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[OMINOUS TONE PLAYING] [MUSIC PLAYING] NARRATOR: A healthy 10-year-old boy is found
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dead on his bedroom floor. It was so sad. Oh my goodness, how could this happen?
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NARRATOR: But as questions multiply, it quickly turns into a case unlike any Dr.
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G has ever faced. DR. G: It's really opened my eyes. I just can't forget it. NARRATOR: Then, a young girl is struck by lightning,
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and tragically does not survive. And then the doctor is telling me this is it. You know, I'm sorry Mrs. Chappelle,
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Erica's no longer with us. NARRATOR: And suddenly, Dr. G must make a potentially
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life saving decision. That's one of the calls we get in the middle of the night:
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if you deny those organs, you know, people may die. [MUSIC PLAYING] NARRATOR: Altered lives, baffling medical mysteries,
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shocking revelations, these are the everyday cases of Dr. G, medical examiner. [MUSIC PLAYING]
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69-year-old, history of heart disease, let's see-- NARRATOR: As chief medical examiner of the District 9
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morgue in Orlando, Dr. Jan Garavaglia's days are usually jam packed. This is going to be a mess.
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NARRATOR: But if there's one thing she'll always make time for, its consultations with fellow medical examiners,
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like her good friend Norma Jean Farley. And it's face down, and it's a strangulation.
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Dr. Farley and I practice in different states, but oftentimes, when either one of us
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wants to bounce off ideas about a case, we'll just both pick up the phone, and drop what we're doing, and talk to each other.
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We-- we think very much alike. I really value her judgment, and she's an excellent pathologist.
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NARRATOR: They first met in the 1990s, at the Bexar County medical examiner's office in San Antonio, Texas.
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Back then, Dr. Farley was a pathology fellow, working under Dr. G's guidance. During the fellowship, Dr. G was one of my mentors.
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I would often consult Dr. G about cases that I may have had in the morgue, any questions or anything I wasn't sure about.
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NARRATOR: And in the winter of 1999, Dr. Farley sought Dr. G's advice on a case that
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seemed impossible to crack. --at this point. NARRATOR: Little did either know, it would soon become one of the most
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confounding and emotionally charged cases of both pathologists' careers. I was just involved somewhat peripherally,
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but I just can't forget it. It was a child, and it was so sad and so unexpected,
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that it's just never left me. NARRATOR: September, 1999. Danny Evans is 10 years old and living with his parents
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in San Antonio, Texas. Like a lot of kids his age, he loves sports and video games,
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but he also has a passion for music. In fact, he spent much of the past summer teaching himself
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to play electric guitar. This is a happy, happy go lucky child with a nice family.
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NARRATOR: But as the school year gets underway, parents Katie and Tom begin to notice a troubling change
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in Danny's behavior. He wasn't his normal self. He's a little too hyper, and he was having
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a hard time in school sitting still, focusing, and concentrating. NARRATOR: Determined to get a better handle on the problem,
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Danny's parents arranged for a consultation with his pediatrician. What they discover next changes their lives forever.
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They finally got him diagnosed, and he had ADHD, attention deficit hyperactivity disorder.
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And there's certainly different variations of that, but it's basically that these children
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have a hard time focusing and concentrating, and are very hyperactive. NARRATOR: The doctor prescribes Ritalin, a drug commonly
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used to treat ADHD. The effect on Danny is dramatic. He was finally given the proper medication,
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and, I mean, he reached his potential. He was just a go getter, always adventurous.
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And, from my understanding, he wanted to be a doctor. And they were just so excited.
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DR. G: He went from a special ed kid to a gifted and talented student. So the family was very happy about his progress
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with the medication that he was taking. NARRATOR: But their happiness is short lived.
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Only three months after his diagnosis, the unthinkable happens. It's a chilly Monday morning and Danny's
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running late for school, again. His parents assume he's overslept as usual. But stepping into his bedroom, Katie is startled to find
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Danny crumpled on the floor. He wasn't breathing, and he was cold to the touch. They immediately called 911.
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NARRATOR: Paramedics arrive within minutes, but they only confirm Katie and Tom's worst fear.
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DR. NORMA JEAN FARLEY: They did try CPR, because with children we want to try so hard, you know,
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to resuscitate them and bring them back. But it was unsuccessful. No, actually, I don't have an address.
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I-- NARRATOR: Medical investigator Steve Hansen, who is also working in Texas at the time,
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moves quickly to gather as much information as possible about Danny. This was a tragedy.
