NEW MEXICO AND EL PASO HAS SLOWLY BEAT ME ' TO DEATH,' PREDICTABLE OUTCOME.
A PAINTING THAT I SOLD A LADY ON ' SILVER ST.,' A GALLERY. NOW YOU
KNOW:
 |
| ' DELINQUENTS ' IN PROCESS: PENTAGONS; ' TRICKS.' |
 | ||||
| ' TWISTED NEEDLES AND SMALL TALK,' |
| LOVELESS FOR KNEE REPLACEMENT. | IN THE MUSCLE ? |
REPORTING CHILD ABUSE AND ' SEXUAL GROOMING, ' AND DEALING WITH DOUBLE KNEE REPLACEMENTS WHILE HUNDRED X-RAYS EXIST; LOWER LUMBAR. CHANCE OF BULLET FRAG. IN SKULL OR INSIDE HEAD.
FROM ORIGAMI PAPER T-REX AND ALBUQUERQUE HIGH GRAD, A SOCIAL SECURITY SOCIAL WORKER TO THE LAST OF MY ' APPOINTMENTS,' ' HAZEN ' AND AN EMPTY HOUSE ON THE OUTSKIRTS OF SANTA FE, NEW MEXICO.
  |
| LAST APPOINTMENT SS SENT ME TO IN SANTA FE, NM., 2015. NO ONE THERE. THE TWO PICTURES ARE JOINED TO SHOW, ONLY SMALL LIGHT LEFT ON INSIDE HOUSE. |
DON'T LET ME MISLEAD YOU. SOME WOMEN ARE JUST AS GUILTY, AND SO MUCH MORE SO.
I AM IN THE PROCESS OF ARRANGING ALL MY HOSPITAL VISITS AND DOCTORS APPOINTMENTS FOR WELFARE/FOOD STAMPS AND GENERAL ASSISTANCE AND SOCIAL SECURITY.
I DON'T KNOW THE RESULTS OF MY ECHO-CARDIOGRAM BECAUSE OF MY LAST PHONE AND ALL THE ' SPYWARE,' ' HACKING ' AND ' MIC-SPYWARE;' ' BROAD-CASTING/PHONE ITSELF AND G_D KNOWS WHAT ELSE. I DESTROYED IT.
ANYTIME THAT I TURNED IT ON, AND NEW CELLPHONE TOO. THE PROTECTION OF PRUDENCE BY CONSCIENCE HAS BEEN ' HACKED ' BY THE HOMOSEXUAL ' METH ' CROWD AT UNM IN ALBUQUERQUE AND AFD AND APD EVERY TIME THAT I USE ONE OF THEIR COMPUTERS.
THE HOMOSEXUALS BEHIND THE DESK ARE BEHIND SOME OF IT AS WELL AS ' LAVELL DRAKE ' AND ALBUQUERQUE 'S NIGGERS/DRUG DEALERS.
NOT AFRICAN AMERICANS. HOWEVER THE MINDS BEHIND IT ARE ' WHITE.'
FOR THE BENEFIT OF WHOM ? ' PEDOPHILIA.'
I DO NOT CARE IF THERE ARE DEATHS OF THOSE WHO HAVE ' HACKED ' MY BLOGS
https://www.youtube.com/watch?v=ugkxGck-BYc&feature=youtu.be
 |
| KEEP 'EM AT SCHOOL TO ' HAZE ' AND ' DRUG ' EM UP ! |
 | ||
| THIS IS NOT ABOUT ' HOMOSEXUALS,' WHAT ABOUT ' RAPE KITS ?' |
UP-DATED 1-11-2017
THE LOCATION OF THE ' VIDEO ' BELOW TAKEN ON ALICE STREET, AS DESCRIBED IN ' DETAILS ' ON MY NEW PHONE IS COMPLETELY WRONG WHEN ' LOCATION ' IS TURNED ' ON,' ON THE PHONE.' Details on Location.' 5307 Granite Avenue Northeast, Albuquerque, New Mexico 87110. 1-10-2017,10:27 pm.
I was at 5413 Alice NE.
Five million, I guess. who ? Colors ?
Outgoing DA slams APD in
letter
“Frankly, if any other group of individuals were acting the way APD has allegedly been acting, some of us in law enforcement might refer to them as a continuing criminal enterprise and/or engaged in the act of racketeering. I appreciate how bold a statement that is.”
Albuquerque’s outgoing district attorney, in her final days in office, slammed the Police Department one last time – accusing it of cover-ups and other problem..........THE REST BELOW:
https://www.abqjournal.com/924992/outgoing-da-slammed-albuquerque-police-in-letter.html
FOR ' CAROL ' AT FOOD STAMPS, PHONE NUMBER 1505 222 9692, EX 29692 #, THIS NUMBER IS INVALID. THIS IS THE NUMBER YOU CALLED ME FROM ASKING ABOUT REASON FOR ' HANDICAP, OR DISABILITY.'
