Pathology Medical ExaminerMr.McNiffCHSForensics

Who are Medical Examiners

A doctor who performs an autopsy when someone dies an accidental or violent death.They determine the cause of death as well as time of death.

forensic pathologist

A forensic pathologist is a

physician who has received

special training in pathology

and forensic pathology.

Their training takes

approximately six years after

graduating from medical

school.

Medical Examiner vs. Coroner

A medical examiner is always a medical doctor whereas it is not necessary for a coroner to be a medical doctor.

A medical examiner is appointed while a coroner is usually elected.

Medical Examiner vs. Coroner

A medical examiner gives objective information on the circumstances of a victim’s death. A coroner must give subjective opinions based on evidence found surrounding a victim and their death. Coroners usually have legal powers such as subpoena powers.

ClassificationIn a forensic autopsy, death is placed into five different categories.

NaturalAccidentHomicideSuicideUnknown

Natural DeathDeath by natural cause is a term used by coroners to describe the death of someone by occurring disease process, or is not apparent given medical history or circumstances.The majority of natural death is caused by old age. Other causes of natural death are heart disease, stroke, gentic disorders, etc.

Accidental DeathAccidental death is a death that is often caused by mistake or in a freak occurrence. Deaths are not planned yet can be explained by surrounding circumstances.

Homicidal DeathThe term ‘homicide’ refers to the act of killing another person.There are different types of homicide.

Infanticide - Killing of an infant Fratricide - Killing of one's brother; in a military context, killing of a friendly combatant Sororicide - Killing of one's sister Parricide - Killing of one's parents Patricide - Killing of one's father

Homicidal DeathMariticide - Killing of one's spouse Uxoricide - Killing of one's wife Filicide - Killing of one's child Regicide - Killing of a monarch. Genocide - Killing of a national, ethnic, racial or religious group

Homicide is often the most investigated death, therefore making it the most autopsied.

Suicidal DeathThe act of ending ones own life. These autopsies often easily identify source, cause, and other factors of the death.Suicide is often identified in the forensic autopsy as a cause of toxic, firearms, blunt force trauma, etc.

Unknown DeathIn some jurisdictions, the Undetermined category may include deaths in absentia, such as deaths at sea and missing persons declared dead in a court of law; in others, such deaths are classified under "Other“ .

laws

Although State laws vary in specific requirements, deaths that typically require investigation are those due to unusual or suspicious circumstances, violence (accident, suicide, or homicide), those due to natural disease processes when the death occurred suddenly and without warning.

Medical Examiner

Human remains are treated as a separate and unique type of forensic evidence.

An autopsy of the remains is completed to determine the cause and manner of any death that is violent, unusual or untimely.

Medical Examiner

A forensic pathologist will examine the human remains (post-mortem examination) and consider death scene findings.The medical history of the individual may also be reviewed to help determine if the death was natural, accidental or criminal.

External Investigation

The body must be measured and weighed and placed on an autopsy table prior to making the Y-cut.A general description of the body is made before any further examinations are done. All identifying features are noted including:

Race Sex Hair color and length

External Investigation

identifying features cont.Eye color Approximate age Any identifying features (scars, tattoos, birthmarks, etc.)Any wounds inflicted on the outside of the body (burns, ligature marks, stab wounds, bullet wounds)

Photograph the body

Identification of the deceased

If the Identity of the deceased is unknown then the M.E. needs to ID the body.The condition of the body due to scavengers or decomposition can make a visual ID impossible.

Identification of the deceased

Three common methods used to ID a unknown victim:

DNA (from tissue or bone)Dental recordsFingerprints due to decomposition some fingers need to injected with liquid to make the print usable.

Internal Investigation

The body is opened using a Y-shaped incision from shoulders to mid-chest and down to the pubic region.

Internal Investigation

If the head is to be opened, the pathologist makes a second incision across the head, joining the bony prominences just below and behind the ears.

Internal Investigation

Types of Evidence

Injuries:Describe injuries • Location • Type

– Blunt force– Laceration– Cut – Gun shot

• Severity• Distinguishing markings

Types of EvidenceInjury patterns:

Describe patternsAssociated with weapons, objects, detailsBlood flow patterns• Note• PhotographDirectionality patterns• Injury• Blood spatter

Mechanical asphyxiation

including strangulation, can be marked by the appearance of petechial hemorrhages on the conjunctiva, as shown here.

Mechanical asphyxiaFinding ligature marks on the neck, hyoid bone fracture, and/or soft tissue hemorrhages in neck and larynx may help to determine the mechanism of injury.

Hanging

Inspect the knotType / How tied• Running/fixed

Point of suspensionHow affixed

Distance from ground/floorEvidence of previous suspensions

AutoeroticPosition of bodyLivor mortisPlatform

Stabbing WoundsLocation of woundsDefense woundsAttempt to determine the type of weapon usedInjury patternsBlood spatter patterns

Location of initial injury versus location of body blood stains in a separate area from the location of the body

Gunshot wound

Location of wounds Type of woundPowder marks, stippling WeaponCaliberOwnership Secondary impact points if the bullet exited the body

Directionality consistent with the known details

Falls

Reason for the fallIntentional (suicide)Slip (accidental)Pushed (homicide)

Details of fallPoint from which the decedent fell Distance to point of impactVertically from point of elevation

Blunt force trauma

How injuries may have occurredInjuries and injury patterns Consistent with any surrounding objects

Object at the scene that may have caused the injuries

Drug related

Drugs or paraphernaliaLocation in reference to death scenePossible type of drugs involvedCollection and preservationEvidence on the body that may indicate drug use• Injection sites• Indications of inhalation, or huffing

Lacerations

Exsanguination Exsanguination is the extensive loss of blood due to internal or external hemorrhage.

Pictures

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Refrences

Thompson, Darrell. "Forensic Death Scene Investigation." Tarrant County. Web.Rahman, Mahmuda. "The Medical Examiner/ Forensic Pathologist." Web.Kacher, Emie. "A Day in the Life of a Forensic Pathology.“USA. CDC. Department of Health and Human Services. Medical Examiners and Coroners Handbook on Death Registration and Fetal Death Reporting. By Donna L. Hoyert, Ph.D and Arialdi M. Minino. Edition ed. Vol. 2003. Print