Forensic Pathology (Autopsy) Report
Group Member #1:
Rafael Rosas
Group Member #2:
Nayeli Diez de Bonilla
Group Member #3 (if applicable):
N/A
Case File (example, HTH-12):
HTH-14
I. Cause of Death
(2013, https://www.humira.com/psoriasis/how-humira-treats-psoriasis)
II. Mechanism of Death
III. Manner of Death
(2014, Cunha, retrieved from http://www.rxlist.com/humira-side-effects-
drug-center.htm)
IV. In 1-2 paragraphs, describe your overall opinion using evidence about how the individual in your case file died.
Our case file was about a relatively young wife and mother of two, who died a in San Diego a few hours after landing from a flight which departed from Houston, Texas. After reviewing the Autopsy report and narrative, several things stuck out to us that we believed could help us determine the cause of death. First of all, we registered that our decedent was taken to a minor hospital four days before her death for symptoms that included back pain, nausea and cloudy urine. In addition, the decedent had suffered from severe Psoriasis, a skin condition that causes skin redness and irritation, and had been taking prescription Humira to help fight the Psoriasis for over a year. Our research showed us that some of the side effects of Humira included easy bruising and a weakened immune system. The autopsy showed that there were slight bruise marks over around the knees and ankles, and brown-pink ecchymosis over the left breast. It also showed several grey and purple colored specks scattered across the lungs, and an unnaturally excessive buildup of white blood cells in the heart.
Essentially, we had to determine the cause, mechanism, and manner of death. It was relatively easy to determine that the decedent’s manner of death came from a natural cause, as there was no evidence to suggest that it was homicide or suicide (both in the background story and in the autopsy), and the death was not accidental since she was neither intoxicated or drugged during her death, hit by a car, or in any other way accidentally killed. After spending what felt like hours going over every single detail in the autopsy, we determined that the mechanism of death was cardiac arrest. Several pieces of evidence helped us get to this conclusion. First of all, the microscopic examination of the heart was the only part of the autopsy that showed major malfunctions in any of her major organs. Additionally, the decedent was in fact found in cardiac arrest when the ambulance arrived for her at the airport. Finally, the ecchymosis over the left breast was a major clue, as ecchymosis skin discoloration is caused by the escape of blood into the tissue from ruptured blood vessels. The heart is on the left side of the chest, and for the decedent to have shown ecchymosis on her left breast was a major pointer that something had gone wrong within her heart. The third, and most challenging part of this assignment, was identifying the cause of death. Our search began with us asking ourselves what could have caused cardiac arrest. After realizing that the decedent had shown some side effects of Humira (such as the small bruises on her knees and feet), we decided to start our search there. That is when we discovered that another side effect of Humira is a weakened immune system, which would have made it extremely easy for an infection to find it’s way into the decedent’s body. We believe she contracted the infection during the time that we went to a minor emergency clinic after showing symptoms such as back pain, nausea, and cloudy urine (symptoms very common with UTI’s, kidney infections, and several other kinds of infections). Already having a naturally weak immune system made even weaker by the prescription Humira, the infection easily and quickly found its way into the decedent’s heart. Her immune system, trying to fight off the infection, attacked her heart with white blood cells, but instead of destroying the infection, it sent her heart into cardiac arrest and, ultimately, killed her. To sum it all up, the decedent’s manner of death was a natural one, the mechanism of death was cardiac arrest, and the cause of death was her body’s reaction of attacking the infection, that had reached her heart, with white blood cells. On a side note, we believe that if the surplus of white blood cells in her heart had not killed her, the infection eventually would have.
V. References - share your vocabulary list with appropriate links with me
References:
Rafael Rosas
Group Member #2:
Nayeli Diez de Bonilla
Group Member #3 (if applicable):
N/A
Case File (example, HTH-12):
HTH-14
I. Cause of Death
- What was the cause of death?
- What pieces of evidence (from the report or the internet) do you have?
(2013, https://www.humira.com/psoriasis/how-humira-treats-psoriasis)
II. Mechanism of Death
- What was the mechanism of death?
- What pieces of evidence (from the report or the internet) do you have?
III. Manner of Death
- What was the manner of death?
- What pieces of evidence (from the report or the internet) do you have?
(2014, Cunha, retrieved from http://www.rxlist.com/humira-side-effects-
drug-center.htm)
IV. In 1-2 paragraphs, describe your overall opinion using evidence about how the individual in your case file died.
Our case file was about a relatively young wife and mother of two, who died a in San Diego a few hours after landing from a flight which departed from Houston, Texas. After reviewing the Autopsy report and narrative, several things stuck out to us that we believed could help us determine the cause of death. First of all, we registered that our decedent was taken to a minor hospital four days before her death for symptoms that included back pain, nausea and cloudy urine. In addition, the decedent had suffered from severe Psoriasis, a skin condition that causes skin redness and irritation, and had been taking prescription Humira to help fight the Psoriasis for over a year. Our research showed us that some of the side effects of Humira included easy bruising and a weakened immune system. The autopsy showed that there were slight bruise marks over around the knees and ankles, and brown-pink ecchymosis over the left breast. It also showed several grey and purple colored specks scattered across the lungs, and an unnaturally excessive buildup of white blood cells in the heart.
