Lonnie 'Ted' Binion (AP)

Lonnie Ted Binion, a wealthy Las Vegas resident and former gambling executive, was found dead in his home on September 17, 1998.  Next to him was an empty prescription bottle for Xanax, and it was soon revealed that he'd had a substance abuse problem with heroin.  Once again, the crime scene was poorly processed and based on what live-in girlfriend Sandy Murphy described, a drug overdose was the accepted cause of death.

Accepted, that is, by all but Binion's family.  They believed it was a homicide and they wanted a ruling against Murphy.  They hired a private detective, who called Dr. Baden to review the autopsy report.  He also revealed that a lover, Rick Tabish, had surfaced for Sandy Murphy, and he was deep in debt.  Right after Binion's death, Tabish had been arrested for digging up the deceased millionaire's silver bullion, buried secretly in the desert.  Binion had also told his lawyer the night before he died that he feared that Sandy might kill him.  The ME for Clark County, Larry Sims, did the autopsy and found a large dose of Xanax in Binion's tissues. 

At the time Baden was called in, a cause of death had not yet been issued.  "I reviewed the case," he says, "and because of the circumstances, I thought it could have been a homicidal overdose.  Then, as they were preparing for the preliminary hearing, Sims came down with that ruling, so I thought I wasn't needed anymore.  The family was concerned that Murphy and Tabish would get away with murder and now they had a good ruling.  Yet they asked me to come anyway to take a look at the residence, photos, and slides and give a fuller report."

Baden had no idea then that he'd come to an entirely different conclusion than the ME had.

"I went to the ME's office to look at the photos, and I noticed petechial hemorrhages in the eyes suggestive of suffocation.  I also recognized handcuff marks on Binion's wrist, abrasions around his lips, and marks on the chest that looked like shirt button compression.  That alerted me to the possibility of burking."

William Burke, sketch

In the early 1800s in Scotland, two men had been supplying doctors with specimens for their anatomy courses, and rather than dig up graves, they were just killing people.  They managed to create sixteen cadavers before they were caught.  To prevent leaving marks on the corpse, which would make it less valuable, they'd used a method of suffocation that involved sitting on the chest and holding the nose and mouth closed.  The man hanged in 1829 for this was William Burke, so the method came to be known as burking.

"When I looked at the original toxicology results," Baden recalls, "it turned out that the results I'd been sent had a significant error.  They'd said there was a huge amount of Xanax present, but on the original report, it was only present in therapeutic levels.  So I met with the two prosecutors and said this was awkward because I didn't think he'd died of an overdose.  I mentioned the marks on the body that gave me the opinion that he'd died from burking suffocation.  So now we had two different causes of death from two experts.  They thought about it and decided to use both opinions."

The expert for the defense was a friend and colleague, Cyril Wecht, who agreed with Sims on the drug overdose but believed it was a suicide.  That meant that Baden not only disagreed with the local ME, but also with someone he respected.  While such moments between colleagues are awkward, they happen.  "In some cases, there's room for disagreement," says Baden.  "We all know this."

In the end, on May 19, 2000, the lovers were convicted of first-degree murder.

A conflict among experts over evidence interpretation is nothing compared to the breach of ethics that occurs when doctors protect their own.  Baden has discovered this in cases where he's examined the victims of health care professionals, and one in particular proved to be quite astonishing.