07x03 - Playing with Fire

[bunniefuu]

[music playing]

NARRATOR When a -year-old man erupts

in a violent rage at his brother's birthday party,

everyone is taken aback.

He's screaming, he's angry, very agitated.

NARRATOR But when he collapses to the ground

and dies only moments later, his family

can hardly believe their eyes.

DR. G I can't imagine what they're going through.

They deserve an answer.

NARRATOR Then, a pregnant woman dies

suddenly leaving her husband and parents in a state of shock.

DR. G The families lost two in one.

That's two individuals in a family at once

that they're grieving for.

NARRATOR But the case gets stranger by the moment

as evidence suggests the young mother may have

been keeping a deadly secret.

She was playing with fire, and unfortunately, it

didn't work out for her.

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

These are the everyday cases of Dr. G., Medical Examiner.

As one of America's top forensic pathologists,

Dr. Jan Garvaglia encounters all types of deadly diseases.

This is a sick, sick [inaudible]..

That is just a shame.

NARRATOR But there's one that she

always finds especially tragic.

DR. G It's been called one of the most devastating illnesses

to mankind, not for just what it does to the person,

for what it does to the family.

NARRATOR And unfortunately, one of its victims

has just arrived at the district nine morgue.

It's a warm spring afternoon in Saint Cloud, Florida,

and -year-old John Gardner is enjoying

the day with his family, grilling and playing baseball.

DR. G He's at his younger brother's birthday party.

The family's over there.

They're out in the backyard, and they're

just having a good time.

NARRATOR But without warning, John's behavior

suddenly changes.

DR. G He becomes extremely violent, extremely aggressive.

He starts attacking one of the cousins.

And then says he's going to go get the baseball bat

and k*ll her. - Bash your brains.

I'm just gonna drive it right through your forehead.

I'm getting the bat. I'm gonna--

DR. G The family tries to bring him to the ground to keep

him from getting the bat.

But during this struggle, he collapses

and becomes unresponsive.

[sirens wailing]

They immediately call EMS, but any attempts of resuscitation

are all in vain.

He dies.

[music playing]

[sirens wailing]

NARRATOR Now, shaken by their sudden loss, John's family

looks to Dr. G for answers.

And she can't help but wonder if they may have somehow

contributed to his death.

DR. G Did they play a role in his death or not?

It's definitely something we need to answer.

OK, so--

NARRATOR As a first step, Dr. G.

reads through the investigator's report.

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

He does have schizophrenia.

That's a shame.

DR. CARLOS RUIZ Schizophrenia is a disorder where

A person has problems with their thought process,

and as a result, can sometimes exhibit

bizarre, strange behaviors.

DR. G They have paranoid thoughts

that people are after them.

They hear voices in their head.

NARRATOR Given this history, Dr. G.

wonders if John's death may have had something

to do with his mental illness.

DR. G People with schizophrenia have

a decreased life expectancy.

They have an increased incidence of many different kinds

of natural disease mostly because of their lifestyle.

They're usually chainsmokers.

They're obese, and they don't take

very good care of themselves.

It's going to take me a while to read this.

NARRATOR Sure enough, the medical records

confirm that John fits this profile

to a T. He's overweight, a heavy smoker,

and has a history of hypertension

or high blood pressure.

This is a troubled youth.

NARRATOR And with no shortage of possibilities,

an overdose is also high on her list of suspects.

DR. G He's on medication.

He's on some of the newer what's called atypical antipsychotics,

but it's not just that I'm going to focus on the schizophrenia.
[ … ]

Another thing I really worry about in this fellow

would be a stimulant, a cocaine or a methamphetamine.

NARRATOR But Dr. G. must also consider an even

more chilling possibility.

That when John's family tried to restrain him,

they unintentionally k*lled him.

DR. G Perhaps when they brought him down, he hit his head.

So him dying from the trauma of the struggle

is a real possibility.

So this is really wide open.

I'm going to have to see how all of these components

play out with what I find at autopsy.

OK, so when I first see him at the external exam,

he's clearly morbidly obese.

Oh, boy.

He's inches and weighs pounds.

Somebody must have attempted CPR.

Oh, they did because they cut his clothes off.

NARRATOR Right off the bat, Dr. G.

can see that paramedics went to extreme measures to save John.

