Documents in Michael Jackson's Death

CASE REPCRT ACCIDENT! NATLIRAL 1 C:":kbrity. l\ kJ ia Inll:n:st ~009-04-t 15 S.c. # JACKSON, MICIIAEL JOSEPH ,\Dcn~:$S CITY SfA,H: ZIP 100 NORTII CAROI.WOOD DRIVE LOS ANGELES CA 90077 ~ex RM,C CD6 AGE li(,jr .~al E:(fS 'IAIR IEETK FACIAL HAiR o .... 1f"W . cO,"'mlT10N APPEARS t1'SI1A\'EN ?\U 1'An'IUL .\lAU?. BI.ACK X/2lJ'19511 50 ()9 i'j 136 Ill, BROWN BIWWN TI:UII Yes FAIR '''RK TYPE MARK 1 QCAT10N ~;AR;'; C'E SCRIPT leN NOTIFIEO ti'Y DATE 6i2512009 Dt. ~o STATE PENDING6Y Nlih8579K L'A IOMF-THOD {'i\I.IFORNlt\ DHIVER'S l.ICI:NSI: MAIN. MJUfAfoi:V' P06 LA' INDII\N:\ IDENTiFIED BY NAMI: (PRINT) RELA TlONStilP PHONe DATE liME CDl. 6/25/200'.1 PLAce OF DeATH I PI Ace FOUND AOOfU:S$ OR tOeA nON CoN l.IP HOSPITAL 757 WESTWOOD PLAZA DRIVE LOS ANGELES 90095 RONALD REAGAN/UCLA MEDICAL CENTER PLACE or INJURY AI' WORK DATe TIME . LOCATION OR ADllRESS ZIP RI;SIDENCl: 100 NORTIICAROI.WOOD DRIVE.I.OS t\NGl?l.I:S. CA \l0077 No 000 TIME FOUND OR PRONOUNCED BY 6/2;/2009 : 1426 DR COOI'ER REI'ORT NO. 'NOTlflCO By NO OTHER "GENCY '''IV OFFIceR PHONE , I.I\I'D ROBllERY IJOMICIDI: DIVISION - DI'L SCO (2IJHK5-2167 fRAN:lPOR fED 6Y TO DATe TIME t\1.I?:X,\NDER I' PERI:! LOS ANGELES I'SC 6125/2009 IK:50 PAJ'lPT MORfUARY F1NGERPHlNTS1 Y.:s CLOTHING No No iNVEST PHOTO. SF.AL TYPE HOSP RPT MeD rv Yes 30 NOT SEALED Y.:s PHY$ EV , .v,oeNCi? LOG Yes PROPERTY' Yes HOSPCHART Y.:s No GSR NO ACPT NO PFNO surCIUE NOTF': No 231940 397-5944 SYNOP~15 Till' DITFDENT IS 1\ 50- YI'.'\R-OI.D BLACK t>.fALE WIlO SUrF!,REI> RESI'II{XroR Y i\RREST \\11111.1: AT 110M!: UNI.H:I{ '1'1 IE (',?\IU: 01' IllS I'RIMI\I{ Y I'IIYSlel:\N, ON Till: D.'\ Y OF IllS DEAlI 1. Till: DITEDENT COMPI.AINED 01' DE! IYDRATION ,\NI) NOT HElM; ABU; TO SLEEP. SIVER"l. IIOl IRS [.:\'1'1 :R. Till; I >ITI:DI;NT STUI'I'!:IJ BRI:AI'IIIN( I I\ND COl 'Ll) NOT Ill' RJ'SUSllATED I'i\R:\MI;1 lieS TR ..\NSI'( JlnT/) I tiM TO l'l'I.-\ i\11:1 JIC/\1 CI;NI J:R. \\ IIU{E III.: W,\S l'lHlNOlJNCED DEAD TllE DECEDENT W.\S IAKIN(j Sl:V1.R:\l. I'RISCRWIION M!:DICS!lONS INC!.I 'DING ( 'Ie J~V.I:I'.?\!\l. ITt VOl )ONI:. 1)1,\lI:I',\i\'1. U lR)\!.I'I',\i\1 A~J1) 1'1 lJi\1.\X IllS 1'NKN()WN IF IlL \,AS ('( Ji\ 11'1.1,\ N I WITlllIIS ~ll /)1(',\ III J';SI! II: ')I( '11)1 N I' "1 :FII:RI?n FRl )\1 Villi [UD /INI) II.\D NO IIIST()({ Y (JI. IIII\I{ I' ['I(UIJLI :,\lS 1'11\":\ I 1'11'\1>\ .1 1)-111, I '). C _. FORM #3 NARRATIVE TO FOLLOW? '""  Count}' of Los Angelcs, Dcpartmcnt of Coroncr lnvestig~ltor's Na rrati\'c Case Number: 2009-04415 Decedent JACKSON, MICHAEL Information Sources: 1. Detective W Porche, LAPD- West Los Angeles Division 2. Detective S. Smith, LAPD- Robbery Homicide Division 3. UCLA MedIcal Center, medical record #397-5944 Investigation: On 6/25/09 at 1538 hours, Detective W. Porche from the Los Angeles Police Department (LAPD) reported this case as an accidental vs. natural death to the Los Angeles County Department of Coroner. Lieutenant F. Corral assigned this death investigation to me at 1615 hours. I arrived at UCLA Medical Center at 1720 hours. along with Assistant Chief E. Winter and Forensic Attendant A. Perez. Upon my completion of the body examination at the hospital, the decedent was transported by the Los Angeles Sheriffs Department-Air Bureau to the Coroner's Forensic Science Center (FSC). Forensic Attendant Perez escorted the decedent's body during transport. Assistant Chief E. Winter and I left the hospital and went to the decedent's residence. We arrived at the residence at 1910 hours and I performed a scene investigation. We departed the scene 2020 hours and returned to the FSC. Location: Place of death: UCLA Medical Center, 757 Westwood Plaza Drive, Los Angeles, CA 90095 InformantIWitness Statements: The following information is preliminary and subject to change pending further investigation by the appropriate law enforcement agency. I spoke with Detective S. Smith from the LAPD and he reported that on the early morning of 6/25/09 at approximately 0100 hours, the decedent placed a call to his primary physician,.Gardiologist, Dr. Conrad Murray. The decedent complained of being dehydrated and not being able to sleep. Dr. Murray went to the decedent's residence and administered medical care. The details and extent of this medical care are currently unknown; though the decedent slept for several hours and Dr. Murray was at the bedside. Around 1200 hours, Dr. Murray found that the decedent was not breathing and he pulled the decedent onto the bedroom floor and began CPR. 911 was called and paramedics responded to the house. According to the medical record (listed above), the paramedics arrived at the home at 1226 hours and found the decedent asystolic. Paramedics continued CPR and ACLS protocol including two rounds of epinephrine and atropine. The decedent was then intubated and CPR efforts continued. The decedent remained unresponsive; his pupils were fixed and dilated. Under advisement of Dr. Murray, the decedent was placed in the ambulance and transported to UCLA Medical Center Throughout the transport, all medical orders were given by Dr. Murray. The decedent presented asystolic to the hospital. Central lines and an intra-aortic balloon pump were placed but the decedent remained without vital signs. Dr Cooper pronounced.death at 1426 hours on 6/25/09. According to Detective S Smith, the decedent had been undergoing daily strenuous exercise in preparation for an upcoming planned music tour, in which It would have been necessary for the decedent to be in strong physical condition The decedent did not have a history of heart problems. He was taking several prescription medications including clonazepam, trazodone, diazepam. lorazepam and Flomax but it is unknown if he was compliant.  Decedent: JACKSON, MICHAEL Scene Description: The decedent's residence is a two-story mansion located in Bel-Air on a quiet residential street. The home is clean and well-groomed. I observed the bedroom on the second floor of the home, to the right of the top of the staircase. Reportedly, this is the bedroom where the decedent had been resting and entered cardiac arrest. His usual bedroom was down the hall. The bedroom to the right of the staircase contained a queen size bed, numerous tables and chairs, a dresser and a television. There was also a large attached walk-in closet. The bedding was disheveled and appeared as though someone had been lying on the left side of the bed. There was a blue plastic pad lined with cotton on the left side of the fitted sheet near the center of the bed. Near the left foot of the bed, there was a string of wooden beads and a tube of toothpaste. Miscellaneous items remained on the right side of the bed including a book, laptop computer and eyeglasses. Also near the foot of the bed, there was a closed bottle of urine atop a chair. Next to the left side of the bed, there were two tables and a tan colored sofa chair. Reportedly, the decedent's doctor sat here. A green oxygen tank was also on this side of the bed. The decedent's prescription medication bottles were seen on the tables with various medical supplies including a box of catheters, disposable needles and alcohol pads. Several empty orange juice bottles, a telephone and lamp were on the tables as well. An ambu-bag and latex gloves lay on the floor next to the bed. Evidence: I collected medical evidence from the decedent's residence on 6/25/09; see form 3A for details. Body Examination: I performed an external body examination at the hospital on 6/25/09. The decedent was wearing a hospital gown. The body is that of an adult Black male who appears to be approximately 50- years-old. He has brown colored eyes, natural teeth and brown hair. The deced~nt's head hair is sparse and is connected to a wig. The decedent's overall skin has patches of light and dark pigmented areas. The ambient temperature in the hospital room was 68 degrees F at 1815 hours. At 1811 hours, rigor mortis was not present throughout the body and lividity blanched with light pressure. Lividity was consistent with a supine position. There was a dark black discoloration on the decedent's upper forehead near his hair line. Dark coloration was present on the decedent's eyebrows, eyelashes and lips. A small piece of gauze was found on the tip of his nose and an ETT, held in place with medical tape, was seen in his mouth. A red discoloration is prominent on the center of his chest. Gauze covering a puncture wound was taped to his right neck and IV catheters were present in his left neck and bilaterally in the inguinal area. There was also an external urine catheter present. Additional puncture wounds were seen on his right shoulder, both arms and both ankles. There is a bruise on his left inner leg, below his knee and 4 discolored indentations were found on his lower backside, Identification: The body was positively identified as Michael Joseph Jackson by visual comparison to his California Drivers License on 6/25/09.  County of Los Angeles, Departmcnt of Coroncr Investigntor's Nnrrative . Case Number: 2009?04415 Decedent: JACKSON, MICHAEL Next of Kin Notification: The decedent was not married and his children are under 18 years of age. His mother, is the legal next-of-kjn and was notified of the death on 6/25/09. Tissue Donation: The hospital record does not indicate if the decedent's family was approached regarding donation. Autopsy Notification: Detective S. Smith from the lAPD-Robbery Homicide Division requests notification of autopsy. See file for contact information. ~---' ELISSA FLEAK. Investigator 6/2612009 COUNTY OF LOS ANGELES MEDICAL EVIDENCE DEPARTMENT OF CORONER CASE # 2009-04415 3A DECEDENrS NAME: JACKSON, MICHAEL JOSEPH ODD: 6/2512009 INCOMING MODE: Page 1 of2 Drug Name Rx Number Date of Issue IIssued IRemaining IFonn Number Number Dosage IRx Physician Phannacy Phonel Directions Comments BENOOUIN LIQUID 20% LOTION IN TUBE APPLIED PHARMACY _ . L -__ SERVICES NO SCRIPT INFO .---. .......---. -. ??--1---?-?? CLONAZEPAM 1793217 4/1812009 30 8 TABLET 1MG 1 AT BEDTIME METZGER RITE AID 310-273-3561 DIAZEPAM C0222066 612012009 60 57 TABLET 10MG 112 TO 1 EVERY 6 HRS I MURRAY CVS 310-273-5252 -.... '--- .. ???1--?? ?????---?-----?--1-- .. _ _ 0'- FLOMAX 567153 613/2009 30 24 CAPSULE I O.4MG ONCE DAILY MURRAY CVS 310-474-2152 - ?. 1.. HYDROOUINONE LIQUID 8% LOTION IN TUBE APPLIED PHARMACY SERVICES NO SCRIPT INFO L1DOCANE 6636823 5/1412009 60 LIQUID 4%PLO I LOTION IN TUBE MURRAY APPLIED PHARMACY SERVICES 702-304-0770 -----_... __.. ~ .. --- '-". .-- PRESCRIBED TO DR. MURRAY LORAZEPAM C567154 412812009 30 9 TABLET 2MG ONCE AT BEDTIME MURRAY CVS 310-474-2152 TEMAZEPAM C541756 12122120081 30 3 I CAPSULE 30MG -----?loNcE AT 'BEDTIME~s'l-MURAAY CVS 310-474-2152 N _. __._--'. Paraphernalia Description Investigator: ELISSA J. FLEAK (497061) ONE GREEN OXYGEN TANK; A BROKEN SYRINGE; AN OPEN BOX OF HYPODERMIC DISPOSABLE NEEDLES; AN OPEN BOX OF N-eATHETERS: UVA ANTHELIOS XL LOTION; OPEN BOTTLE OF BAYER ASPIRIN; EMPTY GLASS VIAL OF PROPOFOL INJECTABLE EMULSION 1%; AND EMPTY GLASS VILE OF FLUMAZENIL INECTION 0.5MGIML Date: 612612009 COUNTY OF LOS ANGELES MEDICAL EVIDENCE DEPARTMENT OF CORONER CASE # 2009..Q4415 3A DECEDENT'S NAME: JACKSON. MICHAEL JOSEPH DOD: 6/25/2009 INCOMING MODE: Page 2 of2 Drug Name Rx Number Date of Issue Number Number Issued Remaining Fonn I IDosage IRx Directions IPhysician Phannacy Phonel Comments TEST ._-,_ .. _.. _.. ~ __ .n~'''_",' --_._-_ .. - ,.- . _., .__.__ __._._._.. .. ' ~ n " _ ~ _ . ~ . _ TIZANIDINE 1812056 6"12009 10 8 TABLET 4MG HALF TABLET AT BEDn KLEIN RITE AID 310-273-3561 PRESCRIBED TO OMAR ?..? _- -_._" ._- -_._- ARNOLD TRAZADONE 1793218 4/1812009 60 38 TABLET SOMG 2 AT BEDTIME AS NEED METZGER RITE AID 310-273-3561 / Paraphernalia Description investigator: ELISSA J. FLEAK {497 1i- yr....Att/ . j .