REPORT OF AUTOPSY
CASE NO. M93-6833
I hereby certify that I, Shirley H. Smith, M.D., City Medical Examiner I, have performed an autopsy on the body of Seth Speken on the 28th day of August, 1993 commencing at 9:00 am in the Manhattan Mortuary in the presence of Drs. Alandy and Leach.
EXTERNAL EXAMINATION: The body is that of a well developed, well nourished, white man, measuring 5’6″ in length and weighing 175 lbs. appearing the given age of 23 years.
The scalp hair is wavy, black, 2″ in length. There is a 1/8″ stubble of facial hair. The irides are brown. The conjunctivae are pale with no evidence of jaundice, hemorrhage or petechiae. The oral cavity contains natural teeth. A 1/2″ x1/4″ vesicular rash is present at the right corner of the mouth. The anterior and posterior aspects of the torso are symmetrical. The upper and lower extremities are symmetrical. The genitalia are that of a circumcised male.
POST MORTEM CHANGES: Rigor mortis is strong. Liver mortis is blanching and present on the back. The body is cool to touch.
SCARS: There is a faint well-healed scar in the right lower quadrant of the abdomen measuring 2 1/2 by 1/8″
TATTOOS: No tattoos are found.
CLOTHING: When first viewed, the body is unclad.
THERAPEUTIC PROCEDURES: Puncture sites are noted in the right and left antecubital fossae and the right femoral area. The dorsa of both right and left wrists are shaved.
INJURIES: Several facial abrasions (excoriations) are noted on the left side of the face including the left side of the nose, measuring 1/2″ by 1/2″ and multiple 1/8″ by 1/8″ lesions on the left cheek in the pre-auricular region. There is a 2″ by 2″ red/brown ecchymosis on the left kneecap. There is a 1″ by 1″ ecchymosis on the dorsum of the left hand which is reddish/brown in color.
HEAD: The scalp has no contusions or hemorrhage. The skull has nofractures. The internal table of the skull shows yellow staining. The brain weighs 1600 grams and has symmetrical hemispheres and gyri. The brain is fixed in formaldehyde and saved for further examination.
NECK: The strap muscles and paratracheal soft tissue contain no hemorrhage . The hyoid bone, cervical vertebrae, tracheal and laryngeal cartilages are intact. There is no upper airway obstruction. The upper esophagus is unremarkable.
BODY CAVITIES: A trace amount of serous fluid is present in the pericardial sac, pleural cavities and peritoneal cavity.
CARDIOVASCULAR SYSTEM: The heart weighs 380 grams. The coronary circulation is right dominant. Serial cross-sections of the coronary arteries reveal no atherosclerosis. The aortic arch gives rise to the major vessels in a normal anatomic distribution. The thoracic and abdominal aorta are unremarkable. There is no thrombus in the right atrium or the right ventricle. On cut section, the heart is homogeneous and dark red. The left ventricular wall thickness is 1.1 cm., interventricular septal thickness is 1.1 cm., and right ventricular free wall thickness is 0.2 cm.
RESPIRATORY SYSTEM: The lungs weigh 600 grams each. The right and left pulmonary arteries both contain thromboemboli which are dark red and arborize throughout the pulmonary arterial tree on both
sides. The pleural surfaces of both lungs are smooth. The lung parenchyma, on cut section, is homogeneous and dark red. The tracheobronchial tree is free of obstruction although frothy edematous fluid is present.
LIVER: The liver weighs 1900 grams. The capsular surface is smooth and glistening with well formed liver edges. On cut section, the liver is homogeneous and dark red.
GALLBLADDER: The gallbladder contains approximately 50 cc. Of brown bile with no stones.
PANCREAS: The pancreas is lobulated and reddish/tan and soft.
HEMIC AND LYMPHATIC SYSTEM: The spleen weighs 300 grams. The capsular surface is intact. On cut section, the splenic parenchyma is dark red and soft. The cervical, hilar and periaortic lymph nodes are not enlarged. The hilar lymph nodes are anthracotic.
GENITOURINARY SYSTEM: The right kidneys weigh 210 grams each. The capsular surfaces of both kidneys are dark red and smooth. On cut section, the kidneys are dark red with identifiable corticomedullary junctions and well-formed medullary pyramids. The ureters are unremarkable. The bladder contains a trace amount of cloudy urine.
