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Coroner | Medical Examiner

Bureau of Justice Statistics Medical Examiners and Coroners’ Offices, 2004

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About 2,000 medical examiners and coroners' (ME/C) offices provided death investigation services across the United States in 2004. These offices were responsible for the medicolegal investigation of death. They may conduct death scene investigations, perform autopsies, and determine the cause and manner of death when a person has died as a result of violence, under suspicious circumstances, without a physician in attendance, or for other reasons. As of 2004, 16 States had a centralized statewide medical examiner system (see map). Fourteen States had a county coroner system, 7 had a county medical examiner system, and 13 had a mixed county medical examiner and coroner system. Eight States with decentralized death investigation systems also had a State medical examiner office performing medicolegal duties (Alabama, Arkansas, Georgia, Iowa, Kentucky, Montana, North Dakota, and Tennessee). The District of Columbia reported a city medical examiner office, which functioned similar to a statewide system. ME/C offices employed an estimated 7,320 FTE employees. Estimated annual budgets for these...

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Postmortem Changes and Time of Death

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Quotations
"The time of death is sometimes extremely important. It is a question almost invariably asked by police officers, sometimes with a touching faith in the accuracy of the estimate. Determining the time of death is extremely difficult, and accuracy is impossible". (Ref. 8 at p. 115.) "No problem in forensic medicine has been investigated as thoroughly as that of determining the time of death on the basis of post mortem findings. Apart from its obvious legal importance, its solution has been so elusive as to provide a constant intellectual challenge to workers in many sciences. In spite of the great effort and ingenuity expended, the results have been meagre". (Ref. 15 at p. 33.) "Repeated experience teaches the investigator to be wary of relying on any single observation for estimating the time of death (or "duration of the post mortem interval"), and he wisely avoids making dogmatic statements based on an isolated observation". (Ref. 12 at p. 151.)

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Dilemma for Autopsy Surgeon

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Introduction:

Forensic medicine is best learned by a judicious combination of theoretical and practical knowledge. A good forensic expert is one who has not merely a vast experience in conducting autopsies, but one who has trained himself to make precise and correct interpretation of the findings. One must not allow dogmatism or inflexibility to cloud one’s judgment. A self- opinionated expert is a poor expert. There are several inherent pitfalls that must be avoided in the course of medicolegal autopsies which can lead to erroneous or fallacious conclusions. Every forensic pathologist must familiarize himself with these postmortem artefacts that are liable to misinterpretation. Postmortem Artefacts are due to any change caused or features introduced in a body after death. The artefacts are physiologically unrelated to the natural state of the body or tissues or the disease process, to which the body was subjected to before death. Ignorance and misinterpretation of such postmortem artefacts leads to:...

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Skeletal Remains Presumed Submerged in Water for Three Years Identified Using PCR-STR Analysis

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ABSTRACT:

We describe the successful identification of the remains of a saponified body found in a dam by typing of nuclear DNA. Whereas DNA extracted from soft tissues yielded negative PCR results, DNA extracted from the bone by a slightly modified Qiagen procedure allowed the typing of sex (AMG locus) and of 10 additional STR loci. An identity document was found belonging to a man missing for 3 years and comparison of the results to the DNA profiles of his son and wife confirmed the identity. The longest delay reported until now for successful nuclear DNA genotyping after immersion in river water was 18 months. This case demonstrates a delay of up to 3 years.

Recovery of human DNA from bones of severely decomposed bodies was reported for the identification of unidentified bodies like murder victims (1) or ancient human remains (2). Nevertheless, few studies concern genotyping of bodies immersed in water, the longest reported delay for successful identification being 18 months (3). The mai...

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An Autopsy Report Case of Rape Victim by the Application

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Sexual assault is usually an un-witnessed crime. Therefore, forensic investigation and identification of the spermatozoa and semen on the specimen collected from the vagina of female victims plays an extremely important role in the court testimony to confirm the recent episode of sexual intercourse. In fact, microscopic visualization of the spermatozoa is a gold standard method to prove that the female victims had recently been violated. However, if the male offender is a vasectomized or azoospermic individual, it is impossible to prove the recent sexual event by identification of the spermatozoa and this may let the offender go free. In the US, the reported frequency of azoospermia is 1% to 9% in seminalstains or swabs-examined sexual assault cases and the frequency of contraceptive vasectomy has been estimated to be 750,000 to 1,000,000 per year(1,2)In recent years, the acid phosphatase test was generally used as a routine test for identification of the semen in stains or swabs. However, according to scientific results, acid phosphatase test is only...

