06x05 - Deadly Decisions

[bunniefuu]

[music playing]

NARRATOR An unidentified body is found

lifeless on the side of a road.

She has no ID on her, or anything that will

give us an idea who she was.

There's a lot of trauma to her head.

Almost to the point of being unrecognizable.

NARRATOR Now, it's up to Dr. G to figure out who this woman

is, and exactly how she d*ed.

There are clues here.

We just need to find them.

NARRATOR Then, a routine boat ride turns deadly.

They do find him at the bottom of the lake,

in about feet of water.

NARRATOR And each new discovery only deepens the mystery.

Oh, my God.

Look at that.

There, I find something else.

Something totally unexpected.

Oh.

He's got some problems here.

[theme music]

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

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

It's early morning in Orlando, Florida.

And Dr. Jan Garavaglia, Chief Medical

Examiner at the District Morgue, is already at work.

Today, there is a difficult case that requires

her immediate attention.

Wow.

This case was initially called in to the police

by a truck driver who was just driving his rig down the road

and sees something suspicious.

[music playing]

NARRATOR It appears to be a person,

face down and motionless on the side of the road.

I just saw a body.

The police arrive.

They do their initial scene investigation.

NARRATOR What they discover is a woman's

body, battered, bloody, and clearly dead.

Dr. G wastes no time dispatching medical investigator Steve

Hanson to examine the scene.

He'll look at the body to kind of give

the police some indication of what happened.

We've got a body that shouldn't be

in a place alongside the road.

There's significant trauma.

We proceeded with the idea that she may have been beaten,

or she'd been hit by a car and then slid along

the ground for or feet.

This is potential homicide.

NARRATOR Police immediately launch an investigation,

but they have their work cut out for them.

JAN GARAVAGLIA She has no ID on her.

She has no purse around.

She has no vehicle around, or anything that will

give us an idea who she was.

When you have what might be suspected to be homicide,

historically, you start looking at who the people

that know the person are.

Husbands, wives.

And start building that chain to find out what was going on,

and who it is, and who might have done it.

NARRATOR But with an unidentified victim

on their hands, police don't even know where to begin.

They're really anxious for us to get

the body into the medical examiner's office

and do an examination.

NARRATOR Dr. G's job is straightforward.

But far from easy.

Help police make a positive ID on the victim,

determine the cause and manner of death,

and look for any evidence that could shed light

on who, or what, k*lled her.

The moment Jane Doe's body rolls into the morgue,

the race to identify her is on.

Because I know that her identification is going

to be crucial, as soon as I clear those hands,

and I'm done taking trace evidence off of her skin,

I'll let Steve usually come in and fingerprint

the body for me.

NARRATOR He takes two types of prints.

First is a digital scan.

We use this Quick Print ID system that we've got.

We roll the laptop into the morgue.

So we'll go ahead and put the index and middle finger.

We'll transmit that through the laptop into the database.

NARRATOR Then Steve also pulls traditional rolled

ink prints from the victim.

The fingerprints will be sent over to the police ASAP.

They'll run it through their system very quickly.

NARRATOR In addition to taking fingerprints,

Dr. G usually takes photos of the decedent.

But today, this is not an option.

The trauma is simply too severe.

I don't think anybody's going to be able to identify

her through a photograph.

NARRATOR As a result, Dr. G will have to provide police
[ … ]

with the next best thing--

a detailed physical profile of the victim.

She had, you know, not a lot of wrinkles.

She looks like maybe she's in her s.

She's a black woman.

Now, one of the things we'll look at for identification

is going to be teeth.

Because teeth will certainly give us unique characteristics.

Oftentimes, we get a presumptive ID some other way,

and then make the scientific ID through comparing

your dental records with your teeth.

Let's see her mouth.

Oh no, it's--

NARRATOR But here, Dr. G encounters another challenge.

JAN GARAVAGLIA Well, we see right off that she

doesn't have any teeth.

She has dentures.

Now, it would be the holy grail if her social security

number was engraved on the dentures,

but not many dentists do that.

NARRATOR But the prosthetic teeth

do provide one possible clue.

She had a gold tooth on her denture.

So her dentures were somewhat unique.

NARRATOR Dr. G creates a preliminary profile

for homicide investigators.

