03x05 - Deadly Arrest

[bunniefuu]

[music playing]

NARRATOR A young father dies in a violent struggle with police.

Did the officers b*at him to death?

Their actions are definitely going to be under scrutiny.

NARRATOR Or did he fall victim to something more mysterious?

And he starts acting bizarre, running from a police.

NARRATOR Then, an -year-old girl dies suddenly

and her parents arms after suffering a seemingly

routine miscarriage.

I really tried to save her life.

NARRATOR The truth behind her death shocks Dr. G.

There's no reason you have to die from this.

NARRATOR And later, the countdown continues--

Are you getting nervous yet?

NARRATOR To the big day.

Oh, I got lipstick all over you, baby.

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

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

Monday morning, rush hour.

It's the beginning of an extra crazy week for Dr. Jan

Garavaglia, chief medical examiner, mother of two,

and bride to be. - Hi, sweetie.

How are you?

NARRATOR She and her soon to be husband,

Dr. Mark Wallace, only had three and a half weeks

to plan the entire wedding.

We're both very, very busy.

We've got school schedules, work schedules.

And yet we wanted to be together.

Are you getting nervous yet about the wedding?

NARRATOR The wedding is just six days away.

DR. G (VOICEOVER) Billion things I got to do.

Plan the flowers, find shoes to match

that dress, final numbers on the dinner.

And on top of that, I know I have several cases

in the morgue waiting for me.

I just read over the paper.

And I'm preparing a talk.

I can't wait til I'm married and it's over.

I didn't even drink my coffee.

NARRATOR AM, Dr. G begins the day's first autopsy,

a young man who d*ed last night in a violent encounter.

According to the investigators' report, it unfolded as follows.

The police are just driving down the street,

minding their own business.

And this fella jumps out right in front of their car.

NARRATOR The car stops in time.

And the man is not hurt.

But the real danger is just beginning.

They could see that he was in trouble.

There was something wrong.

He starts acting bizarre, running from the police.

They actually tried to spray pepper spray on him.

It didn't help.

He runs away, dives back into the street.

NARRATOR Soon, other officers arrive on the scene.

The struggle quickly escalates.

He fights back with unexpected strength.

It takes their combined force to finally

wrestle the man to the ground and bring him under control.

They get him subdued.

They've got him handcuffed.

He seems to be OK.

NARRATOR Then, something shocking happens.

The man suddenly falls limp.

DR. G (VOICEOVER) As soon as he went unconscious,

they called EMS to get there.

They tried.

But he was pretty much dead when I got there.

NARRATOR Through fingerprints, police

identify the man is Toby Holmes, a -year-old father of two.

And now, his family wants to know, how did he die?

And are the police to blame?

If someone dies while in police custody,

their actions are definitely going to be under scrutiny.

NARRATOR The officers deny using excessive force.

But only forensic evidence can prove or disprove their case.

You worry about some type of police brutality.

The police officer that did that would've been prosecuted.

NARRATOR But Dr. G must also consider

a second possible cause of death involving the officers.

Pepper spray, you know, we have

to make sure he's not allergic to pepper spray,

he didn't have an asthmatic att*ck

brought on by the pepper spray.

Tragedy can occur.

People can die even when the police used a force that

wasn't supposed to be lethal.

NARRATOR Considered an illegal w*apon in the UK

and Canada, pepper spray, or oleoresin capsicum,

is an oil extract from cayenne peppers that's

times as strong as jalapenos.

A single dose can be fatal if it triggers

a severe asthma att*ck.

But then, Dr. G finds a puzzling detail in the report.

After jumping in front of their car,

Toby had yelled, just k*ll me or go away.

Basically, the-- the guy makes a comment that he would like

the police officer to k*ll him.
[ … ]

NARRATOR More than , people commit su1c1de in the US

each year.

On rare occasions, they directly involve police officers

in a scenario known as su1c1de by cop.

su1c1de by cop is-- is basically

when a person is suicidal and they want the cop to k*ll them.

Typically, what we see as su1c1de by cop

is that'll draw a g*n on a police officer.

You draw a g*n on a police officer

and he's gonna sh**t you.

