DEPARTMENT OF HEALTH I OFFICE OF THE CHIEF MEDICAL EXAMINER 830 SOUTHAMPTON AVENUE . SUITE 100 NORFOLK. VIRGINIA 23510 (757) 683-8366 N0: 6?7-2014, Saturday TIME: 9:00 AM REPORT OF AUTOPSY DECEDENT: DAVID LAIHAM AUTOPSY AUTHORIZED BY: Doctor Candace Nhitehurst, Medical Examiner for Norfolk BODY IDENTIFIED BY: . PERSONS PRESENT AT AUTOPSY: Hospital tags as David Latham, hospital band as TP49826 Sergeants and Jarvis, Investigator Cogswell (Norfolk Police Department), Alison Lautz _Rigor: Complete Livor: Indistinct Distribution: Posterior Age: 35 Race: Black Sex: Male Length: 71? Height: 273 lb Eyes: Dark brown Pupils: Equal Hair: Black Mustache: Black Beard: Black Circumcised: Yes Body Heat: Cool CLOTHING. PERSONAL EFFECTS, EXTERNAL WOUNDS. SCARS. TATTOOS, OTHER IDENTIFYING FEATURES: GENERAL EXTERNAL EXAMINATION: The decedent is received in an unsealed white body bag, labeled, and unclothed with evidence of recent surgery and multiple marks of therapy. His hands are wrapped in gauze. There are no visible gunshot residues on the hands. There are injuries to both hands with smeared blood present on them. The fingernails are medium-to-long with dysmorphic right middle and ring fingernails and a relatively short left middle fingernail. His dentition is natural with a maxillary diastema. He is obese with symmetrical torso and extremities. I CLOTHING AND PERSONAL EFFECTS: None received with the body. A bloodsoaked shirt is photographed while it remains in the custody of thelpolice personnel. A button is missing from the shirt. EXTERNAL HOUNDS: Multiple gunshot wounds to the torso and upper extremities (see pathological diagnoses for details.) There is a 1/8" abrasion below the right knee. SCARS: No surgical scars identified. Thick, hypertrophic scars of the knee. TATTOOS: None identified. MARKS OF THERAPY: Gauze on right eye, endotracheal tube, vascular catheters of the right neck, right groin, and left wrist. Foley catheter with collection device, pulse oximeter of the left ring finger, fresh sutured abdominal incision. The right upper arm, right forearm and hand, and left hand are wrapped in gauze. Sequential compression devices of the Tower extremities, monitor pads of the left flank, right chest tube. Postmortem x?rays of the torso reveal four residual bullets: right upper shoulder, right chest, right abdomen, and left flank. A review of antemortem hospital x?ray reveals an additibnal bullet that was recovered at surgery. The right upper shoulder bullet is not visualized on antemortem x?rays. X-rays of the hands and right arm reveal a fine mist of metallic fragments in the forearm and comminuted fractures of the right ulna. HISTORY: Shot by a police officer. PATHOLOGICAL DIAGNOSES: 1. Multiple gunshot injuries, nine, with one intact bullet recovered during surgery and four intact bullets recovered during autopsy. The wounds are numbered for descriptive purposes and do not imply the order in which they were received. None show evidence of soot or stippling on the skin. a. Gunshot wound Perforating gunshot wound ofrthe right upper arm with a penetrating reentry into the chest. Entrance anterolateral upper arm. It consists of a 1/4" round defect with concentric abrasion located at 17-1/2" from the top of the head. hemorrhagic wound track through skin and soft tissues of the upper arm with no palpable fracture. Exjt_ang axilla. These are characterized by a pair of 1/2 1/4" irregular defects located on the medial upper arm and lateral upper chest in the axilla. They are located at approximately 16" from the top of the head and 8?1/2" right of midline. Bullet_path skin, right anterolateral sixth rib fracture, lung, diaphragm, liver, diaphragm and impacting the right posterior 11th rib. Egllet medium~to?large caliber, copper jacketed bullet is recovered lying free in the right hemithorax. It impacts the 11th rib at 19" from the top of the head and 2? 