Professional Documents
Culture Documents
MEDICO-LEGAL ASPECTS
OF DEATH
Death
* is the termination of
life/complete cessation of all
the vital functions (heart and
lungs) w/o possibility of
resuscitation.
Kinds of death:
1. Somatic or clinical death
persistence of vital functions
2 .Molecular or cellular death 3 to six
hours after cessation of life, death of
indiv. cells
3. Apparent death or ''State of
suspended animation''
transient loss of
consciousness/temporary cessation of
the vital fxns of the body, as in
hysteria,uremia, electric
shock,catalepsy
Importance of Death
determination:
1.The civil personality of a natural person
is extinguished by death.
2. The property of a person is transmitted
to his heirs at the time of death.
3. The death of a partner is one of the
causes of dissolution of partnership
agreement.
Brain death
BRAIN DEAD
2)
CR death-(CARDIORESPIRATORY)
>MD pronouncement based on
intuition/ordinary standards of
med practice.
> death occurs when there is a
continuous & persistent
cessation of heart action &
respiration.
CARDIORESPIRATORY DEATH
Signs of death:
1. Cessation of heart action
and circulation.
-entire and continuous cessation of heart
axn and flow of blood in the whole vascular
system
-as a gen rule, (-) heart axn for a period of 5
mins, death is regarded as certain
-in judicial hanging, heart continues to beat
for 25mins or half an hour after he has been
executed although its beating is irreg and
feeble
b) Examination of peripheral
circulation
1) Magnus test application
of ligature around the base of the
finger w/ mod. lightness bloodless
area at site of application
dead man no change in color
2) Icards test injection of
flourescein subcutaneously
- greenish yellow discoloration in
the whole skin dead man sol'n will
remain
at the site of injection
4) Pressure on fingernails
5) Application of heat on the skin
blister
6) Palpation of Radial pulse
7) Dropping of melted wax
Winslows
test
*POSTMORTEM
CALORICITY
is the rise of temp. of the body
after death due to rapid and early
putrefactive changes. Usually in
the first 2 hours.
>seen in cholera, liver abscess,
tetanus, RF, Strychnine poisoning,
Peritonitis
2. Chemical Method
( Schourups
4. INSENSIBILITY OF THE
BODY AND LOSS OF POWER
TO MOVE
may be seen in the living
with- apoplexy, epilepsy ,
trance, catalepsy, hysteria
,cerebral concussion.
c) Stage of Secondary
flaccidity or Commencement
of putrefaction
( DECAY OF MUSCLES)
> muscle are flaccid, not respond
to stimuli, reaction is alkaline.
> due to dissolution of muscle
proteins.
3. Cadaveric spasm or
Instantaneous Rigor
> instantaneous rigidity due to
extreme nervous tension,
exhaustion, injury to the nervous
system.
> findings of weapon in hand,
weeds-alive before disposal.
RIGOR MORTIS
CADAVERIC SPASM
1.) Time of appearance
3-6H after
death
Immediately after death
2.) Muscles involved
All muscles
Certain group
3.)Occurrence
Natural phenomena after death
- May or may
not appear
4.)Medico-legal signif.
Approximates time of death
- Determine
nature of crime
ANTEMORTEM CLOT
POSTMORTEM CLOT
1. Consistency
Firm
Soft
2. Surface of blood vessels
Raw after clots are
removed
Smooth,
health after
3. Clots
Homogenous in construction so it:
cannot be stripped into layers
can be
stripped off in layers
*Physical characteristics of
Postmortem Cadaveric
Lividity
1) Occurs in the most dependent
areas
2) Involves the superficial layer of
the skin
3) Does not appear elevated from
the rest of the skin
4) Color is uniform
5) No injury of the skin
*Kinds
of Postmortem
Cadaveric Lividity
1) Hypostatic lividity
2) Diffusion lividity
*Importance of Cadaveric
lividity:
1) One of the signs of death.
2)Determines the position of
the body has been changed
after its appearance in the
body.
*Points to be considered
which may infer the position
of the body at the time of
death:
1) Posture of the body when
found.
