Unlike Herrera, though, Artiga manages the bodies, runs the business and does all the cutting himself. His colleague, the pathologist Stephan Grigorian, leads the autopsy analysis and medical results. “Right now, I’m reviewing an autopsy,” Grigorian told me. “It’s, like, done by a moron.” A hospital was being sued because of it. Families can pay thousands of dollars and initiate lawsuits, all based on reports that turn out to be flawed. Grigorian explained he can’t afford to make such mistakes.
“I’m going to do my autopsy,” Grigorian told me. “Then, I’m going to review theirs.” His secondary exam will try to determine if the first pathologist “did something wrong, something they were not supposed to do. It’s like a critique,” a kind of death peer review.
Aiken, of the National Association of Medical Examiners, uses a more cautious metaphor, comparing second autopsies to getting another opinion on a knee injury: One doctor might suggest physical therapy, while another recommends surgery, but “it may not be that either one of them was wrong.” Differences in opinion in the autopsy world might come down to each individual pathologist’s training and experience, Aiken explained, without it necessarily being clear whose viewpoint deserves to carry more weight.
Even so, Aiken says she welcomes additional critiques of her own forensic work. “When cases of mine go out, as they frequently do, for review, I really like to know what the other person said,” she said. “That’s quality improvement. That’s feedback. Many times, they just agree with you. There are times when their slant might be a little different.” Either way, she added, it’s valuable to have multiple perspectives. “That’s why I like the system we have. It’s adversarial.”
Every expert might agree that a person died while hanging from a rope, for example, based on marks on the neck and evidence at the scene. But pathologists may differ on the manner of death. One pathologist might call it suicide. Another might conclude that the person was strangled before being hanged by a rope (as the forensic pathologist hired by Jeffrey Epstein’s brother is claiming). In the absence of clear video footage or eyewitnesses, there is still room for interpretation — the particular angle of a neck-bone break does not prove, without a doubt, what caused it.
The fact that there is room for interpretation at all allows for competing findings and dueling expert witness testimonies in court, and the relatively low bar for entering the field attracts people willing to profit from that gray area. Shawn Parcells, who assisted in the autopsy of Michael Brown, started a private-autopsy business in Kansas in 2012. Prosecutors claim that he performed autopsies, though he had no medical degree, and lied to coroners about doing so. Parcells has been banned from the autopsy business since March 2019, until the charges against him are settled.
In the trial of Derek Chauvin, David Fowler, the former chief medical examiner of Maryland, testified on behalf of the defense. Fowler said that Floyd did not die of asphyxia, but other important factors included cardiac arrhythmia, heart disease, drug use and potential exposure to carbon monoxide from the exhaust pipe. A few years before, in 2018, Fowler determined that the death of 19-year-old Anton Black, which occurred after an encounter with the police, was an accidental sudden cardiac incident. Black’s family filed a federal lawsuit in December against Fowler and officers, claiming that Black was held in a prone position for roughly six minutes after he had been tased and handcuffed as he “struggled to breathe, lost consciousness and suffered cardiac arrest.” The police claimed drugs were involved, according to the complaint, although toxicology tests showed no evidence of that. Black’s mother watched her son plead for help while officers pinned him down in front of her home.