Death Investigation: A Field Guide

Cover
Half Title
Title Page
Copyright Page
Dedication
Table of Contents
Preface
Preface
Author Biography
Contributor Biography
Chapter 1 Philosophy and Approach to Death Investigation
1.1 Philosophy of Forensic Pathology and Death Investigation
1.1.1 Philosophy of Forensic Pathology
1.1.2 Philosophy of Death Investigation
1.2 Role of the Death Scene Investigator
1.3 Notification of a Death
Chapter 2 The Body and the Scene
2.1 Statutory Responsibilities
2.2 Confirm, Pronounce, and Validate the Death
2.3 Securing the Death Scene
2.4 Evidence at the Death Scene
2.5 Documentation of the Scene and the Body
2.5.1 Documentation By Photography
2.5.2 Documentation By Diagrams
2.6 Forming Preliminary Opinions: Be Suspicious But Objective
2.7 Examination of the Body at the Scene
2.8 Pathologist’s Role at the Scene
2.9 Other Forensic Experts at the Scene
Chapter 3 Assessment of the Body at the Scene
3.1 Position of the Body at the Scene
3.2 Blood at the Scene
3.3 Vomitus at the Scene
3.4 Physical Examination of the Body at the Scene
3.4.1 The Scene Assessment
3.5 Starting the Scene Assessment of the Body and Time of Death
3.5.1 Rigor Mortis
3.5.2 Livor Mortis (Blood Settling)
3.5.3 Algor Mortis (Body Cooling)
3.5.4 Eyes
3.5.5 Determining Time of Death By Scene Investigation
3.5.6 Clothing
3.5.7 Forensic Entomology and Time of Death
3.5.8 Forensic Botany and Time of Death
3.5.9 Decomposition
3.6 Other Decompositional Changes
3.6.1 Adipocere
3.6.2 Mummification
Chapter 4 Detailed Physical Assessment of the Body at the Scene
4.1 Introduction
4.2 Common External Signs of Disease Or Trauma
4.2.1 General
4.2.2 Skin
4.2.3 Extremities
4.2.4 Trunk
Chapter 5 Medical Records, History, and Other Investigative Records
5.1 Obtaining a Medical History at the Scene
5.2 Searching the Scene
5.2.1 Signs and Symptoms of Disease—Get Details!
5.3 Obtaining Medical Records Or Information
5.4 Reviewing Medical Records
5.5 Additional Records Helpful in Death Investigation
Chapter 6 Natural Diseases and Death Investigation
6.1 Introduction
6.2 Sudden Death
6.3 Cardiovascular System
6.3.1 Ischemic Heart Disease (Atherosclerotic Cardiovascular Disease)
6.4 Respiratory System
6.4.1 Upper Respiratory System
6.4.1.1 Epiglottitis and “Café Coronary”
6.4.2 Lower Respiratory System
6.4.2.1 Pneumothorax
6.5 Gastrointestinal Tract and Pancreas
6.5.1 Massive, Fatal Hematemesis (Vomiting Blood)
6.5.2 Peritonitis and Abdominal Sepsis
6.5.3 Bowel Infarctions
6.5.4 Pancreatitis
6.6 Liver
6.6.1 Fatty Change Or Fatty Metamorphosis
6.6.2 Cirrhosis
6.6.3 Hepatitis
6.7 Vascular System
6.7.1 Aortic Aneurysm and Aortic Dissection
6.8 Central Nervous System Disorders
6.8.1 Epilepsy (Seizure Disorder)
6.8.2 Subarachnoid Hemorrhage
6.8.3 Strokes
6.8.4 Meningitis
6.8.5 Encephalitis
6.9 Systemic Diseases
6.9.1 Carcinomatosis
6.9.2 Sepsis and Other Causes of Disseminated Intravascular Coagulation
6.9.3 Diseases of Pregnancy Leading to Critical Illness and Death
6.9.4 Diabetes Mellitus
6.9.5 Alcohol Abuse
