That Texas law enforcement officials are responsible for her death.
Either through her violent and unlawful arrest, the mishandling of her suicide risk and the mistreatment (or non-treatment) of her documented epilepsy – all of it adding up to lethal culpability and complete negligence for Texas law enforcement.
The brazen dehumanization of the 28-year-old woman was noted by the Harris County’s Medical Examiner, who documented that she still had foreign plant matter on her back, even after three days in custody.
World-renowned forensic pathologist Dr. Cyril H. Wecht was outraged in our interview upon determining that [__Sandra Bland was not even given a shower__](https://soundcloud.com/photographyisnotacrime/sandra-bland-autopsy-reveals-inconsistencies-says-forensic-pathologist-dr-cyril-wecht#t=12:56).
There are two main questions we seek to answer in this article:
Does the Waller County Sheriff’s Office share blame with Texas State Trooper Brian Encinia for Bland’s death on July 10th, 2015?
Was the state trooper merely the provocateur of events by making the unlawful arrest, leading to her subsequent detention and her ultimate death in a cell a few blocks from his bureau?
There is plenty of blame to share here. And it goes way beyond her refusal to put out a cigarette.
After listening to the podcasts of our independent experts, which included two doctors and a former paramedic, you’ll learn that both Sudden Unexplaned Death in Epilepsy [__(SUDEP)__](http://www.epilepsy.com/learn/impact/mortality/sudep) and suicide by lean-in ligature hanging have the same method of death: hypoxia.
One of these doctors is [__Cyril H. Wecht__](https://en.wikipedia.org/wiki/Cyril_Wecht), a high-profile forensics pathologist, who said it is theoretically possible that Bland died from a combination of traumatic brain injury from her arrest during which she exhibited concussion symptoms of hearing loss, a fact [__confirmed by a dramatic witness video__](http://photographyisnotacrime.com/2015/07/texas-sheriff-tried-confiscating-camera-during-violent-arrest-of-sandra-bland-48-hours-later-she-died/).
The initial Harris County medical examiner’s report supports that plausible theory noting a lack of [__hematoma__](http://www.merriam-webster.com/dictionary/hematoma) or broken blood vessels in the brain.
While it’s just another theory, it is very possible that Bland died in her sleep from ([__SUDEP__](http://www.epilepsy.com/learn/impact/mortality/sudep)), then was later hanged by Waller County Sheriff’s Officers in her cell to simulate suicide for a medical examiner’s report by panicked jailers.
Without video evidence, anything is possible.
Sandra Bland: Stripped of her medication
It is also possible that she committed suicide after being denied her epilepsy medication, Keppra, which comes with strong warnings to withdraw gradually.
Furthermore, a cursory google search of the anti-convulsant drug [__Keppra__](http://www.drugs.com/keppra.html) ([__Levetiracetam__](https://en.wikipedia.org/wiki/Levetiracetam)) reveals a suicide risk of “one in 500” according to the drug’s [__official website__](http://www.keppraxr.com/).
That’s more than 20 times higher risk than a normal American’s 10 per 100,000 rate of suicide.
According to our expert interview with Dr. Cyril H. Wecht, it is additionally strongly possible that Bland died from a combination of traumatic brain injury from her arrest, coupled with stress and the denial by jailers of her epilepsy medication.
The long duration of described events would give ample time for jailers to string up the 28-year-old Prairie View A&M University alum after death with a ligature noose.
If the dose of Keppra found in [__Sandra Bland’s blood is found to be significantly below therapeutic levels__](https://soundcloud.com/photographyisnotacrime/sandra-bland-had-epilepsy-did-she-die-from-sudep#t=16:22), there’s an elevated probability that her death was caused by SUDEP; not hanging as is currently purported.
Dr. Wecht said a professional medical examiner can rule the cause of death by exclusion based on a person’s history, if the presented explanation of death is not apparent after a complete autopsy has been performed.
Wecht was [__called to testify__](http://c/) in a case which were brought before the United Nations from an Australian Aborigine who died in custody from a suspicious hanging. In that case, the professional medical opinion of Wecht and his colleagues indicated a mode of death other than suicide, though the death was presented as intentional self-hangings.
Ultimately, there may be many sworn law enforcement officers sharing some of the blame for Bland’s death. However, it’s sadly unlikely they will share punishment for Bland’s tragic early death, which occurred under color of law.
The many documents released by Waller County Sheriff’s Office (WCSO) jailers contradict each other and are a story apart from this report.
They [__do confirm__](http://photographyisnotacrime.com/wp-content/uploads/2015/07/Sandra-Blands-booking-documents1.pdf) that Bland did inform her jailers that she had epilepsy and was on Keppra. Video evidence also [__captures Bland informing Encinia__](http://photographyisnotacrime.com/2015/07/breaking-new-video-show-texas-state-police-officer-lies-to-dispatch-about-sandra-bland-arrest/) that she had epilepsy, which prompted Encinia to say, “good.”
That malicious indifference to her medical necessities evidently continued with her jailers, who do not appear to have made any effort to ensure she would not miss a dose, despite being informed she was on the medication.
And as [__you can read here__](http://www.epilepsy.com/connect/forums/medication-issues/keppra-withdrawal) from other people’s experiences, sudden withdrawal from Keppra can not only lead to epileptic seizures, but to depression, alienation, anxiety and cloudy vision, which is why a gradual withdrawal is recommended, lowering the dose over a period of weeks.
Podcasts with PINAC’s Medical Expert Interviews and Staff Expert
In this story, we will synthesize three podcast medical expert interviews
__1.__[__Interpreting the Autopsy of a purported hanging victim with world renowned forensic pathologist Dr. Cyril H. Wecht__](https://soundcloud.com/photographyisnotacrime/sandra-bland-autopsy-reveals-inconsistencies-says-forensic-pathologist-dr-cyril-wecht) recorded on July 29th, 2015.
https://soundcloud.com/photographyisnotacrime/sandra-bland-autopsy-reveals-inconsistencies-says-forensic-pathologist-dr-cyril-wecht
__2.__[__Sudden Unexplained Death by Epilepsy (SUDEP) with National SUDEP Registry Board Member Dr. Jose Gonzalez-Sandoval__](https://soundcloud.com/photographyisnotacrime/sandra-bland-had-epilepsy-did-she-die-from-sudep) who is also the Medical Director of the Epilepsy Foundation of Florida recorded on July 27th, 2015.
__3.__[__Closed Head Injuries and Blunt Trauma with PINAC Medical Director Felipe Hemming__](https://soundcloud.com/photographyisnotacrime/sandra-bland-report-analysis-with-pinac-medical-expert-felipe-hemming) who has 25 years experience as a Paramedic and EMT Trainer recorded on July 17th, 2015. As this interview was based solely on the original witness video and audio from that smartphone recording, it is the most speculative. However, Mr. Hemming defines the terms and anatomical locations of many potential types of brain trauma.
https://soundcloud.com/photographyisnotacrime/sandra-bland-report-analysis-with-pinac-medical-expert-felipe-hemming
Waller County DA: “Flawed Autopsy”
Harris County Medical Examiner’s [__initial toxicology report__](http://www.nytimes.com/interactive/2015/07/28/us/29toxicology-report-sandra-bland.html) has stirred the most vehement reactions for it’s disputed determination that Sandra Bland ingested marijuana in an initial toxicology report.
It’s also a red herring, deferring the real questions:
*Why wasn’t a suicide watch in place solely when Sandra Bland’s Keppra prescription became known to officials or immediately upon a documented instance of suicidal behavior indicated?*
*Was Sandra Bland unable to access the epilepsy medication Keppra while in custody?*
*Why didn’t Texas jailers allow Sandra Bland to shower once in three days in custody?*
Full autopsy reports contain three parts: a microscopic report, a complete toxicology report as well as a post-mortem physical inspection. Two of the three reports are complete and pending an independent study.
The partial autopsy report released thus far was performed Susan N. Doyle, MD. of the Harris County Medical Examiner’s office.
Major metropolitan city Houston lies at the heart of Harris County. Both located just an hour southeast of the town of Hempstead, which houses the Waller County Jail.
We asked Dr. Werth numerous questions pertinent to any death by hanging, then more specifics about Bland’s unlawful and frightening arrest.
For starters, Werth confirmed that there is a major difference between the mechanism of death by state-sanctioned hanging vs. death by suicide. While state hangings, [__still legal in two states,__](http://abcnews.go.com/US/LegalCenter/story?id=2805323) use force to snap bones leading to death, a suicide, particularly a sit down hanging, causes death by asphyxiation or lack of oxygen to the brain.