The victim is an African-American woman,

about years old, with dentures and a gold tooth.

Police then run a check to see if the description

matches anyone who's been reported missing

in the surrounding area.

But detectives will be relying on Dr.

G for more than just a profile.

It's my job now to try to figure out exactly what

happened to her, so we need to gather as much information--

forensic information-- as we can.

So we've got--

NARRATOR Dr. G begins by examining each of the injuries

on Jane Doe's head.

So we've got the second and third.

The cheek bones are fractured.

The mandible's fractured.

Her nose is fractured.

NARRATOR And clearing away the blood and dirt

that's matted to Jane Doe's scalp,

Dr. G begins to get a glimpse of what this woman endured.

Oh, gosh.

OK.

NARRATOR This was no hit and run.

She was beaten.

I find blows to the head.

Lacerations where the skin has torn.

I draw each one of them individually,

and I measure where they're located on the scalp.

NARRATOR One of the reasons Dr. G scrutinizes the wounds so

closely is so that she can try to determine

what was used to make them.

If Dr. G can make a determination of the type

of instrument that's used, and she passes that

on to the police, well, they can certainly

pass that onto their crime scene people

who are looking at the scene.

NARRATOR Once they know what to look for,

detectives might have an easier time finding

the w*apon that was used.

That w*apon could harbor fingerprints

or other identifying evidence that could

lead police to a perpetrator.

Looking at the size and shape of the wounds,

Dr. G begins to get an idea of what type of w*apon was used.

Clearly, multiple areas of trauma, all

with a blunt instrument.

NARRATOR But she can't specify what type of blunt instrument

until she examines the inside of the cranium.

Until I see the skull and see the injuries internally,

I really can't make much of a determination

of what type of instrument.

NARRATOR And as she makes her way down the body,

Dr. G is confronted with another gruesome discovery.

Oh, look at this.

I can't imagine who would do this to this woman.

You know, what did she do that would deserve this?

[music playing]

NARRATOR Dr. G is examining the body

of an unidentified woman, who police found brutally m*rder*d

on the side of the road.

And she's just made a startling new discovery.

She's got at least five g*nsh*t wounds.

NARRATOR One pierced her abdomen.

Two on her left leg.

One on her hip.

And one that went straight through her hand.

It's a brutal display of v*olence.

But it could also be the biggest clue yet.

Are there b*ll*ts in her?

Where are these to be retrieved?

NARRATOR Dr. G orders a full body X-ray.

Any b*llet still lodged inside Jane Doe's body

could lead detectives to her k*ller.

They could be matched to a g*n that caused her g*nsh*t wounds.
[ … ]

NARRATOR As soon as the X-rays are completed,

she carefully examines the images.

We can find things on X-ray that

may help us identify the body.

NARRATOR And sure enough, Dr. G discovers a unique feature.

We see evidence of an old broken wrist, which may or may

not help us identify her later.

And if we have a presumptive identification,

and I get then an X-ray--

a previous X-ray, I can say for sure that's who it is.

NARRATOR But something else she sees

could help the case even more.

When we do the X-rays, we find two b*ll*ts.

NARRATOR Luckily, two of the b*ll*ts did not exit the body.

They could now be the key pieces of evidence

that ultimately lead detectives to the perpetrator.

We always will retrieve the b*llet if one is present.

So I really need to do the internal exam.

NARRATOR Dr. G cuts open the body from the shoulder blades

to the pelvis with a Y incision.

And using only her gloved fingers,

she carefully extracts the b*ll*ts.

Hopefully, the casings will match up with a w*apon

that police already have on file.

When a b*llet extends down the end of the barrel,

there are unique nicks and imperfections on that barrel

that will impart unique characteristics

on the edge of the b*llet.

So if we have the g*n, they can test fire it

and see if it matches to the b*llet

I've recovered from that body.

NARRATOR And examining the five g*nsh*t wounds more closely,

she notices something odd about the trajectory

of the b*llet paths.

They're all kind of going downward.

NARRATOR This gives Dr. G an idea

of where the victim was positioned

in relation to the sh**t.

It suggests that she's sitting up.

And that the wounds are from somebody slightly

higher sh**ting at her.

