___________ __ BOARD OF MEDICOLEGAL INVESTIGATIONS OFFICE USE ONLY OFFICE OF THE CHIEF MEDICAL EXAMINER Central Otticu 1)01 N Stonewall Oklahoma City, Oklahoma 73117 (405) 239-7141 Fax (405) 230-2430 Re Co I hereby certify that thm is a true and correct copy ol the original document. Valid only when copy bears imprint of tile otlice seal. Eastern Division 1115 Wmmst 17th Tuy:,i, OkItliomna 74107 (01))) 205-3400 Fax (918) 51)5 1549 By REPORT OF INVESTIGATION BY MEDICAL EXAMINER DECEDENT First-Middle-Last Names (Please avoid use of initials) CHARLES WARNER Dale Age 47 Birth Dale 7/20/1967 Race BLACK Sex M DATE TIME HOME ADDRESS No. Street, City, State CORNER OF WEST AND STONEWALL. MCALESTER, OK - - EXAMINER NOTIFIED BY NAME TITLE (AGENCY, INSTITUTION, OR ADDRESS) - - @ AGENT KATHY MORDECAI DEPARTMENT OF CORRECTIONS INJURED OR BECAME ILL AT (ADDRESS) OKLAHOMA STATE PENITENTIARY CITY 1115 WESTI7THSTREET TYPE OF VEHICLE: fl AUTOMOBILE DESCRIPTION OF BODY Jaw Legs DRIVER LIGHT TRUCK fl Unknown TIME 19:28 DATE MORGUE TIME 1/16/2015 11:02 PEDESTRIAN HEAVY TRUCK BICYCLE MOTORCYCLE OTHER: — RIGOR LIVOR Complete Passing Passed Anterior E D EXTERNAL OBSERVATION - Color PURPLE Lateral [ Posterior Absent J I PASSENGER TYPE OF PREMISES TULSA TIME DATE 1/15/2015 PENITENTIARY COUNTY TULSA IF MOTOR VEHICLE ACCIDENT: TYPE OF PREMISES PITTSBURG 20:45 DATE 1/1 5/2015 PENITENTIARY COUNTY MCALESTLR BODY VIEWED BY MEDICAL EXAMINER TYPE OF PREMISES PITTSBURG CITY OKLAHOMA STATE PENITENTIARY Neck Arms COUNTY MCALESTER LOCATION OF DEATH EXTERNAL PHYSICAL EXAMINATION 1/15/2015 CITY - - Beard GREY Hair Eyes: Color BROWN Mustache Y Opacities Pupils. - —- GREY MOUTH EARS BLOOD OTHER - Li — -- 8 4MM L 4MM NcU Decomposed Regional Body Length 67 Significant observations and Injury documentations (Please use apace below) SEE AUTOPSY PROTOCOL” — NOSE - - - - - Body Weight 186 LBS - “ Probable Cause of Death: Manner of Death: JUDICIAL EXECUTION BY LETHAL INJECTION Natural Suicide Unknown Other Significant Medical Conditions Accident D Homicide Pending Li Case disposition: Autopsy YES Authorized by JOSHUA_LANJERMJ1 Pathologist . - — — JOSHUA LANTER M.D. Not a medical examiner case —-- - j - MEDICAL EXAMINER: Name. Adaress and Telephone No. JOSHUA LANTER M.D. I hereby state that, after receiving notice of the death described herein, I conducted an investigation as to the cause and manner of death, as required by law, and that the facts contained herein regarding such death are true and correct to the best of my knowledge. 1115W. 17TH TULSA, OK 74107 Date Signed Signature of Medical Eminer computer generated report CME (REV. SRI / JOSHUA LANTER M.D. 1 500255 1/16/2015 Oate Generated - Board of Medicolegal In vestigations Office of the Chief Medical Examiner CER’l’IFICATION I her dry certify hat liirrrh,cirrrierrl is a Inrearril cornet copy of he iirurn.;i tk 17 115 West Street Tulsa, Oklahoma 74107—1800 918-295-3400 Voice 918-585-1549 Fax iirrciiirieiil. sir irupa I/thu itt of oiiI’ ryhuri copy the rh ice wit, y tt Date REPORT OF AUTOPSY I)eccdent CHARLES WARNER Age Birth Date Race Sex 47 7/20/1967 Case No BL M 1500255 Type of I)euth ID By WHILE IN PENAL INCARCERATION VISUAL RECOGNITION Authority for Autopsy JOSHUA LANTER, M.D. Present at Autopsy GARRETT ROSSER. KYLA JORGENSON, APRIL SHELTON. JOSHU LANTER, A M.D. PATHOLOGIC DIAGNOSES I. Judicial execution by lethal injection A. Execution protocol medications included midazolam, rocuronium bromid and e, potassium chloride B. Intravenous access with attached intravenous apparatuses/catheters of right antecubital fossa