MODULE

FORENSIC PATHOLOGY

STUDENTS BOOK

FACULTY OF MEDICINE UNIVERSITAS GADJAH MADA

Address: Jl. Farmako Sekip utara
Yogyakarta, 55183

Undergraduate Program in Medicine UGM 1

 Block 4.3 Module
FORENSIC PATHOLOGY

MODULE COORDINATOR TEAM:

COORDINATOR
Dr.Yudha Nurhantari,Ph.D.,Sp.F

MEMBER

Dr. IBG Surya Putra Pidada, Sp.F

Coordinator of Practical work and tutorial

Dra Suhartini,Apt.MS
Coordinator of Practical Work

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 CONTENTS

Module Coordinator Team .......................................................... 2

Contents ................................................................................... 3
Overview .................................................................................... 4
Topic Tree ................................................................................. 4
Learning Activities....................................................................... 6
Blueprint Assesment ................................................................... 8

Week 1
Scenario 1 ....................................................................... 9
Lecture ............................................................................. 9
Practical Session ............................................................. 11
Field Visit.......................................................................... 11
Time allocation ................................................................. 12

Week 2
Scenario 2 ....................................................................... 13
Lecture ............................................................................. 13
Practical Session ............................................................. 15
Time allocation ................................................................. 16

Undergraduate Program in Medicine UGM 3

 OVERVIEW

Forensic Medicine has only limited parts included in the blocks

given in undergraduates curriculum. However, general practitioner have
to master enough skills in forensic medicine, the reason is based on
KUHP (Kitab Undang-Undang Hukum Pidana) which mention that all of
the doctors are expert and have to conduct forensic examination when
there is a written request from law inforcement. Rejection of the request
may have a consequence. In the other hand, since the students have
not enough basic knowledge, so our department have to work hard in
the stage of clinical rotation of forensic medicine.
This Forensic Pathology, an elective module, are very helpfull
for us to give basic knowledge of forensic medicine, especially for the
student who are interested in forensic medicine. We provide lectures,
tutorial, practical and video sesions, and also eld visit, to reach the
forensic medicines competences of the students.

LEARNING OBJECTIVES
General Objectives
The student are expected to be able to understand forensic
pathology, from death and pathophysiology of death, determination the
cause and time of death, traumatology, toxicology, including spesic issue
of transportation injury. The student are also expected to understand the
role of medical doctor in the court as an expert witness.

Spesic Objectives:
1. Explaining denition of death
2. Explaining the cause, manner, and mechanism of death
3. Understanding postmortem changes of body (tanathology)
4. Explaining estimation of the time of death
5. Understand asphyxial death
6. Understand forensic autopsy
7. Explaining pathology, mechanism, and classication of wound
8. Understand gunshot and explosion deaths
9. Understand infanticide and child homicide
10. Understand drowning, burnt, and poisoning death

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11. Understand the importance and procedure of forensic autopsy and
exhumation
12. Explaining forensic Identication:
13. Understand forensic aspect of transportation injury :
14. Explaining visum et repertum and the role of doctor as an expert
witness
15. Understand forensic laboratory examination

CENTRAL DISCIPLINES :Forensic Medicine

RELATION WITH OTHER BLOCK : Block 2.2; 2.4 ; 2.6; 4.2

TOPIC TREE

Thanato
logy
Medico
legal
Forensic
Pathology

Trauma
tology

Undergraduate Program in Medicine UGM 5

LEARNING ACTIVITIES
1. Tutorials
Tutorial will be done using 7 jumps technique as routine procedures
of tutorial in every blocks. Two interesting scenarios were provided
to achieve the goal of this module : Broken heart, and Robbery.

2. Lectures
The experts in thier elds will give lectures. From the lecture, the
students were expected to be triggered to explore more about the
topics. The student may have opportunity to have discussion during/
after the lecture. The student have to attend at least 75% of the
lecture.

No Title
1 Introduction to Forensic
Pathology
2 Thanatology
3 Forensic autopsy and
exhumation
4 Infant death and child
homicide
5 Clinical forensic
6 Visum et Repertum and
expert witness
7 Traumatology Forensic
8 Gunshot and explosion
9 Asphyxial death
10 Burnt and drowning
11 Sudden Death
12 Forensic Odontology
13 Forensic Patology Anatomy
14 Transportation injury
15 Forensic Toxicology
16 DNA ngerprint
Lecturer
dr Yudha
Nurhantari,Ph.D.,Sp.F
dr Yudha
Nurhantari,Ph.D.,Sp.F
dr. Yudha Nurhantari, Sp.F
dr .Beta Ahlam Gizela,Sp.F
dr. IBG. Surya Putra P,Sp.F
dr. Martiana S,Sp.F
dr. Hendro Widagdo.,Sp.F
dr. Hendro Widagdo,Sp.F
dr. IBG. Surya Putra P,Sp.F
dr. IBG. Surya Putra P,Sp.F
dr . IBG. Surya Putra P,Sp.F
Drg. Sara Afari Gadro, M.Kes
dr Dr Harijadi,Sp.PA
dr. Yudha
Nurhantari,Ph.D.,Sp.F
dra. Suhartini, Apt., M.S
dr Yudha
Nurhantari,Sp.F.,Ph.D

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3. Practical Sessions
Six kinds of practical session were provided in the module of Forensic
Pathology. The student will be divided into small group consists about
10 student in each session under supervision of a trained instructor.
The students have to attend all of the practical sessions. The one
who cannot attend the session, have to submit written permission
with accepted reason to the module coordinator to get assignment/
replacement. No evidence to permission of the abscence will be
resulted in red mark of professional behavior assesment.
Week Topic Venue
1 Forensic slides demo R. Lecture
2 Writing VeR Tutorial room/Dept. of Forensic
Medicine
3 Virtual autopsy Computer room, Library, FM
4 Forensic Toxicology Lab. of Forensic Medicine, Dr
Sardjito Hosp.
5 Photography Forensic Tutorial room/Dept. of Forensic
Medicine

4. Video session
The student will have opportunity to learn the full autopsy procedures
from the video, under supervision of an instructor. After this session,
there will be a mini test to assess the achievement. The student
have to attend this session, the failure to attend have to get written
permission to block coordinator to get assignment/replacement. No
evidence to the permission will resulted in red mark of professional
behavior assesment.

5. Field Visit
In this module, the student will have an opprtunity to visit the
Department of Forensic Medicine, Dr Sardjito Hospital. The students
will be guided by the instructor, and may discuss about the Forensic
Medicine equipments, process, rooms, document, etc. During the
visit, the students do not allow to take any photograph/video. After
the visit, each student have to write a short report. The student
have to attend this session, the failure to attend have to show written
permission to the block coordinator to get assignment/replacement.
No evidence of permission to the abscence will be resulted in red
mark of professional behavior assesment.

Undergraduate Program in Medicine UGM 7

 BLUE PRINT ASSESMENT

Resume of blue print assesment :

Method of
Description Proportion
asesment
Final Examination 85 items of MCQ, 5 items @ 60 %
lecture.
Mini test 5 items of short essay in each 15 %
scenario of tutorial. It will be held
at the end of second discussion of
each group
Practical session a. Forensic Slides : 5 items of short
examination essay after the session
b. Toxicology Forensic : 10 items of 20%
MCQ in minitest after the session
c. Expert Witness (Role play): 5
items of short essay questions
after the session
d. Virtual autopsy: 5 items of short 5%
essay after the session
e. Writing VeR : short essay after
the session.
Video session 10 items of short essay after the
exam session
Field visit Individual Report
Professional Presence of activies (100% of Pass or fail
Behavior activities, excepted lectures), and
the ethics during the activities

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 WEEK 1
TOPIC: THANATOLOGY

Scenario 1
Broken heart

Lenny, a student of a university, looked so depressed after noticed

that she did not get two months of her periods. She tried to talk to
her boy friend, but unexpectedly, he got mad and quickly decided to
seperate. He does not want to meet Lenny anymore. He said that he
wanted to concentrate on his study, after 2 semesters delayed. However,
soon Lenny get new boyrend. After several days, in a sunny morning,
about 07.00 WIB, Lenny was found dead, hanged on a mango tree in
the campus park. The body was then send by the police to Department
of Forensic Medicine to performed autopsy to investigate the cause,
manner, and time of death.
Examination was performed at 09.00 and revealed full rigor mortis
in all joints, postmortem hypostatis was found on the dorsal part of her
body with bright-red color. A rope, with diameter 0,5 cm was found on
her neck, with ligature mark line up to the dorsal of her neck. The tongue
was protruded with bloody-foamy liquid come out from the mouth. Uterine
was about swans egg size, the conseption was found inside. Cyanida
was investigated 15 mg/l on her blood. HGC test was +

