01x06 - Who is Watching the Children?

[bunniefuu]

[MUSIC PLAYING]

NARRATOR Two young children are found dead in their own home.

The scene was atrocious.

That's the worst house that I've ever been in.

NARRATOR Police theories run from carbon monoxide poisoning

to accidental overdose.

But Dr. G's shocking findings thr*aten to turn

a community upside down.

It was very worrisome, right from the beginning,

that I was going to be dealing with something very odd here.

NARRATOR Then, a -year-old pregnant mother of two

dies within a week of checking into a homeless shelter.

Can Dr. G wade through a long history

of abuse and poor health to discover what

k*lled this woman so suddenly?

Unbelievable.

This is abnormal.

[GASPS]

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations--

these are the everyday cases of Dr. G, medical examiner.

[MUSIC PLAYING]

It's part of Dr. G's job to remain

objective, to get the facts, and uncover the truth.

But sometimes, her findings are not what people want

to hear, especially when they point to the most unlikely

of suspects.

[MUSIC PLAYING]

[SIRENS WAILING]

[INDISTINCT RADIO CHATTER]

On January , , a panicked call comes in

to San Antonio's operator.

A man named Rick tells them that he's

with a baby who's turning blue.

First on the scene are the paramedics

who find the tiny body of five-month-old

Timothy Gutierrez on a couch.

He isn't just blue.

He's dead.

They note that rigor mortis is already setting in.

Sergeant David Evans is one of the first police officers

to arrive on the scene.

The scene was atrocious.

That's the worst house that I've ever been in.

There were toys.

There were clothes.

It was dirty.

There was food everywhere, and it stank.

It smelled like there was just trash in the house.

It was pitiful.

So we had to focus in and try and stay focused

on what we were there to do, which was

then investigate this death.

NARRATOR Police soon learned that the property

is home to several members of two different families.

DAVID EVANS We soon found out that there

were eight children and four adults

living in this one house.

NARRATOR Emergency personnel on the scene

are alarmed by their findings.

But the situation is even worse than they imagined.

Just as the police begin their investigation on the infant,

the man who called --

Rick-- informs them that there is yet

another body in a back bedroom.

[MUSIC PLAYING]

There, lying on a mattress, is a second dead child--

Renee Alicia, Timothy's two-year-old sister.

She's lying on her side and has vomited next to her.

NARRATOR Something in this house is k*lling children.

A feverish hunt begins.

Is it a poisoning, gas leak, or could they

have overdosed on medication?

We notice there are some medicines,

so our focus then becomes, is there an overdose

on the children's medicine?

NARRATOR But after finding no obvious signs

of trauma or as*ault on the children's bodies,

detectives spot another more likely suspect--

the house's heaters.

It's cold that day, so we're concerned that maybe

there's a possibility of some type

of carbon monoxide poisoning.

NARRATOR While emergency responders begin checking

the house for carbon monoxide, the bodies of the two

dead children are transported to the county

medical examiner's office.

Dr. G gets the call.

[MUSIC PLAYING]

JAN GARAVAGLIA Initially, I was on call.

I got a call from my investigator

that we had two children dead in a house.

And they were worried it was carbon monoxide.

NARRATOR But from the circumstances,

Dr. G is already skeptical about the carbon monoxide theory.

There is a boyfriend in the house that

didn't seem to have symptoms.

And there was another caregiver in the house--

a -year-old girl that's one of the children--

didn't seem to have symptoms.
[ … ]

NARRATOR When Dr. G gets her first look at the two children,

her suspicions are confirmed.

They are obviously not victims of carbon monoxide poisoning.

As soon as I saw them in the morgue,

they had no evidence of carbon monoxide.

Carbon monoxide deaths tend to have

a real cherry-pink lividity--

very common for me to see that from the other side

of the room.

And neither one of these children had that.

NARRATOR After death, blood stops circulating

and succumbs to gravity, pulling at the dead bodies' lowest

point.

Normally, the pooled blood will appear as purple or maroon

on the skin, much like the color of a bruise.

