07x04 - Deadly Bite

[bunniefuu]

[dramatic music]

[theme music]

NARRATOR When a body arrives at the morgue covered

in scratches, Dr. G suspects that the perpetrator

could be man's best friend.

[dog barking]

That dog was just clawing at that man.

NARRATOR And during his autopsy--

Oh.

NARRATOR --the case quickly moves from the unusual

to the bizarre.

I've really got to admit, I've never quite seen this before.

NARRATOR Then tragedy strikes first-time parents

when their baby girl dies suddenly

in the middle of the night.

That was like one of the worst feelings I ever had in my life.

NARRATOR But after a series of baffling dead ends,

Dr. G worries that she'll be unable to give

the family an explanation.

Nothing's really gelling.

[theme music]

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

These are the everyday cases of "Dr. G, Medical Examiner."

[upbeat music]

Every day, Dr. Jan Garavaglia solves

the mysteries of the dead.

What was the circumstances on that?

Does he know what happened?

She just woke up dead?

NARRATOR But she can't do her job without the help

of her morgue staff.

And one of the most critical players on the team

is that of the medical investigator.

Did you bring in the guy, Carlos?

Here's the deal.

There was no law enforcement involvement in this.

Apparently, they transported him from the Links place.

BILL STRATTON (VOICEOVER) I've been a medical investigator

for years.

My responsibility is to respond to the scene of the death.

[telephone ringing]

Medical examiner's office, Bill.

Do you have a last name of the decedent?

BILL STRATTON (VOICEOVER) I'll gather my camera gear

and get my vehicle, respond to the scene,

and get an idea of what type of a death we may have.

JAN GARAVAGLIA When Bill goes to the scene,

he is to be my eyes and ears, and he

is to take pictures of everything

around that body, the circumstances.

When I get back to the office, I'll

prepare photographs and a report so

that Dr. G can go ahead and review

everything and do the autopsy.

JAN GARAVAGLIA (VOICEOVER) This is a -year-old male

of Eastern European descent, who Bill says, he's

never seen anything like it.

I love it when they give me that lead in.

So I'm like, OK, what's this case about?

[dramatic music]

NARRATOR It's a sunny Saturday afternoon in late September

and Kissimmee, Florida native Jeanne

Henderson is on her way to visit her neighbor Roy Baranski.

She had spent the night before drinking with him.

So she came in to check on him the next afternoon.

NARRATOR But as Jeanne approaches Roy's door,

she can tell right away that something isn't right.

Roy?

She called for him outside of the house

and didn't get any response.

Roy?

The door was unlocked, but she didn't want to go in--

[dog barking]

--clearly because of this -pound,

kind of aggressive-looking mutt that lives there.

So she gets another neighbor to come in with her.

[knocking on door, dog barking]

Roy?

NARRATOR Her friend manages to restrain the dog,

and together, they cautiously enter the apartment.

Roy?

[dog whimpering]

NARRATOR But as Jeanne makes her way into the bedroom,

she gets the shock of her life.

Roy!

JAN GARAVAGLIA She finds him dead on the bed.

NARRATOR When Bill arrives at the scene,

he immediately begins to gather clues.

We know he's a painter.

BILL STRATTON (VOICEOVER) Several of the rooms

had a lot of tools and equipment that the decedent

used at his work.

The place is a mess.

He is not quite sure what's going on.

I did notice two empty .-liter

vodka bottles that were just to the right of the bed.

And there were some vials of medications

found on the windowsill.

NARRATOR But the most telling clues are on the body itself.
[ … ]

JAN GARAVAGLIA He's found with an incredible amount

of scratch marks on his chest and some bite

marks to his face.

It looks like it's all from his dog.

[dog barking]

BILL STRATTON This is an aggressive type of an animal

that was rather scary looking.

The crime scene people and Bill are worried

that this dog k*lled this guy.

You know, I see what dogs do to people.

I have autopsied kids who have been mauled by dogs.

I've autopsied, you know, people who've been eaten by their dogs

after they d*ed.

And I see the bad effects.

