POSTMORTEM EXAMINATION OF THE BODY OF Connor S. Betts Case # - 19-3701 Montgomery County I. Multiple gunshot wounds: A. Gunshot wound of the superior lateral right shoulder (A): 1. 4. 5. Entrance: Superior lateral right shoulder, no thermal effect, soot, or stippling. Pathway: Right lateral shoulder soft tissues, lateral right scapula, upper lateral right chest soft tissues. Exit (I): Lateral right chest near posterior axilla area, large defect with focal abrasion. Direction: Downward. Associated findings: Right lung contusion. B. Gunshot wound of the right lower lateral neck/right medial shoulder (B): 1. Entrance: Right lower lateral neck/right medial shoulder, no thermal effect, soot, or stippling, irregular abrasion collar. Pathway: Sequentially perforates lower neck soft tissues and left major vasculature with associated dense extravascular blood. Exit (E): Left lateral lower neck. Direction: Right to left, slightly back to front. and slightly upward. 361 WEST THIRD STREET « DAYTON, OHIO 45402 + (937) 225-4186 « wwrw.mcohio orgigovernmenticoroner National Accreditation by NAME, ABFTConnor S. Betts Case# 19-3701 C. Gunshot wound of the anterior upper chest (C): 1. 4. 5. Entrance: Anterior upper chest, no thermal effect, soot, or stippling, abrasion collar most prominent from the 12 to 4 o'clock positions. Pathway: Sequential perforation of the mid anterior upper chest soft tissues, enters the chest through the area of right rib 2, right lung, and exits the chest through complex fractures and defect at the level of lateral right ribs 3, 4, and 5. Exit (H): Right lateral upper chest near the anterior axilla area, irregular large defect, associated contusion, Direction: Left to right, somewhat front to back, slightly downward. Associated findings: Right hemothorax (approximately 100 mL). D. Gunshot wound of the right medial proximal upper arm (X): 1. Entrance: Right medial proximal upper arm, irregular, presumed re- entry, no thermal effect, soot, or stippling. Pathway: Right upper arm soft tissues. Exit (Z): Right mid posterior lateral upper arm. Direction: Left to right, somewhat front to back, and slightly downward. Associated findings: Right humerus fracture. E. Gunshot wound of the right anterior chest (D): 1 Entrance: Right anterior chest, no thermal effect, soot, or stippling, abrasion collar more prominent from the 6 to 11 o'clock positions. Pathway: Sequentially penetrates the right anterior chest soft tissues, enters the chest through the area of right ribs 5 and 6, right lung, heart base, left ung, left pleura at the level of left lateral ribs 5 and 6. Recovery: Large-caliber projectile free within the blood contained in the left chest cavity. Direction: Right to left and front to back. Associated findings: Right hemothorax (approximately 100 mL, see above), left hemothorax (approximately 1000 mL). Page 2Connor 8. Betts Case# 19-3701 F. Gunshot wound of the lateral right back (KK): 1 2. 3. 4, G. Gunshot wound of the left posterior lateral hip area (G) 1. 2. 3. 4. Entrance: Lateral right back, no thermal effect, soot, or stippling. Pathway: Sequentially perforates the right upper back soft tissues. Exit (JJ): Left mid upper back, superior associated abrasion and contusion, Direction: Right to left, somewhat upward, and slightly back to front. Entrance: Left posterior lateral hip area, no thermal effect, soot, or stippling, irregular abrasion collar but most prominent at the 12 to 4 o'clock positions. Pathway: Left lateral hip soft tissues, Exit (F): Left anterior lateral hip area, irregular defect. Direction: Back to front, somewhat downward. H. Gunshot wound of the right proximal posterior lateral thigh (M): iy 3. 4. I. Gunshot wound of the right lateral lower buttock area (TT): 1 Entrance: Right proximal posterior lateral thigh, no thermal effect, soot, or stippling, abrasion collar most prominent from the 3 to 9 o'clock positions. Pathway: Sequentially perforates the soft tissues of the proximal right thigh. Exit (J): Right anterior proximal thigh, supported abrasion Direction: Front to back, slightly right to left, upward. Entrance: Right lateral lower buttock area, no thermal effect, soot, or stippling, abrasion collar most prominent at the 9 to 3 o’clock positions. Pathway: Sequentially perforates right buttock and upper right thigh soft tissues. Exit: Right proximal anterior thigh (K). Direction: Back to front, left to right. Associated findings: Right proximal femur fracture, pelvis fracture, dense pelvic soft tissue blood. Page 3Connor S. Betts Case# 19-3701 J. Gunshot wound of the right lateral hip area (UU): 1. Entrance: Right lateral hip area, no thermal effect, soot, or stippling, abrasion collar most prominent at the 7 to 4 o'clock positions. Pathway: Sequentially perforates soft tissues including pelvis fracture and proximal right thigh soft tissues, Exit (L): Right anterior thigh with associated contusion and abrasion. Direction: Right to left, back to front, slightly downward. Associated findings: Pelvis fracture, right proximal femur fracture and dense pelvic soft tissue blood (see above). K. Gunshot wound of the right mid to proximal posterior thigh (VV): 1. Entrance: Right mid to proximal posterior thigh, no thermal effect, soot, or stippling, abrasion collar most prominent at the 5 to 12 o'clock positions. Pathway: Sequentially penetrates the right thigh soft tissues. Recovery: Lateral mid right thigh, large-caliber jacketed projectile. Direction: With the body in the standard anatomic position, slightly downward. L. Gunshot wound of the right lateral mid to proximal thigh (N): 1. Entrance: Right lateral mid to proximal thigh, no thermal effect, soot, or stippling, abrasion collar most prominent at the 3 to 9 o’clock positions. Pathway: Sequentially penetrates the right thigh soft tissues. Recovery: Right lateral mid thigh, large-caliber jacketed projectile Direction: With the body in the standard anatomic position, slightly downward, and slightly back to front. M. Gunshot wound of the right proximal medial lower leg (O): 1 Entrance: Right proximal medial lower leg, no thermal effect, soot, or stippling, abrasion collar most prominent from the 1 to 11 o'clock positions. Pathway: Sequentially penetrates the soft tissues of the medial right lower leg. Page 4Connor S. Betts Case# 19-3701 3. Recovery: Medial right thigh, large-caliber jacketed projectile. 4. Direction: With the body in the standard anatomic position, the wound direction is left to right, and upward. N. Gunshot wound of the left proximal posterior medial thigh (YY): 1. Entrance: Left proximal posterior medial thigh, no thermal effect, soot, or stippling, abrasion collar most prominent from the 7 to 12 o'clock positions. 2. Pathway: Sequentially perforates the upper thigh soft tissues. 3. Exit (P): Left proximal anterior thigh, irregular wounds with irregular supported abrasion. 4. Direction: With the body in the standard anatomic position, back to front, right to left, and slightly upward ©. Gunshot wound of the left distal posterior thigh (ZZ): 1, Entrance: Left distal posterior thigh, no thermal effect, soot, or stippling, abrasion collar most prominent at the 11 to 7 o'clock positions. 2. Pathway: Sequentially perforates the left distal thigh soft tissues. Exit (Q): Left distal anterior lateral thigh. 4. Direction: With the body in the standard anatomic position, back to front, somewhat right to left, and downward. P. Gunshot wound of the left proximal medial upper arm (V): Entrance: Left proximal medial upper arm, no thermal effect, soot, or stippling. 2. Pathway: Left upper arm soft tissues. 3. Exit (R): Left anterior lateral mid upper arm. 4. Direction: With the body in the standard anatomic position, right to left, somewhat back to front, slightly downward. Q. Gunshot wound of the left posterior lateral elbow area (1): 1. Entrance: Left posterior lateral elbow area, no thermal effect, soot, or stippling. 2. Pathway: Left posterior elbow area soft tissues and fracture of the left proximal ulna. Page 5Connor S. Betts Case# 19-3701 3. Exit (U and $): Left proximal posterior left forearm at the elbow area (embedded dark material) and the left distal lateral upper arm. 4. Direction: With the body in the standard anatomic position, left to right, slightly downward. R. Graze wound of the left lateral thumb base area, anterior to posterior and downward, associated contusions of the thenar prominence and the left proximal index finger. S. Ballistic/ shrapnel wounds of the left proximal lateral index finger and the left lateral anterior palm. T. Gunshot wound of the right posterior proximal upper arm (AA): 1, Entrance: Right posterior proximal upper arm, no thermal effect, soot, or stippling, uniform abrasion collar. Pathway: Right upper arm soft tissues and right humerus. Exit (Y): Right anterior proximal upper arm, superior wound, irregular defect. 4. Direction: With the body in the standard anatomic position, back to front, slightly right to left. U. Gunshot wound of the right posterior mid lateral upper arm (BB) 1, Entrance: Right posterior mid lateral upper arm, no thermal effect, soot, or stippling, abrasion collar most prominent at the 2 to 10 o'clock positions. Pathway: Right upper arm soft tissues and right humerus. Exit (¥): Right anterior proximal upper arm, inferior wound, irregular defect. Direction: With the body in the standard anatomic position, back to front, slight right to left, slight upward. V. Gunshot wound of the right lateral proximal forearm (Fb): 1. Entrance: Right lateral proximal forearm, no thermal effect, soot, or stippling, uniform abrasion collar. Pathway: Soft tissues of the right forearm with multiple right radius and ulna fractures. Page 6Connor S. Betts Case# 19-3701 3. Recovery: Right anterior wrist, large-caliber jacketed projectile and core fragment. A jacket fragment is recovered along the path in the mid right forearm, 4. Direction: With the body in the standard anatomic position, front to back and downward. W. Gunshot wound of the right posterior proximal forearm at the elbow area (DD): 1, Entrance: On the right posterior proximal forearm at the elbow area, no thermal effect, soot or stippling, abrasion collar most prominent at the 3 to 9 o'clock positions. 2. Pathway: Right elbow soft tissues with fractures of the right distal humerus and proximal right radius/ulna with resultant diverging pathways of bone and/or projectile. 3. Exits (EE, FFa, and CC): Right posterior lateral distal upper arm (CC), right proximal medial forearm and elbow area (EE), and right proximal lateral forearm (Fa). 4. Direction: With the body in the standard anatomic position, back to front. X. Gunshot wound of the right distal lateral forearm at the wrist (GG): 1, Entrance: Right distal lateral forearm at the wrist, no thermal effect, soot, or stippling, abrasion collar most prominent at the 7 to 4 o'clock positions. 2. Pathway: Right wrist and hand soft tissues with palpable probable fractures at the wrist. 3. _ Exit (HH) and recovery: Right mid proximal hand palm, a small jacket fragment is recovered protruding from the exit defect. 4. Direction: With the body in the standard anatomic position, downward and right to left. Y. Deep graze wound (II) of the right anterior mid small finger with fracture. Z. Gunshot wound of the right lateral lower back (LL): 1, Entrance: Right lateral lower back, no thermal effect, soot, or stippling, abrasion collar most prominent at the 2 to 10 o'clock positions. 2. Pathway: Back soft tissues. Page 7Connor S. Betts Case# 19-3701 3. Recovery: Right back just right of midline, large-caliber jacketed projectile. 4. Direction: Right to left, and upward AA. Gunshot wound of the mid lower back (MM): 1. Entrance: Mid lower back, no thermal effect, soot, or stippling, abrasion collar most prominent at the 3 to 9 o’clock positions. 2. Pathway: Back soft tissues with fracture of the posterior aspect of right rib 11, 3. Recovery: Left back (00), large-caliber jacketed projectile 4. Direction: Somewhat right to left and upward. BB. Gunshot wound of the left upper lateral buttock area (NN): 1. Entrance: Left upper lateral buttock area, no thermal effect, soot, or stippling, abrasion collar most prominent at the 7 to 3 o'clock positions. 2. Pathway: Left buttock soft tissues and the left posterior pelvis or femur head with associated fractures. 3. Recovery: Left side of the anus, large-caliber jacketed projectile. 4. Direction: Left to right, downward, and slightly back to front. CC. Graze wound of the mid left buttock area (PP), appears to be right to left and downward. DD. Gunshot wound of the right mid buttock area (QQ) 1, Entrance: Right mid buttock area, no thermal effect, soot, or stippling. 2. Pathway: Right buttock soft tissues, pelvis soft tissues, to large bowel. 3. Recovery: Large bowel, small-caliber jacketed projectile. 4. Direction: Somewhat back to front, slightly right to left, and upward. EE. Gunshot wound of the right lower mid buttock area (RR) 1. Entrance: Right lower mid buttock area, no thermal effect, soot, or stippling, abrasion collar most prominent from the 1 to 8 o'clock positions. 2. Pathway: Right buttock soft tissues, pelvis soft tissues, bowel loops, liver. Page 8Connor S. Betts Case# 19-3701 nL 3 4. Recovery: Liver, small caliber jacketed projectile. Direction: Somewhat back to front, slightly left to right, upward. FF, Gunshot wound of the right mid lower buttock area (SS): iy 2. 3. 4. Entrance: Right mid lower buttock area, no thermal effect, soot, or stippling, abrasion collar most prominent from the 1 to 8 o'clock. Pathway: Right buttock soft tissues, right proximal femur fracture Recovery: Anterior right hip area, small caliber jacketed projectile. Direction: Back to front, slightly right to left. GG. Gunshot wounds of the anus area (WW), presumed 2 wounds: L Entrances: Irregular confluent overlapping tissue defects, no thermal effect, soot, or stippling. Pathways: Soft tissues into the anterior lower abdomen and left pelvis, (labeled “left sacrum”), complex fractures, prostate disruption and bladder defect. Recovery: Two (2) large-caliber jacketed projectiles are recovered, one from the left abdomen and one from the left pelvis (labeled “left sacrum”) Direction: Back to front and upward as well as somewhat right to left, upward, and somewhat back to front. HH. Gunshot wound of the left medial lower buttock area (XX): 1 2. 3. 4. Entrance: Left medial lower buttock area, no thermal effect, soot, or stippling, uniform marginal abrasion. Pathway: Left buttock soft tissues and pelvis with complex fractures. Recovery: Left pelvis, large-caliber jacketed projectile. Direction: Back to front, slightly right to left. Il. Ballistic/shrapnel wounds of the left mid to distal lateral lower leg (AAA), no recovery attempt due to fragment size. JJ. Graze wound, left posterior heel, undetermined direction. When clothing is present overlying associated wounds, defects are present. X-rays show foreign material and various projectiles or projectile fragments are recovered from clothing or external surfaces as labeled. Page 9Connor S. Betts Caset 19-3701 IM, Other injuries: A B. @ D. Left proximal anterior lateral lower leg, abrasions Anterior knee surfaces, small abrasions. Lower anterior left abdomen, healing small contusion, Bilateral wrist areas, linear pressure impressions. OPINION It is my opinion that the cause of death of Connor S. Betts is: Multiple gunshot wounds. It is my opinion that the manner of death is: Homicide. hls. S30 ZF Kent E. Harshbarger, M.D.(A.D., M.B.A., Forensic Pathologist Date Coroner, Montgomery County, Ohio Page 10Connor S. Betts Case# 19-3701 A postmortem examination of the unembalmed body of a 24-year-old white male, identified to me as Connor S. Betts, is performed at the Montgomery County Coroner's Office on August 5, 2019 and continuing into August 6, 2019. The examination is conducted by Kent E. Harshbarger, M.D., J.D., M.B.A., and is begun at 12:15 p.m. ATTENDANCE: In the performance of their usual and customary duties, Autopsy Assistants Denny Blevins, Cody Miller, and Photographer Cynthia McGillivary are present during the autopsy. CLOTHING: The body is received clad in two shoes, two socks, shorts, belt, briefs, hoodie, tee-shirt, body armor vest, and winter head /face cover. PROPERTY: Valuables on the body include cash totalling $11.79. IDENTIFICATION TAGS: y Montgomery County Coroner’s Office identification bands are around the left and right ankle. EXTERNAL EXAMINATION: The body is that of a well-developed, well-nourished, white male adult who appears appropriate for the stated age. The body weight is approximately 224 pounds, and the body length is approximately 70 inches. Rigor mortis is fully developed and generalized. Postmortem lividity is purple-red and fixed on the posterior surfaces of the body, except in areas previously exposed to pressure. The body is cold to touch. Artifacts of putrefaction include green discoloration of the superior anterior right thigh. The head is normocephalic. The scalp hair is brown, approximately 2 inches in maximum length. The irides are green, and the sclerae are white. There are no contact lenses present and there are no conjunctival petechiae. The pupils are round and equal in diameter. The nose and ears are well developed. The two ear lobes are pierced. There is slight mucus in the nares and mouth. The teeth are natural and in adequate repair. ‘The tongue appears normal. Page 11Connor S, Betts Case# 19-3701 ‘The neck is unremarkable. The thorax is well developed and symmetrical. There is no gynecomastia or palpable masses of the chest. The abdomen is flat. The anus and back are unremarkable. The external genitalia are those of a normal adult male with short foreskin; however, there is a palpable, non-reducible left inguinal hernia. ‘The upper and lower extremities are well developed and symmetrical. Jaundice is not present in the skin. IDENTIFYING MARKS: ‘The upper anterior left chest has a tattoo. The lateral left upper arm has a tattoo. EVIDENCE OF MEDICAL INTERVENTION: ‘There is no evidence of medical intervention. EVIDENCE OF INJURY: 1. Multiple gunshot wounds: A. Gunshot wound of the superior lateral anterior shoulder (A): 1. Entrance: On the superior lateral right shoulder, at the point identified by the right acromion process, 8 1/2 inches right of the anterior midline and 59 inches to the inferior aspect of the right heel, is an oval 1/4x 1/4 inch defect with marginal abrasion, most prominent from the 7 o'clock to 9 o'clock position. No thermal eflect, soot, or stippling. 2. Pathway: The hemorrhagic wound path sequentially perforates the right lateral shoulder soft tissues, lateral right scapula, and upper lateral right chest soft tissues. 3. Exit ((): On the lateral right chest near the posterior axilla area, 8 1/2 inches right of the posterior midline, 5 1/2 inches below the plane identified by the right acromion process, and 52 inches to the inferior aspect of the right heel, is a 2 3/4 x 1 1/2 inch large defect with focal abrasion, most prominent from the 3 o'clock to 7 o'clock positions. 4. Direction: With the body in the standard anatomic position, the wound direction is downward. Associated findings: Right lung contusion. Page 12Connor S. Betts Case# 19-3701 B, Gunshot wound of the right lower lateral neck/right medial shoulder (B): 1, Entrance: On the right lower lateral neck/right medial shoulder, 1/2 inch from the plane identified by the right acromion process, 3 1/2 inches right of the anterior midline, and 60 inches from the plane identified by the inferior aspect of the heel, is a 5/8%5/16 inch defect with irregular marginal abrasion. No thermal effect, soot, or stippling. 2. Pathway: The hemorrhagic wound path sequentially perforates the lower neck soft tissues and left major vasculature with associated dense extravascular blood. 3. Exit (E): On the left lateral lower neck, 1/4 inch from the plane identified by the left acromion process, 23/4 inches left of the anterior midline, and 61 1/4 inches from the inferior aspect of the left heel, is a 3/8 x 1/8 inch defect. 4. Direction: With the body in the standard anatomic position, the wound direction is right to left, slightly back to front, and slightly upward. C. Gunshot wound of the anterior upper chest (C): 1, Entrance: On the anterior upper chest, 1/4 inch right of the anterior midline and 54 1/4 inches from the inferior aspect of the right heel, is a 1x 3/4 inch defect with an abrasion collar most prominent from the 12 o'clock to 4 o'clock positions. No thermal effect, soot, or stippling. 2. Pathway: The hemorrhagic wound path sequentially perforates the mid anterior upper chest soft tissues, enters the chest through the area of right rib 2, right lung, and exits the chest through complex fractures and defect at the level of lateral right ribs 3, 4, and 5. 3. Exit (H): On the right lateral upper chest near the anterior axilla area, 5 inches from the plane identified by the right acromion process, 81/2inches right of the anterior midline, and 52 1/4 inches from the inferior aspect of the right heel, is a Page 13Connor S. Betts 5. Case# 19-3701 13/4 inch irregular large defect with surrounding associated contusion. Direction: With the body in the standard anatomic position, the wound direction is left to right, somewhat front to back, and slightly downward. Associated findings: Right hemothorax (approximately 100 mL} D. Gunshot wound of the right medial proximal upper arm (X} 1. Entrance: Located 1/2inch from the right axilla crease is a 11/2x1/2inch irregular presumed re-entry wound without thermal effect, soot, or stippling. There is an associated marginal laceration at the 9 o'clock position. Pathway: The hemorrhagic wound path is through the right upper arm soft tissues. Exit (Z: On the right mid posterior lateral upper arm, 21/4inches right of the posterior midline, 7 inches from the plane identified by the right acromion process and 21 inches to the distal tip of the right long finger, is a 3/4 x 1/2 inch defect. Direction: With the body in the standard anatomic position, the wound direction is left to right, somewhat front to back, and slightly downward. Associated findings: Right humerus fracture. E, Gunshot wound of the right anterior chest (D): 1 Entrance: On the right anterior chest, 4 1/2 inches right of the anterior midline, 48 1/2 inches to the inferior aspect of the right heel, is a 7/8x 1/2 inch defect without thermal effect, soot, or stippling, and marginal abrasion collar most prominent from the 6 o'clock to 11 o'clock positions, Pathway: The hemorrhagic wound path sequentially penetrates the right anterior chest soft tissues, enters the chest through the area of right rib 5 and 6, right lung, heart base, left lung, left pleura at the level of left lateral ribs 5 and 6. Recovery: A large-caliber projectile is found free within the blood contained in the left chest cavity. Page 14Connor S. Betts Case# 19-3701 4. Direction: With the body in the standard anatomic position, the wound direction is right to left and front to back. 5. Associated findings: Right hemothorax (approximately 100 mL, see above), left hemothorax (approximately 1000 mL). F. Gunshot wound of the lateral right back (KK): 1, Entrance: On the lateral right back, 6 3/4 inches from the plane identified by the right acromion process, 7 1/4 inches right of the posterior midline, and 51 1/2 inches from the inferior aspect of the right heel, is a 3/8 x 3/16 inch defect without thermal effect, soot, or stippling. 