Alameda County Coroner?s Bureau Gregory J. Ahem, Sheriff/Coroner 2901 Peralta Oaks Court, Oakland, CA 94605 (510) 382-3000 Coroner Investigator's Report NAME OF DECEASED (LAST. FIRST MIDDLE) TENTATIVE I UNIDENTIFIED CASE NUMBER 0 PAJUELO, Cesar Augusto 2019-00829 REPORTED BY REPORTED BY PHONE REPORTING AGENCY REFERENCE NUMBER Mixon, L. 9259970452 Stanford Health Care-Valley Care 2' Medical Center 0 INVESTIGATOR CALL DATE AND TIME CASE TYPE WILSON, Damon 3/10/2019 1008 Removal Case DATE AND TIME OF DEATH DATE OF BIRTH AGE GENDER RACE MARITAL STATUS VET 3/10/2019 0950 2/10/1949 70 Years Male Hispanic Divorced No HGT WGT EYE COLOR HAIR COLOR OCCUPATION EMPLOYER 70? 149 lb Brown Gray Baker Lu 0 Lu 0 LOCATION OF DEATH LOC TYPE Stanford Valley Care Hospital ADDRESS (b I . CITY, STATE, ZIP) COUNTY 5555 West Las Positas Blvd., Pleasanton, CA, 94566 Alameda Manner Homicide Death Certi?cate Signed By Cause A Multiple blunt force traumatic injuries Interval Hours 5 Cause Interval a Cause Interval Cause Interval Other None Signi?cant Conditions LEGAL NEXT OF KIN RELATIONSHIP TELEPHONE NO. NOTIFIED BY METHOD DATE AND TIME :2 WILSON, Damon In Person 3/10/2019 1651 IDENTIFICATION METHOD DATE AND TIME Fingerprint Comparison 3/10/2019 1015 LOCATION OF INCIDENT AT WORK I- Santa Rita Jail ADDRESS (STREET, CITY, STATE, ZIP) COUNTY DATE AND TIME OF INCIDENT 5325 Broder Boulevard, Dublin, CA, 94568 Alameda 3/10/2019 0531 INVESTIGATING AGENCY INV AGENCY PHONE NUMBER OFFICER Alameda County Sheriff's FUNERAL HOME BODY RELEASE TO FUNERAL HOME ON a. Santa Cruz Memorial 3/13/2019 Full Autopsy Partial Autopsy Inspeclion Record Review Inspection w/Specimen EXAM BY Yes CHEN, Angellee Coroner Investigator's Report - Page 1 of 2 Alameda County Sheriff ?5 Of?ce Coroner?s Bureau 2901 Peralta Oaks Court, 2nd Floor, Oakland, CA 94605-5319 Gregory]. Ahern, Sheriff Director of Emergency Services Coroner - Marshal A DATE: March 11, 2019 FROM: Angellee Chen, M.D., J.D. TO: Case File 2019?00829 SUBJECT: AUTOPSY PROTOCOL Autopsy performed upon the body of Cesar Augusto Pajuelo at the Coroner's Bureau, 2901 Peralta Oaks Court, Oakland, California, on March 11, 2019, at 9:15 a.m. AUTOPSY FINDINGS I. MULTIPLE BLUNT FORCE INJURIES A. HEAD AND NECK l. SUBARACHNOID HEMORRHAGE 2. CEREBRAL EDEMA 3. HEMORRHAGE WITHIN TEMPORALIS MUSCLES 4 EXTENSIVE CONTUSIONS OF THE FACE AND NECK A. LARGE PATTERNED CONTUSION ON LEFT SIDE OF THE FACE . BILATERAL CONJUNCTIVAL PETECHIAE 6. LACERATIONS OF THE LEFT EAR, THE BRIDGE OF THE NOSE, LEFT UPPER LIP, AND RIGHT SIDE OF THE JAW 7. EXTENSIVE CONFLUENT HEMORRHAGE WITHIN SOFT TISSUES OF THE ANTERIOR NECK 8. FRACTURES OF THE HYOID BONE, THYROID CARTILAGE, AND C5 VERTEBRA B. TORSO l. HEMORRHAGES WITHIN SOFT TISSUES OF THE ANTERIOR CHEST AND ABDOMINAL WALLS 2. MULTIPLE BILATERAL RIB FRACTURES A. HISTORY OF FRACTURE OF LATERAL RIGHT 6TH RIB B. HISTORY OF FRACTURES OF ANTERIOR LEFT 3RD, 4TH, AND 5TH RIBS C. HISTORY OF FRACTURES OF POSTERIOR AND 12TH RIBS 3. HISTORY OF LEFT PNEUMOTHORAX Page 2 Sheriff?Coroner Alameda County Body of Cesar Agusto Pajuelo BILATERAL HEMOTHORACES (RIGHT 75 ML, LEFT 600 ML) LACERATION OF THE RIGHT LUNG CONTUSION OF THE LEFT LUNG FRACTURE OF THE T8 VERTEBRA LACERATION OF THE LEFT KIDNEY . HEMORRHAGE WITHIN RETROPERITONEAL SOFT TISSUES C. EXTREMITIES I. MULTIPLE CONTUSIONS OF BILATERAL UPPER AND LOWER EXTREMITIES II. PULMONARY PULMONARY ADHESIONS IV. LIPOMA OF THE RIGHT LOWER ABDOMINAL WALL V. CHOLELITHIASIS VI. NODULAR PROSTATE GLAND CAUSE OF DEATH: MULTIPLE BLUNT FORCE TRAUMATIC INJURIES cc: District Attorney 21' Page 3 Sheriff?Coroner Alameda County Body of Cesar Agusto Pajuelo I Circumstances: The decedent is a 70-year-old Hispanic male who' was an inmate at the Santa Rita Jail when he was beaten to death- by a cellmate. Hewas transported to a hospital where he was resuscitated and_diagnosed withmultiple_traumatic injuries and cerebral edema. The_decedent?s condition rapidly deteriorated and he died seVeral hours after admission. .Clothing and Personal Effects: No clothing or valuables_are on the body. A white identification band bearing the deCedenth name and_photograph is around the right wrist. Evidence of Mbdical Intervention: .A tan adhesive bandage is on the bridge of the nese. A rigid cerVical spine immobilization _collar is with the bedy. A nasogastric tube is inserted into the left nostril. An endotracheal tube is inserted into the mouth. A defibrillator pad is on the central chest. Electrocardiograph electrode pads are on the right arm (3'pads), the left arm (2 pads), the left upper chest (2 pads), the central chest (1 pad), the left mid chest (4 pads), the-right side of the abdomen, the left side of the abdomen, the right leg, and the left leg. A blood pressure cuff is around the left arm. Intravenous catheters are inserted into the right and left antecubital Page-4p Sheriff-Coroner Alameda County Body of Cesar Agusto Pajuelo regions. Blue is on.the right antecubital region. A A tan adhesive bandage is on the radial side of the right wrist- A gauze pad is taped to the back of the right wrist. Another gauze pad is taped to the back of the left hand. A pulse oXimeter probe'is attached to the tip of the right-index finger, An intraosseous catheter is inserted into the proximal right shin. A Foley catheter extends from the urethral meatus and is -connected to a collection receptacle, WhiCh contains approximately 165 mL of bloody urine. A catheter stabilization clip is adhered to the left thigh. A white hospital identification band bearing the decedent?s name and MRN: _75900985 is around the left wrist. pAn evidence bag attached to the left great toe contains four blood culture bottles (2 blue, 2 red) and 7 specimen tubes. _Special Procedures: The fingernails are clipped. External Examination The body is that of a well?developed, thin, 70~inch, 149-. pound, elderly white' man who appears consistent with his reported age of 70 years. Rigor mortis is well?develOped.. Blanchable pink livor mortis is distributed along the posterior 'Page 5 Sheriff?Coroner Alameda County Body of Cesar Agusto Pajuelo 42 aspect of the body. No decompositional changes are present. A -:43 brown paperbag is over each hand. A tan tag and a yellow tag 44 each bearing the decedent?s name and caSe number 2019 00829 are 45 attached to the left great toe. The body has extensive acute 46 injuries that are described in the EVIDENCE OF INJURY seCtiOn. 47 The sCalp has normally distributed straight gray hair that 48 is approximately 10.5 cm ill average-leng?i at the topof the 49 head. The face has a short gray~and-black mustache and a short 50 gray goatee, The irides are brown and the pupils are 0.3 Cm in 51 diameter. The corneas are clear and have mild arcus senilis. The 52 sclerae are not icteric. The ears have no drainage. Soft brown 53 -Vomitus is around the nose and mouth. The nasal sethm is intact 54 -and deviated to the left. Multiple teeth are misSing from both 55 sides of the upper and_loWer jaws. A 56 The left side of the' chest is Idepressed. The 57 abdomen is n?ldly protuberant and has no conspicuous-scars. A 58 large soft mObile mass bulges from the right lower quadrant of 59. the abdomen. The penis' is circumcised. Both testicles are 60 descended within the scrotum. The back has-no conspicuous Scars 7.61 or acute injuries. The buttocks and the anus are unremarkable. 