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Age: 38 years old
Weight: 165 pounds
Height: 64 inches ( 5 ft 4 inches)
Race: Hispanic
Sex: Female
Date and Time of Autopsy: August 15- 11:00 a.m. and performed by Dr. King

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Crime Scene:

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The sickle form of the hemoglobin gene is created when an adenine nucleotide is changed to a thymine. This changes the codon for the sixth amino acid in the b-globin protein from GAG to GUG, which causes the sixth amino acid in the protein to become valine instead of glutamic acid. This specific mutation is called a point mutation. It creates a natural resistance to malaria. It is an autosomal recessive disease and is passed through generations via chromosomes. This is done through a process called mitosis which is when body cells replicate and it results in the formation of two cells having 46 chromosomes that are identical to the 46 chromosomes of the original cell.

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According to food diaries, Anna did not maintain a healthy diet. She had much more calories than the normal 2300 and ate in large quantities as well as high glucose though she is diabetic.

Age 16 -  dizziness after insulin and then seizure.

Age 25- didn't control dessert intake resulting in excess blood sugar and had frequent thirst and dehydration symptoms. These symptoms are due to osmosis.

Age 10-  extreme chest pain. Feelings of frustration, sadness, and loneliness.

Age 17- pain crises and acute chest syndrome. Feelings of being different and not fitting in as well as worry for reactions to meds and illness like hair falling out and yellow eyes.

Age 22- hip replacement for the avascular necrosis in hip caused by lack of blood supply to bone due to sickle cells blocking the main artery. Physical therapy and facing constant pain.

Age 31- started planning for kids.

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Anna was found on the ground with a head wound. There was blood and hair on the corner of a fallen table. An empty syringe was next to Anna's right hand as well as a spilled cup. There were pills on the floor along with a pill bottle. There was a knocked over lap and there were fingerprints left behind. There was vomit on the ground next to Anna's head. There were also shoe prints. Crime scene investigators have collected the evidence for further examination.

Crime Scene Sketch:

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Physical therapist

Hematologist

Phlebomotologist

Family physician and pediatrician

Orthopedist

Genetic Counselor

Cardiologist

EKG Technician

Psychologist

911 operator

EMT

CSI

Morgue Assistant

Toxicologist

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It was a hot, 92°F summer morning. The emergency call came in at 9:45 am. Anna Garcia's neighbor, Doug Greene, called the police, worried about her. He informed that he last saw her the previous morning around 6:30 am. He noted that she was wearing a sweater even though they were currently experiencing a heat wave. He tried to call Anna on the telephone, but no one answered. Next he tried ringing her doorbell, but there was no answer. The 911 operator notified the local police and the emergency medical technicians (EMT). Both the police and the EMT arrived at the scene at 9:56 am. They found Anna lying face down in the entry hallway. It was 73˚F inside the house. The EMT determined that Anna was dead.

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1. Alex Garcia - Former husband of Anna Garcia,  bad divorce, remarried and expecting a baby, and financial difficulties. He is beneficiary of Anna's life insurance plan and saw her the night before her death.
2. Doug Greene - Anna's neighbor who called 911 dispatcher, had romantic relationship which ended abruptly.
3. Erica Piedmont - Alex Garcia's new wife, sat in a car parked on the street in front of Anna’s house the day before her death, had a heated argument with Alex.
4. Lucy Leffingwell - Anna's best friend and co-owner of a local bakery. Lucy wants to expand business (Anna disagrees) and is considering to buy her out. Mentioned went to hospital recently due to back pains.

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Blunt head force trauma (accidental).

Natural causes due to sickle cells blocking arteries resulting in oxygen deprivation and she could have fallen due to that. The sickle cell disease could have resulted in many of the later diseases she had.

The head wound could have been pre-planned by ex-wife Erica (murder).

She could have died of infection which is extremely dangerous with sickle cell and diabetes.

Splenic sequestration could have caused oxygen deprivation so she reaches for aspirin and she could have had an ischemic stroke and fell.

