01x01 - Redemption

[bunniefuu]

[music playing]

NARRATOR A mother's shocking su1c1de

attempt wreaks havoc on the emotions

of a devout Catholic family.

God doesn't want you to take your life.

She has about pills of her darvocet missing.

NARRATOR Did mom commit su1c1de or did

a silent k*ller take her life?

Then, a transient just turning his life around

dies suddenly in the night.

There he was. He was dead.

Very depressing.

NARRATOR With no medical history to go on,

Dr. G must assume the worst.

How do I know somebody didn't come in last night

and beat him?

NARRATOR And in the dead of the night,

a -year-old mother of three inexplicably

dies in her husband's arms.

I looked in her eyes.

And-- and there was-- there was nothing there.

After a battery of hospital tests,

no one can tell the grieving husband what k*lled his wife.

The woman he loved, the mother of his two children,

he's left with two children, dies suddenly,

and nobody can give him an answer why she died.

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

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

Lord, God, you have said to us--

NARRATOR -year-old Maria Rossetti is dying.

Are there people sick among you?

Let them send for the priest of the church.

NARRATOR Is the elderly woman dying of natural causes?

In the name of the Lord.

NARRATOR Or is she about to become a su1c1de?

hours earlier, Maria Rossetti decided

to end her own life by overdosing

with a common prescription pain medication.

Later, she regains consciousness long enough to express

regret for her actions.

So my wife said, your mother's gonna to be OK, you know?

And I thought she was gonna be fine.

NARRATOR When she passes away that night in the hospital,

her family is awash in sadness and torment.

Kissed her, I love you.

And when I left, my stepson was there.

An hour later, she died.

NARRATOR Compounding their loss is their fear that their mother

may have died by her own hand, a faithful Catholic who

went to her grave, a su1c1de.

God doesn't want you to take your life.

My mother believed that, you know?

I know she did.

NARRATOR Each year in Orange County, Florida nearly

people take their own lives.

By law, each of these deaths becomes the business

of the medical examiner.

In this county, that person is Dr. Jan Garavaglia,

better known as Dr. G.

Not much to cheer about yet.

Nobody thinks he intended to k*ll her.

That's not gonna happen.

NARRATOR She investigates about one su1c1de every three days.

Today is an exception.

When she arrives at the morgue this morning,

there are two suspected cases waiting for her.

OK.

Now--

NARRATOR The first seems obvious,

a self-inflicted g*nsh*t victim.

We've got a -year-old man.

I think this is gonna be pretty straightforward.

He did leave a note.

I just don't understand the--

the reasons yet of why he would commit su1c1de.

NARRATOR The second case, Maria Rossetti,

is reported to have overdosed on pain medication.

She's reported, as per the law,

because she comes in and she come--

and they felt that she came in to the hospital

because of a darvocet overdose.

NARRATOR Like the g*nsh*t victim,

Maria's overdose looks like a textbook su1c1de.

But if it was the overdose that k*lled her, why would

she have regained consciousness before she died?

For the Rossetti family, Dr. G's findings

will either deliver peace of mind

or confirm their worst fears.

We get a lot of people who are religious.

And certainly, they don't like me ruling su1c1de.

Obviously, I don't take that into consideration.

I only put what I--

I can scientifically back up.

NARRATOR The investigator's report

tells Dr. G that Maria was discovered inside her apartment

by her son Anthony.

DR. G (VOICEOVER) What happened is

that the son found his mother in bed, unresponsive.

He found a bottle of pills next to her.
[ … ]

NARRATOR Dr. G also learns that Maria suffered

from a well-known risk factor for su1c1de,

with a long history of anxiety and depression.

Been very depressed.

NARRATOR Depression that was made worse by the recent death

of her beloved pet.

This is the second case in the past, probably

a month and a half, I've had where somebody's dog died

and they were--

appears to have committed su1c1de.

OK.

So--

NARRATOR But the most convincing evidence of su1c1de

are Maria's toxicology reports.

Blood tests revealed toxic amounts

of darvocet, a popular prescription pain reliever.

Its active ingredients are propoxyphene,

a narcotic, and acetaminophen.

When she was found, pills were missing from the bottle,

enough to k*ll her.

Not the best one to OD on.

I wouldn't recommend it.

Because it's kind of a slow, painful death.

You have to have-- it destroys your liver.

NARRATOR The case history points to su1c1de.

But an internal examination is needed before Dr.

G can finish her report.

