1. AUTOPSY
What is an autopsy?

2. Procedure performed by a pathologist to determine cause of death

3. Legal requirements:
Coroner – They are usually elected lay individuals who contract with physicians to provide autopsies and medical expertise to support their investigations.
They determine:
The cause of death
The manner of death
The mechanism of death

4. MEDICAL EXAMINER
a medical doctor who has a medical degree and specialized education and experience in the field of pathology and forensic pathology. Medical examiners are almost always appointed to their positions, and they are physicians with training in medical legal death investigations

5. Pathologist – physician who studies a variety of natural diseases and works in a hospital, laboratory, morgue or private setting

6. Forensic Pathologist
A specialized area of pathology. The forensic pathologist performs autopsies to determine the cause and manner of death in situations falling under the jurisdiction of the local medical examiner or coroner

7. Reasons for autopsy:
Determine which disease or injury caused death – this can provide family members with information about diseases or conditions that they also may be at risk for developing

8. 2. Diagnosis – confirmation and understanding – may be done to help understand how a given disease progresses or to determine the effectiveness of the treatment for that disease
3. Evaluate possible public health issue – helps Health Departments or other government agencies identify and track a disease or potential public health hazard (such as a suspected contagious disease or contaminated drinking water)

9. Certain deaths must be investigated by the medical examiner or coroner’s office:
Suddenly or unexpectedly
Under suspicious circumstances
3. As a result of an injury

10. Preparation If not required by law, permission needed from next of kin
Legal consent form must be signed

11. Procedure Complete medical history & review of records
External physical exam
a. Body tag
b. Weight & height
c. Clothing & valuables identified

12. Scars, tattoos, injuries, wounds, bruises recorded
Foreign objects noted
3. Photos & x-rays taken if needed

13. a. Dissection of head & abdomen
4. Complete internal exam – Y incision
a. Dissection of head & abdomen
b. Organs removed, weighed, measured, & examined
c. Tissue samples examined under microscope
d. Fluid samples tested for drugs, infection

14. 5. After autopsy is completed, the pathologist will fill out a legal death certificate giving the results of his finding as:
a. Natural death – disease or old age
Heart attack or heart failure, stroke, Alzheimers, blood clot, wasting syndrome
b. Unnatural death – unnatural, unexpected, or unusual causes –bullet wounds, automobile or plane crash, fire, drowning, electrocution, death resulting from extreme heat or cold, poisoning or drug overdose

15. FIVE MANNERS OF DEATH
Unnatural
Natural
Homicide
Suicide
Unknown

16. Methods to determine time of death
1. Traditional indicators:
A. Rigor Mortis
Begins three hours after death in face & eyelid muscles
Takes twelve hours to affect entire body
Process reverses after 36 hours

17. Rigor mortis is the state a body reaches when oxygen supply to the muscles ceases but the cells continue to respire anaerobically (without oxygen).
This causes lactic acid to build up, which affects the muscles causing stiffening – rigor mortis.
Bodies become stiff after about three hours and remain that way for around 36 hours.
Rigor mortis ceases as the body cells die, enzymes are released and the cells decompose.
During rigor mortis, the tissues are acidic because of the lactic acid and this makes them unpalatable to fly larvae. However the larvae can still feed on serum between the muscle fibers, and because the larvae excrete ammonia, they eventually neutralize the acid.

18. 2. Lividity (hypostasis)
Visible minutes after death
Red cells settle & skin below turns red
In 6 – 10 hours, color becomes permanent

19. 3. Body Temperature Falls at rate of one degree per hour
Obesity & warm environment slows cooling
4. None of the above are totally reliable & can be manipulated

20. THE SIX Ws of FORENSIC PATHOLOGY
WHO Sex, race, age, and particular characteristics of the victim
WHEN Timing of death and injuries
WHERE Scene and circumstances of death
WHAT Type, distribution, pattern, path, and direction of injuries
WHICH Significance of injuries – major vs. minor, true vs. artifactual or postmortem
WHY How injuries were produced – mechanism and manner of death

21. FIVE KEY CRIME SCENE QUESTIONS
1. Did the death take place where the body was discovered or was it moved?
2. Was there any attempt to alter the scene?
3. Does the scene suggest a motive for murder (robbery, drugs, insurance fraud, for example)?
4. Is a cause of death clearly apparent?
5. Are there sufficient clues (physical evidence) to indicate how the crime occurred, and where the victim and the perpetrator were in relation to each other during the commission of the crime?

22. Let’s play----- http://health.discovery.com/fansites/drg/tour/
tour.html