South Coast Forensics Stephen Pustilnik, M.D. Forensic Pathologist 2219 Dorrington Street Houston, Texas 77030 Date: February 19, 2019 To: District Attorney Sunshine Stanek Lubbock County, Texas Re: Allegations of Misconduct against Drs. Samuel Andrews and Evan Matshes (BRADY MATERIAL for distribution) Dear District Attorney Stanek: |!am writing in response and to clarify allegations published by doctors Sam Andrews and Evan Matshes in memos to you and Judge Parrish dated January 28, 2019, January 29, 2019, and January 30, 2019, Please share this BRADY MATERIAL with members of the criminal defense bar, as you are my best point of contact. |! was the contract senior forensic pathologist for Lubbock County from 2015 to 2018, which spanned the time of Dr. Sridhar Natarajan as chief medical examiner and Dr. Sam Andrews as. Part time contract pathologist starting in February 2018 and interim chief medical examiner beginning August 4, 2018. | believe someone other Dr. Andrews authored the memoranda in order to make overly dramatic, inferential, and partially comical statements to be put into the Public realm, in light of the multiple law-enforcement investigations and the Texas Medical I Board investigation into the unlicensed performance of autopsies by Dr. Matshes, with the participation by Dr. Andrews. which include Dr. Natarajan being an alcoholic, Dr. Natarajan using Lubbock county resources for private pathology cases, and Dr. Natarajan taking bribes to change cause and manner of death statements. {n the January 28, 2019, memorandum, | am cited as the source of the three specific allegations | | Ihave never suspected that Dr. Natarajan was ever in the office in an intoxicated state. |had both brief and extended conversations privately and in the presence of other ME staff, and we never suspected Dr. Natarajan was intoxicated. Dr. Natarajan did have a brisk private consulting practice that the county acknowledged that he could continue it in his last reappointment, in either December 2017 or January 2018 when he reduced his salary. | would see him with private casework along with his luggage and laptop in his office because he was either leaving on a trip from the office or returning from a trip for his private practice to the office prior to going home. Dr. Natarajan has reiterated to me that all private work was done on his own time. Page 1 of 6The allegation that Dr. Natarajan took bribes is both fantastical and comical. When I read this, it took me several minutes to recover from the fits of laughter brought about this ridiculous statement. | did have a conversation with Dr. Matshes about the former elected corner in ‘Alabama who | replaced who | suspected was taking bribes. It is a mystery to me why Dr. Matshes would twist this into an accusation against Dr. Natarajan. | never stated that Dr. Natarajan took bribes. The allegation that | made this statement is patently false. Bribery committed by a public official is a felony and would result in a prison sentence, if convicted. Such conduct would be investigated by law enforcement after publishing the memorandum dated January 28, 2019. To date, | have not been contacted by anyone affiliated with Lubbock County for a statement, details, recollections, clarification, suspicions, etc. regarding these alleged bribes. | believe this is prima facia evidence that this and the other two allegations ascribed to me are considered “bunk" by the District Attorney. ‘The only professional ethical and financial violation | am aware of in a Medical Examiner Office if from a witness from the Travis County Medical Examiner Office whose information has been provided to law-enforcement investigators and the Texas medical board discovered that Dr. ‘Andrews, while an Assistant Medical Examiner at the Travis County Medical Examiner office, wanted to ship a brain to NAAG pathology in San Diego for neuropathologic examination. There would be a charge to the Travis County Medical Examiner office for this examination. Prior approval for this was required by either an administrator or the Chief Medical Examiner himself for the expenditure. NAAG has two websites (attached). One, www.autopsyassay.com, has the names and photographs of all its associated pathologists. Dr. Andrews is pictured and listed there as well as, Dr. Matshes. No prices are published on this website for their services. The second website, www.naagpathology.com, has no pathologists listed. It does list the prices for its consultations. The witness reports that Dr. Andrews showed the website with the prices and without his or Dr. Matshes’s name or photographs, in an attempt to obfuscate his relationship with NAAG to an administrator at the