06x09 - Deadly Dive

[bunniefuu]

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NARRATOR A mother comes face to face

with her worst nightmare when she finds her son

under six feet of water.

I imagine that's the worst feeling

in the world to see your child at the bottom of the pool.

NARRATOR But when the clues don't add up,

Dr. G is forced to consider a horrific scenario.

Maybe somebody just throw in the water

to disguise his death.

NARRATOR Then a train engineer panics when he spots

a man lying on the tracks.

It takes almost a mile for a big train to stop

and he clearly hits him.

NARRATOR Now it's up to Dr. G to piece together

how and why this man d*ed.

Is it a su1c1de, is it an accident, is it a homicide?

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NARRATOR Altered lives, baffling medical mysteries,

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

medical examiner.

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It's early morning in Orlando, Florida

and the district morgue is already abuzz with talk

of the day's cases.

WOMAN What's all the dots on his back?

I think he's got petichial hemorrhages all over.

It's a busy day in the morgue.

We got homicides, we got unknown deaths, we have drug overdoses,

we have a woman who might be su1c1de, might be a natural.

NARRATOR It promises to be a heavy workload so Dr. G waste

no time prepping for her first case

of the day, a -year-old apparent drowning

victim named Joey Lucas.

This is a sad case that unfortunately we

see all too often in spring and summer here in Florida.

We average, just my jurisdiction, about

a year of children who die from drowning.

I don't know what we're going to find

but hopefully we'll see why he is found

at the bottom of the pool.

NARRATOR It's a hot Tuesday night in the quaint suburb

of Winter Park, Florida.

Phil McGovern is heading off to bed

when he notices -year-old Joey Lucas swimming in the pool

next door.

The timing's a little interesting.

The neighbor sees him swimming at around midnight

and nobody else is out there.

NARRATOR Phil is surprised to see Joey swimming so late

at night but thinks little of it since he

often sees him in the pool.

A few hours later, Joey's mother wakes up

to get ready for her early morning shift at the diner.

She peeks into her son's room to check

on him but to her surprise, he isn't there

or anywhere else in the house.

As a last resort, Linda goes outside

to check the place Joey spends most

of his spare time, the pool.

And then she opens the door and steps out on the patio,

she comes face to face with a mother's worst nightmare.

She finds him at the bottom of the pool.

I imagine that's the worst feeling

in the world to see your child at the bottom of the pool

not moving.

NARRATOR Phil hears Linda screaming, rushes over to help

and calls .

Within minutes emergency workers arrive and desperately trying

to revive the -year-old.

They transport him to the hospital,

but it's already too late.

[beeping]

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NARRATOR Now Joey's body and the investigators report

are in Dr. G's hands and Joey's family

is counting on her for answers.

Today we have a real sad story.

This is a boy that's found at the bottom of the pool.

The family says he's a very good swimmer.

They say he likes to play Diver Dan rescue in the pool.

And sure enough, in the pool was the mask,

the diving mask and a snorkel.

Oh, boy.

Now there's some really sad facts about this case.

For one, this little boy is depressed, for a good reason.

NARRATOR According to the investigators report,

at just years old Joey Lucas has already had a hard life.

This is a child who's only that's given

way too much responsibility.

He is pretty much made to take care

of the father who's a partial quadriplegic

from an automobile accident.

And unfortunately, the vast majority of his care

falls on this young boy.

His mother has got some mental issues

and he doesn't appear to be very well supervised.

In some ways you think that he's got

all of these responsibilities and he's

made to grow up so fast but on the other hand,
[ … ]

we hear that he likes to play games in the pool

and pretend he's a diver rescuing people.

It's a sad juxtaposition of those two stories.

NARRATOR But as she reads on, it only seems to get worse.

He has used marijuana before.

And he has been given sleeping pills in the past.

A -year-old should not be given sleeping pills.

What's going on in this child's life?

Why is he there swimming at midnight?

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

And at the top of her list of suspects is accidental trauma.

Possibly he's running around the pool

and he trips and falls and hits his head

or he dives into the pool and hits his head.

