if JEFFERSON COUNTY CORONER MEDICAL EXAMINER OFFICE 1515 Sixth Avenue South Birmingham, Alabama 35233-1601 NAME: ED YOUNG AGE: 59 years RACE: Black SEX: Male PATHOLOGIST: Gregory G. Davis, MD. AUTOPSY NO: 2015-0914 DEATH: Date: 05/09/2015 Hour: 1130 AUTOPSY: Date: 05/10/2015 Hour: 0830-1215 HEIGHT: 72.5 inches WEIGHT: 242 pounds DEPUTY CORONER: Derrick Perryman AUTOPSY FINDINGS 1. History of schizophrenia, being treated in mental hospital. A. History of agitation on May 8 with restraint roughly 10 minutes prior to becoming unresponsive. B. Contusion of right frontal portion of scalp and right temporal muscle. II. History of hypertension. A. Hypertensive heart disease (heart 610 grams with concentric left ventricular hypertrophy). B. Status post cardiopulmonary resuscitation on May 8. 1. Fracture of sternum at insertions of third ribs. 2. Fracture of left ribs 2-8 anteriorly. 3. Fracture of right ribs 2-6 anteriorly. 4. Fat emboli in pulmonary arterioles at autopsy. Haloperidol, chlorpromazine, and detected in iliac veins (see toxicology report). CAUSE OF DEATH: MANNER OF DEATH: Hypertensive heart disease. It runs. Zol? Gregoly C. Davis, M. D. Chief Coroner/Medical Examiner 2015-0914 ED YOUNG Identi?cation: A tag attached to the body bag identi?es the body as ?Ed Young, BM, 5-9-15, 1635, Perryman, Sanders, GGD, 15-914.? Clothing: The body is received clad in a blue hospital gown. No clothing accompanies the body. Evidence of Medical Therapy 1. An endotracheal tube exits the mouth. 2. ECG monitor stickers are on the torso. - 3. Vascular lines exit the right antecubital fossa, the dorsum of the right hand, the left forearm, and each side of the groin. A needle mark is in the right forearm. An intramedullary catheter exits the left shin. 4. A Foley catheter exits the penis. A fracture is through the sternum at the insertions of the third ribs. Left ribs 2-8 are fractured anteriorly. Left ribs 2-6 are fractured anteriorly. EXTERNAL EXAMINATION General: The unembalmed, well preserved body is that of a black male 72.5 inches in length and weighing 242 pounds. Rigor mortis is present and broken with dif?culty. Fixed purple livor mortis covers the back. The body is cool and has been refrigerated. The body is free of tattoo. Head and Neck: The decedent has curled black hair with abundant grey. The sclerae are anicteric. The irides are brown. The conjunctivae are pink and free of petechiae. The corneae are cloudy. The earlobes are not pierced. The nares are patent. The lips are free of laceration and contusion. No teeth remain. The decedent has a mustache and beard. No fracture is palpable in the zygomatic arches. The neck is appropriately mobile and free of mass and sear. Torso: Onthe left side of the chest is a 1.7 inch scar. A 2.7 inch scar is on the right lower quadrant of the abdomen. Both testes are descended. The back and anus are free of scar. Arms: A 1.3 inch scar is on the lateral aspect of the left arm near the elbow. The arms are free of needle track. No fracture is palpable in the long bones. Five digits are on each hand. The nails extend 1-2 mm beyond the ?ngertips. The nails are roughly trimmed and dirty. The nail beds are purple. Legs: Scars up to 1.5 inches in length are on the knees and shins. No fracture is palpable in the long bones. The legs are free of edema. No hair grows on the legs. Five toes are on each foot. EVIDENCE OF INJURY Periorbital soft tissue hemorrhage encircles the left eye. Re?ection of the scalp shows contusion of the right side of the frontal portion of the scalp and contusion of the right temporal muscle. INTERNAL EXAMINATION Body Cavities: The mesothelial surfaces are smooth, glistening, and free of mass. The pleural, pericardial, and peritoneal cavities are free of excess ?uid. 2015-0914 ED YOUNG Cardiovascular System: The coronary arteries arise normally and follow their usual courses. The circulation is right dominant. Atheroma narrows the right coronary artery 3.5 cm from its origin by 20%. Atheroma narrows the anterior descending branch of the left coronary artery 2.5 cm from the aorta by 10%. Otherwise, the coronary arteries are free of atheroma. Serial sections of the 610 gram heart reveal maroon myocardium free of softening, discoloration, and scar. The left ventricular free wall and interventricular septum are of similar thickness. The chambers are moderately dilated. The heart shows concentric left ventricular hypertrophy. The septa are free of defect. The endocardium is free of mural thrombi. The valves are thin, pliant, and normal in form. The aorta contains mild atheroma. Pulmonary System: The right lung is 970 grams. The left lung is 880 grams. Each lung is composed of spongy maroon tissue free of consolidation, thromboemboli, and mass. The trachea and bronchi are patent. The tracheal mucosa is smooth and dark pink. Liver and Pancreas: The 2,030 gram liver has an intact capsule and is composed of brown tissue free of mass and scar. The gall bladder wall is thin, pliant, and free of mass. The gall bladder contains no stones. The pancreas is composed of tan tissue free of cyst, mass, and scar. System: The 110 gram spleen has an intact capsule and is composed of red and white pulp free of focal lesion. The cervical, hilar, and peritoneal nodes are not enlarged. Endocrine System: The thyroid is composed of maroon tissue free of cyst, mass, and scar. The adrenal glands are composed of yellow cortices and brown medullae. Each adrenal gland contains yellow cortical nodules up to 6 mm in diameter. Gastrointestinal Tract: The esophageal mucosa is smooth and purple. The stomach contains 350 m1 of maroon liquid. The stomach and duodenum are free of mass and ulcer. No mass is palpable within the small or large intestine. The appendix is present. Genitourinary System: The right kidney is 270 grams. The left kidney is 210 grams. Each kidney is composed of a brown cortex and maroon pyramids free of mass, scar, hemorrhage, abscess, and stone. Each kidney contains simple that have begun to replace the normal The largest in the right kidney is 5.5 cm in diameter, and the largest in the left kidney is 1.5 cm in diameter. Innumerable smaller are scattered through each kidney. The ureters are not dilated. The bladder mucosa is smooth and clear. The prostate is not enlarged. Musculoskeletal System: See ?Evidence of Medical Therapy.? The abdominal panniculus is 4 cm at its thickest point. The spine is normal in form and free of fracture. Neck Organs: The tongue is free of laceration and contusions. The pharynx is not obstructed. No contusion involves the strap muscles, but a ?lm of blood is on the deep surface of the right sternocleidomastoid muscle at the level of the larynx; this ?lm of blood covers 2 1.5 cm. The thyroid cartilage and hyoid bone are free of fracture. The laryngeal mucosa is smooth and pink. Head and Central Nervous System: See ?Evidence of Injury.? The calvarium is free of fracture. No thrombus is in the dural sinuses. The meninges are smooth, glistening, and free of 2015-0914 ED YOUNG mass. No blood is in the epidural, subdural, or subarachnoid space. The hemispheres are symmetric. The 1,370 gram brain is free of tonsillar, uncal, and cingulate gyrus herniation. The vessels at the base of the brain are intact and free of dilatation and atheroma. The cerebral hemispheres, midbrain, pons, cerebellum, and medulla are free of cystic scar, hemorrhage, and mass. The distribution of the grey and white matter is normal. The ventricles are not enlarged and contain no blood. MICROSCOPIC EXAMINATION Heart (6 sections, The sections show no increase in the connective tissue between myocyte and myocyte bundles. The myocardium is free of in?ammatory in?ltrate and necrosis. In particular, no contraction band necrosis is detected. Lungs (5 sections, Sections of the right (slide 4) and left (slide 5) lungs show alveoli normal in form. The sections are free of in?ammatory in?ltrate and birefringent foreign body material. Many pulmonary arterioles contain round spaces characteristic of fat emboli. Liver (1 section, The hepatocytes are free of histopathologic change. The liver is free of both scar and in?ammatory