Medical Jurisprudence - Autopsy

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M edi cal Jur i spr udence - Autopsy

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Q. What are the objectives of Autopsy? Explain the rules that govern a medico legal post mortem examination. What facts should be incorporated in Post Mortem Report. How does post mortem help in crime detection? What is Post Mortem staining in detail. How does it help in crime detection? What is Viscera? Autopsy The word autopsy autopsy is from Ancient Ancient Greek Greek with αυτος (autos) meaning to do s ome thing to to ones elf and όψις (opsis ) meaning eye ey e hence autops y mea ns 't 'to o s ee for onesel f' f'.. It is used specifically for for the post-mortem ex exam am ination of a hum an corpse. It is als o known as a pos t-mortem examination, necropsy (part (particularly icularly as to animals ), autopsi autopsi a cadaverum, cadaverum, or obduction and is a me dical procedure that consis ts of a thorough exam exam ination of a corpse to determine the cause and ma nner of death and to evaluate ev aluate any diseas e or injury that that may be present. It is us ually performed performed by a s pecializ pecialized ed m edical doctor called a pathologist. Kinds of Autopsy  Autops  A utops ies are either perform ed for legal or m edica edicall purpos es . For For exam exam ple a forens ic autops y is carried ca rried out when the caus e of death may be a criminal m att atter, er, while a clinical or academ ic autopsy is performed to find the medical caus e of death and is us ed in cases of unknown or uncertain uncertain death, or for research purpos es. Autopsies Autopsies can be further further class ified into cases where external external examination s uff uffices, ices, and thos e where the body is d iss ected and internal exami exami nation is conducted. Once an internal autopsy is com plete the body is reconstitut reconstituted ed by sewing it back together. together. Consent of relative relative is required in cas e of  academi c autopsy but is not required in l egal autopsy, which is ordered by the the m agistrate or other appropriate legal authority authorit y. In case of legal au topsy topsy,, all three - cranial, thoratic, thoratic, and abdom inal cavities cavities are opened, while in cas e of academ ic one, it may be lim ited to an area of interest. Techniques of Autop Autopsy sy 1. Virchow - organs are removed one by one. 2. Tokit Tokitanski anski - a combination of in situ diss ection with with en bloc removal removal 3. Ghon - Thoratic Thoratic and cerv cervical ical organs , abdom inal organs , and urogenital urogenital organs are rem ov oved ed separately as organ blocks. 4. Letulle - All All organs are removed en mas se and s ubse quently disected into organ blocks. blocks.

Objective of an autopsy is autopsy  is to determi determi ne the following information 1. 2. 3. 4. 5. 6. 7. 8.

Establ is h the iden Establis identity tity of the the body if unknown. Asce scertain rtain the the tim tim e of death. Asce scertain rtain the the cause of death. Whether Whet her the the death was natural or unnatural. If death was unnatural, whether it was hom icidal, suicidal, or accidental. accidental. In case of new born infants, determine whether it was a liv live e birth and its viability. viability. The manner of death such as kind injury, injury, wound, or impact. Whether Whet her there was any psychological disturbance or derangement resulting in cause of death such as asphyx asphyxia, ia, coma, or s yncope.

Rules governing medico-legal Auto Autopsy psy www.hanumant.com/MJ- Autopsy.html

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Medical Jurisprudence - Autopsy

1. Must never be undertaken unles s there is a written order from a police officer or the dis trict mag istrate. A letter from the IO asking the medical officer to carry out the ML autopsy and authorizing him to collect any material from the body for furtherinvestigations, if necess ary, is required 2. Before comm encing, the MO should carefully read the police report on the appearance and s ituation of the body when it w as first found and the caus e of death as ascertained. A copy of the “Panchanama ” carried out by the IO at the site of death. This document pictures the s cene of death for the pros ector. 3. Dead Body Challan: Is a set of ques tions to be answ ered by the investigating officer pertaining to the death under  investigation. This docum ent provides background information to the prosector A police cons table accompanies the dead body along with these documents. 4. It shoul d be as compl ete and through as is poss ible. Incomplete or partial pos t mortem is not acceptable. All three cavities m ust be analysed. 5. In exceptional s ituations the MO may be taken to vis it the scene of death where the dead bo dy ma y be lying. In this case, he s hould note the place and nature of the s oil where the body is placed, its pos ition, and state of its clothes. The ground where the b ody is lying sho uld be carefully searched for any footprints or other evidence s uch as fibre or  dust. 6. Protect different parts of the body in plas tic bags or pads to prevent los s of contact tracer. 7. The MO mus t establish the identity and record the m eans of identification. 8. All details of post mortem observed by the MO should be entered by him on the spot in the pos t mortem report, which can be used in a leg al inquiry. Nothing s hould be eras ed and all alterations m ust be initialized. Facts to be incorporated in Autopsy report  All the facts mus t be entered in appropria te format pres cribed by law for the purpos e. On the body of: Body identified by police constable: Probable age: Height

Place: Date: Time : Probable time since death:

External Exam ination 1. 2. 3. 4. 5. 6. 7. 8.

Condition of the body - muscularity, rigor mortis, livor mortis, em aciation, and putrefaction. Marks of identification Eyes State of natural orifices External injury marks State of lim bs - contents of hand if clenched. Genitalia, breasts Additional rem arks

Internal Exam ination 1. Head and Neck 1. Scalp, skull 2. Vertbrae 3. Membranes 4. Brain, base of skull 5. Spinal cord 6. neck structures 7. Additional Rem arks 2. Thorax 1. Walls, ribs, cartilages 2. Pericardium 3. Pleurae, diaphragm 4. Heart with weights, cavities and valves coronary 5. Larynx, trachea and bronchi 6. Lungs with weights 7. Addititional Rem arks 3. Abdomen 1. Walls 2. Liver and gall bladder  3. Peritoneum www.hanumant.com/MJ-Autopsy.html

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4. 5. 6. 7. 8. 9. 10.

Pancreas Spleen Kidneys and Bladdar  Esophagus Stomach and its contents Small and large intestine and their contents Additional Rem arks

Viscera and other sam ples/m aterials collected from the body. Opinion as to the cause and m anner of death. Place : Date:

Medical Officer:

The National Hum an Rights Com mis sio n has recomm ended video recording of the autopsy in case of custodial death. Circular directing the police to do this recording have been iss ued by many states s uch as Gujarat and TN. In case of Dayaram vs State 1986 , it was ob served that a pos t mortem report is undoubtedly a very impo rtant document, which not only aids the m edical officer in determining the nature of the injuries during their evidence at the trial but also he ps the court in appreciating the evidence in the case. In Gofur Sheikh vs State 1984 , it was held that where the MO who conducted the autopsy is n ot exam ined in court nor the PM report has been tendered in evidence, the sam e cannot be us ed as subs tantive evidence. In Sharad vs State of Mah 1984 , serious interpolations were found in the PM report. The entries in the PM report filed i n court and in the copy of PM report sent to the chemical examiner were different. The SC invalidated the PM report and also debarred the m edical officer from performing the PM in future. Post Mortem Staining (aka Livor Mortis) Livor m ortis or pos tmortem li vidity or hypostas is (Latin: livor—bluish color, mortis—of death), one of the s igns of death, is a settling of the blood in the lower (dependent) portion of the body, causing a purplis h red dis coloration of the s kin: when the heart is no longer agitating the blood, heavy red blood cells sink through the serum by action of gravity. This dis coloration does not occur in the areas of the body that are in contact with the ground or another object, as the capillaries are compressed. Coroners can us e the presence or absence of livor mortis as a mean s of determining an approximate time of death. It can als o be us ed by forensic i nvestigators to determine whether or not a body has been moved (for instance, if the body is found lying face down but the pooling is present on the deceas ed's back, investigators can d etermine that the body was originally posi tioned face up). Livor mortis starts 20 m inutes to 3 hours after death and is congealed in the capillaries in 4 to 5 hours. Maximum lividity occurs within 6-12 hours . The blood pool s in to the interstitial tissue s of the body. How does autopsy help in crime detection Fatta Viscera Viscera are the internal organs of the body, specifically those wi thin the chest (as the heart or lungs ) or abdom en (as the liver, pancreas or intestines). The singular of "viscera" is "viscus " meaning in Latin "an organ of the body." The following procesure is usual ly adopted to collect viscera for medi colegal purpos es:

1. The viscera are pres erved in wide mou thed glass bottles of 1 to 1.5 ltr capacity having a s crew cap lid. Containers made up of synthetic m aterial like polyurethane,plastic etc are not to be us ed as the material is likely to react with the viscera pres erved and alter their chemical com position. Saturated sa lt solution is the comm on preservative us ed to prevent putrefaction except in cases of corrosive m ineral acid (H2SO4, HCl,HNO3) pois onings . Rectified s pirit (not denatured spirit) is ideal pres ervative which can be us ed in al l case s, except ethyl/methyl alcohol poi soni ng. Sodium www.hanumant.com/MJ-Autopsy.html

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2.

3.

4.

5.

fluoride is us ed as preservative for blood along with potass ium oxalate as anticoagulant. 30 mg o f potass ium oxalate and 10 mg of sodium fluoride are required for 10 ml blood . For viscera the preservative sol ution is add ed in equal volume. As a rule 1/3 volum e of the container is to be occupied by viscera, 1/3 by the preservative and 1/3 to be empty as room for any gases evolving. This also prevents spillage of  the contents during transportation and thus avoids s poiling of the label on the bottle. The viscera s hould be fully imm ersed in the pres ervative. Large pieces shoul d be partly sli ced to ens ure entry of the preservative to the inner  portions. Usua lly, whole of stom ach, after having opened (along the greater curvature) and exami ned, and its contents; 6”- 8” (one loop) of sm all intestine tied at both ends wi th contents ins ide, are put into one bottle. This represents the unabsorbed, s till in the gut, portion of the pois on. 500 gm of liver along with intact gall bladder, one half of each kidney, de-capsulated, and half of spl een are put into the second bottle. This repres ents the absorbed portion of poison. 50 ml of blood is preserved in a third sm all mouthed s crew capped bottle. A sm all penicilli n vial containing control sam ple of preservative us ed is also to be sent along with. These bottles, sealed with a legible s pecific seal of the prosector and labeled legibly, are handed over to the authorised pol ice constable, packed in the wooden viscera box. The receipt obtained from the constable to that effect is to be pres erved as proof of chain of custody of evidence.

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