That's what he's trained to do.

NARRATOR No firearms were involved in Toby Holmes' death.

But in speaking with the family, investigators

discover a possible warning sign of su1c1de,

a sudden radical change in behavior.

They've contacted his wife.

He's supposedly very-- had been very abusive to her.

But recently, today, for some reason, prior to this incident,

had been very nice to her.

NARRATOR According to his wife, Toby had left the house

earlier that day in tears, saying he would

never see his family again.

Little did she know, he would be right.

Did suicidal intend to play a part in Toby's death?

If so, it could have repercussions

for the investigation across the board.

Everybody wants those answers.

The family wants those answers.

Police executives want those answers.

NARRATOR And they're all counting on Dr. G

to figure out the truth.

Dr. G begins by studying Toby's face, which

is covered in cuts and bruises.

Let's see.

NARRATOR She's on the lookout for signs of excessive force.

He's got a contusion to the middle of his forehand.

He's got some abrasion on the lateral aspect

of the right eye.

He's got some cheek abrasions.

NARRATOR The wounds provide a snapshot of Toby's fight

with the officers.

They certainly subdue them face down.

And his head goes down on the ground.

So it's definitely in a struggle.

NARRATOR The external injuries are extensive.

But to prove whether or not police

had actually caused his death, Dr. G must

go inside Toby's body and head.

A bruise on the face is a bruise on the face

until it affects your brain or causes some trauma internally.

NARRATOR For now, she continues with the external exam,

searching for any further injuries,

self-inflicted or otherwise.

Some contusions or bruising around the wrist.

They were very classic for a struggling against a handcuff.

NARRATOR And on his forearms, she makes a telling discovery.

He has multiple scars running along the major veins.

So what we see are vascular, kind of linear,

fibrosis over vessels.

He's got a lot of them, a lot of old vascular scars.

NARRATOR But these scars are not the result of Kn*fe wounds

sustained in a su1c1de attempt.

Instead, they are clearly the consequence

of drug use, specifically repeated

injections of an intravenous narcotic, such as heroin.

People who sh**t up dr*gs will often

sh**t things into their system that cause this--

the vessels to kind of scar up.

One, two, three, four, five, just

on the front of that right arm.

So he is really sh**ting up a lot of drug.

That was really quite amazing.

NARRATOR The scars further complicate Toby's case.

They suggest yet another possible cause

of death, a drug overdose.

But if so, was it accidental or intentional?

su1c1de, I don't know how that plays into this.

NARRATOR Then, as Dr. G takes a closer look at the needle

tracks, she discovers one puncture

wound on the right hand that commands her attention.

It's a needle puncture mark surrounded

by pallor, kind of whitening of the skin, where

there's no blood.

And then, ecchymosis, or bleeding,

around that area of pallor, which I don't often see.

NARRATOR It's a half inch forensic clue that

could clear the officers names or condemned

them as Toby's K*llers.

Coming up next, was Toby suffering

from the mysterious and deadly effects of drug abuse?

Smashing out windows, big dents in your cars

with their fists.

Oh my gosh.

NARRATOR When "Dr G, Medical Examiner" continues.

Morgue technicians photograph the extensive needle marks

on Toby Holmes' arms, looking for clues

to his strange behavior and sudden death.

Yesterday, after an abrupt farewell to his family,

the -year-old father of two provoked a fierce and fatal

fight with police.
[ … ]

To explain his demise, Dr. G must untangle a complex web

of theories, including police brutality,

a reaction to pepper spray, and a suicidal or accidental drug

overdose.

I am just trying to get to the fact of what happened.

NARRATOR And now, she's found a distinctive mark

on his hand that may lead to a stunning revelation.

She closely inspects the circular wound.

The defect is not only familiar, but Dr. G knows it could

be the key to solving the case.

DR. G (VOICEOVER) It's pale with a central needle

puncture mark and then bleeding around it.

He's actually got a classic cocaine needle puncture mark.

NARRATOR Cocaine, a central nervous system stimulant,

is most often inhaled through the nose

or smoked in the form of cr*ck.

But about % of addicts inject the drug into their veins

for a shorter, but more intense high.

