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Coroner | Medical Examiner

Her Last Words: Dying Declarations and Modern Confrontation Jurisprudence

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Dying declarations have taken on increased importance since the Supreme Court indicated that even if testimonial, they may present a unique exception to its new confrontation jurisprudence. Starting with Crawford v. Washington in 2004, the Court has developed strict rules concerning the use of testimonial statements made by unavailable declarants. Generally, testimonial statements (those made with the expectation that they will be used to prosecute the accused) may be admitted only if they were previously subject to cross-examination. The only exceptions appear to be dying declarations and forfeiture by wrongdoing when the accused intentionally rendered the declarant unavailable. This Article argues that the dying declaration merits examination for two important reasons. First, its status as an exception to the Court's new confrontation rules seriously undermines the Court's dramatic new interpretation of the Confrontation Clause and demonstrates the internal contradictions of the Court's originalist approach. Second, the...

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The Postmortem Examination in Cases of Suspected Homicide

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The postmortem examination in cases of suspected homicide represents one of the most important applications of medicolegal science to the needs of the community. Its proper performance is of paramount concern to those agencies of government responsible for law enforcement and the effective administration of justice. In view "of the desire of the medical and legal professions, increasingly evident in recent years, to improve the standards and quality of medicolegal practice throughout the country, it was considered timely and appropriate to review again the subject of the postmortem examination in cases of homicide, and to point out what is expected in the way of performance of the person entrusted with it. In a paper published several years ago, the author described and discussed the routine procedures necessary in such examinations.' Inadequacies of Medicolegal Agencies and of the Statutes Pertaining to Them At present, in most sections of the country, the postmortem investigation of homicide is... inexpertly and

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Time Since Death and Decomposition of the Human Body: Variables and Observations in Case and Experimental Field Studies

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There are few studies on the decomposition rate of the human body [1-4]. 3,4 However, nonhuman studies have been conducted on such varied topics as the decay and putrefaction rates of frozen, thawed, and mechanically injured rats [5]; carrion insect activity of pigs [6--8]; and scattering and destruction of mammalian and human remains by carnivores [9-I3]. Difficulty in obtaining bodies, lack of suitable areas for placement and study of the bodies, and negative public opinion all contribute to deter most human decay studies. However, it is crucial that forensic scientists have adequate knowledge to estimate accurately how long a person has been dead if they are to contribute to the resolution of the legal issues involved when a human body is recovered. The most common way to obtain such information is to conduct controlled studies on deceased individuals of known age, race, sex, weight, and cause/manner of death in natural, rather than laboratory, settings. In the natural setting,

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Characterization Of The Volatile Organic Compounds Present In The Headspace Of Decomposing Human Remains

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ABSTRACT

Law enforcement agencies frequtly use canines trained to detect the odor of human decomposition to aid in detuermining the location of clandestine burials and human remains deposited or scattered on the surface. However, few studies attempt to identify the specific volatile organic compounds (VOCs) that elicit an appropriate response from victim recovery (VR) canines. Solid-phase microextraction (SPME) War combined with gas chromatography mass spectrometry (GC–MS) to identify the VOCs released into the headspace associated with 14 separate tissue samples of human remains previously used for VR canine training. The headspace was found to contain various classes of VOCs, including acids, alcohols, aldehydes, halogens, aromatic hydrocarbons, ketones, and sulfides. Analysis of the data indicates that the VOCs associated with human decomposition share similarities across regions of the body and across types of tissue. However, sufficient differences exist to warrant VR canine testing to identify potential mimic odor chemical profiles that can be used as training aids. The resulting data will assist in the identification of the most...

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Charred Body: Virtual Autopsy with Multi-Slice Computed Tomography and Magnetic Resonance Imaging

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ABSTRACT: The correct examination of a charred body is a forensic challenge. Examination, interpretation, and conclusion in respect to identification, vital reactions, toxicological analysis, and determining cause and manner of death are all more difficult than without burns. To evaluate what can be seen in the case of a charred body, we made an examination with the new radiological modalities of cross-section techniques, via multi-slice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI), prior to performing the classical forensic autopsy. In a charred body case of a single motor vehicle/fixed object collision with a post crash fire, the radiological methods of MSCT and MRI made it possible to document the injuries caused by burn as well as the forensic relevant vital reactions (air embolism and blood aspiration). In conclusion, we think postmortem imaging is a good forensic visualization tool with a great potential for the forensic documentation and examination of charred bodies...

