Rich Piana Autopsy Results Has Been Released

Rich Piana Autopsy Results Has Been Released

Six medical Examiner has done the Rich Piana autopsy, and the causes seems a bit mysterious.

Following the autopsy report provided by Muckrock, this are some a few key details:

Rich Piana Autopsy Results

  • Ascites (accumulation of protein-containing fluid in the abdomen)
  • Necrotic brain tissue (i.e. dead cells)
  • An enlarged heart from a “significant heart disease”
  • Mild coronary atherosclerosis (plaque buildup in the artery walls)
  • Fatty liver
  • Congested thyroid
  • Discolored and congested kidneys
  • Brain edema (swelling)
  • An enlarged heart from a “significant heart disease”
  • Ascites (accumulation of protein-containing fluid in the abdomen)

Here is the full report of the Rich Piana autopsy

10900 Ulmerton Road
Largo, FL 33778
. (Fax 727-5 82-6820)

District Six

Pasco Pinellas Counties


NAME: Piana, Richard CASE NUMBER: 5171418
DATE OF DEATH: August 25, 2017 AGE: 46 SEX: Male RACE: White
INVESTIGATING AGENCY: Pinellas Park Police Department AGENCY CASE 17-61159

DATE AND TIME OF AUTOPSY: August 25, 2017 1130 


1. Cardiomegaly (670 gm) with mild coronary atherosclerosis
Bronchopneumonia with bilateral purulent pleural effusions
Brain with edema, isohemia and necrosis
Yellowish discoloration of skin and sclerae
No recent signi?cant injuries
No hospital admission specimen available for toxicology testing


CAUSE QE DEATH: Undetermined

MANNER DEATH: Undetermined
Noel A. Palma, MD
Deputy Chief Medical Exa er
Date Signed: October 30. 2017


With the prolonged hospital survival time (1 8 days), the signi?cant heart disease revealed at autopsy, the
lack of hospital admission specimens for toxicologic testing (hospital discarded admission specimens
despite speci?c requests for retention), and the reported history of drug use, the cause and manner of
death cannot be determined with certainty.
NAME: Piana, Richard CASE NUMBER: 5171418


The body was that of a septic appearing muscular normally developed white male with the
recorded age of 46 years. The body measured 72 inches in length and weighed 221 pounds. The
body was received nude. The skin had a slight yellowish discoloration (jaundice). The head was
normocephalic and the scalp hair was black, gray, wavy and short. There was stubble brown/gray
facial hair. The eyes had yellowish/icteric sclerae, pale conjunctivae, gray irides and clear
corneas. The conjunctivae had no petechiae. There were no crepitus to palpation over the bridge
of the nose. The external nares were unremarkable. The dentition consisted of natural teeth. N0
lesions of the oral mucosa were identi?ed. The lips had no injuries. The external ears appeared
normally developed. There were no masses discernable in the neck. The thorax was symmetrical
and unremarkable. The abdomen was ?at. The external genitalia were those of an adult male.
The penis appeared atraumatic and appeared circumcised. There was no gross or palpable
cervical, axillary or inguinal The upper extremities were well ?developed and
were symmetrical. The lower extremities were symmetrical and were well -developed. The
extremities had no edema. There were no missing digits. The back was atraumatic. No visible
scars were on the anterior aspects of the wrists. Tattoos were on the torso, extremities, neck,
eyelids and sides of face/ sideburns. The mid-upper back region had a focal area of
decubitus ulcer.


The mid anterior lower neck had a tracheostomy and a tracheostomy tube. The mid left upper
abdomen had a PEG tube. The medial aspect of the right arm had an IV catheter. An indwelling
catheter was protruding from the urethra. The right wrist had hospital ID and DNR bracelets. A
rectal tube was in place.




No abnormality was noted in the re?ected scalp, calvarium, dura, meninges or the base of the
skull. The gyri were ?attened with no obvious herniation. The cerebral
vascular system was unremarkable. The circle of Willis and other basal vasculature appeared
intact and normally formed. The 1500 gm soft friable dusky decomposing/necrotic
appearing brain was free of gross neoplastic masses. The ventricles were compressed.
The thalamus, the hypothalamus, the basal ganglia, the midbrain, the pons, the medulla and the
cerebellum were normally situated and were atraumatic.


No signi?cant pathological abnormality was appreciated in the cervical muscles, laryngeal
cartilages, or the trachea. No obstructive material or neoplastic masses were in the glottis or the
larynx. The strap muscles and subcutaneous tissue were free of any masses or signi?cant
pathologic abnormality. The carotid arteries and the jugular veins were unremarkable.


