01x11 - Fighting for the Truth

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[MUSIC PLAYING]

NARRATOR A known roughneck is found

dead in a restaurant kitchen.

Whenever this individual's there,

he did seem to draw troubled.

There's a knife.

NARRATOR The police have dozens of clues

and even more theories.

There were a lot of things going through my mind.

NARRATOR But it's Dr. G's discovery

that breaks the case wide open.

Very small octagons with, then,

parallel, linear contusions.

NARRATOR And then, a man is rushed to the hospital

suspected of overdosing on a common, over-the-counter pain

medication.

He looked bad and he was turning gray already.

NARRATOR The question for Dr. G is, was his death a su1c1de

or an accidental overdose?

It was unusual that he came in right away and-- and that

coded, or became unresponsive with

no pulse or blood pressure.

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

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

It's almost AM on Monday in a sleepy south Texas town.

Cook Jason Montez arrives to work

at the local Mexican restaurant.

He immediately senses something amiss.

By this hour, the place is usually bustling with activity.

Head cook Michael Graham would usually

be greeting vendors, accepting deliveries, and preparing

for the lunch crowd.

But today, the restaurant is silent.

Then, as Montez walks into the kitchen, he sees why.

His friend, Graham, is lying on the floor,

not breathing and unresponsive.

Michael.

Montez calls the local police.

Just before o'clock, a call came

out that they had found an individual

inside the restaurant.

NARRATOR When police arrived, they

immediately declare the entire restaurant

property a crime scene.

Detectives then begin documenting

and collecting an array of puzzling evidence

found at the scene.

A large knife lies on the floor near Graham's body.

A kitchen telephone has been torn from the wall.

[INAUDIBLE]

On the floor, police discover blood, a series

of spatters leading from Graham to a car in the parking lot

out back.

It's am obvious trail of blood that

goes over to an old abandoned car

that was sitting in the back.

The windows are smashed.

The tires are cut.

NARRATOR They also find what appears

to be Graham's address book, along with an open, empty cash

box.

Looked at the cash box and, naturally, I'm thinking,

well, we got a robbery.

Maybe he startled a robber.

I don't know.

NARRATOR The morgue's field investigator

soon arrives at the scene.

Both he and police make an appraisal of the body.

Graham has several minor scrapes and a few black and blue marks,

but nothing to suggest a cause of death.

Despite the presence of the bloody knife,

field investigators find no visible s*ab wounds

and are certain that there's not enough blood

on the floor to indicate that Graham has bled to death.

SGT. BILL GABBARD (VOICEOVER) There's no pool of blood.

There's nothing indicative, to me,

that he'd had his head crushed open or anything like that.

NARRATOR They still have no idea what k*lled Graham.

But his demise isn't something that comes as a shock

to local police.

There was a long history between himself and myself

and other officers, where he was pretty much well

known as-- as a rabble rouser.

Just one of those guys that was always

drinking and smoked a lot and ran around with with kind

of that type of crowd.

NARRATOR According to the police,

he's also been known to settle problems with his fists,

a brawler ready to fight with little provocation.

Whenever this individual's there,

it did seem to draw trouble.

So there was always gonna be a fight or a confrontation

or so forth.

NARRATOR But police know there is another side to Graham.

Despite his checkered past, he has

been a trusted and valued employee of the restaurant

for many years.

So trusted, police discover, that the owner had permitted

him to take up temporary residence
[ … ]

there after a recent eviction.

As the detectives and field investigator ponder the scene,

the evidence seems to point in several directions at once.

Was he stabbed, as the knife by his body might suggest?

Do his multiple bruises indicate that he'd

fallen or been beaten?

Does the empty cash drawer point to a robbery?

Then, there's the possibility that Graham's lifestyle

and health had finally caught up with him.

Looking at his age, I'm looking

at his lifestyle, a drug user, a heavy smoker, heavy drinker.

I'm thinking, Ah, it looks like maybe he just

had heart attack, possibly.