I HAVE ANOTHER DR.'S APPOINTMENT WITH NEW MEXICO HEART INSTITUTE THIS FRIDAY FOR ' RESULTS ' OF HEART CARDIOGRAM, AND ASSOCIATED SURGERY; REASON FOR REFERRAL. http://phaethonstar-soberover.blogspot.com/2016/08/up-dated-9-2-2016-9-1-2016-pin-cushion.html?m=1
 |
| HERNIA REPAIR. BELOW, PAGE IN THIS BLOG. |
BELOW FROM OFFICE OF THE MEDICAL INVESTIGATOR, UNM HEALTH SCIENCES CENTER, VICTORIA MARTENS AUTOPSY REPORT :
CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected <15 mmol="" p="">Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine <0 .4="" 1.3="" dl="" mg="" p="">Glucose <3 dl="" mg="" p="">The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected mmol
/L)Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine dL
)Glucose dL
)The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected mmol
/L)Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine dL
)Glucose dL
)The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected mmol
/L)Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine dL
)Glucose dL
)The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31CAUSE OF DEATH
Manual strangulation
MANNER OF DEATH
Homicide
DEATH INVESTIGATION SUMMARY
Case Number: 2016-04676
MARTENS, VICTORIA
Matthew Cain, MD
Medical Investigator, Assistant Professor of
Pathology
Rebecca Asch-Kendrick, MD
Forensic Pathology Fellow
All signatures authenticated electronically
Date: 11/22/2016 3:42:52 PM
County Pronounced: Bernalillo
Law Enforcement: APD; case 160078669
Agent: VC Josh Brown/crim. Nick Lasker
Date of Birth: 8/23/2006
Central Office Investigator: Philip Dees
Deputy Field Investigator: Philip Dees
Pronounced Date/Time: 8/24/2016 11:30:00 AM
Printed: 1/9/2017 1:17:59 PM Report Name: Death Investigation Reporting Tool
Death Investigation Report page 1 of 31
DECLARATION
The death of MARTENS, VICTORIA was investigated by the Office of the Medical Investigator under
the statutory authority of the Office of the Medical Investigator.
I, Matthew Cain, MD, a board certified anatomic, clinical, and forensic pathologist licensed to practice
pathology in the State of New Mexico, do declare that I personally performed or supervised the tasks
described within this Death Investigation Summary document. It is only after careful consideration of
all data available to me at the time that this report was finalized that I attest to the diagnoses and
opinions stated herein.
Numerous photographs were obtained along the course of the examination. I have personally
reviewed those photographs and attest that they are representative of findings reported in this
document.
This document is divided into 9 sections with a final Procedural Notes section:
1. Summary and Opinion
2. External Examination
3. Medical Intervention
4. Postmortem Changes
5. Evidence of Injuries
6. Internal Examination
7. Microscopy
8. Ancillary Lab Studies
9. Postmortem Computed Tomography
Should you have questions after review of this material, please feel free to contact me at the Office of
the Medical Investigator (Albuquerque, New Mexico) - 505-272-3053.
Printed: 1/9/2017 1:18:00 PM Report Name: Death Investigation Summary
Death Investigation Report page 2 of 31
Medical Investigator
Matthew Cain, MD
Amendment:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
Last Date Saved:
Amendment: Page 1 Printed: 1/9/2017 1:18:00 PM
Case Number: 2016-04676 Amendment MARTENS, VICTORIA
Death Investigation Report page 3 of 31
Medical Investigator
Matthew Cain, MD
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
PATHOLOGIC ANATOMIC DIAGNOSES:
I. Evidence of manual strangulation
A. Multiple abrasions and contusions involving head and neck.
B. Intramuscular hemorrhages of anterior strap muscles, inferior pharyngeal constrictor, subcutaneous tissues of the
posterior neck, and the right erector spinae muscle.
C. Petechial hemorrhages of palpebral conjunctivae, bilateral eyelids, bilateral periorbital region, and upper gingiva.
II. Dismemberment and sharp force injury
A. Midline, incised wound with exposure of chest and abdominal cavity.
a. Portion of sternum, the heart, and the left lobe of the liver received separately.
b. Incised wounds of heart and liver.
c. Apparent tool marks on sternum.
B. Dismemberment of right and left upper extremities at the shoulder joints and attempted dismemberment of left leg
at hip.
a. Spiral fracture of left humeral diaphysis.
b. Possible tool markings on left clavicle and scapula, both humeral heads, and left femur.
C. Multiple superficial incised wounds on torso.
III. Evidence of prior sexual abuse
A. Viral cytopathic effect, rectum (microscopic).
VI. Post-mortem charring of lower extremities
A. Less than 5% carboxyhemoglobin saturation.
B. No soot present in airway.
V. Penetrating rectal trauma
VI. Evidence of ethanol use; see Toxicology Report.
SUMMARY AND OPINION:
Ms. Victoria Martens was a 10-year-old white female who was reportedly found by law enforcement personnel in a
bathtub and unresponsive. According to reports, she was wrapped in a blanket that had been set on fire in her mother’s
apartment. Her arms, a portion of sternum, heart, and left lobe of liver were found wrapped in a plastic bag in a laundry
basket.
Autopsy revealed a well-developed, well-nourished young female wrapped in plastic bags and a charred piece of cloth.
The bilateral upper extremities, heart, left lobe of liver, and sternum were received separately and wrapped in plastic
bags. Multiple contusions and abrasions were present on the head, neck and torso. There were contusions on the inner lip
that corresponded to the decedent’s teeth. Petechiae (small pinpoint hemorrhages) were present in the eyes, mouth, and
on the face. Hemorrhages involved the muscles of the anterior and posterior aspects of the neck and corresponded with
overlying contusions. Hemorrhage was also found around the spinal cord. Post-mortem sharp force injuries which
lacked a vital response included a large midline incision exposing internal organs, dismemberment of the bilateral upper
extremities and an attempt to remove the left lower extremity at the hip (see separate forensic anthropology report).