He's got needle marks up and down his arms.

You see these?

There's clearly a lot of intravenous lines in him

where they were trying to resuscitate him.

So one on the wrist, too, right?

Yeah.

NARRATOR Next, Dr. G. inspects his head, searching

for any signs of trauma, and it's not long before she

finds a suspicious clue.

DR. G There is a small abrasion over his eyebrow.

There's clearly some trauma to his head.

Is it because they att*cked him and threw him

down to the ground and hit his head,

or did something else happen?

I don't know.

I have to keep an open mind.

I'm going to let the body speak for itself.

NARRATOR Dr. G. has just discovered a small abrasion

on the forehead of -year-old John Gardner,

who collapsed to the ground during a violent rage.

Now, she can't help but wonder if his family may have somehow

contributed to his death.

DR. G Perhaps when they brought him down, he hit his head.

I'm not going to know if that played a role in his death

or not until I look into his head.

So I reflect the scalp, and I do see a scalp contusion

or bruise, but no underlying skull fracture

and no underlying hemorrhage.

NARRATOR But Dr. G. can't rule out fatal head trauma until she

examines the brain itself.

Go ahead for the head.

[saw buzzing]

NARRATOR Using an oscillating saw,

morgue technician Tom Hemphill saws open the skull.

I remove the calvarium, and I don't see any evidence

of internal trauma.

He doesn't look like he hit his head.

NARRATOR But despite the absence of trauma,

Dr. G.'s cranial exam is not over yet.

DR. G He's got this history of hypertension,

so he could have had possibly a hypertensive bleed.

NARRATOR Carefully, she slices through the brain tissue inch

by inch looking for any evidence of natural disease.

DR. G When I cut the brain, he had

really nothing wrong with it that I can see with my eyes.

Right now, I'm not seeing much.

NARRATOR Unfortunately, after an extensive inspection,

Dr. G. still has little to go on.

DR. G I can clearly rule out head trauma

as his cause of death, but I need

to do the internal examination on the rest of the body.

All righty.

TOM HEMPHILL All right.

NARRATOR Dr. G. makes a y incision across John's torso.

DR. G I look for any evidence of bleeding

underneath the skin, possibly evidence

that somebody was sitting on him or holding down his chest,

but I really don't see any.

NARRATOR Digging deeper, she scans his abdominal cavity

for signs of trauma.

His abdominal cavity looks fine.

Nothing.

I don't see any trauma.

All right, let's see what kind of tox we're getting.

NARRATOR Next, Dr. G. takes blood and urine samples

to send out for analysis.

DR. G Toxicology could be important in this case.

Is he taking something, some type of stimulant

like a cocaine or methamphetamine that

could have precipitated this?

NARRATOR Then, she turns her full attention

to John's chest cavity.

DR. G Once I take that chest plate off,

you can really see how small his pleural cavity is, the area

that the lungs can expand into.

Look at that.

He had a tremendous amount of visceral or abdominal fat

that's pressing on his diaphragm really decreasing his chest

cavity, making it more difficult for him

to breathe and get oxygen.
[ … ]

NARRATOR But while Dr. G. doesn't believe

this condition alone caused his death,

it may have contributed to it.

I really can't rule out that the family didn't constrict

his breathing from the way they were possibly holding him

because we already know that he's got a small chest cavity

and is going to have difficulty expanding his lungs.

Were those lungs having more of a difficulty

expanding with everybody maybe sitting on top of him?

That's a real possibility, but I would

have to rule out everything else before I

could make that determination.

NARRATOR Searching for a more definitive cause of death,

she moves on to John's heart.

And as Dr. G. removes the organ from the pericardial sac,

she immediately spots an alarming clue.

There, I find something else.

Look at this.

Something totally unexpected.

[somber music]

NARRATOR Dr. G. has just made a key discovery

in the internal exam of -year-old John Gardner.

DR. G When I see his heart, I can clearly see it's large.

And the heart is-- is this accurate?

And when I weigh it, it's heavy.

We have .

What is it that's causing his heart to be like that?

OK, let's see.

NARRATOR To find out, she must thoroughly dissect the organ.

Hmm, it's a little thick.

When I look at the muscle, he has a thickening

of the left ventricle.

