A WHITE MAN in his 30s fell from a ladder at work and broke his back (lumbar vertebral fracture). He was taken to a local hospital where he was given supportive treatment while being evaluated for surgical repair of the fracture. About 4 days after admission, he suddenly became dyspneic, underwent cardiopulmonary arrest, and died. During resuscitation, subxiphoid aspiration using a pericardial needle was performed, revealing blood. The clinicians felt that death resulted from hemopericardium probably due to a ruptured coronary artery aneurysm and certified the cause of death as such. The medical examiner was notified of the death but did not investigate, presumably because a natural cause of death was reported by the clinicians. An autopsy was not performed at the hospital. The body was buried a few days following death.
Hanzlick R, Hutchins GM, and the Autopsy Committee of the College of American Pathologists. Case of the MonthPrivate Autopsies. Arch Intern Med. 1998;158(9):947-948. doi:10.1001/archinte.158.9.947