But when blood has been tainted by carbon monoxide,

the lividity will appear bright pink.

The normal lividity of the two children

tells Dr. G that, whatever k*lled them,

it definitely was not carbon monoxide.

The lividity of baby Timothy also

tells Dr. G something else--

how long the infant had likely been dead.

Baby had anterior lividity.

It had been dead for a while.

The lividity-- or where the blood pools-- was fixed.

It was fixed on the face.

NARRATOR The fixed lividity indicates to Dr. G

that the baby was dead for a period of time,

possibly several hours, before EMS arrived.

But as she continues the autopsy,

the possible time of death seems to be the only thing

Dr. G can determine for sure.

We found absolutely nothing--

no trauma, no natural disease, nothing.

There was nothing significant on Timothy that was found.

It was very worrisome, right from the beginning,

that I was going to be dealing with something very odd here.

NARRATOR The infant's body fluids

are sampled and sent to the toxicology lab for testing.

But the results come back negative

for any lethal substances.

Under different circumstances, this case may

have been diagnosed as SIDS--

Sudden Infant Death Syndrome.

More of a phenomenon than a medical condition,

SIDS is a diagnosis of last resort--

one that is made when a complete autopsy, examination

of the death scene, and review of the infant's

clinical history reveals no other rational explanation.

On babies, we sometimes see that,

and those are called sudden infant death syndrome

if the circumstances are right.

NARRATOR But SIDS only affects children

in the first year of life.

So it's not a possibility in the death of Renee Alicia.

JAN GARAVAGLIA Two-year-olds are very uncommon to die.

You're past the infant-death stage, and yet you're--

not dying, usually, unless it's an accident-- a car

accident, or drowning accident.

So it's a very uncommon age for us to see.

NARRATOR At first glance, Dr. G finds no trauma

on Renee Alicia's body.

But telltale signs of a difficult life are evident.

JAN GARAVAGLIA She was very unkempt.

She had the worst set of head lice

I have ever seen in my life.

It was just swarming in her hair.

NARRATOR Initially, Dr. G sees nothing

to suggest how this two-year-old may have died.

But Dr. G's exam has just begun.

A five-month-old baby and his two-year-old sister

have died under mysterious circumstance.

Police have a host of possible culprits--

carbon monoxide, overdose, SIDS.

But all of the theories are about to be

thrown out when Dr. G makes one startling discovery.

[OMINOUS MUSIC PLAYING]

As part of every autopsy, Dr. G examines

the inside of the mouth to check for obstructions

or other clues.

When she opens the mouth of two-year-old Renee Alicia,

this mysterious death instantly becomes a homicide case.

What I saw were the impressions

of her teeth abrading the inner aspect of her lips--

not a bite mark, mind you.

It's hard to bite the upper inner aspect of your lip.

They were impressions, as if somebody had pressed

something-- a hand, or pillow--

against that mouth to suffocate her.

NARRATOR From the outside, there

are often no markings to confirm suffocation.

But pressure on the top of the mouth from a hand or pillow

would create a linear abrasion from the lower

edge of the teeth marking the inside of the upper lip.

Turned to the detective and said,

this is a homicide, unless you can tell me

somebody did CPR in this child.

And they said, no.

Nobody touched this child.
[ … ]

Nobody did CPR.

She immediately told me, this child had been suffocated,

because of those impressions.

So she was able to find that and rule homicide in that death.

NARRATOR What's more, Dr. G is immediately convinced

that the baby Timothy was also smothered,

even though she found no teeth marks during his autopsy.

Now, this baby doesn't have any teeth,

so it's a very easy to suffocate it with no marks.

So I said, most likely, both of these are going to be homicide.

We know the two-year-old definitively is.

By inference, the second one is.

We've got someone that has suffocated at least one child,

probably another, since we have two

dead infants at the same time.

And so the focus of the investigation at

that time is, who was the last one with the child?

JAN GARAVAGLIA So far, we're looking good.

NARRATOR With Dr. G's findings on hand,

police are now on the hunt for a k*ller.

Their chief suspects-- the four adults who live in the house

where the dead children were discovered.

Topping the list-- the victim's own mother, Mary.

Incredibly, she'd already lost a baby

under mysterious and strikingly similar

circumstances five years earlier.

It appeared that it was some type of pneumonia

that the child died from.

It was undetermined whether or not the child

died of the pneumonia or SIDS.

It was really an undetermined death.

If parents have one child die of SIDS,

then it's a sad occurrence.

But then, when they start having other children die of SIDS,

then you need to look further into that,

because that usually means there's some sort

of foul play involved.

NARRATOR And despite initial suspicions in this case,

Mary has a rock-solid alibi.

A neighbor recalled hearing two-year-old Renee

Alicia cry at the time the mother was leaving the house.

So Renee Alicia was apparently alive the last time

Mary was with her.

For police what, at first, seemed like a pattern of m*rder

becomes only a cruel coincidence.

Next, police focus their attention

on Mary's boyfriend, Rick--

the only adult present when the children died.

He also discovered the bodies and called .

His alibi, at first, seems unbelievable.

And he just said that he didn't know what happened.

He was sitting there watching TV.

NARRATOR Police are not buying his explanation.

But then, they talk to a -year-old child, Victoria.

She is the daughter of the other family that lives in the house.

She confirms Rick's story.

When we'd bring up anybody else's name,

she said, I was the one that was in charge of the kids.

It was my responsibility.

I was the last with them.

NARRATOR The -year-old goes on

to tell police about her somewhat

unusual role in the household.

DAVID EVANS Many times, she was the primary caretaker.

If one of the other children had a disciplinary problem,

if they did something wrong, then

Victoria was disciplined for not taking care of it.

She was in charge of those kids.

And if the other kid's messed up,

Victoria got punished because the other kid's messed up.

And it was just a sad situation over all.

Everybody described it as a dysfunctional home.

There was a lot of neglect of other children,

including Victoria.

NARRATOR With all the adults in the house

providing solid alibis, police turn their attention

to -year-old Victoria, a girl who many considered to be

a victim of neglect herself.

To me, it seemed that their primary focus

was always on Victoria.

They just seemed to target her.

NARRATOR But from Dr. G's perspective,

it's the how, not the who, that concerns her.

I felt strongly that someone k*lled the two-year-old,

without a doubt.

I don't know if it's Victoria.

That's not my job.

It's the police job, and the prosecutor's job,

to figure out who did it.

NARRATOR San Antonio police question their chief suspect--

Victoria Dalton-- without her mother or a lawyer present.

I think it was six hours or more.

It was quite a long time.

She was not allowed to leave the room.

And remember, this is the child that had never

been in trouble before, never had any kind of problems

with the law.

Victoria had not even been to the principal's office, really,

in her school.

So she had never been questioned by authorities,
[ … ]

or anybody in a position to intimidate her.

And she was there, by herself.

The mom was not in the room.

JUAN NERRI She was confused.

She was distraught.

And it was quite traumatic.

After six hours of questioning,

Victoria admits that she suffocated Renee Alicia.

But she insists it was an accident.

She suffocated the two-year-old.

She used a pillow.

Pillow was found next to her, when

you look at the scene pictures.

But once Victoria has legal representation,

she soon recants much of what came out

in her six-hour interrogation and claims

that she is innocent of the murders.

When the public learns that the police suspect

a -year-old girl for the murders, many in the community

become incensed.

JUAN NERRI This is one of the very first cases

where you had a child of accused of the m*rder.

And so it really stirred a lot of emotion.

There were candlelight vigils.

She was getting all kinds of letters of support.

CARY CLACK She was so young.

And people didn't want to believe that someone--

this child-- could have done these two heinous acts.

And so that easily fit into people

wanting to believe that she was innocent

and wanted to support her.

Public opinion was that they forced

that confession out of her.

They had the wrong person.

