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Forensic Pathologists

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One year of training at a large coroner's or medical examiner's office required: ... Information from medical history, witness statements, scene examination, and ... – PowerPoint PPT presentation

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Title: Forensic Pathologists


1
Forensic Pathologists
  • Perform autopsies and diagnose circumstances
    surrounding the cause and manner of death
  • Determine whether death was
  • Accidental
  • Suicidal
  • Homicidal

2
Coroner vs Medical Examiner
  • Coroner An elected official whose duty is to
    investigate the death of a person
  • Medical Examiner An appointed medically
    qualified officer whose duty is to investigate
    deaths and bodily injuries that occur under
    unusual or suspicious circumstances, to perform
    post-mortems, and sometimes to initiate inquests.

3
Medical Examiner System
  • Many rural areas are still served by elected
    coroners some states still have both coroners
    and medical examiners- confusion still exists

4
Forensic Pathologists
  • Pathologists first began appearing in mid 19th
    century
  • Use of microscope to examine tissues propelled
    this study
  • Pathology means
  • Study of disease, its causes and its diagnosis

5
Training Requirements for a Forensic Pathologist
  • Bachelor degree or equivalent, 4 years
  • Medical school, 4 years, from a recognized
    allopathic (M.D.) or osteopathic (D.O) medical
    school
  • Postgraduate training, 4 years anatomic
    pathology or anatomic and clinical pathology
  • One year of training at a large coroners or
    medical examiners office required Intern
    normally receives pay

6
Training Requirements for a Forensic Pathologist
  • After 5 years of postgraduate training, Must pass
    a 2-4 day examn to become a board certified
    forensic pathologist
  • There are an estimated 500 forensic pathologists
    practicing in the United States
  • About 25 pathologists have both medical and legal
    degrees

7
Training Requirements for a Forensic Pathologist
  • Many forensic pathologists also specialize in a
    certain area, such as
  • Toxicology
  • Serology
  • Tool mark or Impression evidence
  • Firearms examination
  • Crime scene analysis
  • Forensic Anthropology
  • Forensic Odontology

8
Duties of Forensic Pathologists
  • Investigate the deaths of persons who die
    suddenly and unexpectedly or as a result of
    injury
  • Normally employed by cities, counties or division
    of government
  • Some forensic pathologists work as consultants in
    litigation

9
Reviewing Medical History
  • Forensic pathologists deal primarily with
    determining cause of death, but also review past
    medical history to understand issues raised by
    that death
  • Medical history is the starting point of
    investigation

10
Reviewing Medical History
  • When death is reported to coroner or medical
    examiner, a two pronged test takes place
  • Is the death sudden?
  • Is the death unexpected?

11
Reviewing Medical History
  • To certify cause of death, forensic pathologists
    must
  • Determine cause of death based on delayed effects
    of injury
  • Careful study of medical history to determine
    causes and manners of death of persons with
    trauma is required
  • Be able to discern injuries from treatment from
    emergency personnel- needle marks, incised
    wounds, etc

12
Reviewing Witness Statements
  • Forensic pathologists seek to gather witness
    information about activities of deceased prior to
    death, because
  • Assists in determining jurisdiction of death
  • Assists in recreating circumstances of death
  • Allows use of a hypothesis which can be tested
    scientifically based on statement of witness

13
Autopsy Examination
  • Autopsy means to look at oneself
  • Necropsy means to look at the dead
  • Autopsies have been practiced since the middle
    ages
  • Term autopsy generally used in United States

14
Limitations on Autopsies
  • Middle Eastern religions forbid autopsies
  • Forbidden by Egyptian polytheism (Mummification)
  • Judaism, Islam and Christianity vary in their
    prohibitions
  • Next of kin may object to autopsy

15
Required Autopsy
  • A medical examiner has the legal authority to
    order an autopsy without permission from family
    when
  • Sudden or unexpected
  • Results from an injury
  • Under suspicious circumstances
  • Other circumstances defined by law