To Dr. G's expert eye, Toby's puncture wound looks fresh.

He may have injected cocaine just before his death.

This discovery sheds a whole new light on this complicated case.

It's now possible that Toby was suffering from one of the worst

effects of cocaine abuse, not a basic overdose,

but a dangerous condition called excited delirium.

Typically, these are chronic cocaine users, where

this last episode puts them over the edge

and they start having delusional, excited

thoughts and behavior.

NARRATOR While the physiological phenomenon

of excited delirium is not fully understood,

researchers believe excited delirium is caused

by a chemical reaction in the body

that triggers violent actions.

These are the type of people that are smashing out windows,

plate glass windows with their hands,

putting big dents in your cars with their fists.

I would run the other way.

They would scare me to death.

NARRATOR But police cannot just run away.

It's their job to bring the violent person under control.

Unfortunately, in some cases, the subject dies.

There are two possible explanations

for excited delirium deaths.

The first is that the excited delirium triggered

an arrhythmia, an irregular heartbeat that prevented blood

flow to Toby's major organs.

This would have k*lled him, regardless of any injuries

sustained in the scuffle.

But Dr. G can only make this ruling

after eliminating all other options,

because arrhythmias leave no tangible proof

after they occur.

DR. G (VOICEOVER) It's a cardiac arrhythmia.

The electrical component, the heart,

isn't causing a uniform b*at.

So we're not gonna see anything.

NARRATOR The second possible cause of death, however,

would leave hard evidence.

If the excited delirium had turned Toby so violent

that the officers reacted with extreme force

above and beyond what they needed to restrain him.

Was the intervention and the use of force necessary?

Was the amount of force justifiable?

Was it reasonable?

In the heat of the moment, maybe

he got a nice blow to the head that I can't see with the hair.

I don't know.

NARRATOR For answers, Dr. G must

now turn to the internal exam.

So we're ready to go, right?

Ready to go.

NARRATOR Dr. G makes the standard Y

incision from the shoulders through the torso.

She's in search of hard evidence that can pinpoint Toby's k*ller

among many suspects, Pepper spray,

a drug overdose, arrhythmia from excited delirium, or trauma.

First, she checks the abdominal cavity for excess blood

that may have resulted from a b*ating.

Because blood really is the trail to the trauma.

Is there blood collected in his abdominal cavity?

Could there have been a blow to to the liver?

NARRATOR Seeing no pools of blood, however,

she proceeded to examine the ribs.

A blow to Toby's chest or the weight of officers fighting

to subdue him may have broken a rib bone, causing

fatal internal injuries.

Sometimes a kick can cause a displaced rib to go into a lung

or or even a heart sometimes.

NARRATOR But all the ribs appear intact.

And the lungs are clear of puncture wounds.

We're also looking for evidence

of maybe an allergic reaction, possibly from the pepper spray.

His bronchi looked fine.

They were all patent.

The air could go through them.

So that ruled that out.

NARRATOR So far, she's found no evidence of any internal trauma

inflicted by the police.

But the internal search for clues to Toby's sudden death

is not over.
[ … ]

While her assistant takes blood and urine samples for a tox

screen, Dr. G continues exploring

the possibility of police brutality, inside his head.

We're looking for evidence of him having a skull fracture

and a blow to the head or something that happened

to him that shouldn't have.

NARRATOR And her thorough examination

reveals no injuries.

There was no skull fractures.

There was no bleeding in the brain.

No skull fractures at the base of the skull.

So I really-- there was no trauma to the brain.

NARRATOR The negative findings add up to one conclusion.

The officers are not responsible for k*lling Toby

Holmes with excessive force.

There's no proof of that.

Nothing.

Nada.

NARRATOR With the autopsy now over,

Dr. G can finally eliminate a few theories

about Toby's sudden death.

He certainly didn't die from trauma.

He didn't die from the police b*ating him up.

He didn't have an allergic reaction to the pepper spray.

NARRATOR But that still leaves two possibilities remaining,

a suicidal overdose or heart arrhythmia

brought on by excited delirium.

And we have nothing anatomically

that we can find at autopsy.

