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As previously discussed, we have provided your offices with a packet pertaining to Dr. Sam Andrews that was sent to us by Travis County. In addition, I have also let you know that based on allegations presented to our office, we have asked the Texas Rangers to conduct an investigation. Please find attached letters related to same that were sent to our office. They have also been turned over to the Rangers for purposes of their investigation. We will continue to keep you informed of this investigation and any relevant information that may pertain to our criminal cases. Please share with members of the criminal defense bar, as you are my best points of contact. Let me know if you have any questions. LUBBOCK COUNTY MEDICAL EXAMINER Sam Andrews BSe MD FRCPC FCAP D-ABP Chief Medical Examiner 28 January 2019 TO: Ms, K, Sunshine Stanek District Attorney Lubbock County Texas FR: Dr. Sam Andrews Chief Medical Examiner RE: Allegations of misconduct against Dr. Natarajan Dear District Attorney Stanek, On Wednesday, August 29, 2018, Dr. Stephen Pustilnik was working as a contract pathologist for Lubbock County at the Medical Examiner's Department {LCME). Or. Matshes was visiting the LCME that same day for administrative reasons. Toward the end of the business day, Dr. Pustiinik asked to meet with Dr. Matshes and I to discuss two topics: (a) his desire to obtain permanent employment at the LCME, and (b) concerns he had about LCME operational matters under Dr. Natarajan. As was our standard of practice, information about our conversation with Dr. Pustilnik was conveyed to County officials at the time. In light of new information that has 4434 South Loop 289 ‘Lubbock, Texas 79414 hone ($06) 687-9434 Fax (806) 687-9438 or (806) 775-7908 Forensic Pathology Services provided by NAAG Pathology Labs PC + 1-800-985-5346 + ‘Sam Andrews BSc MD FRCPC FCAP D-ABP Chief Medical Examiner recently come to my attention (see "Case Reviews" below), | am executing my obligations as Chief Medical Examiner by formally bringing these matters to your attention for potential criminal review. The allegations raised by Dr. Pustilnik were that: 1. Dr. Natarajan was an “alcoholic” who was regularly intoxicated while at work, and while ‘on-call after hours, and that his “functional alcoholism” impaired his abilities in his medical examiner work; 2. That Dr, Natarajan used County facilities, equipment, personnel and resources to fund his private forensic pathology practice; and 3. That Dr. Natarajan accepted “bribes” to change cause and manner of death statements, and other opinions. To that end, Dr. Pustilnik cited two “closed” LCME cases by case number, and suggested that the cases be reviewed, and that we perform a broader review to look for patterns in Dr. Natarajan’s medical decision making. While | am not in a position to discuss the veracity of Dr, Pustilnik’s claims of alcoholism and misuse of public resources, | will note that several former employees brought similar allegations to my attention. Case Reviews As you are aware, prior to my official arrival as Chief Medical Examiner on October 1, 2018, we became aware of a significant backlog of cases at the LOME, It was initially believed that Dr. 4434 South Loop 289 Lubbock, Texas 79414 Phone (806) 687-9434 ay (800) 687-9438 or (806) 775-7908 Forensic Pathology Services provided by NAAG Pathology Labs PC ~ I-400-985-5346 + Page 205