Getting It Right – The Importance of Forensic Pathology
Recently, one of our Forensic Nurse Consultants at Godoy Medical Forensics was involved in a 2016 case in Mississippi regarding a mother who was arrested, prosecuted for the capital murder of her 8-day old daughter, and was detained without bail for nearly a year. The mother, 26 years of age at the time, was visiting a rural area in Mississippi for a family wedding when she went into labor six weeks prematurely. She lived in Douglasville, GA and had two other children by the baby’s father. She had an emergency C-section. The baby remained in the hospital for five days due to some physical difficulties and was sent home weighing approximately five pounds. The baby was home for approximately 36 hours and during that time she never woke up for a bottle and never cried. The mother knew something was wrong. On September 21, 2016, the mother gave the baby a sponge bath and shortly afterwards the baby made two loud “screeching” sounds that startled everyone in the household. Everyone assumed the baby was having stomach pain and the mother had planned on taking the baby to the doctor the following day due to failure to feed. However, 10-15 minutes later, the baby suddenly appeared pale, her lip had “caved in”, and she was gasping for breaths. The mother and father rushed the baby to the nearest emergency department at a small, rural hospital, calling 911 on the way. The nurse met them outside and started CPR. A large children’s hospital in Memphis was consulted and a helicopter was dispatched to airlift the baby. However, the flight team was struggling to get her stabilized enough for transport. Shortly after midnight on September 21, 2016, the medical staff informed the family that the baby had died.
Weeks turned into months and the mother could not understand why she had not received the autopsy report. The autopsy had been performed on September 23, 2016. However, the final autopsy report was not released until November 29, 2017. The medical examiner stated that the cause of death was blunt force trauma with features of strangulation. The manner of death was listed as a homicide.
The mother was not questioned until 2018 by a Georgia law enforcement officer. At that point, she was pregnant with her fourth child. She was informed of the autopsy results and also told that the findings had suggested the baby had been sexually assaulted. The mother insisted that she had never been away from the baby and that this could not have occurred. At that point, Georgia child protective services monitored the family only allowing the mother supervised visits with her children. Months later the CPS case was closed.
Then, in May 2019, the mother was charged with capital murder in the death of her daughter. On April 16, 2019, the grand jury indicted her for capital murder while engaged in the commission of felonious child abuse. She was arrested May 30th after turning herself in at the jail in Mississippi. She had no criminal history but was denied bond because of being a possible flight risk and danger to her children. Her children had been left in the care of her mother in Georgia. She was offered several plea deals but turned them down as she knew she had done nothing wrong. After 10 months and 23 days of incarceration, bond was set and she posted $100,000 on April 23, 2020, then returned to Georgia.
The mother was represented by a public defender who reviewed the autopsy report and immediately knew that the baby was sick and had not been murdered. The attorney spoke to the ED physician who was on duty the night the baby died. He discounted everything in the autopsy report, so the attorney engaged a forensic pathologist in California to review the findings. In June 2020, the expert opinion was given to the state who then sent the report to the medical examiner who initially performed the autopsy. He did not respond. However, the attorney re-sent everything to the medical examiner again in the fall of 2021, asking if his opinion had changed. On October 7, 2021, the Mississippi medical examiner made a statement say that after reviewing the “newly presented” records detailing the various lifesaving efforts undertaken in the ED, he could conclude that the injuries were consistent with lifesaving efforts performed by the medical staff. He changed his opinion to say that the cause of death was NOT blunt force injuries with strangulation and a homicide as originally determined. He contended that he had not had the ED records at the time of the autopsy but only obtained them on October 1, 2021. The case was then dismissed, and the mother was exonerated. The mother is now filing a civil rights lawsuit against the county and the Mississippi officials.
So, how did forensic medicine evolve over the years and how could such a horrific error have been made in 2016? The short answer is that Mississippi is still using the elected coroner system in all 82 counties with only 2-3 medical examiners who are actually physicians working for the Medical Examiner’s office performing all autopsies. In a Los Angeles Times article dated May 2, 2022, regarding autopsy backlogs in Mississippi, the Associated Press reported that Mississippi has long operated in violation of national standards for death investigations. The national standards recommend most autopsy reports be completed within 60 days. Autopsies that should take days take weeks and autopsy reports that should take months take a year and even longer. There are too few pathologists doing too many autopsies. As of April of 2022, the MS State Medical Examiner’s Office was waiting for about 1,300 reports from as far back as 2011. Around 800 of those are homicides. The state has resorted to transferring cases to neighboring states for reports without the family’s knowledge. The National Association of Medical examiners dictates that 90% of autopsy reports be returned within 60-90 days. Mississippi’s office has never been accredited. There were 597 homicides in 2021 and 578 in 2020 with a population of only 3 million. Needless to say, the forensics laboratory and the medical examiner’s office is not a priority for funding or staffing with an unchanged budget since 2008. The national recommendation is that one pathologist should perform no more than 250 autopsies a year. In 2021, the two MS pathologists performed 461 and 421 autopsies. In 2021, 284 autopsies were completed by contractor pathologists.
Part II of this article will be featured in next month’s newsletter:
Getting It Right – The History of Forensic Pathology in America
Bibliography
Centers for Disease Control and Prevention. (2019, Jan 12). Death Investigation Systems. Retrieved from CDC: https://www.cdc.gov/phlp/publications/coroner/death.html
Delta News TV. (2020, Jan 13). Jocelyn McLean Story: A Mother of 4 charged with capital murder. Retrieved from Delta News TX: https://www.deltanews.tv/news/jocelyn-mclean-story-a-mother-of-4-charged-with-capital-murder/article_b3a31eae-35f6-11ea-883d-f346fe876cb1.html
Innocence Staff. (2022, June 22). Wrongfully Accused Mother Pursues Civil Rights Lawsuit Against Mississippi Officials. Retrieved from Innocence Project: https://innocenceproject.org/wrongfully-accused-mother-pursues-civil-rights-lawsuit-against-mississippi-officials/
McFerrin, C. (2021, Oct 29). Mother Exonerated in 2016 Death of Infant Recalls Ordeal, Lingering Fears. Retrieved from Tallahatchie News: https://www.tallahatchienews.ms/mother-exonerated-2016-death-infant-its-not-over#sthash.1m9iStCd.dpbs
Willingham, Leah; Associated Press. (2022, May 2). Autopsy backlog plagues Mississippi, wiith worst delays in US. Retrieved from Los Angeles Times: https://www.latimes.com/world-nation/story/2022-05-02/autopsy-backlog-plagues-mississippi-with-worst-delays-in-u-s#:~:text=The%20National%20Medical%20Examiners%20Assn,performed%20461%20and%20421%20autopsies.
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