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State of Kansas Office of Coroner REPORT OF DEATH ---PERSONAL INFORMATION--- TIME: 1625 hours Notified ____________ SN12-12-39 Case Number: _____________ 12/13/2012 Date: ______________ Pojman Shawnee County Jurisdiction: __________________ Coroner: ________________ DOB _____________ Sex: _____ Ethnic Code: ___ C 30 mo 06/19/2010 F Savannah Edwards Name: _________________________________ Age: ________ in ---LOCATION INFORMATION--- hours Time Departed 1741 _______________ nl 1643 hours Time Arrived _______________________ e 66611 3101 SW Randolph Ave. Apt. #E, Topeka, Kansas Address: ________________________________________________ Zip: _______ CSI Sgt. Lewis Officers Present: ______________________________ JO Shawnee County Sheriff Agency: _____________________ 12-7217 Agency #: _____________ 12/13/2012 SE Cross ST, Topeka, Kansas 66619 Date: ____________ Injury Location: 5831 ________________________________________________ 1557 hours Time __________ C Stormont Vail HealthCare Trauma 12/13/2012 Time: _________ 1621 hours Death Location: _________________________________________________ Date: ______________ Date Pronounced Dead: 12/13/2012 ______________________ 1621 hours Time of Pronouncement: ________________ fr om Dr. Matt Lockwood Name of Pronouncer: ______________________________ License #: _________________ ---NEXT-OF-KIN INFORMATION--- Amanda Ashwill, mother Next-of-Kin Name: _______________________________________ d Penwell-Gabel Midtown Funeral Home (Topeka, KS) 354-8558 Mortuary of Choice:________________________________________________________________________________ de ER / SNSO Guhr, RN / Sgt. Lewis Information By: Chris _____________________________ Informant Address: SV ______________________________________ ---IDENTIFICATION INFORMATION--- oa Dr. Matt Lockwood Attending Physician: ______________________________________________________________________________ Mother Identified By: _______________________________________ nl Shawnee Co. Morgue Body Sent To: _______________________ Identification Method: Visual __________________________ Autopsy Exam Type: ________________ ow Donald V. Pojman, MD Exam By: ___________________________________ Accident Manner of Death: ___________________________________ Autopsied, Released Disposition of Body: ________________________________ --DIAGNOSIS--- D Craniocerebral crush injuries Diagnosis: _________________________________________________________________________________________ Due To: _________________________________________________________________________________________ Due To: _________________________________________________________________________________________ Due To: _________________________________________________________________________________________ Contributory Factors: ________________________________________________________________________________ AC Reporting Investigator's Initials: ______ FINALIZED: 04/02/2014 Coroner SN12-12-39 Name: Savannah Edwards Shawnee County Kansas 12-13-2012 LOCATION: Stormont Vail Trauma Room TIME ARRIVED: 1643 hours LAW ENFORCEMENT AGENCY: Shawnee County Sheriff Office LEAD INVESTIGATOR: CSI K. Lewis, in e INITIAL BACKGROUND INFORMATION: Bruce in dispatch called on 12/13/2012 at approximately 1625 hours to request a medical investigator to the scene of child death involving a dog at 5831 SE Cross Topeka, Kansas 66619. While in the process of leaving the request was changed to proceed to Stormont Vail HealthCare. C JO nl Contact was made with Shawnee County Sheriff Office CSI K. Lewis and Chris Guhr RN. 2 year old Savannah Edwards was transported by AMR code blue to the Emergency Department and arrived about 1615 hours with head trauma. Savannah was unresponsive, intubated and CPR in process en route and upon arrival. Resuscitation efforts continued for a short time after arrival to trauma unit. Dr. Matt Lockwood pronounced death at 1621 hours. fr om Savannah and her mother Amanda Ashwill were visiting relatives at the SE cross address. Savannah had been crying and Amanda got up to check on her when the dog attacked. Amanda said she was approximately 5 feet away from her daughter. She did not know how to get the dog to stop so she left the house to get help from the neighbors. d The above is information as originally received and prior to full investigation. oa de OBSERVATION