Post Mortem explained for Lawyers, Lay people,Medical Students

1. Dr. Avinash Bhondwe M.B.B.S. President I.M.A. Pune (2008-09) Post-Mortem Examination(Autopsy)

2. POST-MORTEM: DEFINITON Post-mortem (meaning after death) may refer to: In science: an examination and dissection of a dead body to determine cause of death or the changes produced by disease. Post-mortem examination, or autopsy, an examination of a corpse in order to determine cause of death Postmortem studies, a neurobiological research method

3. Objectives of Autopsy : To find out the Cause of Death To ascertain whether death is Natural or Unnatural Whether death is Homicidal, Suicidal or Accidental To ascertain Time passed since death To establish the Identity of the body Whether still-birth or live-birth of newly born infant

4. Burns PM PM In Action Infant PM

5. Modes of Death Asphyxia(Respiratory Failure) Syncope(Circulatory Failure) Coma(Brain Death) Mortuary Post-Mortem

6. COMATOSE PATIENT HOSPTAL MORTURY Bodies outside an Autopsy Room

7. Rules of Post-Mortem Written order from the Police Officer Day time Place: In the Hospital Where the dead body lies Identity of the deceased to be established Three great cavities opened (Cranial, Thoracic and Abdominal) Writing post-mortem report on the spot

8. Contents of Post-Mortem Report Name of the deceased, Identification Place, date and time of post-mortem External Examination Internal Examination Viscera and Samples collected for analysis Opinion as to cause and manner of death

9. Instruments & Accessories for Autopsy

10. Instruments & Accessories for Autopsy Scalpels, knives, scissors, bone-cutters, Chisels, hammer, Measuring tape, Balance, Glass bottles, vials Facility for X-Ray, Photographs & Video-graphy Chemicals as preservatives, like Formalin 40%,Rectified spirit, Saturated solution of common salt

11. External Examination of Unknown Body for Identification Race, Sex, Age Tattoo marks Teeth Distribution of Hair Occupational Characteristics Body should be photographed Finger prints taken

12. External Examination to ascertain time passed since death Rectal Temperature Hypostasis Rigor Mortis Stage of Putrefaction Ova of flies and maggots

13. Approximate times for algor and rigor mortis in temperate regions

14. Post mortem changes 1. ALGOR MORTIS (BODY COOLING) 2. RIGOR MORTIS 3. LIVOR MORTIS (HYPOSTASIS, POST MORTEM LIVIDITY, POSTMORTEM SUGGILLATIONS) 4. POST MORTEM DECOMPOSITION ( PUTREFACTION) 5. ADIPOCERE 6. MUMMIFICATION 7. MACERATION

16. External Examination of Natural Orifices For foreign bodies, injuries, discharges (blood/pus, froth) Take swabs for examination Nose Mouth Ears Anus Urethra Vagina

17. External Examination Presence of Teeth/Dentures

20. Shape of tooth

21. Shape of root

22. Placement of tooth

23. Quantity of teeth

24. Combinations of dental work done:

25. Crowns

26. Extractions

27. Bridge

28. Fillings

29. Root canals Various dental work

30. External Examinationof Marks Cord, ligature mark Finger marks round the neck Its exact position, Manner Application of the knot

31. External Examination of Hands & other parts Hands: For hair, cloth, mud, blood or weapon grasped Scraping from under the nails taken Genitalia, breasts Condition of the body: Stout or Emaciated?

32. External Examination of Injuries From head to foot& from front to back Injury: Situation (Position) Extent Nature (Contusion, Abrasion, Lacerated, Incised, Stabbed or Punctured) Dimension Condition of Edges Course and direction of bullet Direction of blood smear

33. External ExaminationTypes of Injuries Contusion Abrasion Laceration Incised Wound Punctured/Stabbed wound

34. Contusion Abrasion Laceration Incised wound Incised wound Punctured Wound

36. Type of the Weapons Hard & Blunt Objects Sharp Objects

38. External Examinationof Burns First Degree Second Degree Third Degree Cause of burns: Fire, Fluid, Corrosive, Explosive Percentage of Burns

39. First Degree Second Degree Charred Body Third Degree

43. Internal Examinationof Head Order of Exam: Head-Thorax Abdomen Head: Transverse section Skull bones for fracture Brain : for injury, effusion of blood, tumour

51. Internal Examinationof Thorax Pericardium Heart Chambers of Heart Coronary Arteries Aorta,

52. Internal Examinationof Thorax Larynx, Trachea, Oesophagus

53. Internal Examination of Abdomen Peritoneum Abdominal Cavity Abdominal Organs Pelvic Cavity

54. Internal Examinationof Abdomen Stomach Small and Large Intestine Liver, Gall bladder

56. (Surface, Size, Weight)

58. Size, Colour Weight,

60. Internal Examination Spinal Cord

61. Internal Examination of Female Pelvis

62. Internal Examination of Female Pelvis

63. Internal Examination General General Missing Organs: To be noted Videography: When custodial death Suspected Poisoning: Tissues/Samples of:- Stomach, Small & Large Intestine, Liver, Spleen, Kidney, Nail scraping, Skin (Inj.), Uterus, Vagina, Spinal Cord, Heart, Lung, Brain, CSF, Long Bone, Blood, Vomit, Urine, Faeces,

64. Postmortem Forensic Toxicology Suspected drug intoxication cases Homicides Arson fire deaths Motor vehicle fatalities Deaths due to natural causes

65. Internal Examination General Samples/Organs kept in Preservative, Closed in a Container, Sealed and Labeled and Locked and To be sent to Chemical Analyser

66. Examination of Mutilated Bodiesor Fragments Identification: Dentures, Fingerprints, DNA Sampling, Tattoo marks, Condition of Teeth, Deformities,

67. Examination of Mutilated Bodiesor Fragments Circumscribed Penis Probable Age: From Skull, Teeth, Dentures, Gums in jaws Colour of Hair, Ossification of bones Sex: From Head & Trunk (Hair, pelvis, femur, prostate, ovary, uterus etc.)

68. Examination of Fragments Bones Whether Bones are Human or not Whether Female or Male (From Pelvis, Femur)

69. Examination of Fragments Bones The Age of the individual (From the centres of Ossification, Osteoporosis,Osteoarthritic changes) Metallic poisoning (Like Arsenic, Antimony)

70. Post-Mortem ReportIts Value Not substantive piece of Evidence Statement of the Medical Officer made in Court is substantive evidence Medical Officer can use it for refreshing his memory while giving evidence For Corroboration & Contradiction of Medical Officer Reserving Opinion as to the cause of death pending result of chemical analysis. Negative Autopsy