Forensic medicine the medico-legal autopsy


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Forensic medicine the medico-legal autopsy

  1. 1. The Medico-Legal Autopsy <ul><li>History </li></ul><ul><li>Social-from relatives, friends, police </li></ul><ul><li>Medical-from GP, hospital notes. Often indicates the likely cause of death. </li></ul><ul><li>Psychiatric-from GP, hospital notes. May indicate possibility of suicide. </li></ul><ul><li>Autopsy authority: </li></ul><ul><li>Police or Coroner (Magistrate) </li></ul><ul><li>‘ Police 61’ form (Permintaan Pemeriksaan Mayat) </li></ul>
  2. 2. <ul><li>Identification </li></ul><ul><li>Visual (relatives) </li></ul><ul><li>Circumstantial (address, car, papers, cards, keys, clothes) </li></ul><ul><li>Medical (scars, teeth, x-rays, DNA) </li></ul><ul><li>Fingerprint </li></ul>
  3. 3. <ul><li>Personal effects and clothing </li></ul><ul><li>By contrast with the hospital autopsy, the examination of personal effects and clothing is an integral part of the medico-legal autopsy providing information on life style, events leading to death, and often the actual cause of death. </li></ul><ul><li>Clothing findings are correlated with historical and scene information, e.g. appropriateness of clothing, source of stains, trace, materials. Clothing findings must also be correlated with other autopsy data, e.g. injuries, source of blood stains. </li></ul>
  4. 4. <ul><li>External Examination </li></ul><ul><li>This is a detailed head to toe examination of a naked body, documenting stains and soiling, general and specific individualizing characteristics, postmortem changes (temperature, lividity, rigor mortis, putrefaction) </li></ul><ul><li>The location, extent and type of staining or soiling of the body are described. </li></ul>
  5. 5. <ul><li>Internal examination </li></ul><ul><li>The internal examination is systematic description of natural disease and recent injuries. Negative observations are included, e.g. no pulmonary thrombo-emboli, no significant coronary atherosclerosis, etc. </li></ul><ul><li>Other examinations </li></ul><ul><li>Any special dissections, (neck dissection), or further examination of organs (brain after formalin fixation), together with microscopic, biochemical and toxicological studies should also be described. </li></ul>
  6. 6. <ul><li>Definition </li></ul><ul><li>Cause of death : the disease process or injury for initiating the train of events, brief or prolonged, which produces the fatal end result. </li></ul><ul><li>Mechanism of death : the physiological or biochemical derangement produced by the above cause, which is incompatible with life; I.e. how the disease or injury leads to death. </li></ul><ul><li>Manner of death : explains how the cause of death came about; I.e whether natural, accident, suicide, homicide, or undetermined/ unascertained. The manner or death as determined by the forensic pathologist is an opinion based on the facts concerning the circumstances leading up to and surrounding the death in conjunction with the findings at autopsy and the laboratory tests. </li></ul>
  7. 7. <ul><li>Opinion (conclusion or commentary) </li></ul><ul><li>This section is interpretative and subjective, representing the opinion of the pathologist. It includes the cause of death as appearing on the death certificate. The commentary is in simple layman’s tern and brings together all the relevant information obtained from examination of the body, the scene of death and the history of the deceased. Information obtained second-hand (hearsay) may be included i.e.from police reports, medical records, etc. The relevant issues are addresses i.e. what happened, to who, when, where, why, and how. It is directed to the law officer investigating the death and any legally interested parties who may obtain access to the report subsequently. </li></ul>
  8. 8. <ul><li>THANK YOU….. </li></ul>