[FORENSIC PATHOLOGY ] IIB med

FORENSIC PATHOLOGY • Perform autopsies and diagnosecircumstances

surrounding the cause and manner of death
• FORENSIC SCIENCE • Determine whether death was
– FORENSIC SEROLOGY - Accidental
– FORENSIC CHEMISTRY - Suicidal
– FORENSIC GENETICS - Homicidal
– FORENSIC BIOCHEMISTRY/MOLECULAR
BIOLOGY MEDICOLEGAL OFFICER’S RESPONSIBILITIES
– FORENSIC ANTHROPOLOGY
– FORENSIC ODONTOLOGY . Identify the deceased
– FORENSIC ENTOMOLOGY . Establish the TOD and DOD
– FORENSIC BOTANY . Determine a medical COD —the injury or disease that
resulted in the person dying
FORENSIC PATHOLOGY• FORENSIC MEDICINE . Determine the MEOD—the physiological reason that
– FORENSIC PATHOLOGY the
– FORENSIC OBSTETRICS person died
– FORENSIC GYNECOLOGY . Classify the MOD
– FORENSIC PEDIATRICS - Natural
– FORENSIC PSYCHIATRY - Accidental
– FORENSIC PHARMACOLOGY - Suicide
– FORENSIC ENT/OPTHA - Homicide
• MEDICAL JURISPRUDENCE - Undetermined
. Notify the next of kin

Person of Historical Significance Autopsy Examination

Edmond Locard (1877-1966) • Autopsy means to look at oneself

• Necropsy means to look at the dead
. French professor • Autopsies have been practiced since
. Considered the father of criminalistics the middle ages
. Built the world’s first forensic laboratory in France in • Term autopsy generally used in
1910 Philippines