So that means it's gonna be toxicology.

NARRATOR Coming up next, a critical discovery

may help Dr. G solve the case of Toby Holmes.

Very few things cause you to go from walk, talking one

minute to flatline the next.

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

OK.

So we have peripheral blood, bile, little bit of urine.

Oh.

NARRATOR Dr. G orders a full toxicology screen

on Toby Holmes' fluid samples.

I got to see what his levels are.

NARRATOR Through a negative autopsy,

she's determined that this young father

was not a victim of police brutality

or a pepper spray mishap.

But whether he d*ed of a suicidal overdose

or suffered from excited delirium

depends on the type and amount of dr*gs he'd taken that day.

DR. G (VOICEOVER) We just don't look for one thing.

We don't have a hypothesis and say that this is cocaine.

No.

We're looking for everything.

You know, what really happened?

Let the toxicology speak to me.

NARRATOR A few weeks later, the final lab reports arrive.

As expected, Toby's blood and urine show the presence

of an illicit stimulant.

Cocaine.

And the level is not that of a suicidal overdose.

He's got cocaine, a pretty hefty amount,

but not like super hefty, like we'd

see with a massive overdose of cocaine.

If this man was truly trying to k*ll himself,

he wasn't very efficient at it.

NARRATOR For Dr. G, these tox results, together

with the negative autopsy findings,

leave only one logical explanation

for his sudden death.

So what we have is a man who d*ed

very suddenly after bizarre behavior,

who has recently used cocaine.

Well, that's a setup for that excited delirium.

NARRATOR And the actual mechanism of his death

may lie in the organ most vulnerable

during excited delirium.

DR. G (VOICEOVER) One minute he's kicking and thrashing.

And the second later, he is limp.

Very few things cause you to go from walking, talking one

minute to flatline the next.

And that really indicates it's his heart.

Now, why would his heart do that?

Cocaine can do this to you.

He's clearly dying from a sudden cardiac arrhythmia

brought on by that cocaine.

NARRATOR Now, Dr. G can finally explain

the strange circumstances of Toby's untimely death.

After leaving his family, Toby Holmes spends his last hours

on earth injecting cocaine.

But he's far from committing su1c1de with an overdose.

Instead, he takes just enough to fuel his addiction.

As a drug abuser, Toby's cocaine intoxication is nothing new.

Except this time, his body reacts in a shocking way.

He begins experiencing excited delirium,

a condition often associated with chronic cocaine use.

Why this time it puts him over the edge,

I can't give you that answer.

But ultimately, what's happening is

it starts causing him to get excited.

It starts causing him to have some delusional thought.

And his heart's b*ating harder and harder.
[ … ]

NARRATOR Wandering down the street,

he suddenly jumps in front of a police

car, not to commit su1c1de by cop,

but driven by excited delirium.

The police officer ends up chasing him.

The guy's acting bizarre.

NARRATOR In his drug-induced state,

Toby resists arrest with tremendous strength.

The officers struggled to restrain him,

increasing his agitation.

But when they finally managed to handcuff him--

His heart's b*ating harder and harder.

And eventually, his heart starts to quiver.

It doesn't b*at anymore.

It just quivers.

NARRATOR The quivering, or arrhythmia,

prevents the heart from pumping any blood.

With no blood circulating in his system,

Toby suddenly collapses and dies in the arms of the officers.

We need EMS, ASAP.

And then, in conclusion and in consideration

of the circumstances surround the death--

NARRATOR Dr. G files the autopsy report

as a case of excited delirium.

No officers are charged with his death.

For his family, the findings are not easy to accept.

Some of them just don't understand

this whole phenomena.

Some of them cannot believe that trauma

didn't k*ll their loved ones.

They had-- the police had to have done something wrong.

NARRATOR Coming up next, Dr. G discovers shocking evidence

in the case of a young girl who d*ed after a miscarriage.

If she had been diagnosed properly, she'd be alive.

NARRATOR And later, wedding plans come down to the wire.

Talking to the next of kin one second

and then they'd be talking about flowers.

Flower girl, my niece.