NARRATOR Could Graham have simply fallen over

from a heart attack, landing on the hard tile floor

and cutting his face?

Was the evidence, the phone, the cash box, and the smashed car

just a coincidence?

To make sense of the myriad clues,

the police need the expertise of Dr. G. When she gets

the body and the investigator's report,

Dr. G is immediately struck by the unsanitary condition

of Graham's body.

When I got the body, it was the next day,

we see a very disheveled man who looks homeless.

NARRATOR She also reads a brief history of Graham's

fighting and drug abuse.

But to Dr. G, his checkered past has

no bearing on the task at hand.

DR. G (VOICEOVER) I don't care if you'd

had run-ins with the law.

I don't care if he has a past history of drug abuse.

I don't care if he's the CEO of a company or a transient fella

who has got a drug problem.

I mean, I treat them both the same.

I put the same effort into them.

Gary, it looks like we have an old injury here.

NARRATOR The external exam confirms

what police already know.

Michael lived a hard life.

Scrapes, cuts, and bruises cover his body.

And many are weeks, even months old.

We've got that laceration on the back of his head

here and with an abrasion.

We have a contusion of his-- of his lip.

We have a contusion and laceration under his eye.

We have contusions of both ears.

And the contusion, or bruise, goes

onto the scalp, particularly bad on the right side.

He's got a little blood coming out of his nose.

I don't see, really, much on his face.

NARRATOR Confirming field investigators' theories Dr.

G's external exam indicates that Graham's injuries

weren't fatal, nor were they inflicted

by the knife found by his body.

There's nothing on him, externally,

that suggested that he was dead from his injuries.

He had bruises.

A lot of drunks have bruises.

I've had people who get so drunk that they're

constantly falling and looked like they've been beaten.

NARRATOR Dr. G orders toxological screenings

for Graham's blood, in part to determine

his blood alcohol level.

In four weeks, when the results come back,

she will be able to determine if Graham was intoxicated or had

other dr*gs in his system.

But by the end of the external exam,

Dr. G has eliminated only one police theory.

He wasn't stabbed.

So when we get inside, we'll--

we'll see what's going on.

NARRATOR Dr. G makes the classic Y

incision across the torso, cutting

from shoulder to sternum.

She quickly sees that Graham's body

is as battered on the inside as it is on the outside.

First, three of his ribs show signs of fractures.

But surprisingly, they weren't caused

at the time of his death.

Once the fracture breaks, it starts to reheal and forms

like a callus over it.

And then, you can-- you can see that these were old.

They weren't recent, because they'd already started to heal.

NARRATOR However, the injury that Dr. G finds next is recent

and, without question, an indication of foul play.

There was hemorrhage in the neck,

on both sides of the strap muscles.

And there was a broken superior horn of the thyroid cartilage.

Your thyroid cartilages in your neck.

It was quite clear that there was

an attempt of strangulation.

NARRATOR These injuries provide the first real evidence

that Graham was assaulted.

But so far, none of Graham's internal injuries,

even those resulting from attempted strangulation,

are severe enough to have k*lled him.

Dr. G has only one place left to look

for answers, Graham's head.

As she opens his skull and examines the brain,
[ … ]

she immediately sees that the injuries are worse than they

appeared from the outside.

There's also a subdural hematoma.

Blood has collected over the right cerebral hemisphere,

which is where the skull fracture was

and where the bruising was, all of on the right side.

NARRATOR The discovery is the key to determining

Graham's cause of death.

A strong blow to the head can rupture

blood vessels below the brain's thin outer membrane, the dura.

The resulting bleeding is known as a subdural hematoma.

The pooling blood, coupled with the swelling

and the bruised brain, creates enormous pressure in the skull.

This pressure cuts off vital blood circulation to the brain,

typically resulting in a coma, then death.

Graham's subdural hematoma is directly under his skull

fracture, a pattern of injury that occurs only

when the head is struck, not when an injury is

sustained from a fall.

