Medico-Legal Aspects of Death

Dr. Khalid Y. Mattar

objectives
1. Forensic Medicine in the Holy Quran

2. Definition of Forensic Medicine

3. Branches of Forensic Medicine

4. Autopsy

5. Definition and types of death

6. Changes after death

2
 ‫‪Forensic Medicine in the Holy Quran‬‬
‫ﺳورة اﻟﺑﻘرة‬
‫}وإذ ﻗﺗﻠﺗم ﻧﻔﺳﺎ ﻓﺎدارأﺗم ﻓﯾﮭﺎ وﷲ ﻣﺧرج ﻣﺎ ﻛﻧﺗم ﺗﻛﺗﻣون * ﻓﻘﻠﻧﺎ اﺿرﺑوه ﺑﺑﻌﺿﮭﺎ ﻛذﻟك ﯾﺣﻲ‬
‫ﷲ اﻟﻣوﺗﻰ وﯾرﯾﻛم آﯾﺎﺗﮫ ﻟﻌﻠﻛم ﺗﻌﻘﻠون{‬

‫ﺳورة ﯾوﺳف‬
‫}واﺳﺗﺑﻘﺎ اﻟﺑﺎب وﻗدت ﻗﻣﯾﺻﮫ ﻣن دﺑر وأﻟﻔﯾﺎ ﺳﯾدھﺎ ﻟدى اﻟﺑﺎب ﻗﺎﻟت ﻣﺎ ﺟزاء ﻣن أراد ﺑﺄھﻠك‬
‫ﺳوءا إﻻ أن ﯾﺳﺟن أو ﻋذاب أﻟﯾم * ﻗﺎل ھﻲ راودﺗﻧﻲ ﻋن ﻧﻔﺳﻲ وﺷﮭد ﺷﺎھد ﻣن أھﻠﮭﺎ إن ﻛﺎن‬
‫ﻗﻣﯾﺻﮫ ﻗد ﻣن ﻗﺑل ﻓﺻدﻗت وھو ﻣن اﻟﻛﺎذﺑﯾن * وإن ﻛﺎن ﻗﻣﯾﺻﮫ ﻗد ﻣن دﺑر ﻓﻛذﺑت وھو ﻣن‬
‫اﻟﺻﺎدﻗﯾن * ﻓﻠﻣﺎ رأى ﻗﻣﯾﺻﮫ ﻗد ﻣن دﺑر ﻗﺎل إﻧﮫ ﻣن ﻛﯾدﻛن إن ﻛﯾدﻛن ﻋظﯾم{‬

‫ﺳورة اﻟﻘﯾﺎﻣﺔ‬
‫} أﯾﺣﺳب اﻹﻧﺳﺎن أﻟن ﻧﺟﻣﻊ ﻋظﺎﻣﮫ * ﺑﻠﻰ ﻗﺎدرﯾن ﻋﻠﻰ أن ﻧﺳوي ﺑﻧﺎﻧﮫ{‬
Definition of Forensic Medicine 7

Forensic Medicine is a branch of

FEB
Medicine that applies the principles
and Knowledge of the Medical
Sciences to problems in the field of
law.
 Branches of Forensic Medicine
living BIT 7
Clinical Forensic Medicine Forensic Pathology
Mainly concern about all types of Mainly Concern about the decease,
e
assaults occurs to a living body

• Sexual assaults & Child Abuse

• Time since death
• All types of injuries
• Cause of death
It
• Injuries associated with work
F • Mechanism of death
protection to work e
• Determination of age
f • Manner of death
• Malpractice gas
 Cause, Mechanism, and Manner of Death
Cause of death Mechanism of Manner of death
death
Refers to “How Death Refers to “an Refers to
Occur” abnormal “circumstantial
physiological event around
 Natural disease
_All state that pertained death”
 Traumatic
at the time of death”
 poisoning Alcoholic Drugs
Bleeding
 Asphyxiation
coma, heart failure, (Homicide, Suicide,
 Thermal & drowning, pen
cardiac arrest, Accidental or Natural)
pulmonary edema, …. e
 Autopsy 3
c
anatomy
Academic Autopsy

Clinical Autopsy Pordity

annottity
(Hospital)
rate

Forensic Autopsy a
I
 Autopsy 3
Forensic Autopsy
 Usually carried out to help the legal authority.

IS
 Take forensic samples for legal investigation.
 Performed on the instruction of the legal
authority. 4

 Doesn't Need permission from the next of kin.