NARRATOR But there are a number of ways

even strong swimmers can get into trouble in the water.

Maybe he's holding his breath to stay

underwater for an extended period of time

and you can pass out.

If nobody's around to see this, you're going to drown.

Kids need supervision in the water, even strong swimmers.

NARRATOR And despite his young age an apparent clean bill

of health, Dr. G will also be on the lookout

for natural disease.

Although we don't expect it would kids,

they can have a heart att*ck, they can have a seizure.

And if you have a heart att*ck or you have a seizure,

you may who survived it on land but you may

not survive it in the water.

So we're always going to be looking

for that when somebody drowns.

NARRATOR But given Joey's history of depression,

Dr. G must also consider an even more tragic scenario.

I'm a little worried that he's got ready access

to a lot of pills in the house because I could

see this poor kid taking a bunch of medication

and then going swimming and drowning.

NARRATOR Still taking into account

all of the circumstances, Dr. G can't ignore

the possibility that Joey simply fell

victim to some form of abuse.

Maybe

They couldn't take him anymore and so

you know they strangle him and throw him into the pool.

We must rule out child abuse.

All right we're ready, right?

Yes.

When you have a drowning case it is unwitnessed,

oftentimes you don't know exactly what happened

and you never will.

The only thing you can do is piece together

a possible scenario but you probably will never

have the definitive answer.

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Okey dokey, let's go for it.

We look very carefully on the external examination

because you don't know what it's going to tell us.

You know, that's the first step in determining what happened.

All right, let's see.

So I'm surprised when I see him.

Not only was he given responsibilities way older

than he should have had, he looks older.

This -year-old boy is foot

and he looks more like a or -year-old.

Gosh.

NARRATOR As her gaze moves downward,

Dr. G has her eyes peeled for any visible signs of abuse.

We're going to look for bruises about the face,

the mouth, the neck.

NARRATOR Inch by inch, she scans the year old's body.

Not a mark on him.

I don't see any evidence of trauma.

I certainly don't see any evidence of struggle

but that could be at fault too.

There is some subtle trauma that can

k*ll children that may leave very

little marks on the outside.

For a -year-old, he sounds pretty precocious

and he looks precocious.

So I'm looking for everything.

I'm looking for previous su1c1de attempts,

I'm looking for even drug use.

OK, does his hands look black?

NARRATOR She begins by checking for horizontal cuts or scars

across the wrists.

No evidence of any kind of previous su1c1de attempt.

NARRATOR Then she scans the body

for evidence of drug use like bruised needle puncture marks.

I don't think he injects.

I don't see any vascular scars, I

don't see any needle puncture marks,

I don't see anything abnormal.

Nothing.

NARRATOR So far the external exam

has revealed nothing of note.

But then a subtle clue catches Dr. G's eye.

Do you see these?

His hands aren't wrinkled and his feet aren't wrinkled.

It made me think he probably wasn't in the water

all that long.
[ … ]

And now, that was interesting.

NARRATOR For Dr. G, this brings the most horrific possibility

to the forefront.

Maybe somebody just throw them in the water

to disguise his death.

I mean, that is paranoid thinking

but that's why I get paid.

I get paid to always think of the worst,

could the worst of happened?

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NARRATOR Dr. G has just discovered a disturbing clue

in the case of Joey Lucas, a -year-old suspected

drowning victim.

He didn't have any wrinkling of his hands and his feet.

NARRATOR And this makes her wonder if there could be

something more sinister afoot.

Maybe somebody just throw them in the water

to disguise his death.

I doubt it, his snorkel is there, his mask is there

and the neighbor saw him swimming.

We have a child that's dead and we don't know what to believe.

So where we go from here is we'll

start at he head and we'll look to see if there's any trauma.

OK.

I'm looking for everything.

It could be blows to the head, could be delayed trauma

or maybe diving in, hitting his head, going unconscious,

that sort of thing.

When I reflect the scalp, I don't

see any evidence of contusion, I don't see any skull fractures.

Next, morgue technician Tom Hemphill assist Dr. G by sawing

through the skull itself.

