Monday, May 23, 2016

"Probable drowning" (SB 1189, Pan & Jackson)

"Undetermined" is  the word used in the official Autopsy Protocol issued by the Coroner Division, San Bernardino County Sheriff's Department, to describe the "manner of death" of Roman Serna Lopez, Jr.

The report tells us some intriguing details as to the manner of death, for instance, that Lopez was found with "his head and torso in the trashcan, with his legs across and on top of the hamper. Lopez had a cloth bag over his head and face." The psychiatric technician who found decedent Lopez in this contorted state "pulled Lopez out of the trashcan and placed him supine on the floor. The cloth bag, which was only loosely around Lopez' head, fell off at that point. Lopez was unresponsive and 911 was called."

How's that, you ask? The autopsy report said that "Lopez had a cloth bag over his head and face." Are we supposed to believe that Lopez put the bag over his own head and face and then took a nose dive into a trashcan? Actually, the facts are even more incredible than that. The autopsy report also says that the trashcan was "filled with 13 inches of water." Are we being led to the possible conclusion that Lopez, whose medical history includes diagnoses of schizophrenia and polysubstance abuse, took a nosedive into 13 inches of water after pulling a cloth bag over his head and face and may have committed suicide in this peculiar manner? The decedent's toxicology screen which included search for cocaine metabolites, amphetamines, opiates, benzodiazepines, fentanyl, and cannabinoids was negative.

The actual examination showed some unusual findings, for example, "a single small petechial hemorrhage in the upper outer quadrant of the of the left sclera" and pulmonary findings showing "marked vascular congestion and alveolar hemorrhage."

There were a "few petechiae found in the sclerae and conjunctivae, consistent with a head down position" plus "acute hemorrhage of tongue."

In the section entitled Diagnosis the first listed diagnosis is "probable drowning." The decedent's body was found "with head inside plastic garbage can with an estimated 13 inches of water." The report adds that the "head was found submerged within the water." There was no evidence of significant blunt force trauma although the decedent's chest showed "mild congestion across the upper chest."

Dr. Trenkle's comment in conclusion was that the cause of death was "probable drowning, minutes." Doctor Trenkle stated that "the cause of death is probable drowning based on the scene description of the decedent being found with his head submerged in water and the absence of another significant competing reason for death."

Witnesses at the autopsy reportedly included Dung Van Tran, MD, and several law enforcement representatives.

My Comment: It is debatable whether or not persons in charge of a decedent's custody while the decedent were alive should be allowed to be present at an autopsy for the person for whose safety during life they were responsible. On the other hand the presence of such personnel is considered desirable if the pathologist or coroner has questions. The theory is that the person doing the autopsy should be able to ask questions that may help establish the manner of death. Law enforcement personnel, by contrast, are not supposed to question the pathologist lest so doing be construed as an attempt to influence the findings.

This issue of The Weinmann Report antedates a scheduled hearing at Senate Appropriations scheduled for later today when Dr. Pan is expected to present with reference to pending legislation, SB 1189 (Pan & Jackson) on this subject. We expect to post again on this matter after the hearing or even if the hearing is delayed. 

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