NARRATOR Since Jane Doe was found lying down

on the side of a road, this finding

indicates that she was most likely

sh*t in a different location.

But that's not all.

Following the paths of the b*ll*ts

through Jane Doe's body, Dr. G makes

another surprising discovery.

They didn't hit any major vessel.

It didn't hit any major organ.

None of the g*nsh*t wounds are fatal.

They're not the cause of death.

So the last thing I do is the internal exam on the head.

NARRATOR Dr. G slices through Jane Doe's scalp,

and peels it back, exposing the top of the skull.

And immediately, she makes a gruesome discovery.

The victim's cranium is completely shattered.

She's got these multiple displaced fractures,

not just on the top of the skull and sides,

even the base of the skull.

NARRATOR Dr. G scrutinizes the fragmented pieces of skull

in an attempt to determine what kind of instrument

inflicted the injuries.

Now, what I look for, though, is to see

if I can see any imprints.

Like, if you have a hammer, you'll

oftentimes see these curvilinear imprints on the bone.

If I have like a thin crowbar, sometimes you

can see those fractures a little different.

This fracture really indicated something

more broad-base, not thin.

NARRATOR This finding suggests that Jane Doe

was beaten with a blunt object.

But the skull is too damaged for her

to determine what type of blunt object was used.

Piece by piece, she removes the fragments of skull.

Usually, her morgue assistant would

open the skull by sawing across from one end to the other.

But this case is different.

We'll actually use some of these large fractures

to help open the cranial cavity.

Oh.

Her head's not good.

I am really surprised at the sheer amount of deep trauma

to her brain.

This woman has pieces of bone fragments driven into her brain

to the point where her brain stem is lacerated.

Clearly, these are unsurvivable injuries.

These are injuries that would have caused her death.

At this point, the autopsy is done.

NARRATOR But Dr. G's work is far from over.

Well, the big thing left is, we still need to identify her.

But at this point, unfortunately, I

get word from the fingerprint examiners,

that they can't make her identification off

of fingerprints.

Once we can't identify her through fingerprints,

you know, people think we'll just use DNA.

Well, there's no database for the most part in DNA.
[ … ]

So that's not going to work.

And that's going to take a couple weeks.

The case will be cold by then.

Oh, wow.

NARRATOR Police also report that the b*ll*ts

found in Jane Doe's body have failed to provide any leads.

And Dr. G's initial physical profile

hasn't panned out either.

The municipality where this occurred

didn't have any missing persons report that matched.

NARRATOR No clues.

No leads.

No ID.

The case is growing colder by the moment.

If Jane Doe's body isn't identified soon,

she will be laid to rest anonymously.

There is nowhere to send this body,

because she's unidentified.

There's nobody to claim her.

There's nobody to have a funeral on her.

So unfortunately, she'll be buried as an unidentified.

NARRATOR It's a prospect that doesn't sit well with Dr. G.

I don't like putting people in the ground

where no one is there to grieve for them.

No one knows who they are.

I don't even know if their next of kin

would want that, you know?

Maybe that's against their religious objections.

They'd rather have her disposed of in another way.

You know, I just always hate doing it.

NARRATOR And worse, police may never track down her k*ller.

Is it possible her k*ller is never brought to justice?

Yes.

There is a real possibility.

Particularly if you never figure out who she is.

[music playing]

NARRATOR Dr. G has just finished

autopsying the unidentified victim of a grisly homicide.

But none of her findings have led

to a positive identification.

It's very difficult to solve the case

if you don't know who it is.

NARRATOR But Dr. G's not ready to give up yet.

JAN GARAVAGLIA Somewhere in this town,

somebody is missing this woman.

Now, my police agency that has this case

doesn't have any missing persons reports.

But somewhere, I have a feeling somebody is looking for her.

NARRATOR Fortunately, she and her investigators

have one last tool at their disposal.

I am going to have to put the word out to the media.

When it goes on the evening news,

we will get calls from people who

are looking for their missing loved ones or friends.

NARRATOR But the first wave of news reports hit the airwaves

and still the phone lines in the morgue remain eerily quiet.

After hours, Dr. G knows the chances of identifying Jane Doe

and catching her k*ller are slim.

