COMPLAINT / Shashi Gore, M.D.
Sent to Florida Dept. of Health on May 2, 2003 by Francine Yurko
On 29 November, 1997 at 10: 15 A.M., Shashi B. Gore, MD performed autopsy
on Alan Ream Yurko, wherein he attributed the cause of death to subdural
hematoma (SDH) due to Shaken Baby Syndrome. (SBS), and the manner of death
a homicide. This Complaint surrounds the autopsy report and procedure as
well as Dr. Gore's testimony and role in the connected criminal proceedings.
Attached to this Complaint in the form of a compact disc are copies of the
autopsy report, hospital records, trial transcripts, and other relevant data.
It is alleged that Dr. Gore performed a substandard autopsy, cross-contaminated
data and tissue from another case, provided numerous erroneous facts and
false testimony in a First-Degree Murder Trial, and altered evidence after
trial to deflect attention from his errors.
Perusal of the autopsy report will verify the facts enumerated below.
1.) Page 1 and page 3 state decedent was two months old, whereas decedent
was (10) weeks old..
2.) Page 2 states there were no hemorrhages at the thoracic, lumbar, or sacral
spine, whereas page 7 states that there are hemorrhages in the lower thoracic,
lumber, and sacral spine.
3.) Page 6 states that head circumference is 22 cm, whereas decedent was
born with a 31.5 cm head, and just prior to autopsy, decedent is noted to
have a 37.5 cm head.
4.) Page 9 has a description of microscopic examination of inner heart musc1e
tissue, whereas pages 2 & 5 state that the heart was surgically absent
as a result of organ harvesting. Special Procedures on page 6 notes that
blood was obtained at harvesting, but no heart tissue. TransLife records
do not indicate tissue samples saved for the ME. Tissue blocks on file at
Dr. Gore's office do not contain a heart sample. The expert for the defense
in the subsequent criminal trial noted in testimony that heart tissue slides
were not included in the set. Tissue samples of myocardium are not logical
for donor organs. The heart was successfully transplanted.
5.) Page 6 notes a normocephalic head, whereas hospital records note swelling,
bulging fontanelle, and visible edemic/macrocephalic conditions prior to
autopsy. As well, a 22 cm head circumference on a 9 lb. baby would indicate
a microcephalic head. ,
6.) Page 4 notes a contusion of the left lateral surface of the chest, whereas
page 8 states that the skin does not show any subcutaneous contusions of
the buttocks, chest or abdomen. Yet, elsewhere on page 8, a chest contusion
is noted.
7.) No toxicology, virology or bacteriology testing was ordered by Dr. Gore.
8.) Page 10 notes that decedent was a 2 month old black male, whereas he
was a 10 week old white male.
9.) After the criminal trial, Dr. Gore altered his report to state the correct
race without notice to the courts, or involved parties, and thus altered
evidence in criminal proceedings. Dr. Gore testified that the mistake was
a typographical error; however, it should be noted that there are no letters
in the word "black" that are in the word "white." (TT Vol. III p.272; 24
thru p.273; 23)
10.) Dr. Gore testified that he did not seek or review medical history of
the decedent, which would have revealed a 75-hour course of heparin overdose
in an absolutely contraindicated setting (decedent had received iatrogenically
1095 IUs of heparin every five hours, whereas maximum dosage for this infant,
according to the Physicians Desk Reference (2002 and 1997 editions), is only
125 IUs of heparin every five hours; and, as stated, heparin was absolutely
contraindicated due to the high risk of hemorrhage. Furthermore, had Dr.
Gore properly investigated, he would have seen that CT scans revealed only
an
antemortem intra'cranial hemorrhage, 10 hours post terminal hospital course
admission. As well, the CT scans revealed only one "tiny" subdural hemorrhage
occurring in hospital. Therefore, the bilaterality and inclusion of subarachnoid
hemorrhages indicate that these hemorrhages occurred during the hospital
course and could not have been SBS, but were a result of absolutely contraindicated
over-heparinization, infused at 8.8 times maximum recommended allowances.
11.) Dr. Gore testified that he did not, nor did his office, interview the
caretakers or get the medical history/records of the infant-necessary procedures
in diagnosing SBS. Dr. Gore admitted that this was necessary to make the
diagnosis, yet made the diagnosis despite it. (IT Vol. III pp. 246; 20 thru
254; 2) 12.) Dr. Gore testified that he removed the heart, lungs and all
the organs, whereas TransLife removed the heart, liver, pancreas, spleen
and other organs. (TT Vol. III p.218; 14-17, p.246; 2-5 & p.277; 20-23)
13.) Dr. Gore testified that he observed Diffuse Axonal Injury (DAI) in the
decedent; however, the autopsy report makes no mention of DAI. (TT Vol. III
p.280; 2-25, p.281; 1-6)
14.) Dr. Gore testified that DAI is very minute pinpoint hemorrhages in the
brain, thereby providing the court with erroneous definition: DAI involves
no blood or hemorrhage, but rather, injury to brain axons.