Travis County Medical Examiner office to gain the approval for payment for this neuropathologic examination. Another source, whose contact information has been provided to law-enforcement and the Texas Medical Board, has stated that Dr. Andrews and Dr. Matshes both have ownership interest in NAAG pathology. The Travis County ME witness alleges that this is a violation of professional and ethical standards and financial misconduct in the state of Texas for Dr. Andrews to direct state funds into his own pocket for profit or use government resources by a county employee/official. Similar to the allegations Dr. Andrews has raised against Dr. Natarajan. The approval was given for the shipment to and payment for neuropathologic consultation by NAAG pathology. Subsequently, this transaction was discovered by medical staff at the Travis County Medical Examiner's Office. The person who initially approved the shipment and payment allegedly attempted to obfuscate the incident to minimize their unwitting complicity. However, the close personal relationship between Doctors Andrews, Matshes, and Pinkard Page 2 of 6(Chief Medi i i nae edteal lied of Travis County) since they were both coworkers at the New Mexico ee cal Investigator makes it, in my opinion, unrealistic to believe that Dr. Pinkard e of this conflict and did not refer it for a professional ethics investigation. Sos and Dr. Matshes have identified an extra 133 cases to finalize at the Apap E of fice, at a rate of $1,500.00 per case completion (based on the previous coe i 427 cases to be completed), they stand to make an additional is) SOD eae sian cee that this is a significant impetus and motivation for making in my Baers i aries ‘statements about the case review they are conducting. This alone, in aa , Should prompt a full and deep investigation into the total financial dealings of \G pathology, income, expenditures, officers, and shareholders. It should especially prompt an investigation of the expenditures and distributions of monies received from Lubbock County in their contractual agreements with NAAG pathology. {tis my opinion that the cited “senior NAA group forensic pathologist” in this memo is Dr. Matshes. The “review” of two cases of Dr. Natarajan conducted in December 2018 and January 2019 is in my opinion simply an unnecessarily overly dramatic difference of professional opinion and is stated in such a way as to try to induce suspicion of sinister motivation of Dr. Natarajan in the reader. The subsequent paragraph is, in my opinion, a blatantly backhanded way to falsely ascribe an air truthfulness to the false allegations ascribed to me against Dr. Natarajan for accepting bribes, by using the phraseology “I cannot refute Dr. Pustilnik’s allegation that Dr. Natarajan ‘accepted bribes’... .” The use of the phrase “medical evidence” is in my opinion a disingenuous attempt at obfuscation of merely a difference of professional opinion only. | am genuinely surprised there isn’t a sinister dramatic musical soundtrack included with their memoranda. Dr. Andrews addresses allegations of former employees that Dr. Natarajan was “routinely absent from the autopsy suite, sometimes for the entire autopsy.” | am suspicious that this is actually an allegation made by Dr. Luiza Florez (a former employee of the medical examiner office) in her legal action against the medical examiner office and Lubbock county in 2015. | have personally been in the medical examiner office on occasions too-numerous- to-count when Dr. Natarajan was personally performing the autopsies. It was the routine practice to circulate between rooms if two cases we're being performed simultaneously. That practice is routine in numerous medical examiner ‘offices across the country. Dr. Natarajan did not routinely eviscerate the body (another common practice amongst forensic pathologists) which is the published job duties of the Lubbock County morgue technicians. | have never once observed a morgue tech doing an ‘examination in any capacity of the individual organs after ‘their evisceration from the body. ‘And every one of the cases! observed Dr. Natarajan doing, he personally performed the organ dissection, Dr. Natarajan also directed all the examination of the decedents at multiple points throughout each of his cases. Copious notes were taken by him and | have personally observed him doing dictations of the cases for transcription. Cases were subsequently transcribed for editorial purposes and finalization. In fact, during my time there the morgue techs were very timid about even handling the long organ dissection knives because | maintained their edges and kept them razor sharp. As the Chief Medical Examiner, Page 3 of 6