04x04 - Life Interrupted

[bunniefuu]

[music playing]

NARRATOR An aspiring young soldier

is abducted from her army base in the dead of the night.

I was really hoping they'd find her alive.

NARRATOR But prayers for her return

go unanswered when police find her tortured body.

TANYA K. PIERCE It wasn't just a k*lling.

This was an over-k*lling.

It would have been less cruel had he just sh*t her.

NARRATOR Can Dr. G deconstruct this savage att*ck

and help bring a m*rder*r to justice?

My stakes are to get the truth.

NARRATOR And then an elderly woman

dies just three days after undergoing

a routine knee operation.

But as Dr. G soon discovers, the autopsy

will be anything but routine.

It's just one of those things that happens.

It's a rare complication.

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

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

It's another gorgeous day in Orlando, Florida.

And for a change, chief medical examiner Dr. Jan Garavaglia

won't be spending it in the morgue.

Today, unfortunately, I have to go to court.

A lot of people think the only thing I do

is sit in the morgue all day.

And actually, forensic pathology encompasses

a lot more than that.

I appear in court minimum once a month, and often, many times

more.

NARRATOR Her testimony regarding evidence she uncovers

during an autopsy provides a point of view like no other,

especially when it comes to homicides.

JAN GARAVAGLIA I'm the one that's the voice for the dead.

It may be the key point in convicting someone.

NARRATOR But justice may never be

served if Dr. G fails to find crucial evidence

in a suspected m*rder.

These were the stakes in one of Dr. G's

most difficult and publicized cases during her early days

at the Bear County morgue in San Antonio, Texas.

Back in --

I vividly remember it--

we had a young private abducted from the base in Texas.

NARRATOR The shocking m*rder captured national headlines,

went as high as the Supreme Court of the United States,

and turned into one of the most unpredictable

forensic investigations of Dr. G's career.

This is the story of Tracie Joy McBride.

As a young girl, Tracie McBride had a special knack

for spreading joy.

STACIE MCBRIDE-COX Always had a smile on her face.

Very energetic towards life, towards people.

And she lived her life with incredible purpose.

She liked to bake.

And she was a cheerleader for soccer at the high school.

And they loved her so much, because every week,

she brought them chocolate chip cookies.

NARRATOR Shortly after graduating from high school,

Tracie made a surprising and life-changing decision.

She made the announcement that she

was going to go into the army.

We were all completely shocked.

NARRATOR Her parents were uneasy.

Standing barely five feet tall, Tracie

was hardly the typical soldier.

But she completed her basic training with flying colors.

She just loved it, which is totally in contrast

to the girly girl that we knew.

[applause]

NARRATOR In early February of ,

the -year-old was assigned as an army

private to the Goodfellow Air Force Base

in San Angelo, Texas.

IRENE MCBRIDE She was just a determined young woman.

She wanted to be the best--

you know, the best that she could be.

That was truly the way Tracie lived.

NARRATOR But only days after arriving on base,

her dreams came to a screeching halt.

Tracie disappeared from Goodfellow

Air Force Base on February the th of about PM.

My first recollection of the case

is hearing about it in the news.

NARRATOR According to the reports,

a fellow soldier was walking by the laundry facility

when he stumbled into a strange and alarming scene.

He saw Tracie McBride, scared to death,

being taken against her will. - Hey!

NARRATOR The soldier immediately

came to Tracie's aid.

But in the dark, her abductor was fast and fierce.

Knocks him out cold.

NARRATOR By the time he came to, Tracie was gone.

Word of the att*ck stuns her family.

We tend to think of m*llitary bases as very secure.

So that didn't even seem remotely a possibility.

Everybody was hoping that she was going to be found alive.
[ … ]

NARRATOR But two weeks later, on March ,

those hopes are crushed when a former m*llitary officer

steps forward with a chilling confession.

Maybe he had some-- a bit of need to get it off his chest.

NARRATOR The man, Louis Jones Jr. claims he kidnapped

and m*rder*d Tracie McBride.

He claims he k*lled her with a tire iron.

NARRATOR He then leads police to

a muddy, blood-stained culvert under a highway bridge

about miles from town.

There, they find Tracie's dead body.

He admits to k*lling her and leaving her there.

NARRATOR Although the body was found outside of Doctor G's

jurisdiction, officials immediately

send it to the San Antonio Bear County

Medical Examiner's Office.

The case suddenly gets personal for Dr. G.

I would be doing that autopsy.

And I knew that was going to be a huge job.

NARRATOR Every shred of evidence she finds

will be critical in making sure Jones pays for his crimes.

And Tracie's family believes he should pay the ultimate price.

The first thing my husband had said

when they found Tracie was that he wanted them

to go for the death penalty.

NARRATOR While they're eager to win a conviction that they

believe fits the crime, US attorney

Tanya Pierce is concerned they may

not win any conviction at all.

And you can't just depend on the confession.

NARRATOR Defense attorneys could suppress the statement,

argue that he was mentally insane,

or claim he was desperately seeking attention

for the sensational crime.

The confession alone is not enough.

TANYA K. PIERCE His confession, in my opinion,

was not complete.

It was a challenge, that you only

have two people that know what happened during this crime.

One's dead.

The other one doesn't always have to tell the truth.

NARRATOR And the confession is all the prosecution has so far.

Unfortunately, investigators have yet

to find the m*rder w*apon or any other physical evidence that

actually ties Jones to Tracie.

As elementary as it sounds, we still

have to prove that it happened at the hands of Louis Jones.

Now, they're counting on Dr. G to find

that proof in autopsy so they can convict him in trial.

But to win capital punishment for Tracie's family,

they'll need even more evidence, proving

that Jones k*lled her in an unusually

cruel and heinous manner.

We've got to show the jury the reasons that this man

deserves the death penalty.

Things like r*pe, the viciousness of the crime--

that was, to me, the biggest fight we had.

NARRATOR Though Dr. G is not a proponent of the death penalty,

politics have no place in the morgue.

My personal views of the death penalty do not come into this.

Whether I like the death penalty, whether I think

he deserves the death penalty, I'm not

emotionally involved in that.

NARRATOR Instead, she must approach her mission

as an objective scientist.

We're going to come up with the facts,

what the body is telling us.

Did he k*ll her immediately after kidnapping her,

or was b*ating with a tire all he did to her?

Could have strangled her?

Could he have also drugged her to keep her quiet?

I want to know everything!

NARRATOR Once at the gurney, the rest of the world recedes.

My mind is spinning, thinking, OK, what can I tell?

What is she going to tell me?

Looking just very carefully at the body.

I don't touch a thing.

I just examine it.

NARRATOR And on a first glance, the very state of Tracie's body

screams out to her, this was no ordinary m*rder.

I was almost shocked at what I found.

NARRATOR As Dr. G begins to examine the body of Private

First Class Tracie McBride, she immediately notes

the young girl's massive head injury.

Part of her skull was just crushed in.

She has severe head trauma.

NARRATOR Some of this she expected from the news reports.

But she never could have imagined the condition

of the rest of her remains.

I knew she was coming in.

So I had obviously some preconceived notion

that I was going to find this disheveled,

decomposed young girl.

NARRATOR On the contrary, Tracie

is fully clothed in US Army battle dress

that's stunningly pristine.

Her buttons were all buttoned.

Her shirt was tucked in.

Her belt was buckled nicely.

And I thought that was very odd.
[ … ]

NARRATOR But despite the puzzling condition of the body,

Dr. G must stay focused, inventorying everything

she sees in the external exam.

You don't know what may turn the case.

NARRATOR First, she catalogs Tracie's possessions,

each a heartbreaking glimpse into her.

Life

In her pocket, she had a US Marine--

obviously a man's ring on a chain.

Tracie did have a boyfriend who she cared for tremendously.

In fact, we were quite confident that they would have been

married within the near future.

NARRATOR Next, she thoroughly combs her uniform

with a magnifying glass.

If she finds trace evidence proving the girl was in Jones's

apartment or car, prosecutors can physically

tie him to the m*rder.

Maybe unique fibers from a carpeting,

dog hairs or animal hairs that maybe match a pet where

the perpetrator had kept her.

NARRATOR But strangely, the uniform

is forensically as immaculate as it looks to the naked eye.

That clothing was very clean, and really no trace

that you could speak of.

NARRATOR The negative findings straight

Dr. G and investigators as the possible sign

of a meticulous cover-up.

The perpetrator went to great lengths

to clean any traces of him off of her.

NARRATOR No hard evidence could mean no conviction.

To help bring Tracie's k*ller to justice,

Dr. G must now dig deeper in the body for answers,

starting with the head.

First, Dr. G externally examines Tracie's head

wound, searching for forensic evidence

that confirms Jones's guilt.

She had a lot of hemorrhaging on the left side of her face.

Her ear was just lacerated in half, even the cartilage.

All of that had a lot of hemorrhage.

NARRATOR And the deeper Dr. G goes,

the more terrifying the truth about Tracie's death becomes.

This is worse than most really high-impact car wrecks.

NARRATOR Dr. G carefully inspects the gaping injury

on Tracie McBride's head.

She was definitely alive when she got that blow.

NARRATOR But despite the brutality of Tracie's head

wounds, prosecutor Tanya Pierce is concerned they may not even

be able to win a conviction.

Jones has a clean record.

He's never been in jail.

And as a decorated w*r veteran with years

serving his country, his character appears flawless.

TANYA K. PIERCE The defense brought

in a lot of different angles.

Look at his m*llitary record.

Look at his lack of criminal conviction.

He had a job.

He had an education, a single parent raising

his daughter-- all this.

NARRATOR Now, Pierce needs evidence

to convince the jury that this seemingly

honorable man k*lled Tracie and deserves the death penalty.

As a prosecutor, it's my job to see that justice is done.

It's not to get a conviction.

It's to see that justice is done.

NARRATOR One look at Tracie and it's clear she

suffered a massive head injury.

But as Dr. G examines it more closely,

she discovers that the damage isn't from a single strike.

JAN GARAVAGLIA She's got multiple blows to the head,

horrendously severe.

NARRATOR The girl's injuries are heart-wrenching.

But she approaches every one of them with a scientist's eye.

I don't deal with emotion when I have the body.

I have to think.

NARRATOR Three wounds on the left side,

two more to the rear, another four across to the right.

She's got, at minimum, nine blows

to the head with nine separate lacerations-- big lacerations.

So many fractured bones.

NARRATOR And amidst this devastating trauma,

she spots a unique fracture.

On closer inspection, Dr. G quickly

realizes that it contains a vital piece of evidence--

an imprint of the m*rder w*apon.

A long linear object, very powerful.

It is consistent with a tire iron

or something small and narrow with a lot of force.

NARRATOR This is a critical finding.

I k*lled her.

NARRATOR It matches the type of w*apon

Jones described to police in his confession, a tire iron.

It gave me the evidence that I needed to explain to the jury

that she was beaten with some blunt instrument that

is consistent with a tire iron.

So what she had to say definitely

corroborated what his confession was.

NARRATOR It's a huge breakthrough

for the prosecution.

But securing a conviction is one thing.
[ … ]

Determining punishment is another.

And now, as Dr. G continues evaluating the wounds,

she must ascertain just how savagely Jones att*cked

Tracie with the tire iron.

She basically-- she has all these openings in her head.

NARRATOR Not only is this skull smashed,

but the fractures are so severe that the dura,

or the cover that protects the brain, is also torn.

But in this case, this dura mater

is so lacerated with these blows that the pieces of skull

go through the dura into the brain.

I've seen -mile-an-hour car wrecks that didn't have

head trauma as bad as she has.

These are wounds to her head that

are incompatible with life.

So these are clearly her cause of death.

It would have been less painful and less cruel

had he just sh*t her.

In my mind, justice would not have been served

by him spending life in prison.

NARRATOR Prosecutor Tanya Pierce

believes the sheer cruelty of the m*rder

could help the McBrides in their quest for the death penalty.

This is a brutal, brutal, brutal, vicious crime.

It wasn't just a k*lling.

This was an over-k*lling.

NARRATOR But even this level of brutality

may not be enough for the court and a jury

to agree to an execution.

To win this battle, Pierce may need

to prove that Jones not only k*lled

Tracie, but also r*ped her.

It's the one aspect of the m*rder he vehemently denies.

He was specifically asked about sexual as*ault,

specifically.

He did not sexually as*ault her at all, according to him.

NARRATOR Prosecutors suspect he's lying.

But evidence of a r*pe can be very subtle.

And in this forensic exam, Dr. G faces a major challenge--

two weeks worth of decomposition.

JAN GARAVAGLIA There are spider webs on her.

She was starting to mummify on her hands a little bit.

Honestly, in most decomposed bodies, after two weeks,

I wouldn't be able to tell that subtle trauma,

especially in the genital region.

It bloats.

It gets green.

NARRATOR Now, layer by layer, Dr. G

removes Tracie's clothing.

And what she discovers underneath shocks

everyone in the morgue.

Dr. G removes the strangely clean m*llitary uniform from

homicide victim Tracie McBride.

Her shirt was neatly tucked in.

Her buttons on her fly were completely buttoned

and her belt was done.

NARRATOR Her tidy appearance belies a grim possibility,

that the k*ller, Louis Jones Jr.,

r*ped her before bludgeoning her to death.

And Tracie's family feels he deserves

to be punished for his crime.

We believe that, you know, death penalties fit the crime.

NARRATOR Based on Tracie's mummified hands,

Dr. G fears she'll find the rest of her remains

in the same decomposed state.

But she's surprised when she removes her clothes.

JAN GARAVAGLIA Her thighs are pristine.

Her abdomen was pristine.

She had a beautiful tattoo on her hip that was easily seen.

She was amazingly well-preserved.

NARRATOR Dr. G believes two factors created this paradox--

the recent weather and where the k*ller left the body.

JAN GARAVAGLIA It was unseasonably cold in Texas.

And she was in the shade.

She was protected from the sun, being under a bridge.

NARRATOR These conditions preserved the remains

like a refrigerator, keeping bacterial and insect

activity in check.

Despite this lack of decomposition,

recovering evidence of sexual as*ault will be a long sh*t.

It's actually unusual for me to find a lot

of trauma on the r*pe-homicide.

NARRATOR Often, rapists drug or incapacitate their victims

so they won't resist.

Let me get you some ice.

NARRATOR With no resistance, forced sex can leave little

or no discernible trauma.

So if she's just lying there unconscious,

or if she's not fighting back, probably she's not

going to get as much bruising.

NARRATOR Dr. G turns to the genital area,

searching for the slightest hint of brutality.

And immediately, Tracie's body speaks to her loud and clear--

contusions on the labia, a hard scratch

near the vaginal opening.

Bruises that are, you know, half an inch by half

an inch in the genital area.

She even had a bruise to her cervix

at the end of her uterus.

To find that much trauma was actually very unusual.
[ … ]

NARRATOR The injuries are so well-preserved,

she can even discern their color.

So it looked all fresh, pinkish-blue.

NARRATOR Based on these findings,

Dr. G believes that Tracie was not only r*ped,

she was fighting back.

JAN GARAVAGLIA It ruled out that he had drugged her.

Because there is a lot of trauma.

It looks like she wasn't cooperating.

That indicates forceful sex.

And that indicates a sexual as*ault.

NARRATOR Now, prosecutors have no doubt that Jones kidnapped,

k*lled, and r*ped Tracie.

