Autopsy

CRAVEN, CHRISTOPHER Page 1 of 13 A20-1431 Department of Pathology Medical Center Blvd Winston-Salem, NC 27157 Phone: (336) 716-4311 Fax: (336) 716-7595 MEDICOLEGAL AUTOPSY REPORT Pathologist: P. E. Lantz, M.D. Patient Name:: CRAVEN, CHRISTOPHER Resident: LUCY MAY BRADLEY , MD Medical Record #: Autopsy Assistant: Lindsay Crater DOB/Age:: 11/13/1981 (Age: 38) Service: Race/Gender: W/M Admitted: Expired: 8/2/2020 Autopsied: 8/6/2020 Reported: 3/12/2021 Attending Physician: NCBH Path #: A20-1431 Medical Examiner: Allison L. Pack Olson Iredell County Medical Examiner FINAL AUTOPSY DIAGNOSIS I. Multiple gunshot wounds (labeled for recording purposes only) A. Gunshot wound of the neck, non-exiting: 1. Entrance: anterior neck (A) 2. Range: indeterminate 3. Projectile sequentially perforated and penetrated: a) Neck b) Thyroid c) Left shoulder 4. Recovered: a 46.0 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of 0.5 cm from the left shoulder 5. Trajectory: front-to-back, right-to-left, and slightly downward B. Converging and diverging gunshot wounds (4) of the right and mid torso, non-exiting: 1. Entrances: a) Upper right chest (B) b) Lower right chest (C), atypical entrance c) Lower right chest (D) d) Lower midline chest (E) 2. Range: indeterminate 3. Projectiles sequentially perforated or penetrated: a) Upper right chest b) Lower right and midline chest c) Right lung d) Liver e) Right kidney f) Right hemidiaphragm g) Right coronary artery h) Right atrium of the heart i) Right back 4. Associated injuries a) Fractures of the posterior right 7th through 12th ribs 5. Recovered: a) A 3.8 grain metal projectile fragment recovered from the soft tissue of right chest b) A 39.0 grain, markedly-deformed projectile with a partial metal jacket and an overall length of 1.5 cm from right lung NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 2 of 13 A20-1431 c) A 51.8 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of 0.5 cm from the intercostal muscle between the posterior right ribs d) A 34.6 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of 0.5 cm from mid right back (AF) e) A 50 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of 0.5 cm from the medial mid right back 6. Exits: none 7. Trajectory: front-to-back C. Gunshot wounds of left torso: 1. Gunshot wound of the lower left chest, non-exiting: a) Entrance: lower left chest (F) b) Range: indeterminate c) Projectile perforated: (1) Left chest (2) Left lung (3) Left atrium of the heart d) Associated injuries: (1) Left hemothorax, 300 mL e) Recovered: 41.8 grain, markedly-deformed, projectile with a partial metal jacket and a base diameter of 0.5 cm from the mid left back (AE) f) No exit g) Trajectory: front-to-back, slightly downward, and slightly left 2. Gunshot wound of left arm, lateral upper left chest, and lateral upper left abdomen; partial exit: a) Graze wound of medial left upper arm (R) (1) Range: indeterminate b) Atypical partial entrance: lateral upper left chest (I) c) Projectile perforated: (1) Left chest (2) Left lung d) Associated injuries (1) Fractures of the left 6th to 8th ribs e) Recovered: (1) A 1.8 grain metal projectile from the lateral left chest (2) A 47.8 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of from the left pleural cavity f) Atypical superficial graze wound: lateral upper left abdomen (G) (1) Projectile penetrated skin and subcutaneous tissue 3. Gunshot wound of the lower left abdomen, non-exiting: a) Entrance: lower left abdomen (H) b) Range: indeterminate c) Projectile sequentially perforated intestines d) Recovered: a 49.0 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of 0.5 cm, left of the spine e) Trajectory front-to-back, slightly to the right, with minimal upward/downward deviation D. Gunshot wounds of upper extremities: 1. Gunshot wound of superior left shoulder, exiting: a) Entrance: superior left shoulder (M) b) Range: indeterminate c) Projectile perforated skin, subcutaneous tissue, and musculature of left shoulder/upper back d) No projectile recovered e) Exit: upper left back (AC) f) Trajectory: front-to-back, downward, and left-to-right 2. Gunshot wound of the right elbow/forearm, exiting: a) Entrance: dorsal right elbow (L) b) Range: indeterminate c) Projectile perforated right elbow and forearm d) Associated injuries: fractures of distal right humerus and proximal