Professional Documents
Culture Documents
= Icards test – injection of flourescein SQ 1. If body temp. is normal at the time of death:
- greenish yellow discoloration in the = the average rate of fall of the temp. during the first 2 ½ hours is ½ of
whole skin the
- dead man only in the area of difference of the body temperature and that of the air.
injection = the body attains the temp. of the surrounding air from 12 to 15 hours
= Pressure on fingernails after
= Diaphanous test – fingers are spread wide death in tropical countries.
through a strong light- Red
= Application of heat on the skin - blister 2. Chemical Method ( Schourup’s formula for the determination of the
= Palpation of Radial pulse time of death of any cadaver whose CSF is examined for the
= Dropping of melted wax concentrations of L.A., NPN, A.A.
= L.A> 15 mg to 200 mg/100cc rapid in 1st 5 hours.
2. Cessation of respiration – more than 3 ½ minutes = NPN inc. from 15 to 40 mg/100 cc in 1st 15 hours
= A.A. inc. from 1 mg to 12 mg% 1st 15 hours.
Methods of detecting cessation of respiration:
a) Observance of movement of chest and abdomen
b) With the aid of stet. 4. INSENSIBILITY OF THE BODY AND LOSS OF POWER TO MOVE
c) Examination with a mirror = may be seen in the living with- apoplexy, epilepsy , trance, catalepsy,
d) Examination with a feather or cotton fibers hysteria
e) Examination with a glass of water
5. CHANGES IN THE SKIN – opacity, flattening, loss of
elasticity b) Age
= early onset – aged and newborn
6. CHANGES IN AND ABOUT THE EYE = delayed – good health, good muscular development
a) Loss of corneal reflex – seen I n live pts: G.A.,
uremia, narcotic poisoning c) Integrity of nerves
b) Clouding of cornea = section of the nerve will delay onset, paralyzed muscle
c) Flaccidity of the eyeball
d) Pupil in the position of rest.
e) TACHE NOIR DE LA SCLEROTIQUE – spot found in
the sclera after death.
2. Cuticle Abraded by the same violence Unabraded 2. Evolution of gasses in the tissues
that produce the bruise.
CO2, ammonia, H2, Suphurated hydrogen, methane.= offensive odor
3. Bruise Appears at the seat or surrounding Always dependent
may or may not be dependent
Effects of pressure of gasses of putrefaction:
