Forensic Pathology Pathology 1

The Science of Pathology Branch of medicine associated with the study of structural changes caused by disease or injury Two branches Anatomic Deals with structural alterations of the human body Includes autopsies Clinical Deals with laboratory examination of samples removed from the body Includes toxicology screens, blood tests, microbiology, hematology

The Coroner/M.E. Systems Coroner Usually elected Need not even be a medical doctor, although they should have had at least some medical training Not exempt from civil liability for acts of negligence

The Coroner/M.E. Systems Medical examiner Operates out of centralized county to state level offices Frequently vested with both law enforcement powers (to hire their own homicide investigators) and quasi- judicial powers (to call inquests and take sworn testimony). Exempt from civil liability for acts of negligence

Forensic Pathology Adds the word "unnatural" or "suspicious" to pathology Most forensic pathologists are experts in both branches of pathology All are medical doctors certified by American Board of Pathology Can be called as “expert witnesses” and must understand court systems and legal proceedings

Certification Certification Certification At least 2 years beyond medical school At least 2 years beyond medical school Must pass a Board exam Must pass a Board exam All certified F.P.s are certified at: All certified F.P.s are certified at: Establishing cause of death Establishing cause of death Estimating time of death Estimating time of death Inferring the type(s) of weapon used Inferring the type(s) of weapon used Distinguishing homicide from suicide Distinguishing homicide from suicide Establishing the identity of the deceased Establishing the identity of the deceased Determining the additive effect of trauma or pre-existing conditions Determining the additive effect of trauma or pre-existing conditions

The Medical/Legal Purpose F.P.s have to serve two groups F.P.s have to serve two groups To investigate any death in the “public interest” To investigate any death in the “public interest” Serve both the criminal justice and public health systems Serve both the criminal justice and public health systems Must investigate cooperatively with but separate from law enforcement and prosecutors Must investigate cooperatively with but separate from law enforcement and prosecutors

The “Public Interest” Violence Violence Non-natural deaths Non-natural deaths Otherwise healthy Otherwise healthy Infants/children Infants/children Unusual or suspicious circumstances Unusual or suspicious circumstances Those in custody Those in custody Threatening diseases to public health Threatening diseases to public health Under care of a physician Under care of a physician

Obligations of M.E./Coroner Perform autopsies Perform autopsies Supervise all personnel assisting in process Supervise all personnel assisting in process Perform dissections/organ removal Perform dissections/organ removal Determine need for special testing or dissections Determine need for special testing or dissections Interpret all lab results Interpret all lab results Determine circumstances/cause of death Determine circumstances/cause of death Issue death certificate Issue death certificate