Remember that the summary of the findings of the autopsy report are just that-- a summary of another document. That summary says they will not be releasing any additional information, so presumably they will not release the actual autopsy report.
BK was unconscious/ comatose for 6 months before death, was ventilator dependent, and had many, many invasive medical interventions during that almost 6 months-- including months of ICU level care. She had a trach, feeding tube, and was ventilator dependent, in addition to many other serious and invasive interventions, line placements, and including prolonged intracranial pressure monitoring. IC pressure monitoring would have been discontinued before movement to hospice, and those areas/ ports would begin to heal, but leave evidence of therapy.
The weight of 93 pounds reflects her body weight at time of death, not weight at admission 6 months earlier. Someone in her condition, with a devastating anoxic brain injury, completely unconscious, vent dependent, will lose weight at a rapid pace-- even scavenging muscles such as the diaphragm. You can't pour enough liquid tube feed into patients in that condition to prevent the catabolism, weight loss, and wasting physiological effects of sustained critical illness. IV hyperalimentation/ TPN, or enteral J-tube "tube feeds", are not at all equivalent to eating a normal diet.
Critically ill patients, especially those with devastating brain injuries, are in a sustained hypermetabolic state. She was very thin to begin with, from pictures-- so didn't have much reserve. And from family member comments, she had struggled with drug abuse for quite some time, which can also produce malnourishment and weight loss, among other physiological effects.
From this summary of the autopsy results, it's impossible to draw any conclusions at all about scars or injuries that may have been present BEFORE her OD/ near drowning. The prolonged medical interventions and her anatomical and physiological derangements from being critically ill for 6 months will produce a lot of disfigurement, weight loss, bleeding/ clotting disorders, etc. People who die after sustained critical illness are ravaged, and don't look a thing like their old selves. It's very sad for families. On autopsy reports, scars, disfigurement, bruising, and marks from medical intervention will be recorded as "evidence of therapy".
It's sad that the media has jumped on these isolated bits of info about bruising and scars, insinuating that these were present on admission, or somehow evidence of foul play. Journalists should, IMO, be responsible, and remind readers that she received high level intensive care for 6 months before her death.
We *can* draw conclusions about the presence of the listed drugs at admission, because the ME listed COD as multi substance intoxication, and facial immersion, leading to resuscitation and the sequelae of hypoxic ischemic encephalopathy, with pneumonia.