NMS Labs CONFIDENTIAL

3701 Welsh Road, PO Box 433A, Willow Grove, PA 19090-0437

Phone: (215) 657-4900 Fax: (215) 657-2972
e-mail: [email protected]
Robert A. Middleberg, PhD, F-ABFT, DABCC-TC, Laboratory Director

Toxicology Report Patient Name WATTS, SHANANN

Patient ID AW18-155
Report Issued 08/29/2018 17:09
Chain NMSCP2551
Age 34 Y DOB 01/10/1984
10695 Gender Female
To:
Weld County Coroner Workorder 18244666
495 North Denver Ave

Loveland, CO 80537 Page 1 of 3

Positive Findings:

Compound Result Units Matrix Source

Ethanol 128 mg/dL 001 - Spleen Blood
Blood Alcohol Concentration (BAC) 0.128 g/100 mL 001 - Spleen Blood

See Detailed Findings section for additional information

Testing Requested:
Analysis Code Description
8051B Postmortem, Basic, Blood (Forensic)

Specimens Received:
ID Tube/Container Volume/ Collection Matrix Source Miscellaneous
Mass Date/Time Information
001 Gray Top Tube 8 mL 08/17/2018 11:30 Spleen Blood ALTERNATE CASE ID:
18-435
002 Gray Top Tube 6.75 mL 08/17/2018 11:30 Spleen Blood

All sample volumes/weights are approximations.

Specimens received on 08/21/2018.

NMS v.18.0

D0622018CR002003 DISCOVERY PAGE 993

 CONFIDENTIAL Workorder 18244666
Chain NMSCP2551
Patient ID AW18-155

Page 2 of 3

Detailed Findings:
Rpt.
Analysis and Comments Result Units Limit Specimen Source Analysis By

Ethanol 128 mg/dL 10 001 - Spleen Blood Headspace GC

Blood Alcohol 0.128 g/100 mL 0.010 001 - Spleen Blood Headspace GC
Concentration (BAC)
Ethanol Confirmed mg/dL 10 001 - Spleen Blood Headspace GC

Other than the above findings, examination of the specimen(s) submitted did not reveal any positive findings of
toxicological significance by procedures outlined in the accompanying Analysis Summary.

Reference Comments:
1. Ethanol (Ethyl Alcohol) - Spleen Blood:
Ethyl alcohol (ethanol, drinking alcohol) is a central nervous system depressant and can cause effects such as
impaired judgment, reduced alertness and impaired muscular coordination. Ethanol can also be a product of
decomposition or degradation of biological samples. The blood alcohol concentrations (BAC) can be
expressed as a whole number with the units of mg/dL or as a decimal number with units of g/100 mL which is
equivalent to % w/v. For example, a BAC of 85 mg/dL equals 0.085 g/100 mL or 0.085% w/v of ethanol.
Sample Comments:
001 Physician/Pathologist Name: BURSON
001 County: WELD

Unless alternate arrangements are made by you, the remainder of the submitted specimens will be discarded one (1) year
from the date of this report; and generated data will be discarded five (5) years from the date the analyses were
performed.

Workorder 18244666 was electronically

signed on 08/29/2018 16:15 by:

William M. Schroeder, M.S.

Certifying Scientist

Analysis Summary and Reporting Limits:

All of the following tests were performed for this case. For each test, the compounds listed were included in the scope. The
Reporting Limit listed for each compound represents the lowest concentration of the compound that will be reported as being
positive. If the compound is listed as None Detected, it is not present above the Reporting Limit. Please refer to the Positive
Findings section of the report for those compounds that were identified as being present.

Acode 50010B - Amphetamines Confirmation, Blood - Spleen Blood

-Analysis by High Performance Liquid Chromatography/ Tandem Mass Spectrometry (LC-MS/MS) for:

Compound Rpt. Limit Compound Rpt. Limit

Amphetamine 5.0 ng/mL Methamphetamine 5.0 ng/mL
Ephedrine 5.0 ng/mL Norpseudoephedrine 5.0 ng/mL
MDA 5.0 ng/mL Phentermine 5.0 ng/mL
MDEA 5.0 ng/mL Phenylpropanolamine 5.0 ng/mL
MDMA 5.0 ng/mL Pseudoephedrine 5.0 ng/mL
Acode 52250B - Alcohols and Acetone Confirmation, Blood - Spleen Blood

NMS v.18.0

D0622018CR002003 DISCOVERY PAGE 994

 CONFIDENTIAL Workorder 18244666
Chain NMSCP2551
Patient ID AW18-155

Page 3 of 3

Analysis Summary and Reporting Limits:

-Analysis by Headspace Gas Chromatography (GC) for:

Compound Rpt. Limit Compound Rpt. Limit

Acetone 5.0 mg/dL Isopropanol 5.0 mg/dL
Ethanol 10 mg/dL Methanol 5.0 mg/dL
Acode 8051B - Postmortem, Basic, Blood (Forensic) - Spleen Blood

-Analysis by Enzyme-Linked Immunosorbent Assay (ELISA) for:

Compound Rpt. Limit Compound Rpt. Limit

Amphetamines 20 ng/mL Fentanyl / Acetyl Fentanyl 0.50 ng/mL
Barbiturates 0.040 mcg/mL Methadone / Metabolite 25 ng/mL
Benzodiazepines 100 ng/mL Methamphetamine / MDMA 20 ng/mL
Buprenorphine / Metabolite 0.50 ng/mL Opiates 20 ng/mL
Cannabinoids 10 ng/mL Oxycodone / Oxymorphone 10 ng/mL
Cocaine / Metabolites 20 ng/mL Phencyclidine 10 ng/mL

-Analysis by Headspace Gas Chromatography (GC) for:

Compound Rpt. Limit Compound Rpt. Limit

Acetone 5.0 mg/dL Isopropanol 5.0 mg/dL
Ethanol 10 mg/dL Methanol 5.0 mg/dL

NMS v.18.0

D0622018CR002003 DISCOVERY PAGE 995



AUTOPSY BODY DIAGRAM

NAME: DOD: DOA:

TOD: TOA:
CASE: DOB: AGE:

COUNTY: ASST:
Clothing:
Medical:

Marks & Scars:

Rigor: + / -

Livor: + /-

HEIGHT: WEIGHT: BMI:

D0622018CR002003 DISCOVERY PAGE 996

 EXTERNAL EXAMINATION

1) HEAD:
i) HAIR COLOR: BROWN BLONDE RED GRAY
ii) HAIR LENGTH: CM
iii) DISTRIBUTION: NORMAL MPD RECEDING PULLED BACK
b) EYES:
i) COLOR: BROWN BLUE GREEN HAZEL
ii) PUPILS
(1) SYMMETRIC: CM
(2) ASYMMETRIC: R= CM L= CM
iii) SCLERAE:
(1) WHITE
(2) CONGESTED
iv) PETECHIAE:
(1) CONJUNCTIVAL: Y N
(2) SCLERAL Y N
c) NOSE:
d) ORAL CAVITY:
i) DENTITION: NATURAL: G F P ABSENT: DENTURES: U L
ii) PETECHIAE: Y N
2) NECK: MIDLINE DEVIATED LYMPHADENOPATHY: Y N
3) CHEST: MALE FEMALE ABNORMAL:
4) ABDOMEN: FLAT MILD MOD MARK PANNUS: FLUID: Y/N
5) EXTERNAL GENITALIA:
a) MALE: CIRC UNCIRC TESTES
b) FEMALE:
6) EXTREMITIES:
a) UPPER; NAILS: CLEAN/DIRTY G F P
b) LOWER: NAILS: CLEAN/DIRTY G F P
7) BACK AND SACRUM:

D0622018CR002003 DISCOVERY PAGE 997



ABNORMAL FINDINGS:

INTERNAL EXAMINATION

BRAIN: SDH: SAH EDEMA:

HEART: LAD: LCX RCA THROMBUS

R LUNG: FIRM: THROMBUS: EDEMA:

L LUNG: FIRM: THROMBUS: EDEMA:

LIVER: GB: NODULAR: FATTY:

SPLEEN:
R KIDNEY: EASE MODERATE MARKED SURFACE

L KIDNEY: EASE MODERATE MARKED SURFACE

URINE:

GYN:

STOMACH:

APPY: Y N

D0622018CR002003 DISCOVERY PAGE 998

 DIAGNOSES:
I.

II

III

IV

COD:

MOD:

D0622018CR002003 DISCOVERY PAGE 999

 Michael A. Burson, MD PhD
Forensic Pathology Consultant

P.O. Box 419 Monday-Friday

Loveland, CO 80539 8 am to 5 pm
E-mail: [email protected] (970) 820-4126
After-hours:
(970) 820-4151
Fax:
(970) 820-2509

AUTOPSY REPORT

Name of decedent: Shanann Watts Case#: AW18-155

Investigation#: WCCO 18-435

Date and time of death: August 16, 2018 at 0005 hrs (pronounced)

