Morgan’s Medical Past

I am posting this today, but it will always be available on the upper right hand side at the top of this blog under helpful pages – just click on Morgan’s medical past.

Contrary to what some believe – Morgan’s right to privacy survives her –

  • If there was a medication that was involved in her death then that is a different situation that can become public record.
  • However; if there is a current or past medication that was not a part of her death then her right to privacy with respect to that information is still in full force and effect.
  • The original Toxicology report found ONE MEDICATION and its naturally occurring synthesis. No drugs of abuse, no alcohol, ZERO. Just Amitriptyline AKA Elavil.
  • When Dr. Kurtzman performed the autopsy he reported seeing no pills or pill fragments, this led to the conclusion it could not have been a suicide.
  • Two facts drove our research and seeking out 2ndopinions about Morgan’s death.
    • We had to know what killed Morgan as we have grandchildren and wanted to be sure they were not in any danger from an as yet unknown condition.
    • Dr Kurtzman wrote that in view of the stalking at the time of her death, that should additional information be provided he was open to changing her manner of death.  So we wanted to see if such information existed.
  • The very first 2nd opinion was an opinion with no doubt in her mind that this case was not natural causes, but a homicide.  We were not expecting this and were shocked.  And concurring opinions just kept piling up.  Dr. Kurtzman was resistant to this and the lone voice supporting his conclusion.  As we moved toward finding a cause of death and engaged toxicologists we were again shocked to begin hearing the level of Amitriptyline being described as massive.  Once again Dr Kurtzman was the lone dissenter to find Morgan’s level as insignificant, and continues to this day to believe she was prescribed and taking Amitriptyline daily right up to the day she died, she was not, and this is an irrefutable medical fact.  This caused an immediate issue for us.  That she had amitriptyline levels being accepted as the certain cause of her death and she was not taking amitriptyline.  If she ever had in that distant past that would certainly be part of her Medical History and off limits.
  • We were being advised by other specialists that Morgan’s death was a homicide based on the super high levels of amitriptyline and possibly contributing could be the fear response to stalking.  Meanwhile; Dr. Kurtzman found her death to be caused by Porphyria – DESPITE THE MEDICAL FACT Morgan had never been diagnosed with Porphyria.  Hard enough to properly diagnose in the living, virtually impossible once deceased.
  • Based on expert medical opinions we disagreed with the conclusions being made by Dr. Kurtzman.  This disagreement led Dr. Kutzman to threaten Toni on three occasions to abandon her efforts to see the manner and cause of death corrected from Natural Causes to Homicide.
  • The second Toxicology test run in June 2012 again found Amitriptyline. And also the presence of five other drugs commonly referred to and contained on the standard date rape panel. The levels of two were established and the sample exhausted before the last four could be.
  • In the second autopsy report Dr. Kurtsman admits to the two drugs with established levels, but chooses to ignore the other four, which were definitely present in Morgan, just in unknown quantities.  Any one, or all of these other drugs could have played a role in Morgan’s death.
  • Dr. Kurtzman is credited with having said that upon re-examination of the gastric contents he saw a “granular substance” which he assumed to be Amitriptyline.  This “substance” was not collected, preserved, or tested and is now lost forever.  Based upon this substance and the number of pills he calculated would be needed, in his opinion, he changed her death to a suicide.
  • In the state of Colorado we have been told that to find a suicide requires intent to be established.  This is generally accomplished though multiple assessments and interviews with, doctors, teachers, employers, parents and friends.  No attempt has ever been made to establish intent, a requirement under state law.
  • I have just started to read police reports.  All references to drug use contained are second hand reports, “hearsay”. This is pure speculation.  That Morgan might have tried something once would be one thing.  I seriously doubt if she would have become a regular user of any drug and there is nothing in the report that establishes drug use as a fact.  Quite the opposite, it is a FACT that her toxicology report is completely clean as to any recreational drugs.  One of the Detectives on this case told me there was probably not a person in the Sheriff’s department who had not tried cocaine at least once.  I do not know what he bases this on, but I doubt that it is completely true.  That Morgan could be just one of those people who choose not to do drugs is very difficult for some to believe -but then her lifelong friends all find it easy to believe – perhaps there is something to that.

