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- MIAMI-DADE COUNTY
i; EXAMIMER DEPARTMENT
-- Number One on Bob Hope Road COUNT,
A Miami, FL 33136
Phone (005) 545-2400 Fax (305) 545-2400
Q6 Cgi ?s
BUERSON, David Case No. 2011-00457
February 18, :15 A.M. I
CAUSE OF DEATH:
. Gunshot Wound of Chest
Emma O. Lew, M.D.
Deputy Chief Medical Eicaminer
Date:
EOL
Pace ozros
THE MIAMI-DADE COUNTY MEDICAL EXAMINER DEPARTMENT. MIAMI, FLORIDA -- in
DUERSON, 18, A.M. No. 2011-00457 -
ATTENDEES:
FORENSIC Obed Blanco
PHOTOGRAPHER: Christina'Gonzalez
Detective Joe Zanconato, Miami-Dade Police Department
li EXTERNAL EXAMINATION:
The body is that of a muscular 6 foot 1 inch, 225 pound black male appearin consistent with the
given age of 50 years. The Body Mass Index (BMI) is 29.7 kilograms per meter squared. A green strap
encircling the left wrist has the inscription "26054."
The atraumatic scalp is shaved of hair. Multiple smart dark scars form an infe_riorly convex
curvilinear band across the occipital scalp. Facial hair consists of a full moustache and a short beard.
The brown eyes have round 2 millimeter pupils, thin rin of arcus senilis and no conjunctival
or petechiae although the left conjunctivae are injected. A 1.5 centimeter scar is through -
the left eyebrow. The nose has an intact bridge and septum. The ears have no deformities and are not
pierced. The atraumatic mouth has natural upper and lower dentition. A 4 millimeter crusted healing
lesion and a 5 millimeter crusted healing lesion are on the undersurface of the left side of the
The neck has no scars or evidence of recent injury.
The symmeirical chest, flat abdomen and the back have no obvious surgi scars. Multiple small
dark scars are on the upper abdomen. The penis is circumcised and the testes are intrascrotal. The
anus has no abnormalities. A few small faint scars are on the buttocks.
The upper and lower extremities have no obvious bony defomiities, digital clubbing or palpable
fractures. A 5.5 centimeter oblique linear scar is on the proximal exbensor aspect of the left forearm. The
antecubital fossae and the tlexor aspects of the foreamrs and wrists have no scars or incised wounds. A
2.5 centimeter longitudinal surgical scar is on the anterolateral aspect ofthe right knee. Small scars are
on both knees.
A tattoo on l.he left upper chest depicts a heart on a crucifix. The Tasmanian Devil and 2 chinese
words are on the lateral deltoid area ofthe left upper ami.
Electrocard lo raphic patches are on the anterior aspects ofthe shoulders and on both sides of the
abdomen. - .
A gunshot wound is on the left mid chest laterally. 1-1l2 inches inferior and SIB inch lateral to the
left nipple, 20 inches below the top of the head and 5-1/4 inches to the left of the midline. The 8
millimeter ovoid wound surrounded by an abraded muzzle imprint that is 4 to 5 millimeters wide. A
triangular abrasion at 3 o'clock and a round abrasion at 4 o'clock cover a 2.5 centimeter by 2.3
centimeter area. Black residue stains the wound edges. A semi-circular abrasion at the 10 o'clock
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DUERSONI, A.M. No. 2011-00457
position is 1 centimeter in diameter and appears to be in continuity with an erythematous ring around the
entire wound. .
The projectile perforates the anterolateral aspect of the left fourth intercostal space, contuses the
lingula of the left lun perforates the pericardial sac, enters the lateral left ventricular apex, exits the
lateral left ventricular base, perforates the posterior aspect ofthe pericardial sac and T7 vertebral body,
lacerates the parietal pleura of the posterior rig ht sixth intercostal space and penetrates I the
posteromedial aspect of the right lower lobe of lu ng. A mildly deformed medium caliber lead projectile rs
recovered from the subpleural region ofthe posteromedial aspect of the right lower lobe of lung.
The projectile path is from front to back, left to right and upward.
The gunshot wound is associated with 1 140 milliliters of clotted and tluid blood in the left pleural
cavity, 760 millilitere of clotted and tluid blood in the right pleural cavity and 180 milliliters of clotted and
fluid blood in the pericardial sac. The apical left ventricular entrance wound is 4 centimeters and the
basal left ventricular exit wound is 2 centimeters. The projectile does not enterthe thoracic spinal canal.
A small amount of spinal subdural surrounds the focally softened thoracic spinal cord which
has small The posteromedial aspect ofthe right lower lobe of lung is
dark red and boggy.
