On July 22, 2026, attorney Ben Crump stood in front of two poster boards at the NAACP National Convention in Chicago and read the preliminary findings of Nolan Xavier Wells’ second autopsy, out loud, line by line. The report itself is dense, clinical language — “etiology unknown,” “anterior internal neck structures absent.” Here’s what each of those findings actually means, explained simply.
Who wrote the report, and why there’s a second autopsy at all
Mississippi’s state medical examiner did the first autopsy on July 7, three days after Wells disappeared during a July 4 boat trip to Horn Island. That office still hasn’t released a public cause-of-death ruling[1]. Because the family didn’t want to wait in the dark, they commissioned a second, independent autopsy — performed July 10 by Dr. Roger A. Mitchell Jr., a board-certified forensic pathologist, former chief medical examiner for Washington, D.C., and current president of the National Medical Association, funded by Colin Kaepernick[1]. His preliminary report is dated July 19; Crump made it public three days later.
Claim 1: “A focal area of red discoloration… etiology unknown”
What it says: Dr. Mitchell found a patch of reddish discoloration in the soft tissue at the back of Wells’ head, in the occipital region (the base of the skull). What “etiology unknown” means: in plain English, he can see the mark, but he cannot say what caused it — not a bruise from an impact, not a mark from decomposition, not something else. It’s a documented finding without an explanation, not proof of an injury.
Claim 2: Marked decomposition limited what could be seen
What it says: By the time Dr. Mitchell examined the body on July 10 — six days after Wells went missing and roughly two weeks in Gulf Coast July heat and water — decomposition had already set in. What it means: decomposition changes skin color and tissue texture in ways that can look like bruising or mask real bruising. A forensic pathologist genuinely cannot always tell the two apart once decomposition is advanced enough, which is why the report frames so many findings as “cannot rule out” rather than definitive conclusions either way.
Claim 3: A coronal incision and Y-shaped incision were already there — from the first autopsy
What it says: When Dr. Mitchell received the body, it already had a coronal incision (a cut across the top of the skull, used to remove the brain) and a Y-shaped incision on the torso (used to open the chest and abdomen), both standard parts of a routine autopsy — because the state medical examiner’s office had already performed the first exam. The organs were not inside the body; they were separately bagged and returned with it, another normal practice. What it means for the second exam: Dr. Mitchell was doing a second, independent look at a body that had already been fully dissected once. That’s a real limitation — some things you can only see clearly on a body no one has opened yet — but it is not itself evidence of anything improper by the first medical examiner.
Claim 4: The neck structures were “absent” — and why that’s the biggest gap
What it says: The anterior (front) internal structures of the neck — things like the trachea (windpipe), the laryngeal cartilage, the thyroid gland, and the hyoid bone — were not present for Dr. Mitchell to examine. The state examiner’s office had already removed and retained them. Why this matters: the neck is exactly where a forensic pathologist looks for evidence of strangulation or other neck trauma. A fractured hyoid bone, for example, is one of the classic signs medical examiners check for. Without those structures, Dr. Mitchell’s report says plainly that he cannot rule out injury to the neck — not because he found evidence of one, but because the evidence that would let him check either way wasn’t available to him.
Claim 5: No direct exam of the airway or stomach contents
What it says: Because the chest and abdominal organs had already been opened and examined once, Dr. Mitchell could not independently examine the lungs for water (a classic drowning indicator) or the stomach contents in their original, undisturbed state. What it means: this is the same “second look at an already-opened body” limitation as above, applied to the drowning question specifically. It’s part of why the report doesn’t rule drowning in or out with confidence.
Claim 6: Toxicology is still pending
The preliminary report doesn’t include toxicology results — those tests (checking for drugs, alcohol, or other substances) take longer and haven’t been finalized. Both the state’s original autopsy and the family’s independent one are, as of this writing, still waiting on toxicology to come back[2].
The bottom-line conclusion: “cannot rule out”
Dr. Mitchell’s report lands on “Undetermined – Pending Investigation” for both cause and manner of death — the same conclusion the family’s team announced when the findings went public[1]. In the report, he states he cannot rule out whether non-accidental factors contributed to or caused Wells’ death. That is a narrower, more careful statement than “this was foul play.” It means the evidence available to him doesn’t let him close the door on that possibility — not that he found proof of it. We covered the July 22 announcement itself, including reaction from officials and the family, in our earlier report on the “undetermined” finding.
Crump also said the family is asking that Dr. Mitchell be allowed to testify before the grand jury reviewing the case, so his findings — and their limitations — can be weighed directly by the people deciding whether charges are warranted.
Race relations in Mississippi, and where things stand now
This case isn’t unfolding in a vacuum. Wells is an 18-year-old Black teenager who died in a state with a long, well-documented history of racial violence, and that history has shaped how the case has been covered and discussed from the start[3]. Mississippi NAACP chapter president Rev. John Whitfield put the community’s core demand plainly: “Justice cannot thrive in the shadows… When an 18-year-old life is lost under troubling circumstances, transparency is not a privilege to be granted – it is a public obligation.”
