September 29, 2025 • 28 mins
This week’s episode of Pathology with Dr. Priya, a Zone 7 series, is all about your questions on the science behind death investigation. Together, Sheryl McCollum and Dr. Priya Banerjee take on the topics that listeners are most curious about, from family rights and religious objections to what autopsies can and cannot reveal. They also dispel misconceptions about embalming, toxicology, and even what really happens at the funeral home. With clarity and respect, Dr. Priya and Sheryl break down the science, the law, and the realities behind the most-asked questions in forensic pathology.
Highlights
- (0:00) Welcome to Pathology with Dr. Priya: A Zone 7 series—Sheryl and Dr. Priya open with a discussion of the Celeste Rivas case
- (6:45) The "CSI-effect": how media shapes public perception of forensic science, the risks of misinformation, and why caution is critical in cold case investigations
- (8:45) Can a forensic pathologist always determine the cause and time of death?
- (11:15) Can family members refuse an autopsy, and how do religious objections work?
- (17:00) Can any family member request a private autopsy, or must it be the legal next of kin?
- (19:00) Does an autopsy prevent an open-casket funeral?
- (21:15) Do funeral homes use newspapers or sawdust to fill body cavities?
- (23:15) Can an autopsy be performed after embalming, and how does that affect toxicology?
- (25:30) The role of funeral directors and double-checks before cremation, catching missed injuries and ensuring nothing is overlooked
About the Hosts
Dr. Priya Banerjee is a board-certified forensic pathologist with extensive experience in death investigation, clinical forensics, and courtroom testimony. A graduate of Johns Hopkins, she served for over a decade as Rhode Island’s state medical examiner and now runs a private forensic pathology practice. Her work includes military deaths, NSA cases, and high-profile investigations. Dr. Priya has also been featured as a forensic expert on platforms such as CrimeOnline and Crime Stories with Nancy Grace. She is a dedicated educator, animal lover, and proud mom.
Website: anchorforensicpathology.com
Twitter/X: @Autopsy_MD
Sheryl McCollum is an Emmy Award–winning CSI, a writer for CrimeOnline, and the Forensic and Crime Scene Expert for Crime Stories with Nancy Grace. She works as a CSI for a metro Atlanta Police Department and is the co-author of the textbook Cold Case: Pathways to Justice. Sheryl is also the founder and director of the Cold Case Investigative Research Institute (CCIRI), a nationally recognized nonprofit that brings together universities, law enforcement, and experts to help solve unsolved homicides, missing persons cases, and kidnappings.
Email: coldcase2004@gmail.com
Twitter/X: @ColdCaseTips
Facebook: @sheryl.mccollum
Instagram: @officialzone7podcast
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:08):
Welcome to Pathology with doctor Priya. Doctor, welcome back to
Zone seven and welcome home.
Speaker 2 (00:15):
Yes, yes, I went on a little bit of an adventure.
As always, I'm always traveling in between here and there.
But for good reason. It was the most beautiful wedding
of an old family friend. I've known this family for
over thirty years. I used to babysit them, My mom
used to babysit them. And the middle son, who I
held as a baby at his prisoning, got married. Oh
(00:38):
and so I was in tears, and oh, yeah, I'm fallen.
Speaker 1 (00:41):
Yes I do. I love a wedding. Even if I
don't know the people, I can enjoy it.
Speaker 2 (00:47):
Yes, it's such a beautiful thing. You know, so much
hope ahead. And then I feel like these celebrations are rare, right,
they're beautiful moments. We got to embrace them every just everything,
ounce of it right exactly. So that was that. I
went to a concert, I saw some friends from high
school and had some productive meetings in New York.
Speaker 1 (01:10):
So, you know, all good, fantastic, all right. Well, you
know what, before I get to the topic for tonight,
I wanted to tell you you were so timely when
you were teaching us, you know, when more investigation needs
to happen, that they'll use sometimes terminology that we're not
familiar with regarding the cause of death. You know, they
(01:32):
just did that in the fifteen year old's death when
she was found in the trunk of the car of
the singer David And that's what they put And I went,
I know what that means, because doctor Pria just told me.
Speaker 2 (01:45):
Yeah, And I mean I did a little blurb on
Court TV. They don't pay me to say that, but
it's sort of explaining the same thing. You know, why
hasn't he been charged? And I mean, I'm not a
legal mind. I'm the Emmy, but you know, I'm speaking
from a doctor's perspective handled cases like this, As we said,
they're very complex and they can't you know, until we
(02:05):
find a cause of death in her, which, as we discuss,
is you know, challenging ahead. Many many modalities need to
be used. How can you even bring a charge right
without knowing what your what the crime is really other
than you know, are they even going to call it
a homicide based on the condition of her body? So
I don't want to jump ahead and assume guilt. There's
(02:27):
been other rumblings online, nothing that's been verified about other
people maybe involved, you know, in his close knit circle.
Then her family might have known about the involvement or
when she became involved. There's a video from school like circulating,
which I haven't really looked at that much. You know,
(02:47):
I'm really trying to stay on the medical aspect of it,
the forensic pathology aspect. This is where the police, you know,
I think we talked about, really need to dig deep
and set the stage for what happened. You'll put the
story together because how you know, how did she end
up in the trunk dismembered? And then you know, when
was the last time she was heard from? She's been
(03:07):
missing for a year. What's going on? You know, I
suspect she's not in that trunk a year, but you know,
because I started smelling right and it was abandoned. But
who knows? And that's really where it is. Who knows.
Speaker 1 (03:23):
But you know, Priya, when I saw the word deferred,
I thought, we've just learned that from doctor Priya because
I had never seen that before.
Speaker 2 (03:31):
Right, And that's really like a weird thing to say.
Speaker 1 (03:36):
But it literally just means they need more investigation.
Speaker 2 (03:38):
They don't know, correct, right, But I think they also
need so you know, we can just touch on it.
I always say pending for their studies because yes, any investigation,
but I think they also need her toxiclly, there's other
medical stuff.
Speaker 1 (03:50):
That I think that's why there hasn't been an arrest.
They're waiting for it all the time.
Speaker 2 (03:54):
Yeah, they can't charge him until they know what they're
charging and who they're charging, et cetera.
