Forensic Medicine Procedure Manual Revised 2010

Forensic Medicine Procedure Manual Revised 2010 Katelyn Brownlow Laura Garcia Chanelle Graham Anyssa Melbourne

Table of Contents • Forensic Medicine……………………………………………………………... Title page • Table of Contents……………………………………………………………… Slide 2 • How to Get Started…………………………………………………….............Slide 3 • Overview of Competition………………………………………………………..Slide 4 • Difference Between the Written and Clinical Portions…………………….Slide 5 • The Written Category……………………….………………………………….….Slide 6 • Study Weeks……………………………………………………………………......Slide 7 • Sections………………………………………………………………………..Slides 5- 71 • Psychology/ Psychiatry • Anthropology - Entomology • DNA Analysis - Pathology • Odontology - Taphonomy • Toxicology - Traumatic Death • Identification of the Blood - Nursing • Tips From Us to You ……………………………………………………………..Slide 72

Getting Started • Open your internet browser and go to www.hosa.org • On the left hand side select competitive events • Locate the competitive events guidelines • Select Forensic Medicine under the teamwork events category. • Review the pdf file that appears.

Overview of Competition • Round 1: Each team will be evaluated by a fifty question exam. This test must be completed in one hour. • Round 2: Each team is required to solve a crime. The team will be given a 5 x 8 index card for note taking. The competition consists of two sections, case study analysis ( 6 minutes) and written conclusion (30 minutes).

Psychology Table of Contents • What is Forensic Psychology? • Education • History • Distinction Between Clinical and Forensic • Psychological Testing • Deception Syndromes

What is Forensic Psychology? • The application of the science and profession of psychology to questions and issues relating to law and the legal system. • Functions performed within forensic psychology • Competency evaluations • Sentencing recommendations • Evaluating the risk of reoffending • Testimony as an expert witness • Child custody evaluations

What is Forensic Psychology? Cont. • Forensic psychology can take one of two different directions • 1. Research findings have been used to inform various legal processes. • 2. The practice of clinical forensic psychology has become an integral part of the overall field of forensic science.

Education • Obtain an undergraduate degree in psychology and criminology • Obtain a masters/ doctorate in clinical psychology • Attend seminars in forensic psychology • Intern for two years • Pass state certification exam • Attain certificate from the American board of Psychology

History • 1909 William Healy established the first juvenile court clinic (1914 adult) • Didn’t gain licensure as an independent profession until 1970s • In 2001, the American Psychological Association officially recognized forensic psychology as a specialization within psychology.

Distinction Between Clinical and Forensic Psychology • Scope • Client’s Perspective • Voluntariness • Validity • Relationship between psychologist and client • Pace and setting

Psychological Testing Personality, Psychopathology, and Mental Function Purpose- Use establish standards to compare one person with others on various characteristics Types; • Personality Inventories • Projective Personality tests • General Intellectual Functioning • Memory Functioning • Neuropsychological Impairment • Specific Disorders

Types of Tests • Projective tests- (i.e. Rorschach) • Individual shown ambiguous stimuli and asked to respond to it. • Effective in determining personality • Personality Inventory • Typically assesses personality traits and characteristics. Provides general personality profile.

Deception Syndromes • Malingering- Conscious attempt to feign mental illness. • Defensiveness- Deliberate attempt to minimize or deny symptoms of mental illness • Pseudo malingering- mentally ill individual feigns the mental illness they actually have.

Forensic Psychiatry Table of Contents • What is Forensic Psychiatry? • Training and Education • Assessment of Competency • Legal Insanity/ Diminished Capacity • Post trial Sentencing

What Is Forensic Psychiatry? • Subspecialty of psychiatry that deals with people involved in legal matters either criminal or civil. • Evaluation of individuals rather than treatment of psychiatric patients

Training • Board Certification in forensic psychiatry from the American Psychiatric Association or the American Board of Psychiatry and Neurology • Certification lasts ten years, after which it is required to take another certification test to renew certification. • Those wishing to be certified must take a 1- year accredited program in psychiatry.

