Final Autopsy and Toxicology Report

Discussion in 'Elisa Lam' started by Conductor71, Dec 31, 2013.

  1. sabpascu

    sabpascu New Member

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    Okay, well it seems I was wrong and any kind of MD in the US and Canada can prescribe psychiatric medication (that's illegal where I live).
    However, most doctors will probably not do it because their license is on the line if something goes wrong especially with that kind of medication and especially if it's a serious problem (like maybe suicide), so they'll refer these patients to psychiatrists. Doctors aren't allowed to practice medicine outside of their training post and hence shouldn't prescribe medication other than in connection with that post.

    Well, usually if there's a chance the dosage will be altered they won't give a refill one. Patients who are on psych drugs must be monitored closely, too, because of the side effects and especially because suicide risk. So it's not like psychiatrists will prescribe you 6 months worth of medication supplies and then you go see them again in 6 months, you'll probably see them sooner than that, maybe once a month or even once a week depending on the severity of your disease.
     


  2. Nickfalzone

    Nickfalzone New Member

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    I know of several friends/family that have been prescribed anti-depressants through their general practitioner, not a psychiatrist. That being said, it sounds like Elisa's doctor was actually a psychiatrist. Which does not mean that she is unable to make mistakes - doctors make mistakes all the time, and this may even be more prevalent in the risk-prone prescribing done in psychiatry. As far as the # of pills she had, I also agree with Conductor's post that the #'s are somewhat irrelevant. Unlike say an allergy or heart medication, psych meds are often under regular adjustment in terms of dosage, and when you are taking 4 psych meds I can guarantee there was quite a bit of adjustment going on. Elisa may also have taken more meds with her than necessary in order to be safe for the trip - ie she may have been only 2/3rds through a previous script before she got a new one. What I'm saying is that it is naive to think that the # of pills in the bottles is an accurate depiction of her either taking too much or too little of the meds. That would be easier to detect through a detailed history with her doctor and/or an autopsy that found levels of certain meds way out of whack. Neither of those happened in this case.

    As a side note, I have been following the details on this case for awhile, and also have quite a bit of knowledge of psych meds, and have come to the conclusion that circumstances at the Cecil combined with the mix of meds created a paranoid schizophrenia type of mindset where she became paranoid about someone following her and she crawled into the tank as a hiding place. Several of the meds she was taking have side effects of paranoia... which is kind of why I have suspect feelings about her prescribing doctor. I believe that due to this paranoia, she felt scared on the street, felt scared anywhere in the hotel, and felt hiding in that spot on the roof would keep her safe from any (likely imagined) threats. I still hold that there is a possibility, say 25%, that she died as the result of another person(s). But the more I read about the case, including some comments from her friends regarding her concerns about "stalkers, creepers" (not just on her social media), and I think she had a genuine paranoia that she was always dealing with (see posts referencing her possible agoraphobia while at home in BC). Something happened on that trip that elevated that paranoia to extreme levels, and she accidentally killed herself in the process. 25% of me still says she was taken advantage of while she was in that state. Unless any further details come to light, that 75/25 estimate will remain my belief in the matter.
     
  3. Backfire

    Backfire New Member

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    It appears Elisa Lam was seeing a psychiatrist through the Student Health Services at her university.

    http://www.bcdoctordirectory.ca/vancouver/doctor-scarfe-sarah-elizabeth-e-8244.html

    We also know from the autopsy that Elisa's sister told authorities that Elisa had suffered with bipolar and depression.

    Elisa also made posts on her blog referring to her Hypomania and depression. She also made a post where she detailed making an appointment with a doctor to discuss Electroconvulsive Therapy.
     
  4. Figuring

    Figuring New Member

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    Respectfully snipped for space.

    Just want to say, I've worked for a mental health hospital for the past 3 yrs and it broad practice for GPs (family doctors without a specialty) to prescribe anti-psychotics etc. I do not know of any current cases where they've been in trouble for it.

    The only thing Drs here (in Toronto, Canada actually, but beyond as well), have actually been on the line for is for prescribing "opioids," which are an addictive pain reliever, not an anti-psychotic.
     
