Loading...
HomeMy WebLinkAboutCoroner Report - Gonzalez_Redacted_Part1ORANGE COUNTY SHERIFF-CORONER 1071 W. Santa Ana Blvd. Santa Ana, CA 92703 Coroner Division DECEDENT: GONZALEZ, Jessica CASE NUMBER: 13-02615-BB AGE: 35 Years DOB: SEX: Female RACE: Hispanic PLACE OF DEATH: UCI Medical Center DATE/TIME OF DEATH: 06/23/2013 08:55 AUTOPSY DATE/TIME: 06/26/2013 9:00 PLACE OF AUTOPSY: Orange County Coroner Facility 1071 W. Santa Ana Blvd. Santa Ana, CA 92703 AUTOPSY ATTENDANTS: Felicia Burke, OCSD Aide Sahagun, OCSD Julian Rodriguez, SAPD Loren Dawson, OCDA Alana R. Hoesch, OCSD Alana R. Hoesch, OCCO CAUSE OF DEATH: Multiple gunshot wounds OTHER CONDITIONS: None MANNER: Homicide CERTIFICATE ISSUED: 6/26/2013 AMENDMENT: \ ~ 1 Etoi M. Davenport, M.D. Forensic Pathologist GONZALEZ, Jessica ORANGE COUNTY SHERIFF-CORONER AUTOPSY REPORT EXTERNAL EXAMINATION AND EVIDENCE OF INJURY EVIDENCE OF MEDICAL INTERVENTION 13-02615-BB Page 2 1. Endotracheal tube extending from the mouth, located 21 cm at the teeth, with an attached white cloth strap extending over the cheeks to the back of the neck. 2. Medical monitoring pads adhered to the anterior left shoulder, the mid upper abdomen, and the left abdomen. 3. Pulse monitoring strip adhered to the 2 nd left finger with the distal end of the monitoring cord found looped through a fractured rib of a lateral left thoracotomy site. 4. Gaping thoracotomy site of the anterolateral left chest. 5. lntraosseous catheter extending from anterior left leg. 6. Paper bags secured over the hands and wrists, with clear tape surrounding the wrist area. 7. There is a chest tube extending from the lateral right chest. There is bloody fluid within the tubing. GENERAL: The body is that of a normally developed, thin woman, appearing consistent with the listed age of 35 years. The length is 65 inches and the weight is 97 pounds as received. POSTMORTEM CHANGES: The body is well preserved, cool to touch, and has not been embalmed. Rigidity is mildly to moderately developed in the jaw and extremities. Lividity is dorsal, faint-pink, and barely blanches with pressure. HEAD: The scalp is covered with medium length dark brown hair. The ears are normally formed and located. The irides are brown and the corneas are clear. The conjunctivae and sclerae are free of petechiae or evidence of injury. The nasal bridge and facial bones are intact and free of palpable fractures. The lips ~ 6/27/2013 bl (13547) Etoi M. Davenport, M.D., Forensic Pathologist GONZALEZ, Jessica ORANGE COUNTY SHERIFF-CORONER AUTOPSY REPORT 13-02615-BB Page3 are normally formed. The teeth are natural and in fair condition with patchy areas of yellowish-brown dental discolorations. NECK: The neck is straight and symmetrical. CHEST: The breasts are symmetrical without palpable masses. ABDOMEN: The abdomen is flat and soft without palpable masses. EXTERNAL GENITALIA: The external genitalia is that of a normal adult woman. The pubic hair is closely shaven. UPPER EXTREMITIES: The arms are normally formed. The fingernails are trimmed. The ventral right forearm has an ovoid-shaped, elongated, retracted, hyperpigmented scar measuring 7 ¾ x 2 ¼ inches. In the midst of this scar is a gunshot defect (described below). At the superior medial border of this scar is a broad band of 4 x ½ inch hypopigmented healed scar extending onto the medial ventral right arm. The medial ventral left forearm has a small½ inch linear healed scar. The dorsal 2nd left finger has a 1/4 x 5/16 inch brown scabbed lesion. The dorsal 4th right finger has a 1/16 inch brown scabbed lesion, and a ¼ inch faint pink contusion. LOWER EXTREMITIES: The legs are normally formed and free of edema. The toenails are trimmed with dark-red polish . The anterior medial right thigh and groin has two broad bands of linear; retracted healed scars, both vertically oriented. There are also 4 adjacent round, scabbed, 1/16 inch in diameter each, lesions (possible healing needle punctures). The left groin has a ¾ inch in diameter hyperpigmented raised lesion with central necrosis. The bilateral thighs and legs have numerous hypo-and hyperpigmented scars, with some being retracted and all ranging between¾ to¼ inches in dimension, individually. In the midst of these healed scars are multiple faint blue contusions (described below under "Evidence of Injury"). 