They're finally ready to seek the death penalty.

But there's one issue they need to be

prepared to address in court.

Tracie had a boyfriend.

And she may have been sexually active.

We have to anticipate what the defense might be.

And easily, a young woman, a defense might be,

maybe she had consensual sex with somebody else.

Maybe she had rough sex with somebody else.

NARRATOR To counter this defense,

they'll need irrefutable proof that Jones r*ped Tracie.

The best thing I could have would be something that we

could have some DNA value.

NARRATOR Now, to search for Jones's DNA,

Dr. G completes a full r*pe kit.

I take multiple swabs to collect any fluids

in her vaginal region, in her a**l region,

even in her oral region.

NARRATOR The samples will go to the Bear

County Forensic Science Center for a full analysis.

She's a healthy -year-old woman that would have

lived a long life if she had not crossed

path with this m*rder*r.

NARRATOR The final outcome of this case

and whether Tracie's family will get

the justice they seek may hinge on the results of the r*pe kit.

More technicians prepare -year-old Tracie McBride for

transport to the funeral home.

Ex-m*llitary man Louis Jones Jr. admits

he kidnapped and k*lled her.

Based on Doctor G's findings of trauma,

prosecutors believed he also r*ped her.

What they would like is the DNA to prove it.

We wait for the results of the serology,

see if there's any semen.

NARRATOR Only a positive match can prove Jones's guilt

and ensure absolute justice for Tracie.

Less than a month later, Dr. G gets the report

on the r*pe kit samples.

And lo and behold, all my specimens taken

from the vaginal area, a**l area,

oral area come back negative.

No evidence of sperm, no evidence of semen.

There is no sign of Louis Jones from a DNA standpoint.

NARRATOR The unexpected blow devastates prosecutors.

Without this smoking g*n, they fear

the defense could easily argue there

was never any r*pe at all.

I was trying to think of every explanation possible.

I had my agents searching for condoms.

I had them searching for spermicide-- something

that would explain a lack of evidence, a lack of DNA.

As hard as Dr. G may try, no matter

what kind of medical examiner she is, if it's not there,

it's not there.

NARRATOR But Dr. G disagrees.

You know, I think they were a little

worried that, somehow, I was not going to be able to testify.

NARRATOR She firmly believes that the negative finding

does not undermine the medical evidence of r*pe.

Keep in mind, there are some people that don't ej*cul*te.

This isn't about sex.

It's about v*olence.

Maybe it was an object that was used that caused that trauma.

NARRATOR In addition, she recalls a detail

about Tracie's genital injuries that

just might help prosecutors--

their color.

Everybody's seen a fresh bruise.

They're usually pinkish to a little blue.

NARRATOR Over time, the red blood cells break down,

appearing as a shift in hue.

Yellow, and then eventually green,

and kind of a brown color at the end.

NARRATOR All of Tracie's bruises

were pinkish-blue, proof that she was

r*ped just before her death.

The bruising is on all recent, maybe hours before she d*ed.

NARRATOR The timeline makes it extremely unlikely

that Tracie sustained her genital injuries

during consensual sex with someone else.

TANYA K. PIERCE The -hour part is important.

Because Louis Jones, he was with her

for the majority of that time period before she was k*lled.

NARRATOR Police also confirm that Tracie's boyfriend was out

of state when she was kidnapped and could

not have caused the bruising.
[ … ]

With this final piece of evidence in hand,

US attorneys present their case in court.

Louis Jones Jr. should face execution

for the savagery of his crimes against Tracie McBride.

Ultimately, Attorney General Reno made the call.

And she made the decision that we

could seek the death penalty.

NARRATOR Now the final challenge will be for Dr. G

to convince the jury, without DNA,

that Jones committed the r*pe.

You somehow have to try to get the jury to understand you

and to believe you.

Because if the jury doesn't understand it,

we're kind of lost here.

NARRATOR October, .

Eight months after the autopsy, the trial begins.