  5. guybrush

    guybrush New Member

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    First time poster, I've read most of the stuff on this case and registered to post my final thoughts about it.

    A ton is probably a bit of an overstatement. I have some experience with the use of GHB recreationally some years back (it has effects similar to MDMA in low doses). It came in liquid form which I understand is common when bought in this context (hence "liquid ecstasy"). For me, around 20ml would get the desired intoxicating effect, but the threshold differs individually. For some anecdotal evidence, a female friend who I took it with fell into a really deep, several hours sleep from only 15ml, to a point where she didn't realize she was put on a sofa under a blanket until she woke up 3 hours later.

    I heard that it's hard to detect GHB in the blood which may or may not be true, but in any case, unless I read the toxicology report wrong, they did not test for GHB or metabolites of it.

    We know from the autopsy report that she did in fact drown. I suppose it is technically possible that she took GHB. Someone could have slipped it in a drink (it does not have a strong taste), or she could have taken it on purpose and overshoot the dosage for the intoxicating effect. She might have then fallen asleep in a bathtub and drowned there, and someone put her in the tank to cover up.

    However, I understand from the previous discussion on the autopsy that transporting a body shortly after death would still result in bruising from being carried, or abrasions from being dragged - but the autopsy does not show such injuries. In order to maintain the drowning elsewhere theory, we would have then have to assume several things about the person who might have carried her. First, they would have to be aware that such injuries would show up in the autopsy and prove a post mortem transport. Second, they would have to care enough to avoid it, which is only likely for long term residents of the hotel, since everyone else would have been long gone by the time the body would be discovered. Assuming it was a long term resident, he would, at the same time, have to be crazy enough to hide a corpse in the water tank that feeds their own tap. And finally, and most importantly, they would have to have a means to transport her up to the roof and onto the water tanks without causing it. At least getting onto the tanks would include scaling a ladder as is clearly visible from the rooftop fotos. I can't even imagine how one would accomplish something like that, maybe using a stretcher and a crane?

    So in order to uphold the transportation hypothesis we have to assume so many other extremely unlikely things, that it makes the hypothesis itself extremely unlikely. "when you hear hoofbeats, think of horses, not zebras."

    My wild speculation as to why she might have entered the tanks is as following (IMO if that's not obvious). We know there was flooding on the floor she stayed on prior to her disappearance. Later on, residents reported water discoloration which is thought to have come from the corpse, but can also be caused by rusty pipes. Others have noted that her strange behavior in the elevator video might point to her hallucinating which would be consistent with her skipping parts of her medication, and her bipolar disorder. In a delusional state, she might have noticed similarities to the film Dark Water, where there is also a corpse in a water tank, and its ghost causes flooding and water discoloration. She might even have interpreted her hallucinations as ghostly apparitions (IIRC, elevators also feature prominently in Dark Water). We know from her tumblr that she loved Left 4 Dead, which is a horror game, so it's very possible she watched horror films as well. She might have then gone to the roof to inspect the water tanks in search for a corpse, and fallen into the tank where she drowned since she couldn't get out.
     
  6. thesetup85

    thesetup85 Member

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    Nice post... BTW... is your screen name from the video game Monkey Island?
     
  7. Bernina

    Bernina Well-Known Member

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    Dr. S.E. Scarfe:

    http://doctorcheckup.org/doctors/profile/6848-Sarah-Elizabeth-E-Scarfe

    "Specialty: Psychiatry - medical field specializing in the prevention, assessment, diagnosis, treatment, and rehabilitation of the mind and mental illness."

    http://www.bcdoctordirectory.ca/vancouver/doctor-scarfe-sarah-elizabeth-e-8244.html

    "Student Health Services Psychiatry University of British Columbia M334-2211 Wesbrook Mall Vancouver BC V6T 1Z3 Canada"

    Dr.s who treat students who are not minors, have doctor/patient confidentiality, and EL's family may have not been privy to her conditions or the extent of them. (Are Chinese families "shamed" for having a mentally ill family member? Could this explain the father's denial of any mental illness?)

