Dr. Lary Simms, chief medical examiner for Clark County, viewed Ted Binions unclothed body as it lay on the cold, stainless steel table inside the morgue at 1704 Pinto Lane, located only a few blocks from Ted Binions home. It was his job to perform the autopsy on Binions body, as well as collect blood samples and other bodily fluid samples that might be used as evidence in the event that this suspicious death case became a criminal case at some point.
During the external portion of the postmortem autopsy, Simms noted the presence of beard stubble on Binions face, and he guessed that he hadnt shaved for a day or more prior to his death. Binion, he noted, had a condition known as pectus excavatum, in which the chest looks like a small bowl. The condition causes the sternum to depress and the ribs to grow inward toward the spine, giving the appearance that the ribs and surrounding tissue had caved in and never returned to their normal position. He also noted the presence of substantial lividity, the gravitational settling of blood after death, on the right side of Binions body, including Binions right arm and the right side of his face. This observation led Simms to believe that Binion had been lying on his right side for a minimum of four hours prior to the discovery of his body. His belief was based on prior experience and medical literature that suggests that the time frame could have been from six to eight hours. Because Simms also observed fully developed lividity on Binions back, he concluded that Binion had likely been lying in that position, on his back, for an additional two to three hours before discovery of the body was reported and raised the question of whether Binions body had been moved by someone after his death significantly before the paramedics had arrived.
As he continued with the external examination, Simms noted a small circular erosion in the center of Binions chest, a faint discoloration nearly a half-inch in diameter and about the size of a small button. Simms observed two fresh bruises on the right side of Binions body and on the back area, prompting him to believe that they had been caused by recent blunt force trauma. He also noted post-mortem discoloration and skin sloughing in the area of Binions mouth, and he reasoned that the cause could have been a result of chemicals or regurgitation of bodily fluids, but otherwise considered it unremarkable. Simms also observed a small patterned abrasion on the posterior side of Binions right wrist that consisted of superficial lines and measured nearly one half inch in dimension. There were also several single superficial scratches up to three and one third inches in length pressed together in the proximity of the patterned abrasion.
After Simms opened Binions body with the usual y-shaped incision, he observed a one-inch hemorrhage in the left chest. The tongue, epiglottis, and larynx showed no evidence of before death injury. The hyoid bone was intact. In cases of strangulation, the hyoid bone is usually broken, and there is normally bruising if the victim was manually strangled and ligature marks if some kind of device, such as a cord, rope or belt were used. Because the hyoid bone was intact, and because there were no bruises or ligature marks present in the neck area, Simms could safely rule out strangulation as a cause of death.
Similarly, when Simms examined Binions esophagus he found nothing unusual. However, his stomach content consisted of forty milliliters of a gray-brown fluid, but there was no digested food as part of his stomachs contents, nor was there any food particles present. Simms collected the gray-brown fluid from the stomach, and he took samples of the peripheral blood, heart blood, vitreous humor, and liver tissue. Because Ted Binion was known to smoke tar heroin, he also collected samples of lung tissue for further testing.
When the collected samples were sent to an outside pathology lab for testing, it was determined that there was no trace of heroin in the lung tissue. The finding did not mean that Ted Binion had not smoked heroin sometime in the past, but it was an indication that he had not smoked it recently, at least not in the hours or perhaps even days before his death. The results of toxicology tests on the gastric fluids from Binions stomach did, however, reveal a concentration of morphine of 1755 milligrams per milliliter of blood; 13,317 milligrams per milliliter of blood of 6-monogacetylmorphine, a metabolite of heroin; 81 milligrams per milliliter of blood of codeine; and 872 milligrams per milliliter of blood of alprazolam, also known as Xanax. As a result of the toxicology tests revealing high concentrations of heroin and Xanax, it was clear that Binion either ate the heroin and Xanax or nasally ingested it. It was Dr. Simms opinion that Ted Binion died within one to two hours after ingesting the drugs, regardless of how he ingested them. Medical literature regarding oral heroin overdose has shown that death has occurred from significantly smaller amounts being ingested than the amounts found inside Binions stomach.
It is significant to note that throughout all of Ted Binions years of drug abuse, he was never known to snort heroin or to eat it. His preferred method of taking the drug was to smoke it. The fact that such a large quantity of heroin was found inside his stomach served to lend credence to his death being investigated as suspicious. Although Dr. Simms was not able to determine a precise time of death, it was his opinion, based on the postmortem lividity to the right side of Binions body, that Binion died sometime between 5:30 a.m. and noon on Thursday, September 17, 1998. He narrowed the time gap by stating that he believed that Binion probably died between 5:30 a.m. and 10:00 a.m., and his official conclusion was that Binion died because of a lethal dose of heroin and Xanax.
Dr. Ellen Clark, a deputy medical examiner with the Washoe County Coroners Office in Reno, was subsequently asked to review all of the autopsy records regarding Ted Binion. Afterward, she related that it was her opinion that Binions body was moved and cleaned by someone after he died. She cited that the abrasions on Binions face near his mouth were consistent with the face having been vigorously rubbed or cleaned, which differed from Dr. Simms opinion that there was nothing remarkable regarding the sloughing by Binions mouth. She also stated that the absence of purge, or vomit, on Binions body suggested to her that it had been cleaned up after death. It was possible, Dr. Clark said, that changes in the postmortem lividity and pressure patterns on Binions face could have been the result of substantial blunt trauma in the form of sustained pressure subjected to Binions face, perhaps during cleaning. According to Dr. Clark, the injuries to Ted Binions body, specifically the injuries to his face, wrist and chest, were features of postmortem trauma, and therefore also suggest movement of the body after death but before the arrival of death investigation personnel. She believed that Binions body was moved after death from a facedown position to a face-up position.
As part of his inquiry into Ted Binions death, Dr. Simms paid a visit to Binions 8,000-square-foot home. As he moved through the house he observed, from the dining room, which is adjacent to the main living area, that French doors opened onto a veranda that led to the large backyard and pool area. The French doors were the doors where gardener Tom Loveday first observed Binions dogs on the day of his death, the same doors that the disturbed dogs couldnt gain entry through and wouldnt leave alone. When he entered the den from the marble floored dining room Simms noted, from the point where the marble floor ended and turned to carpeting, several dried droplets on the carpeting that he recognized as a gastric contents-like fluid that ran in a linear manner and didnt stop until they reached the area where Binions body was found, yet another suggestion that Binions body had been moved to the location where it was discovered.
Although Dr. Simms had earlier observed some discoloration inside Binions lower eyelids during the autopsy, it was his opinion that these did not consist of petechial hemorrhaging, the telltale dots of blood that would indicate suffocation. He also noted that he did not find any fibers or anything else that would indicate that the drugs had been force-fed to Binion, nor did he find any other evidence that Binion had been suffocated. Even though he considered Binions death suspicious, lacking any substantial evidence at the scene that would indicate foul play, Dr. Simms official opinion as to cause of death was that Ted Binion had died as a result of drug intoxication due to an overdose of heroin and Xanax.