62 The upper extremities have no angular deformities. A small 63 amount of soft brown material that looks like feces is smeared Page 6? Sheriff?Coroner_I Alameda County .Body of Cesar Agusto Pajuelo on the right forearm. The lower-extremities are symmetrically developed and have. no ?angular deformities. The ankles have prominent blue superficial veins.7 The toenails .are long and thickened. Evidence of Injury Blunt Force Injuries Head and Neck:7 Hemorrhage.is within both temporalis muscles. The cerebral gyri are flattened and the sulci are narrowed. Blood is within the subarachnoid space. A small amount of.blood is within the ventricles. The upper half of the face is diffusely swollen by pink? Vpurple contusions. A pink?purple contusion is on the glabella. Broad pink?purple contusions are on the right and left lateral surfaces Of' the forehead. A dark ?pink contusion is on the lateral half of the left eyebrow. The periorbital regions are gray?purple and edematous. Multiple petechial hemorrhages are on Athe lower palpebral conjunctiva of each eye. A large patterned contusion is on the left side of the face. It extends across the left cheek to the area lateral to the left and across the 'left ear. The pattern consists of faint oblique parallel lines Page 7 Sheriff?Coroner Alameda County Body of Cesar_Agusto Pajuelo 85 bordering a bandflike area of pallor within a broad pinkspurple 86 contusion. 87 I The? lower? part of 'the left_ ear ihas a. 2.0 (Hm laceration 88 along the antihelical fold. The bridge <3f the nose appears. 89 crooked. A 2.0 cm horizontal laceration is on the bridge of the. 90 nose. The dorsum of the nose is contused.'A 3.0 2.0 cm red '91 .abrasion is on the right side of the face below the right ear. A '92 1.0 cm linear laceration is on the right side of the jaw; The 93 mucosa of the left side of the upper lip is swollen and has a 94 laceration surrounded by a purple-contusion. 95 The anterior surface of the "neck is swollen and is 96 diffuselypink and contused. Confluent hemorrhage is within the '97 soft tissues of the neCk, including the strap muscles. The hyoid 98 bone i1; fractured. The thyroid cartilage iS'fractured between I 99 the right and left laminae. - 100. The C5 vertebra is fractured. Hemorrhage is within the soft 101 tissues of the larynx surrounding the thyroid cartilage and 102 hyoid bone. 103 Torsoi 104 A 5.0 5.0 cm area of red abraSions is on the right upper 105 chest. Pink contusions are on the left upper chest overlying the 106 left clavicle. ll 4.0 (mm pink contusion is (x1 the left upper Page 8 Sheriff?Coroner Alameda County Body of-Cesar Agusto Pajuelo 107 chest. A 1;2 cm blue contusion is'medial to the right nipple. AA 108 4.0 inn pink contusion is (ml the central chest. Multiple blue. ?109 contusions are CH1 the left lateral surfaCe of the chest just 110 - below. the_ armpit. .A 4.3 x? 1.0 cm. blue 'contusion is on the- 111? lateral left side of the abdomen. 112 Hemorrhage are within the soft tissues of the chest wall 113 oVerlying_thelower ribs bilaterally. The lateral aspects of-the 7114?right 2nd thrOugh 9th ribs are fractured. The anterior aSpects ?115 of the left2nd through 7th ribs are fractured. Some of-theSe' 116 Ianterior fractures could be related to attempted cardiopulmonary .117 resuscitation. The posterior aspects of the left 4th through 8th 118 ribs are fractured. -Hemorrhage is within the' soft tissues 119 surrounding the fractures. 