The following is the second chapter in an NPR/ProPublica/Frontline report on death investigation in the United States.
After Cayne Miceli died in January 2009, her body was brought to the New Orleans morgue, a dingy, makeshift facility in a converted funeral home, for Dr. Paul McGarry to autopsy.
An autopsy, the dissection and evaluation of a corpse, generally begins with a physician scrutinizing the body, noting visible injuries. With a scalpel, a doctor then slices a long, Y-shaped incision in the torso and studies the innards, removing and weighing each organ, and using a small rotary saw to remove the top the skull. An autopsy can trace the path of a bullet through a body, or reveal microscopic damage to blood vessels in the brain, or identify a lethal clog in an artery.
By the time Miceli's body was laid on the stainless-steel examination table, McGarry had performed such work for three decades in Louisiana and Mississippi. In New Orleans, he was one of several forensic pathologists overseen by the parish coroner, Frank Minyard, a trumpet-playing local legend who has held his elected office for more than 35 years.
Miceli, 43, had died after being held in a cell in the parish jail, bound to a metal bed by five-point leather restraints. During the autopsy, McGarry observed "multiple fresh and recent injection sites" on Miceli's forearms. He determined that drugs—he didn't specify the variety—had killed her, according to his report.
But doctors who had treated Miceli the day she died encouraged her father, Mike Miceli, to look more closely into his daughter's death. He had her body flown to Montgomery, Ala., for a second autopsy by Dr. James Lauridson, the retired chief medical examiner for the Alabama Department of Forensic Sciences.
Lauridson concluded that McGarry had misconstrued the needle marks on Miceli's arms. "In fact, all of the needle puncture marks were therapeutic—drawing blood, IV's, that sort of thing," Lauridson said.
McGarry's finding also was contradicted by a central piece of evidence: a screen for drugs and alcohol didn't turn up either in Miceli's blood. McGarry had reached his conclusion days before he got the test results, records show.
Lauridson soon pinpointed the real reason for Miceli's demise. On the day of her death, Miceli had gone to the hospital to be treated for an asthma attack. She was arrested after an altercation with hospital staffers; Miceli thought they were trying to discharge her too soon, court records show. Peering at Miceli's lung tissue under a microscope, Lauridson was certain that severe asthma, combined with the way she was restrained at the jail, had caused her death.
"As I examined her lungs, it was very clear right away that her lungs and all of the airways were completely filled with mucous," he said. "To put an asthmatic flat and then tie them down during an acute asthma attack is nearly the same as giving them a death sentence."
McGarry had been wrong, and not for the first time. In fact, a review of medical records, court documents and legal transcripts shows McGarry has made errors and oversights in autopsy after autopsy.
In three instances since 2005, his findings in cases in which people died in the custody of police officers have been challenged by doctors brought in to perform second autopsies. In each case, McGarry's findings cleared officers of wrongdoing. The other specialists concluded the deaths were homicides.
Contacted by phone, mail and in person, McGarry repeatedly declined to comment for this article or related radio and television stories.
Some in the field champion McGarry, praising his track record. "I have the utmost respect for Dr. McGarry and he taught me much when I was in a forensic fellowship program," said Dr. James Traylor in an e-mail. Traylor was trained by McGarry and worked alongside him in the New Orleans morgue. "I am unaware of any 'mistakes' that he may have made."
Second autopsies are a rarity in most jurisdictions, but New Orleans civil rights attorney Mary Howell said she often taps forensic pathologists to perform follow-ups when she knows McGarry has handled a case. The degree to which their findings have differed from McGarry's is "shocking," Howell said. In some cases, they discovered, McGarry's work was so incomplete that bodies were "half-autopsied," she said.
Determining Gerald Arthur's Death
Gerald Arthur, a 45-year-old construction worker with a history of drug arrests, died after a struggle with police on a New Orleans street in 2006. Based on McGarry's findings, coroner Minyard ruled the death an accident, but a forensic pathologist with the Georgia Bureau of Investigation brought in by Arthur's family to perform a second autopsy found four broken ribs that McGarry had not noted. In his report, the GBI pathologist also stated that McGarry "failed to dissect" key neck muscles, causing him to miss hemorrhages that, in his view, suggested Arthur had been strangled.
In a deposition, McGarry disputed that assertion, saying he had dissected the neck muscles but had come to a different conclusion. "I don't have any evidence that this man had a death due to neck strangulation," he said.
No criminal charges have been brought in connection to Arthur's death. His family settled a lawsuit against the police department last year for $50,000.
Autopsy Mistakes After Police Encounters
Also in 2006, McGarry autopsied Lee Demond Smith, a 21-year-old man who died in jail in Gulfport, Miss. McGarry decided that Smith had been killed by a pulmonary embolism, a blood clot in the lungs, based on evidence of internal bleeding. Again, another specialist brought in to do a second autopsy found injuries that McGarry had not: abrasions on Smith's forehead and chest, as well as a half-dozen bruises on his legs and hands. The doctor concluded that Smith, like Arthur, had been strangled.
No criminal charges have been filed in Smith's death either.
Raymond Robair, a 48-year-old handyman who died shortly after an encounter with police, was autopsied by McGarry in 2005. Based on McGarry's examination, coroner Minyard declared Robair's death an accident.
But McGarry had not noted the wounds covering Robair's legs and arms. A second forensic pathologist hired by Robair's family documented 23 separate bruises, including a thigh contusion more than a foot long. The fatal injury was a severe laceration of Robair's spleen that caused extensive internal bleeding, according to the second autopsy, which was performed by another GBI doctor, Kris Sperry. Robair "was the victim of a beating," his autopsy report states.
Robair's sister, Pearl LeFlore, said her sibling's battered body was communicating a message: "This is what happened to me. ... I died brutally. I was beaten." McGarry's autopsy was "a lie altogether," she said.
From The Beginning
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Based on McGarry's autopsy, records show, the district attorney's office decided not to prosecute any police officers in connection with Robair's death. "The officers were effectively exonerated by the initial autopsy performed by the Orleans Parish Coroner's Office," wrote an assistant district attorney in a 2008 letter sent to the police department.
Ultimately, in 2010, after conducting an extensive investigation, the U.S. Department of Justice indicted New Orleans Police officer Melvin Williams for allegedly beating Robair to death and charged another officer with allegedly helping to cover it up. The officers have pleaded not guilty.
Cayne Miceli's father is still seeking justice. Mike Miceli has sued McGarry in Orleans Parish court, saying his actions were "extreme and outrageous," and has filed a separate suit against the Orleans Parish Sheriff's Department for wrongful death. Both cases are pending.
"There's no reason for a family to have to go through this," Mike Miceli said. After the lawsuits were filed, Minyard amended the autopsy report, changing Miceli's cause of death from a drug overdose to asthma and labeling it a natural death.
Minyard declined to discuss the Miceli autopsy or other cases in which McGarry's findings have been challenged. He defended McGarry's work more generally. "I'm not aware of any impropriety," the coroner said. "I'm not aware of any mistakes."
Last year, McGarry stopped doing autopsies for Orleans Parish, but he is still working for three Mississippi counties. "He lives in Mississippi, and he's helping them over there," Minyard said. "The travel back and forth was too much."
Continue reading this NPR News investigation in partnership with ProPublica and PBS's Frontline:
Chapter 3: Academy Recommends Phasing Out Coroners
Chapter 4: A State Office Struggles With Mismanagement
Chapter 5: Shortage of Death Detectives To Perform Autopsies
Chapter 6: Oklahoma's Lack of Resources Means Few Autopsies
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