A 33-year-old man died in the Wake County jail last year. Here’s what his autopsy says.
A 33-year-old man who died at the Wake County jail last year succumbed to heart disease, a newly released autopsy from the State Medical Examiner’s Office states.
The Wake County Sheriff’s Office announced the death of Alvin Saunders in October 2025, The News & Observer previously reported. He was being held on $100,000 bail after being charged with felony assault on a person with a disability and other crimes.
Saunders had an enlarged heart, moderate coronary artery disease, a buildup of plaque in his aorta and thickening of the walls of his heart chambers, according to the autopsy report.
The autopsy found no illicit substances or trauma that could have caused Saunders’ death and concluded his cause of death — hypertensive and atherosclerotic cardiovascular disease — was “natural.”
DA: No criminal activity found
As is standard for in-custody deaths, the Sheriff’s Office asked the State Bureau of Investigation to investigative, The N&O previously reported.
Wake County District Attorney Lorrin Freeman reviewed the SBI’s investigation and determined there was no criminal activity associated with Saunders’ death.
Details from the investigation report
The medical examiner’s preliminary summary in the case reveals that the day of his death, detention officers twice saw Saunders lying on the floor naked before they found him unresponsive around 7 a.m.
Saunders was being held in the Wake County Detention Center’s psychiatric unit, according to the investigation report. He had a history of autism, mental disorders, substance abuse and suicidal ideation. He stayed in a single cell for 23 hours a day, but the report does not say why.
At 12:05 a.m. Oct. 11, 2025, Alvin Saunders lay naked in his cell, according to the report. Officers determined he was breathing, and his eyes were moving, but the report states it is not clear if he was responsive or in an altered mental state. Officers told a facility nurse, but the report states it is unclear if the nurse took any action.
At 5 a.m., an officer placed breakfast for Saunders onto his cell mattress, according to the report. The officer noted Saunders was still on the floor but did not check on him further.
At 7:09 a.m., an officer performing a routine check found Saunders still on the floor, according to the report. Officers entered the cell, found Saunders unresponsive and not breathing and began CPR.
Fire and EMS crews arrived at 7:31 a.m. and took over CPR, according to the report. Saunders was pronounced dead at 7:47 a.m.
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