right radius and ulna e) No projectile recovered NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 3 of 13 A20-1431 f) Exits: the ventral right elbow (J) and the ventral right forearm (K) g) Trajectory: dorsal-to-ventral E. Gunshot wounds of right thigh (5), exiting and non-exiting: 1. Entrances: a) Lateral right thigh (U,V,W,X) b) Anterior distal right thigh (T) 2. Projectiles perforated skin, subcutaneous, and musculature and converge and diverge within right thigh 3. Associated injuries: comminuted fracture of right femur 4. Recovered: a) A markedly-deformed unjacketed projectile, maximum dimension of 0.9 cm, and smaller fragment, of combined weight 28.2 grains, from area of right femoral fracture b) A 3.6 grain projectile fragment from right thigh c) A 43.6 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of 0.5 cm 5. Exits/ partial exits: a) Anterior right thigh (S, Q) b) Medial right groin (P) (1) Re-entrance: right scrotum (AI) (2) Re-exit/partial exit: midline scrotum (AH) c) Right groin (O) d) Right groin (N) e) Right buttock (AG) 6. Trajectories: a) (U,V,W,X) back-to-front, right-to-left, with minimal deviation in the horizontal plane b) (T) upward, with minimal deviation in the horizontal or sagittal planes F. Gunshot wounds of the left thigh (2): 1. Entrance(s) a) Anterior proximal left thigh (Y) b) Dorsomedial distal left thigh (AB) 2. Range: indeterminate 3. Projectiles perforate skin, subcutaneous tissue, and musculature and converge and diverge in the left thigh 4. Recovered: 32.2 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of 0.5 cm from near left femoral head 5. Exit(s): a) Medial mid left thigh (Z) b) Medial mid left thigh (AA) 6. Trajectories: left to right G. Recovered from scene: 1. 23.8 grain, moderately-deformed projectile with a partial metal jacket and a base diameter of 0.5 cm II. Abrasions and contusions on the chest and back, skin and subcutaneous tissue III. Abrasions on the right thigh, skin and subcutaneous tissue IV. Abrasions on the left thigh, skin and subcutaneous tissue V. Two small contusions on the left leg, skin and subcutaneous tissue ***Electronically Signed Out By: P. E. Lantz, M.D.*** sra Summary of Findings Major findings at autopsy were multiple gunshot wounds of the torso and extremities. The deceased was shot at least 15 times, and 15 projectiles or projectile fragments were recovered from the body. The atypical entrance wounds represented a projectiles that had struck an intermediate object. A deformed bullet was collected from the scene. Toxicological analysis detected ethanol (170 mg/dL), amphetamine (less than 0.25 mg/L), bupropion (less than 0.05 mg/kg), hydroxybupropion (0.11 mg/kg), citalopram (less than 0.25 mg/L), caffeine, and nicotine from his blood (left thorax). NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 4 of 13 A20-1431 According to the Iredell County Medical Examiner, law enforcement officers responded to a domestic disturbance and shot the decedent multiple times. CAUSE OF DEATH: Multiple gunshot wounds of chest, abdomen, and extremities MANNER OF DEATH: Homicide EXTERNAL EXAMINATION Body Weight: 198 lb Body Length: 69 in BMI: 29.2 A representative for the North Carolina State Bureau of Investigations is present during the autopsy. The body is that of a well-developed, well-nourished, adult Caucasian man, who appears compatible with the stated age. Body identification includes a band bearing the decedent’s name on the left ankle. The body bag was sealed (# 0028488). The body is received clothed in tan shorts with a brown belt and black underwear. Personal effects accompanying the body include a gun holster, a black watch, and a gray metal ring. The body is cool to the touch. Rigor is passing in the extremities and jaw. Minimal, fixed, livor extends over the posterior surfaces of the body and the left side of the face, sparing areas subject to pressure. The scalp hair is brown, curly, and measures to 3 cm in length over the crown, and is shorter on the sides. The irides appear brown; the pupils are symmetrical. The corneae are slightly cloudy. The sclerae and conjunctivae are pale. No petechiae are on the palpebral or bulbar conjunctivae. The nose and ears are not unusual and the nasal septum is intact. The lips and gums are pale. No trauma involves the buccal mucosa. The teeth are natural and in