REPRODUCTIVE SYSTEM: Both testes are descended into the scrotal sac and on cut section are homogeneous and tan. The prostate itself is unremarkable, although small vessels surrounding the prostate gland contain dark red clotted blood.
ENDOCRINE SYSTEM: The pituitary, parathyroid and thyroid glands are unremarkable. The adrenal glands are normal in size with dark red medullary regions.
DIGESTIVE SYSTEM: The esophagus is unremarkable. The stomach and duodenum contain no ulcers. The stomach contains approximately 20 cc. of mucoid grey material. There are focally hyperemic dark red areas throughout the small and large intestine, but no ulcers are present. The bowel contents are dark red. The appendix is absent.
MUSCULOSKELETAL SYSTEM: The musculature is symmetrically developed. The vertebrae, ribs and pelvis contain no fractures.
In both legs, the major veins are free of thrombus. Thrombi are found within the tiny vessels of both extremities, including those near the achilles tendons.
DIAGNOSES:
CAUSE OF DEATH:
PULMONARY THROMBOEMBOLUS DUE TO IMMOBILIZATION DUE TO PSYCHIATRIC DISORDER.
MANNER OF DEATH:
NATURAL.
Shirley H. Smith, M.D.
City Medical Examiner I
SS:ms
9/10/93:DRAFT:rmd
3/9/94:FINAL:rs
NEUROPATHOLOGY REPORT
CASE NO. M93-fi833
SETH SPEKEN
Dr. Mastri dictating Neuropathology Report
The autopsy was done by Dr. Smith on August 28, 1993
The brain is examined by Dr. Smith and Dr. Mastri on September 22, 1993
The cerebral dura is not remarkable. The cerebral hemispheres are symmetric. The gyri are of normal size, configuration and consistency. The external aspects of the brain stem and cerebellum are not remarkable. The arteries at the base of the brain follow a normal distribution and are free of atherosclerosis.
In coronal sections of the cerebrum, no focal abnormalities are noted in the cortex, white matter or deep nuclear structures, Serial sections of the brain stem and cerebellum are not remarkable. The ventricles are of normal size and configuration, No sections are taken for histology.
DIAGNOSES:
NONE.
Angeline R, Mastri, M.D. 10/14/93
A.M. 10/14/93
ENID G, BOURNE/GW
REPORT OF MICROSCOPICAL EXAMINATION
NAME OF DECEASED: SETH SPEKEN M.E.# M93-6833
DATE OF REPORT: 1/28/94
Lungs: Well-formed thromboemboli are present within large-caliber arteries of the lung. There is associated infarction of pulmonary parenchyma.
Periprostatic veins: Well-formed Thrombi are present within Periprostatic Veins. There is no Prostatitis.
Myocardium: The Myocytes show mild Hypertrophic Nuclear changes.
Kidney: There is Acute Tubular Necrosis of the Kidneys.
Liver: There is Acute Passive Congestion of the Liver.
Spleen: The Spleen is congested.
Throid: The Thyroid is unremarkable.
Testes: The Testicular Tissue is unremarkable.
Shirley Smith, M.D.
520 FIRST AVENUE
NEW YORK, N.Y. 10016
TOXICOLOGY LABORATORY
DECEASED: SETH SPEKEN
LAB. NO.: 5234/93
M.E. CASE NO.: M93-6833
AUTOPSY BY DR.: Smith
LOCATION OF AUTOPSY: Manhattan
DATE OF AUTOPSY: 8/28/93
Blood Bile Stomach Contents Brain Liver
SPECIMENS RECEIVED 1N LABORATORY BY: Dr. S Mukherji
DATE RECEIVED: 8/30/93
BLOOD:
SIGNED: Dr. Marina Stajic 10/1/93
520 FIRST AVENUE
NEW YORK. N.Y. 10016
DECEASED: SETH SPEKEN
LAB. NO.: 5234- 93
M.E. CASE NO.: M93- 6833
AUTOPSY BY DR: Dr. SMITH
LOCATION OF AUTOPSY: Manhattan
DATE OF AUTOPSY: 8/28/93
SPECIMENS SUBMITTED:
Blood Bile Stomach Contents Brain Liver
SPECIMENS RECEIVED IN LABORATORY BY: DR. S. MUKHERJI
DATE RECEIVED: 8/30/93
LIVER: Benzodiazepines- not detected- radioimmunoassay (RI)
NOTE: Refer to initial report dated 10/01/93
SIGNED: Dr. Marina Stajic 3/23/94