In-custody death: Robert Minjarez autopsy

Case Number: 055?] 4LAF REPORT OF THE PATHOLOGIST LOUISIANA FORENSIC CENTER, LLC P. 0. B07: 308 Youngiwille, LA 70592 Phone Fax 337?5?4-2808 The autopsy summarized in this report was perliirmed on the decedent listed below in With the duties outlined in Revised Statute 33:57 3 ol?LouiSiana State Law. Name of Decadent: Minjarez, Robert .5.. Jr. ?athTimc of Death: 1616 hours Address: . Date/Time ofAumpsy: ?3110/14. 0930 hours Social Security Niimherz Body Identified By: Lafayette Parish Coroner?s Of?ce. Rate of Birth: Tray: 3 Flam of Eeath: Lafayette General Medical Center Investigator: Fit-it}! Tniamn Security Tag Number: Not available Refine-Hz? intro-it's: r?i 9 Eli'nsec?or: Completed: Mt.) Forensic l?atl'iologist Assisteii By: Jeremy Johnson, Louisiana Forensic CAUSE 0F DEATH MANNER OF DEATH t'omnressional due to thee-down physical Homicide restraint hr law enforcement of?cers: with eontnhution ot?i'halidoinyolysis and cocaine. toxicin? ANATQMIC SUMNIA RY I. Video (store) and audio (law enforcement dash cam) evidence to 12m? physical restraints with bodies: A Face down with hands behind buck and cuffed (prone): l. Hip: and legs on sidewalk and eurlx upper limit on lower street level l3. Legs? cuffed (not attached to handcuffs) C. At least 3to 4 law enforcement officers on or partially on decedent while restrained lace ?or minn?cs: a. No spontaneous movement out? In. Decode-m can he heard with an increasingly muffled, hoarse, and strained voter: declaring he can?t breathe multiple timer-?- 1! 265 lb officer on upper hack D. Loss of consciousness while being restrained face down with multiple law enforcement officers on 10p of decedent: l. Last sound from decedent, zipproxim alely 3 minutes 50 seconds since start (if thesilown restraining position: 3. Law is heard to note decedent unresponsive at 4 minutes 5?9 sceondn after start of l?aeedown restraint Minjarez, Robert Joseph Jr. Case Number: 055-14LAF Page 2 of I I ll. Cocaine toxicity: A. Hospital blood (via LOPA) positive for benzoylecgonine (cocaine metabolite) and lorazepam ill. Miscellaneous external injuries; A, Abrasions. lell. forehead and nose: No scalp hemorrhages, no skull fracture and no traumatic brain injury B. Contusions, upper arms C. Contusions, right upper chest with yellow D. Pinpoint contusions. le? leg E. Abrasions. bilateral knees F. Contusions, shins and feet G. Abrasions. lingers, dorsal aspect: . Left l1 and. DIP joints. 2?4; PIP joint. 1. Right hand. Dll" joint, 3"1 H. Abrasion, right elbow l. Abrasion, le? dorsal wrist N. No internal injuries V. Status post LOPA organ donation anti Bank donation: A. Lungs. liver. kidneys (adrenals). pancreas (spleen) l. Pictures of organs show no injury and no gross disease Eve-s Vi. No natural disease in remaining non?donated organs Min jarez. Robert Joseph Jr. Case Number: has-14mm l?age 3 of It EXTERNAL EXAMINATIQ. . The body is that etc well?developedr well-nourished white man accompanied with no personal items. The body is identi?ed by the Lafayette. Parish Coroner?s Of?ce. An identi?cation tag is present on the right foot. The body weighs 169 pounds, is 68 inches in height and appears compatible with the reported age of 30 years. The body is cold. Rigor is present to an equal degree in all extremities. Fixed lividity is distributed on the posterior surfaces of the body. except in areas exposed to pressure. The scalp hair is black and 1.0 cm in length. Facial hair consists of a brown heard. The eyes have been surgically donated. The lid conjunctivae are white. The external auditory canals are free of foreign material and abnormal secretions. The nasal skeleton is palpably intact. The mates are free of foreign material and abnormal secretions. The lips are without evidence of injury. The oral cavity is free of foreign material and abnormal secretions. The teeth are natural without restorations. Examination of the neck reveals no evidence of injury. The chest is unremarkable. The abdomen is unremarkable. The extremities show no gross bony deformities. The ?ngernails are intact. There are multiple tattoos. Needle tracks are not observed. The external genitalia are those of