adequate condition. Facial hair consists of a 10 cm curly brown beard and a 2 cm brown mustache. The neck is without masses and the larynx is in the midline. The thorax is symmetrical and the abdomen is slightly protuberant. The external genitalia are those of an adult male; the testes are descended within the scrotum. The anus and back have no unusual features except as noted. The upper and lower extremities are well-developed without absence of digits. Identifying marks and scars consist of a monochromatic half-sleeve tattoo including a gargoyle or demon and thick curvilinear lines on the right arm; a monochromatic tattoo of a design of intersecting curvilinear lines on the lateral left shoulder; a polychromatic tattoo of a geometric design of interweaving lines around the left arm. No evidence of emergency resuscitation or medical therapy is present. Evidence turned over to the representative from the North Carolina State Bureau of Investigations during the autopsy includes the body bag seal, a blood spot card, pulled scalp hair, recovered projectiles and projectile fragments, and the decedent’s clothing and personal effects. EVIDENCE OF INJURY HEAD AND NECK The gunshot wounds are labeled for recording purposes only and do not reflect the sequence of firing or the severity of the wounds. GUNSHOT WOUND OF NECK: On the anterior neck (labeled “A”), 25 cm below the top of the head and NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 5 of 13 A20-1431 midline, is a 2.5 x 2.0 cm irregular entrance wound defect. There is no soot, stippling, or gunpowder particles present on the surrounding skin. The projectile sequentially perforated and penetrated the skin and soft tissue of the neck; the left lobe of the thyroid; and the muscles of the left shoulder. A 46.0 grain, moderately-deformed, gray metal projectile with a partial, orange metal jacket and a base diameter of 0.5 cm is recovered from the muscles of the left shoulder. There is no exit wound. The trajectory is front-to-back, right-to-left, and slightly downward. CHEST AND ABDOMEN GUNSHOT WOUNDS OF TORSO: Converging/diverging gunshot wounds (4) of the right and mid torso: On the upper right chest (labeled “B”), medial to the right nipple, 41 cm below the top of the head and 7 cm right of the midline, is a 0.7 cm in diameter round defect with a 0.2 cm in width marginal abrasion, widest from 12 to 3 o'clock position (entrance gunshot wound). There is no soot, stippling, or gunpowder particles on the surrounding skin. The projectile sequentially perforated the skin and soft tissue of the upper right chest, the intercostal muscles, and the right lung. The wound path converged with other wound tracks. A 3.8 grain metal projectile fragment is recovered from the soft tissue of the right chest. On the lower chest, 52 cm below the top of the head, are three defects (entrance gunshot wounds) arranged in a transverse line. On the lower right chest (labeled “C”), 10 cm right of the midline, is a 1.5 x 2.3 cm irregular defect within a 2.5 x 6.0 cm abrasion (atypical entrance). Also on the lower right chest (labeled “D”), 4 cm right of the midline, is a 0.4 cm in diameter round defect with a 0.1 cm in width marginal abrasion. On the lower midline chest (labeled “E”) is a 0.5 cm in diameter round defect with a 0.1 cm in width marginal abrasion, widest from the 4 o'clock to 7 o'clock position. The projectiles associated with the three wounds perforated the skin and soft tissue of the chest; the intercostal muscles between the anterior right and left 6th and 7th ribs; and converged in the liver, which has multiple parenchymal lacerations. One wound track through the liver continued through the right hemidiaphragm and the lower lobe of the right lung, converging with the wound track of (B). A 39.0 grain, markedly-deformed gray metal projectile fragment with a partial, orange metal jacket and an overall length of 1.5 cm, is recovered from the right lung lower lobe. A projectile went through the right lung, transected the right coronary artery; lacerated the anterior wall of the right atrium; and perforated the intercostal muscle between the posterior right 5th and 6th ribs. A 51.8 grain, moderately-deformed gray metal projectile with a partial, orange metal jacket and a base diameter of 0.5 cm, is recovered from the intercostal muscle between the posterior