NARRATOR But after interviewing Roy's neighbor on the scene,

Bill begins to suspect that the -year-old may have in fact

fallen victim to foul play.

She tells us that there was actually

a verbal altercation with another neighbor

earlier that evening.

[shouting, sirens blaring]

BILL STRATTON The detectives track him down,

and he claims that the argument was only verbal.

But we have a man that's dead with a lot of trauma.

JAN GARAVAGLIA What the police want

to know is was it a m*rder?

Was it a homicide?

And so they're very anxious to figure out why he d*ed.

NARRATOR But despite the suspicious circumstances,

Dr. G must also consider the possibility

that Roy simply succumbed to some form of natural disease.

I went ahead and reviewed his medical records.

He has high blood pressure, and he's got elevated cholesterol.

He smokes.

And we know that he's a chronic alcohol user.

You know, we just have a whole assortment of things going on.

But about four months ago, he checked himself into

the hospital for alcohol rehab.

It sounded like he was getting better.

But I don't think it took because a lot

of the empty vodka bottles were found in his room.

They also note on those medical records

that he's gone into delirium tremors

before when he doesn't get the alcohol.

NARRATOR Delirium Tremens, or DTs,

is a severe and often fatal form of alcohol

withdrawal that causes symptoms such as body

tremors and seizures.

JAN GARAVAGLIA DTs have a high mortality rate.

Did he try to stop drinking again on his own

and he goes into alcohol withdrawal?

Or alcohol poisoning may have gotten him.

Too much alcohol, too little alcohol--

either one of them could k*ll him at this point.

NARRATOR But there's one more tragic

possibility on the laundry list of potential K*llers.

JAN GARAVAGLIA He also is very depressed over the loss

of his wife several years ago.

He was given some anti-depressants,

but he continued being depressed.

Maybe he overdosed.

I mean, su1c1de is a possibility.

JAN GARAVAGLIA (VOICEOVER) But I don't know what's going on.

Did the dog k*ll him?

Did the neighbor k*ll him?

Did he k*ll himself?

Did he drink himself to death?

We've got a lot of possibilities on this case.

[dramatic music]

NARRATOR Dr. G pulls back the protective sheet

and gets her first good look at Roy Baranski's body.

That is just a shame.

It's really quite remarkable what this man looks like.

Did you see these?

- Oh, jeez. - Gosh.

JAN GARAVAGLIA (VOICEOVER) There

are bite marks to his mouth.

There's even puncture marks to the eyelids.

JAN GARAVAGLIA Scratches on his face.

I have never seen so many scratch marks on a body.

That dog was just clawing at that man.

It was really disturbing looking.

Oh, boy.

JAN GARAVAGLIA (VOICEOVER) I don't really

know what's going on at this point but to me

that raises a red flag.

Did the dog k*ll him?

[dramatic music]

NARRATOR Dr. G has just discovered that Roy Baranski

whose body is covered in severe scratch and bite marks,

and she believes his pet dog is to blame.

[dog barking]

We've got this horrible -pound

aggressive dog that looks like he's mauled his owner.

We need to document his injuries.

That is really bad.

JAN GARAVAGLIA (VOICEOVER) Is this pre-mortem, the injuries,

or are these post-mortem injuries?

I've had cases where dogs have k*lled people.

And then I've had cases where dogs have eaten
[ … ]

their owners after they d*ed.

And when you look closely, those scratch marks,

some are clearly post-mortem.

But some of them are red and raw,

and it could be just about the time he d*ed.

He's got some bruising on his arm.

He's got some other minor bruising on the body

and bruising of the eyelids.

I'm not sure that's from the dog or if that's

from the altercation, from this angry neighbor.

JAN GARAVAGLIA Let me see his mouth first.

Hold on.

NARRATOR Next, Dr. G closely examines the inside

of Roy's mouth, a part of the body that might shed light

on an alcohol-related death.

JAN GARAVAGLIA (VOICEOVER) For us to figure out

if he d*ed from delirium tremors,

I would look for evidence of a seizure.

Oftentimes, they'd bite their tongue.

Is there blood?

Is there trauma?

