MEDICOLEGAL POST-MORTEM REPORT

Department of Forensic Medicine

Sri Manakula Vinayagar Medical College & Hospital, Puducherry.
1. PRELIMINARY DETAILS:

As per the information furnished by the police in form no 146 (ii), it is alleged that the on
06/02/2020 morning at 09:30 hrs, Halladi – 76 Village, Heruru place, the deceased was climbing
on a coconut tree and he suddenly fell down. On 07/02/2020 at 08:45 am, he died in SMVMCH,
Puducherry, while under treatment.

SCHEDULE OF OBSERVATIONS:

EXTERNAL EXAMINATION:
Dead body was covered in a white cloth. Removal of the cloth revealed the body to be of an
adult male, wheatish in complexion, moderately built and nourished, measuring 170 cm in length
and 50 Kg in weight.

Pink coloured adhesive hospital bandage was present over the both the sides of the neck, and the
left leg.
Pink coloured adhesive hospital bandages, were present over the back involving both sides,
starting from the lower border of shoulder blade to the gluteal cleft.
White hospital plaster was present over the outer aspect of the right forearm.
White hospital plasters, were present over the outer aspect of the entire left thigh.

Body was cold and rigor mortis was present all over. (Preserved in mortuary cold chamber)
Postmortem lividity was faintly visible over the back and was not fixed.
Bilateral conjunctivae were congested.
Boggy swelling was present over the posterior aspect of the neck.
Excoriation of the upper and lower lips was present.
Reddish brown stains were present over the teeth.
Crepitus was present over the right side of the chest wall.
Comparative fullness of the left inguinal region was present.
Bloody discharge was present at the urethral orifice.
All other external body orifices were intact and unremarkable.
Following therapeutic artefacts were present over the body:
Needle puncture mark, was present over both the side of the neck.
Needle puncture mark, was present over the outer aspect of the right forearm.
Needle puncture mark with associated extravasation of blood, measuring 5 x 5 cm, was present
over the front of the right elbow.
Needle puncture mark with associated extravasation of blood, measuring 4 x 3 cm, was present
over the front of the left elbow.
Needle puncture mark with associated extravasation of blood, measuring 5 x 3 cm, was present
over the outer aspect of the left wrist.
Punctured wound, measuring 0.5 x 0.3 cm x muscle deep, was present over the front of the left
leg, situated 6 cm below the left knee.
Punctured wound, measuring 1 x 0.5 cm x muscle deep, was present over the outer aspect of the
left leg, situated 6 cm below the left knee.

Following external injuries were present over the body:

1. Multiple abraded contusions, reddish in colour, over an area of 11 x 6 cm, varying in sizes
from 3 x 2.5 cm to 0.5 x 0.5 cm, was present over the front of the chest in the midline, situated 6
cm below the supra sternal notch.
2. Abraded contusion, reddish in colour, measuring 12 x 4 cm, was present over the outer aspect
of the chest on the right side, situated 7 cm below the right posterior axillary fold.
3. Vertically placed surgically stapled wound with intact staples, measuring 5 cm in length, was
present over the outer aspect of the left gluteal region, situated 3 cm below and 3 cm away from
the left posterior superior iliac spine, with a plastic tube present in situ, situated at a point 2 cm
above the upper end of the wound.
4. Vertically placed surgically stapled wound with intact staples, measuring 3.5 cm in length,
was present over the outer aspect of the left thigh, situated 10 cm below the previous injury, with
surrounding contusion, bluish in colour, measuring 8 x 6 cm.
5. Vertically placed surgically stapled wound with intact staples, measuring 2 cm in length, was
present over the outer aspect of the left thigh, situated 5 cm below the previous injury, with
surrounding contusion, bluish in colour, measuring 15 x 2 cm.
7. Vertically placed surgically sutured wound with intact sutures, measuring 25 cm in length,
was present over the back in midline, starting at a point 4 cm below and 8 cm inner to the
inferior angle of the scapula and ending at a point 12 cm above the gluteal cleft, with a plastic
tube present in situ, situated at a point 2 cm above the upper end.

All the aforementioned injuries were antemortem in nature and caused due to blunt force trauma.
INTERNAL EXAMINATION:
(I) Cranium: Skull and Vertebrae, Membranes, Brain.

Scalp: Contusion, measuring 3 x 2 cm, was present over the right frontal region.
Skull: Intact and unremarkable.
Meninges: Intact and unremarkable.
Brain: Weighed 1,115 g. Brain was soft and congested. There was coning of orbital part of
frontal lobe, uncal part of hippocampal gyrus of temporal lobe and cerebellar tonsils bilaterally.
Brain was unremarkable on cut section.