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And I mean, everybody was upset about this. Here's a kid that should be OK, and he died basically
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a sudden, unexpected death. DR. G: He's 10 years old when he died. That's a very uncommon age to come into the morgue.
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NARRATOR: Danny's case promises to be tough. But when his body arrives at the morgue,
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Dr. Farley, on a one year fellowship at the time, volunteers to do the autopsy. As a fellow, I always try to be
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in on the most difficult and interesting cases. NARRATOR: Now, as she pores over Danny's medical history,
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one detail catches her eye. Looking at the investigative report, I saw the child was taking Ritalin, or methylphenidate,
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for his ADHD. NARRATOR: Both Ritalin and its generic version, methylphenidate, are widely used and considered very safe.
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As she continues reading Danny's medical history, she discovers an alarming piece of information.
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The child had asthma. Asthma as a chronic, lifelong lung disease. Usually a person can live with the chronic part
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of the disease, they may have some coughing, but when they have an acute asthma attack,
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then that's when it becomes life threatening. The airways constrict, and they get inflamed, and you--
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you have a hard time breathing. It can kill you, especially if you don't have a fast acting inhaler near you at the time
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of your asthma attack. NARRATOR: But Dr. Farley must also explore the ultimate tragic scenario:
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that Danny's untimely death involved no disease at all. You know, we have a child that's dead.
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And the sad truth of it is, child abuse is still present in our society. DR. NORMA JEAN FARLEY: Even the happiest family
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might be hiding dark secrets. And in our field, we really know this. NARRATOR: As a mother of three children herself,
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Dr. Farley understands all too well that the stakes are high, and the answers may be grim.
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But I don't let my emotions get in the way. In the end, the family has to be held accountable
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if we find something. [MUSIC PLAYING] MAN: [INAUDIBLE] I think we're ready to go.
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We look very closely at the outside of the body. We look for any injuries to the body at that point,
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and we also look for scars. DR. G: We're going to look for subtle marks, because those marks might help us determine how he was hit,
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and what he was hit with. Is there anything that can give us a clue of what happened.
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NARRATOR: But soon, a subtle injury catches Dr. Farley's eye. Got a small, blue contusion here on the right chest,
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right at the nipple. OK, I got 1.5 centimeters. I wasn't very worried about it. This was a very small contusion, and it really wasn't
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suggestive of any foul play. That could just be from cardiopulmonary resuscitation
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where they had EKG pads. Looks like they gave him quite a bit of fluids when they
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were trying to resuscitate him. Hmm. No other injuries neither to the abdomen or chest.
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NARRATOR: But after scouring Danny's body for any hint of injury, Dr. Farley comes up empty handed.
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He looked like a well developed, well nourished 10-year-old, and the external really
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didn't give us any hints. NARRATOR: Still, if there's one thing Dr. G and her team know,
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it's that physical abuse can leave surprisingly little evidence. I will tell you that I've worked many cases where there
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is not a mark on the child, and until the autopsy is done, you don't know that the physical trauma is there.
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DR. NORMA JEAN FARLEY: Everybody ready? We must rule out child abuse, we must rule out that something
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happened to this child. [MUSIC PLAYING] [OMINOUS TONE PLAYING] NARRATOR: At the Bexar County morgue in Texas,
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forensic pathology fellow Dr. Norma Jean Farley is determined to find out what, or who,
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killed 10-year-old Danny Evans. The police investigating this mysterious surroundings
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of the death started suspecting the parents, which were the last people to have seen him.
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The parents were in a state of shock. Couldn't even believe that they were actual suspects in this,
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you know, the death of their son. It was a nightmare for them. NARRATOR: But when it comes to the unexpected death
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of a child, the forensic team has no choice but to explore even the darkest scenarios.
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The worst thing we can do is to assume things. We ask what seem to be an awful lot of stupid, basic questions,
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but-- but they turn out not to be. Because these are the basic questions that we--
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we really need to ask. You really have to finish the internal examination to rule out foul play.
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I've been fooled before. [MUSIC PLAYING] So, we start with a y-shaped incision, which
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comes across the chest in a v, and then a single line down to the pelvic region.
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I'm going to make a few cuts in the soft tissue, just make sure there's no contusions that we're not seeing,
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little bruises that might be hiding. But I didn't see any soft tissue injury at all in this child.
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There's no blood in any of the cavities, there's no rib fractures that we can see.
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So right now, I'm not seeing anything that worries me that this is trauma. NARRATOR: To completely rule out foul play as a cause of death,
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Dr. Farley still needs to examine Danny's head for injuries to his skull and brain.