48 thoughts on “Morgan’s Medical Past

  1. With all the information you have read and kept track of and as Morgan’s mom, the one person in the World who knew the most about her, do you think that someone slipped this drug to her before she came home her last night?
    She was late coming home, she didn’t feel too well, I think u said, and went to her room. Could the drug (med) have already started affecting her? I wonder if the killer found his/her chance that evening.
    Your quest for the true story of your daughter’s death is so needed.
    Thank you for all the time you spend telling us, total strangers, your story.
    There are many of us praying for you daily.

    • Thank you for your encouragement Betsy, This thought was on my mind and asked so many times. The best answer is that the dose she had of Amitriptyline was so large she would have been showing effects within 30 minutes at the most. Steve was talking with her 30 minutes after she came in the front door and would have noticed. But he noticed nothing out of the ordinary, just a happy normal Morgie. It was a long time to accept but the combination of 6 drugs, along with the wound on her forehead, the torn nails, and blood on her lips – this all happened sometime during the night. And for the last week I have been spending time with an investigator painstakingly recreating the last 48 hours and so much more information than I would have ever imagined is coming forth.

  2. I don’t know, Toni from Morgan’s pictures, her likes, her caring character to other’s doesn’t show me at all that Morgan was or has ever used recreational drugs. If some of her friends did, they might have assumed Morgan did too but with my experience growing up in the 70’s (drug crazy times) All my friends either tried it or used it often however I didn’t. If you were to go and interview some of my friends back then I bet 10 to 1 they would all have assumed I did too.

    I’m like Morgan in that I don’t like pills, I rather help my body naturally. Even in my older age while now I do take some prescription medication, I tend to go off them because my body just doesn’t react well with all those fillers in them.

    Another point, even if she had, that has no bearing on this case whatsoever!!!!!!!!!!!!

    That is like blaming a rape victim because she wore a skirt too short.

    God Bless

    • You are right about all that and Morgan was so into everything natural she would even juice in the morning with organic veges and drink out of her own stainless steel or glass water bottle all day – would go to the vapor caves in Glenwood Springs with her Eucalyptus essential oil to steam if she felt a cold coming on, etc. She was much more into natural remedies than I was at the time – I used to be when I was younger.

  3. Well Done Toni!!!

    I’m sorry have i missed something?….. I thought we were living in the year 2012 not 1950 something! You would like to think that in today’s society we have learnt valuable lessons over time, but i am now starting to think maybe we have not.

    WHY ARE WE STILL BLAMING THE VICITIMS……….

    We ALL have a right to medical help, clean water and food, help from the law (as it is there to protect us), freedom of speach and the right to privacy.

    I have to say that i am disgusted and shocked that PRIVATE medical reports and Police reports have been made available for anyone to read. Morgan’s family should have seen these documents first, before being made public. I am sure if it was a member of your family you would have liked to have seen these documents first. It is also about respect for another human being.

    Another issue I have is it seems from comments being made that Morgan is the one under investigation not the person/people responsible. I am a firm believer in the right to prove yourself innocent, but that does not mean that the victim/victims are to be dragged through the mud either. We do not know all of this story yet and Toni will make this available via this blog as she is doing, until then how can anyone know what happened!. We do not have all the information and until we know the entire story, assumptions are being made.

    At the end of the day a tragic thing has happened to this family……….Morgan was stalked/bullied whatever you want to call it for months.THIS IS NOT ACCEPTABLE for anyone to go through. Then Morgan is found dead and the law officals and medical officals who are employed to protect and serve us have not done their job. If this was someone you loved, you would expect that evidence was collected and that the laws your country has in place are being followed. You would want a proper investigation done to find out what happend and that respect, dignity and justice was given to this person.

    We are all reading this blog for the same purpose and that is to find and get justice for Morgan and her family. They deserve it just like anyone else does.

    We all need to change the small town mentality that if you are the victim of a crime then you brought it on yourself or you deserved it. Nobody deserves to have bad things happen to them or their families and until we change this mentality in our communities then it will keep on happening.

    We all deserve to live our lives the way we want to. No one is perfect and we all try new things and experiences and we all make mistakes, but doesn’t that make us who we are. Just because someone does something that you don’t approve of or wouldn’t do yourself doesn’t mean that they deserve bad things to happen to them.