We're just documenting, making sure that it is what it seems.

NARRATOR Right away, it's clear why Maria needed

the powerful pain medication.

DR. G (VOICEOVER) You can see she's had back surgery.

We could see the scars.

She's had back surgery, both knees,

knee surgery, possibly replaced, those scars are so big.

NARRATOR Her body also shows signs of the valiant efforts

made by the doctors who tried to save her only hours earlier.

DR. G (VOICEOVER) What you can see is black material

over her buttocks.

And she's also got the same material in her nose.

And what's happened is, she's gone

to the hospital with the darvocet

and they've tried to give her the charcoal

to deactivate the drug before it gets absorbed.

And what's happened is she's passing the charcoal.

NARRATOR Charcoal gastric lavage

is one of the most common emergency procedures used

to treat victims of poisonings.

Activated charcoal is administered

through a feeding tube.

Acting like a sponge, the charcoal

absorbs toxic substances before they are

absorbed into the bloodstream.

But in the case of Maria Rossetti,

it appears that the procedure came

too late to save her from the effects of the medication

in her system.

The key to finding out for sure will

be Maria's liver, the organ that would be

most affected by an overdose.

That's unusual.

Yeah.

NARRATOR But in the case's first surprise finding,

Maria's liver appears normal.

Doesn't look like she had, really, much problems, when you

look at the liver and her other organs,

that she didn't have any problems from the overdose.

They must've pumped out a lot of the pills.

NARRATOR It's a puzzling observation,

because a healthy liver tells Dr. G that the charcoal

procedure may have stopped the toxic effects of the overdose.

But if that's so, what else could

explain Maria's sudden demise?

For her family, another cause of death would be a huge relief.

Dr. G's next finding is even more unexpected.

That's nasty.

NARRATOR Maria's heart is a mess.

It shows signs of a festering infection.

She's got a pericarditis, where she's got inflammation.

It's inflamed, her heart lining.

I don't really know the reason for it.

Pericarditis occurs when there is

extra fluid in the space between the heart and the sack

that surrounds it.

The extra fluid is usually caused by an infection,

but it can also be a result of injury or trauma.

Yeah.

NARRATOR To find out what caused Maria's pericarditis,

Dr. G must examine samples of Maria's heart.

The heart should look glistening.

This-- the heart-- even the heart's surface

is all red and inflamed.

Pericardial sac is red and inflamed.

NARRATOR Coming up next on Dr. G,

what looked like an open and shut su1c1de turns

into a complex case that will have

Dr. G searching for answers.

Oh, this one kept going back and forth.

NARRATOR And later, when a homeless man is found dead,

Dr. G must investigate the man's checkered past for clues

as to what or who k*lled him.
[ … ]

How do I know somebody didn't come in last night

and beat him?

NARRATOR Dr. G is working the su1c1de case

of -year-old Maria Rossetti.

But what she's found so far isn't adding up.

That's unusual.

Yeah.

NARRATOR If Maria died from a self-inflicted overdose

of painkillers, her liver should be ravaged, but it's not.

Instead, Maria's heart is raising questions.

Why is the protective sack surrounding

it so severely inflamed?

Awaiting the findings is the devout Catholic Rossetti

family.

They desperately want to believe their mother

didn't commit su1c1de.

DR. G (VOICEOVER) A lot of people--

some of those, the families get very, very upset

and fight us the hardest on the su1c1de rulings.

NARRATOR Now, peace of mind from Maria's family

may rest in the hands of Dr. G.

OK.

I got-- I got to change gloves.

NARRATOR Dr. G's first task is to figure out why

Maria's heart is so damaged.

It's puzzling, because Maria has no history

of suffering a heart attack.

Every clue counts.

There's very subtle things sometimes.

NARRATOR Her heart is removed, weighed,

measured, and dissected.

As Dr. G cuts into the heart, she

not only finds the cause of Maria's damaged heart sack,

but a condition that changes the entire case.

Maria's coronary artery is completely blocked.

And you see the clot.

You can see the rupture in the coronary artery.

And you can actually see the blood clot in the artery.

That supplies that part of the heart.

The blood clot forms and stops blood flow

to that part of the heart, i.e. a heart attack.

And that heart muscle dies.

NARRATOR For Dr. G, this finding

is the cardiac equivalent of a smoking g*n.

She is certain that the heart attack

is what k*lled Maria Rossetti.

But for Dr. G and the family, one question remains.

