MEDICAL EXAMINER DEPARTMENT - DISTRICT 19 St. Lucie, Martin, Indian River, and Okeechobee Counties Name... OVERHOLT, Joseph........December 5, 2017......01:10 p.m........Case No, 17-19-941 CAUSE OF DEATH: MITRAGYNINE TOXICITY MANNER OF DEATH: ACCIDENT Associate/Medical Examiner Date_ OUI SN/psName..... OVERHOLT, Joseph,.......December 5, 2017, 10 pam. .......Case No, 17-19-941 EXTERNAL EXAMINATION: ‘The body is that of a well-developed, 5 foot 9 inch, 215 pound man, who is the reported age of 28 years. The body is in an early state of putrefactive decomposition characterized by green and purple discoloration, generalized skin slippage, marbling, bloating, and a putrid odor. A white identification bracelet is around the left ankle, The scalp has black, short hair in a normal distribution, The irides are brown. The corneas are cloudy. The sclerae are pink-white and the conjunctivae are congested. The nasal septum and nasal bones are intact. The teeth are natural and in good repair. Facial hair consists of stubble. ‘The neck and chest are asymmetrical and atraumatic, ‘The abdomen is tense. The back is symmetrical. The external genitalia normal adult man, The anus is unremarkable. A star-shaped tattoo is on the right aspect of the chest, An elaborate patterned tattoo is on the right arm. INTERNAL EXAMINA’ Internal manifestations of decomposition include softening and semi-liquefaction of solid and muscular organs, approximately 50 milliliters of dark purple decompositional fluid within each pleural cavity, discoloration and softening of the mucosal surfaces, gas formation within the tissues, gascous distention of the gastrointestinal tract, a small amount of yellow, fatty fluid within the abdominal cavity, and a putrid odor. ‘The muscles and soft tissues of the neck are red-purple, soft, and traumatic. The hyoid bone, thyroid cartilage, and larynx are intact. The tan-purple, soft thyroid gland has a normal size and shape, and unremarkable parenchyma. The 300 gram heart has red-brown, smooth epicardial surfaces. The four cardiac chambers have no thromboemboli. The four, red-purple, thin, cardiac valves have vegetations. The normally positioned ostia of the left main and right coronary arteries are patent. The gray- brown myocardium has no visible fibrosis, necrosis, or areas of erythema, The coronary arteries and their branches have no atherosclerosis. ‘The left and right ventricles are 1.1 centimeters andName... OVERHOLT, Joseph,.......December 5, 2017.......1:10 p.m.......Case No. 17-19-941 0.2 centimeters thick, respectively. The interventricular septum is 1.3 centimeters thick. The thin elastic aorta is smooth and has no atherosclerosis. The upper airway is clear of debris and foreign material, The mucosal surfaces are gray- purple, smooth, and unremarkable. ‘The trachea and mainstem bronchi are clear of debris and foreign material. The right and left lungs are 525 grams and 475 grams, respectively. The pleural surfaces are gray-purple, smooth, and glistening. The purple pulmonary parenchyma exudes a large amount of purple, thin fluid and has no masses, gramulomata, or discrete areas of consolidation, The pulmonary arteries are patent and have no thromboemboli, The bronchomediastinal lymph nodes are not enlarged. The 1275 gram liver has an intact, smooth, gray-purple capsule covering gray-purple, soft parenchyma with no masses or lesions, ‘The extra and intrahepatic vessels are patent. The gallbladder contains approximately 6 milliliters of green, viscous bile and no stones, The gallbladder mucosa is yellow-green and velvety. ‘The cystic duct is patent. The tongue has green-brown discoloration and is otherwise unremarkable. The esophagus is lined by gray-white, smooth mucosa and is not dilated or stenosed. ‘The dilated stomach contains 600 milliliters of gray, viscous fluid and partially digested food. The gastric mucosa is free of ulcerations, ‘The smail and large intestines are normal in length, configuration, and have smooth, shiny serosal surfaces, and no palpable masses or obstructions. ‘The appendix is unremarkable. The yellow-orange pancreas has an intact lobular architecture and patent duct. The 125 gram spleen has an intact red-purple capsule covering purple, friable parenchyma, The right and left adrenal glands are yellow-orange and friable, The right and left kidneys are each 100 grams. The surfaces are red-brown and finely granular, The parenchyma has severe corticomedullary demarcation, ‘The renal vessels are patent. The ureters have @ normal course and caliber. The urinary bladder is empty. ‘The mucosa is tan-pink, bubbly, and intact. ‘The prostate gland is unremarkable. ‘The musculoskeletal system is well-developed. The muscles of the chest, abdomen, and iliopsoas are symmetrical, soft, and red-purple. ‘The ribs, pelvic bones, and vertebral bodies of the cervical, thoracic, and lumbar spine are unremarkable. ‘The skull is intact and has no fractures of the calvarium or skull base. There is no epidural or subdural hemorrhage.