This case involves an otherwise healthy middle-aged woman who suddenly died after undergoing a medical workup at her local hospital and being discharged. She presented to the emergency room 3 weeks before her death with complaints of chest pain. She was seen by an emergency room physician who requested an EKG and a CXR. Both tests showed no abnormalities, and the patient was discharged with no diagnosis. She presented to her primary care physician several days later complaining of fever and was diagnosed with the common cold. The patient was prescribed a steroid nasal spray. 2 weeks later, the patient collapsed while at work. She was immediately rushed to the emergency room but died en route. The autopsy revealed a mediastinal abscess, a bacterial infection in the lung, and fat build-up on the artery walls.
Question(s) For Expert Witness
- 1. Will you be able to review the records and autopsy report and opine on the cause of death?
Expert Witness Response E-009680
I am a board-certified anatomic and forensic pathologist with 20+ years of experience. I have performed 9,000+ autopsies and testified in civil procedures and criminal in excess of 400 times. I am an assistant professor of pathology at a major medical university. In this case, the issue is what was more important as a contributing cause of death: a) the abscess location and the expansion into a disseminated infection or b) hypertensive and arteriosclerotic cardiovascular disease. Were those equally important, more important or contributing factors would have to be considered. It is unusual for a healthy middle-aged patient to develop such an abscess. It will be important to determine size and origin. Reviewing the autopsy, microscopic slides, and photographs are essential in addition to reviewing the medical records.