There was a spiral fracture of the left upper extremity without soft tissue hemorrhage. There was evidence of perimortem
penetrating trauma to the rectum including a posterior tear and abrasions anteriorly.
Microscopic exam revealed mild hypoxic ischemic changes of the brain and viral cytopathic changes consistent with
human papilloma virus (a sexually transmitted disease) in the rectum. Cytologic screening of swabs taken from the
mouth, neck, chest, abdomen, vagina, back, anus and buttocks, and the thighs were all negative for spermatazoa.
Postmortem toxicology of liver tissue revealed an ethanol concentration of 210 mg/100 g. In an alcohol naïve person,
this level of alcohol could cause cognitive and physical impairment. The postmortem carboxyhemoglobin level on liver
was less than 5% (normal level). Laboratory testing of the vitreous fluid (eye fluid) detected no significant abnormalities
of the electrolytes.
Postmortem computed tomography scans (CT scan) correlated with the autopsy findings. These findings were reviewed
and a report was compiled by Dr. Gary Hatch, Forensic Radiologist (see separate radiology report).
SUMMARY AND OPINION
Cause Of Death: Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 4 of 31
Compression of the neck structures causes impaired blood flow to the brain and results in loss of consciousness and
death. The findings of abrasions and contusions around the head and neck, hemorrhage in the neck muscles, and
petechiae in areas such as the eyes or lips are consistent with manual strangulation. The sharp force injuries described
above showed no vital response – a finding in keeping with being inflicted post-mortem. No soot was found in the
airway and the level of Carbon Monoxide/carboxyhemoglobin was low (normal) – indicating that there was no evidence
of inhalation of products of combustion. Therefore it is our opinion, based on all the currently available information and
findings at autopsy, that Ms. Victoria Martens died as a result of manual strangulation. The manner of death is best
classified as homicide.
Cause Of Death: Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Summary Opinion MARTENS, VICTORIA
Death Investigation Report page 5 of 31
Medical Investigator
Matthew Cain, MD
Authority for examination:
Body length (cm):
Body weight (kgs):
BMI:
Development:
Stature:
Age:
Anasarca:
Edema localized:
Dehydration:
Scalp hair color:
Scalp hair length:
Eyes:
OMI
141.00
40.60
20.42
Well-developed
Well-nourished
Appears to be stated age
No
No
No
Brown
Long
Both eyes present
Irides:
Eyes corneae:
Eyes sclerae:
Hazel
Translucent
White
Eyes conjunctivae:
Eyes petechiae:
Palpebral petechiae:
Bulbar petechiae:
Facial petechiae:
Translucent
Yes
Yes
Yes
Yes
External exam date time: 8/25/2016 9:00:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Means used to confirm identity:
Other verification means:
Location of orange bracelet:
Name on orange bracelet:
Other name on orange bracelet:
Location of green bracelet:
Name on green bracelet:
Other name on green bracelet:
Hospital ID tags or bracelets?
If yes specify stated name and
location:
Dental
Left ankle
Decedent name
Left ankle
Decedent name
No
ID confirmed at time of exam: No
Development comments:
See evidence of injury.
Skin comments:
External Examination Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 6 of 31
Oral mucosal petechiae:
Nose:
Ears:
Lips:
Facial hair:
Facial hair color:
Maxillary dentition:
Mandibular dentition:
Condition of dentition:
Neck:
Trachea midline:
Yes
Normally formed
Normally formed
Normally formed
None
Does not apply
Natural
Natural
Good
Abnormal - See Evidence of Injury
Yes
Chest symmetrical:
Chest diameter:
Abdomen:
Anus comment:
Back:
Spine:
External genitalia:
Breast masses:
Genitalia comment:
Right hand digits complete:
Left hand digits complete:
Right foot digits complete:
Yes
Appropriate
Flat
See evidence of injury.
Abnormal - See Evidence of Injury
Normal
Female
None
See evidence of injury.
Yes
Yes
Yes
Breast development: None
Chest development:
Left foot digits complete: Yes
Muscle group atrophy:
Senile purpura:
Pitting edema:
No
No
No
Muscle other: No
Tattoo(s)
Tattoos present: No
Cosmetic Piercing(s)
Extremities:
Extremities comment:
Well-developed and symmetrical
See evidence of injury.
Bilateral upper extremities received separate from torso.
Normal
Anus: Other
External Examination Page 2 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 7 of 31
Cosmetic piercing present: Yes
Cosmetic piercing right ear: Yes
Cosmetic piercing left ear: Yes
Scar(s)
Scar(s) present: Yes
Scar abdomen: Yes
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:17 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Reporting Tracking
The bilateral upper extremities, heart, left lobe of the liver, and sternum are received separately. See evidence of injury.
External exam comment:
External Examination Page 3 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 External Examination MARTENS, VICTORIA
Death Investigation Report page 8 of 31
Medical Investigator
Matthew Cain, MD
Evidence of medical intervention: No
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:28 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Medical Intervention Page 1 Printed: 1/9/2017 1:18:01 PM
Case Number: 2016-04676 Medical Intervention MARTENS, VICTORIA
Death Investigation Report page 9 of 31
Medical Investigator
Matthew Cain, MD
Body temperature:
Rigor mortis:
Livor mortis - color:
Livor mortis - fixation
(if applicable):
Livor mortis - position
(if applicable):
State of preservation:
Skin slippage:
Cool subsequent to refrigeration
Fully fixed
Purple
Fully Fixed
Posterior
No decomposition
Yes
External exam date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:36 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Postmortem Changes Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Postmortem Changes MARTENS, VICTORIA
Death Investigation Report page 10 of 31
Medical Investigator
Matthew Cain, MD
Autopsy date: 8/25/2016 10:07:00 AM
Evidence of Injury:
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
# Injury Location Injury Description
1 Mechanical asphyxia Head and neck Evidence of Manual Strangulation:
Behind the auricle of the left ear are multiple punctate, purple
contusions. Behind the auricle of the right ear is a linear, red
abrasion that measures 1.8 cm. On the left anterior aspect of the
neck are multiple red-brown abrasions that range in size from
1.0 to 3.5 cm. On the left posterior aspect of the neck are
multiple white and red abrasions with skin sloughing that range
in size from 0.1 to 0.5 cm. On the right posterior aspect of the
neck is a square, purple contusion that measures 4 x 2.5 cm.
Internally, there are multiple foci of acute hemorrhages that
involve the following:
1. The anterior neck strap muscles including the left
sternocleidomastoid, the bilateral sternohyoid and sternothyroid
muscles.
2. The inferior portion of the pharyngeal constrictor muscle.
3. The subcutaneous soft tissue of the posterior neck.
4. The right erector spinae muscle.
There are multiple, scattered, petechial hemorrhages involving
the palpebral conjunctivae, bilateral eyelids, periorbital area,
and the upper gingiva.
2 Blunt injury Head Subgaleal and subscalpular hemorrhages overlie the left and
right sides of the frontal bone and the left side of the occiput;
no corresponding external contusion is observed.
A small amount of hemorrhage is in the cervical epidural
space.
3 Sharp injury Other The body has multiple sharp force injuries and is partially
dismembered; these injuries lack an apparent vital response.
The arms have been removed at the glenohumeral joint and the
left leg is partially amputated. These injuries are described in
the region in which they occurred.
Torso:
Starting just below the clavicle and extending to just below the
umbilicus is a linear, full-thickness incised wound that
measures 36 cm in length; extending inferiorly and
continuously from this wound is a 5.5 cm superficial incised
wound. The superior portion of the incised wound measures 7
cm wide at its widest point. This wound exposes the internal
cavities of the body and internal organs. Multiple, superficial
incised wounds extend roughly parallel and to the right of the
previously described midline incision and average 18 cm in
length. Multiple linear incised wounds, that range in size from
Are there any injuries: Yes
Evidence of Injury Page 1 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 11 of 31
1.5 to 3 cm, are located at 10 o’clock and at 2 o’clock to the
large midline incised wound.
Examination of the chest plate reveals that a segment of
sternum is absent; this segment corresponds to ribs 3-8.
Additionally, ribs 2 through 8 are cut bilaterally on the anterior
surface. Internally, the anterior aspect of the aorta has a linear
incised wound measuring approximately 5 cm.
Around the proximal left thigh at the hip is a circumferential
incision that exposes 4 cm of bone, muscle and soft tissue. The
area around this injury has patchy charring of the soft tissue
and muscle.
Received in a separate bag is a section of sternum, two arms, a
heart, and part of the left lobe of liver. The segment of sternum
corresponds to ribs 3-8 and has apparent tool markings (see
separate anthropology report).
The decedent's arms have been removed from the body at the
joint of the glenoid fossa and humeral head. The humeral head
is present and exposed on each arm and has apparent tool
markings (see separate anthropology report). Each arm has
been cut circumferentially through the soft tissue and muscle.
Along each cut are occasional irregular cut marks with
remaining jagged skin and subcutaneous tissue. Along the cut
edge are irregular linear abrasions. Each arm will be described
individually.
Right arm: The right arm measures 62 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length from the cut edge. On
the anterior aspect of the forearm are 3 abrasions measuring 0.5
cm, 1 cm, and 3 cm. On the lateral surface of the arm are
scattered small scars. On the right elbow is a 1 cm red
contusion, a 0.8 cm purple contusion, and an adjacent 3 cm
abrasion. On the posterior aspect of the right forearm are
scattered small abrasions. On the right hand are scattered
abrasions.
Left arm: The left arm measures 61 cm in total length,
including the cut margin and the exposed humerus. The
exposed bone measures 2 cm in length and the head of the
humerus has prominent apparent tool markings. On the anterior
aspect of the left forearm are scattered small abrasions. On the
posterior-lateral aspect of the left arm is a 1 cm abrasion and
multiple scabs. On the left elbow is a 1 cm red contusion. On
the left hand are scattered small abrasions.
On the anterior surface of the heart is a linear, incised wound
measuring 1.5 cm. On the posterior surface of the heart are two
irregular, incised wounds measuring 0.5 cm and 1.8 cm.
A portion of the left lobe of liver is also received separately.
On the anterior surface of the left lobe of liver are multiple
linear, incised wounds that range in size from 0.5 cm to 2.5 cm.
On the posterior surface of the left lobe of liver is a 2 cm
incised wound.
Evidence of Injury Page 2 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 12 of 31
4 Blunt injury Trunk Chest and abdomen:
In the right axilla (underarm) are multiple, linear, superficial
abrasions that measure 2 cm in length. In the lower right
abdominal quadrant, abutting the central incised wound
described above, is an irregular purple contusion that measures
4.5 x 2 cm.
Genitalia:
Several blunt injuries involve the both the vaginal area and
anus. These are described below.
Vagina:
1. On the clitoris is a red linear abrasion measuring 1.0 cm.
Anus/Rectum:
The posterior rectum is designated 12 o'clock and the anterior
perineum is 6 o'clock in the description below.
1. At the 11 o'clock and 1 o'clock positions are partial thickness
abrasions of the anus.
2. At the 6 o'clock position of the anus is a linear tear that
measures 0.5 cm.
Back:
Superior to the gluteal cleft is a 6 x 3 cm irregular purple
contusion.
5 Thermal injury Other Thermal Injuries
Thermal injuries involve the torso and lower extremities;
however, no soot is seen in the airway.
On the right lateral flank is a circular area of superficial
charring. There is superficial charring of the bilateral lower
extremities involving 30% of the right thigh, 60-70% of the
right lower leg, 30% of the left thigh, and 40% of the left lower
leg.
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 9:34:04 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Evidence of Injury Page 3 Printed: 1/9/2017 1:18:02 PM
Case Number: 2016-04676 Evidence of Injury MARTENS, VICTORIA
Death Investigation Report page 13 of 31
Medical Investigator
Matthew Cain, MD
Date of Internal Exam:
Chest cavities examined:
See evidence of injury section
Organs in normal anatomic
position
Other organ position comments
Diaphragm:
Serosal surfaces:
Body cavity adhesions present:
Fluid accumulation present:
Brain examined:
See separate forensic
neuropathology consultation report
See evidence of injury section:
See evidence of medical
Intervention section:
8/26/2016 9:30:00 AM
Yes
Yes
No
The heart and liver are absent from the body cavity.
Intact
Smooth and glistening
No
No
Yes
No
Yes
No
See postmortem changes section:
Facial skeleton:
Calvarium:
Skull base:
No
No palpable fractures
No fractures
No fractures
Dura mater:
Skull comments:
Dural venous sinsuses:
Leptomeninges:
Epidural hemorrhages /
hematomas:
Subdural hemorrhages /
hematomas:
Subarachnoid hemorrhages:
Cerebral hemispheres:
Gyral and sulcal patterns:
Gyral convolutions and sulci:
Uncal processes:
Unremarkable and without masses
Patent
Thin and transparent
Absent
Absent
Absent
Symmetrical
Unremarkable
No widening or flattening of gyri and no narrowing of sulci
Unremarkable
Date of Autopsy: 8/25/2016 10:07:00 AM
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
BODY CAVITIES
HEAD
Brain fresh (g):
Brain fixed (g):
1295
Internal Examination Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 14 of 31
Spinal cord examined:
Middle ears examined:
Yes
No
Cerebellar tonsils:
Cranial nerves:
Basilar arterial vasculature:
Cerebral cortex:
White matter:
Corpus callosum:
Deep gray matter structures:
Brainstem:
Cerebellum:
Spinal dura:
Spinal cord:
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
See Evidence of Injury
See Evidence of Injury
Neck examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section
See Postmortem Changes section:
Subcutaneous soft tissues:
Strap muscles:
Jugular veins:
Carotid arteries:
Tongue:
Epiglottis:
Hyoid bone:
Larynx:
Palatine tonsils:
Yes
Yes
No
No
See Evidence of Injury
See Evidence of Injury
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Not examined
Spinal Cord
Middle Ears
Neck
CARDIOVASCULAR SYSTEM
See separate Cardiovascular
Pathology report:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Right coronary ostium position:
Left coronary ostium position:
Supply of the posterior
myocardium:
No
Yes
No
No
Normal
Normal
Right coronary artery
Heart examined: Yes
Heart
Heart fresh (g): 140.0
Internal Examination Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 15 of 31
Aorta examined:
Right coronary ostium:
Proximal third right coronary
artery:
Middle third right coronary artery:
Left coronary ostium:
Left main coronary artery:
Proximal third left anterior
descending coronary artery:
Middle third left anterior
descending coronary artery:
Distal third left anterior descending
coronary artery:
Proximal third left circumflex
coronary artery:
Distal third left circumflex coronary
artery:
Cardiac chambers:
Tricuspid valve:
Pulmonic valve:
Mitral valve:
Aortic valve:
Other valve comments:
Yes
0
0
0
0
0
0
0
0
0
0
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Unremarkable
Tricuspid valve - 10.0 cm
Pulmonic valve - 6.5 cm
Mitral valve - 8.0 cm
Aortic valve - 5.0 cm
Right ventricular myocardium:
Left ventricular myocardium:
No fibrosis, erythema, pathologic infiltration of adipose tissue or areas of accentuated
softening or induration
No fibrosis, erythema, or areas of accentuated softening or induration
Distal third right coronary artery: 0
Middle third left circumflex
coronary artery:
0
Coronary artery stenosis by atherosclerosis (in percent):
Ventricular septum:
Right ventricular free wall
thickness:
Left ventricular free wall thickness:
Interventricular septum thickness:
Other heart comments:
Orifices of the major vascular
branches:
Unremarkable
0.1 cm
0.6 cm
0.8 cm
See evidence of injury.
Patent
Atrial septum: Unremarkable
Aorta
Heart fixed (g):
Cardiac Chambers and Valves:
Internal Examination Page 3 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 16 of 31
Great vessels examined: Yes
Coarctation:
Vascular dissection:
Aneurysm formation:
Complex atherosclerosis:
Other aortic pathology:
Vena cava and major tributaries:
Lungs examined:
See separate Cardiovascular
Pathology report:
See Evidence of Medical
Intervention section:
See Evidence of Injury section:
Upper and lower airways:
Pulmonary parenchyma color:
Pulmonary parenchyma congestion
and edema:
Pulmonary trunk:
Pulmonary artery thrombi:
No
No
No
No
Yes - See comments
Patent
Yes
No
No
No
Unobstructed, and the mucosal surfaces are smooth and yellow-tan
Dark red-purple
Slight amounts of blood and frothy fluid
Free of saddle embolus
None
Other aortic comments:
See evidence of injury.
See Postmortem Changes section: No
Vena Cava
RESPIRATORY SYSTEM
Liver examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Hepatic parenchyma (color):
Hepatic parenchyma (texture):
Hepatic vasculature:
Gallbladder:
Gallstones:
Intrahepatic biliary tree:
Yes
Yes
No
No
Red-brown
Unremarkable
Unremarkable and free of thrombus
Unremarkable
None
Unremarkable
Pulmonary artery atherosclerosis: None
HEPATOBILIARY SYSTEM
Lung right (g):
Lung left (g):
Liver (g):
210
160
900
Bile vol (mL):
Gallstones autopsy:
Gallstones autopsy desc:
No
Internal Examination Page 4 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 17 of 31
Extrahepatic biliary tree:
Alimentary tract examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Course:
Mucosa:
Mucosa:
Pylorus:
Luminal contents:
Unremarkable
Yes
No
No
No
Normal course without fistulae
Gray-white, smooth and without lesions
Usual rugal folds
Patent and without muscular hypertrophy
Partially digested food
Other hepatobiliary comments:
See evidence of injury.
GASTROINTESTINAL SYSTEM
Esophagus
Stomach
Colon
Pancreas
Small Intestine
Caliber and continuity:
Luminal contents:
Mucosa:
Caliber and continuity:
Form:
Genitourinary system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Cortical surfaces:
Cortices:
Calyces, pelves and ureters:
Appropriate caliber without interruption of luminal continuity
Formed stool
Unremarkable
Appropriate caliber without interruption of luminal continuity
Normal tan, lobulated appearance
Yes
Yes
No
No
Smooth
Normal thickness and well-delineated from the medullary pyramids
Non-dilated and free of stones and masses
Kidneys capsules: Thin, semitransparent
Mucosa: Unremarkable
GENITOURINARY SYSTEM
Kidneys
Kidney right (g):
Stomach contents vol (mL):
70
150
Kidney left (g): 75
Urine volume (mL):
Appendix found:
0
Yes
Stomach contents description:
Partially digested food.
Internal Examination Page 5 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 18 of 31
Urinary bladder mucosa: Gray-tan and smooth
Urinary Bladder
Female
Breasts
Female Genital Tract
Female:
Breast tissue comments:
Uterus:
Breast tissue:
Uterine cervix:
Fallopian tubes:
Ovaries:
Vagina:
Other female genital tract
comments:
Spleen (g):
Thymus (g):
Yes
Prepubertal breast tissue. Tanner stage II.
Unremarkable and non-gravid
Other - See comments
Infantile
Unremarkable
Unremarkable
Other - See comments
See evidence of injury.
90
Urine description:
Reticuloendothelial system
examined:
See Evidence of Injury section:
See Postmortem Changes section:
Color:
Regional adenopathy:
Yes
No
No
Red-brown, homogeneous and ample
No adenopathy
See Evidence of Medical
Intervention section:
No
RETICULOENDOTHELIAL SYSTEM
Spleen
Bone Marrow
Lymph Nodes
Endocrine system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Yes
No
No
No
Parenchyma: Tan-pink
Thymus
ENDOCRINE SYSTEM
Pituitary Gland
Spleen parenchyma: Moderately firm
Spleen capsule: Intact
Spleen white pulp: Prominent
Internal Examination Page 6 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 19 of 31
Adrenal right (g):
Adrenal left (g):
5
5
Size:
Position:
Size:
Parenchyma:
Size:
Musculoskeletal system examined:
See Evidence of Injury section:
See Evidence of Medical
Intervention section:
See Postmortem Changes section:
Bony framework:
Subcutaneous soft tissues:
Other musculoskeletal system
comments:
Normal
Normal
Normal
Homogeneous
Normal
Yes
Yes
No
No
Other - See comments
See Evidence of Injury
See separate anthropology report.
Parenchyma: Yellow cortices and gray medullae with the expected corticomedullary ratio
Musculature: See Evidence of Injury
Thyroid Gland
MUSCULOSKELETAL SYSTEM
Adrenal Glands
ADDITIONAL COMMENTS
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:25 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Internal Examination Page 7 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Internal Examination MARTENS, VICTORIA
Death Investigation Report page 20 of 31
Medical Investigator
Matthew Cain, MD
Microscopic description:
Heart: No significant histopathologic findings.
Thyroid: No significant histopathologic findings.
Trachea: The sections are free of significant histopathologic abnormality, inflammation, or soot in the airway.
Lung: Non-occluding foreign plant material is in the large airways. Otherwise, the sections are free of significant
histopathologic abnormality and polarizable foreign material. No soot is in the airways.
Kidney: The sections are free significant histopathologic findings and polarizable foreign material.
Liver: No significant histopathologic findings.
Skin and soft tissue: Sections from the skin on the chest at the sites of incised wounds showed no evidence of
inflammation or tissue response.
Posterior vagina and lower uterine segment: Chronic inflammation and fibrosis.
Rectum: Koilocytic change consistent with human papilloma virus, chronic inflammation and pronounced vascularity.
Brain: Occasional neurons demonstrate hypoxic ischemic change. The vessels are free of inflammation.
Medical lnvestigator Trainee
Rebecca Asch-Kendrick, MD
*Unless otherwise indicated sections are stained only with hematoxylin and eosin (H&E).
Microscopy: Page 1 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 21 of 31
Block Tissue Location Description Stain
A1 Liver and soft tissue
A2 Thyroid and trachea
A3 Left lung and kidney
A4 Right lung and kidney
A5 Proximal trachea
A6 Heart
A7 Posterior vagina
A8 Posterior vagina
A9 Anterior vagina
A10 Anterior vagina
A11 Brain
A12 Brain
A13 Brain
A14 Brain
A15 Rectum 12 o'clock
A16 Rectum 2 o'clock
A17 Rectum 3 o'clock
A18 Rectum 5 o'clock
A19 Rectum 6 o'clock
A20 Rectum 7 o'clock
A21 Rectum 9 o'clock
A22 Rectum 11 o'clock
A23 Rectum distal
A24 Rectum mid
A25 Rectum proximal
A26 Tissue from cut adjacent to midline cut
A27 Tissue from midline cut
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/21/2016 9:51:32 AM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Microscopy: Page 2 Printed: 1/9/2017 1:18:03 PM
Case Number: 2016-04676 Microscopy MARTENS, VICTORIA
Death Investigation Report page 22 of 31
Medical Investigator
Matthew Cain, MD
Study type(s):
Results of ancillary studies:
Vitreous electrolyte screen
Cytology screening
Sodium 121 (expected 135-150 mmol/L)
Potassium >15 (expected mmol
/L)Chloride 108 (expected 105-135 mmol/L)
VUN 15 (8-20 mg/dL)
Creatinine dL
)Glucose dL
)The sodium is marginally low but may represent postmortem change.
Cytologic screening of swabs taken from the hands, chest, abdomen, neck, back and left thigh were negative for
spermatazoa.
Autopsy date: 8/25/2016 10:07:00 AM
Medical Investigator Trainee
Rebecca Asch-Kendrick, MD
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Matthew Cain, MD on 11/22/2016 2:15:36 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Ancillary Lab Studies Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 Ancillary Lab MARTENS, VICTORIA
Death Investigation Report page 23 of 31
Medical Investigator
Matthew Cain, MD
Study date:
Accession number:
Exam type:
Technique:
Comparison:
Comments:
Martens, Victoria 2016-04676
GENERAL: Mild decomposition.
HEAD/NECK: No intracranial hemorrhage. Cerebral edema, without herniation. Extensive intra-arterial gas. No skull,
facial, or cervical spine fracture detected. No hyoid or thyroid cartilage fracture detected.
CHEST: Gaping defect in anterior lower chest, at and just to the left of midline, through the tip of the sternum and left
costochondral cartilage. The heart is absent. Moderate left and small right hemothorax. No rib, or thoracic spine fracture
detected.
ABDOMEN/PELVIS: The lower chest defect carries on an inferior direction, to a level just below the umbilicus. A
portion of the left liver lobe is absent. The bowel is gas distended and protrudes through the anterior abdominal wall
defect. No other solid organ injury. No free fluid. No lumbar spine or pelvic fracture detected.
EXTREMITIES: Comminuted fracture of the distal third of the left humerus. The fracture is in three major fragments,
with a somewhat triangular-shaped central fragment, as can be seen in butterfly type fractures. No other fractures in the
extremities. Bilateral arm amputations at the glenohumeral joints. Deep circumferential laceration in the proximal left
thigh, down to bone.
Disclaimer: Autopsy and postmortem imaging are different techniques and therefore will not always perfectly
correspond. Findings/structures not explicitly mentioned are either forensically irrelevant, normal, or were not assessed.
Further specific questions may be addressed in supplementary requests.
Date of examination: 8/25/2016 10:07:00 AM
Reported by: Rebecca Asch-Kendrick, MD
Verified by: Gary Hatch MD on 11/22/2016 3:42:14 PM
Reviewed and approved by: Matthew Cain, MD on 11/22/2016 3:42:52 PM
Report Tracking
Computed Tomography Page 1 Printed: 1/9/2017 1:18:04 PM
Case Number: 2016-04676 PMCT MARTENS, VICTORIA
Death Investigation Report page 24 of 31
Yellow Sheet Morphology Technician
Identification Darla Bentzen
Autopsy Michael Jarvis
Evidence Darla Bentzen
Evidence Darla Bentzen
Radiology Darla Bentzen
Retention Darla Bentzen
Toxicology Michael Jarvis
Toxicology Michael Jarvis
Toxicology Michael Jarvis
LabOther Michael Jarvis
Attendees Michael Jarvis
Case Number:
Date of Examination:
Pathologist:
Fellow/Resident:
2016-04676
8/25/2016 10:07:00 AM
Matthew Cain, MD
Rebecca Asch-Kendrick, MD
Decedent Name: MARTENS, VICTORIA
Morphology technican(s) present
Morphology technican supervisor(s) present
Yellow Sheet Morphology Technician Lead
LabOther Erika Cavalier
Identification Michael Jarvis
Attendees Daniel Gutierrez
Toxicology Erika Cavalier
Autopsy Brittany Vallejos
Evidence Michael Jarvis
Radiology Michael Jarvis
Retention Michael Jarvis
Procedural Notes Report Page 1 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 25 of 31
Autopsy attendees
Specimens obtained for toxicology testing
Other morphology technicians present:
Michael Jarvis - Sr. Tech
Darla Bentzen - Staff Tech.
