The next morning, at the end of the autopsy session, the consulting Medical Examiner declared the COD to be "drowning," pending toxicology reports. A drowning determination as a COD is implicitly a positive result based on physical evidence determined to be present, not a logical elimination of some number of other possible CsOD. To make a drowning determination, there must have been evidence present of the involuntary inspiration of ocean water (in this case) accompanied by specific histological changes indicative of hypoxia (oxygen-starvation), such as acute congestion and swelling of the capillary endothelia or over-distension of the alveoli, to make that assertion. That positive determination, once determined to have been made, should have overridden all other CsOD, unless there was further positive evidence in the toxicological results or possibly while noticing further evidence from viewing the body during the autopsy.
Arrhythmia as a COD leaves no detectable sign of its having occurred. If it is not observed by a competent medical professional over the few minutes in which it might have occurred, there is not trace or deciding test after-the-fact. Arrhythmia might be a reasonable inference if the victim has had a medical history of heart troubles, but the victim’s brother represented that Ms. Fuddy was neither given to stress (as she was experienced at heading up a large organization such as the HDOH), nor did she have any history of heart disease.
The arrhythmia COD arrived upon by the Medical Examiner relied on the non-sworn representations of passengers that accompanied Ms. Fuddy through the crash aftermath. That "testimony" was relayed from the NTSB Investigator In Charge.
For the Medical Examiner to have allowed her drowning COD for which it is generally safe to presume there was positive evidence (though allusion to such only appeared in an interim report) to be overridden by statements from medically untrained observers seems highly unusual and--in context of the rest of the hoax--more than suspicious.
He may have mixed up his cm’s with his inches and no one caught it. 4 to 5 inches vs 4 to 5 cm’s...(who cares about hair measurements and never bothered to issue a mild correction).... unless the ME was sending out a “upside down flag” type signal hoping that someone would take a closer look at the sham report he was being forced to write!