Man is the maker of his own happiness..

1. Man is the maker of his own happiness..

2. Forensic PathologyTime of Death Investigation Dr. Venkatesh M. Shashidhar Associate Professor of Pathology Fiji School of Medicine – Commitment to Excellence…

3. DEATHCessation of spontaneous heart and breathing functions with-out the use of any mechanical devices.Brain deathIrreversible loss of cerebral function.

4. SUSPENDED ANIMATION(Apparent death)In this condition signs of life are not found as the functions are interrupted for some time, or are reduced to minimum.However,life continues and resuscitation is successful in such cases.

5. Involuntary suspension of animation of animation lasting from a few seconds to half-an-hour or more may be found in newborn infants, drowning, electrocution, cholera, after anaesthesia, typhoid fever, shock, sunstroke, cerebral concussion, insanity, etc.

6. Changes in the skinSkin becomes pale and ashy-white and loses elasticity within a few minutes of death.The lips appear brownish, dry and hard due to drying

7. Changes in the eye- loss of corneal reflex- opacity of the cornea- flaccidity of the eyeball - pupils dilated- retinal vessels show fragmentation of the blood column

8. Quotes… “A medical witness who attempts to determine the time of death from temperature estimation in minutes or fractions of hours is exposing himself to a severe challenge to his expertise which may well amount to near ridicule, thus denigrating the rest of his evidence"

9. Sources of Evidence • Corporal evidence - present in the body. • Environmental and associated evidence. at the site of crime. • Anamnestic evidence, i.e. that based on the deceased's ordinary habits, movements, and day to day activities. All three sources of evidence should be explored and assessed

10. Methods for estimating TOD: • The rate method: by measuring events that occur at known rates.E.g. Rigor mortis, body temp, degree of putrefaction. • The concurrence method: By Comparing the occurrence of events which took place at known times. E.g. a wrist watch stopped by a blow during an assault, the extent of digestion of the last known meal.

11. Postmortem changes and TOD: • Many physico-chemical changes occur after birth in a fairly orderly fashion until the body disintegrates. • Each change has its own time factor or rate. • influenced by internal & external factors. • Longer the PM interval, the less precise is the estimate of the time of death.

12. 1. Algor Mortis: (body cooling) • Most useful single indicator in first 24 hours. (in cool places only – not in tropic) • No Oral or axillary temperature. • per rectum or the intra-hepatic/sub-hepatic temperature an abdominal stab. • clinical thermometer’s range is too small. • A chemical thermometer 10-12" long with a range from 0-50o Celsius or digital probe thermometer is ideal. • Normal Temp 35.9oC (96.7oF) to 37.2oC (99oF). The rectal temp is + 0.3oC (0.5F)

13. Algor Mortis: Factors affecting. • The "size" of the body. Fat slow..! • Clothing and coverings • Movement and humidity of the air. • Immersion in water. • Clothed body will cool in air at the rate of about 1.5oC an hour for the first 6 hours & 1oC for the first 12h.

14. "What we see depends mainly on what we look for."Sir John Lubbock1834-1913, British Statesman and Naturalist

15. MUSCULAR CHANGESAfter death, the muscles of the body pass through three stages:1) Primary relaxation or flaccidity2) Rigor mortis or cadaveric rigidity3) Secondary flaccidity

16. RIGOR MORTIS • Body becomes hard & fixed. (no shortening) • The shape or position depends upon the position at the time of death. • If the body is supine then the large joints of the limbs become slightly flexed. • Rigor does not cause any significant change in the attitude adopted at death. • Rigor involves both voluntary and involuntary muscles.

17. Rigor Mortis:

18. 2. RIGOR MORTIS • Latin for "stiffness of death". • Starts within the first 4 hours(90%) • The face first then hands and feet. • Maximal rigor develops in 12 to 48 hours • Rigor disappears in 36-48h in cool temp or early 9-12h in hot climates. • Intensity of rigor depends on muscle mass. • Later leads to flaccidity due to lysis.