OF THE ENVIRONMENT: The hospital scene was in a trauma room. CSI K. Lewis, Shawnee County Sheriff Officers, nursing staff, hospital chaplain and hospital security was present. nl OBSERVATION OF THE DECEDENT: The decedent was supine on a hospital bed, covered up to the chin with a blanket. The decedent had medium length brown hair. ow The decedent was wearing a disposable diaper. Clothing was previously collected by the Shawnee County Sheriff Department Officers. D There was massive trauma to the decedent’s head exposing brain matter. There were lacerations to the face neck and chin. No other trauma was noted. There was an endotracheal tube taped in place at the mouth. EKG pads were on the decedent’s chest. There was a blood draw site on the left arm. An intraosseous IV was located in the decedent’s left tibia. There was an identification band on the right ankle identifying “Trauma Fortynine”. 1 SN12-12-39 Name: Savannah Edwards Shawnee County Kansas 12-13-2012 SCENE IMPRESSION: This appeared to be a death caused by head trauma caused by dog bite wounds. An autopsy was ordered. e SCENE CONCLUSION: First Call of Kansas was called to transport the decedent to the Shawnee County Coroner’s Office. in An identification band was placed on the right wrist and the body bag. The body bag was sealed with yellow seal number 9902617. JO nl Scene was departed at 1741 hours. D ow nl oa de d fr om C INVESTIGATOR: AC 2 SN12-12-39 Shawnee County, Kansas SAVANNAH EDWARDS 12/16/2012 AUTOPSY REPORT AUTOPSY FINDINGS: e Multiple punctures/lacerations of the head consistent with dog bites. Large full thickness avulsion of the top of the scalp. Triangular shaped displaced skull fracture on the right side the top of the head with extrusion of a portion of the right cerebral hemisphere. in I. II. III. nl SUMMARY: C JO This 30-month-old female died from crush injuries of the head. The pattern of injuries was consistent with multiple dog bites. 04/02/2014 11:19:53 am D ow nl oa de d Donald V. Pojman, M.D. Shawnee County Coroner fr om SigPlus1 1 SN12-12-39 Shawnee County, Kansas SAVANNAH EDWARDS 12/16/2012 INITIAL INFORMATION: According to the initial investigation information, the decedent was a 30-month-old girl who was attacked by a dog. She was taken to the hospital where she was pronounced. CIRCUMSTANCE OF EXAMINATION: in e The autopsy examination takes place at Shawnee County coroner’s office on 12/16/2012 at 0420 hours after cardiac donation. nl IDENTIFICATION: JO The body is received in a sealed body bag with an intact yellow seal number 9902617. The seal was broken prior to tissue donation. Visual identification was made by the child's family. C EXTERNAL EXAMINATION: fr om The body is of a 33 pound Caucasian female child who is said to be 30 months of age. The crown-to-heel length is 35 1/2 inches and the crown-to-rump length is 22 inches. The decedent is without clothing. There is a thin green rubber band in the hair that is cut and discarded. de d The scalp has light brown hair that is secured into a ponytail. The eyes are covered with embalming caps. There is full eruption of the deciduous teeth. There is no injury to the oral mucosa. The upper and lower oral frenula are intact. oa The torso is without accessory nipples. There are no surgical scars. The external genitalia are that of a female child. The back is without scoliosis or spina bifida. nl The upper and lower extremities each have five normally formed digits. There is a small amount of black polish predominantly on the toenails of the great toes. ow EVIDENCE OF MEDICAL INTERVENTION: D Within the left antecubital fossa is a puncture covered by gauze. Encircling the right wrist is a coroner's band with the decedent’s name. Encircling the right ankle is a hospital band with the name "Trauma Forty-Nine". An intraosseous needle is positioned within the left pretibial region. EVIDENCE OF INJURY: INJURY A is within the anterior midline of the forehead just anterior to the hairline. It consists of a 1 x 0.5 cm ecchymosis with a small epidermal abrasion. INJURY B is on the left side of the forehead just anterior to the hairline. It consists of a 2 SN12-12-39 Shawnee County, Kansas SAVANNAH EDWARDS 12/16/2012 0.4 cm laceration into the dermis with a 1 x 0.7 cm red ecchymosis at the 3 o'clock position. INJURY C is on the left lateral aspect of the forehead just at the hairline. It consists of 