Okay, you’ve narrowed and prioritized the list of possible diagnoses in this case. That’s great. I have some new information that should help you draw some conclusions about the cause of death. I’m attaching tissue slides for Nick Herren along with the results of his toxicology test.

Examine the tissue slides and toxicology results

Much like the autopsy photos you examined, the slides of the organ tissues will enable you to determine what’s normal and abnormal with regard to the decedent’s heart and brain, now at the microscopic level. In addition, I’d like you to review the results of the toxicology report to see if there were any drugs or chemicals that could have played a role in Herren’s death.

Document your findings

Update your draft of the Autopsy Report with any new conclusions you’re able to draw. Remember that the Autopsy Report evolves as the case evolves. So, again, rule out diagnoses that are no longer relevant to the case and narrow down or confirm the one(s) that you think is (are) more likely to explain the cause of death. As always, include a rationale with evidence to support it.

Your updated report should include the Microscopic Examination, Pathologic Diagnosis, and Opinion sections.

I have also attached another draft autopsy report for comparison. It’s an updated version of the report I sent you earlier and demonstrates the evolution of that case. Consider my inline comments as you work on the second draft of the Herren case.

I look forward to reviewing your latest work.

Regards,

Cameron Wood, M.D.

Chief Medical Examiner

Highland Medical Examiner’s Office