Could this fatal heart attack have

been caused by the overdose?

To find the answer, Dr. G will have to look closer than she

can with her naked eye.

I did want to confirm that with the microscope.

And I did.

And that-- microscopically, it looks at least about ,

days old, minimum.

But this muscle was necrotic.

It died already.

This is something several days old at least.

And that predates that overdose.

NARRATOR Dr. G has made the key discovery in the case.

Maria's heart attack happened before her overdose.

With this final piece of evidence,

along with the earlier discovery that Maria's liver was

unaffected by the dr*gs she took,

Dr. G can finally piece together the true story

behind Maria Rossetti's death.

And it's a story that will stun Maria's troubled family.

Days before attempting to take her own life,

without realizing it, Maria suffers a major heart attack.

Plaque built up over years on the inside

of her coronary artery ruptures, triggering a blood clot.

The clot blocks the already narrowed artery completely.

With no blood getting through, tissue beyond the blockage

is starved of oxygen. Muscle begins

to die and dissolve away.

With her, the muscle in the left ventricle

was already gone.

And it was just a thin, thin piece of muscle left.

NARRATOR Her heart is now a time b*mb.

Sudden death could occur at any moment.

DR. G (VOICEOVER) It's about ready to blow.

All it had was a little bit more to go.

NARRATOR Then, a day later, Maria

ingests a toxic dose of pain medication

with the intention of k*lling herself.

ANTHONY (VOICEOVER) She said she just wanted to go to sleep.

She thought she was just--

I don't know.

She-- what went through her mind.

It just was a shock.

Probably the whole reason she took the pills was she

was tired of being tired.

And that was a symptom of-- of all her heart problems,

that they weren't--

they didn't know she had.

NARRATOR By the time her son Anthony finds his mother,

she is barely alive.

I said, oh my god.

I think she took whatever darvocets were in here.

NARRATOR In a panic, he calls .
[ … ]

Emergency workers find the near empty bottle of pills

and suspect a drug overdose.

Unconscious and near death, she is rushed to the hospital.

They're pumping her stomach and they're getting pills out.

NARRATOR Efforts to arrest the toxic effects of the dr*gs

are successful.

And Maria regains consciousness.

She's in bed and combing her hair

and eating Jell-o that night.

So he figures, all's fine.

NARRATOR But all is not right, not with Maria.

She's still feeling weak and is wracked with guilt and regret,

because she thinks she's dying by her own hand.

Desperate, she calls for a priest

to administer to her the last rites

and to ask for God's forgiveness.

During the night, she passes away.

But according to Dr. G, it's her weakened heart, not

her drug overdose which deals the final blow.

The electrical component of the heart

is irritated by all that necrotic muscle

and ends up going into a rhythm that can't sustain the pumping.

And so you-- you don't pump any blood,

because of the electrical component.

NARRATOR Dr. G's conclusion?

Maria Rossetti's death from heart failure

during the time she was hospitalized for an overdose

was just coincidental.

It was simply a matter of time.

I didn't believe that the overdose had anything

to do with the heart attack.

NARRATOR Under the circumstances,

the news Dr. G passes on to the family

should bring a bit of comfort.

Hi.

Is this Anthony?

Hi.

This is Dr. Garavaglia again at the medical examiner's office.

I'm fine.

I think I have some good news for you.

ANTHONY (VOICEOVER) When they told me about the heart,

that she had it before, I was amazed, you know?

Because I never thought my mother

had suffered a heart attack.

Women, in particular, but even actually

about %, % of all heart att*cks,

they have no symptoms whatsoever.

They don't even know-- people don't

even know they're having it.

i Kind of feel good, because she came

back and asked for forgiveness.

DR. G (VOICEOVER) I was really excited to tell him,

because I think it made him feel better that this had really

nothing to do with su1c1de.

People, when they don't have the facts

and the facts aren't explained to them

why their loved one died, people's imaginations run wild.

And they imagine all sorts of things.

And they don't really--

I hate that word closure, but you can't move on,

if you don't know why they died and you're

always suspicious of something.

NARRATOR Maria Rossetti's story is about a death

that was inevitable.

Dr. G's next case, however, is about a man

whose years of hard luck were starting to change.

Walter Pryce seems to be in good health the day

he helps a friend with yardwork.

In fact, he has only hours to live.

At years old, Walter has known tough times

since early childhood.

He was found abandoned before receiving foster care.