a normal adult, circumcised man. The posterior torso is essentially without note. The anus is atrauniatic. The skin is free of lacerations and burns. Scars from prior trauma are noted including a well-healed seat with skin grafts on the ventral left forearm. EVIDENCE OF THERAPY Evidence of recent medical intervention consists of endotracheal tube, urinary bladder catheter. IVS. Evidence of prior medical intervention consists of a well?healed scar on the left ventral forearm secondary to skin grafts. Evidence of organ procurement consists of covers over the eyes and a closed midline incision over the body (secondary to LOPA). EVIDENCE OF EXTERNAL INJURY Miscellaneous external in juries: There are miscellaneous external injuries. There are abrasions lo the left forehead and nose but there is no scalp hemorrhage, no skull fracture and no traumatic brain injury. There are contusions to the upper arms and contusions to the right upper chest with yellowing discoloration. There are pinpoint contusions to the left leg and abrasions to bilateral knees. There are contusions on the shins and feet. There are abrasions on the ?ngers including the dorsal aspects on the left hand DIP joints 2-4 and PIP joint on the 4lh as well as the right hand DIP joint on the digit. There is an abrasion to the right elbow and 1 the left dorsal wrist. There are no internal injuries. INTERNAL EXAMNATION. Minjarez, Robert Joseph Jr- Case Number: 055-I4LAF Page 4 of 11 Body Cavities: The body is opened by extending the LOPA incision and following the usual thoracoahdominal incision and the chest plate is removed in pieces. No adhesions or abnormal collections of ?uid are present in any of the body cavities. The non-surgically donated organs are present in the normal anatomical positions. The subcutaneous fat layer of the chest wall is 0.5 cm thick. The subcutaneous fat layer of the abdominal wall is 1.0 cm thick. There is no natural disease. Musculoskeletal System: Muscle development is normal. No bone or joint abnormalities are noted. Neck: Examination of the soft tissues of the neck, including strap muscles, thyroid gland and large vessels, reveal no abnormalities. The hyoid bone and larynx are intact. Cardiovascular System: The heart weighs 350 and has a normal con?guration. The pericardial surfaces are smooth. glistening and unremarkable; the pericardial sac is free of signi?cant ?uid or adhesions. The coronary arteries arise normally, follow the usual distribution and are widely patent with no evidence of signi?cant atherosclerosis but no thrombosis. The chambers and valves exhibit the usual size-position relationship and are unremarkable. The left ventricle measures 0.8 cm thick. the septum measures 0.8 cm thick and the right ventricle measures 0.3 cm thick. The myocardium is red?brown, ?rm with no focal lesions; the atrial and ventricular septa are intact. The foramen ovale is closed. The aorta shows no atherosclerotic involvement. The pulmonary trunk does not show signi?cant atherosclerotic involvement. The aorta and the pulmonary trunk and their major branches arise normally and follow the usual course. The ductus arteriosus is closed. The vena cavae and their major tributaries return to the heart in the usual distribution and are free of thrombi. Respiratory System: The lungs have been donated. Alimentary System: The tongue exhibits no evidence of recent injury. The esophagus is lined by gray-white. smooth mucosa. The gastric mucosa is unremarkable and the lumen contains 100 cc of brown fluid. The small and large bowels are unremarkable. The pancreas is surgically donated. The appendix is present. Liver and Biliary System: Minjarez, Robert Joseph Jr. Case Number: 055-] 4LAF Page 5 of The liver has been surgically donated. The gallbladder is sealed and received separately from the missing liver in the body with 30 cc of green-brown bile; the mucosa is velvety and unremarkable. Genitouringy System: The kidneys are surgically donated. The urinary bladder contains no urine; the mucosa is gray-tan and smooth. The prostate gland, seminal vesicles and testicles are without note. Reticuloendothelial System: The spleen has been surgically removed secondary