(snipped by me: SBM)
Also, something else to consider is that according to the second opinion posted yesterday from the Arapahoe County Coroner/ME/Forensic Pathologist, the Flexiril is what was found in gastric contents, the amitriptylene and nortriptylene (sp?) were found in tests done on her blood, so doesn't it remain possible that those two COULD have been administered via some sort of creme or patch or something of the sort and not by pills or spiked food/drink? Hopefully I haven't just been misunderstanding what everyone has been saying.
Cornbread, the only way one can have something in the gastric juice/contents would be by consumption - oral. The Flexeril was in the gastric contents, thus the only way she could have taken it was via mouth. It won't show up in the gastric contents UNLESS she swallowed it - that's pretty much the only way to get stuff into your belly.
If the Flexeril was injected, it would have been found in her blood...and while it may have been in her blood to some extent (through absorption), the fact that it was located from testing the stomach contents tells me that it was an oral ingestion.
However, the amitriptyline was NOT found in her stomach contents. That leads me to believe one of three things:
A) it had been ingested, but there was sufficient time for the med to be absorbed, and left no pills or fragments behind;
or
B) it was injected;
or
C) it was administered transdermally
Going on the assumption that it was an ingestion, it almost would have to be in liquid form, because of the amounts found in her blood stream would lead one to believe that death was not too long in coming. Once death occurs, and indeed, with this drug's mechanism of action, gastric emptying is delayed/slowed as the drug takes effect. For there to be no remnants or fragments of pills, I would lean heavily towards it being a liquid simply because the drug effects, the amount of drug, and there being no remnants of pills in the stomach.
Going on the assumption it was an injection, it would have to have been a high concentration, and done intramuscularly and not into a vein. Absorption could be rather quick, especially if there was a fight/struggle, as the use of muscles will increase the release time of whatever's been injected (when you get a flu shot, it's intramuscularly; the reason it hurts so much over the next 24 hours is because the muscle holds the med in it; if one were to use their arm a bit in the day immediately after the injection, the pain is actually less, because absorption is increased, thus limiting the bolus of med sitting around irritating the muscle). Further, to get it into a vein would take a skill level and a stillness of the arm/leg/area that the injection was placed in, and I don't quite see that happening.
If one assumes it was a transdermal gel, one would need to "spike" the material somehow, and then the material (say, a body lotion) would need to be used in enough concentration (e.g. lots of lotion all over the body) for the drug to be absorbed through the skin. I can say that this is an interesting thought/technique, but I'm not sure of the science behind it totally...I'll have to do more research.
So, my conclusion is based on two things: KISS, and location of drug during autopsy. I suspect that the amitrip was either injected, was a forced oral intake, or it was put into something she ate or drank the night she died. Depending on timing and observations of Morgan before she died, I don't really have a clear "winner" in the race, except to say that it would be easier - although less predictable - to have spiked her drink/food before she went to bed.
In re: the Flexeril. I'm more of a mind that this was a forced ingestion, close to the time of her death. I suspect that the flexeril was crushed from tablet form to powder, mixed with something, and then she was forced to drink it. The reasoning behind this is fairly simple: as the amitrip was taking effect, the gastric motility would have slowed. As the gastric activity slowed, digestion and absorption would have similarly slowed.
As the Flexeril *was* found in her gastric contents during testing 6/6/12, I would assume that it was administered a time after the amitrip, and was not fully absorbed because of the gastric slowing, and thus remained in the stomach and found during testing.
I also believe the Flexeril was in a converted liquid form, because there were no pills or fragments of pills, found in her stomach; if she'd consumed either the amitrip or the flexeril in pill form, I would expect to find some fragments due to the gastric slowing. Yet, there were none.
I've wondered about this too. Perhaps he saw that she was alone (or knew she would be, if he did indeed have some sort of bug in the house), and seized the opportunity, meaning only to incapacitate her, and instead killing her?
My difficulty with that is why would s/he bring along powdered flexeril? Would he believe in advance that the amitrip was not taking effect as expected, and knew s/he needed a "chaser" of sorts? Why else bring the flexeril? I don't believe s/he powdered it at Morgan's house, so it would have had to be prepared in advance. Why do that if you thought Morgan would already be incapacitated?
While I'm not ruling the opportunity aspect out, and while I do think this may have been more "accidental" v. deliberate, I don't know why s/he'd bring a prepared drug if he thought the amitrip would be enough...
Of course, we may be dealing with someone who mixed drugs all the time, and/or who believed in being prepared for all circumstances. Or, for some reason, there was advance notice which led to a belief that the flexeril would be needed.
IMHO, Dr. Dobersen's report does quite a lot to substantiate Toni's story and lend her more credibility while doing the exact opposite for the GC authorities, most especially the coroner/pathologist.
SBM
I agree completely. An independent review, by a reputable pathologist, in the same state, saying that he very strongly disagreed with the original report and the original and ammended cause of death to me is very telling.
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Herding Cats
