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Alex is Anna’s former husband.

Alex and Anna went through a nasty divorce last year. As soon as the divorce was finalized, Alex quickly remarried a much younger woman.

Alex and his new wife are currently expecting a baby.

Alex is rumored to be having financial difficulties and is still the beneficiary on Anna’s life insurance plan.

Alex last saw Anna last night when he went to her house to discuss some paperwork.

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Erica is the new wife of Alex Garcia.

Reported that Erica was seen sitting in a car parked on the street in front of Anna’s house the day before her death.

Erica and Alex were seen at a local diner recently having a heated argument.

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Doug is Anna’s neighbor and friend who called the police.

Doug last saw Anna when she was walking her dog at 6:30am yesterday morning.

Doug reports that Anna usually walks her dog every morning, but that recently she’s been skipping the morning walk. He stated that Anna lives alone, has no family that lives close by, and her closest companion is her dog.

Doug and Anna recently were involved romantically, but Anna abruptly ended the relationship last week.

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Saturday – August 11, 2012

Breakfast

2 egg whites, scrambled, no butter

2 slices thick turkey bacon

1 slice whole wheat toast with 1 pat butter

1 cup coffee with artificial sweetener and 1 tbsp. light coffee creamer

Lunch

1 12oz can Sprite

1 turkey sandwich (2 slices whole wheat bread, 3 slices turkey lunch meat, 1 slice cheddar cheese, ½  tbsp. mayonnaise)

16 fat-free tortilla chips with salsa

Snack

1/4 cup dry roasted peanuts

1 small apple

Dinner

½ cup apple juice

6 ounces salmon filet

1 cup brown rice cooked with salt and butter

1 cup steamed broccoli

Dessert

½ cup sugar free lemon gelatin

Sunday – August 12, 2012

Breakfast

1 cup Shredded Wheat

½ cup skim milk

½ cup blueberries

Lunch

1 cup low-fat strawberry yogurt

6 Ritz crackers

1 cup canned, low-sodium vegetable soup

1 12oz can cola

Snack

1 single serving bag potato chips

Dinner

2 slices thick crust pepperoni pizza (14” pizza)

2 cups tossed salad

4 tbsp. Caesar dressing

Dessert

1 cup vanilla ice cream with ½ cup mini marshmallows

5 Oreo cookies

Monday – August 13, 2012

Breakfast

1 cup whole milk

1 biscui

*Note that Anna’s entries stopped on the morning of August 13th. The entry for breakfast appears to be incomplete.

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Nutrients | Target | Average Eaten | Status
Total Calories | 1800 Calories | 2676 Calories | Over
Protein (g)*** | 46 g | 30 g | Under
Protein (% Calories)*** | 10 - 35% Calories | 10% Calories | OK
Carbohydrate (g)*** | 130 g | 337 g | OK
Carbohydrate (% Calories)*** | 45 - 65% Calories | 50% Calories | OK
Dietary Fiber | 25 g | 17 g | Under
Total Fat | 20 - 35% Calories | 41% Calories | Over
Saturated Fat | < 10% Calories | 14% Calories | Over
Monounsaturated Fat | No Daily Target or Limit | 12% Calories | No Daily Target or Limit
Polyunsaturated Fat | No Daily Target or Limit | 13% Calories | No Daily Target or Limit
Linoleic Acid (g)*** | 12 g | 34 g | OK
Linoleic Acid (% Calories)*** | 5 - 10% Calories | 11% Calories | Over
α-Linolenic Acid (g)*** | 1.1 g | 3.9 g | OK
α-Linolenic Acid (% Calories)*** | 0.6 - 1.2% Calories | 1.3% Calories | Over
Omega 3 - EPA | No Daily Target or Limit | 13 mg | No Daily Target or Limit
Omega 3 - DHA | No Daily Target or Limit | 15 mg | No Daily Target or Limit
Cholesterol | < 300 mg | 242 mg | OK
Minerals | Target | Average Eaten | Status
Calcium | 1000 mg | 1361 mg | OK
Potassium | 4700 mg | 2975 mg | Under
Sodium** | < 2300 mg | 3781 mg | Over
Copper | 900 µg | 1280 µg | OK
Iron | 18 mg | 22 mg | OK
Magnesium | 320 mg | 256 mg | Under
Phosphorus | 700 mg | 1514 mg | OK
Selenium | 55 µg | 111 µg | OK
Zinc | 8 mg | 14 mg | OK
Vitamins | Target | Average Eaten | Status
Vitamin A | 700 µg RAE | 1035 µg RAE | OK
Vitamin B6 | 1.3 mg | 1.5 mg | OK
Vitamin B12 | 2.4 µg | 5.8 µg | OK
Vitamin C | 75 mg | 32 mg | Under
Vitamin D | 15 µg | 5 µg | Under
Vitamin E | 15 mg AT | 12 mg AT | Under
Vitamin K | 90 µg | 162 µg | OK
Folate | 400 µg DFE | 1067 µg DFE | Over
Thiamin | 1.1 mg | 2.0 mg | OK
Riboflavin | 1.1 mg | 2.5 mg | OK
Niacin | 14 mg | 22 mg | OK
Choline | 425 mg | 207 mg | Under

