The six-year-old son of a multimillionaire pharmaceutical tycoon has died, just days after his father's girlfriend was found dead hanging naked from a balcony with her hands and feet bound.
Two days before Rebecca Nalepa's bizarre death, Max Shacknai had fallen down the stairs of his father's historic mansion in Coronado while in her care.
He died at Rady's Children's Hospital in San Diego yesterday, Medicis Pharmaceuticals chief executive Jonah Shacknai announced.
Last Monday, Max fell down the stairs at the Spreckels mansion in what police called a tragic accident. He was not breathing and did not have a pulse when paramedics found him.
On Wednesday, Miss Nalepa, Mr Shacknai's 32-year-old girlfriend of two years, was found dead hanging naked from a balcony at the mansion, her hands and feet bound.
Mr Shacknai's brother, Adam, who was staying in the mansion's guesthouse, cut Miss Nalepa down to try and save her then called 911. Jonah Shacknai was not at home, police said.
Sheriff's Captain Tim Curran has called the death 'very bizarre.'
Investigators have not established any connection between the two deaths, have not determined if Miss Nalepa was a crime victim and have made no arrests. They said they have not ruled out suicide.
Max's death deepens the tragedy surrounding Mr Shacknai, a multimillionaire known as a highly driven and ambitious player in the pharmaceuticals industry, whose firm has a $700million annual turnover producing cosmetic drugs similar to Botox.
It also emerged that Miss Nalepa, who has a past conviction for shoplifting, had given up her job as an ophthalmic technician in December to devote her time to Mr Shacknai, Max and his other two children.
In a joint statement with ex-wife Dina Romano, the boy's mother, Mr Shacknai said: 'With great sadness, Dina and I convey the tragic passing of our beloved son, Max (affectionately known as Maxie).
'Despite heroic efforts on the part of paramedics and hospital staff, he was unable to recover from the injuries suffered early last week. His loving, kind and vibrant spirit will be forever in our hearts and those whom he touched every day.'
Miss Nalepa was discovered naked, hanging from a second-storey balcony with her feet and hands bound with orange electrical cord, police have revealed.
She met what officers described as a 'very violent and very suspicious end' at the mansion.
While an autopsy has been completed, police are not releasing the details and have not yet ruled whether her grisly death was murder or suicide.
Speculation mounted it could be connected to the accident just days before, when Mr Shacknai's son fell down the property's grand staircase.
Miss Nalepa, a Burmese woman who had been in a relationship with Mr Shacknai for two years, was reportedly looking after the little boy at the time.
The mystery surrounding her death, which police have described as 'bizarre', deepened as it emerged a loud party had been held at the 27-room house on Tuesday night, the day before Miss Nalepa died - and the day after the little boy's accident.
San Diego County Sheriff's Office said Miss Nalepa's naked body was discovered by Mr Shacknai's brother, Adam, early on Wednesday morning.
Adam, who had been staying at a guesthouse on the property, told detectives he found her hanging by her neck from a second floor balcony, with her hands and feet bound.
He cut her down from the balcony to try to save her, before calling 911.
Firefighters tried to revive Miss Nalepa, who they described as being 'in distress', but she was later pronounced dead at the scene.
When news cameras circled overhead, her naked body was lying sprawled in a grassy courtyard, with what appeared to be orange electrical wire trailing to one side.
Tim Curran, with the San Diego County Sheriff's Department, described the circumstances as 'very suspicious', telling NBC San Diego that it appeared the victim had died a 'violent' death.
He refused to rule out suicide, saying: 'That is a possibility. [The] circumstances are bizarre.'
'It appears to be some type of a violent death, and I'm not going to compromise the integrity of the investigation by giving anything more than that at this time,' he added.
Mr Curran said Adam Shacknai is not currently being considered a suspect, although he was the only other person believed to have been in the 27-room mansion when Miss Nalepa died.
Both brothers and Mr Shacknai's ex-wife Dina, who is six-year-old Max's mother, are being questioned by police as witnesses, Curran said.
Mr Shacknai, who has been married twice before, is described as a highly-driven chief executive who makes a point of calling 1,500 dermatology customers each year on their birthdays.
Gary Nachman, a Wall Street analyst, told the San Diego Tribune: 'Jonah is very much the blood that runs through Medicis. They are a very meaningful player in the dermatology market.'
Although in Arizona, where his business is based, Mr Shacknai is known as a 'community leader' for his charity work, in Coronado he has has earned a reputation for being arrogant.
When he bought the historic Spreckels mansion in 2007, preservation officials said he agreed not to make any major changes to it. Yet he soon began petitioning to make alterations, including adding a hydraulic roof over part of the property, they claim.
Jeff Alison, a neighbour who went to City Hall meetings on the proposed changes, said: 'I thought he was as arrogant as hell. It was his way or the highway.'
In May, Miss Nalepa, who had lived with Mr Shacknai for about two years, had successfully petitioned to revert to her maiden name, Rebecca Zahau.
Her ex-husband, Neil, told 10News; 'This is all overwhelming. I'm just trying to wrap my head around it.
A friend told NBC San Diego Miss Nalepa was a 'survivor' who would never have allowed herself to have been seen naked and would not have considered suicide.
Miss Nalepa's brother-in-law Doug Loehner also issued a statement, defending her boyfriend. He said: 'Jonah is a stand-up guy. He was very devoted to Rebecca. She treated his kids as her own,' he said.
It emerged Miss Nalepa has a past conviction for shoplifting.
In 2009, she went into a Macy's store and put more than $1,000-worth of jewellery into different shopping bags. Security officers grabbed her as she was walking out and called police.
Miss Nalepa pleaded guilty to a misdemeanour, agreed to pay a $500 fine and attend a shoplifting 'diversion' course.
But her former boss at Horizon Eye Specialists & Lasik Center in Phoenix has paid tribute to Miss Nalepa, describing her as a dedicated professional who was 'full of life', the San Diego Tribune reports.
Miss Nalepa began working there as an ophthalmic technician in April 2008, but left in December last year to devote more time to Mr Shacknai and his three children.
Michael Trier said; 'We are saddened and troubled by the circumstances of her death. It is our hope that justice can be served for Rebecca.
'She was very good with our patients. She was very committed for several years to her career. She was a personality very much full of life.'
The 27-room Spreckels mansion was built in 1908 in the wealthy seaside suburb of about 24,000 people on San Diego Bay. It is named for its original owner John D. Spreckels, who also owned the majestic Hotel del Coronado and two local newspapers, the San Diego Union and San Diego Tribune.
Coronado had just one homicide last year, and the police department asked the sheriff's department to help with the investigation.
Mr Shacknai founded Medicis, based in Scottsdale, Arizona, and has been chairman and CEO since 1988.
The company's products include acne treatments Solodyn and Ziana and facial wrinkle treatment Restylane.
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