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NAME: Piana, Richard CASE NUMBER: 5 171418

Thorax and Body Cavities:

The organs of the thoracic and the abdominal cavities were normally disposed. The thoracic and
abdominal musculatures and subcutaneous adipose tissue appeared normal. The diaphragm was
unremarkable. The sternum, ribs, spine and pelves had no recent fractures. The anterior cervical
spine was palpably unremarkable. The pleura, the pericardial and the abdominal cavities were
free of adhesions. There was ~>200-300 ml of yellowish grayish effusions (purulent pleural
effusions) in the chest cavities and ~>400 ml of clear yellowish ?uid in the peritoneal cavity

Cardiovascular System:

The 670 gm heart had a normal con?guration and an unremarkable epicardial surface. The
coronary arteries were normally developed and had mild atherosclerotic disease. The myocardial
cut surfaces had no ?brosis, infarctions or focal lesions. The chambers were not dilated. The
atrial and the ventricular septae were intact. The heart was enlarged with the myocardium of the
left ventricle and the right ventricle hypertrophied. The papillary muscles and chordae tendineae
were thickened. The endocardium and heart valves were not ?brosed. The aorta had mild
atherosclerosis. The major arteries and great veins showed normal distribution.

Respiratory System:

The larynx and trachea were essentially unremarkable and were clear of debris and foreign
material. The pleural surfaces of the lungs had no adhesions. There was a slight degree of
anthracotic pigmentation outlining the pleural The right and left lungs weighed 1060
gm and 1000 gm, respectively. The pulmonary arteries were normally developed, patent and
without a thrombus or embolus. The bronchi and bronchioles were unremarkable and were
patent. The lung appeared moderately?markedly congested with scattered areas of
consolidations associated with greenish purulent exudates in the cut surfaces. Air spaces were
not enlarged. No neoplastic masses visible or palpable in the cut surfaces.

Hepatobiliary System:
The 3160 gm liver had a smooth serosal surface and that was yellowish-tan and greasy

in texture from (mild) fatty change with no gross ?brosis, cirrhosis, necrosis, or neoplasm. The
gallbladder was unremarkable.

The 420 gm spleen had an unremarkable capsule and a moderately congested with

no apparent ?brosis, calci?cations, neoplastic masses or necrosis in the There was
no signi?cant
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NAME: Piana, Richard CASE NUMBER: 5171418

Alimentary System:

The omental and the mesenteric fat had no signi?cant pathological abnormality. The esophagus
and stomach appeared grossly unremarkable. The gastroesophageal junction was free of varices.
The esophageal mucosa appeared intact and was free of any ulcers or erosions. The gastric
mucosa was free of ulcers or erosions. The stomach contained 100 ml of tan grayish liquid
material. The visible serosal surfaces of the small intestine, ascending colon, transverse colon
and descending colon appeared grossly unremarkable. No neoplastic masses were palpable
throughout the gastrointestinal tract.

Endocrine System:
The thyroid gland, the adrenal glands and the pancreas appeared unremarkable. No neoplasm,
infarcts or ?broses were grossly identi?ed.

Genitourinary System:

There was no urine in the urinary bladder. Urine was present in the urine drainage bag. The right
kidney weighed 350 gm. The left kidney weighed 350 gm. Each kidney had normal appearing
cortical surface and unremarkable cortico-medullary region, calyceal system and pelvis. No
calculi, neoplasm or in?ammatory process were grossly identi?ed.

Musculoskeletal System:

All the muscles and axial skeleton were free of any signi?cant abnormalities. The skeletal
system and the bone marrow of the ribs and clavicles appeared normal for age and had no
signi?cant pathologic change.

Microscopic Findings:

Lungs (A, B, C) congestion, edema, necrosis, acute and chronic in?ammatory cells, micro-
abscesses, anthracotic pigments, scattered apparent fat emboli, no polarizable foreign bodies
Pancreas (D) unremarkable

Kidneys (D) congestion, rare dark grayish cast-like materials in tubules

Thyroid (D) congestion

Heart (E, F, G, M) myocytes with nucleomegaly and hyperchrornatic nuclei, no myocarditis,
no acute or remote infarcts

Brain (H, I, L, K) edema, necrosis, ischemic changes

Liver (J) =congestion, hepatosteatosis

Spleen (J) congestion
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NAME: Piana, Richard CASE NUMBER: 5171418

no recent significant injuries

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