1.1C IDENTIFICATION & MEDICOLEGAL ASPECTS OF DEATH.pdf

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LEGAL MEDICINE 1.1C IDENTIFICATION & MEDICOLEGAL ASPECTS OF DEATH IDENFICATION OF A DEAD PERSON IS IMPORTANT IN THE: 1. Prosecution of criminal offense 2. Facilitation of settlement of estate 3. Retirement 4. Insurance and other social benefits 5. Resolving anxiety of relatives and friends.

RULES OF IDENTIFICATION 1. The greater the number of points of similarities and dissimilarities of two persons compared, the greater is the probability for the conclusion to be the correct. – the “Law of Multiplicity of Evidence in identification”. 2. The value of the different points of identification varies in the formulation of conclusion. – Positive: fingerprints on file is the same with the dead body. – Corroborative: body marks (moles, scars, complexion, shape of nose, etc.) – Fingerprints and Dental Records have greater value compared with Visual recognition by relatives and friends 3. The longer the interval between death and the examination of the dead body for identification, the greater is the need for experts in establishing the identity. • It is necessary to act in the shortest possible time specially in cases of mass disaster. METHODS OF IDENTIFICATION 1. By comparison: – Identification criteria recovered during investigation are compared with records available in the file. – Post-mortem findings are compared with ante-mortem records. 2. By exclusion: – If two or more persons have to be identified and all but one is not yet identified, then the one whose identity has not been established may be known by elimination METHODS OF APPROXIMATING THE HEIGHT OF A PERSON A. Measure the distance between the tips of the middle finger of both hands with the arms extended laterally = height. B. 2 x length of one arm + 12 inches from the clavicle and 1.5 inches from the sternum = height. C. 2 x length from the vertex of the skull to the pubic symphysis = height. D. Distance between the supra-sternal notch and the pubic symphysis = 1/3 height. E. Distance from the base of the skull to the coccyx = 44% of height F. The length of the forearm measured from the tip of olecranon process to the tip of the middle finger = 5/19 of height. G. 8 x length of the head = height INFORMATION INCLUDED IN THE BERTILLON SYSTEM 1. Descriptive data: color of the hair, eyes and complexion, shape of the nose, ear, etc. 2. Body marks – moles, scars, tattoo marks, deformities, etc 3. Anthropometrical measurements: – a. Body Measurements – b. Measurement of the head – c. Measurement of the limbs EXTRINSIC FACTORS IN IDENTIFICATION OF DEAD BODY 1. Ornamentations – rings, bracelet, necklace, hairpin, earrings, lapel pin, etc.

2. Personal belongings – letters, wallet, driver’s license, residence certificate, personal cards, etc. 3. Wearing apparel – tailor marks, laundry mark, printed name of owner, size, style, and texture, footwear, socks 4. Foreign bodies – dust in clothings, cerumen in the ears, nail scrappings may show occupation, place of residence or work, habit, etc. 5. Identification by close friends and relatives. 6. Identification record on file at the police department, immigration bureau, hospitals, etc. 7. Identification photograph. SCIENTIFIC METHODS OF IDENTIFICATION OF A DEAD BODY A. DNA TESTING B. Fingerprinting C. Dental Identification D. Handwriting E. Identification of Skeleton F. Determination of Sex G. Determination of Age H. Identification of Blood and Blood Stains I. Identification of Hair and Fibers

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FINGERPRINTING Universally used because: There are no identical fingerprints. • The chances of two fingerprints being the same are calculated to be 1:64 billion. Fingerprints are not changeable. • Fingerprints are formed in the fetus in the 4th month of pregnancy. • Fingerprints are an indelible signature which a person carries from the cradle to the grave PRACTICAL USES OF FINGERPRINTS Help establish identity in cases of dead bodies and unknown or missing persons. Prints recovered from the crime scene associate person or weapon. Prints on file are useful for comparative purposes and for the knowledge of previous criminal records. Among illiterates, right thumbprint is recognized as a substitute for signature on legal documents.

