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Characters repeat "This changes everything" threes times during the episode. See more
Dr. Warner determines cause of death to be exsanguination (bleeding to death) caused by a ruptured spleen which was caused by blunt force trauma. Later, when she learns of Ryan's heart condition she concludes cause of death to be heart failure. Any first year medical student would know that when the heart stops blood pressure drops to zero, ruling out much bleeding. If cause of death was heart failure there would be very little blood in the body cavity, ruling out exsanguination as a cause of death. Elliot did not do enough CPR to push much blood out. If cause of death is exsanguination from internal bleeding it is quite clear due to the large amount of blood in the body cavity. In addition death from exsanguination would take quite a lot longer than the few seconds between the time Elliot subdues, and cuffs Ryan and realizes Ryan is dead. See more