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Case# 2019-0239 MEDICAL EXAMINER'S REGISTER CITY AND COUNTY OF SAN FRANCISCO - RECORD OF DEATH Name: ADACHI, JEFFREY Dias: ADDRESS "45 SAN BENITO WAY, SAN FRANGISCO.CA 94127 DATEOF DEATH: 027292019 TIME: OBSS4PM_ REPORTED GY: RITIKCHANORA MD DATE OF REPORT: 02/a1@019 TIME: 07:35PM REPORTED AGENCY: CPNC-PAGIFIC PLACE OF DEATH: 2333 BUCHANAN STREET, SAN FRANCISCO,CA 94115. TWOEOF case UNKNOWN INCIDENT DATETIME: ananoraas4s PM RELATIVE Spouse DATE NOTIFIED: azr2ro0 BIRTHOATE: N291950 AGE: 69 SSF S64-4002000 SEX! MALE RACE: ASIANJAPANESE RECEIVED AT MEDICALEXAMINER: 02/23/2010 IME: 10:0 PM RELEASED To: RELEASED DATE: 2752018 RELEASE SIGNED BY RELATIONSHIP. Pouck: PROPERTY LISTING: 7 o PROPERTY 1 COSF ID GARD ‘ D PROPERTY 1 COL presume eo aE SEER ORONO TONERS aan Weert ce aes See eet womomerioucas ‘Be mr carne ars eeaeonom Guest Belted CEE nme mney EO rae CRM Mens BNeisaree Eee: elec can Baers alien etcnrre eu Ee conor enmore Grliaaas irae Sameer Semtnean sage > ry seman Pa yon Seeeiat TEED on oma vennor vane We 22 UY SHO val igh caste 2010-0200 PAGE:2 -RGHT UPPER CHEST WET SWAB (APPARENT WRITING) ‘ie es Ro CORAL HAND {NET gwae RIGHT DORSAL HAND Drv sw Leer Pata ‘et gvne LEFT Pat Wereontnot sie Dey conrRoL ses Bay Sis sear Wer swe scxorunt Dav aga swika WEFT MARE) ‘WEY SNAB LEFT NASAL LEFT RARE) Dh stias LEFT DORSAL HAND ier SAB LEFT DORSAL HAND Sy sans Pent Oka ies} risro cass COMTAN (Necs}nisT0 cass CONTAIN PUBUC ADNENISTRATOR! DATE NOTIFIED: PRRECEWED AMOUNT: BODY SEARCHED BY: ar PREMISES SEARCHED By ar PREMISES SEALED BY: DATE: EXAMINATION: AUTOPSY PERFORMED BY: MOFFATT MD invesngators: BaRORICH ETA cchuaka #120 Repos 168 (210) Case#: 2019-0239 MEDICAL EXAMINER / INVESTIGATOR'S REPORT ECORD OF ove Name: Adachi, Jeffrey Date/Time of Death: 02/22/2019 18:54 Marital Status: Marred —Age:59.— «Sex: MALE HE: S10" Wt: 169 Lbs Nature: Orug Related Race: Asian-Japanese Home Address: 146 San Berto Wisy, San Francisco, CA 98127 Place of Death: CPMC Paciic Campus, 2333 Buchanan Street, San Francsco, CA 98115 Case involvements: Chandra M.D. CPMC-Pactie Campus ‘Sgt Payne #2544 SFPD Cental Station Nursing Supervisor Rad CPMC-Pacific Campus Flagerpints Taken: Yes Retatve Noted: Spouse Case History: ‘The subject, 289 yoo ld mal, ese wt is wife at 145 San Galo Wey in San Francisco, Catania On 2222010 te sujet became unresponsive while a 48 Telegrash Place In San Frerciso, when an unknown indhidusl contacted ‘911 and parsmesics wore cspaichod tothe loan. Paramedics Warapted the subject othe emegency dopanment a Callmia Pace Macca Centar Page Canpus (CPMC PAC), where death was proncunced win the emergon=y _epareren st 1854 hours Accorting to infarmation blained om te stndng emergency depatmont physician Dr. Rik Chanda, Nursing Superiser Samareh Rad FN, the King Amedican Ambulance Patent Care Repo, and interviews conducted wih he ‘boca spouse, brothers, cubacs fend (Wines; W), locaton of inden bung ena (Wines 2; 2) land a scene invesigaton cocuring with SFPO oficers at te lation of ice, te flowing Medial Examine Inwostgatve Report wae gnarled. On 22272019 at 1749 hours a S11 call as pace for ene by 2 unknown Indvidual Emergency senices wore dspached 1 46 Telegraph Place where hey were greeted by a winess or Dossbe winesses, Paramedics and Fre Osparment personel reported that wrasse a he scene std thet ho ‘ect ttn ning “sng ae nie hse a ording i eth baer clapsng, Emergency sans ound te subject urvosponsie on the oro bedoom.Caropulensyreautcaton was isd nd contd on seen ‘Two inubaion allem wore made atthe Scene bul Wao UnSUECSSI. A King tube was than placed with sucton| {oltming toon ate. Paramedics reported good ces se end ung sounds. The subjct was shocked mull ines and ‘agminstored epnepvine and Narcan, Paramedics reports a sow carts puis for 2 few seconds bear it was est. Resusctaive eaten! was conned and We subject was han wanspred at 182 hous to he emergency depatmont ‘of CPC PAC, Paramedies repoted that te subjec's conden dd net change en route to the hosts, and he boc care wa ansfaredt tha nop att 1829 hows, tots Newhall stret San Francisco # CA 94124 « Phone (415) 641-3600 + Fax (415) 641-3650