Daniel Pastorek died over two years ago, on Thanksgiving Day, 2020, in a mental health unit in the Allegheny County Jail.
He struggled with housing and suffered from schizophrenia. He was arrested and booked at the jail after failing to appear for an appeal in magistrate’s court on a public drunkenness case. He was 63 years old. Since April 2020, 20 men have died following their incarceration at the Allegheny County Jail.
A month after his death, a public information request was filed for Pastorek’s autopsy. Nearly three years later, that request was granted after a 6-1 decision by the Commonwealth Court determined the county must provide the records to this reporter.
The Allegheny County Medical Examiner’s office did not conduct a full autopsy, or surgical procedure, to determine Pastorek’s cause and manner of death.
Instead, an ‘external review’ of Pastorek’s body was performed, concluding that he died of atherosclerotic cardiovascular disease based on his “clinical history of cardiac issues,” “alcohol abuse” and “mental health issues.”
“They didn’t do an autopsy—they didn’t perform one. They did an external examination. They looked, they took his temp, they found he had no injury,” said Roger Mitchell, the chief medical examiner of Washington D.C. He is the co-author of ‘Death in Custody: How America Ignores the Truth and What We Can Do about It.’
Mitchell said an internal review of a cardiac event, or full autopsy, “is one of the rare cases” in which a pathologist can determine when the heart attack happened and how long it took for emergency services to respond.
“We could find out if someone responded and when. I can tell you from six hours to three days–under the microscope.” he said
[Daniel Pastorek’s records were obtained after a nearly three-year legal journey following a public information request. Read more about Allegheny v Hailer]
The four-page external review does not indicate that Pastorek died in the jail. Nothing in the records provided by the medical examiner describe when or how he was found, when he was incarcerated, or that he died in custody. The review also does not indicate how Pastorek’s referenced medical history was obtained or in what manner it was determined.
The office of the medical examiner declined to comment directly on whether Pastorek’s medical history was based on information provided by the jail except to say, “Medical history is a factor reviewed by the doctor, but it is not always central to the determination of cause and manner.”
Guidance on when a full autopsy is conducted varies from county to county across the Commonwealth, as do the inclusion of narratives describing the circumstances of a death in a coroner or medical examiner’s report.
The decision to conduct a full autopsy is at the pathologist’s discretion, according to both state law and county policy, but, some pathologists and researchers argue a full internal examination should be conducted each time an individual dies in custody
In 2021, Allegheny County Medical Examiner Karl Williams echoed the importance of full autopsies for in-custody deaths when he provided comment after PINJ first reported on Pastorek’s death:
“A complete autopsy is virtually always performed,” for those who die in the jail, Williams said, “Unless the death is clearly natural based on a long-standing and well-documented medical history. Even then, the office will sometimes perform an autopsy.”
For this story, Williams did not directly comment. The medical examiner office provided comment through an email via the county. Decisions to perform a full autopsy are made on a case-by-case basis and “are at the discretion of the doctor assigned to the case,” according to the email. “This is the process for all cases, not just in-custody deaths.”
The medical examiner office declined to comment on Williams’ prior statements to PINJ in 2021.
Pennsylvania law only requires an autopsy to be conducted if, during the course of an investigation, a cause or manner cannot be determined, according to Scott Grim, Executive Director of the Pennsylvania Coroners Association.
Mitchell is principal investigator of the The National Association of Medical Examiners white paper, “Deaths in Custody,” a guidance for investigations which recommends that there should be, “a lower threshold than normal to perform autopsy examinations on deaths in custody.” The information gathered from autopsies conducted for natural deaths could help lower the mortality of prisons, the report concludes.
Without a full autopsy and narrative, researchers and journalists cannot analyze trends across jail deaths or jurisdictions, according to Terence Keel who has reviewed hundreds of autopsies of law enforcement deaths in his nation-wide research for the BioCritical Studies Lab at the University of California, Los Angeles.
“They’re weaponizing your access which prevents you from telling the whole story. They’re promoting a vision of them as a law-abiding jail facility and a law-abiding death investigation system, by only releasing files that put them in a positive light. It is using death records to their advantage,” Keel said.
Mitchell was more conservative in his assessment of the information provided by the county in regard to the death of Pastorek. A natural death determination indicates that an investigator ruled out someone harming the deceased, he said.
“If there was this major appearance of neglect, that death investigation would continue until it remedied the neglect. A natural death that got an external examination is telling you that there are no untoward circumstances that the medical examiner saw to lead to the person’s death,” Mitchell said.
Jonah Walters, post-doctoral researcher under Keel, is based in Pennsylvania and has reviewed autopsies from county jails across the state. Even a natural death, such as a heart attack, should be considered preventable and raise questions, he said.
“This is a 63-year-old who died of a preventable, treatable, disease–he died under constant supervision, with immediate access to healthcare. The fact that he’s died of an apparent heart attack, or of cardiovascular disease in those circumstances demands an explanation,” he said.
Pastorek’s records are the first inmate death records made public in Pittsburgh under Allegheny v Hailer. In August, PINJ submitted a request to the medical examiner for the autopsies of 16 men who died after entering the jail. That request is pending.