ADVANTAGES OF USING FINGERPRINTS AS A MEANS OF IDENTIFICATION 1. Not much training is necessary for a person to take, classify and compare fingerprints. 2. No expensive instrument is required in the operation. 3. The fingerprint itself is easy to classify. 4. Actual prints for comparative purposes are always available and suspected errors can easily be checked.

DENTAL IDENTIFICATION The role of the teeth in human identification is important for the following reasons: 1. The possibility of two persons to have the same dentition is quite remote. 2. The enamel of the teeth is the hardest substance of the human body.

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1.1C IDENTIFICATION & MEDICOLEGAL ASPECTS OF DEATH

The more recent the ante-mortem records of the person to be identified, the more reliable is the comparative or exclusionary mode of identification that can be done. HANDWRITING A person may be identified through his handwriting, hand printing and hand numbering. Proven by: Statement of witness who saw the writing made and is able to identify it as such. Opinion of persons who are familiar with the handwriting of the alleged writer Opinion of an expert who compares the questioned writing with that of the other writings which are admitted or treated to be genuine by the party against whom the evidence is offered.

IDENTIFICATION OF SKELETON The following can be determined in the examination of bones: 1. Whether the remains are of human origin or not. 2. Whether the remains belong to a single person or not. 3. Height 4. Sex

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DIFFERENCES BETWEEN A MALE AND A FEMALE PELVIS MALE FEMALE Heavier construction wall more • Lighter construction wall less pronounced pronounced Height greater and flays off its • Height lesser and flays off its wall more pronounced wall less pronounced Pubic arch narrow and less • Pubic arc wider and rounder round • Diameter of the true pelvis Diameter of the true pelvis less greater Curve of then iliac crest reaches • Curve of the iliac crest is of the a higher level lower level Narrow greater sciatic notch • Wide greater sciatic notch Body of the pubis narrow • Body of the pubis wider Iliopectineal line sharp • Iliopectineal line rounded • Obturator foramen triangular Obturator foramen egg-shaped • Sacrum long and wide Sacrum shorter and narrow Less curve of shaft • More curve of shaft Mastoid process larger • Predominance of cranial roof over cranial base. Mastoid process smaller Cranium placed horizontally – • Cranium placed horizontally – rests on mastoid process rests on the occipital and maxillary bone Forehead higher and more • Forehead less high and more oblique vertical Superciliary ridges less sharp or • Superciliary ridges sharper more rounded Styloid process shorter • Styloid process longer and Zygomatic arches and frontal slender sinuses more prominent • Zygomatic arches and frontal Lower jaw larger and wider sinuses less prominent Face larger in proportion to the • Lower jaw narrower and lighter cranium and chin not projecting • Lower jaw narrower and lighter and chin not projecting

IDENTIFICATION OF HAIR & FIBERS How the Hair and Fiber Changes Color: 1. Addition of a substance that will coat the outer surface of the hair so as to impart a different color. Ex. Salts of bismuth, lead, silver and pyrogallic acid 1. Addition of substance which bleach or change the natural color of the fiber or hair. Ex. Hydrogen proxide, chlorine and diluted nitric acid THE VEGETABLE & ANIMAL FIBERS MAY BE DIFFERENTIATED AS FOLLOWS 1.Ignition Test: a. Animal fibers – Burn and fuse; smell of burnt hair, fused and globular; fume turns red litmus to blue b. Vegetable fibers – Rapid combustion, end charred and break sharply; smell of burning wood; vapor turns blue litmus to red 2. Chemical Tests: NITRIC ACID a. Animal fibers – turns yellow b. Vegetable fibers – No change in color POINTS OF IDENTIFICATION TO THE DEAD PERSON 1. Tattoo marks – May help in the identification of the person. • Inscribed name, date of birth, language, religion, name of spouse, etc. – May indicate memorable events in life. – May indicate the social stratum to which the person belongs. • Generally, tattoing is practiced by members of the lower economic class – Implies previous commitment in prison or membership in a criminal gang. MEDICO-LEGAL ASPECTS OF DEATH 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 heris at the time of death. 3. The death of a partner is one cause of dissolution of partnership agreement. 4. The criminal liability of a person is extinguished by death. 5. The case for claims . BRAIN DEATH No universally accepted criteria yet to establish a condition of brain death. • Harvard report criteria/Philadelphia protocol: 1. Unaccepatability and unresponsibility 2. No movements or breathing 3. No reflexes/responses 4. Flat electro-encephalogram 5. Falling arterial pressure •