Theory that I think most likely happened: She might have been pregnant which is why she was taking castor oil, but Alex got married and didn't want the child or Erica didn't want the child so one of them killed her by switching meds to aspirin so she hit her in the head.

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Toxicology:
1. Trace amounts of aspirin, BAC  0.015, no evidence of overdose. Anna had high amounts of glucose in her blood at the time of her death.
2. Blood: Blood glucose level 280 mg/dL (hyperglycemia), A1C- 11%, Hydroxyurea (used to treat sickle cell). Abnormal amount of WBCs. Evidence of statins and an ACE inhibitor.
3. Stomach Contents: No evidence of toxins or poisons and 125 mL of partially digested food.
4. Urine: Significant protein and ketones in urine (ketoacidosis).
External Examination
1. General Appearance: Well developed and nourished, no evidence of post-mortem tampering, and rigor mortis is generalized.
2. Clothing and Valuables: Ring on right ring finger, clothes are stained with blood, and small amount of vomit on shoulder of blouse.
3. Head and Neck: Injury to the right temple and an open wound where pre-mortem bruising is present. No signs of neck injury.
4. Trunk: Abdomen is distended (swollen) on the left side indicative of splenic sequestration.
5. Extremities: Inflamed, red injection sites on left thigh and edema of ankles.
6. Injuries: Head wound at the right temple .
Physical Examination: Generalized pallor and blue/gray of fingernails indicative of oxygen deprivation. Evidence of vomit in oral cavity, blunt trauma to the head, and edema of ankles.
Internal Examination
1. Gastrointestinal System: The gastric mucosa is intact and pink without injury.
2. Head and Neck: Lens of eye is cloudy (cataract), blood vessels in eye are swollen, abnormal blood vessels are present on left retina, vision compromised. Plaque buildup in oral cavity, receding gums, unfilled dental (oral health problem).
3. Trunk: Left kidney is pale and signs of necrosis.
4. Cardiovascular System: left ventricle hypertrophy, mitral valve prolapse, evidence of atherosclerosis, and mild peripheral vascular disease in the left leg. Stent is present in the left anterior descending coronary artery.

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The height at which Anna's head was struck was determined through a blood spatter experiment. The diameter of the blood splatter at the crime scene was  3/8 inch. The blood spatter analyst spattered blood on paper to analyze the diameter and see if it matches the original diameter. At a height of 19 inches and a 90 degree angle the diameter of the spatter matched the original diameter of the spatter. It can be assumed that Anna was struck 19 inches above the ground before falling.

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Blood contains a molecule called DNA. It is the hereditary material in humans and all living organisms.  The basic structure of DNA is called a nucleotide. It is composed of a Deoxyribose sugar molecule, a phosphate group and a nitrogenous base (A T G C). DNA can be used to identify a person, and determine the suspects in a case.

DNA profiling is the process of testing DNA by cutting it into strips and letting it flow through gel electrophoresis. Once the DNA is extracted it is cut by Restriction Enzymes at its base pairs. Then the DNA fragments are placed in wells of a jelly like substance. When given electricity the negatively charged DNA will flow at different paces through the gel based on the strand length (this process is called gel electrophoresis). "Scientists can use these

RFLPs, Restriction Fragment Length Polymorphisms, a set of DNA puzzle pieces unique to the individual, to create a pattern called a DNA fingerprint." This is the sequence used to analyze the different suspects and the sample found at crime scene. Polymerase Chain Reaction enables scientists to produce millions of copies of a specific DNA sequence from a small amount of DNA.

The DNA found at the crime scene belonged to Anna Garcia which we were able to determine through gel electrophoresis.

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Investigators are trying to piece together what happened between the time that she was last seen alive and when she was found dead at the scene. After death, a body will lose heat at a rate approximately one-and-a-half degrees per hour until it reaches the temperature of the surrounding environment. he body core temperature can be measured rectally or with a hypodermic probe of the liver or brain. Using the Glaister Equation we were able to determine the time of death at around 7:00 a.m.