They were sure that she was not the person

that k*lled these children.

With tensions high in the household where the children

died, Victoria leaves and moves in with her grandmother,

miles from San Antonio.

Meanwhile, police continue their homicide investigation.

DAVID EVANS The thinking at that

time was to let her go home.

We'll continue with the investigation.

And we will just present this to the district attorney

and let them proceed with the case at that time.

But then, investigators get a disturbing phone call

from Victoria's grandmother about her dog.

It seems it's dead.

The grandmother saw Victoria playing with the dog's throat

and asked Victoria what she was doing.

And Victoria replied, well, I'm just looking for some lumps

on this dog's throat.

And then, several hours later, she asked

Victoria, where's the dog?

And Victoria said, well, I don't know.

And so amazingly, they looked in the living room

and found the dog wrapped in blankets.

And the dog was deceased.

So at that time, the grandmother said,

I don't want Victoria around the house anymore.

A little bit too much to go without concern, even

to the grandmother.

So the grandmother notified the detectives of this fact,

and the detectives notified me.

NARRATOR Proving that Victoria strangled

the dog may be a critical link in establishing

a deadly pattern of behavior.

But the grandmother's story won't be enough.

[MUSIC PLAYING]

Dr. G has ruled the death of two small children homicides.

And police have put a -year-old girl,

Victoria Dalton, at the top of their list of suspects.

But a challenged confession-- obtained

without the girl's lawyer, or parents, present--

is their only evidence, until police receive a strange call

from Victoria's grandmother claiming that Victoria

has just k*lled her poodle.

Now, the fate of a -year-old girl charged

with a double m*rder hangs in the balance

as Dr. G attempts to discover what

or who k*lled the family dog.

[MUSIC PLAYING]

This is the first time that I'd ever

heard of an autopsy being performed on an animal

to see that it had been m*rder*d in any way.

I am no poodle expert, so I found two

experts in veterinary medicine.

One was a veterinary pathologist,

and one was a veterinary radiologist.

And we all performed the autopsy together.

NARRATOR And it won't be easy.

Dog anatomy differs greatly from that of humans.

Dr. G's objective-- to determine whether the dog

died of natural disease, or of trauma.

Part of the autopsy is to show the negatives-- the fact that

there's nothing else wrong.

NARRATOR Ruling out natural causes

will add considerable weight to the authority's contention

that the dog's death is part of an ongoing pattern of v*olence.

We found no evidence of any natural disease.
[ … ]

Dog, internally-- although it was years old--

had nothing wrong with it.

Had some hot dogs and aluminum foil in its stomach,

but other than that, nothing wrong with it.

NARRATOR Nothing wrong-- until they

inspect the canine's mouth.

Dr. G sees a minor, but possibly telltale, injury.

THERESE HUNTZINGER The extent of the injury on the poodle

would suggest that the suffocation

was a cut to the tongue.

Those injuries were very similar to Alicia's injuries, which

led Dr. G's opinion and cause of death

to be suffocation because of internal injuries

and external on her upper and lower lip.

NARRATOR After the incident with the dog, prosecutors feel

that-- even at years old--

Victoria could pose a danger to those around her.

She is arrested on the charge of the double m*rder.

Many of the citizens of San Antonio

remain convinced of her innocence.

There was a strong bias for Victoria

without knowing a lot of the facts.

Somehow, they've got the wrong person,

or my findings were wrong.

And I just can't--

to me, I have to ignore that part.

I can only go with the facts that I

have with my investigation of what I've done.

Medical examiners-- there's a perception that they are

there to work for the state.

They may be paid by the county, but their opinions

are not paid and bought for.

NARRATOR Victoria Dalton's capital m*rder

trial opens in October, .

For the prosecution, the task is daunting--

how to convince a jury that a -year-old child

is a m*rder*r, without any eyewitnesses,

and no clear motive?

THERESE HUNTZINGER Why would a -year-old girl k*ll Alicia--

and then to go back and, literally, hold her hand

on the back of the head of the infant,

and hold him down into the couch sufficiently long enough

to suffocate his little body and to leave

him laying there, still?