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To Be Published In The Official Reports Office Of The Attorney General

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ANALYSIS

The question presented for analysis concerns access by police and district attorney investigators to the medical and psychiatric records of a deceased person that are in the possession of the county coroner. May the records be disclosed by the coroner without the issuance of a court order, search warrant, or subpoena duces tecum? The issue arises when the coroner determines that a person has died under circumstances which suggest that the death was a homicide, and the coroner must notify the appropriate law enforcement agency. Government Code section 27491.11 provides: “In all cases in which a person has died under such circumstances as to afford a reasonable ground to suspect that the person’s death has been occasioned by the act of another by criminal means, the coroner, upon determining that such reasonable grounds exist, shall immediately notify the law enforcement agency having jurisdiction over the criminal investigation. Notification shall be made by the most direct communication available. The report shall state the name of the......

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Injuries & Its Medico Legal Injuries & Its Medico Legal Aspect

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INTRODUCTION

Injury is also known as trauma or wound and can be defined legally as any harm whatsoever in nature caused illegally to the body, mind, reputation or property (Bhullar, 2007). Medicolegally (clinically) it is defined as breach or dissolution of the natural continuity of any of the tissues of a living body by actual physical violence. The legal aspect views trauma in two forms, simple and grievous while medicolegally trauma has various types’ mechanical, thermal, chemical, electrical/lightening, radiation (Bhullar, 2007). The mode of injury could be suicidal, homicidal or accidental. Doctors should therefore be abreast with medico-legal procedures to identify and differentiate failed homicidal, suicidal from accidental cases. This will go a long way to wholishically manage a patient, as they may eventually succeed in their attempts leading to deaths if not properly managed. Injuries of medicalegal importance include:
1. Hesitation cuts/tentative cuts: These are parallel superficial cuts suggestive of suicidal nature, seen in the (precordial area), wrist etc....

Additional Resource: Medicolegal Notes in Injuries, an Emerging Clinical Importance (2236 downloads )

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Auto Erotic Hanging Brought As A Case Of Suicidal Hanging – A Case Report

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ABSTRACT:

A rare case of auto erotic hanging brought as a case of suicidal partial hanging is reported in this paper. Hanging is usually considered suicidal if not proved otherwise. The findings which were corroborative of auto erotic hanging decided that this was a case of accidental and not suicidal hanging.

INTRODUCTION:

Accidental hanging in the course of some abnormal sexual practice has certain characteristics which are virtually specific. The victims are exclusively males. Some are nude, some are attired in female garments and others, if normally clothed, may have opened their trousers and there is evidence of manipulation or bandaging of the genitals. Protection of the neck is by soft material, a handkerchief, vest or other cloth, interposed between the ligature and the skin of the neck [1].

CASE REPORT: One day, it was reported to the police that a constable of the 1st IRB (Indian Reserve Battalion) posted at Imphal was found hanging in the morning Inside his quarter.

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Clinical Study On Stab Wounds Of Chest–Factors That May Influence Their Mortality

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Abstract

Stab wounds of the chest occupy an important position in penetrating thoracic injuries in Japan. A retrospective review of 117 patients with stab wounds of the chest admitted to our hospital over the past 12 years (from 1975 to 1987) revealed some factors that might influence their mortality. Seven patients died from trans-diaphragmatic injuries of intra-abdominal organs. The management of intra-abdominal injuries was very important in thoracic stab wounds. Many of the patients with stab wounds of the precordial chest (danger zone) had cardiac or major vascular injuries, and the mortality rate of them was high. The mortality rate of the patients with stab wounds of the right lateral thorax was high, because many of them had trans-diaphragmatic liver injuries. We thought that right lateral thorax as well as precordial chest is the danger zone in thoracic stab wounds. Survival rate in the patients whose circulatory condition had been unstable when...

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Management Of Penetrating Stab Wounds Of The Chest: An Assessment Of The Indications For Early Operation.

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Abstract

Haemothorax, haemopneumothorax, and pneumothorax were the most common complications in 85 patients with penetrating stab injuries of the chest. These complications were amenable to conservative treatment by aspiration or drainage of the pleural space. Immediate operation was indicated in 30 cases. Indications for surgery were haemorrhage from a major systemic or pulmonary vessel or the heart, cardiac tamponade, diaphragmatic penetration, oesophageal and bronchial tears, and sucking chest wounds. The need for immediate operation was clinically obvious at presentation in most cases. It should have been suspected from the situation of the entry wound, the nature of the weapon used, the size of the haemothorax, and the clinical findings in the others. All 11 deaths occurred in that group in which early operation was indicated, and some could have been averted had the need for operation been suspected early. Seven patients developed an empyema; five were in the group...

