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The Autopsy

The Autopsy. Pathology 2. The Autopsy. An examination of the body after death to document any natural disease processes and/or injuries which may have contributed to the death Purpose is to render an opinion regarding the cause and manner of death which is specified on the death certificate.

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The Autopsy

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  1. The Autopsy Pathology 2

  2. The Autopsy • An examination of the body after death to document any natural disease processes and/or injuries which may have contributed to the death • Purpose is to render an opinion regarding the cause and manner of death which is specified on the death certificate

  3. Criminal violence Infant/child Result of police action In custody of local/state/federal institution Workplace injury Electrocution Alcohol, drugs, poisons Drowning Unidentified persons Skeletonized remains Charred remains As deemed necessary When is an Autopsy Required?

  4. The Autopsy • Usually consists of external and an internal exam • External • Documents identifying features such as scars and tattoos to assist in the identification of the body • Internal • Looks at the internal organs to document any natural disease processes and/or injury

  5. The Autopsy • Most autopsies are “uneventful” • Not always necessary if a natural cause of death is known • May be required for insurance purposes • Generally range from 30 minutes to several hours to complete • Usually performed in the medical examiner's or coroner's office • Sometimes in a funeral home or hospital

  6. The 4 Stage Model 1. Contributing Cause of Death 2. Mechanism of Death 3. Immediate Cause of Death 4. Manner of Death

  7. 1. Contributing Cause of Death • Usually pre-existing illness or condition • Could ultimately be actual cause of death • Examples: Pneumonia, asthma, HIV

  8. 2. Mechanism of Death • What events happened to lead to death • Usually in medical jargon • Example:”…lungs became obstructed by fluid and could no longer transport oxygen”

  9. 3. Immediate Cause of Death • The actual cause of death • Example: Asphyxia, “GSW to the head”

  10. 4. Manner of Death • By law, a fatality must be identified as one of the following categories • Suicide • Homicide • Accidental • Natural • Unknown

  11. “Rules of the Road” • Mechanism + Immediate Cause = Manner • If Mechanism is undetermined… • Manner must be ruled “Unknown” • Example: Poisoning, strange phenomena • If Immediate Cause aggravates pre-existing condition… • Manner must be ruled “Natural” • Example:

  12. “Rules of the Road” • Most traffic fatalities are ruled “Accidental” • If a suicide involves additional individuals in the Immediate Cause… • Manner must be ruled “Homicide”

  13. Reporting Deaths • Necessary for legal and financial reasons • Report is required in order to issue Death Certificate • Considered public record • May not list certain information due to confidentiality laws

  14. Unidentified Persons • General Procedures • Take photographs with case number in photograph • Obtain and archive specimen for DNA • Take X-rays of body • Document clothing and personal effects

  15. The External Exam • Preliminary Procedures • Review known information • Think before you examine • Measure body length and weight • Examine external aspects • Take photographs Warning: Graphic Image follows…

  16. Case Study 1

  17. The External Exam • Preliminary Procedures • Correlate clothing with injuries • Search/collect trace evidence on clothing for criminal cases • Remove clothing • Photograph/list clothing and personal effects

  18. The External Exam • Record physical characteristics • Apparent age • Sex • Race/ethnic characteristics • Hair • Eyes • Abnormal body conditions/parts • Scars, tattoos, lesions, amputations • Presence/absence of dentition

  19. The External Exam • Record physical characteristics • Inspect/describe head, neck, thorax, abdomen, extremities, hands • Inspect/describe posterior body surface • Prior medical or surgical intervention

  20. The External Exam • Describe livor mortis • Most pronounced ~10 hours after death • Describe rigor mortis • Begins ~6 hours after death • Disappears after ~24 hours • Post mortem changes • Evidence of embalming • Decompositional changes Warning: Graphic Image follows…

  21. Case Study 2

  22. The External Exam • Specific Procedures for Sexual Assault • Swab oral, vaginal and rectal cavities • Pubic hair combings or tape lifts • Fingernail scrapings or clippings • Pubic or head hair exemplars • ID and preserve foreign fibers, hairs and biological stains

  23. The External Exam • Specific Procedures for Injuries • Describe injuries • Type, location, size, shape, pattern • Correlate to internal injury • Document track/direction of wound • Recover foreign body(ies) • Document object(s) Warning: Graphic Image follows…

  24. Case Study 3

  25. Patterned Injuries

  26. The External Exam • Specific Procedures for Firearms • Wound size • Use anatomic landmarks and measure wound location • Be specific • Soot/stippling (residue) • Abrasion ring, searing, muzzle imprint, lacerations Warning: Graphic Image follows…

  27. Case Study 4

  28. The External Exam • Specific Procedures for Burns • Appearance of burns • Distribution of burns with special emphasis on degree of burn/chars Warning: Graphic Image follows…

  29. Case Study 4

  30. The Internal Exam • Exam all internal organs in place • Be methodical • Position of abnormal medical devices • Evidence of surgery

  31. The Internal Exam • Internal Organs (after removal) • Record weight of brain, heart, lungs, liver, spleen, kidneys • Dissect and describe organs

  32. Postmortem Exam Report • Prepare postmortem exam report for each case • All relevant forensic information (date, time, investigator, etc.) • Summary of external and internal exam findings • Separate section for injuries • Describe findings in enough detail to support opinions and conclusions • Identify cause and manner of death

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