Medical examiner: severe coronary disease likely cause in restraint-involved death; classification can be 'natural'
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Summary
An unnamed medical examiner told a forensic lecture that a case involving law-enforcement contact and an electro-muscular disruptive device was best explained by severe coronary artery disease and should be classified as a natural death, while acknowledging some colleagues favor homicide or undetermined rulings.
An unnamed medical examiner reviewing case studies said severe coronary artery disease, not alcohol or the use of an electro-muscular disruptive device, was the immediate cause of death in a detention-related incident. "He died of, severe coronary artery disease," the presenter said, adding: "The manner of death, in my opinion, should be natural."
The presenter described the decedent as having obstruction of three major coronary arteries, with some collateral circulation visible on imaging, and noted a reported blood alcohol concentration of 0.15. He said those findings and the pathophysiology supported a natural classification even though law enforcement had engaged the person before he collapsed and died. "The alcohol didn't kill him," the presenter said.
Colleagues in other jurisdictions have reached different conclusions, he acknowledged. "Some people say it should be undetermined because if law enforcement is involved, well, it's not entirely natural," he said, and some experts argue that contact with officers and the application of force should lead to a homicide ruling. The presenter urged examiners to document findings and, where available, include an opinion section in autopsy reports explaining the rationale for cause and manner classifications.
He emphasized that each case must be assessed on its own facts, and that thorough autopsy work, special dissections and comprehensive toxicology are essential to support the written opinion. The presenter closed the segment by inviting attendees' views and moving on to the next topic.
