02x05 - Burning Questions

[bunniefuu]

[music playing]

NARRATOR A car in a parking garage bursts into flame.

DALE REYNOLDS The fire crews extinguish the fire.

They realize that there is a body in the car.

NARRATOR A promising young man is dead

and no one knows how or why.

If he's dead when the fire started,

that's very suspicious.

The thought of homicide was right from the beginning.

NARRATOR Then Dr. G investigates

a bizarre tale of distress.

It was strange just because I couldn't

understand why it took four days for somebody

to make it to the hospital.

NARRATOR And a natural hospital death that may not

have been so natural.

RHONDA My mom was being accused of murdering my dad.

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations, these are the everyday cases of Dr. G,

Medical Examiner.

[music playing]

NARRATOR It's after midnight and Robert Terrible

is celebrating in a bar in Orlando, Florida.

The last two days have been a peak experience

for this newly minted electrical engineer

on his first professional job.

MARIE He was happy when he get his first job,

because there was a lot of traveling involved.

And he wants to be going places.

NARRATOR He's the son of Haitian immigrants,

who have watched his achievements with pride.

NARRATOR In addition to being a good student.

Robert is also a popular fraternity member.

And when he travels, he never misses a chance to connect

with his fraternity brothers.

MARIE Robert loved to go out with his friends.

What was special about him is was the way he used to approach

people, the care inside.

NARRATOR Tomorrow, he'll sober up and go home

to his parents in New York.

NARRATOR But tonight, he's hanging

with some local friends, cutting loose and drinking

more than he usually does.

At AM, Robert finally decides to call it a night.

There's only one problem.

He has to drive back to his hotel.

minutes later, a parking attendant spots

a car with its engine running.

In the passenger seat is a man apparently sleeping.

The attendant, however, does not wake the occupant

and returns to his office.

A half hour later, he gets the shock of his life.

[explosions]

DALE REYNOLDS Parking garage attendant

starts hearing explosions, which I'd

believe to be probably popping sound which are tires

exploding or glass breaking.

NARRATOR The man's car is engulfed in flames.

And the horrified attendant can't even

get near the vehicle.

At that point, he called --.

-- tells him to pull the fire alarm.

NARRATOR Arriving on the scene, the Orlando Fire Department

quickly puts out the fire.

When the smoke clears, investigators

get their first clear look at what is

for them a most uncommon sight.

To have a fire death in a car is unusual.

NARRATOR Less than % of all auto fires result in a death.

And most of those occur as a result of crashes.

The reason-- when a car fire starts, an able-bodied person

inside will usually get out before being b*rned.

Because the driver did not get out in time,

investigators immediately suspect that he was already

dead when the fire started.

It is not uncommon for the body of a homicide victim

to be b*rned in order to help destroy evidence

and thwart the investigation.

Within an hour a team of specialists

arrive at the scene to investigate

what could be a homicide.

One is Dale Reynolds, an arson and b*mb

investigator with the Orlando Fire Department.

DALE REYNOLDS I received a page from our dispatchers.

Said that we had a car fire in a parking garage with a fatality.

We also asked for a homicide detective or someone

from the violent crimes unit of the City

of Orlando Police Department.

And then also we asked for CSTs, crime scene technicians,

because this is going to be a long, drawn out case.

When we started an investigation of the external of the car,

of the parking garage, the area around him,

we don't want to get around the body very much because we don't

want to destroy any evidence that the medical examiner may

find.

NARRATOR Meanwhile chief medical examiner Jan

Garavaglia, better known as Dr. G, hears about the case

during her morning commute.

DR GARAVAGLIA I'm always listening to the radio.

And I heard about it driving in that there was a car fire
[ … ]

in one of the garages downtown.

And I thought, oh.

And that there was a dead body in one of the cars.

And I thought, oh boy.

NARRATOR As soon as the medical investigator

finishes documenting the site and removes the body,

Investigator Reynolds begins his examination

on the inside of the car.

His primary objective-- find out the exact cause of the fire.

It is a tedious process.

DALE REYNOLDS We took samples of the carpet

in the driver's seat area.

We took samples from the carpet behind the driver's

seat, samples from the back seat passenger side.

And we took samples from the seat

where the occupant was actually sitting.

A lot of thoughts are going through your head

of all the possibilities.

And when I get to work, he was waiting for me.