(II) Spine and Neck: Para-vertebral contusion was present corresponding from T11 to L2
vertebra, with screw fixation of the vertebra.

(III) Thorax:

1) Walls, ribs and cartilages: Contusion, measuring 20 x 15 cm, was present over the anterior
chest wall, involving both the sides. Fracture of the right 2nd to 9th ribs, was present along the
mid-scapular line, with associated contusion of inter-costal muscles, measuring 28 x 14 cm.
Fracture of the left 2nd to 5th ribs, was present along the mid-clavicular line, with associated
contusion of the inter-costal muscles, measuring 30 x 18 cm. Fracture of body of the sternum
was present.
2) Right Pleura: Right pleura contained 3500 ml of frank blood.
3) Left Pleura: Left pleura contained 200 ml of frank blood.
4) Larynx and trachea: Tracheal lumen contained scanty amount of brownish mucous plug.
Tracheal mucosa was pale.
5) Right lung: Weighed 240 g.
6) Left lung: Weighed 215 g.
Both Lungs: Both the lungs were soft and collapsed inside the cavity.
7) Pericardium: Defect, measuring 7 x 3.5 cm, was present on the right postero-lateral aspect.
8) Heart: Weighed 280 g. Defect, measuring 1.3 x 1 cm, was present over the right auricle, with
surrounding contusion. Valves were competent. Left ventricular wall thickness was 1.7 cm and
right ventricular wall thickness was 0.4 cm. Left anterior descending coronary artery showed 25
% of occlusion of its lumen, situated at a point 4 cm from its origin. All the other coronaries
were patent on cut section.
9) Large vessels:
Aorta: Para aortic contusions were present. Multiple atheromatous streaks and plaques were
present over the aortic intima at several places.
Inferior venacava: Intact and contained blood clot.

(IV) Abdomen and Gastrointestinal tract:

1) Walls: Intact and unremarkable.

2) Peritoneum: Contusion, measuring 20 x 10 cm, was present over the whole of inferior pelvic
aspect. Retroperitoneal contusion was present.
3) Mouth, Pharynx and Oesophagus: Oesophageal lumen contained scanty whitish yellow
mucoid fluid. Oesophageal mucosa was pale.
4) Stomach and its contents: Weighed 400 g; Stomach contained scanty greenish mucoid
material with no identifiable rice particle and with no abnormal odour. Stomach mucosa was
unremarkable.
5) Pancreas: Intact and unremarkable.
6) Small intestine & its contents: Intact and unremarkable.
7) Large intestine & its contents: Intact and unremarkable.
8) Adrenals: Both the adrenals were unremarkable on cut section.
9) Liver: Weighed 1025 g; Pale on cut section with yellowish areas.
10) Spleen: Weighed 75 g; Unremarkable on cut section.

(V) Genito-Urinary Organs:

1) Right Kidney: Para-nephric contusion was present. Weighed 95 g; Congested on cut section.
2) Left Kidney: Weighed 100 g; Congested on cut section.
3) Bladder: Empty.
4) Organs of generation, external and internal: Bloody discharge was present at the urethral
orifice.

(C) INVESTIGATIONS:
Perusal of the hospital records of the deceased bearing No.02706528, SMVMCH, Puducherry,
revealed the following:
1. Hospital Diagnosis: (?) Pulmonary embolism, D11 – L2 burst fracture with scoliosis and left
inferior pubic rami fracture, left sub-trochantric femur fracture.
2. Laboratory investigations:
D-Dimer: 710.23 microgram/mL (Normal Value: 0 – 5 microgram/mL)
CK - MB (Mass): 156.2 ng/mL (Normal Value: 0.6 – 6.3 ng/mL)
Troponin T hs: 1.300 ng/mL (Normal Value: upto 0.02 ng/mL)
3. Procedure: Spine decompression with strabilization and open reduction internal fixation of the
left femur.

Following tissues were sent for histo-pathological examination: Piece of right lung, piece of left
lung, blood clot from pericardial sac, blood clot adherent to right ventricular wall, blood clot
from right atrium, blood clot from inferior vena cava, pericardial sac with the defect, and entire
heart.

OPINION AS TO CAUSE OF DEATH:

DECEASED DIED DUE TO HAEMORRHAGE AS A RESULT OF LACERATION OF THE

HEART SUSTAINED AS A RESULT OF BLUNT FORCE TRAUMA TO THE CHEST.