Coroner at Large

Coroner at Large

by Thomas T. Noguchi MD, Joseph DiMona

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Product Details

ISBN-13: 9781497638464
Publisher: Open Road Media
Publication date: 07/01/2014
Series: Coroner , #2
Sold by: Barnes & Noble
Format: NOOK Book
Pages: 245
Sales rank: 178,823
File size: 3 MB

About the Author

Thomas T. Noguchi was born in Japan and came to the United States in 1952 to complete his residency in pathology at Orange County General Hospital in California. In 1960 he joined the Los Angeles County Coroner’s Office as deputy medical examiner, and subsequently was appointed chief medical examiner. After he left that post in a storm of controversy, his colleagues elected him president of the National Association of Medical Examiners.

Joseph DiMona has been called by the New York Times “an example of the successful collaborator whose own name may be as recognizable as the subject’s.” In addition to his collaborations with controversial figures such as H. R. Halderman (The Ends of Power) and Dr. Noguchi (Coroner), he has written bestselling novels, including Last Man at Arlington and To the Eagle’s Nest

Read an Excerpt

Coroner at Large

By Thomas T. Noguchi, Joseph DiMona


Copyright © 1985 Thomas T. Noguchi, M.D. and Joseph DiMona
All rights reserved.
ISBN: 978-1-4976-3846-4




No judicial proceedings in recent history have aroused greater public curiosity than the two trials in which Claus von Bülow was accused of the attempted murder of his wife, Martha "Sunny" von Bülow. Press coverage was exhaustive, and both trials were broadcast in their entirety on television—an almost unprecedented occurrence. Viewers were able to follow the intricate legal maneuvers of the prosecution and the defense, listen to testimony and see revealing gestures and facial expressions as if they themselves were in the courtroom. Twice, Von Bülow was to be judged not only before a jury of twelve men and women, but before an audience of millions. And, in a twist that might strain the credulity of even the most jaded television viewers, his first trial resulted in conviction, the second in acquittal.

What more is there to be said about a real-life drama that has already inspired so much comment and speculation? My investigation of the case was centered around a key question. With her husband's innocence established, where does the blame reside for the tragic condition of Sunny von Bülow, still lying helpless in an irreversible coma?


Newport, Rhode Island, is perhaps America's preeminent domain of the rich. There, decades ago, the aristocrats of our society built sprawling mansions, extravagant imitations of the great houses of the European aristocrats they so much admired. Time and inflation have caused many of these mansions to be sold, turned into museums or simply shuttered up because even their rich owners could not afford their upkeep.

But a few of the great houses that line Cliff Walk are still open and in use. And among the most beautiful of them is Clarendon Court, the "summer place" of Sunny von Bülow and her husband, Claus. In fact, in 1950 the house was chosen as one of the settings for a movie about the tangled love affairs of a beautiful heiress, a movie called, appropriately enough, High Society.

Sunny von Bülow could have played that role. Her father, George Crawford, was a utilities magnate of immense wealth. He was also seventy-one years old when his only child was born. He died a few years later, and his young wife, Annie Laurie, and her mother, Mrs. Robert Wormack, also a very rich woman, raised the fatherless child. Otherwise, Sunny's childhood and adolescence were normal for those of her wealth and social background: private schools, chauffeur-driven limousines, "seasons" in New York, Newport, Palm Beach and Europe. There the lovely young American heiress almost inevitably met a handsome but penniless Austrian prince, Alfie von Auersperg. And in 1957, almost as inevitably, she married him.

Two children were born of this marriage, but it did not last and Sunny again married a European, this time the mature, urbane Claus von Bülow, a Danish aristocrat whose pedigree, while distinguished, did not match that of her first husband, the Austrian prince. In fact, there were some who believed Claus von Bülow was a social climber determined to wed a rich woman. But others believed Sunny was the fortunate one of the two, because Von Bülow was so charming. Several years after their marriage, his charm would be evinced in a strange setting: outside a courtroom in Newport, Rhode Island, where Von Bülow was being tried for twice attempting to murder his rich wife.