NARRATOR At the start of most cases,

Dr. G carefully reviews her medical investigator's field

report.

DR GARAVAGLIA So what I have for information

is that there is a security guard.

And he found a fellow who he thought

was sleeping in the passenger side of the car.

And about minutes later, he notices a car fire.

My understanding is there was an expl*si*n.

And sure enough, his car was on fire.

It was consumed in flames.

And there he is very badly charred inside his car.

NARRATOR The scenario is rife with complex questions.

What or who caused the fire?

And how could a young man burn to death in a parked car?

Unless he was m*rder*d.

At this point, we didn't know a lot.

We didn't know who he was.

So a lot of possibilities are going through your head.

Although we have the security guard stating that he

saw a half hour before, I mean, I

don't necessarily believe that.

And how does he know he's sleeping?

How did he know he wasn't just dead in the car?

Or did this guy maybe k*ll him?

Is he trying to cover something up?

Did he really even go on his rounds?

Could be a million and one scenarios.

I don't believe anybody.

NARRATOR While the list of unanswered questions

is daunting, Dr. G is confident of one thing, at least for now.

The thought of homicide was right from the beginning.

NARRATOR Next, Dr. G makes a discovery

with ominous implications.

DR GARAVAGLIA Even if nobody did anything to him,

but he's asleep in the car and somebody else starts

the fire, that's a homicide.

NARRATOR When "Dr. G, Medical Examiner" continues.

[music playing]

NARRATOR The charred remains of an unidentified fire victim

are taken by lab techs to be X-rayed.

One of the first things I'm going to do

is doing full body X-rays.

Head to toe, we will X-ray that body.

NARRATOR Only hours earlier, the body

was found in an Orlando parking garage

in a car engulfed in flames.

Because of the fire's mysterious circumstances,

foul play is strongly suspected.

Why is he there?

What caused him not to get out of the fire?

NARRATOR Now it's up to Dr. G to find answers

to these and other complex questions.

[music playing]

NARRATOR One of the first priorities in a case involving

a fire victim is to determine the victim's physical condition

at the moment the fire began.

DR GARAVAGLIA I have to make a determination,

was he alive or dead?

If he's dead, when the fire started,

that's very suspicious.

He might have been placed there and then the fire

started to cover up evidence.

NARRATOR Because it is nearly impossible to detect any

injuries on charred remains externally,

Dr. G must rely on X-rays to show her what she cannot see.

DR GARAVAGLIA I have a man that is charred beyond recognition,

charred from the head to the toe.

The external exam is more difficult because with all

that charring, with the skin being gone,

I could easily miss a g*nsh*t wound.

NARRATOR Dr. G examines the developed film.

And even before making a single incision,

she can already draw one tentative conclusion.

On the X-rays, at least, there appears

to be no sign of any trauma that could have led to the victim's

death before the fire.

The only injuries Dr. G can see on the film

are those sustained during the blaze.

When she examines the actual corpse,

she is faced with one of forensic pathologies most
[ … ]

daunting challenges--

autopsying burn victims.

DR GARAVAGLIA I have no idea who he is.

I'm trying to figure out even if he's white, black.

It's very difficult when you're black charred head to toe.

When I mean charred, I mean it's black.

His skin in most areas have burnt off

and the underlying muscle is blackened from the burning,

just like a charcoal briquette black.

NARRATOR During the external exam,

one of Doctor G's first tasks is to analyze

the body's unique burn pattern.

Burn patterns can confirm whether or not

the victim was motionless while the fire b*rned.

The posterior back and buttocks and backs of the legs

are not charred as much, not burnt as much,

because they're up against the seat

and there's less oxygen getting to that.

NARRATOR The lack of burning in these areas

proves that the victim never moved after the car ignited,

another possible indication that he may have been

dead before the fire started.

DR GARAVAGLIA Well, that was all

consistent with him sitting in that seat

when the fire was going on.

NARRATOR In burn cases, there are specific parts of the body

that can reveal even stronger indicators

of when a person d*ed--

the nose and mouth.

DR GARAVAGLIA What we're going to look

for is was he breathing?

Was he breathing the products of combustion?

It would be carbon monoxide that he's breathing.

And he'd be breathing hot gases.

And he'd be breathing a lot of sooty material.

NARRATOR If she finds no soot, it's a sure sign

that the victim was not alive.

There's only one problem--

there is soot.

We find that sooty material inside his mouth, his nose.

NARRATOR It's important, but not conclusive.

The soot in the mouth and the nose

could simply mean that the smoke from the intense contained fire

drifted into the open cavities rather than the victim

breathing them in.

The only way Dr. G can know for sure

is to inspect the respiratory tract from the inside.

She begins with the y incision and after opening the rib

cage finds that for the most part,

the victim's internal organs were not affected by the heat.

Once we get past that layer of charring

and even the deeper muscles, it's going to look fine.

NARRATOR Dr. G takes fluid samples

from the victim for toxicology tests

and then begins her search inside the body's cavity.

Because the death is a suspected homicide,

she looks carefully once again for any signs of foul play

or trauma, which may not have been perceivable

on the X-rays, such as internal bleeding

or perhaps even strangulation.

DR GARAVAGLIA I removed some of the char

to see if there's evidence of strangulation

by hemorrhages in those muscles.

NARRATOR But here, too, she finds nothing out

of the ordinary and no sign of injuries

indicating that the victim may have been restrained.

DR GARAVAGLIA No evidence of strangulation.

No blood in the pleural cavities.

No evidence of any type of trauma to the chest or abdomen.

NARRATOR But then she opens the respiratory tract.

Within seconds, she uncovers something

that contradicts almost every previous assumption

in the case.

There is soot in the victim's trachea and lungs.

There's soot all the way down.

There was soot all the way into the mainstream bronchi,

going into each right and left lung.

And when you cut the lungs, there's soot even in the tissue

of the lung itself.

That soot has gone all the way down into his lung tissue.

NARRATOR This finding is undeniable.

The victim was alive during the fire.

Without a doubt, he's breathing

that sooty material in there.

Once I saw on that sooty material

that he inhaled down his trachea into his lungs.

I know he's alive when that fire occurred.

NARRATOR Coming up next, the victim is identified

and his family learns of his horrendous death.

DR GARAVAGLIA They were kind of lost.

They came here from New York.

Nobody was telling them anything.

It's just heart wrenching what they're having to go through.

NARRATOR When "Dr. G, Medical Examiner" continues.

[music playing]

NARRATOR Dr. G has completed the autopsy

of an unidentified young man found dead in a car fire.

Her original hypothesis-- that he was dead before

flames engulfed his car--

has been shattered by the discovery of soot
[ … ]

deep inside the victim's lungs, clear proof that he was

alive after the fire started.

Without a doubt, he's breathing

that sooty material in there.

NARRATOR With this finding, she can now

determine the cause of death.

DR GARAVAGLIA He d*ed from inhalation injuries

due to a conflagration, meaning a huge fire.

And an expl*si*n was heard and that

was consistent with everything that I found.

NARRATOR In other words, the vapor and smoke from the fire

itself caused the victim's respiratory system to fail.

What she still doesn't know is the manner of death.

Was it a homicide or something else?

DR GARAVAGLIA Well, why is he there in the passenger seat?

How did this fire get started?

What's he doing there?

And why didn't he get out?

A lot of that wasn't answered by just doing the autopsy.

[music playing]

DR GARAVAGLIA Right after the autopsy,

I listed the things that I do know, all my facts.

And then just say, well, we're going to pend this.

We're going to have to pend it for the arson investigation.

We're going to have to pend it for the toxicology.

NARRATOR But while Dr. G awaits these results,

the homicide detectives uncover another lead.

A cell phone is salvaged from the wreckage

and police managed to identify the victim

through phone records.

They immediately contact his family.

The victim's name is Robert Paul Terrible.

PERLOW I got a phone call around o'clock,

do you know Robert Paul?

And because we found a body--

or we found a cell phone.

And right then and there, I just knew it was him.

DR GARAVAGLIA The mother and the aunt came.

And I felt so bad for them.

They were kind of lost.

They came here from New York.

Nobody was telling them anything.

It's just heart wrenching what they're having to go through.

But you know what?

The main thing is they just want the truth.

They just want to know that somebody

cares and is going to try to get the answers for them.

And I think after talking to me they

felt confident that I was going to give him

the answers, the best I could.

NARRATOR Dr. G then learned from the family

that the night of his death Robert had been out at a party

with some of his college fraternity brothers

who live in the Orlando area.

It's not much, but at least now Dr. G

knows who the victim is and some of the circumstances

leading up to his death.

It takes several more months for the preliminary results

of the arson investigation to arrive.