Data table of body temperature change:

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During her hospital stay, she had extreme leg pain son she was confined to her bed and required a urinary catheter to empty her bladder. Experienced urinary symptoms like frequent urination but little urine was passed. It was cloudy and slightly pink in color and it was positive for urinary tract infection. This was probably a nosocomial infection. Results were positive for bacteria. A microbiologist created cultures of the bacteria to determine treatment and type of bacteria. It was K. rosea which is pink/red and is associated in occasional urinary tract infections.

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Diagnosed with sickle cell disease as a baby.

Glucose in urine along with fatigue,  thirstiness, and tingling sensation in feet indicating Diabetes.

Family has history of cardiovascular disease (non-modifiable risk factor).

Family has history of sickle cell (non-modifiable risk factor). Her ex-husband was a carrier

Diagnosed with Type 1 Diabetes through GTT (hyperglycemia).

High hematocrit level above the normal range. This can cause oxygen deprivation.

Diagnosed with sickle cell anemia.

Age 14 months- elevated breathing and heart rate of 175 bpm. Symptoms of diarrhea and lack in appetite.

Prescribed hydroxyurea for sickle cell, but off of it at age 31

Avascular necrosis in hip joint.

Family has history of heart disease and hypertension.

Age 37- Took a daily aspirin to deal with pain and stress. High heart rate.

o   Total Cholesterol – 389 mg/dL
o   LDL – 243 mg/dL
o   HDL – 60 mg/dL
o   Triglycerides – 145 mg/dL
·      Fasting blood sugar – 85 mg/dL
·      Hemoglobin A1c – 7.1% (high cholesterol).

Diagnosed with hypercholesterolemia and results in high LDL level.

Diagnosed with left ventricle hypertrophy

Diagnosed with mitral valve prolapse.

Blood pressure is 142/85 over course of blood work suggesting evidence of hypertension.

She is a tachycardiac – average resting heart rate ranged from 90-105 over the course of the day.

Slight heart murmur.

Few premature ventricular contractions (PVCs) on EKG.

Mitral regurgitation according to Holter monitor.

Blockage in the left anterior descending coronary artery. Recommended to have an angioplasty performed.

Nosocomial infection of urinary tract infection of K. rosea. Prescribed antibiotics.

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1. Pills: With multiple presumptive tests we were able to determine the substance was Acetylsalicylic Acid, also known as aspirin. By comparing the reactions of different types of drugs like cocaine, aspirin, ecstasy, etc. with the indicators the unknown pills' reaction was identical to aspirin.
2.  Syringe: Through a confirmatory test, we were able to determine the substance in the syringe. When the indicator was added to the substance it changed color to magenta. Because of this specific color change we were able to determine that the substance was castor oil.
3. Blood: The blood found at the crime scene was type B. This matches with Anna Garcia's blood type so it belongs to her.
4. Hair: The forensic scientists were able to determine the hair sample was human. The hair sample belongs to Anna Garcia. The smoothness and diameter of the cuticle match. The thickness match and the medulla is visible. Also the pigment, hair color, is the same as Anna Garcia. None of the other persons of interest have the same hair features.
5. Fingerprints: The fingerprint found at the crime scene matches with Alex Garcia. Both the fingerprints have the same shape and size. Both had a loop pattern. Also multiple minutiae match including a double ridge, double fork, and ending ridge.
6. Shoe Print: Almost all footwear bear under soles with distinctive patterns. The shoe prints belong to Anna Garcia. The shoe pattern at the crime scene matches Anna's shoes and is also the same size.
7. Vomit: By using indicators like benedict's and iodine we were able to examine Anna's stomach contents. She had an unbalanced diet consisting of carbohydrates, proteins, and lipids according to her food diaries and the tests for carbs, proteins, and lipids came out positive.

Alex's Fingerprint:
Hair Sample: