California 1991: Court order prevents autopsy, toxicology sample only

At approximately 23:15 on 10 July, 1991 Alcor Suspension Team Leader Jerry Leaf experienced cardiac arrest in his home in Downey, California. His wife Kathy, who is a Registered Nurse, began CPR immediately and summoned the paramedics. After an unsuccessful attempt to establish an IV and re-start his heart with defibrillation, Jerry was transported to the Emergency Room of Downey Community Hospital, where he arrived at 23:41.

At the hospital vigorous attempts to resuscitate him were carried out for over 45 minutes, but to no avail. Alcor was notified of the situation by the ER staff at approximately 00:15. At 00:35 Jerry was pronounced legally dead by the ER physician. The ER was staff incredibly cooperative (it should be noted that Jerry's wife Kathy is head of Nursing at the hospital) and continued CPR for another 45 minutes and administered some transport drugs.

A transport team consisting of Ralph Whelan, CRT, Carlos Mondragon, Tanya Jones CRT, and Mike Darwin, CRT, departed the Alcor facility at 00:50. When consideration is given to the fact that with one exception all personnel responding needed to be wakened and summoned from home (Mike Darwin was home, but awake) this response time is excellent. (Nevertheless we are working on ways to improve it further.)

When the Transport Team arrived at the hospital, CPR had been discontinued and Jerry's head had been incompletely packed in ice in plastic bags and he had been placed on a cooling blanket. His rectal temperature was 35°C.

Since Jerry experienced cardiac arrest suddenly and without a prior history of heart disease, he was automatically a Medical Examiner's (ME) case. Initially it was hoped that the ME would waive the case and give an ME's release number, enabling Alcor to take immediate custody and begin administering transport medications and continue external cooling.

However, when the Los Angeles County ME's office was reached by the ER physician they refused to issue a release number and ordered that no further transport medications be given. However, they did allow Alcor personnel to transfer Jerry to the portable ice bath (PIB) and begin cooling him with crushed ice in direct contact with his skin. The Transport Team was further informed that it would be sometime after 09:00 before an investigator could be sent out to determine if the ME was going to take custody and/or perform a partial or complete autopsy. This meant at least seven additional hours of ischemia (no blood flow).

Thus at 02:13 Jerry was transferred onto a bed of crushed ice in the PIB on the Mobile Advanced Life Support System (MALSS) cart and covered over with additional ice. He was then moved to the hospital morgue walk-in cooler for refrigeration until the ME investigator arrived.

Throughout this interval Saul Kent was hard at work on the phone making arrangements to fly in our back-up surgeon and handle other logistic details. When it was determined that the ME was not going to release Jerry, Saul was apprised of this and he began an effort to reach Alcor attorney Chris Ashworth. Chris had recently moved and we did not have his new home phone. By an incredible stroke of luck Chris was working late and when Saul (in a last-ditched effort) called the law office at about 02:00, Chris answered the phone!

Once Chris was told of the situation he went into high gear and placed a phone call to Judge Aurelio Munoz and explained the circumstances. Judge Munoz then offered to issue a court order ordering Jerry's immediate release to the Alcor Transport Team. After some quick discussion Carlos decided to take this course of action and within a short time Judge Munoz contacted the Administrator of Downey Community Hospital and ordered Jerry's immediate release. The ME was also notified of this court order. The ME then contacted Carlos and a compromise was worked out wherein the ME would have an investigator on the scene within 40 minutes and the ER physician would draw blood via a femoral stick for the ME so that a toxicology screen could be done to rule out foul play via poisoning. The ME investigators arrived in slightly under 40 minutes, carried out an external exam (to rule out trauma) and made a photographic record.

We felt it important to make this compromise even though it resulted in another hour's delay. Our reasons for this decision were that 1) given Jerry's condition an added (relatively) short period of time was not going to make much difference: with such a long down-time most of the up-front injury had already occurred and there was not much we could do to hasten cooling or improve the situation beyond external cooling which was already underway, 2) The ME was being reasonable and friendly and, considering the circumstances and the delicate nature of the situation we felt it was prudent to be reasonable in return. We know we will have to work with the LA ME's Office in the future, and creating a bad situation will not make this any easier, 3) We wanted to reduce the chances that there might later be questions regarding the cause and mode of death by allowing the ME to do the modest examination they requested and to take the toxicology sample they needed.

SOURCE: Jerry Leaf Enters Cryonic Suspension (Case Report Excerpt)