2. Pathway: The hemorrhagic wound path sequentially perforates the right upper back soft tissues. 3. Exit (JJ): On the left mid upper back, 3/4 inches left of the posterior midline, 3 1/2 inches from the plane identified by the left acromion process, and 57 inches from the plane identified by the inferior aspect of the left heel, is a 1/2x 1/4 inch irregular defect with superior associated abrasion and contusion suggesting a supported or shored wound. 4, Direction: With the body in the standard anatomic position, the wound direction is right to left, somewhat upward, and slightly back to front. G. Gunshot wound of the left posterior lateral hip area (Q): 1, Entrance: On the left posterior lateral hip area, 7 1/2 inches left of the posterior midline, 22 inches from the plane identified by the left acromion process, and 37 inches from the plane identified by the inferior aspect of the left heel, is a 1 1/2x 1/2inch defect without thermal effect, soot, or stippling, and an irregular abrasion collar most prominent at the 12 o'clock to 4 o'clock positions. 2, Pathway: The hemorrhagic wound path sequentially perforates soft tissues of the left lateral hip. 3. Exit (F): On the left anterior lateral hip area, 6 1/2 inches left of the anterior midline, 23 1/2 inches from the plane identified by Page 15Connor S. Betts Case# 19-3701 the left acromion process, and 36 inches to the inferior aspect of the left heel, is a 7/8 x 1 inch irregular defect. Direction: With the body in the standard anatomic position, the wound direction is back to front and somewhat downward. H. Gunshot wound of the right proximal posterior lateral thigh (M): 1 Entrance: On the right proximal posterior lateral thigh, 2 inches right of the anterior thigh midline, 28 inches from the plane identified by the right acromion process and 30 1/4 inches to the inferior aspect of the right heel, is a 11/2x1/2inch defect without thermal effect, soot, or stippling, and abrasion collar most, prominent from the 3 o'clock to 9 o'clock positions. Pathway ‘The hemorrhagic wound path sequentially perforates the soft tissues of the proximal right thigh. Exit (J): On the right anterior proximal thigh, 5 1/4 inches right of the anterior midline, 24 1/2 inches from the plane identified by the right acromion process, and 34 inches to the inferior aspect of the right heel, is a 1/2 x 5/16 inch defect with marginal abrasion suggesting a supported or shored exit wound. Direction: With the body in the standard anatomic position, the wound direction is front to back, slightly right to left, and upward. L Gunshot wound of the right lateral lower buttock area (TT): 1. Entrance: On the right lateral lower buttocks area, 4 3/4 inches right of the posterior midline, 31 1/2 inches to the inferior aspect of the right heel, and 26 1/4 inches from the plane identified by the right acromion process, is a 3/16 x 3/16 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 9 o’clock to 3 o'clock positions. Pathway: The hemorrhagic wound path sequentially perforates the right buttocks and upper right thigh soft tissues. Exit (K): On the right proximal anterior thigh, 27 inches from the plane identified by the right acromion process and 32 inches from the inferior aspect of the right heel, is a 3/4 x 3/8 inch irregular defect with abrasion collar most prominent from the 12 o'clock to Page 16Connor S. Betts Case# 19-3701 6 o'clock positions suggesting a supported or shored exit wound. No thermal effect, soot, or stippling. Direction: With the body in the standard anatomic position, the wound direction is back to front and left to right. Associated findings: Right proximal femur fracture, pelvis fracture, and dense pelvic soft tissue blood. J. Gunshot wound of the right lateral hip area (UU): 1 Entrance: On the right lateral hip area, 7 inches right of the posterior midline, 31 3/4 inches from the inferior aspect of the right heel, and 25 1/4 inches from the right shoulder, is a 3/8x 1/8 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 7 o'clock to 4 o'clock positions. Pathway: The hemorrhagic wound path sequentially perforates soft tissues, including pelvis fracture and proximal right thigh soft tissues. Exit (L): On the right anterior thigh, 1 1/4 inch left of the anterior midline of the thigh, 28 3/4 inches to the plane identified by the left acromion process and 30 inches from the inferior aspect of the left heel, is a 3/4x 1/2 inch defect having associated contusion and abrasion suggesting a supported or shored wound. Direction: With the body in the standard anatomic position, the wound direction is right to left, back to front, and slightly downward. Associated findings: Pelvic fracture, right proximal femur fracture, and dense pelvic soft tissue blood (see above). K. Gunshot wound of the right mid to proximal posterior thigh (VV): 1 Entrance: On the right mid to proximal posterior thigh, at the posterior midline of the leg, 24 3/4 inches from the inferior aspect of the right heel and 32 1/2 inches from the plane identified by the right acromion process, is a 3/4x 3/4 inch irregular defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 5 o'clock to 12 o'clock positions. Page 17Connor S. Betts Case# 19-3701 Pathway: The hemorrhagic wound path sequentially penetrates the right thigh soft tissues. Recovery: A large-caliber jacketed projectile is recovered from the lateral mid right thigh. Direction: With the body in the standard anatomic position, the wound direction is slightly downward. L. Gunshot wound of the right lateral mid to proximal thigh (N): i Entrance: On the right lateral mid to proximal thigh, 3 1/2 inches right of the posterior midline, 29 1/4 inches from the right heel, and 30 inches from the plane identified by the right acromion process, is a 3/4x 1/2 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 3 o'clock to 9 o'clock positions. Pathway: The hemorrhagic wound path sequentially penetrates the right thigh soft tissues. Recovery: A large-caliber jacketed projectile is recovered from the lateral mid right thigh. Direction: With the body in the standard anatomic position, the wound direction is slightly downward and back to front. M. — Gunshot wound of the right proximal medial lower leg (0): 1. Entrance: On the right proximal medial lower leg, 2 inches left of the anterior midline, 7 1/4 inches from the inferior aspect of the left heel, and 42 inches from the plane identified by the left acromion process, is a 3/4x3/8 inch irregular defect without thermal effect, soot, or stippling, and abrasion collar most prominent from the 1 o’clock to 11 o'clock positions. Pathway: The hemorrhagic wound path sequentially penetrates the soft tissues of the medial right lower leg. Recovery: On the medial distal right thigh. Direction: With the body in the standard anatomic position, the wound direction is left to right and upward. Page 18Connor S. Betts Case# 19-3701 N. Gunshot wound of the left proximal posterior medial thigh (YY) a Entrance: On the left proximal posterior medial thigh, 4 inches right of the posterior leg midline, 28 1/4 inches to the inferior aspect of the right heel, and 32 inches from the plane identified by the right acromion process, is a 5/8x3/8 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent from the 7 o'clock to 12 o'clock position. Pathway: The hemorrhagic wound path sequentially perforates the upper left thigh soft tissues. Exit (P): On the left proximal anterior thigh, 1 inch left of the thigh midline, 27 inches to the plane identified by the left acromion process and 32 3/4 inches to the inferior aspect of the left heel, are 3/4 x 1/2 inch and 3/4 x 3/8 inch irregular defects with irregular abrasion suggesting supported or shored exit wound, Direction: With the body in the standard anatomic position, the wound direction is back to front, right to left, and slightly upward. ©. Gunshot wound of the left distal posterior thigh (ZZ): 1. Entrance: On the left distal posterior thigh, 1/4 inch left of the posterior midline, 22 inches from the inferior aspect of the left heel, and 38 1/2 inches from the plane identified by the left acromion process, is a 1/2x1/2inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 11 o'clock to 7 o'clock positions ending in a total wound length of 1 1/8 inch. Pathway: The hemorrhagic wound path sequentially perforates the left distal thigh soft tissues. Exit (Q): On the left distal anterior lateral thigh, 1 1/2 inch left of the anterior midline, 22 inches to the inferior aspect of the left heel, and 37 1/2inches to the plane identified by the left acromion process, is a 5/8 x 5/8 inch irregular defect. Page 19Connor S. Betts Case# 19-3701 4. Direction: With the body in the standard anatomic position, the wound direction is back to front, somewhat right to left, and downward. P, Gunshot wound of the left proximal medial upper arm (V): 1. Entrance: On the left proximal medial upper arm, 2 inches right of the posterior midline, 7 1/4 inches from the plane identified by the left acromion proces and 7 inches below the plane of the elbow, is a 5/8 x 5/8 inch defect with no thermal effect, soot, or stippling. 2. Pathway: The hemorrhagic wound path sequentially perforates left upper arm soft tissues. 3. Exit (R): On the left anterior lateral mid upper arm, 1 1/2 inch left of the anterior midline, 8 inches from the plane identified by the left acromion process and 4 inches from the area of the elbow, is a 3/4 x 5/8 inch irregular defect. 4, Direction: With the body in the standard anatomic position, the wound direction is right to left, somewhat back to front, and slightly downward. Q. Gunshot wound of the left posterior lateral elbow area (1): 1, Entrance: On the left posterior lateral elbow area, 1/2 inch left of the posterior midline, 1/2 inch from the area of the elbow, and 11 inches from the plane identified by the left acromion process, is 5/8 x 1/8 inch defect without thermal effect, soot, or stippling. 2, Pathway: The hemorrhagic wound path sequentially perforates the left posterior elbow area soft tissues and causes fracturing of the left proximal ulna. 3. Exit (U and §): On the left proximal posterior left forearm at the elbow area (embedded dark material), at the midline of the elbow is a2 1/2x 1/2 inch irregular defect and on the left distal lateral ‘upper arm, 1/2 inch right of the posterior midline, 1 inch from the area of the elbow and 11 1/2 inches from the plane identified by the left acromion process, is a 3/4x 1/2 inch irregular defect Page 20Connor 8. Betts R Graze Case# 19-3701 containing marginal abrasion suggesting a supported or shored wound. Direction: With the body in the standard anatomic position, the wound direction is left to right and slightly downward. wound of the left lateral thumb base area, anterior to posterior and downward, associated contusions of the thenar prominence and the left proximal index finger. Ballistic/shrapnel wounds of the left proximal lateral index finger and the left lateral anterior palm. T. Gunshot wound of the right posterior proximal upper arm (AA) 1 Entrance: On the right posterior proximal upper arm, 1 inch left of the posterior midline, 5 1/4 inches from the plane identified by the right acromion process and 25 inches from the distal tip of the right long finger, is a 1/2x 3/8 inch round defect with uniform abrasion collar and no thermal effect, soot, or stippling. Pathway: The hemorrhagic wound path sequentially perforates right upper arm soft tissues and right humerus. Exit (¥): On the right anterior proximal upper arm, 1/2 inch left of the anterior midline, 5 inches from the plane identified by the left acromion process, and 22 inches from the distal tip of the left Jong finger, is a 1/2 x 3/8 inch irregular defect. Direction: With the body in the standard anatomic position, the wound direction is back to front and slightly right to left. U. Gunshot wound of the right posterior mid lateral upper arm (BB): 1 Entrance: On the right posterior mid lateral upper arm, 3/8 inch left of the posterior midline, 7 3/4 inches from the plane identified by the right acromion process, and 21 1/4 inches to the distal tip of the right long finger, is a 1/4 x 3/8 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 2 o'clock to 10 o'clock positions. Pathways: The hemorrhagic wound path sequentially right upper arm soft tissues and right humerus. Page 21Connor 8. Betts Case# 19-3701 Exit (Y}: On the right anterior proximal upper arm, centered 1/2inch left of the anterior midline, 5 inches from the plane identified by the right acromion process and 22 inches from the distal tip of the right long finger, is a 1/2 x 1/2 inch irregular skin defect. Direction: With the body in the standard anatomic position, the wound direction is back to front, slightly right to left, and slightly upward. V. Gunshot wound of the right lateral proximal forearm (Fb): 1 Entrance: On the right lateral proximal forearm, approximately 31/4 inches from the plane identified by the right acromion process and 14 1/4 inches distal to the tip of the long finger, is a 3/4x1/2inch skin defect without thermal effect, soot, or stippling, and surrounding abrasion collar. Pathway: The hemorrhagic wound path sequentially penetrates soft tissues of the right forearm with multiple right radius and ulna fractures. Recovery: At the right anterior wrist, a large-caliber jacketed Projectile and core fragment are recovered. A jacket fragment is recovered along the path in the mid right anterior forearm. Direction: With the body in the standard anatomic position, the wound direction is front to back and downward. W. — Gunshot wound of the right posterior proximal forearm at the elbow area. (0D): 1, Entrance: On the right posterior proximal forearm at the elbow area, 1/8 inch left of posterior midline, 16 inches to the distal tip of the right long finger, and 12 1/2 inches from the plane identified by the right acromion process, is a 3/8 x 3/16 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 3 o'clock to 9 o'clock positions. Pathway: The hemorrhagic wound path sequentially perforates right elbow soft tissues with fractures of the right distal humerus Page 22Connor S. Betts Case# 19-3701 and proximal right radius/ulna with resultant diverging pathways of bone and/or projectile. Exits (EE, FFa, and CC): On the right posterior lateral distal ‘upper arm, 1/8 inch left of the posterior midline, 1 inch to the posterior elbow area, and 9 inches to the plane identified by the right acromion process, is a 2 1/4x 7/8 inch defect (CC). On the right proximal medial forearm, 2 1/4 inches left of the anterior midline, 13 inches from the plane identified by the right acromion Process, and 15 inches to the distal tip of the right long finger, is a 41/4 x3 inch gaping irregular defect (EE). On the right proximal lateral forearm, linch right of the posterior midline, 13 1/4 inches from the plane of the right acromion process, and 14 1/4 inches to the distal tip of the right long finger, is a 1x 1 inch irregular defect (Fa). Direction: With the body in the standard anatomic position, the wound direction is back to front. X. Gunshot wound of the right distal lateral forearm at the wrist (GG) 1 Entrance: On the right distal lateral forearm at the wrist, 7 3/4 inches to the distal tip of the right long finger, 1 inch right of the posterior midline and 8 1/4 inches from the elbow crease, is a 1x 3/4 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 7 o'clock to 4 o’clock positions. Pathway: The hemorrhagic wound path sequentially damages right wrist and hand soft tissues with palpable fractures at the right wrist. 