    Several of those meds are also used for paranoid schizophrenia/psychosis. Bipolar may also include psychotic episodes. Combined, bipolar can cause the individual to change their attitude and behavior within mere seconds, also become fixated or obsessed (psychosis), and suicidal (depression).

    Having lived with an ex husband with bipolar/paranoid schizophrenia/chronic depression and my current BF with bipolar/chronic depression, this looks like suicide. Removing her clothes most likely was fed by her fixated state.

    I think maybe a review of the culture that EL was brought up in may shed some light on the denial by the father and his intent of having this pronounced anything but suicide. Maybe that attitude, in itself, fueled EL to take her own life, to protect her family from "shame".

    Just an idea............may be worth researching?
     
  8. Montjoy

    Montjoy Inactive

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    This is something that has been mentioned in the threads here several times. It's quite well established that the Chinese culture (forgive the overgeneralized expression) is not especially sympathetic towards mental illness. (This attitude is by no means unique to the Chinese.)

    E.g., from an article in Psychology Today entitled 'Mental Healthcare in China', we read:

    "In Chinese society mental illness is still strongly associated with shame and stigma. And although people's attitudes toward some mental disorders, such as depression or anxiety disorders, have changed a lot because of the increased awareness and knowledge about these disorders, the stigma of schizophrenia is still very severe."

    http://www.psychologytoday.com/blog/the-perfectionists-handbook/201201/mental-healthcare-in-china

    So far as I'm aware, the only statement we have from Elisa's father regarding her mental illness (or presumed lack thereof) was in the Chinese media. It's possible, IMO, that even if a family member was aware of her mental health issues, that s/he might be inclined to deny or refuse them to save face both for him/herself and for Elisa.
     
  9. Bernina

    Bernina Well-Known Member

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    :gthanks:
     
  10. ATHLOS

    ATHLOS New Member

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    Dr. Sarah E. Scarfe is a psychiatrist in Vancuver
     
  11. LisaB

    LisaB Well-Known Member

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    There is a lot of misinformation out there, so I wanted to check in on a few points...
    1. I have read that her clothing was never found, that it was found in the tank, and that it was found on the roof, but only the jacket was wet. The clothing (if found) was covered in a fine particulate matter like sand. Was this part of the water filtration system? It seems unlikely the sand would stay on the clothes the whole time in the tank, and come out with them.
    2. Empty stomach. No sign of pills, including her own prescriptions, though the levels of those medications she was taking for bipolar did show up in the autopsy tox screen, if I understand correctly. She had no trace of alcohol or illegal drugs, including date-rape drugs. Is it possible she WAS given some sort of drug, or took it willingly, and that it had completely metabolized prior to her being placed in the tank?
    3. Why do we think she died right after the video was taken in the elevator? Only because nobody saw her after that and she had the clothing with her that she was wearing in the elevator video?
    4. I have also seen that the tank lids were too heavy for one person to remove, and that they are not a hinged type of cover. So how did she remove it to get into the tank? And how did she put it back on the tank, once inside? That doesn't even seem possible.

    Why couldn't she have been drugged, abducted, taken to a room (hers or another) and KEPT for several days prior to her death? The fact that she was not taking her prescriptions according to the instructions may mean somebody else was administering the medications to her during that time, knowing she took them (this means it would be someone she had taken meds in front of, or to whom she had mentioned that she had to take them). I have read that she lost her cell phone prior to the elevator video. This seems like something that someone might take to prevent her calling for assistance, if, in fact, it was missing. If she'd been held for several days, she'd have had an empty stomach, not byproducts of alcohol or a date rape drug would exist in her system, and she could then have been put in/led to the tank.
     
  12. Heroine

    Heroine Here I come to save the day....

