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The ultimate cause of death was determined to be  sudden cardiac arrest to due the history of arrhythmia Anna Garcia had. This includes the pronged Q-T intervals and tornadoes de pointes from the 6.1.2 autopsy report and her PVCs and Ventricular Tachycardia as seen in her 4.2.1 medical history sheet. In addition to blockages being a possible cause of cardiac arrest her vast-occlusive crisis from 6.1.2 and 80% occluded coronary arteries from 4.1.2 support this.  High levels of a hormone that is associated with damage to the heart muscle and low electrolyte counts contribute to the proof for the dysfunction of the heart muscle. Also supported by ischemia throughout the heart tissue that is provoked by a oxygen deprivation of the heart tissue associated with cardiac arrest.
The prolonged Q-T interval was observed in the medical history report made when she was treated for a sickle cell crisis shortly before her death.
Substances that contributed to her death were two substances called Macrolides and Fluoroquinolones. These medications were not prescribed to her, they were prescribed to her dog for a skin infection.  These antibiotics are known to prolong the QT interval, and contributed to the sudden cardiac arrest responsible for her death.

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Reasons:
-Victim had been in to see the hostiple realitivly prior of her death
-Medications for pain were found at the scene which corrisponds to testimonies of back pain radiating to her sides
-Anna had not been taking the antibiotics prescribed
-A diabetic, blood sugar and A1c reading suggest she was not taking good care of the issue.
-Evidence of Ketones in urine found in in autopsies
-Pacemaker and stent in heart. Year prior many issues of cardiovascular disease were discovered and many more appeared in her later autopsy
-Anemic due to sickle cell may correspond with the lack of oxygen found from her autopsy
- Fluoroquinones and macrolides were found in her blood
-Pradofloxacin and erythromycin, prescribed for Anna's dog, were found in her kitchen; this explains the antibiotics listed above found in her blood
- It is likely that Anna took both antibiotics either accidentally or in an effort to treat the UTI; these exacerbated her prolonged QT, leading to sudden cardiac arrest.

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From of crime scene and the clues provided:
Suicide
Possibility of a drug overdoes and presents of a gun and the location of the injury corresponds to the manner of death
Natural causes
Anna was mysteriously found wearing a sweater despite the 90' heat outside and 72' degree heat inside.
-All of her various medical conditions could have led various, lethal complications
Murder

Anna may have attacked in her home by Lucy, Anna was hit by the Lamp then died of blunt force Trauma

Lucy's hair and possable footprint  at crime scene

Lamp at crime scene

Disagreement in business giving motive

Alex Garcia killed Anna with gun (Pistol whipping) and died. Then Alex planted drugs to make it look like overdoes

Fingerprint at the crime scene

last to see her alive

may have stayed the night and not left like he said

Gun at crime scene

Syringe at scene but no Drugs in system

Beneficiary of Anna's life insurance and needs it, especially with baby on the way.

Erica Piedmont killed her out of jelousy over Alex

Blood type of blood spatter found at crime scene matched that of Erica suggesting she may have bled

Later disproved from DNA analysis

Accidental
Anna stepped on a nail, bled out, then fell back onto the cart and died of head trauma

Nail at crime scene

Blood spatter and pool of blood as well as blood on cart

Head injury

-Drug overdoes due to location of blood splatter presents of pills and syringe and cart that the woman may have fallen on in addition to the vomit

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Background Information and description of victim and time of death

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Background Information and description of victim and time of death

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A neighbor called 911 after  a dog had been barking for some 2 hours and there was no answer to a phone call made to the house. When EMT's arrived the home owner, Anna Garcia, was found dead in her front hall entryway. Anna Garcia is a 38 year old hispanic woman who lives alone with her dog. She died August 25th at 7:00am in her home's foyer. She was discovered by police at 11:00am that day.

