We Now Know Gabby Petito’s Cause of Death

Brent Blue, MD, the coroner of Teton County, Wyoming, gave a press conference on Tuesday updating his office’s findings in the Gabrielle Petito death investigation. About a month ago, he announced the manner of death as a homicide and said that determination of the cause of death was pending additional investigation following the completion of the autopsy. In this week’s news conference, Blue reported that he had certified the cause of death as strangulation. He refused to say whether the strangulation was manual or ligature, or to discuss any anatomic findings that might support this diagnosis. When pressed by reporters, he reiterated several times that Wyoming statutes bar him from releasing to the public any more information than the cause and manner of death.

Blue did, however, answer some press questions about the investigation. In his answers we learned the following:

• Petito’s dead body was “outside” and “in the wilderness” for 3 to 4 weeks
• Blue would not specify whether or not the body had been buried, nor would he say if there was decomposition or postmortem predation by scavengers that would complicate interpretation of the autopsy findings
• Petito was not pregnant when she died
• A full-body CT scan was done
• FBI agents took DNA samples and specimens for consultation with a forensic entomologist
• The postmortem examination was not performed by Blue, who is a doctor of emergency medicine, but by a forensic pathologist; this pathologist prepared the autopsy report
• Blue consulted with an anthropologist and received the report of a toxicologist
• The coroner’s office will not be making the toxicology report public; however, intoxication was notably absent in the cause of death and was not mentioned as a contributing cause
• The coroner had not completed the death certificate at the time of the press conference
• There would not be an exact date and time of death on the death certificate; Blue explained that Wyoming death certificates allow for an estimated date or an approximate range for the time of death
• The autopsy examination was performed in the coroner’s facility in Teton County, and the body was not sent elsewhere for a postmortem; the body was then returned to a mortuary of the family’s choosing for the disposition of the remains
• When a reporter asked him whether the cause of death was “obvious” from the autopsy examination, and why it had taken him several weeks to rule on the cause of death when the homicidal manner was so readily apparent, Blue replied that “in a situation like this, nothing is obvious … the cause of death required investigation”

The timeline of this death investigation indicates that Petito was last seen alive on August 27 in Grand Teton National Park. Her parents reported that they last received a text from her phone on August 30, though the odd nature of the text — referring to her deceased grandfather by his first name — made Petito’s mother suspect that the text wasn’t from her daughter, or that something was wrong. Petito’s body was recovered in the park near a campsite on September 19. The 24 days between her last being seen alive and the recovery of her body would correspond with the 3- to 4-week postmortem interval cited by the coroner.

If the body had not been buried during this time period and had instead been lying outside in the open, the coroner would have good reason to seek consultation from a forensic entomologist and an anthropologist. Entomologists examine the larvae, insects, and pupal casings that populate and surround a decomposing carcass. Their estimates can narrow a time interval from several weeks down to a couple of days. Anthropologists are consulted when remains are badly decomposed or skeletonized. They have expertise in distinguishing whether defects to the recovered bones are due to inflicted antemortem injury or due to postmortem depredation by scavengers.

The diagnosis of strangulation in markedly decomposed or partially skeletonized remains can be made by the presence of fractures to the bones or cartilage of the neck, and if any soft tissues remain, there may also be evidence of hemorrhage that can be uncovered on microscopic examination of the strap muscles of the neck. The distinct omission of the words “manual” or “ligature” from the cause-of-death statement suggests that the coroner’s pathologist saw some injury to the neck structures, but, given the condition of her body, could not answer to a reasonable degree of certainty which method of strangulation her assailant had employed in killing Petito.

Brian Laundrie, Petito’s fiance, is a person of interest in this case. I expect that if the police find him, he will likely be charged with her murder. Given the restrictions on the autopsy findings inherent in Wyoming law, Blue is unlikely to make available any additional information about the postmortem examination until prosecutors file charging documents.

Petito’s parents may make the autopsy report public if they wish. They may also choose to hire someone to conduct a second autopsy. If the Teton County Coroner retained the anatomic specimens that confirm the diagnosis of strangulation, something that is often done in forensic autopsies, then a second autopsy might not yield useful additional information. It is the first autopsy that prosecutors generally rely upon in any case. In this case, that is the autopsy that was performed by a forensic pathologist working for Blue in his capacity as Teton County Coroner. It’s unlikely that Blue will be called to testify to the determination of cause and manner of death. That role will more likely fall to the as-yet-unnamed forensic pathologist who performed the postmortem examination of Petito’s remains.

But these are considerations for further down the line. For now, the priority is the ongoing search for Laundrie, and any new information that surfaces from the public.

Judy Melinek, MD, is an American forensic pathologist and CEO of PathologyExpert Inc. She is currently working as a contract pathologist in Wellington, New Zealand. She is the co-author with her husband, writer T.J. Mitchell, of the New York Times bestselling memoir Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner, and two novels, First Cut and Aftershock, in the Jessie Teska forensic detective series. You can follow her on Twitter and Facebook.