Medicine - sudden and suspicious death

Question 1

Intro to suspicious deaths

Answer 1

o Often obvious
o Witnessed
o Nature of injuries – shooting, stabbing
o Difficult
o Un-witnessed - asphyxia, babies
o Decomposed
o Alcoholics
o Minimal/non-specific findings

Question 2

Those involved in sudden and suspicious death

Answer 2

o Coroner
o Police
o Scene of Crime Officers
o Forensic Scientists
o Pathologist

Question 3

Forensic procedure

Answer 3

History
Scene
Post-mortem examination
Further investigations

Conclusions
Report
Evidence in court

Question 4

Forensic procedure - history

Answer 4

o Medical history
 Epilepsy, asthma, some heart diseases
o Medication
 Medicines are dangerous
o Drugs and alcohol
 Need to take samples, tolerance
o Circumstances of death
 Electrocution, drowning, asphyxia, blunt injury
o Resuscitation
 Can cause severe injuries
o Uses of history
 Determines what is done at post-mortem
 Determines what samples are taken at post mortem
 Massively affects interpretation of findings

Question 5

Forensic procedure - the scene

Answer 5

o Collection of samples
o Time of death
o Cause of death
o Reconstruction of events
o Initial assessment

Question 6

Forensic procedure - Post-mortem examination (documentation, samples, identification, cause of death, time of death, reconstruction of events)

Answer 6

o Objectives
1. Document injuries and disease
* Blunt injuries
o Causation
o Age
* Sharp injuries
o Self inflicted?
o Accidental?
o Knife used?
o Blood contamination?
* Asphyxia
o How long squeezed?
o How much force?
* General
o Order inflicted
o Inflicted after death
o Time till death
o Activity after injury

2. Obtain samples/photographs
   * How taken
   * Continuity
   * Interpretation of results
3. Identification
   * Facial
   * Clothing/possessions
   * General appearance
   * Individual characteristics
   o Scars, tattoos, teeth, finger prints
   * Blood group
   * DNA
4. Cause of death
   * Usually obvious
   * Can be open to interpretation
   o Delayed death
   o Significant natural disease
   o Alcohol/drugs
   o Minimal findings
   o Lots of injuries
5. Time of death
   * Body temperature
   o Problem is never know what body temperature was when they died
   o People cool down at different rates – depends on clothing, where the body is etc
   * Hypostasis – pooling of the blood in the body after death
   o Almost useless for time of death
   o Can indicate position body been in
   o Causes suspicious marks
   * Rigor mortis – stiffness of the muscles after death
   o Caused by ATP running out in muscles
   o Factors affecting:
    Temperature of environment
    Physical activity (cadaveric spasm)
    Muscle bulk
    Strength of assessor
    ‘Breaking’ of rigor
   * Chemical changes
   * Decomposition
   o Depends on temperature and dryness
    Warm and dry – mummification
    Cold and wet – adipocere -> skeletalization
    Warm and wet – putrefaction
   o Some internal organs very resistant
    Heart
    Prostate, uterus
   * Non-medical indicators
   * Time of death is terribly inaccurate
6. Reconstruction of events

Question 7

Forensic findings - the report

Answer 7

o Often poor documentation
o Over interpretation
o Going beyond expertise

Question 8

Forensic procedure - the police

Answer 8

o Agent of the coroner – coroner and CPS decide charges
o Gathering and presenting evidence