in?ltrate. Kidney (1 section, Simple are evident in the section. Glomeruli remain and are free of histopathologic change, but the glomeruli are only about half as numerous as would be expected. The arteriolar walls are not thickened. The section is free of birefringent foreign body material. - Brain (1 section, The hippocampal nuclei are free of histopathologic change. The vessels are not in?amed. SPECIMENS TAKEN Toxicology: Blood from the ascending portion of the aorta and from the pulmonary trunk, blood from the iliac veins, vitreous humor, urine, bile, liver, and brain are retained. Three tubes of blood accompany the body from the hospital. One tube has a blue top. The other tubes have purple tops. Each tube bears a label with the decedent?s name, patient number 427615, and date 8 May 15 at 1520 hours. Radiographs: None taken. Physical Evidence: Fingerprints and blood samples on ?lter paper are retained. The blood samples are secured in the evidence room. Ancillary Laboratory Studies: None requested. 2015-0914 ED YOUNG CASE SUMMARY Mr. Ed Young was a 59 year old black male with a history of hypertension and schizophrenia who became combative on May 8 at Hillcrest Mental Health Hospital where he was staying, A few minutes after receiving a dose of medications he became unresponsive. He was treated at a Ideal hospital, where initial evaluation suggested ST segment elevation. A cardiac catheterization showed no signi?cant narrowing of the coronary arteries, however. Mr. Young died the following day, on May 9. Autopsy showed no signi?cant narrowing of the coronary arteries. Autopsy did show concentric left ventricular hypertrophy of the heart, a pattern of enlargement characteristic for hypertension. Fat emboli were present in keeping with the fractured ribs and sternum, injuries that can occur during attempts at cardiopulmonary resuscitation even when the resuscitation is properly performed. Toxicological analysis detected haloperidol, chlorpromazine, and in blood obtained at the hospital on May 8 at 1520 H. The various medications were in concentrations that could occur with appropriate therapeutic use of these medications. ST segment elevation can occur in the absence of signi?cant coronary artery narrowing by plaque. Risk factors associated with ST segment elevation in the absence of signi?cant coronary artery narrowing include race (black more likely than non-black) and concentric left ventricular hypertrophy, as was present in this case. It is my opinion, based on the circumstances surrounding death and the ?ndings at autopsy, that Mr. Ed Young died as a result of hypertensive heart disease. The manner of death is best classi?ed as natural. Na,\ ll JUNE. 'Zol5 Gregory/ Davis, M. D. Chief Coroner/Medical Examiner a1 JEFFERSON COUNTY MEDICAL EXAMINER OFFICE BODY DIAGRAM 110m Back FWL ,3 3- . WW 9 ommcom W?15u "ngch ML) {>me 1? ED j: ram..? :9 or [1035; ?0?me l?i ?111' L) 19 2 Dacedent'a Height inch?s Name 50 Weight pounds Examined By Bantams 49.45 (7 tom?: 7.015 University of Alabama at Birmingham Department of Pathology Division of Forensic Pathology Toxicology Section TOXICOLOGICAL ANALYSIS REPORT NAME: Young, Ed CASE 15-914 RECEIVED FROM: Jefferson County Medical Examiner Dr. Davis RECEIPT DATE: 5/11/15 REPORT DATE: 5/28/15 ANALYSIS OF SPECIMENS REVEALED THE FOLLOWING: SPECIMEN ANALYSIS METHOD Blood, AM (5I8I2015 Ethanol GC ND 1520) Blood, AM (5/8/2015 DA NDD 1520) . Blood, AM Haloperidol GCIMS 0.01 1520) Blood, AM (5/8/2015 Chlorpromazine GCIMS 0.003 1520) Blood, AM (5/8/2015 GCIMS 0.14 1520) DA NA Not analyzed ND Not detected NDD No drugs detected Present, not quantified QNS Quantity not sufficient for analysis *Units Alcohol and Volatiles, gm/dL; Blood, mg/L; and Tissue, ?4 Wilt/AW ii Drugs of abuse (Amphetamine, Barbiturates, Benzodiazepines, Cocaine (Cocaine Metabolite), Opiates, 6-Monoacetylmorphine (ES-MAM), Tricyclic Antidepressants, Methadone) C?A?Robinson, Ph. D, Director, Forensic To 1 70 Bow 28 2015 logy wag/J? JEFFERSON COUNTY CORONERI MEDICAL OFFICE CORONER REPORT 7? . . CGH Yes Division Birmingham