The Locard Exchange Principle Purposes of Autopsy

• Every time an object comes into contact with 1. determine or confirm the cause of death
another object, it either leaves a portion of itself or 2. improve the diagnosis of a specific disease
takes a portion of the other object with it 3. advance medical and scientific knowledge
– Every contact leaves its trace 4. aid in the evaluation of new techniques,procedure or
medications
CRIME SCENE TEAMCRIME SCENE TEAM 5. help clinicians avoid repeating errors in diagnosis
..A group of professional investigators, each trained in and therapy in future cases
a variety of special disciplines. 6. aid in medical education
..Team Members 7. may absolve guilt and remove concern about
..First Police Officer on the scene possible genetic defects.
..Medics (if necessary)
..Investigator(s) Autopsy Under the Philippine System
....Medico legal Officer Or Forensic Pathologist
(if necessary)(if necessary) • MEDICOLEGAL AUTOPSIES
..Photographer and/or Field Evidence Technician • NON-MEDICOLEGAL AUTOPSIES OR HOSPITAL CASES
..Lab Experts
Autopsy Process
Processing a body
- Incisions created in chest, abdomen
1. Obtain victim’s clothing for more and head;
thorough analysis in lab - Removal of organs from those areas
2. Fingernail scrapings - Y or T-shaped incision is typically
3. Hair sample used, because it facilitates
4. Blood sample examination of tongue and neck
5. Other bio-samples - Brain is removed via incision from
6. Hand swab (for GSR) behind one ear to behind other ear
- Scalp is pulled upward and backward
- Skull is sawed circularly or in a
Forensic Pathologists tonsorial manner
- Brain may be dissected immediately, or
placed in formaldehyde to preserve
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tissue for better examination
• Other internal organs are removed and
weighed
• Organs are also dissected to determine
disease or injury
• In certain cases such as child abuse,
spinal injury, and subtle blunt trauma
more extensive dissection and removal
may be completed
Obtaining Appropriate Specimens
• Toxicology requires adequate
specimens for testing
• Blood is usually taken from aorta
• Bile taken from gall bladder
• Blood, urine, liver, kidney and brain
used to determine presence of drugs
• Blood-alcohol or Urine-drugs
• Information from medical history,
witness statements, scene examination, and autopsy
may be used to search for other drugs or poisons
Microscopic Examination
• Small portions of organs are put into
a solution of formaldehyde to
preserve them for study
• Diseased or injured sections of
tissue are taken, as is normal tissue
• Tissue is encased in paraffin and
mounted on slides with H&E dye for
examination under light microscope
DNA Analysis
• Preserve one specimen of tissue for DNA analysis
• If tissue sits in formaldehyde for too long, DNA
becomes hydrolyzed and unsuitable for study
• DNA embedded in paraffin blocks or cut into sections
and made into
slides will not further decompose
DNA Collection
• Methods to accomplish this:
– Blood spotted on absorbent paper
allowed to dry then stored in envelope
– Pull head hairs, including bulbs, and
place in envelope
– Cut hair has mitochondrial DNA, bulbs include
nuclear DNA
Photography
• Both film and digital photography are used,
depending on law
enforcement jurisdiction
• Multiple photographs must be taken
DEATH
IIB med
•Complete
•Irreversible
• The Organ Donation Act of 1991
(RA7170), as amended, defines death
as “the irreversible cessation of
circulatory and respiratory functions or
the irreversible cessation of all functions
of the entire brain, including the brain
stem.”
• Cardiopulmonary Death
– there is an absence of natural respiratory and cardiac
functions and, attempts at resuscitation would not be
successful in restoring those functions.
– In this case, death shall be deemed to
have occurred at the time these functions ceased; or
• Brain Death
– there is an irreversible cessation of all
brain functions; and considering the absence of such
functions, further attempts at resuscitation or
continued supportive maintenance would not be
successful in resorting such natural functions.
– In this case, death shall be deemed to
have occurred at the time when these
Conditions first appeared.
POSTMORTEM CHANGES AND POSTMORTEM
CHANGES AND
TIME OF DEATH
1. ALGOR MORTIS (BODY COOLING)
AND
2. RIGOR MORTIS.
Body warm not stiff less than 3 hours
Body warm stiff 3-8 hours
Body cool stiff 8-36 hours
Body cool not stiff more than 36 hours
3. LIVOR MORTIS (HYPOSTASIS, POST MORTEM
LIVIDITY, POSTMORTEM SUGGILLATIONS)
4. POSTMORTEM DECOMPOSITION (PUTREFACTION)
5. ADIPOCERE
6. MUMMIFICATION
7. MACERATION
8. AQUEOUS HUMOUR POTASSIUM
9. STOMACH CONTENTS
10. Forensic Entomology
11. last known activity (last sighting,
newspaper/mail)
INDIVIDUAL OBSERVATIONS USED TO ESTIMATE
TIME OF DEATH
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• When used together the following
individual observations of a body may
be used to estimate the time of death
– body temperature
– rigor mortis
– livor mortis
– decomposition changes
– stomach contents
Cause of Death and Manner of Cause of Death
and Manner of Death
•The Cause and Mechanism of Death is the
physiological incident which
started the physical progression of
death in the body.
•The Manner of Death, on the other
hand, is which category the death falls
into. Manner of Death can be one
of five categories: Homicide, Suicide,
Natural, Accidental, or Undetermined.
EVIDENCE FROM WOUNDS
COMMON TYPES OF WOUNDS
No blackening around entry; star-shaped, often
with flaps
directed outward
Blackening around entry; grains of powder and
deposits of
powder residue
None of the above characteristics appear
Firearm:
Contact (muzzle against
body)
Close (less than 18
inches)
Distant (18 inches or
more)
Characteristics and Type of Wound
GUNSHOT WOUNDS
BULLET WOUNDS
•Point of Entry and Exit Point
- Bullet is spinning as it hits the body
area is usually smaller than the exit wound.
• Bullet may ricochet inside the tissue &
travels a path which is not a straight line.
• Powder burns -near range hits.
• contusion ring (abrasion collar) around the bullet
wound usually indicates the angle and close range.
A BULLET PENETRATING THE SKIN
• When a bullet penetrates the skin:
– the skin is pressed inward
– the skin is stretched and perforated
– the skin then returns to its original position
[FORENSIC PATHOLOGY ] IIB med
Bullet Entry wound – contact
range star-shaped laceration
Abrasion ring – contact range
Bullet Trajectory -Murder
• CLOSE WOUND
– Petechiae
– Contusion
– Hematoma
• OPEN WOUND
– Incised
– Stab
– Punctured
– Laceration
Contusions color changes a bruise goes through can
give rough
estimate of time of injury
• Dark blue/purple (1-18 hours)
•Blue/brown (~1 to 2days)
•Green (~ 2 to 3 days)
•Yellow (~3 to 7 days)
Assumes person is healthy.
BLUNT TRAUMA
The blow produces a crushing effect
Resulting in contusions, abrasions,
lacerations, fractures, or rupture of
vital organs.
• Red-blue contusions are always
present, but this varies by the weight of
the individual (obese people bruise
easier than lean people).
Contusion: 1 week. (Yellow
green)
COMMON TYPES OF WOUNDS
Strangulation
- Ligature and Manual
Mark encircling neck in a horizontal plane overlying
larynx or upper trachea; sometimes broken at back of
neckwhere
the entry hand grasped ligature; abrasions and contusions of
skin not usually present
Abrasions, contusions and fingernail marks on skin.
Defenses
Commonly found on palms of hands, fingers, forearms
Lacerations
Open, irregularly shaped wounds, caused by clubs,
pipes, pistols and other blunt instrument wounds
accompanied by bruising or bleeding
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Puncture – Holding breath -while struggling

Can be caused by ice picks, leather punches, and – Pink foam – exhalation of fluid.
screwdrivers; result in small wounds with little or no – Respiratory arrest -Pupils dilate.
blood – Final struggle -3-4 quick attempts to breath.

