OFFICE OF THE MEDICAL
EXAMINER
COUNTY OF OAKLAND, MICHIGAN
AUTOPSY PROTOCOL
NAME OF DECEASED: MARJORIE WANTZ
CASE NUMBER: 91-2753
AUTOPSY NUMBER: 622
AGE: 58
RACE: White
SEX: Female
LOCATION OF DEATH: Oakland Township
DATE OF DEATH: October 23, 1991
PRONOUNCED DEAD: October 23, 1991
TIME OF DEATH: Unknown P.M.
DATE OF AUTOPSY: October 24, 1991
TIME OF AUTOPSY 11:05 A.M.
CAUSE OF DEATH: POISONING BY
MULTIPLE DRUG INJECTION
MANNER OF DEATH: HOMICIDE
WANTZ, Marjorie
#91-2753
EXTERNAL EXAMINATION:
The body clad in a tri-color blue/white jogging top and light green jogging
pants, white socks, white bra, and white underwear panties is that of a 5'6
1/2", 187 pounds, well-nourished white female reported to be 58 years of age.
The body is received together with a white pillow and white bedspreads where a
black comb and a burgandy color pen are found on the right side of the pillow.
Rigor mortis is fully developed in the cold body and livor mortis is dorsally
distributed and fixed. The scalp hair is gray with some brown and measuring up
to 4" in length. The irides are brown with bilateral mild arcus senilis. The
earlobes are creased bilaterally and pierced once bilaterally. The external
ear canals are free of foreign material and abnormal secretion. The external
nares are without note. The nasal skeleton is palpably intact. The lips are
without evident injury. There is dried up white foamy purge present in the
left corner of the mouth. Natural dentition is present in the upper and lower
jaw. The neck and anterior torso are unremarkable. There are multiple
Duragesic transdermal Fentanyl patches present in the front aspect of the right
shoulder, right upper and lower front thigh, left front thigh, and left and
right upper back areas. A transverse scar measuring 6" in length is present in
the lower front abdominal wall. A small periumbilical scar is present. A 12"
long scar is present in the inner aspect of the inner aspect of the front part
of the right thigh. Another 3 1/2" scar is present on the outer aspect of the
left knee. A 4" midline scar is present in the lower back. The external
genitalia and the anal orifice are without note. Finger clubbing and
peripheral edema are absent.
EVIDENCE OF INJURY:
A stabilizing arm board with yellow sponge padding is attached to the right arm
by means of white gauze strips tied in a know around the right upper arm area
and the board an the right wrist area and the board. Affixed to the inner
aspect of the right forearm by means of white adhesive tapes is an intravenous
line connected with a bottle labeled 0.9% sodium chloride. The bottle was
removed by me at the scene prior to this examination. Another line is
connected to this intravenous line, on its right side, connected with a bottle
labeled potassium chloride and succinyl choline. Another line inserted on the
left side of the intravenous line is connected with a bottle labeled
methohexital sodium 1%. Both of these bottles were disconnected by myself at
the scene. After removing the intravenous lines, one fresh needle puncture
wound is identified in the right cubital fossa. A black string knotted around
the left index finger is present with a green plastic clip at its end. A white
string is knotted around the left ring finger with green plastic clip at its
free end.
INTERNAL EXAMINATION:
HEAD:
The scalp is reflected after making the usual intermastoid
incision and is free of subcutaneous and subgaleal hemorrhage. The calvarium
is intact. The external meninges are unremarkable, without epidural or
subdural hemorrhage. The 1248 grams brain is covered by glistening transparent
leptomeninges and the cerebrospinal fluid is clear. The vessels at the base of
the brain pursue their usual anatomic courses and are patent. Both the brain
and the spinal cord with sacral ganglia are placed in formaldehyde fixative
prior to the examination. The bones at the base of the skull are without
evidence of fracture. The examination of the brain and the spinal cord after
fixation reveals no evidence of external or internal anatomic abnormality.
NECK:
There is no evidence of injury to the soft tissues or bony
structures of the neck. The laryngeal cartilages, hyoid bone and cervical
spine are intact. The lumen of the larynx and trachea shows a small amount of
white foamy fluid. The mucosa is without note.
