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QA QT><i AUtMATVQNt redacted CERTtREQ COPY QF VITAL RECQROS STaTEOFCAUFORNIA )S COUNTY OF Santa CLaRA DATE ISSUED JVJH W W . . _ T7W t rv *AO ncKI f^nroa^caon o< <Tm .<*KUfr*rri rg*tr<3 *nd 0*ok1 on M ntrm VltAL fltCQWOS SECHOft, OEPaATWOTT OP PUBUC HtM-Trt. STEJ>hH A COflAY. WO HEALTH QPPKIEfl ANO LOCAl. flGtSTHAfl OP a^THS A HQ OEATHS Thu =007 not 'll.d unloj prrarcd on enm-cd border dijplijnnj jcnl ind ntitiiurc of Rexmrar. i ir.MPnnnnn^79^ Mmmmi *51 fcprktST^tr; ****** mu*mm*mH*wTm<m*ymw*TfmTnw=m*mT COUNTY of SANTA CLARA HEALTH DEPARTMENT 2220 MOORPARK AVE., SAN JOSE. CALIFORNIA 95128 r^: If'. *5*s*. i- PHYSICIAN/CORONER'S AMENDMENT FORM Redacted USE 8UCX INK ONLY--MAXE NO BUISJRE, WHTEOUTS. OR OIH0 ALTmnONS STATU rnj NUMSCT . G3 OKATH C3 ffTTAL DHATX CH WTR Redacted LOCAL *aSTWATtaN 013TWICT Aa ComflCATS NUWUR INKJRMATX3N Saj D*amTD 0 OHK3NAL CL.TnffO.TI ! *m NAME-----A13T laiVKMV Redacted 2_ a ATT OF EVENT' XTM. OAT. TTAA January 3, 1991 J > MIOOLJl Redacted JA. cm- Q* OC.tCUMWNi^ Palo Alta 2 erf 2 5C. L>3T ! Redacted j Ott. CaUHTT OP OCCU*tP^C* I Santa Clara . I io. sex !M rr* ? j 5a. IHCOMCr INFORMATION ON CFTfONAL CCnTIffCATe SaJ^ORMATION L3 FT 5HOUU3 SK STATED 71 A .. .2ia,, 21C 25 29 P^ndinq Blank. Blank Blank Pendino Acute Branchooneumon-ia and Seosis Coronarv Arterv 8voass Grafts Artariosclarotic Cardiovascular Oiseasa Pulmonary fibrosis Natural II. *K r --* 3*/ 3 rt 33*4 H i>- ,. 3k I K li.,: fp PJ l UST OWE ITEM m lim< t DCCL>NATION OF COTTTFfWC FHT3JCIAN : OH COftONG* 7a. sjohatuhe of cfirp9rvHa m>cLKsro ccponm ` 7a. qatt* skpnmcd L l th cwnrnNo ,-?*-- ? 'feA^^d^J^^--goronar ! 5/15/91 N A V | M a IMONAI. HNOWL(045 O * l^M<3fWATK3fi rrM>CX k*OOil3 I AMC OF CCTTUrnNa FMTJICIAH Ofl GQROfilrt wkmwt cm Trr 8*l OtcytEE Q TTTU rue in>omtiOm Qnioi nallt NtroRTfD. oCLAR* UNOW >AALTT O* r+MJiJWT TMAT th* A*OV WONMATKX L* T*v AMO COWUCT TtJ T> mxt om k John E. Hauser ftc. AOO*g33--mrr ahp mama to. orr M.D. 850 Thornton j. amcj op jtati o local pranvks L STATIAjCCAL REGlSmAfl Office of State Registrar U5C OM.Yj w ot Vital Statistics Way San Jose ia oati Acc*rr*a fo* *eaisr*AnoN JUN OS 1931 irm or xuu. anoi a. *xtx max amt or irirt ncrnui REDACTED CERTIFIED COPY OF VITAL RECORDS STATE OF CALIFORNIA 1 COUNTY OF SANTA CLARA J * -D--A--T--E--I-S-JSUUNED 1A 1991 ar ThM * a V\* and n*d r^roouemn ak TW doojm*r* offloafty r*gJ*r*J *rxI pUc*d v' dsr*] ^P onMiiM VITAL. RfeCOflOa SECTION. OCPLrtTWfiNT OF PnjBUC HEALTH. STEPKH K COFAY. MO " HEALTH OFTCAMO LOCAL A8CTRAA OF 3**THS AND QEATHS Thii copy rnX nlxj unless prepared on enjrvcd border drip-Uyinj ical xnd ujnaiun: of Rc^isirar. i ir.MP=nnnnn^7?R Redacted 2- - INTERNAL EXAMINATION: ' _ As previously mentioned, the body has been recently embalmed. The internal organs are examined and described in the embalmed state. Head: The scalp, calvarium, and the base of the skull are .intact and show no evidence of injury. The brain weighs 1550 grams and is symmetrical. No remarkable abnormalities or evidences of injury are apparent on the external surface or on multiple coronal sections through the cerebral hemispheres, cerebellum, or brainstem. The ventricular system is of the usual caliber. The meninges are smooth. The blood vessels comprising the Circle of Willis show minimal atherosclerosis. There is no epidural, subdural, subarachnoid, or intracerebral hemorrhage. Neck: The hyoid, larynx, soft tissues, and cervical spine are unremarkable and show no evidence of injury. The trachea shows a tracheostomy opening at about the level of the second tracheal ring. Body Cavities: Some fibrous adhesions are present between the parietal and visceral pleura of both chests. No calcified plaques are seen on the pleura. There is extensive fibrous scarring of the pericardium and the pericardium is intimately adherent to the pleural surface of the lower lobes of both lungs. The peritonea.1 cavity contains approximately 200 cc. of cloudy grayish-pink fluid which is probably a mixture of embalming fluid and gastrointestinal contents. There are several trocar perforations of the anterior abdominal wall and some of the loops of small and large intestines. Cardiovascular System: The heart is markedly enlarged, weighing 770 grams. The walls of the left ventricle and right ventricle measure up to 2.5 cm. and 0.6 cm. in thickness, respectively. As previously described, there is extensive fibrous scarring of the pericardium and epicardium. No remarkable valvular abnormalities are seen. The myocardium shows many scattered foci of fibrous scarring. No infarcts are recognized. There is evidence of previous and more recent surgical procedures. In the proximal ascending aorta just above the level of the aortic valve are three coronary artery graft orifices, two of which are completely closed. The third is partially open. Also present are two more recent graft orifices connected to two grafts which are both patent. One of the grafts terminates on the left lateral wall of the left ventricle. The other terminates over the left i ir.MFnnnnn379R