    This family has the right to find out what happened to Morgan and Morgan has the right to justice. Sloppy autopsy results, and sloppy police investigations does not equal justice, respect and dignity for anyone.

    • No worries Bluebird we will find out – it might take a while but we are on the right track and we have so many wonderful people helping us that I just know there will come a day that the whole truth will come out. Thanks for your support!

    • Whoa now! To be fair, all of those docs are available under the FOIA. And Toni has stated a few times that the reports were faxed to her but she hadn’t had the time to read them. (But I think she posted that she finally did this week). Toni and Steve were never prevented from reading the information on those reports. Toni said she made the choice not to. That is different.

      I want justice for Morgan but we have to focus on what is true and what is spin. It only muddies things up when we start calling perfectly legal doings “violations”.

      How do those reports victimize Morgan? They don’t. There is nothing in them that makes her appear to be a bad person. Just a lovely 20-year-old woman who died too soon. Sorry but the misplaced anger gets too scary for me sometimes. 🙂

    • I don’t know if we would ever know the answer to that, but we wondered – don’t know how they could have gotten it into her bottle, and we never found a bottle or anything that could have been used in her room. Her water bottle was still in the car from her drive home that night she didn’t bring it in.

  4. I’m so sorry for your loss, Toni. RIP Morgan.

    I can’t imagine what a shock it must have been for you when you got the 2nd report. Could you share it with your blog followers? The truth could be such a slap in the face for all the nonbelievers. Also I did not know that the medical reports were out for the public to see. That is so not right.

    • It really wasn’t a shock when we received the revised report at the end of August because Dr. Kurtzman knew we weren’t about to back down with so many imminent doctors and another forensic pathologist telling us he was wrong and he threatened me 3 separate times that he could do that but in a way maybe some good came out of it because when he sent her gastric fluid in to be tested (without telling us) thinking it would obviously still come up with amitriptyline like the first lab results what I don’t think he counted on was that that test would come back showing positive for 6 different date rape drugs. Kind of blows his theory of suicide. Then I sent all the results to Dr. Dobersen (Arapahoe County Corner and Forensic Pathologist) and he did the 2nd opinion which you can read on this blog under the date of September 10th.

  5. It must have been such a shock and so heartbreaking when you got the 2nd opinion that it was homicide. Could you share it with us? Was it someone other than Dr. Kurtzman?

    • It was Dr. Michael Dobersen from Arapahoe County – former President of the Coroner’s Association of Colorado and now the Arapahoe County Coroner and Forensic Pathologist. You can see his report posted on this blog on September 10th

  6. I’m curious why the killer was not caught on camera the night of her death? Do you think this was planed or a spur of the moment decision?

    In regards to her medical history, I agree that it is no one’s business. You have already given detailed information about what was in her system when she passed. The only other question that lingers is how she was the month or so before she died. Was Morgan still invested in her health? If so this would discredit a lot of speculation about suicide.

    I feel you have a strong case for the stalking. I hope that in the least the predator will be caught. Murder will be far more difficult to prove. You are starting at the right place by having her manner of death determined. If the Dr. who preformed the original autopsy is correct in his findings, he shouldn’t have a problem with reviews of his work by other qualified medical professionals. If there is ANY doubt it makes perfect sense to reevaluate not only her death but the events surrounding it. The evidence will speak for itself.

    It will all be worth it in the end. I can’t imagine going through what you are to help not only Morgan but other women too. You’re already making a difference! God bless!

    • The month before Morgan was killed she was exhausted and stressed, just like Steve and I were, but she was still taking good care of herself, juicing in the morning, bringing her big water bottle with her to stay hydrated, still going to 2 ballet pointe classes per day + one day per week doing her jazz class. The weekend before she was killed her younger cousin was leaving to go back to college, and stopped by to say goodbye – Morgan was so happy – she had another friend over and Morgan tied on her cute little apron and made cake from scratch for everyone. So no matter what anyone out there thinks – I greatly doubt if they were going through what Morgan went through in that four month period that they would have done better than her – she was strong, she was a fighter, and she loved life, loved her family, friends, pets and niece and nephew. She wasn’t about to go without a fight and I am beyond disappointed in our County for completely failing her…and I don’t want to see them do it again to another person, this has to end!

