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Forensic Pathology: Unraveling Mysteries of Death

Explore the realm of forensic pathology, where death teaches the living. Delve into the roles of coroners and medical examiners, the investigation process, training requirements, and key forensic concepts like postmortem changes. Learn about causes and manners of death, forensic investigations, and the importance of rigorous methods in determining the circumstances of death.

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Forensic Pathology: Unraveling Mysteries of Death

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  1. Forensic Pathology “This is the place where death rejoices to teach those who live.”

  2. Introduction • A death that is unexpected or is thought to have been caused by injury or trauma is always investigated. • Coroner • Medical Examiner (how different?)

  3. Coroner vs. Medical Examiner • Coroner – • a public official • appointed or elected • makes inquiries into deaths • completes death certificates • Determines cause/manner of death • Decides if foul play • May or may not have medical training

  4. Coroner vs. Medical Examiner • Medical Examiner – • a physician • evaluates medical history • physical exam of deceased to determine cause and manner of death (autopsy) • Must receive special training to become a forensic pathologist • Forensic Pathology – determine unnatural or suspicious disease or injury • In most large US cities, the medical examiner is required to be a forensic pathologist.

  5. Forensic Pathologist Education and Training • Medical school – 4 years • Residency in general pathology-3 to 5 years • Fellowship- work in medical examiner's office (forensic pathology)- 1 year • American Board of Pathology Exam • Training / Knowledge in other areas of Forensics

  6. In US- 500 Forensic Pathologists • About 25 of the 500 also have LAW DEGREES

  7. Deaths Investigated Two Main Categories • 1. Persons who die suddenly when in apparent good health • Ex. • Public Health Threat (bacterial meningitis) • Death in public places (electrocution in public place) • Maternal Death • Death outside of medical facility

  8. Deaths Investigated 2. Deaths caused by unnatural causes Examples?: • Acts of violence • Drug related • Trauma / Asphyxiation • Weather • Vehicular accident

  9. Deaths Investigated • Special Categories: • Under 18 • Death of an individual under legally dependent care. • Death in correctional facility • On aircraft or ship • MURDERS ARE THE SMALLEST NUMBER OF DEATHS INVESTIGATED!

  10. Three facets of guilt? • Means • Motive • Opportunity

  11. Medical Examiner’s Duties: • Review eyewitness statements • Examine crime scene • Autopsy • Photography • Report • Testimony

  12. Duties and Responsibilities • Establish the cause of death • Establish the time of death • Infer the type of weapon used • Determine the manner and mechanism of death • Identify the deceased • Determine the effects of trauma or pre-existing conditions.

  13. Postmortem Lividity(Livor Mortis) • The Settling of blood that causes the skin to change color

  14. 30 Minutes: • Changes in skin color first appear on fair-skinned persons

  15. 4 to 8 hours: • The blood in capillaries bursts out and settles according to gravity (RBC very dense) • where is red/purple coloration if one dies upright? on stomach? on back? • Eventually blood is fixed (8 hours) no matter how body is moved

  16. Between 1 and 8 hours: • (1) Blanching • whiteness of skin due to pressure on capillaries • after 8-12 hours, skin will not change color anymore Light-colored marks made by finger pressure

  17. (2) • Why would a trained investigator begin here when looking for blanching? • If a body was moved, it is likely that the person put their hands under victim’s armpits.

  18. Why is livor mortis important? • time of death estimation • to determine if the body has been moved

  19. Rigor Mortis • The period of time that a body goes through a state of rigidity • Caused by lack of ATP to release muscle contraction.

