Content Warning: This episode contains discussion of death of individuals. If you’re sensitive to this topic, this episode may not be for you.

In forensic pathology, a single word on a death certificate can carry the weight of an entire investigation. In this episode of Mayhem in the Morgue, Chief Medical Examiner Dr. Kendall Crowns details the difference between cause of death and manner of death and explains why manner is often an evidence-based opinion rather than a simple label. He discusses the five standard manners and tests them against real cases, including a multi-fatality crash, Russian roulette, a delayed medical consequence tied to an old stabbing, and an 18-year-old college student whose death remained unsolved. It's a practical guide to how one classification can reshape everything that follows.

Highlights

• (0:00) Welcome to Mayhem in the Morgue with Dr. Kendall Crowns

• (0:15) Cause of death versus underlying mechanism

• (1:45) Manner of death as a classification built from scene context, autopsy, and investigative follow-through

• (2:15) The five manner and the NAME guidebook framework for definition and disputes

• (4:45) Why “clear-cut” cases still fracture consensus inside a medical examiner’s office

• (5:15) Case one: multi-fatality collision and the initial assumption of accident

• (7:30) Investigative information changes the classification: suicide attempt by driver, homicide for the victims

• (9:30) Court outcomes, public backlash, and why intent to kill is not required for homicide classification

• (10:15) Russian roulette, “redneck Russian roulette,” and the never-ending suicide- versus-accident argument

• (13:15) Case two: vitreous glucose, acetone, and the autopsy logic behind diabetic ketoacidosis

• (16:15) Records connect the death to an old abdominal stabbing that damaged the pancreas and reshaped the manner

• (17:30) The “but for” principle and why delayed consequences can still be classified as homicide

• (20:00) Case three: 18-year-old college student with no findings, no answers, and an undetermined conclusion

About the Host: Dr. Kendall Crowns

Dr. Crowns is the Chief Medical Examiner for Travis County, Texas, and a nationally recognized forensic pathologist. He has led death investigations in Travis County, Fort Worth, Chicago, and Kansas. Over his career, he has performed thousands of autopsies and testified in court hundreds of times as an expert witness. A frequent contributor to Crime Stories with Nancy Grace, Dr. Crowns brings unparalleled insight into the strange, grisly, and sometimes absurd realities of forensic pathology.

About the Show

Mayhem in the Morgue takes listeners inside the bloody, bizarre, and often unbelievable world of forensic pathology. Hosted by Chief Medical Examiner Dr. Kendall Crowns, each episode delivers real-life cases from the morgue, the crime scene, and the courtroom. Expect gallows humor, hard truths, and unforgettable investigations.

Connect and Learn More

Learn more about Dr. Kendall Crowns on Linkedin. Catch him regularly on Crime Stories with Nancy Grace and follow Mayhem in the Morgue where you get your podcasts.

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