As a retired research pathologist and physician I believe that I have a professional view of the situation with Sandra Bland.
There are too many questions still to be answered – this is a very disturbingly confused situation, suggesting a need for an in depth and thorough investigation
Sandra Bland was arrested after an officer stopped her for not using a signal to change lanes and then, although legally but questionably as he had no reasonable basis to do so, told her to stop smoking and then got mad at her and made her get out of the car because she seemed to object to this request.
I have carefully now considered the description of the autopsy report and it's contents.
The autopsy does not prove she hung herself. There are too many questions still to be answered.
When she got out of the car and was verbally vigorously and firmly objecting to the officer’s requests, the officer then slammed her to the ground causing her to smash her head down, simply because he appeared to be angry at her questioning of him.
Then she complained she couldn't hear, which is heard on the audio portion of the videotape taken while she was out of the car being arrested, which indicates she suffered a concussion.
She told the officers she had epilepsy and was on a medication, Kepra.
The jail then claims she committed suicide by hanging three days later with a plastic bag.
Yes it is possible to hang yourself by "leaning in", if if on your knees, after securing your hands so you cannot get the bag or rope away from suffocating you even without any drop. Many prisoners have killed themselves in this manner called “leaning in hanging”.
If the jail denied her the epilepsy medication, it is possible that she died from a seizure as the medication wore out of her system and then made her prone to a seizure. The stress of the situation and lack of medication could have contributed to having a seizure. Then they could have staged the hanging. If this was true, then there would be no bleeding after death around the ligature (plastic bag) which was around her neck and no petechiae (pin point hemmorhages). Petechiae however, are not always present with hanging or suffocation, so they are not definitive in terms of use in a diagnosis as to cause of death.
If she was strangled and then the hanging staged, the autopsy report, if it was done properly, should show that the ligature furrowing was concentric and not consistent with hanging. A hanging will have non-concentric furrowing as the ligature has more pressure on one side due to gravity.
There was also plant matter in her abrasions on her back, consistent with the day she was arrested, having been thrown to the ground and dragged. It is negligence for the jail not to have cleaned and treated her abrasions or allowed her to shower properly for three days to clean the wounds.
If the blood tests show she did not have her medication, then that also would be negligence, as lack of medication needed for epilepsy could have precipitated a seizure.
The reports say she told the officers she was suicidal, but the jail did not have her on a suicide watch. That would also be negligence. Suicide in jails often occurs during the first few days in jail as that is when the detainee is most upset about the situation. Ms. Bland certainly had reason to be upset as the circumstances of the arrest and slamming her to the ground seems excessive.
In addition, she had an unusually high amount of marijuana in her blood. Therefore, she was given a large amount of marijuana in the jail which she either ingested or smoked. That needs investigation. I am not an expert on effects of marijuana so I cannot comment on whether this can increase suicidal ideation or depression or if it can trigger seizures. These possibilities however, should be considered.
A senior well-known forensic pathologist, Dr. Cyril Wecht , who is also an attorney agrees with much of the above assessment during an interview on the radio here.
ADDENDUM: I have now reviewed the actual autopsy report, not just considered the descriptions of the autopsy report by Dr. Wecht or news reports. This is what appears on it to add to above:
If the drop was very small, then there may be no damage to the upper airway except for compression cutting off air, but it would be patent. The airway was patent. The drop seems to be a small amount if at any. There would be no cervical damage and no break of hyoid bone if there was not a sufficient drop to produce it like in a judicially ordered hanging. The neck cervical bones and hyoid bone were intact. The tongue may or may not be swollen. If the death was by circumferential equal pressure so that all lymph and venous blood return to heart was stopped, then tongue could swell. However this was not even circumferential strangulation. The marks or furrows matched the pattern of a hanging with deeper furrows in front of neck, furrow pattern upward along sides of neck and absent for several inches in the back. This was definitely not a circumferential strangulation by a ligature. It was death by hanging, but I cannot say if she was unconscious due to a seizure prior to the actual stopping of the heart. It is still possible that she was found unconscious or having a seizure and that she was then hanged by someone. This was not a "leaning in" type of hanging.
There was bruising consistent with her being slammed to the ground. Fingernail scrappings were taken but not yet analyzed. Rape kit was done, but no DNA testing was yet done on it to look for foreign DNA.
There were also superficial healing multiple cuts on one forearm which could be consistent with self-inflicted wounds done by mentally ill or prisoners to seek attention, when extremely stressed. "The volar left forearm contains approximately 25 to 30 horizontal faint linear healing scabbed superficial incised wounds with focal pale, scarred regions of healing, which are parallel and range in length from 3/16 to 1 inch."
The reports in the press state she had a high level of THC in her body. The stomach was essentially empty except for a little grayish fluid.
I appreciate the astute comments about reports of her kicking and "no examination of legs'. However, the autopsy did examine legs and there were no contusions. So if her footwear was flip flops, then the lack of injuries to her toes were not necessarily indicative of not kicking. She may have kicked so lightly as to produce no injury. The autopsy cannot confirm if she kicked or not.
It is appreciated from the comments that THC can produce anxiety, but also the observation from a previously suicidal person that her suicidal thoughts decreased with THC. The injuries to left forearm, likely self-induced may indicate she was under extreme mental stress and had a mental breakdown to a state of attention seeking behavior known as "cutting". For no one to notice this prior to her death, while she was so upset per the news reports is likely negligence, considering her statement of suicidal thoughts per press report ( I don't know if this is true and it is not mentioned in the autopsy report - there is no mention of any type of jail screening for mental health issues or medical issues on the autopsy report, not even mention of epilepsy or any referral to physician for treatment of her epilepsy or prescription of drugs she was on).
So I cannot exclude the following possibilities:
Seizure due either to concussion (although this would more likely have occurred on first day) or due to stress along with lack of needed medications, unconscious, then hanging without a struggle resulting in final death.
Self-hanging due to extreme anxiety after self-cutting, influenced by large intake of THC by unknown means - which may have increased anxiety or induced paranoia (apparently heavy users of THC can have a paranoid psychosis, but this is just what I've read and I am NOT an expert on psychological affects of THC). Hanging could have been with belief it would cause death, or just a suicidal gesture that she thought would gain attention and cause her to be transferred to a hospital. She may have thought that the jail was intolerable and done everything possible to force transfer to a hospital, which some inmates believe is more tolerable than jail. Some suicidal gestures of hanging, which the person may believe will not kill them, end up killing them. We have no way of knowing for sure what she was thinking at the time, except for the fact that she was extremely stressed out according to what she said in the alleged phone call to a family member.
It is unlikely that there was a struggle as there were no defensive wounds.