That demand has drawn people into the streets. Hundreds gathered in Ocean Springs on July 11 to honor Wells and call for transparency, one of several demonstrations tying his death to a longer pattern of unresolved questions around young Black men’s deaths in the state[4]. The Mississippi NAACP had already pressed for “urgency and absolute transparency” in the investigation a week after Wells disappeared[5].
That pressure has, in turn, produced pushback. After NAACP President Derrick Johnson accused Mississippi officials of being “derelict in their duties,” state and federal officials from the area rallied behind Jackson County Sheriff John Ledbetter. Congressman Mike Ezell, a former sheriff himself, said he has “full confidence in Sheriff Ledbetter and all of our law enforcement officials,” adding that he knows “firsthand the demands and pressure of their job” and trusts they’ll “handle this matter with integrity.” State Senator Jeremy England made a similar case for patience over speed: local investigators “take their time, they make sure they get it right, and they’re doing that out of respect for the family and for the entire community”[6].
On the investigation itself, Jackson County District Attorney Angel Myers McIlrath’s office has said the case will go to a grand jury — as is standard for nearly every Mississippi death that isn’t natural causes or a non-criminal accident — and that the autopsy findings will stay sealed until that review happens, which is also why officials have been instructed not to comment publicly in the meantime[7]. Separately, TMZ obtained video, timestamped 2:23 p.m. on July 4, showing a person in swim trunks matching ones Wells was seen wearing earlier that day, standing on a boat on Horn Island roughly two hours before his friends’ boat left the island around 4:30 p.m. The person’s face isn’t visible, so the video hasn’t been confirmed to show Wells, but it has been turned over to investigators[8].
None of that resolves the central question the second autopsy couldn’t answer either: what happened to Nolan Wells in the hours between that video and when his body was found. For the full day-by-day account of the case, see our companion timeline article.
The bottom line
Every finding in Dr. Mitchell’s preliminary report is a documented observation with an honestly-stated limitation attached to it — not a conclusion of foul play, and not a conclusion of accident. The biggest open question is the one the report itself identifies: without the neck structures the first autopsy retained, no pathologist looking at this body can currently rule injury to the neck in or out. That gap, plus the still-pending toxicology results from both exams, is why “undetermined” remains the only word either pathologist has used — and why the case is headed to a grand jury rather than to a public verdict from either autopsy alone.
References
- Mississippi Free Press. (2026, July 22). Nolan Wells’ independent autopsy finds his cause of death ‘undetermined,’ Crump announces. https://www.mississippifreepress.org/nolan-wells-independent-autopsy-finds-his-cause-of-death-undetermined-crump-announces/ ↩a ↩b ↩c
- CBS News. (2026, July 22). Nolan Wells’ cause and manner of death undetermined, attorney says, citing family’s autopsy. https://www.cbsnews.com/news/nolan-wells-independent-autopsy-results/ ↩
- Mississippi Today. (2026, July 13). Mississippi’s racist history a backdrop in Nolan Wells’ death. https://mississippitoday.org/2026/07/13/racism-nolan-wells-death-mississippi/ ↩
- thegrio. (2026, July 13). Hundreds gather in Mississippi to honor Nolan Wells, demand transparency as investigation continues. https://thegrio.com/2026/07/13/nolan-wells-ocean-springs-protest-community-march-transparency/ ↩
- WLOX. (2026a, July 9). Mississippi NAACP demands ‘urgency and absolute transparency’ in Nolan Wells death investigation. https://www.wlox.com/2026/07/09/mississippi-naacp-demands-urgency-absolute-transparency-nolan-wells-death-investigation/ ↩
- Fox News. (2026, July 23). Nolan Wells case: Mississippi officials defend sheriff over NAACP claims. https://www.foxnews.com/us/nolan-wells-hometown-officials-rally-behind-sheriff-derelict-duties-attack ↩
- WLOX. (2026b, July 23). Nolan Wells autopsy report to be withheld until grand jury review, district attorney says. https://www.wlox.com/2026/07/23/nolan-wells-autopsy-report-be-withheld-until-grand-jury-review-district-attorney-says/ ↩
- TMZ. (2026, July 21). Nolan Wells case: New video potentially the last before he went missing. https://www.tmz.com/2026/07/21/nolan-wells-new-video-might-show-him-before-going-missing/ ↩
Methodology: The explainer above is based on Dr. Mitchell’s preliminary report as read aloud and displayed by attorney Ben Crump at the July 22, 2026 press conference. A figure cited verbally for the size of the discoloration area was not legible enough on the report boards to confirm independently, so it is omitted here rather than repeated as fact. Every other claim is attributed to a named news organization or the report itself. This is a developing story; for the full case history, see our timeline article, and if any fact here is later corrected by investigators, this post will be updated.