The Kevorkian Verdict

AUTOPSY REPORT FOR SHERRY MILLER


OFFICE OF THE MEDICAL EXAMINER
COUNTY OF OAKLAND, MICHIGAN

AUTOPSY PROTOCOL


NAME OF DECEASED: SHERRY A. MILLER

CASE NUMBER: 91-2752

AUTOPSY NUMBER: 621

AGE: 43

RACE: White

SEX: Female

LOCATION OF DEATH: Oakland Township

DATE OF DEATH: October 23, 1991

PRONOUNCED DEAD: October 23, 1991

TIME OF DEATH: Unknown P.M.

DATE OF AUTOPSY: October 24, 1991

TIME OF AUTOPSY: 10:10 A.M.

CAUSE OF DEATH: POISONING BY CARBON MONOXIDE

MANNER OF DEATH: HOMICIDE

EXTERNAL EXAMINATION:
The body clad in a mauve color sweater, yellow T-shirt, patterned pants, knee-hi nylon stockings, and a diaper is that of a 4'11", 89 pounds, under-nourished white female reported to be 43 years of age. Rigor mortis is well-developed in the cold body and livor mortis is dorsally distributed, cherry-pink in coloration and unfixed. The scalp hair is brown and partly gray, measuring up to 7" in length. The irides are brown, the corneae are clear, and the sclerae and conjunctivae are unremarkable. The external auditory canals are free of foreign material and abnormal secretion. The external nares are without note. The nasal skeleton is palpably intact. The lips are without evident injury. There is natural dentition n present in the upper and lower jaw. The neck and anterior torso is without note except for striae present in the areas of both left and right breasts and the lower front abdominal wall. A scar is present in the area of the left iliac crest. The external genitalia are without note. The posterior torso and the anal orifice are unremarkable. There is atrophy of the muscle bulk of all four extremities. Finger clubbing and peripheral edema are absent. The body hair in the area of the left armpit is shaved off while the body hair from the right armpit is not shaved.

EVIDENCE OF INJURY:
There is deep pink-cherry coloration of the skin of the decedent in the areas where livor mortis is present. There is a fresh needle puncture wound in the right cubital fossa surrounded by an area of subcutaneous bleed. Two additional needle puncture wounds are present in the right cubital fossa with no evidence of accompanying subcutaneous bleed. There is a fresh needle puncture wound on the back of the right hand surrounded by an area of recent.


INTERNAL EXAMINATION:

HEAD:
The scalp is reflected after making the usual intermastoid incision and is free of subcutaneous and subgaleal hemorrhage. The calvarium is intact. The external meninges are unremarkable, without epidural or subdural hemorrhage. The 948 grams brain is covered by glistening transparent leptomeninges and the cerebrospinal fluid is clear. The vessels at the base of the brain pursue their usual anatomic courses and are patent. The overall appearance of the brain is one of moderate atrophy without evidence of structural change of the cortical ribbon. The brain is fixed in formaldehyde together with the spinal cord prior to the examination. The bones at the base of the skull are without evidence of fracture. The spinal cord is removed and placed in formaldehyde fixative prior to examination. Coronal sectioning of the brain after fixation reveals a moderate number of multiple sclerosis plaques distributed in the centrum semiovale adjacent to the wall of the lateral ventricles. There is moderate dilatation of the ventricular system due to loss of the white matter and retraction of the gliotic tissues in those area. Parasagittal sectioning of the cerebellum reveals focal small multiple sclerosis plaques generally distributed in the subcortical locations. Transverse sections of the brain stem and the spinal cord reveal evidence of multiple small plaques involving the white matter of the structures of the neuraxis at various levels. There is evidence of gross lower thoracic spinal cord atrophy.

NECK:
There is no evidence of injury to the soft tissues or bony structures of the neck. The laryngeal cartilages, hyoid bone and cervical spine are intact. The lumen of the larynx an trachea is free of foreign material and abnormal secretion. The mucosa shows pink coloration, but is otherwise unremarkable.

