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An autopsy is a postmortem examination conducted by medical doctors to determine the cause of one's death. Autopsies are required when someone dies unexpectedly, suddenly, and by the family's request. This is done by making a Y-incision in the body, removing and weighing the organs, stomach contents, and brain, noting any abnormalities, and sewing the body back.

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Anna Garcia, a 38 year old woman, was last seen at 6:30 in the morning walking her dog in the neighborhood on a hot, 92 degree Fahrenheit summer morning. The emergency call came at 9:45 am and the EMT arrived at the crime scene at 9:56 am. Anna was found dead lying face down in the entry hall of her home wearing a sweater, even though it was a cool 73 degrees Fahrenheit inside.

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Alex Garcia is Anna's former husband. Alex and Anna went through a nasty divorce, and as soon as it was over, Alex married a younger woman. Alex was having financial difficulties and was the beneficiary on Anna's life insurance plan. Alex saw Anna the night before her death to discuss paperwork.

Doug Greene is Anna's neighbor. He called 911 after he heard Anna's dog barking loudly continually. Doug and Anna were romantically involved, but Anna abruptly ended their relationship a week before her death.

Erica Piedmont is Alex Garcia's new wife. Erica and Alex are currently expecting a baby. She was sitting in a car parked on the street in front of Anna's house the day before the death.

Lucy Leffington is Anna's best friend and co-owner of a local bakery. Lucy wanted to expand the business and add a sugar-free line of products, but Anna refused. Lucy has been debating on whether or not she should buy Anna out of the business. This business conflict has had a definite strain on their friendship.

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Anna Garcia died at about 7:00 am in the morning. The time of death is calculated using the Glaister Equation and bodily signs, such as core body temperature, rigor mortis (stiffened muscles), lividity (blood pooling), algor mortis (body cooling), cloudy corneas, decomposition, and dried tissues.

Anna Garcia is Hispanic, 38 years old, 165 pounds, and 64 inches tall.

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The syringe found at the crime scene was filled with Castor Oil. Castor oil balances hormones, relieves constipation, boosts circulation, and fights skin infections and wounds.

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The opened pill bottle found at the crime scene location was white, opaque, and powdery. After thorough investigation with three different indicators, the substance was found to be acetylsalicylic acid, commonly known as Aspirin, which Anna Garcia took daily.

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The blood splatter at the crime scene location formed a perfect circle. This indicates that it fell from a 90 degree angle. Through thorough experimentation, it was discovered that the blood fell from a height of about three feet.

There are four blood types, A, B, AB, and O. The blood was analyzed and determined to be Type B blood. This matches the blood type of Anna Garcia and Alex Garcia.

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General Information
DNA stands for deoxyribonucleic acid and consists of a phosphate group, a carbon sugar, a ribose, and nitrogen bases (adenine, guanine, cytosine, and thymine). Adenine and Guanine are purines. Cytosine and Thymine are pyrimidines. The structure of the DNA can be described as a double helix, consisting of two complementary strands. This was discovered by two scientists, James Watson and Francis Crick. DNA is located in the nucleus and chromosomes of the cell and contains genes. Each person's DNA is different due to the sequence of the nitrogen bases.
Chargaff's Rule
Adenine and Thymine pair together; Cytosine and Guanine pair together. Because of this, the amount of A=T and the amount of C=G in the composition of DNA.

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Restriction enzymes act as molecular "scissors" that cut the DNA sequence in certain locations. This occurs through a process called gel electrophoresis,  which cuts the DNA into Restriction Fragment Length Polymorphisms of varying length, size, and number of bases using a buffer and a centrifuge. The Polymerase Chain Reaction allows scientists to produce large amounts of DNA from a limited sample. This is important because it helps narrow down the suspects of the crime. The gel electrophoresis confirmed that the blood at the crime scene belonged to Anna Garcia.

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The shoe print found at the crime scene was classified as belonging to Anna Garcia after comparing the patterns and structure of the shoes of each suspect.

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There are three main types of finger print patterns; whorl, loop, and arch. The fingerprints found at the crime scene had a whorl shape and matched 10-12 points on Alex Garcia's fingerprints, officially classifying it as his.

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It was reported that Anna Garcia's blood alcohol content was 0.015%. In order to be considered intoxicated, the BAC must be 0.8% or higher. This proved that Anna Garcia had not overdosed on any medications or drugs.