Date and time of autopsy: August 17, 2018 at 1030 hrs Age: 34 YEARS

Sex: Female

DIAGNOSES:
I. HISTORY OF BEING REPORTED MISSING AND SUBSEQUENTLY BEING FOUND
UNRESPONSIVE IN AN OBVIOUS STATE OF DEATH IN A SHALLOW GRAVE:
A. ASPHYXIATION DUE TO MANUAL STRANGULATION:
1. BRUISING OF THE ANTERIOR STRAP MUSCLES OF THE NECK
(RIGHT > LEFT)
B. MILD TO MODERATE DECOMPOSITION CONSISTING OF GENERALIZED
DISCOLORATION, BLOATING AND SKIN SLIPPAGE
II. HISTORY OF INTRAUTERINE PREGNANCY, SECOND TRIMESTER:
A. LARGELY DECOMPOSED FETUS AND PLACENTAL UNIT
1. FOUND EXPELLED FROM THE GRAVID UTERUS
III. TOXICOLOGY:
A. POSTMORTEM – BASIC, SPLEEN BLOOD:
1. ETHANOL-----------------------------128 mg/dL
2. BLOOD ALCOHOL CONCENTRATION (BAC)---0.128 g/100 mL

TOXICOLOGY:
Reference Lab: NMS Labs
3701 Welsh Road
Willow Grove, PA 19090

D0622018CR002003 DISCOVERY PAGE 1000

WATTS, SHANANN
Weld County, Colorado
Autopsy No. AW18-155 -2-

OPINION:
Based on the history provided and the autopsy findings, the cause of
death is asphyxiation due to manual strangulation by another
individual. The manner of death is homicide.

Michael A. Burson, M.D., PhD

Forensic Pathology Consultant
Signed: September 26, 2018

MB/NW AD: 08/17/2018 AT: 08/19/2018 MD: 09/01/2018 MT: 09/01/2018

D0622018CR002003 DISCOVERY PAGE 1001

WATTS, SHANANN
Weld County, Colorado
Autopsy No. AW18-155 -3-

HISTORY: The decedent is a 34-year-old Caucasian female (DOB:

01/10/1984) who has a largely unknown medical history at the time of
this autopsy. Reportedly, the decedent returned home from a business
trip on the early morning hours of August 13, 2018. This was the last
time she was seen alive. The decedent was subsequently reported missing
on the afternoon of August 13, 2018. Following an extensive search and
investigation by law enforcement, the decedent was found unresponsive
in an obvious state of death in a shallow grave in rural Colorado. The
decedent was pronounced dead at the gravesite at 0005 hours on August
16, 2018.

WITNESSES: Personnel present for the postmortem examination include

Michael Burson, MD PhD, Pathologist and Joey Weiner, Autopsy Assistant.
For a complete list of individuals present at the autopsy, please see
the investigative report file held at the Weld County Coroner’s Office.

District Attorney Disclaimer: At 1010 hours on August 17, 2018 the

representative from the District Attorney’s Office read a portion of an
email which he received from the Public Defender’s Office. In this
email the Public Defender has requested that we swab the necks of the
children for residual trace DNA. According to him and his expert DNA
witness, they anticipate trace DNA being preserved on the neck
structures of the children despite being confined in a container of
oil, water and associated sludge matter over the course of several
days.

IDENTIFICATION:
• By the Weld County Coroner, State of Colorado.

CLOTHING: The decedent is received in a sealed body bag (seal# 0420295)

and clad in the following clothing items:
• A purple t-shirt
• A pair of blue underwear
• A black bra
• A white metal piercing in the left naris
• Paper bags are around each hand

D0622018CR002003 DISCOVERY PAGE 1002

WATTS, SHANANN
Weld County, Colorado
Autopsy No. AW18-155 -4-

IDENTIFYING MARKS AND SCARS:

• None visualized

EVIDENCE OF MEDICAL/SURGICAL INTERVENTION: Evidence of medical/surgical

intervention consists of the following:
• None

EVIDENCE OF INJURY

EXTERNAL EVIDENCE OF INJURY:

• Possible patterned abrasions of the neck and left aspect of the
face (see below)

INTERNAL EVIDENCE OF INJURY:

• A 1 cm area of probable bruising on the anterior subcutaneous neck
tissue
• Bruising of the superior aspect of the right sternocleidomastoid
muscle
• Bruising of the soft tissue and fascial tissue of the surface of
the right thyroid cartilage
• Bruising of the soft tissue associated with the right horn of the
thyroid bone, which is intact

GENERAL EXTERNAL EXAMINATION

The autopsy is commenced at 1030 hours, on August 17, 2018 on the body
of Shanann Watts at the McKee Medical Center, Loveland, CO. This
autopsy is performed at the request of the Weld County Coroner, State
of Colorado. The body is that of a well-developed, well-nourished
although decomposing Caucasian female whose appearance is generally
consistent with the reported age of 34 years. The body measures
approximately 67-inches long and weighs 144 pounds.