  20. Rigor Mortis Progression • Jaw and Neck

  21. 2) Shorter muscles – fingers and toes

  22. 3) Then moves down and out the long muscles of the legs and forearms

  23. 4) Legs stiffen last

  24. Rigor Mortis Timeline • 1-4 hours: Jaw and neck rigid, rest of body limp • Up to 8 hours: everything down to the legs is rigid • 12 hours: everything remains rigid • 24 hours: Jaw is limp, everything else is rigid • 30-32 hours: everything but the legs are limp • 36 hours: entire body is limp (no rigidity) decomposition has begun

  25. Circumstances affecting Rigor Mortis? • Starvation

  26. Extreme temperatures

  27. Physical exertion

  28. Effects of fire

  29. or water (in the case of drowning)

  30. Algor Mortis • Either Liver temperature (LT) or Rectal Temperature (RT) • Drop of about 1-1.5 degrees per hour

  31. Factors affecting temperature loss?: • Size (mass) of body • Body Temperature at death • Temperature of crime scene • Clothing worn

  32. Decomposition • Bacteria: CO2 is produced, abdominal swelling • Autolysis (self digestion by enzymes): Produces Methane, Ammonia

  33. Blood vessels: • discoloration of skin in upper abdomen • marbling effect • Red → darker red → purple → green

  34. Putracine – foul- smelling, nauseating odors • (1,4 diaminobutane)

  35. Cause, Manner, and Mechanism of Death? • Cause – disease or injury that initiated the lethal chain of events that lead to death (ex?) • Mechanism – biochemical or physiological abnormality produced by the cause of death that is incompatible with life. (ex?) • exsanguation, haemorrhage, acidosis, asytole, ventricular fibrillation, sepsis,

  36. Manner of Death (5) • Homicide • Suicide • Accidental – trauma occurring from acts NO REASONABLE person would have felt have a high probability of injury or death • Natural cause • Undetermined

  37. Determination of Cause of Death • One can die of a massive hemorrhage • (the mechanism of death) • due to a gunshot wound through the head • (the cause of death) • as a result of being shot (homicide), • shooting yourself (suicide) • dropping the gun and it discharging (accidental), • or not being able to tell how it occurred (undetermined). • All of which are manners of death.

  38. Challenges that a medical examiner faces? • Emotionally? • Professionally? • Physically?

  39. The Autopsy Examination “You've got to be the type of person who can emotionally disconnect [from] it. I mean, if you went into a case looking at it as, 'Geez, this is somebody's little girl or somebody's little boy,' you'd never be able to do the case. You can't personalize it in any way... When you walk in, you never forget that this is somebody's loved one. You never forget that, but when you walk in to do the job, you kinda put that information aside. You look at them more as a puzzle, and your job is to sort out this puzzle. I've got to find out what happened. Who, what, why, when, where? I mean, that's what my job is, to sort out and get those answers. And, do it in a respectful way. A lot of people can't do this type of job. A lot of people don't want to do this type of job. There are a lot of jobs I wouldn't want to do either.” Eric Kiesel Atlanta's Fulton County Deputy Chief Medical Examiner

  40. HISTORY OF AUTOPSY • EGYPTIANS • 1600 BCE • HIPPOCRATES • – 5TH + 4TH CENTURY BCE

  41. AUTOPSIES- DETERMINE THE CAUSE OF DEATH: (Rembrandt painting)

  42. The Autopsy Examination • Legality • Permission required – family can request an autopsy be performed • Next of kin must sign autopsy permit. • Religious considerations • Mandatory when death is suspicious (of foul play) or if public health concern (in most states)

  43. The Autopsy Examination • Attending Personnel • Diener – autopsy assistant • Prosector - pathologist • Pathologist Assistant • Precautions – protective clothing

  44. Forensic Autopsy An intensive search for information and to locate PHYSICAL EVIDENCE to determine the cause of death

  45. The Autopsy Examination • At this point, a general description of the body is made. All identifying features are noted including: • Race • Sex • Hair color and length • Eye color • Approximate age • Any identifying features (scars, tattoos, etc.)

  46. The Autopsy Examination • The External Exam = done first when body is examined. • Looking for: • Wounds • Contusions (Bruises) • Unusual marks on the body • Overall impression of the body

  47. The Autopsy Examination • Opening the Body • Y-incision: incision made from left and right shoulders to mid-chest and straight down to pubic region.

  48. No bleeding (usually) because there is no blood pressure. • If head is to be opened, an incision is made across the head from one ear to the other. -----------------------------------------

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