A Breck Death (Jill Quint, MD, Forensic Pathologist Series Book 3)

by Peche, Alec

  Just as Jill predicted, ten minutes later she had her checklist ready, her specimen containers laid out and ready to be filled, and she was wearing one of their protective gowns. She wore her own face shield and goggles.

  “If you’ll help me flip him over on his stomach, I’ll begin by examining his skin for any findings.”

  She put her goggles on and using a tape recorder clipped to the rim of her gown she began dictating what she saw on examination.

  “Record on. No visible tattoos on the posterior side of the body, olive skin hue, lean man. No bumps to touch, no bruises on the back other than the pooling that occurred at the time of death. A minor cut on one finger, light bruise six centimeters from the spine on the right side, at the bottom anterior angle of the scapula. Record off. Dr. Jones, what are your thoughts for this bruise and what looks to be a needle hole?”

  “I didn’t have an explanation. I noted it in the report and biopsied the surrounding tissue in case there were any drug traces if indeed that is a needle stick.”

  “Interesting or maybe it is nothing at all. I’ll do the same thing as you by taking tissue and blood samples from this space. I’ll also draw blood from his extremities to look at the chemistry of various locations of his circulatory system. Okay, let’s turn him over so I can complete the examination. How long was he estimated to have laid on the ski trail before ski patrol discovered him?”

  “Two to three hours. It is hard to get an exact reading given the air temperature and high altitude. His body was very cold when the ski patrol found it. They have a ticket system at the resort, so the last record of Joseph on a chairlift is at two in the afternoon. The lift takes seven minutes to reach the top, and then he had to ski down to where they found him in the trees. So time of death might have been as early as eight minutes past two. He was discovered by the ski patrol around five-thirty.”

  “The ski pass time is helpful. Were there also cameras on top of the lift poles or at the top?”

  “I didn’t ask, but it would have affected the cause of death by a few minutes swing at best.”

  Jill turned her recorder back on and continued with her visual examination of the skin noting nothing of interest. She then re-opened the Y slice that Dr. Jones had used several hours ago to examine Joseph’s internal organs, weighing them and looking for abnormities. His heart muscle looked healthy, ruling out most congenital defects. She was left with perhaps two avenues to pursue as to why his heart stopped - asphyxia leading to his heart not getting enough oxygen to function or an electrical malfunction.

  Asphyxia might result from several sources - poisoning of the air around him with smoke or carbon monoxide. She would rule that out as Joseph was likely breathing some of the cleanest air on earth and yes the air was thin at eleven thousand feet, but unless he had low hemoglobin or a lung ailment like emphysema, he would have been fine. Since he lived in the mile high city, he already had a raised level of hemoglobin that would have helped his body deal with the higher altitude. It could also result from someone putting something over his nose and mouth to prevent air from entering his body. Usually if that was the case there would be broken blood vessels around the face called petechiae. If someone strangled him there should be ligature marks around the neck. Another source would be paralysis of the diaphragm, where he would be unable to expand his lungs to take in air. She would have to do further examination to rule out that cause.

  Thinking about an electrical problem with his heart - either a complete failure such as might occur after being struck by lightning or some other electrical current. Again he could have a rare genetic defect, but really such a problem should have killed him by the time he was twenty. Her last option to evaluate would be a problem with his ions - sodium, potassium, or magnesium. Potassium chloride was one of three drugs generally used to execute prisoners since it stopped the heart from functioning. She would check the blood levels of his electrolytes, but she was sure that Dr. Jones had already tested for that as it should be routine in a case like this. Still she liked to check readings in different areas of the body to look at how concentrations differed around the body as the body naturally broke down certain substances.

  She explained this last point to Dr. Jones and her colleagues, “when I worked for the State, I would routinely send off blood for chemistry analysis. In the eighty or so autopsies I have done since I left the lab as a private consultant, I have learned to do what I would call extremity sampling. Every once in a while I find something strange that leads me somewhere.”

  “Can you give us an example of what you have found?” asked one of Dr. Jones’ colleagues.

  “I performed an autopsy on a young man who by all indications died of septic shock caused by necrotizing fasciitis. When I started that autopsy I knew and had great respect for that medical examiner. I thought I would be confirming his diagnosis. Then I sampled two different sites of infection - one on the lower leg and the other on the upper arm. The results came back as an exact genetic match with an exact growth pattern of the infection. How could that happen except by intentional exposure to the bacteria at both sites - the growth pattern wasn’t Mother Nature at work, but rather the hand of a murderer.

  “Early in my career, I had a gentleman with several chronic diseases whose life was cut short by five to ten years as one of his grandchildren provided him with a little extra heart medication in his daily protein shake. The extremity testing painted a picture of how saturated the tissues were in his fingers compared to blood levels elsewhere in the body. However, I will admit that most of the time this ends up yielding no new information.”

  Jill continued taking tissue and skin samples as she completed the autopsy. She then asked to see the deceased’s belongings. She didn’t think again that she would find anything but it was worth looking at. Some body fluids would have leaked out after death into the personal effects, but it was just part of a thorough exam.