  7. Amitriptyline, Nortriptyline, Guaifensin, cyclobenzaprine, desalklflurazepam, flurazepam, promethazine (all found listed on the date rape panel when screened for – hers showed up on a comprehensive drug panel) – these were all tested to be positive in Morgan on the 2nd lab test that Dr. Kurtzman ordered on Morgan and from this report he only noted amitriptyline and the cyclobenzaprine (flexeril) and said she committed suicide – I guess he thought maybe no one would read the lab test results that came back or maybe he thought no one would understand what they meant, but either way he was wrong she did not commit suicide she was murdered.

    I love your last paragraph – obviously as a Mom wanting to protect her daughter that would have seemed like a good idea at the time, but I don’t think I would have ever thought of it at that time. I do think people have the right to protect and I do believe people that are being victimized should try all different methods to self empower themselves so they can deal with a stalker, be it self defense classes or tasers or concealed permits to carry.

  8. “The second Toxicology test run in June 2011” – that’s be June 2012, right? Also, just because I don’t know how it all works, wouldn’t waiting for 6 months to do another toxicology test have some effect on levels of things found in the body?

    • i don’t know – maybe, maybe not – it definitely would not make things appear that were not there originally, but maybe they would show up in lesser quantities, because the samples might degrade, but I think a Forensic Pharmacologist could better answer that question.

  9. Leslie – forgot to answer your other question. Dr. Jensen is a holistic doctor – doesn’t like prescription medications, that’s why Morgan went to him. I adjusted her back and gave her homeopathics sometimes but usually it was only an adjustment.

  10. Hi Toni-
    Sorry I keep commenting this morning but I have one other question; what is a “date rape panel”? I didn’t see that mentioned in either of the reports and I have researched and couldn’t find anything called a “date rape panel” in reference to toxicology. This case is getting more and more confusing.

    • My fault – I was looking at two different things when I wrote that – so sorry. It’s called a Sexual Assault Panel and it lists all the different drugs that are used for date rape. Morgan’s sample was run with a Comprehensive Drug Panel because obviously they were looking for things like alcohol or illegal drugs which they did not find in her. I asked them why they didn’t test for other poisons and things and Dr. Kurtzman said that is not something they normally would not test for unless there was an indication or some reason they should. Well excuse me but she died under suspicious circumstances, no rape kit was done, I did not see any notes that he even checked under her nails in case she fought back, and then 7 months later while trying to prove suicide he sends her gastric fluid in for testing and it comes back positive for 6 date rape drugs – and that wasn’t even on the sexual assault panel that they would normally run to find that. I guess he wasn’t expecting that result, but we did see it on the lab results and so did Dr. Dobersen.

  11. As a 20-something woman who had friends in high school who tried drugs and I’ve never ever tried any sort of drug I do believe that Morgan could have/was drug free. It’s sad that in our society we automatically assume that teens/young adults are trying this out. I grew up in the valley and have been following the blog religiously. I keep you all in my prayers.

    • Thanks – I know what you mean…there are a lot of really sad things about how our society reacts to things. I really feel strongly about the newer generation trying to make this a better place, and make all those changes that are so overdue.

  12. Toni – I am 30 and the only drug I have ever experimented with is marijuana (and that wasn’t until I was 21). I have been exposed to drugs many times in the last 15 years and I have never tried or had the desire to try them. I believe that is it very possible Morgan never tried them. I also believe that as her mother you would have known. Just the same as my mother would have known. I talked to my mom about my first experience with marijuana… I have faith that this relationship between my mom and I isn’t exclusive, it exists between other mothers and daughters, as I believe it did between you and Morgan, and Steve and morgan. And yes it is POSSIBLE for kids/teenagers/young adults/adults to go their whole lives without every experimenting with drugs.

    • Natalie – I hope there are a lot of mother/daughter relationships out there that are really good, because at the end of the day your family is always the most important thing you have. Thanks for leaving your comment – I appreciate it.

