:34:29
because some vessels don't--
00:34:31
they aren't right.
00:34:32
They don't go to the right place in the heart.
00:34:34
But none of that showed any congenital abnormality.
00:34:40
So that heart's about normal size.
00:34:43
This heart looks completely fine.
00:34:45
And then I move on to the lungs.
00:34:48
I suspect--
00:34:49
I don't know what's going on down here.
00:34:52
Boy, she is really congested.
00:34:54
The lungs are very dense, and they're very wet.
00:34:59
It could mean the babies is having some type
00:35:01
of infection in its lungs.
00:35:03
I'm worried about pneumonia.
00:35:05
NARRATOR: Delicately, she dissects each lung,
00:35:08
searching for the telltale signs of pneumonia,
00:35:11
inflammation, or pus.
00:35:13
JAN GARAVAGLIA: But no clearcut evidence
00:35:14
of bacterial pneumonia.
00:35:17
But that looks like from CPR most likely.
00:35:20
NARRATOR: Dr. G takes sections of tissue
00:35:22
to examine under the microscope.
00:35:24
She'll need a magnified view to rule out infection for sure.
00:35:28
So it's time to move on to the abdomen.
00:35:30
Sandy, would you be willing--
00:35:31
What do you need?
00:35:32
--to write these down?
00:35:33
Absolutely.
00:35:35
I look at the kidneys.
00:35:36
I look at the pancreas.
00:35:38
I even look at her little uterus,
00:35:40
the little baby ovaries.
00:35:43
All of that looked normal.
00:35:46
That's weird.
00:35:47
JAN GARAVAGLIA (VOICEOVER): But I do see
00:35:48
this massively enlarged spleen.
00:35:50
Aha-ha.
00:35:52
JAN GARAVAGLIA (VOICEOVER): She's only four months old.
00:35:53
It looks more like a four-year-old spleen.
00:35:58
That's how much it is expanded.
00:36:01
Kids, particularly with sickle cell, at the early stage,
00:36:06
will have enlarged spleens.
00:36:09
NARRATOR: But Laniya's spleen is over twice its normal size,
00:36:12
much larger than she would expect
00:36:14
to see in a baby suffering from sickle cell disease.
00:36:16
JAN GARAVAGLIA (VOICEOVER): This one is a little worrisome.
00:36:18
It's a little too big.
00:36:20
NARRATOR: As with the lungs, Dr. G
00:36:22
most inspect the tissue from the spleen on a microscopic level
00:36:26
to figure out exactly what's going on.
00:36:28
I can't put this together yet.
00:36:31
At this point, nothing's really gelling.
00:36:37
The more I click off the list, we're left with,
00:36:42
why did this baby die?
00:36:44
JAN GARAVAGLIA: We don't know what's going on yet.
00:36:46
JAN GARAVAGLIA (VOICEOVER): We need
00:36:47
to look under the microscope to look at the tissues
00:36:53
and what's going on.
00:36:57
BRIAN MACHULSKI: Things that come in here, some
00:36:58
of the cases, are very obvious.
00:37:01
Sometimes, when they're not so obvious,
00:37:04
that's when Dr. G will turn to one of her very closest
00:37:07
friends, and that's the microscope,
00:37:09
so that they'll be able to provide better answers for her.
00:37:14
To get an answer, particularly for the parents,
00:37:17
because they deserve an answer.
00:37:20
We wanted to know what actually
00:37:21
happened because, honestly, you tend to blame yourself.
00:37:32
NARRATOR: It's near closing time on Friday afternoon,
00:37:35
but Dr. G isn't heading home just yet.
00:37:38
The slides she's been eagerly awaiting
00:37:40
have finally arrived from the lab.
00:37:42
I have to look at those glass slides
00:37:44
before I can make a diagnosis.
00:37:47
I want to look at what's going on with this child.
00:37:50
NARRATOR: She turns the dial to focus in on the first image
00:37:53
and with one glance, Dr. G believes
00:37:56
she can finally explain exactly what led
00:37:58
to baby Laniya's tragic death.
00:38:04
[DRAMATIC MUSIC]
00:38:12
NARRATOR: It's 9:30 PM, and Whytnea Matthews is rocking
00:38:15
her baby girl Laniya to sleep.
00:38:19
It's a typical night for mother and daughter,
00:38:21
except Laniya seems to be a little under the weather.