Speaker 1 (03:59):
And you know, there's all kind of rumors that are
already swirling around. One was that there was a baby
found somewhere near and all that, and you know, y'all,
that has not been verified, so don't keep spreading that
till we know something. And that's not anything that's been
released from the autopsy. I'll tell you that, not.
Speaker 2 (04:18):
At all, not at all, not that I know of.
And as far as I know, she was the only
one in the trunk, in the plastic bag. That's what
I think is the most reputable piece of information, you know,
not you know, they said the producer might have involved.
I mean, there's so many sort of speculative things that
can't be verified, and obviously the police, right are the
(04:41):
ones to verify that, and that's why there's so much
going on that And really, you know, I think I've
hinted at this that in the past, we have, at
least in Rhode Island, seven days to release a death certificate. Okay,
And let's say I know the cause and manner of death, okay,
But they don't want the candidate suspect to know that
(05:05):
I know, because if he if let's say, I know
it's a strangulation, he goes, oh, she was strangled. Wait,
that's not released to the public. How do you know that? Right?
You trip them up in the interview. And so I
have held legally held I've released the body, but I've
held the death certificate from being public, if you will.
And every state law is different, like is the cause
(05:25):
of death public? Is the manner of death public? Here,
the cause of death is public, the manner of death
is not. I have no idea why that's been dictated
by law for eons, like way before my time here,
And it's a very specific state to state. But at
the same time, like, we don't want any information while
they investigate to be leaked to the public. So sometimes
(05:49):
they will artfully either stay pending or deferred or they'll
have me like in my case is they'll be like, doc,
can you hold it a few days until you hear
back from us to give us that power in that
interview process. And for me, I'm happy to comply. That
doesn't mean I'm favoring the police. My exam is my exam.
Speaker 1 (06:13):
Right, Your fundings aren't going to change.
Speaker 2 (06:15):
So if they say hold it a few days, that
helps the investigation, that's to help the deceit it that
I examined, right, I'm not like convening with the police,
like I'm not biased. I want to be careful about that,
but it's just to make sure the investigative process is fair,
really unbiased. They have information and let's see what we
can find and that may also help their scene investigation
(06:38):
further and their analysis.
Speaker 1 (06:40):
There have been some great questions sent to us, so
I'm just going to start with the first one.
Speaker 2 (06:45):
Okay, cool. I want to predicate this though, So this
is actually something that's been on the front burner for
me because I was fascinated at Crime Con Like how
many people that came in. Obviously that's a select audience, right,
but they really follow show, and they follow they might
have more knowledge about death death investigation in certain cases
(07:06):
than let's say the average person. But what I think
is a double edged sword, if you will, is if
you're learning only from TV, whether you know, we'd be
a documentary because everybody has their own even a documentary
has a perspective correct and there's not always uh the
(07:27):
director or the people who use you know, are filming
it are not medically oriented. Usually they may have a pathologist,
but everything has I would say, a point of view.
Now it's not unbiased like just the just an autopsy finding.
So I thought like, wow, these people would have to
you know, they can be helpful. Right in the cold
(07:48):
case searches of the missing loved ones that were posted.
I mean they're they're doing internet deep dives. But at
the same time, if you really careful who might come
up in the search and whether that's a valid accusation involvement,
you know, you'd be really careful with what you think
based on certain findings. And so that's you know, the
(08:09):
CSI effect or you know, the effect of the media
on crime and investigation. I think was really at the
forefront of my mind because I'm like, oh, we got
to not overstep you know, the medical point of view
of it or the scientific point of view. You don't
want to create something out of nothing.
Speaker 1 (08:28):
I think that's the best advice you could give, because
you know, again, if you're getting it from TV, it
may or may not be accurate. It may you know,
do some harm if you're putting bad information out. So
here's the first question that I got over and over
and over. Can you always determine the cause of death
and the time of death?
Speaker 2 (08:47):
So I find these questions fascinating, and it's great that
people want to be educated. No, and so I wish
my life and your life was as black and white
as law and order and everything's completed in an hour,
you know, or whatever show C s I, you know,
pick one, right. But the issue is we have these
(09:10):
you know, cause of death can be anything. Manner and death.
We have the five manners, including undetermined. Okay, and really,
if you think about it, if we could pigeonhole everything
into the other manners and not need undetermined, that would
be ideal, right, But there's always that gray area. You know,
the cause and manner of death is a medical opinion
(09:32):
of the pathologist. Uh, sometimes I agree with them when
I review, you know, secondary review of cases. You know,
when I'm asked as the expert on by a lawyer
or family, and sometimes I don't right, I might have
a different interpretation because I'm looking at I have more
information now than they did at the beginning. It may
be just that my training and experience and my the
(09:56):
way I interpret things are slightly different. You know, in
any case, the there's multiple variables that go in. But no,
I've definitely certified cases as undetermined undetermined, you know, whether
it's a skeletal remain that doesn't have any clear trauma.
But if you're missing most of the body and the organs,
(10:17):
I can't tell you much, right, I can't be one
hundred percent certain it wasn't something else. So when I
have just a bag of bones, that's how we do it.
You know, if it's severe decomposition where things are missing
and it's not evident and toxicology can't necessarily be optimized.
You know, there's so many factors that we have to
think about. And remember, I treat the body as a
(10:41):
system as a whole, right, So I can't look at
just the liver without looking at the heart and the
brain and everything else. Right, So giving me half a
body or a decomposed body. Is it's valid to examine
that and gather what you can, But obviously knowing your
limitations is also important, and not to overpromise or overstep
(11:05):
what can be proven with the autopsy or additional testing.
Speaker 1 (11:10):
Gotcha, next question, family members can refuse an autopsy.
Speaker 2 (11:17):
So let's define autopsy because I think you need to
understand like under which conditions autopsies happen, and then we
can get into the family involvement. Okay, So obviously we
live in a complicated society, many beliefs, many backgrounds, and
we try to you know, the law supports the medical
(11:38):
examiner being around and operating in context of still respecting
you know, values, especially religious values. So when I talk
about a medical examiner or corner system, that is a
legal system where someone dies of unexplained means, sudden unexpected death,
(11:58):
their death needs to be investstigated and the laws surrounding
that depending on the county, the state, the district operates,
the corner operates, and the medical examiner operates to do
the autopsy that does not require family permission. So the
only real time that can be denied or the family
(12:22):
can request it not to be done is under religious exception.