Dr. G's ruling puts to rest the remaining police theories.

Graham didn't OD.

He didn't have a heart attack.

And he didn't fall over drunk.

Michael Graham was struck hard in the head

and died as a result.

This was clearly a homicide as soon as the autopsy was over.

NARRATOR But now that Dr. G has discovered

how Graham died, can she help determine who k*lled him?

For a known brawler with more enemies than friends,

answers will be hard to come by.

Coming up, Dr. G makes a strange discovery.

But is it enough to catch a k*ller?

The man was smart enough to know

that there was some evidence to be gained by those shoes.

NARRATOR Then, will Dr. G's findings

about a deceased drug addict give his family

the comfort they seek?

I knew.

Deep in my heart, I knew.

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

Dr. G has determined that short order

cook Michael Graham was m*rder*d, k*lled by a blow

to the head.

But with evidence from the crime scene

pointing in multiple directions, police still do not have

a clue who the k*ller could be.

Did he interrupt a robbery?

Was it a burglary and maybe he walked in through the back?

Did he commit the theft himself and maybe--

who knows?

There were a lot of things going through my mind.

He's got a nice knot to the back of the head.

NARRATOR During the initial external exam,

none of Graham's bruising had seemed life threatening.

But after discovering evidence of a fatal head

injury in the internal exam, Dr. G revisits his facial bruising.

I do feel like there's maybe something back here.

NARRATOR She quickly notices that one

peculiar bruise on Graham's face appears to have a pattern.

DR. G (VOICEOVER) Very small octagon with then

parallel, linear contusions.

These parallel, linear contusions

were also found on other parts of his body,

on his lower abdomen, on the back of his arm near his wrist.

NARRATOR It's a pattern that Dr. G recognizes.

Little octagonal pattern at the bottom.

That's what you're gonna find at the bottom of the shoe.

NARRATOR The marking made by the sole of a shoe

could be a virtual fingerprint of what might

very well be the m*rder w*apon.

I sketch it.

I photograph it.

And in fact, I photographed it in a way

that it could be reproduced, in case

we needed a one on one comparison

if they ever found the shoe.

NARRATOR Police now have a litmus

test for finding their culprit.

Match the shoe print, catch the k*ller.

But first, police need a list of possible suspects.

Graham himself provides police with their first lead,

an address book found near his body.

In it, they discover a listing for Drew Parker, another name

familiar to city police.

There was a name and a phone number for an individual who

I'm familiar with, many of us were,

that I knew used to run with this individual, the victim.

NARRATOR After interviewing several restaurant employees,

police learned that Graham had recently fired Parker

and that Parker wasn't happy about it.

He had made threats about getting even with him

for losing his job, to more than just one person.

NARRATOR In fact, just a few weeks earlier,

according to Graham's friends, the feud

had erupted into a fistfight.

He and the victim had gotten into a fight in the kitchen.

Words were exchanged.

And the victim ended up with a couple of broken ribs.

NARRATOR This fight accounts for the older broken ribs Dr.

G had discovered in autopsy.
[ … ]

With Parker now the prime suspect in Graham's m*rder,

police go to his home to question him.

He admits to the fist fight, not the m*rder.

He says, I have not been at that restaurant

since I was terminated two weeks ago.

Sticks with the story.

He said, you know, I had plenty of opportunities and so forth.

But I didn't do it.

And I certainly wouldn't go over there and k*ll him for it.

Yeah.

I was angry I lost my job.

And he sticks along those lines.

NARRATOR But police have their ace in the hole, the shoe print

provided by Dr. G. If it matches Parker's shoes,

they'll have proof that he k*lled Graham.

But when they compare the shoes in Parker's apartment

to the print, none of them match.

They also learn that Parker has a credible alibi.

He was partying with friends on the night of the m*rder

and never left his apartment.

The lead appears to be a dead end.

Coming up, with their main suspect eliminated,

police are back to square one.

Well, now, the focus of the investigation changes.