>t ONE GREEN OXYGEN TANK; A BROKEN SYRINGE; AN OPEN BOX OF HYPODERMIC DISPOSABLE NEEDLES; AN OPEN BOX OF IV-CATHETERS; UVA ANTHEUOS XL LOTION; OPEN BOTTLE OF BAYER ASPIRIN; EMPTY GLASS VIAL OF PROPOFOL INJECTABLE EMULSION 1%; AND EMPTY GLASS VILE OF FLUMAZENILINECriON 0.5MGIML Date: 612612009  *** 2:"1) FORM 3A *** Initiated on 6129/2009 for evidence collected from second scene "isH COUNTY OF LOS ANGELES MEDICAL EVIDENCE DEPARTMENT OF CORONER CASE # 2009-04415 3A :lECEDENrs 'JANE DOD JACKSON. MICHAEL JOSEPH 6/25/2009 INCOV.:NG M~}CE Accident ~'s. Natural Pa~e I of 3 l Dr~ N~~- Number Rx Physician .---IPharmacy Phonel Number Remaining Directions i Comments Propofol 10/0 liquid i 3 - 100 mL \'ials injectable emulsion no prescrip on directions and ~o patient or doctor names I Propofol 1% liquid 1 8 - 20 mL ,'ials injectable emulsion no prescrip on directions and no patient or doctor names Lidocaine HCI liquid : 6 - 30 mL ,'ials injectable no prescripijon directions and .0 patient or doctor names Midazolam injectable I I I i I IliqUid I I l I 5 - 10 mL "ials no prescrip,on directions and ~o patient or doctor names Paraphernalia Description Investigator: :::L1S::;" J. FLEAK .49 ~8'3' I 2 blue plastic/canvas bags. I square black bag, 5 business cards for Dr. Conrad Murrary, I IV side clamp, I hlue ruhber strip. I Starline aneroid sphygmomanometer (blood pressure cuff), I red stained piece of gauze, Date: 6/291200Q I pulse finger monitor (Nonin- Onyx), and I bag of medical supplies including crumpled packaging  *** 2:\D FORM 3A *** Initiated on 6/2912009 for evidence collected from second scene \'isit COUNTY OF LOS ANGELES MEDICAL EVIDENCE DEPARTMENT OF CORONER Cl..SF. # 2009 -0441 S 3A 0ECEDENT'S NAN':: :JOD !~,.jC:?'1.1'JG JACKSON. MICHAEL JOSFPH 6/25/2009 MDDE Accident \?s. :\atural Pa~(' 2 of 3 Drug Name Rx Number Date of Issue Number Issued Number Remaining Fonn Dosage Rx Directions Physician ! Pharmacy Phonel \ Comments Flumazenil liquid I 4 - 5 mL vials injectahle no pres ription directions 1nd no patient or dodor names I ! Lorazepam ! , liquid f 2 - 4 mL vials injectable I no pres ription directions and no patient or doctor names ! ! Lorazepam I liquid i I t - 10 mL \'ial i injl:l:tabll: I no pres ription directions ~nd no patient or doctor names I I Ephedrine, ! 14 black and red plastic pill hottle with ntl Caffeine, i red prescription directions and no ! I ' Aspirin I capsules i patient or doctor names I Paraphernalia Description Investigator: ELlSS.t.,. J FlE.t...I< ;":9;)"?' I Date: 6/'Y.Q':::!(I\N  *** FORM 3A *** 2'iD Initiated on 6129/2009 for evidence collected from second scene visit COUNTY OF LOS ANGELES MEDICAL EVIDENCE DEPARTMENT OF CORONER CASE # 2009-04415 3A DECEDENT'S NAME:: JACKSON, MICHAEL JOSEPH I DOD 6/2:;'/2009 !NCQM~"'G M()~E -_.- Accident "s. Natural Page 3 of 3 Drug Name Rx Date of Number Number Fonn Dosage Rx Physician r Pharmacy Phonel Number Issue Issued Remaining Directions , Comments BQIKAfRA white tube oflotion I liquid Ino prescription directions and Applied Pharmacy Services j no patienl or doctor names i t Bausch&Lomb liquid i over the counter eye drops I i t I I I I i I j I Paraphernalia Description Investigator: ~LlSSA J FLEAK .1l;};J5' \ Date: '" .J 6/29/1009 ( '-; f -  *** 3rd FORM 3A *u Initiated on 7/9/2009 for evidence brought to FSC by family COUNTY OF LOS ANGELES MEDICAL EVIDENCE DEPARTMENT OF CORONER CASE # 2009-04415 3A =ECEL;['JT'~ N~fv'+" JOD "r"C2\!'NG MODE JACKSON, MICHAEL JOSEPH 6/25/2009 Accident \"S. Natural Paee J of J Drug Name Rx Date of Number Number Form Dosage Rx Physician I Pharmacy Phonel Number Issue Issued Remaining Directions , Comments I , Zanaflex 7018879 11/6/08 4 0 tablet 4mg Y2 to I tab at bedtime Kleill. Arnold I Mickey Fine Pharrn ~lo-nl-6128 I Prednisone 1795927 4/25/09 10 0 tablet 10mg 6 tab now, 4 tomorrow Klein, Arnold 1 Rite Aid ! 310-273-3561 I I Amoxicillin 53380 2/2/09 28 21 caps 500mg 4 times daily , Dwight James! i Patient name hlackcd ~ Cheril)'n Lee lout on label Azithromycin 54729 3/9/2009 6 2 tablet 250mg 2 tabs first day Dwight .lames! ! patient name: Kathlyn Hursey then I for 4 days Cheril\'n Lee ; Paraphernalia Description OTC- Rausch and Lomb eye drops, small tube of "Ultravate" ointment l !, _LlSS'- J FLE:At< ''-'''',.,c,? I --- Date: 7/9/2009 COUNTY OF LOS ANGELES DEPARTMENT OF CORONE No. AUTOPSY REPORT 12 at I performed an autopsy on the body of the DEPARTMENT OF CORONER + 1 2009-04415 JACKSON, MICHAEL _ Los Angeles, California on JUNE 26, 2009 (Date) @ 100 a HOURS ?--(l\m~e)-- .__..~--- From the anatomic findings and pertinent historY I ascribe the death to: (A) ACUTE PROPOFOL INTOXICATION DUE TO OR AS A CONSEQUENCE OF (Rl DUE TO OR AS A CONSEQUENCE OF IC) DUE TO OR AS A CONSEQUENCE OF ~(D~l=~==~=T=~~N=-B=:7N==--:-:::-;:::::-::==-:~=-;-:;:;'::-:::-:-=~-::-:::--='="---?------_?_--?---- OTHER CONDITIONS CON RIBUTI G UT OT RELA reD TO THE IMMEDIATE CAUSE Of DEATH ..- - - - - BENZODIAZEPINE EFFECT Anatomical Summary: 1. Toxicology findings (see separate report). A) Propofol, lorazepam, midazolam, lidocaine, diazepam and nordiazepam, identified in blood samples (see toxicology report for details) . B) Propofol, midazolam, lidocaine and ephedrine identified in urine. C) Propofol and lidocaine identified in liver tissue. D) Propofol identified in vitreous humor. E) Lidocaine and propofol identified in stomach contents. 2. Nodular prostatic hyperplasia. A) Prominent intravesical median lobe enlargement. B) Urinary retention. 3. Vitiligo. 4. Tubular adenoma of colon. ~. Evidence of therapy. A) Endotracheal tube. B) Intravascular catheters of left neck, and both femoral re9Lons. UNTY OF LOS ANGELES DEPARTMENT OF CORONER No. AUTOPSY REPORT 12 2009-04415 JACKSON, MICHAEL C) Intra aortic balloon pump, inserted through left femoral artery. D) Punctures and contusions of right neck, both arms, left calf, and right ankle. E) Condom catheter. F) Resuscitative abrasion-contusion of central chest. G) Resuscitative fractures of sternum, right 4th and 5th ribs, and left 3rd through 5th ribs. H) Resuscitative alveolar hemorrhage of lungs. I) Resuscitative transmural hemorrhage of stomach. 6. See separate consultation reports: A) Neuropathology. 1. Mild cerebral vascular congestion. 2. Mild diffuse brain swelling without herniation syndrome. 3. Mild basal ganglia calcification. B) Pulmonary pathology. 1. Marked diffuse congestion and patchy hemorrhage of right and left lungs. 2. Marked respiratory bronchiolitis, histiocytic desquamation, and multifocal chronic interstitial pneumonitis. 3. Multifocal fibrocollagenous scars. 4. Organizing and recanalizing thromboemboli of two small arteries. 5. Intravascular eosinophilia with occasional interstitial eosinophilic infiltrate. 6. Suggestive focal desquamation of respiratory lining cells with squamous metaplasia. C) Radiology. 1. Minimal degenerative spondylosis of the lower thoracic spine. 2. Right C7 cervical rib. 3. Degenerative osteoarthritis of lower lumbar spine facet joints, distal interphalangeal joints of the right index and long f inget-8, and dl stal Illte.lphalan']eal joint of left little fin,]er.  -----------~~._-------_._-- -----_._._.. - _. ... COUNTY OF LOS ANGELES DEPARTMENT OF CORONER No. l\UTOPSY REPORT 12 .I'aglo: 3 2009-04415 JACKSON, MICHAEL 4. Mild calcified arterial atherosclerosis of both legs. D) Odontology. 1. Root canal therapy, tooth #13. 2. Endosseal implants, teeth #18 and #19. 3. Metallic/ceramic restorations of lower right quadrant. 4. Multiple all-ceramic restorations of maxillary teeth. E) Anesthesiology. CIRCUMSTANCES: The decedent is a 50 year old man who was found unresponsive in his residence on June 25, 2009. He was taken to UCLA Medical Center, where he was pronounced dead. EXTERNAL EXAMINATION: The body is identified by toe tags and is that of an unembalmed refrigerated adult Black male who appears the stated age of 50 years. The body weighs 136 pounds, measures 6~ inches in length, and is thin. Over the lower back are several 1/4-1/2 inch perimortem abrasions. (Comment: Scene photographs show beads on the bed) . EVIDENCE OF RECENT THERAPY: An endotracheal tube is appropriately positioned in the trachea. Intravascular catheters enter the left jugular vein and both femoral vessels. An intraaortic balloon pump enters the left femoral artery and is appropriately positioned within the aorta. A condom catheter is present. There are numerous punctures over both arms. Additional punctures are present on the medial left knee and the medial right ankle. Gauze pads are present on the right neck, left antecubital fossa, left forearm, and right antecubital fossa. The central chest shows a 1 1/2 x 1-1/4 inch irregular abrasion with a surrounding 3 x 3 inch bruise. The soft tissue of the left anterior chest shows a 3-1/2 x 2 inch bruise and the soft tissue of the right .anterior chest shr)ws a 5 x 3 -1/2 inch bruise. The sternum is fractured at the level of the 3~d rib . . .,.,~ .. :,q.. '-:-:--.,. - - - - J _ _ _ _ _ .. ..... - ..11:111 ......"" ...... _ _ , ? ? _ COUNTY OF LOS ANGELES DePARTMENT OF CORONER No. AUTOPSY REPORT 12 2009-04415 JACKSON, MICHAEL The right 4th and 5th ribs are fractured at the chondrocostal junction. The left 3rd, 4th and 5th ribs are fractured at the chondrosternal junction. The following scars are present: 1. There is a 3/4 inch scar behind the left ear and a scar- like area behind the right ear. 2. There are scars at the lateral border of the alae nasi, 3/5 inch in length on the right and 5/8 inch in length on the left. 3. On the top of the right Shoulder is an irregular scar-like area approximately 4 inches in diameter. 4. At the posterior base of the neck are two downsloping scar- like areas measuring 3-1/4 inch on the left and 3 inches on the right. (See microscopic examination, slide U) . 5. The left arm shows a 1/4 inch scar on its anterior surface just proximal to the antecubital region. The left wrist shows a 1/8 inch scar. 6. There is a 7/8 inch scar on the right thenar eminence, and a 1/8 inch scar of the right wrist. 7. There is a 2 inch surgical scar in the right lower quadrant of the abdomen. 8. There is a 5/8 inch scar around the area of the umbilicus. 9. There is a 2 x 1/8 inch semicircular scar of the right knee, with several smaller scars distal to it measuring 1/2 to 1/4 inch in length. 10. On the anterior right shin is a 5 x 2-1/2 inch area of hyperpigmentation. The following tattoos are present: There is a dark skin discoloration resembling a tattoo on the anterior half of the scalp. There are dark tattoos in the areas of both eyebrows and at the superior and inferior borders of the palpebral fissures. There is a pink tattoo in the region of the lips. There is focal depigmentation of the skin, particularly over the anterior chest and abdomen, face and arms. Rigor mortis is present in the limbs and jaw. Livor mortis is fixed and distributed posteriorly. The head is normocephalic and is partly covered by black hair. There IS fnmtal b.:,\ldlng and the haIr can be descrlbed as short I ~, ;-a 1t 1 1 I -: ...',-:,:,,_. _n_d_t_:1_' __ _ _ _Y_l:_U_l_l_e_'d_'__ _ 9 A_m_u_s_t a_C_h_e_d_r_1d_b_e_a_r_d_':l.__'e _ __ _ d_b_f3_t"_l_lt _.