The intact scalp has no sub aleal The skull has no fractures in the calvarium orthe
base. The smooth pachymeninges have no masses or focal areas of discoloration. The 1350 glam
brain is covered by smooth translucent Ieptomeninges. The cerebrum, cerebellum and brainstem have
no cortical contusions, lacerations or other obvious abnomialities externally. The arteries at the base of
the brain are thin--vvaIled with a single eccentric yellow tibrofatty atherosclerotic intimal plaque that
produces 60% to 70% Iuminal stenosis in the distal basilar artery. are not seen at the
epidural, subdural or subarachnoid levels. The brain is forwarded to the NFL Brain Bank (Boston
University Medical Campus Center for the Study of Traumatic Encephalopathy) in accordance with the
family's request. The atlantc-occipital ligaments and cervical spine are intact.
The tongue has no bite marks, lacerations, intramuscular or masses. The hyoid
bone and thyroid cartilage are intact. The larynx and trachea are patent. The mainstem bronchi contain
red tluid. The 500 gram right lung and 340 gram left lung have smooth pink-tan pleural surfaces with
mild gray anthraccl;ic pigmentation. The lungs are spon with dark red bogginess ofthe contused
lingula and right lower lobe. Granulcmata and masses are not visible or palpable in either lung. The
pulmonary arteries .are patent, with no thromboembcli. The small hilar nodes are soft and black.
The left and ri ht pleural cavities have no fibrous adhesions or pleural plaques.
The pericardial sac has no adhesions to the epicardial surfaces of the 550 gram heart. The four
cardiac chambers clo not contain mural thrombi or thromboembcli. The fossa ovalis is fused. Yellow
fatty infiltration expands the thickness of the interatrtal septum to 1 centimeter anteriorto the fossa ovalis.
The four thin pliable cardiac valves have no deformities or ve etations. The mitral valve is 11.5
centimeters in circumference. The mural endocardium is thin, smooth and translucent. The red-brovvn
myocardium ofthe left ventricle is 1.5 centimeters thick in the lateral free wall and in the interventricular
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DUERSON, 18, A.M. Nc. 2011-00457
septum. The myocardium has no fibrosis or yellow necrosis. The left ventricle is mildly dilated; 8
centrmeters from the apex, the internal diameters of the left and right ventricles are 5.5 centimeters and
2.7 centimeters, respectively. The ostia cf the left main and right coronary arteries are patent and
posrtroned normally. The right coronary ostium is small. The left circumtlex artery becomes the posterior
descending artery. Eccentric fibrofatty atherosclerotic intimal plaques produce 20% luminal stenosis in
the proximal left anterior descending artery. The left circumflex and right coronary arteries are thin-
walled throughout. No thrombotic occlusions are in any ofthe coronary arteries. The thin elastic aorta
has yellow fatty streaking of the intima. .
This 9$?Phagus, stomach and duodenum have no ulcers or masses. The stomach contains 15
of opaque- turbid red-tan fluid. The small bowel, vemriform appendix, colon and rectum have no
abnorrnalrtres externally. The peritoneal vity does not contain free fluid, blood or exudate. The
subcutaneous fat ofthe anterior abdominal wall is 2 centimeters thick._ -
The 1980 gram liver has a smooth capsular surface. The homogeneous brovrm-tan hepatic
has no nodules or masses. The gallbladder contains 20 milliliters of brovrm-yellow bile and -
fou-r irregular black calculi, the largest of which is 9 millimeters. The extrahepatic biliary tree is normal in
calrber and patent. The portal tract structures have no obvious abnormalities. The pale tan lobulated
Pancreas has no masses, calcification or chalky yellow deposits.
The 180 gram right kidney and 180 ram left kidney have pale purple--tan cortical surfaces.
The cut surfaces of the kidneys, and the renal calyces, pelves and ureters have no abnonnalities. The
renal arteries are patent. The bladder contains 30 milliliters of yellow urine. The pale bei prostate is
not enlarged and has no nodules. The tan testes have no or masses.
The 100 gram spleen has a smooth intact capsular surface. The purple-red splenic
has small follicles of white pulp, is not evident in the body cavities.
The pituitary, purple-tan thyroid and yellow adrenals have no abnonnalities.
The thoracolumbar spine has minimal osteophytic lippin and no abnomral curvatures. The left
and clavrcles and ribs have no fractures or obvious callouses. The stemum is intact. The pelvis has
no palpable fractures.
1. Penetrating gunshot wound to left mid chest:
a. Contact entrance wound.
b. Perforation of pericardial sac, left cardiac ventricle and T7 vertebral body.
c. rum caliber lead projectile recovered from posteromedial aspect cf right lower lobe of
ung,
d. Contusion of lingula and right lower lobe of lung. I .
e. Massive hemothoraces and hemopericardium. -
f. Contusion of thoracic spinal cord.
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- THE MIAMI-DADE COUNTY MEDICAL EXAMINER DEPARTMENT, MIAMI, FLORIDA
DUERS-ON, 18, 2011 No. 2011-00457
. 2. Cardiomegaly with left ventricular hypertrophy and dilatation.
3. Atherosclerosis: I
a. Basilar artery, moderate.
b. Left anterior descending coronary artery. mild.
4. Cholelithiasis.
Tissues submitted for histology include entrance gunshot wound, heart, lung, liver and kidney.
Emma o. Lew,
Deputy Chief Medical Examiner
EOL
4