I take the calvarium off.

No evidence of hemorrhage, no evidence of trauma.

I also look for any kind of evidence that may

have precipitated a seizure.

Although he has no history of seizure,

maybe there's some anatomic problem with his brain

that may have caused a seizure.

If you have a seizure in the water and nobody's around,

you're pretty much going to drown.

Once I get in and look at the brain,

his brain for the most part looks completely normal.

NARRATOR Unfortunately after an extensive cranial exam,

Dr. G still has little to go on.

I found nothing that I could pinpoint

to his head that would have caused

him to drown in that water.

So we'll have to wait till we get into the internal

and see what's there.

So I do my Y incision, of course,

looking for trauma the whole way.

Maybe evidence of falling on the side of the pool,

breaking a rib, puncturing a lung, puncturing his spleen,

all of those are possibilities.

Explains it, OK.

That all looks normal, don't see any trauma whatsoever.

There's nothing there.

NARRATOR Now it's looking less likely

that Joey suffered either an accidental or inflicted injury.

But Dr. G can't rule it out for sure

until she examines his neck at the end of the autopsy.

All right.

But at this point I want to make sure it

still looks like he drowned.

NARRATOR Next, Dr. G head straight

to the lungs looking for the telltale signs of drowning.

Usually you see a very heavy lung,

very wet lung, frothy fluid coming up the trachea.

The lungs weigh sometimes twice, three

times what they normally do.

But this problem is there's no really great test for drowning.

Because sometimes in drownings, the lungs are quite dry.

The water starts going down the trachea

and there's almost a spasm that occurs

and the water doesn't fill up the lungs.

And even though we pull them out from under water,

the lungs are remarkably not wet.

NARRATOR But just one glance at Joey's lungs

tells her this isn't the case.

Nice heavy lungs, consistent with his suspected

mode of death.

Our guy's lungs are pretty classic for a drowning.

His lungs are just full of fluid.

They're wet, they're heavy.

NARRATOR With these findings in hand,

Dr. G can finally rule Joey's official cause of death

as drowning.

Well, I think we have our cause of death.

So now we have to question what are the factors

that caused him to drown?

Is there anything we can find that played

a role in his drowning?

NARRATOR And with no shortage of possibilities,

an overdose is still high on her list.

Time to take the toxicology because I'm

very worried about access to those pills

and his history of depression.

So I remove urine, I removed blood.

All of that will be sent to toxicology.
[ … ]

NARRATOR But she'll have to wait

several weeks for the results.

In the meantime, even though she's established a cause

of death, Dr. G must finish her examination

of Joey's major organs.

I'm expecting all of his organs to look normal, as they

should and a -year-old.

Is this accurate?

But much to my surprise, there's something abnormal.

So just to clarify, .

His heart is twice as big as it should be.

NARRATOR And as she dissects the muscle,

Dr. G spots another abnormality.

The heart muscle of the left ventricle is thickened

and his septum, the heart muscle between the left ventricle

and the right ventricle, is asymmetrically thickened.

He has a classic hypertrophic cardiomyopathy.

Hypertrophic meaning a big heart.

And it's a big heart due to a thickened muscle.

This is a genetic mutation that he inherited

from one of his parents.

If anything, there is one important thing

that comes out of this autopsy.

The family needs to know that their child had

this congenital abnormality.

He was at risk for sudden arrhythmias and sudden death.

At this point, I think that I at least have one possibility

of why he drowned in that pool.

NARRATOR But the investigation doesn't stop here.

An arrhythmia leaves no trace evidence in the body

so the only way to know if Joey's heart is to blame

is to first rule out everything else.

I'm looking for anything that would tell us

anything more about this child.

What do we got left here?

NARRATOR And the last stop in the autopsy

is the neck where she'll be on the lookout

for any sign of accidental or inflicted trauma.

So I do a dissection of the neck,

both the strap muscles, the trachea

and then the spinal cord.

But he has no evidence of a broken neck

and he has no evidence of any kind of strangulation.