- - - J --------------------_._------- OUNTY OF LOS ANGELES DEPARTMENT OF CORONER No. l\.UTOPSY REPORT 12 Pagl.: 5 2009-04415 JACKSON, MICHAEL Examination of the eyes reveals irides that are brown and sclerae that show no injection or jaundice. There are no petechial hemorrhages of the conjunctivae of the lids or the sclerae. The oronasal passages are unobstructed. A bandage is present on the tip of the nose. Upper and lower teeth are present and in good repair (see odontology consultation). The neck is unremarkable. There is no chest deformity. There is no increase in the anterior posterior diameter of the chest. The abdomen is flat. The genitalia are those of an adult male. The penis appears uncircumcised. The extremities show no edema, joint deformity, or abnormal mobility. CLOTHING: The body was not clothed and no clothing is available for review. INITIAL INCISION: The head and body cavities are entered through the standard coronal incision and the standard Y-shaped incision, respectively. No foreign material is present in the mouth, upper airway and trachea. NECK: The neck organs are removed en bloc with the tongue. There are small contusions inside the lips as well as in the central area of the tongue. On the mucosa of the left pyriform recess are three slightly raised nodules measuring 0.2 cm in diameter each. There is no edema of the larynx. Both hyoid bone and larynx are intact without fractures. No hemorrhage is present in the adjacent throat organs l investing fascial strap muscles, thyroid or visceral fascia. There are no prevertebral fascial hemorrhages. CHEST .1\}/D .l'\BDOMINAL CAVITIES: The pleural cavities contain minimal fluid and no adhesions. No pneumothorax is demonstrated. The parietal pleurae are intact. The lungs are well expanded. Soft tissues of the thoracic and abdominal walls are well preserved. The organs of the abdominal ~.",:-:-" "-:::"1,:;7",1>"7:",:-:-" ----------------------------- J  ----------_..'.." """.,----_..--_.. . _-=_.__. . . - ---- COUNTY OF LOS ANGELES OEPARTMENT OF CORONER ~c\UTOPSY No. REPORT 12 2009 04415 JACKSON, MICHAEL cavity have a normal arrangement and none is absent. There is no fluid collection in the abdomen. The peritoneal cavity is without evidence of peritonitis. There are no adhesions. SYSTEMIC AND ORGAN REVIEW CARDIOVASCULAR SYSTEM: The aorta is fairly elastic and of even caliber throughout with vessels distributed normally from it. It shows lipid streaking. There is no tortuosity, widening or aneurysm of the aorta. The major branches of the aorta show no abnormality. Within the pericardial sac there is a minimal amount of serous fluid. The heart weighs 290 grams. It has a normal configuration. The right ventricle is 0.2 cm thick and the left ventricle is 1.4 cm thick. The chambers are normally developed and are without mural thrombosis. The valves are thin, leafy and competent. Circumferences of valve rings are: Tricuspid valve 12.8 cm, pulmonic valve 7.0 cm, mitral valve 8.8 cm, and aortic valve 7.2 cm. There is no endocardial discoloration. There are no focal lesions of the myocardium. There is no abnormality of the apices of the papillary muscles. There are no defects of the septum. The great vessels enter and leave in a normal fashion. The ductus arteriosus is obliterated. The coronary ostia are widely patent. The right coronary artery is the dominant vessel. There is no coronary artery atherosclerosis. No focal endocardial, valvular or myocardial lesions are seen. The blood within the heart and large blood vessels is liquid. RESPIRATORY SYSTEM: Scant secretions are found in the upper respiratory passages. The mucosa of the larynx is focally hemorrhagic. The lungs are subcrepitant and there is dependent congestion. The left lung weighs 1060 grams (see Special Procedures below) and the right lung weighs 940 grams. The visceral pleurae are smooth and intact. The parench~na is moderately congested. The pulmonary vasculature is without thromboembolism. - - - - -_ _J __________ __ ~ ~_.?_l'lll'l:l_._? d ...._ . _ ,- - - - - - - - - - ?P. . . r _ ~ . _ COUNTY OF LOS ANGELr.:.S DEPARTMENT OF CORONER No. AUTOPSY REPORT 12 2009-04415 JACKSON, MICHAEL GASTROINTESTINAL SYSTEM: The esophagus is intact throughout. The stomach is not distended. It contains 70 grams of dark fluid. There are a few mucosal hemorrhages, but no ulceration. Portions of tablets and capsules cannot be discerned in the stomach. The external and in situ appearance of the small intestine and colon are unremarkable. The small intestine and colon are opened along the antimesenteric border, revealing a 2 mm pedunculated polyp of the sigmoid colon. The colonic mucosa is purple. The appendix is present. The pancreas occupies a normal position. There is no pancreatic necrosis. The parenchyma is lobular and firm. The pancreatic ducts are not ectatic and there is no parenchymal calcification. HEPATOBILIARY SYSTEM: The liver weighs 1480 grams. It is red-brown and the capsule is thin. The consistency is soft and the cut surface is smooth. There is a normal lobular arrangement. The gallbladder is present and its wall is thin and pliable. It contains 10 grams of bile and no stones. There is no obstruction or dilatation of the extrahepatic ducts. The periportal lymph nodes are not enlarged. URINARY SYSTEM: The left kidney weighs 120 grams and the right kidney weighs 140 grams. The kidneys are normally situated and the capsules strip easily revealing a surface that is smooth and dark purple. The corticomedullary demarcation is preserved. The right kidney shows a 0.2 cm off-white well circumscribed medullary mass. The pyramids are not remarkable. The peripelvic fat is not increased. The ureters are without dilatation or obstruction and pursue their normal course. The urinary bladder is distended and trabeculated. It contains 550 grams of clear yeJ.Iow-orarJge urine. GENITAL SYSTEM: The prostate is moderately enlarged, with a prominent lntr aves lca 1 111ldd Ie (medlan) lobe. The pr ostat 1 c parenchyma 1 S nodular. Both testes are in the scrotum and are unremarkable clnd ?,.Jithout tl.dUma. -----------_._--------------------------~. , .?..._--~ . COUNTY OF LOS ANGELES DEF'ARTMENT OF CORONER No. AUTOPSY REPORT 12 I'agl' 8 2009-04415 JACKSON, MICHAEL HEMOLYMPHATIC SYSTEM: The spleen weighs 110 grams. The capsule is thin and the parenchyma is dark red. There is no increase in the follicular pattern. Lymph nodes throughout the body are small and inconspicuous in general. However, there is a 1.5 cm well circumscribed off-white lobulated mass located in the periaortic region just medial to the left adrenal gland. The bone is not remarkable. The bone marrow of the vertebra is red and moist. ENDOCRINE SYSTEM: The thyroid gland is unremarkable and weighs 24 grams. Tissue from the parathyroid area is submitted for microscopic evaluation. The adrenals are intact without necrosis or hemorrhage and weigh 5 grams each. The thymus is not identified. The pituitary gland is of normal size. HEAD AND CENTRAL NERVOUS SYSTEM: There is no subcutaneous or subgaleal hemorrhage in the scalp. The external periosteum and dura mater are stripped showing no fractures of the calvarium or base of the skull. There are no tears of the dura mater. There is no epidural, subdural or subarachnoid hemorrhage. The brain weighs 1380 grams. SPINAL CORD: The spinal cord is not dissected. NEUROPATHOLOGY: The brain is placed in formalin solution for further fixation and later neuropathology consultation. Note: Following neuropathological examination, residual brain tissue is released to the mortuary on 7 8-09. HISTOLOGIC SECTIONS: Representative specimens from various organs are preserved in two storage jars in 10% formalin. A separate storage jar of OUNTY OF LOS ANGELES DEPARTMENT OF CORONER No. AUTOPSY REPORT 12 I'ag", 9 2009-04415 JACKSON, r"!ICHAEL selected areas of brain tissue is preserved by the neuropathologist on 7-8-09. Sections are submitted at autopsy for slides. The slide key is as follows: A - adrenal glands B - left pyriform recess C - parathyroid area D - thyroid gland E - left periaortic mass F - bone marrow G - aorta, right ventricle H - pituitary I - cardiac interventricular septum J - left ventricle K - right lung L - right testis M - left testis N - stomach and gallbladder o - pancreas P - spleen Q - liver R. - right kidney S - left kidney T - bowel U - scar-like area from right posterior neck V - prostate TOXICOLOGY: Blood, bile, liver tissue, stomach, urine and vitreous humor have been submitted to the laboratory. A comprehensive screen is requested. SPECIAL PROCEDURES: The left lung is referLed to pulmonary pathology for examination (see separate report). Note: Following pulmonary pathology examination, residual left lung tissue is released to the mortuary on 7-8-09, after selected sections of the perfused inflated lung are preserved in one of the original storage jars. ",1 j:""  _-----_........._--------_._-- --_.. COUNW OF LOS ANGELES DEPARTMENT OF CORONER No. AUTOPSY REPORT 12 2009-04415 JACKSON, MICHAEL PHOTOGRAPHY: Photographs have been taken prior to and during the course of the autopsy. The following photographs taken by the coroner are reviewed prior to signing the autopsy report: 1. 17 photographs taken at the hospital on 6-25-09. 2. 13 photographs taken at the scene on 6-25-09 showing the bedroom where paramedics treated the decedent. 3. One intake photograph taken at the Forensic Science Center on 6-25-09. 4. 61 photographs taken on 6-26-09 before and during autopsy (documenting resuscitative injury and intravesical prostatic enlargement) . 5. 3 photographs of a silver BMW 645 Ci taken on 6-29 09. 6. 13 photographs taken at the scene on 6-29-09 showing the dressing room with closets where additional medical evidence was collected. 7. Three contact sheets showing 108 photographs (items 1 to 6 above) . 8. Four photographs taken on 7-23-09 of the Stokes litter from Sheriff's Air 5 helicopter used in transporting decedent. 9. Five enlarged scene photographs taken by the police are reviewed with Dr. Calmes, in addition to some of the other police photographs pertaining to medical evidence. RADIOLOGY: Sixteen x-rays are obtained. WITNESS: Detective Scott Smith of LAPD witnessed the autopsy. DIAGRJ".MS USED. Diagram Ponns 20 and 22 were used during the rfonnance of the autopsy. The diagrams are not intended to be a facsimile. COUNTY OF lOS ANGELES DEPARTMENT OF CORONER No. AUTOPSY REPORT 12 P:il:!(: 11 2009-04415 JACKSON, MICHAEL OPINION: Toxicology studies show a high blood concentration of propofol, as well as the presence of benzodiazepines as listed in the toxicology report. The autopsy did not show any trauma or natural disease which would cause death. The cause of death is acute propofol intoxication. A contributory factor in the death is benzodiazepine effect. The manner of death is homicide, based on the following: 1. Circumstances indicate that propofol and the benzodiazepines were administered by another. 2. The propofol was administered in a non-hospital setting without any appropriate medical indication. 3. The standard of care for administering propofol was not met (see anesthesiology consultation). Recommended equipment for patient monitoring, precision dosing, and resuscitation was not present. 4. The circumstances do not support self administration of propofol. CHRISTOPHER ~GERS, MD,MBA DATE CHIEF FORENSIC MEDICINE DIVISION /1 /' //// fV ~/v-tlv7 41rv-...... :rlr'V""''' . . ?''?- C' !), ~ .....-----:: ?? II',. ( V' /' ,. VAKSHMANAN SATHYAVAGI SWARAN, MD DATE 'FRCP (C) , FCAP, FACP CHIEF MEDICAL EXAMINER-CORONER CR:mlm:c D 06/26/09 T 06/30/09  ---.--.--- ......,,-~------------- COUl''TY OF LOS ANGELES FORENSIC CONSULTANT'S REPORT DEPARTMENT OF CORONER 13 2009-04415 Jackson, Michael July 31. 