JAN GARAVAGLIA You know, most of all of our cases

that come in unidentified, we will

identify them very quickly.

And your chance of identifying them

really goes down, the colder it gets.

Yes, this is Jessica with the medical examiner.

NARRATOR Then, six full days after the autopsy,

they finally get a hit.

One of my investigators gets a phone call.

And their mother is missing.

I haven't seen my mother in six or seven days.

She is a black woman.

She's about foot , in her late s.

NARRATOR But Dr. G had presumed that the woman on her table

was at least years younger.

So we lost a little bit of hope.

NARRATOR But then, the caller says something that

instantly changes the game.

They got further information.

And although the age didn't match,

all the other details matched really well.

What's a good time for you?

Tomorrow?

She's got dentures.

In fact, one of the teeth of her dentures

was covered with gold metal.

So we're sitting here going, OK,

more and more of it's clicking.

This could be her.

We immediately called law enforcement,

that we have a good lead, and that we were having

her come in that afternoon.

It must be a terrible, terrible thing

to have to come down to the morgue

to try to identify your mother.

I can't imagine.

I don't know if they really--

I am assuming they hope it's not her.

Hi, my name is Jessica.

NARRATOR In a conference room at the morgue,

one of Dr. G's investigators sits down

with the distraught family member
[ … ]

and pictures of the decedent.

JAN GARAVAGLIA The first thing we

do is we showed her a picture of the left side

of her face, which wasn't as d*sfigured as the right.

And they couldn't say for sure.

So we had to work something else out.

At some point in time, the daughter

said she could recognize her if she just saw her feet.

JAN GARAVAGLIA It was extremely odd.

But we went down, we pulled her out,

and we took a picture of her feet.

As soon as she saw that picture of the feet, she said,

that's my mom.

She was able to identify the body.

NARRATOR To confirm the identity,

the daughter gives Dr. G her mother's medical records

to review, including a chest X-ray that Dr. G compares

to one taken of the dead body.

They're a perfect match.

At this point, I was able to put my signature on the fact

that this was this woman's mother.

[music playing]

NARRATOR Jane Doe finally has a name.

She's Jeanette Dawson, a divorced -year-old mother

of two, who earns a living bartending at a local tavern.

The positive ID is devastating news for Jeanette's family.

But at least now there's a chance

that police will be able to get a lead on a possible suspect.

JAN GARAVAGLIA Once we knew who she was,

they know where to start looking.

Where she's last seen, where she worked.

And sure enough, when they go to the bar

where she's a bartender, people remember that she

had given somebody a ride.

[police sirens]

NARRATOR Police track down the last man

seen with Jeanette, a convicted criminal named Danny Barton.

And when presented with the evidence

Dr. G uncovered at autopsy, along with the findings

from the investigation, Barton quickly cracks under pressure.

JAN GARAVAGLIA He gave details and a scenario

that perfectly matched what I found at autopsy.

I have no doubt that he's telling the truth.

NARRATOR It's o'clock in the morning.

And -year-old Jeanette Dawson is

finishing up her shift at a downtown tavern in Orlando.

JAN GARAVAGLIA This fellow was there and struck up

a conversation with her.

When she got off work, she gave him a ride home.

NARRATOR But the friendly encounter

soon takes a sinister turn.

JAN GARAVAGLIA He had ulterior motives for the ride home.

DANNY BARTON OK.

Pull over.

JAN GARAVAGLIA He pulled a g*n out.

Shut up and just do as I tell you.

He wants the title of her car.

NARRATOR Barton forces Jeanette off the road.

Anything, anything.

NARRATOR She complies with his demands and hands

over the keys and title.

But for Barton, it's not enough.

Afraid she'll go to the police, he decides

then and there to end her life.

He exits the car, comes around to the driver's side,

and sh**t her several times.

[g*nshots]

JAN GARAVAGLIA The direction of those b*llet wounds

match the fact that she was sitting in that car

when he sh*t her.

NARRATOR But Barton has a problem.

JAN GARAVAGLIA She's still alive.

And he was out of b*ll*ts.

JEANETTE DAWSON Please, please.

JAN GARAVAGLIA He finds the area, drags her from the car,

and then he bludgeons her to death multiple times.

