01x08 - A Cry for Help

[bunniefuu]

[MUSIC PLAYING]

NARRATOR Police discover a dead man

lying naked in a pool of blood.

DR. G He has matted hair, blood everywhere.

There aren't too many things that

will give you that much blood on the outside of your body.

NARRATOR A clear cut case of m*rder?

Or is there another, stranger explanation?

Then, an Orlando security guard calls home on his cell phone

for help in the last moments of his life.

He was terrified.

I could tell by his voice he was scared.

NARRATOR Can Dr. G determine who or what k*lled him?

And a -year-old spends the night partying with his family.

The next morning, he doesn't wake up.

[INAUDIBLE]

I had to take my two hands and turn him over.

And his eyes was open.

And I started screaming.

NARRATOR What could have shut this young man's

body down so quickly?

Altered lives, baffling medical mysteries,

shocking revelations.

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

It's PM on a warm January evening.

Two police officers cruise through one of the city's

roughest neighborhoods.

The radio crackles with routine chatter, when suddenly,

without warning, the unmistakable sound of g*nf*re

explodes through the streets.

Moments later comes the call.

[INAUDIBLE]

A body has been found just a few blocks

from the officers' patrol car.

When they arrive on the scene, they

are confronted with a strange and horrific sight--

a man, naked, face down, in a pool of blood, dead.

Here in Florida, where so many flock to rest and play

beneath carefree skies, five people

die from g*nshots every day.

By law, each of these deaths becomes the business

of the Chief Medical Examiner.

In Orange County, that person is Dr. Jan Garavaglia,

better known as Dr. G.

DR. G Is there nothing going on today?

What's after school?

Just Spanish, right?

Tuesdays.

All right, so who's picking you up today?

NARRATOR When death strikes without explanation,

she's the one who must unlock the secrets

and answer the questions.

What claimed this mysterious man's life?

Was this a cold blooded m*rder?

If so, who did it and why?

When Dr. G arrives at the morgue at AM,

last night's victim is first on her roster.

Homicides are always the highest priority at the ME's office.

I got a couple calls on this guy

last night, in fact, several.

And two police officers were patrolling in this area

and they hear some g*nshots.

And then they get a call that somebody reported a man down.

And they go to investigate and found

this gentleman, nude, face down, with a lot of blood on him.

It didn't sound good.

NARRATOR First Dr. G preps the body

to check for the number one suspected culprit, a b*llet.

DR. G Anytime I do suspect a g*nsh*t wound,

I would X-ray the body.

NARRATOR Any b*llet fragments will show up

as small specks of light, like these seen in the X-ray

of another g*nsh*t victim.

Using the film as a roadmap, Dr. G

will probe the victim's body for clues

to turn over to police ballistic experts.

While she waits on the X-rays, a quick glance over his body

reveals a life that was anything but easy.

We really don't know much about him.

We don't know his age.

We don't know his name.

By looking at him, though, he seems

like he's had a rough life.

He's got yellow staining of his beard,

consistent with nicotine staining.

He's also got nicotine staining of his fingers.

He's got deep, deep furrows in his face.

We often see that with heavy cigarette smokers.

Looks just generally unkept, dirt

under his nails, disheveled hair.

Looks like a transient.

NARRATOR As soon as the X-ray is ready,

Dr. G inspects the image for b*llet fragments.

But there is something strange.

After a thorough going over, she doesn't see a b*llet at all.

The head X-ray shows no b*ll*ts.

So it's basically negative for a projectile.

But that doesn't mean the projectile didn't exit.

And I have heard of pathologists--

forensic pathologists who do autopsies and actually
[ … ]

miss g*nsh*t wounds to the head, especially

a small caliber, , , exits, and you

may not see anything on X-ray.

NARRATOR The only way to know for sure

is to open the man's skull, starting with a slit

across the top of the head.

Dr. G's assistant frees the scalp, which is then

carefully, but forcefully, rolled down over the face.

Using a vibrating saw, the same type used to remove hard casts,

he cuts through the skull.

Dr. G then steps in and begins her internal examination.

But after a painstaking inspection

of the inside of the skull cavity,

there is still no evidence whatsoever

of a wound to the head.

No b*llet.

So we don't see any b*llet there.

So he definitely doesn't have a b*llet in his head.

NARRATOR Dr. G is back at square one.

As the autopsy poses even more questions,

field investigator Dean Smith looks

outside the morgue for answers.

