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The Autopsy. Pathology 2. The Autopsy. An examination of the body after death to document any natural disease processes and/or injuries which may have contributed to the death Purpose is to render an opinion regarding the cause and manner of death which is specified on the death certificate.

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the autopsy

The Autopsy

Pathology 2

the autopsy1
The Autopsy
  • An examination of the body after death to document any natural disease processes and/or injuries which may have contributed to the death
  • Purpose is to render an opinion regarding the cause and manner of death which is specified on the death certificate
when is an autopsy required
Criminal violence

Infant/child

Result of police action

In custody of local/state/federal institution

Workplace injury

Electrocution

Alcohol, drugs, poisons

Drowning

Unidentified persons

Skeletonized remains

Charred remains

As deemed necessary

When is an Autopsy Required?
the autopsy2
The Autopsy
  • Usually consists of external and an internal exam
    • External
      • Documents identifying features such as scars and tattoos to assist in the identification of the body
    • Internal
      • Looks at the internal organs to document any natural disease processes and/or injury
the autopsy3
The Autopsy
  • Most autopsies are “uneventful”
  • Not always necessary if a natural cause of death is known
  • May be required for insurance purposes
  • Generally range from 30 minutes to several hours to complete
  • Usually performed in the medical examiner's or coroner's office
    • Sometimes in a funeral home or hospital
the 4 stage model
The 4 Stage Model

1. Contributing Cause of Death

2. Mechanism of Death

3. Immediate Cause of Death

4. Manner of Death

1 contributing cause of death
1. Contributing Cause of Death
  • Usually pre-existing illness or condition
  • Could ultimately be actual cause of death
  • Examples: Pneumonia, asthma, HIV
2 mechanism of death
2. Mechanism of Death
  • What events happened to lead to death
  • Usually in medical jargon
  • Example:”…lungs became obstructed by fluid and could no longer transport oxygen”
3 immediate cause of death
3. Immediate Cause of Death
  • The actual cause of death
  • Example: Asphyxia, “GSW to the head”
4 manner of death
4. Manner of Death
  • By law, a fatality must be identified as one of the following categories
    • Suicide
    • Homicide
    • Accidental
    • Natural
    • Unknown
rules of the road
“Rules of the Road”
  • Mechanism + Immediate Cause = Manner
  • If Mechanism is undetermined…
    • Manner must be ruled “Unknown”
    • Example: Poisoning, strange phenomena
  • If Immediate Cause aggravates pre-existing condition…
    • Manner must be ruled “Natural”
    • Example:
rules of the road1
“Rules of the Road”
  • Most traffic fatalities are ruled “Accidental”
  • If a suicide involves additional individuals in the Immediate Cause…
    • Manner must be ruled “Homicide”
reporting deaths
Reporting Deaths
  • Necessary for legal and financial reasons
  • Report is required in order to issue Death Certificate
  • Considered public record
    • May not list certain information due to confidentiality laws
unidentified persons
Unidentified Persons
  • General Procedures
    • Take photographs with case number in photograph
    • Obtain and archive specimen for DNA
    • Take X-rays of body
    • Document clothing and personal effects
the external exam
The External Exam
  • Preliminary Procedures
    • Review known information
      • Think before you examine
    • Measure body length and weight
    • Examine external aspects
    • Take photographs

Warning: Graphic Image follows…

the external exam1
The External Exam
  • Preliminary Procedures
    • Correlate clothing with injuries
    • Search/collect trace evidence on clothing for criminal cases
    • Remove clothing
    • Photograph/list clothing and personal effects
the external exam2
The External Exam
  • Record physical characteristics
    • Apparent age
    • Sex
    • Race/ethnic characteristics
    • Hair
    • Eyes
    • Abnormal body conditions/parts
    • Scars, tattoos, lesions, amputations
    • Presence/absence of dentition
the external exam3
The External Exam
  • Record physical characteristics
    • Inspect/describe head, neck, thorax, abdomen, extremities, hands
    • Inspect/describe posterior body surface
    • Prior medical or surgical intervention
the external exam4
The External Exam
  • Describe livor mortis
    • Most pronounced ~10 hours after death
  • Describe rigor mortis
    • Begins ~6 hours after death
    • Disappears after ~24 hours
  • Post mortem changes
  • Evidence of embalming
  • Decompositional changes

Warning: Graphic Image follows…

the external exam5
The External Exam
  • Specific Procedures for Sexual Assault
    • Swab oral, vaginal and rectal cavities
    • Pubic hair combings or tape lifts
    • Fingernail scrapings or clippings
    • Pubic or head hair exemplars
    • ID and preserve foreign fibers, hairs and biological stains
the external exam6
The External Exam
  • Specific Procedures for Injuries
    • Describe injuries
      • Type, location, size, shape, pattern
    • Correlate to internal injury
    • Document track/direction of wound
    • Recover foreign body(ies)
      • Document object(s)

Warning: Graphic Image follows…

the external exam7
The External Exam
  • Specific Procedures for Firearms
    • Wound size
    • Use anatomic landmarks and measure wound location
      • Be specific
    • Soot/stippling (residue)
    • Abrasion ring, searing, muzzle imprint, lacerations

Warning: Graphic Image follows…

the external exam8
The External Exam
  • Specific Procedures for Burns
    • Appearance of burns
    • Distribution of burns with special emphasis on degree of burn/chars

Warning: Graphic Image follows…

the internal exam
The Internal Exam
  • Exam all internal organs in place
    • Be methodical
  • Position of abnormal medical devices
  • Evidence of surgery
the internal exam1
The Internal Exam
  • Internal Organs (after removal)
    • Record weight of brain, heart, lungs, liver, spleen, kidneys
    • Dissect and describe organs
postmortem exam report
Postmortem Exam Report
  • Prepare postmortem exam report for each case
    • All relevant forensic information (date, time, investigator, etc.)
    • Summary of external and internal exam findings
    • Separate section for injuries
    • Describe findings in enough detail to support opinions and conclusions
    • Identify cause and manner of death