NARRATOR Dr. G has now safely ruled

out both a fatal diving accident and foul play.

He probably drowned as a result of an arrhythmia

with his cardiomyopathy.

NARRATOR But just as she's about to close the book

on Joey's internal exam, chief medical investigator

Steve Hansen rushes in with an unexpected piece

of information.

Well as I'm wrapping up the autopsy

and I really think I have this under control,

my investigator comes in with a new twist to the story.

Oh my!

I don't know what's going on.

[music playing]

Oh my!

NARRATOR Chief medical investigator, Steve Hansen,

has just made a startling new discovery in the case

of -year-old Joey Lucas.

The mother found a propane t*nk in the skimmer.

It's one of those little propane tanks

that you use was one of those portable gas stoves.

Well-- now that makes me think, oh, this guy

was playing Diver Dan rescue.

Was he using that propane t*nk as a pretend oxygen t*nk

or something more sinister?

I'm glad I had that information before I sent blood

to the toxicologist because propane isn't routinely picked

up in our toxicology screens.

Let's see what the tox shows first.

So I'm hoping toxicology is going to give me the answer.

NARRATOR Five weeks later, Joey's lab work finally arrives

at the district morgue.

When we get the tox back, we see the sleeping medication,

the diphenhydramine, an antihistamine

that's often used to sleeping.

It was a fairly high level, but it was OK.

But there is something else on that toxicology

that's quite disturbing.

His blood is testing positive for propane.

You just have to shake your head.

There is just so many facets of the story that are sad

and this is just one more.

And I think that's the final piece of the puzzle.

[music playing]

NARRATOR It's just before AM on a school night

and Joey Lucas has had a long, difficult day.

So he heads outside to the backyard

pool for a much needed escape.

He's got tremendous responsibilities

put on his shoulder and a very dysfunctional family.

He's clearly unsupervised and he has a history of depression.

This is a recipe for disaster.

NARRATOR Unfortunately on this night, it all comes to a head

when Joey's favorite game of Diver Dan rescue

goes tragically beyond child's play.

He's huffing, he's huffing propane in the pool.

With his history of marijuana, I am
[ … ]

not that naive to think that he doesn't know what he's doing.

I suspect that he's huffing that propane on purpose to get high."], index ,…}

NARRATOR As he breathes in the propane,

it prevents oxygen from reaching his brain

creating a feeling of euphoria.

But unbeknownst to Joey, the dangerous chemicals are also

having an effect on his heart.

The propane will actually sensitize

your heart to adrenaline.

And with any kind of exercise, it'll

also have a direct effect on your heart

that may precipitate arrhythmias.

NARRATOR And coincidentally, Joey's undiagnosed heart

condition has already put him at an increased

risk for sudden death.

We have two deadly mixes, huffing

propane and an already enlarged heart from a cardiomyopathy.

That is a setup for a cardiac arrhythmia.

NARRATOR Joey's damaged heart soon

goes into overdrive as it struggles to pump

blood to his vital organs.

And it isn't long before it begins to b*at erratically.

He has a cardiac arrhythmia.

He's in a pool.

He has no chance of surviving.

He passes out and drowns at the bottom of the pool.

[music playing]

Even though I figured out what happened to him,

I never really figured out why he didn't

have wrinkled hands and feet.

Perhaps it was just as youth or they

dried out before I saw him.

Sometimes you just can't figure out all the answers.

Ultimately, I rule the case a drowning

associated with propane use and an enlarged abnormal heart.

NARRATOR It's a tragic end to a young life.

And for Dr. G, this case serves as a reminder

of the growing problem of inhalant abuse

among adolescents.

Huffing, believe it or not, is the second most common drug

of abuse for young teenagers.

They take common household chemicals, anything that they

can sniff of huff, that can cause a high for them,

a temporary high, euphoria.

But unfortunately there's some definite dangers

associated with it.

These can k*ll.

Kids need to be watched, I don't care how mature they act.

A -year-old is a -year-old and he still

needs parental supervision.

I just pray that your own don't make such stupid decisions.

