 Field of Medicine concerned with identifying disease  Forensic Pathology – subspecialty of pathology concerned with identification of human remains and determination of the cause and manner of death  The Field that performs an after death investigation of sudden or unexpected death or injury

 Deaths with violence – accidents, suicides, homicides  Suspicious Deaths  Sudden, unexpected deaths,  Deaths without a physician in attendance  Deaths in a prison or jail

 Identify:  Cause – The event/ injury that starts the process towards death  Manner -  Mechanism – the normal body function that results in death  Whether Time of death is consistent with proposed time

 Formerly not a problem  End of heart and/or lung function  No oxygen or blood = no life  Brain death  Individuals may be kept alive by artificial means through machines that breathe as lungs would or that pump as a heart would

 The process that starts the chain of events leading to death  Atherosclerosis  Heart Attack  GSW to Chest  infection of lungs  Car Accident  death during surgery 10 years later  Blunt Force injury to head  not swallowing correctly  Choke

 Natural  Accident  Suicide  Homicide  Undetermined

 Atherosclerosis  Pneumonia  Cancer  Long term Alcohol/Drug abuse

 Car Accident  Alcohol/ Drug overdose  Drowning  Suffocation

 GSW  Stab Wound  Drug Overdose  Drowning  Car Accident  Asphyxia

 Not enough information about circumstances surrounding death  Drug overdose – accidental overmedication or suicide  Cause of death unknown  Skeletonized remains  No anatomical or toxicological explanation

Medical and legal conclusions rely on thorough scene investigation  Identity  Approximate time of death  Evidence and clues to circumstances around death  Was the house locked?  Were there signs of struggle  Position of body  Suicide notes

 Visual by family/friends  Location of body – in their home?  ID – driver’s license, distinctive feature – tattoo  Comparing x-rays  Dental Records  DNA  Fingerprints

 The immediate activity that results in death.  Hemorrhage  Widespread infection  Heart Attack

 Important for time of the murder, eliminate or suggest suspects, confirm or disprove alibi  Most methods are to a degree unreliable and inaccurate.  The longer the time between death and the attempt to estimate the time of death, the less precise the estimate of the interval

 Body temperature – 98.6 – rectal temp /1.5  Insect action  Stomach contents – stage of digestion  Last known activity – newspaper/ mail, phone conversation/ text

 Livor Mortis is a reddish/ purple coloration due to accumulation of blood in the small vessels of the gravity dependent areas.  Occurs 30 min to 2 h after death  Fixed at 8-12 h  Important to determine position of body  Rigor – stiffening of the body due to disappearance of muscle energy  Usually appears 2-4h after death, fully develops 6-12 h after death  Classically  Jaw  arms -> legs

 Body Temperature  Time since death = (98.6°F – Rectal Temp) / 1.5  Based on assumption body temp is normal at death  Decomposition (Decomp)  Breakdown of Cells and Organs by chemical process  Breakdown by bacteria and fermentation 1. Green discoloration of abdomen (24-36h) 2. Green spreads to head, neck and shoulders 3. Swelling of the face and abdomen due to gas formation 4. Marbling – breakdown of blood gives green/black color of blood vessels 5. Generalized bloating (60-72 h) 6. Skin slippage 7. Dry/ skeleton phase – 2 weeks in hot humid temps, months in snow

 Different insects are attracted at different stages after death  Flies are the most common form of insect associated with dead bodies  Lay eggs in orifices and open wounds  Eggs generally are deposited immediately after death in the day time  Only eggs on the body = 1-2 days  Maggots grow excessively larger in different stages each about 1 day  Adult flies emerge at days

 General Size and Appearance  Clothing /personal belongings  Major Injuries – cause of death signs  Medical Intervention  Signs of struggle – Frenulum, broken bones, scratches around the hands  Bruises, cuts, petechiae  Scars, tattoos  Livor, Rigor  Teeth, eyes, hair  Blood, eye fluid, urine

Trauma to the Human Body 1.Determine type of wound 2.Measure the dimensions (length, width, depth) 3.Position relative to anatomical landmarks 4.Determine initial location if wound involves cutting, slashing, etc. 5.Determine height from heel

Types of Wounds 1.Lacerations 2.Incised Wound 3.Puncture 4.Abrasion 5.Contusion 6.Gunshot

Laceration s

Incised Wounds Slash Stab Puncture – penetrating injury due to an object with no blade

Abrasions

Contusions Color changes a bruise goes through can give rough estimate of time of injury Dark blue/purple (1-18 hours) Blue/brown (~1 to 2days) Green (~ 2 to 3 days) Yellow (~3 to 7 days) Assumes person is healthy.

Gunshot Wounds Things for pathologist to learn: type of firearm distance of gun to victim entrance vs exit wounds track of projectile

Gunshot Wounds Starring of a contact wound – barrel touching the skin Stippling – powder burns on the skin when the gun is inches to a few feet from the victim

Autops y Y incision

 Y Shaped insicision  Remove Sternum  Exam any signs of injury internally (gunshot hole, stab wound)  Exam for signs of blood inside

 Exam each organ, weigh them, cut them open, take pieces for microscope exam  Heart  Lungs  Kidneys  Liver  Spleen  Bladder  Brain

 Heart Attack

 Contact  Muzzle imprint, star-like cuts if close to bone, gunpowder and soot enter wound  Close Range  Increased diameter of soot of tattooing around wound  Particles of gunpowder around wound, soot on skin, tattooing of skin  Intermediate  Up to 3 feet  Increase in diameter again of particles and stippling, no soot  Long Range  No gunpowder, soot, tattoing  Difficult to determine distance –6 feet not different from 16 feet

 Entrance Wounds  Usually smaller than exit wounds  May have star-like appearance  Inward beveling of skull  Ring of gunpowder and stippling  Exit wounds  Usually larger than entrance due to deflection by tissue  Outward beveling  No gunpowder, soot or skin injury

 Anything that interferes with oxygen uptake or utilization  Suffocation  Failure of oxygen to reach blood  Choking, drowning, carbon monoxide poisoing  Compression of chest – heavy objects  Strangulation  Usually cuts off blood supply to brain, not cutting off air.

 Death due to smoke inhalation, incineration or infection  Establish – ID, whether the victim was alive at the time of fire  Cause of death  Manner of death  75% of fire related deaths due to inhalation of toxic smoke – carbon monoxide, cyanide

 Low voltage  Burns present at entry and exit sites  Death due to heart attack  High Voltage  Electrical burns  Charring  Death due to hearth attack or paralysis of breathing muscles

 Brain Contusion – coup occurs at site of blow to head  Bleeding under skull and into brain  Tearing of arteries and veins that supply the brain  May kill immediately, or have slow growth of blood in the brain that compresses brain and prevents brain function

 Patterned abrasions / bruises from steering wheel and seatbelt  Damage to liver and spleen