NARRATOR But the one thing that the prosecution does

have is the testimony of Dr. G. It

will be the most crucial part of the state's

case against Victoria.

When you're talking about sh**ting cases, infant deaths,

the kinds of case--

is it an accident?

Is this accidental?

Is this intentional?

What are the other circumstances?

It's not always just about that cause of death.

It's all the surrounding circumstances.

It's the forensics of it that are intriguing.

And they're called upon to offer their opinion

and their investigation.

Her testimony was vital.

It was an integral part of the case.

NARRATOR On the stand, Dr. G explains the complexities

of her conclusions and why, in her opinion,

both children were suffocated.

JAN GARAVAGLIA We have clear evidence that this one was

a homicide-- the two-year-old-- with the marks

on the inside of the lips.

But I didn't have any marks on this baby.

There's no reason for the baby to be dead.

I can't call it a SIDS, because I have the two-year-old dead

at the same time.

And so these two are both homicides,

and because it is so easy to suffocate that baby

without leaving a mark.

And I clearly have one of them already suffocated.

It's kind of hard to get that over to the jury.

This is a case where we needed, desperately,

to have a jury understand the medical examiner's

testimony's critical.

NARRATOR The courtroom listens to Dr. G with rapt attention,

especially Victoria.

She was the most intense defendant at the trial

I have ever witnessed.

She hung on to every word I said.

She was just looking at me and was fascinated

by what I was saying.

NARRATOR After three weeks of grueling testimony,

the case goes to the jury.

They are left to consider the prosecution's chilling account

and decide whether Dr. G's testimony proves that Victoria

suffocated the children or not.

It takes the jury only five hours.

Victoria is found guilty of capital m*rder.

They went ahead and convicted her.

She was found guilty.

I think the most remarkable part of this case

is that a jury was able to, after weeks of testimony,

decide on her guilt--

that she had committed a capital m*rder--

within hours.
[ … ]

NARRATOR Although the jury finds Victoria

guilty of a capital crime, they give

her a compassionate sentence--

years out of the maximum of .

Victoria is sent to the care of the Texas Youth Commission.

And there, she served her sentence

until , when she was released

into a transitional home.

During her incarceration, Victoria

admitted that she had k*lled both Timothy and Renee Alicia,

and expressed deep remorse.

She is now on her own, trying to put her childhood behind her.

JUAN NERRI She is the type of person-- she is going

to make the best out of it.

And I think she has.

NARRATOR If Dr. G hadn't uncovered the subtle sign

of suffocation indicated by the impression of Renee Alicia's

teeth and made the connection between that death

and the m*rder of her grandmother's dog,

the murders might have gone unpunished.

It took an objective eye for Dr. G

to get to the truth, no matter how inconceivable.

Had Dr. Garavaglia not ruled homicide,

we wouldn't have had a case.

Dr. G-- she's just an extremely

valuable resource to have.

[MUSIC PLAYING]

NARRATOR Every death that passes through the Orange

County Medical Examiner's Office has a story to tell

about the life that was lived--

a life shortened by illness, a life

lived long and well, a life whose death

might have been prevented.

For Dr. G, it's those deaths that

could have been prevented that are, in some ways,

the most tragic--

such as the case of Veronica Murphy.

-year-old Veronica Murphy has fallen on hard times.

She's just ended a reportedly abusive relationship,

has been evicted from her apartment,

and is desperately looking for a new start.

She turns to a local Orlando homeless

shelter for assistance.

She arrives at the shelter with her two small children--

one six years old, and a four-month-old infant.

She tells the staff that she's expecting

another baby in seven months.

She also informs them that she is

suffering from ovarian cancer.

WOMAN One day, she just sit down and talk to me.

She said, been to the doctor.

They say the cancer has spreaded,

and there's nothing that they can do about it.