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

DR. G (VOICEOVER) Donna, this is

Dr. Garavaglia, Garavaglia-Wallace wedding

this Saturday.

NARRATOR As chief medical examiner, and a bride to be,

Dr. G's lunch break isn't about lunch.

It's about juggling two worlds.

Planning that wedding and having those phone calls come

in and you'd be talking to the deceased's next of kin one

second and then the phone would ring

and they'd be talking about flowers.

And so if you could arrange for some rose petals--

You know, and then, I'd put it down

and I'd be talking to a detective one second.

And then, you know, I'd still have to be--

you know, reminders that I hadn't picked the menu yet.

Allergic to the nuts and the dairy.

I can't believe how you remember everything.

It was kind of tipping me over the edge there.

It's just too much.

All right.

Thank you very much.

I'll-- we'll meet on Saturday morning.

NARRATOR But before long, Dr. G's lunch break is over.

And it's time to direct her attention to another case.

Thank you very much.

You've been great.

Bye bye.

All right.

We got two more.

NARRATOR Back in full work mode,

Dr. G reads the investigators' report for her next autopsy.

So we have a sad case today.

Dad.

Come on.

Get that out of here.

The decedent is Isabel Foster, an -year-old

just out of high school.

an independent spirit and avid dancer,

Isabel had her heart set on studying musical theater when

she got to college in the fall.

At the time of her death, however, she

was still living at home with her parents,

recovering from one of the most traumatic events in her life.

Seven days earlier, she'd gone to the hospital,

complaining of unusual vaginal bleeding.

And they found out she was pregnant.

NARRATOR After taking a sonogram of her uterus,

the doctor tells Isabel that her bleeding is

from an early miscarriage and that the embryo,

just seven weeks old, would soon pass naturally.

DR. G (VOICEOVER) A couple of days.

They were just gonna treat it conservatively,

just watching her.

NARRATOR Shaken by the experience, Isabel goes home.

After two more follow-up visits, her ordeal seems to be over.

The doctor finds no evidence of the embryo.

Then, just a day and a half later--

She's watching TV on the couch.

She falls asleep.

The family thinks she's just taking a nap.

NARRATOR But when they try to wake her up,
[ … ]

she doesn't respond.

Something is terribly wrong.

Isabel's father immediately calls .

And paramedics rush her to the emergency room.

But it's too late.

And she's basically dead on arrival to the hospital.

NARRATOR Isabel's sudden death stuns her parents

and fills Dr. G's mind with questions.

We have a young girl, a late teens that's dead on the couch.

I mean, what could it be?

Does it relate to the miscarriage at all?

NARRATOR Miscarriages occur in up to % of pregnancies

and are often the body's natural mechanism

of aborting an unhealthy baby.

In most cases, hormonal changes prompt the uterus

to shed its lining along with the embryo, causing

bleeding and severe cramping.

While often emotionally traumatic,

miscarriages usually cause no physical problems.

But on rare occasions, there are at least

two complications that can be fatal

and may have k*lled Isabel.

One is if the bleeding doesn't stop.

If the pregnancy does not completely miscarry, if she has

not completed the process, the patient

can lose a significant amount of blood,

and that tends to be the most common

complication that we'll see.

NARRATOR Another danger is if an infection

takes hold and sends toxic bacteria into a woman's blood.

You always do have a small risk of infection,

because you have exposure of the organisms that are

in the vag*na to the uterus.

NARRATOR Isabel's full medical records could

shed more light on the mystery.

But they're held up at the hospital.

All we're getting is what the EMS told the hospital.

NARRATOR Did Isabel die as a result of a complication

from the miscarriage?

Could the death have been prevented?

They are counting on Dr. G for answers.

As Dr. G starts the external exam,

she learns from the investigators' report

that paramedics had made every effort to revive Isabel.

She has a lot of medical intervention.

They really tried to save her life.

NARRATOR Her first task is to catalog and inspect

each item of Isabel's clothing.

As we normally do in forensic, you know,

sometimes clothing can give us hints of what's going on.

NARRATOR If Isabelle had continued to hemorrhage

due to her miscarriage, Dr. G would

expect to find bloodstains on Isabel's

underwear or sanitary pad.