We've just met with the police on the gentlemen.

They have gained access to his residence.

We know who he is now.

NARRATOR The mystery man now has a name--

Charles Simmons.

He was a drifter who called a ramshackle, vacant apartment

home.

But that's not all they discover.

Inside his makeshift residence, police find

an important clue for Dr. G--

tissues soaked with blood.

One possibility, which is looking more likely,

is that it may be something that he's coughing up

blood or vomiting blood from a gastrointestinal tract

or from his lungs.

NARRATOR But what condition would cause him

to cough up that much blood?

And was that condition fatal?

Dr. G goes back to the X-rays, this time looking at the chest.

She notices clusters of small specks on his lungs.

She believes the specks are granulomas, tiny clumps

in the lungs, where immune cells have surrounded

and encased the bacteria, a possible sign

of severe tuberculosis.

What does worry me, though, is that his X-ray

of his lung doesn't look good.

He's got some very big hilar lymph nodes.

There's some other material in his lungs

that I can't tell at this point.

Could be TB.

I'm very worried about TB from the lymph nodes.

NARRATOR Tuberculosis is a dangerous infection

of the respiratory system that usually

occurs when a certain type of bacteria

is inhaled into the lungs.

Left untreated, tuberculosis bacteria

will develop granulomas, which grow in the lungs'

oxygen rich air sacs.

They destroy tissue as they expand,

eventually causing enough damage to rupture the blood vessels.

The presence of tuberculosis could change all presumptions

about the case.

But with it comes serious risk.

If mishandled, even after the carrier's death,

TB can be a highly contagious, even deadly pathogen.

Next on "Dr. G, Medical Examiner",

the Orange County morgue is about to become

hazardous territory.

We're not going to get TB from him with him just lying here,

but once we open up him, there's a chance

we could get TB if he had it.

So this is where we're going to go ahead and put our masks on.

NARRATOR And later, moments before he

died, this man made a last desperate call for help.

KIM MORRIS I kept saying, Glen, what is wrong,

and he kept saying, I don't know, I don't know.

NARRATOR Can Dr. G determine who or what k*lled him?

[MUSIC PLAYING]

Chief Medical Examiner Dr. Jan Garavaglia

is up against a baffling case.

Charles Simmons was found naked, dead in a pool of blood,

just after g*nshots were heard.

Yet after a series of X-rays and a full examination

of the skull, Dr. G has come to the surprise conclusion

that he wasn't shot.

We are % sure now there is absolutely no trauma.

Now we're % sure, no b*llet wounds.

NARRATOR So what did k*ll him?

Her primary suspect is now tuberculosis,

a deadly and highly contagious bacteria,

that if gone untreated can cause its victim to cough

up lethal amounts of blood.

The only way to confirm this theory

is to dissect the man's lungs.

But by doing so, she puts herself

and her entire team at risk.

So in this individual, since I am worried about TB,

we're going to go ahead and wear a mask.
[ … ]

And we'll wear that mask until I either prove it's not TB

or we get rid of him out of the morgue.

NARRATOR Dr. G makes a y incision across the torso,

cutting from shoulder to sternum,

to fully reveal the internal organs

and the man's ravaged lungs.

This is not looking good.

You can already see the adhesions.

I'm palpitating the lungs.

I'm feeling them.

And it looks like he's got a possible TB in his lungs.

NARRATOR By examining the outside surface of the man's

lungs, Dr. G's becoming more convinced that he had once

suffered from tuberculosis.

But she soon realizes that tuberculosis may

be just the tip of the iceberg.

By palpating the lungs, you can feel that there's

firmness to the lungs.

There should be air in the lungs.

But here, there's a firmness, like maybe TB, maybe pneumonia.

But what's worse is on the top of this right lung,

at the upper portion, is a large mass, what feels like a mass.

And I'm suspecting that it's cancer.

But when we cut into it, we'll be able to see.

Yes, absolutely, that's what it is.

It's lung cancer in the upper right portion of his lung.

NARRATOR And it's one of the worst cases she's ever seen.

Like the suspected g*nsh*t wound,

the TB was a red herring, a dormant illness

that no longer posed a health risk

and wasn't the cause of death.

Cancer is the culprit.

It's white, it's firm.

It's eroding into the lung tissue.

So he has a cancer in his lung.

And that's a really quite large cancer.

