Mirna-Jessica Case

1. Mirna-Jessica Case Gatot Susilo Lawrence, LAO The Scientific Approach for Reporting Cause Of Death Expert Opinion in Jakarta Court on September 14, 2016

2. Medical Science, of particular Forensic Pathology, is defined as a branch of medicine that deals with the use of medicine in legal proceedings. • In a court of law, cases are won and lost on facts and evidence. In science or medicine, cases are not won or lost on facts or evidence; merely theories are hypothesized and refuted with new observations or experiments [Ken J. Berger. Evidence-Based Forensic Medicine: A Canadian Perspective, R.G. Beran (ed.), Legal and Forensic Medicine, Springer-Verlag Berlin Heidelberg 2013] • Guy Paul Morin Case: The Commission on Proceedings Involving Guy Paul Morin (Kaufman Report). Toronto: Ontario Ministry of the A.G; 1998

3. “ Vietnamese Ice Coffee “

4. Proses Detoxifikasi (MenetralkanRacun) di Hati Maxine A. Papadakis, Michael W. Rabow, Stephen J. McPhee: Current Medical Diagnosis And Treatment 2016

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7. G.Law 02: TRANSLATING PENDULUM HYPOTHESIS2005 Conception Genotype Molecular - Microenviroment MED Genotype Cellular - Microenvironment Pre-Morbus Genotype Organs - Microenvironment Morbus Complication Death

8. Whole body organs cellular subcellular molecular Dissection of a complex trait at different levels of biological organization Phenotypical Level Environment BLOOD PRESSURE LEVEL Environment IPs Environment IPs Environment IPs Environment IPs Genetic Background (Polygenes) Candidate Genes IPs, intermediate phenotypes Camussi A, Bianchi G. Hypertension 1988;12:620-627

9. May WayanMirnaSalihin RIP May God gives us Peace and Truth The Orbis Analysis Translating Pendulum Minum Vietnamise Coffee 6 Jan 16; Jam 17:18 [A14-972; B4-387] Datang ke Klinik Damayanti Cab Grand Indonesia 6 Jan 16; Jam 17:25 s/d 17;30 [A9-526; B4-387] Penggeledahan T4 Tertutup 3 Feb 16; [A4-324] RS Abdi Waluyo 6 Jan 16; Jam 18:00 [A9-529; B9-712] 1 RIP W. Mirna Salihin Penyitaan BB Tersangka 6 Jan 16; Jam 18:30 [B9-712] 1 30 Jan 16; Jam Tidak disebutkan [A4-302] Keluarga minta CT-Brain Pemeriksaan Lab. Kriminalistik PuslabFor 1 6 Jan 16; Jam 19:00 [B9-712] 21 Jan 16; Jam Tidak disebutkan [B3-300] Pemeriksaan Mayat & Pengambilan Sampel Keluarga minta Pengambilan Cairan Lambung 1 6 Jan 16; Jam 19:40 [B9-713] 10 Jan 16; Jam 00:00 [B9-715] S Jenazah disemayamkan 6 Jan 16; Jam 22:00 [B9-713]

10. May WayanMirnaSalihin RIP May God gives us Peace and Truth The Orbis Analysis Translating Pendulum Minum Vietnamise Coffee 6 Jan 16; Jam 17:18 [A14-972; B4-387] Datang ke Klinik Damayanti Cab Grand Indonesia 6 Jan 16; Jam 17:25 s/d 17;30 [A9-526; B4-387] Penggeledahan T4 Tertutup 3 Feb 16; [A4-324] RS Abdi Waluyo 6 Jan 16; Jam 18:00 [A9-529; B9-712] 1 RIP W. Mirna Salihin Penyitaan BB Tersangka 6 Jan 16; Jam 18:30 [B9-712] 1 30 Jan 16; Jam Tidak disebutkan [A4-302] Keluarga minta CT-Brain Pemeriksaan Lab. Kriminalistik PuslabFor 1 6 Jan 16; Jam 19:00 [B9-712] 21 Jan 16; Jam Tidak disebutkan [B3-300] Pemeriksaan Mayat & Pengambilan Sampel Keluarga minta Pengambilan Cairan Lambung 1 6 Jan 16; Jam 19:40 [B9-713] 10 Jan 16; Jam 00:00 [B9-715] Jenazah disemayamkan 6 Jan 16; Jam 22:00 [B9-713] 1

