Michael Kerr Autopsy Report
Uploaded by
Attila KissMichael Kerr Autopsy Report
Uploaded by
Attila KissNorth Carolina Department of Health and Human Services
Office of the Chief Medical Examiner
3025 Mail Service Center Raleigh, NC 27699-3025
Telephone 919-743-9000
Fax 919-743-9099
REPORT OF AUTOPSY EXAMINATION
DECEDENT
Document Identifier B201400792
Autopsy Type ME Autopsy
Name Michael Anthony Kerr
Age 53 yrs
Sex M
AUTHORIZATION
Authorized By Susan E. Venuti MD Received From Wake
ENVIRONMENT
Date of Exam 03/13/2014 Time of Exam 09:07
Autopsy Facility Office of the Chief Medical Examiner Persons Present Dr. Lauren Scott
CERTIFICATION
Cause of Death
Dehydration
The facts stated herein are correct to the best of my knowledge and belief.
Digitally signed by
Susan E. Venuti MD 25 September 2014 10:49
DIAGNOSES
In-custody death
Dehydration and electrolyte imbalance
Postmortem vitreous fluid electrolytes with elevated sodium, chloride and urea nitrogen
Focal coronary artery disease with up to 50% luminal narrowing of proximal left anterior descending
coronary artery
Pulmonary anthracosis
Obesity (BMI 32 kg/m²)
Contusion to right frontal head with no intracranial injury
Abrasions to distal forearms and left knee
Rib fractures, status post cardiopulmonary resuscitation
Review of provided records indicates clinical history of hypertension, hyperlipidemia, obesity and
schizoaffective disorder, bipolar-type and depressive-type
IDENTIFICATION
Body Identified By
Papers/ID Tag
EXTERNAL DESCRIPTION
Length 73 inches
Weight 243 pounds
Body Condition Intact
Rigor Rigor mortis is firmly developed in the extremities, neck and jaw.
Livor Livor mortis is indiscernable.
Hair The scalp hair is black and measures up to 1 1/2". The decedent wears a black mustache and
beard.
Eyes The irides are brown.
Teeth The teeth are natural and in good repair.
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The body is received supine in a body bag with a red identification tag and a red seal #2410268.
Identification tags are present on the left great toe and attached to a rubber band encircling the right
wrist.
CLOTHING AND PERSONAL EFFECTS: The body is received clad in gray pants, cut up as in
resuscitative practice, white boxer shorts and a white tee shirt worn inside-out. The body is not
accompanied by any personal effects.
EVIDENCE OF MEDICAL/SURGICAL INTERVENTION: Extending from the mouth is an oral airway.
Electrocardiogram monitoring pads are present over the chest and abdomen. At the midline chest is a
superficial red-brown abrasion, measuring in aggregate 1 1/2 x 1 1/4". Extending from the bilateral
proximal legs are intra-osseous catheters.
IDENTIFYING MARKS, SCARS AND TATTOOS: On the right anterolateral chest is a 3/4" scar. On the
left anterior lower chest is a 1/4" scar. On the midline abdomen is a 1" scar. A 2 x 1/2" area of
hyperpigmentation is present on the right anterior lower abdomen. On the left lateral upper arm is a
round vaccination scar. On the left posterior forearm is a 1 1/2" scar. At the left anterior wrist is a 1/4 x
1/4" scar. Multiple healed scars are present on the left medial and lateral wrist. Irregular faint scars
are noted on the right lateral forearm. On the right medial forearm is a 1 1/2" scar. On the left lateral
thigh is a 1 3/4" scar. Inferior lateral to the right knee is a 2" scar. On the right medial buttock is a 1 x
1" scar.
The body is that of a black male appearing consistent with the reported age of 53 years. The head is
normocephalic. The body is received with the eyes open with focal tache noire over the right lateral
sclera. The conjunctivae and sclerae are mildly injected. Conjunctival petechiae are not present. The
ears are normally formed. The nares are patent. The mouth is open. The teeth are natural and in good
repair. No oral mucosal lesions are present. The neck is unremarkable. The chest is symmetrical. The
abdomen is mildly obese. The upper and lower extremities are symmetrical. The fingernails are soiled.
The toenails are trimmed and clean. The external genitalia are those of an adult male. The testicles are
not palpated. The back and buttocks are unremarkable. There is no blood or stool present at the anus.
INJURIES
The body is received with an adhesive bandage over the right wrist with underlying abrasions to the
distal forearm, medially measuring 1 x 1/2", posterior medially measuring 1/4 x 1/4", and posterior
laterally measuring 1 x 1/4". Over the distal anterior forearm is a thin diagonal 1" abrasion. A small
pink abrasion is noted above the right lateral ankle measuring 1/4 x 1/4". A 1 x 1 1/2" abrasion is
present on the left knee. Some healing brown scabbing is present on the left medial lower leg,
measuring 2 x 1 3/4" in aggregate.
A round area of firm edema is present on the right frontal forehead measuring 1 x 1" with an
associated underlying deep scalp red-purple contusion. No intracranial head injury is present.
DISPOSITION OF CLOTHING AND PERSONAL EFFECTS
The following items are released with the body
Clothing.
The following items are preserved as evidence
None.
INTERNAL EXAMINATION
Body Cavities
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The body cavities are examined by the customary Y-shaped incision. No blood or excess fluid is present
in the bilateral pleural or peritoneal cavities. No pleural or peritoneal adhesions are present. The
abdominal panniculus measures up to 2" at the level of the umbilicus.