But there's really none of that.

NARRATOR But right away, another unusual detail

catches her eye.

Oh, bad-- really bad.

He doesn't have any teeth.

I don't think he's got one in his mouth.

JAN GARAVAGLIA (VOICEOVER) The gums have eroded down.

I mean, there's really little gum tissue or even bone left.

It is not uncommon to see decedents with no teeth.

If you don't take care of them, they're going to fall out.

JAN GARAVAGLIA Ah, what else have we got going on here?

JAN GARAVAGLIA (VOICEOVER) But there's

really no other clues that would help me narrow down

my hypothesis on why he d*ed.

We still need a cause of death on this guy.

We're not going to know the answer

till I look on the inside.

[dramatic music]

It's OK.

JAN GARAVAGLIA (VOICEOVER) I do my Y incision,

look at the chest muscles to see if there's

any blows to the chest.

Hmm.

JAN GARAVAGLIA (VOICEOVER) But I don't see any.

I open the abdomen.

I don't see any free blood.

You notice there's no blood in there.

There's nothing in there.

You can pretty much rule out that the dog

did anything to him.

All of those external scratch marks and bites

were most likely post-mortem or at the time that he was dying.

It makes really no sense.

Why he was scratching him so, but it certainly

did not cause his death.

NARRATOR But while Roy's dog has

been ruled out as a suspect, foul play has not.

JAN GARAVAGLIA (VOICEOVER) Next, we look very carefully

for any other types of trauma.

I don't see a g*nsh*t wound.

I don't see a s*ab wound.

We don't see any other trauma.

There's no free blood in the belly.

I see no major trauma.

NARRATOR Next, Dr. G draws fluids to send

to the lab for analysis.

All right, let's see what kind of tox we're getting.

NARRATOR The results could reveal

a fatal overdose of medication or an alcohol-related death.

Toxicology can be the key to this case.

NARRATOR Then she begins looking at his organs,

one by one.

And given his history of chronic alcoholism,

her first stop is the liver.

I'm still waiting for that nice peek of his liver.

Where is it?

A healthy liver is--

have a brownish, almost mahogany look.

So it has a very sharp edge, but his liver is rounded,

and it's fatty.

That is one nasty looking liver.

It is a liver of a chronic alcoholic.

Oh, wow.

That's [inaudible]

JAN GARAVAGLIA (VOICEOVER) His liver was bad,

but it didn't look really bad enough to k*ll him.

It probably at this point is not his cause of death.

NARRATOR No closer to an answer,

Dr. G switches gears to examine the organs

in Roy's chest cavity.

So first I remove the lungs.

Look at that.

That's terrible.

JAN GARAVAGLIA (VOICEOVER) He clearly has emphysema.

JAN GARAVAGLIA Look at that black in his lungs.

But I don't see anything acute, recent

going on in his lungs.

To my eye, they don't look like they've k*lled him today.

Now, if he'd have continued smoking, if he'd have lived,
[ … ]

those lungs could have really been his cause of death

down the road.

NARRATOR Dr. G then turns her attention

to the -year-old's heart.

On first glance, it appears healthy.

But she'll have to dissect an exam in each valve and chamber

to find out for sure.

So right off the bat, I caught the heart--

JAN GARAVAGLIA It's not looking good.

JAN GARAVAGLIA (VOICEOVER) And whoa, lo and behold, I see--

JAN GARAVAGLIA Oh, my god.

JAN GARAVAGLIA (VOICEOVER) --evidence of a heart att*ck.

JAN GARAVAGLIA Whoa, whoa, whoa.

I really think I've got the smoking g*n.

But when I cut the heart muscle, it's not acute.

It just didn't happen right before he d*ed.

So this heart att*ck happened about a week ago.

Some people can have heart att*cks,

and they didn't even know they had it.

Although it happened seven to days ago,

it's very critical because that heart is very sensitive.

NARRATOR In fact, any added stress on Roy's heart

could have caused the fatal arrhythmia at any time.

JAN GARAVAGLIA He was a ticking time b*mb,

and he did have an altercation with that neighbor.

