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Summary of Findings
The cause of death is stab wounds of neck and torso.
Major findings at autopsy include stab wounds of the neck with injury to the underlying spinal cord; a stab wound of the chest with
injury of the left lung; incised wounds of the head, left thigh, genitalia and hands; and blunt/ chop injuries of the hands with
amputation of several fingers. Evidence of perimortem decapitation and dismemberment through the cervical spine, bilateral
humeri, and bilateral femurs is present, with matching apposing body segments. Postmortem toxicologic analysis on urine revealed
amlodipine and no other substances included in a routine screen.
According to investigative reports, the decedent was last known to be alive on 4/8/2017. When his residence was entered on
4/10/2017, blood was on the carpet and in the kitchen. In the bathroom was a black duffel bag containing dismembered body
parts, including his head, arms and legs. Knives and a hacksaw were in the kitchen and a hatchet was on the couch. His torso was
not at the scene. Concurrently in Randolph County, the Sheriff's Office responded to a body found by NCDOT workers near
Archdale, NC. The remains (torso matching dismembered body parts) were found in a wooded area off of Canter Road near
Woody Creek. After speaking w/ the Randolph County SO and ME (Charles Reeder) and consultation w/ NC OCME, the torso
was brought to WFBMC for autopsy along with the dismembered body parts from 308 Timberline Drive.
EXTERNAL EXAMINATION
Body Weight: 153 lb Representatives for Winston Salem Police Department are present
Body Length: 71 in during the autopsy.
BMI: 21.3
The body is that of an African American male received in two sealed
body bags labelled “John Doe”, one containing the torso with attached
segment of neck and proximal thighs and the other containing the head/
proximal neck, upper extremities, and distal lower extremities. Winston
Salem Police Department subsequently confirmed the decedent’s
identity by visual means.
The body portions are cold to touch. Rigor and livor mortis are difficult to
appreciate secondary to perimortem dismemberment.
The head and proximal neck are severed at the level of the thyroid
cartilage with complete transection through the cervical vertebra and
spinal cord posteriorly and associated fractures of the bilateral superior
horns. The scalp hair is gray and sparse and in the distribution of male
pattern baldness. The irides appear light with overlying cloudy cornea.
The sclerae are white. Inferior palpebral petechiae are present
bilaterally. The nose and ears are not unusual. The lips and gums are
pink and atraumatic. The teeth are in natural condition. Facial hair
consists of a gray beard.
The torso portion consists of the neck distal to the thyroid cartilage plane
of section; right shoulder with attached 2 ½-inch segment of humeral
head and shaft; left shoulder with attached 2 3/8-inch segment of
humeral head and shaft; and both thighs which are severed through the
distal femur. The thorax is symmetrical. The abdomen is flat. The
external genitalia are those of a normal adult male; the testes are
bilaterally descended within the scrotum. The anus is unremarkable.
EVIDENCE OF INJURY:
NOTE: The sharp force injuries are labeled for documentation purposes only. The lettering does not denote the severity of the
injuries nor does it denote the chronologic order in which the injuries were received.
On the back of the neck, ½-inch below the top of the neck
dismemberment site and 1 ¼-inches left of the posterior midline, is a
5/8-inch in length, horizontal stab wound (“B”). Also on the back of the
neck, ¾-inch below the top of the neck dismemberment site and 1 inch
left of the posterior midline, is a 1 3/16-inch in length, oblique stab
wound (“C”). Blunt and sharp aspects of both wounds are
indeterminate. There is no abrasion or other injury on the skin
surrounding the stab wounds.
The paths of stab wounds “B” and “C” overlap, sequentially perforating
the skin and soft tissue of the neck with hemorrhage into the
paravertebral musculature, left transverse process of vertebra C7 (2
defects), and one penetrates the cervical spinal cord (single defect).
On the right side of the neck posteriorly, 7/8-inches below the top of
the neck dismemberment site and ¾-inches right of the posterior
midline, is a 9/16-inch in length, slightly oblique stab wound (“D”).