right 5th and 6th ribs. A projectile went through the liver, perforated the right kidney and penetrated the musculature and soft beneath the 12th posterior right rib. A 34.6 grain, moderately-deformed, gray metal projectile fragment with a NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 6 of 13 A20-1431 partial, orange metal and a base diameter of 0.5 cm, is recovered from the soft tissue of the mid right back (labeled “AF”). A 5 x 5 cm irregular red contused abrasion is in the skin overlying this projectile. A 50 grain, moderately-deformed, gray metal projectile fragment with a partial, orange metal jacket and a base diameter of 0.5 cm, is recovered from the medial mid right back. None of the aforementioned wounds have corresponding exit wounds. The trajectories of (B), (C), (D), and (E) wounds are front-to-back. It is difficult to discern the other vectors of these wound tracks as they converge and diverge. Associated injuries include fractures of the posterior right 7th through 12th ribs. Gunshot wounds (4) of the left torso: On the lower left chest (labeled “F”), 52 cm below the top of the head and 6 cm left of midline, is a 0.5 cm in diameter round defect with a 0.1 cm in width marginal abrasion, widest from the 3 to 9 o’clock position (entrance gunshot wound). There is no soot, stippling, or gunpowder particles on the surrounding skin. The projectile perforated the intercostal muscle between the anterior left 5th and 6th ribs and the upper and lower lobes of the left lung. It then lacerated the left atrium and perforated the intercostal muscle between the posterior left 8th and 9th ribs. Associated injuries include 300 mL of clotted blood in the left pleural cavity. A 41.8 grain, markedly-deformed, gray metal projectile with a partial, orange metal jacket and a base diameter of 0.5 cm, is recovered from the soft tissue of the mid left back (labeled “AE”) 55 cm below the top of the head and 7 cm left of midline. The trajectory is front-to-back, slightly downward, and slightly to the left. On the medial left arm (labeled “R”), 34 cm below the top of the head and 14 cm below the top of the left shoulder, is a 5 x 3 cm deep graze wound that perforated skin, subcutaneous tissue, and muscle, with a 0.3 cm marginal abrasion near the 3 o’clock position. The trajectory is left-to-right and downward. On the lateral upper left chest (labeled “I”), 39 cm below the top of the head and 25 cm left of the midline, is a 6 x 3 cm atypical entrance wound. There is no soot, stippling, or gunpowder particles on the surrounding skin. The projectile perforated the intercostal muscles, lateral left 6th rib and the lower lobe of the left lung. There are associated fractures of the lateral left 6th to 8th ribs. A 1.8 grain metal projectile fragment is recovered from the skin and soft tissue of the lateral left chest. A 47.8 grain, moderately-deformed, gray metal projectile with a partial, orange metal jacket and a base diameter of 0.5 cm is recovered from the left pleural cavity. [Comment: in the photographic records of this case, the photo of this bullet was mislabelled as “MID R BACK M” and that there is another bullet properly labelled “MID R BACK M”] NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 7 of 13 A20-1431 On the lateral upper left abdomen (labeled “G”), 54 cm below the top of the head and 16 cm left of the midline, is a 1.2 cm in diameter irregular defect within a 13 x 3.5 cm irregular abrasion (atypical superficial graze wound). There is no soot, stippling, or gunpowder particles on the surrounding skin. The projectile fragments penetrated skin and subcutaneous tissue. On the lower left abdomen (labeled “H”), 73 cm below the top of the head and 3.5 cm left of the midline, is a 0.5 cm in diameter round defect (entrance gunshot wound). There is no soot, stippling, or gunpowder particles on the surrounding skin. The projectile sequentially perforated the skin and soft tissue of the abdomen; the mesentery; and penetrated the soft tissue near the spine. A 49.0 grain, moderately-deformed, gray metal projectile with a partial orange metal jacket and a base diameter of 0.5 cm, is recovered from the soft tissue just left of the spine. The trajectory is front-to-back, slightly to the right, with minimal upward or downward deviation. On the mid left back (labeled “AD”), 55 cm below the top of