DALE REYNOLDS Our job is to find the origin

and the cause of the fire.

And I would say in % of our cases,

we know what caused them.

The point of origin was somewhere in the driver's seat

at seat level, the area of the dash.

But we couldn't come up with a definitive cause.

NARRATOR But they are fairly certain that the fire was not

set by any person, including Robert.

We could not find any evidence that

would support an arson finding.

DR GARAVAGLIA They're pretty emphatic that an accelerant

wasn't used.

And they don't believe it was a fire

that was started by anyone.

DALE REYNOLDS We cut samples.

They were all tested for ignitable liquids.

None found.

So that's key.

I mean that to me rules out homicide for me.

NARRATOR But it leaves the arson investigation

with only theories.

There are many things.

The car could have shorted out.

Without the ability to prove a theory, we don't want to say.

NARRATOR Although Dr. G may never know how the fire began,

she hopes that the toxicology results

will help shed light on the other remaining mystery--

why Robert didn't get out of the car once it started burning.

We didn't have trauma, but maybe

we've got something chemically that's causing him

not to leave.

NARRATOR Something such as a drug overdose.

But it's an implication that Robert Terrible's

family denies emphatically.

Their son does not use dr*gs.

DR GARAVAGLIA I'm looking for dr*gs of abuse.

I didn't expect any after talking to his family.

He's a really nice kid.

But sometimes the family doesn't know.

And so, you know, you always sometimes get
[ … ]

a little surprise.

NARRATOR However, in this case, toxicology tests prove

that Robert's family is right.

He did not use any illicit substances

on the night of his death.

But he did apparently drink quite a bit.

His toxicology showed him to be very intoxicated,

slightly over a . milligrams per deciliter

of ethanol in his blood.

And driving while intoxicated, just to give you a rough idea,

is ..

So very highly intoxicated.

NARRATOR With the toxicology report in hand,

Dr. G now believes she can explain why Robert Terrible did

not get out of the burning car.

He was too intoxicated to escape the fire.

It is the key that enables Dr. G to explain

the tragic circumstances that led to Robert Terrible's death.

After a long day of business meetings,

Robert goes out for drinks with college fraternity friends.

It was kind of unusual that he was out doing that.

He's very alcohol kind of naive in that

he doesn't drink much alcohol.

NARRATOR By the time he leaves the bar,

Robert's blood alcohol level is very high,

over twice the legal limit.

At the garage, he gets in the car, starts the ignition,

and turns the air on to keep him cool on a hot Orlando evening.

But he quickly realizes he's too drunk to drive.

He then does what many would consider prudent.

He puts the car into park and decides to sleep it off.

DALE REYNOLDS He's probably too tall to sleep

behind the steering wheel.

We theorize that he got out of the car,

walked around to the passenger seat,

you know, kind of scooched down in the seat

and got where he was comfortable so he could sleep.

NARRATOR Within the half hour, a fire breaks

out somewhere under the dash.

DR GARAVAGLIA It's not a smoldering fire.

It's fairly fast fire.

NARRATOR The fire quickly engulfs the passenger

side where Robert is sleeping.

Because he has excessive alcohol in his system

and he is not usually a heavy drinker,

Robert remains unconscious.

Alcohol is a central nervous system depressant.

So that would delay him being aroused from a fire.

NARRATOR The fire consumes the vehicle

and Robert along with it.

The car's tires explode, which alerts the garage

attendant, who calls --.

But for Robert, it is too late.

The searing vapors he breathes in burn his trachea

and fill his lungs with blackened soot, which causes

his respiratory system to fail before the fire

is even extinguished.

He had a lot of burning to his posterior pharynx,

or back of his throat.

And then the complete charring, I

felt he d*ed from the inhalation injuries

associated with thermal burns.

To have a fire death in a car is unusual, especially this one

where there is no violent act.

He just d*ed because he was sleeping in the car

while it b*rned.

NARRATOR Although questions remain,

Dr. G is confident in her conclusion.

Even though they feel they don't know the exact reason

for the fire in that car, I feel that we have enough evidence--

we have a preponderance of evidence-- saying

that it's an accidental death.

It's an accidental fire.

And that it's just a tragedy.

He was just a good kid sleeping it off, and a tragedy occurred.

NARRATOR But death, no matter what the circumstances,

always leave survivors with the same difficult questions.

Life can change completely in seconds.

