OFFICEOFTHEMEDICALEXAMINER701W,
Jefferson
St.
Phoenix,
AZ85007REPORTOFAUTOPSYDECEDENT:.ErnestMartyAtencioCASE:11-07638DATEOFEXAMINATION:12/21/2011TIME.:0806HoursPERSONSPRESENTATEXAMINATION:
MaricopaCountySheriff'sOffice:
DetectiveCluff#S0961PATHOLOG,ICDIAGNOSES
1.
Clinicalhistoryofcardiacarrest.II.Complicationsofabove.A.Acutehypoxic/ischemicencephalopathy,withdiffusecerebraledema,cerebellartonsillarherniation,acutehemorrhag.es,andclinicalhistoryofbraindeath.B.Clinicalhistoryofhyperglycemiaandthrombocytopenia..C.Clinicalhistoryofmultisystemorganfailureincludingacuterespiratoryfailureandsubsequentdevelopmentofacutebronchopneumonia.III.Circumstantialevidenceconsistentwithacutepsychosis.
A.
Clinicalhistoryofcognitivedisorder,nototherwisespecified(NOS),schizoaffectivedisorder,depression,andpriorsuicidalideation/attempt.PATHOLOGICDIAGNOSESCONTINUEDONNEXTPAGECAUSEOFDEATH:Complicationsofcardiacarrestinthesettingofacutepsychosis,lawenforcementsubdual,andmultiplemedicalproblemsMANNER:Undetermined
OS/30/12
DaleSigned
WILLIAMT,STANOIII,MDMEDICALEXAMINER
ERNESTMARTYATENCIO11-07638
PATHOLOGICDIAGNOSESCONTINUED
B.Clinicalhistoryofpriorprolongedinpatienthospitalizationsforacutepsychosis.IV.Historyoflawenforcementsubdual,includingapparentcarotidchokehold,proneplacementandrestraint,useofconductedelectricaldevice,anduseofhandcuffs.
A.
Skinlesionsofchestandleftposteriorthigh(consistentwithconductedelectricaldevicecontactpoints).B.Focalsofttissuehemorrhageoflaryngealprominence.C.Ecchymosisofleftshoulder.D.Abrasionsofabdomen,leftwrist,rightposteriorthigh,andleftcheek.V.Multiplemedicalproblems.
A.
Clinicalhistoryofhyperlipidemiaandhypertension.B.Cardiomegaly(500grams),mild,withmyocytehypertrophyandmildpatchyinterstitialandperivascularfibrosis.C.Arteriolarsclerosisofkidneys.D.Aorticatherosclerosis,moderatetosevere.E.Coronaryarteryatherosclerosis,mildtomoderate.F.Clinicalhistoryofpastpolysubstanceabuseanddependence(alcohol,cannabis,methamphetamine).G.Hepaticsteatosis,severe.H.Clinical.historyofantemortemelectrocardiogramspositiveforprolongedOTinterval.
l.
Clinicalhistoryofchronicrightshoulderpain;statuspostremoterotatorcuffsurgery.
J.
Clinicalhistoryoftobaccosmoking.VI.ClinicalhistoryofprolongedperimortemCPR,includingchestcompressionsperformedbymultipleindividuals.A.Multiplebilateralanteriorribfractures.B.Liverlaceration.C.Focalmesenterichemorrhageofsmallintestine.VII.Toxicologyandpostmortemvitreousfluidelectrolyteanalysisnon-contributory.
REPORTEDCIRCUMSTANCESOFDEATH
Thedecedent,a44yearoldmilitaryveteran,hadalongandcomplicatedmedicalhistorythatincludedhypertension,hyperlipidemia,evidenceofaheartarrhythmia(prolongedOTinterval),chronicrightshoulderpain(statuspostremoterotatorcuffsurgery),tobaccosmoking,andpolysubstancedependencewithpriorepisodesofalcoholandmethamphetamineabuse.Healsohadmultiplementalhealthproblems,includingschizoaffectivedisorder,cognitivedisorder,NOS,depression,andpriorPage2of11
ERNESTMARTYATENCIO11-07638suicidalideation/attempt.Thedecedenthadalsohadtwoseparateinpatienthospitalizationsforpsychiatriccare.InMay2009hewashospitalizedduetohallucinations,hearingvoices,alcohol,cannabis,andmethamphetamineabuse,andmedicationnon-compliance.Hisadmittingdiagnosisatthattimewasschizoaffectivedisorder,manictype.HewasdischargedtohomeinJune2009.InJuly2010,hewasagainhospitalized,thistimeduetoanacutepsychosisthatincludedhearingvoicestellinghimtokillhimself.Duringthathospitalization,hewasalsodescribedasbeinghomelessanddepressedsecondarytohiswifeleavinghim.Hewastreatedwithmedicationandtherapy,andrespondedwellenoughtothepointofbeingdischargedtohomeinOctober2010.HislastknowndocumentedmedicalinformationwasfromanunscheduledvisittoaVeteransAdministration(VA)carefacilityforamedicationupdateinAugust2011.Atthattimehewasdescribedaslivingatanassistedlivingfacility(ALF),andhismedicationswereupdated.FromAugust2011toDecember15,2011,allinformationregardingthedecedentisunknown.Therewerenoreceivedmedicalrecordsfromthattimeframe,anditisunclearwherehewasliving,whetherhewasemployedorhomeless,whetherhewascompliantwithhismedications,andwhetherhewasexperiencinganyneworrecurrentmedicalorpsychoticsymptoms.OnDecember21,2011,aninvestigatorwiththeOfficeoftheMedicalExaminer(OME)spokewiththedecedent'snextofkin(NOK),andtheonlyinformationobtainedatthattimewasthatthedecedenthadhad"heartmedications",thathe"smokedcigarettes",andthathehadhad"personalissues."FurthercontactwithNOKtoinquireinformationaboutthedecedentfromAugusttoDecember2011wasprecludedbylegalproceedings.DuringtheeveninghoursofDecember15,2011,awomannoticedthedecedentaggressivelykickingtheoutsidedoortoanapartment.Itwasunclearifthewomanknewthedecedent,anditwasunclearwholivedinthatparticularapartment.Thewomanwalkedintotheapartment'sparkinglotandcalledemergency911usinghercellphone.Thedecedentthenwalkedupbehindheraggressivelyandbeganyellingatherwithhisfaceinchesawayfromhers.Atthatpointthewomanfeltthedecedentwasgoingtohither,butshestatedhebecamedistractedbyapassingcarandbeganchasingit.WhenPhoenixPoliceDepartmentofficersarrivedatthescene,theyobservedthedecedentaggressivelypointinghiscellphoneatthewoman.Theyimmediatelyrecognizedthedecedentasthesamemantheyhadmadecontactwithearlierthesamedayatalocationnotfarfromtheapartmentcomplex.At211
o
hours,theofficersarrestedthedecedentforassault.From2110hoursonDecember15,2011to0101hoursonDecember16,2011,thedecedentwasinPhoenixPolicecustodywhilebeingtransportedtovariouslocations.Accordingtoseveralotherarrestedwitnesseswhowerebeingtransportedwiththedecedent,hewasshowingsignsofacutepsychosisatthattime.Page3of11
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Ernest 'Marty' Atencio's Autopsy Report
Maricopa County Medical Examiner's Report into the death of Ernest "Marty" Atencio, who died after a Dec. 16, 2011 fight with officers inside one of Sheriff Joe Arpaio's jails in Arizona.
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