0.5 cm red ecchymosis with a central small abrasion. e INJURY D is a 0.2 cm blue ecchymosis above the midportion of the left eyebrow. nl in INJURY E is approximately 1 inch above the medial aspect of the left eyebrow. It consists of an obliquely-oriented 1.3 x 0.3 cm puncture that is surrounded by an abrasion. The puncture carries towards the 4 o'clock position and strikes the bone. C There are a few petechiae at the tip of the nose. JO INJURY F is on the bridge of the nose. It is a 1.2 x 0.3 cm curvilinear full-thickness laceration with abraded edges. It is surrounded by a 1.5 x 1.2 cm blue to red ecchymosis. fr om INJURY G is on the center of the left cheek. It is a 0.9 x 0.8 cm dried yellow abrasion that may be the result of drying artifact due to medical tape to stabilize the endotracheal tube. d INJURY H is just lateral to injury G and consists of a horizontally-oriented, ellipticalshaped, 1.1 cm laceration that extends into the adipose tissue. The edges are dried and there is a slight surrounding ecchymosis. oa de INJURY I is on the lateral aspect of the left cheek and consists of a vertically oriented 1.2 x 0.2 cm ecchymosis with superior abrasion. At the inferior edge is a 0.3 cm puncture that extends into the adipose tissue. Located 0.7 cm lateral to this wound is a 1.1 x 0.2 cm vertically-oriented erythematous mark. nl INJURY J is on the right lateral aspect of the glabella. It is a vertically-oriented 0.5 cm elliptical laceration that is surrounded by dried abrasion and erythema. ow INJURY K is a 0.4 cm vertically-oriented laceration that is at the medial edge of the left eyebrow and approximately 0.5 cm away from injury J. D There is slight bruising of the right upper eyelid. INJURY L is a group of three horizontally oriented elliptical full-thickness lacerations surrounded by erythema that are approximately 1 1/2 inches above the lateral aspect of the right eyebrow. From superior to inferior they are 0.3 cm, 0.2 cm and 0.3 cm. They are each separated by approximately 0.4 cm and form a slight curvilinear line. Injury M is a 2.9 x 0.9 cm full-thickness avulsion of the right lower eyelid. 3 SN12-12-39 Shawnee County, Kansas SAVANNAH EDWARDS 12/16/2012 INJURY N is a 0.8 x 0.5 cm abrasion on the right side of the nose just beneath the avulsed right lower eyelid. INJURY O is a 12 x 9 cm full-thickness avulsion of the top of the head with three main skin flaps. There are associated comminuted fractures of the underlying calvarium. in e INJURY P is within the hairline several inches above the left external auditory canal. The 1.5 cm obliquely-oriented, full-thickness, elliptical laceration is oriented in approximately the 4 o'clock position. JO nl INJURY Q is also on the left side of the head, approximately 2 cm superior to and parallel with injury P. It is a 2.5 cm elliptical, full-thickness laceration with slight abraded edge. C INJURY R is a 7 x 2.5 cm gaping laceration that begins above the right ear and extends towards the lateral aspect of the right eyebrow. The edges are somewhat irregular and dry. The wound carries through the calvarium and exposes the underlying right cerebral hemisphere. fr om INJURY S is a group of three elliptical lacerations with abraded edges that are superior to injury R. From posterior to anterior the lacerations measure 1.4 cm, 1.0 cm, and 0.6 cm. The injuries extend through the calvarium and expose the underlying right cerebral hemisphere. de d INJURY T is on the posterior aspect of the head and has its center just to the left of the posterior midline and in line with the tops of the ears. The 3.5 cm full-thickness laceration is oriented in the 2 o'clock position. It has a rounded left lateral coroner and a sharp right lateral corner. There is no appreciable abraded margin. nl oa INJURY U is at the occiput within the posterior midline of the head. At the left lateral edge is a 0.5 cm puncture. There is a 1.2 cm thin abrasion that travels towards the right at approximately the 2:30 position. ow INJURY V is a 0.5 cm red ecchymosis across the submental region within the anterior midline and just behind the anterior edge of the chin. D INJURY W is a 0.5 cm red ecchymosis just to the left of injury V. INJURY X is a reversed L-shaped abrasion with surrounding erythema just to the right of the midline on the submental region approximately 3/4 inch behind the tip the chin. Each arm of the abrasion