NARRATOR And later, could an over-the-counter painkiller

have turned deadly for a man in his s?

I was a little worried that maybe there is another--

there could be another drug there.

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

After the m*rder of short order cook Michael Graham,

Dr. G has given police a virtual litmus test with which to catch"], index ,…}

his k*ller, the clear pattern of a shoe print

found on Graham's face.

But when police compare the imprint

to the shoes of their primary suspect, Drew Parker,

they don't match.

Looking for some connection between their first suspect

and a new one, police questioned several of Parker's friends.

When they do, a surprising piece of evidence emerges.

Witnesses claim that Graham had called Parker's

apartment the night he died, just as the phonebook

seemed to indicate.

But he wasn't calling to speak with Parker.

He asked for another man at the party,

a man named Tommy Shriver.

- Yeah. - Yeah, look.

You know, I had thought--

NARRATOR It was not a social call.

Graham was picking another fight, this time over a car.

What?

What are you, nuts?

SGT. BILL GABBARD (VOICEOVER) And the victim's

upset and irate.

He wants the car moved.

He's adamant about it.

He makes a statement along the lines of,

he either comes and moves the car or I'm trashing it.

OK?

Goodbye.

NARRATOR According to party goers,

Shriver left the apartment in a rage,

with his girlfriend in tow.

or minutes later, they both

come back in the apartment.

He's sweating.

He's nervous.

He's agitated.

And we ask him, what happened?

He said, man, that blankety blank had gone over there

and cut the tires on my car.

And you know, I just beat the [BLEEP] out of him.

He said he was gonna call the cops.

We got to get out of here.

Grab a couple beers, grabs his duffel bag,

throws everything in it that he's got.

He and the girlfriend leave.

Well, now, the focus of the investigation changes.

NARRATOR With the focus now solely on Shriver,

police find more evidence connecting

him to the crime scene.

First, they confirmed that he was the owner

of a car with slashed tires and broken windows

parked at the restaurant.

Police also find a surveillance tape from a nearby convenience

store proving that Shriver was in the area the day

of the m*rder, at around the same time as Graham.

The victim is seen entering, buying some stuff.

And later on, we determine that the suspect also comes in.

NARRATOR Detectives quickly locate their new prime suspect,

Tommy Shriver.

He denies having even seen Graham that day.

Then, with warrant in hand, the investigators

confiscate the suspect's shoes to compare

them to Dr. G's photo print.

But none of Shriver's shoes match.

Undeterred, they decide to question

the girlfriend, Audrey Small.

I felt confident if we could talk to her,

she would be the one, ultimately,

that would break this case.
[ … ]

She had a lot to lose.

She had a young son.

She was fearful of going to jail.

NARRATOR Their instincts proved correct.

Audrey Small turns on her boyfriend,

telling police that she was present during a brutal

fistfight at the restaurant and that Shriver stomped

on Graham's face, a description that fits Dr. G's findings

to a T. But police worry that Audrey Small, who

has had many scrapes with the law herself,

won't make a credible witness.

Police need physical evidence to tie Shriver to the m*rder.

They need the shoes.

So the man was smart enough to know

that there was some evidence to be gained by those shoes.

And he hid the shoes.

NARRATOR Incredibly, Audrey tells police that she

knows where the shoes are.

She says, they're in the laundromat

of the apartment complex.

I said, are they still there?

She said, they should be.

I said, let's go over there.

She looks in there.

There's both shoes.

NARRATOR A pair of white dark shoes with a sole pattern

of half moon shapes.

By looking at them, we could tell

that the imprint on the shoe did match the impressions

left on the victim's face.

NARRATOR But the shoes give up even

more damning evidence, trace amounts of blood and hair.

A DNA test confirms that the blood is Graham's.

It's the proof police need to arrest Shriver

for the m*rder of Graham.

With the information given by Shriver's girlfriend, coupled

with Dr. G's autopsy findings, a complete picture

of what happened to Michael Graham

has finally come into focus.

