A. Marie Silver

A. Marie Silver

The Unexpected Death

This is a continuation of last week’s blog – Postmortem Identification. You’re always welcome to read it but if you don’t have time, I’ll sum up last week’s discussion. 

  • Ran all over the city collecting medical/dental records
  • Interrogated by a dentist and his receptionist
  • Made it to my final destination to collect records at a hospital
  • Security guard tells me there is a deceased there who died of a drug overdose
  • Security guard was a little too excited about my presence.
  • And so I asked…..

“Where is the deceased?”

“In his hospital room. We found him with a syringe in his arm.”




If you remember from last week – or if you don’t – I was new to this medical examiner’s office and my supervisors were keeping under close supervision.



Even though I wasn’t new to the job (I had almost two years experience) my new supervisors weren’t ready for me to conduct scene investigations solo. So, naturally, when they sent me out to collect medical records, a scene needing investigation would happen…..at one of the places I was sent to collect records.




I called my office to let them know what was going on.

“We need you back here,” my supervisor told me. “Just send for transport.”



I think it’s safe to say that I didn’t explain things very well to him. He probably thought what I initially thought when the security guard first told me about the case. “People die in the emergency room all the time.”

But that’s not what happened and I had all of these lingering questions. Is the needle in the still in his arm? What drug did he use? Did he bring it with him to the hospital or did he “borrow” some from the hospital? What am I having for lunch? If he “borrowed” the drugs from the hospital, how did he acquire them?

Insubordination isn’t something I ever want to put on my resume but in this case, I felt it necessary to at least take a peek around the hospital room and see if I could answer some of these questions.

I took the elevator up to the floor. That was an interesting situation. I had to share it with a bunch of other people who were looking at me, wondering what my uniform and scene kit were about.  I could only imagine what these people were thinking.



I got off the floor and found the room. There were a few nurses waiting for me along with someone from the hospital’s legal department. I think. It’s been many years and all I remember was that she wasn’t a nurse or doctor and the name of her department was weird.

I pulled out my clipboard and started writing down everyone’s name and contact information. Then I walked into the hospital room. It was your standard hospital room with a bed, a television on the wall, and a bathroom tucked away in a corner. The deceased was on the bed. The hospital staff explained they moved him there to work on him, after finding him unresponsive. Since he was found in the bathroom, I walked around to that end of the room and popped my head inside. And there it was. The reason why a scene investigation was absolutely necessary. There was a small amount of blood on the bathroom floor. Now, in addition to the suspected drug-related death, there is another forensic question.


Since no one witnessed the drug overdose, it was speculated that the deceased passed out, striking his head along the way. That begged the question, did the drug overdose cause the fall? Or did he fall for some other reason? Was the head injury what killed him?

I got on the phone and called my office. At this time, the only other person in the room with me was the woman from the legal department. The door to the hospital room was closed. 

“The thing is,” I began, “I took a quick peek in the hospital room and there’s blood on the bathroom floor.”

“Shit,” my supervisor said. “What is this again?”

You have to understand, on this particular day, people were dropping like flies all over the four counties we worked. It was insane. They were calling in investigators who were off-duty asking them to come in to work. Asking me what case I had wasn’t unexpected.

“It’s the overdose at the—”

“We don’t know it’s an overdose,” the lady from the legal department said, interrupting my phone conversation.




“We don’t know it’s an overdose,” she said again.



“Be quick about it,” my supervisor said. “We need you back here.”

“Will do.” I hung up the phone.

“We do not know this was a drug overdose,” the lady said, a third time.



Here’s a few things to consider. First, she’s absolutely right. We don’t know that it was a drug overdose. Just because he was found with a needle in his arm doesn’t mean he died of a drug overdose. He could’ve had a heart attack. Or a stroke. He could’ve been bitten by snake. Or he could’ve been strangled by a serial killer. Or choked on cotton balls.



Second, speculation regarding cause and manner of death is never allowed in a scene report. The information that goes in scene reports is strictly fact/witness statements/observations. For example:

  • Deceased complained of chest pains.
  • Deceased was admitted to the hospital for observation.
  • Deceased was found unresponsive by hospital staff
  • A hyperdermic needle was found in the right anterior cubital fossa (inside of the elbow.)
  • A laceration was present on the forehead
  • The McRib is back at McDonald’s
  • Red fluid – identified by hospital staff as blood, was found on the floor of the bathroom.

It’s important to mention that at both of the offices I worked at, the investigators were not allowed to classify anything in the reports. For example, we couldn’t say we found cocaine. We had to say “white powdery substance.” It’s not cocaine until a lab confirms it’s cocaine. Same thing with blood. Even though I’d seen enough blood to know it was blood, I still couldn’t write, blood, in my scene reports. But, I could write that someone else at the scene (in this case, the hospital staff) identified the red fluid as blood.

Third, while speculation is not allowed in my reports, I am allowed to speculate with people in my office and the pathologists like knowing what kind of cases are coming in. So while I appreciated this person from the hospital’s legal office was trying to keep things under wraps by yelling at me while I was talking to my office, I am allowed to say that I think the deceased died from a drug overdose. Although, you could make the argument that I should’ve said, “suspected drug overdose”, when I was talking to my supervisor. You just never know. Sometimes cotton balls happen.



If memory serves, he had the drugs in his possession but stole the syringe from the hospital. Manner of death: Accident. Cause of death: Drug overdose.

I finished up my scene investigation, called for transport and swung by the records department to pick up the paperwork (the whole reason I came to the hospital) that was needed for another case.




As always, if you have any questions leave them in the comments or send me an email at contactme@amariesilver.com.

Thanks for shopping Snark, Sass, & Sarcasm. I’ll see you next time!

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A. Marie Smith

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