120 . A. contusion is (Hi the anterior surface the .heart in '121 right atrioventricular region. This injury could be related to 122 attempted cardiopulmonary resuscitation. 123 Approrimately 75 Im; of blood is within the right pleural 124 cavity, and approximately of blood is within the left .125. pleural cavity. A.8.8 cm.laceration is on the upper lobe of the 126 right lung. Hemorrhage is within the lower lobe of the left 1127 lung.? 128 The T8 vertebra is fractured. Page 9 Sheriff-Coroner Alameda County Body of Cesar Agusto Pajuelo 129 - Hemorrhage is within the soft tissues 'of the upper 130 abdominal wall. Zk'small amount of_ free'bdood':h3 within Ithe 131 abdominal cavity. The upper pole of the left kidney has a 3.0 cm 132- laceration. Hemorrhage _is Within? the' retroperitoneal psoft 133 tissues of the lower abdomen. 1 I 134 Extremities: 135 I 1A 3.0 cm purple~bluecontusion is on the medial surfaceof 136 the mid right arm. Multiple light blue contusions are on the 137 right forearm. 1.5 cm. blue contusion is on. the mid? right 138? forearm. A 3.0 cm blue contusion is on the back of the mid right . 139 forearm? Multiple small pink contusions and a 1.0 cm orange 140 abrasion are on the back of the.right hand. 141 A 3.0 cm blue contusion is on the back of the mid left 142 forearm..A 3.0 0.4 cm blue contusion and a 0.8 cm faint blue 143 contusion are on the back of the left wrist. 144' A 4.0 1.0 cm blue?purple Contusion is on the right hip. A 145 2.5 cm pink contusion is-on the right knee. A 2.3 1.3 cm dark 146 red abrasion is lateral tx> the right patella. 11 3.0 cm 147 contUsion is on the lateral_surface of the proximal right leg. 148 A A .1.2 broad dark red abrasion surrounded by' a pink 149 contusion is lateral to the left patella. A 2.0 0.6 cm purple 150 contusion is on the dorsum of the left foot. Page lb Sheriff?Coroner Alameda County Body of Cesar Agusto Pajuelo 151 A - Internal Examination 152 Chest and ?Abdominal walls and -Body Cavities: ?The anterior 153 abdominal wall has an average of 2.8 cm of subcutaneous adipose 154 tissue. The clavicles. the sternum, and hthe pelvis have no 155 dpalpable fractures. The pericardial cavity has no abnormal fluid 156' collection. Moderate fibrous adhesions are within the p?eural_ 157 -cavities Hat the rapices?:of the lungs. No Iconspicuous fibrous- -158 adhesions are within the pericardial or peritoneal cavities. The 159 pericardiumand the diaphragm are intact. . 160 -.An approximately_ 15.0 cm. lipoma is within the right lower 161 abdominal wall. 162 I 163' Cardiovascular System: The heart weighs 330 grams and has a 164 moderate amount of epicardial adipose tissue.-The left anterior 165 descending coronary artery has a calcified atheromatous plaque 166 within the proximal portion. The rest of the corOnary arteries 167 appear widely patent. The epicardium is smooth and glistening. 168 The: myocardiunl iS- red?brown and firnn It. has no -conspicuous 169 focus of pallor or softening and no visible fibrous scars. The 170 endocardium. is thin and transparent. There .is IK) ventricular 171 dilatation or hypertrophy. The foramen ovale is not patent and Page 11 Sheriff?Coroner Alameda County. Body of Cesar Agusto Pajuelo 172 the heart has no 'mural thrombus. The atrioventricular_ and 173 semilunar Valves are morphologically normal and have no 174? calcifications, vegetations, thickening, or stenosis. The' . 