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The death of Bill Bishop: Was it a heart attack?

This is the second in a series exploring theories into Bill Bishop’s death.

After developer Bill Bishop was apparently found unconscious with a dog leash around his neck and later died, investigators became suspicious of his teenage son Alexander and charged him with murder.

Alexander has suggested it was a tragic accident caused by the family dog, Winston. Yet Bishop’s ex-wife and family has posed a simpler explanation: Bill died of a heart attack.

But the heart attack theory doesn’t hold up very well. Four forensics experts who reviewed his autopsy report for the 9th Street Journal were doubtful that Bill died of a heart attack. Three said there was no evidence of one, and the fourth said it was unlikely. 

“There’s no evidence of a cardiac event. The defense is just trying to fish,” said Bill Smock, police surgeon for the Louisville Metro Police Department and a staff member of the Training Institute for Strangulation Prevention in San Diego. 

Where is the case now?

It’s not clear how much Alexander’s attorney Allyn Sharp will rely on a possible cardiac event in her defense. With the case far from trial amid of a backlog of murder cases, she has a lot of time to prepare. 

Sharp did not respond to request for comment in time for publication. She has previously told the 9th Street Journal that she will not speak about the case outside the court record. 

In a February hearing, Sharp said Alexander didn’t kill Bill, never had any issues with discipline, and had no motive to kill his father. 

Alexander told first responders on April 18, 2018 he found Bill unresponsive in the theater of the family’s Hope Valley home. He said his father was in an armchair with Winston’s leash wrapped around his neck, with Winston still on the leash, according to court documents. Bill died three days later at Duke Hospital. 

The case was shaken up earlier this fall when Judge Orlando F. Hudson Jr. threw out swaths of key evidence that implied Alexander had plotted to kill Bill and reap the benefits of his $5.5 million estate, pending an appeal. 

“When you remove those material misstatements and omissions, it is simply a death that is tragic, but not suspicious,” Sharp said at a September hearing in her eventually successful bid to exclude evidence.

There has not been a trial date set in the case. Alexander, who was 16 at the time of his father’s death, is free on a $250,000 unsecured bond. 

Alexander suggests the dog did it; family blames heart attack

How will Sharp build her case to defend Alexander? There are clues in his statements to first responders and comments that family members have made to the media.

Before calling 911 that evening, Alexander called his mother, Sharon Bishop, five times. In the 911 call, Alexander said he thought that Bill was dead and that he took the leash off his neck. 

“I think my dog got his [leash] wrapped around his throat and his face is purple,” he said.

Bill Bishop with his dog Winston.

An emergency supervisor at the scene said that Alexander thought that “the dog just happened to freak out and get him wrapped up in it,” according to court documents. Bill died three days later. 

The “dog killed my dad” defense is weak, experts say. The 9th Street Journal spoke with four forensics experts who all agreed it was unlikely Winston could have killed Bill. The injuries described in the autopsy report were not consistent with a dog essentially strangling Bill with a leash, they said. 

“It looks like someone took the dog leash and then came up from behind him, wrapped it around one time and strangled him,” said Kendall Von Crowns, deputy chief medical examiner with the Travis County (Texas) Medical Examiner’s office.

Medical examiner says homicide;  family says heart attack

The state medical examiner determined Bill’s death was a homicide caused by strangulation with a “ligature,” or a cord-like object. 

This conclusion was based upon a mark on Bill’s neck that signaled strangulation, cartilage fractures in his neck, and hemorrhages. 

Bill also had an enlarged heart and an 80 percent blockage in his heart’s left main coronary artery and a second left coronary artery, the report found. The report added that Bill had a history of depression, a recent divorce, and prostate cancer, in addition to an injury to his right arm in 2012 that rendered it “largely functionless.”

The Bishop family hired a pathologist, Dr. Jonathan Privette, who studied the autopsy report and argued that the medical examiner should have ruled the cause of death “undetermined” instead of a homicide. 