the head and 19 cm left of the posterior midline, is a 1.1 cm in diameter irregular defect (exit wound of a projectile fragment) associated with one of the above wounds. OTHER INJURIES: A 10 x 5 cm area of multiple irregular, red-brown abrasions, ranging from 2 to 7 cm in length, on the upper midline chest. A 10 x 10 cm area of multiple irregular yellow-red abrasions, ranging from 2 to 5 cm on the upper right chest. A 10 x 5 cm round, purple-red contusion on the lower right chest. A 5 x 2 cm oblique, irregular/band-like, red abrasion on the mid right back. UPPER EXTREMITIES GUNSHOT WOUNDS: On the superior left shoulder (labeled “M”), 25 cm below the top of the head and 11 cm left of the midline, is a 0.6 cm round defect (entrance gunshot wound) with a 0.3 cm in width marginal abrasion located anteriorly. There is no soot, stippling, or gunpowder particles on the surrounding skin. The projectile sequentially perforated the skin and soft tissue of the superior left shoulder, the muscles of the left shoulder, and the skin and soft tissue of the posterior left shoulder. No projectile is recovered. On the upper left back (labeled “AC”), 33 cm below the top of the head and 7 cm left of the midline, is a 2.0 x 1.5 cm irregular defect (exit gunshot wound) without marginal abrasion. The trajectory is from front-to-back, downward, and left-to-right. On the dorsal right elbow (labeled “L”), 25 cm below the top of the right shoulder and midline of the right extremity, is a 0.5 cm in diameter round defect (entrance gunshot wound) with a 0.2 cm in width marginal abrasion. There is no soot, stippling, or gunpowder particles on the surrounding skin. NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 8 of 13 A20-1431 The projectile perforated the right elbow fracturing the distal right humerus and proximal right ulna and radius before perforating and exiting the soft tissues and skin of the ventral arm and forearm. No projectile is recovered. On the ventral right elbow (labeled “J”), 23 cm below the top of the right shoulder and midline of the right extremity, is a 9.5 x 7.0 cm defect (exit wound). On the ventral right forearm (labeled “K”), 29 cm below the top of the right shoulder and midline, is a 15 x 12 cm defect (exit wound). The hemorrhage and tissue damage of the right extremity is continuous between (L), (J), and (K). The atypical entrance wound of the right chest (C) may represent a re-entrance wound from the perforating wound of the right extremity. LOWER EXTREMITIES GUNSHOT WOUNDS: Gunshot wounds of the right thigh (5): On the lateral right thigh, 112 cm below the top of the head, 17 cm below the gluteal fold, and 6 cm lateral of the midline of the thigh, is a grouping of four defects (entrance wounds). The most proximal of these (labeled “U”) is a 0.5 cm in diameter round defect with a 0.1 cm in width marginal abrasion. The second most proximal of these (labeled “V”) is a 0.5 cm in diameter round defect with a 0.1 cm in width marginal abrasion. The third most proximal (labeled “W”) is a 0.7 cm round defect with a 0.1 cm in width marginal abrasion. The most distal (labeled “X”) is a 0.6 cm in diameter round defect with a 0.1 cm in width marginal abrasion. The projectile tracks of these four wounds converge with wound path of an entrance wound of the anterior right thigh (T). The projectiles perforated skin, subcutaneous tissue, muscle of the right thigh and created a comminuted fracture of the right femur. On the anterior distal right thigh (labeled “T”) , 113 cm below the top of the head, 18 cm below the gluteal fold, and midline of the extremity, is a 0.5 cm in diameter round defect (entrance gunshot wound) with 0.2 cm in width marginal abrasion. A markedly-deformed gray metal, unjacketed projectile fragment, with a maximum dimension of 0.9 cm, and a smaller fragment, of combined weight 28.2 grains, are recovered from the hemorrhagic wound track of the right femur. A 3.6 grain projectile fragment is also recovered from the right thigh. On the anterior right thigh (labeled “S”), 112 cm below the top of the head, 13 cm below the gluteal fold, and 9 cm lateral of midline, is a 13 x 13 cm triangular shaped defect (exit/partial exit wound) continuous with the wound tracks of defects “T”, “U”, “V”, “W”, and “X.” On the anterior right thigh (labeled “Q”), 99 cm below the top of the head and midline, is