The Medical Examiner Differences Between Medical Examiner and

The Medical Examiner

Differences Between Medical Examiner and Coroner Ø Medical examiner is a medical doctor, usually a pathologist and is appointed by the governing body. Ø A coroner is elected and needs no medical training or special knowledge.

Responsibilities 1. 2. 3. 4. 5. Identify the deceased. Establish the time and date of death Determine the medical cause of death and the manner of death. Determine the mechanism of death—the physiological reason that the person died classify the manner of death. a. b. c. d. e. 6. Natural Accidental Suicide Homicide Undetermined Must notify the next of kin

Postmortem lividity or livor mortis Blood settling and causing the skin to change colors. Ø a. b. c. 30 min. --first seen on a fair-skinned individual. 4 to 8 hours-- all blood in capillaries sets permanently. Between 1 & 8 hours – visible PML can be affected by finger pressure

More on Livor Mortis Ø Blanching– Light-colored marks made by pressure of the fingers. Ø Armpits– where a trained investigator will begin Ø Importance of livor mortis-- Helps to establish time of death; whether the body has been moved.

Rigor Mortis Ø Definition – the period of time that bodies go through a state of rigidity. a. Results from – lactic acid; body changes from alkaline to acid b. Anatomical progression – begins with the shorter muscles of the face and extremities, the fingers and the toes; then the neck; moves down and out the long muscles of the extremities and the forearms with the legs stiffening last.

Ø Time 1. 1 -4 hours– jaw and neck rigid; rest of body limp. 2. Up to 8 hours—everything down to the legs is rigid 3. For 12 hours—everything remains rigid. 4. 24 hours—jaw is limp but everything else is rigid. 5. 30 -32 hours—everything but the legs are limp 6. 36 hours—no rigidity and some form of decomposition.

Circumstances Effecting Rigor Mortis Ø Starvation Ø Extreme temperatures Ø Physical exertion Ø Victims of drowning and/or fire

Decomposition -Bacteria • CO 2 is a by-product; abdominal swelling -Blood Vessels • Discoloration near skin in upper abdomen; marbling effect; darker red to purple to green. -Putracine • Vile smelling, nauseating odors

Algor Mortis Ø Rectal temperature (RT)/liver temperature (LT) Ø Degrees dropped per hour-2 Ø Factor effecting temperature loss l l l size of body temp at death scene temp.

Organ Inspection Ø Ø Ø Ø Heart—trauma damage; stenosis; ventricular fibrillation Lungs—trauma; toxic gases, vapors and dusts; fire; CO; heroin overdose; lung disease. Liver—cirrhosis; trauma damage Kidneys—failure; jaundice; BUN test Stomach—drug overdose; stomach contents Bowel—sliced and stripped; trauma and disease; drug packages Head—brain removed, weighed, sectioned and checked for internal trauma

Manner of Death a. b. c. d. e. Accident Suicide Homicide Natural causes Undetermined

Cause of Death Ø Brain Damage 1. 2. 3. Extra dural or subdural hematoma—blood clot; between skull and dura or between dura and brain. Subarachnoid hematoma—between arachnoid and brain. Intracerebral hematoma—free blood within the brain tissue.

Suffocation 1. 2. 3. 4. SIDS—when all known causes of death have been eliminated and infant’s death remain a mystery. Positional asphyxiation—a position of the body such that breathing is impaired SADS—sudden adult death syndrome; person dies of unknown reasons. Food bolus--choking

Drowning Vomitos amigos—drowning in your own vomit 2. Drug intoxication—causes people to fall and drown 1.

Neck Injuries 1. 2. 3. 4. 5. Strangulation—accidental, suicidal or murder Petechial hemorrhage—ruptures in tiny capillaries particularly in whites of eyes and eyelids. Hyoid bone—fracture may indicate murder Hanging—material ligature and the nature of the knots. jugulars—internal, external and superficial; If cut, blood flow is difficult to stop and death results from loss of blood.

Stab Wounds Sharp force– may be able to describe the knife (width, length, double-edged or single edged. Stab– may puncture vital organs. l Slice– tend to be more defensive. Blunt force– being struck by a flat surface. l

Gunshot Wounds Ø Ballooning and blow back—inward expansion of bone, muscle, etc. from gases; 8 pointed star-shaped tear of the skin. Ø Muzzle Imprint—heated muzzle causes a contusion, resembles a cattle brand.

Gunshot Wounds Ø Powder Burns—describes the effects of gunshot at close range; 12 inches or less. l l l Muzzle flash—flame hot enough to burn or singe the skin or clothing; 6 inches or less. Tattooing—permanent markings; within 6 to 9 inches. Stippling—any pattern of tiny dots.

Gunshot Wounds Ø Near Contact—no tearing; tight dark circle of debris an inch or less in diameter. Ø Trajectory—insert long probes along path bullet traveled