Walter was left in a barn somewhere,

to my understanding, left in a barn

to make it for him on his own at four years old.

And they had to train him and teach him how to talk, walk.

NARRATOR Though homeless for most of his adult life,

recently, things are beginning to look up.

He's joined a church, has a roof over his head,

even landed a job fixing up investment properties

for his friend, Bill.

He was homeless, but he did want to get a job

and try to get on his feet.

NARRATOR But Walter would never get that chance.

After working in the yard all day,

Walter and Bill share a meal together at Bill's home.

It's a pleasant evening.

Even Walter's complaint of a headache

is easily handled with a few aspirin.

Later, Bill drives Walter home.

He looked back at me and said, I'll see you in the morning.

And--

NARRATOR But that plan is made in vain.

At the next morning, when Bill

arrives to pick up Walter for work,

something is clearly not right.

Wouldn't answer the door.

He wasn't waiting for me.

He usually is always standing in the doorway waiting for you.

And I started trying to figure out how to get in the house,
[ … ]

because I didn't have a key.

He had the key.

So I opened up a back window and I climbed through the window.

And I went in.

And there he was.

He was dead.

Very-- very depressing.

NARRATOR Walter was found on top

of his bed, the circumstances of his death unknown.

He immediately becomes another case for the Orange County

Medical Examiner's Office.

Investigator Dean Smith gathers what little information

he can about Walter's past.

DEAN SMITH (VOICEOVER) We have a -year-old male.

Right now, there's no family contact.

We don't know of any medical history.

The representative of the church states he doesn't

smoke or drink or do dr*gs.

But we don't have any idea of any history

or anything that would cause a sudden, unexpected death.

NARRATOR Without a documented medical history,

Dr. G has no leads.

From an ME perspective, Walter is a blank slate.

So Dr. G's autopsy starts at square one.

And for an ME, square one is always ruling out m*rder.

DR. G (VOICEOVER) Basically, we know

very little about this man.

That's why we look at him very carefully externally

and open him up inside to try to get

some answers of what happened and definitely rule out

foul play.

So little bit of blood in the mouth.

The blood in the mouth does not necessarily mean trauma.

A lot of that is just broken little blood

vessels from the increased congestion in the caillaries.

A lot of times, you'll see that in the nose.

NARRATOR Dr. G next makes note of the body's lividity.

When the heart stops, blood succumbs

to the laws of gravity, running down and pooling at the body's

lowest point, creating what looks like bruising

under the skin.

But it's a slow process.

And if the blood is fixed in more than one area,

it could indicate that the body's position

was altered after death.

But Walter was found on his back and that's just where

Dr. G finds the lividity marks.

Lividity is consistent.

Yeah, it's fixed in the position right where they found him.

So we don't think he's been moved by anybody.

NARRATOR At the end of the external exam,

Dr. G is confident that Walter's hard luck life

didn't end in a violent death.

So what could have caused this seemingly

healthy -year-old to die?

Coming up next, false leads and smart findings.

Walter's death holds warnings that can't be ignored.

And then, Dr. G must solve one of the most difficult cases

of her career, the untimely death

of a -year-old mother of two.

-year-old Walter Pryce saw a life not untypical of Americans

living at the margins.

He moved often, work was unsteady,

and like so many transients, rarely saw the inside

of a doctor's office.

Any history?

we don't know at all, anything about the man.

NARRATOR And so it's on to the internal examination.

Dr. G hopes she can unlock the secret

to Walter's untimely death.

At first, as Dr. G begins her internal exam,

nothing seems out of the ordinary.

OK.

So we've opened his abdominal cavity.

And he's got all the parts it looks like god gave him.

Appendix still there.

NARRATOR Exploring further brings

the first bit of surprise.

Big lungs.

They are big.

.

NARRATOR Not just big, but grossly oversized.

A lung's weight is measured in grams.

For a man Walter's size, the average weight

is about grams.

And this lung is over ,.

It's at ,.

NARRATOR Dr. G makes a tentative observation.

Heavy, fluid-filled lungs like these

indicate Walter somehow fell into a coma

and died a slow death.

This is often an indicator of a drug overdose.

Fluid starts building up in the lungs, with the overdoses.

They tend to be in a coma for a while and then die.

When we start seeing that and I don't see any other cause yet,

one always worries about a drug overdose.

NARRATOR Except that there's a contradiction.

No one has spoken of Walter having a drug problem.