So certain religions, certain religious beliefs, they don't want autopsies performed.
And after discussion with the family, we usually do explain that,
you know, this can even limit what we can determine,
and they might have to sign off on that. But
(12:43):
that's okay, and I have signed off. Going back to
the first question, you know, cause of death cannot be
determined due to refusal of autopsy, but.
Speaker 1 (12:53):
If law enforcement needs it for a homicide investigation, that
trump's religious beliefs.
Speaker 2 (13:00):
Oh, that's a very difficult one. We may need a
court order.
Speaker 1 (13:03):
Okay, here's your answer.
Speaker 2 (13:05):
That's usually yeah, usually we have to push for it.
I start freaking out because I want to do the autopsy,
and because the families also, you know, they're in shock
the religious beliefs, you know, over arch and help them,
you know, in a time of need, right, But they
don't see down the road. They don't know down the
road what the implications of not getting an autopsy are.
(13:27):
And I'm thinking, oh my god, if this is suspicious
and I don't do my full job, this is my
one shot deal. So it's sort of hard to communicate that, like,
please put your religious beliefs aside, trust me, right, you
know who is I'm not of Jewish faith, I'm not
of Muslim faith. Like those are the ones that usually
have had the most I've had the most experience with
(13:48):
with having religious objections. So that's why I was pointing
that out. And yeah, we might need a court order.
I've even done autopsies with a rabbi in the room,
So we make a lot of accommodations. Do you understand,
like the family rabbi will come stand there. We won't
retain specimens other than toxicology. We will put every blood
(14:09):
stained scalpel, tissue like you know, towel anything that we
use back in the bag so the body can be
buried whole. Do you understand, Like every drop of blood,
every fluid, we do everything we can to catch the
fluid and not but still get the information. It just
it really is a collegial process, you know, trying to
(14:32):
work with the family, help them understand and then go
from there. And the opposite side is what I would
call a medical or non forensic autopsy or private autopsy,
which I do do. So I actually have two people
waiting for me this week for a private autopsy. The
families have reached out to me. I never solicit, but
they I treat this because it's not a medical examiner's
(14:53):
office that I'm doing it under its private I have forms,
legal forms that they have to give me written permission,
so they can say I only want you to look
at the brain, I only want you to look at
the heart, or I want you to look at the
whole body, et cetera. You know, we go through quite
a detailed discussion back and forth before that's established, and
then I go forward and I don't do anything that's
not permitted, and sometimes it was interesting. It's like an
(15:17):
evolving process. I remember one case, I think they wanted
me to look at the heart only okay, And then
I was like, I called the wife. I said, the
heart's questionable. It's not a slam dunk like cause of death,
and I don't want you to wonder. I said, would
you be okay with giving me permission to also look
at the brain? You know, I said, it's not what
(15:38):
we I sort of used my findings because I had
to make a sort of in process decision. I called
her and she was like, yes, that's okay. I said,
I just want to make sure there wasn't a stroke
or something else, like he hit his head, you know,
because I just want to make sure we rule out
the big things that you're concerned about. And it's a
tailored process. And that's why working with the family, like
I'm very open to discussion and open a discussion like
(16:02):
this is where I provide the guidance. And oftentimes I say,
you know, you want to hire me and you want
to pay me money, but I don't feel comfortable doing
an autopsy because I think we're not going to gain
new information.
Speaker 1 (16:16):
I know the way you operate and everything is a map,
and you do treat it like a system. So if
you opened somebody up to only look at the heart,
but you just happen on your way to the heart
to see something with the lung, you couldn't ignore that.
Speaker 2 (16:31):
Nope, and I would stop. I actually stopped in the
middle of that private autopsy and called the wife. You know.
I said, she's the legal next of kin, that's who
signed the permission slip, and I said, look, and I
amended the you know, like I documented the conversation saying, okay,
it's not heart only now it's heart and brain. But
you know, based on our conversation at I don't know, six
o'clock in the evening or something, but you know, I
(16:52):
wanted her to be okay with it. But my job
is to also provide closure and give an answer. So
how would I do that if I didn't think like
the pertinent things were looked at? You know.
Speaker 1 (17:03):
Well that kind of goes into the next question, and
that is, can any family member request an autopsy?
Speaker 2 (17:11):
So that's tricky. I think yes, Like usually when a
family calls me, and I'm talking more on the private side,
so I think in the medical examiner side, if there
is a concern by anybody known to the person the decedent,
it's usually like they need to follow a police report, right,
and the police will then relay that information to us
(17:31):
because in an official capacity, and that may drive the
autopsy being done. You know, the body wasn't coming into
the medical but now we need to investigate this death
because so and so said xyz. It doesn't have to
be a relative, do you follow, but the person should
know the decedent. It can't just be some stranger saying
I want mister Smith to have an autopsy. There has
(17:52):
to be some you know, questions, some concern that needs
to be looked at in the flip side, when we're
talking about a private autopsy outside of the Emmy or
coroner system. I do need the legal next of kin,
so it could be the spouse, the parent, the brother, sister,
those are the usual ones. Unless you have a power
(18:13):
of attorney, they would need to sign the paperwork. Now
if they talk to cousin Jim, and Cousin Jim's like, well,
I know David was I don't know doing drugs or
I don't know doing something right, like not drugs, but
complaining about his chest pain when we were going for
a walk. And the wife didn't know that, right because
men don't tell us anything, at least my David doesn't.
Speaker 1 (18:35):
You know.
Speaker 2 (18:35):
That may be a new piece of information. So cousin
Jim calls the wife and says, hey, but honestly, I
need the wife, the legal next of kin and this
hypothetical to sign the form. So Cousin Jim couldn't just
request it. Do you follow? He doesn't have the legal authority,
but they can chime in, and oftentimes it's a multi
person you know, when I have siblings and a spouse
(18:56):
and a grandparent left like it may be multi level discussions.
They talk as a group and get back to me.
Speaker 1 (19:02):
Crazy, So some people believe. And one of the questions says,
isn't it true that if you have an autopsy you
can't have an open casket.