But she finds nothing.

It appears Isabel was not bleeding

vaginally when she d*ed.

So maybe the miscarriage, did we get the right story?

Because I don't have her medical records yet.

And-- or maybe she's over the miscarriage?

But she certainly did have any blood in her panties.

NARRATOR Next, Dr. G checks Isabel's airways

for a possible drug overdose.

Occasionally, from drug abuse, we'll see

foam in the nose and the mouth.

But we don't always see that.

That's just kind of a little telltale sign.

It doesn't give us the answer.

Oftentimes, we see drug overdoses with nothing

in the nose or mouth.

NARRATOR Isabel's nose and mouth are clear.

But nevertheless, Dr. G will continue

exploring the possibility of an overdose later in the autopsy.

Next, as with all autopsies she performs,

Dr. G examines Isabel's body from head to toe,

searching for clues.

We didn't really expect to find anything.

You know, she looks like a normal young woman.

NARRATOR But then, she notices something very subtle.

Isabel's stomach feels slightly distended to the touch.

Could this be some kind of fluid from an injury

or undetected disease?

It could even just be changes in post-- in postmortem.

So it really is hard to tell what that little

rounded abdomen is from.

NARRATOR The answers will have to wait

until she opens Isabel's body.

OK.

You did you take her ID pictures?

OK.

So she's ready to go?

NARRATOR First Dr. G makes the standard Y incision.

When she folds back the skin and subcutaneous fat,

she immediately sees what made Isabel's belly soft.

And it's not just any fluid.

There's a major pool of blood in the abdominal cavity.

Depending on size, the average human body

contains about four liters of blood, which

flows through the cardiovascular system,

delivering oxygen to the vital organs.
[ … ]

If more than % of Isabel's blood, about . liters,

had drained into her abdomen, it would have been fatal.

And you're in shock, because you just don't have

enough blood in the vessels.

It's all accumulating into your abdomen.

And you die.

Your heart doesn't get enough blood

and your brain doesn't get enough blood.

Measure this blood.

NARRATOR To see how much blood Isabel has lost,

Dr. G methodically removes it from her body.

We ladle it out with the soup ladle that we use,

collect that, and measure it.

But I can't look at where it's coming from,

til it's all out of there.

NARRATOR The total amount is shocking.

A full two leaders had drained out of Isabel's

cardiovascular system.

OK.

Dr. G now knows what k*lled Isabel.

The young girl bled to death, internally.

That's clearly why she d*ed.

Now, we've got to figure out why that's there.

NARRATOR Coming up next, could Isabel's k*ller

be a common procedure used to treat her miscarriage?

It can result in disastrous consequences.

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

A week after doctors told Isabel Foster she had suffered

a miscarriage, the -year-old's parents

found her unconscious on the couch, never to wake again.

This would not be something we would expect.

We see blood where it's not supposed to be here.

NARRATOR Dr. G now surveys Isabel's internal organs

in situ, or in place.

She's just blood into her abdominal cavity.

Organs like her brain, her lungs, everything

looks real pale.

NARRATOR Dr. G has discovered that Isabel lost half her blood

through internal bleeding.

But how?

Often, internal bleeding is caused

by an injury to a major organ, such as the liver or spleen,

or when blood vessels are disease

or torn by broken bones.

But in Isabelle's case, Dr. G suspects

the hemorrhage could be related to the reported miscarriage.

The girl may have suffered complications

from a follow-up procedure called a D&C,

or dilation and curettage.

It's a common follow-up to a miscarriage to make

sure all the products of conception

are out of the uterine cavity.

NARRATOR In a D&C, the doctor scrapes

out the lining of the uterus.

Examining this lining can reveal why the miscarriage occurred.

As minor as it is, however, a D&C is a surgical procedure.

And up to % of cases result in complications

ranging from infections to trauma

from the sharp instruments.

The most common risks with a D&C

are perforation of the uterus.

You could have injury to organs around the uterus,

such as the ovaries, the tubes, the intestines.

So it can result in disastrous consequences,

even in the best of hands.