I've been given the story that he doesn't drink,

he doesn't smoke it, he doesn't use illicit dr*gs.
[ … ]

NARRATOR To rule out drug use, Dr. G will

call on her lab researchers.

And Arden's gonna go for the tox now.

NARRATOR They'll run a battery of toxicology tests,

complex chemical analysis of Walter's blood

that will identify any traces of dr*gs or other poisons.

Meanwhile, the internal exam moves on to the heart.

And another clue is discovered.

We have a very heavy heart, a cardio--

cardiomegaly in fact.

The heart's enlarged and the wall has thickened.

NARRATOR Walter's enlarged heart is nearly %

larger than it should be.

Dr. G explains how it develops.

What's happened this is is the muscle has gotten hypertrophy.

The muscle has gotten bigger, just as

if you would continue to do biceps exercises

like with a weight.

Your muscle would get larger, your biceps.

Well, his heart muscle has to work harder and harder

over time, because it's pumping against this increased

resistance causing his high blood pressure.

NARRATOR High blood pressure is a dangerous sign

that can't be ignored and a huge contributor to cardiac arrest.

Dr. G's suspicions are easily tested.

She dissects the heart muscle and inspects the valves.

The aortic valve looks fine.

The mitral valve looks fine.

Tricuspid valve looks fine.

NARRATOR A clean valve system.

It means heart attack is looking less likely.

DR. G (VOICEOVER) We'll see.

Right now, I still have to look at his brain.

And that certainly could be a cause or of the--

the toxicology.

NARRATOR To examine the brain requires

sawing a circle around the top of the head

and removing the skull cap.

This exposes the brain.

Taking a peek.

No.

So far, we don't see anything bad.

NARRATOR But when Dr. G removes the brain itself

and exposes the front surface of the brainstem,

including an area called the pons, what she sees

defies the odds.

Well, I'll be darned.

It's the exact same thing as the other guy the other day.

He's got a pontine hemorrhage inside the pons.

I don't get these too often, maybe a couple times a year

max.

NARRATOR Loosely translated, pontine means pons bridge.

And it's so named, because the pon serves

as a bridge or link between the central nervous system

and the midbrain.

And we've got a big hemorrhage with a blood

clot inside the pons.

NARRATOR Bleeding in the pons is usually fatal.

But what causes it?

Well, for one thing.

It's how the body can react to a drug overdose.

DR. G (VOICEOVER) When you see an intracerebral hemorrhage

like that, you always have to rule out

that he's not on a stimulant.

Because stimulants, like cocaine,

amphetamine, methamphetamine, will cause your blood pressure

to increase.

NARRATOR And the resulting pressure can literally burst

open a vital blood vessel.

The toxicology reports will expose any drug connection.

Before long, they're in.

Walter Pryce's blood reveals not a single trace

of illegal dr*gs.

Dr. G takes a moment to reconsider

and checks with those who knew him.

Turns out Walter had spoken of the very symptoms

often associated with high blood pressure.

He complained a few times about having

arms that were sleepy, like sticky,

like they'd been asleep.

NARRATOR Having completed her primary exams

and with the results of the toxicology tests,

Dr. G does the mental review.

-year-old white male.

NARRATOR Walter's lungs are heavy with fluids,

a clear indication that he died in a coma.

But concerns that the coma was drug-induced

ended when his bloodwork, the toxicology report,

came back clean.

In consideration of the circumstances

surrounding the death and after examination of the body--

NARRATOR With this information, Dr. G

can now recreate the sequence of events that took Walter's life."], index ,…}

Walter suffers from chronic high blood pressure, which

works his heart muscle so hard that it

balloons to a lethal size.

Left untreated, the force of this high blood pressure

fatally weakens a blood vessel in the pons area of his brain.

What they feel happens in the brain is there's probably some

of the vessels inside the brain have
[ … ]

weakened walls, because of this chronic high blood pressure.

And eventually, the weakened walls will bulge out and bleed.

NARRATOR Days earlier, as Walter finishes his yardwork,

the vessel is ready to rupture.

Later that evening, when he complains

of a little discomfort, no one thinks much of it.

BILL (VOICEOVER) He just had a headache.

I remember that.

And my wife had given him some Tylenol I believe it was.

When he has a headache at the end, most likely,

it's probably starting to bleed.

NARRATOR Unsuspecting, Walter goes to bed.

But inside his brain, the bleeding continues.

Alone and unaware, he falls into a coma and his body starts

to malfunction.