Incident Case 20150914 Called fi?y Date 5/9/2015 Time 1355 Scene No Arrival time Family notified Yes Name Terry Young Relationship brother Date 5/9/2015 Time Death certificate to be signed by Gregory G. Davis Decedent Information: Decedent name First Ed . Middle Last Young First Middle Last Age 59 . Race Sex Date of Birth 119/1956 41 8-78-4786 Home address 1679 18th Place SW Birmingham Al. Zip 35211 Occupation Next of Kim 7 . Name Terry Young Relationship brother . Phone H: 904-86051069 Address Zip Alt. telephone Particulars of Death: Last seen alive Trinity Medical Center (800 Montclair Rd Bham, Zip 35213 Date 5/9/2015 Time Place of injury 6869 5th Avenue South B'ham, AI. (Hillcrest Zip 35212 Date 5/7/2015 Time Place found 6869 5th Avenue South B'ham, Al. (Hillcrest Zip 35212 Date 5/7/2015 Time Place of death Trinity Medical Center (800 Montclair Rd Bham, Zip 35213 Date 5/9/2015 Time 1130 pronounced by Dr. Arshad Means of death 0n the job No Police agency Birmingham PD Agency case 2015-00088390 Officer Burke Technician Detective Evidence Property Identified: Yes 7 Date Time Identified by Trinity Staff Identified where Hospital 5/9/2015 Condition of Decedent and Premises: Rigor Livor Body temp Medical record Condition of premises inside Disposition of Decedent: Disposition Per Relationship Decedent released by Security Date Time Remarks: printed: 5/10/2015 1:03:09 AM Deputy Coroner Derrick Perryman JEFFERSON COUNTY CORONER I MEDICAL OFFICE NARRATIVE ?if? s'Sur j; .3 Particula Deputy Coroner: Derrick Perryman Case 2015-0914 Trinity Nursing Staff called and stated that the decedent was brought to the ER by Birmingham Fire and Rescue on 05/08/2015 in cardiac arrest at approximately 1444. The only information known to them is that the decedent was being treated at the Hillcrest Mental Hospital when he became combative. The Nursing Staff at Hillcrest gave the decedent a shot of Hal-dol 5mg, Benadryl 50 mg, and Thorazime 100 mg to calm him. A short while later the decedent became unresponsive. The medics responded and was able to revive the decedent and then transported the decedent to the hospital. Today, 05/09/2015, the decedent died and was pronounced at approximately 1130 hours by Dr. Arshad. Jurisdiction was assumed and the decedent was - brought to Cooper Green Morgue by Steele City Transport for examination. All records and admission blood were requested with the body. spoke with the Birmingham Police Department Dispatcher and they stated they were called to Hillcrest Hospital on and unresponsive person on at approximately 1421 hours. When the Police Department arrived on scene, the decedent had already been transported to the hospital by Birmingham Fire and Rescue. A copy of their report will faxed to the office with more information. printed: 5/10/2015 page 1 Joseph D. Pediatric 400 Vestavia Parkway, Suite 130 Invoice Vestavia, AL 35216 Invoice 1376 Invoice Date: 2/26/2014 Bill To: Barry Walker Case The Harris Building 115 Richard Arrington Jr. White, Kennedy Tyre? Birmingham, AL 35203 Description HoursIQty Rate Serviced Amount Record Review of Deposition and Test Material 300.00 2/14/2014 1,200.00 Court/Deposition Preparation (Af?davit 300.00 2/15/2014 600.00 Preparation) 90133 Total $1,800.00 PaymentsICredits $0.00 Balance Due $1,800.00 Cost report f0 A arm/net Wake? rSleets, Shelia v. The Heights at Sky and lex i as?; rims: 1:1. new aw Date askCode Payee Description Cd?t Acct/Check No AB Merion Heighs Postage Fee $10.34 n/ Postage Summary $7.74 Postage Summary $5.06 Postage Summary $0.92 5/30/2012 ARC Invoice re Permit to ARC $29.98 6/25/2012 Construction Guide re Retaining Wall $56.99 11/12/2012 Chart Release Invoice to Gray Lloyd $84.90 11/14/2012 advancement Walker Law, LLC loaned Ms. Sleets $70.00 for gas and travel to $70.00 Attorney medical appointment. 