Dr. McDonnell - Expert Witness

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- Graduated in UW School of Medicine and Public Health in 1993
- Did internship in internal medicine and changed focus to forensic pathology
- Worked for WHO in Nigeria identifying communicable diseases
- Went back to UW School of Medicine for Masters in epidemiology
- Thesis was on containing abuse of narcotic pain killers
Do you know how many pills the decedent took?Based on the levels of oxycodone found in the toxicology report I confirmed he ingested 40mg's of the substance, which was one pill from the bottle found.Is that a safe dose?Well dosage is different for everyone. For a full adult who has a history of taking this medication, yes it is a safe dose. In Riley's case, based off his height, weight, and lack of a tolerance, I do not believe this was a safe dose for him.Is 0.491 mg/mL of ingested oxycodone a lethal dose to a human?While this level is relatively low, I personally have performed several autopsies on teenagers with equal or lesser amounts of the drug in their blood.What is oxycodone and is it a controlled substance?Oxycodone is a narcotic agonist-analgesic used for pain relief. It works by attaching to opiate receptors in the brain and inhibits ascending pain pathways. Yes oxycodone is a controlled substance, it is currently classified as a schedule 2 drugWhy is oxycodone a controlled substance?Due to its high abuse and addiction potential.How did you know this was a lethal dose?Riley showed the signs and symptoms of heart failure, which causes the lungs to fill with fluid. Although there was no foaming at the mouth, there are 2 possibilities for this. His lungs were scarred and had mucus which would inhibit the production of foam. But also only about 80% of people foam at the mouth and he could be part of the 20% who do notDo you have an opinion on when the deceased ingested the oxycodone?Based on text messages sent to Charlie Davis at 11:36pm, the timing of the 911 call and when he went into severe respiratory distress, I would estimate he took the pills approximately an hour before going into distressDoes oxycodone cause respiratory distress?Yes, oxycodone and other opiates typically cause death by respiratory depression. The patient will typically go into a coma, develops anoxic brain injury from lack of oxygen, then dies. Riley Thomas fell into a coma from a lack of oxygen then died a few hours laterDid you review Riley Thomas's medical history?Yes I didDo you believe CF caused his death?No, I would've expected Thomas to live at least another 10 years, if not more. I found no indication that cystic fibrosis itself could cause a sudden death in Thomas, even with the presence of cigarettes and alcohol.Did you have prior knowledge that the deceased was drinking and smoking the night of the overdose?Yes, the toxicology report showed that ethanol was found in his system.Did that have any impact on the cause of his death?I do not believe that Thomas died from just alcohol poisoning. Even though he had vomited, there was no evidence that he aspirated or choked on his tongue. So lack of oxygen to the brain wasn't caused by alcohol poisoning. So although the BAC was high for someone his size, it was not enough on its own to cause death. Plus, he had a history, that he admitted to, of drinking which means his tolerance to alcohol would be higher than expected.Considering all the evidence, what's your conclusion? Why?My conclusion is the oxycodone alone killed Riley Thomas. This is due to my findings on the lack of oxygen to his brain, lack of aspiration from the alcohol, and the dosage he took.