NARRATOR From the trauma to her skull,

Dr. G concluded that Jeanette was struck with a blunt object.

And not surprisingly, this coincides precisely

with investigators' findings.

Barton b*at her with a large wooden log.

JAN GARAVAGLIA Until, in his words, her head gets soft.

And that's what we found.

And then he leaves her there, takes the car,

and drives the car until it doesn't drive anymore.

NARRATOR Barton is sentenced to years in prison.

And while it won't heal her wounds,

Jeanette's daughter is relieved to know that her mother's

k*ller is locked away.

JAN GARAVAGLIA You know, it always feels

good to know that you add a little piece

of the puzzle to help a criminal be held accountable

for his crime.

[music playing]

There's no rhyme or reason to this world sometimes.

I don't understand the senseless k*lling.

What was the purpose of it?

What did it mean?

Sometimes you just-- it's hard to put things in perspective.

[music playing]
[ … ]

NARRATOR Every day, families are depending on Dr. G

to solve the mysteries behind their loved ones'

sudden deaths.

But some mysteries are more baffling than others.

And when -year-old Cisco Rivera is found dead

at the bottom of a lake, his family

is left groping for answers.

We have a guy that's just out taking his boat out,

and the next thing we know, he's in the water.

What happened?

[music playing]

NARRATOR Beaches, lakes, and plenty of sunshine.

Fans of water sports flock to Florida's shores all year

round.

JAN GARAVAGLIA In Orange County alone,

we have over named lakes.

We have a lot of water skiing, a lot of fishing.

So my dream is to someday own a boat.

NARRATOR But as the chief medical examiner

for these counties, Dr. G knows that boating

can also be deadly.

We have quite a few drownings that come through our office.

[music playing]

NARRATOR And it appears as if her next decedent may be one

of these unfortunate victims.

A repairman named Cisco Rivera, who

was found at the bottom of a lake near Orlando last night.

[music playing]

NARRATOR It's PM on Saturday.

And the shores of East Lake Toho are packed.

Not with boaters and their families,

but with paramedics, police, and one

of Dr. G's medical investigators, Carol Crosby.

I was at work and received a notification call

from the police department, indicating

that they had found a gentleman who had

perhaps fallen off his boat.

[music playing]

There's numerous firefighters, rescues, there's

different agencies there.

NARRATOR And Carol is at the center of the action,

with the dead body of Cisco Rivera,

and his grieving cousin Manny, the last person

to see him alive.

CAROL CROSBY Our job is to find out everything we can

about what occurred.

So I spoke to him, trying to obtain some information.

You saw him go out?

NARRATOR Manny tells Carol that earlier that same day, Cisco

had invited him to come to the lake,

so he could see his new boat.

This boat's old.

It's from the late 's, early 's.

So it's just a metal jon boat.

And he wanted to make sure that it

was safe to put in the water.

[music playing]

NARRATOR At about AM, they

lower the boat into the lake.

It doesn't appear to have any leaks or structural problems.

So Manny waits on shore, while Cisco

takes it out for a quick spin.

And that's the last the cousin sees of him.

NARRATOR An hour later, Cisco has still not returned.

And he's waiting.

And he's waiting.

And the next thing he knows, another boater is coming in

and says, there's a boat out there with nobody on it.

CAROL CROSBY So the rescue boat went out.

They did discover the boat.

JAN GARAVAGLIA Now the boat engine is still on.

It's idling.

But they can't find this fellow.

He's nowhere to be found.

So the dive team comes out, and they search the water.

And unfortunately, after about six hours,

they do find him at the bottom of the lake,

in about feet of water.

[music playing]

JAN GARAVAGLIA Let's see.

NARRATOR Dr. G thumbs through Carol Crosby's

detailed investigator's report.

On first glance, she's surprised to discover that Cisco

was a strong swimmer.

But she doesn't believe the -year-old

just went for an impromptu dip.

JAN GARAVAGLIA He was fully clothed.

And he had his cell phone in his pocket.

So I doubt that he just went in the water, because it was hot,

and he decided to go for a swim.

NARRATOR To add to the mystery, investigators found Cisco's

life jacket in the boat.

Though Manny insists he was wearing it when he left.