NARRATOR In the final analysis, it

was not random urban v*olence that k*lled this man,

but an unchecked cancer that aided

his lung for years on end.

The tumor was in his right long in the upper portion

of his right lung, more towards the midline,

in the bronchus, the breathing tube.

It starts growing there, inside the bronchus,

on the wall of the bronchus, and then it starts growing out

into the lung itself.

NARRATOR With this discovery, Dr. G

can now piece together the last moments of the man's life.

On the night of his death, Charles Simmons begins

a violent fit of coughing.

Inside his chest, the tumor has dealt its final blow,

pushing through the wall of his lung

and opening a hole into his pulmonary artery.

Like a bursting dam, blood begins

to flow through the hole, filling his lungs.

And the blood could just come straight

out through that tumor, right into the bronchus.

NARRATOR Alone and unable to cry for help,

he suddenly realizes the severity of his condition.

I'm sure he was panicked.

That would be a very scary way to die.

NARRATOR Perhaps seeking help, and with no time to dress,

he leaves his residence, stumbling

naked onto the street.

But it's too late.

He's lost pints of blood.

By the time he collapses in the parking lot,

there's not enough blood left to carry oxygen to his brain.

He is bleeding to death from the inside.

Then somewhere nearby, a g*n is fired.

DR. G That night, the police were on patrol

and they heard two g*nshots.

OFFICER sh*ts fired--

WOMAN [INAUDIBLE] , repeat the location.

Then they got a call that somebody called in ,

and that there was a person down about two blocks away.

[SIRENS]

NARRATOR But, of course, he did not have a g*nsh*t wound.

And the source of the g*nf*re heard

that night by patrolling officers

was never accounted for.

Incredibly, the man who came into the morgue

as a m*rder victim is leaving as the victim of natural disease.

Dr. G believes that the way the man died

provides a poignant glimpse of how he lived.

DR. G Obviously, this is a somewhat of a transient, didn't

take good care of himself.

And in that population, we do tend to see horrific things

that these tumors do.

They let them go, and go, and go.

NARRATOR By all accounts, Charles Simmons

led a difficult life.

But in cracking this complicated case,

perhaps Dr. G has done something for the man in death

that others could not do for him while he was alive.

DR. G I have a lot empathy for people who died suddenly

and nobody cares about them.

So if nobody is going to care about him,

I'm going to care about him, and I'm

going to work just as hard to try to figure out why he died.
[ … ]

NARRATOR In cases like Charles Simmons,

the victim has no family to mourn for them.

But more often than not, there are

many loved ones left behind who need

answers to difficult questions.

It's AM on a Sunday morning in February.

And the moment the phone rings, Kim Morris and her daughter,

Kara, know something is wrong.

KIM MORRIS Hello.

NARRATOR Kim's longtime boyfriend, Glen Carter,

should be returning home after working an all-night shift

as a security guard.

Instead, he's calling from his cell phone,

and Kim can barely understand what he's saying.

KIM MORRIS Glen would never call me in the morning.

And when I picked it up, I thought

it was somebody playing a joke.

I could not understand this person, what they were saying.

His voice was so slurred and his words were so drawn out.

That's why I kept saying, who is this?

And that's when he told me, he says, it's Glen.

NARRATOR Glen Carter, is a year veteran police

officer from Michigan.

Only three years earlier, after retiring from the police force,

he relocated to Orlando, Florida with his girlfriend, Kim,

and their -year-old daughter, Kara.

There, he planned to pursue his dream job,

as a security guard at a local Orlando theme park.

KIM MORRIS To Glen, it was never work.

I mean, that's all he talked, that's all he lived,

it's all he breathed.

He loved it.

NARRATOR Now however, Glen is obviously in trouble.

Still hanging on the phone with Kim,

he seems to be growing increasingly confused.

KIM MORRIS I kept saying, Glen, what is wrong?

And he kept saying, I don't know, I don't know.

NARRATOR Kim pleads with Glenn to tell her where he is.

Finally, he says something she can understand.

KIM MORRIS He told me, he said, at work.

And I yelled at him to call .

And he kept telling me he couldn't.

He couldn't, he couldn't.

NARRATOR Then the agonizing minute

phone call abruptly ends.

The line goes dead.

KIM MORRIS I tried calling them over, and over,

and over, and over, and over.

NARRATOR Kim is beside herself.

Has Glen been injured?

Fallen victim to a violent crime?

Or perhaps he's become desperately ill.

Well, at that point I was scared.

NARRATOR Unable to reach Glen on his cell phone,

Kim at once calls his job and begs his co-workers

to look for him there.

KIM MORRIS I said something's horribly wrong,

you need to find him now.

NARRATOR Then she dials .

As friends and co-workers search for Glen

in and around the theme park, the Orange County Sheriff's

Office tracks the miles of roadway between Glen's

home and his job.

But no one can find him.

KIM MORRIS I talked to about times.

I talked to his work about times.

And I tried calling him over, and over,

and over, and over, and over.

NARRATOR Then finally, nearly two hours later,

one of Glen's co-workers finds him in the middle of the theme

park's acre parking lot.

He is unconscious and not breathing.

KIM MORRIS He yanked the door open

and started CPR on him until the ambulance arrived.

NARRATOR But the ambulance is too late.

Glen Carter is dead.

And for Glen's girlfriend and family,

there are only difficult questions.

What or who k*lled him?

And more distressing, if help had arrived sooner,

could Glen Carter have been saved?

KIM MORRIS I wanted to know what he died from, of course.

And could it have been prevented, you know,

was he suffering?

DR. G We have a -year-old man who works as a security guard.

He calls his girlfriend, and says, something

about that he's in trouble.

She calls a friend of his that she knows works there.

And he goes out and finds his car in the parking lot

and him pretty much dead inside.

NARRATOR Most deaths that are reported

to the Orange County morgue do not require autopsies.

After reviewing medical history and the circumstances of death,

approximately % of the cases do not need an autopsy

to determine cause of death.

DR. G We look at the circumstances of death.

We look at the age.

We look at natural disease.

If you're years old, and just in bed,

and there's no evidence of foul play, we don't have to autopsy.
[ … ]

NARRATOR On first blush, Glen Carter's may be one such case.

His medical records show that he suffered

from acute coronary artery disease

and hypertension, both natural diseases that

could have led to his death.

That's by far the thing we see most

at the medical examiner's office, a sudden death

associated with heart.

NARRATOR But in Glen's case, one odd piece of information

from the field report grabs Dr. G's attention,

suggesting that his death might not have

been caused by heart failure--

the minute phone call.

DR. G Usually, when we see the sudden deaths from heart,

they go pretty fast and don't have a lot of time to call.

It didn't quite sound right to me.

NARRATOR Also troubling Dr. G is the family's

feeling of culpability that they could

have done more to save Glen.

DR. G She was very worried.

I think that needed to be put to rest,

if that was something that could have happened or not.

Because she would always be thinking about that.

NARRATOR Then too, is the possibility that Glen

was the victim of a crime.

In Dr. G's estimation, the only way

to get to the bottom of Glen Carter's unexpected death

is to perform a full autopsy.

She starts with a thorough examination

of the outside of the body.

They looks like little abrasions,

or some skin slippage.

NARRATOR During the external exam,

Dr. G documents the physical traits of the body.

Dr. G also searches for any external clues

on the body that might indicate a cause

of death, including foul play.

As a security guard, Glen served as the front line

for any trouble in the theme park.

Perhaps his slurred speech and disorientation are

symptoms of a blow to the head.

Maybe something bumped him on the back of the head.

There's always that possibility.

And you always keep an open mind that there's

maybe something else going on.

NARRATOR Externally, though, it is

sometimes difficult to detect trauma,

especially a cranial injury.

This will have to wait until later in the autopsy.

What is obvious during the external exam,

however, is evidence of Glen's coronary artery disease.

DR. G We've got the midline scar

associated with his previous heart surgery.

It doesn't take a genius to recognize the scars

or bypass on his chest, you know a big scar going right down

your chest, and scar going up your leg,

where they take the graph from to sew into your heart.

So that was clear.

NARRATOR But not much else is.

The external exam has yielded few clues as to what

happened to Glen Carter.

At this point, Dr. G cannot rule out anything.

But she remains undeterred.

We're going to figure out why he died and could

somebody have saved him.

NARRATOR Next on "Dr. G, Medical Examiner."

Dr. G leaves no stone unturned in the search

for what k*lled Glen Carter.

DR. G There's always a suspicion of foul play,

because we don't know what's going on on the other end

of the phone.

We just know something was wrong.

NARRATOR And later, a seemingly healthy young man

inexplicably dies in his sleep.

What took Richard's life?