At this point, I think I have my answer.

He probably d*ed from arrhythmia.

NARRATOR But unlike Roy's minor heart att*ck,

an arrhythmia leaves no trace evidence in the body.

So Dr. G will first have to rule out everything else,

and there's one last place to look.

So I have to finish the autopsy and look at the neck.

Did that neighbor choke him?

Did he strangle him?

So we reflect the skin up off of those neck muscles.

I'm looking for trauma.

That's what I'm doing in the neck.

JAN GARAVAGLIA (VOICEOVER) And then we, layer by layer,

look at those muscles to see if there's any hemorrhage--

no hemorrhage.

He has no evidence of any kind of strangulation.

NARRATOR But what she sees next--

JAN GARAVAGLIA Oh, look at that.

NARRATOR --takes her completely aback.

I've never seen it before.

It's wet.

Oh, my gosh.

JAN GARAVAGLIA (VOICEOVER) I couldn't even believe my eyes.

[dramatic music]

I can't even see the-- oh, here's where--

OK.

Look at that.

NARRATOR Dr. G has just uncovered

one of the strangest findings of her over--year career.

Lo and behold, I'm shocked.

Oh.

I've never seen that.

NARRATOR Deep inside the larynx of -year-old

Roy Baranski is something that doesn't belong there--

dentures.

JAN GARAVAGLIA There in his larynx.

All right.

His dentures are impacting on the vocal cords

and partially going through them.

I was totally surprised.

I didn't know the guy had dentures.

His gums are just-- they must have been so loose.

So I know a lot about this case, but I don't

think I have the answer yet.

We know he's got a very bad heart that could

have k*lled him at any time.

But we also know that he has got dentures down in his larynx.

NARRATOR And the unusual finding notwithstanding, it's

still unclear if the dentures played a role in Roy's death

or how they got three inches down his throat

in the first place.

JAN GARAVAGLIA (VOICEOVER) I don't know what's going on.

So I think tox is going to play a key role here.

[dramatic music]

NARRATOR Three weeks later, the report finally arrives

from Wusthof Toxicology Lab.

I'm hoping I have an answer.

NARRATOR And as her eyes scan down the page,

one unexpected detail jumps out at her.

I was actually very surprised.

NARRATOR And with this last clue in hand,

Dr. G can finally replay the chain of events

that led to Roy's sudden death.

JAN GARAVAGLIA (VOICEOVER) So I think that puts all the pieces

of the puzzle together.

I think we know what k*lled him.

[dramatic music]

NARRATOR Roy Baranski has had a tough couple of years

since the death of his wife.

He's suffering from severe depression,

and his chronic alcoholism has been spiraling out of control.

I think depression plays a huge part

in many alcoholics and people who just stopped

taking care of themselves.

NARRATOR Recently, the -year-old's been trying
[ … ]

to get his life back on track.

JAN GARAVAGLIA He said he wanted to get off of alcohol.

He spent about three weeks in rehab.

He was detoxed.

NARRATOR But Roy isn't able to stay sober for long,

and eventually he slides back into old habits.

On a Friday evening, several neighbors gather at his house

for a night of hard drinking.

[chatter]

JAN GARAVAGLIA There's a lot of drinking.

These guys are extremely drunk.

NARRATOR Roy and one of his neighbors begin arguing,

and the party soon breaks up, but Roy doesn't stop drinking.

I was actually very surprised just how drunk he was.

His level was just about a ..

Most people would die in and of itself with a ..

But for drinkers that have been going at it for years and years

and years, it's not uncommon, but you're

on that edge of death.

NARRATOR With his blood alcohol rising,

it isn't long before Roy passes out on the bed.

While he's intoxicated, his denture becomes too loose

because his bone is eroded.

The dentures are old.

They didn't fit well at all, and they slip off,

and they slip down into his throat.

Normally, we would have a gag reflex.

We would try to cough that up immediately.

He doesn't have that.

That is all blunted because of the alcohol.

You've decreased your central nervous system

to the point where you can't even

coordinate your swallowing.

That's why people choke.

That's what makes it easy for him to aspirate.

