It noted that Adachi had heart disease and that Adachi's heart already compromised, could not sustain the stress caused by drugs and alcohol and that the stimulants caused his death.
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Cause of death from Dr. Dylan Miller, an independent pathologist-- sudden cardiac arrhythmia. In lay terms-- a heart attack. Manner of death-- Natural.
Jeff Adachi died February 22nd. So, two different conclusions. So different-- how could that be?
"There were enough red flags in the autopsy report that it didn't reflect the truth."
Bob Chan is the Adachi family lawyer. They hired Dr. Dylan Miller. He says the autopsy reveals Adachi's left artery was "80 percent" clogged. His right artery-- "50 percent" blocked-- and that it also says Adachi had an "abnormally enlarged heart" and that he had untreated cardiovascular disease.
This chronology from the Autopsy report of the night Adachi died. It says he and a female friend had dinner together at a restaurant.
His friend says he started complaining of a stomach ache and began sweating profusely, classic symptoms of cardiac arrest. They took a rideshare to a North Beach apartment which he had borrowed from a friend for the week.
Adachi's symptoms became worse. He became unresponsive. His friend called 911.
Adachi was taken to the hospital where he died. The family Chan says, is surprised at the autopsy's conclusions.
"It basically said that Jeff died of alcohol and cocaine toxicity but that the levels that were detected were too low to even be quantified."
The family's experts say that's what the Autopsy shows. The so-called "peripheral blood" tests for cocaine and alcohol, blood draws normally from the arms or lower extremities, the preferred more accurate test.
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Adachi's blood alcohol level was only ".01 percent."
Jim Norris is one of two toxicologists hired by the Adachi family. He was the longtime director of Forensic Services at the SFPD.
"That's the lowest reported level that you could possibly report. In an average-sized man, that's drinking about half a beer."
Dr. Nicholas Lemos was approached by the Adachi family and offered to review the file for free. He's the former Medical Examiner's Chief Toxicologist.
Lemos also concludes Adachi did not die from an overdose. The peripheral blood test shows "no cocaine."
A cardiac blood draw, normally a secondary test, showed only a trace of it.
"They detected cocaine but at a very low level, less than 10 nanograms per milliliter," Norris said.
So why would the Medical Examiner's conclusions show drug and alcohol overdose? The family has its suspicions.
"We were afraid there was a conflict of interest in the handling of this case," Chan said.
Chan is referring to Christopher Wirowek, the Medical Examiner's Director of Operations. He personally took charge of the ME's investigation into Adachi's death. He even went to the apartment the evening he died.
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Deputy Public Defender and Managing Attorney Danielle Harris says she's never seen an administrator from the ME's office respond to death scenes.
"The fact that this man had personally responded seemingly outside of protocol was very significant and very concerning."
Concerning because Harris says Wirowek should have recused himself from the case.
Adachi had complained about him, charging that he engaged in "dishonest conduct" and if true, that he should be "terminated."
Adachi claimed in this letter, that Wirowek lied about an important accreditation by the National Association of Medical Examiners.
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"The office had lost that accreditation and that they were misrepresenting that they were still accredited."
The City Administrators office investigated the complaint and cleared Wirowek of any misconduct.
Adachi continued to pursue the issue until his death.
The Chief Medical Examiner's office issued this statement Wednesday saying they "routinely conduct autopsies. Forensic pathologists sign off on the cause and manner of death and their reports speak for themselves."