BODY CAVITIES:
The body cavities are entered in the usual manner. All cavities are fee of excess or abnormal fluid accumulation and adhesions. The organs are in their usual anatomic locations. The lungs are expanded. There is no internal evidence of blunt force of penetrating injury to the chest cavity or abdominal cavity.

CARDIOVASCULAR SYSTEM:
The 145 grams heart has a glistening epicardial surface. The tan-brown myocardium is without evidence of diffuse or focal lesion. The endocardium and heart valves are without note. The coronary ostia are patent and the coronary arteries show no evidence of atherosclerotic change. The aorta and its major branches are without evidence of significant compromise. The vena cavae and pulmonary arteries are free of antemortem thrombus.

RESPIRATORY TRACT:
The right lung weighs 239 grams and the left lung weighs 207 grams. Their pleural surfaces are smooth and glistening. The parenchyma is a cherry-red in color but otherwise without evident diffuse or focal lesion. The bronchi and their major branches are unremarkable.

LIVER, BILIARY TRACT, SPLEEN AND PANCREAS: The 835 grams liver has a glistening capsular surface with sharp anterior margins. On sectioning, the tan-brown parenchyma is of the usual consistency and free of focal lesion. The gallbladder contains approximately 35 mls of bile and the bile passages are patent. The 130 grams spleen has a glistening intact capsule and an unremarkable parenchyma. The pancreas is without external sectioned abnormality.

GENITO-URINARY SYSTEM:
The left kidney weighs 64 grams and the right kidney weighs 72 grams. Their capsules strip with ease to reveal a smooth cortical surface, except for a small pitting scar on the surface of the right kidney. On sectioning there is a good cortico-medullary definition and the calyces, pelves and ureters are unremarkable. The urinary bladder contains less than 50 mls of urine. The mucosa is without gross lesion. The uterus, tubes and ovaries are present and without abnormality.

GASTRO-INTESTINAL TRACT:
The tongue is without evident recent injury. The pharynx and esophagus are unremarkable. The stomach contains approximately 150 mls of green dark fluid with no identifiable solid food particles. The mucosa is without note. The duodenum and remainder of the small and large bowels are without evident abnormality. The appendix is present.

ENDOCRINE SYSTEM:
The thyroid, pituitary and adrenal glands are unremarkable.

MUSCULOSKELETAL SYSTEM:
The skeletal muscle is showing a decreased muscle bulk with is particularly prominent in the skeletal muscles of the lower extremities. The long bones of the extremities, the bony thorax and vertebral column are without evidence of fracture.


MICROSCOPIC EXAMINATION:

UTERUS: No pathological diagnosis.

OVARIES: No pathological diagnosis.

LIVER: No pathological diagnosis.

KIDNEY: No pathological diagnosis.

HEART: No pathological diagnosis.

PANCREAS: No pathological diagnosis.

ADRENAL GLAND: No pathological diagnosis.

THYROID: No pathological diagnosis.

LUNGS: Congestion and mild edema.


CENTRAL NERVOUS SYSTEM:
Multiple sclerosis with plaques present at all levels of the neuraxis, with the preponderance in the lower spinal cord.


DIAGNOSIS:

1. Poisoning by Carbon Monoxide.

2. Multiple sclerosis.

3. Multiple recent needle puncture wounds of right arm.


OPINION:
This 43 year old white female, Sherry A. Miller, died as a result of poisoning by carbon monoxide administered by a facial mask connected via a tube to a commercial pressurized carbon monoxide tank. In consideration of the circumstances surrounding this death, examination of the scene of death, the autopsy findings, and the toxicological findings, the manner of death is homicide.



L.J. DRAGOVIC, M.D.
CHIEF MEDICAL EXAMINER



FRONTLINE / WGBH Educational Foundation
web site copyright 1995-2014 WGBH educational foundation
SUPPORT PROVIDED BY

FRONTLINE on

ShopPBS