CLARK COUNTY CORONER MEDICAL EXAMINER
1704 PINTO LANE
LAS VEGAS, NV 89106

September 18, 1998
Case No. 98-4751

PATHOLOGIC EXAMINATION ON THE BODY
OF
LONNIE THEODORE BINION

DIAGNOSES

OPINION

CAUSE OF DEATH: It is my opinion that the decedent, Lonnie Theodore Binion death as a result of ALPRAZOLAM AND OPIATE INTOXICATION.

MANNER OF DEATH: Homicide.

Lary Simms, DO, MPH,

Chief Medical Examiner

Clark County, Nevada (Las Vegas)

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September 18, 1998
Case No. 98-4751

POSTMORTEM EXAMINATION OF THE BODY OF

LONNIE THEODORE BINION

AUTOPSY: The autopsy is performed by Lary Simms, Do, MPH, Chief Medical Examiner, at 0900 hours, 18 September 1998.

CLOTHING: The body is received unclothed.

EXTERNAL EXAMINATION: The body is that of a normally developed white adult. Rigor mortis is present equally and symmetrical in all joints. Lividity is fully developed posteriorly and on the right side of the head and next and to a greater extent on the right lateral torso than on the left lateral torso.

The head hair is black-gray in color. Facial stubble is present. The scalp is unremarkable. The eyes are closed. The corneas are clear. The irises are brown. The nose, lips and moth are unremarkable. Scattered areas of postmortem discoloration are on the left side of the lower lip and in the perioral skin. The teeth are natural and in fair repair. No injuries are identified on the external neck. The chest demonstrates pectus excavatum. The rest of the chest is unremarkable. The abdomen is scaphoid and unremarkable. The extremities are equally and symmetrically developed. Fingerprint ink is present on the hands, bilaterally. The fingernails and toenails are medium in length and clean, The external genitalia are male. The penis is circumcised. The testes are descended, bilaterally. The back and buttocks are unremarkable. Identification writing is present on the left thigh.

Height: 71 inches
Weight: 157 pounds
Heart: 352 grams
Lungs: 1412 grams
Liver: 1539 grams
Spleen: 198 grams
Kidneys: 395 grams
Brain: 1410 grams

BODY CAVITIES: The body is entered by a Y-shaped incision. The peritoneal surfaces of the body cavities are smooth, glistening and without adhesions. The intra-abdominal organs present retain their normal anatomic position and relationships.

NECK ORGANS: The anterior muscles of the neck have no evidence of antemortem hemorrhage. The tongue, epiglottis, hyoid bone, external and internal larynx and anterior cervical vertebral column show no evidence of antemortem injury. The thyroid gland has a normal size on serial sectioning and is unremarkable.

CARDIOVASCULAR SYSTEM: The aorta and great vessels are unremarkable

The coronary arteries have a normal surface course and configuration. On serial sectioning the left coronary artery, anterior descending branch demonstrates focal eccentric atherosclerosis with narrowing up to 20 percent. Serial sectioning of the left coronary artery, curcumflex branch is negative. Serial sectioning of the right coronary artery demonstrates focal eccentric atherosclerosis with narrowing up to 40 percent.

The valves of the heart are unremarkable. The ventricular chambers are dilated. On serial sectioning the myocardium displays no focal pathologic change.

RESPIRATORY SYSTEM: The major bronchi and pulmonary vessels are unobstructed. On serial sectioning the pulmonary pareenonyma demonstrates generalized edema and congestion but is otherwise unremarkable.

HEPATOBILIARY: The surface of the liver demonstrates a 0.3 inch surface neoplasm that is yellow-white in color. The rest of the surface is smiooth and without adhesions. On serial sectioning the hepatic parenonyma has a normal consistency and color. The gallbladder and biliary tract are unremarkable.

HEMOLYMPHATIC: The serosal surface of the spleen is smooth and without adhesions. On serial sectioning the splenic parenonyma has a common mixture of red and white pulp. The internal lymph nodes identified are unremarkable.

