The document summarizes a post-mortem report of a victim of a road traffic accident. The report details the injuries observed on external and internal examination of the body including lacerations and fractures to the head, face, chest, and limbs. Based on the pattern of injuries, which are consistent with those expected in a car accident, the cause of death is determined to be from the injuries described and their complications. The report also discusses common injury patterns seen in car accidents and the functions of seat belts and air bags in preventing certain types of injuries.

1. ROAD SIDE ACCIDENT
A CASE SUMMARY
Presented by Coordinated by
Dr. Pradeep Yadav Dr. Jitender Kumar Jakhar
PG student Assoc. Professor

3. Before proceeding towards case report of a
victim of road traffic accident, I would like to
discuss some salient features of Medicolegal
autopsies in our country.

4. • In our country, Medicolegal autopsies are carried out on the
request of a legal authority responsible for the investigation of
sudden, suspicious, violent or unnatural deaths.
• In the present case, a request was received from ASI of PS
Sadar Bhiwani to conduct post- mortem examination on
dead body of Mr. XYZ

5. OBJECTIVES OF AUTOPSY
• To determine the cause, manner and time since death
• To establish identity of deceased when not known
• To document injuries and to deduce how the injuries occurred
• To determine the question of viability and live birth in
newborns
Information so obtained is invaluable in the disbursement of
justice.

6. Points to be take care before commencing of
Autopsy
• Performed only when there is an official order authorizing autopsy from police or magistrate.
(Request received from ASI.
• The body must be identified by police man & relatives/friends & their names must be recorded. In
unidentified bodies, marks of identification, photographs, finger prints & all other means which
may helpful must be noted. (Body identified by brother in law, brother of deceased and IO)
• It should be conducted only in mortuary & never in a private room. (PGIMS Mortuary)
• All Medical Practitioners Registered at MCI or SMC, who are in Government Service/ at centers
which are authorized by government are authorized to conduct the medicolegal autopsy.
• Inquest report, case sheet or summary must be read carefully by doctor. (An accident between car
and heavy vehicle which result in three casualties)

7. Inquest
• Police inquest: (Section 174 CrPC) To be conducted by police officer. The
investigating officer has to draw up the report in Forms 25.35 (1) A, B or C
• Form A—death from natural causes
• Form B—death by violence
• Form C—death by poisoning.
In the present case, I received inquest paper in Form 25.35 (1) A

8. Inquest
• Magistrate’s Inquest (Section 176 CrPC) To be conducted by District
Magistrate/Sub-divisional Magistrate/Executive Magistrate/Judicial
Magistrate.

9. SECTION OF IPC IN A CASE OF
ROAD SIDE ACCIDENT
• Section 279 to 289, Section 304 A, 336, 337 and 338 of Indian Penal code
deal with the accused’s rash and negligent conduct endangering the safety
of others.
• Section 304A, 337 and 338 are specific provisions relating to cases in
which rash and negligent driving or riding result in the death of another
person or in hurt or grievous hurt caused to another person.
• In the present case police registered FIR Under section of IPC 279,
337, 304 A.

10. 279 IPC
• Rash driving or riding on a public way. —Whoever drives any vehicle, or
rides, on any public way in a manner so rash or negligent as to endanger
human life, or to be likely to cause hurt or injury to any other person,
shall be punished with imprisonment of either description for a term
which may extend to six months, or with fine which may extend to one
thousand rupees, or with both.

11. 304 A IPC
• Causing death by negligence. —Whoever causes the
death of any person by doing any rash or negligent act
not amounting to culpable homicide, shall be punished
with imprisonment of either description for a term which
may extend to two years, or with fine, or with both.

12. 337 IPC
• Causing hurt by act endangering life or personal safety of
others. — Whoever causes hurt to any person by doing
any act so rashly or negligently as to endanger human life,
or the personal safety of others, shall be punished with
imprisonment of either description for a term which may
extend to six months, or with fine which may extend to
five hundred rupees, or with both.

13. • After receiving request paper to conduct postmortem
examination, going through inquest paper and
identification of dead body, the autopsy should be
performed without undue delay.
• In the present case paper received at 00.00 AM on
00/00/0000 and autopsy started at 00.00 PM on
00/00/0000 .

14. PARTS OF PMR (AUTOPSY REPORT)
It consist of three parts
• PRE-AMBLE (INTRODUCTORY DATA)
• BODY (FINDINGS OBSERVED ON
EXAMINATION)
• POST-AMBLE i.e. OPINION BASED ON THE
FINDINGS/ OBSERVATIONS

15. PREAMBLE- First Part of PMR
PMR No PMR/000/0000
Name XYZ
Sex Male
Age 00 Years
Father/Husband
Name
XYZ
Caste AAAAA
Address EEEE PS QQQQQ, District pppppp, Haryana
Continue…
.

