Patient: Thomas, Ky'air A.

Case: 23-0518
DOB: 07/09/2022
Race: African American / Black
Sex: Male
Age: 6 months
Date of Death: 01/28/2023
Time of Death: 23:44
Date of Exam: 01/30/2023
Time of Exam: 09:30
County: Franklin, OH
Identification: Visual (Witness)
Pathologist: Todd Barr, M.D.
Autopsy Procedure: Full
Autopsy Assistant: Katie Tyne

Postmortem Examination Report

CAUSE OF DEATH: Sudden Unexplained Infant Death.

Other Significant Conditions: Unsafe Sleep Environment; post-prandial infant placed face down (prone),
unsupervised, on an adult bed, surrounded by excess pillows and blankets.

MANNER: Undetermined.

FINAL DIAGNOSIS:

1. Sudden Unexplained Infant Death:

1. Birth History:
1. Late preterm infant (gestational age: 36 weeks 2 days; multiple gestation) delivered via
spontaneous vaginal delivery on 07/09/2022 to a 21-year-old G2P0112 mother.
2. Birth weight: 5 pounds 8.5 ounces (2510 grams).
3. Birth length (9 inches (48.3 cm).
4. Mother's Group B streptococcal status unknown.
5. Hypoglycemia, resolved.
2. PerkinElmer Genetics panel negative.
3. Ohio Department of Health Newborn Screening Program (07/10/2022) Risk Level Low.
4. Blood cultures, cerebrospinal fluid (CSF) cultures, Gram stain CSF non-contributory.
5. Gram stain of lung tissue non-contributory.
6. Respiratory panel non-contributory.

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Patient: Thomas, Ky'air Case: 23-0518

7. Skeletal survey negative for acute or healing fractures.

8. Immunizations up-to-date.
9. Toxicology non-contributory.
10. Histological examination is unremarkable.
2. History significant for Ky'air and twin brother Kason were abducted during a carjacking in December of 2022
and found several days later. When Ky'air was found he reportedly did not require any medical attention.
No significant concerns were noted from the encounter.
3. Scene investigation:
1. The circumstances surrounding the death as reported by the Columbus Police Department Detective
following their investigation; the infant was placed/found face down (prone) on an adult bed with
excess bedding and pillows (unsafe sleep environment), unsupervised, and in a post-prandial state.
4. Fine petechiae are noted on the epicardial surface, visceral pleural surfaces of the lungs and on the thymus.
5. Remainder of autopsy is completely unremarkable and reveals no evidence of trauma, foul play, abuse, or
neglect.
6. Status post resuscitation efforts.

OPINION:

Based on all information known to me at this time, it is my opinion that Ky'air A. Thomas, a 6-months-19 day infant
African American / Black Male, died as the result of Sudden Unexplained Infant Death with Other Significant
Conditions including Unsafe Sleep Environment; post-prandial infant placed face down (prone),
unsupervised, on an adult bed, surrounded by excess pillows and blankets.

The circumstances surrounding the death as reported by Columbus Police Department Detectives following their
investigation includes the infant was placed facedown on an adult bed with excess bedding and pillows (unsafe
sleep environment), unsupervised, and in a post-prandial state. It is well documented that infants under the age of
8 months have limited strength in the neck musculature to reposition their airway when encountering possible
obstructions. It is postulated that infants can rebreathe uncirculated air until they are hypoxic (oxygen deprivation to
the brain), increasing the respiratory drive which creates an increased thoracic pressure, thereby creating fine
petechiae to appear on the surfaces of the thymus, lungs, and heart (as in this case), and eventually they become
unresponsive. This is a form of oxygen deprivation (anoxic brain injury), however, because a contributory
component of mechanical or obstructive asphyxia can be neither confirmed nor excluded in this infant’s death as
determined by the investigation and circumstances, the manner of death is best ruled as Undetermined. The
Cause of Death is ruled Sudden Unexplained Infant Death with Other Significant Conditions including Unsafe
Sleep Environment; post-prandial infant placed face down (prone), unsupervised, on an adult bed,
surrounded by excess pillows and blankets.

I hereby certify that I, Todd M. Barr, M.D., Deputy Coroner/Forensic Pathologist, have performed an autopsy on the
body of Ky'air A. Thomas on the 01/30/2023 commencing at 09:30 AM in the mortuary of the Franklin County
Forensic Science Center in Columbus, Ohio.

Columbus Police Department Detectives Darren T. Egelhoff (#1843) and Ronald A. Lemmon, Jr. (#235) were
present for the autopsy.

IDENTIFICATION:

At the time of the autopsy, a yellow/white Franklin County Forensic Science Center identification tag is around the
left ankle.

CLOTHING:

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The decedent is received wearing a slightly soiled disposable diaper. Two yellow metal studs, with clear stones are
present and pierced through the right and left lobes of the ears. They are photographed, packaged, and submitted
to property at the conclusion of the autopsy.

ANCILLARY STUDIES:
Skeletal survey from Nationwide Children's Hospital is negative for acute, subacute, and chronic fractures.
Additional studies include full body LODOX radiography, collection of cerebrospinal fluid, blood, and lung tissue for
culture. Toxicology and histology are also completed.

EXTERNAL EXAMINATION: The body is that of a well-developed, well-nourished African American / Black Male,
whose appearance is compatible with the reported age of 6 months and 19 days. The body weighs 18 pounds
(8150 grams) and is 28.5 inches (72.4 cm) in length.

When examined the body is cool to the touch and unclothed. The body is received within a body bag, supine,
unclad and with therapeutic/resuscitative instrumentation in place. Rigor mortis is absent. Lividity is purple-pink,
fixed, and present on the posterior surface of the body, except in areas exposed to pressure. The skin temperature
is cold due to a period of refrigeration. Additional measurements include:

Head circumference: 17.25 inches (43.8 cm)

Chest circumference: 16.5 inches (41.9 cm)

Abdominal circumference: 16.75 inches (42.5 cm)

Crown-rump length: 18.75 inches (47.6 cm)

Crown-heel length: 28.5 inches (72.4 cm)

Right foot length: 3.75 inches (9.5 cm)

The scalp hair is brown, gathered in multiple pigtails with black elastic bands, and has a normal distribution. The
anterior fontanel is open and soft, and the posterior fontanel appears closed. The facies are unremarkable. The
irides are brown and the conjunctivae are without hemorrhage, petechiae, or jaundice. The sclerae are white and
unremarkable. The external auditory canals, external nares and oral cavity are free of foreign material and
abnormal secretions. The nasal skeleton is palpably intact. The mouth is edentulous in the upper jaw and two
small midline central incisors are in the lower jaw and are in good condition; there is no clefting of the lip or palate.
The lips, gums and frenula are atraumatic. There is no significant tongue tie. The neck is unremarkable, and the
trachea is midline. The anterior and posterior aspects of the torso are unremarkable. The umbilicus is
unremarkable. The upper and lower extremities are without palpable fractures. They are normally developed with
five fingers on each hand and fives toes on each foot. The creases of the left and right hands are unremarkable.
The external genitalia are normal infantile male; of circumcised conformation, and atraumatic. The anus is
unremarkable and patent. There is no icterus.

DISTINGUISHING MARKS:

Scars:

1. Two linear, tan scars, posterior right lower leg, 1 1/2" and 1/2" in length.
2. Multiple punctate, tan scars are noted on the distal and posterior aspect of both lower legs.

EVIDENCE OF RECENT MEDICAL THERAPY:

Evidence of medical intervention includes:

1. An endotracheal tube is in place.

2. An orogastric tube is in place.
3. Three (3) electrocardiogram pads, upper chest, left lower chest.
4. Defibrillator pads (2), central chest, central back.

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5. Compression depth monitor, central chest.

6. Venipuncture marks (2), dorsal left hand, with associated ecchymosis.
7. Hospital patient identification band, right wrist.
8. Intravascular catheter, dorsal right hand, taped in place.
9. Tan oxygen monitors (2), left thumb, left great toe.
10. Intraosseous catheters (2), right and left lower legs.
11. Hospital patient identification tag, right great toe.
EVIDENCE OF RECENT INJURY:

No recent or remote traumatic injuries are identified by the external and internal examinations. The remainder of
the external examination of the head, neck, trunk, and extremities is unremarkable.

INTERNAL EXAMINATION:

BODY CAVITIES: The viscera of the thoracic and abdominal cavities occupy their normal sites. The serosal
surfaces are smooth and glistening. No abnormal fluid collections are present within the pericardial sac or
abdominal cavity. There is approximately 20 mL of serosanguinous fluid in the right chest cavity, and approximately
10 mL of serosanguinous fluid in the left chest cavity. There are no abnormal adhesions or masses present. The
edge of the liver is below the right costal margin; the spleen is above the left costal margin. There is no internal
evidence of blunt force or penetrating injury to the thoraco-abdominal region.

HEAD: The scalp has no galeal hemorrhages. The skull is intact. The dura is smooth and glistening. The
leptomeninges of the brain are translucent. The convexities of the cerebral hemispheres are symmetrical. The
epidural, subdural or subarachnoid space does not contain any hemorrhage. The cerebrum has normal
convolutions, with no flattening of the gyri or deepening or widening of the sulci. There is no evidence of subfalcial,
uncal, or cerebellar tonsillar herniation present. The arteries at the base of the brain are normally developed. The
roots of the cranial nerves are unremarkable. The cut surfaces of the cerebral hemispheres have a grossly normal
cortical ribbon and underlying white matter. The basal ganglia have no gross abnormalities. The brainstem and
cerebellum have no gross lesions or abnormalities. The ventricular system is symmetrical and of normal size and
configuration and contains no blood. After removal of the brain, no fractures are seen within the base of the skull.
The brain weighs 850 grams. There is no hemorrhage in or around the optic nerves.

SPINAL CORD: Serial cross sections through the spinal cord show no gross abnormalities. There is no
hemorrhage around the cervical nerve roots.