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Diabetes

Hypoglycemia- common in diabetics

Stroke- Thick blood due to sugar as seen by A1c readings and oral cavity sugar evidence

Heart attack- High blood sugar

Kidney failure- Kidney Necrosis evident due to high sugar and water content rendering kidneys unable to filter blood

Ketoacidosis- Evidence of ketones from autopsy

Pulmonary edema- thickened blood and high blood pressure as a result

Sickle Cell

Stroke- clotting in blood due to sickle cell clumps

Acute Chest Syndrome

Oxygen Depravation- inability of cells to carry oxygen due to sickled cells

Organ Necrosis- clotting of sickled cells in organs blocking blood flow

Infection- clots not allowing appropriate white blood cell flow, preoccupying white blood cells

Heart Disease

Heart Attack (MI)- High LDL reading and irregularities in electrical signals of the heart

Blood Clot- High LDLs

Kidney failure- Renial artery narrowing

Coronary arterie desses- occluded coronary artery with stent

Oxygen deprivation- Pace maker

Mitral Regurgitation- echocardiogram video

Pulmonary Edema- high blood pressure and LDL readings

Heart Failure- Enlarged left ventricle and mitral valve issues as well as occluded coronary artery

Stroke- high amounts of LDL as well as high blood pressure

Sudden Cardiac Arrest- History of arrhythmia such as PVCs, tordas de pointes and prolonged Q-T intervals. This is Also supported by the high levels of a hormone that is associated with damage to the heart muscle and low electrolyte counts contribute to the dysfunction of the heart muscle that is proved by ischemia throughout the heart tissue

Infectious Disease

Kidney Failure

Sepsis

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Evidence From Crime Scene (General Information)

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Evidence From Crime Scene (General Information)

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Pool of blood
Hair
Nail
Syringe
Gun
Cup
Shoe Pint
Unknown Drug
Cart
Lamp
Blood Spatter Patterns
Body
Vomit

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The results of the DNA found at the scene was concluded to belong to Anna Garcia after electrophoresis revealed her bands that matched hers.

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Cart

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Cup

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Gun

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Lives alone with her dog

38 years old

Co-owner of a bakery

Divorced but dating

Deceased

Hispanic

5'4

No family

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-Heart Stent
-Diabetic emergencies
-Sickle cell crisis
-Back Pain
-Chest pain
-Unhealthy bpm, pulse and blood pressure throughout her life

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Unit 1
-evidence of low oxygen levels
-Anna fell and hit her head but it was not he cause of her death. Open right temple wound with no skull fracturing, 2cm in length and 5cm in depth. Bruised area with limitted bleeding.
-Limited bleeding shows lack of sufficient blood flow
-Ketones in urine as well as significant protein
-Left kidney shows necrosis
-Trace amounts of pain killer medication
-No post-mortem tampering
-Abdomen is distended
-Edema, swollen ankles and moderate fluid accumulation
Diabetes
-Blood glucose found above normal amounts at 280mg/dL
-Esophagus found grey-pink
-Inflamed red left thigh where probably a syringe of insulin had been injected
-Oxygen deprivation characterized by blue/grey nails
-Vomit in oral cavity and partially digested food in stomach
-Abnormal blood vesicles in left retina leaving vision comprimised
-Reciting gums and plaque build up in oral cavity
Sickle Cell
-Hydroxyurea found in blood used to treat sickle cell
-Low hematocrtic, 32% corresponding to anima
-Sickled cells apparent as well as low white blood cell levels
Heart Disease
-Statins equivalent to 40mg/day and Vasotec an ACE inhibitor found at scene yet not present in system
-Concentric left ventricular hypertrophy
-Mild mitral valve prolaps
-Stent present in left anterior coronary artery yet 80% occluded lumen due to scare tissue and clots
-Renal and cerebral arteries are narrowed showing atherosclerosis
-Mild peripheral vascular disease in left leg
Infection
Unit 6
-High trop in levels suggest an issues with the heart pr kidneys
-Low electro light levels suggest the muscles weren't conducting electrical currents as they normally would have
-Ischemia throughout heart tissue shows lack of blood flow to the entire heart
-Prolonged Q-T Intervals
-High ventricular rate shows tornadoes se pointes causes ventricular fibrillation and can lead to sudden cardiac arrest

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Results show Anna died around 7:00am the on the morning of her discovery

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Fingerprint at the crime scene matched that of Alex Garcia. Although Alex used to live in the house before their divorce witch can explain the fingerprint without putting him at the scene of the crime. Alex was also present the night before her death which could be the reason it was there.