[MUSIC PLAYING]

After a desperate minute call to his family for help,

Glen Carter was found dead inside his car

in the parking lot of an Orlando theme park.

Glen's history of heart problems and bypass surgery

points to a deadly heart attack.

But one nagging issue keeps raising questions for Dr. G.

DR. G He's calling up, complaining that there's

something not right, not usually what we see with sudden death

from heart disease.

NARRATOR Glen's family continues

to wonder whether he could have survived

had help only arrived sooner.

Dr. G hopes to find answers to their question

by examining Glen internally.

First up is his heart.

And Dr. G is surprised by what she finds.

His coronary artery disease is dangerously advanced.

I don't see any area for the blood to get through.

It's completely occluded.

NARRATOR Despite her lingering reservations,

Dr. G is now wondering if heart failure is

the cause of Glen's death as some of the outward evidence

suggests.

DR. G Well, the disease progressed.
[ … ]

He'd had the surgery nine years ago

and the disease just progressed.

NARRATOR In many cases, bypass surgery

results in a normal, functioning heart for many years.

But sometimes the lasting effects are much briefer.

Well in Glen's situation, the plaque was

built up in the blood vessels.

And it was building up in the bypass grafts.

And so it was still--

his heart wasn't getting enough blood.

That's not good.

NARRATOR Inside Glen's artery, plaque had accumulated.

When the blockage interfered with blood flow,

his body grew a network of smaller blood vessels

to feed the starved tissue.

This process is known as angiogenesis.

In Glen's heart, angiogenesis was well underway.

A lot of smaller, what we call collaterals,

had to have been formed.

Because so many of the other ones were completely clogged.

NARRATOR Despite the extra collateral blood flow

from the angiogenesis, Dr. G can see

that Glen's heart was still not receiving

sufficient blood supply.

She finds many areas of dead or dying tissue in the muscle.

Some are several months old, some more recent.

I can see that he's got a little listing

depressed area here.

This is at least two months old.

He's got a small area here that's several weeks old

that it hadn't gotten enough blood and was dying.

So there's little parts of his heart that are dying.

NARRATOR This means that apparently Glen

had been suffering from imperceptible yet damaging

heart att*cks for some time.

There is a very high percentage--

some people say up to , %, some people say %--

of heart att*cks, you just don't feel them.

NARRATOR Then when Dr. G weighs Glen's heart,

she finds another problem.

It's greatly enlarged, a harmful effect of hypertension.

DR. G You could see that he had high blood pressure.

His heart was enlarged, not from the coronary artery disease,

but enlarged from hypertension.

NARRATOR Contrary to her initial hunch,

the evidence so far is leaning strongly toward a heart attack.

So the heart, after seeing it, thought, boy,

that's a good candidate for sudden death.

NARRATOR But how can Dr. G be sure?

When a person dies within a few minutes of a fatal heart

attack, the body doesn't have enough time

to produce any changes to the heart muscle

that you can see with your eyes or even a microscope.

Changes will only be visible on someone

who has survived at least four to six hours

after the coronary event.

So oftentimes, when people die of a heart attack

and it's very sudden, I don't see

any heart damage whatsoever.

NARRATOR Glen's case is no different.

His heart shows no signs of a fatal attack.

Determining whether or not he died of heart disease

will require one thing--

ruling out everything else.

DR. G We'll make sure--

we'll make sure there's nothing else going on.

I wanted to make sure that autopsy

was done I wanted to see if something trump the heart.

The brain, that's all I had left.

OK, so we're ready to--

Arden's ready to go ahead and reflect the scalp

and we'll look at that.

And we do we have all the weights written down?

Thank you.

NARRATOR Once the scalp is reflected, or peeled back,

and the skull is opened, Dr. G's first task

is to determine whether or not Glen could have

died from trauma to his head.

DR. G So that's all we reflected.

Nothing, no bruises on the inside.

NARRATOR Not only is there no trauma,

but Glen's brain looks perfectly normal for a -year-old man.

His brain looks fine so far.

We see the top the hemispheres of the brain.

They look pretty good.

Yeah that's when I was getting a little disappointed.

I was a little disappointed, because I really

thought it was the brain.

NARRATOR But as Dr. G removes the brain

from the skull cavity, she finally uncovers

the first abnormality--

coagulated blood.

I could see that it wasn't quite right.

It was swollen, and then you could see a little bit

of blood coming out.

NARRATOR Leaking blood, such as this, is never a good sign.

It means Glen suffered some sort of stroke.