GASTROINTESTINAL: The esophagus is unremarkable. Stomach content is 40 milliliters of gray-brown fluid. No food particles are identified. The stomach, small bowel and colon have a regular surface color, configuration and length. The appendix is present.

GENITOURINARY SYSTEM: The renal surfaces are smooth. On serial sectioning the renal cortex has a normal thickness. The calyces, pelves and ureters are unremarkable.

ENDOCRINE SYSTEM: Unremarkable.

CENTRAL NERVOUS SYSTEM: The scalp, subgaleal soft tissue and calvaria show no evidence of injury. On entering the cranial cavity the membranous compartments are free o f hemorrhage. The leptomeninges are clear. The surfaces of the cerebral hemispheres demonstrate flattening of the gyri and narrowing of the sulci. The vessels at the base of the brain have a normal configuration. The base of the skull shows no evidence of injury. On serial sectioning the brain reveals not grossly visible changes of natural disease.

MICROSCOPIC EXAMINATION

CENTRAL NERVOUS SYSTEM: (1) Section of cerebellum shows mild granular layer attenuation. (2) Sections of neocortex are negative.

CARDIOVASCULAR: (1) Section of coronary artery shows atherosclerosis. (3) Sections through the ventricular walls show some intramyocardial vessels with narrowing due to intimal hyperplasia.

GENITOURINARY: (1) Section of kidney shows arterionephrosclerosis; a single focus of chronic inflammation is noted.

HEPATOBILIARY: (3) Sections of liver show some protal tracts with increased macronuclear cells; a number of subcapsular haled granuloma are present.

RESPIRATORY: (8) Sections of lungs show bread areas of patchy intra-alveolar edema; many alveoli contain pigmented macrophages; the tissue shows generalized mild autolysis; vascular congestion is present.

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SUPPLEMENTAL PATHOLOGY EXAMINATION

GROSS: After autopsy and removal of all organs, observation of the paracervical, peri-clavicular and chest wall soft tissue shows areas of nonspecific discoloration measuring up to 1 inch in dimension (see photographs A through C; sctions to formalin stock).

September 25, 1998

Multiple sections of formalin-fixed tissue are submitted from the paracervical muscles bilaterally, the peri-clavicular tissues, bilaterally, the pericostal soft tissue from a bruise on the right back. The tissue from the bruise shows gross hemorrhage. The other tissue fragments show areas of curvilinear discoloration consistent with vascular discoloration.

All tissue is serially sectioned at 2-4 millimeters intervals. Focal areas of vascular congestion are noted in paracervical peri-clavicular and pericostal tissue fragments. Diffuse hemorrhage is present in the section of the back bruise (section). An area of irregular discoloration is present in the pericostal tissue (section).

Tissue submitted (2).

MICROSCOPIC EXAMINATION: A Section of a bruise on the right side shows hemorrhage.

1. Section of the left periocostal thissue shows hemorrhage.

Lary Simms, DO, MPH,

Chief Medical Examiner

Clark County, Nevada (Las Vegas)

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SCENE INVESTIGATION

NARRATIVE: The home of the deceased is large with multiple rooms totalling about 6000 square feet. The deceased was found in a family room just off the dining room.

Upon entering the family room where the decedent was found from the dining room, which has a marble floor, I noticed a number of dried drops in the carpeting of apparent gastric contents-like fluid. The drops were arranged in a line stopping in the area where the body was found.

Proceeding through the family room I entered a garage which had a trap door at one side. I had to walk down stairs to a sub-garage basement room. A number of pictures were scattered on the floor.

A number of small insects, probably roaches, were flushed from beneath the pictures. A bed at one end of the room was examined and was unremarkable.

Going back to the family room I entered a bathroom from the family room and noted dried and broken plants on the floor.

Moving back to the dining room, which is also adjacent to the main living room, I noted a number of French doors which opened out to a veranda and just beyond was a large pool and backyard.

Examination of he rest of the house was unremarkable except for some non-specific stains on the concrete floor of a garage at the opposite end of the house. In addition, a number of dead ants were noted in the cabinet below a sink in a guest bathroom.

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