1. Forensic Pathology
Pathology 1

2. 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

3. The Coroner/M.E. Systems
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

4. The Coroner/M.E. Systems
Medical examiner
Operates out of centralized county to state level offices
Frequently possess both law enforcement and limited judicial powers
Can initiate homicide investigations
Can take sworn testimony
Exempt from civil liability for acts of negligence

5. 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

6. The Autopsy
Pathology 2

7. The Autopsy
A post mortem examination of a body to document anything that may have contributed to death
Purpose is to render an opinion regarding the cause and manner of death
Results are included on a death certificate

8. When is an Autopsy Required?
Criminal violence
Infant/child
Result of police action
In custody of local/state/federal institution
Workplace injury
Electrocution
Alcohol, drugs, poisons
Drowning
Unidentified persons
Skeletonized remains
Charred remains
As deemed necessary

9. The Autopsy Usually consists of external and an internal exam External
Assists mainly in body I.D.
Internal
Assists in determining cause of death

10. The Autopsy Most autopsies are “uneventful”
Not always necessary if a natural cause of death is known
May be required for insurance purposes
Generally range from 30 minutes to several hours to complete
Usually performed in the medical examiner's or coroner's office
Sometimes in a funeral home or hospital

11. The 4 Stage Model 1. Contributing Cause of Death 2. Mechanism of Death
3. Immediate Cause of Death
4. Manner of Death

12. 1. Contributing Cause of Death
Usually pre-existing illness or condition
Could ultimately be actual cause of death
Examples: Pneumonia, asthma, HIV

13. 2. Mechanism of Death What events happened to lead to death
Usually in medical language
Example: ”…lungs became obstructed by fluid and could no longer transport oxygen”

14. 3. Immediate Cause of Death
The actual cause of death
Example: Asphyxia, “GSW to the head”

15. 4. Manner of Death
By law, a fatality must be identified as one of the following categories
Suicide
Homicide
Accidental
Natural
Unknown

16. “Rules of the Road” Mechanism + Immediate Cause = Manner
If Mechanism is undetermined…
Manner must be ruled “Unknown”
Example: Poisoning, strange phenomena
If Immediate Cause aggravates pre-existing condition…
Manner must be ruled “Natural”
Example:

17. “Rules of the Road” Most traffic fatalities are ruled “Accidental”
If a suicide involves additional individuals in the Immediate Cause…
Manner must be ruled “Homicide”

18. Reporting Deaths Necessary for legal and financial reasons
Report is required in order to issue Death Certificate
Considered public record
May not list certain information due to confidentiality laws

19. The External Exam Procedures Review known information
Think before you examine
Measure body length and weight
Examine external details
Take photographs
Warning: Graphic Image follows…

20. Case Study 1

21. The External Exam Preliminary Procedures Link clothing with injuries
Search/collect trace evidence on clothing for criminal cases
Remove clothing
Photograph/list clothing and personal effects

22. The External Exam Record physical characteristics Apparent age Sex
Race/ethnic characteristics
Hair
Eyes
Abnormal body conditions/parts
Scars, tattoos, amputations
Presence/absence of dentition

23. The External Exam Record physical characteristics
Inspect/describe head, neck, thorax, abdomen, extremities, hands
Inspect/describe posterior body surface
Prior medical or surgical procedures

24. The External Exam Describe livor mortis Describe rigor mortis
Most pronounced ~10 hours after death
Describe rigor mortis
Begins ~6 hours after death
Disappears after ~24 hours
Post mortem changes
Evidence of embalming
Decompositional changes
Warning: Graphic Image follows…

25. Case Study 2

26. The External Exam Specific Procedures for Sexual Assault
Swab oral, vaginal and rectal cavities for fluids, DNA
Pubic hair combings or tape lifts for hair/fiber
Fingernail scrapings or clippings

27. The External Exam Specific Procedures for Injuries Describe injuries
Type, location, size, shape, pattern
Correlate to internal injury
Document track/direction of wound
Recover foreign body(ies)
Document object(s)
Warning: Graphic Image follows…

28. Case Study 3

29. Patterned Injuries

30. The External Exam Specific Procedures for Firearms
Wound size and location (be specific)
Soot/stippling (residue)
Abrasion ring, searing, muzzle imprint, lacerations
Warning: Graphic Image follows…

31. Case Study 4

32. The External Exam Specific Procedures for Burns Appearance of burns
Distribution of burns with special emphasis on degree of burn/chars
Warning: Graphic Image follows…

33. Case Study 4

34. The Internal Exam Position of abnormal medical devices
Exam all internal organs in place
Be methodical
Position of abnormal medical devices
Evidence of surgery

35. The Internal Exam Internal Organs (after removal)
Record weight of brain, heart, lungs, liver, spleen, kidneys
Dissect and describe organs

36. Postmortem Exam Report
Prepare postmortem exam report for each case
All relevant forensic information (date, time, investigator, etc.)
Summary of external and internal exam findings
Separate section for injuries
Describe findings in enough detail to support opinions and conclusions
Identify cause and manner of death