1/2" right of midline. Ee;exit - none. Directign_gf fire right to left, downwards, front to back. The arm would have been abducted to achieve a path through the arm and chest. i. Status post right chest tube and laparotomy with diaphragm repair. b. Gunshot wound Penetrating, surgically altered gunshot wound of the anterior torso. Entrance anterior chest/upper abdomen near the xiphoid process. It consists of a 3/4? irregular round defect with minimal irregular concentric abrasion collar located at 19?3/4" from the top of the head and 1-1/4" right of midline. altered_bu]1gt_ggth skin and into the left lobe of the liver. Bullet medium?to?large caliber, copper jacketed bullet is recovered from the left lobe of the liver during surgery: Exit none. Direction of fire, in general front to back. PATHOLOGICAL DIAGNOSES, continued on page 2. CAUSE OF DEATH: Gunshot wounds to the torso. Draft report: Final Report: xx 7 pages total The facts stat er i rue and correct to the best of my know?gd?? belief. . ,3 acme Norfolk, VA Place of Autopsy Si nature of Pathologist El abeth Kinnison, M.D. CHEEF MEET-CAL T-294-14 i DAVID LATHAM PATHOLOGICAL DIAGNOSES, continued from page 1. c. Gunshot wound Penetrating, surgicaiiy aTtered gunshot wound to the anterior torso. Entrance right upper abdomen. It consists of a 3/4 1/4" ovai defect with irreguiar marginai abrasion and an adjacent area of 1?3/4 1" red bruising. The defect is centered 22" from the top of the head and 5-3/4" right of midiine. Surgicaliy aitered bu11et path - skin and intestines, status post partiai iTeocoiectomy with gunshot injury to the cecum described in the hospitai record. Bu11et medium?to-iarge caiiber, copper jacketed buiiet recovered in the right retroperitoneum at 27" from the top of the head and 4" right of midiine. Exit none. Direction of fire front to back, downwards, right to Teft. i. Associated findings with gunshot wounds #2 and 3. 1. Status post Taparotomy. a. Status post hepatorrhaphy and ieft sUbtotai hepatectomy. b. Status post partiai i1eocoiectomy. 2. Fragmentation injury of the anterior torso. It consists of an 8 5?1/2" area of irreguiar bruises and abrasions ranging from 1/8" to A singie, smaii copper jacket fragment is recovered from the superficiai subcutaneous tissues of the anterior chest. d. Gunshot wound Penetrating gunshot wound to the posterior torso. Teft upper back. It consists of a 1/2" irreguiar defect with a 1/2 1/2" mediai marginaT abrasion and a 3/4 1/2" 1atera1 marginai abrasion. It is Tocated 11-3/4" from the top of head and 2?3/4" Teft of midiine. Builet path superficiai wound track through skin and subcutaneous tissues with no penetration of the chest cavity. BuTTet medium?to?Targe caiiber, copper jacketed huiiet is recovered from the top of the right shouider. The buiiet is recovered at 9? from the top of the head and 4" right of midiine. Exit - none. Direction of fire - 1eft to right, upwards, and siightiy back to front. e. Gunshot wound Penetrating gunshot wound of the posterior torso. Entrance 1eft Tower back. It consists of a 1/4" round defect iocated at 27?1/4" from the top of the head and 1?3/8" ieft of midiine. Buiiet path hemorrhagic wound track through skin and soft tissues. gellet - medium?to-Targe caTiber, copper jacketed buiiet is recovered from the Teft fiank. It is recovered at 23" from the top of the head and 8" ieft of midiine. Exit none. Direction of fire - right to Teft, upwards, siightiy back to