JAN GARAVAGLIA Interesting enough,

the life vest was in this boat, which he had

on when he first took the boat out.

NARRATOR But despite the seemingly suspicious

circumstances, Carol's thorough investigation

quickly rules out foul play.

There was no sign.
[ … ]

No sign of a struggle or that anything else occurred.

JAN GARAVAGLIA There's a lot of factors

that can play a role in why somebody

can't get out of the water.

Foul play is probably low on the list of possibilities here.

NARRATOR su1c1de is also low on that list.

Dr. G knows that intentional drownings are unusual.

And there was no evidence at the scene to suggest

this is what happened.

JAN GARAVAGLIA This wasn't a su1c1de.

NARRATOR But one possibility immediately springs to mind.

JAN GARAVAGLIA % of adults who drown, the vast majority

of which are male, will have alcohol in their system,

and are intoxicated.

Alcohol and water do not mix.

NARRATOR But a closer look at the investigator's report

tells her that this case may not be so simple.

Let me go get a quick verbal.

Hey, Carol, could you give me a quick verbal on our guy there?

NARRATOR According to his cousin,

Cisco didn't consume any alcohol while they were together.

And Investigator Crosby saw no evidence in the boat

to suggest otherwise.

OK. Thanks.

CAROL CROSBY I found no indication

that the decedent had been drinking

or doing any kind of dr*gs.

There was no alcohol found, no beer cans found.

NARRATOR So then how did the seemingly healthy -year-old

end up dead at the bottom of the lake?

JAN GARAVAGLIA Did he have some type of natural disease,

whether it's seizures, whether it's a heart att*ck,

whether it's something wrong with diabetes?

All of those things can occur in the water.

NARRATOR And Dr. G knows that there's

only one way to find out.

That's why we do autopsies.

OK.

Let's see.

NARRATOR Dr. G begins by examining Cisco's head.

And not surprisingly, she finds his airways filled with water.

JAN GARAVAGLIA If you spend enough time in water,

even dead, you might get water up your nose,

into your sinuses.

[music playing]

NARRATOR But then she notices a gash close to two inches

long across the bridge of his nose.

JAN GARAVAGLIA He's got a lot of blood

concentrated in the area of the nose and on the forehead.

So was it that he slipped and fell,

and got hit by the propeller?

NARRATOR In Cisco's case, police

have made a special request, that Dr.

G check for trace evidence in his head wound.

Their theory is that he fell off

the boat, hit the propeller, and that's

what causes him to drown.

So they asked me to look for fiberglass,

which is what the propeller blade was made out of.

So I don't want to clean it too much before I look at it.

Could you hand me-- throw me that towel?

So I try to dab some of the blood away.

NARRATOR With each dab, the reported gash on Cisco's face

comes into better view.

And what Dr. G sees next casts serious doubt on this theory.

It really is highly improbable that that

was from the propeller.

[music playing]

NARRATOR But if the propeller didn't k*ll Cisco,

then what did?

We have a guy that's just out taking his boat out,

and the next thing we know, he's in the water.

What happened?

[music playing]

NARRATOR Dr. G gently palpates around the injury

on Cisco Rivera's face.

Last night, the -year-old was found

dead at the bottom of a lake.

Until now, it seemed likely that he

drowned after falling from his boat,

and hitting the propeller.

But Dr. G has just found a surprising clue

that contradicts that theory.

Once we clean the blood off, he--

there really isn't a gash on the forehead.

There is an abrasion to the nose,

but it really is superficial.

There's-- there's nothing else there.

It really wasn't consistent with, at all,

with being hit by a propeller.

Even on a small engine.

OK.

NARRATOR She now suspects that Cisco received these wounds

after he d*ed, when police were recovering

his body from the lake.

JAN GARAVAGLIA They'll often use

a wire mesh basket with sides.

They'll get scrapes and bangs to the body

that are actually postmortem.

[music playing]
[ … ]

NARRATOR But this revelation only deepens the mystery.

JAN GARAVAGLIA We're not going to know anything

until we finish the autopsy.

[music playing]

OK.

Tom, let's do his head.

[music playing]

NARRATOR Dr. G begins the next stage of her investigation

by drawing her scalpel across the back of Cisco's head.