and left posterior hand C. Two recent needle puncture marks of right posterior hand II. Cardiovascular system A. Cardiomegaly (480 grams) with concentric left ventricular hypertrophy; consis tent with hypertensive cardiomyopathy B. Myocardial bridging involving left anterior descending coronary artery CAUSE OF DEATH: JUDICIAL EXECUTION 13Y LETHAL INJECTION MANNER OF DEATH: HOMICIDE fire Lucts stated herein ire true and correct to he best of toy knowledge and belrel. OCME. Eastern Division JOSHUA LANTER. M.D CME-2 Page I Ibrensic Pathologist Location of Autopsy 1/16/2015 I 1:02 AM Date and ‘lime of Autopsy Decedent: OFFICE OF THE CHIEF MEDICAL EXAMINER CHARLES WARNER CASE NO: 1500255 MEDICOLEGAL INVESTIGATION I. CIRCUMSTANCES OF DEATH: This 47 year old male (DOB: 7/20/1967) reportedly died secondary to a judicial execut ion. IL AUTHORIZATION: The postmortem examination is performed Lmder the authorization of the Office of the Chief Medical Examiner, Eastern Division, Tulsa, Oklahoma. III. IDENTIFICATION: The body is identified by Agent Kathy Mordecai. Digital photographs and radiog raphs of the deceased are taken. POSTMORTEM EXAMINATION I. CIRCUMSTANCES OF THE EXAMINATION: The postmortem examination of Charles Warner is performed at the Office of the Chief Medical Examiner, Eastern Division, Tulsa, Oklahoma, on 1/16/2015 commencing at 1102 hours. Assisting in the examination are Garrett Rosser, Kyla Jorgenson and April Shelton. II. CLOTHING AND PERSONAL EFFECTS: Worn on body includes a gray shirt, gray pants, gray boxer shorts and black shoes. Written on the back of the pants over the left buttock is “LB”. Submitted with the body includ es: 1. 3 empty 60 mL syringes labelled “60 mL Heparin\saline” and “3B”, “250 mg Midazolam” and “2B”, “250 mg Midazolam” and “1B”. 2. 3 empty 60 mL syringes with attached white tape labelled “120 mEq Potassium Chloride” and “7B”, “120 mEq Potassium Chloride” and “8B”, “60 mL Hepari n\saline” and “9B”. 3. 3 empty 60 mL syringes labelled “50mg Rocuronium Bromide” and “4ff’, “50 mg Rocuronium Bromide” and “5B”, “60 mL Heparin\saline” and “6B”. 4. Fluid bag with attached intravenous apparatus labelled “0.9% Sodium Chloride Injection USP 1000 mL” with approximately 500 mL of liquid within bag. 5. Fluid bag with attached intravenous apparatus labelled “0.9% Sodium Chloride Injection USP l000mL” with approximately 500 mL of liquid within bag. 6. White box containing 12 empty vials labelled “20 ml. single dose Potassium Acetat e Injection, IJSP 40 mEq\2 mEq\mL”, insert labelled “Heparin Lock Flush Solutio n, USP”, pill bottle containing 2 empty vials labelled” Rocuronium Bromide Injection 100 mg\10 mL”, 9 red vial caps, 1 yellow vial cap and 1 green vial cap. 7. Cardboard box containing 2 empty containers labelled “Midazolam Injection, USP 50 mg\lOmL”, I vial approximately 3/4 full labelled “2% Lidocaine HCI Injection. USP 20 mg\mL” and “50 mL”, “Midazolam Injection, USP” insert, infusion apparatus, empty 10 CME-2 Pagc 2 Decedent: OFFICE OF THE CHIEF MEDICAL EXAMINER CHARLES WARNER CASE NO: 1500255 rnL syringe, empty needle package labelled “B—D 180 Precision Glide needle”, 20 empty vials labelled “Midazolam 1nection, USP 50 mg\ ID mL”, 10 mL vial, 17 vial caps. 8. White sheets x2 l:Note: All medication vials and lliiid bags are sent to the toxicology laboratory at the Oftce of the Chief Medical Examiner in Oklahoma City. III. EXTERNAL EVIDENCE OF RECENT MEDICAL THERAPY: I. Intravenous apparatus with percutaneous catheter of left posterior hand 2. Intravenous apparatus with percutaneous catheter of right