      • I understood from that article that young woman’s death scene was treated like a crime scene, evidence was actually taken & it seemed like they had witnesses that were interviewed. The Ingrams’ case was not handled properly from the beginning to establish chain-of-command for anything of evidentiary value. Is there a Law Enforcement Review Panel that can help with Morgan’s case? its important to find out who was stalking Morgan independent from proving who was responsible for her death. This type of person needs to be stopped from doing these things. Stalking is a crime that needs to be taken seriously. Especially when it leads to the death of innocent victims. Sending you love & light as always…

  13. Is it possible that Morgan ever received medical treatment/medicine that you were not privy to? That would also fall under HIPPA, and the doctors would not be able to divulge that information to you, even after her passing. I do believe it would be available to the authorities.

    • Jessica if you knew Morgan the answer would have to be a big no – she was still under my insurance and always used her insurance card and my flexben credit card for any medical charges – Morgan usually ran around with about $5 max in her purse and not much in her checking account and money didn’t really ever matter to her. If she was hungry she would stop at the grocery store and buy a head of Kale and eat it – very strange I know…I could never eat like that.

  14. Hi Toni, I have been keeping up with your blog for the past few weeks and I wanted to take a second and tell you how sorry I am for the loss of your beautiful vibrant daughter.
    Reading your blog has opened my eyes to the fact that a lot of people, me included, walk around with a false sense of security when it comes to the law.
    One would assume that if your a good person who does good things that you will be protected and if you do bad things then you will be caught and punished, If only it was truly that simple.
    You, your Husband and dauhter have been failed by the system, over and over again.
    I hope with all my heart that in this fight not only do you find justice for Morgan but some level of peace and closure for you and your husband.

    Much love & support 🙂

    S.

    • Thank you so much – I do hope that more and more people take something away with them after reading this blog and it helps them sometime in their life.

  15. I find it so annoying when people assume that “everyone” has at least tried drugs. Like TG, I grew up in the drug culture (in high school in the 60s in California, for heaven’s sake!). I knew dozens of people who were smoking pot, taking pills, and then in the 80s hitting cocaine really hard. Yet, I chose never to ever try any of them. From what I’ve read about Morgan, she made similar choices, not even wanting to use pharmaceuticals for pain. I rarely even use Tylenol, relying on more natural pain relievers when needed. Don’t let anyone convince you that just because she was a college student, or even that she knew people who did drugs, that she was also using them. The officer who told you he figured everyone in the sheriff’s department had tried cocaine at least once is telling more about himself than anything.

    • Jessica, yes it was mentioned and the owner of those two items retrieved them that evening. Just as the owner of the backpack with a bottle of vodka in it picked that up earlier in the day. I feel like the reports are really not very clear. In one instance they make it sound like Morgan’s, which it was not and then pages later clear it up. The LR3 sat, unsecured in the street for most of the day. More than what they found in it, I have always wondered if something was taken out.

    • So funny you mentioned Tylenol because I could always tell when she had a bad headache and would try to get her to take Tylenol but she wouldn’t do it. I know that’s how I was when I was younger too but after I got older I didn’t mind taking Tylenol or Advil…anything to get rid of a headache and keep moving – probably not as healthy though.

  16. I remember you saying she left her water bottle in her car that night. Did you ever have it tested for anything just to be sure someone didn’t slip something in there?

  17. Guaifenesin is an expectorant/decongestant and is used in many OTC cold medications. It has a very short half-life, only ~3 hours. Promethazine is a first-generation antihistamine, but is also the ingredient in Phenergan, an anti-nausea medication with an intense sedative effect. It has a half-life of 10-19 hours. Flurazepam is an anticonvulsant, sedative and muscle relaxant. It is marketed and sold to treat insomnia. It generates an an “active” metabolite, desalklflurazepam, which has an extremely long half-life, 40-250 hours and can remain active in the bloodstream for up to four days. It causes next-day sedation/sleepiness, impaired cognitive and psychomotor functioning and can cause impairments in driving and balance. Cyclobenzaprine, of course, is the drug behind Flexeril, which is a muscle relaxant. It, too, causes dizziness and sleepiness. It has a half life average of 18 hours with a range of 8-37 hours. Amitriptyline is an older generation SSRI tricyclic antidepressant; nortriptyline is its metabolite. In addition to being used as an antidepressant, Amitriptyline is used in lower doses to relieve pain in certain spinal/skeletal conditions, to treat bedwetting in children, chronic fatigue syndrome, migraines, chronic pain, chronic cough, carpal tunnel, fibromyalgia, irritable bowel syndrome, apparently, even tinnitus. Its main side effect is drowsiness, though like many psychotropic drugs, it can commonly cause dizziness, anxiety/nervousness, blurred vision, nausea, constipation, changes in sexual function and dry mouth.

