KENT E. J.D., M.B.A. MONTGOMERY COUNTY, OHIO KENNETH sETz, a SUSAN L. ALLEN. no LEE o. MD. sI:w.n.N o. CASTD. PUSTMORTEM LAUREEN D-AEIFT OF THE BODY OF s. snort. MD. C-I-EF UE CURCINEFE N. Fox Brittany Sty-hes HUS sE LL L. UPTEGRCNE. NLD Gaga Brown County I. Gunshot wound of the neck: A. Wound of entrance: left side of neck, no soot or stippling, indetenninant or distant range of fire. B. Patliway: through the and soft tissue of the neclt. C. 'Wound of exit: posterior neck. D. Direction: front to back. left to right. and upward. ll. Gunshot wound of the chest: A. Wound of entrance: left side of chest, no soot or stippling, indetenninsnt or distant range of fire. 3. Pathwaj,r: through the skin and soft tissue of the left chest, left rib 5, left lung, pericardial sac, heart, right lung, between right ribs 4 and 5, right side of chest {midaxillarjr line]. C. Wound of exit: right side of chest [midaadllary line}. D. Direction: left to right, front to hack and upward. E. Associated injury: fracture left rih 5 and bilateral heinothoraces [approximately 1,f}flf} rnL, right and left chest]. Gunshot wound of the right arm: FL. Wound of entrance: medial surface of right arm, no soot or stippling, indetentninant or distant range of fire {most likely wound]. B. Pathway: through the skin and soft tissue of the right arm. 351 WEST THIRD STREET - DAYTON. CIHICJ 193?] 225-4156 - Nationally Accrediration by NA ME. AEFI ASCL Elrittan}; Stykee Case# 13-3401 C. Exit: posterior-lateral right arm. D. Direction: left to right. IV. Ahraeione ahove the right eye, ehin. below left ear, right leg, and left hand. Contueione of the forehead, right forearm and right thigh. Pregnant: Fetus [reported clinical history of week gestation}. No evidence of significant trauma. No evidence of eignifieant congenital abnormalities. Single placenta with three--vease] unihilieal eorcl. UPINIDH It ie my opinion that the cause of death of Brittany Stykee ie: Gunshot wound of the cheat. to/2 3 ?uean L. Allen, 13.0., Forensic Pathologist Date Deputy Coroner, Montgomery County, Ohio Page 2 Brittany Cases-' 13-3-4G1 A postmortem examination of the body of a 22-year-old white female, identified as Brittany Stykes, is performed at the Montgomery County Coroner's Cfiice on August 29, 2013. The e:-tamination is conducted by Susan L. Allen, D.CI., and is begun at 8:49 a.m. ATTENDANCE In the performance of their usual and customary duties, Autopsy Assistants Denny Blevins, Donald Webb, and Photographer Kory Riley are present during the autopsy. Also present during the autopsy are investigators from the Bureau of Crintinal Investigations and Identification [Ed Hunter and Tish Schuller] and Detectives from the Brown County Sheriffs Cifice {Corey Gould and Rick Haney}. CLOTHING: The body is received clad in a tee-shirt, tanlt top, bra, shorts, underpants, socks and shoes. The decedent's upper body garments {tee-shirt. tank top, bra} have multiple defects corresponding to the wounds described below. PROPERTY: Property includes two hair ties, a white metal ring with a green setting, two white metal rings with clear settings, a yellow metal ring with a clear setting, two white metal hoop earrings, bobbic pins, photo identification, miscellaneous cards and papers, and $125.61 in cash. IDEITTIFICATIDN TAGS: A Montgomery County Coroner's Office morgue identification hand is around the left ankle. A Brown County identification band is around the right anlde. EXTERNAL EXAMINATION: The body is that of a well--developed, well-nourished, adult white female; 1713 pounds and 65 inches, whose appearance is appropriate for the reported age. The body is cool to touch. Rigor mortis is developed. Livor mortis is red--purple, posterior. and does not blanch with pressure. Brittany Stvkes Case# 13-3401 The scalp hair is brown, 15 inches in maximum length. The irides are The sclerae and conjunctivae are clear. The nose and ears are not unusual. The tooth are natural, and in adequate repair. The tongue appears normal. The neck is remarkable for a gunshot wound below. The thorax is well developed and symmetrical with a gunshot wound described below. The abdomen is protuberant. The anus and back are unremarkable. The external genitalia are those of a normal adult female. The upper and lower extremities are well developed and symmetrical. IDENTIFYING MARKS: No marks or scars are readily apparent. EVIDENCE OF MEDICAL INTERVENTION: Evidence of medical intervention includes electrocardiogram pads on the chest and abdomen. EVIDENCE OF l. Gunshot wound of the neck: A. Entrance: On the left side of the neck, 'Finches below the top of the head, 5 1,32 inches to the lelt of the anterior midlinc, and 1 1,32 inch from the inferior attachment of the left ear, is an entrance gunshot wound consisting of a 3 4 inch defect with marginal abrasion. Soot, unburned gunpowder particles and gunpowder stippiing are not visible on the skin surrounding the wound. El. Path: The wound path is through the skin and soft tissue of the ncck. C. Exit: Dn the posterior neck, 5 2 inches below the top of the head and in the posterior midli.ne, is an exit gunshot wound consisting of a 1 J4 inch laceration without marginal abrasion. D. Direction: direction of the wound is from the decedent's front to back, left to right, and upward. Brittany Stykes II. Case# 13-3-4Dl Gunshot wound of the chest: Ft. Entrance: On the left side of the chest, 112! inches below the top of the left shoulder, inches to the left of the anterior midline, and 45 1,32 inches above the inferior plane of die left heel, is an entrance gunshot wound consisting of a 1 2 inch defect with a margnal abrasion. Path: The wound path is through the skin and soft tissue of the left chest, left rib 5, left upper lobe of the lung, pericardial sac, heart lapex, septum, right atrium], right middle lobe of the lung, between right ribs 4 and 5, right side of the chest line}. E:-tit: On the right side of the chest in the line, 6 inches below the top of the right shoulder, 9 inches to the right of the anterior midline, and 50 1,52 inches above the inferior plane of the right heel, is an exit gunshot wound consisting of a 1 inch laceration with surrounding purple contusion. . Direction: The direction of the wound is from the decedent's left to right, front to back and upward. Associated injury: Fracture of the left fifth rib and bilateral hemothoraces IODO rnL, right and left chest}. Gunshot wound of the right arm: Pt. Entrance: On the medial surface of the right arrn, Er inches below the top of the right shoulder and 3 inches above the right elbow, is an entrance gunshot wound consisting of a inch defect with a marginal abrasion. Soot, unburned gunpowder particles and gunpowder stippling are not visible on the skin surrounding the wound [most likely' a re-entry wound]. Path: The wound path is through the skin and soft tissue of the right E1111. E:-tit: On the posterolateral right arm, 6 inches below the top of the right shoulder and 3 inches above the elbow, is an exit gunshot wound consisting of a inch laceration. . Direction: The direction of the wound is from the decedent's left to right. Britten}? Stvkes Case# 13-34131 Additional injury: A inch faint red contusion is on the right side of the forehead. A inch yellow abrasion is above the right eye. A inch yellow abrasion is below the left ear, 1 inch anterior to the entrance wound of the neck. Multiple yellow abrasions are on the chin. ranging in size from 1,34 1 M4 inch. A 1 inch purple contusion is on the right forearm. Multiple abrasions are on the left long finger and ring fingers, 1 inch each. A yellow- purple contusion [1 J4 inch] is on the right thigh and two _ve1low abrasions are on the anterior right leg. ranging in sise from 1 134 1 1 3'2 inch each. INTERNAL EKAMINATTDN: The internal organs are of normal anatomic distribution. No adhesions are in the body cavities. Approximately 1000 mL of blood is in the right and left chest cavities. CARDIOVASCULAR S'r"STEl'v'l: The heart is 245 grams. The pericardial sac has a gunshot wound described above. Coronary arteries arise normally, following a right-dominant pattern with no significant atherosclerotie stenoses. The chambers and valves have the usual size and position relationship. The right ventricular wall thickness is 0.3 cm; the interventricular septum thickness is 1 cm; the left ventricular wall thickness is 1 cm. The mvocardium is red- brown with a gunshot wound described above. The aorta and its major branches arise normally and follow the usual course with fatty strealr. atherosclerosis. The vena cava and its major tributaries are thin walled and patent, in the usual distribution. RESPIRATORY STST EM: The right lung is 200 grams, the left lung is grams. The tracheobronchial tree is patent and mucosal surfaces are intact. Pleural surfaces show gunshot wounds of the right middle lobe and left upper lobe, as described above. The pulnronarjv is pink-tan to dark red--purple and exudes a moderate amount of blood and froth}? fluid. Puhnonary arteries and veins are developed and patent. HEPATCIEILIARY SYSTEM: The esophagus is lined by intact tan-white smooth mucosa. The gastric mucosa is arranged in die usual rugal folds, and the lumen contains apprordmatelv 1 of tan- brown fluid and food material. The small and large intestines are unremarkable. The :3 Brittany Stykes Case# 13-3 401 mesentery and cmentum appear ncnnal. The contains farmed steel. The pancreas has the usual tan lcbulated appearance. The liver is 1340 grams and has a intact capsule ccvering red-brawn The thin--walled gallbladder ccntains approximately' 5 mL cf viscid bile with me gallstenes. ENDOCRINE The thyroid, and adrenal glands are unremarkable. SYSTEM: The normal-shaped lcidneys tcgether are 265 grams. The capsules are thin, sernitransparent, and strip with ease the underlying pale ccrtical surfaces. The ccrtices are sharply delineated from the pyrarnids. The calyces, pelves, and ureters are unremarkable. The urinary bladder is empty; the mucc-sa is gray-tan and intact. The vagina, cvanes and fallopian tubes are unremarkable. The uterus ccntains a fetus, described belew. SYSTEM: The is in size and ccnfiguraticn for the age of the decedent. The spleen is l'?5 grains and has a intact capsule ccveritig red--put-pie The regcnal nudes have the usual distributicn and appearance. The bane niarrcw ends] is red-brawn and without fecal MUSCULDSIELETAL SYSTEM: Aside injuries, the bony framewcrk. musculature. and soft tissues are net unusual. NECK: Aside previcusly-described injuries, the tissues cf the neck, including strap muscles and large vessels, reveals nc The hyc-id bcne and laryn:-t are intact. The tcngue is ncrmal. J';s tar: Stykes Case# 13-3401 NERUU US SYSTEM: The brain is l2SDgran'1s. The dura mater and fab-t cerebti are intact, and the leptomeninges are thin and delicate. The cerebral hemispheres are with a normal pattern and distribution of sulci and gyri. The structures at the base of the brain, including cranial nerves and blood vessels, are intact and free of abnonnality. Sections of the cerebral hemispheres reveal no lesions within the cortex, subcortical white matter, or deep of either hemisphere. The cerebral ventricles are of normal caliber, containing clear cerebrospinal fluid. Sections through the brainstem and cerebellum are unremarkable. SPECLAL STUDIES: Postmortem radiographs reveal no retained projectiles. FETUS: The uterus contains a 128 gram fetus with a head circumi"erence of 13 cm, a chest circumference of 1 1.5 cm, an abdominal circumference of 10.5 cm, a foot length of 2 cm, crown-rump length of 1 1.5 cm, and crown--foot length of lT.5 cm. The fetus is connected to the placenta by a 13 inch three--vessel umbilical cord. The umbilical cord has a insertion in the placenta. The fetal surfaces of the placenta are smooth and glistening. The maternal surfaces of the placenta are intact. The placenta is 10 I ll] 1-: cm and weighs 72 grams. EXTERNAL FETAL EXAMINATION: Facial features are normally formed. The chest has a normal ante1ior--posterior diameter. Ezrtremities are equal and The back, buttocks and anus are unremarkable. INTERNAL FETAL EXAMINATION: The internal organs are of a normal anatomic distribution. No adhesions or abnormal fluid collections are in the body cavities. CARDIOVASCULAR SYSTEM: The heart is less than 1 gram. The pericardial surfaces are smooth, glistening and unremarl-table. The pezicardial sac is free of significant fluid or adhesions. Coronary arteries arise normally. The chambers and valves have the usual size and position relationship. The myocardium is uniform red--brown and free of abnormal markings. Brittany Stykes Case# 13-3401 The aorta and its major branches arise nonnallv and follow the usual course. The vena cava and its major tributaries are thin--walled and patent and in the usual distribution. RESPIRATORY SYSTEM: The right lung is 4 grams, the left lung 2 grams. The tracheohronchial tree is patent and mucosal surfaces are intact. Pleural surfaces are translucent, smooth and glistening. The pulmonary is pink-tan to dark red--pu1'ple and exudes a slight amount of blood and frothy fluid. HEPHTUEILMRY SYSTEM: The esophagus is lined by intact tan-white smooth mucosa. The gastric mucosa is arranged in the usual rugal folds. The small and large intestines appear normal. The mesentery and omentum appear normal. The pancreas has the usual tan lohulated appearance. The liver is 6 grams and has a smooth intact capsule covering red-brown STSTEM: The pituitary, thyroid and adrenal glands are unremarkable. The norn1al--shaped kidneys together weigh less than 1 grain. The capsules are smooth, thin, semitransparent and strip with case from the red-hrovvn cortical surfaces. The cortices are sharply delineated from the medullary pjrramids. SYSTEM: The spleen weighs less than 1 gram and has a smooth intact capsule covering red--purple MUSCULDSKELETAL SYSTEM: The bony frarneworlc, supporting musculature, and soft tissues are not unusual. NERVOUS SYSTEM: The hrain is 18 grams. The dura mater and fab: cerehri are intact and Ieptomeninges are thin and delicate. The cerebral hemispheres are symmetrical with softening. Sections of the cerehral hemispheres reveal no obvious lesions within the cortex, suhcortical white matter, or deep of either hemisphere. Brittany' Case# 13-3401 EXAMINATION HEART: Fecal extravascular bleed. LUNGS: Cengestien. UTERUS: Decidual tissue. FLACENTA: Consistent with secencl Lrirnester placenta. UMBILICAL CDRD: Three--vesse] umbilical cord with no: evidence ef cells. FETAL MEMBRANES: No evidence ef inflarnmatery cells. FETAL TISSUE (Liver, Kidney, Heart, Lung]: Ne significant tfistepafllelugic abnermaljty in sections examined. LIVER, PANCREAS, KIDNEY, SPLEEN, BRAIN, ADRENAL GLAND, GLAND, AND GLAND: Ne diagnostic histepstl-1e]-egic abnerrnalities are noted in scctiens cf these ergans. 1Uf1lfl3 Montgomery County Coroner's flffiee 3-at West Third Street, Dayton. Ohio 4s4o1 Kent E. Ho rger. Coroner Tosieology Laboratory Report '!t'enrs ('use 13-3-Itll Requesting Agency': H-rottn County Coroner Tosieology S-erriee Requested Sen-ieer Consists of screening tests for Bosh' Iitrforiies tethanol. methanol. aoelone, and isopropoitoli and Um: Screen by Eiisa imntuooaszmy class. buduitun-res. earisoprunlol. metabolite. marijuana metabolite and opiates}- :1It-:1 quootilation ore perfontted on positive sore-ens. initial Screening Tests and Results Essie 'Volatiles Screen Specimen Results Basie 'H-irlifltiies Ethanol. Methenoi. Isopropanol. Blood. Not Detected ftoetnnet Immunoissiy Streets Spctimcn Results Drugs Berbimretes. E-Hood. Nu: Detected Emisupmdol. Cneoine. Cipiotes. Metabolite) This toxicology report eontoins me oruj opinions ol'|J1e sigatutory and of the on the tin:t| results from oli testing Results reviewed by: 9 -a 1 --I 3 Luttroert J. ."u1:1riItettI, Completed Chief Fnrensie Aeeredfred The A merierm Eon rd of' orensie Tofleo fogg- I: of I Data current Lot of: ut