1:9: rnvt,-run: nuIu_.rt| DYNACARE UWW fig?aififlm University orrenneesee Medic-at Center Phone: Drawer U-108 Fax. (865) 305-6366 199.4 Alcoa Highway Knoxville, TN 37920 Autopsy Final Report Patient: EVANS, Accession at: A13-153 Moo. Reo. nil: chant: JF01 Dofileender: 972 (Age: 40) Expiration Date: 03106/2013 soo. soorat Autopsy Date: 0310712013 13:13:00 Location: Reported: 528/201 3 . Authorized By: Emmett Manley, M.D. Relationship to Patient': Jefferson Co Medical Examiner Restriotione: None . Persons Attending Autopey: fipeciai Agent Kutjirn Sadiku, Federal Bureau of investigation flarrative CAUSE OF DEATH: Multiple gunshot wounds Final Anatomic Diagnosgg 1. Gunshotweuhd Undetermined range penetrating gunshot wound or neck and cheat A. Entrance iett side of neck B. Fractures of cervical and thoracic epinoos processes C. Rig ht rib fractures with lung laceration D, Bullet recovered from right upper back E. Pathway left to right, downward. backward Ii. Gunohpt B: Undetermined range penetrating gunshot wound or oheot A. Enlranoe left upper arm 1. Exit medial upper arm 2. Re-entry left bu? Lr B. Left rib fraoturea C. Laceratione of left lung D, Thoroolo spine fracture with cord laceration E. Bullet recovered from right mid back F. Pathway left to right. downward, backward W0!-Ind CI Ufldaiefitllfi-Gd Penetrating gunshot wound of chest and abdomen Entrance left chest wall Fractures of posterior ribs Bullet recovered from right lower back Pathway left to tight. downward, backward Report Electronically Signed Steven C. Cogewoil, MD EVANS. SCOTT Page 1 4 5 'ti 3L?0'?ii i'ieli03Z HOE - i cera "top ofthe he cl, 45 inches at 'in LVIJ Hvgv-'Flt in [us Reppt_t:W__ M3-153 nrv-rv OF INJURY: Gunehotwound A is an undetennlned range penetrating gunshot wound ofthe neck and chest, with its initial grazing entrance on the left side of the neck, 7 inches below the top of the head, 56 1/it inches above the heel, and 1 ".75 inches posterior to the lateral rnidline. The initial entrance wound is 'xi 3-: 3lB lnohee. with it 318 inch wide marginal abrasion in the 11 to 12 o'clcok position. There ie a inch wide skip area associated with a skin fold, than the entrance defect into the body. flfhie 9/16 inch detect without marginal abrasion -I i it A 1 of the posterior aspect of the upper lobe of the tight: lu 719 ter hernothorax are associated. 14 inches below the top of the head. 4-9 %incl:tet-1 above the heel. and 8 36:] chips to the right of the posterior niidlineet ii he entrance not to 1/3 3H6 inches, with a 34 inch wt riiarglnal abrasion in the 6 to 11 o'clool< position. No muflle imprint, charting, soot or to associated. -- or The irregular reehtw"5nlo' to 9 o'clock position. topper and It etrl Ree vorto . A 50 milliliter left hemothorax ae well as eubdural and eubarachncid hematomas extending up to the been ofthe brain are associated. eatin aV 0 Inches below the tee an A inches to the right of the posterior midline. The The range of fire is undetermined. The wound pathway is left to righi'. downward and backward, ell, to inohee below the top of the head, 46 Inches above the heel, and 1 rior to the lateral midline. The entrenoe wound to 3116 inch diameter. with a 3l16 inch wide marginal abrasion in the 10 to 2 o'clook position. No muzzle imprint, ohaning, soot or stippling is associated. EVANS. BGOTT Page 2 of 4 QlGl'l'OlJ I l.tl17lt:7 cm? rt. tuna nun .-rev 1V-u Autopsy Report 1313-153 The bullet passes through the muscle and soft tissue of the back, laoetating the interoostal space posteriorly and fracturing the posterior aspeot of left ribs 10 and 11. The adjacent kidney is undamaged. 24 in bullet is ileiild The range oriire is undetermined. The woundpathway is left to light. downward and backward. I Blunt Pores [mgries consist of a 54 118 inch abrasion on the basic of the right ring finger and a 1 35 inch abrasion of the left knee. There are no other injuries on the body. EXTERNAL EXAMINATION The body is a 64 inch. 184 pound, well developed white male appearing consistent with the recorded age of 40 years. Body habitus is normal. Rigor rnortle to fully developed. Fixed purplered liver mortis is posterior, except in areas exposed to pressure. Decomposition is absent. Clothing consists only of EOGKS. Except as noted below, the external examination is unremarkable. The scalp hair ls brown and shaved. The earlobee are creased. The eyes are blue without arcus senilis. The corneas are clear. The ecloreo and oonjunotivae are