    Two of the names listed as drugs are actually metabolites of the main drug… desalklflurazepam is a metabolite of flurazepam and nortriptyline is a metabolite of amitriptyline.

    This is quite a lethal cocktail of drugs. With the exception of guaifenesin, all four of the remaining drugs are, essentially, sedatives… or have a strong sedative effect… and cannot be obtained without a prescription. This stood out to me immediately, so I decided to go check it out, and here’s what the pharmacological literature has to say on combining those drugs (I’ll cut and paste the clinical explanations, because they explain exactly what happens in your body):

    1. Amitriptyline & Flurazepam:

    MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

    MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

    2. Amitriptyline & Promethazine:

    MONITOR: Coadministration of a phenothiazine with a tricyclic antidepressant (TCA) may result in elevated plasma concentrations of one or both drugs as well as additive adverse effects. Most phenothiazines and TCAs have been found to undergo metabolism by CYP450 2D6, thus competitive inhibition of the enzyme may occur when more than one of these agents are administered. Although these drugs have been used together clinically, the possibility of increased risk of serious adverse effects such as central nervous system depression, tardive dyskinesia, hypotension, and prolongation of the QT interval should be considered, as many of these agents alone can and have produced these effects. In addition, excessive anticholinergic effects may occur in combination use, which can result in paralytic ileus, hyperthermia, heat stroke, and the anticholinergic intoxication syndrome. Peripheral symptoms of anticholinergic intoxication commonly include mydriasis, blurred vision, flushed face, fever, dry skin and mucous membranes, tachycardia, urinary retention, and constipation. Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.

    MANAGEMENT: Concurrent use of phenothiazines and TCAs should be approached with caution, particularly in the elderly and those with underlying organic brain disease, who tend to be more sensitive to the central anticholinergic effects of these drugs and in whom toxicity symptoms may be easily overlooked. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication (e.g., abdominal pain, fever, heat intolerance, blurred vision, confusion, hallucinations) or cardiovascular toxicity (e.g., dizziness, palpitations, arrhythmias, syncope). Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A dosage reduction in one or both drugs may be necessary if excessive adverse effects develop.

    3. Flurazepam & Promethazine:

    MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

    MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

    4. Amitriptyline & Cyclobenzaprine:

    MONITOR: Agents with anticholinergic properties (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants; disopyramide) may have additive effects when used in combination. Excessive parasympatholytic effects may result in paralytic ileus, hyperthermia, heat stroke, and the anticholinergic intoxication syndrome. Peripheral symptoms of intoxication commonly include mydriasis, blurred vision, flushed face, fever, dry skin and mucous membranes, tachycardia, urinary retention, and constipation. Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures. Central nervous system-depressant effects may also be additively or synergistically increased when these agents are combined, especially in elderly or debilitated patients. Use of neuroleptics in combination with other neuroleptics or anticholinergic agents may increase the risk of tardive dyskinesia.

    MANAGEMENT: Caution is advised when agents with anticholinergic properties are combined, particularly in the elderly and those with underlying organic brain disease, who tend to be more sensitive to the central anticholinergic effects of these drugs and in whom toxicity symptoms may be easily overlooked. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and/or hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A reduction in anticholinergic dosages may be necessary if excessive adverse effects develop.

    5. Flurazepam & Cyclobenzaprine:

    MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

    MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

    6. Promethazine & Cyclobenzaprine:

    MONITOR: Agents with anticholinergic properties (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants; disopyramide) may have additive effects when used in combination. Excessive parasympatholytic effects may result in paralytic ileus, hyperthermia, heat stroke, and the anticholinergic intoxication syndrome. Peripheral symptoms of intoxication commonly include mydriasis, blurred vision, flushed face, fever, dry skin and mucous membranes, tachycardia, urinary retention, and constipation. Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures. Central nervous system-depressant effects may also be additively or synergistically increased when these agents are combined, especially in elderly or debilitated patients. Use of neuroleptics in combination with other neuroleptics or anticholinergic agents may increase the risk of tardive dyskinesia.