  Al brought a bag of stuff into the autopsy room for Jill to look at. She asked Dr. Jones, “Did you review his personal effects, or were they simply logged in?”

  “One of the aides logged in the personal effects, and that will become a part of the autopsy report. They will soon be offered back to the family for collection.”

  Jill spread out the belongings on an empty exam table. She noted his wallet had his credit cards, money, and driver’s license. There was also men’s underwear, ski pants, and boots, a jacket, turtleneck, hat, and goggles. There was a tiny backpack that probably carried his lunch and had a water reservoir in it. She took a sample of the fluid in the water reservoir and swabbed its mouthpiece. There was a tear near the knee of one the ski pants, and his boots looked well used. Jill searched the pockets of the jacket and then held it up to the light. Since she had a suspicious mind she searched the jacket for pinholes, tears, body fluids. Holding the jacket up to the light she thought she spotted a tiny hole that might be the same place as the needle stick on his scapula. However, it was a long day and this might just be wishful thinking on her part.

  She pointed out the tiny needle hole in the fabric and said “This may be nothing more than poor eyesight on my part or a fabric imperfection, but I am going to sample this spot of fabric to see if there is anything there.”

  Dr. Jones commented, “I think I’ll also sample the fabric. So far, except for the extremity sampling that you did, I think we have tested the exact same areas. The water reservoir would have to be tested by the crime scene investigators if the case was referred to them.”

  “I don’t have a perfect approach to autopsies; instead my findings seem to arise from chasing loose threads like this jacket hole. I agree that the preliminary indications are that he died from a heart attack. He was a very fit and healthy man so I have been unable thus far to find a natural reason for the resulting heart attack. Do you have any theories? “

  “My theory was an unexpected arrhythmia. Nothing else makes sense as I agree that most genetic abnormalities would have killed him two decad
es ago. I haven’t received his medical records yet or the results of most of his tests, so either one or both of those might change my opinion.”

  “I have to agree with you, Dr. Jones. I am done here and as soon as I pack up my specimens, I’ll get out of your way. I really appreciate your assistance and cooperation in this matter. I know it is not easy having a stranger verifyyour work.”

  “If that ski jacket sample comes back with anything that gives us more information on Mr. Morton, then I have learned a valuable lesson today about the deceased’s belongings.”

  “It may also be nothing more than my vivid imagination,” cautioned Jill while she looked at her watch. “It’s late, so I am going to head back towards the airport and find a hotel for the night before flying back to California in the morning. As soon as I have test results, I’ll share them with you and I would appreciate if you would do likewise.”

  “I will,” replied Dr. Jones and she escorted Jill out to the parking lot. She bet her ears would be burning all the way to the hotel as Dr. Jones and her colleagues discussed Jill’s intrusion into their case. She had no complaint as they had all been very accommodating.

  Using an app she had on her phone she located a hotel near the airport at a great last minute rate. She would sleep there and catch an early flight that would put her in her lab around nine the next morning. She sent David a text indicating she had completed the autopsy, and had settled in at the hotel. She had informed him earlier of how she was going to process her tests in California and that she would arrive in Breck either the next evening or the following day.

  Chapter Three

  Jill awoke for the early flight, arrived at the airport to check her investigation kit filled with specimens. She wanted a special discussion with security on her specimens. She was fine with the case being scanned and x-rayed. However, if they opened any tubes or tissue specimens, they could destroy the samples. She also wanted to make sure that the dry ice continued to keep the specimens cold. In a little more than two hours later she was driving towards her property thinking about the order of processing the specimens. Those that took the longest, she wanted to process first. Really though, she was dying of curiosity about the jacket. Was there something there or was it a figment of her imagination?

  She had called Nathan while she was driving from the airport and they were going to have lunch together. She pulled into her driveway and went straight away to her lab. An hour later she had all her specimens being processed by her analyzers. She would soon hear the various analyzer printers typing away with results.

  She had swabbed the jacket and was most interested in seeing if the spot on the jacket was a stain, a figment of her imagination, or an actual source of the heart attack. She pulled the jacket swab out of its evidence bag and went to work on it. An analysis was rarely that easy, but maybe she would catch a break. She had also cultured Mr. Morton, but she didn’t really believe he had died of any kind of infection; there were simply no signs of an infectious agent. The cultures would take the longest and the rapid test method would be complete just before she headed back to the airport. If something came up, she would set in motion some testing that would take another seventy-two hours, which would require her to return to California potentially sooner than she planned.

  She went back to her house and packed for a longer stay in mountains, collecting winter clothing as well as her ski equipment. She loved to ski, but she didn’t know if she would have time to mix work and leisure time. Next she looked at her options for lunch and decided it was best if Nathan brought over a pizza as she didn’t have much in the house and didn’t want a mess if she was leaving again on business.

  Nathan and Trixie arrived for a quick lunch. Nathan knew Jill was anxious to get back to her lab. She was usually eaten up with curiosity about something in each case. He had been annoyed when they began dating about her single-mindedness when it came to an autopsy result. He personally had thought he was a more exciting guy than the dead people she was so enthused about. He had quickly come to realize that it was a part of her complete package. She deeply cared about giving loved one answers, blocking the escape of murderers, and the quality of her work. Once she was over a case, then that single-mindedness was turned on him and he could bask in her attention.