2009 This consultation is provided at the request of the Chief Medical Examiner-Coroner. Dr. Lakshmanan Sathyavagiswaran. Gross Description: The weights of the left and right lung are provided in the Autopsy Protocol. On 6/26/09. the bronchus of the left lung was cannulated with a plastic tube that was slightly smaller in diameter than that of the bronchus. The tube was attached to a perfusion-inflation apparatus containing -40 gallons of 10% bufTered (monobasic and dibasic phosphate) formalin. Perfusion was maintained for -72 hrs at 30cm water pressure. following which the formalin was replaced with tap water and perfusion continued for -24 hours. The formalin-fixed and washed lung was then placed in an electrical rotary slicer and five sagittal slices of whole lung tissue were obtained beginning at the hilum. The inflated left lung measured 25.0 cm in sagittal height, 12.0 cm in coronal width, and 12.0 cm in sagittal dcpth. The visceral pleural surfaces were generally thin and transparent with the exception that the lateral surface ofa large portion of the lower lobe was slightly thickened and had a milky appearance. There was also a patchy anthracotic pigment deposition that involved primarily the superior and lateral portions of the upper and lower lung lobes, with band-like distributions along the rib cage. There were no pleural adhesions or areas of consolidation other than several poorly defined smalhiodules in the apical portion of the upper lobe in association with a few whitish streaks having an apparent lymphatic distribution. The anterior margin of the upper lobe showed a patchy film-like opacification. The main stcm bronchus of the left lung measured 2.5 cm in length and was grossly unremarkable. A few hilar lymph nodes were noted that were grossly unremarkable except for slight anthracotic pigmentation. Gross examination of the sliced section at the base of the Left Lower Lobe showed three relatively firm and nodular masses of tissue immediately below the pleura surface. am cut section, thc largest of the nodular masses was irregular and measured 0.6 cm x 0.8 cm x 0.5 cm. Two other masses, each measuring 0.5 cm x 0.5cm and 0.7 cm, were moderately firm in consistency and, in large part. associated with congestion and hemorrhage. An area of brownish discoloration of the apical pleura overlying the Left Upper Lobe measured 0.5cm x 0.6cm, with superficial involvement (-I.Omm) of the subpleural tissue. Additional small areas of subpleural brownish discolorations were nearby. At the base of the Left Upper Lobe, a reddish-brown and hemorrhagic mass was found that measured 0.6 cm x 0.6cm x 0.4 cm. Five sections of the formalin-perfused lung tissue were excised for microscopic study. Sections taken for paraffin embedding and processing: Cassette B - apex. Left Lower Lobe; Cassette D - base. Left Lower Lobe I Casscttc A - base. Lett Upper Lobe; Cassette E - base, Left Lower Lobe Cassctte C- Main stern bronchus, transverse section Ilistopathologic Findings On examination of the base of the Lett Lower Lobe, tour roughly rectangular scar areas were found that measured approximately 3.5mm x l.4rnm, 7.6ml11 x 4.2mm, 4.8mm x 0.9mm, and l.4mm x O.6mm. All shared in common acellular fibrocollagcnous tissue. derungl:ll1cllt or brolll.:hioloaiwolar structures, hemorrhage. proteillacl:ous-fibrinous deposits, and aggn:gaks of heavily riglllcllh:d nHH:rophagcs. In St'ml: scar arcas there was a fibrous thickcnillg orbronchi%alvcolar "ails \\ith nJlIlld cdl illfiltratcs alld aggrcgaks ofpigmcnted histiocytes. Thl:re is slight to modcrate thickening urlhe pleura that uvcrlics libro-illllallllllatory Icsiuns. Sevcral fiJci of round cclls aggrcgatcs are IHltcu, illcluding pcriarteriolar alld pericapi Ilill) sites. 'I __jJ COUNTY OF LOS ANGELES FORENSIC CONSULTANT'S REPORT DEPARTMENT OF CORONER 13 July 31. 2009 2009-04415 Jackson, Michael Page 2 Histopathologic Findings (ConL) There is widespread bronchioloalveolar histiocytic infiltration and patchy histiocytic desquamation. Ccntriacinar derangement is noted with and without chronic inflammation. Two small arteries are observed that contain organizinglrecanalizing thromboemboli. One of the vessels with a thromboembolus (base of upper lobe) is associated with a localized, subpleural area of hemorrhage. Eosinophils are often noted within capillaries and other vascular channels, and are also seen occasionally within interstitial tissues ofthe lung. In two instances, an air space was observed that contained cells consistent with respiratory lining cells that have undergone squamous metaplasia. Histiocytes often contained birefringent particulates in association with anthracotic pigment. Birefringent particles were absent elsewhere in the lung. Slight chronic inflammation was seen in the bronchial section. The foregoing findings were in part observed in the "K" section of the uninflated lung (H&E stained section). PAS and iron stains of Slides 0 and K were reviewed. DIAGNOSIS: Marked diffuse congestion and patchy hemorrhage of right and left lungs. Marked respiratory bronchiolitis, histiocytic desquamation, and multifocal chronic interstitial pneumonitis. Multitocal fibrocol1agenous scars with and without congestion and hemorrhage. Organizing and recanalizing thromboemboli of two small arteries. Intravascular eosinophilia with occasional interstitial eosinophilic infiltrate. Suggestive focal desquamation of respiratory lining cells with squamous metaplasia. OPINION The above tindings reflect a depletion of structural and functional reserves of the lung. Reserve depletion is the result of widespread respiratory bronchiolitis and chronic lung inflammation in association with fibrocollagenous scars and organizinglrecanalizing thromboemboli of small arteries. It should be noted that the above lung injury with reserve loss is not considered to be a direct or contributing cause of death. However, such an individual would be especially susceptible to adverse health ctlects. Respectfully submitted, Russell P. Shcfv.in. M.D. Deputizcd Consultant in Pulmonary Pathology Pro lessor of Patiloillgy Keck School or Medicine L!niH.lrsit} urSuulht:rn CalitlJrllia Kl'S/vr ---_.. .".-._==----._---_. . ._._----__----_.._-_.- -------- . . . t:OlllltV 01 I,os Angell's .?OREN~lC CONlSULTANT'!S KJ!;I'OKT !il'paIIllll'lil 01 l,llI'Olll'! 13 ODONTOLOGY CONSULT CC #2009-04415 JACKSON, Michael Joseph REQUEST: The decedent is a 50 year old black man who died unexpectedly. Please examine for den- tal contribution to cause of death. FILMS: Post Mortem AP and lateral skull FINDINGS: Review of the two films reveal history of routine restorative dentistry. There were incom- plete dental records from two Las Vegas dentists who performed restorative and surgical treatment for this decedent. There is root canal therapy completed on tooth #13. There are endosseal dental implants in the positions of teeth #18 and #19. There are also me- tallic/ceramic restorations present in the lower right quadrant. There are multiple all ce- ramic restorations present in the maxillary teeth. There is no gross pathology seen on these two radiographic views, even though these are not the standard views for a dental exam. .' ,I f r. , I- I '/' j J,L,(./ j_~t."__ \ "1-O (" ,'r;" .!;:h v !-.,_._ _-!/--.:.-_ . /1 ...1-- ( ? \,~,/ _ _ _ _ _ _ _--JI- I,L/;.- / .<:7 _ Cathy Law( D.D.S. Date DENTAL CONSULTANT c1:ECL hw 7/10/09 ---_._--~ 'OlINTY OF I ( l' ANGELES FORENSIC CONSl1I.TANT'S REPORT DEP?\RTMENT OF (,ORO~ER 13 NEUROPATHOLOGY _. "---_ - .. -.~ 2009-04415 JACKSON, MICHAEL J. July 8, 2009 AGE: 50 years DATE OF DEATH: June 25, 2009 REFERRING DME: Christopher Rogers, M.D. CIRCUMSTANCES: The following information is taken from the Investigator Report, preliminary autopsy notes, and records from UCLA Ronald Reagan Medical Center currently in the file. This 50-year-old man was reportedly found unresponsive in his residence at approximately 1200 hours on 6/25/09, and arriving paramedics found him to be in cardiopulmonary arrest. He was transported to UCLA Ronald Reagan Medical Center, but did not respond to resuscitative efforts and was pronounced at 1426 hours on 6/25/09. Available records reveal no remarkable prior neurological symptoms or findings, and no history of trauma of seizures preceding the cardiopulmonary arrest. At the time of postmortem examination on 6/26/09 the findings included evidence of therapy, and no scalp, skull or intracranial abnormalities were described. Brain weight at removal was 1380 grams. GROSS DESCRIPTION: Specimens available for examination are cranial dura mater and brain. The specimens are identified as to source by the identification tag indicating specimen number and decedent name on the specimen container, and separately on a plastic card within the specimen container, within the green surgical cap surrounding the brain. The cranial dura mater submitted includes dorsal convexities with falx cerebri, posterior fossa with tentorium cerebelli, and the bulk of the middle and anterior fossae bilaterally. External and internal surfaces of the dura mater are smooth and shiny, without evidence of discoloration, hemorrhage, subdural neomembranes, mass lesions, or other significant ('Ol'NTY OF I (IS ANGELES Foa..:NSIC CONSl'l,TANT'S REPORT DEP>\RTME"IT OF CORONER 13 NEUROPATHOLOGY ------_ .. _- 2009-04415 JACKSON, MICHAEL J. finding. No calcific plaques are palpated within the dura. Dural venous sinuses are normal in pattern. The cerebral leptomeninges show a very mild degree of increased opacity over the dorsal convexities, well within normal limits for age group, and are otherwise thin and delicate. There is a mild degree of leptomeningeal vascular congestion. The hemispheres are approximately symmetrical, with a midline and closely apposed interhemispheric fissure. There is mild diffuse cerebral swelling, with mild flattening of gyral crowns and narrowing of sulci, but no evidence of herniation at the uncus, cerebellar tonsillar/biventer lobule region, superior cerebellar vermis or cingulate gyrus. The convolutional pattern is unremarkable. No recent or remote cerebral or cerebellar cortical contusions are identified. No focal areas of softening, increased firmness, or focal discoloration are present. Rectus-orbital and basitemporal areas are intact. Cranial nerves, I through XII, are present and unremarkable except for avulsion of the olfactory bulbs bilaterally. Major basal arteries are as follows: the left vertebral artery is slightly larger than the right vertebral artery, as they fuse to join the basilar artery. The anterior communicating artery is duplicated. Major basal arteries are otherwise unremarkable, without major anomalies, aneurysms, or significant occlusive vascular disease. Belly of the pons and medulla have a normal configuration, discounting some minor brain removal artifact consisting of a superficial incision in the anterolateral left medulla which crosses the inferior olivary nucleus. Cerebellar hemispheres are approximately symmetrical, with mild swelling of the folia. Basal cisterns are minimally narrowed, consistent with the mild degree of brain swelling previously described. The brain is sectioned in a coronal plane. and the brainstem and cerebellum in a transverse plane. The cortical ribbon is normal in thickness and color, and gray/white demarcation is distinct. Underlying white matter is homogeneous and clear, discounting a somewhat softer consistency of parenchyma in deep hemisphere areas (which is not infrequently encountered in formalin-fixed tissue). Corpus callosum is normal in thickness, color and symmetry. Lateral ventricles are normal in si~e. with only a trace asymmetry noted, consisting of a COl'NTY Of U)\;\ <\NCiELES f"OR..;NSIC CONSlllTANT'S REPORT DEPARTMPH OF CORONER 13 NEUROPATHOLOGY 2009-04415 JACKSON, MICHAEL J. trace rounding of the superior angle of the left lateral ventricle compared to the right, which is sharp. Septum pellucidum is non-fenestrated, and there is a small cavum septi pellucidi. Third ventricle is midline and does not exceed 0.3 to 0.4 cm in maximum transverse diameter. Cerebral aqueduct and fourth ventricle are normal in size and configuration, and choroid plexus is unremarkable bilaterally. Basal ganglia are normal in size, symmetry, contour and color. Substantia nigra is normally pigmented. Hippocampal formation, amygdaloid complex of nuclei, mamillary bodies and pineal body are all grossly unremarkable. Multiple transverse sections of the brainstem and cerebellum reveal no abnormality. Selected areas are retained in storage. Representative sections are submitted for microscopic examination. GROSS IMPRESSIONS: A. Mild cerebral vascular congestion. B. Mild diffuse brain swelling without herniation syndrome. C. Otherwise grossly unremarkable adult brain and coverings. 