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But for now, she continues her inspection of his internal organs, looking for any sign
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of natural disease. DR. NORMA JEAN FARLEY: I want to stay focused on the organs of the chest.
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And I was very anxious to do this, because I wanted to take a look at the lungs,
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since one of the main clinical clues was the fact that this child had asthma. NARRATOR: Upon opening the chest plate,
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Dr. Farley gets her first good look at Danny's lungs. Really, these-- these lungs are
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deep within the chest cavity. They feel like they're a little bit heavy, but they're not overexpanded at all.
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Not what we typically would expect in a-- an acute asthma attack. So maybe the fact that they were doing CPR
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would push some of that air out of the lungs. NARRATOR: If that's the case, asthma
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still may be the culprit. To find out, she now extracts the lungs to examine Danny's bronchi, the airway passages
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that extend through the organ. DR. G: With asthma, you produce a overabundance of mucus.
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You get a lot of mucus mixed with some eosinophils or inflammatory cells. And they plug up all those bronchi,
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so you can see that they weren't able to exchange air. NARRATOR: She dissects the organ, inspecting every slice
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for mucus plugs that could have robbed him of oxygen. But the search is difficult.
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Oh, well, the bronchi do car-- they have a little bit of a green tinge to mucus.
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And that's pretty much all I found. Hmm. There really wasn't a lot. There was a little mucus there, but it wasn't
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like there was a plug of mucus. Again, I had to remember though, this child had CPR.
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And so could some of that mucus been moved out of these smaller airways during the time they
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were trying to resuscitate him? So basically, we can't rule in or rule out asthma at this point.
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What I'm going to have to do is take microscopic sections of the lungs, and multiple sections in different areas,
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and see if I can prove this acute asthma by the microscopic examination of the tissue.
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Keep a little bit of this. So maybe microscopics will give us something on this one.
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NARRATOR: Dr. Farley prepares the lung samples to send out to a lab, where they'll be chemically
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treated, mounted onto slides, and stained for her examination. But the process will take at least a week.
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In the meantime, she still has a long way to go on Danny's autopsy. And next up is the heart.
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Well, the heart looks normal within the sac. Doesn't look too big. Just to make sure, I'm going to go ahead and take the heart out
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to make sure that there's no anomalies to the heart or the great vessels. NARRATOR: Carefully, she removes Danny's
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heart from his chest cavity. And as she turns the organ over in her hand, she makes a discovery that's completely unexpected.
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DR. NORMA JEAN FARLEY: Hmm. There were some small contusions, little tiny bruises or areas of hemorrhage,
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on the surface of the heart. Could be the cause of death of this child. [OMINOUS TONE PLAYING]
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NARRATOR: The baffling case of Danny Evans is putting Dr. Farley to the test. So far, she's uncovered two possible causes of death:
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an acute asthma attack and foul play. But now, as she inspects the heart, she finds evidence of a third possible killer.
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Ah, now right here on the front of the heart, there are scattered little contusions here.
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See? It's-- Some tiny ones there, like a myocarditis. Myocarditis is an inflammation of the heart itself,
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the tissue in the heart. And it's usually caused by some type of infection, especially
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a viral type infection. And so this inflammatory process actually injures and starts eating away at the heart,
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and can result in fatal cardiac arrhythmias. That could definitely cause death in a kid this age.
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NARRATOR: The symptoms of myocarditis can resemble the flu, with fatigue, fever, and a sore throat.
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Oddly, this fits with a minor detail in Danny's medical history. About two weeks before his death,
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he was diagnosed with a case of the flu. But if myocarditis is the true culprit,
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she can only prove it under the microscope. So I typically put five pieces in different locations.
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One more from here. All right. NARRATOR: These samples will go to the lab, along with Danny's
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lung tissue, and return as microscopic slides in several days. Only then can Dr. Farley determine
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if the young boy died of asthma, myocarditis, or even something else. But the autopsy is still not over.
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She has one place left to look for evidence of foul play: Danny's head. We start this, of course, by reflecting the scalp,
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and looking, again, for any soft tissue hemorrhages that may not have made it to the skin surface.
00:19:03
And there weren't any. We also look at the skull itself. All right. And no skull fractures.
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You see the suture lines, because this is a child, and his head's still growing.
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So they're all open, but no fractures at all. Totally clean. And there's no blood here, so there's
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no signs of any kind of trauma. I continued, and we removed the brain as well, and I didn't see any abnormalities to the brain.
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There was no evidence of any type of meningitis, or inflammation to the membrane around the brain.