Speaker 2 (19:12):
Oh my god, No, that's the beauty of the autopsy.
I actually, every time I counsel family on a private autopsy,
that's probably one of the first things I said. And
it's funny you say that, because I'm going to put
together a frequently Asked Questions document on my website, maybe
based on this conversation, because I get asked these questions
so much that we do it. Okay, let's back up.
(19:36):
If a body is decomposed, the funeral home is not
going to prepare it for open casket, right, that's not appropriate,
assuming the decedents bodies and you know, normal work, normal
recognizable condition. The way we make our cuts are very hidden,
very subtle, very precise. Okay, So it is like a surgery,
(19:57):
and then we sew up the body and the funeral
home also takes I mean, they do remarkable work. And
I'm telling you, like sometimes I've seen cases I've done
because I've had to revisit the body in the funeral home,
and I'm like, wow, she looks really good, like really healthy,
doesn't look you know, whether injuries are sewn up, makeup
(20:18):
is put on. Like. They do a lot of beautiful
work for the people they care for. So to me, no,
they're you know, nothing is done in areas that we
can see. Now that being said, if someone has an
injury to the right side of the head, you know,
I might have to shave the hair when doing the autopsy.
(20:40):
Maybe I save the hair so it can be glued
back on, or you know, maybe they can put a
scarf around the head or a hat. You know, maybe
the pillow can be styled in a way that will
cushion the head more. You know. I mean there's again
this is getting into nuances. But just a general autopsy
does not preclude open casket that we aim for that
(21:02):
you know, we're very careful and we aim to it
might operationally add a day or two until you can
have services, but no way does it interfere with the service.
Speaker 1 (21:13):
All right, last question, isn't it true in some small
towns they use newspaper or saw dust to fill in
cavities in the body.
Speaker 2 (21:25):
So I have never seen newspaper, okay, and I've so
my experience is very limited, and it would be only
with embalmed bodies, okay, so bodies that have been prepared
for funeral and then I do the autopsy, okay, So
that is a very limited number of cases compared to
the decedent who just died, right, and then I autopsy
(21:50):
and then they go to the funeral home and then
they have a funeral. So when we mix up those steps,
that's when I might see how the body was prepared.
I have seen sawdust, not so much in the cavities
but maybe under the body. But usually what I see
in embalmbed bodies like there's usually gel or I mean
(22:10):
there's fancy embalming methods, you know that really allow the
chemical into the body, into the blood vessels to really
soak through without leaking. So there may be some addition
of sawdust to help keep the body dry, but it
(22:31):
wouldn't be the predominant component. And I have never seen newspaper.
I mean, I can't speak. Remember, this is just just me,
you know. And I haven't practiced in very many small areas, right,
I'm trained in big cities, and I practice for the state,
and I've worked in other big cities, so I have
I can't say, you know, in small town West Texas
(22:52):
what they're doing. I have no idea, you know, I
don't know about newspaper even how absorbent it would be.
But you know, sawdust is a natural material, right. Usually
when it's sawdust's it is really light and fluffy. You know,
it's not dirty wood or anything that I've seen.
Speaker 1 (23:11):
Doctor Pria, I learned something every single time I talk
to you. But you just said something, and I want
to be yeah, I guess super clear that I understand
what you just said. Are you saying that you can
do an autopsy after somebody's been embalmed.
Speaker 2 (23:30):
It's less than ideal, and I'll tell you why. So
the way embombing works, right, is the funeral director the
embalmber cut like we'll cut into the blood vessels, so
those big blood vessels in the neck, the carotid arteries,
and then they will poke into the belly and then
the growing vessels and they'll use a pump to put
formaldehyde through those vessels, and that's how the organs get
(23:55):
chemically cured. They'll also use a poker like this they
call a probe that has a channel through it where
the formaldehyde can be inserted into organs, and I ask them,
if I know that there's going to be an autopsy
post embombing, to please be gentle with the trocar this
probe so there's less holes made in the body, if
(24:18):
you will. Okay, But yes, absolutely, I think one of
the two decedents this week that I am autopsying in
the next few days is embalmed because of my travels
and the time of death and other issues with the
family deciding. I just said, hey, you know, the one
thing that is limited is a toxicology, okay, right, because
the blood and urine and all that has been pumped out, right,
(24:41):
So I cautioned the family, but this would be a
second autopsy that I'm doing such that toxicology has already
been performed, and so then that becomes you know, null
and void consideration, and then we can just keep going. So, yeah,
there's no issue with that. The toxicology is what gets
very tricky. You know, we want a good specimen, get
good talks, right, and so I'm not you know, once
(25:02):
you have the alcohol and the pumping and the mixing
of blood with these chemicals, things are shifting around and
the measurements are less accurate.
Speaker 1 (25:11):
I've only known the process of somebody is murdered, they
have an autopsy, and they're embalmed, they go to the
funeral home. I just never heard that, and when you
said it, I was like, wait a minute. So again,
thank you so much for clearing that up and teaching
us once again.
Speaker 2 (25:31):
And I want to shout out to the you know,
funeral directors, because sometimes what happens is maybe the person
died without us being called, us being the emmy or
you know, some sort of autopsy process okay, and then
the funeral director gets the body like oh man, there's
a bump on the head or there's this weird bruise
(25:52):
like that doesn't sit well with the end. They don't
want to like miss something, so they'll call. And it's
sometimes having someone else like because you know, it sort
of starts trips up the process. It goes, oh, hey,
this is not normal, you know, but we've never laid
eyes on the body. If the emmy's not called, does
that make sense? If it goes straight from the home
(26:13):
hospital whatever, and they might be like, oh, you know,
this old elderly lady has a bump on the head
that the hospital totally like didn't report to us, and
that's why the EMMY wasn't called there, you know, And
now on the funeral director may be like, look, what
do you want to do about this? And you know,
and that's just an example, but right, you know, we
have other people in the chain that are responsible. And
(26:37):
the other really good thing like is like Massachusetts does it.
