MEDICAL EXAMINERS AND THEIR FORENSIC AUTOPSIES

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MEDICAL EXAMINERS AND THEIR FORENSIC AUTOPSIES

• Nadira Haque
• SBF6-02
• Instructor
• M. Villani

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What is a Medical Examiner?

• A medical examiner is a doctor specialized in
• anatomical pathology
• forensic pathology
• The Medical Examiner performs autopsies on bodies
  to determine
• How, When, and Where the victim died.

3
Coroner Versus Medical Examiner
Nadira Haque SB5-02 M. Villani

• Coroners, unlike Medical Examiners, are not
  Medical Doctors.
• Coroners provide subjective opinions of the
  situation.
• Medical examiners provide objective opinions
  based on their observations.

4
Qualifications of a Medical Examiner
Nadira Haque SB5-02 M. Villani

• After high school, education includes
• 4 years undergraduate training
• 4 years medical school
• 4 years residency in anatomic and clinical
  pathology
• 1 year pathology fellowship
• MEs must pass Medical Boards in both topics
• In order to maintain a license, 20 hours per year
  of approved medical education is necessary.

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The Forensic Autopsy
Nadira Haque SB5-02 M. Villani

• Forensic pathology was first recognized in the
  United States in 1959.
• A forensic autopsy is an examination of a corpse.
  This is done to determine the
• cause and manner of death
• time of death
• location of death
• The body is examined internally and externally.

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The Important Contents of an Autopsy Report
Nadira Haque SB5-02 M. Villani

• Autopsy reports contain objective opinions from a
  medical examiner
• These report includes the
• The Cause of Death based on the Autopsy
• The circumstances surrounding the cause of death
• All wounds and injuries found on body
• A report on the bodily fluids and its contents

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Circumstances of Death
Nadira Haque SB5-02 M. Villani

• The circumstances of a death refers to the
  manner of death.
• The major categories are
• To pathologists, the subcategories of unnatural
  death include

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Determining Time of Death Algor Mortis
Nadira Haque SB5-02 M. Villani

• Algor Mortis is known as the coolness of death
• Normal body temperature is 98.6o F.
• Body temperature decreases 2o C in the first hour
  if in a controlled environment
• Then the body temperature is decreased 1o C per
  hour, after the first hour.
• This occurs due to the respiratory system failing
  to work after death

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Time of Death Livor Mortis

• Livor Mortis is referred to as color of death.
• When the heart stops pumping, blood no longer
  flows through the body. Therefore, red blood
  cells gather with plasma cells at the lowest
  point of the body.
• If the body is not moved, there will be a visible
  area of coloration.

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Time of Death Rigor Mortis

• Rigor Mortis is known as stiffness of death.
• A dead body stiffens in this order eyelids, jaw,
  face, arms, legs, torso.
• Rigor mortis shows up after 2 hours of death
• Body stiffness peaks at 12 hours
• At 12-24 hours, the body begins loosing stiffness
• After 24 hours, rigor mortis is no longer present

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Time of Death Pallor Mortis

• Pallor Mortis is referred to as paleness of
  death.
• This identification is only useful if the body is
  found quickly after it has died.
• Capillary circulation stops when a person dies,
  thus giving the paleness
• It shows up 15-20 minutes after death.

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Protocol for External Examination
Nadira Haque SB5-02 M. Villani

• At the scene, the body goes into a body bag.
• The body is then brought into the medical
  examiners room where it is weighed.
• It is then placed on a cadaver dissection table.
• Gender, race, hair, age and other defining
  factors are noted of.

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Wounds found in External Examination of Body
Nadira Haque SB5-02 M. Villani

• Wounds are noted of and photographed.
• Common injuries include
• Bruises (contusions) black and blue marks.
• Abrasions made by dragging and scraping.
• Lacerations ragged cuts
• Cuts superficial injuries
• Marks of ligature indicating torture and being
  bound
• Pinpoint hemorrhages

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Internal Examination of Body Autopsy Process (1)

• Step 1 A body block made of plastic or rubber
  is used. It props up the back, and allows the
  arms and head move backwards.
• Step 2 A deep Y-shaped cut is made, starting
  from the armpits, down the front of the chest,
  and ending at the sternum. The incision is then
  extended to the pubic bone. The cuts are made to
  the left.