So Eric and I will have a talk tonight,

it'll be about the stupid decisions, it'll be about the

better not be using dr*gs or I'll

go after them with a scalpel.

Our kids are only young once and we just

have to put all our effort in getting

them to adulthood intact.

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NARRATOR Tragically, child deaths can often

be the result of a lack of experience

and poor decision making.

But the case of -year-old Andy Santana

supports Dr. G's belief that older is not always wiser.

This goes in the category of bad men behavior.

Trying to b*at a train, trying to walk in the train tracks,

trying to sleep on a train tracks, not a good thing to do.

[music playing]

Going to turn on your lights.

[music playing]

NARRATOR As chief medical examiner of Osceola and Orange

Counties, Dr. G sees her fair share

of motor vehicle fatalities.

Oh we got three today.

These two must have been really going fast.

I don't think there's an inch on this girl that isn't bruised.

I'll get out of your way so you can take the pictures.

NARRATOR But it's surprising how

many railroad related accidents come

through the morgue each year.

Railroad deaths are not that uncommon.

As it turns out, we probably get a couple a year.

Oftentimes they're just devastating injuries

and they take a lot of work doing the autopsy,

trying to figure out the injuries.

[music playing]

So today we have a -year-old Hispanic male

who's just gotten off of work, works

at a citrus packing plant.

He usually crosses the railroad track, gets a beer

and then waits for his girlfriend to pick him up.

NARRATOR But on this fateful Wednesday,

Andy Santana's daily routine takes an unexpected turn.

His girlfriend states that he called her

but the guy at the gas station said,

didn't buy his beer today.

The next we know, he's next to the railroad track

and here comes an oncoming train.

NARRATOR The train's engineer can hardly believe his eyes

when he spots Andy lying face up on the tracks
[ … ]

less than feet in front of him.

He describes him as having his head on the rail,

he's on his back.

He tries to blows whistle but it takes almost

a mile for a big train to stop.

[train whistle]

And he clearly hits him.

And they actually found his body about

feet from where the engineer said he impacted him.

Of course, the engineer is devastated

and it's very disturbing to him.

He has a lot of guilt about this and he would

like to know what happened.

NARRATOR In the meantime, Andy's grief stricken family

and girlfriend are also counting on Dr. G for answers.

They want to know why he d*ed and that's

ultimately why I'm here.

[music playing]

He's a good looking boy.

NARRATOR As a first step, Dr. G calls through the investigators"], index ,…}

report.

The history of this fellow is he started drinking

and smoking as a teenager.

In fact, his long term girlfriend

left him about six months ago because of alcohol and drug

use.

He's got a new girlfriend that he lives with

and the drinking problem continues.

He's got the nicotine patch.

We know that he drinks heavily.

Could it have been an accident that he was

passed out on the road track?

That is actually the biggest percentage of people getting

k*lled on train tracks, are people who are intoxicated

and sleep on train tracks.

NARRATOR In fact over % of all railroad

deaths are ruled as accidents with the majority of them

being alcohol or drug related.

In my experience, the vast majority of them are men.

This goes in the category of bad men behavior.

Trying to b*at a train, trying to walk in the train tracks,

trying to sleep on a train tracks, not a good thing to do.

When I was in Texas, we knew the local culture

for some of the illegal aliens that were coming across,

they'd sleep on the railroad tracks

to make sure the snakes didn't get them.

Thinking that they would wake up from the vibrations of

the train to get out in time.

They were more afraid of the snakes than the train.

NARRATOR But the gas station attendants statement

makes Dr. G question whether Andy

was drunk in the first place.

We know that he just gotten off

work about minutes earlier according to his girlfriend,

but we know from the attendant at the gas station

where he usually buys his beer, he didn't show up today.

NARRATOR Now Dr. G must consider the possibility

that Andy wasn't drunk and his tragic death was no accident.

When anybody hears death and been run over by a train,

they're thinking the worst.

They're immediately thinking, could it have been a su1c1de.

So we need to look at what's going on in this life.

Does he have any history of previous su1c1de attempts?