They have examiners that go to the body and look
at the body. I'm just speaking from experience because I've
signed their cremation certificates and they have an investigator look,
look the body ONTs over to make sure there's no
unexplained injuries. And that's special to Massachusetts as far as
(26:59):
I know. That's not done Rhode Island. But we also
sometimes investigate before the body's cremated, because once it's gone,
it's gone, right, you don't want to miss something. So
everybody has sort of a double check in place, especially
for cremations, to investigate further, to get medical records pulled
the body if you needed, or visit the body, et cetera.
Speaker 1 (27:18):
So yeah, outstanding, Well, ma'am, I appreciate it again.
Speaker 2 (27:23):
Welcome home, Thank you, I'm going to you soon we'll
have a we'll have a meeting in person and Linke Tobias.
Speaker 1 (27:29):
So that I cannot wait for that.
Speaker 2 (27:33):
My next next in two weeks, i'll be a week
and a half I'll be heading out. So yeah, it'll
be awesome.
Speaker 1 (27:38):
Yeah, we're gonna have a tremendous time. And Scott Duffy,
former SAC with the FBI, Sergeant Joe Jackloane from NYPD,
retired homicide ooh honey, it's gonna be a good time yep.
Speaker 2 (27:53):
So and animals are involved, so I'm always gonna be happy.
Speaker 1 (27:57):
Yeah, that was an easy sale with you. That was
that really was Yeah, all right, Doc, I appreciate you.
Speaker 2 (28:03):
All right, good night, m
Welcome to Pathology with doctor Priya. Doctor, welcome back to
Zone seven and welcome home.
Speaker 2 (00:15):
Yes, yes, I went on a little bit of an adventure.
As always, I'm always traveling in between here and there.
But for good reason. It was the most beautiful wedding
of an old family friend. I've known this family for
over thirty years. I used to babysit them, My mom
used to babysit them. And the middle son, who I
held as a baby at his prisoning, got married. Oh
(00:38):
and so I was in tears, and oh, yeah, I'm fallen.
Speaker 1 (00:41):
Yes I do. I love a wedding. Even if I
don't know the people, I can enjoy it.
Speaker 2 (00:47):
Yes, it's such a beautiful thing. You know, so much
hope ahead. And then I feel like these celebrations are rare, right,
they're beautiful moments. We got to embrace them every just everything,
ounce of it right exactly. So that was that. I
went to a concert, I saw some friends from high
school and had some productive meetings in New York.
Speaker 1 (01:10):
So, you know, all good, fantastic, all right. Well, you
know what, before I get to the topic for tonight,
I wanted to tell you you were so timely when
you were teaching us, you know, when more investigation needs
to happen, that they'll use sometimes terminology that we're not
familiar with regarding the cause of death. You know, they
(01:32):
just did that in the fifteen year old's death when
she was found in the trunk of the car of
the singer David And that's what they put And I went,
I know what that means, because doctor Pria just told me.
Speaker 2 (01:45):
Yeah, And I mean I did a little blurb on
Court TV. They don't pay me to say that, but
it's sort of explaining the same thing. You know, why
hasn't he been charged? And I mean, I'm not a
legal mind. I'm the Emmy, but you know, I'm speaking
from a doctor's perspective handled cases like this, As we said,
they're very complex and they can't you know, until we
(02:05):
find a cause of death in her, which, as we discuss,
is you know, challenging ahead. Many many modalities need to
be used. How can you even bring a charge right
without knowing what your what the crime is really other
than you know, are they even going to call it
a homicide based on the condition of her body? So
I don't want to jump ahead and assume guilt. There's
(02:27):
been other rumblings online, nothing that's been verified about other
people maybe involved, you know, in his close knit circle.
Then her family might have known about the involvement or
when she became involved. There's a video from school like circulating,
which I haven't really looked at that much. You know,
(02:47):
I'm really trying to stay on the medical aspect of it,
the forensic pathology aspect. This is where the police, you know,
I think we talked about, really need to dig deep
and set the stage for what happened. You'll put the
story together because how you know, how did she end
up in the trunk dismembered? And then you know, when
was the last time she was heard from? She's been
(03:07):
missing for a year. What's going on? You know, I
suspect she's not in that trunk a year, but you know,
because I started smelling right and it was abandoned. But
who knows? And that's really where it is. Who knows.
Speaker 1 (03:23):
But you know, Priya, when I saw the word deferred,
I thought, we've just learned that from doctor Priya because
I had never seen that before.
Speaker 2 (03:31):
Right, And that's really like a weird thing to say.
Speaker 1 (03:36):
But it literally just means they need more investigation.
Speaker 2 (03:38):
They don't know, correct, right, But I think they also
need so you know, we can just touch on it.
I always say pending for their studies because yes, any investigation,
but I think they also need her toxiclly, there's other
medical stuff.
Speaker 1 (03:50):
That I think that's why there hasn't been an arrest.
They're waiting for it all the time.
Speaker 2 (03:54):
Yeah, they can't charge him until they know what they're
charging and who they're charging, et cetera.
Speaker 1 (03:59):
And you know, there's all kind of rumors that are
already swirling around. One was that there was a baby
found somewhere near and all that, and you know, y'all,
that has not been verified, so don't keep spreading that
till we know something. And that's not anything that's been
released from the autopsy. I'll tell you that, not.
Speaker 2 (04:18):
At all, not at all, not that I know of.
And as far as I know, she was the only
one in the trunk, in the plastic bag. That's what
I think is the most reputable piece of information, you know,
not you know, they said the producer might have involved.
I mean, there's so many sort of speculative things that
can't be verified, and obviously the police, right are the
(04:41):
ones to verify that, and that's why there's so much
going on that And really, you know, I think I've
hinted at this that in the past, we have, at
least in Rhode Island, seven days to release a death certificate. Okay,
And let's say I know the cause and manner of death, okay,
But they don't want the candidate suspect to know that
(05:05):
I know, because if he if let's say, I know
it's a strangulation, he goes, oh, she was strangled. Wait,
that's not released to the public. How do you know that? Right?
You trip them up in the interview. And so I
have held legally held I've released the body, but I've
held the death certificate from being public, if you will.