He's choking on his dentures.

They occlude his airway.

He's probably having difficulty breathing.

He already had lower lung capacity

because of his emphysema.

NARRATOR And with a heart already

damaged by a recent coronary, the scenario

is a recipe for disaster.

JAN GARAVAGLIA He's not getting enough oxygen into his lungs

and with a heart that's already so sick

that any kind of decrease in oxygenation

would have put it over the edge.

NARRATOR The -year-old's heart

begins to b*at erratically.

And within seconds, Roy Baranski dies.

Dr. G can now officially rule on a cause of death.

But one question remains--

what about the dog scratches?

He was just furiously scratching at his master.

Why was the dog doing this?

[dramatic music]

NARRATOR Dr. G has just closed the bizarre case

of Roy Baranski.

JAN GARAVAGLIA In my years as a medical examiner,

I have seen people aspirate boluses of food,

pieces of steak, even a wad of paper towel,

but I've never seen anybody aspirate their own dentures.

NARRATOR But there's still one piece of the puzzle

that's been left unsolved.

Why was Roy's body covered in dog scratches and bites?

Why was the dog doing this?

NARRATOR It's a perplexing question.

But after re-examining all the findings,

Dr. G comes to another surprising conclusion.

I actually was dead wrong from the beginning.

I really thought that dog might have played

a role in his death, or at the very least

was trying to eat that fellow.

I was wrong.

I really think that dog was trying to save his life.

I think the dog saw that he was in distress.

Animals are very keen to what's

going on in their environment.

He's probably scratching at his master to try to help him out.

I guess he's doing doggie CPR.

My view of that dog has changed.

I guess he's not the bad dog that I thought he was.

[dog whimpering]

Maybe dogs aren't all bad.

I personally take a lot away from this case.

So lesson is it may appear to be one thing at the scene,

but you never know until Dr. G completes the autopsy

and gives us the full, final answer.

[upbeat music]

NARRATOR Dr. G is always excited about solving

a mystery.

And while her next case promises to be just that,

it's one that she'd just as soon never see in the morgue.

I have to deal with many infant deaths.

This is a little baby--

gosh, how old?

JAN GARAVAGLIA (VOICEOVER) It's a really difficult autopsy.

We wish we could bring the baby back.

We can't.

We can just diagnose.
[ … ]

So that's why you have to do an autopsy.

As with all baby cases, this is a sad one.

This is a -month-old.

JAN GARAVAGLIA (VOICEOVER) It's our job

then to figure out what happened and give the family answers.

[dramatic music]

NARRATOR It's late September in Orlando, Florida.

Peek-a-boo.

NARRATOR And Whytnea Matthews is enjoying an evening at home

with her daughter Laniya.

I had a little routine that I did for her every night.

I played with her a few hours before she went to bed.

I'd put that CD on with the classical music,

and I'd rock her a little bit.

And once her eyes start to close, I'd lay her down.

And then I laid down myself around , .

NARRATOR But Whytnea could have never imagined

that within just a few hours her seemingly

ordinary day would turn into a mother's worst nightmare.

I woke up close to o'clock in the morning,

came back to check on her, and I noticed she wasn't breathing.

I was like, maybe the dark us playing tricks on my eyes.

[sobbing]

NARRATOR Panicked, Whytnea immediately dials --.

(FRANTIC) Something is wrong with my baby.

NARRATOR Her next call is to the baby's father, Jefferson.

JEFFERSON DELVA So I rushed over,

and we just was trying to do CPR,

trying to just do anything possible.

[sirens blaring]

NARRATOR Paramedics arrived just seconds behind him

and attempt to resuscitate the -month-old.

JEFFERSON DELVA Just like a lot of emotion

going through your head.

The baby's not breathing.

JEFFERSON DELVA They're trying to save

my child's life right now.

NARRATOR They performed CPR for over an hour,

but it's too late.

JEFFERSON DELVA There was nothing more they could do.

That was like one of the worst feelings I ever had in my life.

NARRATOR In just the blink of an eye,

Laniya's life is cut tragically short.