a 2 x 2 cm irregular defect (exit/partial exit wound). A hemorrhagic wound track goes through the subcutaneous soft tissue of the right thigh between defects “T” and “Q”. In the medial right groin (labeled “P”), 100 cm below the top of the head and 9 cm left of the midline of the extremity, is a 9 x 4 cm irregular defect (exit/partial exit gunshot wound). A hemorrhagic wound track goes through the subcutaneous soft tissue of the right thigh and groin between defects “O” and “P”. NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 9 of 13 A20-1431 In the right groin (labeled “O”), 93 cm below the top of the head and 7 cm right of the anterior midline is a 1.5 cm lentiform defect (exit/partial exit gunshot wound). A 43.6 grain, moderately-deformed, gray metal projectile with a partial, orange metal jacket and a base diameter of 0.5 cm, is recovered. On the right scrotum (labeled “AH”), 96 cm below the top of the head and midline, is a 0.2 cm in diameter round defect. A hemorrhagic wound track goes through the subcutaneous soft tissue of the scrotum between defects “AH” and “AI”. On the underside of the scrotum (labeled “AI”), 99 cm from the top of the head and 2 cm right of the anterior midline, is a 6.8 cm in diameter irregular defect (exit/partial exit gunshot wound. On the right groin (labeled “N”), 91 cm below the top of the head and 7 cm right of the anterior midline, is a 1.5 cm lentiform defect. On the right buttock (labeled “AG”), 97 cm from the top of the head, 8.5 cm right of the posterior midline, and 6 cm above the gluteal fold, is a 0.5 cm irregular defect. The trajectories of “U”, “V”, “W”, and “X”, are back-to-front, right-to-left, with minimal deviation in the horizontal plane. The trajectory of “T” is upward, with minimal deviation in the horizontal or sagittal planes. Gunshot wounds of the left thigh: On the anterior proximal left thigh (labeled “Y”), 97 cm below the top of the head and 5 cm medial of the midline of the extremity, is a 0.8 cm round defect (entrance gunshot wound) with a 0.3 cm in width marginal abrasion, widest from the 12 to 3 o’clock position. On the dorsomedial distal left thigh (labeled “AB”), 124 cm from the top of the head, 26 cm below the gluteal fold, and 5 cm medial of the midline of the thigh, is a 0.5 cm in diameter round defect (entrance gunshot wound) with a 0.2 cm in width circumferential marginal abrasion. The hemorrhagic wound tracks of converge and diverge in the left thigh. A 32.2 grain, moderately-deformed, gray metal projectile fragment with a partial orange metal jacket and a base diameter of 0.5 cm, is recovered from the soft tissue adjacent to the left femoral head. On the medial mid left thigh (labeled “Z”), 117 cm below the top of the head, 14 cm below the gluteal fold, and 8 cm medial of the midline of the extremity, is a 3.5 x 5.0 cm irregular defect (exit gunshot wound). On the medial mid left thigh (labeled “AA”), 121 cm below the top of the head, 18 cm below the gluteal fold, and 11 cm medial of the midline of the thigh, is a 3.5 x 5.5 cm irregular defect (exit gunshot wound). OTHER INJURIES: A 5 x 8 cm area of four parallel, round-to-linear, red-yellow abrasions, ranging from 2 to 4 cm in length, on the medial right thigh. A 5 x 5 cm irregular area of multiple 0.2 cm fresh, red abrasions on the posterior mid left thigh. Two 3 cm round brown contusions the anterior left leg. RECOVERED: NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 10 of 13 A20-1431 A 23.8 grain, moderately-deformed, gray metal projectile with a partial orange metal jacket and a base diameter of 0.5 cm, was recovered from the scene. CLOTHING: SHORTS: On the right leg front panel are: a 0.4 cm frayed, round defect near the top of the inseam; a 10 x 12 cm irregular defect near the outer seam; and a 2 cm frayed, round defect, mid panel. On the left leg front panel are: multiple round, frayed defects, ranging from 0.5 cm to 1 cm. On the right leg back panel are: a 4 x 4 cm right-angled frayed tear; a frayed, round 2 cm defect, distal to the larger tear; and a 10 cm frayed, round defect near the inseam. On the left leg back panel are: a 5 cm frayed, longitudinal, linear defect; and four frayed defects, ranging from 1.5 cm to 3 cm, near the hem. UNDERWEAR: On the right leg front panel are: a 2 cm round frayed defect, near the outer seam; a 4 cm cluster