And every state law is different, like is the cause
(05:25):
of death public? Is the manner of death public? Here,
the cause of death is public, the manner of death
is not. I have no idea why that's been dictated
by law for eons, like way before my time here,
And it's a very specific state to state. But at
the same time, like, we don't want any information while
they investigate to be leaked to the public. So sometimes
(05:49):
they will artfully either stay pending or deferred or they'll
have me like in my case is they'll be like, doc,
can you hold it a few days until you hear
back from us to give us that power in that
interview process. And for me, I'm happy to comply. That
doesn't mean I'm favoring the police. My exam is my exam.
Speaker 1 (06:13):
Right, Your fundings aren't going to change.
Speaker 2 (06:15):
So if they say hold it a few days, that
helps the investigation, that's to help the deceit it that
I examined, right, I'm not like convening with the police,
like I'm not biased. I want to be careful about that,
but it's just to make sure the investigative process is fair,
really unbiased. They have information and let's see what we
can find and that may also help their scene investigation
(06:38):
further and their analysis.
Speaker 1 (06:40):
There have been some great questions sent to us, so
I'm just going to start with the first one.
Speaker 2 (06:45):
Okay, cool. I want to predicate this though, So this
is actually something that's been on the front burner for
me because I was fascinated at Crime Con Like how
many people that came in. Obviously that's a select audience, right,
but they really follow show, and they follow they might
have more knowledge about death death investigation in certain cases
(07:06):
than let's say the average person. But what I think
is a double edged sword, if you will, is if
you're learning only from TV, whether you know, we'd be
a documentary because everybody has their own even a documentary
has a perspective correct and there's not always uh the
(07:27):
director or the people who use you know, are filming
it are not medically oriented. Usually they may have a pathologist,
but everything has I would say, a point of view.
Now it's not unbiased like just the just an autopsy finding.
So I thought like, wow, these people would have to
you know, they can be helpful. Right in the cold
(07:48):
case searches of the missing loved ones that were posted.
I mean they're they're doing internet deep dives. But at
the same time, if you really careful who might come
up in the search and whether that's a valid accusation involvement,
you know, you'd be really careful with what you think
based on certain findings. And so that's you know, the
(08:09):
CSI effect or you know, the effect of the media
on crime and investigation. I think was really at the
forefront of my mind because I'm like, oh, we got
to not overstep you know, the medical point of view
of it or the scientific point of view. You don't
want to create something out of nothing.
Speaker 1 (08:28):
I think that's the best advice you could give, because
you know, again, if you're getting it from TV, it
may or may not be accurate. It may you know,
do some harm if you're putting bad information out. So
here's the first question that I got over and over
and over. Can you always determine the cause of death
and the time of death?
Speaker 2 (08:47):
So I find these questions fascinating, and it's great that
people want to be educated. No, and so I wish
my life and your life was as black and white
as law and order and everything's completed in an hour,
you know, or whatever show C s I, you know,
pick one, right. But the issue is we have these
(09:10):
you know, cause of death can be anything. Manner and death.
We have the five manners, including undetermined. Okay, and really,
if you think about it, if we could pigeonhole everything
into the other manners and not need undetermined, that would
be ideal, right, But there's always that gray area. You know,
the cause and manner of death is a medical opinion
(09:32):
of the pathologist. Uh, sometimes I agree with them when
I review, you know, secondary review of cases. You know,
when I'm asked as the expert on by a lawyer
or family, and sometimes I don't right, I might have
a different interpretation because I'm looking at I have more
information now than they did at the beginning. It may
be just that my training and experience and my the
(09:56):
way I interpret things are slightly different. You know, in
any case, the there's multiple variables that go in. But no,
I've definitely certified cases as undetermined undetermined, you know, whether
it's a skeletal remain that doesn't have any clear trauma.
But if you're missing most of the body and the organs,
(10:17):
I can't tell you much, right, I can't be one
hundred percent certain it wasn't something else. So when I
have just a bag of bones, that's how we do it.
You know, if it's severe decomposition where things are missing
and it's not evident and toxicology can't necessarily be optimized.
You know, there's so many factors that we have to
think about. And remember, I treat the body as a
(10:41):
system as a whole, right, So I can't look at
just the liver without looking at the heart and the
brain and everything else. Right, So giving me half a
body or a decomposed body. Is it's valid to examine
that and gather what you can, But obviously knowing your
limitations is also important, and not to overpromise or overstep
(11:05):
what can be proven with the autopsy or additional testing.
Speaker 1 (11:10):
Gotcha, next question, family members can refuse an autopsy.
Speaker 2 (11:17):
So let's define autopsy because I think you need to
understand like under which conditions autopsies happen, and then we
can get into the family involvement. Okay, So obviously we
live in a complicated society, many beliefs, many backgrounds, and
we try to you know, the law supports the medical
(11:38):
examiner being around and operating in context of still respecting
you know, values, especially religious values. So when I talk
about a medical examiner or corner system, that is a
legal system where someone dies of unexplained means, sudden unexpected death,
(11:58):
their death needs to be investstigated and the laws surrounding
that depending on the county, the state, the district operates,
the corner operates, and the medical examiner operates to do
the autopsy that does not require family permission. So the
only real time that can be denied or the family
(12:22):
can request it not to be done is under religious exception.
So certain religions, certain religious beliefs, they don't want autopsies performed.
And after discussion with the family, we usually do explain that,
you know, this can even limit what we can determine,
and they might have to sign off on that. But
(12:43):
that's okay, and I have signed off. Going back to
the first question, you know, cause of death cannot be
determined due to refusal of autopsy, but.
Speaker 1 (12:53):
If law enforcement needs it for a homicide investigation, that
trump's religious beliefs.
Speaker 2 (13:00):
Oh, that's a very difficult one. We may need a
court order.
Speaker 1 (13:03):
Okay, here's your answer.
Speaker 2 (13:05):
That's usually yeah, usually we have to push for it.
I start freaking out because I want to do the autopsy,
and because the families also, you know, they're in shock
the religious beliefs, you know, over arch and help them,
you know, in a time of need, right, But they
don't see down the road. They don't know down the
road what the implications of not getting an autopsy are.
(13:27):
And I'm thinking, oh my god, if this is suspicious
and I don't do my full job, this is my
one shot deal. So it's sort of hard to communicate that, like,
please put your religious beliefs aside, trust me, right, you
know who is I'm not of Jewish faith, I'm not
of Muslim faith. Like those are the ones that usually
have had the most I've had the most experience with
(13:48):
with having religious objections. So that's why I was pointing
that out. And yeah, we might need a court order.