NARRATOR Coming up next, what appears

to be a natural hospital death may turn

out to be anything but natural.

This roommate is making allegations

that the wife m*rder*d him, that she strangled him.

NARRATOR When "Dr. G, Medical Examiner" continues.

[music playing]

NARRATOR -year-old Nick Blazge

is in critical condition.

And for a week, he's been fighting to stay alive

despite his failing kidneys.

Before this illness struck, things had been looking up

for the retired truck driver.

He had just asked his ex-wife Joyce to marry him again,

hoping to pick up where they left off years earlier.

She was his first love.

And there wouldn't be any other.

NARRATOR But their wedding is not to be.

On the seventh day in the intensive care unit,

Nick finally loses his battle.

The only one with them at the end,

his ex-wife Joyce, at least that's what she believes.
[ … ]

The hospital records his death as natural due to kidney

disease.

But Nick's roommate has a very different opinion.

And the next morning, what he tells

the nurse changes everything.

This roommate is making allegations

that the wife m*rder*d him, that she strangled him.

I was stuck with very little information at that point.

So I said, OK, you know, bring it in.

I'm not going to just ignore it.

Let's look into it.

NARRATOR There's just one problem.

Nick's body has already been sent to the funeral home

where it is set to be embalmed.

DR GARAVAGLIA They drain your blood out.

They put preservatives in you.

They put cotton in your eyes.

They wire your mouth shut.

They stick a probe into your abdominal cavity, like blindly,

and stick embalming fluid in there.

So there's a lot of trauma that occurs to the body

that then makes my job harder.

NARRATOR Just as the morticians are

ready to begin the phone rings.

[phone ringing] It is Investigator Guiroga

of the medical examiner's office ordering

them to halt any and all procedures on the body.

HENRY QUIROGA It was a close call.

He was set to be prepared.

And that would have made things difficult.

NARRATOR As the body of Nick Blazge

is transported to the Bexar County Morgue,

Dr. G reviews the details of the accusation made

by Nick's hospital roommate.

According to Quiroga's report, the roommate

was in a semi-sedated state that evening behind a curtain.

HENRY QUIROGA He had heard some kind of gasping,

possibly struggling to breathe.

Gradually the breathing became more ragged.

NARRATOR The disturbing sounds suddenly stopped.

The roommate claims he then saw Joyce rush past his bed

and into the hallway.

HENRY QUIROGA She told the nurse, He's gone, he's gone.

And then promptly left the hospital.

The nurse thought that was a little strange.

NARRATOR According to the Department of Justice,

almost % of all murders are committed by a member

of the victim's family--

a fact known all too well to Dr. G and her investigators.

It sounded like it might have been credible.

So I take it seriously.

The morning after my dad passed away,

I got a phone call.

And it was the medical examiner telling me

that some accusations had been made, that my mom was being

accused of murdering my dad.

NARRATOR The phone call provides

Dr. G with a far different portrait

of the reengaged couple.

RHONDA I don't remember a lot of good times.

I had noticed a lot of arguing between my mom and my dad,

a lot of just little mean looks.

NARRATOR They eventually divorced.

But Joyce never quite left the picture.

RHONDA My mom had remarried.

And when she would get tired of this guy,

she would move back and forth.

And my dad always took her back.

I honestly thought my dad was fool.

NARRATOR At first blush, the couple's

stormy past could lend credence to the roommate's accusations.

Did Nick Blazge die of natural causes

as the hospital believes?

Or did his ex-wife give mother nature a little push?

HENRY QUIROGA That's definitely something that needs to be

looked into and investigated.

RHONDA We had a couple family members

that actually questioned it.

Could this have happened?

NARRATOR Coming up, the bizarre accident that started it all.

DR GARAVAGLIA I realize that his natural disease

may not quite be so natural.

NARRATOR When "Dr. G, Medical Examiner" continues.

[music playing]

NARRATOR Before conducting her autopsy,

Dr. G reviews The large volume of records.

She's received about Nick Blazge's -week hospital stay.

DR GARAVAGLIA They had enough CAT scans and examinations that

show that the problem was the renal failure,

the acute renal failure.

NARRATOR According to doctors, the -year-old

d*ed of advanced kidney disease in the hospital.

But his hospital roommate says that Nick's ex-wife

is responsible for his death.

Now Dr. G has a m*rder investigation on her hands.