(TT Vol. III p.226; 15-25, p.227; 1-4)
15.) Dr. Gore's attention to the medical history would have shown that egregiously
excessive administration of bicarbonate occurred also. Bicarbonate was continuously
infused, despite pH levels of 7.6 and 7.7, accounting for the hypoxic, edematous
and other changes seen intracranially and in the CNS.
16.) Dr. Gdre did not decribe the microscopic appearance of the meninges
or the presence of DAI in the brain or spinal cord.
17.) Dr. Gore presented no description of his x-ray findings of the rib changes.
18.) Dr. Gore presented slides and testified about the old callous of the
5th, 6th & 10th ribs, unrelated to the present condition, as there was
no new callous; yet he notes the 7th as well in his report. (TT Vol. ~1I
p.221; 1- 17)
19.), Dr. Gore's description of the bleeding in the subdural spaces indicates
a 3-5 day process, yet he testified that the bleeding occurred in a few minutes
or seconds. (TT Vol. III pp. 256; 15-20, p.275; 9-25, p.276; 1-3, p.279;
16-25 & p.280; 1-11) ,
20.) The presence of bleeding in the lungs and lower spinal cord is not indicative
of SBS, yet Dr. Gore maintains his diagnosis of SBS.
.21.) Dr. Gore testified that he did not test the cerebrospinal fluid (CSF)
because it was mixed with blood,
whereas his autopsy report notes on page 7 that the CSF was clear. (TT Vol.
III,p. 238; 20-25, p.239; 1-22, p.242; 23-25 & p.243; 1-6) ,
22.) Dr. Gore t~stified decedent did not have meningitis; however, his autopsy
report in'dicate~ that there was meningitis. Tissue samples of the meninges
revealed prominent and acute meningitis. (TT Vol.'III p.278; 9-14) 23.) Dr.
Gore presented photos of decedent in trial and remarked about two bruises
on, the head, thereby presenting evidence not related to the cause of death:
he later admitted that these bruises occurred in the hospital as a result
of handling. (TT Vol. III p.215; 21-25, p.216; 1-18, p.254; '12-25 &
p.255; 1-8)
24.) Neither Dr. Gore, nor his office, performed a crime-scene investigation,
per protocol.
25.) Numerous other discrepancies are revealed when Dr. Gore's autopsy report
and his testimony are
scrutinized and compared by independent analysts.
Dr. Gore's neglect, errors, false testimony, and malfeasant performance led
to a wrongful conviction, placing an innocent man in prison for life without
parole. Moreover, he caused severe mental, emotional, and financial harm
to an already grieving and traumatized family.
Appendix A is contact information for experts who have reviewed the materials
and assert Dr. Gore's negligence, as well as the serious and grave questions
surrounding the integrity of Dr. Gore's autopsy and testimony.
Also attached is an article which reports on an internal investigation which
reveals that, among other things, hundreds of cases in the Medical Examiner's
office were cross-contaminated as early as 1994. This article also points
out that Dr. Gore is not a board certified forensic pathologist. Another
attached article indicates ethical misgivings surrounding Dr. Gore.
Based on the above information, it is clear that an exhaustive and extensive
independent review of Dr. Gore's role in this case be examined and proper
disciplinary action be taken. Dr. Gore's incompetence is a liability to Orange/Osceola
County and a threat not only to his profession and the courts, but to the
families and citizens he serves. It is also noted that the two Orlando newspapers
and three Orlando TV-news stations are reporting the case, as are dozens
of other media sources here and abroad. This elevates the need for exhaustive
review to the level of great public importance. Dr. Gore's long history of
incompetence and unethical practice calls for swift and thorough resolution.
Francine Yurko
PO BOX 585965
Orlando, FL 32858-5965
May 2, 2003
Enc: Complaint
Notarized Release
Appendix A.
Articles re: Dr Gore (2)
Compact Disc/records, transcripts
CC: Loren Rhoton, Esq.
Mohammed A. Al-Bayati, PhD, DABT, DABVT
Harold E. Buttram, MD, FAAEM
Michael Innis, MB.BS, FRCPA, FRCPath, DTMH
File
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