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Due to the presence of multiple medical problems and illnesses, this would lead us to think Anna Garcia died as a result of a combination between them. Anna Garcia was inflicted with heart disease, high blood pressure, strokes, diabetes, sickle cell anemia and kidney problems. According to the information Gathered from the autopsies and previous medical History that Anna Garcia's Death was accidental. The cause was partial organ failure. Due to the high stress put on her body from multiple diseases we can observe her organs 'cracking under the pressure' , evident from her stroke and development of heart disease. Also, her combination of sickle cell anemia and diabetes meant that her blood was practically useless for the delivery of nutrients to each organ, meaning they were slowly failing anyway. The question is, "What directly caused the failure?". Well, by viewing and examining the contents of her stomach we were able to dictate that her meal had a high content of things her body could not break down or use, such as complex sugars and carbohydrates. So, her spleen, the main regulator of the body, was trying to 'quality  control' Anna's blood. Sickle cells in Anna's body collected in and blocked her splenetic artery, causing blood to be trapped in her spleen, and preventing oxygenated blood from entering the spleen. Her spleen became overflowed with sickle cells, and that caused splenetic sequestration. Which meant that her immune sytem was esentially gone which made the bacteria evident in the crime scene more dangerous than normal. The infection present in her body sent her body into shock due to not having any response tools. The added pressure on the other organs to pick up the slack cause them to fail. Consequently causing death by Acute Organ Failure.

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Crime Scene Recreation with Key

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Anna’s best friend and co-owner of a local bakery.

Business has been doing very well lately, but Anna and Lucy have been arguing over whether or not to expand the business and create a sugar-free line of products. Lucy really wants to expand, but Anna refuses.

Last saw Anna at work yesterday. Anna left work a little early because she said she had something to take care of.

Lucy has been debating whether or not to buy Anna out of her half of the business. The conflict with their business arrangement has caused a lot of strife in their friendship.

Lucy mentioned that Anna had been in the hospital recently, but assumed that she was feeling better as Anna told her that she was no longer taking the antibiotics prescribed to her. Anna did however note that she had been experiencing back pain radiating towards her sides.

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Laboratory Results:

Toxicology:

1.     Blood:

No evidence of alcohol.

Evidence of statins, equivalent to 40mg/day. NOTE: A prescription bottle for Vasotec, an ACE inhibitor, was found at the scene, although there is no evidence of this drug in the blood. The decedent most likely had not taken this medication for at least 3-4 days.

Blood glucose level 280 mg/dL (normal range 70-125 mg/dL)

External Examination

The following X-ray image was obtained of the heart and lungs before internal examination. Lungs appear normal with no infiltrates.

Internal Examination

Cardiovascular System:

Examination of the heart revealed concentric left ventricular hypertrophy. There is also evidence of mild mitral valve prolapse (this means that the mitral valve does not close properly).

Description of left ventricular hypertrophy:

Left ventricular hypertrophy (LVH) is a condition in which the muscle wall of heart'sleft pumping chamber (ventricle) becomes thickened (hypertrophy). Other conditions, such as heart attack, valve disease and dilated cardiomyopathy, can cause the heart (or the heart cavity) to get bigger.

A stent is present in the left anterior descending coronary artery; however, scar tissue and clots partially block or occlude the lumen of the vessel. The right coronary artery is 80% occluded. Narrowing is also noted in the renal arteries as well as the cerebral arteries and provides evidence of atherosclerosis.

Evidence of mild peripheral vascular disease in the left leg.

Possible Causes of Death: Heart attack.

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Laboratory Results:

Toxicology:

1.     Blood:

No evidence of alcohol

No evidence of non-prescription drugs or overdose of prescription drugs

Blood glucose – 280mg/dL

A1C – 11 percent

1. Urine

No evidence of non-prescription drugs or overdose of prescription drugs

Microalbumin test reveals significant protein in the urine

Ketones in urine

Explanation of Results:

Internal Examination

Head and Neck:

Lens of the right eye appears cloudy. Blood vessels in both eyes are swollen. Abnormal blood vessels are present on the left retina. Vision was most likely compromised.

Examination of the oral cavity revealed significant plaque buildup on the teeth as well as severely receding gums. 4-5 unfilled dental were visible.

Trunk

Left kidney appears pale and shows the beginning signs of necrosis. Right kidney appears normal.

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Physical Examination Results:

External Examination

Nails on fingers blue/gray in color

Laboratory Results:

Toxicology:

1. Blood:

Hydroxyurea, trace amounts – used to treat Sickle Cell Anemia

Hematocrit:

Lower percentage than normal, 33.33% Erythrocytes.

Microscopic analysis of blood:

Abnormalities found: Sickle shape of blood cells didn’t allow for proper blood flow.

Possible Causes of Death:

Palpitations of the heart, combined with weakness of body and extremities as well as lack of nutrients and oxygen to extremities made the heart over exert itself leading to failure or stroke.