I've even done autopsies with a rabbi in the room,
So we make a lot of accommodations. Do you understand,
like the family rabbi will come stand there. We won't
retain specimens other than toxicology. We will put every blood
(14:09):
stained scalpel, tissue like you know, towel anything that we
use back in the bag so the body can be
buried whole. Do you understand, Like every drop of blood,
every fluid, we do everything we can to catch the
fluid and not but still get the information. It just
it really is a collegial process, you know, trying to
(14:32):
work with the family, help them understand and then go
from there. And the opposite side is what I would
call a medical or non forensic autopsy or private autopsy,
which I do do. So I actually have two people
waiting for me this week for a private autopsy. The
families have reached out to me. I never solicit, but
they I treat this because it's not a medical examiner's
(14:53):
office that I'm doing it under its private I have forms,
legal forms that they have to give me written permission,
so they can say I only want you to look
at the brain, I only want you to look at
the heart, or I want you to look at the
whole body, et cetera. You know, we go through quite
a detailed discussion back and forth before that's established, and
then I go forward and I don't do anything that's
not permitted, and sometimes it was interesting. It's like an
(15:17):
evolving process. I remember one case, I think they wanted
me to look at the heart only okay, And then
I was like, I called the wife. I said, the
heart's questionable. It's not a slam dunk like cause of death,
and I don't want you to wonder. I said, would
you be okay with giving me permission to also look
at the brain? You know, I said, it's not what
(15:38):
we I sort of used my findings because I had
to make a sort of in process decision. I called
her and she was like, yes, that's okay. I said,
I just want to make sure there wasn't a stroke
or something else, like he hit his head, you know,
because I just want to make sure we rule out
the big things that you're concerned about. And it's a
tailored process. And that's why working with the family, like
I'm very open to discussion and open a discussion like
(16:02):
this is where I provide the guidance. And oftentimes I say,
you know, you want to hire me and you want
to pay me money, but I don't feel comfortable doing
an autopsy because I think we're not going to gain
new information.
Speaker 1 (16:16):
I know the way you operate and everything is a map,
and you do treat it like a system. So if
you opened somebody up to only look at the heart,
but you just happen on your way to the heart
to see something with the lung, you couldn't ignore that.
Speaker 2 (16:31):
Nope, and I would stop. I actually stopped in the
middle of that private autopsy and called the wife. You know.
I said, she's the legal next of kin, that's who
signed the permission slip, and I said, look, and I
amended the you know, like I documented the conversation saying, okay,
it's not heart only now it's heart and brain. But
you know, based on our conversation at I don't know, six
o'clock in the evening or something, but you know, I
(16:52):
wanted her to be okay with it. But my job
is to also provide closure and give an answer. So
how would I do that if I didn't think like
the pertinent things were looked at? You know.
Speaker 1 (17:03):
Well that kind of goes into the next question, and
that is, can any family member request an autopsy?
Speaker 2 (17:11):
So that's tricky. I think yes, Like usually when a
family calls me, and I'm talking more on the private side,
so I think in the medical examiner side, if there
is a concern by anybody known to the person the decedent,
it's usually like they need to follow a police report, right,
and the police will then relay that information to us
(17:31):
because in an official capacity, and that may drive the
autopsy being done. You know, the body wasn't coming into
the medical but now we need to investigate this death
because so and so said xyz. It doesn't have to
be a relative, do you follow, but the person should
know the decedent. It can't just be some stranger saying
I want mister Smith to have an autopsy. There has
(17:52):
to be some you know, questions, some concern that needs
to be looked at in the flip side, when we're
talking about a private autopsy outside of the Emmy or
coroner system. I do need the legal next of kin,
so it could be the spouse, the parent, the brother, sister,
those are the usual ones. Unless you have a power
(18:13):
of attorney, they would need to sign the paperwork. Now
if they talk to cousin Jim, and Cousin Jim's like, well,
I know David was I don't know doing drugs or
I don't know doing something right, like not drugs, but
complaining about his chest pain when we were going for
a walk. And the wife didn't know that, right because
men don't tell us anything, at least my David doesn't.
Speaker 1 (18:35):
You know.
Speaker 2 (18:35):
That may be a new piece of information. So cousin
Jim calls the wife and says, hey, but honestly, I
need the wife, the legal next of kin and this
hypothetical to sign the form. So Cousin Jim couldn't just
request it. Do you follow? He doesn't have the legal authority,
but they can chime in, and oftentimes it's a multi
person you know, when I have siblings and a spouse
(18:56):
and a grandparent left like it may be multi level discussions.
They talk as a group and get back to me.
Speaker 1 (19:02):
Crazy, So some people believe. And one of the questions says,
isn't it true that if you have an autopsy you
can't have an open casket.
Speaker 2 (19:12):
Oh my god, No, that's the beauty of the autopsy.
I actually, every time I counsel family on a private autopsy,
that's probably one of the first things I said. And
it's funny you say that, because I'm going to put
together a frequently Asked Questions document on my website, maybe
based on this conversation, because I get asked these questions
so much that we do it. Okay, let's back up.
(19:36):
If a body is decomposed, the funeral home is not
going to prepare it for open casket, right, that's not appropriate,
assuming the decedents bodies and you know, normal work, normal
recognizable condition. The way we make our cuts are very hidden,
very subtle, very precise. Okay, So it is like a surgery,
(19:57):
and then we sew up the body and the funeral
home also takes I mean, they do remarkable work. And
I'm telling you, like sometimes I've seen cases I've done
because I've had to revisit the body in the funeral home,
and I'm like, wow, she looks really good, like really healthy,
doesn't look you know, whether injuries are sewn up, makeup
(20:18):
is put on. Like. They do a lot of beautiful
work for the people they care for. So to me, no,
they're you know, nothing is done in areas that we
can see. Now that being said, if someone has an
injury to the right side of the head, you know,
I might have to shave the hair when doing the autopsy.
