An autopsy report on a disabled 13-year-old girl whose skeletal remains were found in the woods in North Carolina in 2016 showed she was malnourished and had broken bones all over her body.

Parson's adoptive parents, Sandy and Casey Parsons, are currently serving time for fraud and will likely face charges in Erica's death in the coming months, according to law enforcement officials.

The Office of the Chief Medical Examiner in Raleigh has concluded that Erica Lynn Parsons died of "homicidal violence of undetermined means", having been unable to determine the exact cause and manner of death due to the level of decomposition, the Daily Mail reports.

Battered: An autopsy determined that Erica had fractures in various stages of healing in her nose, jaw, upper right arm, nine ribs and several vertebrae. Photo / Dr Phil
Battered: An autopsy determined that Erica had fractures in various stages of healing in her nose, jaw, upper right arm, nine ribs and several vertebrae. Photo / Dr Phil

The report, which was issued on January 3 and released to media outlets on Tuesday, said fractures in various stages of healing were found in the teenager's nose, jaw, upper right arm, nine ribs and several vertebrae.

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Parsons may also have had an untreated infection, sepsis, renal failure or poisoning, all of which could have resulted in her death.

Citing the child's "history of physical abuse", the medical examiner has not excluded a terminal blunt force injury, suffocation or strangulation as possible causes of death.

Her smaller than normal, low-density bones showed a growth deficit consistent with malnourishment, according to the report.

Erica's adoptive father, Sandy Parsons, led authorities to her remains in Chesterfield, South Carolina, in October 2016.

The child's skull and bones were found by detectives in a shallow grave in the Pageland Mount Croghan area, not far from where Sandy Parsons' mother lived.

Carolyn Parsons, Erica's birth mother (pictured), put her up for adoption at birth because she had no money to raise her.
Carolyn Parsons, Erica's birth mother (pictured), put her up for adoption at birth because she had no money to raise her.

It is not known what prompted him to begin working with the authorities after years of denying anything to do with his adoptive daughter's disappearance.

The Parsons are serving jail terms for fraud for accepting US$12,000 in federal benefits for the girl after she went missing.

The adoptive parents were arrested in 2014 and found guilty the following year. Sandy Parsons is serving eight years in a federal prison in Michigan and Casey Parsons is serving 10 years in a federal prison in Florida.

Casey Parsons, Erica's uncle, and his wife took in the disabled child when she was 5-months-old and adopted her in 2000. Her birth mother, Carolyn Parsons, told the Charlotte Observer she had no money to raise her and did not want her to be in foster care.

Erica was reported missing from the Parsons' household in Salisbury on July 30, 2013, by a young relative who said she had been missing since December 2011, when she was reportedly sent to live with her biological grandmother, Irene "Nan" Goodman, according to the report and previous media coverage.

Sandy and Casey Parsons spoke to Dr Phil about Erica's disappearance in 2013. Photo / Dr Phil
Sandy and Casey Parsons spoke to Dr Phil about Erica's disappearance in 2013. Photo / Dr Phil

An investigation was launched and attempts to locate the grandmother and child were unsuccessful. Several family members later came forward claiming that Erica was subjected to persistent physical and emotional abuse by her adoptive parents.

The developmentally disabled, malnourished girl was reportedly beaten with a belt buckle that broke her skin, was choked and thrown to the ground, had her hand slammed in a door, was forced to sleep in a closet and fed dog food.

The report mentions instances in which her fingers were bent "all the way back" and one episode in which her tooth was knocked out. At another time, the report states, her arm was fractured and a homemade cast was applied "to avoid seeking medical attention", as a result of which the limb never healed properly.

"There were other children in the home, but none of the other children were subjected to this treatment," the documents state.

Tortured to death: An autopsy report on Erica Parsons has concluded that the 13-year-old died of
Tortured to death: An autopsy report on Erica Parsons has concluded that the 13-year-old died of "homicidal violence of undetermined means". Photo / Dr Phil

A review of medical records revealed that Erica's last visit to a paediatrician was when she was 6, at which time the doctor "expressed concern for her poor growth".

A week before her disappearance in 2011, her siblings described her as "looking grey with sunken eyes, smelling bad with open, oozing cuts, very weak and complaining of not being able to breathe", the report stated.

The Rowan County Sheriff's Office says Casey and Sandy Parsons will likely face additional charges in Erica's death, but it could take up to several months.

"I want to see them get the death penalty," Erica's biological aunt Teresa Goodman told WSOC-TV following the release of the graphic autopsy report. "That's what I want because that's what they deserve."