CALL INFO Alameda County Coroner?s Bureau Gregory J. Ahem, Sheriff/Coroner 2.901 Peralta Oaks Court, Oakland, CA 94605 (510) 382-3000 Coroner Investigator's Report NAME OF DECEASED (LAST. FIRST MIDDLE) BELTRAM JR., Frank Alexander TENTATIVE I UNIDENTIFIED CASE NUMBER 2015-01484 REPORTED BY M. Salamida REPORTED BY PHONE REPORTING AGENCY REFERENCE NUMBER Valley Care Medical Center INVESTIGATOR RAFAEL PLASENCIA CALL DATE AND TIME 5/10/2015 0041 CASE TYPE Removal Case DECEDENT DATE AND TIME OF DEATH 5/9/2015 2345 DATE OF BIRTH AGE 12/11/1965 GENDER 49 Years Male RACE Black MARITAL STATUS VET Married HGT WGT EYE COLOR Brown HAIR COLOR Gray OCCUPATION re?nery worker EMPLOYER Prelimina Summa DEATH LOCATION OF DEATH Valley Care Medical Center L730 TYPE HOSP ADDRESS (STREET, CITY, STATE. ZIP) 5555 W. Las Positas Boulevard, Pleasanton, CA, 94588 COUNTY Alameda Manner Natural Death Certificate Signed By Cause A Cause Cause Cause Cardiac insufficiency Acute myocardial infarction Coronary atherosclerosis Interval Minutes Hours Years Interval Interval Interval Other Significant Conditions NOTIFIC. LEGAL NEXT OF KIN NOTIFIED BY METHOD RELATIONSHIP TELEPHONE NO. Other DATE AND TIME 5/11/20151500 IDENTIFICATION METHOD Finger Prints DATE AND TIME 5/12/2015 0000 INCIDENT LOCATION OF INCIDENT AT WORK ADDRESS (3 HEI: r, CITY, STATE, ZIP) COUNTY DATE AND TIME OF INCIDENT INVESTIGATING AGENCY Alameda County Sheriff's Office-ETS INV AGENCY PHONE NUMBER OFFICER DISP FUNERAL HOME PITTSBURG FUNERAL CHAPEL BODY RELEASE TO FUNERAL HOME ON 5/14/20151417 Full Autopsy Inspection Yes Partial Autopsy Record Review Inspection w/Specimen EXAM BY THOMAS W. ROGERS Coroner Investigator's Report - Page 1 of 1 Alameda County Sheriff's Office Gregory J. Ahern, Sheriff Coroner Coroner's Bureau, 2901 Peralta Oaks Ct., Oakland, CA 94605 (510) 382-3000] (510) 382-3033 (fax) According to medical records from Valley Care Medical Center, Beltram Jr. had history of- According to the Paramedics Plus Patient Care Report, Beltram Jr. collapsed during pod time and was taken to the Santa Rita Jail infirmary. He was experiencing respiratory distress, altered level of consciousness, and incontinence. He was transported code-3 to Valley Care. (RRP1868) According to medical records from Santa Rita Jail, Beltram Jr. had history of? According to Santa Rita Jail Mental Health records, Beltram Jr. showed no evidence of any treatable disorders and was not interested in any treatment. Copies of medical records from Valley Care Medical Center and Santa Rita Jail were placed in the case file and Pathologist Autopsy inbox for review. (RRP1868) Description of the Death/ lnjury Scene: Beltram Jr. died in the Valley Care Medical Center Emergency Department. (RRP1868) Body Identification: Alameda County Sheriff's Office Gregory J. Ahern, Sheriff Coroner Coroner's Bureau, 2901 Peralta Oaks Ct., Oakland, CA 94605 (510) 382-3000 (510) 382-3033 (fax) Investigator Narrative Decedent: BELTRAM JR., Frank Alexander Case Number: 2015-01484 Investigator: Rafael Plasencia First Call Information: On Sunday, May 10, 2015, about 0041 hours, Nurse M. Salamida called and reported the death of Frank Beltram Jr. Nurse Salamida reported the following: Beltram Jr. was a 50 year old male who died in the Emergency Department (ED) at Valley Care Medical Center in Pleasanton. Beltram Jr. was a Santa Rita Jail inmate that was transported to the ED by ambulance and was admitted at 1842 hours, for altered level of consciousness and respiratory distress. He remained in an altered state throughout his stay and was intubated due to respiratory distress. Beltram Jr. became unresponsive at about 2327 hours and life saving measures were attempted but unsuccessful and Dr. R. Kwak pronounced death at 2345 hours on 