Why a sister is disputing the ME's cause of death for her sibling
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Jessica Witzel died last August in a corner store parking lot with a body temperature of 126 degrees, per an autopsy, but the Bexar County Medical Examiner's Office didn't mark heat as a contributing factor in her death, a decision her sister disputes.
State of play: Witzel's autopsy concludes that methamphetamine toxicity was the cause of death. It does not list any contributing factors. (The autopsy was first reported on and obtained by Deceleration, a nonprofit journal focused on climate change and the environment.)
- The high temperature on Aug. 22, 2024, when Witzel died, was 106 degrees. But the heat index, or the "feels like" temperature due to humidity, was 110 degrees that afternoon, local meteorologist Jason Runyen tells Axios.
- "The role the environmental exposure may or may not have played in the death cannot be definitively determined, especially in the setting of methamphetamine use," the autopsy reads.
What they're saying: "It's just unbelievable … 126, and they put down meth?" Witzel's sister, Jemmy Coleman, tells Axios.
- Coleman says her sister was unhoused and had been diagnosed with schizophrenia.
- Witzel took medication for ADHD, Coleman says, which sometimes includes levels of methamphetamine. Both ADHD and antipsychotic medications can increase the risk of heat-related illness, medical experts say.
Listing heat on the autopsy "would mean everyone in San Antonio would know that she died from being too hot," Coleman says. "And that she wasn't protected by the people that should be protecting her."

The other side: Chief medical examiner Kimberley Molina declined an interview request from Axios. Bexar County spokesperson Isaac Neri tells Axios the office does not comment on specific cases.
- Bexar County Judge Peter Sakai also declined an interview request.
- "We know that co-occurring issues like substance use and prolonged homelessness can make a person more vulnerable to extreme temperatures, hot or cold," Bexar County Public Health Department director Andrea Guerrero told Axios in an email.
- "From a public health perspective, the more information we know, the better. But we know enough at this point to understand extreme temperatures impact the communities we serve."
The big picture: As Axios has reported, people have increasingly been dying of heat-related causes in Texas, official figures show — but some counties, like Bexar, don't share how often it's happening or to whom.
It's harder to prevent heat-related deaths when the public doesn't have information about them, Kerry Cook, climate science professor at the University of Texas at Austin, tells Axios.
- "Any attempt at standardizing would really help us with trying to evaluate what we're gonna be dealing with in the coming years and decades," she says.
How it works: If heat exacerbates a pre-existing condition that leads to death, the ME can list heat as a contributing factor, Neri says. But because of how the information is kept, the office says it can't tell the public how many cases involve heat.
Zoom out: Other medical examiner's offices — such as in Houston's Harris County and Phoenix's Maricopa County — share the number of heat-related deaths in their communities.
- Austin's Travis County only records deaths as heat-related if it's the direct cause, per the Texas Tribune.
Coleman says she's struggled for years trying to get her sister off the streets and into a mental health care facility, finding a lack of local options. Had she been able to find care for Witzel, she thinks she would be alive today.
- "She shouldn't be dead."