And as she traces the blood to the base of the brain,

Dr. G can see right away what k*lled

Glen Carter without a doubt.
[ … ]

He's got a Pontine hemorrhage.

Yeah.

NARRATOR The pons is a part of the brain stem, located deep

within the base of the brain.

Though it is a small area, about the size of a walnut,

it serves as a vital conduit between the brain

and the spinal cord.

Any injury to the pons can be devastating.

Let me make sure I check--

NARRATOR Dr. G's original hunch was correct after all,

Glen's heart didn't k*ll him.

It was a hemorrhagic stroke in his brain, most likely

caused by his high blood pressure.

Based on her findings, Dr. G can now

reveal what happened to Glen Carter

as he left work at the Orlando theme park that Sunday morning.

According to Dr. G, Glen Carter likely

suffered from high blood pressure

without treatment for many years.

Over time, this caused the walls of the small blood vessels

within the vital area of the pons to weaken and bulge.

As Glenn walks to his car after work that morning,

it is likely that one of the weakened vessels

begins to bleed.

DR. G I think it started out slow.

He's not feeling well.

He's sensing something's wrong, and then his speech

starts getting slurred.

NARRATOR Once in his car, he calls his girlfriend, Kim.

KIM MORRIS He kept saying I love you.

I kept saying, Glen, Glen.

I could hear him kind of breathing.

DR. G I think he knew.

I think he knew that he was probably dying.

That's why he's telling her he loves her.

NARRATOR By this point, Glen might not

be able to see or control the fine motor

movements in his hands and fingers needed to call .

The hemorrhage begins to affect his speech and brain function.

Within minutes, as the bleeding in the pons

begins to overwhelm Glen's brain, he loses consciousness.

His respiratory system fails.

His heart ceases to beat, and he dies.

Based on Dr. G's findings, Glen's family

now knows that they could not have saved

him had help arrived sooner.

A Pontine hemorrhage is almost always fatal.

Even if he'd had medical attention right away,

there was nothing you could have done for him.

NARRATOR Glenn's death also illustrates

how high blood pressure can be a silent k*ller.

You can high blood for years and never know it, because you

don't have any symptoms.

You don't have any symptoms till it starts causing problems

with your heart, or you get a huge bleed in your brain,

or you destroy your kidneys. from it.

I still grieve.

I mean, what are you going to do?

I think of Glen every day.

There's nothing that doesn't happen in my home

we don't think about him, every day, every day.

NARRATOR Next on "Dr. G, Medical Examiner," a family

vacation ends in tragedy.

I said no, hold on, he's been dead all ready, he's been--

this already happened.

NARRATOR Was this young woman's brother

harboring a deadly secret?

[MUSIC PLAYING]

It's the final day of -year-old Richard DeSoto's

vacation to Orlando, where he and his brother, Alex,

are visiting their sister, Michelle.

We'll fool around like we were little kids, play

around, we'll pillow fight.

We'll play video games together.

NARRATOR Although Richard is normal in most respects,

he suffers from a mysterious long term

medical condition affecting over million Americans-- epilepsy."], index ,…}

He lost oxygen when he was born.

When he was about years old, he got his first seizure.

He would stay in bed the whole day that they got a seizure.

NARRATOR This unpredictable condition

has been an obstacle for Richard throughout his life.

He was afraid to do anything, because he thought he

was going to catch a seizure.

NARRATOR Richard, the father of a young child,

does not work and lives on disability.

According to his siblings, he has a difficult time

functioning outside the loving support

structure of his family.

He was-- he was so at peace.

He was so easygoing.

He was so happy.

I could see the joy in his face.

He was so kind.

He was at ease.

NARRATOR As the final hours of his vacation wind down,

Richard spends a carefree evening partying.

He made me laugh so much, I [INAUDIBLE] my stomach.

I got a cramp.

He was so happy.
[ … ]

NARRATOR Before turning in for the night,

he calls his mother back in New York.

He says mom I'll be home on Tuesday.

And I says, OK, honey, I'm happy that you're coming home,

I really miss you.

NARRATOR Those are the last words Carmen

will ever hear her son speak.

It's AM the next morning when

Michelle, still half asleep, hears

her brother in the shower.

But when she gets up a few hours later,

she senses that something isn't right.

MICHELLE I opened the door, he was face down,

his head was in the pillow.

Richard get up.