05/09/2015. (RRP1868) Medical Summary: Alameda County Sheriff's Office Gregory J. Ahern, Sheriff Coroner Coroner's Bureau, 2901 Peralta Oaks Ct., Oakland, CA 94605 (510) 382-3000 (510) 382-3033 (fax) Beltram Jr. was identified by his Alameda County issued identification armband. The armband included a photograph which was used to identify him by his likeness to the photograph. (RRP1868) On May 12, 2015, a fax was received from the Alameda County Central Identification Bureau (CIB) confirming that the fingerprints taken from the decedent were a match to the fingerprints associated with Person File Number: - with the name Frank Beltram. (KEE1917) Next of Kin Investigation: On Monday, May 11,2015, about 0810 hours, I (Hovda) ran an accurint report for Frank Beltram. I called a phone number listed in the report for-and Frank Beltram in and spoke -told me the following-is the uncle of Frank Beltram Jr. As far as knew, Frank Beltram Jr. was not married and had one minor child. did not know the child?s name or contact information. is Frank Beltram?s mother and lived at the same residence. - was asleep and could not come to the phone. I provided the Alameda County Coroner?s Bureau phone stated he would notify-of her son?s death and give her the information when she woke up. (JSH1432) number and case number On Monday, May 11, 2015, about 1500 hours, I (Hovda) calle- was tol had called Santa Rita Jail and inquired about her son Frank Beltram?s medical condition. tated she was concerned about the medical care her son was receiving and was checking on his well-being. informed her son had died and ofthe Coroner?s Bureau involvement in this case. .told me the message I left with-earlier that day had not been forwarded to her by her brother. .informed me- may have forgotten because he is mentally handicapped. Alameda County Sheriff's Office I '5 . Gregory J. Ahern, Sheriff/ Coroner Coroner's Bureau, 2901 Peralta Oaks Ct., Oakland, CA 94605 (510) 382-3000 (510) 382-3033 (fax) .told me the following about her son Frank Beltram Jr.: Frank Beltram was divorced and has two sons, and --is a minor ?and-is an adult- lives with and she will inform him of his father?s death. (JSH1432 called the Coroner?s Bureau and identified On Monday, May 11, 2015 about 1745 hours herself as the legal wife of Frank Beltram Jr. state 5 was notified of Frank Beltram?s death on Monday, May 11, 2015 about 1500 hours by .stated she is still legally married to Frank Beltram Jr. and will be making funeral arrangements in this case with the assistance of--stated she never filed divorce paperwork from Frank Beltram Jr. (JSH1432) On Monday, May 11, 2015, about 1800 hours, (Hovda) called and informed her of claim of still being legally married to Frank. stated she was not positive her son ha She stated Frank signed divorce paperwork but did not know if the paperwork was ever filed. stated she and-will be making funeral arrangements together in this case. informed-that the legal next of kin in this case. (JSH1432) Other Agency Reports: Refer to Alameda County Sheriff?s Office report #15?007958. (RRP1868) On July 16, 2015, (Plasencia) printed a copy of Alameda County Sheriff?s Office report #15?007958 for review and included it in the case file. The report was consistent with the information originally reported to me with the addition of a signed statement from another inmate that stated Beltram Jr. Alameda County Sheriff's Office Gregory J. Ahern, Sheriff Coroner Coroner's Bureau, 2901 Peralta Oaks CL, Oakland, CA 94605 (510) 382-3000 (510) 382-3033 (fax) According to his toxicology report, no common acidic, neutral, or basic drugs or alcohol was detected. (RRP1868) Property and Evidence: (Plasencia) issued property receipt #36043 for the body, clothing, and property items in this case to Deputy McDaniel #2130. (RRP1868) As of May 12, 2015, all property items in this case were released to Beltram Jr.?s wife,- (RRP1868) Coroners Fees: As of May 10, 2015, Coroner?s fees including body removal ($254) and body preparation (S67) fees totaling $321.00 apply in this case. (RRP1868) As of July 14, 2015, all associated fees in this case were paid in full. See Accounting Receipt #06613. (RRP1868) Investigative Details: Alameda County Sheriff's Office Gregory J. Ahern, Sheriff/ Coroner Coroner's Bureau, 2901 Peralta Oaks Ct., Oakland, CA 94605 (510) 382-3000 (510) 382?3033 (fax) On May 10, 2015, about 0235 hours, Deputy Unubun and (Plasencia) arrived at Valley Care Medical Center in Pleasanton. Beltram Jr. was lying face up on a hospital bed in the Emergency Department. He was wearing a hospital gown. There was medical therapy attached to Beltram Jr.?s body and everything was left in place. I examined his body and saw no signs of foul play or trauma. Deputy Unubun and I moved Beltram Jr. onto a gurney and into the Coroner?s van for transportation back to the Coroner?s Bureau without incident. About 0310 hours, Deputy Unubun and I arrived at Santa Rita Jail in Dublin. i met with Sgt. Leca, who was the acting Watch Commander for the day, and he provided me with Beltram Jr.?s booking information, personal property, money, and copies of his in custody medical records. He advised me that at about 0006 hours, the Records Deputy spoke to US Marshal Deputy Clopper #4940 and advised him of Beltram Jr.?s death. According to intake records from Santa Rita, Beltram Jr. was booked into custody on 04/01/2015, by the US Marshals. (RRP1868) On Saturday, May 23, 2015, about 0910 hours, I (Meldrum) spoke to Santa Rita Jail Sergeant Lenthe. Sergeant Lenthe told me there were inmates that knew Beltram Jr who? said he was According to Santa Rita Jail Mental Health records, Beltram Jr. had no history. (RRP1868) On May 11, 2015, Coroner?s Pathologist Dr. Thomas W. Rogers conducted a full autopsy on Beltram Jr. The cause of death was deferred due to a request for toxicology and histology. (RRP1868) Alameda County Sheriff's Office Gregory J. Ahern, Sheriff/ Coroner Coroner's Bureau, 2901 Peralta Oaks Ct., Oakland, CA 94605 (510) 382-3000 (510) 382-3033 (fax) On May 12, 2015, Central Valley Toxicology (CVT) conducted a complete drug screen on hospital samples and a post mortem femoral blood sample from Beltram Jr. The complete drug screen yielded the following results: No common acidic, neutral or basic drugs detected. No Ethyl Alcohol detected. (RRP1868) On May 14, 2015, Jay Becker from Pittsburg Funeral Chapel arrived at the Coroner?s Bureau to take possession of Beltram Jr. for his final disposition. -authorized the release and Coroner?s fees were not paid at this time. (RRP1868) On June 25, 2015, Dr. Rogers gave the following cause of death: Cardiac insufficiency due to acute myocardial infarction due to coronary atherosclerosis. (RRP1868) Findings: On Thursday, July 16, 2015, (Plasencia) reviewed this case to determine a manner of death. A full autopsy on Frank Alexander Beltram Jr. was performed by Coroner?s Pathologist Dr. Thomas W. Rogers to determine a cause of death. Dr. Rogers listed the cause of death as, "Cardiac Insufficiency,? with secondary conditions of, ?Acute Myocardial Infarction and Coronary Atherosclerosis." Based on the listed cause of death, I determine the manner of death for this case to be natural. (RRP1868) Supervisor Review: On August 4,2015, (Sergeant P. Wilson) reviewed this case for closure. i agree with the findings and consider this case closed. Alan'leda (Lou nty Sheri (Nike Coroner's Bureau . 2901 Peralta Oaks Court, Floor, Oakland, CA 94605-5319 DATE: FROM: TO: SUBJECT: Gregory]. Ahern, Sheriff Director ofEmergency Services Coroner - Marsha) A May 11, 2015 Thomas Wayne Rogers, M.D. Case File 2015?01484 AUTOPSY PROTOCOL Autopsy performed upon the body of Frank Alexander Beltram Jr. at the Coroner's Bureau, 2901 Peralta Oaks Court, Oakland, California, on May 11, 2015, at 9:15 a.m. AUTOPSY FINDINGS GENERALIZED ATHEROSCLEROTIC CARDIOVASCULAR DISEASE: A) CARDIOMEGALY B) ACUTE MYOCARDIAL INFARCTION (MICROSCOPIC DIAGNOSIS) C) CORONARY ATHEROSCLEROSIS D) AORTIC ATHEROSCLEROSIS E) GRANULARITY OF KIDNEYS. REMOTE RIGHT THORACOTOMY: A) PROBABLE PARTIAL PNEUMONECTOMY B) ADHESIONS, RIGHT PLEURAL CAVITY. CHRONIC PASSIVE CONGESTION, LIVER. DIABETES MELLITUS: A) EARLY KIMMELSTIEL-WILSON DISEASE (MICROSCOPIC DIAGNOSIS). CAUSE OF DEATH: CARDIAC INSUFFICIENCY DUE TO ACUTE MYOCARDIAL CC: EMS INFARCTION DUE TO CORONARY ATHEROSCLEROSIS. District Attorney Investigations Bureau Page 2 Sheriff-Coroner Alameda County Body of FRANK ALEXANDER BELTRAM JR. EXTERNAL EXAMINATION The body is that of a male, stated age of 50 years. There is a Coroner's identification tag present on the left big toe. The body is 70 inches long and weighs 245 pounds. 'The body is presented in a supine position with the head in the normal position. Both arms lie alongside the body. The body is nude. Paper bags cover the distal aspects of both arms; IRigor mortis is passing. Lividity is present over the backside of the body. There is the following evidence of MEDICAL THERAPY: l) A medical band about the right wrist. 2) A dressing covering_the dorsal aspect of the right hand. Removal of this does not reveal a needle puncture mark. 3) A vascular catheter in the right antecubital fossa. 4) Cardiac monitoring pads on the torso, both loWer legs and both upper arms. 5) Electrical conduction pads on the torso. 6) A dressing Covering a blunt injury on the dorsal aspect of the right foot; 7) A dressing covering a blunt injury on the dorsal aspect of the left foot. 8) A Foley catheter in the external genitalia. Page 3' Sheriff?Coroner Alameda County 'Body of FRANK ALEXANDER BELTRAM JR. 9) An oral?gastric tube in place. 10) Two medical bands about the left wrist.' 11) A.vascular catheter on the dorsal aspect of the left hand. 12) Hospital specimens attached to the left big toe. There are the following BLUNT INJURIES to the body: HEAD AND NECK: None present. RIGHT ARM: None present. LEFT ARM: None present. RIGHT LEG: I l) A 3/4?inch eschar over the tibial tubercle. 2) A l/Z?inch eschar on the lateral knee. 3) A healing abrasion on the dorsal aspect of the foot. 'Granulation tissue is present in its base. LEFT LEG: l) A l/2?inch healing abrasion on the dorsal aspect of they foot, with granulation tissue in its base. $382: None?present. Page 4 Sheriff?Coroner . Alameda County Body of FRANK ALEXANDER BELTRAM JR. ?The hair is black, graying, and 1/4 inch long. Pupils are round; ?Irides are brown. Sclerae are white. No petechial hemorrhages are noted., Ears, nose and lips are normal. A short mustache and beard are present. There is a 1?inch, puckered, well-healed scar over the midline of the neck. The chest is flat. Breasts are consistent with an adult male. In both axillary areas are a moderate number of papillomatous?appearing skin tumors.' These range upwards to 3/8 inch in greatest dimension. Over the right side of the torso, roughly over the chest, are approximately seven well? healed scars. These are irregularly shaped and-range upwards to .1 inch in greatest dimension. In addition, there is a well? healed right thoracotomy scar. The abdomen is mildly obese. A small umbilical hernia is present. 