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Rigor Mortis In Smooth Muscle And A Chemcal Analysis Of Fibromyoma Tissue

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Studies of rigor mortis recorded in the literature have been made almost exclusively on skeletal muscle, and whatever conclusions there may be regarding its occurrence in smooth muscle seem to have been reached largely by inference from such studies, rather than by actual experimental observations. Wells’ states that all forms of muscle, striped, smooth, and cardiac, undergo rigor mortis, manifested by a shortening and thickening. SaxJ2 investigating the distribution of muscle proteins in bovine uteri, observed no difference between the analyses of tissues fresh and aft,er 24 hours. He did not see a postmortem rigidity of the seuteri. Nasse, according to this investigator, found the intestinal wall firmer several hours after death than immediately post mortem, and concluded that this is a rigor mortis contraction of the intestinal musculature. Hawk,3 referring to Saxl’s study, says there is a difference of opinion regarding the occurrence of true rigor in non-striated (smooth) muscle. Such statements in the literature are sufficiently at variance with the observed contraction

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South African Medical Journal Penetrating Stab Wounds Of The Chest

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Penetrating stab wounds of the chest constitute an everpresent problem in many hospitals in South Africa. At Baragwanath Hospital, where approximately 1,500 cases are admitted annually, our experience in common with many other workers is that the mortality rate is steadily decreasing. Peace-time figures only are quoted, since war-time injuries involve tearing injuries by high velocity fragments as compared with the simple incised wound, common in peace-time. Representative mortality rates are: Boland' (1935) 13%, Elkin and Cooper' (1942) 62%, Skapinker" (1949) 6%, Gray et al: (1960) 3·8%, Garzan et al: (1964) 2%, and Baragwanath Hospital (1963) 1·6% (including those cases with thoraco-abdominal wounds who died during the postoperative period). The purpose of this paper is to discuss the factors operating in the patho-physiology of this condition and the treatment in relation to the patho-physiology, resulting in the lowered mortality rate.PATHO-PHYSIOLOGY IN PENETRATING WOUNDS OF THE CHEST Penetrating injuries of the chest produce ill-effects as a result of the following factors

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Effective Preparation For Examining A Pathologist In A Homicide Case

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Introduction

In 2008, the government of the province of Ontario (Canada) established a Commission tasked with ‘The Inquiry Into Pediatric Forensic Pathology in Ontario’: The Inquiry’s mandate was to conduct a systematic review and an assessment of the policies, procedures, practices, accountability and oversight mechanisms, quality control measures, and institutional arrangements of pediatric forensic pathology in Ontario from 1981 to 2001 as they relate to its practice and use in investigations and criminal proceedings. The Commissioner was asked to make recommendations to address systemic failings and restore and enhance public confidence in pediatric forensic pathology in Ontario.

The Goudge Inquiry [Stephen Goudge was the appointed Commissioner] was made necessary by the revelation that a physician who had been conducting pediatric autopsies in the province had been providing opinions based on reported findings that, in several cases that when reviewed, proved unsustainable. A succinct example, discussed in the archives related to the Inquiry, was a case in...

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Fractures of the Hyoid Bone and Thyroid Cartilage in Suicidal Hanging

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Hanging is a form of ligature strangulation in which the force applied to the neck is derived from the gravitational drag of the body weight(1-7). Most hangings are suicides, while only a few are accidents or homicides(1-9). As a method of suicide, hanging is found as frequently as drug use or poisoning(5,10-13). The position of the knot of hanging is very important because it can cause unequal pressure to the neck and result in different injuries to the organs(14). The type of hanging can be divided by pressure into two groups, complete and incomplete hanging. Complete hanging is a hanging in which the full body weight acts upon the ligature and places pressure on the neck, Incomplete hanging is a hanging in which some organs touch the floor, using only part of the body weight to load and cause pressure to the neck(1,2,9). Fractures of the hyoid bone and thyroid cartilage are important pathogenesis to forensic science, especially when death is caused...

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Establishing Identity Using Cheiloscopy And Palatoscopy

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Abstract Establishing a person's identity can be a very difficult process. Dental, fingerprint and DNA comparisons are probably the most common techniques used in this context, allowing fast and secure identification processes. However, since they cannot always be used, sometimes it is necessary to apply different and less known techniques. In this paper, the authors describe two unusual techniques: cheiloscopy and palatoscopy. It is known that due to their special features, both lip grooves and palatal rugae can be used successfully in human identification. This paper reviews the techniques of cheiloscopy and palatoscopy, and describes the different classifications and their advantages and limitations....

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The Coroner’s Autopsy The Final Say in Establishing Cause of Death?

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The Present Coronial System

The process of determining cause of death through the coronial autopsy has been a cause of concern amongst both coroners and pathologists for a considerable period of time. The Wright report (1936), the Broderick report (1971) and the Luce report (2003) all highlighted the problems before Dame Janet Smith called for rigorous reform to protect the public. The Luce report stated: “There is, indeed, a general lack of evidence about the utility and justification for coroner’s autopsies on the scale on which they are practised in England and Wales. If the 121,000 autopsies a year that are now performed were surgical procedures carried out on living people there would long ago have been an evidence base compiled to assess the utility and justification for the scale of intervention.” In its response to the Luce report, the Coroners’ Society of England and Wales noted that:6 “it hopes fervently that this report will receive the attention and implementation that its predecessor reports.”