Assessment of Competency • Phases of Criminal procedure • Pretrial Phase, Trial Phase, and Post trial phase. • Competency to stand trial • Defendant must have no mental illness that impacts their ability to know what is happening in their case. • No set time for assessment but after 2-3 years the court asks the psychiatrist to give an opinion about if the defendant will be competent in the near future.

Legal Insanity/Diminished Capacity • 3 elements of mental state • cognitive, • conative (emotional), • volitional • Crime Consists of two parts • Mens Rea- guilty intent • Actus reus- Guilty act • Diminished Capacity • Individual couldn’t or didn’t form the specific intent or could not act in a knowing and purposeful manner.

Post Trial Sentencing/ Exam and Report Findings • A psychiatrist should know the different treatment facilities in the community and give testimony for the court’s assessment during sentencing. • Cases requiring psychiatrist testimony • Homicide, robbery, arson, kidnapping and almost all sexual cases., domestic relations crimes • Exam report findings • All Available info- exam in detail, state that examiner gave defendant limitations of confidentiality, dates and times of appointments, and time spent reviewing other information and records

Odontology Table of Contents • What is Forensic Odontology? • History • Training and Education • Testimony • Bite Mark Analysis • Collecting bite mark evidence

What is Forensic Odontology? • Forensic Odontology(forensic dentistry) is the application of the arts and sciences of dentistry to the legal system. • It includes: • 1. Use of dentition in the identification of individuals by comparing the unique aspects of the teeth with previous dental records • 2. Comparison of dentition with pattern injuries in human tissue (bite marks). • 3. Analysis of personal injuries to the head or neck to determine the presence of injury claimed such as abuse or a struggle.

History • First use of forensic dentistry was in Century 1 A.D. when a jealous wife of Roman Claudius. She demanded tosee the decapitated head of the mistress because the mistress was known to have a discolored tooth. • In 1776, Paul Revere is said to have used a denture to indentify a deceased patient in the Battle of Bunker Hill. • The first recorded use dentitions in body identifications associated with mass disasters was at the Vienna Opera House. • Almost 100 years later, a human bite mark was allowed in court for the identification of biting a assailant. (Doyle vs. Texas, 1952) • Today, computer programs were developed to assist in mass disasters.

Education 1. A forensic dentist always starts out as a regular dentist and requires nearly 4 years at a university,4 years at a dental school, and 4 years at residency. 2. Dental School: • First year: - Studying the whole human body. • Second year: - Studying the structures and diseases of the oral cavity. - Start learning how to perform procedures. • Third and fourth year: - Devoted to treatment of dental patients under the supervision of licensed practicing dentists.

Training • Before a dentist can go into forensics, they must complete four years of additional training in one of the nine areas of dentistry: - oral and maxillofacial pathology - prosthodontics - oral and maxillofacial surgery - orthodontics - oral and maxillofacial radiology - dentofacial orthopedics - pediatric dentistry - dental public health - endodontics • These programs will take about four years and leads to a certificate in one of the fields. • Then the dentist specialist may choose to take of series of tests to get certification by the A.D.A. (American Dental Association). • ALL dental graduates must take a state examination in order to practice dentistry. • Finally, once certified, they may choose to practice forensic dentistry but it’s required to gain extra training in the field.

Testimony One of the objectives of forensic odontology is to provide witness testimony in the courts of law. Forensic dentist are mainly used to: - provide information on the dentition of the victim. (Either a fact witness or Expert Testimony) - analyze bite marks and pattern injuries on victims, assailants or inanimate objects. - testify on personal injury cases based on the extent of the damage to the patient.

Bite Mark Analysis continued… • There are different types of bite marks: - Hemorrhage: a small bleeding spot. - Abrasion: undamaging mark on the skin. - Contusion: a broken blood vessel. - Laceration: torn or punctured skin. - incision: neat puncture. - avulsion: removal of skin. - artifact: bitten off piece of the body. • All these categories indicate a certain degree of violence. This helps investigators develop a profile of the assailant.