Stab
As above; manner in which knife is thrust into and
pulled out of body can result in wounds of different
shapes made with same knife
Incised
Cutting wound inflicted with sharp-edged instrument,
wound typically narrow at ends and gaping in middle
with a great deal of blood
STAB WOUNDS
• Slash wounds: cuts are as wide and they are long.
look like superficial bullet wounds.
Other types of slash wounds are called
"hesitation marks" commonly found in
suicide cases.
• Incision wounds: lengths greater than their depth,
greater amount of subsurface tissue is exposed in an
almost oval fashion.
• Puncture wound: Stab or shive wound.
distinguishable by its clean-cut edges.
SMOTHERING
• Obstruction of airway. If soft object e.g.
pillow or blanket. No trauma.
• Injury on the inner lips.
• Cyanosis may or may not.
• Petechial hemorrhage on the face,
typically around the area of the eyes.
BURN wounds
• may be cased by heat, a chemical or electricity.
• Fire victims are often found in a “pugilistic” position
with a clenched fist,
resembling the pose of a boxer.
• Heat generally causes the protein in
the body to contract.
• Blood and lung samples are often
taken for various reasons.

INCISED WOUNDS RAPE

• Typically bleed a lot
• Are inflicted with knives or razors • Art. 266-A. Rape is committed –
• Are narrow at the edges and gaping in – 1. By a man who shall have knowledge of a woman
the middle under any of the following circumstances:
a. through force, threat or intimidation;
b. when the offended party is deprived of reason or is
STRANGULATION otherwise unconscious;
c. by means of fraudulent machination or grave abuse
• Homicidal, suicidal and accidental of authority
d. when the offended party is less than (12) years of
• PM Features: age or is demented.
– Intensive heart congestion (enlarged heart; right
side ventricle) 2. By any person who, under any of the
circumstances mentioned in para (1)
– venous engorgement (enlarged veins above point hereof, shall commit an act of sexual
of injury) assault be inserting his penis into another person’s
mouth or anal orifice, or any instrument or object, into
– cyanosis (blue discoloration of lips the genital or anal orifice of another person.
and fingertips).
History and Physical Examination
AUTOEROTIC DEATH
• A brief description of the assault indicates areas for
• In autoerotic death cases medical investigation and treatment; recounting the
the investigator will typically find: events is often frightening for the patient, and a
– a white male partially complete description may have to be deferred until
suspended and nude immediate needs have been met.
– dressed in women's
clothing or undergarments • The reasons for the questions and for the
- or with his penis exposed. examination procedure are not always clear to
patients; eg, the female patient may need to be told
DROWNING that knowing when her last menstrual period was or if
she uses a contraceptive helps determine the risk of
• Rapid formation of mucus block -Bronchi. pregnancy or that information about the time of the
– "foam cone" covering the mouth and nostrils. previous coitus helps establish the validity of sperm
– "dry drowning" -edema of Larynx -no fluid testing.
• Stages in drowning:
– Surprise -Inhales water.
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• Because these patients have experienced coercion,
enlisting their cooperation and requesting permission
for the examination are important.
• Details of the pelvic examination should be
described and explained as it proceeds, and the results
should be reviewed with the patient. Because being
examined by a physician of the opposite sex may
make the patient feel anxious, a nurse or volunteer of
the patient's sex should be present to give support and
to corroborate the procedures.
• The slide demonstrates one of
the best positions to examine younger
children. This child is sitting on the
mothers lap with the mother holding her.
DRUG FACILITATED SEXUAL ASSAULTS
• Rohypnol (street name Roofies), known as the drug
flunitrazepam, belongs to a class of drugs called
benzodiazepines
– It produces a spectrum of effects including skeletal
muscle relaxation, sedation, and reductions in anxiety
• GHB. Gamma hydroxybutyrate or GHB (also known
as Gamma-OH, Liquid Ecstasy, Georgia Home Boy, or
Goop)
– It is another central nervous system depressant that
is used to perpetrate sexual assaults
ROHYPNOL
• Drug used by sex offenders at:
– parties
– bars
– clubs
– social drinking locations
COLLECTION OF EVIDENCE DURINGCOLLECTION
OF EVIDENCE DURING THE MEDICAL
EXAMINATION OF RAPE VICTIM
• Physical evidence to
be collected:
– vaginal swabs,
– oral and anal swabs,
– pubic combing,
– head and pubic hair
controls,
– saliva sample,
– blood sample,
– fingerprint scrapings,
– all clothing.
ITEMS ROUTINELY COLLECTED FROM SUSPECTS
• All clothing,
• pubic hair combing,
• forcibly removed head and pubic hair controls,
• saliva and blood samples.
FORENSIC SEROLOGY
IIB med
• An analysis must be performed on a stain to
determine whether or not it is actually blood. If the
sample is blood, the species must then be determined.
• Conventional serological analysis analyzes the
proteins, enzymes, and antigens that are found in
blood.
• If the blood sample is human, it goes on to further
identification and then individualization.
• Blood analysis is a comparison analysis. The victim’s
blood and the suspect’s blood must be compared to
the blood found at the crime scene.
• Restriction fragment length polymorphism (RFLP)
DNA analysis directly analyzes certain DNA
sequences found in white blood cells.
• Polymerase Chain Reaction (PCR) DNA analysis
analyzes DNA sequences that have been replicated
numerous times. This procedure works well with small
samples of blood. It, however, cannot individualize a
blood sample.
IS THE RED STAIN BLOOD?
– Benzidine color test,
– Phenophthalein test,
– Leukomylokite test,
– Luminol test,
– Microcrystalline test.
SEMINAL STAINS
• Seminal stains found at a crime scene are collected
with cotton swab and placed in an airtight container so
that they may not be contaminated.
• A spermatozoa search is a microscopic analysis
where
sperm cells are visually observed.
• The acid phospatase is a presumptive analysis that
test for the general existence of semen.
• Anti P-30 is a quantitative and qualitative test that
identifies
the presence of protein P-30 (found only in human
semen). This test may also serve to individualize
seminal evidence.
• DNA analysis to determine if the DNA pattern
extracted from a crime scene semen stain matches the
DNA pattern
of the suspect:
– RFLP,
– PCR.
Maximum Reported Time Intervals For Sperm
Recovery in Living Sexual Assault Victims
(a) Vagina: 6-28h (motile sperm); 14h-10d (non-
motile sperm)
(b) Cervix: 3-7.5d (motile sperm); 7.5-19d (non-
motile sperm)
(c) Mouth: 2-31h (non-motile sperm)
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(d) Rectum: 4-113h(non-motile sperm) DNA Detection

(e) Anus: 2-44h(non-motile sperm)
• Amplified DNA fragments are labeled with a
Sources of Biological Evidence fluorescent tag
Blood
Semen • DNA fragments are separated by electrophoresis
Saliva (electric current)
Urine
Hair • The size of the fluorescent DNA fragment is
Teeth determined by a machine which displays the
Bone information
Tissue graphically.
Perspiration
Vaginal secretions • Analysts read the graph to determine the DNA type

The Cell DNA Analysis

• Smallest unit of life •Short Tandem Repeats (STRs) are short stretches of
• Compose all living things DNA that are repeated several times at a particular
• The “nucleus” (one of location on a chromosome
many organelles) contains genetic information the cell
needs to exist and • The number of repeats and, therefore, the length of
reproduce the Short Tandem Repeat DNA varies from person to
-most cells organize genetic information into person
chromosomes
• Each individual has two different (or two equal)
Steps in DNA Analysis length repeats at the same location on a chromosome

collection→specimen • STR DNA testing determines the length of the STR

storage→extraction→quantitation→
genotyping→interpretation of the result→ database
(storage and searching)
DNA Extraction
• DNA analysis begins with DNA extraction from
biological evidence
• DNA extraction is:
– A chemical process by which DNA is released from
cell(s)
– Other cellular components are removed leaving a
pure sample of DNA in an aqueous (liquid) solution
DNA Amplification
• After DNA extraction DNA is amplified using the
Polymerase Chain Reaction (PCR)
DNA at 13 different chromosomal locations
• STR DNA testing analysis is the most commonly used
forensic DNA analysis method
Statistics
• The 13 STR DNA tests produce exceedingly rare DNA
profiles
• A STR DNA profile might be found in 1 person out of
a quadrillion (that is, a billion million) people
• A match between two DNA samples, say, a crime
scene stain and the DNA of a suspect, can link a
subject to a crime
• A non-match may shift the focus away from a
particular suspect

• PCR amplification makes many copies of the DNA to Philippine Cases -DNA
allow for detection (think photocopies)

Gel Electrophoresis • People vs. Vallejo. 2002

• People vs. Yatar, 2004
• Gel with different sized pores • Agustin vs. CA, 2005
agarose and acrylamide are common • Herrera vs. Alba, 2005
materials

• Load DNA samples into wells at top of gel

• Run electric current through the gel

• DNA moves due to negative charge

• Smaller bands run “faster”