The events that climaxed in the trial had occurred on a typical evening for the Von Bülows. That "typical" evening was not, as one might imagine, a great ball, a festive dinner, or a magnificent lawn party with white-coated servants carrying trays of champagne. Instead, the incredibly rich Von Bülows had a little family dinner at home, then stood in line at a local movie house to buy tickets. Two of Sunny's children, Alexander von Auersperg, by her first marriage, and Cosima von Bülow, whose father was Claus, ate dinner with their parents that night. The dinner was earlier than usual so that they would arrive at the Jane Pickens Theatre in Newport in time for the first showing of 9 to 5, with Jane Fonda, Dolly Parton and Lily Tomlin.

Sunny complained of a headache at dinner but was otherwise in good spirits. And instead of eating the main course, she asked the butler to bring her a large helping of vanilla ice cream with the special caramel sauce that the cook always kept in jars in the refrigerator for her.

At nine o'clock the four family members returned from the movie. Von Bülow went to his study to telephone an aide in New York on business. The other three adjourned to the library, Sunny excusing herself to go to the bathroom. She was back in only a few minutes, having changed into a dressing gown, and carried a glass containing a beverage that appeared to be ginger ale. She then chatted with her children for half an hour. At this point, Von Bülow came out of his study and asked his wife if she wanted anything. She said she would like a cup of chicken soup, if there was any left from dinner. Von Bülow left the room to get it.

While he was out of the room, Sunny suddenly looked weak and her voice started to grow so faint that Alexander had trouble hearing her. Von Bülow returned from the kitchen with the soup, which he placed before her, then went back to his study to resume his telephone calls to New York. But meanwhile Sunny became weaker and weaker. She got up, and seemed to stagger. Alexander rushed over, picked her up and half carried her to her bedroom. Then he returned to tell Von Bülow, who was still in his study on the telephone, that his mother was ill.

When Von Bülow arrived in the bedroom, Sunny was under the bedcovers. She asked her husband whom he had been speaking to on the phone, and he told her it was a business associate. While this conversation was going on, Alexander, according to his later testimony, searched the bathroom and the bedside tables looking for any drugs she might have taken. He said he found none. As he was about to leave, Sunny asked him to open the window. Apparently she liked to sleep in a cold room, with an electric blanket to keep her body warm. Alexander opened the window, then left his mother and stepfather, who were conversing normally.

When Von Bülow awoke at five-thirty the next morning, according to his later testimony, he found Sunny sleeping normally. He arose, let their dogs out of the bedroom, then showered and shaved. As was his habit, he took a brisk morning walk. And when he returned, he read the morning newspaper.

At 8 A.M. he passed through the bedroom to his study to resume his call to his Shearson—American Express co-worker Margaret Neilly, with whom he had been speaking the night before. They spent an hour discussing a financial report which they couldn't understand, finally discovering that an irrelevant page had been inserted by mistake, thus rendering the whole report indecipherable.

Von Bülow was furious. To clear his anger he decided to take another walk in the fresh air, far from financial reports and bungling accountants. When he returned, it was almost eleven o'clock and both Alexander and Cosima were having breakfast. Surprised to find that Sunny was not yet up, he went to the bedroom to check on his wife, and found that she wasn't in bed. Then he looked into the bathroom, and saw a terrible scene.

His wife lay sprawled across the pink marble floor, her head under the toilet.

Water was running in the basin of the sink. She was breathing, but icy cold to the touch.

Von Bülow quickly summoned Alexander and telephoned for an ambulance.


When Sunny von Bülow arrived at the hospital, her body temperature was an astonishingly low 81.6 degrees, and her low pulse rate, highly constricted pupils and other symptoms showed that she was deeply comatose. Dr. Gerhard Meier, on duty that day, looked for needle marks but found none. He ordered routine blood tests and then went to speak to Von Bülow about his wife's medical history. Von Bülow said that she had taken only one Seconal. In the middle of this conversation, a nurse rushed in to say that Sunny had suffered cardiac arrest, and Dr. Meier went to her bedside to resuscitate her. When she was stabilized, he gave her the first of several glucose "pushes," a routine treatment for unconscious patients to determine if their illness involves low sugar in the blood.