1 ~ .. _. ?lk./l"-t ((?(.A?(( ~;~, JOHN M. ANDREWS, M.D. DATE DEPUTY MEDICAL EXAMINER NEUROPATHOLOGY CONSULTANT JMA:mtm:c T-07/08/09 '()l'NTY Of U)S I\NGELES I'OR..:NSIC CONSLJLTA~T'S REPORT DEPARTMENT OF CORONER 13 NEUROPATHOLOGY 2009-04415 JACKSON, MICHAEL J. July 14, 2009 MICROSCOPIC DESCRIPTION: Sections of brain (8) stained by H&E method include the right frontal lobe (slide A), right basal ganglia (slide B) / left and right hippocampi (slides C and D, respectively), right thalamus (slide E), right parietal lobe (slide F), medulla (slide G) / and cerebellum (slide H) . A few vessels in the sections (e.g. slide B), demonstrate sparse small lymphocytes in perivascular spaces, considered within the normal range. Very sparse extravasated blood is seen around rare parenchymal vessels (e.g. slide C). Rare leptomeningeal vessels show mild intimal thickening and fibrosis, without significant lumen compromise (e.g. slide G). A minority of neurons in some sections (e.g. slides B, C, D and E) shows slightly more shrinkage than the majority of neurons, at times with a mild magenta tint to the cytoplasm, considered mildly suspicious for, but insufficient for the diagnosis of, acute neuronal hypoxic/ischemic injury. The majority of neurons are unremarkable. Patchy dark neuron change is also present in the sections. Relatively mild, patchy fine granular black to purplish concretions are seen in globus pallidus, in vessel walls of some of the larger vessels and in neuropil. The smaller, generally separate granules in the neuropil are also mainly vessel-centered. The appearance of these black to purplish concretions is consistent with mild mineralization (e.g. calcification) . There is no evidence of meningitis, encephalitis, abnormal neuronal inclusions, developmental anomalies, or neoplasia. FINAL NEUROPATHOLOGIC DIAGNOSIS: A. Mild cerebral vascular congestion. B. Mild diffuse brain swelling without herniation syndrome. C. Mild basal ganglia calcification (see comment) . co! '\Tn OF f ( l'i ANGELES FORENSIC CONSl'I.TANT'S REPORT 13 NEUROPATHOLOGY 2009 04415 JACKSON, MICHAEL J. Page 2 Comment: The type of mild basal ganglia mineralization present in the globus pallidus in this case is not unusual in this age group. In the absence of any clinical evidence of endocrine or metabolic disorder, it is interpreted as an incidental finding unrelated to the cause or manner of death. JOHN ~ ANDREWS, M. D. DATE I DEPUTY MEDICAL EXAMINER NEUROPATHOLOGY CONSULTANT JMA:mtm:c T-07/16/09  .. "' .. """"""' - - .. _ - -_. _ .. . 13 ANI:sn IESIOI.OG Y CONSUI.L\TION JACKSON, Michael Joseph 2009-04415 l)g. 101'2 This spccial consult is at the n.:qucst or thL' Los Angeles County Chief \ kdkal Examiner ('oroner, Dr. Lakshmanan, for u 50 year old decedent \vho \"'lS ('ound with physical evidence or the anesthetic drug propofol in his home. RELEVANT INFORMATION ON PROPOFOL AND ITS ADMINISTRATION: Propolol is an intravenous anesthetic with highly favorable properties: rapid onset of sedation and/or uncon- sciousness, predictable dose response (usually) and duration of action, rapid return of consciousness, little post- anesthesia "hang-over" and little postoperative nausea and vomiting. Unfavorable properties include respiratory and cardiovascular depression. especially on induction or if the IV bolus is rapid. Respiratory and cardiovascular depression is usually dose dependent and is accentuated if other sedatives, such as benzodiazepines. are present. There is also a narrow margin between mere sedation and full general anesthesia. with possible loss of the patient's ability to breathe and maintain their airway. (These properties are the most relevant to this case; other properties of propofol arc not listed.) Since its introduction into clinical practice in 1989, propofol has been widely used for induction and mainte- nance of anesthesia for surgery and to supplement regional and local anesthesia, It is widely used tor sedation dur- ing uncomfortable diagnostic procedures and is also used in Ie Us for sedating critically ill patients. It is reported to be used to relieve the pain of acute migraine headaches, in pain clinic settings. There are NO reports of its use tor insomnia relief, to my knowledge. The only reports of its use in homes are cases of fatal abuse (!irst reported in 1992), suicide. murder and accident. Propofol must be given intravenously. Administration techniques include single IV bolus (fbr induction of general anesthesia, going on to additional anesthesia drugs). repeat IV boluses (when there is a short-term need fi)f sedation in a quick painful procedure) and IV bolus followed by continuous infusion (used tor both general anesthe- sia with the addition of other drugs or for lengthy diagnostic procedures). The infusion technique requires precision control of the dose by way of a controllable infusion pump, because of the narrow margin between mere sedation and full general anesthesia and build-up of the drug as it is administered long-term. Because propotol is painful on . injection, lidocaine (1 cc of 1%) is usually given, either immediately betore injection or mixed into the amount to be .infused. Propofol solutions easily support bacterial growth, and attention to antisepsis is required as well as dis- carding vials and syringes within 6 hours of usc. Full pati~nt monitoring is required any time propofol is given. The most essential monitor is a pcrson trained in an.:sthesia amJ in resuscitation \\ho is cOlltinuously pn,:sl,.'nt and not involved in the on-going surgi...:al! diagnostic proc\..'Jure. Other monitors .:.'\pected would be a l'lHltinuous pulse llximder. I:K(i and blood pn.:ssure curl: prdi:rably one that autonwti...:ull} influtes. An end-tidal CO: monitor would be used I\.lr fully unesthdiz\..'d pa- tknts and is also highly desirabk in sl.'datcd patil.'nts. Although the measurement or CO: would not he aCl.'urate in s.:datcd patil.'llts, \\!lo ha ve a loose mask or nasal cannula ftlr suppleml:ntal oxygen, the presence of CO: docul11l.:nts that the patient is breathing und that the airwuy is open. If CO: stops bdng present. f()r \\hate\er reason, the moni- tor \vill alarm (audible and visual signals). which calls attention to the possibk apnea and/or airway obstruction, so action can be taken promptly. Of course. airway de\ices and drugs for resuscitation must always be present. Sup- pkmcntal (): sh()uld a/ways he dcliwrcd to pati.. . nts n:l.:ci\ ing propoliJI. and Ihey should uh\ay s han: a n.:cmcry pe- riod with monitoring and obsl:n ation hy trained rewvl:ry nurses.  13 ANESTHI:SIOI.OGY CONSULTATION JACKSON, Michael, Joseph 2009-04415 Pg.:2 01'2 Because ofthc:: risk of sudd~n onset of full general anesth~sia, propotol should be given only by an~sth~si ologists or other sup~r\'ised Jn~sthesia provid~rs, who arc fully trained to recognize and tn.-at the possibl~ respira- tory and cardiac deprc::ssion. In thc leu setting, propotbl should be given by ACLS c~rtitied critical care level nurses, following physician orders. Crhes~ patients are intubated and vcntilated, decreasing the need to deal with respiratory depression or air\vay problems from propotbl.) In procedure rooms such as endoscopy sllit~s, propotol is sometimes giwn by nurses (hopefully ACLS c~rtit1ed) und~r the supervision orthe physician doing the proce- dure. This is not ideal and is the subject of conflict betw~~n gastroenterologists and anesth~siologistsat the national level. THIS PARTICULAR CASE: Questions to be answ~red include was the standard of care tor administering propofol m~t, could thc decc- dent have administered the propofol to himself and what is an anesthesiologist's point of view on the toxicology screen results. Was the standard of care for giving propofol met? It is not known whether trained medical personnel were continu- ously observing the decedent while propofol given. There was no evidence of an infusion pump fur control of an I V infusion. No monitors were found at the scene~ a blood pressure cuff and portable pulse oximeter were recov- ered from a closet in the next room. A tank of oxygen with some kind of non-rebreathing bag with a clear plastic mask (fur positive pressure ventilation) was near where the patient was found by the paramedics. This tank was empty when examincd on 7/13/09. A non-rebreathing bag was not attached when the tank was examined. Multiple opened bottles of propofol were found, with small amounts of remaining drug. A used bottle should be discarded 6 hours after opening, to avoid possible bacterial growth. The standard of care for administering propofol was not met. Could the decedent have given propotol to himself? It is unknown where the propofol physically came from. It would have been difficult for the patient to administer the drugs (others besides propofol were administered) to him- self. given the configuration of the IV set-up. The IV catheter was in the left leg. The injection port of the IV tub~ ing was 13.5 cm from the tip in the catheter. He would have had to bend his knee sharply or sit up to reach the in- jection port and push the syringe barrel. an awkward situation. especially if sleep was the goal. If only bolus injec- tions via a syringe were used, sleep would not have been maintained, due to the short action of propot(.)l. Someone with medical knowledge or experience would haw started the IV. Anyone could have drawn up and administered the medications after the IV was started. What is an anesthesiologist's view point onthe toxicolog\'screen results? The lc\"cls of propo to I found on toxicol- ogy exam are similar to those round during general anesthesia lor major surgery (intra-abdoll1 inal) with propofol infusions, atkr a bolus induction. During l1l~jor surgl.'ry. a patient \\ith these hlood h.~vels of propofhl \vould be intubated and \cnti lated hy an ancsthl'siologist. and any cardiovasl.:ular ~kpression v,ould be noted and treated. An~sthl'siologists would also comment on Ihe prescm:e of other sl..'dative drugs in the toxit.:ology Sl.'l"ccn. I.orazepam. a long-al.:ling bl.'llzodiazepine, is present at a pharmacologically significant Icn:l and wuuld have aCl.'en- tuut....d the respiratory and cardiovascular dl'pression from propot(ll. ('-' { . . - <-=_::~_:--- C'"~ .~ A,Li-.'