antecubital fossa 3. Bandage of right posterior hand 4. Cardiac monitor pads of chest IV. COLLECTIONS: A scalp hair sample, facial hair sample, pubic hair sample, oral swab, rectal swab, fingernail swabs of left and right hands and a blood DNA card were procured and introduced as evidence. All items submitted with the body, with the exceptions of the medication vials and the fluid bags, were procured and introduced as evidence. The intravenous apparatuses and percutaneous catheters attached to the left posterior hand and right antecubital fossa were collected and introduced as evidence. EXTERNAL EXAMINATION The body is received in a blue body bag. The body is that of an unembalmed, well developed, well-nourished male appearing consistent with the recorded age of 47 years. The body weight is measured at 186 pounds. The body length is measured at 67 inches. The state of preservation is good in this unembalmed body. Rigor mortis is moderately advanced in the arms, legs, and jaw. Lividity is noted in the posterior arms, legs, and back, is purple in color and blanches. The chest and back are symmetrical with normal conformation. The neck is symmetrical and without masses or unusual mobility. Both upper and lower extremities are symmetrical throughout. The head, neck, and shoulders are not congested. There is no peripheral edema present. Personal hygiene is good. No unusual odor is detected as the body is examined. The hair is gray and worn to a short length. It represents the apparent natural color. There is facial hair composed of gray stubble. The body hair is of normal male distribution. The pupils are round, regular, equal. and somewhat dilated. The sclerae are normal in color. The orbital and periorbital tissues are unremarkable. The conjunctival surfaces are not remarkable. The irides are brown in color. Tache noire is noted of the right eye. No petechiae are identified within the eyes. The teeth are in a fair state of repair. The gums are normal in appearance. The oral cavity is normal. There are no injuries to the lip or tongue. The nose is symmetrical and the air passages are open. The external ears are normal in appearance and without injury. Examination of the skin reveals a small amount of clotted blood of the left groin (this is secondary to removal of a postmortem femoral blood specimen on 1/15/2015 at the OCME). Dried blood is noted of the right posterior hand adjacent to the previously described bandage. The male breasts are normal. Examination shows no significant external lymphaderiopathy. CME-2 Page 3 Decedent: OFFICE OF THE CHIEF 1’4EDICAL EXAMINER CHARLES WARNER CASE NO: 1500255 INJURIES There are no acute injuries or fractures identified. EVIDENCE OF RECENT NEEDLE PUNCTURE MARKS There are two recent needle puncture marks of the right posterior hand with underlying subcutaneous hemorrhage. Attached to the left posterior hand is an intravenous apparatus with a percutaneous catheter. Tape attached to the intravenous apparatus is labelled “A” in two separate locations. The cathete r enters the skin of the left posterior hand and dissection shows the catheter penetrating the superficial subcutaneous tissues to terminate within a blood vessel. Focal hemorrhage is noted within the subcutaneous tissues surrounding this vessel. Attached to the right antecubital fossa is an intravenous apparatus with a percutaneous catheter. Tape attached to the intravenous apparatus is labelled “B”. The catheter enters the skin of the right antecubital fossa and dissection shows the catheter penetrating the superficial subcutaneous tissues