Eventually it would be found that the repeated glucose pushes lowered the blood sugar instead of elevating it as it should have done, an indication that there was an excess of insulin, which "eats" sugar, in Sunny's blood. It was this finding that would later form the core of the case against Von Bülow, who was charged with attempting to murder his wife by the surreptitious injection of insulin. At the time, however, all the facts seemed to point to Von Bülow's innocence of any role in her illness.

First, he had had no opportunity to inject her. The family had been together all evening, until Claus went into his study. While he was there, Sunny, in the library with her children, became ill. It was a surprising feature of the case against Von Bülow that the prosecution admitted he had had no opportunity to inject his wife. Instead, it was hypothesized that he injected her with insulin later that night after she had become ill for other reasons.

Secondly, Von Bülow claimed he had promptly called for medical assistance upon finding his wife ill—and thereby saved her life. And thirdly, he had saved his wife's life once before, just a few weeks prior to this terrible event, by rushing her to a hospital when he found her unconscious from an aspirin overdose.

Why, Von Bülow would ask, would he save his wife's life and less than three weeks later attempt to kill her? He could have allowed her to expire from the aspirin overdose if he was, indeed, a murderer.

Nevertheless, the state pressed charges, and at his trial a web of circumstantial—and medical—evidence gradually wove around him.

To begin with, Dr. Gerhard Meier testified to the presence of insulin in Sunny's blood as revealed by the reaction to glucose pushes administered when she arrived at the hospital. But had it been naturally produced or was it artificial insulin that had been injected into her body? Because he was so busy saving the life of his patient and did not suspect murder, the doctor had not immediately ordered the C-peptide test which would have indicated whether the insulin was artificial or natural. That test could have settled the case right there: if the insulin was artificial, it had to have been injected; if natural, Von Bülow was innocent.

But the most stunning early revelation in the trial was that, almost exactly one year before, Sunny had been admitted to the hospital in a similar coma. That time she had recovered, but the incident fueled suspicions in the mind of her maid, Maria Schrallhammer, and eventually in the minds of the two Auersperg children, Ala and Alexander, for the maid said that Von Bülow had delayed calling the doctor the year before, even though she had pleaded with him that his wife was ill. And on several occasions thereafter, Maria would later testify, she saw a "little black bag" among Von Bülow's possessions, filled with drugs, hypodermic needles and, on two occasions, a bottle marked "insulin."

It was also revealed that after her first coma Sunny's health seemed to deteriorate, and that in April 1980 she checked into a hospital for tests. There, when it was discovered that her blood sugar was remarkably low, she was diagnosed as suffering from "reactive hypoglycemia," which is a temporary reaction to an abundance of blood sugar in which excess insulin is produced. But the insulin output is not enough to cause a coma, as Dr. Richard Stock, Sunny's family doctor in New York at the time of her checkup, testified at the trial. Instead, he told the court, he believed the cause of her coma was "the surreptitious administration of insulin."

Oddly, another prosecution witness, Dr. Kermit Pines, one of the specialists brought in by Dr. Stock to examine Sunny at the time of that checkup, disagreed with Stock's testimony. He said that when he had asked Stock if there was any possibility that Sunny was receiving insulin injections, Stock had looked aghast at the idea and denied it.

All during that year, 1980, Sunny suffered spells of wooziness, with slurred speech. Then, on December 1, she took an overdose of aspirin, and Von Bülow saved her life. Three weeks later in Newport she was found prostrate in the coma which she still endures.

After that coma occurred, the children, inspired by the suspicious maid, hired a private investigator, Richard Kuh, whose fee drew gasps from the court: almost $100,000. But Kuh earned his money. He journeyed to the Newport home with Alexander and a locksmith to search for "the little black bag." The locksmith wasn't needed, because the key to the closet in which the bag was found was in a drawer in Von Bülow's desk. There was no insulin bottle in the bag, but Kuh did discover a hypodermic needle that appeared to have been used, as well as various drugs. When tested, the drugs turned out to be Amobarbitol (a sleeping pill) and Valium (a tranquilizer). And when laboratory tests revealed the presence of insulin on the used needle, the evidence was turned over to Rhode Island police. It was later introduced at his trial, and the web of evidence tightened more strongly around Claus von Bülow.