First of all, you have the blood going into an area

that it shouldn't be.

And it's putting pressure on the cells that are there.

And so it can k*ll off some of the brain cells.

Your brain will start to swell.

So eventually, your brain is not gonna

get oxygen, because it's not as much blood

is gonna go up into your brain.

NARRATOR Though now in a deep coma,

Walter's enlarged heart keeps pumping.

And his lungs, which had been of normal size

start filling with fluids, a phenomenon most

often associated with coma.

Walter's brain, constricted by the increased pressure

generated by the pontine bleed finally

shuts down, stopping his heart.

That something as common as high blood pressure

could have such devastating effects surprised

Walter Pryce's friend Bill.

I have right here at the house, a way

to check his blood pressure.

And I didn't even offer to do it.

I don't know why I didn't do it.

We pull it out all the time and check everybody and myself

routinely.

And if he had high blood pressure,

I didn't know it-- he said he had some symptoms,

but I didn't understand them.

That kind of makes me feel a little guilty that I might've

been at fault for that.

NARRATOR And for Dr. G too, Walter Pryce's death is

a tragic cost of homelessness.

The lesson from him would be easy to say is,

you know, go and get your blood pressure

checked and-- and get a--

and get a checkup.

But then again, he's homeless.

He has no money.

Where's he going?

NARRATOR Discovering the pontine hemorrhage

is very rare in the autopsy room.

And it guided Dr. G's findings.

But what do you do when every clue leads to a dead end?

Next on Dr. G, the mysterious and unexpected death

of this young mother of two.

Completing a death certificate is

not the only reason to get to the bottom

of a medical mystery.

For friends and family, Dr. G's findings

are the final chapter in the lives of their lost loved ones,

the final word that, though often bittersweet,

can offer a much needed peace of mind.

In the cases of Walter Pryce and Mario Rossetti,

the final analysis came quickly.

Then, there are the cases, like Stacey Gomez, which stumped Dr.

G for three agonizing months.

Waiting for a breakthrough, her husband Ju.

You want to know exactly what happened.

And it's not even really for peace of mind.

It's just so that maybe one day, you won't--

you won't hate--

NARRATOR Ju Gomez, a -year-old father of three,

has recently lost his wife to a sudden and mysterious illness.

His family's tragic story begins on an evening like any other,

when Stacey Gomez says good night to her husband.

With two kids and a secretarial job to make ends meet,

she usually tires out early.

And on this night she's in bed by PM.

Two hours later, Ju Gomez joins her.

JU (VOICEOVER) About I heard this noise, kind

of like an air conditioner, just one continuous sound that was--"], index ,…}

that my ears picked up on.

I turned and I banged the air conditioner a couple times.

And I said, what's wrong with this thing?

NARRATOR But the strange sound isn't coming

from the air conditioner.

It is emanating from his wife.

JU (VOICEOVER) I'll never forget that sound.

It wasn't breathing.

It wasn't-- it was just like something was escaping her.

DR. G (VOICEOVER) She's probably already

hypotensive, or in a coma.

At that point, she was probably pretty

sick is what I'm trying to say.

When I realized something was wrong with Stacey,
[ … ]

I jumped over the bed.

I ran, looked at her.

I was just thinking, maybe she was choking or something.

And I turned and I noticed her stomach.

She looked like she was nine months pregnant.

Her stomach was completely bloated.

NARRATOR In a panic, Ju calls for help.

While he was calling , saying how sick his wife was,

she stops breathing.

And so he starts, I believe, CPR.

And when I went to go do the third breath,

there was a smell that came out of her.

And it didn't smell right.

It smelt like, you know, like a toxin,

some kind of like a poison.

NARRATOR By the time the emergency medical team arrives,

Stacey is barely hanging on.

She isn't breathing.

Her heart has stopped.

DR. G (VOICEOVER) They were able to get her heart back,

but basically, she was already brain dead at that point.

NARRATOR Once Stacey arrives in the ICU,

she is being kept alive by machines.

I looked in her eyes and--

and there was-- there was nothing there.

What made Stacey wasn't there anymore.

DR. G (VOICEOVER) They did heart tests on her.

They did an angiogram to send a dye

through her coronary arteries.

They did CAT scans.

They did all sorts of tests.

NARRATOR All of their test results were inconclusive.

JU (VOICEOVER) At the end of that night,

they said they couldn't find anything wrong with her.

Nothing.

She was completely healthy.