of small defects, mid panel; a 1 cm frayed defect, near the hem. On the midline front panel is a 0.5 cm frayed defect. On the left leg front panel are two 0.5 cm frayed defects. On the right leg back panel are: a 1.5 cm frayed defect, near the midline; and two frayed defects, 0.5 cm and 0.7 cm, near the hem. POSTMORTEM RADIOGRAPHY: Anterior-posterior and lateral radiographs reveal 11 deformed projectiles, small projectile fragments and “snowstorm” debris patterns of radiopaque material, comminuted fracture of the right femur, fractures of the right humerus, radius, and ulna, and fractures of ribs. INTERNAL EXAMINATION BODY CAVITIES Panniculus adiposus: 3.0 cm Injuries as described in the "Evidence of Injury" section. All body organs are present in normal and anatomical position. CENTRAL NERVOUS SYSTEM Brain weight: 1320 gm No subscalpular contusions or skull fractures are present. The dura mater and falx cerebri are intact without adherent blood. The superior sagittal sinus is patent. The leptomeninges are thin and translucent and with no areas of extravasated blood or exudates. The cerebral hemispheres are symmetrical without edema, atrophy or mass lesions. The structures at the base of the brain, including cranial nerves and blood vessels, are intact and free of abnormality. The arteries of the Circle of Willis are in the usual anatomical configuration and are patent. Sections through the cerebral hemispheres reveal no lesions within the cortex, subcortical white matter, or deep parenchyma of either hemisphere. The cortex is continuous and of uniform thickness. The basal ganglia, thalami, and Ammon's horn have no unusual features. The cerebral ventricles are lined by glistening ependyma and of are of normal caliber. Sections through the brain stem and cerebellum reveal no lesions. The substantia nigra and locus ceruleus have age appropriate pigmentation. The cerebral aqueduct is patent and the fourth ventricle is not dilated. NECK NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 11 of 13 A20-1431 See "Evidence of Injury" section for description of injuries. Except as noted in the "Evidence of Injury" section, the soft tissues of the neck, including strap muscles, and large vessels, have no abnormalities. The hyoid bone and laryngeal structures are intact and the adjacent musculature has no areas of extravasated blood. The lingual mucosa is intact; the underlying firm red-brown musculature is devoid of hemorrhage. CARDIOVASCULAR SYSTEM Heart weight: 310 gm See "Evidence of Injury" section for description of injuries. Except as noted in the "Evidence of Injury" section, the pericardial surfaces are smooth and glistening; the pericardial sac is free of significant fluid or adhesions. The coronary arteries arise normally, follow the usual distribution of a right-dominant pattern and are widely patent, without significant atherosclerosis or thrombi. The chambers and valves bear the usual size-position relationships. The circumference of the valves is as follows; pulmonic, 6.5 cm; aortic, 6.6 cm. The tricuspid and mitral valves are not able to be measured. The myocardium is dark red-brown and firm; the atrial and ventricular septa are intact. The thicknesses of the ventricular walls are: left ventricle 1.5 cm; interventricular septum 1.3 cm; right ventricle 0.3 cm. The aorta and its major branches arise normally, follow the usual course and are widely patent, free of significant atherosclerosis and other abnormality. The vena cava and its major tributaries return to the heart in the usual distribution and are free of thrombi. RESPIRATORY SYSTEM Right lung weight: 330 gm Left lung weight: 330 gm See "Evidence of Injury" section for description of injuries. Except as noted in the "Evidence of Injury" the upper airway is clear of debris and foreign material; the mucosal surfaces are smooth and yellow-tan. The pleural surfaces are smooth and glistening. Lobar divisions are of the usual configuration. The pulmonary parenchyma is dark red-purple, exuding slight amounts of blood and frothy fluid; no focal lesions are noted. The pulmonary arteries are normally developed, patent, and without thrombus or embolus. LIVER AND BILIARY SYSTEM Liver weight: 1410 gm Bile volume: 2 mL See "Evidence of Injury" section for description of injuries. Except as noted in the "Evidence of Injury" section, the hepatic capsule is smooth, glistening and intact, covering red-brown parenchyma with no focal lesions. The gallbladder contains brown, slightly mucoid bile; the mucosa is velvety. The extrahepatic biliary tree contains no calculi. The portal vein and its tributaries are patent. ALIMENTARY TRACT See "Evidence of Injury" section for description of injuries. The esophagus is lined by gray-white, smooth mucosa. The gastric mucosa is arranged in the usual rugal folds, and the lumen has minimal contents. The pancreas has a gray-tan, lobulated appearance and the ducts are unobstructed. GENITOURINARY TRACT Right kidney: 150 gm Left kidney: 140 gm Urine volume: 2 mL See "Evidence of Injury" section for description of injuries. The renal capsules are smooth and thin, semi-transparent, and strip with ease from the underlying smooth, red-brown, firm, cortical surface. The cortex is sharply delineated from the medullary pyramids, which are red-purple to tan. The calyces, pelves, and ureters are not dilated. The relationships at the trigone are arranged in the usual anatomical configuration. The mucosa of the urinary bladder is gray-tan and NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 12 of 13 A20-1431 smooth. The prostate and seminal vesicles have no abnormal findings. RETICULOENDOTHELIAL SYSTEM Spleen weight: 140 gm The spleen has a smooth capsule covering red-purple, soft parenchyma; the lymphoid follicles are indistinct. The regional lymph nodes appear normal. The bone marrow is red-purple and homogeneous, without focal abnormality. ENDOCRINE SYSTEM See "Evidence of Injury" section for description of injuries. The pituitary, thyroid, and adrenal glands contain no lesions. MUSCULOSKELETAL SYSTEM Except as noted in the "Evidence of Injury" section, the bony framework, supporting musculature, and soft tissues are not unusual. Block Summary: 1. Heart Microscopic Description: No histopathological abnormality. TOXICOLOGY Toxicology Folder: T202007905 Case Folder: F202010264 Date of Report: 14-oct-2020 Status of Report: Approved Report Electronically Approved By: Sandra Bishop-Freeman, Ph.D, F-ABFT =============================================================================== SPECIMENS received from Patrick E. Lantz on 12-aug-2020 S200027056: 20.0 ml Blood CONDITION: Postmortem SOURCE: Left Thoracic Puncture OBTAINED: 06-aug-2020 Amphetamine--------------------- Less than 0.25 mg/L 10/14/2020 Benzodiazepines ------------- None Detected LCMS 10/14/2020 Bupropion----------------------- Less than 0.050 mg/kg 10/14/2020 Caffeine -------------------------- Present 10/14/2020 Citalopram---------------------- Less than 0.25 mg/L 10/14/2020 Cocaine metabolite ---------- None Detected LCMS 10/14/2020 Ethanol ---------------------------------- 170 mg/dL 08/29/2020 Gabapentin/Pregabalin ------- None Detected LCMS 10/14/2020 Hydroxybupropion ------------------------- 0.11 mg/kg 10/14/2020 Nicotine -------------------------- Present 10/14/2020 Opiates/Opioids ------------- None Detected LCMS 10/14/2020 Organic Acids/Neutrals ------ None Detected 10/14/2020 Other Organic Bases --------- None Detected 10/14/2020 _______________________________________________________________________________ S200027057: Spleen CONDITION: Postmortem SOURCE: Spleen OBTAINED: 06-aug-2020 _______________________________________________________________________________ S200027058: Liver CONDITION: Postmortem NC Office of the Chief Medical Examiner NC OCME CRAVEN, CHRISTOPHER Autopsy Report A20-1431 CRAVEN, CHRISTOPHER Page 13 of 13 A20-1431 SOURCE: Liver OBTAINED: 06-aug-2020 _______________________________________________________________________________ S200027059: 0.1 ml Vitreous Humor CONDITION: Postmortem SOURCE: Eye OBTAINED: 06-aug-2020 Ethanol ----------- Quantity Not Sufficient 08/29/2020 Specimen quantity not sufficient for analysis. _______________________________________________________________________________ S200027060: 20.0 ml Urine CONDITION: Postmortem SOURCE: Urinary Bladder OBTAINED: 06-aug-2020 Ethanol ---------------------------------- 250 mg/dL 08/29/2020 _______________________________________________________________________________ Accredited by the American Board of Forensic Toxicology, Inc. 101420 19:03 * * * E N D O F R E P O R T * * * COPY TO: Allison L. Pack Olson, PA NC Office of the Chief Medical Examiner NC OCME