to donation of the pancreas. The regional nodes appear normal. The bone marrow is red and ?rm. The thymus is absent. Endocrine System: The adrenal glands are absent secondary to kidney donation, otherwise the pituitary and thyroid are unremarkable. Head/Central Nervous Svstem: The scalp is re?ected and is intact; The calvarium of the skull is intact and removed. The dura mater is intact; there is no epidural or subdural hemorrhage. The data! sinuses are patent. The brain is removed and weighs 1290 g. The basilar portion of the cranial vault is intact. The leptomeninges are thin and delicate. The cerebral hemispheres are symmetrical. The structures at the base of the brain, including the cranial nerves and blood vessels, are intact. Coronal sections through the cerebral hemispheres reveal no focal lesions. The ventricular system is of normal caliber. Transverse sections through the brainstem and cerebellum reveal no abnormalities. The spinal cord is not dissected. Histologic Sections: Representative samples from various organs are preserved in a storage container in 10% formalin. Toxicology: Hospital blood received via LOPA, bile from autopsy, and vitreous humor via Bank are submitted to the laboratory. A toxicology screen is requested. Photography: Photographs are taken during the course of the autopsy. Minjarez, Robert Joseph Jr. Case Number: 055-14LAF Page 6 of I 1 Pictures reviewed from the organ harvesting Show no injuries and no gross disease including no evidence of stcatosis or cirrhosis. Radiology: X-Rays are not obtained. Diagrams Used: Male diagram. Audio Video Visual Evidence: (Received via request to the Lafayette Parish Coroner?s office) Video Evidence (Store Surveillance File 201403021833 14L Video surveillance item the store showing the sidewalk and front of store is reviewed. The video is upside down and backwards with no audio with a 4 second interval and a time date of tififtiiltiitild. The decedent ?rst appears approximately at 1346 and briefly goes off screen Item 184822 to 1848:38. The decedent appears in a red shirt with black and white shorts with white shoes and white socks- He is a white male with medium build and is primarily seen leaning against the storefront glass with some using of his phone and some pacing. At 184725? the apparent store clerk opens the door and contacts him but closes the door immediately after opening it, but the decedent doesn?t move. At 1856 the decedent puts his arms up puts his phone down and then picks his phone up. Again at 1858:49 and 1900 he puts his arms up as if surrendering although there are no police and most ot?the time there are no other people in the vicinity. At 1900125 a law enforcement SUV pulls up near whet-aha decedent is standing with his arms up. The ?rst of?cer appears and disappears. The decedent approaches the Si IV with his arms stitl up and at 1902 the if?l of?cer appears again but with a dog and with the decedent?s arms still up. A officer strives and the decedent is facing against the SUV. The decedent and officers go off screen for approximately 20 seconds as the 2"11 officer attempts to make physical contact with the decedent. Approximately 20 seconds later the decedent is back in video Frame and goes back to the storefront window and sits down with his arms up. The decedent then stands up with his arms still raised. The 2 of?cers stand at 45? facing him. I with what appears to be a TASER and i with a canine. At 1904 the decedent has his shoes off. At 1904157 a and of?cer enter the frame. At approximately 1905 the decedent appears to stand with his arms up at ?rst and then takes them down and starts to turn his back in response to the and 4m of?cers. The 3rd and 4m officers grab the decedent and bring him to the ground on his right side initial iy and then face-down by 1906. There appears to be a struggle from the decedent when grabbed and when he is brought to the ground initialiy. A tier approsimateljv H.106 there is no de?nitive movement of the visible arms out] legs oi? the decedent which remain motionicss except when manipulated by law enforcement. The video shows the legs and hips on an elevated curb and sidewalk with one officer on the legs. one