    MANAGEMENT: Caution is advised when agents with anticholinergic properties are combined, particularly in the elderly and those with underlying organic brain disease, who tend to be more sensitive to the central anticholinergic effects of these drugs and in whom toxicity symptoms may be easily overlooked. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and/or hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A reduction in anticholinergic dosages may be necessary if excessive adverse effects develop.

    What stands out to me is that some of the results of these drug interactions is that it increases the concentration of the other drug in the patient’s plasma… which in turn, increases the effects of the drugs. When the main effect of those four drugs is essentially depression of the central nervous system, what results is a slow and complete shutdown of the body.

    This is only my opinion, of course, and I’ve only recently come to know your beloved daughter’s case via blog surfing, but I think that you would have noticed at least a minimal level of impairment of your daughter had come home with these drugs in her system. She would have seemed off-balance, tired, her speech would may have been slurred or it may have seemed like talking was a huge effort.

    I hope that you find out how she came to have this cocktail of drugs in her system. It is/was lethal, but one thing that may help in the investigation is knowing that these four drugs would have had to have been obtained through a pharmacy.

  18. I’m confused, if the Coroner believes she committed suicide (I don’t believe so), what is his explanation of how a 20 year old obtained all these prescription drugs? What evidence does he have to support his theory that Morgan intentionally took all these medications with the intention of suicide? I believe I read that none of these medications were even found in the house! So shouldn’t he at least ask himself, where did she get these medications and from who?. Since he believes it was a suicide, it is a crime for someone to give another prescription drugs not prescribed to them. Why did he not launch an investigation to prosecute the person or persons that supposedly gave these pills to her after all it is illegal, especially resulting in death.

    • Very good question. There is no evidence of suicide, because she did not commit suicide – the evidence completely contradicts that finding, and the coroner’s office would never answer our questions or ever even answer us for that matter. The coroner was never involved in Morgan’s case – he left it up to his deputy coroner, who had no certifications at all, and was not even a legal deputy coroner – he never even took the most basic step – a body temperature – to help determine the time of death. Never mind that he never answered our calls, certified letters, or emails, he would never answer Morgan’s doctor’s who believed her death was a homicide. His staff was not allowed to ever schedule an appointment for us to meet with him in person. A kind and helpful FBI agent even tried to assist at our request to try to set up a meeting with the coroner, but to no avail…crazy I know, but unfortunately very true. The contracted forensic pathologist, Dr. Robert Kurtzman, who did Morgan’s autopsy, and by law was in charge of her death scene and investigation (which never happened), not only had no evidence of suicide BUT he argued with us (her parents) and her doctors and many other medical experts for 8 months insisting endlessly to all that she really died of natural causes – which was not true, but in essence it kept her from having an investigation into her suspicious death. Then when I wouldn’t stop asking questions this pathologist threatened me, and yes, the sheriffs and coroner were told of these threats in writing, and yes, the pathologist made good on his threats 8 months after her murder changing her to a suicide without any evidence. It is horrendous and unfortunately in the state of Colorado it can and does happen…this in turn still kept her suspicious death from being investigated – and has allowed a murderer(s) to remain free. It makes absolutely no sense to me how this can be allowed.

      You are correct that none of the medications were ever in our house. Morgan had an old expired prescription for a low dose of Amitriptyline, but all her old pills were accounted for, and she did not have enough low dose pills to come close to the levels in her blood, her toxicology results proved not only was she not taking it, but it was a massive one time dose of most likely equine Amitriptyline – enough to sedate a 1,200 lb horse. The amount in her blood could not have been ingested because it was over 10 times the lethal dose, so if it had been ingested she would have died before 1/10th of that amount had entered her bloodstream. All the drugs are on the Sexual Assault Panel, all the drugs are used for horses, and no they never checked to see where the drugs came from even though they knew both suspects in Morgan’s felony stalking investigation had ties to the commercial horse ranch behind our home. But the good new is there is no statue of limitation when it comes to murder. We will never stop trying to find justice for Morgan. I still believe in the justice system, as well as in law enforcement, and those who have been involved in covering up her murder will be held accountable when her case is opened up. Thanks so much for writing in with your questions.

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