4. A 25-year-old, 34 week pregnant female was found obtunded by her husband in bed surrounded by empty medicine bottles and pills of various colors and shapes. The husband reported that they had a violent quarrel three days ago, after which he left the house. He stayed at his parents’ house and did not have any contact with his wife since his departure. According to him, she was having a difficult time coping with college and part-time work. She did not have prior suicide attempts or ideations.
Upon admission to the hospital, she was noted to have severely altered mental status, mild icteric sclera and blood pressure of 90/60 mmHg. The blood chemistry panel showed thrombocytopenia, prolonged PT, PTT, AST of 8460 IU/L, ALT of 4640 IU/L, and alkaline phosphatase of 338 IU/L. Due to absence of fetal movements, an emergency Csection was attempted. An appropriate for gestational age stillborn boy was delivered. In spite of aggressive treatment including massive doses of fresh frozen plasma and NovoSeven, the mother developed multi-organ failure and expired next day. Both bodies were sent to Medical Examiner’s office. An autopsy of the mother revealed a moderately jaundiced Caucasian female. All internal organs displayed scattered petechial hemorrhage. Severe pulmonary congestion, bilateral pleural effusion, ascites and hepatomegaly with steatosis were observed. Microscopic findings in the liver are shown in the picture (see image). All of the following about the main culprit of this female’s demise is true EXEPT: