Omaree Autopsy Report

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Omaree Autopsy Report

Text of Omaree Autopsy Report

  • CAUSE OF DEATH

    Blunt trauma

    MANNER OF DEATH

    Homicide

    DEATH INVESTIGATION SUMMARYCase Number: 2013-06715

    VARELA, OMAREE

    Sam Andrews MD FRCPCAssociate Medical Investigator

    Odey Ukpo MD Forensic Pathology Fellow

    All signatures authenticated electronicallyDate: 3/7/2014 4:50:48 PM

    County Pronounced: BernalilloLaw Enforcement: APD Criminalistics

    Agent: Chad StuartDate of Birth: 2/3/2004

    Central Office Investigator: Daniel WaskoDeputy Field Investigator: Daniel Wasko

    Pronounced Date/Time: 12/27/2013 5:32:00 PM

    Report Name: Death Investigation Reporting ToolPrinted: 3/25/2014 11:45:49 AM

    Death Investigation Report Page 1

  • DECLARATION

    The death of VARELA, OMAREE was investigated by the Office of the Medical Investigator under the statutory authority of the Office of the Medical Investigator.

    I, Sam Andrews MD, FRCPC a board certified anatomic, and forensic pathologist licensed to practice pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks described within this Death Investigation Summary document. It is only after careful consideration of all data available to me at the time that this report was finalized that I attest to the diagnoses and opinions stated herein.

    Numerous photographs were obtained along the course of the examination. I have personally reviewed those photographs and attest that they are representative of findings reported in this document.

    This document is divided into 10 sections with a final Procedural Notes section:

    1. Summary and Opinion

    2. External Examination

    3. Medical Intervention

    4. Postmortem Changes

    5. Evidence of Injuries

    6. Internal Examination

    7. Neuropathology

    8. Microscopy

    9. Radiography

    10. Peer Review

    Should you have questions after review of this material, please feel free to contact me at the Office of the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.

    Report Name: Death Investigation SummaryPrinted: 3/25/2014 11:45:50 AM

    Death Investigation Report Page 2

  • Medical Investigator

    Sam Andrews MD

    Medical lnvestigator Trainee

    Odey Ukpo MD

    According to the initial report given to the Office of the Medical Investigator by Detective English of the Albuquerque Police Department, the decedent's mother reports that on December 27, 2013, the decedent was on a toy horse and was pushed from the horse by his 3 year old sibling, striking his head on the floor and losing consciousness. She stated that she called her husband, the decedent's step-father, who was not at home. Apparently, he placed the decedent in the shower to attempt to revive him. His mother then called his pediatrician who advised her to call Emergency Services.

    Subsequent conversations with the step-father revealed that he was at home and heard the decedent's mother "beating him". Additionally, the mother told police that she knocked him into a dresser and he fell to the floor. While on the floor she stomped on him twice and kicked him in the abdomen.

    The decedent was taken to the University of New Mexico hospital emergency room, where resuscitation was attempted for 30 minutes without success and he was pronounced dead at 17:32 hrs on 12/27/2013.

    Review of the decedent's medical records available to us at the time of this report showed that he was born at 34 weeks gestation by Cesarean section at the Cibola General Hospital while his mother was incarcerated at the Grants County Women's Prison. He had been diagnosed with mild developmental delays, attention deficit hyperactivity disorder, and post-traumatic stress disorder. There had been 9 referrals to the Children Youth and Family Department (CYFD) and two were substantiated. One referral came in 2012 when the decedent reported to school personnel that his mother had hit him on the head with either a bat or phone, and had hit him on the leg with a belt. This referral was substantiated for physical abuse by and unknown perpetrator.

    At autopsy, there were contusions (bruises) of the chest, arms, legs and tongue; abrasions (skin scrapes) of the face; a healing laceration (skin tear) of the scalp (left parietal scalp); and hemorrhage (bleeding) into the muscles between the ribs (intercostal hemorrhage), into the soft tissues of the back, into the diaphragm (muscle that separates the chest and abdominal organs), into an abdominal wall muscle (right internal oblique muscle), into the abdominal cavity (hemoperitoneum), into the soft tissues around the pancreas and left kidney; and on the outer surface (serosa) of the bowel. On the chest were discreet injuries consistent with thermal injuries (burns).

    Microscopically, the chest wounds show features suggestive of a thermal injury, the scalp laceration showed evidence of healing (approximately days old), and there was acute inflammation and hemorrhage into the tongue.

    Forensic odontologic (dental) analysis of the bruise on the right forearm was suggestive of a small human bite.

    Forensic Neuropathology Consultation showed mild cerebral edema (swelling of the brain).

    A skeletal survey showed no osteologic (bone) abnormalities.