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The brain is totally normal at this point. We're not finding anything unusual. NARRATOR: With the cranial exam complete,
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the entire autopsy comes to a close. And looking back, only one thing is clear to Dr. Farley.
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I have now totally ruled out foul play, which I will relate to the investigative officer
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on the case. [MUSIC PLAYING] NARRATOR: But for Danny's parents, being proved innocent of child abuse
00:20:15
is small relief, compared to the agony of losing their only son. They were just in a state of confusion.
00:20:23
They wanted to find out what happened. I was hoping with a microscopic examination,
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I would be able to give the family some type of answer, some type of closure. NARRATOR: A long week after Danny's autopsy,
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Dr. Farley gets the microscopic slides back from the lab. So I do have two possibilities at this point: asthma,
00:20:54
or it may be some type of inflammatory process in the heart itself that caused a fatal, abnormal arrhythmia
00:21:01
that caused the child to die. OK. I began by looking at the heart, and looking for the inflammation that I was hoping
00:21:10
would be there and prove myocarditis. And I didn't see this. Hmm. And the heart looked totally healthy and normal.
00:21:20
NARRATOR: Dr. Farley now knows that myocarditis did not cause his death. She immediately looks at another slide, this time
00:21:30
of Danny's lung tissue. Mostly what I'm looking for is increased numbers of white blood cells, especially eosinophils, which
00:21:38
is a type of white blood cell that we often see and associate with asthma. NARRATOR: Asthma is similar to allergies
00:21:45
in that an attack triggers a flood of inflammatory white blood cells. If Danny died from an acute asthma attack,
00:21:53
she would find a large number of inflammatory cells, specifically eosinophils, saturating his lung tissue.
00:22:03
Slowly, she turns the dial, bringing every cell into sharp focus. And I did see some inflammation, mild to moderate
00:22:12
chronic inflammatory cells. NARRATOR: Danny Evans clearly had asthma, but Dr. Farley isn't certain if her findings prove he
00:22:21
suffered a fatal asthma attack. I then went through the other tissues, looked at the liver,
00:22:27
looked at the kidney, looked at the adrenal glands, the pancreas. I didn't see anything wrong with any of those tissues.
00:22:34
I then went to the brain, and looked at the brain, thinking, you know, maybe I didn't see a subtle meningitis.
00:22:40
But there was nothing wrong with the sections of the brain, either. So after the microscopic examinations,
00:22:47
I'm still at a dead end. I may never have the answers for this boy's family. [OMINOUS TONE PLAYING]
00:23:08
I just dictated this case, could you download it for me? And let me know when it gets back, OK?
00:23:12
Sure. Thanks. NARRATOR: At the Bexar County morgue in Texas, Dr. Farley has hit a brick wall in her search for what
00:23:20
killed 10-year-old Danny Evans. After the microscopic examinations, I still don't have a cause of death in this child.
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NARRATOR: Weighing heavily on her mind are Danny's parents, Katie and Tom, whose anguish is growing each day as they wait for answers.
00:23:37
They just couldn't take the pressure. It was a emotional strain on them of just unbelievable proportions.
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NARRATOR: For their sake, and as a professional, giving up is not an option. Only twice since I've been a forensic pathologist
00:23:53
I've had to say this-- a death was undetermined, and I really don't like to do that.
00:23:58
NARRATOR: She did find hints of asthma in Danny's lung tissue, which leaves the possibility, however slim, that asthma caused his death.
00:24:08
But as Dr. G's pathology fellow, she knows when it's time to get a second expert opinion.
00:24:15
So at this point I decided to go up to Dr. G's office and have her just quickly take a look at the slides,
00:24:20
and in particularly the lung slides, and just make sure I wasn't missing anything in my diagnosis.
00:24:27
At the time of this case, she's clearly the fellow, I'm clearly the staff, and I have to help teach her.
00:24:35
But it was more than that, because we had hit it off. I think we just had a mutual like of each other,
00:24:40
and whenever she had a question, she- she would-- she'd often come to me. With Dr. G, I always felt comfortable that I
00:24:49
wasn't interrupting something. She always made time to discuss the cases with me.
00:24:55
She was kind of on the fence whether it was enough asthma or not, because she really wanted
00:25:02
to give the family the answer. It was getting close to Christmas, she really wanted to just put this to rest
00:25:10
and have some closure for the family. NARRATOR: Now Dr. G carefully scans Danny's lung tissue
00:25:17
for inflammatory cells and diffuse bronchial plugging, which indicate an acute asthma attack.
00:25:25
I really wanted her to be able to find the acute asthma I didn't see on those slides.
00:25:31
But when I looked at the slides, there wasn't-- there wasn't near enough acute changes.