KINDS OF DEATH 1. Somatic/Clinical Death- complete,persistent and continuous cessation of the vital functions of the organ systems. 2. Molecular/cellular death 3. Apparent death/State of suspended Animation- not really death but merely a transient loss of consciousness or temporary cessation of the vital functions of the body .

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1.1C IDENTIFICATION & MEDICOLEGAL ASPECTS OF DEATH

SIGNS OF DEATH 1. Cessation of heart action and circulation. - There must be an entire and continuous cessation of the heart action and flow of blood in the whole vascular system. 2. Cessation of respiration. - Continuous and persistent - Normally can hold breath for a period not longer than 3 1/2 minutes. 3. Cooling of the body ( Algor Mortis ) - Metabolic process ceases and no more heat is produced. 4. Insensibility of the body loss and loss of power to move. 5. Changes in the skin. - Loss of elasticity of the skin. - Opacity of the skin. - Effect of application of heat 6. Changes in and about the eye. - Loss of corneal reflexes - Clouding of the cornea - Flaccidity of the eyeball - The pupil is in the position to rest CHANGES IN THE BODY FF DEATH 1. Changes in the Muscle: a. Stage of primary flaccidity : (post-mortem muscular irritability ). b. Stage of post-mortem rigidity ( Cadaveric Spasm and Rigor Mortis ) c. Stage of secondary flaccidity or commencement of putrefation

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- Principally due to the fact that the last voluntary contraction of muscle during life does not stop after death but is continuous with the act of cadaveric rigidity. DISTINCTION BETWEEN MUSCULAR CONTRACTION VS RIGOR MORTIS DISTINCTION MUSCULAR RIGOR MORTIS CONTRACTION Time of appearance 3-6 hours after death Immediately after death Muscles Involved All muscles Certain muscles Occurrence Natural phenomenon May or may not appear on the person Significance Approximate the time Determine the nature of death of the crime Contracted muscle transparent or Losses translucency translucent and becomes opaque Elasticity

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A. STAGE OF PRIMARY FLACCIDITY Immediately after death, there is complete relaxation and softening of all the muscles of the body. The muscle are still contractile and react to external stimuli, mechanical or electric owing to the presence of molecular life after somatic death. Stage occurs 3-6 hours after death ( in warm places, about 1hour and fifty minutes ).

C. STAGE OF SECONDARY FLACCIDITY OR RELAXATION - After the disappearance of rigor mortis, the muscle becomes soft and flaccid. - Does not respond to any stimulus Due to dissolution of the muscle proteins which have previously been coagulated during the period of rigor mortis. This body while at the stage of rigor mortis, if stretched or flexed to become soft, will no longer be rigid.

B. STAGE OF POST MORTEM RIGIDITY 3-6 hours after death, the muscle gradually stiffen Usually starts a the muscles pf the neck and lower jaw and spreads downwards to the chest, arms and lower limbs. Whole body becomes stiff after 12 hours. Chemically, there is increase lactic acid and phosphoric content of the muscle. Maybe utilized to approximate the length of time the body has been dead.