16. FIR No. …., P.S AAAA. District qqqq
Brought by ASI ……………. Belt No 000/APR PS pppp
rrrr. DDDD. District DDDD, Haryana
Names and details of the persons
identifying the body
Date & hour of death Brought Dead on 00/00/0000 at 00.00 PM.
Date & Time of examination 00/00/0000 at 00.00 PM
Information furnished by Police (regarding
the Cause of death) etc.
Apparent cause of death as per police inquest
report No 14- Accident Ke Karan

17. BODY OF PMR (FINDINGS) –
SECOND PART OF PMR
• It Consists of complete description and findings on external and internal examination
of dead body.
• Description of clothes and belongings.
• General condition of the dead body.
• Examination of External Injuries.
• Examination of Internal organs.
• Muscles, bones and joints (Injury/Injuries, Diseases Deformity, Fractures,
Dislocation)

18. Description of clothes/belonging and
other items worn on the body
• Received a dead body of male individual wrapped in white cloth sheet. The body was
wearing.
• 1. A green colored full sleeved shirt with white and black vertical linings,
smudged with blood at places.
• 2. A white colored sleeveless baniyaan, smudged with blood at places.
• 3. A light brown colored pant tied at waistline with two hooks in situ, torn and
smudged with blood at places.
• 4. A blue colored underwear with elastic at waistline.
• White bandage wrapped around forehead. White bandage with splint wrapped
around both upper limbs and right lower limb.

19. Length 178 cm Physique Average Built
Rigor Mortis Present all over the body.
Post mortem staining
Present over the back except pressure areas and it was fixed.
Any Other
Both eyes were closed. Mouth was closed.
External General Appearance
Ligature Mark Nil.
State of eyes
Pupil(Rt) Dilated and fixed Pupil(Lt) Dilated and fixed
Cornea/Conjunctiva(Rt) Hazy Cornea/Conjunctiva(Lt) Hazy
Natural orifices Clotted blood was present around both nostril and mouth

20. Examination of External Injuries
• The description of wound should include nature,
site, dimensions, position, margins, base, presence
of foreign material and evidence of bleeding in
nearby tissue.

21. External Injuries
A lacerated wound of size 3 x 2 cm was present over lateral end of right
eyebrow. The wound margins were irregular in shape and tissues bridging was
evident. On dissection, underlying soft tissues were ecchymosed. On further
dissection, underlying part of frontal and zygomatic bone were fractured. The
fractured end of bone show blood infiltration in their bony trabeculae.
A lacerated wound of size 3 x 1 cm was present over right eyebrow situated 4 cm right
to midline. The wound margins were irregular in shape and tissues bridging was
evident. On dissection, underlying soft tissues were ecchymosed.
A reddish abrasion of size 3.5 x 3 cm was present over middle one third of forehead
situated 1 cm above glabella.

22. A reddish abraded contusion of size 3 x 3 cm was present over right side of face situated 2
cm below right eye and 1 cm right to midline. On dissection, underlying soft tissues were
ecchymosed. On further dissection, right maxilla bone was fractured. The fractured ends of
bones show blood infiltration in their bony trabeculae.
A lacerated wound of size 2 x 2 cm was present over root of nose. The wound margins were
irregular in shape and tissues bridging was evident. On dissection, underlying soft tissues
were ecchymosed. On further dissection, underlying part of nasal bone was fractured. The
fractured ends of bones show blood infiltration in their bony trabeculae.
A reddish contusion of size 5 x 3 cm was present over right temporal region of scalp situated
4 cm above right ear and 5 cm right to midline. On dissection, underlying soft tissues were
ecchymosed with infiltration of blood underlying peri cranium. On further dissection, diffuse
subdural hemorrhage was present over both cerebral hemispheres.
Multiple reddish abrasion of size varying from 1.5 x 1 cm to 1.2 x 0.8 cm were present over
lateral aspect right chest wall situated 2 cm lateral and below to right nipple present over an
area of size 12 x 6 cm.

23. A lacerated wound of size 4 x 2 cm was present over posterior aspect of right elbow. The
wound margins were irregular in shape and tissues bridging was evident. On dissection,
underlying soft tissues were ecchymosed. On further dissection, trochlea, lateral epicondyle,
shaft of humerus bone in distal one third were fractured. The fractured ends of bones show
blood infiltration in their bony trabeculae.
A reddish contusion of size 5 x 3 cm was present over lateral aspect left side of chest wall
situated along mid axillary line and 8 cm left to left nipple. On dissection, underlying soft
tissues were ecchymosed. On further dissection left pleural cavity contain about 800 ml of
blood. On further dissection, 2nd to 9th left ribs were fractured along mid axillary line. The
fractured ends of ribs show blood infiltration in their bony trabeculae.
Diffuse swelling with deformity was present over middle one third of left arm. On dissection,
underlying soft tissues were ecchymosed. On further dissection, through and through fracture of
shaft of left humerus bone was present. The fractured ends of bones show blood infiltration in their
bony trabeculae.
A reddish contusion of size 12 x 4 was present over lower one third of posterior aspect of right
thigh reaching up to right popliteal fossa. On dissection, underlying soft tissues were ecchymosed. On
further dissection, through and through fracture of shaft of right femur bone was present in lower
one third. The fractured ends of bones show blood infiltration in their bony trabeculae.