DR GARAVAGLIA He believes that the deceased's ex-wife had

smothered him with a pillow.

NARRATOR Unlike the majority of autopsies,

Dr. G will not be cutting Nick Blazge

open to examine his organs.
[ … ]

The medical records already give her a complete picture

of his internal diseases.

DR GARAVAGLIA He had had such a good workup,

I really didn't need to do an internal exam

to look for more trauma.

NARRATOR Instead, she'll concentrate

on the outside of the body in a search for signs of foul play.

The first thing she spots is a huge wound on Nick's back.

Now, we've got a little bit of abrasion there.

NARRATOR Nick has a serious by /

inch bruise behind his left shoulder.

Linear abrasions here maybe from a fall.

NARRATOR The mysterious wound is clearly not

related to the alleged m*rder.

But Dr. G wants to get to the bottom of it

before continuing the exam.

She returns to her investigator's report

and discovers there's more to Nick's story.

HENRY QUIROGA This deceased had actually

suffered an accidental fall four days before he

was admitted to the hospital.

NARRATOR The fall happened in the apartment he

shared with his ex-wife, Joyce.

It is the day of his accident.

And Nick's only health problem is a slight flu bug.

Getting up from the couch, he feels

faint and falls onto a coffee table,

smashing his left shoulder.

In terrible pain, he drags himself

over to the couch to lie down.

And there he will remain for four days unable to get up

and suffering from what he believes is simply a flu.

Day in and day out, Nick's only sustenance are

the ice cubes Joyce feeds him.

And that's the extent of the medical attention he receives.

Eventually, he begins drifting in and out of consciousness.

HENRY QUIROGA It was strange just because I guess I couldn't

understand why it took four days for somebody who

was kind of incapacitated to make it to the hospital.

[music playing]

NARRATOR The account of the accident

gives Dr. G new insight into what likely

triggered the kidney failure recorded

in Nick's hospital record.

His -day ordeal on his couch caused

him to develop a rare medical condition

known as rhabdomyolysis.

Rhabdomyolysis is a fancy word for the breakdown

of your muscles.

NARRATOR When a person lies stationary

for an extended period of time, their skeletal muscles

can begin to physically deteriorate, especially

muscles weakened by injury.

As these muscles break down, the muscle cells often

release proteins called myoglobin into the bloodstream,

proteins toxic to the kidneys.

DR GARAVAGLIA The kidneys aren't functioning.

They can't filter the toxic substances out of your body.

You're building more and more fluid up in your body too.

And that fluid goes all sorts of places.

It goes into your skin, subcutaneous tissue.

It goes into your lungs.

You have difficulty breathing.

NARRATOR In Nick's case, these toxins

run unchecked through the body, ultimately resulting

in multiple organ failure.

DR GARAVAGLIA I suspect he probably

had some chronic alcohol problem, immobility and just

lying there, maybe some dehydration

kind of all combined to cause rhabdomyolysis.

NARRATOR The investigator's account

coupled with Dr. G's findings provide a stunning revelation.

I realize that his natural disease

may not quite be so natural.

NARRATOR Rhabdomyolysis, while potentially fatal,

is preventable in the early stages.

If Nick had gotten medical attention sooner,

his condition could have been reversed.

And according to Henry Quiroga's report,

Joyce was there with him at home during his entire time

on the couch.

And he's getting sicker and sicker and sicker.

And that was important, because, you know,

why do you just leave somebody?

NARRATOR If his ex-wife stood by while he suffered,

it would lend weight to the roommate's m*rder accusation.

Dr. G will have to collect more details

about what Joyce did or did not do during Nick's -day ordeal.

But for now, she still must reach a forensic conclusion

on the original question.

Did Joyce m*rder her ex-husband in his hospital room?

Coming up, the hunt for signs of m*rder

and surprising new details about Nick's accident.

RHONDA I believe my dad would be-- was

very vocal with the paramedics.

NARRATOR When "Dr. G, Medical Examiner" continuous.

[music playing]

NARRATOR Dr. G returns to the main reason for her autopsy--

the hunt for physical evidence of strangulation or suffocation

that would prove Nick Blazge was m*rder*d.
[ … ]

The man spent four entire days and nights

injured on his couch, while his ex-wife stood by.

And now this same woman has been accused of finishing

him off in the hospital.

Dr. G prepares to inspect the one area that will tell her

if these accusations are true.