NARRATOR In spite of these liabilities,

the staff quickly learns that Veronica is a formidable woman,

determined to put her troubles behind her

and make life better for herself and for her children.

WOMAN The resident was very aggressive in establishing

her self-sufficiency.

She identified her own goals and objectives.

And she was very focused on fulfilling those goals.

It was, make a fresh start, you know?

Because from my understanding, that was her whole point

of moving to Orlando--

to get on her feet.

NARRATOR But just six days after she

arrives at the shelter, Veronica's world

comes crashing down.

The early part of Saturday morning, her son

came out of the room.

And he was tearful, and saying that mommy was ill.

By the time the paramedics determined

she did need to be transported to the local hospital,

she was very insistent that her children be taken care of.

And she was reassuring to her children

that mommy would be OK, and mommy would be right back.

NARRATOR She couldn't have been more wrong.

Before even arriving at the ER, Veronica is dead.

When she passed, the first thing

came to my mind was the cancer.

NARRATOR Unfortunately, no one knows for sure

what k*lled Veronica Murphy.

Her body is transferred to the Orange

County Morgue for answers.

[MUSIC PLAYING]

At the Orange County Morgue, about

out of bodies autopsied is classified as homeless.

Homeless cases present special difficulties

for a medical examiner.

Because most homeless victims lack medical records,

the search for the cause of death

can be like looking for a needle in a haystack.

But the case of Veronica Murphy is an exception.

Though homeless, she does have medical records

available for Dr. G to review.

Well, this morning, we have a -year-old

black woman who is short of breath,

complaining of some back pain.

And she's living at the Coalition for the homeless.

She doesn't smoke, drink, or use dr*gs.
[ … ]

She's not employed.

Father's en route, here.

He lives out in California.

NARRATOR The records, however, are not complete

and leave many questions about Veronica's health unanswered.

-year-old Veronica Murphy dies while seeking

shelter at a homeless facility with her two small children.

Now, Dr. G must figure out what k*lled her.

Was it the ovarian cancer she mentioned

to the shelter staff, or something yet to be uncovered?

Because Veronica Murphy reported that she was fleeing

domestic v*olence when she arrived at the shelter,

Dr. G will pay close attention to any signs of trauma

from such abuse that may have led to her death.

Yes, , , --

OK.

Pierce, double-pierced on this side--

ooh, keloid.

NARRATOR But apart from pierced ears and a scar,

there is no external sign of any abuse.

But Dr. G does take note of Veronica's weight.

JAN GARAVAGLIA She is morbidly obese.

She weighs about pounds--

a very big woman.

NARRATOR A person is characterized as morbidly obese

if they weigh more than double their ideal body weight,

or if the person is more than pounds overweight.

Morbid obesity commonly leads to a catalog

of dangerous medical problems, from strokes, to high blood

pressure, to fatal heart att*cks,

and accounts for more than ,

premature deaths every year.

But whether or not Veronica's weight had anything to do

with her death remains unclear.

Preliminary reasons-- there's a lot of different

things we have to worry about.

She's high blood pressure.

She's just had a baby.

Plus, she's pregnant again.

Postpartum cardiomyopathy-- possibility, I guess.

Hypertension, maybe there's a bleed in her head.

There's always a possibility of pulmonary embolist-- blood

clot.

NARRATOR With so many possibilities,

determining how Veronica died will become

a process of elimination for Dr. G,

beginning with the internal exam.

Using a Y incision to cut through the chest and abdominal

cavity, Dr. G opens the body.

Once the internal organs are exposed,

she pursues the obvious, first--

did Veronica die of the ovarian cancer she

reported to the shelter staff?

Ovarian cancer is considered curable, but very difficult

to detect in its early stages.

For a woman like Veronica--

homeless and lacking consistent medical care--

the cancer could have easily progressed to a deadly stage

without any obvious signs.

But when Dr. G examines Veronica's ovaries,

she is surprised to find no signs of cancer.

That ovary didn't look that bad.

She has a little cyst--

kind of a thick-walled cyst--

in her other ovary, but I wouldn't say that was cancer.