The body exhibits mild to moderate decomposition consisting of

generalized discoloration, bloating and skin slippage.

At the time of autopsy, rigor mortis is released in the major muscle

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WATTS, SHANANN
Weld County, Colorado
Autopsy No. AW18-155 -5-

groups. Livor mortis is not readily apparent due to postmortem

artifact. There is however an area of blanching on the right aspect of
the abdomen extending along the groin to the right thigh. This is
likely consistent with an area of pressure, based on the body
positioning at the time of discovery.

HEAD: Head hair is brown, normally distributed although sloughing from

the scalp and measures approximately 30 cm long over the crown. EYES:
The eyes are moderately opacified (postmortem artifact). The irides
appear brown; the pupils are equal at 0.4 cm. The sclerae are dull
although white. There are no discernible scleral or conjunctival
petechiae. NOSE: The nose is midline although dried. It does not grate
upon palpation. ORAL CAVITY: The oral cavity contains natural dentition
in good repair. There are no discernible buccal mucosal petechiae. The
lips exhibit mild drying artifact.

NECK: The neck structures are midline and without palpable adenopathy.
There is a linear array of variably sized, purple-black, circular
defects which extend from the inferior aspect of the chin, along the
jawline, up the left aspect of the face, towards the left temporal
area.

CHEST: The breasts and nipples are normal adult female without palpable
masses.

ABDOMEN: The abdomen is moderately protuberant and tense. There is no

detectable fluid wave.

GENITALIA: The external genitalia are largely normal adult female,

however the internal genitalia are protruding through the vaginal
vault. This likely represents prolapse of the uterus due to pregnancy
and postmortem artifact. Adjacent to the probable uterus is a largely
degraded portion of tissue which is unfortunately covered in sandy
debris from the gravesite. Upon further examination of this tissue, it
is revealed to be a largely decomposed fetus. Gender and age cannot be
determined, however it has the following measurements: crown/rump
length of approximately 10.5 cm and a foot length of approximately 0.7
- 0.8 cm. There is an approximate 17 cm umbilical cord extending to a
disrupted placental disc. The membranes are ruptured and covered with

D0622018CR002003 DISCOVERY PAGE 1004

WATTS, SHANANN
Weld County, Colorado
Autopsy No. AW18-155 -6-

sandy debris. Portions of the placenta, umbilical cord and membranes

will be retained and the fetus will be transferred to the jurisdiction
of CBI for subsequent genetic analysis.

EXTREMITIES:
UPPER EXTREMITIES: The upper extremities are well-developed and
symmetrical with all digits present. The fingernails are long and in
good repair although markedly dirty with sand and debris from the
gravesite. The fingernails are pulled and retained as evidence by law
enforcement. LOWER EXTREMITIES: The lower extremities are well-
developed and symmetrical with all digits present. The toenails are
short and in good repair with the exception of abundant sandy debris
from the gravesite.

BACK AND SACRUM: The back and sacrum are unremarkable.

GENERAL INTERNAL EXAMINATION

The body is opened with a routine thoracoabdominal incision. The

subcutaneous fat measures 2 cm in thickness at the level of the
umbilicus.

BODY CAVITIES: There are no abnormal fluid accumulations or adhesions

in any of the body cavities. The internal organs however do exhibit
marked discoloration and vacuolization due to postmortem artifact. The
internal organs are also markedly dry.

CARDIOVASCULAR SYSTEM: The heart weighs 210 grams. The epicardial

surface is unremarkable. The coronary ostia are patent. The coronary
arteries follow a right dominant distribution. Sectioning reveals no
significant narrowing by atherosclerosis. There is no acute thrombosis.
The endocardial surface and papillary muscles are unremarkable. The
myocardium is red-brown, firm and without fibrosis. The valve leaflets
are thin and pliant. AORTA: The aorta has a normal smooth yellow
intimal surface. There is minimal atherosclerotic streaking noted. The
major branches, including the celiac, superior and inferior mesenteric,
and renal arteries are widely patent. The inferior vena cava is
unremarkable.

D0622018CR002003 DISCOVERY PAGE 1005

WATTS, SHANANN
Weld County, Colorado
Autopsy No. AW18-155 -7-

RESPIRATORY SYSTEM: The right and left lungs weigh 280 and 320 grams,
respectively, and show normal septation. The lung parenchyma is pale
tan-brown and markedly atelectatic. There are no masses or gross areas
of consolidation. The trachea and mainstem bronchi are unremarkable.
There are no foreign bodies or masses. The pulmonary arteries are free
of thromboemboli.