4. Elevated, inflammatory condition Not elevated, blood in b.v. a) displacement of the blood – bleeding in open wounds
CONTUSSION (BRUISE) POST-MORTEM HYPOSTASIS b) bloating of the body
5. Incision shows blood outside the b.v. Blood inside the vessels
c) fluid coming out from nostrils, mouth
= most certain test of difference d) extrusion of the fetus in a gravid uterus
6. Color variegated Uniform color
e) floating of the body
7. Presence of live flies in the clothing in the drowning victim – less than 24H
IN TROPICAL REGION 8. State of clothings - pajama , night
9. Changes in CSF
12 HOURS Rigor mortis all over, hypostasis, greenish- 10. Blood clots inside the b.v. in 6 –8 H after death.
11. Soft tissues of the body may disappear 1 to 2 years after burial.
discoloration caecum
24 HOURS Rigor mortis absent all over, abdominal Post-mortem conditions simulating disease, poisoning or injury:
distention 1. post mortem hypostasis – contusion, inflammation , poisoning
48 H Ova of flies, trunk bloated, face discolored 2. blisters of the cuticle – scald and burns
72 H Whole body grossly swollen, hairs and nails 3. swelling, detachment or splitting - injury
loose
ONE WEEK Soft viscera putrefied
TWO WEEKS Soft tissues largely gone PRESUMPTION OF DEATH
ONE MONTH Body skeletonized Disputable presumption - not heard in 7 years
Presumption of death PATHOLOGICAL AUTOPSY MEDICO-LEGAL AUTOPSY
Absence of 7 years except succession 10 years 1. Requirement Consent of next of kin Law that gives the consent
Vessel for 4 years 2. Confirmation Clinical findings of research Correlate tissue changes to
criminal act
Armed forces 4 years 3. Emphasis Notation at all abnormal findings Effect of wrongful act
In danger of death 4 years 4. Conclusion Summation of all abnormal findings Specific to the purpose
5. Minor Need not be mentioned Included if useful
PRESUMPTION OF SURVIVORSHIP
1. under 15 y.o. – older survives
2. above 60 y.o.- younger
3. under 15, above 60 - former The following manner of death should be autopsied:
4. over 15 and under 60 y.o. – male, older 1. Death by violence
5. under 15, or over 60 y.o. and the other in between - latter 2. Accidental deaths
3. Suicides
MEDICO-LEGAL INVESTIGATION OF DEATH 4. Sudden death of persons who are in good health
5. Death unattended by physician
Inquest Officer – is an official of the state charged with the 6. D.O.A. with no clinical diagnosis
duty of inquiring into certain matters. 7. Death occurring in an unnatural manner
- in medico-legal examination: manner and
cause of death
Mistakes in autopsy:
1. Error or omission in the collection of evidence for identification
The following officials of the government are 2. Errors or omission in the collection of evidence required fro
authorized to make death investigations: establishing the time of death
1. Provincial and City Prosecutors 3. Errors or omission in the collection of evidence required fro the
2. Judges of the RTC, MTC medico-legal examination.
3. Director of NBI 4. Errors or omission result in the production of undesirable
4. SolGen artifacts or in the destruction of valid evidence.
Stages of MEDICO-LEGAL INVESTIGATION: Negative autopsies
1.Crime Scene Investigation – investigation of place of - if after all efforts including gross and microscopic studies and
commission of the toxicological analysis fail to reveal a cause of death.
crime
2.Autopsy - investigation of the body of Negligent autopsy
the victim No cause of death is found due to imprudence, negligence, lack of skill,
lack of foresight.
1. Crime Scene Investigation
- place where the essential ingredients of the crime took
place. MEDICO-LEGAL CLASSIFICATION OF THE CAUSES OF DEATH
- Person composed the Search Team:
a) Physician MLI trained a. Natural death – cause by natural disease condition in the body.
b) Photographer
c) Assistant, evidence collector, note taker b. Violent death
1. Accidental death
2. Autopsy 2. Negligent death
- comprehensive study of a dead body, in addition to the 3. Infanticidal death
external examination . Post-mortem examination- 4. Parricidal death
external exam without incision being made. 5. Murder
6. Homicidal death
Purpose of autopsy:
1. Determine cause of death If signs of violence are associated with the natural cause of death:
2. Correlate clinical diagnosis and symptoms
3. Determine effectiveness of treatment The following are deaths due to natural causes:
4. Study the natural course of the disease 1. Affection of the CNS
5. Educate students and physicians a. Cerebral apoplexy – sudden loss of consciousness followed by
paralysis or
MEDICO-LEGAL OR OFFICIAL AUTOPSY: death due to Hemorrhage from thrombosis
1. Determine cause, manner, time of death or
2. Recovering, identifying, preserving evidentiary embolism in the cerebral vessels.
material b. Abscess of the brain
3. Provide interpretation and correlation of facts c. Meningitis of the fulminant type
related to death
4. Provide factual, objective medical report 2. Affection of the circulatory system
5. Separating death due to disease from external a. Occlusion of the coronary vessels :
causes. =most common cause of Sudden death due to natural
causes.
Dead body belongs to the state for cases that requires b. Fatty or myocardial degeneration of the heart.
medico-legal autopsy. c. Rupture of the aneurysm of the aorta
d. Valvular heart disease
e. Rupture of the heart imprudence
4. Affections of the GIT 5. Infanticidal deaths – Art. 255 killing of a child less than 3 days
a. Ruptured PUD
b. Acute intestinal obstruction 6. Murder Art. 248
- treachery, consideration, means of inundation, occasion of
5. Affections of the GUT calamities,
a. Acute strangulated hernia - evident pre-meditation, cruelty
b. Ruptured tubal pregnancy
c. Ovarian cyst with twisted pedicle 7. Homicidal deaths Art 249
Physical injury : is the effect of some of stimulus on the = It is the sum total of all reactions of tissue or organ to trauma, either
body. observed micro or macroscopically.
Stab wound the effect is immediate but a
blunt object is delayed production on the
contusion. a. RUBOR – redness or congestion of the area due to an increase of
blood supply as a part of the reparative mechanism.