16
Autopsy Process
  • Incisions created in chest, abdomen and head
  • Removal of organs from those areas of the body
  • T-shaped incision is typically used, because it
    facilitates examination of tongue and neck

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19
Autopsy Process
  • Brain is removed via incision from behind one ear
    to behind other ear
  • Scalp is pulled upward and backward
  • Skull is sawed circularly or in a tonsorial
    manner
  • Brain may be dissected immediately, or placed in
    formaldehyde to preserve tissue for better
    examination

20
Autopsy Process
  • Other internal organs are removed and weighed
  • Organs are also dissected to determine disease or
    injury
  • In certain cases such as child abuse, spinal
    injury, and subtle blunt trauma more extensive
    dissection and removal may be completed

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22
Obtaining Appropriate Specimens
  • Toxicology requires adequate specimens for
    testing
  • Blood is usually taken from aorta
  • Bile taken from gall bladder

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24
Obtaining Appropriate Specimens
  • Blood, urine, liver, kidney and brain used to
    determine presence of drugs
  • Blood- alcohol or Urine- drugs
  • Information from medical history, witness
    statements, scene examination, and autopsy may be
    used to search for other drugs or poisons

25
Microscopic Examination
  • Small portions of organs are put into a solution
    of formaldehyde to preserve them for study
  • Diseased or injured sections of tissue are taken,
    as is normal tissue
  • Tissue is encased in paraffin and mounted on
    slides with HE dye for examination under light
    microscope

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28
DNA Analysis
  • Most coroners and medical examiners preserve one
    specimen of tissue for DNA analysis
  • If tissue sits in formaldehyde for too long, DNA
    becomes hydrolyzed and unsuitable for study
  • DNA embedded in paraffin blocks or cut into
    sections and made into slides will not further
    decompose

29
DNA Collection
  • Methods to accomplish this
  • Blood spotted on absorbent paper allowed to dry
    then stored in envelope
  • Pull head hairs, including bulbs, and place in
    envelope
  • Cut hair has mitochondrial DNA, bulbs include
    nuclear DNA

30
Photography
  • Resolution of cameras in pixels
  • 3 megapixel cameras- 2050 x 1500
  • 5 megapixel cameras- 2560 x 1500
  • 35mm film- 9000 x 6000
  • Polaroid 1100 x 1580

31
Report Preparation
  • Forensic Pathologists provide a written report of
    each autopsy
  • Gross examination- can be seen by unaided eye
  • Microscopic examination- requires a microscope
  • Forensic Pathologists dissect then dictate,
    normally

32
Gross Autopsy Reports
  • Should contain information regarding
  • Discussion of external examination
  • Medical treatment evidence on body
  • Evidence of injuries
  • Dissection technique
  • Diagnoses based on gross autopsy

33
Microscopic Examination Reports
  • Dictated after gross autopsy report
  • Histology laboratory report takes several days to
    prepare
  • Additional time required for preparation of
    slides

34
Microscopic Examination Reports
  • Toxicology report created by toxicologist,
    reviewed by forensic pathologist, and appended to
    autopsy report
  • Forensic Pathologist may prepare a final summary
    of external examination, internal dissections,
    microscopic examination and toxicology report

35
Testimony
  • Forensic pathologists may spend considerable time
    testifying as to their findings
  • In criminal court, testimony of a forensic
    pathologist is almost required
  • In civil court, forensic pathologists may be
    called upon to testify as a result of torts
    (civil wrongs) alleged to have caused death

36
Testimony
  • Forensic pathologists either give testimony via
    subpoena for civil cases, or via their presence
    in court for criminal case
  • Forensic pathologists also testify as expert
    witnesses in cases where they did not examine
    body of deceased

37
Testimony
  • Forensic pathologist subject to ad hominem
    attacks by opposing counsel
  • Ad hominem- attack on person themselves instead
    of their testimony
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