They said it was just like she stopped.

That's what happened.

Like she just stopped.

You know, I need an autopsy, because, you know, this

doesn't-- this ain't right.

This just does not--

this is impossible.

DR. G (VOICEOVER) The case of Stacy Gomez was complicated

for several reasons.

One is she has a lot of effects of being in the hospital

basically dead for hours.

NARRATOR After Dr. G opens the body,

she discovers that the emergency treatment Stacey

endured in the hospital will indeed

make her task more complicated.

A balloon pump placed in her heart has lacerated the aorta.

Her brain is also soft, a result of prolonged life support.

DR. G (VOICEOVER) I have to kind of tease apart

what were the changes that were the result of her just being

kept alive for hours versus what were the changes

that were a result of the--

the reason she died?

You find anything?

Not so far.

- Anything in her stomach? - Nothing really.

You know, it's gonna to be a process of elimination,

basically.

You're gonna have-- we're gonna have to see.

NARRATOR Dr. G soon discovers one lead the hospital did not

pursue fully.

The first thing that was really remarkable on her

is that her bowels were distended

with tremendous amount of liquid diarrhea,

all except the left colon.

The left side was clamped down.

And they saw that on the CAT scan.

What they didn't see is that she-- part of that bowel

was dead, that was dying.

NARRATOR When a bowel, or the colon,

dies inside the human body, bacteria

leaks into the bloodstream, which can cause blood pressure

to drop and the heart to stop.

DR. G (VOICEOVER) That colon, probably, was really important.

But what was wrong with that colon?

I wasn't really sure it was dead.

But why?

I knew it was gonna be a hard case.

NARRATOR How did Stacey become fatally ill?

And what clue will enable Dr. G to close another case?

When "Dr. G, Medical Examiner" continues.

One of the toughest cases Dr. G has ever encountered

is that of -year-old Stacey Gomez.

After her vital organs stopped functioning

in the middle of the night, she dies at the hospital.

As she often does in difficult cases,

Dr. G reaches out to a surviving family

member in search of more clues.

The first thing I did is I had to call the husband.

He had to go through with me the steps leading to when

he found her dead in bed.

NARRATOR The phone call marks the beginning

of a remarkable four-month journey for Dr. G and Ju Gomez.

JU (VOICEOVER) She listened.

I was a lot disappointed in the doctors.
[ … ]

But Dr. G, in her position, she--

she took the time to talk to me.

And she really treated Stacey, you

know, like-- like a human being, not like a file.

His reaction from the first time I talked to him

was emotional.

Why wouldn't it not be?

The woman he loved, the mother of his two children,

he's left with two children, dies suddenly

and nobody can give him an answer why she died.

She's like plucked away from him and he has no clue why.

JU (VOICEOVER) She said, I want to find

out what happened your wife.

She said, just give me time.

And I said, OK, you have as much time as you want.

I don't care.

Find out what happened.

DR. G (VOICEOVER) I warned him that there was a chance that we

would not know why she died.

I had to prepare him for that.

NARRATOR As post-autopsy work begins,

Dr. G sends out samples of Stacey's blood

and sections of her colon and other organs

to be analyzed by the toxicology department.

DR. G (VOICEOVER) Toxicology was negative.

No evidence of poisoning.

No evidence of heavy metals.

Her cultures, where we try to find bugs, infectious agents,

were all negative.

She kept trying really hard to find something.

And she was-- she was real worried that

she was gonna have to change--

you know, keep the death certificate the way

it is and say, you know, cause unknown.

And she was really worried about that.

She didn't want to do that.

NARRATOR But as weeks turned to months, Ju's

concerns turned to desperation.

Pain doesn't do this just--

it's not a good word.

They should make a new word for this.

And you know, you're completely in love

and you'll always be in love and that you're talking one minute

and the next minute they're not there,

it's hard to go on even doing the simple things

without knowing what happened.

His reaction was he didn't think

he could go on in life if I-- if he

didn't know why his wife died.

NARRATOR Just when Dr. G is about to designate

the case undetermined, she decides

to make one final attempt to unravel

the mystery of Stacey's death.

She said, well, give me another week.

Let me find--

I want to-- I want to do one more test.

DR. G (VOICEOVER) I was in my office.

I think I was looking at the microscope.

And I just thought, you know, let's look at what exactly

you found again.

Let's just look at everything.

And that's when it dawned on me that she had,

probably, blood clots in her spleen causing infarcts,

or dead tissue.

