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Coroners Report Summary
 
Public affairs officer Elizabeth Jones requested that a synopsis of Anthony Phelps' medical examination be posted, to facilitate the participation of the online audience.
When Jones contacted Memorial Hospital, first-year resident James Denton offered to provide the requested information as follows.
Report Summary
 
When he was found, Anthony Phelps was in a fairly advanced state of rigor mortis, thereby leading investigators to place the time of death at 14-16 hours before he was examined. The examiner states the time of death as being anywhere from 10:00 p.m. to midnight on Friday 9/26.
 
When the van containing Phelps crashed, Phelps sustained two serious injuries. First, Phelps hit his head, causing bruising of both the scalp and the brain. There was some bleeding beneath the skull, and in response, a small blood clot had formed. The bleeding and associated clot exerted pressure on the brain, causing some swelling.
 
Second, and more significantly, Phelps' aorta sustained a small tear at the juncture of one of the main arteries - an injury caused by the rapid impact experienced during the accident. Phelps' body would have responded to the rupture by attempting to block the hole - once again, the blood-clotting mechanism at work. However, as the clot built up and repaired the tear, the resulting lump would have restricted the flow of blood through this vital artery. To relieve the resulting stress on the heart, dissolving agents in Phelps' blood would have acted to weaken the clot. This process can occur over several days, and in Phelps' case it took nearly a week for the clot to grow large and then to be weakened enough to cause a second rupture. With the second rupture, internal bleeding continued unchecked, resulting in Phelps' death. 2.5 liters of blood were found in the chest cavity.
 
Additional notes
 
The head injury in and of itself was not fatal, although Phelps would have been in severe pain. As to the ruptured aorta, Phelps may have felt relatively normal - attributing any pain in the torso to the bruises on his chest - until the bleeding began a second time, during which Phelps would have experienced severe discomfort and weakness, ultimately losing consciousness before dying.
 
Immediate medical attention could have saved Phelps, but because he was probably not aware of the more serious aortic damage, he probably decided that the head injury was not worth the risk of re-arrest.

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