(20:40):
Maybe I save the hair so it can be glued
back on, or you know, maybe they can put a
scarf around the head or a hat. You know, maybe
the pillow can be styled in a way that will
cushion the head more. You know. I mean there's again
this is getting into nuances. But just a general autopsy
does not preclude open casket that we aim for that
(21:02):
you know, we're very careful and we aim to it
might operationally add a day or two until you can
have services, but no way does it interfere with the service.
Speaker 1 (21:13):
All right, last question, isn't it true in some small
towns they use newspaper or saw dust to fill in
cavities in the body.
Speaker 2 (21:25):
So I have never seen newspaper, okay, and I've so
my experience is very limited, and it would be only
with embalmed bodies, okay, so bodies that have been prepared
for funeral and then I do the autopsy, okay, So
that is a very limited number of cases compared to
the decedent who just died, right, and then I autopsy
(21:50):
and then they go to the funeral home and then
they have a funeral. So when we mix up those steps,
that's when I might see how the body was prepared.
I have seen sawdust, not so much in the cavities
but maybe under the body. But usually what I see
in embalmbed bodies like there's usually gel or I mean
(22:10):
there's fancy embalming methods, you know that really allow the
chemical into the body, into the blood vessels to really
soak through without leaking. So there may be some addition
of sawdust to help keep the body dry, but it
(22:31):
wouldn't be the predominant component. And I have never seen newspaper.
I mean, I can't speak. Remember, this is just just me,
you know. And I haven't practiced in very many small areas, right,
I'm trained in big cities, and I practice for the state,
and I've worked in other big cities, so I have
I can't say, you know, in small town West Texas
(22:52):
what they're doing. I have no idea, you know, I
don't know about newspaper even how absorbent it would be.
But you know, sawdust is a natural material, right. Usually
when it's sawdust's it is really light and fluffy. You know,
it's not dirty wood or anything that I've seen.
Speaker 1 (23:11):
Doctor Pria, I learned something every single time I talk
to you. But you just said something, and I want
to be yeah, I guess super clear that I understand
what you just said. Are you saying that you can
do an autopsy after somebody's been embalmed.
Speaker 2 (23:30):
It's less than ideal, and I'll tell you why. So
the way embombing works, right, is the funeral director the
embalmber cut like we'll cut into the blood vessels, so
those big blood vessels in the neck, the carotid arteries,
and then they will poke into the belly and then
the growing vessels and they'll use a pump to put
formaldehyde through those vessels, and that's how the organs get
(23:55):
chemically cured. They'll also use a poker like this they
call a probe that has a channel through it where
the formaldehyde can be inserted into organs, and I ask them,
if I know that there's going to be an autopsy
post embombing, to please be gentle with the trocar this
probe so there's less holes made in the body, if
(24:18):
you will. Okay, But yes, absolutely, I think one of
the two decedents this week that I am autopsying in
the next few days is embalmed because of my travels
and the time of death and other issues with the
family deciding. I just said, hey, you know, the one
thing that is limited is a toxicology, okay, right, because
the blood and urine and all that has been pumped out, right,
(24:41):
So I cautioned the family, but this would be a
second autopsy that I'm doing such that toxicology has already
been performed, and so then that becomes you know, null
and void consideration, and then we can just keep going. So, yeah,
there's no issue with that. The toxicology is what gets
very tricky. You know, we want a good specimen, get
good talks, right, and so I'm not you know, once
(25:02):
you have the alcohol and the pumping and the mixing
of blood with these chemicals, things are shifting around and
the measurements are less accurate.
Speaker 1 (25:11):
I've only known the process of somebody is murdered, they
have an autopsy, and they're embalmed, they go to the
funeral home. I just never heard that, and when you
said it, I was like, wait a minute. So again,
thank you so much for clearing that up and teaching
us once again.
Speaker 2 (25:31):
And I want to shout out to the you know,
funeral directors, because sometimes what happens is maybe the person
died without us being called, us being the emmy or
you know, some sort of autopsy process okay, and then
the funeral director gets the body like oh man, there's
a bump on the head or there's this weird bruise
(25:52):
like that doesn't sit well with the end. They don't
want to like miss something, so they'll call. And it's
sometimes having someone else like because you know, it sort
of starts trips up the process. It goes, oh, hey,
this is not normal, you know, but we've never laid
eyes on the body. If the emmy's not called, does
that make sense? If it goes straight from the home
(26:13):
hospital whatever, and they might be like, oh, you know,
this old elderly lady has a bump on the head
that the hospital totally like didn't report to us, and
that's why the EMMY wasn't called there, you know, And
now on the funeral director may be like, look, what
do you want to do about this? And you know,
and that's just an example, but right, you know, we
have other people in the chain that are responsible. And
(26:37):
the other really good thing like is like Massachusetts does it.
They have examiners that go to the body and look
at the body. I'm just speaking from experience because I've
signed their cremation certificates and they have an investigator look,
look the body ONTs over to make sure there's no
unexplained injuries. And that's special to Massachusetts as far as
(26:59):
I know. That's not done Rhode Island. But we also
sometimes investigate before the body's cremated, because once it's gone,
it's gone, right, you don't want to miss something. So
everybody has sort of a double check in place, especially
for cremations, to investigate further, to get medical records pulled
the body if you needed, or visit the body, et cetera.
Speaker 1 (27:18):
So yeah, outstanding, Well, ma'am, I appreciate it again.
Speaker 2 (27:23):
Welcome home, Thank you, I'm going to you soon we'll
have a we'll have a meeting in person and Linke Tobias.
Speaker 1 (27:29):
So that I cannot wait for that.
Speaker 2 (27:33):
My next next in two weeks, i'll be a week
and a half I'll be heading out. So yeah, it'll
be awesome.
Speaker 1 (27:38):
Yeah, we're gonna have a tremendous time. And Scott Duffy,
former SAC with the FBI, Sergeant Joe Jackloane from NYPD,
retired homicide ooh honey, it's gonna be a good time yep.
Speaker 2 (27:53):
So and animals are involved, so I'm always gonna be happy.
Speaker 1 (27:57):
Yeah, that was an easy sale with you. That was
that really was Yeah, all right, Doc, I appreciate you.
Speaker 2 (28:03):
All right, good night, m
Host
Sheryl McCollum
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