Branches and other sciences related to Forensic Medicine:
 Anthropology
e effs own
 Entomology in

 Forensic Psychiatry and Forensic Psychology

 Odontology (Forensic Dentistry)
 Forensic Radiology to determerforgenbody
 Forensic Science
Forensic Science
 DNA profiling and Finger printing
 Toxicology
 Forensic Biology and Serology
 Forensic Chemistry
 Plastic Science
 Crime Scene
E Investigation
 Forensic Imaging and Computing (Facial Reconstruction)
 Forensic Nursing.
Medico - Legal Aspects of Death
Definition of Death
Death is a process not an event defined
as an “irreversibly cessation” of all body
functions:
1. No Heart beats and Respiratory
movement,
2. Stoppage of the Circulatory System,
3. Irreversible damage to the vital
centers in the brainstem
Death
3
All origins dead
In Somatic Death Cellular Death
5
Irreversibly Cessation
Irreversible of cardio-respiratory
unconscious of function, and the
the individual normal metabolic
activity in the body
tissues and cells
 Indications of Death 2

01 02 03
Unconsciousness Muscular flaccidity Cooling of the body
and loss of all
reflexes
04 Eye signs: 05
• Irregular size of the pupils
Cessation of the heart
• Loss of the pupils circular shape
beat and respiratory
• Unreactive pupils (dilated pupils) or Constractive movements
• Loss of light reflexes
 Changes after death
likeindication
Immediate Changes

Late Changes
Early Changes
• Putrefaction
• Rigor Mortis • Decomposition
• 2 Cadaveric Rigidity • Mummification
• Post-Mortem Hypostasis • Adipocere
• Cooling of the Body • Skeletalnization
Early Changes whole Body
Rigor Mortis
loss of Ateaber

Stiffening of muscles
after death
Relaxation 0–3 h
3

Face 0.5 – 2 h
Neck 2–4 h
Upper limbs 4–6 h
Chest 6–8 h
Trunk- 8 – 10 h
Lower Limbs 10 – 12 h
 If the body feels Warm and is Flaccid, it has been dead less than
3 hours.

 If the body feels Warm and is Stiff, it has been dead from
3 to 8 hours.

 If the body feels Cold and is Stiff, it has been dead from
8 to 36 hours.

 If the body feels Cold and is Flaccid, it has been dead more than
36 hours.
 Medicolegal Importance of RM 3

 Time estimation
 Cause of death
 Know position
 Sure sign of death
Early Changes 3
Cadaveric Rigidity Pant
“Cadaveric Spasm” is the stiffness of some muscles that is said
to have its onset immediately at death, and the basis for this
concept is the finding of items gripped firmly in the hand of the
deceased before the onset of normal rigor mortis.
 Emothed 35
3

E
Early Changes 3
Hypostasis
• Draining of the blood due to gravity to the lowest part of the body and
giving the skin a pinkie bluish or purple or reddish purple colour
(depending on concentration of oxygen in the blood).
• It starts to appear half an hour after death, and get completed between
6 to 12 hour.
 Medico-legal Importance of Hypostasis
Carbain deoxiad
 Sure sign of death a

 Cause of death
1  Time estimation
 Position before/ after death
 Indicate if the body was moved or not after death
Questions & Answers

What are the other skin

discoloration which could
be found over the skin?
 Early Changes
a
Body Cooling / Algor Mortis

• The most useful indicator of time since death during the first
24 hours post-mortem.
• After death all metabolic activity ceases rapidly (muscles, liver)
& circulation stops heat production ceases soon after death
• In practice the temperature is either measured per rectum or
intra-hepatic via an abdominal stab.
• The rate of body cooling:
• 1c / hr in summer
• 1.5c / hr in winter.
If the body feels Warm and is Flaccid, it has been dead less
than 3 hours.

If the body feels Warm and is Stiff, it has been dead from 3
to 8 hours.

If the body feels Cold and is Stiff, it has been dead from 8
to 36 hours.

If the body feels Cold and is Flaccid, it has been dead more
than 36 hours.
 Late Changes 3
Decomposition

Autolysis of the cells and body

tissues by the internal chemical
breakdown from liberated
enzymes, and by the bacteria
and fungi from the intestine
internally and the environmental
factors externally, (temperature,
humidity, animals and predators
interference).
 Late Changes
3
Putrefaction
iliac fossa
Right
• It is the commonest rout
of decomposition taken
by any body after death.
• It is result s in liquefaction
of the soft tissue.
Late Changes Marbile 2
 Late Changes
Mummification (dry putrefaction)

• Dry and leathery appearance

of the tissue due to high
temperature.
• It is most commonly seen in
worm or hot and dry
environments such as the
dessert.
 Late Changes
Adipocere (moisture putrefaction)
depose Eat
It is a formation of wax
substance derived from the
body fat in case of immersion
of bodies under cold and
moist environments, such as
the water or the bodies
which is buried in deep and
moisture graves.
 Late Changes
Skeletalnization

• The environment is more

important than the time in
this process.
• 12-18 months: bone and
tendon tags
• After 3 years: bare bone.
Thank You