24. Examination of Internal Organs
• All the cavity should be opened and completely examined.
• In this case on dissection of abdominal and thoracic cavity lung, liver,
spleen and kidney were pale on cut section.
• Stomach and its contents - Contained about 100 cc of semi digested
food material. Mucosa was pale.
• Small Intestine and its content Contained liquid chyme
• Large Intestine and its content Contained fecal matter and gases

25. Muscles, bones and joints (Injury/Injuries,
Diseases Deformity, Fractures, Dislocation)
• Described in Injuries section

26. POST-AMBLE i.e. OPINION/
INFERENCE BASED ON THE
FINDINGS/ OBSERVATIONS-
THIRD PART OF PMR
• The conclusion as to cause of death must be given , based
on postmortem findings.
• The report should be detailed , comprehensive, honest,
objective and scientific.

27. Cause of Death
In our opinion, the cause of death in this case is injuries
described and their complications.
Antemortem/Postmortem
All described injuries are of antemortem
Probable time
a. Between injury and death ..
b. Between death and postmortem examination Between
12 to 24 hours.

28. “Some points associated with injuries
pattern in a car accident”

29. Accidents
• Most of are head on Collison i.e. front impacts – with another
vehicle or object →→ Severe deceleration
• Less commonly vehicle is hit from behind → Acceleration
• Side impacts
• Roll over

30. OCCUPANTS OF VEHICLES
•Driver
•Front seat passenger
•Rear seat passengers

31. INJURIES TO THE DRIVER
• Head and face hit the windscreen glass frame or side pillars.
• sparrow foot marks- Sparrow’s foot marks are bizarre shaped
lacerations that result from the face coming in contact with shattered
windshield glass. It is a commonly seen in front seat passengers in road
traffic accidents
• In present case, victim suffered injury over Right temporal region,
Forehead, right eye brow, right side of face and Nose. Most
Probably suggestive of hit by side pillar of car.

32. • Tightly hold the steering wheel - upper limb
fractures (shoulder, forearm, humerus)
• In present case, fracture of right humerus in
distal one third and fracture of shaft of left
humerus bone was present over victim body.

33. • Chest injuries
• Abrasion, contusion over chest wall, Fractures of ribs, contusions/
lacerations of lungs. Heart compressed between sternum and vertebrae.
• Sudden deceleration causes a pendulous effect on heart resulting in
step ladder tears of aorta
• In present case, victim suffered injury over left side of chest
which cause fracture of ribs on left side.

34. ABDOMINAL INJURIES
• Rupture of rectus abdominis, liver, spleen, rupture of great
vessels, contusion of bowel, mesenteric tear.
• Pelvic injury
• Lower limb
• Knee injuries due to hitting of dash board.
• In present case, contusion were present over right
knee and right thigh and fractures of shaft of right
femur bone was present.

35. NECK
• Whip lash injuries, Fracture dislocation of cervical spine.
• Due to hyper flexion and hyper extension
• (Hyperextension more serious)
• Bleeding into surrounding muscles
• Rupture of anterior longitudinal ligament of vertebra/e
• Tear of intervertebral discs
• Compression of nerve roots
• Ischemic hemorrhages and pulping of spinal cord
• *Commonest site upper two cervical vertebrae

36. INJURIES TO FRONT SEAT
PASSENGER
• Nothing between body and windscreen
• Risk of thrown forward
• Less anticipation than driver
• Forward projection may hit front parts of cabin.
• Hyper flexion and hyper extension resulting whip lash injuries.
• Injuries due to windscreen glass and windscreen pillar. (Sparrow foot cuts)
• Knees hit the dashboard as in driver.
• Thrown out more common (unrestrained without seat belt).

37. FUNCTION OF SEAT BELTS
• It restrains the body against severe deceleration
keeping body away from frontal obstruction.
• It spreads the deceleration forces over a considerable
area thus it reduces force per unit area.
• The strap stretches appreciably during severe
deceleration, which leads to extends the time of
deceleration and thus reduces force per unit time.
• The belt prevent ejection into the road.
37

38. FUNCTION OF AIR BAGS
• These are designed to interpose itself between the
occupant and frontal structures of the passenger cabin.
• It helps to cushion the impact and prevent
forceful contact and hyper flexion.
Note – Safety features do not reduces number of
accident.
38

39. Medicolegal Aspect of Road side injuries
• To assess injuries for the purpose of treatment.
• To reconstruct the accident.
• To predict the state of the person involved in the accident like drunk or
drugged.
• Identification of the victim.
• Documentation of injuries for the purpose of compensation claims.
• To determine the cause of death.
• To evaluate the circumstances of death.
• Homicide? Suicide? Accidental?