3. Exit (HH) and recovery: On the right mid proximal hand palm, is a 23/4x 1/16 inch slit-like defect where a small jacket fragment is recovered protruding from this exit defect. 4. Direction: With the body in the standard anatomic position, the wound direction is downward and right to left. Y. Deep graze wound (Il of the right anterior mid small finger with fracture that is 1/2 x 3/8 inch. Page 23Connor S. Betts Z. BB. Case# 19-3701 Gunshot wound of the right lateral lower back (LL) 1 Entrance: On the right lateral lower back, 5 1/2 inches right of the posterior midline, 19 1/2 inches to the plane identified by the right acromion process, and 37 inches to the inferior aspect of the right heel, is a 1x 3/4 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 2 o'clock to 10 o'clock positions. Pathway: The hemorrhagic wound path sequentially penetrates back soft tissues. Recovery: On the right back, just right of midline, is a large- caliber jacketed projectile. Direction: With the body in the standard anatomic position, the wound direction is right to left and upward. Gunshot wound of the mid lower back (MM): 1 Entrance: On the mid lower back, over the posterior midline, 21 1/4 inches from the plane identified by the left acromion process and 39 1/2 inches to the inferior aspect of the left heel, is a 3/4x 1/2 inch defect without thermal effect, soot, or stippling, and abrasion collar most prominent at the 3 o'clock to 9 o'clock positions. Pathway: The hemorrhagic wound path sequentially penetrates back soft tissues with fracture of the posterior aspect of right rib 11 Recovery: From the left back at position (00) a large-caliber projectile is recovered. Direction: With the body in the standard anatomic position, the wound direction is somewhat right to left and upward, Gunshot wound of the left upper lateral buttocks area (NN): 1 Entrance: On the left upper lateral buttocks area, 4 3/4 inches left of the posterior midline, 24 inches from the plane identified by the left acromion process, and 27 inches from the inferior aspect of the left heel, is a 1/2x5/8 inch irregular defect without Page 24Connor S. Betts ce. DD. EE. Case# 19-3701 thermal effect, soot, or stippling, and abrasion collar most prominent at the 7 o'clock to 3 o'clock positions. Pathway: The hemorrhagic wound path sequentially penetrates the left buttocks soft tissues and the left posterior pelvis or femur head with associated fractures. Recovery: A large-caliber jacketed projectile is recovered from the left side of the anus area. Direction: With the body in the standard anatomic position, the wound direction is left to right, downward, and slightly back to front. Graze wound of the mid left buttocks area (PP) that appears to be right to left and downward. This wound is located 4 inches left of the posterior midline, 27 1/2 inches from the plane identified by the left acromion process, and 33 1/2 inches to the inferior aspect of the left heel, and the wound is 2 1/2 x 3/4 inch. Gunshot wound of the right mid buttocks area (QQ): 1 Entrance: On the right mid buttock area, 3 1/4 inches right of the posterior midline, 25 3/4 inches from the plane identified by the right acromion process, and 32 3/4 inches from the inferior aspect of the right heel, is a 1/8x 1/16 inch defect without thermal effect, soot, or stippling. Pathway: The hemorrhagic wound path sequentially penetrates the right buttocks soft tissues, pelvis soft tissues, to large bowel. Recovery: A small-caliber jacketed projectile is recovered from the large bowel. Direction: With the body in the standard anatomic position, the wound direction is somewhat back to front, slightly right to left, and upward. Gunshot wound of the right lower mid buttocks area (RR): 1. Entrance: On the right lower mid buttock area, 1 1/8 inch right of the posterior midline, 29 1/2 inches from the inferior aspect of the right heel, and 29 1/4 inches from the plane identified by the right acromion process, is a 1/4 x 1/8 inch defect without thermal Page 25Connor S. Betts FF. GG. Case# 19-3701 effect, soot, or stippling, and the abrasion collar is most prominent from the 1 o'clock to 8 o'clock positions. Pathway: The hemorrhagic wound path sequentially penetrates right buttocks soft tissues, pelvis soft tissues, bowel loops, and liver. Recovery: A small-caliber jacketed projectile is recovered from the liver. Direction: With the body in the standard anatomic position, the wound direction is somewhat back to front, slightly left to right, and upward. Gunshot wound of the right mid lower buttocks area (SS): 1. Entrance: On the right mid lower buttocks area, 2 1/2 inches right of the posterior midline, 30 1/4 inches from the inferior aspect of the right heel, and 28 inches to the plane identified by the right acromion process, is a 5/16 x 1/8 inch defect with no thermal effect, soot, or stippling, and abrasion collar most prominent from the 1 o'clock to 8 o'clock positions. Pathway: The hemorrhagic wound path sequentially penetrates right buttocks soft tissues and causing right proximal femur fracture. Recovery: A small-caliber jacketed projectile is recovered from the anterior right hip area. Direction: With the body in the standard anatomic position, the wound direction is back to front and slightly right to left. Gunshot wounds of the anus area (WW), presumed two (2) overlapping wounds: 1. Entrances: Irregular, confluent overlapping tissue defects are present are over the midline of the anus and are approximately 11/2 1/2 inch, without thermal effect, soot, or stippling. Pathways: The hemorrhagic wound paths sequentially penetrate soft tissues into the anterior lower abdomen and left pelvis (projectile labeled “left sacrum”), causing complex fractures, prostate disruption, and bladder defect. Page 26Connor 8. Betts Case# 19-3701 I. HH. I, Jd, 3. Recovery: Two (2} large-caliber jacketed projectiles are recovered, fone from the left abdomen and one from the left pelvis (labeled “left sacrum’). 4, Direction: With the body in the standard anatomic position, the wound direction is back to front and upward as well as somewhat right to left, upward, and somewhat back to front, Gunshot wound of the left medial lower buttocks area (XX) 1, Entrance: On the left medial lower buttocks area, 1 1/4 inch left of the posterior midline, 31 1/4 inches from the inferior aspect of the left heel, and 29 1/4 inches from the plane identified by the left acromion process, is a 3/4 x 1/2 inch defect without thermal effect, soot, or stippling and surrounding marginal abrasion. 2, Pathway: The hemorrhagic wound path sequentially penetrates left buttocks soft tissues and pelvis with complex fractures. 3. Recovery: A large-caliber jacketed projectile is recovered from the left pelvis. 4. Direction: With the body in the standard anatomic position, the wound direction is back to front and slightly right to left. Ballistic/shrapnel wounds of the left mid to distal lateral lower leg (AAA), no recovery attempt due to fragment size. The wound is located 2 1/4 inches left of the posterior midline, 6 1/2 inches from the inferior aspect of the left heel, and 12 1/2 inches to the area of the left knee, and is 1/8 x 1/8 inch. Graze wound, left posterior heel, undetermined direction, When clothing is present overlying associated wounds, defects are present. X-rays show foreign material and various projectiles or projectile fragments are recovered from clothing or external surfaces as labeled. I, Other injuries: On the left proximal anterior lateral lower leg are small abrasions. The anterior surfaces of both knees have small abrasions. The lower anterior left abdomen has a healing small contusion. Bilateral wrist areas have linear pressure impressions. Page 27Connor S. Betts Case# 19-3701 ARTIFACTS OF POSTMORTEM CARE: None. INTERNAL EXAMINATION SEROUS CAVITIES: ‘The body cavities are opened with a standard Y-shaped incision. The cranial cavity is opened with a coronal incision of the scalp and removal of the calvarium. There are no unusual odors apparent in the body cavities. The lungs fill the pleural cavities and there is no evidence of tension pneumothorax. The pleural cavities have no adhesions. The abdominal cavity is lined with glistening serosa. The abdominal panniculus, at the level of the umbilicus, is approximately 3 cm in thickness. CARDIOVASCULAR SYSTEM: ‘The heart weighs 285 grams and is in the usual position with respect to the great vessels and chest cavity. The coronary arteries arise normally and follow the usual distribution of a right-dominant pattern. The coronary arteries are examined by multiple cross sections and there is no significant coronary artery atherosclerosis. The cardiac chambers and valves have the usual size and position relationship for the age and heart size. The right ventricular wall thickness is 0.3 cm; the left ventricular wall thickness is 1.5 cm. Aside from the previously-described injuries, the myocardium is dark red-brown and firm. The aorta and its main branches arise normally and follow the usual course with no significant atherosclerosis. ‘The vena cava and its major tributaries return to the heart in the usual distribution and are unremarkable. RESPIRATORY SYSTEM: The right and left lungs weigh 230 and 380 grams, respectively. ‘The upper and lower airways are patent and the mucosal surfaces are smooth and pink-tan. The pleural surfaces are otherwise smooth and glistening. The lungs and hilar nodes are mildly anthracotic. Aside from previously-described in juries, the pulmonary parenchyma is dark red-purple. The pulmonary arteries are normally developed and patent. DIGESTIVE/HEPATOBILIARY SYSTEM: The esophagus is lined by gray-white smooth mucosa. The gastric mucosa is arranged in the usual rugal folds, and the lumen contains approximately 100 mL of brown semi- Page 28Connor S. Betts Case# 19-3701 liquid material. ‘The small and large intestines are unremarkable. The mesentery and omentum appear normal, and the vessels are patent. The appendix is present. The colon contains formed stool. The pancreas has a normal gray-white lobulated appearance, and the ducts are clear. ‘The liver weighs 1280 grams. The hepatic capsule is smooth, glistening, and intact, covering red-brown parenchyma. The gallbladder contains approximately 20 mL of viscid bile. No gallstones are present. The extrahepatic biliary tree is patent. ENDOCRINE SYSTEM: ‘The pituitary, thyroid, and adrenal glands are unremarkable. GENITOURINARY SYSTEM: ‘The normal-shaped kidneys together weigh 210 grams. The two kidneys, ureters, and bladder are present in their usual positions without dilatation. The renal capsules are smooth, thin, semitransparent, and strip with ease from the underlying, smooth, pale firm cortical surfaces. The cortices are sharply delineated from the medullary pyramids. The cortex appears of ample thickness, and the medulla appears ample. The calyces, pelves, and ureters are unremarkable. Aside from previously-described injury, urinary bladder mucosa is gray-tan and smooth. The testes are descended into the scrotum and usual in size for the age. Aside from previously-described injuries, on cut section, the prostate, testes, and epididymis appear unremarkable. HEMATOPOIETIC SYSTEM: The thymus is dispersed in anterior mediastinal fat. The spleen weighs 185 grams and has a smooth intact capsule covering red-purple, moderately firm parenchyma. The regional lymph nodes appear normal. The bone marrow (rib ends) is red-purple and homogeneous, without evidence of focal abnormality. MUSCULOSKELETAL SYSTEM: Aside from previously-described injuries, the bony framework, supporting musculature, and soft tissues are not unusual. Page 29Connor S. Betts Case# 19-3701 NECK: Aside from previously-described injuries, examination of the soft tissues of the neck, including strap muscles and large vessels, reveals no abnormalities. The hyoid bone and larynx are intact. There are no tongue contusions. NERVOUS SYSTEM: ‘The brain weighs 1480 grams. The dura mater and falx cerebri are intact, and the leptomeninges are thin and delicate. The cerebral hemispheres are symmetrical. The structures at the base of the brain, including cranial nerves and blood vessels, are intact and free of abnormality. Sections through the cerebral hemispheres reveal no lesions within the cortex, subcortical white matter, or deep parenchyma of either hemisphere. ‘The cerebral ventricles are of normal caliber. Sections through the brainstem and cerebellum are unremarkable. RADIOGRAPHS/SPECIAL STUDIES: X-rays are taken showing foreign material. Other projectile or projectile fragments are recovered from clothing or external surfaces as labeled. MICROSCOPIC EXAMINATION: Representative sections of tissues are preserved in paraffin blocks for future histologic examination, if required. KEH:sm 8/30/19 Page 30Montgomery County Coroner's Office 361 West Third Street, Dayton, Ohio 45402 Kent E. Harshbarger, M.D., J.D., M.B.A., LABORATORY REPORT TO: Dr. Kent Harshbarger Request Started: 8/7/18 Coroner Case Number: 19-3701 Request Completed: 6/15/18 Decedent: Betts, Connor Toxicology Case Number: 19-008551 Submitted Evidence Submission 001: Fluids taken from morgue refrigerator. 01a: Cavity blood (grey) 001b: Cavity blood (grey) 0c: Cavity blood (purple) oid: Vitreous 016: Cavity blood (red) ‘Toxicology Service Requested: B Service 0 Presumptive Drug Screen Results Drug or Drug Screen Result ‘Test Method Results for: Cavity blood (grey) Volatiles Screen Positive GCHeadspace General Unknown Drug Seren Positive coms Drugs of Abuse Screen Positive Lomsims Confirmation Results Analyte Name Concentration ‘Specimen Type aster Benzodiazepines Alprazolam 34 agi. Cavity blood (grey) Loss. ‘Stimulants Benzoyiecgonine 37 £6 ngimL. Cavity blood (orey) Lomsms Cocaine 136 # 18 ngimL Cavity blood (grey) Lomsnas, Ecgonine Methyl Ester 140 ngirnL Cavity blood (arey) Lomsnas, Volatiles Ethanol 0.196 £0.016.9m% Cavity blood (grey) GC Headspace Ethanol 0.100 20.008 gm% Vitreous GC Headspace [AService: Consists of screening tess for volatiles by headspace GC (ethanol, methanol, acetone, and isopropanol) and drugs by LEMSMS for 7-eminocionazepam, alprazolam, amphetamine, benzoylecgonine, buprenorphine, carboxy-THC, fentanyl, hydrocadone, hydromorphone, loperamide, lorazepam, MDA, methadone, methamphetamine, midazolam, morphine, naloxone, naltrexone, nordiszepam, oxazepam, oxycodone, Accredlied by ANAB to ISO 17025 Standards Page t of2Coroner Case Numb 9.3701 Toxicology Report 19-006851 - Continued ‘oxymorphone, PCP, temazepam, acetyfentany/, carfentanil,tetrahydofuran fentanyl, methoxyacety| fentany/, ‘benzy/ fentanyl iso/butyry fentanyl, and isolvaleryl fentanyl. Confirmations and quanttations are performed on positive screens when appropriate B Service: Consists of an A Service and a general screen for drugs and other substances by GCIMS, Confirmation and quantitation are performed on positive screens when appropriate Specific tests ae also performed as appropriate ‘Any analyte on this report with a result including tha symbol < is posive, but below the limit of quantitation. Drug screen positives without confirmatory testing and/or drugs identified as "Presumptive .D.” have not been confirmed, A result of not detected” indicates thatthe drug or class of drugs was not present ata level greater than the limit of detection for the tesvinstrumert, Samples found tobe “unsuitable for analysis’ possess properties that inhibit or prevent the sample from being analyzed successfully for a drug or class of drugs. Estimations of the measurement