CHANGES IN THE BLOOD - Stasis of the blood due to the cessation of circulation enhances the coagulation of blood inside the blood vessels. - Blood clotting is accelerated in cases of death by infectious fevers and delayed in cases of asphyxia, poisoning by opium, hydrocyanic acid and carbon monoxide

CONDITIONS STIMULATING RIGOR MORTIS 1. Heat Stiffening: - if the dead body is exposed to temperatures above 75 C it will coagulate the muscle proteins and cause the muscles to be rigid. - stiffening is more or less permanent and may not easily affected by putrefaction. 2. Cold Stiffening: - may be manifested when the frozen , but exposure to warm condition will make such stiffening disappear. - it due to solidification of fat when the body is exposed to freezing temperature. CADAVERIC SPASM / INSTANTANEOUS RIGOR - Rigidity of muscles which occurs at the moment of death due to extreme nervous tension, exhaustion and injury to the nervous system or injury to the chest.

PHYSICAL CHARACTERISTICS OF POST-MORTEM LIVIDITY 1. It occurs in the most extensive areas of the most dependent poritons of the body. 2. It only involves the superficial layer of the skin. 3. It does not appear elevated from the rest of the skin. 4. The color is uniform but the color may become greenish at the start of decomposition. 5. There is no injury to the skin. KINDS OF POST-MORTEM LIVIDITY 1. Hypostatic Lividity: - Blood merely gravitates into the most dependent portions of the body but still inside the blood vessels and still fluid in form. - Occurs during early stage 2. Diffusion Lividity: - Appears when the blood has coagulated inside the blood vessels or has diffused into the tissues of the body. - Occurs during late stage.

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1.1C IDENTIFICATION & MEDICOLEGAL ASPECTS OF DEATH

SIGNIFICANCE OF POST-MORTEM LIVIDITY It is one of the signs of death. IT may determine whether the position of the body has been changes after its appearance in the body. The color of lividity may indicate the cause of death. It may be determine how long the person has been dead. IT gives us an idea as to the time of death.

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AUTOLYTIC / AUTODIGESTIVE CHANGES AFTER DEATH After death, proteolytic,glycolytic and lipolytic ferments of glandular tissues continue to act which lead to the autodigestion of organs. Action is facilitation by weak acid and higher temperature. It is delayed by alkaline reaction of the tissues of body and low temperature. -

PUTREFACTION - Is the breaking down of the complex proteins into complex components associated with the evolution of foul smelling gasses and accompanied by the change of color of the body. INFLUENCE OF BACTERIA IN DECOMPOSITION - Decomposition is due to action of bacteria in various tissues of the body. Early period, aerobes present, late period both aerobes and anaerobes. Organism that play a dominant role in decomposition is Clostridium. OTHER DESTRUCTIVE AGENTS DURING DECOMPOSITION 1. Maggots: - Dependent on the accessibility of the body to adult flies. - Have strong desire to live in damaged skin surface. - Also observe in bodies buried in shallow graves and even in floating decomposed bodies in water pools. 2. Reptiles: - Lizards and snakes that are attached to dead bodies eats soft tissues. - Small bones may be fractured in the process and may be mistaken for injuries. 3. Rodents: - Rats and mice will nibble the skin and other tissues and may show unexplainable injuries. - Bones may also be attacked and cause certain degree of erosion. 4. Molds: - Growth cause disfigurement and minor superficial erosions of the skin.

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SPECIAL MODIFICATION OF PUTREFACTION Mummification- dehydration of the whole body which results in the shivering and preservation of the body. Saponification /Adipocere formation – fatty tissues of the body are transfromed to soft brownish-white substance which is a waxy mateiral,rancid or moldy in odor. Maceration- softening of the tissues when in a fluid medium in the absence of putrefactive microorganism which is frequently observed in the death of the fetus in utero.

CAUSES OF DEATH A. Natural death --- caused by natural disease condition. B. Violent or sudden Death ---- termination of life which causes quickly under circumstances when its arrival is not expected. C. Judicial Death

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