to Minjarez, Robert Joseph Jr. Case Number: 055-14LAF Page 7 of 11 two officers on the body and lower back and another of?cer on the upper back. The hands are cuffed behind the back and the legs are cuffed. Although the video is of poor quality, the officers appear to be placing signi?cant and continuous weight on the decedent for at least 5 minutes. During the restraint more law enforcement of?cers respond, and some take over for the initial of?cers, but the decedent remained face-down and compressed with the of?cer on the upper hack remaining in position. At 1911 the decedent is rolled onto his back where the police appear to assoss him. While the decpdent is on his back he does not appear to move. At 1914:45 he was rolled t?aceudoum and at 1915 it appears that they are placing EMS cloth restraints on his left hand. The body disappears from the frame of Video at 191722]. Audio evidence from law enforcement dash cam video Videos 14-68246-1 The evidence consists of 2 dashboard candor-ideas with time stamps and date stamps. The ?rst video starts at 1900:05 and shows a law enforcement of?cer responding with lights and sirens arriving on scene at approximately 19045.30. The vehicle is parked in such a way that the sidewalk is not seen although audio is heard. Almost immediately upon arrival, commands can be heard given to the decedent to get down. At 1904;38 the decedent can he heard saying didn?t do anything, I didn?t do nothing, and listen, listen" and then ?okay? to commands. approximately 1905:211- the decedent can be heard screaming ?help, help. help me. get off. you?re going to kill me. you?re going to kill me, you?re going to kill me. what the fuck did I do?, followed by ?you?re going to and can?t breathe" 3 times. Starting at 1907 there is mostly incoherent crying and screaming with the voice becoming increasingly muffled, hoarse and strained with the decedent continuing to repeat ?1 can't breathe.? He says ?please listen? and ?let me tell you? at approximately 1908 and ?they are trying to kill me" andfor ?you are going to kill me? multiple times. A law enforcement officer is heard saying ?you?re not going anywhere". At 1909 the decedent can he heard screaming ?help? multiple times and at 1909:20 he groans and gurgles. At 1909:}? a law enforcement officer is heard to say ?you got 265 on your back, you?re not going anywhere?. At 19092511 the decedent is heard to make an agonal groan and no more sounds are heard from him. A law entorcemenl officer says, ?he?s soaking wet," at 1910;35- At 1910:59 law enforcement officers can be heard to say ?want to ?ip him??, ?he?s unresponsive,? and then. ?yeah, he?s breathing." At approximately 191 1 :20 law enforcement says got a pulse". At approximately 1912 law enforcement can be heard saying ?you got a pulse?" to which another law enforcement officer responds feel something?. At 1913 in the video the ambulance can be seen arriving and the EMS brings out the gurney at 1914. A voice Lathes-rd prior to 1915 states ?he?s out" which is presumably an EMS personnel. At 1917122 the first video ends and the second video starts which shows the decedent leading into the ambulance at 1918 which then departs at 1922 and the video ends at 1923:31. During the restraint one of?cer calls the decedent ?Bobby? and another of?cer apparently refers to the intramuscular injection of versed during the previous night?s encounter with law enforcement on 3/1/2014. Note regarding audio and video evidence: Minjarez, Robert Joseph Jr. Case Number: Page 3 01' 11 The original audio and video were used to prepare this report. The original store video (201403021838 14) was ?ipped and the audio from the dash cam (lit-682464) were combined to make a video for demonstration purposes. This modi?ed video {55 av) shows only from the time just before law enforcement arrives to the time when the body leaves the frame. is missing the time/date stamp, and the audio is only roughly CIRCUMSTANCES The circumstances reported below are pieced together from various sources including hospital medical records, police reports, store video surveillance, and audio from a police dash cam. The decedent was a 30?year?old white man who died in the till approximately 5 days after being restrained by police. and 6 days after leaving the ER. against medical advice with a diagnosis of rhabdomyolysis. There is a report of a previous encounter in December. 