00:25:38
So, unfortunately, I had to tell her that she just did not have enough on that slide under the microscope
00:25:44
to say that's his cause of death. It-- clearly, his cause of death was not asthma.
00:25:50
NARRATOR: Doctor G's analysis is a huge blow to Dr. Farley, and she's beginning to fear she may never find
00:25:58
closure for Danny's parents. And I'm wondering where else I can go. NARRATOR: But then, Dr. G offers one last ray of hope.
00:26:07
What she told me was, Norma, wait for the toxicology, it could have all the answers.
00:26:13
NARRATOR: The chances are extremely small. But there is the slight possibility that a large overdose of Ritalin could have triggered
00:26:20
a fatal arrhythmia, a cause of death that would have been impossible to detect in autopsy.
00:26:26
[MUSIC PLAYING] Unfortunately, toxicology at that time took about three months to come back,
00:26:35
so it meant that the family was going to have to wait before I'd have that result.
00:26:41
It was hard on the family. They were just overwhelmed with the whole process. I mean, the mother was in really bad shape.
00:26:50
But, we want the right answer, not the fast answer. I just want to give them some type of closure.
00:26:56
So now I'm even more anxious to get these toxicology results back. NARRATOR: A grueling month goes by, followed by another.
00:27:09
Finally, on a cloudy Friday afternoon in March, the toxicology report on Danny Evans arrives.
00:27:16
Finally, I get the toxicology results and I'm very anxious to see if there's anything that could help me determine the cause of death.
00:27:24
And I'm expecting to see Ritalin, because the child is on this for the attention
00:27:28
deficit hyperactive disorder. But when the tox came back, it was a surprise to us all.
00:27:34
It was a shock. [MUSIC PLAYING] [OMINOUS TONE PLAYING] NARRATOR: At the Bexar County morgue in Texas,
00:27:55
a bomb shell has just been dropped on the case of 10-year-old Danny Evans. This was a child with ADHD, who was on Ritalin.
00:28:05
And so I'm expecting to see Ritalin in these toxicology results. But, when we got the tox back, it
00:28:12
was a shock, because the toxicology showed no Ritalin whatsoever. DR. NORMA JEAN FARLEY: Instead, I find
00:28:20
a drug I'm not even expecting. I'm finding the drug methadone. NARRATOR: Methadone is a powerful central nervous system
00:28:30
depressant, a synthetic drug strictly monitored by the FDA. It's almost inconceivable that the 10-year-old would have
00:28:38
access to it, because the drug's primary use is to treat heroin addiction and chronic severe pain.
00:28:46
But Dr. Farley is startled to find he not only had methadone in his system, he'd ingested a huge amount.
00:28:55
The methadone level in this child was 0.44 milligrams per liter. That's not only lethal in a child,
00:29:02
but that's lethal in an adult. So at this point, I do have a cause of death: it's an acute methadone
00:29:09
intoxication. NARRATOR: Her discovery sends shock waves through the morgue, and immediately sparks a barrage of questions.
00:29:18
How did he get the methadone? What could possibly be the ways this child could have gotten methadone?
00:29:26
Is he trading his Ritalin, which is a stimulant, for the methadone, which is more
00:29:33
of a downer or a depressant? You know, it's-- it's certainly-- methadone is certainly becoming a very common drug of abuse.
00:29:40
But we mostly see it in teenagers, I've never seen it in one so young. 10 years old is pretty young to be using
00:29:47
methadone as a drug of abuse. But maybe he didn't know what he was trading his Ritalin for.
00:29:54
Or is there someone in the family, the mother or the father, maybe on the medication?
00:30:00
NARRATOR: Dr. Farley and Dr. G call the entire investigative team back into action,
00:30:06
launching an exhaustive search for the origin of the dangerous pills that killed Danny.
00:30:12
All of a sudden, we get a call saying, we need to go back and we need to find out why this kid had methadone.
00:30:18
Go back to the family and see if anybody in the family was on methadone. And there was no one.
00:30:25
Go back to the school and see, what kind of student was this child, was he drug seeking in any ways.
00:30:32
DR. G: But he's not the type of kid. Everybody at school is baffled, and his family's baffled.
00:30:38
Nobody seems to know. DR. NORMA JEAN FARLEY: So, and then I started thinking, where
00:30:43
else would he get methadone? Well, you know, one of the things we finally thought about
00:30:48
is, well, how about those pills that he is supposed to be taking, has anybody checked those?