NARRATOR It appears that Veronica's belief that she

had cancer was unfounded.

She thought that she had ovarian cancer, yes.

And we didn't see any evidence of that.

NARRATOR With ovarian cancer discounted

as the cause of Veronica's death,

Dr. G turns next to confirm whether or not Veronica

was pregnant when she died.

According to Veronica's medical records,

she was weeks pregnant at the time of her death.

To confirm this, Dr. G must carefully

examine Veronica's womb.

It is a delicate process.

JAN GARAVAGLIA The trick is to opening it up without breaking

the amniotic sac.

So what we're going to do is open up through the birth

canal, take a little peek.

NARRATOR Much like the external examination, Dr. G

must inspect the fetus in the amniotic sac

first to make sure nothing is amiss before she moves

on to autopsy the fetus itself.

JAN GARAVAGLIA We opened up, trying

to maintain the integrity of the amniotic sac.

And the amniotic sac was maintained.

And we could see the fetus inside the amniotic sac

looked normally developed.

It was about two inches long.

And from that, we can get a general estimate

of the gestational age.

And it matched what apparently she

felt that her last period was when she'd gone

to the hospital weeks earlier.

It was about or weeks, gestational age.

Dr. G's examination of the fetus

proves that Veronica became pregnant
[ … ]

only one month after she gave birth to her youngest child--

a four-month-old infant.

For Dr. G, this raises a red flag.

When a woman is pregnant, her total blood volume

may increase by as much as %, causing blood

vessels to enlarge and engorge.

Along with this increase in blood volume

comes an increase in the danger of clotting

as the body prepares for the loss of blood during labor.

Pregnancy is known to increase your estrogen level.

And pregnancy makes you more prone to blood clotting,

because of the increased estrogen.

Of course, birth control pills--

some of the birth control pills work the same way.

NARRATOR And Veronica suffers from another major risk factor

for blood clots--

morbid obesity.

OK.

NARRATOR But a k*ller clot can form anywhere in the body,

causing a stroke in the brain, cardiac arrest in the heart,

ischemic colitis in the colon.

And many times, a person doesn't even know they are

in danger until it's too late.

JAN GARAVAGLIA We've seen it in people who

have any type of broken bone.

We've seen it in people with long transcontinental airplane

flights, people who spend eight hours on the airplane

in those lovely, little cramped seats,

and then come off the plane.

They're checking into their hotel, and bam, they go down.

NARRATOR But until Dr. G can prove for sure what

precisely k*lled Veronica Murphy,

her death remains an unsolved case.

[MUSIC PLAYING]

-year-old Veronica Murphy is stricken

without warning at a homeless shelter

and dies en route to the hospital.

ER doctors are at a loss as to what k*lled the young mother.

And so far, Dr. G isn't sure, either.

But she does have her suspicions.

Veronica suffered from two known risk factors for developing

fatal blood clots--

her morbid obesity, and her rapid succession

of pregnancies.

For Dr. G, the hunt is on.

[MUSIC PLAYING]

She begins by inspecting Veronica's respiratory system,

her heart, and lungs.

But the moment that Dr. G sees Veronica's heart,

she wonders whether Veronica died of something other

than a blood clot.

This is a huge heart.

NARRATOR Veronica's heart is more than double the size

it should be.

This is abnormal.

grams-- her heart should be around grams.

She had a massively enlarged heart.

NARRATOR An enlarged heart is often

attributed to high blood pressure, known

medically as hypertension.

With high blood pressure, the heart

must work harder to push the blood through

constricted arteries and veins.

And this never-ending workout causes the heart to grow,

like any muscle in the body.

Only with the heart, unlike other muscles,

bigger isn't necessarily better.

An enlarged heart can place undue strain

on the muscle and result in sudden cardiac death.

years old-- we don't really see a

gram heart in that age group.

NARRATOR And size isn't the only problem

with Veronica's heart.

Oh.

NARRATOR Dr. G can see that the overworked muscle

has obvious signs of trauma.