2/24/2013 Westlaw Research charges $191.07 Westlaw 3/16/2013 Facebook Message to Chris Alsop on Facebook. $1.00 in-house 4/24/2013 Process Service Invoice from BWW $275.00 5/1 /201 3 Postage Expenses $8.53 5/15/2013 Gas Invoice $44.13 6/17/2013 advancement Walker Law, LLC Western Union Emergency loan $1,226.00 7/2/2013 Westin Hotels Resorts invoice $202.50 2/3/2014 advancement Western Union Money Transfer $158.00 Attorney 3/2/2014 Focus Group Walker Law, LLC :Iccthodations for Keenan Focus Group in $1 .75905 in-house American Ex on a 5/9/2014 copies FedEx $10.0 4? 5/27/2014 advancement Walker Law, LLC Western Union Receipt - Loan to Client $1,000.00 in-house 5/30/2014 Copying CC to Def Counsel $195.12 Attorney 10/1/2014 Mailing Postage 9130 $048 11/24/2014 Remaining Expert Expenses of Ackerson and K. $8,865.19 Smith 11/24/2014 CAG Civil Action Finance, LL Financed Expenses CAG 11/24/2014 Depo errill LegalLink Defense Expert Depos $951.00 in-houra/ 11/24/2014 millage Wad trips to Cintronelle .50 1122 miles. $561.00 Who?La 6 WW Probably made 10 round tripes to Eutaw and Cintronelle. 11l24/2014 Walker Law, LLC TBI CLE - Material Essential to Learning to $1,500.00 CLE VVW Litigate a TBI case. 11/24/2014 Walker Law, LLC Legal Research for Summary Judgment Motion $3,984.56 Westlaw 11/24/2014 Walker Law, LLC Deposition Fee of Defense $1,500.00 Def Depos Fee J, 6 11/24/2014 Walker Law, LLC Defs Exp Engineer Depo Fee $300.00 12/1/2014 Mailing Walker Law, LLC Postage 11130 $1.44 Mail Thursday, January 29, 2015 Trial Works Page 1 of 2 Healthport Accounts by Client ?/Ireo?kx/ 925?? wzep?h/mc 1764/17 Client Invoice Patient Name Balance Client Name 1573550 0075112301 HAMEEN WILOA 9.25 WALKER LLC 1573550 0033313751 BROWN 343.17 WALKER 1573550 0053522023 BROWN JESSICA 335.35 WALKER LLC 1573550 0037355005 DAVIS NELLIE 15.35 WALKER 1573550 53321733 BLEVINS KEVIN 0.00 WALKER LLO 1573500 37350435 BLEVINS KEVIN 0.00 WALKER LLC 1573550 0053455150 TONEY JENNIFER 22.53 WALKER LLO 1573530 0003324552 TONEY JENNIFER 5.54 WALKER LLC 1573550 0053270130 LEONARD MELISSA 30.50 WALKER LLO 1573550 0053153301 WATKINS TAKERIA 37.50 WALKER LLO 1573550 0054752275 THOMPSON FELIOIA 0.00 WALKER LLC 1573530 0004352301 DAVIS MARVIN 0.00 WALKER LLC 1573550 0053553274 MCADORY JOHNNY 0.00 WALKER LLO 1573530 0057251335 HOPSON LILLIE BELL 140.20 WALKER 1573550 0055327552 THOMPSON QUINTARIUS 15.35 WALKER LLC 1573550 0055513031 THOMPSON FELIOIA 31.50 WALKER LLO 1573550 0104510071 GRAY BRANDY 335.35 WALKER LLO 1573560 0104555325 GRAY BRANDY 43.15 WALKER LLI: 1573550 0115103551 OHAMES GLORIA 3.35 WALKER LLO 1573550 0133354554 BUFFER PAULEITE 20.22 WALKER LLC 1573550 0145535123 CARTER JAMIERE 113.50 WALKER LLC Balance Sum: 1,570.95 7071335, 2075 PATRICIA Z. DEARZWQ m. 5401 Jefferson Highway Of?ce {504) ~733?8484 Suite A Toll Free (800) 447-0410 New Orleans, Louisiana T0123 . Fax (504) 733-8850 FAX COVER SHEET PRIVACY NOTICE THIS FA CSIMILE TRANSMISSION MA CONTAIN CONFIDENTIAL AND PRIVILEGED INFORMATION. THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS EXEMPT FROM DISCLOSURE UNDER APPLICABLE FEDERAL OR STA TE LAW. IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT OR THE EMPLOYEE OR AGENT FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT: YOU ARE HEREBY NOTIFIED THATANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS 8 TRICTL PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE AND RETURN THE ORIGINAL MESSAGE TO US AT THE ADDRESS ABOVE VIA REGULAR US MAIL. DA TE: - To: AWN?'wmnj mm A Walk: Our Fiia ?75 310-1 Claim Fax #0109026 FROM: Kimberly Johnson FAX {504) 733-8850 COMMENTS: Plaase make check as able to HealthPorl and send directi to the address above. DO NOT SEND PA YMENT TO HEAL THPORT. If invoice is already Qaid. geasa fax over 23 zment information in order for us to dose it out of our of?ce- If aid with a check fax a co Of from and basic of check. If Qaid with a credit card, fax over 93 gment receigt. Make sure the invoice and lar ?le number is on amen! Information that is being sent to our o?ica. Any guss?ons QIease call number/Ext located at the bottom. Is AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION MAY BE FOR THAT PURPOSE. nus FIRM Is A TOTAL NUMBER OF PAGES SENT INCLUDING COVER SHEET: (22 IF YOU DO NOT RECEIVE ALI. PAGES, PLEASE CONTACT US AT (800) 447-0410 Ext THANK YOU.