Lectures
1. Title :
Introduction to Forensic Pathology
Lecturer :
dr. Yudha Nurhantari,Ph.D.,Sp.F
Duration :
1 hour
Content :
Explanation of Block objectives, block activities,
blueprint
Assesment, block evaluation and Introduction to
Forensic Pathology(medicolegal investigation system,
Cause manner-time of death)
Reference : Forensic Pathology Knight Bernard, Forensic Pathology
DiMaio-DiMaio

Undergraduate Program in Medicine UGM 9

2. Title :
Thanatology
Lecturer :
dr. Yudha Nurhantari,Ph.D.,Sp.F
Duration :
1 hour
Content :
Death and postmortem changes : rigor mortis, algor
mortis, postmortem hypostatis, mummification,
adipocere, decomposition, and determination of time
of death (Rigor mortis, hypostatis, body cooling, gastric
emptying, scene marker, body uid chemistry)
Reference : Forensic Pathology Di Maio-DiMaio, Forensic
Pathology Bernard Knight

3. Title :
Autopsy and Exhumation
Lecturer :
dr. Yudha Nurhantari, Ph.D.,Sp.F
Duration :
1 hour
Content :
Denition and yuridical base of autopsy, Teamwork of
autopsy, instrumens needed, procedures(adminitsrative
requirement, allo-anamnesis, external and internal
examination)Exhumation: denition, the procedure
Reference : Forensic Pathology Knight Bernard 1996,

4. Title :
Sudden death
Lecturer :
dr. IBG Surya Putra Sp.F
Duration :
1 hour
Content :
Denition of suddent death, death from diseases:
AMI, Rupture of aneuris, pulmonary thromboemboli,
epilepsy, respiratory obstruction, TB
Reference : Forensic Pathology Knight Bernard 1996, Forensic
Pathology DiMaio-DiMaio

5. Title :
Infant death and child abuse
Lecturer :
dr. Beta Ahlam Gizela, Sp.F,DFM
Duration :
1 hour
Content :
Definition, epidemiology, Sex determination,
age determination, Cause of death, procedure of
examination, laboratory examination
Reference : Forensic Pathology Knight Bernard 1996,

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6. Title : Clinical Forensic
Lecturer : dr. IBG, Surya Putra Pidada Sp.F
Duration : 1 hour
Content : Denition, cases, IC, examination,medical record,lab
examination.

7. Title : Visum et Repertum and expert witness

Lecturer : dr. Martiana S,Sp.F
Duration : 1 hour
Content : Denition, the importance of VeR, How to write, Format
VeR, Medical Report, communication to the family,
police and journalist, ethical consideration, yuridical
base of VeR and Expert witness, Role of doctor in
expert witness.
Reference :

Field Visit
Venue : Department of Forensic Medicine, Dr Sardjito
Hospital
Instructor : see schedule
Duration : 2 hours
Activity : observation and discussion of the administration
document and procedure, autopsy room and equipment,
cadaver storage room, sample storage and forensic
laboratory, safety equipment, process, storage and
documentation of Visum et Repertum. Write individual
report after the visit.

Practical Work :
1. Title : Writing a Visum et repertum
Inatructor : See schedule
Durations : 2 hours
Content : exercise to write a visum et repertum

Video Session
Title : Forensic Autopsy
Instructor : see schedule (coordinator: dr. Beta ahlam Gizela,
Sp.F)

Undergraduate Program in Medicine UGM 11

Duration : 3 hours
Content : techniques and procedures of forensic autopsy.

Allocated Time
Lecture : 7 hours
Tutorial : 6 hours
Field visit : 3 hours
Video Session : 3 hours
------------------------------------
Total : 19 hours

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 WEEK 2
TOPIC: TRAUMATOLOGY

Scenario 2
Robbery

On a day, a male student have to buy a textbook in a book store.