-':-_"'~ Selma Calml's ~I[) Anesthcsiology Consultant I.'ounly 01 Los i\ngt'lt? .'OREN~lC CONl:nJLTANT'~ JU;t'OR'l' J)t'pW'lll1t'l1! III \..O!"OIll'l" 13 RADIOLOGY CONSULT CC #2009-04415 JACKSON, Michael Joseph REQUEST: The decedent is a 50 year old black man who died unexpectedly. Please examine for trauma or natural disease. FILMS: Whole body radiographic survey-Adult FINDINGS: The two views of the skull demonstrate metallic dental "caps" of several right mandibular teeth(pre-molar/ molar) with appropriate post operative dental changes, and at least 2 im- planted left mandibular dental prostheses (pre-molar/molar). The nasal bones are ob~ scured by overlying cranial and facial structures. The remainder of the craniofacial skeletal structures are unremarkable. An endotracheal tube is in place. There are no visible significant thoracic skeletal abnormalities other than minimal degen~ erative spondylosis at TIl /12. A small right C7 cervical rib is present. An iatrogenic de- vice with a linear metallic marker fs present overlying the left thoracic parasagittal region consistent with a known aortic balloon pump, with the tip located at T6. The superficial soft tissues are unremarkable. The abdomen and pelvis are unremarkable except for the presence of iatrogenic catheters consistent with femoral vascular catheters as well as the abdominopelvic portion of the aortic balloon pump and what appears to be mild degenerative osteoarthritis of the lum- bar spine facet joints at L4/5 and L5-Sl. The right upper extremity is unremarkable, except for probable mild degenerative os- teoarthritis of the DIP joints of the index and long fingers. A small portion of the mid right upper extremity (including the proximal third of the forearm) is not included on the films. The left upper extremity is unremarkable except for moderate degenerative osteoarthritis of the DIP joint of the little finger. The skeletal and articular structures of the right lower extremity are unremarkable. Inci- dently noted is a thin 5 em. long calcific collection in the posterior mid to distal leg con- sistent with atherosclerotic arterial calcification. , ,,-,,-~~,._-------------- ----J -------------- 13 RADIOLOGY CONSULT CC #2009-04415 JACKSON, Michael ,Joseph Pag~ ~ of1 The skeletal structures of the left lower extremity are unremarkable. Incidently noted is a thin 2 em. long calcific density in the posterior distal leg consistent with calcified arte- rial atherosclerosis (found at the same level as the ID marker band placed about the lower left leg). There is additional minimal calcified arterial atherosclerotic calcification approximately 1.5 em distal to the larger calcification. IMPRESSION: 1. Right mandibular pre-molar/ molar metallic "caps" with appropriate post-operative changes. 2. Two (2) mandibular pre-molar/molar implanted dental prostheses. 3. Minimal degenerative spondylosis of the lower thoracic spine. 4. Right C7 cervical rib 5. Vascular iatrogenic devices are in place. 6. Mild degenerative osteoarthritis of the lower lumbar spine facet joints. 7. Probable mild degenerative osteoarthritis of the DIP joints of the right index and long fingers. 8. Moderate degenerative osteoarthritis of the DIP joint of the left little finger. 9. Mild calcified arterial atherosclerosis of both legs. DONALD C. BOGER, M.D. RADIOLOGY CONSULTANT DeB/ecl 7/2/09 ".ai.-N.IoWIS'~~" ""V$V"' -_.~I(_" __- 4 _ .:OUNTY OF LOS ANGELES MICROSCOPtC REPORT DEPARTMENT OF CORONE~ + 141 I I performed a micro5copic examination on ;~ (1 () 9 - 0 4 ,11 5 I July 20, 2009 I JACKSON, MICHAEL J. at _ _----=T...:.H:.::E=--=:.D-=E.:.:PA~RT.:_M=__=_=E:.:..N:....::T_:O=_=F:_...=C..:::O.:.::R..:::O.:_N:._=E:.:.:R=_ _ _._ I Los Angeles. California MICROSCOPIC OESCRIPTION The adrenal glands (slide A) are normal in size and structure. No significant inflammation is present. A section of left pyriform recess (slide B) shows several submucosal nodules of lymphoid tissue with keratin material and neutrophils, consistent with tonsillar tissue (Waldeyer's ring). The mucosa is unremarkable. Sections from the parathyroid region (slide C) show several small lymph nodes and a portion of ectopic salivary gland. A cystic area shows a thin rim of parathyroid tissue. A section of thyroid gland (slide 0) shows follicles of roughly uniform size with abundant colloid and low cuboidal epithelium. There is no significant inflammation. Special stains show the usual PAS-positive colloid. Iron is absent. A section of periaortic mass just medial to the left adrenal gland (slide E) appears to be a sympathetic ganglion with normal ganglion cells. The bone marrow (slide F) shows normal cellularity for age. All cell lines are present. A small lymphoid aggregate is noted. Sections of heart (right ventricle, slide Gi interventricular septum, slide Ii left ventricle, slide J) show normal myocardial structure without significant inflammation. Coronary arteries show minimal atherosclerosis. Red cells do not show sickling. 'fr:c: pit!.l':'i:al'j ql .? I~lj (~3li,Je H) is un~?'~rnark)bl(~. The riyht lurhJ (~31ide K) shows scattered alveolar hemorrhage. ~;.:: (:' ['! r. :~ h P. r win' .'; L e p () r t . OUNTY OF LOS ANGELES MICROSCOPIC REPORT ---------------,-_. __ __ _---_.__ .. ..? DEPARTMENT OF CORONER __ .. . 14 200'J-04'115 JACKSON, tvIICl!l\l::L J. Page 2 .. __ .. _----- The right {slide LI and left (slide M) testes show active spermatogenesis with the usual number of Leydig cells. There is no significant fibrosis or inflammation. The epididymides are unremarkable. The stomach (slide NI shows recent hemorrhage into the mucosa, submucosa and muscularis. The mucosa is without ulceration or inflammation. The gallbladder (slide N) is autolyzed. The pancreas (slide 0) shows a normal glandular structure without significant inflammation or fibrosis. Islets of Langerhans are normal in size and number. A section of spleen (slide PI shows the usual follicular structure. The liver (slide Q) is normal in structure. Hepatocytes show no inclusions or lipid droplets. There is no significant parenchymal necrosis or inflammation. The right (slide R) and left (slide $) kidneys show glomeruli which are normal in number and structure. Tubular cells are unremarkable. There is no significant inflammation. The right pyramidal apex (slide R) shows focal interstitial fibrosis. Sections of colon {slide TI show a pedunculated polyp consisting of benign colonic glands in a fibrous stroma. Abundant eosinophils are present. The adjacent colon is unremarkable. Sec1.tOrlS of skin (slide UI ShClW no rneL:,:u10c'ytic pi(Jrnent. ;?1elanocyt s, a.ltr:o'Jgh pn~sr:nt, are reduceci in numb':;r. A The kin 1:-:.> otl:(~noJl.se '_mrernarkF,ble. No scar or suttne materi.al is pr.f~S(:n t.. The pros Lcl te;J] and {slide: VI shows hypc?rplas tic 9 1 dnds in a :iOdular c nfiquratiDfl. Minimal lyrnph0~d infiltrate .i::: ptp:H?r:L. ;:;OUNTY OF LOS ANGELES MICROSCOPIC REPORT DEPARTMENT OF CORONE' 14 ,Jl\O(SON, f\lICflt'\EL J. Paqe 3 Consultation is obtai.ned with Dr. Chandrasoma, Professor of Pathology at USC Keck School of Medicine. Diagnosi~: 1. Colon, tubular adenoma 2. Vitiligo 3. Nodular prostatic hyperplasia 4. Evidence of resus tat ion A} Lung, alveolar hemorrhage B) Stomach, transmural hemorrhage t< 0 .. 1 " ~~J ';(~ /) I-~~ _, st-1 g ~6 (1 --_.__.__.+-- CHRI-STOP~~~A ~G-, DATE CHIEF FORENSIC MEDICrNE DIVISION . ---/4 ( ..,L---.=..tI' '-(~ ?"'V ~1,...'" _~,n,~.V ~ h ,rt .,. . . c-.. "- ~-;;::::::::>.,. /,IV/rv ~'(" .... AKSHMANAN SATHYAVAGISWARAN, MD DATE FRCP(C},FCAP,FACP CHIEF MEDICAL EXAMINER-CORONER CR:LS:mtm:f '1'-7/29/09  COUNTY OF LOS ANGELES MEDICAL REPORT [)EPAflTMENT OF Cor~()NER AUTOPSY CLASS: .4 A ..J B .J C '..J Examination Only 0 :.J FAMILY OBJECTION TO AUTOPSY 15 1 - - -_ _-1 Dale: ~:.j-crt Time: J C,:'~ __ Dr .l~.:t:6/1~~ ~')l~4,\Y1I--_-l FINAL ON: (?'7Cc _.~:_ _ ~ \ By:' IP"nl) ,I. (print) [''<')' :7 'f' iLqf',''1,$l<l"d /1 LI r ? - 1\I'I"110XI MAil. 'N1HlVAI ULTWEf'N IJi'lSi-1 DEATH WAS CAUSED BY: (Enter only one cause per line for A, B. q~ D) I)~~~H IMMEDIATE CAU. SE: /: / ( Un J 1./ .... Age: 0 Gendeq::~~ i ri.!ll1ale (A) !~c\.xtE' PiC /":,,;;:,L,, DUE TO. ORAS A CON!3EQUNCEoF'----- )Jlc~"_.:.. :(?_,?...:..,j-'-'.I.(--,-,-'h~ __ ~~ T_l_~Y\_J..~!;P~R~IO~R~E~XA~M~I~N~AT~I~O~N~R~E:;V~IE:,!W~B~Y..!::D~M~E=-I ....... 1,(1 BODY TAGQ :J CLOTHING (B) ""lIIIIIIl IJ X-RAY (No. _ ) J FLUORO ----.------=-:---c:-,-:-: .. ,-:-:-=-------------...--.---+- - '..J SPECIAL pnOCESSINli rAGJ MED, RECORDS DUE TO, OR AS A CONSEQUENCE OF: ..... ..J AT SCENE PHOTOS (No. . ) (C) CASE CIRCUMSTANCES [)UE TO, OR AS A CON'SEQUENCE O F : . . J EMBALMED ~ .... U~~ 1-::-==-:- =-:-:-:-:-.:-:':7.:-:'=-::-:::-:--=-=--=---=--::-:-=-:=::-::-----: - = -,---__-.....l.. --l U > 24 HRS IN HOSPITAL OTHER CONDlliONS CONTRIBUliNG BUT NOT RELATED TO THE IMMEDIATE CAUSE OF DEATH: I-=U=.:::O:.:.T:..::HE:::R::=::=======::====:::IR:~a:so:n~) ):3 (' V\ toL-~) "i '1(-' /h,~ i2 He c.'t TYPING SPECIMEN fR TYPING SPECIMEN ~KEN BY: ........--"" _ o NATURAL o SUICIDE G3' HOMICIDE SOURCE: I-e"t,i ,~a? o ACCIDENT [) COULD NOT BE DETERMINED COLLECTED BY: TOXICOLOGY SPECIMEN CJ<, l1G HEART BLOOO-(----.::..-:l4I-S""'ro.,...M:-A-C--H-CO-N-:T-=E-NT=--S ..... If other than natural causes, HOW DID INJURY OCCUR? 1.2!i FEMORAL B~O.O~ k'(?l>!Jd VITREOUS TECHNIQUEJwt ,-)<.I.,-::t ------------------_.. __ ... o _------- U j BLOOD I..J SPLEEN BLOOD i..J KIDNEY WAS OPERATION PERFORMED FOR ANY CONDITION STATED ABOVE: I..J YES r.ld NO t(BlLE iJ _ IJlt LIVER IJ TYPE OF SURGERY: ~. DATI::: _ !islURINE'~) U------=-.-_-_- I..J ORGAN PROCUREMENT I.J TECHNICIAN: Z.~Ci"'~ / {).ejr,C-r1C-- _ _ URINE GLUCOSE DIPSTICK RESULT: 4+ 3;Q.'~'.V 0 TOX SPECIMEN RECONCILIATION BY: _~ PREGNANCY IN LAST YEAR I..J YES I..J NO I..J UNK I..J NOT APPLICABLE HISTOLOGY I..J WITNESS TO AUTOPSY I..J EVIDENCE RECOVERED AT AUTOPSY Item Description: U RegUlar (No. .0... 1 I..J Oversize (No. , ) Histopath Cut: l.if Autopsy U Lab { ~~~~ ) TOXICOLOGY REQUESTS FORM 3A: iJI YES U NO !..J NO TOXICOLOGY REQUESTED SCREEN r,j.C U H I..J T I..J SUD rj ALCOHOL ONLY U CARBON MONOXIDE I..J OTHER (SpecifV drug and lissue) --_._----_ .. ------~_ .... - - - - - - _ ......_ _._------ .. ... ---~--"'--"'-----'-'-"" ..... REQUESTED MATERIAL ON PENDING CASES U POUCE REPORT IJ MED HISTORY :.:tt TOX FOR COD ;;I HISTOLOGY ;..J rox FOR RIO iJ INVESTIGATIONS ..J MICROBIOLOGY U EYE PATH CONS. ..J RADIOLOGY CONS J CONSULl ON .. __...._ .._ ... ",,,,,,,_,,,,,,_ ~HAIN SUBMIT lED J NEUHO CONSUL I J OME r0 CU r ..J CRIMINALlSTICS 1-?.. --..? -. _.. . RESIDENT ..J GSRJ SEXUAL ASSAULf J OTHrrl WHITE File Copy CANARY Forensic Lab PINK - Certificallon GOLDENROD? DME  UN'. OF LOS ANGELES AUTOPSY CHECK SHEET .?? DEPARTMENT OF CORONER - - - ,--,-,-,----_._--._--_. 16 EXTERNAL EXAM SCALP Sex 11tj,,~ CALVARIUM, Race 1)\". k BRAINWt I?>% Age {,,() Dura _', .,'. j ' / . Height C: '( Fluid )'Y' (,;. ? Weight 1'2".6 Ventric! H'L, ~n') I '1/'.. Hair ;;'" (..,., Vessels Eyes r-s,.",." Middle ~ars ' Sclera Other ,.1 PITUITARY - 'CA" ,. ; Teeth 'v'".",,..,J Mouth Tongue Nose .: Chest . (L,.~:I " J C,-~?7/?""'i'" \ SPINAL CORD Breasts , " '", ... i. Abdomed "...? " L Scar - .'io::: '.- y .. , ',; l,/ Genital! Edemal Skin ! Decub HEART Wt. ') (/0 SECTIONS FOR Pericard? RV (]-2 HISTOPATHOLOGY -;; ~<':>I, "" Hypert LV 1,1.\ "] . - \ "., . Oil at Septum , ,(.... i ? (~. L. O I ".\..{ " ...... ' F' Muscle "\ \I !},,~ . j Vall/es ;)\.1 '7.0 MteR6Btel:OG\' Coronar ,i Y'71 AORTA .! ) " .' .-. VESSELS" i; .,', ' . DIAGRAMS/ v, ~ ..-:" LUNGS Wt X-RAYS t?, ': 'r" 'I R cILia L I c:{;() ~ . '.r \ \,> Adhes Fluid Atelectasis Oedema Congest Consol Bronchi Nodes PHARYNX "'.""- .,,",'.. : TRACHEA'. ~ THYROID ,1(}"l<1~ Tw.?WS V'),i ,j ' LARYNX ' HYOID ABDOMINAL WALL FAT I ~U':.:.{;: 'f ' Date r'me Deputy Medical ExamrrTe( I " V' . , f'",rn~ AI110P,;y CHECi<', SI'iL'Elltlli do'~ ;'8?(REV ji:Y" COUNTY 0.- LOS ANGELES OEPARTMENT OF CORONER ! (' 20 l ? C , >. ~tr::.LI., ? ./ f"L. I \':'C:~"'" L. '/ ' . .J>~.f"" '" ~ ;'<-t...,..~ -; 4 ?,,~) " ~ ? l "'! c' ~ L._ \ kl t ), .... ~. '~f /..J i '-) .~ ~.,\ '\,,~2) w ' j 1_ >''I'V..;'-I i_I .."" .-<, )(,.1,,'1"; ..v.')' 4/ I":'" 4,: '! {r ~ ...l "f '\ ::.. . ... .',.. ".A. '(.,;.. COUNTY 0.' LOS ANGI::U:S DI::PAKTMENT 0.' CORONER rr=========;;===:::--=-=-=-=""""""- -,.=._=-=-=--===============;======---;O::==========-........""i! 22 \ /  DcpartI11Cnlllr(\mlll~r. County llf Los Al1gel~s :i! .. . .. .. , . .~ . FORENSIC SCIENCE LABORATORIES ., ? , ~ . ~ '. . . : . ~t Laborntory Anal)'sis Summary Report Wt:dncsday. July 15,2009 To: Dr. Rogers ~' PcndlnKTOI Deput)' :\tedical Examiner Subject: Coroner Case Number 2009~04415 JACKSON. MlCHAEL JOSEPH The following results han been technically and administratlwly reviewed lind are the opinions lind interpretations of the Anal),'t: SPECIMEN SERVICE DRUG U;VEL liNITS ANALYST Blood. fl:moral aas~ I.idll.:ain\l IUl4 ugllli I' fu BI,'I11Allli:llepilll.'lI Ulr.lII:pam 10') nlJ,"lnl S. !A'Quintana l'ropoli,1 Pwpofill 2.6 ugml J. I.i nh:llI11nl Blood. H.:art Ael.'laminophl.'l A'.'talllinophl.'Il NO J. l.inlelllllol Alcohol Elnam)l Negative M, Scnuchardl Barbitur.lIC Barbitumtes NO 0, Anderson B,lS~ Liuocllinc 0.68 uglml n Fu Bases Meperidine NO E. Fu Ba~'l> Nomlepl.Tidinc ND E. Fu Basl.'li NorsCl1raiinc NO E. Fu Bases Sl.