The testimony of two distinguished medical experts, Dr. Harris Funkenstein and Dr. George Cahill, further strengthened the prosecution's case. There was no other explanation for Sunny's low blood sugar and the presence of insulin at the time of her coma, they testified, than that the insulin was exogenous (injected). According to these experts, there were only two causes of excessïve natural insulin created in the body, one from insulin-producing tumors in the pancreas, and the other from a disorder of the liver caused by alcoholism. Neither of these two conditions, they said, had been found in Sunny von Bülow.

The medical experts were cross-examined on the fact that Sunny had been diagnosed as having reactive hypoglycemia that very year. In fact, at the time of her routine hospital checkup in mid-1980, she had an even lower blood sugar count than at the time of her second coma. Could the coma have been caused in some way by her natural hypoglycemia? Cahill replied, "I know of no case in my experience in which reactive hypoglycemia caused a coma."

In sum, the insulin had to have been injected; there was no other explanation for it. Together with the fact that the bag found in Von Bülow's closet contained a used hypodermic needle encrusted with the drug, the evidence was damning. But, the defense countered, what was the motive? Von Bülow had plenty of money. Just that year Sunny had given him a trust fund of two million dollars as an outright gift. This plus his other wealth gave him an income of $120,000 a year, which, Von Bülow said, might not seem much to the prosecutors, but was "plenty" to him.

To supply the missing motive, the prosecution summoned a reluctant witness, Von Bülow's lover, Alexandra Isles. Lovely, chic, youthful, she was a former soap opera actress. But no soap opera ever televised contained more drama than her testimony, climaxing with the fact that she had given Von Bülow an "ultimatum" to leave his wife the very month Sunny was stricken with her final coma.

So the jury had medical evidence pointing to Von Bülow's guilt—and now a motive. In vain the defense produced witnesses who testified that Sunny often injected herself with drugs; and argued, finally, that if Von Bülow had attempted to kill her twice, as alleged, why hadn't Sunny said so when she recovered from the first coma in 1979? Would a woman continue living with a man who had tried to murder her?

The jury was faced with a dilemma. The evidence against Von Bülow was purely circumstantial—as it always is in cases where there are no eyewitnesses to the crime. Yet the weight of the medical evidence was so great that on March 16, 1982, Claus von Bülow was found guilty of twice attempting to murder his wife and was sentenced to twenty years in prison.


Like many thousands of others, I was intrigued by the Von Bülow case, but perhaps not for the same reasons. In my own experience as a medical examiner, I have encountered cases where murders were committed by the surreptitious injection of insulin. In fact, such a murder had once been considered a "perfect crime," for while it was possible to detect the presence of excessive insulin in the body, there was no way to determine whether it was naturally produced or artificial—like the insulin used in the treatment of diabetes—and therefore injected. That is no longer the case. Forensic science is now able to detect the presence of artificial insulin. Thus it troubled me that if Claus von Bülow had attempted such a crime—not once but twice—he would not have been aware of that fact. And if he had used insulin and hypodermic needles in attempts to murder his wife, why would he not have destroyed such incriminating evidence?


Excerpted from Coroner at Large by Thomas T. Noguchi, Joseph DiMona. Copyright © 1985 Thomas T. Noguchi, M.D. and Joseph DiMona. Excerpted by permission of OPEN ROAD INTEGRATED MEDIA.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Coroner at Large 5 out of 5 based on 0 ratings. 2 reviews.
Anonymous More than 1 year ago
I bought this through a book club in the 80's. I need to buy a new copy, as my in-laws (accidentally?) gave it away in the last move. It was an excellent book. Dr. Noguchi was the basis for the show "Quincy, M.E."!
Anonymous More than 1 year ago
Very informative. Written so anyone can understand the procedural process. Highly recommend it for people interested in true crime books. ELR