unremarkable with no psteohial hemorrhages. The oral and nasal mucosae are unremarkable- The decedent is edentulous. A mustache and goetee board are present. The neck is remarkable only for the abouenotsd gunshot wound. The chest and abdomen are normally formed and hirsute with no scars or tattoos. There is Increased anteroposterlor chest diameter with flexing of the oostal margins, The breasts are without masses. The abdomen is flat and soft without identifiable scars. The external genitalia are alraurnatlo normal adult olrournoised male. The extremities are nomrally formed and hirsute without absence of digits. The foreerrns have a few irregular scars. The hands and fingsmails are clean with nicotine stains oflhe fingertips. The lower legs have multiple score without atrophic skin. edema or stasis changes. The back is straight and normally formed. EVIDENCE OF MEDICAL THERAPY: i'-'aoeridefibrillator pads are on the chest. INTERNAL EXAMINATION The body cavities have smooth surfaces and contain the usual wetting amounts of serous fluid. The Pailifinefil has a few adheeions. The organs have the normal anatomic relationships. The medlastinum and omentum are unremarkable. The spine has no osteophylio lipping. The bone marrow is normal in appearance. The thoracic and abdominal musculature is unremarkable. HEAD: Reflefllii?l the Si-Yelp TGVGEIS '10 Pmoxlsting lesions. The meninges are thin, transparent and congested- The 1500 gram brain has minimal edema. The external configuration is symmetrical and unremarkable. The vasculature has no atherosclerosis. Serial sections through the oerobral hemispheres reveal no pre-existing lesions within the cortex, subcortisal white matter. or deep perenohyma of either hemisphere. The cerebral ventricles are not dilated. Sections through the brainstem and cerebellum reveal no lesions. Stripping the dura reveals no skull frootures. Page3ot1t'" 1, gran-on niznrz mix 1- 'rnr~ rut .r..ur.2 rttJIm WV 'mm Autopsy Report A'l3-'l53 NECK: The strap muscles have no hemonh-age. There is no airway obstruction or vascular injury. The tongue, hypopharynx, upper esophagus, larynx and trachea are unremarkable on sectioning. The upper cervical spine. laryngeal oertilages and hyoid bone are intact and atraumatlc. HEART: The 340 gram heart has a normal configuration. The coronary artery system is right dominant without atherosclerosis. The left anterior descending coronary has no intrarnyooardial course. The coronary ostia are normally situated and are not constricted by atheroscierotic plaque. Sections of the myocardium are red-brown' without scarring or recent infarction. Sections in the area of the atrioventricuiar node are unremarkable. There is no ventricular hypertrophy or dilation. The valves are normally formed and have no thickening or vegetations. The value is not redundant, The endocardium is not thickened. The thoracic aorta has no atherosclerosis. The great vessels arise normally. The pulmonary arteries and veins are unremarkable, as is the lions cave. The abdominal aorta and its major branches have no atherosclerosis or aneurysm. LUNGS: The right and left lungs weigh 380 and 390 grams, respectively. The pleural surfaces have mild to moderate anthraoosis. The vesoulaturs is normally formed with no thromboemboii. Mild vascular congestion and edema are present. The airways are patent. Sectioning the lungs reveals without consolidation, tumor or granulomas. LIVER: The 1360 gram liver has a smooth capsule and a congested dark red-brown cut surface without Fatty change. Cirrhosis. or tumors. The gallbladder contains approximately 3 milliliters of dark yellow- green bile without stones. The biliary tree has no grossly apparent obstruction. SPLEEN: The 80 gram 'spleen has or smooth capsule and the usual moderately firm and friable The splenic white pulp is inconspicuous. The thoracic and abdominal nodes are grossly unremarkable. EN The thyroid and adrenal glands are unremarkable on sectioning- The pancreas has no fibrosis or fatty replacement. GENITOURINARY TRACT: The right and left kidneys weigh and 120 grams, respectively. The smooth cortical surfaces have no scars or Sections have no cortical thinning, tumors orstohos, The uretore drain freely to the bladder, which contains approximately milliliters of urine and has an unremarkable mucosa. The prostate is moderately enlarged on sectioning. GASTROINTEESTINAL TRACT: The upper gastrointestinal tract is opened along its length and has unremari