Earlier, on the day of the m*rder,

Graham and Shriver have a bitter argument

over a car Shriver parks in the restaurant parking lot.

Graham wants it moved.

Shriver refuses.

Later, drunk and fuming mad, he unleashes

his anger on Shriver's car.

Graham then calls Shriver to boast about what he's done.

He becomes extremely irate, extremely upset.

Storms out of the apartment.

Says he's gonna go take care of this.

NARRATOR Shriver is driven to the restaurant

by his girlfriend, who then witnesses

him viciously attack Graham.

SGT. BILL GABBARD (VOICEOVER) Jumping

up and down on his head, kicking him, violently.

She says the victim never gets up.

He says he's gonna call the police.

He never gets up.

Removes the phone from the wall.

We believe now that he removed the phone to deter

him from calling the police.

NARRATOR When Shriver flees the scene, Michael is still alive,

but he is dying.

The trauma to his head has caused

his brain to bleed and swell.

He laid there unconscious for a while.

We can see that because of how much swelling

there was and the secondary hemorrhages in the brain stem.

So he didn't die immediately.

He was most likely in a coma for a while and then died.

NARRATOR Presented with the overwhelming evidence

against him, Shriver finally confesses to k*lling Graham.

He is sentenced to years in prison.

They didn't have to go to trial.

They just took the plea.

They had so much evidence against him

that it was clear he did it.

And he admitted to it.

He never showed any remorse.

He never-- never showed anything.

NARRATOR Despite the fact that Graham was a violent man living

on the fringes of society, his k*ller

has been brought to justice.

And despite anybody's background or their lifestyle,

such as this victim, in this case we're discussing,

whether we liked him or we didn't like him,

he didn't like us is irrelevant.

He didn't deserve to die.

It's always great to deal with law enforcement

that's competent and that really cares.

The worst for me is detectives that don't seem to care.

I don't come across very many of those.

NARRATOR Coming up, a family reaches out to a troubled loved

one, but it might be too late.

Just left and I heard that he only

took three pills, three or four pills or something like that,

you know.

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

It's a warm spring day outside an apartment

complex in Orlando, Florida.
[ … ]

And Johnnie Rio is stealing a stereo from a neighbor.

According to family members, Johnnie,

who suffers from hepatitis C and HIV,

is in desperate need of cash to support

a decades long drug habit.

In the following days, Johnnie's problems worsen.

Johnnie is ultimately arrested for the theft.

And because he lives with his mother,

she now faces the possibility of eviction.

EDDIE (VOICEOVER) They told him he has to leave.

And management also gave my mother

a warning that if he comes back in here,

she would have to leave also.

NARRATOR For Johnnie's older brother Eddie,

the pattern of behavior is wearing thin.

EDDIE (VOICEOVER) You're a grown man.

I'm tired of this.

I got my own problems.

You know, he wasn't working, wasn't doing nothing.

Just laying up in the room, watching television,

and doing nothing.

I felt very bad for him.

Made me depressed.

NARRATOR Not long after the stereo incident,

a neighbor sees Johnnie take some over-the-counter pain

medication.

But when his mother asks him about it, Johnnie sidesteps.

EDDIE (VOICEOVER) Just laughed and told her

that he only took three pills, three or four

pills or something like that.

But my mother noticed that his mouth was white, dry.

So they decided to call the ambulance.

NARRATOR The ambulance arrives and Johnnie is taken to the ER,

alone.

His family, while concerned for him,

is also skeptical of his motives.

Johnnie has a long history of pulling stunts in order

to get to the hospital, where, in the past,

he's been able to secure prescription dr*gs.

EDDIE (VOICEOVER) I didn't pay too much mind, because I know

that he's done this before.

He goes to the emergency room.

Once he gets his prescription, he walks out and--

and leaves on his own, you know?

And it's not that we didn't care.

We didn't think he was in bad shape.

You know?

NARRATOR By about in the afternoon,

Johnnie is in the ER.

There, he makes an astonishing admission to the medical staff.

That morning, he didn't just take a couple of pills.

Instead, he claims to have swallowed

to acetaminophen tablets in an attempt

to commit su1c1de.

The hospital staff members rush to treat Johnnie

for potential poisoning.

But despite their efforts, Johnnie

rapidly becomes critically ill.

Within only a few hours, he goes into shock

and suffers cardiac arrest.

And while doctors manage to resuscitate him,

Johnnie never regains consciousness.

I get the call from somebody in the hospital that--

that my brother's in very, very bad, critical condition,

that someone from the family should be there.

He looked bad.

And he was turning gray already.

I knew, deep in my heart, I knew, you know?

NARRATOR hours after arriving at the hospital,

Johnnie is pronounced dead.

When the family hears of his death wish, they are baffled.

Despite his many problems, they do not believe Johnnie

would ever take his own life.

Could his su1c1de admission be part of a scam?

His death, the tragic consequence of a troubled drug

addicts plan gone awry?

EDDIE (VOICEOVER) I'll tell you the truth,

I don't think that he actually meant to do it.

Because it wasn't the first time that he went

to the hospital, the emergency room for medication,

stuff like that, you know?

And I think he knows that--

he thought that this wasn't gonna happen.

NARRATOR According to Florida Statute .,

all suspected suicides require investigation

by the medical examiner's office.

And so in the early hours of April rd, less than two days

after he checked himself into the ER,

Johnnie Rio's body arrives at the District Nine morgue.

Dr. G is on call when the case comes in.

DR. G (VOICEOVER) Basically, we have a man.

He arrives to the ER, told the doctor

he wanted to end his own life.

The information I had is that this is a fellow who

has some health problems and admitted

that he had taken around acetaminophen tablets.

He's taken into the emergency room

and they do the usual thing to try to save

you from the acetaminophen.

NARRATOR For Dr. G, the death of Johnnie Rio
[ … ]

is already raising perplexing questions.

If Johnnie wanted to k*ll himself,

why would he do it with acetaminophen?

Acetaminophen is the most widely used analgesic painkiller

in the world.

But even though poisonings from acetaminophen

are relatively common, fatalities from the drug

are rare, occurring in less than % of all overdoses.

Moreover, acetaminophen deaths typically

share one grim attribute.

They are slow and agonizing.

Acetaminophen is a terrible way to overdose.

First day, you might just have some nausea and vomiting.

And then, you get kind of feeling better after that.

And then, you start having some right upper quadrant pain.

But you know, maybe even starting

even to bleed a little bit.

And you don't start really getting sick again,

until your third day, starting to get malaise and tired

and starting to get that nausea and vomiting again.

And then, by the fourth day, you can start going into a coma.

NARRATOR But as she reads Johnnie Rio's hospital report,

she notes that he became critically

ill very quickly, within only hours of his admission

to the ER.

DR. G (VOICEOVER) It was unusual

that he came in right away and then

coded, or became unresponsive with no pulse

or blood pressure.

That's unusual for an acetaminophen overdose.

I was a little worried that maybe there is another--

there could be another drug there.

NARRATOR The other issue Dr. G must

wrestle with is whether or not Johnnie's

death was in fact intentional.

Or was it a result of a desperate drug addict's plan

gone wrong?

There is the question of the su1c1de.

Although, he initially denied it and then admitted it.

NARRATOR For Dr. G, what exactly k*lled Johnnie Rio

and how he actually died are far from clear.

But hopefully, not for long.

OK.

We'll start taking off a lot of this medical paraphernalia.

NARRATOR As Dr. G begins the external exam,

she knows it can tell her many things about how a person died.

But equally important is what it can tell

her about how a person lived.

Does the person appear to have been healthy?

He's had some kind of big surgery over here.

NARRATOR Are there signs of neglect?

Bad teeth.

NARRATOR Even hidden vices.

Looks like he's got a little scar there.

That's where you're going to inject dr*gs.

NARRATOR And sometimes, the outside of a body

can yield clues about what's happening on the inside.

In this case, Dr. G discovers that where

IV needles entered his body, Johnnie

was bleeding internally.

You can see, he's really having problems

controlling his bleeding.

He's already-- he's just having subcutaneous

hemorrhaging around a lot of his needle puncture marks here.

He's lost a lot of blood under his tissue there, ecchymosis,

blood under the skin.

Coagulopathy, obviously, is what he started

to suffer in the hospital.

And basically, you can't clot your blood.

NARRATOR A victim infected with both HIV and hepatitis C

could have numerous causes for internal bleeding.

But which one is the culprit here?

Coming up, Dr. G begins the internal exam in an effort

to determine the cause of Johnnie's hemorrhaging

and whether or not his death was a su1c1de

or an accidental overdose.

Cause not every time they go to the hospital with a story,

does it turn out to be that that's really the story.

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

Hospital records suggest that struggling addict Johnnie Rio

has died as a result of an acetaminophen overdose

after admitting that he was trying to commit su1c1de.

His family does not believe that the overdose was a su1c1de,

but more likely an ill-fated attempt to obtain

medication from the hospital.

Just don't think that he was trying to k*ll himself, take--

take away his life.

I don't think so.

NARRATOR Now, Dr. G must determine if Johnnie Rio's

death was willful or not and whether acetaminophen

was the k*ller.

The first clue is Johnnie's blood.

It was not clotting properly, a sign that Johnnie's

liver may have been impaired.

DR. G (VOICEOVER) The liver does so many things.

It's, obviously, with some of the enzymes, detoxifies dr*gs.

It makes clotting factors.

It helps make bile for your digestion.

There's a tremendous amount of things

that the liver does for you.
[ … ]

NARRATOR But the question is, what specifically

damaged Johnnie's liver?

One definite possibility, an overdose of acetaminophen.

DR. G (VOICEOVER) A little bit of acetaminophen is wonderful.

It's a wonderful pain reliever.

A lot of acetaminophen is toxic.

NARRATOR The only way Dr. G can know

with certainty what caused Johnnie's

liver damage is to dissect it.

So give me about three extra blue tubes.

NARRATOR But first, Dr. G takes samples

of Johnnie's bodily fluids.

While acetaminophen would have already dissipated,

other dr*gs could still be present.

She will also run tests on blood taken from Johnnie

while he was still alive in the hospital

to determine just how much acetaminophen he

had in his system.

Once the fluid samples are taken,

Dr. G makes the first cut of every internal exam,

the Y incision, which opens Johnnie's abdominal cavity.

Every organ is removed, weighed, and dissected.

And Dr. G begins to uncover more of the story.

There are a lot of little like scar tissue that's formed

on the surface of the lung.

NARRATOR Many of Johnnie's internal organs

show signs of ischemia, areas of dead tissue

due to lack of blood flow resulting

from Johnnie's cardiac arrest.

His kidneys show evidence of shock.

His bowels just aren't getting enough blood.

NARRATOR Including Johnnie's liver.

DR. G This liver is discolored.

It's soft.

It kind of has a rounded edge, instead

of that nice sharp edge.

It has almost a mottled of appearance of different colors.

There's even a little bit of hemorrhage in it.

He'd already had started to suffer from liver necrosis.

The cells were starting to die.

And this carries all the way through when you cut it.

And when you look at this-- all this

pale part under the microscope, that's gonna look all necrotic.

It's all dead.

NARRATOR Acetaminophen affects the liver in a very specific

and potentially deadly way.

When a person takes acetaminophen,

the liver is responsible for metabolizing the drug.

But as it does, a small percentage of the acetaminophen

is converted into a highly toxic substance.

Only about % of the acetaminophen

is transformed to this toxic substance

that actually hurts your liver.

So what happens is the liver knows how to deal with this.

NARRATOR With a normal dose, the liver

neutralizes the toxic substance with the body's own compound

called glutathione.

But after taking an overdose of acetaminophen,

the liver is unable to keep up with the conversion, causing

the unconverted toxic substance to destroy

the organ, cell by cell.

This toxic substance starts really doing havoc

with your liver cells and starts--

your liver cells start dying.

Soon as I saw that, that was consistent with

the acetaminophen overdose.

It's kind of cool to see that liver.

You don't see that liver necrosis every day.

NARRATOR The severely damaged liver has

led to an important finding.

Johnnie did overdose on acetaminophen.

But surprisingly, Dr. G concludes that the damage was

not severe enough to k*ll him.

The timeline of events make it virtually impossible.

Johnnie took the acetaminophen less than an hour

before arriving at the hospital.

But acetaminophen-induced liver failure

takes much longer to manifest.

Usually, acetaminophen deaths are lingering.

And that you don't die, usually, until your fourth day

after the overdose.

NARRATOR What did k*ll Johnnie Rio is

revealed when his toxicological tests come back.

They reveal that Johnnie had an extremely high level

of acetaminophen in his blood, over times

the therapeutic dosage.

He took a tremendous amount of acetaminophen, or pills,

all at once.

His levels bear it out.

NARRATOR With such a massive amount of acetaminophen

in his system, Johnnie's body went into shock

within a few short hours.

You have to take a tremendous amount of acetaminophen

to get a central nervous system depressant and code like that.

NARRATOR With the autopsy completed

and the toxicology results in hand,

Dr. G can now describe exactly how Johnnie Rio's life ended.

And most importantly, whether or not she believes his death

was a su1c1de.

According to Dr. G, on the day of his death,
[ … ]

Johnnie Rio ingests approximately to

over-the-counter acetaminophen tablets.

After an ambulance takes him to the hospital,

Johnnie reportedly tells doctors that he

overdosed on the painkiller with the aim of committing su1c1de.

But Johnnie consumed such a vast quantity of acetaminophen

that the drug quickly overwhelms his body.

And unlike most acetaminophen overdoses,

causes his central nervous system to go into shock.

Johnnie's heart stops.

He is suffering a cardiac arrest.

You have to take a tremendous amount of acetaminophen

to get a central nervous system depressant and code like that.

NARRATOR In the ER, doctors managed to resuscitate him.

But he quickly falls into a coma.

He is put on life support, but the cardiac arrest has already

dealt a death blow, depriving his organs of oxygen.

After surviving for hours on a respirator,

Johnnie's body finally gives out and he dies

from multiple organ failure.

But in this case, determining the medical causes

of Johnnie Rio's death is only part of the story.

For Dr. G and Johnnie's family, one question remains.

Did Johnnie fake an overdose in order

to get medical attention, a scam he often used in his past?

Or did his struggle with dr*gs and illness

finally lead him to su1c1de?

EDDIE (VOICEOVER) I feel very upset about it.

I mean, I think about it every day.

NARRATOR For suffering, surviving family members,

the medical examiner's determination of su1c1de

is often the most difficult to accept.

But when drawing her conclusions,

Dr. G can look only at the circumstances and the science.

With medication, our problem is,

is it a su1c1de or is it an attempt of self-medication

or to get high?

Those are our problems with dr*gs.

A lot of times, forensically, what we have to look at

is the sheer amount.

He makes a confession that he had taken around

acetaminophen tablets.

You are doing that to get sick and potentially die, whether it

be a suicidal gesture just to get attention,

it's still him taking that medication

and that's a su1c1de.

I always give the analogy, once you jump off the bridge

to k*ll yourself, but change your mind in the middle

before you hit, that's still a su1c1de, for me.

Maybe not for you and your god, but for me,

it's still a su1c1de.

EDDIE (VOICEOVER) He wasn't gonna change.

There's no-- nothing gonna change for him.

He always talking about it.

But never got to do it.