Cardiovascular System
Heart Weight 430 grams
The epicardial surface is smooth and glistening. The coronary arteries have their usual origin and
distribution with focal atherosclerosis with up to 50% luminal narrowing of the proximal left anterior
descending coronary artery. The left circumflex and right coronary arteries are patent. The
myocardium is red-brown without pallor, hemorrhage or scarring. The left ventricular wall measures
1.3 to 1.4 cm in thickness. The posterior right ventricular wall measures 0.6 cm in thickness. At the
base of the heart the ventricles are mildly dilated, each measuring 5.0 x 5.0 cm. The cardiac valves are
normally formed, thin and flexible. The aorta is of normal caliber with a smooth intimal surface.
Respiratory System
Right Lung Weight 380 grams
Left Lung Weight 310 grams
The lungs appear normally inflated and pink to dark red-purple in the lower lobes. Anthracotic spotting
is present on the pleural surfaces. Cut sections reveal no gross lesions. The airway is patent. The
pulmonary arteries are free of thromboemboli.
Gastrointestinal System
The distal esophagus has linear dark red striations. No esophageal varices are noted. The gastric
mucosa is smooth and without rugae. The stomach contains approximately 50 ml of dark red liquid.
Dark red liquid is also present in the duodenum. The small bowel has multifocal skip areas of serosal
congestion and these areas contain dark red-purple liquid. The remaining small bowel contains tan
liquid. The large bowel contains brown stool. The appendix is present and unremarkable.
Liver
Liver Weight 1660 grams
The capsular surface of the liver is red-brown and smooth. Cut hepatic sections reveal no gross lesions.
The gallbladder contains a large amount of very firm sludge with a scant amount of yellow-green bile.
Spleen
Spleen Weight 140 grams
The splenic capsule is intact. The parenchyma is red-purple and firm.
Pancreas
The pancreas is pink-tan and lobulated.
Urinary
Right Kidney Weight 200 grams
Left Kidney Weight 190 grams
The cortical surfaces of the kidneys are red-brown and smooth. Cut sections of the kidneys reveal well-
demarcated corticomedullary junctions. The urinary bladder contains a scant amount of cloudy yellow
fluid.
Reproductive
The prostate gland is small.
Endocrine
The thyroid gland is symmetrical and purple without gross lesions.
The adrenal glands have yellow-orange cortices and gray-tan medullae.
Neurologic
Brain Weight 1400 grams
A focal subgaleal contusion is noted as previously described. The calvarium and basilar skull are intact
and free of fractures. The dura mater is intact. There is no subdural or subarachnoid hemorrhage. The
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cerebrospinal fluid is clear. The leptomeninges are thin and transparent. The brain is symmetrical. Cut
sections of the cerebrum, cerebellum and brainstem reveal no focal lesions.
Musculoskeletal System
The musculature is red-brown. Rib fractures secondary to cardiopulmonary resuscitation are present.
Rib fractures involve the left anterior medial ribs #4, 5 and 6 and left anterior rib #4. Red-purple
hemorrhage is noted on the parietal pleural surface of the right anterior medial ribs #3, 4 and 5 with a
fracture of right medial rib #5. No fractures involve the pelvis or spine. The strap and paraspinal
muscles of the anterior neck are free of hemorrhage. The hyoid bone, thyroid cartilage and cricoid
cartilage are intact and free of fractures.
MICROSCOPIC EXAMINATION
Microscopic Comment
Representative sections of the heart, lungs, liver, kidney and brain are submitted for microscopic
examination. Except as described below, the remaining histological sections are unremarkable.
Cardiovascular
The left ventricle has prominent intramural vasculature and small vessels with myocyte hypertrophy.
The right ventricular myocardium is congested.
Respiratory
Multiple lung sections reveal small vessels with thickened walls. Bronchioles have convoluted lumina
with prominent smooth muscle hypertrophy and no significant associated submucosal inflammation.
Focal emphysematous changes, focal congestion and small foci of anthracosis are noted.
Liver
The liver has marked sinusoidal congestion.
Genitourinary
The kidney has extensive renal cortical autolysis and vascular congestion.
SUMMARY AND INTERPRETATION
Michael Anthony Kerr, a 53 year old man, was found dead upon arrival to Central Prison following a
transfer from Alexander Correctional Facility. Autopsy examination revealed no evidence of lethal
traumatic injuries or drug intoxication. Abrasions were present on the distal forearms consistent with
restraint devices. Chemical analysis of the postmortem vitreous fluid revealed elevated levels of
sodium, chloride and urea nitrogen indicating dehydration. The Deputy Director of Prisons allowed a
witnessed review of the contents of a Sentinel Event Review documented by the NC Department of
Public Safety; however, no reports were permitted to be retained by the OCME, and no additional
investigative reports were provided for review. Mr. Kerr's psychiatric history was significant for
schizoaffective disorder for which he was not receiving any treatment at the time of his death. It was
not possible to make any firm conclusions regarding this inmate's nutrition and fluid intake, and
whether or not his mental health and/or external factors played a role in the dehydration.
It is opined that Mr. Kerr died from dehydration. However, the nature of his dehydration, whether as a
result of fluids being withheld, or the decedent's refusal of fluids, or other possible factors, is unclear.
Since the circumstances surrounding the development of dehydration leading to death in this
incarcerated adult are uncertain, the manner of death is best classified as Undetermined.
DIAGRAMS
1. Adult (front/back)
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