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Body Snatchers: Organ Harvesting For Profit

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Recently in China, a missing 6-year-old boy was found alone in a field, crying. Upon closer inspection, both eyes had been removed, presumably for the corneas.

In 2012, a young African girl was kidnapped and brought to the UK for the sole purpose of harvesting her organs. She was one of the lucky ones—rescued before she went under the knife. Authorities feel this is just the tip of the iceberg.

This isn't just an international occurrence. Kendrick Johnson, a Georgia teen, died at school January 2013. The local sheriff quickly determined the death was a freak accident, that he suffocated after getting stuck in a rolled up mat in the school gym. Johnson's parents however, could not would not accept that. Six months after his death, they obtained a court order to have the body exhumed for an independent autopsy.

The pathologist was stunned when he found the corpse stuffed with newspaper...

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Studies On The Estimation Of The Postmortem Interval | Burned Bodies

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Abstract

The authors have investigated 15 kinds of findings of 30 bodies burned at known times and autopsied in our laboratory. The conclusions are as follows: As the criteria for determining the time of death, external findings of cadavers burned lose value considerably, but internal findings, especially undigested food in the stomach remain as valuable as in ordinary circumstances. The usual criteria can be applied with the same degree of success to burned bodies, because appearances of findings caused by cadaveric phenomena show neither acceleration nor retardation in bodies burned so far as they are not severely destroyed.

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Alcohol In Decomposed Bodies: Postmortem Synthesis And Distribution.

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Abstract

Blood alcohol (ethanol) concentrations in decomposed bodies can mean drinking during life and/or endogenous production after death. The correct interpretation is important in medicolegal cases. This retrospective study of 286 autopsied medical examiner cases was undertaken to evaluate alcohol concentrations and distribution in various fluids and tissues in decomposed bodies. Cases with alcohol present were classified as endogenous production, ingestion, or unable to determine based upon one or more of the following criteria: the presence of ethanol in only one of more than one body fluids, an atypical distribution of ethanol in body fluids, reliable scene or historical information, the presence of C3 alcohols in body fluids. Alcohol was classified as endogenously produced in 55 cases. The presence of alcohol was attributed to ingestion in 130 cases. No alcohol was detected in 39 cases. We were unable to determine the source of the remaining 62 alcohol concentrations. The highest blood alcohol concentration derived from...

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The Decomposition of Hair in the Buried Body Environment

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The hair protein is consists mainly of such a peptides which is highly coiled-coil in structure and covalently linked peptides that's why these proteins are robust and flexible in structure (Coulomb et al., 2002;Lee et al., 2012). In crime scene investigation hair is forensically important and environmentally stable component compare to DNA (Thompson et al., 2014;Van et al., 2010;Wilson, 2008;Wilson et al., 2007). However, the extraction of DNA from hair is difficult. ...

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Medical Terminology Coding Systems and Medicolegal Death Investigation Data: Searching for a Standardized Method of Electronic Coding at a Statewide Medical Examiner’s Office*

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Abstract

Medical examiner and coroner reports are a rich source of data for epidemiologic research. To maximize the utility of this information, medicolegal death investigation data need to be electronically coded. In order to determine the best option for coding, we evaluated four different options (Current Procedural Terminology [CPT], International Classification of Disease [ICD] coding, Systematized Nomenclature of Medicine Clinical Terms [SNOMED CT], and an in-house system), then conducted internal and external needs assessments to determine which system best met the needs of a centralized, statewide medical examiner’s office. Although all four systems offer distinct advantages and disadvantages, SNOMED CT is the most accurate for coding pathologic diagnoses, with ICD-10 the best option for classifying the cause of death. For New Mexico’s Office of the Medical Investigator, the most feasible coding option is an upgrade of an in-house coding system, followed by linkage to ICD codes for cause of death from the New Mexico Bureau of...

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Dead Body Decomposition Model

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Stella® model and case study by Bob GotwalsView the case study for this model.

Below you will find an image of a model of dead body decomposition. This model was created using Stella® software and was converted to Java for the web using Stella2Java©2001-2003.

Please note that in order to view this Java applet you must use a Java-enabled browser.

As with any model, this one has been simplified in order to demonstrate change in body weight over time. This model could be added to in such a way that it would more closely represent real decay processes in a given geographic area. Manipulate the variables below to see how they change the rate of decomposition.

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