Because he did not have money on his wallet, he had to take some money
at an ATM counter. It was about 08.30 pm, he rode a motor cycle to the
nearest ATM counter. Unfortunately, just after exit the ATM counter, his
head suddenly was hit by a blunt object, and someone took his wallet.
The victim tried to make defences, but the assailant stabbed a sharp
object to his chest.
The body was found dead by the police, and send to performed
autopsy, to investigate his identity, cause of death, kind of weapon, and
identication of assailant. External examination revealed that there was
haematomas and lacerations on his arms. Haematoma was found on
the left temporopariteal part of head. No Identity Card was found and
the victims was labelled as Mr X. Internal Examination showed an
epidural hemorrhage 100 g on his left temporoparietale. A stab wound
was found on the left chest, penetrated the lower lobe of left lungs. 750
ml of blood was measured in the thorax cavity. No alcohol nor poison
was found on his body.

Lectures
1. Title :
Traumatology
Lecturer :
dr. Hendro Widagdo,Sp.F
Duration :
1 hour
Content :
Classication and mechanism of wounding: sharp
(stab, incise, chop) and blunt (laceration, abrassion,
hematoma, bone fracture) impact, electric, chemical,
termal, forensic examination of wound
Reference : Forensic Pathology Knight Bernard

2. Title : Gunshot and explosion

Lecturer : dr. Hendro Widagdo,Sp.F
Duration : 1 hour

Undergraduate Program in Medicine UGM 13

 Content : Balistic, characteristic of wound, shot-distance
estimation,recoset, bullet examination, describing the
wound
Reference : Forensic Pathology Knight Bernard

3. Title :
Burnt and drowning
Lecturer :
dr. IBG. Surya Putra Pidada,Sp.F
Duration :
1 hour
Content :
Deniton Heat Injury, Scalds, dry heat, ante mortem vs
post mortem, Burns, appearence at autopsy, laboratory
examination. Denition of drowning, immersion, cause
and mechanism of death, characteristics appearence
at autopsy, laboratory examination
Reference : Forensic Pathology Knight Bernard

4. Title :
Asphyxial death
Lecturer :
dr. IBG. Surya Putra Pidada,Sp.F
Duration :
1 hour
Content :
mechanical asphyxia ,hanging, chocking,manual
strangulation, strangulation,positional asphyxia,
appearence at autopsy, suffocation,autoerotic
asphyxia, choking, smothering
Reference : Forensic Pathology Bernard Knight, Forensic
Pathology DiMaioDimaio

5. Title :
Clinical Forensic
Lecturer :
dr. IBG Surya Putra Sp.F.
Duration :
1 hour
Content :
definition; circulation diseases, cardiovasculer
diseases, hypertension, infection disease
Reference : Forensic Pathology DiMaioDimaio

6. Title : Forensic Odontology

Lecturer : drg. Sara Afari G adro, M.Kes
Duration : 1 hour
Content : denition, examination,dental record, identication.

7. Title : Forensic Toxicology

Lecturer : Dra. Suhartini,Apt. MS

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 Duration : 1 hour
Content : The danger of Arsen, Napza, CO2, CO, Cyanide,
sampling, preservation, interpretation of results

8. Title : Forensic Histological Examination

Lecturer : dr. Harijadi S.PA
Duration : 1 hour
Content : Histological appreance of decomposition, antemortem
vs postmortem wound, inflamation,hemorrhages,
spesic characteristic of certain diseases(AMI, TBC
etc), necrotic tissue, principal comparison to normal
histological appearence
Reference :

9. Title :
Transportation injury
Lecturer :
dr. Yudha Nurhantari
Duration :
2 hour
Content :
Dynamic of vehicle injury, Pattern injury of vehicle
occupants, Injuries to: motor cyclist, pedalcyclist,
pedestrians, safety in transportation
Reference : Forensic Pathology Knight Bernard, Forensic
Pathology DiMaio- DiMaiao

Practical Session
1. Title : Forensic Photography
Venue : Tutorial room/Department of Forensic Medicine
Content : Simulation of taking a picture of forensic case for
forensic
documentation

2. Title : Virtual autopsy

Venue : Computer/internet Room
Contents : Interactive slides of autopsy cases

3. Title : Writing Visum et repertum

Contents : exercise of Writing Visum et repertum
Venue : Tutorial room/Department of Forensic Medicine

Undergraduate Program in Medicine UGM 15

Time Alocation
Tutorial : 4 hours
Practical session : 6 hours
Lecture : 6 hours
Video Session : 3 hours
________________________
Total : 19 hours

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