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Pulmonary Embolism as Cause of Cardiac Arrest

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Background: Pulmonary embolism (PE) is a possible noncardiac cause of cardiac arrest. Mortality is very high, and often diagnosis is established only by autopsy. Methods: In a retrospective study, we analyzed clinical presentation, diagnosis, therapy, and outcome of patients with cardiac arrest after PE admitted to the emergency department of an urban tertiary care hospital. Results: Within 8 years, PE was found as the cause in 60 (4.8%) of 1246 cardiac arrest victims. The initial rhythm diagnosis was pulseless electrical activity in 38 (63%), asystole in 19 (32%), and ventricular fibrillation in 3 (5%) of the patients. Pronounced metabolic acidosis (median pH, 6.95, and lactate level, 16 mmol/L) was found in most patients. In 18 patients (30%), the diag- nosis of PE was established only postmortem. In 42 (70%) it was diagnosed clinically, in 24 of them the diagnosis of PE was confirmed by echocardiography. In 21 patients, 100 mg of recombinant tissue-type plasminogen activator was administered

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Practice Guidelines For Florida Medical Examiners

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Introduction

The Florida district medical examiner system is perhaps the most effective medical examiner system devised in the United States. One reason for its effectiveness may be that Florida medical examiners have a four-tier system of statutes, rules, guidelines, and office policies that governs their practices. Part I, Chapter 406, Florida Statutes, is the Medical Examiners Act. In it, the legislature creates the medical examiner system, charges the medical examiners with the duty to determine the cause of death under specified circumstances, empowers the medical examiners with the authority to perform autopsies at their own discretion, and broadly defines relationships with law enforcement agencies and the state attorneys. Chapter 11G, Florida Administrative Code, is a set of rules written by the Florida Medical Examiners Commission and adopted by the Florida Department of Law Enforcement after public hearings. The code expands on the statutes. To some extent the code has the force of statute because infractions can result in discipline. Like statute, code is written in absolutes...

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Langers Lines

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Incisions made in the direction of Langer’s lines are less likely to gape. This is because they run parallel to the predominant direction of collagen bundles in the dermis - Langer developed his lines by stabbing cadavers with a conical punch. The resulting defects were often oval, rather than circular, because of the direction of the underlying collagen bundles. Langer joined the long axis of these ovals to establish his lines. The direction of Langer’s line on the torso can be established by placing the patient in the foetal position. Then outline the perimeter of a 20 cent piece over the area of interest. When the patient stand upright the outline of the coin will be oval with the long axis indicating Langer’s line. It is useful to know the surface marking of the entrance of the superior vena cava into the right atrium when positioning a central venous catheter. It is...

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Forensic Interpretation Of Injuries | Wounds Found On The Human Body

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Abstract

Penetrating injuries of the body are most commonly the result of injury/wounds and are often associated with a range of potentially life threatening injuries. In every physical assault, no matter it led to death or not, the attacker had produced/left different types of marks in the victim's body that could be helpful to reconstruct the crime scene and guide to determine the cause of death. In the present study, we have demonstrated some examples of injuries/wounds found of the victim's body with illustrative photos. These provide a proper and useful data for the forensic crime scene investigators.

INTRODUCTION

An injury is define as any harm, whatever illegally caused to any person in body, mind, reputation or property as per Indian Panel Code (Sec. 44). In forensic science, the injuries/wounds are produced by physical violence, which break of the natural continuity of any of the tissues of the living body [1]. Different types of injuries are summarized in

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Fracture Of Hyoid Bone In Cases Of Asphyxial Deaths Resulting From Constricting Force Round The Neck

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ABSTRACT

When any case of hanging, strangulation or throttling comes to the Department of Forensic Medicine for Post-mortem examination, the hyoid bone becomes the most integral part of internal examination at the autopsy table. Many authors and workers in this field have seriously highlighted fracture of hyoid bone. Some have claimed hyoid bone fracture in about 20% cases of hanging. Some have claimed hyoid bone fracture in about 68% cases of hanging. They also claimed that hyoid bone fracture increases with age above 40 years due to calcification and immobilization of joints. Some also claimed that hyoid bone fracture increases with using hard ligature for hanging and strangulation. Fracture of hyoid bone has been ascribed to many factors like manners of constriction, level of application of ligature or force of constriction, long drop or short drop suspension, age of victim, sex of victim etc. Besides getting hyoid bone fracture at autopsy table, it is also very important to check whether it is ante-mortem...

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