~ralin" NO E. Fu Bases Tr.lzodonc NO E. fu BetlZlll.l iai.cpincs Alprazolam ND R. Buud B..:nzlldiaz.. inCll " Oiazcpam <0.10 uglml S. lA-Quinlann !:4enzllI.Iill:/CpinCll UlrJZepnm 162 nglml S. O.. Quintanu - Benzlluiazcpincs Miuazolam 4.6 nglml R. Budd NOTE: H()spital. Blo()d: Tube labeled "Trauma. Gershwin" drawn lm 06,25?09 ? 1330 hours. Urine"': Approximatdy 450 lUis of urine l:oJlectcd from s~cne by lnv, C. rkak. "'Dolle: See Fonn 13. Medical Evidencc Analysis Summary Rl:port. Legend: 1111/g Mkmgmtn p..or Gram 1111.'1111 Microgram PI.T \lIl1dilt:r Dpllc till( \III Ii gr.lln :\ I> ....,,\ Dclc~ h:d 't\'g;Sll\ \.' Ill,! IIlI N.IIl\,gr~lIn I'cr \11111111<:1' 1"'1 ! . / ,. i, '., 1'1l''''111 \dminislruthel} 1'11\ IC\\l'd by: Iluniel T. \lIdl'rSlln ~t1Ill'r\i\ing ('ritninlilisl " l'OIU}IiSIl' L\KOR,\ WRIES  lkpartm~nt of Coroner, (\H1I1ty of Los Angdcs ?? . ~ ,,' ., FORENSIC SCIENCE LABORATORIES .. .. ....:. ' ? . :: .. . ... '. , .. Laboratory Anal)'sis Summar)' Report ~" Wednesday, July 15,2009 To: Dr. Rogers .~I Pendln~TQx I)eputy Medical Examiner Subject: Coroner Case Number 2009-04415 JACKSON, MICHAEL JOSEPH The following results have been techllicall)' and adminisrratinly reviewed and arc the opinions Ilnd interpretlltions of the Ana')'st: SPIKIMEN SERVICE DRUG LEVEL UNITS ANALYST 1:3...11/"dia/.... piIWS Nordia/.,'pam '-IJU; ugiml S. o..'QuinHllla l:3...n/.ollia/....pin<-'S l"lleplon ND R. Budd Carbon Monoxid... Carlxlll Monoxide <10 % Saluration O. Anderson (\><:aine Cocaine lind Mel;llxllill'S ND O. Anderson Cyanide Cyanide NO M. Schuchardl Fcnlanyl Fenlanyl NO O. Anderson G(';MS Tizanidinc NO S. Ol'Quil1lanll Ilalog...nalcd Hydrocarbons Eth...hlorvynol NO R. Budd Iialogcnaled Hydrocarbons Tric hlorclhanol ND R. Budd I.C'iMS 7 -Aminoc!onaz...pam NO 1. Lintcmoot LCIMS Clomlzl-pam NO J Linll'moot LC/MS Oxazepam ND J Lint...mool LCIMS T...lllaZl-pam NO J LiI1l...nlOot Marijuana Carboxy-THe NO O. And...rson Methanlph...lalnine Amphetamine NO O. Plcilcz Methamphetamine Ephl-drim: NO O. Pleite'/. MClhamphel1lmine Mcthamphclaminc NO O. Plcitez Nculrals Propolhl Pr<->scnt D. Andcrsun NOTE: Ilospitai. Blood: Tube labeled "Trauma, Gershwin" drawn on 06/25/09 @ 1330 hours. Urine?: Approximately 450 mJs of urine collected from scene by Inv. E. Fleak. *Dlme: See Fonn 13, Medical Evidence Analysis Summary Repon. ug'g Microgralll per Gram L~gcnd: lIg'ml Mi... l1lgralll p'1'l\lillilli<'r I\lilligralll "'"l Ddcctcd "'qlalil'e 1l!lc 1nl "iallllgralll pC'l \1 illilil...r Pr'''Clll .\dminislnllh?c1) n'\ il'" l'cI h): Hlmil'! T. Anderson SUlll'nising Criminalist /I FORt::~SlC ....\BOR,HORIt:S  Dcpartmcnt ofCoron~r, County of Los Angeles FORENSIC SCIENCE LABORATORIES Laboratory Anal)'sis Summary Report Wt'dnl.'sday. July 15. 2009 '] To: Dr. Rogers .. ,; PendlngTol Deputy Medical Examiner Subject: Coroner Case Number 2009-04415 JACKSON, MICHAEL JOSEPH The following results have been technically and administrativel)' reviewed nnd are the opinions and interprchuions of the Amd)'st: SPECll\U:N SERVICE DRUG U:\'EL UNITS ANALYST ~ Opiat.. Ctlucille ND 0, Andcrsun OpiuK'Il Hydrocodonc ND lJ And..TSon Opiates Ilydrom<1rphoue NO D. And...rson Opial..-s Morphine NO 0, Andcrs\lIl Outsiue T I.-:>t lIemt)~I"bin A IC 5.1 % Quest Diaguostics Oxycodol1e Oxycooonc NO S. D..'Quilllana Phcncyclidine Plll.11cyclidinc NO O. Andcrson Pmp\1fol Propotbl 3.2 uglml J. Linlcmoot Salicylate Salicylate NO J. Lintcmool Blood, Ilospital Acctamilloph..11 " Ac..taminophen ' ND J. Li Iltcmool Barbilunltc Barbiturates ND 1. LilllelTlllot Bils\.'S Diazcpam Prescnl E. Fu ail,es Lidocaine 051 ug;ml E. Fu l3i1ses Meperidinc ND F.. Fu Basc.:.~ Nonnep",ridinc ND E. I'll Bas..'S Norscrtralille NO E. Fu Bases S.. 1mlinc , NO E I'u NOTE: Hospital, Blood: Tube labeled "Trauma, Gershwin" drawn on 06/25/09 QG 1330 hours. Urine": Approximately 450 tnls of urine collected from scene by Inv. E. Fleak. *Done: See Form 13, Medkal Evidence Analysis Summary Report. Legend: tlg/I! Mh;rogmm p~-r Grmn tlg'ml M l,rogl~lrn p....r \-1 iIli lit,r <It lolal 11gb D"ne mg \tilligram ND Not D.. . I<-.;I . . <1 N<?g.ltive ng'l1Il Nanogram p....r \lillilitcr PIl"..'Sl,.'ol . \dmillistrllthdy r~\'i~\\~d by: 1)'lIIiel T. Anderson SIlI)C??rvisill~ (' rimilllliisl II FORE~SIt' I..\HOIUTOIHES  Department of Coroner, COllnty of Los Angeles .~ . ??. FORENSIC SCIENCE LABORATORIES ?? ".. ". .. ..:.. E .~ . . .. Laboratory Analysis Summary Report Wednesday. July 15.2009 To: Dr. Rogers "'i PeudlngTox Deputy Medical Examiner Subject: Coroner Case Number 2009-04415 JACKSON,MICHAELJOSEPH The following results have been technically and administratively reviewed and lire the opinions ~md interpretations of the Annlyst: SPJ<:CIMEN SERVICJt: DRUG LEVJt:L .I:lli!I?, ANALYST Basl.'S Trazodolle NO E. f'u C",.. inc Co,..ine and Metaoolites NO J. Lintel1loot Fentanyl Fcntanyl NO J. Lintcmo"l LOMS 7-Aminoclonazcpam NO 1. LilltCll100t I.C!MS Clonazl."f!all1 NO 1. LintCI1IOOl l.e/MS O~azcpam NO 1. LintCI1100l LCiMS TClllazcpam NO 1. Linlcll100l Marijuana ClIr!lQI\Y-THC NO J. LintcIl1oo1 M,,1humphcl1lll1inc M clhamphl.1allline NO 1. LilllCI11001 Opiates Codcine NO J. [.intcl11oo1 Opialcs Hydmcodone NO J. Linlclllool Opiates Hydroll1orphone NO 1. [.intCIll(J(11 Opiates Morphine NO 1. LintclI100t Phl.'Ilcyclidinc Phencyclidine NO 1. l.intcnlOol Propolhl PI\Jpofol 4.1 uglml J. Lilltcmoot Salkylatc Salicylate NO J. Lintcl1loot Liver Bas\-'!> Lidocaine 0.45 ugig r:. Fu NOTE: Ilosrital. Blood: Tube labeled "Trauma. Gershwin" drawn on 06/25/09 <8) 1330 hours. Urine*: Approximately 450 mls of urine collected from gcene by Inv. E. Fleak. *D{me: Sec Fonll J3, Medical Evidence Analysis Summary Report. u~;g Mkmgmm p<:r Gmll1 Legend: ug..ml Micn l [llOlIll p<:r Milliliter ,,1'1"1:11 fig!> .MJlli/lr:lm Nt) Nol Dd<:dcd :-kgalivc ng'llll N,lIlogmlll per Milliliter Presl'lIt ,\dmlnistrllthely rCl'il~\H'd by: I)uniel T .. \nd(?rson SllpervisinJ,l Criminalist II "'ORI':~SIC L\BOR,\TOR ..:S P:lgc4"IX  Department of Coroner, County of Los Angeles .. .. ? ~ . FORENSIC SCIENCE LASORATORIES ?? , .. "-: ~ . . ?. " .is! :: .. . . .: . Lahoratory Analysis Summar)' Report \\\.'dll\.'sd;l)', July 15,2009 To: Dr. Rogers ''If. Pl'ndingTox Oeput)' Medical Examiner Subject: Coroner Case Number 2009-04415 JACKSON, MICHAEL JOSEPH The following results have been technically llnd administratively reviewed and are the opinions and Interpretations of the Analyst: SPECJl\U:N .IlB.!lli LEVEL UNITS ANALYST PrllJX,fol 6.2 ug.'g J l.int<:llll,ol Mi.'dical E\'idenc~ M~"dieal Evitlence .. Done J. Lin(<:I11<lot StOll1<lch Contents Lidocaine 1.6 mg E. Fu 0,13 mg J. Lintel110ul Urine "[)ipstkk" Glucose N<:gative 1. MUIO Ac<:lalll inophen AC~'1aminoph<.'Il NO 1. Lintcllloot Alcohol Ethanol Negative M. Schuchardt Barbiturate Barbiturutcs NO O. Anderson Bases Lidocaine Present E. Fu Bas<.'5 Meperidine ND E. Fu Bas<.'" Nonnepcridil1e NO E. fu Bases Nors<.'rtmlinc ND E. fu Bases Sertrnlinc NO E. Fu Tmzodol1c NO E. Fu B<.'11ZOdiazcpincs Alpmzolam ND R. Budd NOTE: Hospital, Blood: Tube labeled "Trauma, Gershwin" drawn on 06/25/09 @ J 330 hours. Utine?: Approximately 450 mls of urine collected from scene by Inv. E. rIcak. *Done: Sec Form 13, Medical Evidence Analysis Summary Report. ug'g Micnlgram p<:r Gram Legend: ug'l11l Mll'I'llgrallllJ<'( '\1t1lililer 1111,: \lilligr~1l1 ND Not Dclc~t<.'tI Nq~,ali\c." ......- IIg.T1I1 N~n"gr;ll11 PCI \ltlliJiter 1'1 c"~111 I)llniel T. AIHlerson SUllcnisinl( ('rlmin:t1isl II FORENSIC L\UORATORIES Pag<: 5 of X  [)cpartlllt:nt nf Coroner, County nf Los Angeles o.? e . . , . .. ? ." ',\ a . FORENSIC SCIENCE LABORATORIES :. . :: . ~. ,. . : Laboratory Anal~'sis Summar}' Report '~ . ' Wt:'JnesJay, July 15.2009 To: Dr. Rngcrs ,'II: PendingToll Deputy Medical Examiner Subject: Coroner Case Number 2009-04415 JACKSON, MICHAEL JOSEPH Tit", follm\ing results hav!.!' been technlcnlly and administratively revie\wd and are the opinions nnd interpretations of the Analyst: SPECIMEN SERVICE DRUG LEVEL LNITS ANALYST Bl:nllldia'(l:pin~ MidalOlam 6,S ngml R Budd B"IU.lldia,(l:pinl.'l; Zlkplon NO R. Budd Cocaine Cocainc and Metab(}lit~ NO 0, Ani.krson Fl:nt,m>'1 Fcntanyl NO D. AIHkrson Halogen<lll'd Hydrocarbons Ethdllurvytlul NO R. Budd J Jalogenal\.'(l Hydml:arbons TrichloMhanol NO R. Budd Mariju<llla ('arbolly-THe NO B. Walers Marijuana Tetmhydrocannabinol en fC) NO B, Wall..rs ' MethumphetullIim: Amph.... 1amine ND O. Pleile-I. Methamphl:tamine Ephedrinc Pres"nt O.I'kitc/. Ml:lllal1lphetal11inc Mcthamphetamine ND O. Pfeile/. Neutrals PmjXlfol Prcsl.'lll D. Anderson Opiatl.."S Codeine NO D. Anderson Opiiltl.."S lIydml:lldone NO D. Anderson Opiah,:s Ilydmmurphune NO I). Anderson Opiates Morphine NO O. Andcrson OX>'codone Oxyclldone NO S. DI.'Quintana Pheneyclidinc Ph\.~Jeyclidine NO D. Anderson NOTE: Ilospital, Blood: Tube labeled "Trauma, Gershwin" drawn on 06/25/09 @ 1330 hours. Urine*: Approximately 450 mls of urine collected from scene by {nv. E, Fleak. *Donc: See form 13, Medical Evidence Analysis Summary Report, uglg M il:n>gl1lm pI..'" Gr:lIn Legend: ugml Mkrogram PCl' r-.lillilitcr "" of t",alllgb \1 i1li);I~111l Nollktl'<:ti.?d S,'galll'e 11);'1111 Sallogra1l1 PCI !\'IJilillll:r Plt"I.:nt .\dlllinislr:lth ely n'\ iC\\l'd hy: I)anicl T. Anderson Sllpl:n ising Criminalist II FORENSIC LABOR" WRIES  Dl.:partl11~nt of Coroner, County of l.os Angeles FORENSIC SCIENCE LABORATORIES Laboratory Anal~'sis Summary Report \\'I:dnl:sday. July 15.2009 To: Dr. Rog~rs YJ l'endlngTol Deputy Medical Examiner Subject: Coroner Case Number 2009-04415 JACKSON, MlCHAEL JOSEPH The follo\\'ing results have been technic all}' and administratively reviewed and are the opinions and interpretations of the Analyst: SPECIMEN SERVICE DRUG LEVEL UNITS ANALYST Propofol Propofol n. [5 ug:ml J Lintelllool Salicylate Salicylate ND J l.inlem'lOl Urine* "Dipstick" Glucose N...galive J. MulO Acelaminophen Acetaminophi."I1 ND J. Lilllcmo<JI Alcohol Ethannl Negative M. Schuchardt Barbiturate Barbitumtcs ND D. Anderson Bases Lidm:ainc Pri.'Sent E. Fu Bases Meperidine ND E. fu Bases Nonnepcridine NO E. Fu Basi.'S Norsi.,tralinc ND E. Fu Bases Scrtraline ND E. Fu Bases Trazodonc ND E. fu Benzodiazcpinc.~ Alprazolam ND R. Budd BCI1zodiazcpines Mida;!Olum 25 nglml R. Budd Benzodia,.cpines 2ali."Plon NO R. Budd Cocaine Cocaine and Metabolites ND O. And"''l'Son Fenlanyl f<:ntanyl ND D. Anderson NOTE: Hospital. Blood: Tube labeled "Trauma, Gershwin" drawn on 06125109 @.I!, 1330 hours. Urinc*: Approximately 450 mls of urine collected from scene by Inv. E. Fleak. *Dol1c: Sec form 13, Medical Evidence Analysis Summary Report. llg'g Mi~wgralll pCI' Gram Legend: ug..'ml 1\1 i~r"gralll Jlcr Millilir...r 1'1' t\ltalllgh O"'lC Ill!! 1\lilligralll ND Not D,?,?l~d Nt.'~atj\!c ng'llIl Nanogram p"r Millilitcr l'r"s"llt .\dminislrati\l'I~ r11\icWl!d hy: I)tmiel T. Anderson SnlJl.'nising Criminalist" "'OR~:'IiSI(' L\BOJ(:\TOI~U:S  Dcpal111lcnt of Coroner, County of Los Angeles .. ? :i!: , .