19. RIGOR MORTIS • Fall in ATP – links actin and myosin – rigor. • Exhaustion before death – Rapid rigor. • Rapid cooling of the body after death can inhibit rigor mortis, but rigor appears rapidly when the body is thawed.

20. 3. LIVOR MORTIS • Lividity: Dark purple coloration (not cyanosis) over dependent areas due to pooling of blood. • Starts in 20-30 min as dull red patches then deepen in intensity and coalesce to form large areas of reddish-purple discoloration. • Within 60min blood becomes in-coagulable due to the release of fibrinolysins. • Clots may persist when the mass of clot is too large.

21. 3. LIVOR MORTIS • Carbon monoxide poisoning or refrigeration soon may cause "cherry red“ or pink (methaemoglobin). • After about 10-12 hours the lividity becomes "fixed" and repositioning the body, will result in a dual pattern of lividity since the primary distribution will not fade completely. • The blanching of post mortem lividity by thumb pressure indicates that the lividity is not fully fixed.

22. 3. LIVOR MORTIS • Distribution of lividity reflects the position at death. • Contact pallor or pressure pallor. A supine corpse will display contact pallor over the shoulderblades, buttocks, calves, heels and location of firm fitting clothing, belts or any firm object lying beneath the body. • Lividity becomes visible in 1/2 to 4 hours. well developed in next 4 hours and maximum at 8 to 12 hours. *Polson

23. 3. LIVOR MORTIS • In the heart, lividity may be mistaken for an acute MI, in lungs may appear as hemorrhage or pneumonia. Livid coils of intestine may falsely suggest haemorrhagic infarction. • In the areas of lividity the blood is confined to vessels while in bruising the blood infiltrates the tissues and cannot be readily washed away under running tap water.

24. 4. DECOMPOSITION (Putrefaction) • by the action of bacteria (putrification) and endogenous enzymes (autolysis). • Dissolution of tissues - gases, liquids & salts • Common bacteria are normal commensals coliforms, Clostridium, micrococci etc. fungi, such as Penicillium & Apergillus & sometimes from insects, which may be mature or larval stage. • Septicaemia & temperature will hasten the process. 1-14 days.

25. 4. DECOMPOSITION (Putrefaction) • Obese, oedema bodies putrefy more rapidly. • 1 week of putrefaction in air = 2 weeks in water = 8 weeks in soil at similar temp. Casper's dictum. • Buried in well drained soil, an adult body is reduced to a skeleton in about 10 years.

26. 4. DECOMPOSITION (Putrefaction) • Greenish discoloration of anterior abdominal skin. (sulph-haemoglobin) • Commonly begins in the right iliac fossa. • "marbling" the superficial veins of the skin become visible as a purple-brown network. • Epidermal shedding revealing a shiny, moist, pink base – dry - yellow parchment appearance. resembles ante-mortem abrasions and scalds.

27. Decomposition / Marbling

28. Time line.. • 30 minutes... lividity (light-skinned). Rigor may be • 3 hours... Lividity is usually obvious. • 5 hours... Rigor is usually obvious. • 10 hours... The body feels cold. • 12-18 hours... Rigor is usually maximum. • 24 hours... Rigor is starting to lyse; later if it's hot out • 2 days... Green discoloration (iron sulfide) on the flanks • 2-3 days... Green discoloration on the abdomen • 3-4 days... Marbling (red discoloration of surface veins) • 5-6 days... Epidermis separates from dermis • 2 weeks... Bloated, lots of gas in tissues • 3 weeks... Gas bursting organs, eyes bulge, tissues soft • 4 weeks... Semi-liquid, slime…!

29. Decomposition / Epidermal Peeling.

30. "The world is a great mirror. It reflects back to you what you are. If you are loving, friendly, helpful, the world will prove loving friendly and helpful to you. The world is what you are." Thomas Dreier, Author.