It's time to [INAUDIBLE]

NARRATOR Michelle desperately tries to wake him.

I started poking him.

And it was like a solid--

it was no response, no reaction, nothing.

So I knew something was wrong.

NARRATOR Frantic, Michelle dials .

MICHELLE I was screaming, oh, my god.

Oh, my god.

She said, OK, ma'am, I want you to hold his nose

and I want you to apply pressure.

He released the air back to me.

There was a funny smell.

So I said, oh, no, hold on, he's been dead already.

He's been-- this already happened.

We got a code.

NARRATOR EMS personnel arrive at AM.

They immediately confirm what Michelle already knows.

What's the monitor show?

NARRATOR Her beloved brother is dead.

OK, let's go ahead and call him.

Investigations, Bill.

NARRATOR As with many sudden deaths in Orange County,

Dr. G's field investigators are called to the scene.

Once at the house, they join police

who are conducting a search of the bedroom where Richard died.

There, police make a disturbing discovery--

a trace of cocaine is found in the night table drawer.

Could cocaine have contributed to Richard's death?

His family claims the only illicit drug

Richard used was marijuana.

He did, he smoked all his life, really.

He started smoking since he was a teenager.

NARRATOR But cocaine isn't the only drug

police find in Richard's room.

On the nightstand next to his body,

they discover a bottle of a prescription drug used

to prevent the seizures that had plagued

Richard all of his life.

Epilepsy sufferers can experience

uncontrolled convulsions, foaming

at the mouth, and sometimes loss of consciousness.

Regular medication can often effectively control seizures.

Despite the discovery of dr*gs, and the fact that Richard has

suffered from epileptic seizures all his life,

no one can tell what k*lled the young man.

That, as always, is a task that falls to Dr. G.

[MUSIC PLAYING]

At the morgue, Dr. G begins the external exam.

Right away, she notices something on Richard's

ear, a marijuana leaf earring.

DR. G We weren't sure if cocaine

was going to be involved.

We knew he'd smoked marijuana, so we didn't know really

if he was into dr*gs or not.

NARRATOR In the autopsies preliminary stage,

dr*gs become a prime suspect, because epilepsy,

despite its sometimes violent symptoms, is rarely, if ever,

fatal.

A very low percentage of people who have seizures

will die from a seizure.

It's probably less than %.

NARRATOR No one really knows what

causes most forms of epilepsy.

What is known is that it is centered

in the central nervous system, specifically the brain.

The human brain contains billion nerve cells,

each of which normally fires electrical impulses

about times a second.

However, during an epileptic seizure,

nerve cells fire an astounding times per second.

This causes a violent electrical storm

in the brain, which in turn, can set off

muscle spasms and convulsions.

Sufferers may also experience strange tastes

and hear odd sounds.

But because epilepsy is rarely a k*ller,

Dr. G's most likely culprit remains dr*gs.

She takes samples of blood, urine, and eye fluid

for the toxicology laboratory.

They will determine exactly which dr*gs were in his system

when he died.

DR. G Again, this guy will be full tox, for microscopics.

NARRATOR She will especially be on the lookout

for traces of cocaine.
[ … ]

Cocaine, a volatile stimulant, accelerates heart rate,

raises blood pressure, and can wreak

havoc in epilepsy's homebase, the central nervous system.

Certainly, somebody who has seizure activity

doesn't want to take a stimulant drug, like cocaine

or methamphetamine.

That's just pouring gasoline.

NARRATOR Next, on "Dr. G, Medical Examiner"--

Really, I thought maybe he had done dr*gs.

NARRATOR Did Richard have a drug problem that he

kept hidden from his family?

[MUSIC PLAYING]

-year-old Richard DeSoto, who suffered

from violent epileptic seizures most of his life,

is discovered dead, in bed.

Dr. G's goal, determine if Richard died of a drug

overdose, an epileptic seizure, or possibly

a combination of the two.

There's still no definite lead as to why this young man died.

Meanwhile, the people most in need of answers

remain haunted by disturbing questions.

I'm thinking maybe somebody suffocated him.

So many things went through my head.

Really, I thought maybe he had done dr*gs.

That's fine, just so it doesn't fall on you, Arden.

NARRATOR As she waits for the results

of the toxicology report, Dr. G begins inspecting

Richard's internal organs.

Though a bit large for his age, the heart checks out OK.

But what does seem suspicious is the condition

of Richard's lungs.

They're very congested.

They've got somebody edema to them.

