Forensic Pathology

Question 1

Discuss the role of a medical examiner in society.

Answer 1

• Death certification
• Epidemiological data
• Analysis of violence
• Family physician to the bereaved

Question 2

Identify the primary function of a medical examiner.

Answer 2

• Board certified forensic pathologist
• Appointed by a governor and\or counselor
• Scene investigation/history
• Autopsy
• Ancillary studies

Question 3

List the five categories into which all deaths are classified.

Answer 3

• Natural
• Accident
• Suicide
• Homicide
• Undetermined

Question 4

Name six circumstances when a death must be reported to the medical examiner.

Answer 4

1. Related to a criminal act
2. Suicide
3. Accidental injury
4. Fire or explosion
5. Firearms and\or mortal weapons
6. Public or private conveyance
7. Deaths in legal custody
8. Death in which a body is cremated
9. Death unattended by a practicing of the physician
10. Sudden, unexpected death under 6p in apparent good health
11. Deaths from agent which constitute a public health or environmental hazard
12. Deaths due to poison or illicit substance abuse
13. Anyone under 18
14. Decomposes & skeletal remains

Question 5

Describe the essential steps in conducting a death scene investigation.

Answer 5

1. Identification
   a. Circumstantial
   b. Fingerprint
   c. Dental
   d. Radiographical
   e. DNA
2. Time of death
   a. Rigor mortis
   i. muscle rigidity)
   ii. Smallest muscles rigid 1st
   b. Livor mortis
   i. Post-mortem settling of blood after death
   ii. Blanching only during early rigor mortis
   c. Algor mortis
   i. Temperature difference
   ii. Loss 1.5 C for about 10 hours then equilibrate
   iii. Lots of variables involved
   d. Ocular changes
   i. Cloud over in time
   – Very cloudy (minimum of 72 hours)
   e. Late post-mortem changes
   i. Putrefaction
   – Greening usually starts in RLQ
   – Look larger
   – Anaerobic species = lots of gas
   – Marbling
   ii. Mummification
   – Low humidity favors this over putrefication
   iii. Infestation
   – Beetles (5 days to a week, attracted by maggots)
   iv. Skeletonization
   v. Adipocere
3. Evidence recognition, recovery & chain of custody
   a. Autopsy
4. Interagency cooperation

Question 6

Give a brief history of the evolution of the medical examiner system.

Answer 6

1) The coroner system
2) The medical examiner system
3) Current state of medicolegal death investigation systems in the U.S.

Question 7

List 4 serious errors that one should avoid in association with forensic cases.

Answer 7

1) Errors of commission
2) Errors of omission
3) Errors of judgment