And Dr. G takes the stand in the media spotlight

as witness for the prosecution.

[gavel banging]

I'm testifying to the facts of what

we can say about what happened.

NARRATOR Justice for the senseless death of a young girl

hinges on her testimony.

But her personal views on whether the k*ller

deserves the death penalty have no place on the stand.

I only want to tell the truth.

I only can tell the truth.

NARRATOR Her autopsy findings include indisputable facts

as to what happened between the time of Tracie's abduction

and her death.

Now, she pieces it all together for the jury, including details

Jones never told police.

He didn't confess to a lot of things.

He didn't say the truth, I think, to a lot of things.

But I know what he did to her.

NARRATOR Just days after her arrival at the base,

Louis Jones kidnaps Tracie at gunpoint.

JAN GARAVAGLIA She's got her army fatigues on.

And she gets abducted.

NARRATOR Then, Dr. G is certain,

Tracie endures a violent sexual as*ault.

JAN GARAVAGLIA We know she's not drugged.

She was probably fighting back.

NARRATOR Describing the injuries from the r*pe

is sensitive.

But she carefully professionally presents the evidence.

I was a little hesitant about having to show

some of the genital pictures.

But yet I think once you saw those big bruises

in those areas, they could see that it

was quite a violent act.

TANYA K. PIERCE In fact, I had to warn the family beforehand.

And as soon as Dr. G hit the stand,

I nodded back to the family.

And most of them got up and left,

except the father, who looked at me and shook his head no.

But he lasted through about one slide.

NARRATOR Dr. G explains that, from the nature

of the bruising, Tracie clearly survives

this part of the v*olence.

We know she's not strangled.

He then forces her to help cover up the heinous crime.

He had cleaned her, washed her clothes,

made her clean herself with hydrogen peroxide.

She is made to walk on towels so she doesn't pick up his fibers."], index ,…}

Hence, I couldn't find any at autopsy.

It was just sickening.

[panting]

NARRATOR Jones is not about to let her escape alive.

He takes her to a remote location

under a deserted overpass.

He att*cks her with a tire iron.

NARRATOR He strikes at least nine

times, shattering the skull.

Shards of bone drive deep into the brain.

The trauma is fatal.

You know, your brain is a delicate electrical system

sitting there.

And when you have that much blunt force to the brain,

it short circuits it and it just shuts down.

NARRATOR Tracie collapses, dead.

But then Jones makes a crucial mistake.

He leaves her body in the culvert.

JAN GARAVAGLIA He obviously went

quite a distance to hide the body so it wouldn't be found.

And yet it's ironic that this remote area that he m*rder*d

her at is exactly why I could find that evidence

of sexual as*ault. Because it is in a remote area,

protected from the sun, in a culvert that was wet and cold.

And then, just by luck, the temperature stayed cool

and preserved the body nicely.

NARRATOR Dr. G has now done all she

can to recover every secret from Tracie's body

and share them with the jury.

I want them, truly, in my heart,

to understand what I'm saying.

I look in their eyes to try to explain it to them.

TANYA K. PIERCE I think it had a tremendous impact

on the case.

She was able to give a voice to Tracie McBride in so many ways,
[ … ]

to stand up and say, yes, he r*ped me

before he did this to me.

NARRATOR Louis Jones Jr. is found guilty.

But before his punishment is determined,

a new disturbing piece of information emerges.

Louis Jones told his story to a psychiatrist,

and very much in detail about what

occurred that night at his house with Tracie McBride there.

NARRATOR Jones's unofficial confession confirms

one of Doctor G's key findings.

He does admit to having sex with her.

They said, you were right.

He confessed to sexually assaulting her.

NARRATOR Louis Jones Jr. is sentenced

to death for the violent r*pe and m*rder of Tracie McBride.

He appeals to the US Supreme Court,

but his appeal is denied.

Jones was ex*cuted March the th of

in Terre Haute, Indiana.

NARRATOR It's a bittersweet victory.

