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Everett Palmer Jr. died while in custody at the York County Prison last April. His mother questions the circumstances of his death. York Dispatch

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A forensic pathologist hired by the family of a York County Prison inmate who died in custody said he doesn't believe York County's coroner is hiding anything.

"The coroner's office did a good job," Dr. Zhongxue Hua of New York City told The York Dispatch on Wednesday, June 19. "No one is hiding anything, I believe."

Hua conducted an autopsy on the body of Everett Palmer at the request of Palmer's family. It was the second autopsy performed on the body; the first was done at the request of York County Coroner Pam Gay.

Hua said he agrees with the coroner's determination on Palmer's cause of death, based on the opinion of Forensic Pathology Associates in Allentown, which conducts independent autopsies for York County and other counties in Pennsylvania.

Palmer died of "complications following an excited state, associated with methamphetamine toxicity, during physical restraint," with "probable sickling red cell disorder" as a contributing factor, according to the 22-page autopsy report from Forensic Pathology Associates, which the Palmer family's attorney, Lee Merritt, supplied to The York Dispatch.

However, Hua said he disagrees with the coroner's current finding on Palmer's manner of death, which she has listed as undetermined. Gay has said that ruling can be changed, depending on what the investigation determines.

Hua said he believes the manner of death should be homicide, but he noted that doesn't mean prison guards intended to harm Palmer.

"I would be the first one to say that (they) never tried to kill this person," he told The York Dispatch.

Hua also said that just because a case is ruled a homicide doesn't mean someone intentionally tried to kill a decedent. Homicides can be the result of unintentional actions, the physician said.

Gay has previously said that homicide is "death at the hands of another" and doesn't mean a crime was necessarily committed.

There was no real injury to Palmer's neck, according to Hua. The New York Times has reported that a funeral director saw bruising on Palmer's neck.

Suicidal thoughts? Palmer, 41, of Seaford, Delaware, died April 9, 2018, in York Hospital, where he was taken after being found repeatedly hitting his head against a wall in his prison cell, authorities have said.

He had been locked up for two days.

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State police and the York County District Attorney's Office say the investigation into Palmer's death remains active.

Palmer's family members have said they believe he was murdered. Last summer, they held a protest in front of the York County Judicial Center, seeking answers for their concerns.

The official autopsy report states that when Palmer was admitted to York County Prison on April 7, 2018, he was "reportedly rambling and stated that he had suicidal thoughts."

Palmer was evaluated by nursing staff when he arrived at the prison, then "placed in a single person cell on constant watch as a suicide risk based on the results of his intake psychological evaluation," the report states.

According to the autopsy report, prison records show that medical staff checked on him multiple times over the two days, including when he was seen by staff the day before his death, during which staff found bruises on his elbows and a finger; Palmer reportedly told medical staff he slipped in his cell.

'Rambling, incoherent': When medical staff went to his cell door to do a wellness check at 3:40 a.m. April 9, 2018 — less than two hours before Palmer's death —he "was kneeling behind the cell door and covered the door with his mattress; he was reportedly rambling, incoherent and did not respond to medical staff," the autopsy report states. "He eventually responded to correctional staff and the mattress was removed."

About 25 minutes later, Palmer was seen hitting his head on the Plexiglas portion of his cell room door, according to the report, which states that although the window had a Plexiglas cover, there was a sharp metal plate on the wall with a sharp corner to it.

A correctional officer ordered Palmer to lie down and put his arms behind his back, but he did not comply, the report states. Other guards were called for backup, at which point it was noted that Palmer had cuts and a possible puncture wound to the back of his head, the report states.

One guard, holding a tactical shield, opened the cell door, and a second shocked Palmer with a Taser, which had no effect on Palmer, according to the report.

After Palmer was tased a second time, officers entered his cell, "initially pinned him to the bunk using the shield" and got him to the floor, according to the report.

More: Coroner, DA receive threats after 'false' reports about Everett Palmer's death investigation

More: York County Coroner on prison death: Palmer's organs never 'missing'

More: 'Undetermined': York coroner releases autopsy results days after family claims murder

More: Lawyer, family allege that man who died in York County prison was murdered

"During this time the decedent continued to struggle (including kicking and attempts at biting); the officers secured the decedent by various physical control techniques including securing his mid-section and lower extremities, securing his hand by applying the mandibular angle pressure point, applying shackles to his lower extremities and applying handcuffs to his wrists," according to the autopsy report.

'Spit hood': Correctional officers then put a "spit hood" over his head to prevent him from spitting or biting, according to the report.

"The officers lifted him out of the cell and into the restraint chair and applied the lap belt, leg restraints and hand restraints (in that order). Video footage of the events inside of the decedent's cell did not give a clear picture of the in-cell restraint process until the decedent was fully restrained in the cell," according to the report.

The video footage indicates five guards were in Palmer's prison cell trying to restrain him, the report states. After restraining Palmer, they carried him out of his cell at 4:24 a.m.; he was in the prison's medical unit five minutes later, according to the autopsy report.

Prison medical staff noted Palmer had shallow breathing, a "non-regular" heartbeat and fixed and dilated pupils.

"He did not move and was unresponsive to light and smelling salts per video footage," the report states. "The decedent was removed from the restraint chair onto the floor at 0438 hours. ... Cardiac compressions were started by staff members at 0443 hours and continued by EMS upon their arrival."

Palmer was transported to York Hospital about 5:05 a.m., the report states. He was pronounced dead at 5:46 a.m., according to the report.

The report indicates that although Palmer had extensive bruising to his head, those injuries did not contribute to his death.

Palmer, who was 6-feet-2 and weighed 222 pounds, suffered abrasions and cuts to multiple areas of his forehead and scalp as well as bruising to his extremities, left hip and left side of his torso, according to the report.

Who gave Palmer meth? How a toxic level of methamphetamine got into Palmer's system while he was locked in a prison cell by himself remains a mystery.

The autopsy report summarizes side effects of meth:

"Methamphetamine is associated with confusion, psychosis, hyperactivity and cardiac toxicity (elevated blood pressure and heart rate)."

York County District Attorney Dave Sunday has said he cannot comment about ongoing investigations.

— Reach Liz Evans Scolforo at levans@yorkdispatch.com or on Twitter at @LizScolforoYD.

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