NARRATOR Without the full medical records,

Dr. G can't know for sure whether Isabel had had

a D&C. If she had, her massive blood loss could be

from a serious puncture wound.

To determine this, Dr. G hones in on Isabel's

reproductive organs.

And you just gently lift up some of the small intestines

and you can expose the uterus.

NARRATOR But the uterus appears intact.

No perforations from a D&C. Instead, she finds the culprit

just inches from the uterus.

Lo and behold, you can see, quite readily,

where that bleeding is from.

Clearly we had about a . centimeter defect,

a hole right in the middle of the fallopian tube.

NARRATOR Fallopian tubes are thin conduits

that carry a woman's eggs from her ovaries to her uterus.

Somehow, Isabel's left tube has been torn open.

OK.

Oh, she's OK.

Hold on.

NARRATOR Dr. G immediately realizes

what must have caused the hole in Isabel's fallopian

tube, an ectopic pregnancy.

An ectopic pregnancy is a pregnancy

that has developed outside the uterus,

outside its normal location.

NARRATOR A healthy pregnancy takes

place in the uterus, where the baby

has plenty of room to grow.

But in up to in pregnancies,

a fertilized egg on its way to the uterus

gets stuck in the fallopian tube,

either because it is too narrow or because

of previous scarring from surgery or a sexually
[ … ]

transmitted disease.

There, the embryo implants itself,

digging deeper into the tube as it grows,

until the walls can no longer sustain the pregnancy

and they rupture.

Now, a fallopian tube's very little.

It does not have the capacity to expand

or hold a baby, like a uterus.

And it just basically erodes right through it.

Fallopian tubes can never hold a baby.

They're doomed.

Let me know if it's enough.

NARRATOR Despite the risk of fetal rupture, however,

ectopic pregnancies don't often end in death.

It's rare.

We don't see these anymore.

NARRATOR That's because doctors can typically

remove the embryo surgically to prevent the fallopian

tube from bursting.

But the hospital never diagnosed Isabel's ectopic pregnancy.

Instead, they had supposedly observed

and treated her for a normal uterine

pregnancy and miscarriage.

It's a puzzling contradiction.

When she cuts open the organ, Dr. G

makes a shocking discovery.

The lining is still there.

And there is no sign that an embryo was ever implanted.

You don't see anything to suggest a pregnancy.

NARRATOR The intact lining is proof that Isabel was not

k*lled by a complication from a miscarriage,

because she never had one.

It also confirms that she never had a D&C, the follow-up

procedure that would've warned doctors

of her abnormal pregnancy.

I mean, if she had been diagnosed properly,

she'd be alive.

NARRATOR Suddenly, expl*sive questions

arise from this revelation.

How could the hospital have made such an egregious error?

This is what k*lled her.

NARRATOR Coming up next, the forensic clues

add up to devastating answers and plenty of frustration.

I don't understand how this happened, in this day and age.

NARRATOR Then, the big day finally arrives.

Are you crying?

Yeah.

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

Dr. G wraps up Isabel Foster's autopsy, her mind

already analyzing the findings.

There's no doubt that the -year-old girl

bled to death from a ruptured ectopic pregnancy.

There's a hole right in the middle of the fallopian tube.

NARRATOR But just a week ago, she had been diagnosed

with a normal miscarriage.

She'd gone to the hospital complaining of

some unusual virginal bleeding.

NARRATOR So why didn't they catch her ectopic pregnancy?

Did we get the right story?

NARRATOR The intact uterus, the two liters of blood,

the silent death.

Now, after adding up all the clues from her investigation,

Dr. G reconstructs what she believes

were the likely events leading up to Isabel Foster's death.

About a week before she dies, Isabel

begins experiencing heavy abdominal cramps

and vaginal bleeding.

Concerned, she goes to the hospital, where an ultrasound

shows no baby in her womb.

Then, instead of exploring the possibility

of an ectopic pregnancy, the doctor diagnoses a miscarriage.

I think what happened is they didn't find any u--

any evidence of pregnancy in the uterus

and assumed she was having a miscarriage

because of the bleeding.

You know, that is one of the problems that this can mimic.

It's not unusual for these women to bleed a little bit,

like a miscarriage.