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Internal Examination of Body Autopsy Process (2)

• Step 3 An electric saw is used to cut open the
  chest. This creates dust, so the cavity is opened
  using Shears.
• Step 4 The ribs are cut to make the sternum and
  ribs one removable piece. This exposes the lungs
  and heart. The chest plate is put aside.

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Internal Examination of Body Autopsy Process (3)

• Step 5 The organs are then removed.
• The en masse technique of letulle Organs are
  removed as one large mass.
• Cuts are made along the vertebrae Organs are
  detached.
• The en bloc method of Ghon Organs divided into
  four sections and removed as four sections

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Internal Examination of Body Autopsy Process (4)

• Step 6 The organs are examined and weighed.
  Tissue samples from each organ are taken.
• Step 7 The major blood vessels are cut open and
  inspected for any unnatural blocks or content.
• Step 8 The stomach and intestinal contents are
  examined and weighed.

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Internal Examination of Body Autopsy Process (5)

• Step 9 The body block is shifted, to prop up the
  head. Now, the skull is opened.
• An incision is made from one ear, over the crown,
  to the other ear.
• The scalp is pulled away in two flaps
• A cap of the skull is cut using an electric
  saw the brain is now exposed.
• The brain is observed for any abnormalities or
  damage.

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Internal Examination of Body Autopsy Process (6)

• Step 10 The autopsy is finished. The body is now
  reconstructed. This process is usually assisted
  with filler material, such as cotton.
• Organs are put into plastic bags before being put
  back into the body cavity in order to prevent
  leakage.
• All open areas are fitted back and sewn/sealed so
  the body can be returned to the family.

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The Lungs
Nadira Haque SB5-02 M. Villani

• In humans, the right lung is larger than the
  left.
• Pink lungs belong to younger people.
• With age, the lungs turn a grey color due to the
  amount of gas inhaled throughout a persons life.
  
• The alveoli are closed in the lungs due to the
  capillaries not receiving a gas exchange
• If there is soot and grime in the lungs, the
  victim may have died in a fire.
• Water found in lungs indicates drowning.

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The Kidneys
Nadira Haque SB5-02 M. Villani

• The left kidney is larger than the right.
• As a person gets older
• Their kidneys shrink and become more wrinkly
• These traits in a kidney indicate disease
• Extreme sponginess.
• Presence of cysts.

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The Liver
Nadira Haque SB5-02 M. Villani

• The weight of the liver in a adult is 3 pounds.
• A normal liver is reddish-brown in color.
• A pale-yellow and fatty liver indicates a heavy
  drinker, which could be the natural cause of
  death.

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Stomach Contents
Nadira Haque SB5-02 M. Villani

• Stomach contents can be useful in determining the
  time of death.
• Food naturally passes through the bowels during
  digestion. Digestion occurs within 2 hours of
  consumption.
• If large fragments of food are still present in
  the stomach, the person most likely died not too
  long after he or she ate.
• The emptier the stomach content area, the longer
  the victim has been dead.

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Collection of Body Fluids
Nadira Haque SB5-02 M. Villani

• Body fluids are collected with syringes.
• Blood is collected from the left ventricle of
  heart
• It Contains DNA for identification.
• Urine is collected from the kidneys where the
  nephrons are located
• Urine can show the presence of toxic substances.
• Spinal fluid is collected from a canal at the
  center of the spine through a spinal tap.
• Joint fluid is collected from ball and socket
  joins.
• Vitreous humor fluid is collected from the eye
• The more potassium that has been built up, the
  longer the person has been dead.

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Toxicological Analyses
Nadira Haque SB5-02 M. Villani

• Fluid samples are sent to the toxicology division
  for qualitative and quantitative analysis.
• Gas chromatography provides a chart that
  identifies all components in the fluid and how
  much of each component is in the fluid.
• Sometimes poisons, like cyanide, or drugs, such
  as heroin, is the cause of death.

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Testifying in Court
Nadira Haque SB5-02 M. Villani

• Medical examiners serve as expert witnesses in
  the courtroom.
• They provide the circumstances surrounding the
  death based on their medical findings.
• The State Medical Examiner must clear during his
  or her testimony and present the medical
  information in a way that the jury can
  understand.

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References

• Info http//www.forensicmed.com/faq_forensicpath.
  htm
• Image http//blog.nj.com/iamnj/2007/09/large_hua1
  .jpg
• Info http//en.wikipedia.org/wiki/Coroner
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  20508102137--Medical20School20WEB.jpg
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  large/v_a_408_autopsy.jpg
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  ish.jpg
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