DR GARAVAGLIA So the things I was looking

for was any kind of trauma on the neck, any type of injury

to the neck.

Nothing, just nothing.

NARRATOR It's clear that Nick wasn't strangled

with a cord or anyone's hands.

Still, there's another readily accessible

w*apon in every hospital room--

pillows.

Pillows are often used in suffocation

because they're soft surface leaves no marks on the body--

at least, that's what K*llers think.

But for the medical examiner, such a suffocation

would indeed leave clues, literally

right under the victim's nose.

DR GARAVAGLIA I will look to see

if there is any pillow fibers.

I'll look to see if there's any marks

on the inside of his mouth.

NARRATOR Yet after a thorough examination,

Dr. G can find no traces of cloth fibers and no signs

that any pressure has been applied to his mouth or nose.

DR GARAVAGLIA Nothing to indicate that he and any kind

of foul play or pressure in his mouth, no marks on the outside

or inside the lips.

NARRATOR There is no evidence that Nick was

either strangled or suffocated.

Dr. G is now certain--

Nick's hospital roommate is wrong.

Joyce did not m*rder her ex-husband.

Most likely what the roommate heard

was simply the last labored gasps of a dying man.

RHONDA I was very thankful that Dr. G

could tell just from looking that nothing

had been done like that.

NARRATOR Dr. G's autopsy is finished.

But one looming question remains unanswered.

Why did Nick spend four days on his couch

without getting medical attention,

especially since his ex-wife was with him the whole time.

The medical investigators soon uncover the last remaining

piece of the puzzle--

an emergency response report filed

just one day after Nick's fall.

It reveals that in fact Joyce did call --

and that it was Nick himself who refused treatment.

With this report and her findings,

Dr. G is finally able to piece together

Nick Blazge's last days.

When Nick falls that day, he enjoys his back.

It is not a fatal wound by any means.

But it is enough to force him to lie motionless on the couch.

DR GARAVAGLIA Skin breaks down and there are pressure sores.

And that was from his prolonged immobility.

NARRATOR Joyce, rather than acting neglectful,

she begged him to go to the doctor and even calls --.

Paramedics arrive and attempt to take

Nick into the emergency room.

But he resists, insisting that he merely has a flu bug.

Legally, emergency medical teams are not allowed to treat anyone"], index ,…}

who is unwilling to be helped.

RHONDA She told my dad, you know, you've got to go.

You've got to have this looked at.

You're hurt.

NARRATOR With Nick's stubborn refusals,

the paramedics can do nothing but leave.

Nick continues to lie on his couch day in and day out.

His muscles begin to atrophy.

As they deteriorate, they release proteins

into his bloodstream that are toxic to his kidneys,

triggering the disease rhabdomyolysis.

On the fourth day, Nick loses consciousness

and Joyce again calls paramedics.

This time, the unconscious Nick is in no condition to object.

DR GARAVAGLIA He wouldn't go to the hospital

until he was so out of it, she could get EMS to take him.

NARRATOR But they are too late.

There is no way to medically remove

the toxic proteins that have now spread

throughout his bloodstream.

System-wide organ failure is inevitable.

Ultimately, they realize that there was not much

else they could do for him.

NARRATOR After seven days in the hospital,

Nick's kidneys no longer filter toxins from his bloodstream.

Fluid builds up in his lungs, making it hard to breathe.

His heart begins to fail.

And his final gasps are overheard by the roommate.

DR GARAVAGLIA The guy is in and out of consciousness.

He's just heard some breathing.

And oftentimes what we call agonal breathing,

your last breath, maybe that's what he's hearing.

A lot of these people are on medication,

and they think they're hearing things and seeing
[ … ]

things that aren't occurring.

NARRATOR Nick's kidneys finally give out,

and he dies of multiple organ failure.

RHONDA Dr. G had confirmed that it was the toxins that had shut"], index ,…}

everything down, that there had not

been any foul play involved.

NARRATOR In the end, Dr. G concludes that Nick's death was

not homicide as suspected by the roommate,

nor natural as deemed by the hospital, but accidental.

DR GARAVAGLIA The bottom line is the fall

is what caused him to go into the rhabdomyolysis, which

ultimately caused him to die.

If I had known what the outcome would be,

I would have kicked them into high gear

to get him to a hospital.

It's been very difficult coping with his passing.

My father and I had been very close.

So that was-- it was just phenomenal, his loss.

[music playing]