Tracy Gostomski-Tribble's family's three-month wait to learn how she died ended Friday when the state medical examiner's office provided the answer: It was homicide, based on the final autopsy report.
John Kraemer heads the office's forensics operation. His three forensic pathologists have the difficult, but important task of identifying dead bodies and determining causes of death.
Kraemer's office used dental records and tattoos to identify Gostomski-Tribble when the 35-year-old Council Bluffs woman was pulled from the Missouri River May 19 - a little over two weeks after she was reported missing.
Pottawattamie County Attorney Matt Wilber knew when the medical examiner's office released its preliminary autopsy report May 20 that Tribble had been struck with an unknown object that caused a facial fracture and knocked out several teeth. But the manner of her death remained a mystery until Friday, when Kraemer's office submitted its final report, indicating the most likely cause of death was asphyxia and manner of death a homicide.
Wilber had been waiting for those results to determine if he had a homicide case on his hands. He said Gostomski-Tribble's body had been in the river long enough that blood samples could not be used for some tests.
"They had to use liver tissue, and that made it take longer.
"As a result of this report, we are officially reclassifying Tracy Tribble's case from a death investigation to a homicide investigation," Wilber said Friday.
Gostomski-Tribble's death is not the only high-profile one Kraemer's office has been involved with.
He said one of his toughest and most gratifying cases involved 11 decomposing bodies found in a Denison railcar several years ago.
The Denison railcar deaths made national headlines when illegal immigrants' bodies from several Central and South American countries were found locked in the train car. Kraemer's office had the challenging task of attempting to identify and return all 11 to their home countries.
"It was a very emotional case that affected a lot of people," he said.
Because the bodies were badly decomposed, Kraemer and the FBI used DNA samples.
"We also had to collect samples of possible next of kin in Central and South America. It took six months, but we were able to identify and return all the bodies to their families."
Another recent case making national news was the woman whose skeletal remains were discovered in a barrel May 6 by two mushroom hunters north of the Pottawattamie County Jail.
Kraemer's staff called in a forensic anthropologist who determined the unknown corpse was that of a 24- to 32-year-old woman, approximately 5-feet, 8-inches tall, with short, straight brown hair and who wore size 11 jeans. The pathologist also indicated the subject appeared to be Caucasian, but may have had some African-American ancestry as well and that she likely had a physically active occupation or regularly engaged in strenuous physical exercise.
But the woman's identity remains a mystery.
"We are still trying to determine who she is," Kraemer said. "The degradation of the bones makes it a difficult case. Mother Nature is the biggest enemy with decomposition."
He said his office is calling in the FBI to assist with nuclear and mitochonrial DNA analysis of the remains in hopes a positive identification can be made. Kraemer said bone samples have been sent to the FBI lab in Quantico, Va. The more precise testing gives investigators a much better opportunity to identify the body, he said. Kraemer said he could not estimate when those tests would be completed.
Wilber said he believes he knows what caused the mystery woman's death, but the details are not being released.
"Sometimes people falsely confess. For example, you might have a death row inmate in Texas confess so he can get re-tried here to avoid the death sentence," Wilber said. "So we hold back information to see if they know the circumstances."
Wilber said the autopsy report delay is frustrating. "But, I'd rather have it done correctly rather than quickly," he said. "We've gone as far as we can with the Iowa laboratory."
He said the FBI lab does not charge the county to use its services. Wilber said while a private lab might generate quicker results, it would also cost taxpayers.
Some autopsy reports are delayed waiting for toxicology reports, Kraemer said. He said such delays are the result of two-tier testing. Initial tests could show both true positive and false positive results for the presence of drugs, so a second test is done.
"Some are even done by hand. We have to rule out the false positives. That is why sometimes it takes a while. And we are screening for a lot of different things."
Kraemer said states use three different systems: Medical examiners, coroners or a combination of the two.
"In Iowa we have a state medical examiner, and each county hires a county medical examiner through its board of supervisors," he said. "We provide guidance, training and consultation to the county examiners on deaths that fall under their jurisdiction."
In Iowa, he said, both state and county examiners must be physicians. Pottawattamie County has been without a county examiner since the board of supervisors released Dr. Scott Blair from his contract and decided to revamp the office last July.
Board Chairman Loren Knauss said he's had discussions with three different doctors, all of whom have declined the position.
"It is tough to get someone to leave his or her practice or come out at 2 a.m. on a moment's notice," Knauss said.
He said the county is currently considering whether to hire more than one doctor who could rotate. In the meantime, the county is contracting with Kraemer's office.
Mills County Medical Examiner, Dr. Robert Fryzek, has held that position since 1973. The family practice physician said he took the job to provide a service to the county and its taxpayers.
"I wanted to give back to the community where I have made my living. It doesn't pay enough otherwise," he said.
Fryzek was recently called to a 3 a.m. car accident, where he pronounced two people dead and ordered an autopsy.
"We usually use Douglas County. They are the closest and the cheapest," Fryzek said.
He said in murder or high-interest cases, he usually uses the Iowa medical examiner. That was the case with the badly decomposed female body recently found in a ditch near Glenwood. Fingerprints identified her as 25-year-old Brianne Smith of Omaha. The cause of death has still not been determined.
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