'The external genitalia are nonremarkable. - I There is mild pitting edema of both ankles. Legs and feet are without further abnormalities. The fingernails have been clipped prior to autopsy. VArms and hands are nonremarkable. No-binding indentation sites are present about the arms or hands. No smoke, powder or stippling is identified on either arm or hand.? No needle puncture marks are present. No hyperpigmented soars are present Over Page Sheriff?Coroner Alameda County, Body of FRANK ALEXANDER BELTRAM JR. aCcessible veins. No blunt injuries are noted to arms or hands. The back is normal. INTERNAL EXAMINATION The body is opened through the usual INCISION. BODY CAVITIES: The left pleural cavity is lined by a smooth, glistening surface and contains about 300 cc of clear yellow effusion. The right pleural cavity_is moatly closed by fibrous adhesions. The pericardial sac and peritoneal cavity are lined by smooth, glistening surfaces. Ribs and diaphragms are intact. HEART: In situ, the heart is enlarged. with the apex beyond the left midclavicular line. The heart weighs 630 grams. The epicardial surface is smooth and glistening.? Ventricular myocardium is brown._ There is a vague 3/84inch area of hemorrhage in the posterior wall of the left ventricle. A microscopic section is taken. There is mild four?chamber dilatation of the heart. Valves are normal. Coronary ostia are patent. There is severe calcific coronary atherosclerosis making examination difficult. This is particularly noticeable in the left circumflex and the right coronary arteries. No thrombi are present. VESSELS: The aorta and tributaries are severely involved Page 6 Sheriff?Coroner 7 Alameda County . Body of- FRANK ALEXANDER BELTRAM JR. 89 with atheromatous change.' The pulmonary artery and venous 90 system contain no thromboemboli. 91 TRACHEA AND BRONCHI: 'Lined by pale yellow mucosal 92 surfaces. 93 LUNGS: ,The left lung weighs 1120 grams. it has a smooth 94 surface. It is prominently congested and edematous. Its airway 95 and vessels are nonremarkable. 96 . The right lung weighs 240 grams. It is prominently adhesed '97 into the right pleural cavity. 'Some may be 98 iatrogenically missing, consistent with an earlier partial 99 pneumonectomy. Suture material is identified. The 100 of the right lung is congested and edematous and rather 101 firm. Its airways and vessels are nonremarkable. 102 ORAL Most teeth are chronically missing. The 103 tongue is normal. 104 ESOPHAGUS: Lined by?a white, wrinkled mucosal surface. 105 STOMACH: Contains 100 cc of brown food material. The 106 mucosal surface is tan. No tumors or ulcers are noted. 107 INTESTINES: 1Covered by smooth serosal surfaces. No 108 abnormalities are noted. 109 . LIVER: Weighs 3500 grams. The serosal surface is smooth 110 and glistening. The anterior margin is rounded. The Page 7?'1 Sheriff?Coroner Alameda County . Body of FRANK ALEXANDER BELTRAM JR. 111 is brown and prominently congested. A nutmeg pattern is 112 present, consistent with chronic passive congestion. 113 GALLBLADDER: The gallbladder is of normal size.' Its 114 surface is smooth. _Its wall is of normal thickness. It is .115 lined by a green velvety mucosal surface. It contains 10 cc of 116 bile and no stones. .117 PANCREAS: The pancreas is of normal size. Its 118 is yellow?brown and lobulated. No tumors are present.. No 119 saponification is noted. 120 - SPLEEN: IThe spleen weighs 570 grams. Its capsule is gray' _121 and smooth. Its is red?purple and soft. 122 ADRENAL The adrenals.are normal in size and have 123 their usual triangular shape. Sectioning of them reveals non- 124 'remarkable Cortex and medullary parts. No hemorrhages are 125 present. 126 KIDNEYS: The left kidney weighs 300 grams. The right 127 kidney weighs 290 grams. Surfaces are prominently granular. 