By Alan Prendergast
By Michael Roberts
By Michael Roberts
By Amber Taufen
By Patricia Calhoun
By William Breathes
By Michael Roberts
By Melanie Asmar
On a quiet Sunday morning last February, Jaime Brown arrived at that dark and unthinkable place every young mother dreads. She walked into the room of her three-year-old daughter, Abigail Holland Brown, and found her face-down on her bed. Her skin was cold and blue.
There was no breath, no heartbeat. Abby was gone.
Aurora paramedics and police responded within minutes, but there was nothing that could be done. Abby had a rare genetic disorder that made her prone to grand mal seizures. She'd been hospitalized several times in her short life and put on various medications. In the fall of 2008, Jaime had moved from Durango to Aurora so that Abby could be closely monitored at Children's Hospital. The doctors told Jaime there were fewer than two dozen known cases of girls with her daughter's condition, in which certain chromosomes were either missing or mutated, resulting in developmental delay. At three, Abby's motor skills and vocabulary were those of an eighteen-month-old child.
Yet none of this made the death any less shocking or bewildering to her 25-year-old mother. Abby hadn't had a seizure for four months, and lately she seemed to be making a lot more progress. The day before, on Valentine's Day, she'd visited with friends and had a wonderful time. "When I put her to bed, she was fine," Jaime says. "I went and checked on her, and she was sleeping away just fine."
A bite mark on Abby's lip suggested that there had been a final, massive seizure during the night. But Jaime wanted to be sure. She pressed the police and an investigator from the Adams County Coroner's Office who arrived on the scene that morning. "I asked them if they were going to do an autopsy, because it made no sense to me why she died," she recalls. "They told me that they were."
Jaime had a particularly urgent reason for seeking an autopsy: Abby has a younger sister, Annabelle, now almost two, who shares the same genetic abnormality. Jaime and the doctors at Children's wanted to know more about how Abby died — was it a seizure? heart trouble? a problem with her medication? — because they might learn something that could help in her sister's treatment.
Several days after Abby's death, Jaime received a distressing call from her daughter's neurologist, Carter Wray. Someone from the coroner's office had asked him to sign the death certificate, Wray said. He'd refused, insisting that he couldn't know if she'd suffered a fatal seizure without an autopsy to rule out other causes. But Adams County wasn't planning to do an autopsy after all. The official review of medical records and witness statements had provided no evidence that Abby's demise was anything but a natural death — no signs of abuse, an accident or other factors. The coroner wasn't inclined to probe further in such circumstances, Wray learned.
Adams County Coroner James Hibbard defends his decision in the Brown case. "The county isn't in the business of paying for private autopsies," he says. "I told the doctor we were satisfied with our scene investigation and what we saw in the records. Why would Children's Hospital want my office to conduct a $2,500 autopsy on a child they'd been seeing and tracking on a regular basis? They wanted a free autopsy."
Jaime Brown disputes this. She says the hospital offered to pay for the autopsy and that she authorized the release of her daughter's body to the hospital when it became clear that Adams County wasn't going to investigate further. But instead, for reasons that remain unclear, the body was released to a funeral home. By the time Children's was able to retrieve it and schedule an autopsy, the body had already been embalmed — making efforts to gauge Abby's medication levels and certain other tests useless. The death certificate, signed by a pathologist at the University of Colorado Health Sciences Center, lists her immediate cause of death as brain swelling as a result of a seizure disorder.
Coroners frequently make tough calls about how far to carry a death investigation. Other budget-minded coroners, confronted with similar evidence of an unexpected but natural death, might well have taken the same position that Hibbard did, while still others might consider the medical mystery involved a greater priority. Brown says she understands the county's refusal to autopsy, but she believes the miscommunication and delays surrounding that decision cost an opportunity to help her other daughter.
"That's fine if they don't want to pay for it," she says. "But they just sat there. If they had done their job in a timely way, I think there would have been a different outcome."
In the forensic cop shows on television, including CSI and its many spinoffs, a cadre of highly trained professionals demonstrates on a weekly basis how easy it is to catch crooks and solve fatal mysteries, usually by subjecting a stray hair, carpet fiber, a blood drop or fingernail crud to some elaborate lab analysis. In the real world, the mechanisms of mortality aren't always so obliging. While forensic science has made impressive strides in recent years, it can't provide definitive answers in every death — and in most cases, its resources aren't even utilized. The vast majority of deaths are natural and require little or no investigation. More than 5,000 deaths are reported in Denver every year; on average, autopsies are performed in only 10 to 12 percent of those cases.