  She went back to her lab to begin looking at the first results. The chemistry analyzers had completed the round of tests related to the jacket. Her suspicions were confirmed that the jacket had something on it - it was a paralytic agent ‘d-Tubocurarine’ better known as curare. Yikes, that was a lousy way to die if this was the agent used on Joseph. He would be awake and conscious and panicking about suffocating until the lack of oxygen sent him into unconsciousness. It was a very concentrated amount in a very small circle of the jacket. Next she previewed the tests around the hole in Mr. Morton’s back to see if she had the same finding. Again the analysis showed his skin had evidence of curare. That wouldn’t necessarily be a problem if the curare was limited to the skin surface in that one area. She would look at its concentration elsewhere in the body. If it was high throughout his body, then she likely had a homicide on her hands.

  Curare was used for anesthesia in the early twentieth century until other more predictable drugs were created. If it was swallowed it caused no harm, but when it reached the vascular system it caused paralysis with no pain reliever qualities which had left some patients conscious during surgery and in agonizing pain. She looked at a few more test results and thought she had her confirmation that the paralytic agent killed Joseph Morton. Furthermore, the entry route was likely related to the hole in the back of the jacket which meant that someone had to have injected him on the ski slope. The camera at the top of the lift was increasingly important at determining the time of death. It was time to call Dr. Jones to see what she had found on her end. Jill picked up her phone and dialed Dr. Jones’ number.

  “Hello Dr. Jones, this is Jill Quint.”

  “Hello Jill, I was about to call you. I have received some of the test results back and was going to call to confirm the same finding from you.”

  “I presume you’re talking about the d-Tubocurarine concentration in Mr. Morton’s body, leading to diaphragmatic paralysis and eventually asphyxia.”

  “Yes I found concentrated d-Tubocurarine in the jacket swab, in his back, and in his kidneys, blood, liver, and spleen. Those levels of the drug would be enough to eventually disrupt and stop the beating of his heart when he didn’t receive enough oxygen. At this point his death will be listed as suspicious, and with a little more time that ruling will likely become homicide.”

  “Did your crime scene staff fingerprint his jacket?”

  “I don’t know, if they didn’t dust for prints, I’ll have them do so. I have notified local law enforcement as to this preliminary ruling. This is the first homicide in a long time in that city, and they will likely involve the sheriff and the State Bureau of investigation. Requesting help is standard operating procedure in the smaller cities of Colorado.”

  “I have more tests that I am still running the analysis on, but I don’t expect any surprises there. I’ll provide a written report to David Gomez, Mr. Morton’s partner. Would you like a copy?”

  “Yes, you have been very helpful. I missed the jacket. Regardless, I think the chemistry results would have shown the paralytic drug. The jacket and small pinprick in his back make it pretty definitively murder.”

  “Would you let me know if there are any prints on the jacket?”

  “Yes I will. It has been interesting getting to know you Dr. Quint. Best wishes for the future.”

  “And to you as well. Depending on Mr. Gomez’s preferences, I may stay involved in this case. I’ll probably know later today and I’ll keep you informed.”

  They said their goodbyes and ended the call.

  Jill owed David Gomez a call next, so she dialed his number.

  “Hello.”

  “Is this David Gomez?”

  “Yes”


  “Hi. It’s Jill Quint, calling with some preliminary autopsy results in Joseph’s death.”

  “Okay, what have you found?”

  “The results are not complete at this time, but my initial findings match the medical examiner’s findings. I am afraid it’s very bad news. It appears that Joseph was likely the victim of intentional homicide. My call to you cannot be considered official notification, I just wanted to give you the finding as soon as possible. The medical examiner will be ruling his death as suspicious later today which will put in motion the state police and the county sheriff beginning an investigation into his death.”

  There was a long pause on the other end of the phone. Jill was used to the shock of the next-of-kin upon hearing that what they had thought was a natural death, was actually murder. She waited out the silence until David began asking questions. She had found that it was best to feed someone the answers to their questions as they began to process the news, preferring to answer questions in their order rather than her own order of delivering the facts.

  “What does suspicious mean?”

  “It means that the medical examiner has enough grounds in her autopsy findings that she wants law enforcement brought in to investigate Joseph’s death beyond what she has collected as evidence on the autopsy table. She will probably rule it as a homicide, but she must collect all testing so that the autopsy is complete. Some tests will take another week or two for her to get the results on.”

  “What information has she collected? Will she be calling me?”

  “Let me answer your question about process first. The medical examiner conducts the autopsy and provides test results to law enforcement. An officer will contact you and discuss the results with you and question you extensively about Joseph. I would think they would be contacting you today.

  “Back to the findings which I confirmed independently in my lab, Joseph appears to have been shot with a dart containing a paralyzing drug which interferes with the movement of the diaphragm which is the muscle that moves air through the lungs. Eventually when the lungs no longer introduce oxygen into the blood, the heart muscle as well as the brain quit working.”