    Postmortem toxicological testing on the blood was negative for alcohol and drugs of abuse. Postmortem vitreous (eye) fluid electrolytes (a measure of salt-water balcance) was normal.

    The decedent was physically an appropriately developed boy with injuries at different stages of healing with no evidence of significant underlying natural disease. This pattern is consistent with a history of abuse. There were impact sites to the trunk associated with bleeding into the soft tissues of the abdomen and into the abdominal cavity. A significant amount of blood was lost, accounting for approximately 25% of his total blood volume. A definitive bleeding source could not be identified and, therefore, likely came from small vessels in abdominal organs or soft connective tissue.After significant blood loss, delivery of oxygenated blood to the brain would decrease resulting in cerebral edema.

    SUMMARY AND OPINION

    Page 1 Printed: 3/25/2014 11:45:50 AMCause Of Death:

    2013-06715 VARELA, OMAREESummary OpinionCase Number:

    Death Investigation Report Page 3

  • Medical Investigator

    Sam Andrews MD

    Authority for examination:

    Body length (cm):Body weight (kgs):

    Development:

    Stature:

    Age:Anasarca:Edema localized:

    Dehydration:

    Scalp hair color:Scalp hair length:Eyes:

    OMI

    128.0027.00

    Well-developed

    ThinAppears to be stated age

    NoNo

    No

    BrownShortBoth eyes present

    Irides:Eyes corneae:Eyes sclerae:

    BrownTranslucentWhite

    Eyes conjunctivae:Eyes petechiae:Palpebral petechiae:Bulbar petechiae:Facial petechiae:Oral mucosal petechiae:

    TranslucentNoNoNoNoNo

    External exam date time: 12/28/2013 9:13:00 AM

    Medical Investigator Trainee

    Odey Ukpo MD

    Means used to confirm identity:

    Other verification means:Location of orange bracelet:

    Name on orange bracelet:Other name on orange bracelet:Location of green bracelet:Name on green bracelet:Other name on green bracelet:Hospital ID tags or bracelets?

    If yes specify stated name and location:

    Visual

    Right wristDecedent name

    Right wristDecedent name

    YesLeft ankleTrauma-Alert, Hurdle C

    ID confirmed at time of exam: Yes

    Development comments:

    Hyperpigmentation of the skin of the chest and back.Skin comments:

    Page 1 Printed: 3/25/2014 11:45:50 AMExternal Examination

    2013-06715 VARELA, OMAREEExternal ExaminationCase Number:

    Death Investigation Report Page 4

  • Nose:Ears:Lips:Facial hair:Facial hair color:Maxillary dentition:Mandibular dentition:Condition of dentition:Neck:Trachea midline:

    Normally formedNormally formedNormally formedNoneDoes not applyNaturalNaturalAdequateUnremarkableYes

    Chest symmetrical:

    Chest diameter:Abdomen:

    Back:Spine:External genitalia:

    Breast masses:Right hand digits complete:

    Left hand digits complete:

    Right foot digits complete:

    Yes

    AppropriateUnremarkable

    UnremarkableNormalMale

    NoneYesYesYes

    Breast development: None

    Chest development:

    Left foot digits complete: Yes

    Muscle group atrophy:

    Senile purpura:

    Pitting edema:

    NoNoNo

    Muscle other: NoTattoo(s)

    Tattoos present: No

    Cosmetic Piercing(s)NoCosmetic piercing present:

    Scar(s)YesScar(s) present:YesScar face:YesScar right lateral neck:

    Odey Ukpo MDReported by:Reporting Tracking

    Extremities: Well-developed and symmetrical

    Normal

    Page 2 Printed: 3/25/2014 11:45:50 AMExternal Examination

    2013-06715 VARELA, OMAREEExternal ExaminationCase Number:

    Death Investigation Report Page 5

  • Verified by: Sam Andrews MD on 3/4/2014 4:08:13 PMReviewed and approved by: Sam Andrews MD on 3/7/2014 4:50:48 PM

    Page 3 Printed: 3/25/2014 11:45:50 AMExternal Examination

    2013-06715 VARELA, OMAREEExternal ExaminationCase Number:

    Death Investigation Report Page 6

  • Medical Investigator

    Sam Andrews MD

    Evidence of medical intervention:

    If nasogastric tube present, specify course and position:Nasogastric tube:

    Nasogastric tube comment:If endotracheal tube present, specify course and position:Tracheostomy site/tube:

    Chest tube(s):

    If Foley catheter present, specify course and position:

    Vascular catheter(s):

    Yes

    Yes

    Passes through the nose and nasopharynx, down the esophagus and terminates in the stomach

    No

    No

    No

    No

    Yes

    Left femo