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    I ran across this case today somehow and now I can't get it out of my head. Something just doesn't sit right with me about this. First off, why is it never thought that she was indeed talking to a living being when she's standing outside of the elevator. Her body language to me was that of someone who was frightened. What was she scared of? Why did the elevator not work when she was in there, yet work later on after she left. I get pushing too many buttons can cause it to be slow but to not work at all? Also the ME or coroner making an error stating at first unknown cause then changing it to accident is strange to me. Bipolar disorder won't cause you to jump in a damn water tank. She wasn't schizophrenic. And how did all of her clothes come off? If anything they would be tight fitting with the bloating. And it seems she must have been on her right side in the water more than the left considering the amount of water on the right side of her organs seemed to be more than the left. If so then that makes me think he body was lying on the right, if that is true then it would have been even more difficult for her clothes to have fallen off as her body wasn't in an upright position. IMO.
     
  13. Heroine

    Heroine Here I come to save the day....

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    I agree and have been thinking the same think about opening and closing the water tank. There are just too many questions unanswered IMO
     
  14. the_chosen_one

    the_chosen_one New Member

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    Read through the threads, it has been speculated multiple times that she is talking to someone outside the elevator and many attempts have been made to decipher every little nuances of her behaviour. She presses the door hold button which holds the doors open. The clothes were in the bottom of the tank, but we dont know how they got there because we have neither an eyewitness or video footage. Most likely the clothes were deliberately removed either by EL or whoever. Had she died with clothes on, there is not really a logical explanation as to how they became removed from her body post-mortem.
     
  15. the_chosen_one

    the_chosen_one New Member

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    1. clothing was all in the tank and consistent with what was seen in elevator footage.
    2. possibly. stomach is full of acid and motions would have stopped post mortem, so whatever was in there would have been well and truly dissolved by the time she was discovered.
    3. we don't accurately know with adequate precision to put a time when she died down to the exact hour when you factor in temperature and water issues.
    4. some were hinged, some were lift off lid. I cant remember if EL's one was the lift off lid type, I have a suspicion it was (but could be wrong and CBF'd plowing back through the threads to confirm when it appears you cant be bothered either). There is no reason why one person could not open/close the lid, as they are supposed to be designed in a way to allow one person to be able to do so with one hand (as the other hand will usually be securing the person against a ladder). Regarding the lid being back on the tank, it is possible a maintanence man saw the lid off and replaced it without bothering to look in. It is possible someone knew she was in there and put the lid on. If it was a hinged type, perhaps it could have closed behind her. Perhaps she was hiding for someone and made sure that before she dropped into the tank she was capable of closing the lid behind her to avoid detection. Also perhaps the police report is wrong, or the maintenance man who said the lid was on the tank when he got there didnt really remember? Or didnt want the hotel to look even worse by saying no the lid has been open on the tank so any pollution/junk can be added to the hotels water supply...

    Her MEDS and mobile phone were found in her room by LAPD, although we know nothing of any efforts to retrieve information from the phone. If she had been held for several days, that doesnt inherently mean she would have an empty stomach - whoever was holding her could likely have fed her. It is possible she was not eating properlyof her own accord.

    To play the devils advocate, suppose someone had kidnapped her using drugs and tried to ensure her system was flushed of the drugs by keeping her alive for a few days. the shithole that is the cecil, i think are all shoe box studio apartments... not exactly like you have a basement to leave the body and go about your daily business. It leaves a number of logistical questions:

    - Someone needed to drug EL and transport her to their room without using the elevator and without being detected as acting in a suspicious manner. When was she drugged? After the elevator video? Or was she drugged in the elevator video? If she was drugged in the elevator video how did the person who did the drugging ensure she went to the floor she did before retrieving her?

    - Someone needed to store EL for a number of days, starving her and also providing a mechanism for bowel motions, while also having adequate restraints to prevent her fighting back, attempting to escape or bringing attention to the fact she was being held captive

    - Someone needed to transport EL to the tank without being detected

    Suppose it was some illumanti freemasons satan worshipping clan that occupied an entire floor of the cecil and its administrative staff. Then killing someone in this way would be entirely feasable and no one would ever know unless someone on the inside spoke out about it.

    We dont have enough information to know. The case is effectively frozen unless someone can get inside information/video footage from the cecil employees or LAPD.
     
  16. Heroine

    Heroine Here I come to save the day....