13. Barang Bukti dlm gelas [BB I] : Lihat B3-301 • Barang Bukti dlm botol [BB II}: Lihat B3-301 • Minuman Pembanding [BB III]: Lihat B3-301 • Pipet berisi cairan [BB IV]: Lihat B3-301 5. Toplex isi Lambung [BB I] : Lihat B3-301 6. Toplex isi hati dan empedu [BB VI]; Lihat B3-301 7. Spoit berisi urin [BB VII]: Lihat B3-301

14. Acute Gastritis Chronic Ulcerative Gastritis Acute Ulcerative Gastritis

15. The American Society For Clinical PathologyPolicy Statement. Autopsy (Policy Number 91-01)The performance of autopsy is a professional service of the pathologist to the patient • Deaths in which an autopsy may help explain unknown and unanticipated medical complications. • Deaths in which the cause is not known with certainty on clinical grounds. • Cases in which an autopsy may help allay concerns of the family and/or the public regarding the death, and provide reassurance to them regarding the same. • Deaths occurring in patients who have participated in clinical trials (protocols) approved by institutional review boards. • All obstetric deaths. • All neonatal and pediatric deaths. • Deaths at any age in which it is felt that autopsy would disclose a known or suspected illness that may also have a bearing on survivors or recipients of transplant organs. • Deaths known or suspected to have resulted from occupational or environmental hazards. • Sudden, unexpected, or unexplained deaths in the hospital that are apparently natural and not subject to a forensic medical jurisdiction. Several categories require special consideration. • Unexpected or unexplained death occurring during or following any dental, medical, or surgical diagnostic or therapeutic procedure. • Natural deaths that are ordinarily subject to a forensic jurisdiction, such as persons dead on arrival at the hospital and deaths in which the patient sustained or apparently sustained an injury while hospitalized. • Deaths resulting from high-risk infections and contagious diseases, including AIDS. Pathologists and staff should agree on policies and procedures for handling such cases. • Deaths of organ/tissue transplant recipients who have received a non-living related transplant within 60 days prior to death.

16. England, Wales, Northern Ireland or the offshore islands • Evident trauma; • Cause of death unknown; • Adoctor has not seen the deceased with known disease within the 14 days preceding the death; • The patient died or was certified in an Accident & Emergency department; • Death occurred 14–28 days following surgery (individual coroner dependent); • Death was related to a mishap in hospital; • Industrial disease or acute poisoning.

17. Code of Practice and Performance Standards for Forensic Pathology in New South Wales, Australia • All homicides and suspicious deaths • Deaths requiring attendance by police at the autopsy • High profile deaths or deaths which are a matter of public interest • Cases with identification issues • Skeletal remains • Accidents involving aviation, marine transport, trains and buses • Multiple-death incidents and mass fatalities • Any case requiring disaster victim identification procedures • Workplace-related deaths • Diving and scuba-related deaths • Sudden unexpected infant deaths (see PD2008_070) and deaths of children under the age of 15 years • Maternal deaths • Infectious deaths requiring specific protocols (eg HIV, active tuberculosis, Creutzfeldt–Jakob disease) • Deaths where the person died in circumstances where the person’s death was not the reasonably expected outcome of a health procedure carried out in relation to that person • Deaths of foreign nationals or tourists • All deaths in custody, or police action-related deaths. • Any death outside the practitioner’s normal scope of practice