Does he have a history of depression?

Why anybody would choose to jump in front of the train

to commit su1c1de, I don't know, because there

is a good chance you may not die but you

may live with no arms or legs.

You may end up living in a vegetative state

with severe head trauma.

It isn't always an instant death.

NARRATOR Unfortunately, Dr. G must also consider

a more sinister possibility.

According to his girlfriend, he uses illicit dr*gs.

If you use illicit dr*gs, that means you buy illicit dr*gs.

If you buy illicit dr*gs, that means

you are in contact with people doing illicit things.

If you are in contact with people doing illicit things,

there's a chance you're going to die from it.

It could be a homicide.

They k*ll you and place your body on the railroad track

to make you think it's an accident.

So there is a chance that maybe he just got m*rder*d.

NARRATOR And finally, there's one last thing

she must keep in mind.

There's always a bicycle is something devastating

natural happened to him.

You know, that is something we just have to rule out.

It can be an accident, It can be a su1c1de,

or it could be a homicide.

So those are all the avenues that we're going

to have to kind of weed out.

[music playing]

When I first look at the body, I'm actually surprised.

He's incredibly good shape for being hit by a train.

He's got a pair of jeans on him that aren't even torn, soiled.

He's got a t-shirt on and he's got some definite injuries

to the head.

I need the head, I need a head sh*t.

He's got about a five inch laceration
[ … ]

a couple inches above the ear and there's brain oozing out.

That's pretty much all he's got to the scalp.

And then he's got some abrasions on his face, mostly

the right side.

Those abrasions to the face are from him

being thrown onto those rocks.

Clearly this is a severe impact because we

have a probably , pound locomotive going down

the track, impacting his head, throwing

him off the train track.

And all we really see externally is a five inch laceration.

NARRATOR Dr. G then looks closely

for any signs of Andy's drug use or previous su1c1de attempts.

Of course I'm not going to see a drug overdose

but I would see previous attempts at maybe slitting

his wrists or his throat and I certainly don't

see any evidence of scars.

NARRATOR But when she turns Andy's body over,

she spots another more curious injury.

He's got an abrasion to his upper back.

About inches long about two inches wide and it

just is kind of a scrape abrasion.

NARRATOR Dr. G knows this injury could very

well be from the train but at this point

she can't assume anything.

It certainly raises the possibility

he was beaten but I don't see any defensive wounds as

if he'd been struggling.

No other bruises, no other abrasions, nothing

on his hands, nothing else.

I don't see anything, but just because I don't externally find

a g*nsh*t wound, just because externally I

don't find a s*ab wound, he could still die from a blow

to the head.

He could still have been strangled

and placed on the track.

So not until I do that internal exam will

I really be able to rule anything in or out.

[music playing]

Where is Sandy?

What are you doing, Sandy?

NARRATOR Dr. G is preparing to autopsy

the body of -year-old Andy Santana who was hit by a train

yesterday in Kissimmee, Florida.

What's he doing on the railroad track?

Is that a su1c1de, is it an accident, is it a homicide?

[music playing]

The first thing I need to do is document the injuries.

Yeah, that head a mess.

I know he's got brain coming out of his head

and I can see the laceration but when you look and put that

with the scene, you can see that the train

has a small amount of blood right

on the side of the cow catcher.

The cow catcher is that piece of metal

on the front of the train, it kind of sweeps the track.

I go ahead and reflect the scalp.

Underneath that laceration he has a depressed skull

fracture where the cow catcher just

broke in and dented his skull.

This then causes the base of the skull

to fracture from side to side.

It's a hinge and that it breaks the skull in half.

Those hinge fractures along the base of the skull

are very common from massive side impact injuries.

NARRATOR To get a look at the brain, morgue technician,

Bryan Mulhusky cut through what remains of the fragmented bone.

When I take that calvarium off,

I can see the lacerated torn brain

underneath that depressed skull fracture.

It's torn the dura.

NARRATOR Carefully Dr. G carries

the damaged organ to the dissecting table

for closer inspection.