6.9.6 Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome
Chapter 7 Traumatic Injuries and Definitions
7.1 Blunt Force Injuries Versus Sharp Force Injuries
7.1.1 The Importance of Terminology
7.2 Blunt Force Injuries
7.2.1 Lacerations (Tears)
7.2.1.1 Do Not Confuse a Laceration With a Cut!
7.3 Abrasions
7.4 Contusions (Bruises)
7.5 Color Changes in Contusions Over Time
7.6 Features of Blunt Force Injuries
7.6.1 Avulsions
7.6.2 Crush Injuries
7.6.3 Fractures
7.7 Sharp Force Injuries
7.7.1 Stab Wounds
7.7.2 Hilt Marks
7.7.3 Incised Wounds and Hesitation Marks Or Cuts
7.7.4 Defense Wounds Or Cuts
7.7.5 Puncture Wounds
7.7.6 Chopping Wounds
7.8 Firearms and Gunshot Wounds
7.8.1 Firearms
7.8.2 Gunshot Wounds
7.8.3 Shored Exit Or Entrance Wounds
7.8.4 Graze and Tangential Wounds
7.8.5 Entrance and Exit Wounds of the Skull
7.8.6 Secondary Target Wounds and Trace Evidence
7.8.7 Shotgun Wounds
7.9 Miscellaneous Firearm and Gunshot Wound Facts
7.10 Asphyxia Classifications
7.10.1 Physical Asphyxias
7.10.1.1 Compression of the Neck
7.11 Types of Hanging
7.11.1 Ligature Hanging
7.11.2 Autoerotic Neck Compression Or “Hanging”
7.12 Types of Strangulation
7.12.1 Ligature Strangulation
7.12.2 Manual Strangulation
7.13 Suffocation, Smothering, and Foreign Body in Airways
7.13.1 Mechanical Asphyxia
7.13.2 Positional Asphyxia
7.13.3 Chemical Asphyxia
7.13.4 Environmental Asphyxia
7.13.5 Drowning
7.13.6 Central Nervous System-Mediated Asphyxia
7.14 Electrocution
7.15 Lightning
7.16 Fire Deaths and Thermal Injuries
7.17 Hyperthermia
7.18 Hypothermia
7.19 Motor Vehicle Occupant Injuries
7.20 Pedestrian Injuries
7.21 Blunt Head Trauma
7.22 Pediatric Forensic Pathology
7.22.1 Investigation of Childhood Fatalities and Child Abuse
7.23 Battered-Child Syndrome
7.24 Abusive Head Trauma in Infants and Children
7.25 Neglect, a Crime of Omission
7.26 Sudden Unexpected Infant Death Syndrome
Chapter 8 Identification Methods
8.1 Identification of Remains
8.2 Presumptive Identification
8.3 Visual Identification
8.3.1 Personal Features
8.4 Scientific Forms of Identification
8.4.1 Deoxyribonucleic Acid
8.4.2 Fingerprints
8.4.3 Dental Identification
8.4.4 Objects in the Body, Surgical Implants and So Forth
8.5 Crime Scene Evidence Collection
8.5.1 Scene Investigation and Specific Forms of Evidence
Chapter 9 Signs of Cardiopulmonary Resuscitation and Treatment
Note
9.1 Deaths in the Hospital Following Trauma
9.1.1 Arrhythmias
9.1.2 Infections
9.1.3 Electrolyte Abnormalities and Other Blood Chemistry Abnormalities
9.1.4 Rupturing of Blood Vessels and Hemorrhage
9.1.5 Blood Clots (Emboli Or Thromboemboli)
9.1.6 Shock
9.1.7 Disseminated Intravascular Coagulation
Chapter 10 Signs of Previous Surgeries and Procedures
Note
Chapter 11 The Medical–Legal Autopsy
11.1 Purpose of the Autopsy
11.2 Misconceptions of the Autopsy
11.3 Jurisdiction and Permission for Autopsies
11.4 Death Investigations Requiring an Autopsy
11.5 Cases That Usually Require an Autopsy
11.5.1 Natural Deaths
11.5.2 Unnatural Deaths
11.5.2.1 Homicides
11.5.2.2 Suicides