is 0.5 cm. INJURY Y is a 0.2 cm red ecchymosis that is also on the submental region, just posterior to injury W. INJURY Z is on the left side of the undersurface of the mandible, approximately 1/4 of 4 SN12-12-39 Shawnee County, Kansas SAVANNAH EDWARDS 12/16/2012 an inch anterior to the junction of the submental region and the cervical neck. This 1.2 cm elliptical laceration is oriented in approximately the 3 o'clock position and has dried abraded edges and surrounded by red ecchymosis. Carrying through the superior aspect of this wound is an obliquely oriented 1.5 cm thin laceration with surrounding ecchymosis. e INJURY AA is two shallow punctures surrounded by abrasion and bruising that are anterior to injury Z. These punctures are 0.2 cm and 0.3 cm in diameter. nl in INJURY AB is two side-by-side shallow punctures approximately 1/2 inch lateral to injury Z. The wound consists of two shallow punctures that are each 0.3 cm and surrounded by slight abrasion and erythema. INTERNAL EXAMINATION: fr om C JO The left coronal suture has a 0.7 cm puncture. There is separation of the sagittal suture and the right coronal suture. A triangular shaped portion of the right side of the calvarium is pushed in. The fracture extends from the junction of the sagittal and coronal sutures and extends slightly forward and slightly posterior towards the right side of the calvarium where a coronal fracture connects them at the lower portion of the right parietal bone. There is minimal epidural and subdural hemorrhage. There is mild disruption of the right frontal and right parietal lobes of the brain. de d The head has the previously described injuries. The 890 gm brain is without obvious edema. The left cerebral hemisphere is intact. The cerebellum and brainstem are intact. There is no blood emanating from the foramen magnum. The atlanto-occipital junction is stable. nl oa The anterior strap muscles of the neck are without hemorrhage. The 15 gm pink-tan thymus gland is predominantly within the superior mediastinum. The thyroid cartilage and hyoid bone are without fracture. The red-brown thyroid gland is uniform. Just behind the tip of the tongue are two curvilinear full-thickness lacerations consistent with child bite marks. D ow The anterior chest and abdominal walls are without extravasated blood. The ribs, sternum and clavicles are without recent or remote injury. The heart has its normal shape. The great vessels have the normal distribution pattern. The 11 gm apex is redbrown and uniform. The remainder of the cardiac examination will be performed by a representative of the Midwest Transplant Network. The 64 gm right lung and the 61 gm left lung are trilobed and bilobed, respectively. Both lungs have pink-tan parenchyma without edema or contusion. The 391 gm liver is beneath the right dome of the diaphragm and has a smooth, intact capsular surface and a sharp anterior margin. The hepatic parenchyma is red-brown and uniform. The gallbladder contains a small amount of green liquid bile. 5 SN12-12-39 Shawnee County, Kansas SAVANNAH EDWARDS 12/16/2012 The 45 gm spleen is beneath left dome of the diaphragm and has a smooth, intact capsular surface. The esophagus is intact. The stomach has a tan flat mucosa and is filled with large pieces of hotdog and soft white material with pink centers. The small intestines are without Meckel's diverticulum or volvulus. The vermiform appendix is present. The colon is without intussusception. in e The pancreas has a tan nodular parenchyma. The adrenal glands have thin yellow cortices. JO nl The right and left kidneys are 30 gm and 29 gm, respectively. Both kidneys have retention of the fetal lobulation. The red-brown parenchyma has well demarcated corticomedullary junctions. The pelvicalyceal systems are not dilated. The ureters are normal in course and caliber to the urinary bladder. The urinary bladder is empty. The uterus, fallopian tubes and ovaries are within the pelvic cavity. C SPECIMEN EXAMINATION: fr om Tissues are retained for histologic examination. Tissues and blotter paper are archived at this facility. RADIOLOGY: d No x-rays are taken. de MICROSCOPIC EXAMINATION: No significant histopathologic change. Lungs: Without inflammation. Liver: No vesicular change. nl No significant histopathologic change. SigPlus2 D ow Kidney: oa Heart: 04/02/2014 11:20:10 am Donald V. Pojman, M.D. Shawnee County Coroner 6