NARRATOR Dr. G can see right away that his alveoli,

the elastic air sacs contained in the lungs,

have filled with fluid and have edema or swelling.

This condition could have prevented

Richard's lungs from absorbing oxygen and led to suffocation.

But does this new evidence point to a drug

overdose or epileptic seizure?

DR. G We see that both with people

who die after a seizure and people who die from overdoses.

So it's very non-specific.

NARRATOR After gaining no definitive evidence

from the torso, Dr. G moves up to Richard's head.

Immediately, she observes another clue,

this time in Richard's mouth.

Oh, my gosh, now that's one bad tongue bite.

See, it's kind of raw there.

That goes along with a seizure.

NARRATOR It appears to Dr. G that Richard

did suffer a seizure in the hours before he died.

But his tongue also reveals numerous old bite wounds.

Clearly, he survived those.

What was different this time?

Even though epileptic seizures are rarely fatal,

knowing that Richard had a seizure so close

to the time of his death raises a new possibility.

Could Richard have been the victim of a rare phenomena

called SUDEP--

Sudden Unexplained Death in Epilepsy?

Typically, SUDEP kills people who are young or middle

aged like Richard.

They are usually found lying face down the way Richard was.

Experts have no idea what specifically causes SUDEP

victims to die so suddenly.

And only between % and % of people with epilepsy

will ever succumb to it.

All we know is that we have a subset of seizure patients

where they are usually known seizures,

and they die without any other cause,

often with a bitten tongue.

NARRATOR But despite Dr. G's findings,

by the end of the physical autopsy,

there are still many questions left unanswered.

The final piece of the puzzle can only come

from the toxicology report.

When the toxicology report finally arrives,

it clearly shows what dr*gs are in Richard's system.

But it's what Dr. G doesn't find that helps put the finishing

touches on this unusual case.

He didn't have evidence of death

from any kind of illicit drug or prescription dr*gs.

NARRATOR There was absolutely no trace

of cocaine in Richard's blood.

In fact, with the exception of a little marijuana,

there was no trace of any dr*gs in Richard's system.

And that includes the medication he took to manage his seizures."], index ,…}

The seizure medication is supposed to, in a way,

calm the electrical activity of the brain

so it won't go off on its own.

He didn't have any seizure medication in his system.

He should have.

NARRATOR Tragically the dr*gs, only feet from his bed,

were the key to keeping Richard's

seizures under control.

The medication would made him drowsy and dizzy.

And he said that he would feel off

balance all the time, all day long, throughout the day.

So he said he was frustrated with that.
[ … ]

So I think that was one of the reasons why he stopped.

NARRATOR Having thoroughly investigated

all the possibilities, it's now obvious

that illegal dr*gs had nothing to do with Richard's death.

And the trace amount of cocaine found on his dresser

may never be accounted for.

Dr. G can now tell what happened to Richard

on his final morning.

Sometime before AM, Richard's neurons

begin to fire abnormally, causing

a violent electrical storm in his brain.

With no anti seizure medication in his system,

the most powerful seizure he has ever experienced

overcomes his body.

He loses control of his movements and bodily functions

and bites his tongue nearly in half.

He may have been unable to breathe.

Typically a temporary condition during a seizure,

but this time his breathing might not have returned.

Other people feel that it's probably not the seizure itself

that's k*lling them.

It's a cardiac arrhythmia that these people

tend to have problems.

NARRATOR Possibly, the part of his brain that controls

his heartbeat is adversely affected,

prompting his heart to beat wildly.

The irregular heartbeat then likely causes Richard's heart

to shut down entirely.

During his entire life, Richard had always recovered

from epileptic seizures.

But this one proves fatal.

He has a low level, in fact no level of Dilantin

in his system, his anti seizure medication.

He has a big bite mark to his tongue.

He's got some fluid in his lungs.

Everything's consistent with a seizure

and no other cause of death was found.

Thank god that the tox report says that there

was no sign of cocaine.

NARRATOR Still, Richard's death is a tragedy

that can serve as a valuable lesson

for anyone dependent on a drug therapy plan.

I feel like he did it to himself

and he hurt me so much, that whoever at this point

has the same problem that he has should take his medication

and take it more seriously.

And if you just take your seizure

medication, and make sure that you tell your doctor when you--

don't stop it on your own.

Don't stop it abruptly.

You shouldn't have any problem.

[MUSIC PLAYING]