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Laboratory Results:

Toxicology:

1.     Blood:

No evidence of alcohol.

No evidence of non-prescription drugs or overdose of prescription drugs.

1. Blood glucose level 280 mg/dL     70-110 80-12

2. Stomach Contents:

No evidence of toxins or poisons

125 mL of partially digested food present       23 teaspoons

Internal Examination

Gastrointestinal System:

The mucosa and wall of the esophagus are intact and gray-pink, without lesions or Stomach injuries. The gastric mucosa is intact and pink without injury. The mucosa of the three parts of the small intestine, the duodenum, the jejunum, and the ileum, and the mucosa of the large intestine, the colon and rectum, appears normal. Approximately 125 ml of partially digested semisolid food is found in the stomach.

Analysis of stomach contents:

The contents of the stomach was her lunch the turkey sandwich, sprite etc.

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Anna Garcia | 14 months | Female
Height: | Weight: | Temperature:
26 inches | 20 lbs 2 oz | 101.4°F
Blood Pressure: | Pulse: | Respiration Rate:
N/A | 175 bpm | 40 bpm
Is the patient on any medications? If so please list them.
Patient was given Infant Tylenol to relieve fever.

Chief complaint or primary reason for visit?Patient is running a fever, is extremely lethargic, experiencing breathing problems, and appears to be in a lot of pain.
Onset of condition. Is complaint related to a fall, an accident, or an auto accident?
No
| Duration of condition?

Symptoms started yesterday morning | History of similar condition in past?
No
Physical Exam Notes:
Respiratory Exam:
Patient’s breathing is abnormal. Respiratory rate is slightly elevated and patient seems to be short of breath.

| Skin Exam:
Pale skin, nails, and lips.

| Ears:
Normal. No signs of fluid or infection.

Mouth/Throat:
Normal. No signs of infection. |

Gastro-Intestinal:
Patient does not have any hernias. Patient has not had much of an appetite for the last couple of days. Patient has a bright red diaper rash on bottom and mother said she has been experiencing diarrhea for two days. |

Cardiovascular:
Pulse is 175 bpm. Heart rate is rapid and above normal range.

Urinary:
Higher urine output than normal.

Other:
Lymph nodes are normal. Patient seems very lethargic.

Additional Notes: Patient’s height is below 5th percentile on growth curve.Patient’s weight is between the 10th and 25th percentile on growth curve.Patient’s head circumference measures normal.Patient has swelling in the hands and feet.Abdomen is tender to the touch.Abdomen is enlarged on left side of abdomen – possibly indicative of splenic sequestration.Patient’s parents indicate that the patient has been extremely irritable and fussy and seems to be in a lot of pain. Tests Performed:
CBCHematocritBlood oxygen
CT scan Sickle cell test Results: CBCRed Blood Cell Count reduced levels White Blood Cell Count increased levels Hematocrit Lower than normal hematocrit - 20%
Blood oxygen Lower than normal levels
CT scan Abnormal spleen, indicative of splenetic sequestration
Sickle cell test Positive for sickle cell anemia

Diagnosis:Sickle cell anemia Severe anemia splenetic sequestration (sickling in the splenetic vein resulting in a collection of a large amount of blood in the spleen, causing the spleen to be enlarged).

Treatment:Intravenous hydration Administration of pain medication Red blood cell transfusion Administration of antibiotics to prevent infection Genetic Analysis:  Sickle Cell Anemic

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Anna Garcia
age:38
Weight: 165 lbs
Height: 64 inches
Race:Hispanic
Sex:Female
Autopsy details: August 15th 11:00 am by Dr. King

Lab Results
Toxicology

BAC % 0.015

Trace amounts of Acetylsalicylic acid.

No evidence of overdose.

External Examination
Appearance
Well developed, well nourished body. No evidence of post-mortem tampering. Rigor mortis is generalized.
Valuables
Engagement ring on right ring finger. Traces of vomit on blouse shoulder
Head/Neck
Injury to the right temple, open wound showing pre-mortem bruising.
Trunk
No visible signs of trauma.
Abdomen is distended (Enlarged/ swollen)
Extremities
signs of edema in ankles, graying fingernails, signs of recently healed break in the left distal tibia and right proximal humerus. Inflamed injection sights on left thigh.
Injuries
head wound (right temple): 2cm in length, 5 mm in depth, surrounding area bruised, limited bleeding and no skull fracture.

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Physical Evidence
1. opened (spilled) pill bottle. - Collapsed while trying to take blood thinner.
2. Spilled Orange Juice.- Part of Unfinished breakfast due to loss of appetite.
3. Used syringe.- More drug use to reduce symptoms of splenetic swelling.
4.Finger prints- Lucy Leffingwell
5. Blood splatter.- shows she fell from standing height.
6. Muddy Footprint- Belonging to Alex Garcia. probably unrelated.
7. Hair of Unknown origin.- Anna Garcia, probably just fell out.
8. Bile (Stomach contents)- As a result of body going into shock and gastric failure.