Bite Mark Analysis • Bite mark analysis is the tool in which forensic ondontologists use to analyze bite marks made by humans or animals. • Bite marks are usually seen in victims of abuse and sexual assault. • There are certain areas of the body where bite marks can be found depending on the crime, such as: - non- sexually based assault: neck, nose, ears, fingers, and chest. - Sexually based assault: men: abdomen, chest, arm or armpit, shoulder, penis, and scrotum. women: shoulder, neck, arm, breast, pubic area, buttocks, and thigh.

Collecting Bite Mark Evidence • When there are bites marks on the victim, it is the responsibility of the forensic specialist to collect the evidence by: - photographs - measurements - swabs for saliva • It is important for the forensic specialist to not contaminate the evidence.

Forensic Anthropology

Table of contents • What is it? • Training and education • Body farms • Analyzing bones • Uses

What is it? • Forensic anthropology is the study and analysis of human remains for the purposes of criminal investigations. • Forensic anthropologists can also in the identification of human remains that have been: - burned - decomposed - mutilated - unrecognizable

Training and education • Undergraduate Studies: - major in anthropology and a minor in biology. It is also recommended that undergraduates take chemistry, physics and statistics. • Graduate Studies: - Graduates must obtain masters and a doctoral degree in anthropology. • Post-Graduate Training: - Anthropologists now need to be certified by the American Academy of Forensic Studies.

Body Farms • A body farm is an outdoor field laboratory which helps study postmortem changes. • This facility is located in Knoxville, Tennessee. • The facility contains over 40 bodies buried throughout the lot and each body represents a different scenario. • The information gathered by studying how the body decomposes because of digestive enzymes, bacteria, and insects is most often used to determine the postmortem interval.

Analyzing Bones • Forensic anthropologists analyze human remains to determine certain characteristics to identify a body: - gender - manner of death - age - height - race

Uses • Forensic anthropologists are needed when there are mass disasters and bodies are completely unrecognizable. • Example: On September 11, 2001, there was a great demand for anthropologists to identify the remains of the victims.

DNA Table of Contents What is Forensic DNA? History Training and Education Identification Equipment DNA Typing

What is Forensic DNA? • DNA = Deoxyribose nucleic acid. It is a nucleic acid that contains the genetic instructions used in the development and functioning of all known living creatures. • D NA Forensic is a branch of forensic science which focuses on the use of genetic material in criminal investigation. Also known as DNA typing. • In DNA forensics, laboratory staff collects samples from the scene of a crime and analyze them. These samples include obvious biological material like blood and hair found on a crime scene, along with fingernail scrapings from the victim. • They can be used to gather information about the perpetrator, and if a suspect is identified, samples of his or her DNA can be collected for comparison. This is sometimes called “DNA fingerprinting,” because it takes advantage of the unique fingerprint of DNA markers which every human has. • Although 99.9% of human DNA sequences are the same in every person, enough of the DNA is different to distinguish one individual from another. DNA profiling uses repetitive sequences that are highly variable ,called variable number tandem repeats(VNTR). VNTRs are very similar between closely related humans, but unrelated individuals are extremely unlikely to have the same VNTRs. Which makes it easy to distinguish.

History • Forensic DNA Typing is relatively new. DNA typing was introduced in the mid-1980s. It has revolutionized forensic science and the ability of law enforcement to match perpetrators with crime scenes. • 'DNA fingerprinting' or DNA typing was first described in 1985 by an English geneticist named Alec Jeffrey. Dr. Jeffrey found that certain regions of DNA contained DNA sequences that were repeated over and over again next to each other. He also discovered that the number of repeated sections present in a sample could differ from individual to individual. By developing a technique to examine the length variation of these DNA repeat sequences, Dr. Jeffrey created the ability to perform human identity tests. • These DNA repeat regions became known as VNTRs, which stands for variable number of tandem repeats. The past 15 years have seen tremendous growth in the use of DNA evidence in crime scene investigations as well as paternity testing. Today over 150 public forensic laboratories and several dozen private paternity testing laboratories conduct hundreds of thousands of DNA test annually in the United States.