front. Gunshot wound Perforating gunshot wound of the right forearm. Entrance dorsai forearm. It consists of a 1/ round defect with minimai concentric abrasion ceiiar Tocated 6?1/2" distai to the elbow crease. hemorrhagic wound track through skin with comminuted fracture of the uina (forearm bone). Eullet none recovered from the forearm. Exit ventrai ferearm. It consists of a 1/2 l" irreguiar defect with a 2?3/4 1/2" aggregate of adjacent purpie bruising. The defect is iocated 4" distal to the eibow crease. Direction of fire, with the arm in the anatomic position back to front and upwards. g. Gunshot wound Perforating gunshot wound of the right forearm. Entrance dorsai forearm, aiong the uinar aspect. It consists of a 1/2" irreguiar defect with an irreguiar 1/8" marginai abrasion. There is an adjacent 1?1/2 3/4" aggregate of irreguiar abrasions. The defect is Tocated 8?1/2" distai to the e1bow crease. Builet gath hemorrhagic wound track through skin with comminuted fracture of the uina. Buiiet none recovered from the forearm. Exit ventrai forearm, aiong the radiai aspect. It consists of a 1 5/8" irreguiar defect Tocated 5?1/4" distai to the eibow crease. Direction of fjge, with the arm in the anatomic position - back to front, uinar to radiai, and upwards. h. Gunshot injury Avuision of the right thumb and index finger. The thumb injury consists of 1?3/4 1" jagged avuision Tocated approximateiy 3u3/4" distai to the wrist crease. There is a comminuted fracture and subtotai amputation of the thumb. The index finger injury consists of a 1?1/4 3/4? avuision Tocated at approximateiy 5" distai to the wrist crease. It is associated with disruption of the phaiangeai joint. No buiiet is recovered from this injury, and the direction of fire is indeterminate. i. Gunshot injury Avuision of the ieft middie finger. It consists of a 7/8 1/2" avuision with a marginai abrasion iocated on the dorsum of the middie finger. It inVOTVes the proximai phaianx and adjacent paTm. It is Tocated 4?1/4? distai to the wrist crease with disruption of the metacarpophaiangeai joint with no paipabie fracture. Hg?bullet is recovered from this injury, and the direction of fire is 1ike1y dorsai to ventrai. j. Associated findings: viscera] paiior, subendocardiai hemorrhage. 2. Abrasion of right knee. TOXICOLUGY: A separate report be issued. -2- AUTOPSY DAVID LATHAM GROSS DESCRIPTION SKIN: SEROUS CAVITIES: NECK ORGANS: HEART: ADRTA: LUNGS: LIVER: GALLBLADDER: SPLEEN: NODES: PANCREAS: ADRENALS: GI TRACT: KIDNEYS: BLADDER: GENITALIA: BRAIN AND MENINGES: NormaT skin turgor with copious subcutaneous fat. The Teft hemithorax and pericardium are intact and wdthout accumuTation of bTood or fTuid. 1200 cc of bTood is present in the right chest cavity, and residuaT bToody fTuid is present in the abdominaT cavity (status post Taparotomy). No serous adhesions. There are two defects in the right hemidiaphragm with surgicaT repair. No externa] or internaT neck injuries. Brown mucus streaks the airway. The thyroid gTand is sectioned with the neck organs and shows no enTargement or noduTarity. 409 gm. The coronary artery distribution is normaT with no atheroscTerosis. The vaTves and myocardium are within normaT Timits except for sTight subendocardiaT hemorrhage. Mde atheroscTerosis with fatty streaks. Left 272, right 360 gm. There is a contused buTTet graze wound to the anterior right middTe Tobe and a contused buTTet perforation through the right Tower Tobe of the Tung associated with gunshot wound There is no hemoaspiration or consoTidation. The right Tung is coTTapsed and edematous. 