6/27/2013 bl (13547) Etoi M. Davenport, M.D., Forensic Pathologist ORANGE COUNTY SHERIFF-CORONER AUTOPSY REPORT GONZALEZ, Jessica 13-02615-BB Page4 BACK: The back is straight and symmetrical. The bilateral upper back has a tattoo that reads "Mi Vieja Aurora". The right back also has a tattoo of a girl. Within the tattoo of a girl is a gunshot wound in the abdomen area of the tattoo over the right back (described below under "Evidence of Injury"). The left buttock has a retracted healed scar. I. EVIDENCE OF INJURY BLUNT FORCE INJURIES (NOT ASSOCIATED WITH GUNSHOT DEFECTS): The upper right cheek has a ¾ inch in diameter yellowish-red dry abrasion. The anterior midline neck (centered just left of the anterior neck midline) has a 1 ¼ x % inch yellowish red contusion. The dorsolateral left forearm has a very faint ¾ inch in diameter pink contusion. The dorsal 2nd left finger has a 1/4 x 5/16 inch brown scabbed lesion . The dorsal 4th right finger has a 1/16 inch brown scabbed lesion . The dorsal 4th right finger also has a ¼ inch faint pink contusion. The anterior thighs, anterior right leg, and the dorsal aspects of both feet have numerous patchy blue (some very faint) contusions ranging from ¾ inches to 1 ¼ inches in greatest dimensions, individually. II. GUNSHOT ENTRANCE/TANGENTIAL WOUND OF VENTRAL RIGHT FOREARM: A. ENTRANCE: The ventral right forearm (within a large, elongated healed scar) has a linear, 1 % x 3/16 inch gunshot entrance/tangential wound that is obliquely oriented at the 1-7 o'clock direction. It is just right of the right ventral forearm midline, and is centered 12 1/s inches proximal to the 3rd right fingertip. The right upper extremity measures 27 ½ inches in length. 512112013 bl (13547) Etoi M . Davenport, M.D., Forensic Pathologist GONZALEZ, Jessica ORANGE COUNTY SHERIFF-CORONER AUTOPSY REPORT 13-02615-BB Pages B. PATH: An x-ray of the right forearm reveals two tiny slivers of radiopaque fragment of the right forearm and an indented and fractured right ulnar bone. The bulk of the bullet is not detected on X-ray. C. EXIT: There is none, and the wound was likely caused by bullet fragment that further fragmented once it struck the ulnar bone. D. PROJECTILE/FRAGMENTS: Two tiny slivers of radiopaque fragments are seen on the x-ray of the right forearm. They are not retrieved. E. DIRECTION: Given the standard anatomic position of the body, the direction is front-to-back and upwards. Ill. GUNSHOT WOUND OF VENTRAL LATERAL RIGHT ARM: A. ENTRANCE: The ventral lateral right arm has an ovoid-shaped, vertically-oriented, 1 ½ x ½ inch gunshot entrance wound that is centered 1 inch right of the ventral right forearm midline and 19 ¾ inches proximal to the 3rd right fingertip. It has a peripheral dry abrasion that ranges from 1 /16 to 3/16 inches in width, and a deep wound track at its superior edge. There is no associated sooting, stippling, or muzzle imprint identified on the surrounding skin B. PATH: The bullet perforates the skin, underlying subcutaneous tissues and skeletal muscles of the ventral lateral right arm, and the bullet courses through the skeletal muscles before it exits the ventral medial, proximal right arm, and re-enters the lateral right chest/inferior axilla region. It enters the lateral right 3rd intercostal space, perforates the right lower lobe of the lung, and exits the right chest cavity through a midline defect of the right hemidiaphragm . It then enters the posterolateral right thoracic 6/27/2013 bl (13547) Etoi M. Davenport, M.D., Forensic Pathologist ORANGE COUNTY SHERIFF-CORONER AUTOPSY REPORT GONZALEZ, Jessica 13-02615-BB Page 6 spine (at level T12) and becomes lodged in the left side of the boney lumbar spine. The midline left back has a skin surface 15/16 x 3/4 inch red and pink abrasion. This area overlies a bullet recovered from within the lumbar bony spinal column at level L 1- L2. C. EXIT: There is no exit. D. BULLET/PROJECTILE: A tiny gray metallic fragment is recovered within the bony spinal column at level T12-L 1 and the bulk of the bullet is recovered from within the left bony spinal column at level L 1-L2. It consists of a twisted gray metallic bullet. Other tiny gray metallic fragments are also found within this region . E. DIRECTION: Given anatomic positioning of the body the initial direction is front to back, right to left, and upwards; but once the bullet enters the torso its direction is still front to back, right to left, but now downwards. IV. GUNSHOT WOUND OF RIGHT BACK: A. B. 6127/2013 bl (13547) ENTRANCE: The right back has a gunshot entrance wound, located within a tattoo of a girl, within the abdomen region of that tattoo, that measures ¾ inches in diameter, and is centered 4 ¾ inches circumferentially right of the back midline and 14 ¼ inches from the top of the head. It has a circumferential deep- pink abrasion that ranges from 1 /16 to 3/16 inches in width. There is no associated soot, stippling, or muzzle imprint grossly identified on the surrounding skin. PATH: The bullet perforates the skin, underlying subcutaneous tissues and skeletal muscles of the right upper back , and enters the right chest cavity through a defect of the posterior right 4th rib. GONZALEZ, Jessica ORANGE COUNTY SHERIFF-CORONER AUTOPSY REPORT 13-02615-BB Page7 There is internal surface beveling of this rib with a corresponding fracture. The bullet then perforates the right middle lobe of the lung, the pericardia! sac and grazes the heart, causing a full thickness lacerated defect of the apex of the lateral left ventricle. It then perforates or grazes the inferior edge of the left lingula, before exiting through the anterior left 4th rib, and the overlying skeletal muscles, subcutaneous tissues, and skin of the inferior left chest (of the inferior left breast). C. EXIT: The inferior medial left breast has an irregular-shaped, horizontally-oriented gunshot exit wound that measures 1 x ¾ inches, and is centered 2 ¼ inches left of the chest midline and 18 inches from the top of the head. D. BULLET: None recovered at examination. However, there is a small copper-colored bullet jacket fragment identified within the blood of the left chest cavity. E. DIRECTION: Given the standard anatomic position of the body, the direction is back-to-front, right-to-left, and downward. V. GUNSHOT WOUND OF LATERAL LEFT BACK: A. ENTRANCE: The mid lateral left back has a 5/16 inch in diameter gunshot entrance wound, centered 18 ½ inches from the top of the head and 5 ¼ inches circumferentially left of the back midline. It has a circumferential peripheral pink abrasion that measures 3/16 inches in width. There are also patchy peripheral pink contusions that range from 1/16 to¼ inch in width. B. PATH: The bullet perforates the skin of the mid lateral left back and enters the left chest cavity through the gunshot defect of the 6th intercostal space and superior edge of the 7'h rib, it then ~ 512712013 bl (13547) Etoi M . Davenport , M.D., Forensic Pathologist ORANGE COUNTY SHERIFF-CORONER AUTOPSY REPORT GONZALEZ, Jessica 13-02615-BB Pages perforates the left lower lobe of the lung , and exits the left chest cavity through a defect of the posteromedial left hemidiaphragm. The bullet enters the bony spinal column at level L 1, perforates the lumbar spinal cord, crosses the midline and exits through a slit-like defect over the near midline right back. C. EXIT: The near midline right back has