This tells me that the enlargement of his heart

is from the effects of high blood pressure.

That's interesting.

NARRATOR High blood pressure forces the heart

muscle to work harder, often causing

it to grow abnormally thick.

DR. G Certainly, the large heart

is severe enough to have given him sudden cardiac arrhythmia,

but did that k*ll him?

I don't know.

NARRATOR The problem is an arrhythmia

leaves no physical evidence in the body.

DR. G Arrhythmia is maybe the end process,

but I have to a, rule out everything else,

and I also have to put it in the context of how he d*ed.

NARRATOR And as the autopsy comes to an end,

Dr. G. still can't rule out the frightening possibility

that when John's family to restrain him,

they unintentionally suffocated him.

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.

NARRATOR Three weeks after the autopsy

of -year-old John Gardner, his toxicology results

arrive at Dr. G.'s office.

DR. G So I thought this was going to be a really involved

toxicology report because this person's on least

two antipsychotic medications.

And I suspected maybe there was some

either cocaine or methamphetamine

possibly being used.

As it turns out, there was no cocaine,

there's no methamphetamine, and there's really

no antipsychotics at all.

NARRATOR In other words, John was not taking any medications

to control his schizophrenia in the hours

leading up to his death.

He must have stopped taking his antipsychotics,

and all of his aggressive behavior

could have been just due to his underlying disease.

NARRATOR It's an intriguing finding

and certainly explains John's violent outburst,

but the report offers no other clues as to what could

have caused his sudden death.

DR. G Nothing screams out at us the cause of death.

I'm clearly missing one piece of this puzzle

to help put this all together, and that is from the family.

I need a better description of what was going on leading

up to and during that struggle.

NARRATOR Dr. G. calls John's brother, Adam, looking

for more details on what transpired in the moments

before his death.

DR. G And what he states is that they

didn't throw him to the ground.

They didn't restrain him while he was on the ground.

He actually dies and goes down and hits the ground

while they're holding onto him.

That tells me a lot.

OK, OK.

NARRATOR Considering this seemingly simple piece

of information along with the toxicology results,

Dr. G. can finally connect all the dots

and explain to John Gardner's family

exactly what k*lled the -year-old

on that fateful afternoon.

It's a beautiful Saturday afternoon,

perfect weather for a family barbecue and backyard ballgame.

At first, John Gardner appears to be enjoying himself,
[ … ]

but as Dr. G. learns, it's the calm before the storm.

DR. G He must have stopped taking

his medication because there was not

a trace of it in his system.

NARRATOR And without medication to manage his schizophrenia,

John's behavior begins to spiral out of control.

He starts to get more and more paranoid.

Yeah, yeah, keep talking about me.

He's screaming.

He's angry, very agitated to the point where

he starts to att*ck the cousin.

What are you doing?

NARRATOR But this is no ordinary schizophrenic episode.

Dr. G. believes that sometime during his initial outburst,

John entered into a state doctors

refer to as excited delirium, an extremely dangerous and life

threatening phenomenon.

DR. G This is something that's seen with schizophrenics,

but this is not just typical abnormal

schizophrenic behavior.

This is a very exaggerated violent behavior.

NARRATOR It's unclear what exactly triggers excited

delirium in schizophrenics, but scientists believe

it may be related to increased levels of a chemical

in the brain called dopamine.

DR. G That dopamine is elevated in schizophrenics,

and if it gets high, it can precipitate

this kind of aggressive, delusional behavior.

NARRATOR And in this state of excited delirium--

You freaking talking about me?

NARRATOR --John simply snaps.

He then says he wants to k*ll the cousin

and is looking for a baseball bat to do it with.

NARRATOR His brother and cousins

try to restrain him causing John to become even more agitated.

And in turn, triggering a deadly chain reaction inside his body."], index ,…}

DR. CARLOS RUIZ Your internal core body temperature

goes up, which is, of course, very harmful

to the body and the brain.

NARRATOR It also forces his ailing heart to b*at faster,

placing tremendous stress on the muscle

until finally it lapses into a fatal arrhythmia.

DR. G His heart muscle is quivering.

He can't get a coordinated b*at going.

So consequently, his blood is not going to the rest

of his body, and he dies.

He dies as a result of what forensic pathologists

call this excited delirium associated

with his schizophrenia.

