Title: Forensic Pathologists
1Forensic Pathologists
- Perform autopsies and diagnose circumstances
surrounding the cause and manner of death - Determine whether death was
- Accidental
- Suicidal
- Homicidal
-
2Coroner 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.
3Medical Examiner System
- Many rural areas are still served by elected
coroners some states still have both coroners
and medical examiners- confusion still exists
4Forensic 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
5Training 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
6Training 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
7Training 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
8Duties 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
9Reviewing 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
10Reviewing 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?
11Reviewing 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
12Reviewing 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
13Autopsy 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
14Limitations 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
15Required 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
16Autopsy 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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19Autopsy 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
20Autopsy 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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22Obtaining Appropriate Specimens
- Toxicology requires adequate specimens for
testing - Blood is usually taken from aorta
- Bile taken from gall bladder
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24Obtaining 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
25Microscopic 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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28DNA 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
29DNA 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
30Photography
- 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
31Report 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
32Gross 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
33Microscopic Examination Reports
- Dictated after gross autopsy report
- Histology laboratory report takes several days to
prepare - Additional time required for preparation of
slides
34Microscopic 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
35Testimony
- 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
36Testimony
- 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
37Testimony
- Forensic pathologist subject to ad hominem
attacks by opposing counsel - Ad hominem- attack on person themselves instead
of their testimony