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    Yeah, I haven't had time to go through all of the threads. Sorry about that. However, I did watch some news articles about it. In one article it states that they had to cut a hole in the lid to drain it and get her out and even the news anchor asked well how did she get in and the other anchors says it's a mystery. That's the part that really throws me for a loop. If LE and fire fighters can't even open it to get you out, then how the hell did she get in there in the first place?
     
  17. Nickfalzone

    Nickfalzone New Member

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    Perhaps out of laziness, perhaps out of a lack of substantive evidence to the contrary, but I believe that she got into the tank on her own. With that in mind, I wonder about 2 things: How much water was in the tank when she got in? How did her clothes come off? It is certainly possible that there was only say 1/3 to 1/2 of a tank full of water, in which case she would not have immediately drowned, and could have been alive in the tank for many hours or days. Seems like it would be difficult for anyone to hear her making noise inside. Basically, she would have drowned whenever the water rose above her head, hours, days, or even a week. And the clothes seem strange to me because what she was wearing would not naturally fall off her body in the process of decomposition. It was well-fitting clothes, particularly the hoodie, that would not simply fall off the body. Also the watch, etc. all separated from her body. If she was in fact stuck in the tank, but not drowning, she may have taken it all off herself because it weighed her down. Who knows. The whole thing is so strange from start to finish.
     
  18. the_chosen_one

    the_chosen_one New Member

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    28m0pw0.jpg

    The opening was small, but by no means beyond the capabilities of an average human fitting in, and Elisa was smaller than your average human. If she was forced in we might expect to have seen trauma on the shins/elbows.

    Regarding cutting the tank open, it seems to be the logical way to remove the body and preserve the crime scene. To winch her back out of the hole you run the risk of not only damaging the body/evidence, but also contaminating whatever is already in the tank.
     
  19. the_chosen_one

    the_chosen_one New Member

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    a484aacc7cd98d10093be618203fb80e7aec9081.jpg so i tend to agree with nickfalzone, she entered the tank under her own motion. Had her intention been to go for a swim she surely would have left her clothes/swipe card/watch outside of the tank. The fact she has entered the tank with all of that suggests she was in a rush and was attempting to hide (whether from an actual person or some figment of her imagination). After realising she didnt have a way out, i imagine removing the clothes would have been a response had she not been able to stand and have her head above water. Maybe she also tried to use the clothes to stand on, to block inlet pipes that were delivering new water to the tank, who knows.

    it would be interesting to know if someone in the tank was screaming, how far their voice would travel/would it be detected. With the lid closed, and amidst the backdrop of skid row, not very far i imagine.

    Speculation had also been made previously in relation to the water temperatures atop the cecil in late winter, and from that, it did appear if someone ended up in the tank, hypothermia would have kicked in fairly quickly.
     
  20. Userid

    Userid Well-Known Member

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    They cut a hole in the side of the tank because it obviously would have made removing a limp, lifeless body easier than pulling it from the square hole on the top of the water tank.

    It's my strong contention that Elisa's tank was hinged, because the one directly in front of her tank, has a hinge on the lid. Not only that, but it is also my contention that the lid on Elisa's tank would have opened the same way as the tank directly in front of it also -- because the 2 tanks on the left of the photo are the exact same, as are the 2 tanks on the right side of the photo -- but one pair (the right) differ from the other (the left). The 2 tanks on the right have flat tops; the 2 tanks on the left have somewhat "coned" shaped top surfaces. If you rotate the tank Elisa was found in to match up the hole to the tank in front, you can also find that the hinged lid on Elisa's tank would have been propped open by the one big metal pipe that is connected to both tanks. Rotate Elisa's tank counter-clockwise and you will see what I mean. http://tieryas.files.wordpress.com/2013/05/elisa03.jpg

    It's my contention that Elisa disrobed herself, dropped each article of her own clothing into the square hole of the tank, before entering the tank herself. Whether it was suicide or whether it was her state of mind, we'll never know for certain.

    The lid, having been able to be propped upright (due to the metal pipe), could have simply shut on it's own or been accidentally closed by Elisa herself upon her entrance into the tank (i.e. her arm accidentally flipped/elbowed it closed once she dropped in).
     

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