Privette said that blockages higher than 75 percent can lead to “sudden heart ‘events’ and death.”

That supports the family’s previous statements. An attorney for Alexander and his brother in the estate matters told the Durham Herald-Sun last year that the family thinks a heart attack killed Bill. 

“His physicians told the family that Bill had suffered a heart attack and never told them otherwise,” Idol said. “We believe this was the actual cause of his death.”

And shortly after Bill’s death, Sharon Bishop told the Tampa Bay Times that Bill had suffered a heart attack. 

Experts: Unlikely Bill died from a heart attack, blockages insignificant

Experts agreed that the blockage was enough to cause cardiac events, but that didn’t mean the cause of death was likely a heart attack. 

Jeffrey Springer, a Louisville forensic pathologist, and Kendall Von Crowns, deputy chief medical examiner with the Travis County (Texas) medical examiner’s office, agreed that his coronary arteries were blocked enough to cause some sort of cardiac event. All four experts said Bill had heart disease. 

But the evidence in the autopsy didn’t indicate that a heart attack caused Bill’s death. 

“He’s got coronary artery disease, as probably everyone in (the future jury will have) coronary artery disease. (Yet) the blood is still flowing to the heart. That’s normal,” said Bill Smock, police surgeon for the Louisville Metro Police Department who is on the staff of the Training Institute for Strangulation Prevention in San Diego. 

“There’s a lot of people walking around with 80, 90, or even close to 100 percent blockage of it. When it gets blocked, a heart attack is when blood doesn’t get to an area of the heart. At some point, if you live long enough, it’ll probably get completely blocked. But it has nothing to do with why he is dead. There’s no evidence that this is a cardiac event. Zero.”

Springer said that Bill could have had a heart attack during to the strangulation, but the cause of death still would have been strangulation. 

“When a man is found dead (in the basement chair) with a leash wrapped around his neck and has the autopsy findings Mr. Bishop had, he did not simply suffer a heart attack,” Springer said. 

“He still has ligature marks around his neck. Those wouldn’t be caused by a heart attack,” said Katherine Maloney, Deputy Chief Medical Examiner for the Erie County Medical Examiner’s Office in New York. 

All four experts pointed to a lack of an “acute thrombus” or infarction in Bill’s arteries, meaning there was no blood clot blocking a vein. That is a tell-tale sign of a heart attack, they said. 

Evidence of heart attack can’t be seen unless the victim survives for more than 24 hours after suffering the attack, Crowns said. But Bill survived longer than that, assuming the cardiac event happened on the day Alexander said he found Bill unresponsive. 

Maloney suggested that the family may be using the term “heart attack” loosely to make it more understandable. She suggested they may be referring to a fatal cardiac arrhythmia, an irregular heartbeat that could be a complication from his heart disease. 

But even in this case, it would be unlikely that killed him, Maloney said. In the case of fatal cardiac arrhythmia, people aren’t usually found sitting comfortably in a chair. In these cases, the victim’s heart stops beating suddenly, leading them to “hit the floor” wherever they are standing, she said. 

And the evidence of strangulation and where Alexander said he found Bill don’t match that theory. 

“If he’s sitting in the chair with a dog leash, how does the leash get up in the air and around his neck? The dog jumps up and wraps the leash around his neck?,” Maloney said. “The leash would have to defy gravity to get up around his neck.”

Maloney was also suspicious of the timing. Once a strangulation or arrhythmia victim loses oxygen to the brain, they have six minutes (10 maximum) before they die. 

With that narrow window, she said it was more likely that Alexander was there when it happened and then called 911. Otherwise, Bill wouldn’t have been able to survive for three days on the ventilator; he would have died at the scene. 

“So coincidentally, as either the dog was strangling him or he was having a heart attack, within 10 minutes of that happening, his son finds him? That’s pretty good timing,” Maloney said. “His spidey senses must have gone off.”

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