11.5.2.3 Manner of Death, Accident
11.6 The Autopsy: Assembling a Puzzle
11.7 External Examination of the Body
11.7.1 Suiting Up: Universal Precautions
11.7.1.1 Opening the Body Bag
11.7.1.2 Clothing and Valuables
11.7.1.3 Body Storage
11.7.1.4 Trace Evidence
11.7.1.5 Focus On What Is Not Obvious
11.8 Documenting Traumatic Injuries
11.8.1 Diagrams and Descriptions
11.8.1.1 Radiology and Imaging
11.9 External Examination
11.9.1 Specific Body Areas
11.9.1.1 Overall “Gestalt” of the Body
11.9.1.2 Skin
11.9.1.3 Hair
11.9.1.4 Scalp
11.9.1.5 Face
11.9.1.6 Eyes
11.9.1.7 Nose
11.9.1.8 Mouth
11.9.1.9 Neck
11.9.1.10 Chest
11.9.1.11 Breasts
11.9.1.12 Abdomen
11.9.1.13 Extremities, Hands, Fingers, and Nails
11.9.1.14 Back
11.9.1.15 Genitalia
11.9.1.16 Rectum/Anus
11.10 Internal Examination
11.10.1 Opening of Body Cavities and Initial Assessment
11.10.2 Internal Tissue Examination
11.10.3 Survey of Chest Tissues and Organs
11.10.3.1 Organ and Tissue Removal
11.10.4 Survey of Abdominal Organs
11.10.5 Collecting Blood, Urine, Bile and Vitreous Specimens for Toxicology
11.10.6 Lung Excision
11.10.7 Liver Excision
11.10.8 Spleen Excision
11.10.9 Large and Small Bowel Excision
11.10.10 Adrenal and Kidney Removal
11.10.11 Aorta Exam
11.10.12 Neck Dissection
11.11 Individual Organ Exam
11.11.1 Lung Examination
11.11.2 Neck Organs—Strap Muscles, Thyroid, Cartilages, Hyoid Bone, Trachea, Vocal Cords, and Epiglottis
11.11.3 Liver Examination
11.11.4 Spleen Examination
11.11.5 Urinary Tract—Kidney, Bladder, Ureters, Prostate
11.11.6 Uterus and Ovaries
11.12 Examination of the Head, Skull, Brain, and Spinal Cord
11.12.1 Brain Examination
11.13 Microscopic Examination
11.14 Postmortem Laboratory Analysis
11.14.1 Drugs, Chemicals, and Poisons
11.14.1.1 The Scene and the Body
11.14.2 Specimens to Obtain at Autopsy
11.14.2.1 Blood
11.14.2.2 Gastric Contents
11.14.2.3 Bile
11.14.2.4 Tissues and Other Specimens
11.15 Certifying the Death
11.15.1 Cause, Mechanism, and Manner of Death
11.15.1.1 Cause of Death
11.15.1.2 Mechanism of Death
11.15.1.3 Manner of Death
Chapter 12 Toxicology in Death Investigation
12.1 Introduction
12.2 Testing Strategy
12.3 Testing Process
12.3.1 Pre-Analytical Phase
12.3.2 Analytical Phase
12.3.3 Quality Assurance
12.3.4 Post-Analytical Phase
12.4 Interpretation of Results
12.5 Helpful Tips
12.6 Limitations of the Lab (What We Can’t Do)
12.7 Summary
Chapter 13 Forensic Experts
13.1 Introduction
13.2 Accident Reconstructionist
13.3 Forensic Anthropologist
13.4 Forensic Botanist
13.5 Forensic Geologist
13.6 Crime Scene Investigator
13.7 Criminalist and Criminalistics
13.8 Forensic Engineer
13.9 Forensic Entomologist
13.10 Forensic Pathologist
13.11 Forensic Odontologist (Dentist)
13.12 Forensic Radiologist
13.13 Questioned Documents Examiner
13.14 Serologist
13.15 Toxicologist
Bibliography and Further Reading
Appendix
A Medical Terminology
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Appendix
B Prescription Medicines
Classifications
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Index