Causes of Physical Injuries
b. CALOR – Sensation of heat or increase in temperature.
1. Physical violence
2. Heat or cold c. DOLOR - pain due to involvement of the sensory nerve.
3. Electrical energy
4. Chemical energy d. LOSS OF FUNCTION- due to trauma, the tissue may not
5. Radiation by radioactive substances function.
6. Change of atmospheric pressure
7. Infection The presence of vital reaction differentiates an ante-mortem from a post-
mortem injury.
1. PHYSICAL INJURIES BROUGHT ABOUT BY
PHYSICAL VIOLENCE
EXCEPT: vital reactions not seen even if injury inflicted during life:
= The effect of the application of physical injury on 1. During agonal state of a living person were cells don’t
person is the production of wound. react to the trauma.
= A disruption of the anatomic integrity of the tissues 2. Sudden death as in sudden coronary occlusion.
of the body.
= However, not all physical violence will result in the CLASSIFICATION OF WOUNDS:
production of wound.
1. AS TO SEVERITY
Physics of wound production: a. Mortal wound – caused immediately after infliction that
MV2 is capable of death.
a. Kinetic energy = __________ Parts of body that are mortal – heart, vessels, CNS,
2 lungs, other organs.
`Velocity component is the important factor: b. Non-mortal wound - Not capable of producing death
M16 rifle with a velocity of 3200 ft/ sec causes after infliction.
damage more than a heavier .38
caliber. 2. AS TO KIND OF INSTRUMENT USED
PERFORATING WOUND – Wounding agent produces a.2 – CONTUSSION – is the effusion of blood into the
communication between the inner and outer portion of the tissues underneath the skin on
hollow organs. account of the rupture of the
blood vessels as a result of the application
OR piercing or traversing completely a particular part of the of blunt force or violence.
body causing communication between the points of entry = size of contusion greater than the size of
and exit of the instrument or substance producing it. the object.
= Location of the contusion is not always
5. AS REGARDS TO THE RELATION OF THE SITE OF the site of application of the force.
APPLICATION OF FORCE AND THE LOCATION OF Example: Black eye> Forehead
INJURY
Medico-legal point of view:
A contusion as indicated by its external pattern may
a. Coup Injury – Physical injury which is located at the site correspond to the
of the > shape of the object or weapon used.
application of force. Extent > the possible degree of violence
b. Contre-coup injury – opposite the site of the application applied.
of force. Distribution> indicates the character and manner of
injury as in manual strangulation around the neck.
c. Coup contre-coup injury – site and also opposite of
application of force. Age of Contusion: appreciated from its color change
d. Locus minoris resistencia – Physical injury not located at The size tends to become smaller from the periphery to the
the site nor opposite the site of center and passes through a series of color changes as a result of the
the application of force but in > Disintegration of the RBC and liberation of
some areas offering the least hemoglobin.
resistance to the force applied.
The contusion is red, purple soon after its complete
Example: Blow in fore head > contusion on the development.
region of the eyeball. 4 to 5 days > green
7 to 10 days > yellow and gradually disappears on the
e.Extensive injury – Physical injury involving a greater 14th or 15th day.
area of the body
beyond the site of the application The ultimate disappearance of color varies from 1 to 4 weeks
of force. depending upon the severity and constitution of the body.
Example : Fall or MVA
The color changes starts at the periphery.
6. AS TO REGIONS OR ORGANS OF THE BODY
INVOLVED
Injuries in various parts of the body CONTUSION VS. POST-MORTEM HYPOSTASIS
a. Abrasion ( Scratch, graze, impression mark, 2. Graze – usually caused by forcible contact with rough, hard
friction mark ) objects resulting to irregular removal of the skin
- it is an injury characterized by the removal of the surface.
superficial epithelial layer of the skin caused by a = course indicated by a clean commencement and tags
rub r friction against a hard rough object. on the end.
- Contussion with abrasion = forcible contact before 3. Impact or imprint abrasion ( patterned abrasion, stamping
friction occurs. abrasion, abrasion a la signature)
- the shape varies and the raw surface exudes blood - those whose pattern and location provides objective
and lymph which later dries and forms a protective evidence to show cause, nature of the wounding instrument
covering as SCAB or CRUST. and the manner of assault or death.