BODY CAVITIES:
The body cavities are entered in the usual manner. All
cavities are free of excess or abnormal fluid accumulation and adhesions. The
organs are in their usual anatomic location except for the surgically absent
uterus and ovaries. The lungs are expanded. There is no internal evidence of
blunt force or penetrating injury to the chest cavity or abdominal cavity.
CARDIOVASCULAR SYSTEM:
The 399 grams heart has a glistening epicardial
surface with mild thickening of the tan-brown ventricular myocardium which
shows no evidence of focal lesion. The endocardium and heart valves without
note. The coronary ostia are patent and the coronary arteries are involved by
moderate focal atherosclerosis which in the right coronary artery shows up to
50% stenosis of the lumen, and in the left coronary artery, left anterior
descending branch, and left circumflex branch shows up to 20-30% focal stenosis
of their lumina. The aorta shows moderate atherosclerosis and its major
branches are free of significant compromise. The vena cavae and pulmonary
arteries are free of antemortem thrombus.
RESPIRATORY TRACT:
The right lung weighs 892 grams and the left lung
weighs 644 grams. Their pleural surfaces are smooth and glistening. The
parenchyma is markedly congested and edematous but without evident focal
lesion. The bronchi and their major branches contain moderate amounts of foamy
whitish fluid.
LIVER, BILIARY TRACT, SPLEEN AND PANCREAS: The 1688 grams liver has a
glistening capsular surface. On sectioning, the tan-brown parenchyma is of the
usual consistency. The gallbladder contains approximately 50 mls of bile, and
is free of stones. The bile passages are patent. The 166 grams spleen has a
glistening intact capsule and an unremarkable parenchyma. The pancreas is
without external or sectioned abnormality.
GENITO-URINARY SYSTEM:
The left kidney weighs 124 grams and the right
kidney weighs 108 grams. Their capsules strip with ease to reveal a finely
granular cortical surface. On sectioning there is good cortico-medullary
definition with a slight reduction of the thickness of the parenchyma and an
increase in peripelvic fat. The calyces, pelves and ureters are unremarkable.
The urinary bladder contains approximately 80 mls of urine. The mucosa is
without gross lesion. The uterus, tubes and ovaries are surgically absent.
There are thin focal fibrous bands present in the lower abdominal cavity in the
area of the pelvis adherent to the bowel loops and the mesentery. The vaginal
pouch is surgically reduced.
GASTRO-INTESTINAL TRACT:
The tongue is without evident recent injury.
The pharynx and esophagus are unremarkable. The stomach contains approximately
10 mls of dark brown fluid. The gastric mucosa is without note. The duodenum
and remainder of the small and large bowels are without evident abnormality.
The appendix is present.
ENDOCRINE SYSTEM:
The thyroid, pituitary, pineal and adrenal glands are
unremarkable.
MUSCULOSKELETAL SYSTEM:
The skeletal muscle is firm and without note.
The long bones of the extremities, the bony thorax and vertebral column are
without evidence of fracture.
MICROSCOPIC EXAMINATION:
CENTRAL NERVOUS SYSTEM: No pathological diagnosis.
SACRAL DORSAL ROOT GANGLIA: No pathological diagnosis.
HEART: No pathological diagnosis.
LUNGS: Edema and congestion
KIDNEY: Arteriolar nephrosclerosis, mild.
THYROID: No pathological diagnosis.
PINEAL GLAND: No pathological diagnosis.
PITUITARY GLAND: No pathological diagnosis.
DIAGNOSIS:
1. Poisoning by Multiple Drug Injection:
a. Needle puncture wound in right cubital fossa.
OPINION:
This 58 year old white female, Marjorie Wantz, died as a
result of poisoning by multiple drug injection administered by a system of
intravenous lines into the cubital vein of the immobilized right arm. In
consideration of the circumstances surrounding this death, investigation of the
scene, the autopsy findings and the toxicological findings, the manner of death
is homicide.
L.J. DRAGOVIC, M.D.
CHIEF MEDICAL EXAMINER
FRONTLINE / WGBH Educational Foundation
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