Yes, this is Dr. Garavaglia at the Medical Examiner's Office.

NARRATOR Dr. G. shares her final ruling

with Adam and his family making one thing very clear.

DR. G What didn't play a role is anything that his brother

and cousins did to him.

He was probably without a pulse by the time he hits the ground.

Get the slides back.

NARRATOR Her findings bring John's family some sense

of closure, but his death is another tragic example

of an ongoing battle, one that's being fought by millions

of people every day.

DR. G All of these diagnosis of bipolar, schizophrenia,

and even major depression, they're all

going to have an increased risk of dying suddenly,

not just because of their mental illness,

but because of natural disease because they

tend to ignore their body.

NARRATOR Winning the battle, however,

takes patience, hard work, and a true team

effort between doctors, patients, and their loved ones.

Medications are effective only if taken properly.

But if they're on medication and with the support of family,

with the support of treatment and counselors,

a person can leave a very effective and full life,

In fact.

DR. G Medicine has come a long way,

and we can treat these diseases.

But mental illness is, to me, one of the saddest illnesses

that can inflict us as humans.

It truly can be devastating, and it just shows how we should

be thankful for our health.

[tranquil music]

You did a nice job on the old neck.

NARRATOR More often than not, Dr. G. sees fatalities

that could have been avoided.

And in her next case, a simple piece of information

may have prevented not one but two deaths.

They could have saved her, and they could have saved the baby.

DR. G On any kind of profession,

you want to keep abreast of what's going on

and what other people are saying.

And in forensics, that's no different.

We read journal articles, we go to conferences,

but we also just like to talk about each other's cases.

NARRATOR And one pathologist Dr. G. talks to regularly

is her former colleague, Dr. Norma Jean Farley.

DR. G Dr. Farley and I met when she

was a resident in Bear County, Texas,

and I was one of her teachers.

Immediately, we struck a chord, you know,

some kindred souls or something.
[ … ]

It's not unusual for her to call me up about a case,

or I call her up about a case.

Is this Norma Farley?

NARRATOR More often than not, their conversations

turn to routine procedures.

Yeah, hi.

NARRATOR But in February , Dr. Farley

called with a particularly unusual

case, one that threatened to stump

both seasoned investigators.

Ah, are you kidding?

You know, I think Dr. Farley wanted

to share this case with me because hmm,

this is kind of a medical mystery.

Why did she die?

NARRATOR Kate Edwards, mother of -month-old Alex

and -year-old Lisa, is anxiously awaiting

the birth of her third child.

So far, her pregnancy has gone smoothly with no complications.

But today, Kate is feeling a little short of breath.

DR. NORMA JEAN FARLEY She had been complaining that morning

that she was having these very sharp,

piercing pains to her chest.

NARRATOR Assuming it's just a bad case of indigestion,

Kate heads to her room to lie down.

Can I come in?

NARRATOR But when her father-in-law checks

on her an hour later, it's clear right away

that something's very wrong.

Oh my god.

DR. NORMA JEAN FARLEY He found her down in the bedroom

and called EMS immediately.

My daughter-in-law is unresponsive.

NARRATOR Paramedics arrived within minutes,

but it's too late.

Kate Edwards and her unborn child are already dead.

I can't imagine how devastated this must be.

The families lost two in one.

That's two individuals in a family at once

that they're grieving for.

NARRATOR Kate's body is quickly transported to the Ceballos

Funeral Home in South Texas.

And as a first step, Dr. Farley begins

reading through the investigator's report.

DR. NORMA JEAN FARLEY She was approximately weeks

gestation, so about eight months.

We also got the name of the obstetrician.

Hello, this is Dr. Jerome.

DR. NORMA JEAN FARLEY The doctor informed my investigator

that she hadn't had any complications,

and she's made it through two other pregnancies just fine.

DR. G If she had a pre-existing medical condition,

you would have thought the first two pregnancies

would have shown up then.

NARRATOR Still, there are pregnancy-related complications

Dr. Farley must consider.

Probably most common that I see

are pulmonary emboli or clots that travel up to the lungs.

There are a lot of hormonal changes,

and you may even be less mobile at that late stage

in pregnancy.

So you have several factors going

on with a pregnancy that makes your blood clot more readily.

NARRATOR It's also possible that Kate may have

been suffering from pre-eclampsia or pregnancy

induced hypertension.

Some pregnant women are more prone to get pregnancy

induced high blood pressure.

The hypertension may cause a stroke.

It could also cause a rupture of a blood vessel.

So those are two primary scenarios

that I think about when I'm thinking

about a pregnancy-related death.

Now, it is possible that maybe the cause of death

has nothing to do with the pregnancy at all.

And of course, we always think about dr*gs.

DR. G Believe it or not, particularly

in that very young age group, they sometimes

are still using their cocaine.

NARRATOR But perhaps even more disturbing

is the prospect that Kate could have

fallen victim to foul play.

A lot of pregnant women actually die from homicides

during pregnancy.

It could be strangulations, which I see a little bit more

frequently, and that's subtle.

So we may not have seen it at the scene.

DR. G So even though it's a low on our list in this case,

Dr. Farley couldn't rule that out until she did the autopsy.

Got in today, man.

NARRATOR With a laundry list of possibilities,

Dr. Farley is optimistic the autopsy will bring Kate's

family some sense of closure.

DR. NORMA JEAN FARLEY They were looking forward

to this delivery and this child, and now everything has changed."], index ,…}

Looking at the body, I notice that she's

actually very healthy.

Wow, she's pretty tall.

And she's very tall.

She's inches, so she's about ' ".
[ … ]

She has very long arms and very long legs.

Her fingers are very, very long, and her toes

are kind of long as well.

You don't see it all that often.

Also be looking for if any kind of trauma to this person.

She has a couple of very small abrasions

or scrapes on her left forehead, very tiny.

The biggest one is about . centimeters.

I think that's probably from when she

dropped at the time of death.

Nope, that looks good.

NARRATOR Next, Dr. Farley turns her attention to Kate's legs.

I'm going to be looking for subtle changes

that may tell me that there's a clot

or a thrombosis in the legs.

One of the legs may be slightly more

swollen than the other side.

But I didn't see any swelling in the legs.

So I saw no external signs that there may

have been a pulmonary embolism.

Picture.

NARRATOR But she can't rule anything out just yet.

To begin checking off suspects, Dr. Farley will need

to look inside Kate's body.

OK, we're ready for the internal examination

at this point.

You need a Kn*fe?

We'd be very careful while we do the y

incision, especially over the abdomen that

do we don't cut too deeply.

We're gonna have to go up over this belly.

I will have to spend a lot more time looking at the uterus

and the fetus in this case.

The uterus is very big.

It's way up here sitting high near the liver almost.

Doing that autopsy on the baby is not

going to give you the answer on why the mom d*ed necessarily,

but it could have implications to any kind

of congenital disease that might run in that family.

NARRATOR Dr. Farley performs the delicate task

of opening the uterus to gain access to the fetus.

I'm gonna start low and remove that uterus.

I look at all the features of this fetus

just to make sure there's not any congenital anomalies that I

can pass on to the family.

DR. G When she opened that uterus,

she found a perfectly intact week

old gestational age male fetus.

NARRATOR With the body now open,

Dr. Farley collects blood for toxicology tests.

So we've got plenty for toxicology.

I'm a little bit worried about cocaine.

Sometimes the family will clean it up because they're

embarrassed or--

so just in case.

DR. G This case may rest on toxicology.

She's only years old.

We don't know that much about her.

NARRATOR Dr. Farley packages up the samples that will be

sent to the lab for processing.

Yeah, let's put her up on a block and see.

NARRATOR Then she turns her attention back

to the autopsy starting with an organ high

on her list of suspects.

You think-- let's take the lungs out first,

and then I'll work on that.

NARRATOR One vessel at a time, Dr. Farley

cuts into the pulmonary arteries.

And I'm going to look and see if there are any clots

or emboli in the lungs.

We'll look in these veins, see if we see the culprit

that may have traveled up.

NARRATOR But she's surprised to find no sign of blood clots.

Wow.

So I've now ruled out pulmonary embolus as the cause of death.

So we're gonna move on.

We've ruled out a few things.

NARRATOR But then as Dr. Farley makes her way to the heart,

she sees something that stops her dead in her tracks.

That's unusual.

You don't see that that often.

That's pretty big.

[music playing]

Clamp.

NARRATOR Dr. Farley has just come face

to face with a shocking discovery in the autopsy

of -year-old Kate Edwards.

Something is terribly wrong with her pericardial sac,

the protective membrane surrounding the heart.

DR. NORMA JEAN FARLEY It's bulging outward,

and it's looking blue instead of the usual tan.

And this would have accumulated fairly quickly.

NARRATOR To find out what's wrong,

Dr. Farley pierces the sac with her scalpel

and gets her first look inside.

Make sure--

We're seeing blood, which is kind of unexpected.

I have to scoop the blood out and measure how much is there,

and there's CCs of blood.

A lot of blood in the heart sac.
[ … ]

When this much blood is in the pericardial sac,

it causes the heart to stop.

NARRATOR This is called a cardiac tamponade,

and it's fatal.

DR. NORMA JEAN FARLEY Now, we have to figure out where

that blood is coming from.

NARRATOR To find out, Dr. Farley carefully removes

the heart and immediately spots the culprit,

a tear in Kate's aorta.

DR. NORMA JEAN FARLEY There's probably [inaudible]..

There was a large here there.

It's long, it's almost three centimeters.

NARRATOR Attached to the top of the heart muscle,

the aorta is the largest blood vessel in the body.

So this tear allows the blood that's

supposed to be pumping to all of the body

to seep through this hole and accumulate

within the heart sac.

I think, you know, Norma found the immediate cause of death.

It was the cardiac tamponade, but really, Norma and I

don't like to just stop there.

NARRATOR Now, Dr. Farley is determined to figure out

what caused the tear in the first place,

and she has a hunch as to what it might be.

Now, this type of dissection or tear, we

see that in hypertension.

NARRATOR Dr. Farley collects tissue

samples of the heart muscle to examine under the microscope.

DR. NORMA JEAN FARLEY --from death itself.

So it ruptured--

NARRATOR But first, she inspects

the organ for any signs of high blood pressure.

DR. NORMA JEAN FARLEY Looking at it, it was totally normal.

The coronary arteries were normal.

The cardiac valves looked beautiful.

Very healthy looking heart.

NARRATOR It's a surprising finding,

but with hypertension now ruled out,

Dr. Farley is forced to consider the unthinkable.

DR. G Cocaine is still a possibility because it

can cause an aortic dissection.

And even though this individual is pregnant,

she may have not stopped using illicit dr*gs if she

was used to using them before.

So I need to wait for the toxicology results.

Now it's just really a waiting game.

NARRATOR And it's a difficult wait

for Kate's grieving family.

DR. G It's all happened so fast.

I can't imagine how the family feels.

They deserve an answer.

[somber music]

Where's his folder?

NARRATOR Dr. G.'s colleague, Dr. Norma Jean Farley has yet

to cr*ck the case of -year-old Kate

Edwards, who was over eight months pregnant when she d*ed.

So far, she's ruled out all of her initial theories

except one, dr*gs.

DR. NORMA JEAN FARLEY I'm going to have

to wait for the toxicology results

because cocaine can actually cause aortic dissections.

Hi, how are you?

So finally, I get the toxicology,

and I'm very anxious to see if there's

anything that could help me.

NARRATOR Dr. Farley immediately scans the page for any evidence"], index ,…}

that cocaine may have caused Kate's aorta to rip open.

DR. NORMA JEAN FARLEY And it's totally negative,

so there's no illicit dr*gs.

DR. G But she still doesn't have the answer of why.

What really caused this if it wasn't the cocaine?

DR. NORMA JEAN FARLEY I begin to worry

now that I may never have the answers for this family.

I still need to wait for the microscopic sections

of the aorta to see if there's anything there

that could clue me into the direction

of what happened in this case.

About four days later, I get my microscopics back.

NARRATOR And when she places the slide of Kate's

aortic tissue under the microscope,

the veteran pathologist can hardly believe her eyes.

DR. NORMA JEAN FARLEY I do see that the elastic fibers instead

of holding together, kind of like the elastic

waistband of a pants, they're starting to pull apart.

NARRATOR Dr. Farley immediately recognizes

this as a telltale sign of Marfan syndrome,

a rare connective tissue disorder

that is usually not fatal.

In Marfan syndrome, there's an abnormal gene

that helps make up the elastic fibers in the body.

Marfan syndrome allows the elastic fibers

not to actually form properly, and they begin to spread apart.

NARRATOR People with this disorder often have long

fingers and toes like Kate's.

It causes the extremities to get

very long, causing the very tall statute in these individuals.

NARRATOR But while the physical characteristics themselves

don't pose a health risk, Marfan syndrome can increase

the risk of an aortal tear.

And the cause of death with most
[ … ]

adults with Marfan's is going to be the dissection of the aorta."], index ,…}

NARRATOR All signs now point to Marfan,

but there's one problem.

Dr. Farley can't find a single mention of it

in Kate's medical records from her obstetrician.

So she calls the doctor, and this is the part I think is

interesting is the doctor's like, no way

does this girl have Marfan's.

Are you crazy?

You know, I've been taking care of her her whole pregnancy.

She's got no history.

And Norma actually asked the husband,

no way this girl has Marfan's.

You know, I've been married to her.

Norma was like a little bit disappointed

cause she really thought it all fit together nicely.

DR. NORMA JEAN FARLEY So now, I'm

adamant that I need to know is there any family history

here because Marfan syndrome is inherited.

DR. G I agree with Dr. Farley.

She should dig a little deeper.

I would do the same thing.

NARRATOR As a next step, Dr. Farley reaches out

to Kate's mother, and what she reveals

about her daughter's past provides

the key to the entire case.

Sure.

Bye bye.

NARRATOR At just years old, Kate Edwards

is in the prime of her life, and by all appearances,

she's perfectly healthy.

But Dr. Farley now knows that Kate

was keeping a deadly secret.

DR. NORMA JEAN FARLEY The mother said well, of course,

my daughter had Marfan syndrome.

She was diagnosed very young, around to years old.

NARRATOR Unbeknownst to Kate, over the past years,

Marfan syndrome has caused the tissue in her aorta

to become extremely weak.

DR. NORMA JEAN FARLEY There's high risk for an individual

with this type of disorder to get pregnant

because with the increased blood volume during pregnancy,

they're at high risk for having rupture of the aorta.

NARRATOR On the morning of her death,

Kate thinks she has indigestion.

But in fact, it's infinitely more serious.

Her aorta, the largest blood vessel in the year

old's body is starting to tear.

DR. NORMA JEAN FARLEY And that was a sharp, stabbing chest

pain that she was feeling.

NARRATOR Kate lies down hoping the pain will pass,

but by then, it's already far too late.

DR. G Her aorta couldn't take it anymore at that point

when she had chest pain.

DR. NORMA JEAN FARLEY The elastic fibers

that hold the aorta together cause it to dilate and balloon

and had it got as wide as it could get.

And at that point, the aorta tore.

The blood began to pump out of that hole

and into the heart sac.

It put pressure on the heart causing the heart to stop.

And her father-in-law found her a few minutes later.

My daughter-in-law's unresponsive.

She's on the floor.

She's pregnant.

NARRATOR After three weeks, Dr. Farley finally closes the case

on Kate Edwards and makes the difficult call to her family

to share her findings.

DR. G I don't know how her family felt.

If I was her husband, I would be sad and angry at the same time

to think she should have taken better care of herself,

and yet terribly sad that she d*ed.

NARRATOR The tragedy is compounded by the possibility

that Kate's sudden death along with that of her unborn child

could have been prevented if only

she had shared her previous diagnosis

with her obstetrician.

She had never told the physician that she had this syndrome.

DR. G She had had two other pregnancies,

and nothing had happened.

She was playing with fire, and unfortunately, it didn't work

out for her that third time.

That was irresponsible.

DR. NORMA JEAN FARLEY If she had actually told her doctor,

he would have followed her much more closely.

These individuals can actual undergo

echocardiograms frequently and follow the size of that aorta.

DR. G They could have saved her,

and they could have saved the baby.

As a medical examiner, I come across families all the time

that are not forthright about what was going on, about what

this person was doing because they're

trying to hide something.

I can understand it.

I'm the medical examiner.

You shouldn't be doing that to your doctor.

They need to know everything because your--

that's your life at stake.

That's a whole different ballgame.