2013 allegedly involving cocaine when the decedent received a severe laceration to the arm but reportedly ignored the pain. 011 March 1. 2014. police reSponded to a complaint about the decedent who was reportedly agitated. naked and had destroyed a residence. EMS was called and he was sedated with an intramuscular shot of Versed (a benzodiasepine). 1n the ER. at 1333 he had a temperature of 39.? Celsius (103.5 Fahrenheit.) In addition to being hyperthemic. he had an increased CK of 3021. A urinalysis was positive for cocaine and benzodiazepine. There were mixed liver enzymes with an increased AST at 93 and a normal ALT at 69. On 03/021'14 at 0056 there is an RN. note that reports an increased CPK consistent with rhabdomyolysis. This RN. mentions that the patient is alert. awake and answering questions and has been counseled regarding his diagnosis and diagnostic results. On 03f02f14 at 0353 the last automatic telemetry reading is taken and an MD. note at 0405 notes that the patient has left against medical advice before seeing the doctor. According to video store surveillance and audio from the police dash cam the following is summarized regarding the events of the evening of 3/2/14: The decedent in the store video appears to be hallucinating and multiple times places his arms up as if to surrender long before police arrive and multiple times without anybody present in front of him. Although the decedent appears mentally agitated, he is not physically agitated and primarily is leaning against the glass storefront when he is not raising his arms. He appears to have a phone but no weapon. The decedent is not breathing heavily or quickly as best as can be ascertained. ?l?here is an initial attempt by a canine of?cer and a second officer to restrain the decedent who raises his arms but won?t turn away from the of?cers. They go off screen for approximately 20 seconds. When the decedent and the of?cers return to frame. the decedent sits down on the ground with his hands raised, then stands again keeping his arms raised. The 2 of?cers stand at 45? from the decedent with a TASER and canine and wait for back up. The TASER is not ?red and the dog does not make contact with the decedent. Minjarez, Robert Joseph Jr. Case Number: 055-14LAF Page officer arrive on scene at which point the audio from the dash cam provides audio evidence. The decedent remained with his arms up but appears to refuse to comply with orders to get down. The 3'd and 4"l incoming of?cers bring the decedent to the ground and a brief struggle ensues with the decedent initially on his side. but ultimately face?down with his upper body on the street and his hips and legs on the sidewalk above the street level. At least 3 to 4 of?cers remain on top of, or partially on top of the decedent, with lon the legs, lor 2 on the hip area and lower back. and 1 on the upper back, while they are restraining the decedent and after. Handcuffs and legs cuffs are placed. The leg cuffs are not attached to the hands. From approximately 1906 there is no de?nitive movement from the decedent with the only movement of the body seeming to be manipulation from the officers. Aithough there is no de?nitive movement you can hear the decedent till approximately 1909;50. Prior to becoming silent, he screams multiple times in an increasingly muffled, hoarse and strained voice, ?help?, ?help me?, can?t breathe?. ?you?re killing me", and ?they?re killing me?. At approximately 1910;59 law enforcement of?cers are heard to note that he is unresponsive and turned him face-up. EMS arrives at approximately 1913 with the gurney out at 1914 when an apparent EMS say?s ?he?s out" at 1915. At approximately 1918 the decedent is loaded into the ambulance which leaves at 1922. The decedent arrives via EMS in the HR. at 1943 on 3/2/2014. The EMS report notes that the patient was handcuffed and leg-cuffed face-down (prone) and had blue ears and was not breathing initially. In the ER. the patient was intubated