Orensic Pathology Case Study: A Shot in the Dark”

A 33 y/o male, owner of a strip club, shut the club down early on July 4th and brought his 11 y/o daughter down to the club. They were standing in the parking lot setting off firecrackers when a yellow sports car drove slowly by. A shot was fired from the car, striking the club owner in the left anterior shoulder. He collapsed into the street, his daughter screaming and crying. A passerby called 911. Upon arrival of paramedics, he was noted to take 2 gasping, irregular breaths, and then suffered cardiorespiratory arrest. CPR was initiated, IVs were placed, the patient was intubated, and rapidly transported to the hospital. No cardiac monitor was placed on the patient until arrival at the hospital, at which time he was noted to be in venticular fibrillation. A Resuscitative Thoracotomy was performed and internal heart massage initiated. A bullet wound to the Descending Thoracic Aorta was found and emergently closed in the Emergency Department. The patient was defibrillated multiple times, but was finally pronounced dead.

At autopsy, in addition to a Gunshot Wound to the Aorta, he was found to have triple vessel coronary artery disease with the least amount of occlusion noted to be 90%. The pathologist also noted that the Aorta was filled with blood, and the heart was also full of blood. This is not a hemorrhagic death: he said.

a) If not, why not?

b) What was the cause of death?

c) Did the hemorrhage have anything to do with the patients death? Why or why not?