The report also consisted of high glucose levels, indicating that she had a large meal before her death.

Additionally, trace amounts of hydroxyurea were found in the blood. This is a medication used to treat sickle cell anemia.

There was a pill bottle of statins at the crime scene. However, there is no evidence of this drug in the blood. This means that Anna Garcia had not taken the medication for the past three or four days.

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Anna Garcia has a premortem bruise with limited bleeding on her right temple and another bruise on her right elbow. She had broken and healed her right proximal humerus bone and and left distal tibia bone. The abdomen is swollen.  Her nails had started to turn gray and blue and her skin was very pale, suggesting a deficiency of oxygen. Also, she had red injection sites on her left thigh and edema in her ankles. There was evidence of vomit in Anna’s oral cavity and her head injury suggested a lack of blood flow.

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After examining the hair strand, which contains DNA, thoroughly under a microscope, it was found to be Erica Piedmont's because the structure of the cortex, medulla, and cuticle were very similar and matched.

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Using the Lugol's Iodine solution, Benedict's solution, and Buiret's solution, it was revealed that Anna Garcia had consumed 125 mL of partially digested cereal, crackers, sausage, and mayonnaise shortly before her death. This also suggests that Anna Garcia's digestive system is weak

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Anna Garcia's routine urinalysis, performed when she was 14 years old, shows glucose in the urine, indicating that she has Type I Diabetes. Type I Diabetes occurs when the pancreas produces little to none insulin to help the body decrease the blood glucose levels, resulting in hyperglycemia. Treatments include insulin injections, exercise, and a better diet (less fats and carbs, more proteins, fibers, and vegetables).

Diabetes can lead to many other problems, such as; eye complications, foot complications, skin complications, high blood pressure or hypertension, hearing loss, oral health problems, gastroparesis, ketoacidosis, neuropathy, peripherial artery disease, stroke, and stress.

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Anna Garcia's vision was most likely compromised. The lens of the right eye appears cloudy. Blood vessels in both eyes are swollen. Abnormal blood vessels are present in the left retina. These details suggest muscular edema, glaucoma, cataracts, or retinopathy. Type I Diabetes can cause vision problems.

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Anna Garcia was diagnosed with sickle cell disease when she was a baby. This means that the red blood cells are abnormally crescent and sickle-shaped and can get stuck in blood vessels or on inner arterial walls. Symptoms Anna shows include pain in the joints, fatigue, increased thirst, weight loss, and frequent urination. This also leads to anemia, a deficiency of red blood cells or hemoglobin in the blood.
Treatments include medications, blood transfusions, and a bone-marrow transplant.

Sickle cell disease is an autosomal recessive disease, requiring homozygous alleles. Using a pedigree, it was determined that many of Anna Garcia's relatives and ancestors have sickle cell or are carriers for it. The sickle form of the hemoglobin is formed when an Adenine nucleotide is changed to a Thymine. This changes the sixth amino acid in the polypeptide chain from GAG to GUG, or from glutamic acid to valine. The single amino acid protein replacement changes and distorts the shape of the hemoglobin.

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The Hemoglobin A1C levels should be between 5.7% and 6.4%. However, Anna's test results show it to be 7.1%. These results indicate Type 2 Diabetes.

Type 2 Diabetes is when the insulin receptors no longer activate the glucose channel, causing high blood sugar.

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The microalbumin test reveals high amounts of protein in the urine. Also, ketones in the urine suggest kidney disease. This could have also led to ketoacidosis, when the accumulation of ketones in the bloodstream make the blood very acidic. This was most likely caused by the Type I Diabetes.

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The Type I Diabetes also caused many dental health issues. The examination of the oral cavity revealed a significant buildup of plaque  on the teeth, severely receding gums, and 4-5 unfilled cavities.

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The right kidney appears normal. However, the left kidney shows the beginning signs of kidney necrosis, explaining the partially digested food. Kidney necrosis is caused by a lack of oxygen and blood flow to the kidney tissues. This causes the kidneys to fail and be unable to filter out the wastes and toxins from the bloodstream. Symptoms include back pain, dark or cloudy urine, and tissue pieces in the urine. This was also most likely caused by Type I Diabetes.

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911 Operator
EMT
Crime Scene Investigator
Coroner
Blood Splatter Analyst
Medical Examiner
Toxicologist
Morgue Assistant
Cardiovascular Technologist/Technician
Nuclear Technologist
Cardiovascular Nurse
Clinical Laboratory Technologist
Molecular Biologist
Biochemist
Food Scientist

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The blood hematocrit test measures the values of the total blood cells and the values of each of the separate blood contents.