and there was a return of circulation after receiving epinephrine and Narcan. There is no temperature recorded in the ER record. but the EMS report notes skin temperature to be normal. He was admitted to the ICU. Labs on the 2?"1 were signi?cant for increased lactic acid at 18.4, acidosis with a pH ofless than 6.8 (unmeasurable), a low PCOZ at 27 and a high at 462. Liver functions were abnormally increased with AST at 1071 and ALT at 420. In addition, creatinine was increased. Urinalysis was positive for cocaine and Benzodiazepine as well as blood and protein. The on 03/02/14 refers to metabolic acidosis with a lactate etiology being treated with hydration and bicarbonate. Although the initial notes the previous night?s admission and the patient leaving AMA, no mention of rhabdomyolysis is made. On 03/03 the medical records referred to severe rhabdomyolysis being treated with ?uids and bicarbonate. On 03/05 the decedent?s CK was 43,930 The decedent remained in the ICU and never improved. After being declared brain dead, and with the family?s consent. organs were harvested and he was pronounced on 3/7/2014 at 0800. COMMENT The primary anatomic ?ndings at autopsy are miscellaneous external injuries. There are abrasions to the left forehead and nose but there is no scalp hemorrhage, no skull fracture and no traumatic brain injury. There are contusions to the upper arms and contusions to the right upper chest with yellowing discoloration. There are pinpoint contusions to the left leg and abrasions to the knees. There are contusinns on the shins and feet. There are abrasions on the dorsal aspects of some lingers including on the let hand End?4th digits on the Dll? joints. There are also abrasions on the left 4Ih digit P1P joint, and on the right hand 3rd digit Minjarez. Robert Joseph Jr. Case Number: Page ID of joint. There is an abrasion to the right elbow and the left dorsal wrist. There are no internal injuries. The decedent is status post organ donation (LOPA) and Bank donation including the lungs. liver. kidneys (adrenals) and pancreas and spleen as well as eyes. There is no natural disease in the remaining non-donated organs. Pictures from the harvesting Show organs with no gross evidence of injury or disease. including no evidence of steatosis or cirrhosis of the liver. Toxicology from hospital blood recovered by LOPA is positive for benzoylecgonine (cocaine metabolite) and Lorazepam (likely from therapeutic intramuscular injection on 03/01). There is evidence of compressional via store video and law enforcement dash cam video audio. Thisevidence shows the decedent being placed face?down with hands behind his back, handcuffed with hips and legs on a curb and his upper body and head on a lower street level. The legs are cuffed although they are not attached to the handcuffs. At least 3 to 4 police are on. or partially on, the decedent who is restrained face-down for approximately 4 minutes including a 265 1b of?cer on the upper body. There is no spontaneous movement seen ?'om the decedent during these 4 minutes, but the decedent can be heard with his voice beenming'increasingly mullied, hoarse and strained declaring that he can?t breathe multiple times. There is a loss of consciousness while being restrained. The last sounds from the decedent are at approximately 3:5tl minutes since the start of the restraint. At 4:59 minutes from the start of the restraint, the police note the decedent to be unresponsive and turn him face-up. Mechanical ventilation requires that the chest expand fully during inhalation to bring air into the lungs. This is accomplished by contractng the diaphragm, the intereostal muscles. and accessory breathing muscles of the chest, shoulders and neck. The pressure on the decedent due to the of?cers" weight did not allow for full chest expansion. As the decedent exhaled the chest would compress further. Diaphragmatic ventilation and breathing in general may have been ?n'thcr impeded by the curb. and with the body being lower than the hips and legs. With the hands behind the back, the decedent would be less able to use accessory breathing muscles. A lack of oxygen (hypoxia) and a buildup of carbon dioxide (C02)(respiratory acidosis) would lead to unconsciousness and eventual death. Between the time the decedent encountered the police on 03/02/14 and the time he left at the hospital AMA, it is unknown whether he used cocaine again andlor whether his acidosis was worsening due to untreated rhabdomyolysis. Although as explained, there is evidence of compressional as a cause of death, one might argue that the death was inevitable due to the rhabdomyolysis already developing. However, given the evidence explained above from the video and audio evidence. it appears more likely to be a compressional with a contribution of the rhabdomyolysis rather that the other way around. The body compensates for acidosis metabolically by increasing bicarbonate to neutralize the acid nndi?or by increasing rcspirulions to decrease the C02 (an acid equivalent)(respirat0ry eturtpensation). The. bicarbonate in the hospital was low indicating it had been consumed already leaving primarily the respiratory compensatory mechanism. By any measurement. Minjarez. Robert Joseph Jr. Case Number: Page II of 11 the physical restraint employed by law enforcement of?cers decreased the decedent?s ability to ventilate by a signi?cant amount and therefore severely curtailed his ability to have respiratory compensation for his acidosis secondary to rhabdomyolysis. Since the acidosis from the rhabdornyolysis likely made the decedent more vulnerable to the respiratory acidosis and hypoxia from the compressional it should be considered a contributing factor in the death. Rhabdomyolysis is from the breakdown of muscles and can be caused by drugs such as cocaine and/or from excessive physical exertion, both of which apparently occurred on 3/ 1/ 14. In similar cases. causes of death such as positional, mechanical or restraint are used. Positional is more appropriate for positions achieved accidentally. Mechanical is accurate but may suggest machinery is involved. Restraint suggests that such as the handcuffs themselves caused the death. Compressional seems both most accurate and least ambiguous. Due to the fact that the death was caused by the actions of others during a violent struggle, the manner of death is best considered a homicide for forensic or medicolegal purposes such as a death certi?cate. This does not necessarily address intent nor does it differentiate whether appropriate force was used for any real or perceived threat to law enforcement of?cers or to the public. This document is in compliance with the Louisiana Code of Criminal Procedure Article 719 2265 Executive Drive, Indianapolis, IN 46241 Telephone: (800)875-3894 I Fax: (31 7)243-2789 Toxicology: (317)381?5678 .aboratory Case Number: 261 7356 Subiect?s Name: MINJARH, JR, ROBERT JOSEPH Client Account: 119321 Physician: Report To: Louisiana Forensic Center, LLC Roy Provost 1006 Bertrand Drive Lafayette, LA 70506 FX: 337-504-2803 Agency Case 055-14LAF Date of Death: Not Given Test Reason: Other Investigator: NOT Date Received: 0312012014 Date Reported: 0313112014 aboratory Specimen No: 40406643 :ontainer(s): Serum Date Collected: 0310412014 03:00 Test(s): 70530 Drugs of Abuse Panel, Blood inalvle Name Result Concentration Units Therapeutic Range Lot: AMPHETAMINES Negative BARBITURATES Negative BENZODIAZEPINES POSITIVE Lorazepam POSITIVE Lorazepam, Quant 74.6 50 - 240 CANNABINOIDS Negative COCAINEIMETABOLITES POSITIVE Benzoylecgonine POSITIVE Benzoylecgonine, Quant 70.0 ng/mL FENTANYL Negative Negative OPIATES Negative Negative Negative Negative ALCOHOL Negative Methanol Negative Ethanol Negative Acetone Negative lsopropanol Negative ANALGESICS Negative BUPRENORPHINE Negative STIMULANTS Negative JR., ROBERT JOSEPH .aboratory Case 2617356 Date/Time: {13/31/2014. 10:21 Page; 1 of 13 - a 265 Executive Drive, Indianapolis, IN 46241 elephone: (317)243-2769 Toxicology: (317)381-5678 aboratory Specimen No: 40406643 Continued.. malgtg ?ame Result Concentration Units The?eutic Ranqe Loc Negative Specimens will be kept. for at least one year from the date of initial rep: MINJAREZ, JR, ROBERT JOSEPH Laboratory Case 2617356 Drinfed Datel'l'ime: 03/31/2014, 10:21 Page: 2 of 13 .19 .aboratory Specimen No: 40406649 Iontainer(s): Serum 2265 Executive Drive, lndianapolis, iN 46241 Telephone: (800)875-3894 I Fax: (317)243-2789 Toxicology: (317)381-5678 Date Collected: 03/05/2014 12:00 Test(s): 49900 Not Tested Name Result No Testing Performed MINJAREZ, JR, ROBERT JOSEPH Laboratory Case 2617356 manna nninrrime: 03/31/2014. 