128 is brown and moderately congested._ There is a 129 distinct corticomedullary separation. Papillae are normal. The 130 -calyces and pelves of both kidneys are nonremarkable. No 131 obvious abnormalities are noted of the ureters. No stones are 132 present. Page 8 Sheriff-Coroner . Alameda County. A Body of FRANK ALEXANDER BELTRAM JR. 133 BLADDER: The bladder contains no urine. It is lined by a 134 tan mucosal.surface. No trabeculation or tumors are present. 135 No diverticula are noted. 136 - PROSTATE: The prostate is of normal size. Its 137 dis yellow?white and rubbery. No tumors are noted. 138 Normal. 139 MUSCULOSKELETAL SYSTEM: No abnormalities noted. 140 NECK: 'The hyoid bone and laryngeal structures are intact. 141 7 Soft tissue about the larynx is normal.? The larynx is free of 142 robstrUCting material. The cervical vertebral column is non- 143 remarkable. The thyroid gland is of normal size. Sectioning of 144 it reveals a nonremarkable red?brown 145 CENTRAL NERVOUS SYSTEM: Soft tissue about the cranial 146 ?vault is normal. The brain weighs 1300 grams. The gyri and 147 sulci of the cerebral hemispheres are normal. Sectioning of the 148 brain reveals no abnormalities. No contusions are noted. The 149 'ventricular system of the brain is nonremarkable. No subdural 150 or subarachnoid hemorrhages are present. The vessels at the 151 base of the brain are nonremarkable. Stripping the dura from 152 the inner table of the skull reveals no abnormalities. 153 . SPECIMENS: 154 l) Heart?s blood 155 156 157 158 159 160 161 162 163 164 165 166 Sheriff?Coroner Alameda County TWR/cah Leg blood Stomach content Liver Tissue Histology sections Photographs. Page Body of FRANK ALEXANDER BELTRAM JR. ??in Thomas Wayne Rogers, M.D. (_lm11?nty Sheriff?s (Jilin: Coroner's Bureau 2901 Peralta Oaks Court, Floor, Oakland, CA 94605-5319 rogo ry j. Aliem Sheri Director of Emergency Services Coroner Marshal CASE NUMBER: CASE NAME: 2015-01484 Frank Alexander Beltram Jr. PATHOLOGIST: Thomas Wayne Rogers, M.D. HISTOLOGICAL EXAMINATION HEART: There is a focal area of recent scarring characterized by the presence of ?broblasts. This is consistent with a recent myocardial infarction. A few hemosiderin?laden macrophages are present. In an area close to this is a very early neutrophilic in?ltrate. Rare areas of muscle necrosis are noted. These ?ndings are consistent with an acute myocardial infarction. LUNG: In some areas there are a moderate number of alveolar macrophages present. Otherwise, no abnormalities are noted. LIVER: Congestion is present. No further abnormalities are noted. PANCREAS: The pancreas is autolyzed but otherwise nonremarkable. SPLEEN: Nonremarkable-appearing red pulp and White pulp areas are present. KIDNEY: Numerous hyalinized glomeruli are present. Some of these have the appearance of Kimmelstiel-Wilson disease. Focal areas of infiltrates are also noted. "emu-15" 7M Date Sig ture TWR/cah D: 6/25/15, 1:50 pm. T: 6/25/15 CENTRAL VALLEY TOXICOLOGY, INC. Case Name: TOXICOLOGY NUMBER: Beltram Jr, Frank A Hospital samples. 5 ml blood (3 vials) each labeled "Beltram Jr Frank; 2015- 01484; ecimen Des t' 05/11/2015; MRN 850494; 05/09/15; 1910 hrs" Postmortem samples: 20 m1 femoral mp blood labeled ?Beltram Jr Frank; 2015 01484; 05/11/2015" Delivered by Tricor Date 12?May?15 Received by Bill Posey Date 12?May?15 Request: Complete Drug Screen Agency Case 2015-01484 Requesting Agency Report To Alameda Co. Coroner's Of?ce Alameda Co. Coroner's Of?ce Attn: Acct?s Payable Attn: Dr. Rogers 480 4th Street I 2901 Peralta Oaks Ct., 2nd Floor - Oakland CA 94607 - Oakland CA 94605 RESULTS Specimen: Hospital Blood (Lavender Top Vial) Sample Complete Drug Screen: No common acidic, neutral or basic drugs detected. No Ethyl Alcohol detected. W?s/g 4&5 B.L. PDSEY KIMBLE Directors 1580 Tollhouse Road 13. L. Posey 2% May 21, 2015 Clovis, Califorma 93611 Phone (559) 323-9940 Fax (559) 323-7502