OrlandoSentinel

Ruling in death challenged
By Pamela J. Johnson
Sentinel Staff Writer
October 2, 2002
The director of Orange County Emergency Medical Services has challenged the county medical examiner's ruling
that a handcuffed suspect suffocated because paramedics strapped him facedown on a stretcher.
Dr. Salvatore Silvestri has requested a second opinion in the autopsy ruling that said positional asphyxia killed
Gordon Randall Jones on July 19.
Silvestri oversees paramedics at most Orange agencies that transport patients, including Health Central's Quality and
Physicians Services, which transported Jones after he became combative and was shocked 13 times with a Taser
stun gun by Orange deputy sheriffs. "I frankly think the report is inaccurate," Silvestri said Tuesday.
The autopsy report said Jones, 37, could not breathe because he was lying on his stomach. The report also said
cocaine and the shocks contributed to his death.
In a Sept. 24 letter to Chief Medical Examiner Shashi Gore, Silvestri said the restraints allowed Jones enough
mobility to lift his head, shoulders and upper torso.
Silvestri also questioned why cocaine toxicity was ruled out as the cause of death.
He based his opinion on the autopsy report, hospital records and interviews with EMS crews involved in the
transport from the Rosen Plaza Hotel on International Drive.
During the transport to Sand Lake Hospital, Jones tried to bite, spit and scream at the crew, Silvestri wrote.
When Jones became severely agitated and stopped breathing, a paramedic turned him on his back and resuscitated
him, Silvestri wrote. Jones remained on his back in the ambulance. He died in the emergency room.
Dr. William Anderson, the former deputy chief medical examiner for the Orange-Osceola Medical Examiner's
Office who performed the autopsy, defended his findings.
"The straw that broke the camel's back was strapping him down in the first place," said Anderson, now a pathologist
at the Sarasota-Manatee-DeSoto Medical Examiner's Office.
He said cocaine could not have been the cause of death.
"If he had a cocaine level high enough to stop the heart, it would have stopped it permanently," Anderson said. "But
he was resuscitated."
Anderson said he watched the hotel security tapes andthat Jones did not appear too agitated while being strapped
down. Jones most likely became agitated as he began losing his ability to breathe, Anderson said.
Because Jones was resuscitated after being placed on his back, it strengthens the argument that he died of positional
asphyxia and not a cocaine overdose, Anderson said.
"They didn't bring the level of cocaine in his system down, but they got him in a position where he could breathe
again," Anderson said. "That was the only change. By that time, it was too late."
Sheri Blanton, administrator at the Medical Examiner's Office, said changing an autopsy ruling is rare. Gore, she

said, would consider ordering a second opinion when he returns from a medical examiner's conference Thursday.
Since Jones' death, Silvestri is considering adding a written policy on restraining and transporting combative patients
to the county's medical-treatment policy for paramedics.
Pamela J. Johnson can be reached
at pjohnson@orlandosentinel.com or 407-420-5171.
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