175 chordae tendineae are normal in length and thickneSS. The aorta 176 is pintact. It ohas mild Calcified atherosclerosis land no 177 Significant dilatation. I 178 179 VRespiratory System: The right lung weighs 800 grams and the left .180 plung neighs 570 grams. Both lungs are moderately expanded. The; 181 lapex of each lung is adhered to the chest wall. The right lung 182 also has nwderate fibrous adhesions in.between the lobes. The 183 'pleural surfaces are dull and have patchy opaque fibrosis. The .184 lungs have abundant anthracotic pigment. Both lungs have bullous 1185 changes at the apices and deerate 186 changes. elsewhere. The othe right lung is 187 moderately fibrotic. The lumina of the tracheobronchial tree are apatent.. The 188 patent. The rmain pulmonary I arteries? are .189 tracheobronchial and bronchopulmonary' nodes are 190 anthracotic. 191 System: The esophagus- has ?an unremarkable 192? Gastrointestinal 193 white?tan mucosa and an empty lumen. The stomach COntains Page 12 Sheriff?Coroner Alameda County' Body of Cesar.Agusto Pajuelo 194 approximately 500 mL of brown liquified food. The gastric mucosa 195 is tan and has normal rudal folds. The small bowel and the_colon, 196 'are intact and haVe no evidence of obstruction. The midwsection ?197 -of the vermiform appendix is narrowed and has a_pinpoint lumen. 0,198 The appendix as no evidence of obstruction or inflammation.f - 199 - 200 HepatObiliary-System? The liver weighs 1050 gramsand is intact. 201 The capsule is smooth.and glistening. The hepatic is_ n202 uniformly? brown and nermal in Voonsistency..'The liver. has? no '203 :masses. The gallbladder ?has a thin wall and- an orangeebr0wn 204 velvety mucosa. It contains' a small amount of? orange?brown 205 ViSCous bile and faceted Stones. The largest '206 is 2.0 cm in greatest.dimension. - T207 208 ReticuloendOthelial System: The spleen weighs 70 grams. It has ?209 an. intact. smooth, thin ?capsule and ?unremarkable soft, Idark . 210 ypurple - 211 212 Genitourinary System: The right kidney weighs 120 grams and the 213- left kidney'Weighs 140 grams. The renal surfaces are smooth. The 214 right' kidney is intact. The kidneys' have red?brown cortices, 215 well-defined corticomedullary junctions, and no masSes or Page 13 Sheriff?Coroner Alameda County Body of Cesar Agusto Pajuelo 216 The renal calices are unremarkable. The renal arteries. are 217 patent. The ureters are normal in caliber. The urinary bladder 218 has a tan trabeculated mucosa and is empty. is symmetric and not prominently 219 3 .The prostate gland, 220 enlarged? 'It has tan 'firmf nodular ?The 221 testicles have uniform soft tan and no masses;_' I 222 I 223- Endocrine Systemi The thyroid gland is relatively symmetric and 224 not prominently enlarged. It has brown lobular and no -225 nodules or The pancreas has unremarkable ttan lobular 226 The adrenal glands have thin.golden?yellow cortices, 227' light gray medullae, and no masses or 228 hemorrhages. 229 230 _Neck: The lumen of the larynx, is .patent. 'The inm?: haS' the 231 previously?described extensive acute injuries. - 232 233 Head and Spinal Column: The scalp is intact. The calvaria and? 234 the? base of the skull have' no ,fractures. The dura :mater is 235 unremarkable. The leptomeninges are thin and transparent. There 236 is no epidural or subdural hematoma. Page l4 y: Sheriff-Coroner Alameda County Body of Cesar Agusto Pajuelo 237 The brain weighs 1440 grams. The cerebral hemispheres are 238 symmetric but have the previously?described changes of cerebral 239 edema. The brain has no conspicuous contusions or lacerations. '240 The brainstem and the cerebellum are unremarkable. The arteries_ 241 'at ?the base of the brain are. widely ?patent and have no 242 Thepituitary gland is-not enlarged. 