NARRATOR The doctor's assumption

is a crucial mistake.

Convinced that Isabel is having a normal miscarriage,

she apparently fails to conduct some critical tests,

such as tracking hormone levels.

We want to know now, what is the level of pregnancy hormone?

When is this a normally positioned pregnancy

or an ectopic pregnancy?

NARRATOR In addition, for unknown reasons,

the doctor also decides against doing

a D&C. Without this follow-up, she doesn't realize

that the pregnancy was never in the uterus

and Isabel's condition remains misdiagnosed.

Within a few days, the cramping and bleeding subside and Isabel

believes her miscarriage is over.

But in fact, the embryo is still there,

inside her fallopian tube.

It's been growing now for seven weeks,

stretching the tube beyond capacity.

When the tube expands, there may be some temporary relief

of pain, which sometimes can be misinterpreted by the patient

as everything getting better.
[ … ]

NARRATOR Instead, the danger only

gets worse, until, finally, the walls of the tube give way.

Then, she bleeds out.

And she bleeds out through the fallopian tube.

NARRATOR Half a liter, one liter, a liter and a half.

Undetected, the hemorrhage becomes fatal.

And the blood is spilling out from the hole.

You're not getting enough blood to the brain.

And eventually, you pass out.

NARRATOR Right there on the couch, Isabel slips into shock.

By the time her parents realize something is wrong,

it's too late.

She's lost too much blood and she dies.

Despite what appears to be a series of errors,

Isabel's parents never bring charges against the doctor

or the hospital.

But for Dr. G, the bottom line is clear.

If you're diagnosed prior to it breaking open,

there's no reason you have to die from this.

They have good ways to treat this.

I don't understand how this happened, in this day and age.

It's really not my job to put the blame, but on this one,

she sure fell through the cracks with medical science.

I wish somebody would've picked up on this.

NARRATOR Another case, another workday is over.

And now, it's finally time for Dr. G

to leave the dead and celebrate life with her loved ones.

I'm always very happy to be in the morgue.

There's no question about that.

I'm very thankful that I live in a world that shows

me how important living is.

But once in a while, I'd like to feel thankful not because I'm

standing next to a dead man with multiple g*nsh*t wounds,

that I'm thankful that I'm looking over a beautiful scene

at the ocean.

Are you gonna cry you think?

Yeah.

Just don't go [wiping].

I was very, very worried coming up to the wedding.

There is no question I wanted to marry Mark.

He's the love of my life.

But I love my boys and my older boy

was having a very hard time that I had divorced his father

and now I'm marrying somebody different

and bringing somebody different in their lives.

And he pretty much told me he wasn't going to accept it.

And-- and I had to respect that.

But he's such a beautiful kid.

I mean, at first, he was not gonna

come to the wedding at all.

And then, at the last minute, as I'm

walking out to the ceremony, I saw him sitting there.

And that meant a lot to me.

My younger one, you know, you always

worry how they're accepting it, but he's very, very loving.

And he's the one that walked me down the aisle.

I have enough love for all of us.

And once they see that I'm not gonna

lessen their love just by loving Mark, I think they're--

they're accepting more that we could be a family unit.

Mark, I've never felt as happy and in love as I am with you.

I really believe our love's a gift from God.

I vow to love you with all my heart, until the day I die.

He asked me to marry him approximately years ago.

And you know, I said no.

And I had regretted it the rest of my life.

I vow to be faithful and honest and true to you and myself.

I was thinking with my mind instead of my heart.

I was a scientist.

That's what I was trained to do.

I thought that was the way to do it.

That's how you planned your life.

But sometimes, I guess I'm proven wrong that, you know,

the matters of love don't necessarily--

are something you should do with your mind.

Sometimes you have to follow your heart.

You may kiss your wife.

Thank you, Alex.

Give me a little Dr. G.

Dr. G.

DR. G (VOICEOVER) There is something

outside besides this morgue.

There's something else in life besides my kids

and my morgue-- and the morgue.

That is just wonderful.

They want the U incision, not the Y.

Any wishes for Dr. Mark?

Good luck.

Just kidding.