00:30:55
NARRATOR: Danny's bottle of prescribed Ritalin had been brought to the morgue with his body,
00:30:59
and left untouched ever since. Looking at the label on the bottle, I noticed right away that the name is correct,
00:31:05
but instead of Ritalin, which is what I was told he was on, which is a brand name,
00:31:10
he was on the generic. And that generic was methylphenidate. NARRATOR: Ritalin and methylphenidate,
00:31:18
both drugs are identical. And it's common for doctors to allow a brand name prescription to be filled with the cheaper
00:31:25
generic counterpart. But in this case, Dr. Farley has a strong hunch that this seemingly benign switch
00:31:34
triggered a deadly mix up. If she's right, she'll be able to close the three-month-old case for good, and replay for Danny's
00:31:45
parents the exact chain of events that led to his tragic death. It's 6 PM on a Tuesday, time for Danny to take
00:32:01
his evening dose of Ritalin. Over the past few months, the medication has transformed
00:32:07
his struggle with ADHD. After being properly diagnosed and given the proper medication, he went from being
00:32:14
in special ed classes to being an honor roll student. A gifted and talented little boy.
00:32:20
NARRATOR: His parents, Katie and Tom, couldn't be happier. But recently, they've been dealing with an entirely
00:32:26
new health concern. He was not himself. He was always drowsy, and he would start getting the cold sweats.
00:32:34
NARRATOR: Alarmed by these new and perplexing symptoms, they take Danny to the doctor.
00:32:40
He reassures them that it's only the flu. But the diagnosis couldn't be more wrong.
00:32:47
Unbeknownst to anyone, Danny is actually feeling the effects of a powerful narcotic--
00:32:53
methadone. And Dr. Farley think she knows how it got into his system. She immediately heads to the poison control office
00:33:03
with the contents of the pill bottle. I pass the pill over to the poison control,
00:33:09
and within about 15 minutes, they were able to tell me what the medication was, and it was methadone.
00:33:15
The methadone had been filled, most likely, incorrectly at the pharmacy. I could see how it might happen, methylphenidate,
00:33:24
methadone, both Ms, maybe sitting by each other on the shelf. And inadvertently you pick up the wrong one,
00:33:32
and you fill it in the prescription bottle. When they refilled his prescription three weeks
00:33:39
before he died, they had switched it from the brand name to the generic of methylphenidate.
00:33:46
And the person who filled that prescription inadvertently gave him methadone instead of methylphenidate.
00:33:57
Now, the family didn't pick up on the fact that it was a different-appearing pill,
00:34:03
because they just thought, well, this is the generic, it's a different shaped pill, a different color pill,
00:34:07
as it often is. And the depressant effect of methadone started almost immediately.
00:34:13
DR. NORMA JEAN FARLEY: He's drowsy, they can't wake him up, he seems always tired.
00:34:17
NARRATOR: The symptoms grow worse each day, because methadone has what's known as a long half life.
00:34:23
And basically, a half life just means the time it takes to get half of the drug that you've ingested out of your system.
00:34:30
So the more he takes, the more methadone he's accumulating in his system. NARRATOR: Frightened by his worsening condition,
00:34:38
Danny's parents rush him to the ER. But again, an opportunity to identify this tragic mistake
00:34:45
falls through the cracks. DR. NORMA JEAN FARLEY: They even do a urine drug screen.
00:34:50
But most likely, the urine drug screen that they preformed only looked for five or six different medications.
00:34:57
DR. G: It's totally different in forensics. The drug tests we do are confirmatory,
00:35:03
and they're the gold standard, and they're done in your blood. The drug screen that you get in the emergency room
00:35:08
is very limited. It's only designed to pick up the common drugs of abuse. And methadone has to be looked at and asked for specifically.
00:35:18
And in this case, the drug screen panel did not pick up methadone. In the meantime, Katie and Tom continue
00:35:26
to follow the advice of Danny's doctor, cutting the medication to half the original dose.
00:35:33
But, you know, he's been on methadone now almost a month, so it's accumulating in his system
00:35:39
this whole time. And on this night, it becomes too much for his small body, and he has too high of a level of methadone.
00:35:49
He's breathing slower and slower, until he stops breathing, and dies. [AMBULANCE SIREN]
00:35:59
NARRATOR: Dr. Farley has put together almost all the pieces, except one. She calls the Texas State Board of Pharmacies
00:36:07
to confirm this tragic chain of events. DR. NORMA JEAN FARLEY: Methadone and methylphenidate
00:36:12
are both controlled substances. So we kind of keep a good eye on them. In fact, they do counts on this type of medication
00:36:19
to make sure no one's abusing the medications. In this case, we did find out that they were short
00:36:26
on the methadone the exact number that they prescribed to this child. So it was clearly a pharmacy error.