2) Post-mortem hypostasis or
lividity
3) Cadaveric spasm
CONTUSSION (BRUISE)
POSTMORTEM HYPOSTASIS
1.Small bruises
Below epidermis in true skin
In the
epidermis or
cutis larger ones
below this
2. Cuticle
Abraded by the same violence - Unabraded
that
produce the bruise.
3. Bruise
Appears at the seat or surrounding -Always
dependent may or may not be dependent
CONTUSSION (BRUISE)
POSTMORTEM HYPOSTASIS
5. Incision shows blood outside the b.v. Blood inside the vessels
= most certain test of difference
6. Color variegated
Uniform color
*Internal hypostasis in
Visceral organs::
Organs affected are:
1) Lungs
2) Loops of intestine
3) Brain
2. Mucous membrane
Dull,lusterless
= Not in congestion
3. Inflammatory exudate
Not seen
= Not seen
3. AUTOLYTIC OR
AUTODIGESTIVE CHANGES
AFTER DEATH
After death, proteolytic,
glycolytic and lipolytic ferments
of the glandular tissues continue
to act which lead to the
autodigestion of organs.
*Tissue changes in
putrefaction:
1. Changes in the color of the
tissue
* Hemolysis of blood within blood
vessels > Hgb diffuses through the
walls of BV imparting a Reddishbrown color
* In the tissues > Hgb undergo
chemical change imparting
Greenish-yellow 1st seen at R Iliac
fossa then spreads over whole abd'l
MARBOLIZATION
prominence of the superficial
veins with reddish discoloration
which develops on both flanks of
the abdomen, neck, and
shoulder .
* look like marbled reticule of
branching vein ( esp. observed
among fair complexion )
2. EXTERNAL FACTORS
a) Free air
a.1 air : free air hasten
decomposition
a.2 moderate moisture - accelerates
a.3 loaded with septic bacteria
early aerobes, later anaerobic
* Clostridium welchii= decomposition
b) Earth
b.1 dry absorbent soil - retards
b.2 moist fertile soil - accelerates
c) Running water- more rapid than still
water
d) Clothings early it hastens but
delays in the later stage.
* tight clothings - delay
*CHRONOLOGICAL SEQUENCE OF
PUTREFACTIVE CHANGES OCCURING IN
TEMPERATE REGIONS
1-3 DAYS AFTER DEATH (greenish
discoloration
over iliac fossa, soft
eyeballs )
3-5 DAYS ( frothy blood from mouth,
nostrils)
8-10 DAYS (abdominal distention, nails firm
)
14-20 DAYS( blisters all over the body,
maggots)
*SPECIAL MODIFICATION OF
PUTREFACTION
1. Mummification
*is the dehydration of the whole
body which results in the shivering
and preservation of the body.
* usually occurs when buries in a
hot, dry with free access of hot air.
2) Saponification or Adipocere
formation
* a condition where the fatty
tissues of the body are
transformed to soft brownishwhite substance known as
ADIPOCERE at SQ level.
3. Maceration
> softening of the tissues when
in
fluid medium in the
absence of putrefactive microorg, seen in death in utero .
> reddish or greenish color, skin
peeling off and arms flaccid
and frail.
3. Onset of decomposition
24-48 H after manifested
watery. foul smelling froth,
mouth, nostrils
4. Stage of decomposition
5. Entomology of the cadaver
24 H before eggs are hatched,
maggots
9. Changes in CSF
10. Blood clots inside the b.v. in
68 H after death.
11. Soft tissues of the body may
disappear 1 to 2 years after
burial.
Postmortem conditions
simulating disease, poisoning
or injury:
1) post mortem hypostasis
contusion, inflammation ,
poisoning
2) blisters of the cuticle scald
and burns
3) swelling, detachment or
splitting - injury
PRESUMPTION OF DEATH
Disputable presumption
= not heard in 7 years
Presumption of death
=Absence of 7 years except
succession 10 years
~ Vessel for 4 years
~ Armed forces 4 years
~ In danger of death 4 years
PRESUMPTION OF SURVIVORSHIP
END