1093 gm. Status post subtotaT Teft Tobectomy and hepatorrhaphy with bTue surgicaT sutures intact. The exposed Tiver is ragged with extensive Taceration of the mediaT right Tobe. 20 cc of biTe. No stones. 123 gm. Intact and without injury. No PaTe. Patchy periadrenaT hemorrhage with intact adrenaT gTands. The esophagus is within normaT Timits. The stomach contains green semisoTids. There is a fresh partiaT iTeocoTectomy. The intestines were Teft in discontinuity with bTind intestinaT pouches. There is no anaT injury. Left 150, right 143 gm. The corticaT surfaces are smooth and paTe. The peTves and ureters are normaT caTiber. FoTey catheter in situ with paTe urine present in the coTTection device. NormaT externaT maTe genitaTia. 1150 gm. There is no epiduraT, subduraT, or subarachnoid hemorrhage. The circTe of WiTTis branches normaTTy. The brain is paTe, and coronaT sections are symmetricaT. SKULL: No fractures, staining, or scan hemorrhages. RIBS: A chest tube is present in the right fourth intercostaT space. There is a comminuted fracture of the right anteroTateraT TateraT sixth rib with a buTTet impact of the right posterior 11th rib with disruption of the overTying pTeura (gunshot VERTEBRAE: The anterior vertebraT bodies are intact. PELVIS: No panabTe fractures. EXTREMITIES: No peripheraT edema. Gunshot injuries as described_previousTy. OTHER LAB TDX PHOTO DENTAL FINGERPRINTS MICRO PROCEDURES: HIV DNA CARD GSR OCME ACCELERANTS BACTERIOLOGY VIROLOGY OTHER: FingernaiT cTippings DISPOSITION OF EVIDENCE: TYPE (CTOthing, buTTets, etc.) NAME OF RECIPIENT ADDRESS OFFICIAL TITLE DATE ConsuTt reports none. Department of Forensic Science hospitaT bTood, postmortem bTood, urine, biTe. Department of Forensic Science - buTTets from autOpsy, buTTet retrieved from Sentara NorfoTk GeneraT HospitaT, GSR Kit. fingernaiT cTippings with controT scissors, buccaT swabs, DNA card (this evidence to be turned over to the NorfoTk PoTice Department foTTowing Tab anaTysis). Investigator Moore, NorfoTk PoTice Department CD of autopsy photos. e2 -3- MICROSCOPIC DESCRIPTION AND CASE SUMMARY TISSUE: DESCRIPTION: HEART: (STide 1) Loca1ized subendocardia1 hemorrhage. Patchy myocyte hypertrophy. LUNG: (STide 2) Patchy intra-aTveoTar b100d, terminaT changes of the bronchi. LIVER: (STide 3) Tissue disruption and hemorrhage with focal devitaiization. CASE SUMMARY AND COMMENT: The decedent sustained nine areas of gunshot injury to the torso and upper extremities. One forearm wound and the two wounds of the anterior torso (gunshot wounds were Targe, atypicaT entrance wounds suggesting that they may have been either reentry wounds from the upper extremities or that the buTTet struck an intervening object prior to entry. NaturaT pathoTogy did not pTay a roTe in his death. CAUSE OF DEATH: Gunshot wounds to the torso. hath Kinnison. M.D. AUTOPSY: DATE COMPLETED: JUNE 30, 2014 DECEDENT: DAVID LATHAM e4- BODY DIAGRAM Emma @1153 '5er mtg-t 1 ha i I ?Em ii??/L mom 31a, fb1bu _3f?w?lmj A8??Ev [Ifng (141?Jm?lfly/Ml? fl :1 gm?3ryixr 9&th $825.:me 1 *w?wk j?d? 33?} lag; Himgigga? 6?64!? \d?b ??v?1i?ff (I. hib? as fine/? A) . @51tig?f Mr DECEDENT: MEDICAL EXAMIN R: Name} Did/M Name: 35 Height; inches Date: I Weight: I pounds Autopsy U4 . ?545;- Form CME COMMONWEALTH OF VIRGINIA Rev. 11/21/03 OFFICE OF THE CHIEF MEDICAL EXAMINER 95 (. .3 I 0624M . .394(Moot'm . - Commonwealth of Vlrginla Office of the Chlef Medlcal Examiner Ma?a-w Cgv?k? On "f of 56mm) Wm #142453 ?m?u?gf Decedent's Name DKM4 (m1 5% l? Examined By Date I Autopsy No. ?f as? BODY DIAGRAM I a; ?a . 591.053 DECEDENT: MEDICAL EXAMIN R: Name: 971m 1/ Name: Height: inches Date: 69/1/17 Weight: poImds Autopsy 7' a; 4% r4 COMMONWEALTH OF VIRGINIA OFFICE OF THE CHIEF MEDICAL EXAMINER Form CME - Rev. 11/21/03