Title: Forensic Pathology
1Forensic Pathology
- This is the place where death rejoices to teach
those who live.
2Introduction
- A death that is unexpected or is thought to have
been caused by injury or trauma is always
investigated. - Coroner
- Medical Examiner
3Coroner vs. Medical Examiner
- Coroner a public official, appointed or
elected, who makes inquires into deaths and
completes death certificates. - Determines cause/manner of death
- Decides if foul play
- May or may not have medical training
4Coroner vs. Medical Examiner
- Medical Examiner a physician, evaluates medical
history and physical exam of deceased to
determine cause and manner of death. - Must receive special training to become a
forensic pathologist - Forensic Pathology unnatural or suspicious
disease or injury - In most large US cities, the medical examiner is
required to be a forensic pathologist.
5Forensic Pathologist
- Education and Training
- Medical school 4 years
- Post medical training
- 3 to 5 year residency in general pathology
- Additional year of training
- In medical examiners office (forensic pathology)
- 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
7Deaths Investigated
- Two Main Categories
- 1. Persons who die suddenly when in apparent good
health, those who are unexpected to die, or
those who are without medical treatment for
fatal diseases. - Public Health Threat (bacterial meningitus)
- Death in public places (electrocution in public
place) - Maternal Death
- Death outside of medical facility
8Deaths Investigated
- 2. Deaths caused by unnatural causes
- Examples
- Acts of violence
- Drug related
- Trauma / Asphyxiation
- Weather
- Vehicular accident
9Deaths 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!
10Three facets of guilt
11Medical Examiners Duties
- Review eyewitness statements
- Examine crime scene
- Autopsy
- Photography
- Report
- Testimony
12Duties and Responsibilities
- Establish the cause of death
- Establish the time of death
- Infer the type of weapon used
- Determine the manner of death
- Identify the deceased
- Determine the effects of trauma or pre-existing
conditions.
13Postmortem Lividity(Livor Mortis)
- The Settling of blood that causes the skin to
change color
1430 Minutes
- Changes in skin color first appear
- on fair-skinned persons
154 to 8 hours
- The blood in capillaries settles
- PERMANENTLY
16Between 1 and 8 hours
Light-colored marks made by finger pressure
17(2)
- Where a trained investigator will begin..
18Why livor mortis is important
19Rigor Mortis
- The period of time that a body goes through a
state of Rigidity - Caused by lactic acid build-up in the body.
20Rigor Mortis Progression
- Shorter muscles face, fingers, toes
21 22- Then moves down and out the long muscles of the
legs and forearms
23 24Rigor MortisTime-line
- 1-4 hours Jaw and neck rigid, rest of body
limp - Up to 8 hours everything down to the legs is
rigid - For 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
25Circumstances affecting Rigor Mortis
26 27 28 29- or water (in the case of drowning)
30Decomposition
- Bacteria Co2 is produced, abdominal swelling
31- Blood vessels
- discoloration of skin in upper abdomen
- marbling effect
- Red ? darker red ? purple ? green
32- Putracine foul- smelling, nauseating odors
33Algor Mortis
- Either Liver temperature (LT)
- or Rectal Temperature (RT)
- Drop of about
- 2 degrees
- per hour
34- Factors affecting temperature loss
- Size (mass) of body
- Body Temperature at death
- Temperature of crime scene
35The 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
36HISTORY OF AUTOPSY
- EGYPTIONS
- 1600 BCE
- HIPPOCRATES
- 5TH 4TH CENTURY BCE
37- AUTOPSIES TO DETERMINE THE CAUSE OF DEATH
38The Autopsy Examination
- Legality
- Permission required family can request an
autopsy be performed (usually free) - 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)
39The Autopsy Examination
- Attending Personnel
- Diener autopsy assistant
- Prosector - pathologist
- Pathologist Assistant
- Precautions protective
- clothing
40The 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
41Forensic Autopsy
An intensive search for information To locate
PHYSICAL EVIDENCE to determine the cause of death
42The 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.)
43(No Transcript)
44The Autopsy Examination
- Opening the Body
- Y-incision incision made from left and right
shoulders to mid-chest and straight down to pubic
region.
45- 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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46The Autopsy Examination
- Rib cage is cut at the cartilage that joins the
ribs to the breastbone with a scalpel, saw or
knife to enter the chest cavity. Soft tissue
peeled back to look for abnormalities.
47- Chest plate (ribs and breastbone) are removed and
examined. Often fractured during CPR.
48Skull is cut in front and back for removal.
49The Autopsy Examination
- Removing and Examination of the Organs
- Each organ is removed, photographed and weighed.
Organs are usually dissected and slides prepared
to look for disease or irregularities.
50THE HEART
Checked for TRAUMA
51Pulmonary artery
52- The pulmonary arteries carry blood from the heart
to the lungs.
They are the only arteries (other than umbilical
arteries in the fetus) that carry deoxygenated
blood.