Many have focused on the lack of petechiae in Bland’s autopsy report, those telltale markers of death by asphyxiation.
Dr. Werth explained that those marks, caused by the bursting of small blood vessels leading to distinctive red dots in the skin are typically found in hanging cases.
However, Waller County Prosecutor Warren Diepraam, who likely never spent a day in medical school, told reporters [__during a press conference__](http://www.chron.com/news/houston-texas/article/Waller-County-authorities-to-release-more-details-6401698.php) that petechiae is not consistent with hangings, a statement initially reported by the New York Times before they decided to remove it.
Initially, the [__New York Times__](http://www.nytimes.com/2015/07/24/us/autopsy-of-sandra-bland-finds-injuries-consistent-with-suicide-prosecutor-says.html?_r=0) posted the following as documented by [__Slate:__](http://www.slate.com/blogs/the_slatest/2015/07/23/sandra_bland_autopsy_suicide_indicated_thusfar_rather_than_homicide_officials.html)
> “In a violent homicide or a murder,” Mr. Diepraam said, “it is typical to see some sort of injuries on the person’s hand, defensive injuries.” But the medical examiners “found no evidence whatsoever of any injuries on Miss Bland’s hands.”
> When a person is strangled by someone else, he said, there are usually multiple signs of struggle, like petechiae, or tiny hemorrhages, in the eyes and mouth, and involuntary bite marks in the mouth, but there were none on Ms. Bland. Any object used to strangle her would have moved and slipped, causing multiple marks, but instead, there was “a uniform and consistent ligature mark around her neck,” consistent with hanging.
But if you click on the link to the [__New York Times article__](http://www.nytimes.com/2015/07/24/us/autopsy-of-sandra-bland-finds-injuries-consistent-with-suicide-prosecutor-says.html?_r=0) within the Slate article, you will not find that passage. And if you click [__on this link__](http://newsdiffs.org/diff/942568/942686/www.nytimes.com/2015/07/24/us/autopsy-of-sandra-bland-finds-injuries-consistent-with-suicide-prosecutor-says.html), you can see the edits made by the Times as they updated the developing story.
This is not to say the New York Times is part of the coverup, if there is a coverup, but to point out that perhaps they were not comfortable in maintaining Diepraam’s statements.
Dr. Werth explained that the absence of those marks would make Bland’s autopsy inconclusive, meaning there is no solid evidence as to what caused the death, a result that is not as rare as one would think.
In fact, the [__autopsy for another woman__](http://www.nydailynews.com/news/national/autopsy-inconclusive-n-y-woman-died-custody-article-1.2308043) who died in a New York jail last week was determined to be inconclusive. Raynette Turner, 42, who was arrested for shoplifting, also suffered from health issues where she may have been dependent on medication, including depression and hypertension.
And [__earlier this year__](http://abc13.com/893987/), a 32-year-old man named Jesse Jacobs died from a seizure in a Texas jail cell while serving a 30 day sentence for DWI after he denied his seizure medication and placed on another medication.
The reality is, many Americans take daily medication for a variety of health conditions, but jailers are trained to believe all medication is contraband and all inmates are lying about needing medication.
Werth has his own theories about Bland’s death.
“What she suffered was a concussion, a concussion is a disruption of the neural pathways, it is a break in the synapses along the line of the neural pathways,” said Dr. Werth, “the fact that she had epilepsy certainly could have contributed to this because something of a disruptive, traumatic nature, something of an abrupt concussive nature, could precipitate an epileptic attack.”
He said further that he “heard she was not taken to a doctor to be evaluated for her epilepsy while in the prison.” and while we cannot confirm this as fact, there have been no reports of a physician seeing Sandra Bland at any time before her trip to the Harris County Medical Examiner’s office.
A careful reading of the [__“Custodial Death Report”__](https://www.scribd.com/doc/272598483/Sandra-Bland-in-Custody-Death-Report) notes that Sandra Bland was not taken to a hospital to be declared dead, but rather her death was officially noted by a Justice of the Peace exactly 2 hours and 39 minutes after CPR was ceased.
They didn’t even notify a doctor.
https://soundcloud.com/photographyisnotacrime/sandra-bland-autopsy-reveals-inconsistencies-says-forensic-pathologist-dr-cyril-wecht