to terminate within a blood vessel. Focal hemorrhage is noted within the subcutaneous tissues surrounding this vessel. BODY CAVITIES The body is opened through the customary “Y” shaped incision. Subcutaneous fat is normally distributed, moist, and bright yellow. The musculature through the chest and abdomen is rubbery, maroon, and shows no gross abnormality. The sternum is removed in the customary fashion. The organs of the chest and abdomen are in normal position and relationship. The diaphragms are intact bilaterally. PARIETAL PLEURA: Is smooth, glistening intact membrane without associated adhesions or abnormal effusions. PERICARIMUM: Is a smooth, glistening, intact membrane, and the pericardial cavity, itself, contains the normal amount of clear, straw-colored fluid. PERITONEUM: Is smooth, glistening membrane in both the abdominal and pelvic cavities. The peritoneal cavity contains no abnormal fluid or adhesions. CMF-2 Page 4 Decedent: OFFICE OF THE CHIEF MEDICAL EXAMINER CHARLES WARNER CASE NO: 1500255 1-IEART: The heart weighs 480 gin. It has a normal configuration and location and is enlarged. There are no adhesions between the parietal and visceral pericardium, and the latter is a smooth, glistening, fat laden characteristic membrane. There is myocardial bridging involving the left anterior descending coronary artery; this artery lies approximately 0.3 cm within the myocardium. The coronary arteries arise and distribute normally with no significant atherosclerosis. The coronary ostia are normally located and widely patent. The chambers and atrial appendages are unremarkable. The endocardium is a smooth, gray, glistening, translucent membrane uniformly. The myocardium is intact, rubbery, and red-tan, with the left ventricular free wall myocardium measuring 1.8 cm, the septal myocardium measuring 1.8 cm and the right ventricular myocardium measuring 0.3 cm. The papillary muscles and chordae tendineae are intact and unremarkable. The aorta (arch, thoracic and abdominal) and its major branches are unremarkable. The vena cava and major tributaries are widely patent. NECK ORGANS: Musculature is normal, rubbery, maroon, and the organs are freely movable in a midline position. The tongue is intact and normally papillated, without evidence of tumor or hemorrhage. The hyoid bone is intact. The cartilaginous structures forming the larynx are intact and without abnormality. The thyroid gland is symmetric, rubbery, light tan to maroon, and in its normal posilion without evidence of neoplasm. The epiglottis is a characteristic plate-like structure which shows no evidence of edema, trauma, or other gross pathology. The larynx is comprised of unremarkable vocal cords and folds, is widely patent without foreign material, and is lined by a smooth, glistening membrane. There are no petechiae of the epiglottis, laryngeal mucosa, or thyroid capsule. THYMUS: No significant tissue is identified grossly. LUNGS: The right lung weighs 550 gm, and the left weighs 550 gm. Visceral pleurae are smooth, glistening, and intact with minimal anthracosis and no bleb formation. The overall configuration is normal. The trachea is widely patent and lined by characteristic pink membrane. Likewise. the major bronchi and bronchioles bilaterally are patent, normally formed, and contain no significant occlusive material. The pulnionary arterial tree is free of emboli or thrombi. The parenchyma is congested and edematous, varies from pink-tan to dark purple, and exudes moderate amounts of blood and clear, frothy fluid from its cut surfaces. There is no evidence