= marks of grid of radiator, thread marks of wheel, teeth
Characteristics of abrasion: marks.
1. It develops at the precise point of the 4. Pressure or friction abrasion – caused by pressure
force causing it. accompanied by movement usually observed in hanging
2. Grossly or with the aid of a hand lens or strangulation.
the injury consists of parallel linear = spiral strands of the rope as seen in the skin in
injuries which are in line with the hanging.
direction of rub or friction causing it.
3. It may exhibit the pattern of the
wounding material. Differential diagnosis:
4. Usually ignored by attending physician. 1. Dermal erosion - gradual breakdown or very shallow
Medico-legal viewpoint ulceration of the skin which involves only the
= abrasions caused by fingernails may epidermis and heals without scarring.
indicate struggle or assault
and are usually located in the face, neck, 2. Marks of insects and fishes bites – skin injury is irregular with no vital
forearms and hands. reaction and usually found on angles of the mouth, margins of nose,
= abrasions resulting from friction on rough eyelids and forehead.
surfaces are located in bony
parts and are usually associated with 3. Excoriation of the skin by excreta – found in infants and the skin
contusion or laceration. lesions heals when the cause is removed. No apparent history of rubbing
= nature of the abrasion may infer degree of trauma on the affected area.
4. Pressure sore – usually found at the back at the region Accidental wounds – multiple incised wounds observed on the
of bony prominence. History of longstanding illness, bed passenger and driver of MVA due to broken windshields.
ridden. - kitchen knives in the preparation of food.
Characteristics:
1. The opening of the skin is very small, wound is much
Stab wounds may be: deeper than it is wide.
A.Suicidal 2. External hemorrhage is limited than internally may be
1. Located over vital parts of the body. severe.
2. Usually solitary 3. Sealing of external opening is favorable for the growth
3. Located over covered parts of the body, the and multiplication of anaerobic organism like bacillus
clothing is not involved tetani.
4. Stab wound is accessible to the hand of the
victim Homicidal -
5. Hand of victim is smeared with blood 1. multiple and usually located in different parts of the body.
6. Wounding weapon is firmly grasp by the hand 2. wound are deep
of the victim. 3. there are defense wounds on the victim.
7. If stabbing is accompanied with slashing 4. signs of struggle in the crime scene.
movement
> the wound tailing abrasion is seen towards Suicidal -
the hand inflict the injury. 1. located in areas of the body where the vital organs are
8. Suicide not may be present located.
9. Presence of a motive for self destruction. 2. usually singular, if multiple located in one area.
10. No disturbance in the death scene with 3. parts of body involved is accessible by the hand of the
wounding instrument found near the victim.
victim. 4. clothing usually not involved.
5. wounding is made while the victim is in sitting or standing
B. Homicidal – stabbing with homicidal intent is the position , bleeding is towards the lower part of the body
most common or clothing.
Characteristics:1. Injuries other than stab wound may 6. no disturbance in the crime scene.
be present . 7. wounding instrument found near the body.
2. Stab wound may be located in any
part of the body. Puncturing wound with puncturing instrument loaded with poison:
3. Usually more than one stab wound 1. poison dart – cyanide or nicotine
4. A motive for stabbing, if none then 2. fish spines
the offender either insane/drugs 3. dog bites with hydrophobia virus
5. Disturbance in the crime scene 4. injection of air and poison as a way of euthanasia.
Medical evidence showing the intent of the offender to 5.LACERATED WOUNDS ( TEAR, RUPTURE, STRETCH “PUTOK”)
- is a tear of the skin and the underlying tissues due
Healing is faster healing is delayed
to forcible contact with a blunt instrument.
- May be produced by a hit with a piece of wood, Caused by sharp edged instrument caused by a blunt instrument
iron bar, fist, stone, butt.
- If the force is applied to a tissue is greater than its
cohesive force and elasticity> the tissue tears and
a laceration is produced. POSSIBLE INSTRUMENTS WHEN USED BY THE ASSAILANT IN
INFLICTING THE INJURIES
Lacerated wounds are rarely suicidal. = includes air rifle except of small calibers and limited range.
Edges are clean cut, regular, well defined edges are roughly cut,
irregular, ill-defined
Extremities of the wound are sharp, may be extremities are ill-defined and
irregular
Round, or contused