REPORT OF INVESTIGATIO Name: - Can't: Investigator: Martha J. Scholl Date- SYNOPSIS The deceased is a 38-year>>old white female who died at La 2003. She has a history of narcotics abuse and on April 26'" she and a friend were using Fentanyl patches by boiling them and drinking the resulting "tea". Shortly after she drank the tea she was seen snoring and sometime after that she was found completely unresponsive. EMS was called and she was in full arrest upon their arrival. She was transported to Largo Medical Center where she was pronounced brain dead on the Lite Link harvested organs. Largo investigated. NARRATIVE At 1110 on April 29, 2003 I received a call fiom -Life Link She was in the ICU at Largo Medical Center with a 38--year-old white female who had been declared brain dead the day before. She had received permission for organ donation from the family She stated that the deceased has a known history of narcotics abuse. 0n the evening of the 26'" she and a fi'iend had obtained some Fentanyl patches. They initially applied the patches to their skin, but were apparently not getting the desired effect. They then boiled the patches into a sort of tea and drank the tea. The details at this point are rather sketchy, according to the record. At one point afier drinking the tea she was found to be snoring, then later on was found to be unresponsive and not breathing. Rescue: personnel were called and arrived to find her pulseless and apneic, showing asystole on the monitor. They began resuscitation according to ACLS protocol and transported her emergency status to Largo Medical Centerr Afier arrival in the ED they were able to regain pulses, but she had sustained a severe anoxic brain injury. Her prognosis was grave, Her drug screen came back positive for THC and tricyclics. She underwent brain-death protocol and was pronounced brain dead at 1615 on April 23"" 2003 by Dr, Mark Ritch and Dr. Robert Mills. I discussed the donation request with on R. Chief Medical Examiner and he stated that Life Link could pursue an unrestricted harvest. Again, the family had already given consent for donation and Life Link was in the process of determining whether she was aviable candidate for harvest 1 requested that nut--dart me the History and Physical dictation, ER record. demographic face sheet and lab reports with drug screen. Her mother had positively identified the deceased at the time of admission. She was also notified that the MEG would be involved in the case following organ donation. Largo Police had responded to the scene of the incident. I spoke with Detective Keith Barton who stated that they were not pursuing the investigation at the detective level. nir I:ng an>>.er rub/<> becomes mum Medical Examiner District Six - Florida REPORT OF INVESTIGATION Cneflvz 5030491 Dlte: April 29, 2003 Name: -- Investigator: Martha J. Scholl At 0800 on April 30, 2003 1 received a call fium-Istating that they had finished with their procurement and that she was ready for pick-up in the morgue. She also stated that there were charts and specimens there with her ready to gor I then contacted Semple Removal Service to pick up the body, records and samples and transport them to the MEG. End of original report Martha J. Scholl Forensic Investigator NOTE: His living datum! rue/m Infra:ng updmu ml correction in new unfamilan Dew-In avulhbl: Medical Examiner District Six . Fluridl Page 2 oil Examiner 1401 Lucerne Terrace OrlandoJiorida 32306-2014 Investigator's Narrative Case Number- -- investigator: Bill Siration chlation Date: 07/04/2001 The following info from Det Put Schneider OPD, and the roommate- CIR: This 40 w/m was found unresponsive lying in bed at his residence by his roummat- 911 was called and OFD E-IZ and with Rural Metro responded. The pt was moved to the floor and CPR was started. Intubation and IV was started before the code was terminated by the on call Medical Director at 7:20 pm. The pt was LSA between 4:00 pm and 4:30 pm by his roommate and another friend -- He appeared intoxicated and was helped to bed by Is rien ey also took his car keys as they felt he was not able to drive. This afterno he had been licking the medication from Duragesic patches, Fentanyl 50 ug/ ,and was seen doing this yesterday. He reportedly received this prescription yes erday. Unfilled prescriptions for Duragesic patches and Xanax ated 7-3-01 are found in his cari His friends state he has had a pain meic ion abuse problem for a couple of years. He has problems with lumbar discs. MED: Approx. 