I look at the brain still to make

sure there's no natural disease, nothing

that would have made him collapse on the railroad track.

Like a bleed in his brain or aneurysm burst

and that is something we just have to rule out.

Somebody could have some crazy, loony theory that, you know,

maybe this is because he blew an aneurysm right as he's

walking on the railroad track.

You know, hey, if they come up with the theory,

I have to be able to have the facts to say

it happened or didn't happen.

Just normal looking.

NARRATOR But after a thorough dissection,

she comes up empty handed.

There's really nothing here.

Well the end of the cranial, we have a massive head injury

caused by a single blow that was consistent with the cow

catcher.

And what it appears to have happened

is that cow catcher caught this head and the scalp,

probably part of his shoulder as he's turning, scraping,

and then getting thrown.

NARRATOR Dr. G now knows that all of Andy's injuries,

including the strange abrasion on his upper back,

were caused by the train.

But she still needs to know if he was alive or dead
[ … ]

when the train hit him.

There's always the possibility that it he m*rder*d and dead

and then put on the railroad tracks to disguise

the homicide as an accident.

We need to see if the injuries that the train caused

have hemorrhage associated with them.

That would mean that his heart was b*ating

and he was alive when the train hit him.

But if we see the injuries and there's no hemorrhage

associated with that, then we know his heart's really

now b*ating and possibly he was dead or dying

and placed on the railroad tracks.

[music playing]

Give me a scalpel with a--

NARRATOR Using a scalpel, Dr. G slices

through the tissue of Andy's chest

and performs a standard Y shaped incision.

So I do my Y incision and it's unbelievable

that he has no trauma.

Lord, he has no trauma underneath the skin.

He's got no trauma to the muscles.

NARRATOR Dr. G then surveys Andy's organs

in situ or in their natural place in the body

for any abnormalities.

Let's see what's going on here.

He has really no natural disease.

Anything interesting?

Except for one thing, his liver.

He has a nasty looking liver.

His liver is enlarged, it's fatty, it's round,

and you can see by even palpitating it that he's

got an increased amount of scar tissue,

he's got early cirrhosis.

He's clearly an alcoholic.

So that fits what the girlfriend tells me.

But nothing that would have really k*lled him at this.

Point you want to get the tox?

NARRATOR Then she draws samples of Andy's blood

that will be sent to a lab and tested for the presence

of dr*gs and alcohol.

We really need to get our toxicology

and hopefully that may give us some kind of answer.

NARRATOR But the results won't arrive for several weeks.

In the meantime, she turns her attention

to Andy's heart and lungs.

His heart was completely normal.

He doesn't even have any coronary artery disease.

He has no natural disease to his lungs besides the evidence

of smoking.

He doesn't have any cancer, he doesn't have any emphysema,

he's only .

Smoking I'll get you but it'll get you a little later.

NARRATOR Now with the chest cavity clear,

Dr. G can finally examine the wound on Andy's

back from inside his body.

You can see the second and third rib fractured

on the back, right underneath that area of abrasion,

and a large amount of hemorrhage.

Underneath the pleura is that thin coating

that surrounds that cavity, you can see a massive amount

of hemorrhage under there.

What it tells me is that he's clearly alive when he got

hit by the train.

NARRATOR To confirm this finding,

there's still one more step left in Dr. G's autopsy.

We're going to have to flip him.

Ultimately when I'm done with the autopsy,

turn him over, incise that abrasion

that I could see on his back and see a tremendous amount

of hemorrhage in the muscle of that upper back

where that train hit him.

NARRATOR And with this, Dr. G has the conclusive answer

she's been looking for.

Clearly the cause of death is due to the blow to the head

from that cow catcher that hit his head.

Once the autopsy is done, we've narrowed our possibilities.

As soon as I see that hemorrhage and that he was alive when he

was on that train tracks and the rest of the autopsy

showed no other trauma, I can rule out homicide.

I have not ruled out su1c1de or accident,

we need some other facts.

I'm done with him.

We need to talk to his family members

and we need to paint a picture of what's going on in his life.