And it just-- a light came on.

What's happened here is that she's got Ischemic colitis.

NARRATOR Ischemic colitis is a condition in which a blood

clot kills a person's bowels.

DR. G (VOICEOVER) She's not getting

enough blood to that bowel.

Now, what would be the answer that I can't see why

she's not getting enough blood to the bowel

would be the-- a clot.

It all of a sudden started making sense.

The most likely explanation for her death

is that a blood clot formed in her bowel vasculature,

causing that part of the bowel to die

and then she probably had bacteria in her blood

and caused her to code, or her blood

pressure go down to the point where her heart stops.

NARRATOR But another key mystery remains.

Ischemic colitis is common in older people.

So what could've caused the blood clot in someone so young?

DR. G (VOICEOVER) So we went to the literature.

And we found something in the Journal of Gastroenterology,

I believe it was, at the Mayo Clinic.

They looked in the past years, years,

basically, of all the young people

they had with ischemic colitis.

And it just--

I mean, when you read it, a light goes on.

This was-- this was Stacey.

NARRATOR In the study, females in their s

who suffered ischemic colitis all had one thing in common.

There is a high percentage of these women

on birth control pills.

NARRATOR Six months before her death,

Stacy decided, for the first time in her life,

to use oral contraceptives.

Although the pill is considered one of the world's safest
[ … ]

and most effective forms of birth control,

each package contains specific warnings.

One in particular stood out to Dr. G.

It's a known risk factor for that birth control pills,

that women on it can have blood clots.

NARRATOR Only a very small percentage of women on the pill

ever form blood clots.

At times, they are not even deadly.

Dr. G's research, however, leads her to believe that Stacey

is in that tiny minority.

DR. G (VOICEOVER) Everything in this study really fit Stacey.

It's presumed that possibly it is the clot that is

what causes the bowel to die.

NARRATOR Now, four months into the case,

Dr. G knows for certain that Stacey has died because

of a dead bowel, k*lled by a blood clot in her spleen,

which may have come as a result of taking birth control pills.

I was excited.

I was excited that I really felt good that we

have figured it all out.

NARRATOR Now, Dr. G can finally reach out and place the phone

call she's been longing to make.

JU (VOICEOVER) She told me the next day,

she told me to sit down.

She found out her bowel had died and stopped and forced

toxins into her lungs.

And that's what I smelled that-- that night.

And-- and they said that sound must

have been the toxins escaping.

I kind of dropped the phone.

And I picked it back up and she asked me if I was OK.

And I started-- I just started crying.

I couldn't believe it.

NARRATOR As the facts about Stacey's death sink in,

Ju begins the process of healing.

DR. G (VOICEOVER) Once he found out why she died,

he could start grieving and then going on to the step of now

she's gone.

He was still in the process as like--

as if he was still at the hospital

waiting for a diagnosis.

I mean, in his mind, he knew she was dead.

But he hasn't stepped--

taken that first step that, yeah, she's dead.

I got to move on.

I don't-- I don't think he'd passed that yet.

NARRATOR After four months of shared agony, spent only

on the phone, Dr. G and Ju Gomez finally

agree to meet in person.

DR. G (VOICEOVER) It was very emotional for me.

I was about the only person he told me he could

talk to about his wife dying.

And to see him, it was very emotional for me, because I

know how much he's suffering.

The only thing that kept me sane

was my kids the hope that the doctor would find something.

And she did.

She found out what happened to Stace.

I'm glad I had--

I had the time to take care of her.

- Yeah. - And be there with her.

Now, you got your two beautiful kids too.

NARRATOR The work that goes on here

gives grieving families closure.

It helps them comprehend why their loved

one is no longer with them.

Science often solves the mysteries,

but human connections create the full story.

DR. G (VOICEOVER) Instead of being cold and callous

and trying to build a wall there and saying, no, I'm just

a scientist, I need to find-- just find the answer,

I feel that I can help these people by talking to them.

- Thank you very much. - You're welcome, Ju.

Good luck. OK?

Good luck with those kids.

I have the best job in the world.

Because every day, I see how horrible life is.

And that makes me live my life fuller.

And it's gonna happen.

And you just have to accept that.

And it's not something to shy away from.

Death is not something to ignore.

It happens.

It happens to everyone.

It certainly hurts when it's your loved one,

but it's gonna happen.

And you should live your life like it could happen tomorrow.

[music playing]