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The blood spatter was determined to have fallen from a 90' angle (straight above) and it was estimated to haven been dropped from a height of 90cm

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Pool of blood

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Body

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Footprint

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Diabetes
-14 years old
-Glucose in urine
-Fatigue
-Fells thirty yet excessively urinating
-No change in diet and exercises

Sickle Cell
-14 months old
-Fever of 101.4
-Pale skin and lips
-High white bloods cell count and low red blood cell count showing signs of anemia and infection
-Stickle cell anemia diagnosis
-Splenic sequestration and large amount of blood in spleen to to sickling causing enlargement
-elevated respiration rate of 40bpm
-Underweight at 20 pounds and 2oz between 10th and 25th percentile
-Tachycardia, high pulse of 175bpm
-Shorter than normal with hight of 26 inches below 5th percentile
-High urine Output
-Low appetite
-Bringht red diper rash
-Diarrhea for two days
-Swelling in hands and feet
-Abdomen is tender to touch and enlarged
-Irritable anf fussy
-Lethargic
-Treatment of Red blood cell transfusion, antibiotics, intravenous hydration and pain medications
Heart Disses
-37 years old
-Family History of heart disses and high cholesterol
-Hypertension stage 1 due to a blood pressure of 140/72
-Low pulse, bradycardia of 44bpm treatment is pacemaker
-respiration rate is fast
-self resolved chest pain
-unhealthy diet high in fats, calories and alcohol
-PVC
-tingling sensation in right calf
-Ventricular tachycardia
-Slight heart murmurs
-Weight circumference of 35 inches
-Blockage in left anterior descending coronary artery treated by a stent
-mitral valve regurgitation
-slight Left ventricle enlargement though still in normal limits
-High LDL and total cholesterol
LDL reading at 243mg/dL while normal is under 100mg/dL
-Total Cholesterol at 389mg/dL while normal is under 200mg/dL
-Metabloic syndrome due to waist cercumfrance, blood pressure and A1c readings
-FH
Infectious Disease
-UTI acquired from a catheter used during her stay at a hospital due to a sickle cell crisis
-Persistent urge to urinate yet only small amount of unrine would come out
-Urine was cloudy and slightly pink in color
-UTI of bacteria S. marcescens
-Faitgued and in pain
-Preformed Gross examination of colony morphology, gram staining, various biochemical tests and Urinalysis
-Found to be 1.5mm across a colony, wavy, pink/red color, raised, Gram negative and bacillus
Unit 6
-increase Q-T interval
-Suggested for defibrillator to regulate heart rate incase it goes too fast or too slow
-Told to avoid drugs that could make her worse

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The shoe print at the crime scene matched a pair of shoes that both Anna and Lucy own, possibly placing Lucy at the scene of the crime however Lucy visited the house often and could have been placed there at any other time.

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Blood Spatter

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Pills

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Doug alerted police and made the 911 call

Doug is Anna's neighbor

Last sighting on Anna by Doug was the morning before when she had been walking her dog at 6:30am

Was recently in a romantic relationship with Anna but she ended things a week prior

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The hair at the crime scene was most similar to that of Lucy's hair. This hair is circumstantial since Lucy and Anna were co-workers meaning Lucy may have never been in the house and Anna could have carried it home on her clothes. Lucy was also a friend meaning it could have been left there at another point in time from a previous visit

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Vomit
-After testing results were positive for sugar and starch

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Anna's BFF

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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After an elimination test it was determined the drug was Aspirin, eliminating the theory of an overdose

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Lamp

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Erica is the new wife of Alex Garcia, younger and pregnate

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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Footprint

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Anna's Ex-husband

After being divorced roughly Alex remarried a more attractive woman

Expecting a baby with his new wife Erica

Is the beneficiary of Anna's life insurance and is said to be in need of money

Last person to see Anna alive at her house

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Nail

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The blood sample found at the crime scene was type B, and matched both Anna Garcia and Erica Piedmont’s blood type.  This test rules out the possibility of Doug, Alex, or Lucy being injured at the scene but due to the circumstances most likely belonged to Anna.

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Syringe