Training and Education • You need at a minimum, a Bachelors degree in a physical science such as chemistry, biology or physics. • Whether or not you pursue a graduate degree or a degree specifically in forensic science should be based on your personal situation and preferences.

Identification • Any type of organism can be identified by examination of DNA. To identify individuals forensic scientists scan 13 DNA regions to create a DNA profile of that individual. There is an extremely small chance that another person has the same DNA profile for a particular set of 13 regions. • Forensic scientists can identify a person with DNA through bones, teeth, tissue, hair, saliva, etc. • DNA is used to identify potential suspects whose DNA may match evidence left at a crime scene. Also to exonerate someone wrongly accused. This is also used for the paternity or other family relationships.

Equipment • DNA has a variety of equipment ranging from a paternity swab to the break down of macromolecules in a mass spectrometry. • The most commonly used equipments are the Restriction Fragment Length Polymorphism (REFLP), the PCR analysis (Polymerase Chain Reaction), and the STRs (Short Tandem Report).

DNA Typing • DNA typing is the modern method through which scientists in a court of law can use DNA samples like a fingerprint to catch a criminal or find a child's father. • The process of DNA typing is the careful study of RFLPs . The process of DNA typing is a long one, and first the sample must be prepared. • DNA typing is used for finding a person's parent. • In the criminal courtroom, traces of DNA left at a crime scene can often prove to be crucial evidence. Blood stains on suspects can be matched to victims and vice-versa. Enough genetic information to complete the identification process can be found in any body cell left behind. The accuracy of DNA typing is so extreme that it has generally become a valid tool to use even in the highest-pressure cases.

Toxicology Table of Contents • What is Toxicology • Education and Training • Samples

What is Toxicology • Toxicology is the study of adverse effects of chemicals on living organisms to aid medico legal investigation of death poisoning, and drug use. • Forensic toxicologist must take note of physical symptoms recorded and possible effects of the chemicals. • Must determine which toxic substrate is present and the concentration along with the possible effects of that chemicals. • It is rare for a chemical to remain in its original form once in the body. For example heron is almost immediately metabolized into another substrate.

Education And Training • Earn a college degree in one of these fields: chemistry, clinical chemistry, pharmacology, biology or other similar science. Continue and obtain at least a master's degree. • Obtain certification from the American Board of Forensic Toxicology, the American Board of Clinical Chemistry, or the American Board of Toxicology. • Join at least one of the many available forensic organizations or societies to help you stay current in your field.

Samples • Urine- Quick and easy for live subjects, common for drug testing Does not necessarily reflect toxic substances used at all the time. Can take up to 8 hours for a given substances to be deleted • Blood Sample of usually 10 cm3 is enough to screen and confirm most toxic substances Provides profile of influencing substances at the same time of collection • Hair Samples Hair can record medium to long term or high dose substance abuse Chemicals in the blood stream may store in the follicle providing rough timeline Head hair grows about 1-1.5 cm/month Hair sampling is not standard throughout population. Darker course hair holds more drugs. • Saliva (recent drug use) Typically parallel to blood Drugs that are highly protein bound have lower concentration in oral fluid • Other( organs during autopsy) Gastric contents of deceased Bacteria maggots etc.

Taphonomy • The study of the processes that affect the decomposition, erosion, dispersal, burial, and re-exposure of organisms after, at the time of, and even before death suspiciously • Initially developed in paleontology to explain how and why extinct animals became fossilized and preserved in the geological record

Factors like state of the body before burial, climate, temperature, soil type, organisms, type of casket and/or vault, body composition, quality of embalming all play a role in the rate of decomposition. • Even though embalmed and sealed, the environment is still not sterilized, and any microorganisms can reproduce and start the process of decay.

What is Entomology? • Entomology is the scientific study of insects, the type of insects, and their stages of development. • This can help investigators determining the time of death.

Forensic Pathology Table of Contents • What is Forensic Pathology • History • Education and Training • Duties of Forensic Pathologist

Forensic Medicine Procedure Manual Revised 2010