Chapter 38

CHAPTER 38

I T TOOK DEVINE ABOUT TWENTY minutes to reach the house. He drove east on Interstate 90, over Lake Washington and through Mercer Island, and then turned north toward Bellevue. The house was a fairly new two-story with a white brick front and a two-car front-load garage situated all by itself in a cul-de-sac in a wooded area. A fine mist had formed on the way over that might, at some point, turn to rain, or sleet.

There were lights on in the house, and a gray Lexus coupe with Washington plates was parked in the driveway.

He knocked on the front door and a woman’s voice said fearfully, “Who is it?”

“Dr. Coburn? It’s Travis Devine.”

“Hold up your credentials to the door camera.”

Devine glanced around, saw the door cam, and showed his badge and ID card.

The door opened, revealing Coburn, who was petite with silver hair cut short; she looked to be around fifty. She wore a cream-colored pantsuit with a navy blue blouse open at the collar. A gold chain with a crucifix was around her neck.

“Agent Devine, please come in,” she said in a trembling voice.

Coburn closed the door, locking it. She led him quickly into the dining room, where a black doctor’s bag perched on a chair and a sleek brown leather briefcase was open on the table. There were papers scattered next to it, along with several manila file folders.

“Nice place,” said Devine.

“I don’t live here. My home is in Spokane. That’s the reason I’m one of the medical examiners for that part of the state. A friend who’s out of town let me use her home while I’m attending the conference in Seattle. It’s a forensic science smorgasbord.” She smiled faintly. “But it actually feels good to catch up with colleagues and the technology is changing so fast.”

“You said you were scared?” prompted Devine. “Does this have to do with the autopsies you performed?”

Coburn motioned him to a seat while she sat down across from him.

She said, “I’m still awaiting tox screens on Dwayne and Alice Odom, and those can take a while. Without that I could make no definitive cause-of-death determination. I can’t quite put my finger on it, but something weird is going on.”

Devine said, “Wait a minute, I don’t understand. Your reports list accidental drug overdose as the preliminary COD for both, and they also said you found indications of prolonged substance abuse in both their bodies.”

She looked stunned. “I didn’t find any signs of a drug overdose, or that the Odoms were addicted to drugs.” She looked at him, dread on her features. “Do you have the reports with you?”

He slipped the pages from his jacket pocket and handed them across.

Coburn read through them carefully before handing them back to him. He noted that her hands were now trembling. “Those are not my reports. And that is not my signature.”

“Then who wrote them and why?”

“I don’t know,” she said in a near whisper.

“Maybe you should start from the beginning?” suggested Devine. “What struck you as weird?”

The woman looked close to losing all emotional control. He reached over and gripped Coburn’s wrist. She glanced up at him.

“I’m not going to let anything happen to you, Dr. Coburn. Take a few deep belly breaths, in through the nose, out through the mouth, compose yourself, and let me hear your story.” He let go of her wrist and sat back while she breathed exactly as he had told her to.

Calmed, she began, “There are nationally prescribed procedures for MEs to conduct investigations of, and diagnose and certify deaths due to, opioid overdoses.”

“Like what?”

“Examining the decedent’s medical history, and checking the scene where the death occurred. Also analyzing their living space to look for evidence of substance abuse. Everything from crushed tablets to altered transdermal patches, pills not in prescription bottles, or overlapping prescriptions, cooker spoons, needles, tourniquets, and other drug paraphernalia, things like that.”

“Did you do that?”

“I was given no chance to do that. That’s what was weird. The Ricketts police did not hold the scene of death open for me. I wasn’t even informed of its location. And I was given no opportunity to review the Odoms’ medical history. And I was told their residence was unknown at the time.”

“They lived in Kittitas County in a mobile home. The address was on the title to their car and I’m sure it was on their driver’s licenses, so the police knew exactly where they lived.”

“I was not told or given any of that. I was told that all indications were of an accidental drug overdose. And that Narcan was administered at the scene by the Odoms’ daughter, but was unsuccessful.”

“Who told you that?”

“The officers who found them.”

“Their names?”

“I’d have to check my notes.”

“Which are where?”

She looked hopelessly at him. “Back in Ricketts.”

“Go on with your story,” prompted Devine.

“Protocols also call for the collection of blood, urine, and vitreous humor as toxicology specimens. As well as stomach contents and bile of course.”

“Vitreous humor?”

“Gelatinous mass in the eye between the retina and the lens. And with a suspected drug death, blood from the ilio-femoral vein is routinely considered best. It’s due to the postmortem redistribution of drugs in the blood. I know this is more detail than you want, and I don’t want to get too far out into the forensic weeds, but I need you to understand the situation.”

“So you did all that?”

“Yes. The stomach contents showed they had just eaten lunch.”

“They had at a restaurant in town. You said you ordered a tox screen?”

“Yes, but you do a tox screen for a case of suspected drug overdose only if certain elements are present.”

“Such as?”

“Known history of substance abuse or misuse, or the same being revealed at the crime scene. Having had no access to that info, I couldn’t rely on that, but just on anecdotal evidence from the first responders. Next, if the autopsy findings suggest illicit drug use, you would also order up a tox screen. There were no needle marks on the bodies. That’s not conclusive because many illegal drugs are taken orally via the mouth or nose. But there was also no hepatic cirrhosis, or foreign body cells in the lungs. And no drug-induced froth in the air passages. Those elements almost always present in an overdose case.”

“ Did you find evidence of Narcan in their systems?”

“No, but my examination wouldn’t necessarily reveal it. However, the tox screen would likely show traces of its presence.”

“The reports say that fentanyl is the suspected drug.”

“And as I said, those were not the reports I wrote. I would never have inserted a preliminary cause of death like that, particularly when I had found no evidence of it. Fentanyl has the ability to bypass the brain-blood barrier, which makes it ideal for pain management, but terrible for addiction. There’s also a synthetic opioid coming out of Europe, two-benzyl benzimidazole. It was developed in the fifties as a painkiller but was never approved for medical use. It’s up to twenty times more potent than fentanyl.”

“God help us,” muttered Devine.

“The point is, I’ve had to perform, unfortunately, hundreds of autopsies on fentanyl overdose victims, so I know what to look for. And I did not find it with the Odoms.”

“Okay, but did you find evidence of poisoning ? Is that why you ordered the tox screen? Because you wouldn’t have ordered one based solely on suspected drug overdoses, according to your findings and the protocols you just outlined. There wasn’t any evidence of it.”

She didn’t answer right away. “You’re absolutely right, Agent Devine. I actually suspected cyanide poisoning.”

“Like in an Agatha Christie novel? What, did you smell bitter almonds?”

“No, I smelled garlic , Agent Devine.”