243 I I 244 :Toxicology: See toXicology report. f245 246 Conclusion 247 After considering the known circumstances surrounding the death; 248_ the available medical history. and the findings on postmortem 249? examination of the body, it is'my opinion that Cesar Agusto_ 250 Pajuelo, a 70?year?old Hispanic male, died from Hmltiple blunt 251 force injuries that he sustained from a physiCal assault at the 252b Santa Rita Jail on March 10, 2019. 253 - . 14/4/51 j254 . 'jj- . 255 Angel ee Chen ALERE FORENSICS AT REDWOOD TOXICOLOGY LABORATORY . 3650 Westvvind Blvd. Santa Rosa, CA 95403 Alere Phone 707-5704455 FAX 707?703-1319 Agency 2019-00829 FORENSIC LABORATORY REPORT AF 2019-0010113 To: Pathologist Angellee Chen Alameda Co Sheriff's Ofc - Coroner's Bureau Sample Collection Date: March 10, 2019 Decedent: Cesar Augusto Pajuelo The following evidence was submitted to the Laboratory by a representative of the Alameda Co Sheriff's Ofc - Coroner's Bureau on 3/15/2019 via Courier: Submission 01: One heat sealed plastic bag containing seven tubes of hospital specimens. None of the specimens were marked with a collection time. Item 01-A: One yellow top tube with approximately 7 mL of blood. Item 01-B: One clear snap cap tube with approximately 3 mL of plasma. Item 01-C: One lavender top tube with approximately 1 mL of blood. Item 01-D: One green top tube with approximately 1 mLof blood. Item 01-E: One purple top tube with approximately 2 mL of blood. Item 01-F: One light blue top serum separator tube with approximately 1 mL of serum. Item 01-G: One gold top serum separator tube with approximately 1 mL of serum. Service Reguest: FP2228 - Expanded (Con?rm) - Blood Page I of 3 201 9-001 010-0001 Alere .. Forenaios Drug Screen Results -, ELISA Drug Screen Classi?cation Result Limit of Detection Amphetamine Not Detected 20.0 ng/mL Barbiturates Not Detected 1.0 mcg/mL Benzodiazepines Not Detected 25.0 ng/mL Buprenorphine - Not Detected 1.0 ng/mL Carisoprodol Not Detected 500.0 ng/mL Cocaine Metabolite Not Detected 50.0 ng/mL Fentanyl - . Not Detected 1.0 ng/mL Marijuana Metabolite Not Detected 10.0 ng/mL Methadone Not Detected 25.0 ng/mL Methamphetamine Not Detected 20.0 ng/mL Opiates Not Detected 10.0 ng/mL Oxycodone Not Detected 5.0 ng/mL PCP Not Detected 5.0 ng/mL Tramadol Not Detected 50.0 ng/mL Zolpidem Not Detected 5.0 ng/mL Results Analyte Name - Concentration Method Sample Type Olanzapine Presumptive lD LC-MS-MS Hospital Blood Volatiles IPA, Acetone) Not Detected . GC-Headspace Hospital Blood Page 2 of 3 201 9-001010-0001 Alere tierensics Respectfully, dl Laureen J. Marinetti, Laboratory Director Date of Report: April 29, 2019 Alere Forensics at Redwood Toxicology is accredited by The American Board of Forensic Toxicology (ABF T) and is recognized by the State of California as a Title 1 7 Forensic Alcohol Laboratory. All samples, including the sample packaging, will be retained at the laboratory for one year after the date of report. After one year, the samples and packaging will be destroyed unless the client requests that the samples be returned or an alternate retention policy has been set up with the laboratory. The laboratory cannot ship controlled substances. Comments Analytes reported as Presumptive ID are uncon?rmed results. If con?rmation is required please contact the laboratory. - ethanol, IPA - isopropanol, - methanol Page 3 of 3