00:36:34
Although they didn't do it on purpose, they mixed up the name of methadone and methylphenidate.
00:36:42
Just a-- just a really bad, unfortunate circumstance. Nobody wanted this to happen.
00:36:48
NARRATOR: The State Board issues a fine and suspension, and the case is settled out of court with the family.
00:36:55
But to the pharmacists, it isn't about the money. Oh, it's sad. You know, it was just a small mom and pop type of pharmacy,
00:37:04
they'd been in business for, you know, 40 years. And he was devastated that his business
00:37:12
caused the death of this child. He was grieving just like the-- you know, the family was grieving.
00:37:18
And he lost his business. He-- he sold it. NARRATOR: For Danny's parents, the wounds cut even deeper.
00:37:27
DR. G: Although the family was angry that these mistakes were made, the pharmacy mix-up, the fact that it wasn't picked up
00:37:34
on the drug screen, the fact that no doctor could figure out what was going on, ultimately they were very upset
00:37:42
that what caused his death was what they were giving him to take. It was through their hands that what
00:37:50
they gave him caused his death. Each one of those pills had been cut in half, just
00:37:57
as the parents were told to. They were following the directions given to them by the doctor.
00:38:03
They wanted to do right. And by continually giving those pills that they thought he
00:38:11
needed, they were killing him. [DOOR OPENS] NARRATOR: The impact of Danny's death
00:38:20
runs deep for both Dr. G and Dr. Farley. This is one of those cases you walk away from
00:38:25
and you take with you the rest of your life. When my children get prescriptions now, or my husband, or myself, I actually do look at the pills.
00:38:34
I usually do it on every medication that we get in the family, from-- just because of this case.
00:38:39
DR. G: I've been a medical examiner for over 20 years. I've worked on thousands of cases, well over 6,000.
00:38:46
Why this case stands out, why this case is one that I can't forget, is that it was a surprising ending to me,
00:38:54
and a tragic involvement of the mother who loved him so much. I'm a mom, and you want to do nothing
00:39:03
but good for your children. [MUSIC PLAYING] NARRATOR: The loss of a child is always tragic.
00:39:19
But Dr. G's next case gives her an opportunity to turn tragedy into hope. It's a beautiful case of a tragedy
00:39:31
that this family was able to turn around into something very positive for other people.
00:39:38
[OMINOUS TONE PLAYING] [MUSIC PLAYING] NARRATOR: In her career as a medical examiner,
00:39:56
Dr. G encounters astonishing stories every day. And many of these stories stay with her forever.
00:40:05
This case actually very much stands out my memory, because, you know, this shows you
00:40:12
how our lives turn on a dime, and how precious life is, how fast it can be taken away from us.
00:40:23
[MUSIC PLAYING] NARRATOR: It's August 25, 2004, and fourth grader Erica Chappelle is on her way home from school.
00:40:35
Erica Chappelle was just a healthy, beautiful 10-year-old girl that was having an ordinary day.
00:40:43
NARRATOR: Her mother Bianca still remembers the rainy afternoon as if it were yesterday.
00:40:48
Erica and three other children had gotten off of the school bus. And my daughter Erica was taller than the rest
00:40:58
of the kids in her class. And so she asked them, could she hold the umbrella and everybody come under the umbrella with her.
00:41:09
They heard a crack. [THUNDER STRIKES] She directly got struck by lightning. NARRATOR: Rescue workers arrived just
00:41:24
minutes later to find that Erica has no pulse and is not breathing. CPR is done on her for about 20 minutes
00:41:32
before her heart rate returns, but unfortunately, during that time her brain wasn't getting enough oxygen.
00:41:41
NARRATOR: When Erica arrives at the hospital, she's in a coma. Her chances of survival are slim,
00:41:47
but doctors refuse to give up hope. BIANCA CHAPPELLE: They were trying to regulate her vitals
00:41:53
and figure out how-- where we were going to go from there. Really didn't have a lot of answers,
00:41:58
other than keeping her stable, monitoring her heartbeat, and her respiratory, and all of that.
00:42:04
[MUSIC PLAYING] NARRATOR: Hours pass, then a day, then two. Still, Erica shows no sign of improvement.
00:42:20
To see your child in that kind of state and feel so helpless, you know, not knowing what I was-- what the outcome.
