We now know the official cause of death of the British patient found dead in a stairwell at San Francisco General Hospital 17 days after she disappeared from her hospital room.
The city’s chief medical examiner says 57-year-old Lynne Spalding died from probable electrolyte imbalance, which is essentially dehydration, and delirium, which is known as clinical sepsis.
The report says Spalding was originally in the hospital due to complications of ethanolism, which is another term for chronic alcoholism. A chemical imbalance due to alcoholism led to her death, the coroner has determined.
Haig Harris, an attorney representing Spalding's family, said he is angry and upset over finding about the examiner's report through the media. He said the report has no credibility and called it incomplete.
"How can they say they conducted an examination of a body they haven't found yet? This is bizzare," Harris said, referring to an autopsy reported on Oct. 6 when Spalding's body was found two days later on Oct. 8.
Harris, who also is calling for a grand jury investigation, said alcoholism has nothing to do with why Spalding died.
"She was out there in the elements and she died of either starvation or dehydration," he said. "This report would seem to say dehydration. They don't have to put secondary to a history of alcoholism."
David Perry, a family spokesman who knew Spalding for six years, said he had been pressing for the medical examiner report's release for weeks. He also denied that Spalding ever had an alcohol problem.
"Lynne was certainly not an alcoholic nor was she in any program that I was aware of,'' he said.
Spalding was admitted to the hospital for treatment of a bladder infection on Sept. 19. She disappeared two days later. On Oct. 8, her body was found in a locked, rarely used hospital stairwell.
The medical examiner's report does not specify when Spalding died but noted she was "deceased for some days before being found" in the stairwell. Her death is considered accidental.
According to the report, Spalding's dead body was clad in street clothes when it was discovered -- including a black-and-white jacket, a black top, black pants, and a pair of black boots. There were no signs of injury.
An exact time of death was not determined.
Perry said he was disappointed that no time of death was released.
"The only issue is did she die on Sept. 21 or sometime later,'' he said. "If the answer is she died after Sept. 21, then her family and friends feel that Lynne Spalding was killed through the neglect and malfeasance of San Francisco General Hospital and the San Francisco Sheriff's Department.''
In a statement released Friday, hospital spokesman Tristan Cook said a number of new measures had been put into place after Spalding's death, including daily stairwell checks and new training for security staff.
"Everyone here at San Francisco General is shocked and saddened by Ms. Spalding's loss,'' Cook said. "We have been doing everything we can to learn the facts and to ensure that it never happens again.''
Just how Spalding ended up in the stairwell has never been fully explained. Last month, the San Francisco Sheriff's Department announced staffing changes following Sheriff Ross Mirkarimi's admission of mistakes made by the department in the handling of Spalding’s disappearance.
An attorney for Spalding’s family claimed that sheriff’s deputies “did not conduct a thorough search” despite requests to search the medical center for the missing patient.
The Associated Press contributed to this report.