00:38:24
JAN GARAVAGLIA: The baby did have
00:38:25
a couple days of kind of sniffles,
00:38:27
was felt to be a cold.
00:38:30
NARRATOR: But when Dr. G magnifies Laniya's
00:38:33
his lung tissue, she can see right away
00:38:35
that this was no simple cold.
00:38:38
JAN GARAVAGLIA: It looks like the baby's is having some type
00:38:40
of a viral infection in its lung,
00:38:42
and the virus really got more into her lungs.
00:38:46
It was a little deeper down than just a head cold.
00:38:49
And because of the infection, she wasn't getting
00:38:52
enough oxygen into her lungs.
00:38:55
NARRATOR: In any four-month-old baby with sickle cell,
00:38:58
the stress of the infection and lack of oxygen
00:39:01
would usually cause some sickling.
00:39:04
But in Laniya's case, it has triggered a massive sickle cell
00:39:08
emergency.
00:39:10
JAN GARAVAGLIA: What's most disturbing on these slides
00:39:14
is the amount of sickling that has occurred.
00:39:17
All of her cells are sickled--
00:39:19
everywhere I looked.
00:39:21
NARRATOR: This tells Dr. G that Laniya must have had
00:39:24
an extreme case of the disease.
00:39:27
Her fragile red blood cells had mutated
00:39:29
from their normal round shape into an oblong sickle shape.
00:39:35
JAN GARAVAGLIA: The abnormal shape
00:39:36
causes those cells to be more apt to start getting
00:39:39
stuck in little small spaces.
00:39:42
The sickle-shaped cells begin to move through her bloodstream.
00:39:46
But when they reach the spleen, they
00:39:48
are unable to pass through.
00:39:50
The spleen just sequesters and grabs them all up.
00:39:54
It's kind of like that Roach Motel--
00:39:56
once the blood goes in, it can't go out.
00:39:59
The blood causes Laniya's tiny spleen to expand
00:40:02
to over twice its normal size.
00:40:05
And from there, she begins a rapid downhill decline.
00:40:09
JAN GARAVAGLIA: She's got so much blood caught up
00:40:11
into her spleen that she's not getting
00:40:13
enough to the rest of her body, and she goes into shock.
00:40:18
NARRATOR: Eventually, Laniya's organs begin to shut down one
00:40:21
by one, and it isn't long before her heart
00:40:25
stops beating altogether.
00:40:27
JAN GARAVAGLIA: You know, this was
00:40:28
all going on while the baby was sleeping,
00:40:31
and nobody had a clue.
00:40:41
The family, they did everything right.
00:40:44
Logically, it shouldn't have happened.
00:40:47
She didn't follow the textbook.
00:40:49
It happened at a much younger age than you'd expect it.
00:40:53
Now, why did she sickle at this age when a lot of babies don't?
00:40:59
Some people do have worse sickle cell disease than others.
00:41:05
Some people just have higher concentrations
00:41:07
of that sickle hemoglobin than others.
00:41:10
And she clearly had a bad disease
00:41:14
to have such a bad reaction at such a young age.
00:41:19
NARRATOR: Unfortunately, even if Laniya had survived,
00:41:22
the disease would have eventually taken a toll.
00:41:26
JAN GARAVAGLIA: The baby was going
00:41:27
to have a rough road ahead.
00:41:31
She would have had a lot of chronic pain
00:41:35
and chronic anemia.
00:41:38
It's not an easy row to hoe.
00:41:40
NARRATOR: However, in recent years,
00:41:42
there have been tremendous advancements in managing
00:41:44
sickle cell disease.
00:41:47
We can treat it much better now.
00:41:50
There's actually a medication that helps the sickle cells not
00:41:55
sickle so much, and so this has been a boon for people
00:41:59
with sickle cell disease.
00:42:01
NARRATOR: And while nothing can make up
00:42:02
for their devastating loss, Dr. G's findings
00:42:05
ultimately helped to bring some sense of closure
00:42:08
to Laniya's parents.
00:42:10
Now we know what actually happened,
00:42:13
just the sense of knowing that it wasn't nothing that we did.
00:42:17
Right now, I'll still be cherishing the moments
00:42:19
that I had with her.
00:42:22
You know, it just goes to show you how precious life is
00:42:26
and how fast it can be taken away from us.
00:42:30
You just never know.
