Brittany Murphy-Monjack (did you know her legal name was hyphenated? I did not).
She was 32 years old when she died.
Summary of events leading to her death:
- 32 year old female with history of diabetes and hypoglycemia (low blood sugar) requiring hospitalization, and mitral valve prolapse (one heart valve did not function correctly).
- Long history of heavy menstrual bleeding (medical term = menorrhagia).
- Complained of shortness of breath and abdominal pain for 7-10 days leading up to death.
- Found unresponsive at home by family.
- Vomited prior to arrival of paramedics.
- At time of arrival of EMS, dd not have any vitals signs (heart rate, breathing, etc). Blood sugar at the time was 49 (low).
- Taken to hospital, where they found hypochromic, microcytic anemia (her red blood cells were small and pale, and low in number). EKG showed signs concerning for acute MI (myocardial infarction, aka heart attack).
- Did not respond to resuscitation efforts, and was pronounced. Autopsy ordered by medical examiner/coroner.
Summary of findings at autopsy:
- No external signs of trauma, or evidence of non-iatrogenic (iatrogenic = caused by doctors or medical intervention) puncture marks.
- Appeared noticeably pale at autopsy.
- Hair extensions were noted to be present.
- Mild abdominal distension (bloated).
- Small amount of vomit seen in throat- not obstructing airway.
- 200 ml of cloudy, serous fluid present in each pleural cavity (these are the cavities that the lungs sit in- there should normally be only negligible amounts of fluid present).
- Page describing the heart is missing
- Lungs were congested in the lower lobes on both sides, and sections sunk when placed in water (should float- sinking implies a process present in the lung tissue increasing the density of it)
- Kidneys are pale, consistent with "shock kidney"
- Generalized lymphadenopathy (enlarged lymph nodes) in various areas of the chest and abdomen
- Remaining organs and organ systems are unremarkable
Summary of microscopic findings:
- Mild fibrosis (thickening) of the mitral valve (consistent with reported history of MVP).
- Acute bronchopneumonia, moderate to severe, present in both lungs (sounds like it was pretty bad, and had been going on for at least a few days).
- Adult respiratory distress syndrome (basically, her lungs looked like crap- lots of damage present at the microscopic level)
- Inflammation identified in multiple organs, including the spleen, pancreas, and multiple portions of the bowel.
Summary of additional studies:
- Blood cultures taken the hospital grew a strain of Staph Aureus (similar to, but not the same as MRSA). This means she had bacteria in her blood, most likely causing sepsis, and the most likely explanation for the inflammation seen in her organs.
- Radiology report showed no trauma.
- Full toxicology exam showed elevated levels of multiple drugs (but not necessarily lethal levels), including hydrocodone, acetaminophen, and chlorpheniramine. Combination of drugs consistent with Vicodin and cold medications (remember, she was complaining of abdominal pain and shortness of breath). No illegal drugs or alcohol were identified.
Final Cause of Death: Community Acquired Pneumonia
Factors Contributing to Death: Iron Deficiency Anemia (low blood levels), Multiple Drug Intoxication
Manner of Death: Accident
- The medical examiner in their report stated that the elevated levels of drugs present in her system at the time of death most likely contributed to her death (though were not the primary cause), and that she was more susceptible to adverse effects (bad reactions) to those levels/drugs given her already compromised state due to the pneumonia, and the long standing anemia.
- The type of anemia identified at the hospital is consistent with low red blood cell levels (aka anemia) due to lack of or insufficient amount of iron (important for the production of red blood cells). Given her history of heavy menstrual bleeding and her age, the menorrhagia was thought to be the cause of the iron deficiency anemia (which also weakened her body, making her more susceptible to both infection and the drugs).