NARRATOR Dr. G reaches out to Andy's mother and girlfriend.

We talked to the girlfriend who clearly stated

that he has an alcohol problem.

That she'd been living with him and no evidence of su1c1de.

No evidence of even depression.

We then confirm that with his mom.

NARRATOR Based on this information,

su1c1de is looking less likely.

But if Andy wasn't looking to take

his own life, what would he be doing lying

face up on the train tracks?

Dr. G will need to wait for the toxicology results

for a definitive answer.

What evidence do we have of su1c1de?

What evidence do we have for accident?

Do I have a preponderance of evidence
[ … ]

of one way or the other?

I don't know, but the tox may answer those questions for us.

[music playing]

NARRATOR It's been three long weeks since the autopsy

of -year-old Andy Santana, who was k*lled

instantly by an oncoming train.

So far, Dr. G's found nothing to explain why Andy was

on the train tracks to begin with,

which she's hoping his lab work may hold the answer.

The toxicology is going to help

tremendously because as a forensic pathologist,

we look at patterns.

We look for patterns of injuries but we also look at patterns

of how and what people do.

NARRATOR Today the long awaited toxicology

results have finally arrived at the district morgue.

When I look at the drug tests, he has no illicit dr*gs.

He's at the ubiquitous caffeine and nicotine from smoking

cigarettes and drinking coffee.

NARRATOR But as Dr. G's eye moves down the page,

one number grabs her attention.

And with this critical piece of information in hand,

she can finally close the book on the tragic case

of Andy Santana.

Knowing his history, knowing that he was alive

when the train hit him, there is no other trauma, no natural

disease, we've seen it before.

[music playing]

NARRATOR It's around PM on Wednesday

evening when Andy Santana finishes his day's

work as a citrus packer.

And waits by the train tracks for a ride from his girlfriend.

When we get the toxicology report,

we see that he's highly intoxicated.

He's got above a . in his blood.

The legal limit for driving is a ..

Whether he was drunk at work, it's hard to say

and we never can figure out where he's getting that alcohol

but when we relook at the scene pictures,

there's a big bottle of beer sitting next to him.

NARRATOR Where Andy got the beer

and how he was able to get so drunk on the job

may remain a mystery.

But once under the influence.

the -year-old makes a tragic and fatal decision.

He's waiting for his ride and decides to rest next

to those train tracks and that rail just

happens to prop his head up as a pillow

and he probably falls asleep.

NARRATOR Moments later, an oncoming train comes

barreling down the tracks.

Because he's highly intoxicated with over a .,

he doesn't hear that train.

He would have a decrease in perception of things

around him, he would have slurred speech,

he would be not as coordinated.

He didn't have time to get up off of those tracks.

That train comes upon him, the engineer

sees him only feet before he hits him, can't stop in time.

The cow catcher then hits his head, throws him feet.

He gets some abrasions on his face and a lethal blow

to the head.

And it's an accidental death, I do

not believe he intended to die.

And if you look at where he is on those railroad tracks,

he's at a spot where he can still

see the area where his girlfriend

comes to pick him up.

I think it was just a nice resting spot for him.

[music playing]

NARRATOR With the case finally closed,

Dr. G reaches out to the train engineer

to assure him that he was in no way

responsible for Andy's death.

At least he knows this wasn't his fault.

There's really not a lot that could have been done.

NARRATOR And then she makes the difficult call

to Andy's loved ones.

Hi, this is Dr. [inaudible]--

They're happy that I didn't call it a su1c1de

because they didn't believe it was and nor do I.

But they're left with an accident which they

have a hard time understanding that he

would do something so stupid.

But when you have that high of an alcohol level

and we have that pattern of behavior seen time

and time again, and I explain that to them,

they put it together.

I'm really sorry.

Sometimes there is you know behaviors

that people don't understand.

I mean, who'd have thought that we find

people intoxicated just resting on railroad tracks,

but we see it.

When I tell people that we see cases like this,

they have a hard time believing it.

All right, bye bye.

But it's just another way for alcohol in one way

or another can get you.

[music playing]