Essentially, we had to determine the cause, mechanism, and manner of death. It was relatively easy to determine that the decedent’s manner of death came from a natural cause, as there was no evidence to suggest that it was homicide or suicide (both in the background story and in the autopsy), and the death was not accidental since she was neither intoxicated or drugged during her death, hit by a car, or in any other way accidentally killed. After spending what felt like hours going over every single detail in the autopsy, we determined that the mechanism of death was cardiac arrest. Several pieces of evidence helped us get to this conclusion. First of all, the microscopic examination of the heart was the only part of the autopsy that showed major malfunctions in any of her major organs. Additionally, the decedent was in fact found in cardiac arrest when the ambulance arrived for her at the airport. Finally, the ecchymosis over the left breast was a major clue, as ecchymosis skin discoloration is caused by the escape of blood into the tissue from ruptured blood vessels. The heart is on the left side of the chest, and for the decedent to have shown ecchymosis on her left breast was a major pointer that something had gone wrong within her heart. The third, and most challenging part of this assignment, was identifying the cause of death. Our search began with us asking ourselves what could have caused cardiac arrest. After realizing that the decedent had shown some side effects of Humira (such as the small bruises on her knees and feet), we decided to start our search there. That is when we discovered that another side effect of Humira is a weakened immune system, which would have made it extremely easy for an infection to find it’s way into the decedent’s body. We believe she contracted the infection during the time that we went to a minor emergency clinic after showing symptoms such as back pain, nausea, and cloudy urine (symptoms very common with UTI’s, kidney infections, and several other kinds of infections). Already having a naturally weak immune system made even weaker by the prescription Humira, the infection easily and quickly found its way into the decedent’s heart. Her immune system, trying to fight off the infection, attacked her heart with white blood cells, but instead of destroying the infection, it sent her heart into cardiac arrest and, ultimately, killed her. To sum it all up, the decedent’s manner of death was a natural one, the mechanism of death was cardiac arrest, and the cause of death was her body’s reaction of attacking the infection, that had reached her heart, with white blood cells. On a side note, we believe that if the surplus of white blood cells in her heart had not killed her, the infection eventually would have.
V. References - share your vocabulary list with appropriate links with me
- Psoriasis - A skin disease
- Humira - A medicine that when injected treats psoriasis
- Ventricles - A part of the heart
- Lymphocytic Infiltrates - A skin condition that presents red rashes
- Neutropenia - An abnormally low count of white blood cells
- Epicardium - A fibrous tissue that surrounds the heart and the roots of blood vessels
- Endocardium - The lining of the interior of the heart's’ chambers
- Fibrosis - Excessive fibrous tissue in an organ
- Necrosis - Dead tissue
- Eosinophil - The number of a certain type of white blood cells
References:
- "Diffuse infiltrative lymphocytosis syndrome." Wikipedia. Wikimedia Foundation, 31 Aug. 2014. Web. 19 Sept. 2014. <http://en.wikipedia.org/wiki/Diffuse_infiltrative_lymphocytosis_syndrome>.
- Ecchymosis. (n.d.). Medterms. Retrieved September 19, 2014, from http://www.medterms.com/script/main/art.asp?articlekey=3180
- Endocardium. (n.d.). Medterms. Retrieved September 19, 2014, from http://www.medterms.com/script/main/art.asp?articlekey=3236
- "Eosinophil count - absolute: MedlinePlus Medical Encyclopedia." U.S National Library of Medicine. U.S. National Library of Medicine, 28 Jan. 2013. Web. 19 Sept. 2014.
- Epicardium. (n.d.). Medterms. Retrieved September 19, 2014, from http://www.medterms.com/script/main/art.asp?articlekey=9134
- Learn how HUMIRA works for the treatment of moderate to severe chronic plaque psoriasis.. (n.d.). How HUMIRA (adalimumab) Works for Plaque Psoriasis. Retrieved September 19, 2014, from https://www.humira.com/psoriasis/how-humira-treats-psoriasis
- Necrosis. (n.d.). Medterms. Retrieved September 19, 2014, from http://www.medterms.com/script/main/art.asp?articlekey=4514
- Neutropenia (low neutrophil count). (n.d.).Neutropenia Definition. Retrieved September 19, 2014, from http://www.mayoclinic.org/symptoms/neutropenia/basics/definition/sym-20050854
- Pulmonary Fibrosis. (n.d.). Mayo Clinic. Retrieved September 16, 2014, from <http://www.mayoclinic.org/diseases-conditions/pulmonary-fib>
- Symptoms and diagnosis. (n.d.). Psoriasis symptoms and diagnosis. Retrieved September 19, 2014, from https://www.psoriasis.org/about-psoriasis/symptoms-and-diagnosis
- Ventricular fibrillation. (n.d.). Definition. Retrieved September 19, 2014, from http://www.mayoclinic.org/diseases-conditions/ventricular-fibrillation/basics/definition/con-20034473
- "Diffuse infiltrative lymphocytosis syndrome." Wikipedia. Wikimedia Foundation, 31 Aug. 2014. Web. 19 Sept. 2014. <http://en.wikipedia.org/wiki/Diffuse_infiltrative_lymphocytosis_syndrome>.