19. KronologisKejadianKasus 1 of 3 Minum Vietnamise Coffee Apakah = BB I dan BB II: 6 Jan 16; Jam 17:18 [A14-972; B4-387] Datang ke Klinik Damayanti Cab Grand Indonesia • Mata bukaspontan/ kosong • FRqJantung 80 x/min • Napas 16 x/mnt • Tidakmuntah • Tidakperdarahan • Tidakadaurinkeluar • Rx; O2 dgn nasal kanul 6 Jan 16; Jam 17:25s/d 17;30 [A9-526; B4-387] RS Abdi Waluyo • Naditidakteraba • Napastidakada • Denyutjantungtidakada • RJP 15 menit • Tidakadahasil • Pupil melebar • Reflex CahayaNeg • Bibirkebiruan • EKG tidakaktifitas • RIP dihentikan. Pasiendinyatakanmeninggal 18.30, 6 Jan 2016 6 Jan 16; Jam 18:00 [A9-529; B9-712] Sumber: A9-536 ; B9-712

20. KronologisKejadianKasus 2 of 3 Kesan: Tidak ada kelainan Keluarga minta CT-Brain 6 Jan 16; Jam 19:00 [B9-712] 6 Jan 16; Jam 19:00 [B9-712] Keluarga minta Pengambilan Cairan Lambung • Sampel disimpan dalam 2 container, masing masing 10 cc dan diserahkan pada keluarga utuk tindak-lanjut 6 Jan 16; Jam 19:40 [B9-713] Apakah =BB IV ? Jenazah disemayamkan 6 Jan 16; Jam 22:00 [B9-713] • Alm. Mirna disemayamkan di rumah duka 6 Jan 16; Jam 22:00 [B9-713] • Rumah duka di Darmais 6 Jan 16; Jam 21:30 [A9-545] • Ayah Mirna (Dermawan Salihin) izinkan otopsi kpd penyidik Polda • Metrojaya 7 Jan 16; [A9-545] • Rumah duka di RS Darmais [oleh Arif Setiwan Sumarco] 6 Jan 16; Jam 22:00 [A9-553]

21. KronologisKejadianKasus 3 of 3 BB V, BB VI dan BB VII Pemeriksaan Mayat & Pengambilan Sampel 10 Jan 16; Jam 00:00 [B9-715] Pemeriksaan Lab. Kriminalistik PuslabFor BB I: Sisa minuman (gelas) BB II: Sisa minuman (botol) BB III: Kopi Pembanding BB IV: Cairan Lambung ? (pipet) BB V: Lambung (toples) BB VI: Hati dan Empedu (toples) BB VII: Urine (spoit) 21 Jan 16; Jam Tidak disebutkan [B3-300] Penyitaan BB Tersangka Penetapan Penyitaan Barang Bukti Tersangka Jessica Kumala Wongso Nomor : 133/Pen.Pit/2016/PN.JKT.PST. 30 Jan 16; Jam Tidak disebutkan [A4-302] Penggeledahan T4 Tertutup 3 Feb 16; [A4-324] SuratLaporandanPermohonanPersetujuanPenggelendahanTempatTertutuptanggal 3 Februari 2016

22. InterpretasiHasil • BilamanaHasilPemeriksaan • POSITIF: artinya POSITIF mengandungzat yang diperiksadenganmetode standard yang dapatdipertanggung-jawabkansecara professional. • NEGATIF: artinya TIDAK mengandungzat yang diperiksadenganmetode standard yang dapatdipertanggung-jawabkansecara professional. • TidakDilakukanPemeriksaanterhadapsesuatu (jaringan, sel, pewarnaan, ataukomponen) yang seharusnyadipemeriksa, adalahmerupakansuatutindakan yang TIDAK professional (Untukmenghindariperdebatan yang tidak professional)

24. B9-711

25. B9-712

26. B9-713

27. B9-714

28. B9-715

29. B9-716a

30. B9-716b

31. B9-717

32. B9-718

33. B9-719

34. B9-720

35. B9-721

36. B9-722