- ~. .. FORENSIC SCIENCE LABORATORIES , , " .. .' . ... :. :: : , , . ,. L~lboratory ,\nalpis Summar)' Report "l:!l'I .. \\\?dlwsday. July 15, 2lJ09 To: Dr. Rogers ,.,.1 PcndillgTox Deputy Medical Examiner Subject: Coroner Case Number 2009-04415 JACKSON, MICHAEL JOSEPH The following results have been techniclllly and administratively reviewed and are the opinions and Interpretations of the Anal)st: SI)EqMEN SERnCE !!R!lli LEVEL U:\flTS ANALYST i\larijuana ('urooxy-TIIC ND fl Waters Marijuana TetmhyufIlcannabinol (Tile) NO B, Wali.,'l'S Methamphctaminc Amph~'lamine ND 0, Plcitcl. Mcthanlphctamine Ephedrine Prcscllt 0, Plcitez Mcthalllphctamilll: Methatnph~1allline ND 0, Ptdt.:z Opiates <'';!dcine ND D. Anderson Opiat~'S Hydroeouonc ND D, Andcrson Opiates Hyurotn('rphone ND D, Anderson Opiates Morphme ND O. And~'l"son Oxyeodtlnc Oxyc\!donc NO S, D"..Quintana Phcncyclidinc Phcncyclidine ND D. Andcrson pwporol Propofol <(l,1O uglllll J. Lintellltlot Salicylate Salicylate ND 0, PicHe.. Vitreous Prop(llhl Propolhl <(j,40 uglml J. Lilllcmoot NOTE: Hospital. Blood: Tube labeled "Trauma. Gershwin" urawn on 06/25/09 @ 1330 hours. LJrine*: Approximately 450 mls of urine collected from scene by Inv, E, Fleak. *Dol1c: Sec Fonn 13. Mcdical Evidence Analysis Summary Report. ugig Micmgram p~" Gram Legend: u~ tnl Microgram p.:r \lillil'lcr "" DOll': mg !\l illigram . :'-<f) ~"l Ikl~cl~"d r--kgali v.: "Innl !\I,ull11,r:lI11 PCI' Millililcr PIL''''111 Adlllinislralhely revi"IH'd by: Ollllil.'1 r. Alld"r~lIn "Illl(,f\'isill~ ('rilllimtlist II l'OR[~SIC 1.,\IU}R,\rORlts ,,' fNTY OF I OS "NGRES FORENSIC CONSlJtTi\NT'S REPORT DEPAI<I Mt:N I ur \. \./r..v?" ,,. 13 2009-04415 Jackson, Michael Los Angeles County Department of Coroner Forensic Science Laboratories Medical Evidence Analysis Summary Report Medical Evidence #1 (collected by Coroner Investigator E. Fleak on 6126/09) ? Propofol and Lidocaine were detected in approximately 0.19g of white fluid from a JOee syringe barrel with plunger. Medical Evidence #2 (collected by Coroner Investigator E. Fleak on 6/29/09) ? 4 components of an IV system tested. o Propofol, Lidocaine, and Flumazenil were detected in approximately 0,17g of white tinted fluid from a 10ce syringe. o Propofol, Lidocaine, and FIumazeniI were detected in approximately 0.47g of yellow tinted fluid from a short section of IV tubing attached to a Y connector. o No drugs were detected in approximately 17g of clear liquid from a long section of IV tubing attached to an IV bag plug. o No drugs were detected in approximately 0.38g of clear fluid from a 1000cc IV bag. I i 1 U.:-\;-~\ <. -I"' ~ t ( ( \ \ \,~ ';"' ... '.fl("';"4.?~,"i 7 ( ~ "S \ c_,e~ .\ Jaime Untcmoot nate Senior Criminalist  SUMl\lARY of POSITIVE TOXICOLOGICAL FINDINGS ?. ".' ., n ? 2009?04415 - Jackson, l\'lichael Joseph Specimen (ug/ml or ug/g) Drug Hurt Blood Hospital Blood Femoral Blood Vitreous I.lver Gastric Contents Urine lJ rine-Scl'J1l' Propofol 3.2 4.1 2.6 <0.40 6,2 0,13 mg 0.15 <0.10 Lidocaine 0.68 0.51 0.84 --- 0.45 1.6 mg Present _.. Present Diaz~pam <0.10 Present --- --- _n .. - .. - Nordiazcpam <0.05 .-- --- _n _.- --- -.- _.- I.orazcpam 0.162 ._- 0,169 -.. --- --- _.- ..- Midawlam 0.0046 --- ..- _n --- ..- 0,0068 0.025 Ephedrine ND ._- --- --- --- _.- Present Present D. Anderson Supervising Criminalist I 7/15/09 COUNTY OF lOS ANGELES FORENSIC CONSnTi\NT'S REPORT DEPARTMENT OF CORONER I 13 2009?04415 Jackson, Michael Forensic Science Laboratories Los Angeles County Department of Coroner Criminalist Report Investigating Agency: Los Angeles Police Department Investigating Officer: Detectives Orlando Martinez, Dan Myers, and Scott Smith On August 6, 2009 at approximately 1300 hours, I was notified by Chief of laboratories Joseph Muto that a Coroner Criminalist was requested to collect hair samples from the above listed decedent for potential toxicology testing. The decedent had been to the hospital, autopsied on two separate occasions, and handled by mortuary staff prior to my involvement. The decedent would be under the jurisdiction of the decedent's family and the mortuary during evidence collection. Coroner Chief of Operations Craig Harvey, Forensic Technician II Jose Hernandez, and I arrived at the Glendale branch of Forest lawn Memorial Park, Glendale at 1745 hours. Forest lawn personnel, Darryl Drabing, escorted us to a waiting room while preparations were made for viewing the decedent. At 1835 hours we were permitted to view the decedent in a secured lobby area. Those present included Forest Lawn personnel D, Drabing and Scott Drolet, family member La Toya Jackson and her male companion, and the above mentioned coroner personnel. At approximately 1840 hours I conducted a limited examination of a decedent supine in a yellow casket with blue lining, The majority of the decedent was covered with multiple white towels/sheets leaving only the hands and top of the head exposed, The top of the decedent's head was covered in a wig with long, dark apparent hair, Moving the wig revealed short, dark, curly, natural hair in the temporal regions measuring approximately one and a half inches in length. An unknown dark residue was present on the natural hair. The hair in the parietal region was sparse and covered in an unknown clear adhesive material. Hair samples were collected by plucking with gloved hands, Hernandez took photographs of the hair collection process. The following items of evidence were collected at the mortuary: Ph'isical Evidence (PE) ? Hair Samples (packaged in small PE envelope) Hair Samples from left Temporal Region (packaged in aluminum foil and paper bindle) Hair Samples from Right Temporal Region (packaged in aluminum foil and paper bindle) EVidence Collection was completed at the mortuary on August 6, 2009 at 1920 hours. E-/ldellCe was sealed at the Forensic Science Center (FSC) on August 6, 2009 Cit 1950 !lours and p!3ced in a secured storage locker. '1 "'r "~- C?'.l." --- - ,,j,,.,,.., .r~~::.l . _ _.? (~( n \cC, -.3\ q (C' c( 'j Jaime Untemoot Date Written Date Finalized Senior Criminalist  COpy SUPERIOR COURT OF THE STATE OF CALIFORNIA FOR THE COUNTY OF LOS ANGELES THE PEOPLE OF THE STATE OF CALIFORNIA, CASE NO. SA073164 Plaintiff, v. 01 CONRAD ROBERT MURRAY (02/19/1953) Detendant(s). The undersigned is informed and believes that FEB {': 8 LOW .k).lm/':.. C!ii!rk~j b:~<;:l,ivq ()ni'~cr..'Cl~k COUNT 1 By ?Poll~D -,._~~ On or about June 2S. 2009. in the County of Los Angeles, the crime offNVOLUNTARY MANSLAUGHTER, in violation of PENAL CODE SECTION 192(b), a Felony, was committed by CONRAD ROBERT MORRAY; who did unlawfully, and without malici;:, kill MICHAEL JOSEPH JACKSON, a human being, in the commission of an unlawful act, no.. amountiDg to a felony; and in the commission of a lawful act which might have produced death, in an unlawful manner, and without due caution and circumspection. ***** Rev. 920?6/03 DA Case 30008740 Page 1 Case ND. SA073164 FELONY COMPLAINT FOR ARREST WARRANT  NOTICE: Conviction of this offense will require the defendant to provide DNA samples and print impressions pursuant to Penal Code sections 296 and 296.1. Willful refusal to pl"ovide the samples and impressions is a crime. NOTICE: The People of the, State of Califomia intend to present evidence and seek jury findings regarding all applicable circumstances in aggravation, pursuant to Penal Code section 1170(b) and Cunningham v. California 2007 U.S. LEXIS 1324. NOTICE: A Suspected Child Abuse Report (SCAR) may have been generated within the meaning oj' Penal Code ?? 1116611nd 11168 involving the charges alleged in this complaint. Dissemination ora SCAR is limited by Penal Code ?? 11167 and 11167.5 and a court order is required for full disclosure of the content.. of a SCAR. . Further, attached hereto and incorporated herein are ()fficiat reports and docwnents of a law enforcement agency which the undersigned believes establish probable cause for tIle arrest of defendant(s) CONRAD ROBERT MURRAY for the above-listed crimes. Wherefore, a warrant of arrest is requested for. 1DECLARE UNDER PENALTV OF PERn;RY THAT THE FOREGOING IS TRUE AND CORKECT AND THAT THIS COMPLAINT, CASE NUMBER SA073164, CONSISTS OF 1 COUNT(S), Executed at LOS ANGELES, County ofLos Angeles, On February 8,2010, SCOTT <.'''AITLI DECLARANT AND COMPLAINANT ~~ ..? _ , ~ ???? " ????? I.'f""""'" ".<t , ??? - ~1 ~ ?..? ~??.T ?...?..? _? __ ?, __ .??. , __ , , . STEVE COOLEY, DiSTRICT ATTORNEY BY: ;[2 AGENCY: LAPD - lIO: SCOTT SMITH IDNO.: _ PHONE. ( 2 1 3 ) _ ROBBERY/HOMleI DE DR NO.: PRELIM. TIME EST.: .':"R~ev!.:..~9=.:20'1::.?~6/~03~DQA~C:.2a~se:...Sll:lO::.l!5~O~87=-.:4:;:::O===-=-=-=--=-:c:-:::-:::~~-:-:P:-:a'!::"g~e=:-2i...-.:::-:::-==--:::-;-:-:=-=-:-::-=:- C::::.a:;;:.:s;.:;:e:..:.:No. SA073164 FELONY COMPLAJNT FOR ARREST WARRANT  BOOKING BAIL CUSTODY DEFENDANT ell NO. ____11<)? _ Mi;QMn B:IbLD.t.\IE. It appearing to the Court that probable cause exists for the issuance of a warrant of arrest for the above-named defendant(s), the warrant is so ordered. Judge of the Above Entitled Court Rev 920?6/03 DA C!i!?$ 30508740 Page 3 Case No. SA073164 FELONY COMPLAINT FOR ARREST WAR-RANT  NON-WARRANT DEFENDANTS~ BOOKING BAIL CUSTODY DEFENDANT DOB --lli1.~ __ RECOM'D RTN DATE MURRAY. CONRAD ROBERT 2/19/1953 $0 Rev. 920?6/03 DA Cas~ 30508740 Page 4 _ Ci:lse No SA013164 FELONY COMPlAINT FOR ARREST WARRANT  FELONY COMPLAINT - ORDER HOLDING TO ANSWER?? P.C. SECTION 872 It appearing to me from the evidence presented that the following offentle(s) haslhave been committed and that there is sufficient cause to believe that the following defendant(s) guilty thereof, to wit (Strike (Jut ot add as applicable) o;:'J),NRt\D ROBt;RT MUAAA.Y Count No. Charge ChaI~.ID)gS' ,SlJ~\;j~J.All!<,g.~1iim Alleg. Eff~t:l 1 PC 192(b) 2?3.4 1 order that the defendant(s) be held to answer therefore and be admitted to bail in the sum of: CONRAD ROBERT MURRAY _____________ Dolla.rs and be committed to the custody of the Sheriff of Los Angeles County until such bail is given. Date of arraignment in Superior Court will be: CONRAD ROBERT MURRAY _ _ _ _ _ _ _ _ _ in Dept_ at: A.M. Date: _ '.'-"'''''''-''"'_._-'~"'-'''~'- -------- CommiJting Magistrate Rev, 920-6/03 OA Case 30508740 Page 5 Case (\Jr). SA073164 PPT()NVrnMPl ~lNT lltHl A 1111'P-((T WA1N1ANT TOTAL P.05 LOS ANGELES COUNTY DISTRICT ATTORNEY'S OFFICE MEDIA RELATIONS DIVISION STEVE COOLEY ? District Attorney JOSEPH SCOTT ? Director JOHN K. SPILLANE ? Chief Deputy District Attorney SANDI GIBBONS ? P.I.O. JANE ROBISON ? News Secretary SHIARA M. D?VILA ? Asst. P.I.O. Feb. 8, 2010 Jackson physician charged LOS ANGELES - Michael Jackson's physician was charged by the District Attorney's Office today with involuntary manslaughter in connection with the entertainer's death last summer. Dr. Conrad Robert Murray, 56 (dob 2-19-1953), was charged in case No. SA 073164, filed at the Airport Branch of Los Angeles Superior Court. The count alleged that Murray " did unlawfully, and without malice, kill Michael Joseph Jackson...in the commission of an unlawful act, not amounting to a felony; and in the commission of a lawful act which might have produced death, in an unlawful manner, and without due caution and circumspection." Arraignment was scheduled for later today in Department 144 of the Airport Court, 11701 S La Cienega Blvd. Jackson, 50, was stricken at his North Carolwood Drive home on June 25, 2009, and taken to UCLA Medical Center, where he was pronounced dead. Deputy District Attorney David Walgren of the Major Crimes Division will prosecute the case. Walgren has worked closely with the investigative agencies - the Los Angeles Police Department and the Los Angeles County Coroner's Office. Both agencies worked diligently and exhaustively to collect the evidence leading to filing of the case. If convicted, Murray faces a possible maximum four-year state prison term. Sentencing will be up to the court. sg 18-1112 Clara Shortridge Foltz Criminal Justice Center 210 West Temple Street Los Angeles, CA 90012 (213) 974-3525 LOS ANGELES COUNTY DISTRICT ATTORNEY'S OFFICE MEDIA RELATIONS DIVISION STEVE COOLEY ? District Attorney JOSEPH SCOTT ? Director JOHN K. SPILLANE ? Chief Deputy District Attorney SANDI GIBBONS ? P.I.O. JANE ROBISON ? News Secretary SHIARA M. D?VILA ? Asst. P.I.O. 18-1112 Clara Shortridge Foltz Criminal Justice Center 210 West Temple Street Los Angeles, CA 90012 (213) 974-3525