uncertainty appearing on this report are at @ 95.45% coverage probabil. Estimations of the measurement uncertainty forall other quantitative values on this report are available upon request. Respectuly, Chief Forensic Toxicologst Page 2 of2POSTMORTEM EXAMINATION OF THE BODY OF Megan K. Betts Case # - 19-3693 Montgomery County I. Gunshot wounds of the right forearm and chest: A. Gunshot wound of the right forearm: 1 B. Gunshot wound of the right anterior chest (presumed re-entry): 1. Entrance: Posterior proximal right forearm, no thermal effect, soot, or stippling. Pathway: Right proximal forearm with fractures of the radius and ulna and anterior large soft tissue defect. Exit: Anterior proximal right forearm. Direction: With the body in the standard anatomic position, back to front and slightly upward. Entrance: Right anterior chest, irregular wound with broad associated abrasion most prominent from the 4 to 11 o’clock position. (Presumed Re-entry), no thermal effect, soot, or stippling. Pathway: Right anterior chest soft tissue, enters right medial chest at the level of right rib 5, right lung, pericardial sac, right ventricle, myocardial septum, to posterior lateral left ventricle. Recovery: Small-caliber jacketed projectile, posterior lateral left ventricle of the heart. Direction: Right to left, front to back, somewhat downward. Associated findings: Hemopericardium (approximately 250 mL}, right hemothorax (approximately 400 mL}, blood and frothy fluid in airways. 361 WEST THIRD STREET « DAYTON, OHIO 45402 + (937) 225-4156 + www.mcohio.orgigovernment/coroner National Accreditation by NAME, ABFTMegan K. Betts Case# 19-3693 Il _ Left anterior proximal lower leg abrasion. Il. Mid anterior chest contusion and “parchment”-type abrasions, resuscitation artifact. IV. No anatomic evidence of significant natural disease or other injury. OPINION It is my opinion that the cause of death of Megan K. Betts is: Gunshot wounds of the right forearm and chest. It is my opinion that the manner of death is: Homicide. Le faut hong SLefen4 Kent E. Harshbarger, M.D., JD., M.B.A., Forensic Pathologist. Date Coroner, Montgomery County, Ohio Page 2Megan K. Betts Case# 19-3693 A postmortem examination of the unembalmed body of a 22-year-old white female, identified to me as Megan K. Betts, is performed at the Montgomery County Coroner's Office on August 5, 2019. The examination is conducted by Kent E. Harshbarger, M.D., J.D., M.B.A, and is begun at 10:25 a.m. ATTENDANCE: In the performance of their usual and customary duties, Autopsy Assistants Denny Blevins, Cody Miller, and Photographer Cynthia McGillivary are present during the autopsy. CLOTHING: The body is received clad in shoes, shorts, panties, tee-shirt, flannel shirt, and bra. PROPERTY: Valuables include cash totalling $1.06, one white metal with blue set ring, one black necklace with white metal pendant and yellow metal ring, one white metal necklace with white metal pendant, and one paper arm band. IDENTIFICATION TAGS: ‘Two Montgomery County Coroner’s Office identification bands are around the left ankle. EXTERNAL EXAMINATION: The body is that of a normally-developed, well-nourished, white female adult who appears appropriate for the stated age. The body weight is approximately 184 pounds, and the body length is approximately 64 1/2 inches. Rigor mortis is fully developed and generalized. Postmortem lividity is purple-red and fixed on the posterior surfaces of the Dody, except in areas previously exposed to pressure. The body is cold to touch. No significant artifacts of putrefaction are evident. ‘The head is normocephalic. The scalp hair is brown, approximately 4 inches in maximum length. The irides are blue-green, and the sclerae are white. There are no contact lenses present and there are no conjunctival petechiae. The pupils are dilated, but remain round and equal. The nose and ears are well developed. The two ear lobes are not pierced. There is slight frothy fluid within the mouth as well as blood emanating from the nose and mouth. The teeth are natural and in adequate repair. The tongue appears normal. Page 3Megan K. Betts Case# 19-3693 The neck is unremarkable. The thorax is well developed and symmetrical. The breasts are symmetrical without palpable masses and the nipples appear normal without discharge. The abdomen is mildly protuberant. The anus and back are unremarkable. ‘The external genitalia are those of a normal adult female. ‘The upper and lower extremities are well developed and symmetrical, without significant blunt force or penetrating injury. Jaundice is not present in the skin. IDENTIFYING MARKS: No identifying marks or scars are readily apparent. EVIDENCE OF MEDICAL INTERVENTION: A tourniquet is around the right upper arm. The mid anterior chest has abrasion consistent with resuscitative efforts. A “triage” band is around the right wrist. EVIDENCE OF INJURY: I. Gunshot wounds of the right forearm and chest: A. Gunshot wound of the right forearm: 1, Entrance: On the posterior proximal right forearm, at the posterior midline, 13 1/2 inches to the distal aspect of the right long finger and 3 inches to the posterior elbow area, is a 1/4 inch round defect with no thermal effect, soot, or stippling. 2. Pathway: The hemorrhagic wound pathway sequentially perforates the right proximal forearm with fractures of the right radius and ulna and anterior large soft tissue defect. 3. _ Exit: On the anterior proximal right forearm, at the anterior midline to the left, 15 inches to the distal aspect of the long finger, is a 4 1/2.x3 inch large gaping soft tissue defect. 4. Direction: With the body in the standard anatomic position, the wound direction is back to front and slightly upward. B. Gunshot wound to the right anterior chest (presumed re-entry): 1, Entrance: On the right anterior chest, 3 inches right of the anterior midline, 6 inches from the plane identified by the right acromion process, and 49 inches to the inferior aspect of the right heel, is a 11/4x3/4 inch defect with surrounding marginal abrasion Page 4Megan K. Betts Case# 19-3693 resulting in a 13/4x11/4inch wound, with most prominent abrasion from the 4 to 11 o'clock positions (presumed re-entry}, no thermal effect, soot, or stippling. Overlying clothing is perforated. 2, Pathway: The hemorrhagic wound pathway sequentially perforates the right anterior chest soft tissue, enters the right medial chest at the level of right rib 5, right lung, pericardial sac, anterolateral right ventricle, myocardial septum, to the posterolateral left ventricle. 3. Recovery: A small-caliber jacketed projectile is recovered from the posterior lateral left ventricle of the heart. 4. Direction: With the body in the standard anatomic position, the wound direction is right to left, front to back, and somewhat downward, Associated findings: Hemopericardium (approximately 250 ml}, right hemothorax (approximately 400 mL), blood and frothy fluid in the airways, Other injuries: ‘The proximal anterior left lower leg has a small abrasion. ARTIFACTS OF POSTMORTEM CARE: None. INTERNAL EXAMINATION SEROUS CAVITIES: ‘The body cavities are opened with a standard Y-shaped incision. The cranial cavity is opened with a coronal incision of the scalp and removal of the calvarium. There are no unusual odors apparent in the body cavities. The lungs fill the pleural cavities and there is no evidence of tension pneumothorax. The pleural cavities have no adhesions. The abdominal cavity is lined with glistening serosa and has no free fluid. The abdominal panniculus, at the level of the umbilicus, is approximately 3 cm in thickness. CARDIOVASCULAR SYSTEM: ‘The heart weighs 280 grams and is in the usual position with respect to the great vessels and chest cavity. Aside from previously-described injuries, the pericardial surfaces are Page 5