NECK: There is no evidence of hemorrhage involving the anterior cervical muscles. There is no blood
extravasation in the pharyngeal tissues, or in the prevertebral fascia. Examination of the soft tissues and large
vessels reveal no abnormalities. There is no evidence of a fracture of the thyroid, hyoid, cricoid, laryngeal,
epiglottic, or tracheal cartilages. The laryngeal, epiglottic, and tracheal lumens are patent. The cervical spine is
stable on internal palpation.

CARDIOVASCULAR: The pericardial surfaces are smooth, glistening, and unremarkable; the pericardial sac is free
of adhesions; there are a small petechiae on the anterior surface of the heart and pericardial sac. The heart is
normal in configuration. The coronary arteries arise normally, follow a right-dominant pattern of distribution. The
epicardium is smooth and glistening with a normal amount and distribution of epicardial fat. The cardiac chambers
and valves exhibit the normal positional relationship; the valves are thin, pliable, and unremarkable. Valve
circumferences are as follows: tricuspid valve = 4.0 cm, pulmonic valve = 3.0 cm, mitral valve = 4.0 cm, and aortic
valve = 3.0 cm. The septa are intact and there are no gross congenital abnormalities. The left ventricular free wall
measures 0.6 cm, the interventricular septum 0.6 cm and the right ventricle 0.2 cm in thickness. The foramen
ovale is anatomically open and probe patent. The ductus arteriosus is anatomically closed. The myocardial cut
surfaces have the usual brown appearance throughout without gross evidence of fibrosis or necrosis. The heart
weighs 41.9 grams.

The great vessels connect to the heart in a normal fashion. The aorta and its principal branches are patent
throughout with no thrombi or zones of significant narrowing present. The vena cava and major tributaries are free

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of thrombi or other abnormality.

RESPIRATORY: The upper and lower airways are free of foreign material or obstruction; the mucosal surfaces are
smooth, tan-pink and unremarkable. The right and left lungs have a normal lobar configuration. The visceral
pleurae are smooth and glistening with numerous fine petechiae on the pleural surfaces. The cut-surfaces are red-
purple (anterior portions of right lung are pink and crepitant), subcrepitant with areas of geographic atelectasis and
dependent congestion; no focal lesions are noted. The pulmonary arteries are free of emboli or thrombi; the
remaining pulmonary vessels are unremarkable. The right lung weighs 104.9 grams; the left 100.3 grams.

RETICULOENDOTHELIAL: The spleen has a normal configuration. The capsule is blue-gray and smooth, without
areas of thickening, covering red-purple, moderately firm parenchyma; the lymphoid follicles are unremarkable.
The lymph nodes are not enlarged. Thymic tissue is present and weighs 39.1 grams; several areas of petechiae
are noted on the surface of the thymus. The spleen weighs 21.5 grams.

DIGESTIVE: The tongue exhibits no evidence of recent injury. The esophagus is free of lesions. The stomach has
a normal configuration with smooth and glistening serosal surfaces. The gastric mucosa is arranged in the usual
rugal folds; the lumen contains an estimated 15 cc of tan-pink fluid without identifiable food, foreign objects, or pills.
There are no areas of ulceration or abnormalities. The small bowel, the colon and the rectum are normal in
appearance. The appendix is present.

HEPATOBILIARY: The liver is normal in configuration. The liver capsule is smooth and glistening, covering tan-
brown parenchyma with no identifiable mass lesions. The gallbladder is of normal size and configuration and
contains trace amount of thin bile. The wall is thin, and the mucosa is bile-stained and velvety. The liver weighs
313.6 grams.

GENITOURINARY: The right and left kidneys are similar. The capsules are stripped with ease from the underlying
smooth cortical surfaces. The renal cortices are of normal thickness and are congested. The cortico-medullary
demarcations are distinct. The medullae are unremarkable. The pelvo-calyceal systems are normal in
appearance. The renal arteries and veins are patent and free of narrowing lesions. The right kidney weighs 22.9
grams; the left 25.1 grams.

The testes, seminal vesicles, and prostate gland are unremarkable.

The urinary bladder is of normal configuration and contains no measurable urine. The mucosa is intact and free of
ulcerations, lesions or trabeculations.

ENDOCRINE: No abnormalities are present in the pituitary, thyroid or adrenal glands. The pancreas is soft and
normally lobulated; the cut surfaces are tan-brown with no identifiable gross lesions.

MUSCULOSKELETAL: The musculature is firm, red-brown and normally developed. No fractures are identified
within the clavicles, sternum, ribs, spine or pelvis.

MICROSCOPIC EXAMINATION:

HEART, TRACHEA, THYROID,

EPIGLOTTIS, LIVER, ADRENAL,
KIDNEYS, SPLEEN, THYMUS, PANCREAS,
BRAIN, MIDBRAIN, SPINAL CORD,
CEREBELLUM: No diagnostic pathology.

LUNGS: No diagnostic pathology.

TOXICOLOGICAL ANALYSIS:

Specimens are collected for toxicology testing; see accompanying toxicology report for details.

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Electronically Signed by Todd Barr, M.D. Forensic Pathologist on 03/08/2023 at 15:14

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