Origin of drugs in death sought
Authorities are working to trace the source of multiple drugs that caused the overdose death of a 25-year-old woman at the home of a doctor in Ligonier Township five months ago.
After receiving the result of autopsy and toxicology tests on Mia N. Vottero of Southwest Greensburg, Coroner Ken Bacha has ruled her cause of death as acute combined drug toxicity, but the manner of death remains “undetermined.”
“We could not positively say whether the drugs that were present in her system were self-administered or ingested, which would make the manner of death accidental, or whether they were administered to her by someone else, which would make it a homicide,” Bacha said.
Ligonier Township Police and county detectives have not closed their investigation into Vottero's death on Sept. 14, the coroner said.
If investigators can determine how the drugs were introduced into Vottero's system, Bacha said, the manner of death could change and another death certificate with a different manner death would be issued.
Vottero's parents, P. Christopher and Michele J. Vottero of Southwest Greensburg, declined comment, citing the investigation.
“The family requests privacy at this time and has no further comment,” they said in a statement.
Vottero's body was discovered about 10 a.m. Sept. 14 in the Shawnee Drive home of Dr. William J. Monsour II, 54, who operates a weight loss clinic in Ligonier Borough.
Monsour could not be reached on Friday for comment on the coroner's ruling.
“There was a combination of drugs in her system that caused her death,” Bacha said. He declined to release the specific drugs discovered in Vottero's system because of the active investigation.
District Attorney John Peck said authorities are still trying to determine where the fatal doses of drugs came from and how they were administered.
“It's still an active, open investigation. We're still seeking to determine the origin of the drugs that caused Miss Vottero's death,” Peck said.
According to a search warrant affidavit, investigators discovered a plastic bag with an assortment of unidentified pills in a bedroom, a bag containing 12 pills in the kitchen and two bottles of medication prescribed to two other women.
The search warrant documents did not identify all of the pills found in the residence of Monsour's 54-acre estate in the Darlington-Rector area.
In Monsour's bedroom, where Vottero's body was found, police found a foil packet from a fentanyl patch, according to court documents.
Fentanyl is a powerful pain medication available only by prescription. The patches are pressed onto the bare skin, usually on the back, but also can be placed on the upper arm or chest, and the drug is slowly absorbed to control pain over a long period of time, according to the National Institute of Health.
Police reported Monsour told police that the pair had met a few weeks earlier when Voterro visited his home with a friend. Police said Monsour and Voterro arranged a date for Sept. 13 at the Wicked Googly, a downtown Ligonier bar, where Monsour played a drum solo as part of the evening's entertainment.
Monsour told to police he picked up the woman at her home about 9 p.m. and they drove to the bar. They left the bar about 1 a.m., went to Monsour's home and spent the night together.
When he awoke the next morning, Monsour initially thought Vottero was still asleep and went into another room for a brief time, he told police. About 20 minutes later he attempted to wake her and noticed she wasn't breathing.
Monsour told investigators he attempted to revive her, then called 911 about 10 a.m.
“(Monsour) said that he knew of her drinking some alcoholic beverages, but was not aware of her consuming any drugs or medication,” Ligonier Township Patrolman Robert J. Shapiro wrote in the search warrant affidavit.
Police noted in the affidavit that when officers arrived, Voterro was unresponsive and “appeared that she had been positioned in a clean and neat position on the bed prior to our arrival ... covered neatly with the bedsheets.”
Police found a generic form of the sleep aid Ambien and clonazapam, a relaxant that can cause drowsiness and loss of coordination. Monsour told police that Vottero had a blood-clotting disorder that required medication, but no such medication was found, according to the affidavit.
Paul Peirce is a staff writer for Trib Total Media. He can be reached at 724-850-2860 or firstname.lastname@example.org.