Blunt and sharp aspects are indeterminate. There is no abrasion or other
injury on the skin surrounding the stab wound. The path of the stab
wound sequentially perforates skin and soft tissues only with
surrounding hemorrhage. The hemorrhagic wound track has an
approximate depth of 2 ½-inches and travels from the decedent’s
back-to-front.
On the right side of the head above the ear, centered 1 ½-inches below
the top of the head and 3-inches right of the anterior midline, is a 1
7/8-inch in length, oblique, incised wound. The hemorrhagic wound
track involves skin and soft tissue only, to an approximate depth of
3/8-inch.
On the left side of the chest, 4-inches below the top of the neck
dismemberment site and 4 ½-inches to the left of the anterior midline, is
a 7/8-inch in length, oblique stab wound. Blunt and sharp aspects are
indeterminate. There is no abrasion or other injury on the skin
surrounding the stab wound.
The path of the stab wound sequentially perforates skin, soft tissues, left
rib #4 (2 cm defect), and penetrates the upper lobe of the left lung (1.3 x
0.6 cm defect). The hemorrhagic wound track has an approximate depth
of 4 ¼-inches and travels from the decedent’s front-to-back, left-to-right,
and downwards.
Associated injuries include scant blood within the left pleural cavity.
The path of the stab wound sequentially perforates skin, soft tissues,
and penetrates the spinous process of vertebra S1 without penetration of
the underlying spinal cord. The hemorrhagic wound track has an
approximate depth of 1 ¾-inches and travels from the decedent’s
back-to-front, left-to-right, and downwards.
Over the mons pubis and extending into the penile shaft, 4 ½-inches
from the tip of the penis and roughly centered at the anterior midline, is
a 4 x 3 3/8-inch area of coalescing incised wounds. The region of
incised wounds involves skin and soft tissue with exposure of the
underlying corpora cavernosa of the penile shaft with surrounding soft
tissue hemorrhage. The area of incised wounds has an approximate
maximal depth of 1-inch. An adjacent, 1 ½ x 1-inch region of
hemorrhage is present within the abdominal wall near the umbilicus.
A 4 x ¾-inch, red abrasion is over the left scapula. Two red contusions
(3 ½ x 1 ¾-inches and 1 ¾-inches) is over the right scapula.
A 3/4-inch, superficial incised wound is over the back of the right hand
near the ring finger. A 5/8-inch, superficial incised wound is over the
back of the right thumb.
the fingernail.
On the anterior left thigh at about the level of the genitalia injuries are
two incised wounds (5 ¾ x 3 ¾-inches and 2 7/8 x 1/8-inches) that are
located at 15 ½-inches and 14 ¼-inches from the distal end of the left
femur dismemberment plane and 5 ½-inches and 3 ½-inches left of the
anterior midline through the limb, respectively. The paths of the incised
wounds sequentially perforate skin, soft tissues, and penetrate
musculature with some surrounding hemorrhage and appear to nearly
connect with the incised wound on the posterior left thigh. The
hemorrhagic wound tracks have approximate depths of 2 ½-inches and
½-inches, respectively.
INTERNAL EXAMINATION
BODY CAVITIES Right pleural and abdominal cavities have no abnormal fluid collections
Panniculus adiposus: 2.5 cm or adhesions. All body organs are present in normal and anatomical
position.
CENTRAL NERVOUS SYSTEM The skull has no fractures. The dura mater and falx cerebri are intact.
Brain weight: 1430 gm The leptomeninges are thin and delicate. The cerebral hemispheres are
symmetrical. The structures at the base of the brain, including cranial
nerves and blood vessels, are intact and free of abnormality. Sections
through the cerebral hemispheres reveal no lesions within the cortex,
subcortical white matter, or deep parenchyma of either hemisphere. The
basal ganglia, thalami, and Ammon's horn are unremarkable. The
cerebral ventricles are normal caliber. Sections through the brain stem
and cerebellum are unremarkable.
The hyoid bone is intact. The lingual mucosa is intact; the underlying
firm red-brown musculature is devoid of hemorrhage.