JAN GARAVAGLIA I'll do my usual scalp

reflection to see if there is any trauma

underneath the scalp.

NARRATOR While Cisco clearly wasn't hit by the boat's

propeller, it's still possible that he fell out of the boat

and hit his head on something else.

But after a thorough examination of his exposed cranium,

she finds no signs of damage.

I don't see any kind of impact site.

NARRATOR She presses on, opening up Cisco's skull

and inspecting the brain itself.

Old trauma.

No trauma.

We've ruled out trauma to the brain.

It doesn't look like he was knocked out,

going out on the boat, or knocked out, you know,

hitting the water.

NARRATOR With head trauma ruled out,

she must now search his brain for any natural abnormalities.

Maybe he had a stroke.

Maybe he had a bleed inside the brain.

The head could have the reason why he collapses

and goes in the water.

[music playing]

NARRATOR It's a long sh*t.

Cisco is only years old.

Still, she dissects the brain, scouring

for signs of a fatal or incapacitating stroke.

But I just find the normal brain.

It doesn't look that there is any natural disease

in his brain that would have caused him to go in the water.

His brain looked absolutely great.

I can't really put together the mystery of what

happened to this fellow.

We're going to have to finish the autopsy

and see if there's anything that can give

us a hint of what happened.

[music playing]

OK.

So I do my usual Y incision.

I look at all the body cavities.

What's going on here?

Looking pretty good on the inside.

There really isn't any evidence of trauma.

NARRATOR One thing is now clear.

Cisco did not sustain any physical injuries that

would have caused him to drown.

I think we have fulfilled that he had no trauma.

NARRATOR But then how did the -year-old wind up

under feet of lake water?

Maybe he had some type of natural disease.

[music playing]

NARRATOR As a next step, Dr. G takes

fluid samples for toxicology.

She then begins removing and dissecting

Cisco's organs, one by one, looking

for any signs of illness.

But there doesn't appear to be any natural disease going

on in his abdominal cavity.

Doesn't look so bad.

NARRATOR Next, she cuts open the rib cage

and removes the lungs.

JAN GARAVAGLIA Heavy lungs.

They're going to be full of fluid.

NARRATOR As expected, she can tell right away that they're

heavy with lake water.

JAN GARAVAGLIA And you see the fluid oozing out.

He was face down in the water for about six hours.

Even after death, the water will go in there.

[music playing]

NARRATOR But then she spots something

else that takes her aback.

His lungs do have a lot of anthracotic pigment,

that black, tarry material that's never going to leave

your lungs if you smoke.

NARRATOR This evidence tells Dr. G

that Cisco was a heavy smoker.

That means, despite his healthy appearance,

he was at risk of developing a laundry

list of natural diseases.

Smoking certainly increases the chance of many cancers.

It certainly increases the chance of having heart disease.

NARRATOR With this information in hand,

Dr. G turns her attention to Cisco's heart, still cocooned

in the pericardial sac.

And the moment she exposes the organ,

she can see that something is terribly wrong.

Oh, my God.

Look at that.

There, I find something else.

Something totally unexpected.
[ … ]

Oh, he's got some problems here.

[music playing]

NARRATOR Dr. G is examining the body of Cisco Rivera

for evidence to explain how he wound up

dead at the bottom of a lake.

[music playing]

And when she gets to the heart, she

uncovers her biggest clue yet.

His heart looks enlarged.

Look at that.

That is a big heart.

You know, a heart on this guy should be less than grams.

His is .

That's a big heart.

NARRATOR An enlarged heart is usually a sign that something

is seriously wrong.

To find out what, Dr. G begins slicing it into sections.

The left ventricle, the part of the heart

that pumps the blood through the aorta, is thickened.

That's what we typically see with high blood pressure.

NARRATOR It's clear that Cisco's heart has been severely

damaged by high blood pressure, a condition he probably

didn't even know he had.

And cutting into his arteries, Dr. G finds

another disturbing abnormality.

He has got bad coronaries.

The left main-- the coronary artery

that supplies most of that left side of his heart,

has an % narrowing.

That is severe in that location.

That's a widow-maker.

And then as you go to the left anterior descending, the one

that supplies the front of the heart,

that's still at least an % to % narrowing.