00:42:27
I just didn't really know how to act, other than the fact that I knew I needed to be strong for Erica,
00:42:33
and I needed to be strong for my family. [MUSIC PLAYING] On the third day was when they came to us and said,
00:42:44
we have a test that we have to run on her. And after that we'll be able to tell you whether or not
00:42:49
she's brain dead. It was on August the 28th when the doctor ran the last test. And then the doctor is telling me, this is it.
00:43:03
You know, I'm sorry, Mrs. Chappelle, Erica is no longer with us. NARRATOR: Devastated at their loss, Bianca Chappelle
00:43:19
and her husband are now confronted with one of the biggest decisions of their lives.
00:43:24
They came to us within probably 30 minutes of her passing, and they told me her organs could be donated.
00:43:33
That part was hard. But my husband and I, at that moment, together, looked at each other and went, yeah.
00:43:40
We think that that is going to be a wonderful legacy to her, to save someone else's life.
00:43:52
NARRATOR: But before Erica's organs can be donated, the organ procurement agency must get approval
00:43:58
from one more person: Dr. G. [MUSIC PLAYING] They have to call my office, because she
00:44:12
is an unnatural death, it's a traumatic death, an accidental death, and I have to investigate that death.
00:44:19
NARRATOR: She must decide if she can perform a successful investigation without many
00:44:24
of Erica's vital organs. It's an urgent situation, and every second counts. With Erica's case, we have to make a quick decision,
00:44:34
so they can quickly get her into an operating room and recover the organs before they're damaged any further.
00:44:42
NARRATOR: She quickly runs through all the information she has: hospital records, police reports, and accounts
00:44:49
from her medical investigators. There didn't seem to be any question about why she died.
00:44:57
It was witnessed, she'd already had a CAT scan of her brain, so there was really no questions left.
00:45:04
NARRATOR: Dr. G is always eager to help save a life by facilitating organ donation.
00:45:09
Occasionally, we have to put restrictions on it. We may not let them open up the chest, let's say,
00:45:16
because that's where the injuries are. We may not want them to open up the abdominal cavity.
00:45:24
A couple of times I've had to restrict them from not taking the heart for heart valves, and restrict
00:45:29
them not to take the skin, because I need to look at the bruises. So I will occasionally have to put restrictions on them, if it
00:45:36
looks like there's foul play involved that I am still trying to figure out what happened.
00:45:41
NARRATOR: This time, the decision is easy. Once the hospital gets the official sign off from Dr. G,
00:45:50
the usable organs and tissues are removed from Erica's body, and she's transferred to the District 9 morgue.
00:46:00
[MUSIC PLAYING] She has an incision all the way down her chest and her abdomen, which they
00:46:07
made to get her organs out. But when I see her, she's still a beautiful young girl.
00:46:15
Pretty, dark brown eyes. She still has clear injuries and burns from the lightning.
00:46:22
46. NARRATOR: And she anticipated, Dr. G is able to quickly confirm Erica's cause of death.
00:46:30
It's clear she was a victim of a lightning injury. The way people die from lightning
00:46:38
is usually an electrical event. It harms the nervous system, and guess what keeps your heart pumping?
00:46:46
It's that electrical component of the heart, and so when that electricity splash comes over you,
00:46:55
it can stop your heart. It was a cardiac arrest, and her brain didn't get enough oxygen.
00:47:03
DR. G: [INAUDIBLE] NARRATOR: Dr. G's brief autopsy is now complete. She records the cause of death as cardiac arrest as a result
00:47:12
of lightning strike. But Erica's story is far from over. They were able to use kid--
00:47:21
kidneys, liver, that the valves of her heart were able to be used, that the corneas of her eyes
00:47:30
were able to be used. So she saved three lives. We got a letter from a 17-year-old girl who
00:47:39
lives in Tallahassee who said that she had received Erica's kidney, and if she had not gotten Erica's kidney,
00:47:48
she would have died. And she told us that she loved us, and that she was my daughter because she had
00:47:55
a part of my daughter in her. And that just really, really-- it-- it made it all worth the while.
00:48:06
Erika was a person who I know all through her life loved people. She always had the attitude where she wanted to help.
00:48:15
So that's basically what keeps me going. [WATER RUNNING] NARRATOR: To this day, the strength
00:48:30
of the Chappelle family is a continuous source of inspiration for Dr. G. You know, donating organs of a loved one
00:48:37
is a very personal decision. And it takes a really special family, really special people,
00:48:47
to turn their own grief and tragedy around to try to help somebody else. [MUSIC PLAYING]
00:48:51
(SINGING) Though you're desperate to the believe [INAUDIBLE] ANNOUNCER: (WHISPERED) Atlas.