2 weeks ago he had a or tumor in his left lower leg drained at Celebration Hosp. This caused cramping and swelling in his lower leg for several weeks. A radiology report for his lumbar spine is included in this report. Several doctors have prescribed medications for the pt. See the med. sheet. SO . lieved divorced and separated from his wife 3-4 months ago. does not smoke - drink but has usd illegal drugs in the past. He is a survives irn, and his friends are doing his notification. Family history is not known. I MEDICAL EXAMINER DIST. ,K'sng PINE STREET LEESBURG, FL am: I i I TEL. 352425-5961 352-365-6436 Imus!" - i Ll FOUND ABOUT mmzm: FOUND oN NURSING HOME RESIDENCE UNKNOWN I 5423412224 4-2--03, DECEDENT WAS LAST SEEN ALIVE ABOUT 1:30 AM, AT HIS FRIENDS RESIDENCE, WHEN DECEDENT WENT To SLEEP ON A MATTRESS ON THE LIVING ROOM FLOOR. WAS SEVERELY INTOXICATED AT THAT TIME. 4-2--03 AEOUT 5:00 AM, DECEDENTS FRIEND AWAKENED, WENT To CHECK 0N DECEDENT AND FOUND NIM UNRESPONSIVE. 911 WAS ALERTED, MARION COUNTV FIRE RESCUE ARRIVED AND DECEDENT ABOUT 6:34 AM. PAST MEDICAL ALCOHOLIC, SMOKER, AND KNOWN TO USE NARCOTICS INJECTING DRUGS. MARION COUNYV DEPUTY IS INVESTIGATING AND SUSPECTS POSSIBLE OVERDOSE. (CASE REFILED 5-14-03: DLF) ACCIDENT ,3 DR. MARTIN R: c. VOUNG ROBERTS FH DUNNELLDN FLA. 352489-2421 7" DRUG INYOXIEATIDN Prinuj DICAL EXAMINER DIST. TEL. 352-126-6961 "9 PINE STREET INV NARRATIVE (1 FOR 5 FAX. 352-355-6433 FL 3414: 4-2-03 ABOUT 7:30 WRITER WAS CONTACTED BY MARION COUNTY OFFICE AND DISPATCHED TO 22743 SW RAINBOW LAKES BLVD, IN REGARDS TO THE DEATH OFA 29 YEAR-OLD WHITE MALE. UPON ARRIVAL MARION CSD LT POGUE Is PRESENT AND WRITER WAS ADVISED OF THE FOLLOWING AS STATED IN THE CASE SUMMARY ON Mrua' DURING THE LATE EVENING HOURS, DECEDENT WAS AT A PARTY IN BEVERLY HILLS CITRUS COUNTY DECEDENT WAS VERY INTOXICATED AND CALLED HIS FRIEND IN DUNNELLON TO COME AND PICK HIM UP, WHICH HE DID AFTER RETURNING TO RESIDENCE, DECEDENT THREW A MATTRESS ON THE LIVING ROOM FLOOR AND WENT TO SLEEP HE WAS VERY INTOXICATED AT THAT TIME SCENE, THE HOUSE TEMPERATURE INSIDE IS ABOUT 70 DEGREES. DECEDENT IS OBSERVED LYING ON A FULL SIZE ON THE LIVING ROOM FLOOR IS LYING ON THE RIGHT SIDE WITH HIS HEAD TOWARDS THE WEST IN A SUPINE POSITION AND HIS LEGS ARE OFF THE FOOT OF THE MATTRESS DECEDENT IS WARM TO THE TOUCH, RIGOR IS SLIGHT IN THE OUTER EXTREMITIES, LIVIDITY IS MODERATE AND CONSISTENT WITH HIS NO TRAUMA IS PRESENT HIS RECTAL TEMPERATURE IS 91 DEGREES, I WRITER TOOK DIGITAL 35 MM SCENE PHOTOS COLLECTED DECEDENTS VALUABLES (REFER TO VALUABLES LIST). ATS WAS CONTACTED AND DECEDENT ALONG WITH VALUABLES LIST EMS RUN SHEET WAS MEO, MARION CSO DEPU RAWAY HE HAD TALKED TO DECEDENTS MOTHER 4727012 00 INV. C. YOUNG. COPY fi-- ity of Florida Diagnostic Relerml Lnboralorhs Page: 1 00 SW Drive REF LAB N0: 20787-03711 Gainesville, FL 32608 352265-9900 NAME: - Forensic Toxicology ME. 1 mm" 04/04/2003 RECEIVED: Materials from Dr. Julia Martin, District Five (Marian), Medical Examiners Office, 809 Pine Street1 Leesburg. FL 34748 (353732675961 1 SUBMITTED: blood (subclavian), urine, bile, vitreous humor. liver, stomach contents (51 mL total) and nasal swabs RESULT: Volatiles (blood - subclavian): non: detected Volatiles (urine): Ethanol positive - 79 mg/dL (0.07 g/dL) Volatiles (vitreous humor): Ethanol positive - l7 mg/dL (0.01 g/dL) Comprehensive Drug Screen (blood -- subclavian): 29 (Therapeutic: [050 ng/mL] [Toxic >75 ng/mL] Fenlanyl: 10 ng/mL ['l'ltat'speulic: 1-3 ng/mL] [Taxi/z: >3 ugij Comprehensive Drug Screen (urine): positive Cannabinmds positive Fentanyl positive Oxymdone positive Drug Quantitation (staunch contentsstomach contents RESULT CERTIFICATION: Results Certified by: AMW A a Lek/p.44 Bruce A Goldberger, Ph.lJ., DAB: Director of Toxicology 6: Associate Professor 5/12/03 [0223][0265] '030941120787"