10:21 Concentration Units Therapeutic Hanqe Loc Page: 3 of 13 2265 Executive Drive, Indianapolis, 46241 Telephone: (800)875-3894 Fax: (317)243-2789 Toxicology: (317)381-5678 40406650 Date Collected: 0306/2014 03:00 aboratory Specimen No: Test(s): 49900 Not Tested 01 Serum inalvte Name Result Concentration Units Therapeutic Ranqe Loo No Testing Performed MINJAREZ, ROBERT JOSEPH Laboratory Case 2617356 Drinl'nrl nalnl'i'ime: 03/31/2014. 10:21 Page: 4 of 13 2265 Executive Drive, Indianapolis, IN 46241 - re"! Toxicology: (317)381-5678 Telephone: (800)875-3894 Fax: (317)243?2789 Date Collected: 03/09/2014 22:05 .aboratory Specimen No: 40406651 iontainer(s): Vitreous,EYE Test(s): 49901 Volatiles Not Performed tnalvte Name Flesult Concentration Units The?peulic Range Loo Volatile Testing Not Performed Due to negative blood, tissue, and/or urine Volatile (Acetone, Ethanol, Isopropanol, and Methanol) results, volatile testing wan not performed on the vitreous specimen. MINJAREZ, JR, ROBERT JOSEPH Laboratory Case 2617356 Page: 5 of 13 aphid-AI. na?l'?rriM?' ll- 1 m, . 3 2265 Executive DrlveI Indianapolis, IN 46241 Telephone: (800)875-3894] Fax: (317)243-2739 Toxicology: (317)381-5678 40406653 Date Collected: 03/09/2014 21:50 Laboratory Specimen No: Test(s): 49900 Not Tested Container(s): Vitreous,EYE Analvte Name Result Concentration Unlte Therapeutic Flange Loc No Testing Performed MINJAREZ, .13., ROBERT JOSEPH Laboratory Case 2617356 Date/Time: 03/31/2014. 10:21 Page: 6 of 13 '5 w- . . - 2265 Executive Drive, Indianapolis, IN 46241 Telephone: (800)875-3894 1 Fax: (31 "0243-2789 Toxicology: (317)381-5678 .aboratory Specimen No: 40406655 Date Collected: 03/09/2014 14:00 :ontainer(s): Test(s): 49900 Not Tested inalvie Name Result Units Therapeutic Flange Loc No Testing Performed IINJAREZ, Jn., ROBERT JOSEPH aboratory Case 2617356 rinted Date/Time: 03/31/2014. 10:21 Page: 7 of 13 2265 Executive Drive, Indianapolis, IN 46241 Telephone: (800)875-3894 Fax: (317)243-2789 Toxicology: (317)381-5678 -abcratory Specimen No: 40406658 Date Collected: 03/09/2014 14:00 30ntainer(s): Test(s): 49900 Not Tested Analvte Name Result Concentration Un__lts Therapeutic Range No Testing Performed m, ROBERT JOSEPH .aboratory Case 2617356 nainfl'imn- mmranm 10:91 Page: 3 01' 13 .aboratory Specimen No: 40406659 :ontainer(s): 011RTT 2265 Executive Drive, Indianapolis, IN 46241 Telephone: (800)875-3894] Fax: (317)243-2789 Toxicology: (317)381-5678 Date Collected: 03/09/2014 14:00 Test(s): 49900 Not Tested lnatvte Name Result No Testing Performed WNJAREZ, JR., ROBERT JOSEPH Laboratory Case 2617356 Drlninrl 03/31/2014. 10:21 Concentration Units Therapeutic Range Loc Page: 9 of 13 . i 2265 Executive Drive, lndlanapolis, IN 46241 Telephone: (800)875-3894lFax: (317)243-2789 Toxicology: (317)381-5678 40406660 Date Collected: 03/09/2014 14:00 Test(s): 49900 Not Tested a 1-H ?Tie. Laboratory Speclmen No: Container(s): 011GRT Analyte Name Result Concentration Units Therapeutic Range Loc No Testing Performed MINJAREZ, JR., ROBERT JOSEPH Laboratory Case 26173.56 Printed Date/Time: 03/31/2014, 10:21 Page: 10 of 13 y. 2265 Executive Drive, Indianapolis, IN 46241 .7: ~r Telephone: (800)875-3894 Fax: (317)243-2789 Toxicology: (317)381-5678 .aboratory Specimen No: 40406661 Date Collected: 03/10/2014 012R'l'l? Test(s): 49900 Not Tested Elnalvte Name Result Concentration Unite Therageutic Ftanqe Loc No Testing Performed ROBERT JOSEPH .aboratory Case 2617356 'rinted Page: 11 of 13 I: . . .aboratory Specimen No: 40406662 :ontainer(s): 012RTT 2265 Executive Drive, Indianapolis, IN 46241 Telephone: (800)875?3894 I Fax: (317)243-2789 Toxicology: (317)381-5678 Date Collected: 03/09/2014 14:00 Test(s): 49900 Not Tested tnalvte Name Result No Testing Performed MINJAREZ, JR, ROBERT JOSEPH Laboratory Case 2617356 halnrl'imn- [901 4- 1 0:21 Concentration Units Therapeutic Fianqe Loc Page: 12 of 13