1. INVESTIGATION OF SUSPICIOUS DEATHS FORENSIC PATHOLOGY

2. Pathologist’s Viewpoint “What we require” INFORMATION Status of the Scene Liaison with Technical Bureau/ Scenes of Crime for Scene Visit Coroner MUST be informed!

3. SCENE VISIT Forensic Suit,Overshoes,Mask,Gloves etc. Photography/Video first Limit Examination of Body at Scene----DO NO DAMAGE! Body Temperature—may be preferable to defer until mortuary SWABS—if essential and can be taken without major disturbance

4. SCENE BAGGING of HEAD and HANDS PAPER v.Plastic bags

5. Removal of Clothing Disturbance Loss of Evidence Usually best avoided at Scene---unless special circumstances

6. Potential Weapons BAG for Scientific Examination Avoid bringing into mortuary dissecting room Can examine in a sealed container or bag,in an office,outside the P.M.suite While weapon still secure in a container,can take a photocopy

7. Body Temperature Of little evidential value Best left until mortuary Rectal temperature --- after swabs taken Ambient temperature at scene Mortuary has Space,Light,Technical Assistance

8. AUTOPSY Autopsy is NOT the end of the process,just the beginning Alcohol Toxicology for Drugs (Prescription and Illicit) Histology Neuropathology Cardiac Pathology etc. in rare instances

9. AUTOPSY Debriefing at end of P.M. Summary of Findings Statement if required N.B.--- the Pathologist’s provisional opinion may be revised by the time of the final report

10. ORGAN RETENTION MAY BE REQUIRED IN EXCEPTIONAL CASES Brain for Neuropathological Examination is commonest Heart for expert cardiac pathology Lungs --- Industrial Lung Disease MUST notify Next of Kin of Organ Retention

11. GLOSSARY WOUNDS and INJURIES 1. Bruises 2. Abrasions 3.Lacerations 4. Incised wounds (Slash wounds) 5. Stab (Penetrating) wounds

12. WOUNDS and INJURIES SIZE SHAPE POSITION --- relate to at least two anatomical landmarks Ageing of Injuries

13. PLEA to INVESTIGATORS PLEASE!!! Follow up with additional information requested by us Background Information Medical History Case Notes Clinical Summary (if patient was in hospital)

14. Investigation of a Suspicious Death Accurately establish the circumstances surrounding the death

15. Investigating Officer ASKS Has a crime been committed? If so,who is responsible? If the person responsible is traced,is there sufficient evidence to charge that person and support a prosecution?

16. Role of the Forensic Pathologist Cause of Death --- prompt P.M. Circumstances of Death --- Natural,Accident,Suicide or Homicide Time of Death --- Body Cooling,Rigor Mortis Identification --- Visual, Dental, DNA Collection of Trace Evidence

17. SCENE WHERE THE BODY IS DISCOVERED Where the person died? Where the person was injured? Where body moved to,or was moved to? Where the body was concealed? Where the body was removed from? THE BODY!!!

18. Why Visit the Scene? Because Someone Asked Me To To View the Body In-Situ --- cf relationship to furniture,signs ofdisturbance,bloodstains,potential weapons Assess how long dead Preliminary Assessment of Cause and Mechanism of Death --- marks,pattern of injury

19. Why Not Visit the Scene? No Body at Scene Pathologist does not routinely visit Scene Pathologist too Distant from Scene Pathologist 2 nd,3 rd,4 th to be involved Swift removal of body from scene is desirable Scene is Unsafe Initially not regarded as Suspicious

20. “REVISIT” the SCENE In Person after the P.M. View Photographs View Video Modern Technology --- Video links Sketches Witness Statements

21. Why Visit or Re-Visit Reconstruct Events Identify potential weapons,objects or surfaces that may have caused injuries Identify where the injuries were sustained Assess order of injuries Post-Injury Movement Continuous Attack v. Repeated Attacks

22. Doctor at the scene Confirm death preliminary assessment regarding cause of death unusual or worrying features, particularly injuries assessment of how long dead.

23. Doctor at the scene Confirm death if obviously dead, disturb the body as little as possible, unless the deceased is your patient and a ‘Death certificate’ is going to be issued do as much, but as little as possible, to satisfy yourself that the person is death bodies ‘recovering’ in the mortuary are not common.

24. Doctor at the scene Cause of death natural - dead in bed, sitting or lying on the floor, with no unusual findings accidental - usually obvious from the scene, usually injuries, pattern of injuries consistent with the circumstances suicide - scene suggestive e.g. drugs found, or conclusive e.g. hanging.

25. Doctor at the scene Cause of death ‘suspicious’ position of body state of clothing marks or injuries on the body

26. Doctor at the scene Suspicious death do not disturb the scene disturb the body as little as possible do not make any unnecessary examinations record any changes you make

27. Doctor at the scene Suspicious death Locard’s principle ‘every contact leaves a trace’ do not leave any unnecessary trace of you behind.

28. Doctor at the scene Suspicious death Ask where to walk, look at the ground, avoid obvious trace evidence e.g. blood stains, footprints etc.

29. Doctor at the scene Suspicious death keep your hands in your pockets do not touch anything other than the body keep your examination to a minimum do not remove any clothing and try not to disturb the clothing unnecessarily

30. Doctor at the scene Suspicious death check for a pulse check if breathing check if body feels warm or cold check if jaw, arms and legs stiff or floppy note, but do not disturb, any injuries do not attempt to make a full body examination

31. Doctor at the scene Suspicious death keep your mouth shut say as little as possible do not attempt to give a definitive diagnosis if you don’t say it it can’t be taken down and used in evidence against you ‘haven’t a clue, ask the pathologist’ should be your stock phrase.

32. Doctor at the scene Suspicious death don’t be coerced to do or say more than you are comfortable with don’t take a temperature unless you have checked with the pathologist or you are prepared to interpret it