of consolidation, granulomatous, or neoplastic disease. Hilar lymph nodes are within normal limits with relation to size, color, and consistency. CMH-2 Page 5 Decedent: OFFICE OF THE CHIEF MEDICAL EXAMINER CHARLES WARNER CASE NO: 1500255 6.1. TRACT: The esophagus show’s an unremarkable mucosa, a patent lumen, and no evidence of gross pathology. The esophagogastric junction is unremarkable. The stomach is of normal configuration, is lined by a smooth, glistening, intact mucosa, has an unremarkable wall and serosa, and contains approximately 60 mL of brown homogenate which has passed to the duodenum. The duodenum, itself, is patent, shows an unremarkable mucosa and no evidence of acute or chronic ulceration. Jejunum and ileum are unremarkable and contain soft brown fecal material. There is no Meckel’s diverticulum. The ileocecal valve is intact and unremarkable. The appendix is identified. The colon is examined segmentally and shows no eviden ce of neoplasm or trauma. There are no diverticula. Anus and rectum are unremarkable . LIVER: The liver weighs 1660 gm. It is of normal configuration, rubbery, tan, and intact. Cut surface shows no pathology. GALLBLADDER: The gallbladder lies in its usual position, contains liquid bile, no calculi, and shows a normal mucosa. The biliary tree is intact and patent without evidence of neoplasm or calculi . PANCREAS: The pancreas lies in its normal position, shows a normal configuration , is pink-tan and characteristically lobulated with no apparent gross pathology. SPLEEN: The spleen weighs 170 gm. The capsule is intact. The organ is rubbery. maroo n, and shows characteristic follicular pattern. ADRENALS: The adrenals lie in their usual location, show yellow cortices and tan to gray medull ae. KIDNEYS: The right kidney weighs 190 gm and the left weighs 190 gm. Both are configurated normally with no abnormality. The capsules strip with ease bilaterally and the subcapsular surface s are smooth. Sections show the organs to be moderately congested with unremarkable cortices, medullac, calyces and pelves. Ureters and blood vessels are patent and unremarkable . CME-2 Page 6 Decedent: OFFICE OF THE CHIEF MEDICAL EXAMINER CHARLES WARNER CASE NO: 1500255 URINARY BLADDER: The urinary bladder contains approximately 50 mL urine, unremarkable. its serosa and mucosa are MALE GENITALIA: The prostate is symmetric, rubbery, gray-tan, and of normal size. The seminal vesicles are unremarkable. The prostatic urethra is unremarkable. The testes are bilater ally present and show no evidence of tumor, trauma, or inflammation. The investing membranes are unremarkable as is the epididymis. BRAIN AND MENINGES: The scalp is opened through the customary intermastoid incision and shows no trauma. The calvarium is removed through the use of an oscillating saw and is intact withou t evidence of osseous disease. The brain weighs 1380 gm. Dura and leptomeninges arc unrem arkable without evidence of trauma. Cranial nerves and circle of Willis arise and distrib ute normally and show no significant pathology. Externally the brain is normally configurated and symmetric, and multiple serial sections of cerebral hemispheres, midbrain, pons, medulla, and cerebellum show no gross pathological change apart from moderate congestion. The ventricular system appears sligli ly dilated; otherwise is also symmetric and unremarkable. The base of the skull is intact without osseous abnormality. RIBS: Intact. PELVIS: Intact. VERTEBRAE: Intact. BONE MARROW: Moist and dark red. Unremarkable. CME-2 Pac 7 Decedent: OFFICE OF THE CHIEF MEDICAL EXAMINER