PathCentre LESSONS FROM CELEBRITY DEATHS Dr Clive Cooke PathCentre

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LESSONS FROM CELEBRITY LESSONS FROM CELEBRITY DEATHSDEATHS

Dr Clive Cooke

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CELEBRITY LESSONSCELEBRITY LESSONS

Is it necessary to do anything differently?

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CELEBRITY LESSONSCELEBRITY LESSONS

presume a hidden (concealed) homicide scene clothing time of death blood stains conduct of the post mortem toxicology, etc

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SCENESCENE

scene often disturbed (cleaned)

encourage investigating authority (police) to have best scene investigators

evidence recording• Video• Photographs

evidence collection statements

(as if a homicide)

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BRIEFING MEETINGBRIEFING MEETING

prior to the Post-mortem examination Coroner investigating officer (police) pathologist (s) mortuary manager

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Mortuary FacilityMortuary Facility

State Mortuary not peripheral centre

Forensic pathologist not lesser pathologist

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Mortuary Mortuary

Security locked, refrigerated area (no access, even to staff)

body continuity sheet (register of all body movements)

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Attendance at PM Attendance at PM

Limited to essential, operations personnel mortuary staff (selected)

forensic pathologist (and observers)

Coroner operational investigators (police)

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Medical ObserversMedical Observers

2 forensic pathologists (including the most senior)

professor of pathology

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IDENTIFICATIONIDENTIFICATION

Avoid “Elvis lives” allegation - confirm identification objectively

dental chart (always)

fingerprints (always)

DNA• identification

• paternity

• body part dispute

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Timing of the PMTiming of the PM

normal working hours PM can be planned accusation of too hasty or too tardy

delay transcription of PM report

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Record of the PMRecord of the PM

photographs +++ (official)

video (prints and negatives to be secured)

whole body Radiology

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The PM ReportThe PM Report

closely controlled document homicide level and style

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PM EvidencePM Evidence

toxicology and other samples duplicates (at least)

• 1 set tested

• 1 set stored

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ToxicologyToxicology

there is often allegation of poisoning (irrespective of the COD and MOD)

routine toxicology samples (duplicated)

extras (duplicated)

• hair

• nails

• kidney

• whole of intestine (segmentalised)

• solvent samples – fat, lung, brain

• swabs – nares; hands

Joseph Stalin poisoned by KGB?

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Tested SamplesTested Samples

letter of referral to the lab confidentiality reaffirmed specific testing to be done return of unused samples to the Mortuary (retained)

cc the Coroner

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Body Part RetentionBody Part Retention

neuropathology recommended (likelihood of allegations of aberrant behaviour)

? other (Make sure the Coroner is aware)

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Release of BodyRelease of Body

after debrief identification certain NOK has been identified (multiple partners, children)

NOK aware of body part retention evidence collected – suitable and stored

formal authorisation of release

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AccusationsAccusations

expect accusations of bias incompetence cover - up conspiracy racism

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Outside InterestsOutside Interests

attempted interference whilst the case is hot media authorities

• senior police

• ombudsman

• politicians individuals

further inquiries (might last for decades) commissions of inquiry amnesty books

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Avoiding StressAvoiding Stress

stay above public hysteria (media; politicians; Coroner and mortuary staff; police; public – threatening calls and e mails; pathologists; doctors, etc)

don’t neglect (seek comfort in) normal business be aware of high rate of problems for the

investigators• burn – out

• divorce

• suicide

• dismissal

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Other SuggestionsOther Suggestions

don’t include the case in public presentations (Nelson Rockefeller – Dr M Baden)

don’t falsify information (Tennessee Williams, 1983 – Dr E Gross sent toxicology samples under another name)

don’t give press statements (remember – it is because you are socially inept that you have become a forensic pathologist)

don’t be careless (even if you have battled bureaucracy for years, are under resourced, with little support – this is not the time to make a statement)

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MARILYN MONROEMARILYN MONROE

body found face down on her bed in bedroom, room secure (by maid/nurse)

Dr Greenson attended (body stiff with rigor mortis – “5 minutes to straighten her out”)

police not called for 2 hours

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MARILYN MONROEMARILYN MONROE

problems with the scene examination : associated Press journalist impersonated Coroner’s

officer and gained access no drinking glass or water noted police report said 15 medicine containers on bedside

table – only 8 apparently sent to tox lab (bedroom cleaned the following day and containers destroyed)

delay in police call interference with body

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MARILYN MONROEMARILYN MONROE

problems with the mortuary : 2 photographers gained access, with whisky, and

photographed the body before post-mortem examination

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MARILYN MONROEMARILYN MONROE

Deputy Medical Examiner (Dr Tom Noguchi)

no injection sites (surface of body examined with magnifying glass, including beneath the tongue and vagina)

no tablet residue in stomach, or staining small bruise top of left buttock

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MARILYN MONROEMARILYN MONROE

toxicology : blood : Chloral hydrate = 8mg% liver : Pentobarbital (Nembutal) = 13mg%

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MARILYN MONROEMARILYN MONROE

DME advised Coroner on 10 August COD = “Acute barbiturate poisoning due to

ingestion of overdose” MOD = suicide (“probable” handwritten addition)

Coroner issued finding 1 week later

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MARILYN MONROEMARILYN MONROE

problems with Toxicology : not all intestine contents submitted (other than stomach)

no analysis other than blood and liver no confirmation of medication types (8/15 containers)

samples destroyed within a few weeks

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MARILYN MONROEMARILYN MONROE

alternative theories : accidental overingestion homicide

• injection

• enema

FBI - to protect Kennedy’s

Mobsters – linked to Frank Sinatra (alleged lover)

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MARILYN MONROE - LESSONSMARILYN MONROE - LESSONS

security - scene, mortuary and information scene – everything documented and retained (treated as a

“crime” scene)

post-mortem examination – retain too much toxicology

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MARILYN MONROEMARILYN MONROE

Born : Norma Jeane Mortenson 1 June 1926 (baptised Norma Jean Baker)

Died : Night of 4/5 August 1962 (age 36)

Childhood : foster care and orphanage

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MARILYN MONROEMARILYN MONROE

Married 3 times• 1942-46 : Jim Dougherty (she had just turned 16)• 1954-54 : Joe DiMaggio (baseball star – just retired))• 1956-61 : Arthur Miller (playwright)

1944 : Army promotions photo shoot led to photo model career

1946 : contract with 20th Century Fox – “Marilyn” from fellow actress and “Monroe” from mother’s family name

1950 : “The Asphalt Jungle” 29 movies

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MARILYN MONROEMARILYN MONROE

1950’s : increasing alcohol and prescription drug dependence

• Demerol (Morphine)• Barbiturates – Nembutal; Amytal; Sodium-Pentothal• Chloral hydrate

and occasional use of Mandrax and LSD Required medical treatment for overdoses 1961 : physical ailments included

• Cholecystitis (cholecystectomy)• Menorrhagia• ? Irritable bowel syndrome

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MARILYN MONROEMARILYN MONROE

1960 : Dr Greenson – psychiatrist to the stars

1961 : ? Relationships with JFK and Bobby (President and Attorney-General)

Evening of 4 August 1962 – several phone calls to friends – seemed very depressed; worried because had received threatening calls saying to leave Bobby Kennedy alone