Using 1.5 mL of Anna's blood sample, the test results showed that Anna's percentage of red blood cells compared to the total amount of blood was 54.54%, which is above average. The normal hematocrit percentage for females is less than 35%. These results indicate blood anemia.

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Many of Anna Garcia's vitals are not in the normal range, such as:

Blood pressure: 140/90
(should be 110/70)
Pulse: 102 bpm
(should be 72 bpm)
Respiratory Rate: 23 bpm
(should be 12-20 bpm)

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A prescription bottle for Vasotec, an ACE inhibitor, was found at the scene. The amount of statins in the bottle suggest she was taking about 40 mg per day.

This ACE inhibitor might have helped Anna mediate her cholesterol and blood pressure because it stops the production of the chemical Angiotension II, which causes the blood vessels to relax (or not constrict), which gives the blood more room to be carried in, lowering blood pressure.

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In the hospital, Anna Garcia was confined to her bed and required a urinary catheter. Whenever she tried to urinate, only small amounts of pink, cloudy urine would come out. It was discovered that Anna had contracted a urinary tract infection from the catheter. The laboratory isolated the pathogen from the specimen and used a Gram Stain to identify the bacteria as Serratia Marcescens.

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Cholesterol is produced in the liver and carried through blood vessels. Low-density lipoprotein (LDL)is considered bad because it narrows the arteries. High-density lipoprotein (HDL) is considered good because it is responsible for transporting excess cholesterol to the liver.

Anna's test results show that her total cholesterol is 389 mg/dL (should be less than 200), LDL cholesterol is 243 mg/dL (should be less than 100), HDL cholesterol is 60 mg/dL (borderline normal), and triglycerides are 145 mg/dL (borderline normal).

Anna Garcia has hypercholesterolemia.

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Anna Garcia's cardiovascular system is incredibly weak. There is evidence of mild mitral valve prolapse and concentric left ventricular hypertrophy, the thickening and expansion of the walls of the left ventricle. A stent is present in the left anterior descending coronary artery. The right coronary artery is 80% occluded. The renal arteries are narrow and the cerebral arteries show evidence of atherosclerosis. The left leg shows evidence of mild peripheral vascular disease. Other heart problems include preventricular contractions (PVC's), mitral regurgitation, dilated cardiomyopathy, and a history of heart disease and uncontrolled hypertension.

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This is an X-Ray of Anna Garcia's heart and lungs. The lungs appear with no infiltrates. The pacemaker on the heart is visible.

The purpose of a pacemaker is to replace the AV node, the electrical charge in the heart that goes from the top to the bottom, making it contract and flow blood through the heart and body. Pacemakers can be used to treat irregular heartbeats.

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Manner of Death- natural
Cause of Death- congestive heart failure

After analyzing the evidences and autopsy report, it can be determined that Anna’s manner of death was natural and cause of death was heart failure. The function of the heart is to transport blood and oxygen to all parts of the body, but because Anna’s cardiovascular system was weak, symptoms of oxygen deficiency were visible, such as discoloration in the nails and epidermis. The blunt head trauma also suggests lack of blood flow, showing that Anna’s heart was weak. Symptoms of heart disease include nausea and vomiting too. This explains the vomit found in her oral cavity and her shoulder and also explains that she got her head injury because she was feeling nausea and fell on her head. Also, Anna is overweight for her height with a Body Mass Index of 28.3, which is well above the normal 18.5, suggesting that she did consumed foods with lots of fats and sugar, factors which can lead to heart disease. Furthermore, Anna’s toxicology report does not show evidence of overdose, meaning she was not abusing it. Anna Garcia was taking the Aspirin to help her worsening heart condition by thinning her blood and avoiding blood clotting. Another symptom of a congestive heart failure found in Anna’s body is a bloated abdomen, which is caused by a buildup of fluid in the stomach. Anna most probably took the injections of castor oil to fight against the inflammation and reduce the swelling. Lastly, the edema found in Anna’s ankles can also be explained by a weak cardiovascular system. When the hydrostatic pressure increases in the capillaries, which transfers oxygen from the bloodstream to organs, it causes an accumulation of fluid and heart failure. Therefore, Anna Garcia’s manner of death was natural and she died due to heart failure.