 He points out that Lorber's shirt is wrinkled, from when Lorber grabbed at his chest.He probably flailed around and tried to get to his ticker pills, but he never made it (in the process of flailing around, he also knocked a box of cigars off his desk and onto the floor).Monk reveals that Lorber had been dead for several minutes when he was shot - there isn't enough blood from the bullet holes, and there would have been more blood present if his heart was still functioning when he was shot.