And her heartbroken parents are left struggling

to make sense of the loss.

You go into having a child thinking,

you know, you're going to watch this person, mold this person

into an adult, and then in a split second,

you get it taken away from you.

WHYTNEA MATTHEWS Laniya was a happy baby,

laughing and smiling.

She was very happy.

It was hard to accept that she passed on.

It was unexpected.

There weren't any warning signs.

[dramatic music]

So the story is--

NARRATOR The District morgue has just received the tiny body

of baby Laniya Delva.

JAN GARAVAGLIA This is a four-month-old baby that

d*ed suddenly and unexpectedly.

It's really devastating for the family,

for the mom and the dad.

You know it was just so, like, out of the blue.

It was hard to accept that she was no longer with us.

JEFFERSON DELVA We just wanted to know what really happened.

JAN GARAVAGLIA I really have to figure out

what k*lled this child so I can at least

kind of help the family along to help understand this.

NARRATOR Dr. G begins by reviewing

Laniya's medical history, hoping to glean

any information that could shed light

on the infant's sudden death.

The medical history is that the baby's

had a cold the past couple days, but nothing

major, kind of sniffles.

JAN GARAVAGLIA (VOICEOVER) If that plays a role, I doubt it.

But I'm really not too worried about it.

NARRATOR However, reading further,

she does spot something of note.

Laniya was born with sickle cell disease.

Sickle cell disease affects , people in the United

States and millions worldwide.

NARRATOR Sickle cell disease is a genetic abnormality

of the body's red blood cells.

It causes just a slight variation in the hemoglobin

molecule, the molecule inside the red blood cells

that carry the oxygen. Normally a red cell looks

almost like a donut or disk.

But when these cells get stressed,

this abnormal hemoglobin causes the red blood cell

to change shape, and it looks like a little-- kind

of a half-moon sickle.

NARRATOR But while the disease can sometimes

lead to fatal complications, Dr. G doesn't believe it's

to blame in Laniya's death.

Only four months old--

usually they don't start having trouble until about six months.

It's unusual to find a baby in this age group die suddenly

and unexpectedly from sickle cell disease.
[ … ]

Higher on my list, I'd worry about the typical things

we would see in this age group, and that

would be congenital abnormalities that

didn't get picked up at birth.

Mostly, it would be heart abnormalities.

That's something I'll keep in my mind.

But while Dr. G isn't overly concerned

about the sickle cell, it isn't long

before she comes across troubling evidence

of a completely different sort.

My investigator said she's got a contusion,

or bruise, on her forehead.

That's a little worrisome.

NARRATOR And although Whytnea and Jefferson seem like loving

parents, Dr. G can't help but consider

the worst possible scenario.

JAN GARAVAGLIA (VOICEOVER) This could be child abuse.

And unfortunately, I have to be suspicious,

and I'm going to look for that.

NARRATOR But the most frustrating possibility of all

is that she might never know what

caused the baby's sudden death.

It always bothers me when I can't find the answer.

But with children, a lot of times when there's nothing

wrong with them either at autopsy

or under the microscope, and ultimately if I can't figure

out why this baby d*ed, we rule it

sudden infant death syndrome.

We're not going to know until we start the autopsy.

[dramatic music]

JAN GARAVAGLIA (VOICEOVER) When I approach

the gurney on a baby, you would think my emotion

would be, oh, how sad.

That lasts for maybe a second.

Pretty eyes too.

JAN GARAVAGLIA (VOICEOVER) But what goes through your mind

is I have my work cut off for me because we have

to rule out a lot of things, and some of those things

are quite subtle.

I start out looking--

does the baby look well cared for?

Does it have any really bad rashes

or diaper rash or things that look like it's been neglected?

And she looks pretty good.

Her height, her weight all are normal.

And then, of course, I will be looking for any signs of trauma

there was a little scar on the scalp

that my investigator noticed.

It looks completely healed at this point,

but that doesn't mean that there's

still not trauma internally.

I don't--

NARRATOR Now, Dr G must dig deeper for answers,

and she knows just where to start.