NARRATOR Bottom line--

Cisco's arteries are all but filled

with atherosclerotic plaque.

And when Dr. G opens the right coronary artery,

she finds the smoking g*n.

Oh, look at that.

The plaque has broken open, and has totally

occluded that coronary artery.

% narrowing.

I guess that's it.

NARRATOR Dr. G now knows that on that peaceful Saturday

afternoon, Cisco suffered a heart att*ck.

But as she soon discovers, the chain

of events that led to his death was not nearly that simple.

We already have what appears to be him falling off the boat.

We have the bad heart.

And there's actually another factor that

plays a role that surprised me.

[music playing]

NARRATOR It's a beautiful Saturday morning.

And Cisco and his cousin Manny are

enjoying the fresh air as they prepare to launch his new boat.

Little do they know, inside Cisco's body,

there is a catastrophe brewing.

JAN GARAVAGLIA He's probably got

bad genetics to have such bad coronary artery

disease at his age.

But he also smokes, which accelerates

coronary artery disease.

And he appears to have high blood pressure.

His heart is a walking time b*mb.

[music playing]

NARRATOR But there's also something else going on.

Something that Dr. G had all but ruled out until she

received the results of Cisco's routine blood test.

JAN GARAVAGLIA When I first get the tox report,

I am really surprised.

He was highly intoxicated.

His blood alcohol was over twice the legal limit

for driving and boating.

This was not just a couple of beers in the morning.

There was a period of time between when he left home

to launch that boat and pick up his cousin,

so that blood alcohol was higher just

before he got in the water.

NARRATOR And there's more.

JAN GARAVAGLIA Besides alcohol, he

has alprazolam, which is an anti-anxiety medication,

a central nervous system depressant.

The alprazolam was high.

It wasn't dangerously high.

But it certainly also could have played a role.

[music playing]

NARRATOR Still, Cisco is determined to take

his new boat out for a spin.

JAN GARAVAGLIA They launch the boat.

He had his life jacket on.

Because he's worried that maybe this boat isn't water-safe.

He tools out, the boat's just fine.

NARRATOR But Cisco is not fine.

He's highly intoxicated, and makes a hazardous decision

to remove his life jacket.

JAN GARAVAGLIA It's a hot day.

This is in the summer here in Orlando area.

And he probably got hot and took it off.

So to get that life vest off, he stands in the boat.
[ … ]

NARRATOR But it's a small, unsteady boat.

And standing up inside would be challenging even for someone

who isn't intoxicated.

JAN GARAVAGLIA So he falls over.

And goes into the water.

This panic of trying to rescue himself out of the water

puts extra strain on a heart that's already diseased.

And that could have, in and of itself,

ruptured the plaque, totally occluding that coronary artery.

NARRATOR A fragment of plaque soon breaks away

from Cisco's narrow artery wall, creating

a complete barrier that abruptly stops blood flow to the heart.

JAN GARAVAGLIA The heart muscle was starved of oxygen.

And that set off an electrical instability,

causing an arrhythmia.

NARRATOR Suffering from cardiac arrest,

Cisco can't swim or call for help.

He has no life jacket, and no one is around to witness

his struggle.

Water fills his lungs, and he dies.

[music playing]

As her final duty, Dr. G makes the difficult call

to Cisco's grieving family.

JAN GARAVAGLIA The cousin was shocked

that he had heart disease, because he

looked the picture of health.

SONG Take me away from here.

JAN GARAVAGLIA High blood pressure is a silent k*ller.

Coronary artery disease may not raise its ugly head

until you're dead.

NARRATOR But Dr. G knows that heart

disease was not the lone culprit in Cisco's death.

JAN GARAVAGLIA When you're highly intoxicated,

it affects your judgment.

It affects your coordination.

It affects your ability to think clearly.

SONG I've got no one but myself to ask how did I get here.

You know, it's amazing how alcohol plays a role

in so many people's deaths.

NARRATOR Truth is, if Cisco wasn't intoxicated

in the first place, he might not have fallen in the water

and d*ed when he did.

JAN GARAVAGLIA People really just need

to think about their actions.

Because if you really think about your actions,

you could prevent a lot of what we call accidents.

SONG But it feels like the end.

[music playing]