OFFICE of the WAYNE COUNTY MEDICAL EXAMINER bo ntaaadl 1900 East Warren Avenue caunay orn Detroit, Ml 48207 WAYNE POST MORTEM REPORT ote p23, 2017 Tass ToceRney WAT PERFORMED A POSTMORTEM EXAMINATION ON THE B00¥ Francisco Diaz, M.D., Assistant Medical Examiner es Wayne County Medical Examiner's Office Ape 24, 2017 ‘SUMMARY & OPINION {tis my opinion that death was caused by asphyxia, According to investigative report, the decedent is an 8 month old female infant, born by normal spontaneous vaginal delivery at ful-term, with a past medical history of chronic constipation, who was found unresponsive on April 20, 2017, Emergency medical services were contacted, and the decedent was conveyed to the hospital with resuscitation en route, She was admitted to the hospital, and after several days, ultimately expired on April 23, 2017. According to police report, the decedent was last known alive on April 20, 2017 while left in the care of her father. Ouring this time, both individuals slept adjacent to each on an adult sized bed, and upon waking the decedent's father found her unresponsive. Postmortem autopsy examination, including external examination of the body, internal examination of the organs, extended dissection of the subcuteanous tissue and musculature, en bloc resection of the cervical spine, en bloc resection of the rectum and anus, and special dissection of the eyes and optic nerve sheath, did not reveal any injuries on the body. Incidental autopsy findings included a minute perianal fissure / laceration of unknown etiology wilh histolagic evidence of scarring, a benign vascular lesion on the posterior scalp, and a congenital dermal melanocytic proliferation on the back / buttocks, Histologic examination of the brain showed changes of hypoxic-ischemic injury, consistent with the history of languishing in the hospital for several days before death, None of these findings contributed to death, Postmortem toxicology testing was noncantributory. Unsafe sleep envitonments, including co-sleeping with an adult, are a known risk factor for asphyxia related deaths in children under the age of one. Given the known circumstances, autopsy findings, and postmortem toxicology results, the manner of death is classified as accident printed by: cl Franesco Diaz, M.D., Assistant Medical Examinar June 16, 2017 Martin Ishikawa, MO, Forensic Pathologist Fellow (report inves on next page) ine 18, 2017 11:31:38 AM) Page 1 of 5