People have the misconception that we're all sitting

around high-fiving each other.

That's not what happens.

They've just decided to k*ll somebody.

And above all, no matter what they decide,

the McBrides still don't have their little girl back.

Knowing the hurt he caused both myself and my family,

I couldn't imagine them seeking any other punishment.

We felt that justice had been served,

and that that group of jurors did their job.

NARRATOR But even justice is small compensation

for their tragic loss.

I would go to the cemetery and I would cry

and I would sing until I felt her singing with me.

And I could just feel that comfort, that she was there.

I lost my big sister, my best friend in the world.

NARRATOR For Dr. G, too, Tracie's death,

with its raw v*olence and cruel details,

will stay with her for years to come.

But even this experience she embraces

as part of her calling.

That's my job, to communicate to the jury what happened.

And I'm glad I was able to give a voice to Tracie.

NARRATOR Giving a voice to the deceased

is the primary responsibility of every medical examiner.

And it doesn't just stop with suspected homicides.

Such is the case in Dr. G's next autopsy,

as she struggles to unravel the mystery

behind an elderly woman's sudden demise

just three days after knee replacement surgery.

They discharged her thinking everything was fine,

and then she dies suddenly in front of her husband.

NARRATOR Every year, millions of Americans

go under the Kn*fe.

But as Dr. G knows too well, there is no such thing

as risk-free surgery.

Because when something goes wrong, she gets the body.

We're talking about total malpractice here.

We're talking about inherent risk for death

from the procedure.

Surgery is certain.

NARRATOR But while hospital-related deaths are

always tragic, Dr. G's next case is even more unusual than most,"], index ,…}

when, three days after a seemingly routine surgery,

tragedy strikes.

So what we have is an elderly woman that's dead at home.

NARRATOR According to the investigator's report,

-year-old Mildred Ferry, a retired shopowner and mother

of two, had been recovering from a knee replacement surgery,

and doing quite well.

They discharged her thinking everything was fine,

and then she dies suddenly in front of her husband.

NARRATOR Now, her distraught husband of years

is desperate for answers.

The sudden decline is especially surprising

because, despite her age, Mildred was extremely healthy.

She really doesn't have a strong history.

And she's well enough to go through surgery.

So I knew she probably had to be pretty healthy.

NARRATOR In fact, Mildred and her husband,

who lived in Orlando, Florida, were avid walkers.

And she hoped the knee replacement

surgery would allow her to stay active for years to come.

And she made it through surgery OK.

NARRATOR Given her age, it is possible that she

simply d*ed of natural causes.

But because she was so healthy, Dr. G

suspects her death might be related to the surgery.

There's always, you know, the worry about infection--

that, possibly, you get a systemic infection.

NARRATOR In the US, infections contracted in the hospital

k*ll an estimated , people each year, as many

as AIDS, breast cancer, and auto accidents combined.

Another deadly risk is the formation

of emboli, or blood clots.

So certain types of surgery, particularly

orthopedic surgery, knee surgery, hip surgery,

you're prone to have pulmonary emboli.

You're prone to form clots in your legs

that then go to your lungs.
[ … ]

NARRATOR Recent surgery and immobility

both can slow circulation and allow blood clots to form.

Although most blood clots tend to dissolve on their own,

a clot can be fatal if it breaks off, travels to the lungs,

and lodges in the blood vessels, cutting off oxygen

supply to the rest of the body.

So those are really my two major concerns--

blood clot or an infection too.

There's no way we're going to tell without an autopsy.

NARRATOR Dr. G begins the external exam, first inspecting

the surgical wound itself.

Oh.

We're going to have to take that off.

NARRATOR If Mildred d*ed of a lethal infection,

it would likely have started there.

JAN GARAVAGLIA Does it look red?

Is there pus coming out of it?

All of those things are important to me.

NARRATOR But the knee seems to be healing well.

The wound looks good.

It doesn't look infected.

It looked great.

NARRATOR With a clean surgery site,

Dr. G is beginning to doubt that an infection k*lled the woman.

And the rest of the exam gives her little else to go on.

The external is pretty much negative.

It isn't giving me a whole lot of hints yet.

NARRATOR Now, she must dig deeper for answers

inside Mildred's body.

Take a picture and we're ready to go.

NARRATOR Dr. G opens the torso with the standard Y incision.

Same old thing I do every--

it's like "Groundhog's Day" or something.

NARRATOR Her first stop is the lungs.

She slices them open, searching for fatal clots.

And here, the case takes an unexpected turn.

This lung is a little bit surprising.

I really thought it was going to have pulmonary emboli,

and it doesn't.

She doesn't have any blood clots in the pulmonary arteries.

NARRATOR Dr. G continues the exam,

looking at each individual organ for signs of natural disease.

And we look at each organ piece by piece and dissect it.

NARRATOR But incredibly, she finds

no evidence of abnormalities in any of the internal organs.

You know, things don't look that bad.

So we're going to have to definitely

look under the microscope here.

NARRATOR No infection, no pulmonary emboli,

no signs of natural disease.

As Dr. G concludes the autopsy, she finds herself empty-handed.

Now, she wonders if Mildred's death might be the result

of a deadly medication mistake.

There's always that possibility

of, she OD-ed on her dr*gs.

She was on some pain medication from that surgery.

NARRATOR The only way to find out

is to take Mildred's blood and urine samples

and send them out for analysis.

Dr. G also orders some microscopic slides

of tissue samples from the lungs, brain, and kidneys.

Perhaps one of the organs holds a secret

invisible to the naked eye.

So now we're going to put our hopes on the toxicology

and the microscopics.

NARRATOR Three weeks later, Dr. G gets her slides

and the toxicology results back from the lab.

First, she checks out the report.

It shows Mildred was definitely on dr*gs when she d*ed.

She was taking, you know, a lot of pain medication.

NARRATOR But the numbers are well within normal range.

Dr. G concludes that the woman did not die of an overdose.

Now, the answer to her death rests on what she

can find under the microscope.

At times magnification, she can clearly see the cells.

And among them, she finally discovers an unusual k*ller.

In the lungs and in the brain, most importantly, I see

a little globules of clearness.

NARRATOR These are emboli.

But they're not made of blood.

In this instance, it looks like fat.

And bingo.

I've got my diagnosis.

NARRATOR Mildred's lungs and brain

are flooded with fat emboli, a buildup of fat cells

that have escaped from her bones.

We know that it occurs mostly with broken

bones or surgery on the bones.

Somehow, the pressure or the break

forces this fat in your blood vessels.

NARRATOR Once inside the bloodstream,

these globules of fat travel like clots through the heart,

lungs, and brain.

Most are naturally absorbed by the body.

But if they accumulate, the effect can be deadly.

And that fat goes to your lung and probably

goes through the capillaries and gets to your brain.

So the brain's not getting the oxygen it

should, and you stop breathing.

NARRATOR Every year, thousands of people
[ … ]

undergo knee replacement surgery without developing

fatal fat emboli.

But Mildred was one of the unlucky few.

JAN GARAVAGLIA Fat emboli is a very rare complication.

And honestly, most people survive.

Her age probably contributed to having

it harder to withstand this.

She needed the surgery.

It's just one of those things that happens.

It's a rare complication.

NARRATOR While surprising, Dr. G's findings

do help provide a sense of closure

for Mildred's surgeon and her husband.

Well, it matters to the family.

It matters to the surgeon.

He likes to know, you know, what happens to his patients.

But for me, it matters that I was able to get the answer,

and get the right answer.

NARRATOR In the end, Dr. G still believes,

like many things in life, the benefits of surgery

far outweigh the risks.

If you need the surgery, you get it.

If you want to go skiing, go.

I think you have a--

you have a much higher risk driving to the operation

and getting k*lled in a car accident.

MAN (WHISPERING) Atlas.