Ryan Castillo - Staff Tech.
Daniel Ward - Photo Tech.
Law enforcement officers present:
Andrew HSU
Det. Jones
Det. Wild
Det. Acata
Use antemortem specimens for
testing:
No
Femoral blood collected: No
Heart blood collected: No
Blood other collected: Yes
Preserved vitreous collected: No
Un-preserved vitreous collected: Yes
Bile collected: Yes
Gastric contents collected: Yes
Kidney tissue collected: Yes
Liver tissue collected: Yes
Brain tissue collected: Yes
Muscle tissue collected: Yes
Other tissue collected: No
Urine collected: No
Procedural Notes Report Page 2 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 26 of 31
Specimens obtained for laboratory testing
Approach to autopsy dissection
HIV serology: No
HCV/HBV serology :
Influenza serology:
Other serology:
Freezer protocol:
DNA card:
Metabolic screen:
Cytogenetics:
Med-X protocol:
Urine dipstick:
Blood cultures (bacterial):
Lung cultures (bacterial):
CSF culture (bacterial):
Spleen culture (bacterial):
Stool culture (bacterial):
Other bacterial culture (specify):
Mycobacterial culture (lung):
Mycobacterial culture (other):
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
Rokitansky evisceration: Yes
Virchow evisceration: No
Modified evisceration: No
Viral Cultures: No
HIV spin and store: Yes
Procedural Notes Report Page 3 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 27 of 31
Special autopsy techniques
Tissues retention
Disposition of tissues retained for extended examination
Pericranial membrane removal: No
Neck anterior dissection: Yes
Neck posterior dissection: Yes
Facial dissection: No
Vertebral artery dissection (in situ): No
Cervical spine removal: No
Layered anterior trunk dissection: Yes
Anterolateral rib arc dissection: No
Back dissection: Yes
Posterior rib arc dissection: No
Extremity soft tissue dissection: Yes
Eye enucleation: No
Inner middle ear evaluation: No
Maxilla or mandible resection: No
Spinal cord removal (anterior): Yes
Spinal cord removal (posterior): No
Other dissection(s):
Stock jar with standard tissue
retention:
Yes
Rib segment: Yes
Pituitary gland: Yes
Breast tissue (women only): No
Brain retention: No
Spinal cord retention: No
Cervical spine retention: No
Heart retention: No
Heart-lung block retention: No
Rib cage retention: No
Long bone retention: No
Other retention,specify:
Specimen outcome: Not applicable; no tissues were retained for extended examination.
HIV serology: No
Procedural Notes Report Page 4 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 28 of 31
Number of scene photos produced by the OMI
Number of autopsy photos produced by the OMI
Evidence collected
Personal effects
Scene Photos: 171
Autopsy Photos: 223
FBI blood tube: No
Blood spot card: No
APD blood card: Yes
Thumbprint: Yes
Fingerprints: Yes
Palmprints: No
Print hold: Yes
Oral swab: Yes
Vaginal swab: Yes
Anal swab: Yes
Other swab: Yes
Fingernails: Yes
Scalp hair: Yes
Pubic hair: Yes
Pubic hair combing: Yes
Projectile(s): No
Retain clothing: Yes
Retain valuables: No
Retain trace evidence: Yes
Retain body bag: No
Retain hand bags: No
Ligature: No
Other evidence retained:
Procedural Notes Report Page 5 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 29 of 31
Clothing
Property Type Property Description Property Detail
Blood FTA Blood Card n/a
Hair Scalp n/a
Fingernail Clipping Right Hand w/ clippers
Fingernail Clipping Left Hand w/ clippers
Swabs Oral n/a
Swabs Anal n/a
Swabs Vaginal n/a
Swabs Other Right Hand- Dry
Swabs Other Right Hand- Wet
Swabs Other Left Hand- Dry
Swabs Other Left Hand- Wet
Other Other Blanket & garbage bag around body
Other Other Paint can w/ fabric
Swabs Other Chest- Dry
Swabs Other Chest- Wet
Swabs Other Abdomen- Wet
Swabs Other Swabs- Abdomen Dry
Hair Pubic Combing with Blue Pad and
Comb
n/a
Toenail Clipping Right Foot w/ clippers
Toenail Clipping Left Foot w/ clippers
Hair Pubic n/a
Trace Location Hair- found on right arm
Trace Location Hair- found left thigh
Trace Location Hair- found on left arm
Swabs Other Neck Dry
Swabs Other Neck Wet
Other Other Garbage bags containing arms and organs
Trace Location Hairs from body bag
Swabs Other Left Thigh - Wet
Swabs Other Lower Back - Wet
Swabs Other Lower Back - Dry
Swabs Other Mid Back - Wet
Swabs Other Mid Back - Dry
Swabs Other Upper Back - Wet
Swabs Other Upper Back - Dry
Trace Location From Right Buttock
Blood FTA Blood Card 8/26/16
Valuables Other No Pers. Effects to Inventory
Fingerprints Describe R and L inked prints
Palm Prints Describe R and L palms
Other Prints Taken From R and L feet
Procedural Notes Report Page 6 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 30 of 31
Property Type Property Description Property Detail
Clothing Shirt n/a
Procedural Notes Report Page 7 Printed: 1/9/2017 1:18:06 PM
Case Number: 2016-04676 Procedural Notes MARTENS, VICTORIA
Death Investigation Report page 31 of 31
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