JAN GARAVAGLIA You've got to make sure

that head is fine because that's where most of the child abuse

is.

JAN GARAVAGLIA (VOICEOVER) This is

the part of the autopsy where you take a deep breath

and you reflect the scalp.

Then we remove the calvarium to look at the brain.

And that moment that we take that calvarium off

is very important because with abusive head trauma in this age

group, you may see just a tiny little bit

of subdural blood and some cerebral swelling,

and that might be all we see.

So it's a big moment--

the difference between a natural or a homicide.

This could be child abuse.

It is unimaginable to me, but unfortunately we see it.

[dramatic music]

NARRATOR Dr. G is examining the brain

of four-month-old Laniya Delva on the hunt for any signs

of a fatal injury.

JAN GARAVAGLIA (VOICEOVER) You have

to make sure it's not some kind of abusive or even accidental

trauma that causes her death.

Autopsying babies, the stress is very high

and everybody everybody's concerned

and fixated on that child.

Charges may be pending against parents, so the stress is high.

NARRATOR She carefully removes the brain,

her eyes peeled for subtle signs of swelling or bleeding.

JAN GARAVAGLIA It looks normal.

I don't see any evidence of any kind of trauma,

but I can't rule out trauma at this point.

So I'll wait till I see what I can get inside.

NARRATOR To begin, Dr. G makes a standard Y-shaped incision

from the shoulders to pelvis, just as she

would with a full-grown adult.

JAN GARAVAGLIA (VOICEOVER) When I reflect the skin off the rib

cage, it's very important to look for rib fractures

because with babies, it'll usually indicate some kind

of v*olence and squeezing.

I don't see any on her, thank goodness.

So there is no trauma on this baby.

JAN GARAVAGLIA (VOICEOVER) So at this point, I go ahead,

take the chest plate off.

JAN GARAVAGLIA I'm having a hard time getting blood now.

NARRATOR On the lookout for any congenital abnormalities,
[ … ]

she heads straight to an organ high on her list of suspects--

the heart.

JAN GARAVAGLIA I look at all the vessels

because some vessels don't--

they aren't right.

They don't go to the right place in the heart.

But none of that showed any congenital abnormality.

So that heart's about normal size.

This heart looks completely fine.

And then I move on to the lungs.

I suspect--

I don't know what's going on down here.

Boy, she is really congested.

The lungs are very dense, and they're very wet.

It could mean the babies is having some type

of infection in its lungs.

I'm worried about pneumonia.

NARRATOR Delicately, she dissects each lung,

searching for the telltale signs of pneumonia,

inflammation, or pus.

JAN GARAVAGLIA But no clearcut evidence

of bacterial pneumonia.

But that looks like from CPR most likely.

NARRATOR Dr. G takes sections of tissue

to examine under the microscope.

She'll need a magnified view to rule out infection for sure.

So it's time to move on to the abdomen.

Sandy, would you be willing--

What do you need?

--to write these down?

Absolutely.

I look at the kidneys.

I look at the pancreas.

I even look at her little uterus,

the little baby ovaries.

All of that looked normal.

That's weird.

JAN GARAVAGLIA (VOICEOVER) But I do see

this massively enlarged spleen.

Aha-ha.

JAN GARAVAGLIA (VOICEOVER) She's only four months old.

It looks more like a four-year-old spleen.

That's how much it is expanded.

Kids, particularly with sickle cell, at the early stage,

will have enlarged spleens.

NARRATOR But Laniya's spleen is over twice its normal size,

much larger than she would expect

to see in a baby suffering from sickle cell disease.

JAN GARAVAGLIA (VOICEOVER) This one is a little worrisome.

It's a little too big.

NARRATOR As with the lungs, Dr. G

most inspect the tissue from the spleen on a microscopic level

to figure out exactly what's going on.

I can't put this together yet.

At this point, nothing's really gelling.

The more I click off the list, we're left with,

why did this baby die?

JAN GARAVAGLIA We don't know what's going on yet.

JAN GARAVAGLIA (VOICEOVER) We need

to look under the microscope to look at the tissues

and what's going on.