53- Looking for a blood clot that has dislodged from
a vein traveling through the heart - To the pulmonary artery SUDDEN DEATH
54Blood samples are taken from the AORTA
- Blood-typing and Blood/Alcohol test
55Larynx and Trachea
Food lodged in trachea
Checked for food bolus (choking)
56Lungs
57Drowning
58Diatoms
lungs
stomach
Blood stream
Bone marrow
59Heroin Use
Carbonate crystals
Used to mix heroin
Will be found in the lungs
60Death in fires
If alive During Fire there Will be soot and
ash in the Trachea Bronchi And Lungs
61- If CO2 levels in blood are greater than
2 - The victim was alive at the onset of the fire
62Samples taken
- CO2 and other
- gases in lungs
- Microscopic slides
63Liver
64Liver
- A healthy liver
- Soft, pliable, vulnerable to blunt-force trauma
65Cirrhotic Liver
- Caused by hepatitus, malnutrition, drug alcohol
use
66Jaundiced Liver
67Kidneys filter blood
68The Kidney Punch
- A World Boxing Association foul
69Drug use
- Drug addicts who have a cirrhotic liver
- cannot metabolize proteins
- Toxins pass out of the liver and
- Damage kidneys
70Diseased Kidneys
Jaundiced kidneys
Polycystic liver
71Stomach
- Important in drug-overdose cases
- Helps establish activities prior to death
72-
- POISONS
- CYANIDE
- -red color of organs
- -almond-like odor
- (only 50 of pop can detect the odor)
- -KCN used for executions
73Estimated time of death
- If TIME OF MEAL and MENU are known
74Intestines
Location of food can help determine time of death
75Pair swallows 850 g cocaine..
- Katriya Connor, 23, a chef from Waterloo in
Liverpool, became violently ill on a flight from
Cancun in Mexico to Birmingham on February 6,
after scores of packets of cocaine that she had
swallowed burst in her stomach. She died within
hours on an airport runway in the Azores, where
the flight had been diverted, while paramedics
desperately tried to save her life. A 21-year-old
man, apparently travelling with Ms Connor, also
fell into a coma on the flight and remains
seriously ill on the island. - (from The Guardian)
76Stomach of drug mule
Drug packets in rectum area
77Bladder
URINE SAMPLE
78Reproductive Organs
Inspected for pregnancy
(Teenage suicide)
79The Brain
80Removal of Brain
81A blood clot caused by a blow to the head can
be fatal
82Formaldehyde fixes the brain for better
dissection
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84Autopsy Conclusion
85- Samples are obtained of bodily fluids and sent to
toxicology for examination. - Blood
- Urine
- Bile
86Manner and Cause of Death
- Mechanism biochemical or physiological
abnormality produced by the cause of death that
is incompatible with life. - Manner of Death homicide, suicide, natural
causes, accidental or undetermined. - Cause disease or injury that initiated the
lethal chain of events that lead to death
87Manner of Death
- homicide
- Suicide
- accidental trauma occurring from acts
- NO REASONABLE person
- would have felt have a high probability
- of injury or death
- natural cause
- undetermined
88Determination 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.
89Causes of Death
- Brain Damage
- Subdural hematoma
90-
- Brain Damage Subarachnoid hematoma
91Brain Damage
92Suffocation
93 Positional Asphyxiation
94Positional Asphyxiation
95SADS
96Choking
97Drowning
- Vomitos amigos Drug/alcohol
-
Intoxication
98Neck Injuries
- Strangulation
- accidental
-
suicide - homicide
99Petechial hemorrhage
- Ruptures in the tiny capillaries
100Hyoid Bone
101Hanging
102Suicide by hanging
Female suicide
Male suicide
103Jugular vein
- On average, blood accounts for 8 of total body
weight 5 to 6 liters of blood for males - 4 to 5 liters of blood for females A 40
percent blood loss results in death. - The loss of 1.5 L can
- cause incapacitation.
Jugular vein
104Stab Wounds Sharp Force Trauma
- Type of knife used (width, length, single or
double-edged) - Stabbing wounds
- Slicing wounds
105Blunt Force Trauma
- Caused by being struck by a flat surface
106Gunshot Wounds
107International Gun Statistics
108Classification of Traumatic Death
- Four Categories
- Thermal
- Chemical
- Electrical
- Mechanical
- Asphyxiation interference of oxygen to brain
- Can be caused by all mechanisms
109Mechanical Trauma
- Blunt or Sharp
- Penetrating or Non-penetrating
- Mechanical Trauma occurs when the applied
physical force exceeds tensile strength of the
tissue, causing lacerations (blunt force) or
incised wounds (sharp)
110Mechanical Trauma
- Sharp Force Trauma
- Most common cause of death exsanguination
- Major arteries or the heart are damaged
- Blunt Force Trauma
- Cause contusions or lacerations
- Most common cause of death significant damage
to brain or internal bleeding
111Mechanical Trauma
- Firearm Injury
- Contact wound blackening of skin around wound
(gas burns skin), small in size - Distant wound circular skin defect and rim of
abraded skin around the edges - Exit wound is larger and more irregular than
entry wound.
112Chemical Trauma
- Death that results from drugs or poisons
- Alcohol most common drug that causes death
- Rarely kills directly, but contributes to about
50 of traumatic deaths. - Other chemicals
- Drugs
- Carbon Monoxide
- Cyanide / Arsenic (poisons)
113Thermal Trauma
- Exposure to excessive heat or cold
- Hypothermia excessive cold
- Hyperthermia excessive heat
- Causes death via a breakdown in the normal
mechanisms that maintain body temperature. - Thermal Burns death usually occurs as a result
of complications (shock mechanism multiple
organ failure) - Cause of death in fires inhalation of CO, not
burns
114Electrical Trauma
- Passage of electricity through a person
- Low Voltage heart experiences ventricular
fibrillation (quivering of the heart beats
faster than the body can handle) - High Voltage forces heart into tetany, a
contraction that is broken when the circuit is
broken. Heart generally starts again with a
normal rhythm - Loss of limbs or electrical burns are possible
within seconds of shock.