CARDIOVASCULAR SYSTEM The pericardial surfaces are smooth, glistening and unremarkable; the
Heart weight: 310 gm pericardial sac is free of significant fluid or adhesions. The coronary
arteries arise normally, follow the usual right dominant distribution and
are widely patent, without significant atherosclerosis or thrombi. The
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AGNEW, JOHN DOUGLAS Autopsy Report A17-702
chambers and valves bear the usual size-position relationships and are
unremarkable. The circumferences of the valves are as follows:
pulmonic (7.2 cm); tricuspid (13.5 cm); aortic (7.5 cm); mitral (11 cm).
The myocardium is dark red-brown, firm, and unremarkable; the atrial
and ventricular septa are intact. The thicknesses of the ventricular walls
are: left ventricle (1.0 cm); interventricular septum (1.0 cm); right
ventricle (0.2 cm). The aorta and its major branches arise normally,
follow the usual course and are widely patent, free of significant
atherosclerosis and other abnormality. The vena cava and its major
tributaries return to the heart in the usual distribution and are free of
thrombi.
LIVER AND BILIARY SYSTEM The hepatic capsule is smooth, glistening and intact, covering red-tan
Liver weight: 1110 gm parenchyma with no focal lesions. The gallbladder contains
Bile volume: 5 mL green-brown, slightly mucoid bile; the mucosa is velvety and
unremarkable. The extrahepatic biliary tree is patent, without calculi.
The portal vein and its tributaries are unremarkable.
ALIMENTARY TRACT The esophagus is lined by gray-white, smooth mucosa. The gastric
mucosa is tan-pink with postmortem loss of the usual rugal folds. The
gastric lumen contains approximately 10 mL of tan liquid. The serosa of
the small and large bowel is unremarkable. The appendix is
unremarkable. The pancreas has pink-gray, lobulated appearance and
the ducts are unobstructed.
GENITOURINARY TRACT The renal capsules are smooth and thin, semi-transparent, and strip with
Right kidney: 110 gm ease from the underlying, red-brown cortical surfaces. The cortex is
Left kidney: 120 gm sharply delineated from the medullary pyramids, which are red-purple to
Urine volume: 20 mL tan and unremarkable. A 1.2 cm simple cyst is noted in the left kidney.
The calyces, pelves, and ureters are unremarkable. The relationships at
the trigone are unremarkable. The mucosa of the urinary bladder is
gray-tan and smooth. The testes, prostate and seminal vesicles are
without hemorrhage.
RETICULOENDOTHELIAL SYSTEM
Spleen weight: 30 gm The spleen has a smooth, intact capsule covering red-purple, softened
parenchyma; the lymphoid follicles are indistinct. The regional lymph
nodes appear normal. The bone marrow is red-purple and
homogeneous, without focal abnormality.
ENDOCRINE SYSTEM The pituitary, thyroid, and adrenal glands are unremarkable.
MUSCULOSKELETAL SYSTEM Aside from the injuries and regions of dismemberment noted above, the
remaining bony framework, supporting musculature, and soft tissues are
not unusual.
BLOCK SUMMARY
1. Fibroadipose tissue
2. Paravertebral skeletal muscle, lung
3. Lung, heart
4. Heart, pituitary, thyroid
5. Kidney, liver, heart, skeletal muscle
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AGNEW, JOHN DOUGLAS Autopsy Report A17-702
MICROSCOPIC DESCRIPTION
HEART: The heart has scattered hypertrophic myocytes with an increase in interstitial fibrosis.
LUNGS: The lungs have emphysematous changes and regions of intra-alveolar, extravasated red blood cells. No significant
inflammation is identified.
LIVER: The liver has a moderate, macrovesicular steatosis without significant inflammation or fibrosis.
KIDNEY: The kidney has scattered sclerotic glomeruli and arterioles with an eccentric intimal proliferation.
THYROID: The thyroid is replaced with dense fibrosis and regions of chronic inflammation and scattered follicular epithelium with
oncocytic change.
BRAIN: The sections of brain have no significant inflammation, hemorrhage, or gliosis. The pituitary has an unremarkable mixture
of acidophils and basophils.
TOXICOLOGY
Toxicology Folder: T201704025
Case Folder: F201704345
Date of Report: 04-jun-2017
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SPECIMENS received from Anna Greene McDonald on 19-apr-2017
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COPY TO:
ANNA GREENE MCDONALD , MD