a ¾ inch in length, slit-like gunshot exit wound that is centered ¾ inches right of the back midline, and 20 ¼ inches from the top of the head. It has a peripheral irregular-shaped pink abrasion that ranges from 1 /16 to ¾ inches in width, and it is mostly vertically-oriented. D. BULLET: None recovered. E. DIRECTION: Given the standard anatomic position of the body, the direction is front-to-back, left-to-right, and downwards. INTERNAL EXAMINATION BODY CAVITIES: The right chest cavity has a chest tube protruding into the chest cavity, with approximately 50 ml of dark-red bloody fluid. The left chest cavity has approximately 20 ml of dark-red bloody fluid. The pericardia! sac was opened prior to autopsy, and its internal surface has a thin film of red bloody fluid. There is an obvious gunshot defect involving the distal left ventricle . There are bilateral posterior midline hemidiaphragmatic gunshot defects. The abdominal fat measures up to 2 cm in thickness. There is a very thin film of red bloody fluid over the right retroperitoneal region. Otherwise, the peritoneal cavity is free of significant fluid or adhesions. The organs are normally located, and the serosal surfaces are smooth and glistening. CARDIOVASCULAR SYSTEM: The heart weighs 210 grams and does not appear significantly enlarged. It has the usual shape with mild increased 6/27/2013 bl (13547) ~ Etoi M. Davenport, M.D., Forensic Patholog ist GONZALEZ, Jessica ORANGE COUNTY SHERIFF-CORONER AUTOPSY REPORT 13-02615-BB Page9 epicardial fat. There is patchy epicardial hemorrhage surrounding the gunshot defect of the inferior lateral left ventricle. This defect measures 4.5 x 3.5 cm and has multiple lacerations that extend full thickness into the left ventricular cavity. The coronary arteries have normal origins and distribution with right dominance. They have no significant atherosclerotic changes and are all widely patent. There is hemorrhage with patchy pulpifaction of the anterolateral left ventricle , but otherwise the intact endocardium is smooth and glistening. The ventricles do not appear dilated. The cardiac valves are of normal numbers, intact, and free of vegetations. The tricuspid valve measures 10.6 cm, the pulmonic valve measures 5.6 cm, the mitral valve measures 8 cm, and the aortic valve measures 6.1 cm in circumference. The right ventricular wall measures 0.4 cm, the left ventricular wall measures 1.8 cm, and the septum measures 1.8 cm in average thickness. The intervening red-brown myocardium is uniform without gross evidence of fibrosis or hemorrhage (with the exception of the area of the gunshot defect described above). The aorta follows its usual course, and has no significant atherosclerotic changes throughout its length. There are no vascular anomalies or aneurysms identified. The pulmonary arteries and venae cavae are free of thrombi or emboli. RESPIRATORY SYSTEM: The right and left lungs weigh 280 and 220 grams, respectively. They have normal lobation, and the pleural surfaces are smooth and glistening (with the exception of the gunshot defects), with mild anthracotic changes. There are gunshot defects of the right upper lobe, the right middle lobe and the inferior edge of the left lung lingula. There is surrounding associated parenchymal hemorrhage and a subpleural hematoma of the superior aspect of the right lower lobe. The lungs appear collapsed (hypoexpanded) with decreased crepitus throughout all lobes (left greater than right side). Cut sections of the bilateral lungs reveal pink parenchyma with areas of dark-red hemorrhage (within the areas of the gunshot defects and subpleural hematoma described above). The lungs do not exude any significant amount of fluid. There are no consolidations or enlargement of the air spaces identified. The bronchi contain a thin film of pink mucoid fluid. The mucosa! surfaces are tan-pink and glistening. 6/27/2013 bl (13547) Etoi ~athologist