SPLEEN: The spleen is soft and weighs 120 grams. The capsule is intact,
smooth and glistening. The parenchyma is firm, red-purple and smooth.
There are no infarcts, nodules, scars or cysts present.

LIVER AND BILIARY SYSTEM:

LIVER: The liver weighs 900 grams. The capsule is intact. The
parenchyma is firm and red-brown. No masses are detected. GALLBLADDER:
A thin-walled gallbladder contains one well-formed gallstone.

GASTROINTESTINAL TRACT:
ESOPHAGUS: The esophagus has a uniform diameter and intact mucosa.
STOMACH: The stomach is empty. The mucosa is smooth, glistening and
arranged in normal rugal folds. There are no gastric or duodenal
ulcers. SMALL AND LARGE INTESTINES: The small and large intestines have
a uniform dimension and appear unremarkable. The vermiform appendix is
not visualized.

PANCREAS: The pancreas is tan-orange with lobular architecture. There

is no evidence of hemorrhage or saponification.

ADRENAL GLANDS: The adrenal glands have a golden cortex and gray-brown
medulla.

GENITOURINARY SYSTEM:
KIDNEYS: The right and left kidneys weigh 120 and 100 grams,
respectively. The capsules strip with ease. The external cortical
surface is red-purple and smooth. The cortices are well delineated from
the medullary pyramids. The pelves and ureters are nondilated. URINARY
BLADDER: The urinary bladder is empty. The mucosal surface is tan-pink,
moist and smooth. FEMALE INTERNAL GENITALIA: The fallopian tubes and
ovaries are unremarkable. The uterus (480 grams), measuring 19 x 14 x 2
cm, is prolapsed through the vaginal vault. The uterus is opened to

D0622018CR002003 DISCOVERY PAGE 1006

WATTS, SHANANN
Weld County, Colorado
Autopsy No. AW18-155 -8-

reveal a predominantly empty space with membranous fragments remaining.

There is also red-brown fluid and discoloration of the endometrial
lining.

NECK: Traumatic injury has been previously described. The anterior

musculature is smooth and dull. The epiglottis and hypopharynx are
unremarkable. The hyoid bone and thyroid cartilage are intact. The
laryngeal mucosa is unremarkable. There are no masses or aspirated
material. The thyroid gland has symmetrical lobes and appears
unremarkable.

SPINE: The spine has normal configuration. There is faintly visible

hardware involving the anterior aspect of the cervical spine at the
level of C6. There is no soft tissue hemorrhage or other abnormalities
associated with this prior surgical site.

SKULL AND BRAIN: Reflection of the scalp reveals areas of congestion

and discoloration which are likely associated with postmortem artifact.
There is no evidence of discrete hemorrhage, contusions or lacerations.
Reflection of the skull reveals no evidence of epidural or subdural
hemorrhage. There is no subarachnoid hemorrhage. The brain is markedly
soft and discolored (postmortem artifact) and weighs 1080 grams. The
cerebrovascular system has normal configuration. The cranial nerves are
symmetrically intact. Serial coronal sections through the brain reveal
no areas of hemorrhage, contusion or mass lesion within the cortex,
white matter, brainstem or cerebellum. The atlanto-occipital joint is
intact. The cervical spinal column has normal mobility.

SPECIMENS OBTAINED

SPECIMENS: Specimens retained at the time of autopsy include blood

obtained from the spleen. Representative sections of major organs are
also retained.

TOXICOLOGY: Blood obtained from the spleen is submitted to NMS Labs for
analysis.

D0622018CR002003 DISCOVERY PAGE 1007

WATTS, SHANANN
Weld County, Colorado
Autopsy No. AW18-155 -9-

EVIDENCE:
• The fetus is transferred to the Colorado Bureau of Investigation
for genetic analysis if warranted in the future.
• Swabs:
o The palmar surfaces of the hands
o Anterior and lateral neck surface
o Face
• X-rays: AP and lateral views of the head and neck
• Bilateral fingernail clippings
• Deoxyribonucleic acid blood spot card (DNA)

HISTOLOGY: Sections of heart, lung, liver, kidney, brain, right

sternocleidomastoid muscle, right sternothyroid muscle, soft tissue
from the surface of the right thyroid cartilage and right lobe of the
thyroid are submitted for histology.

MICROSCOPIC EXAMINATION

**ALL TISSUE SECTIONS EXAMINED SHOW MARKED POST MORTEM AUTOLYSIS

D0622018CR002003 DISCOVERY PAGE 1008