CHARLES WARNER CASE NO: TOXICOLOGY See attached report. CMI-2 Page 8 1500255 Decedent: OFFICE OF THE CHIEF MEDICAL EXAMINER CHARLES WARNER CASE NO: 1500255 MICROSCOPIC EXAMINATION Heart: Sections of the left and right ventricular walls are taken. Myocardial fibers appear viable without necrosis or inflammation. E-lypcrtrophic changes to the myofibers are noted. Myocardial bridging is noted in a section. Lu n gs: Sections of each lung are taken. Alveolar septae are mostly thin and delicat e. There is congestion and edema. There is no significant alveolar, bronchiolar, or vascular acute inflammation. There are no antemortem thrombi. Liver: A section shows changes suggestive of perivenular fibrosis. Congestion is also noted. Spleen: A section shows no specific pathologic changes. Kidney: A section shows no specific pathologic changes. Pancreas: A section is auto] yzed and otherwise shows no specific pathologic change s. Adrenal gland: A section shows no specific pathologic changes. Brain: A section shows no specific pathologic changes. Percutaneous puncture sites of right posterior hand (slide #1): A section shows hemorrhage within the subcutaneous tissues. Percutaneous puncture site of left posterior hand (slide #2): A section shows a focal area of hemoiThage within the subcutaneous tissue. Percutaneous puncture site of right antecubital fossa (slide #3): A section shows a focal area of hemorrhage within the subcutaneous tissues. CME-2 Page 9 Decedent: OFFICE OF THE CHIEF MEDICAL EXAMINER CHARLES WARNER CASE NO: 1500255 OPINION The cause oF death is judicial execution by lethal injection. The manner of death is ruled a homicide. CMI -2 I’c 10 ___________ _____ _____ __________ OFFICE USE ONLY BOARD OF MEDICOLEGAL INVESTIGATIONS OFFICE OF THE CHIEF MEDICAL EXAMINER 901 N.Stonewall Oklahoma City, Oklahoma Re. Co. I ins-by certify that this is a true and correct copy of the ohginai document. Valid only when copy bear lw-print by the office seal 73117 REPORT OF LABORATORY ANALYSIS Oats ME CASE NUMBER: DECEDENTS NAME: 1500255 LABORATORY NUMBER: CHARLES WARNER DATE RECEIVED MATERIAL SUBMITTED: BLOOD, VITREOUS, URINE, LIVER, BRAIN, GASTRIC, PHYSICAL EVIDENCE, BILE SUBMITTED B’i NOTES: KYLA JORGENSON HOLD STATUS: 150267 1/20/2015 5 YEARS MEDICAL EXAMINER: JOSHUA LANTER M.D. Duplicate of case 15-0241 ETHYL ALCOHOL: Blood: NEGATIVE (Heart) Vitreous: Other: CARBON MONOXIDE Blood TESTS PERFORMED: NO OTHER TESTS PERFORMED RESULTS: 01/23/2015 DATE Byron Curtis. Ph.D. F-ABFT Chief Forensic Toxicologist OFFICE USE ONLY BOARD OF MEDICOLEGAL INVESTIGATIONS Re. OFFICE OF THE CHIEF MEDICAL EXAMINER 901 N.Stonewall Oklahoma City, Oklahoma Co. I hereby certify that this is a true and correct copy of the oiiqinal document Valid only wnen copy bear rn-print by the office seal. 73117 REPORT OF LABORATORY ANALYSIS By Date ME CASE NUMBER 1500255 DECEDENTS NAME: LABORATORY NUMBER: CHARLES WARNER DATE RECEIVED: 1/16/2005 MATERIAL SUBMITTED: BLOOD HOLD STATUS: 5 YEARS SUBMITTED BY: MEDICAL EXAMINER NOTES: KYLA JORGENSON 150241 JOSHUA LANTER M.D. Duplicate of case 15-0267 ETHYL ALCOHOL: Blood: NEGATIVE (Femoral) Vitreous: Other: CARBON MONOXIDE Blood: TESTS PERFORMED: ALKALINE DRUG SCREEN (Femoral Blood) BENZODIAZEPINES BY LCMS (Femoral Blood) EIA (Femoral Blood) Amphetamine, Methamphetamine, Fentarlyl, Cocaine, Opiates, PCP, Barbiturates. Benzodiazepines (The EIA panel does not detect Oxycodone, Methadone Lorazepam or Clonazepam) - - - - RESULTS: MI DAZO LAM 3.2 mcg/mL - (Femoral Blood) 02/25/201 DATE Byron Curtis Ph.D., F-ABET. Chief Forensic Toxtcologist