BRIAN MACHULSKI Things that come in here, some

of the cases, are very obvious.

Sometimes, when they're not so obvious,

that's when Dr. G will turn to one of her very closest

friends, and that's the microscope,

so that they'll be able to provide better answers for her.

To get an answer, particularly for the parents,

because they deserve an answer.

We wanted to know what actually

happened because, honestly, you tend to blame yourself.

NARRATOR It's near closing time on Friday afternoon,

but Dr. G isn't heading home just yet.

The slides she's been eagerly awaiting

have finally arrived from the lab.

I have to look at those glass slides

before I can make a diagnosis.

I want to look at what's going on with this child.

NARRATOR She turns the dial to focus in on the first image

and with one glance, Dr. G believes

she can finally explain exactly what led

to baby Laniya's tragic death.

[dramatic music]

NARRATOR It's PM, and Whytnea Matthews is rocking

her baby girl Laniya to sleep.

It's a typical night for mother and daughter,

except Laniya seems to be a little under the weather.

JAN GARAVAGLIA The baby did have

a couple days of kind of sniffles,

was felt to be a cold.

NARRATOR But when Dr. G magnifies Laniya's

his lung tissue, she can see right away

that this was no simple cold.

JAN GARAVAGLIA It looks like the baby's is having some type

of a viral infection in its lung,

and the virus really got more into her lungs.

It was a little deeper down than just a head cold.

And because of the infection, she wasn't getting

enough oxygen into her lungs.

NARRATOR In any four-month-old baby with sickle cell,
[ … ]

the stress of the infection and lack of oxygen

would usually cause some sickling.

But in Laniya's case, it has triggered a massive sickle cell

emergency.

JAN GARAVAGLIA What's most disturbing on these slides

is the amount of sickling that has occurred.

All of her cells are sickled--

everywhere I looked.

NARRATOR This tells Dr. G that Laniya must have had

an extreme case of the disease.

Her fragile red blood cells had mutated

from their normal round shape into an oblong sickle shape.

JAN GARAVAGLIA The abnormal shape

causes those cells to be more apt to start getting

stuck in little small spaces.

The sickle-shaped cells begin to move through her bloodstream.

But when they reach the spleen, they

are unable to pass through.

The spleen just sequesters and grabs them all up.

It's kind of like that Roach Motel--

once the blood goes in, it can't go out.

The blood causes Laniya's tiny spleen to expand

to over twice its normal size.

And from there, she begins a rapid downhill decline.

JAN GARAVAGLIA She's got so much blood caught up

into her spleen that she's not getting

enough to the rest of her body, and she goes into shock.

NARRATOR Eventually, Laniya's organs begin to shut down one

by one, and it isn't long before her heart

stops b*ating altogether.

JAN GARAVAGLIA You know, this was

all going on while the baby was sleeping,

and nobody had a clue.

The family, they did everything right.

Logically, it shouldn't have happened.

She didn't follow the textbook.

It happened at a much younger age than you'd expect it.

Now, why did she sickle at this age when a lot of babies don't?

Some people do have worse sickle cell disease than others.

Some people just have higher concentrations

of that sickle hemoglobin than others.

And she clearly had a bad disease

to have such a bad reaction at such a young age.

NARRATOR Unfortunately, even if Laniya had survived,

the disease would have eventually taken a toll.

JAN GARAVAGLIA The baby was going

to have a rough road ahead.

She would have had a lot of chronic pain

and chronic anemia.

It's not an easy row to hoe.

NARRATOR However, in recent years,

there have been tremendous advancements in managing

sickle cell disease.

We can treat it much better now.

There's actually a medication that helps the sickle cells not

sickle so much, and so this has been a boon for people

with sickle cell disease.

NARRATOR And while nothing can make up

for their devastating loss, Dr. G's findings

ultimately helped to bring some sense of closure

to Laniya's parents.

Now we know what actually happened,

just the sense of knowing that it wasn't nothing that we did.

Right now, I'll still be cherishing the moments

that I had with her.

You know, it just goes to show you how precious life is

and how fast it can be taken away from us.

You just never know.