Yes, look at that.

She's got fibrosis in her heart.

Look at that.

Isn't that horrible?

NARRATOR For Dr. G, the finding of scar tissue in Veronica's

already weakened heart means that it was an organ

struggling under great duress.

The question is, did her heart k*ll her?

JAN GARAVAGLIA I thought, that's what she died from,

when I saw that heart.

NARRATOR With such an unhealthy heart,

it is possible that Veronica Murphy could have suffered

from a fatal heart attack.

But regardless of the state of her heart,

Dr. G's next finding is the key to the case.

She's got one of the causes of death

where it's really quite obvious at autopsy.

And even though she has the biggest heart I've seen

probably this past few months--

maybe this year-- she died from pulmonary embolis.

NARRATOR As Dr. G suspected, Veronica Murphy

died from the effects of blood clots,

specifically pulmonary embolism in the vessel

leading to her lungs.
[ … ]

This is a blood clot.

This is a blood clot.

This is a blood clot.

NARRATOR Now that Dr. G has discovered the fatal blood

clots, she is able to piece together

the final chain of events in the death of Veronica Murphy.

According to the medical evidence, when Veronica Murphy

checks into the homeless shelter,

she's suffering from a deadly combination of risk factors

for developing blood clots--

she's morbidly obese, is weeks pregnant,

and just gave birth to a child four months ago.

At some point during the next few days,

the blood flowing through the deep veins of Veronica's leg

begins to pool and clot.

When you're obese, you don't have

the muscle that's actually helping contract

to bring the blood back.

So there's more stasis, or pooling of the blood,

when you're obese.

NARRATOR This syndrome, called deep vein thrombosis,

may well have been occurring without any real discomfort.

JAN GARAVAGLIA I don't think she had really any symptoms

that would have drawn her to seek medical attention prior

to this event.

We didn't hear anything about pains in her legs.

We didn't hear anything about having

intermittent shortness of breath,

or any type of chest pain.

We didn't hear anything about that.

So this was pretty quick for her.

NARRATOR On Veronica's sixth night in the shelter,

the clock runs out.

Several enormous clots break free

in the deep veins of her legs.

Her huge heart swiftly pumps them up, into her heart,

and straight into the pulmonary arteries where they begin

to block the flow of blood.

As they're leaving the heart to get to the lungs,

they're getting smaller and smaller and smaller.

So they just get caught up.

NARRATOR Veronica begins to suffer hypoxia--

lack of oxygen.

JAN GARAVAGLIA Her pulmonary artery is occluded

with these blood clots.

They couldn't get even through.

And so going into both lungs, both lungs

are completely occluded.

So neither lung is getting any blood, so that's

incompatible with life.

She died of a bilateral pulmonary thromboembolism.

So the bilateral-- it's on both sides,

because it's including both lungs.

Pulmonary-- it's in the lungs.

Thrombembolis is, the thrombos is the blood clot.

An embolis is anything that goes free in your blood system

and then lodges somewhere.

And so that is a cause of death that we know,

definitively, why she died.

NARRATOR As she does with many cases,

Dr. G calls Veronica Murphy's family to help them understand

and to come to grips with their sudden loss.

She had blood clots in her leg that broke free

and went to her lungs.

The reasons for why a young woman would

get blood clots like that--

one of them is--

the risk factor is being overweight and obese

like she was.

The other problem is she's pregnant.

NARRATOR In the eyes of Dr. G, Veronica Murphy

was a person whose premature death was, sadly,

predictable and preventable.

It's sad that somebody passes on at a young age.

But it's also sad to me that somebody at

can weigh pounds.

I mean, I don't know what was in her life

that would make her like that.

I don't know what brought her to the Coalition for the homeless."], index ,…}

Obviously, there's something going on with her that's

sad that I don't know about.

NARRATOR It's a story Dr. G reads

all too often in the bodies that pass through the Orange County

Morgue.

[MUSIC PLAYING]

MAN Atlas.