This is a forensic topic from my book FME ,I am working on it for the last two years.

2. recent Exhumation of a
Mummified body in Chakaisar
opal shangla (after a period of 10
months )lapsetime)

3. Autopsy
All un-natural & sudden deaths must be investigated
except where the dead person has been
under the care of a physician or the medical
history suggests natural death. If the
physician suspects foul play he should refuse
to issue death certificate.

4. MEDICOLEGAL
AUTOPSY
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AUTOPSY; autos-means self ,opis -view literally
means to see for oneself.
Inspection &dissection of body after death
Autopsy means detailed scrutiny(study , exam) of both
ext surface &internal contents of the body after opening
its cavities,
including exams such as histology , biochemistry ,
toxicology of collected material.
Medical autopsy; is the one conducted
for medical reasons to confirm or establish diagnosis,
in cases where clinical investigations remained futile
(unsuccessful) in establishing it.
Medico legal autopsy means an autopsy performed
by a qualified &Registered medical officer specifically to
meet certain requirements of law.-----

5. MLA
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MLA autopsy is performed in the pursuance of law to
establish the cause &manner of death &
also to establish or rule out foul play.
Pm exam ; is the exam of external surfaces of the
corpse by inspection
e out giving incision for systemic exam
,however specimens like blood &bile, urine may be
collected.
Psycholollgical autopsy ;is undertaken for
alleged(suspected ,so-called) case of suicide to know
about the mental status of the deceased at the time of
death.
The pm exam should be meticulous(careful
,scrupulous) complete &routinely recoded all +tive
findings

6. Autopsy
VIRTOPSY

A procedure to record forensic pathological
findings applying radiological & digital imaging
methods i.e. X-rays, Ultrasonography, CT Scan,
MRI and MSCT (multi slice computed
tomography), photogrammetry & 3D optical
measuring techniques (photographic
measurements ) and replacing the standard
autopsy procedures.

7. Objectives of a ml autopsy

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1-To determine the identity of a person.
2-To determine the cause of death.(disease ,
trauma or intoxication)
3- Manner of death;
natural or un natural, if unnatural –suicidal,
homicide or accidental.
4-In homicide any trace evidence left by the
accused on the victim.
5-To determine the time since death
6-In case of newly born infants ,determine the
question of viability of the child. & live birth or
still birth
An autopsy performed by forensic
pathologist/RMP.

10. MEDICOLEGAL AUTOPSY
PROTOCOL

Valid Written Authority – from Police or Court

Examination of relevant papers including;
FIR/ POLICE INQUEST REPORT) Naqsha-e-Zarar
DEAD BODY CHALLAN(REQUISITION TO A
MEDICAL OFFICER)
IDENTITY BY POLICE & RELATIVES

11. Precautions for MLA
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1-permission or authorisation;
it is carried out at the permission of legal
authority.
1-in a routine case(suicidal/accidental)-police
ASI.
Homicide ;-SHO(station house officer)
EXUMATIONMagistrate or circle inspector (IG)
DEATH in prison
,police custody
,or by police firing
authority is Executive Magistrate class1

12. Precautions MLA
2-DEAD BODY CHALLAN;
 it is a requisition submitted by
investigating police officer to a medical
man while handing over the body for
performing autopsy.
 It contains the name ,age,
sex,religion,of the deceased,as well as
 suspected cause of death&the
purpose for which the body is sent.


13. It also gives the place
 ,the distance from where the body
has come ,the name of person
accompanying the body for protection
& identification ,the details of articles
&clothing e it.
 The MLO should fill up the columns
indicating the time of arrival of the
body in Mortuary &the time of post
mortem exam


14. Precautions of a MLA
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3-Inquest Report
it is a report in which the available hx of
the case
&the circumstances under which the
body was found or recovered are
recorded.
it also contain the recoded opinion of the
witnesses & the police officer
,regarding the injuries,
manner of their causation,
the cause of death
,the indication of suspected foulplay,if
any.

15. Precautions of a MLA
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4-Identification;the body of the deceased should be identified by
the police constable who brought it .
It should also identified by two relatives wd
names&address of persons ,signed or finger pr
In unknown body note all points of
identification ;
race ,religion,sex,age,height&wt dental status,
the finger prints if asked by police.
police should take photograph of unknown
bodies
Finger prints if required from terminal phalanx
dissect the entire thickness of the skin of each
finger ,preserved in10%formalin &labell it.

16. Protocol for Performing A Forensic
Autopsy?
The corpse is brought to the medical
examiner’s office
 The body is then placed on the cadaver
dissection table.


23. Autopsy
STANDARD AUTOPSY SUITE:

Autopsy room

Storage area
◦ Dead body freezers / Chemicals / Instruments / Linen

Change room / sterilization room

Record room

Waiting area for relatives

Offices

Toilets – staff & public

Entry & exits better if separate

24. Autopsy
Autopsy Room

Walls – ice blue tiles

Natural sunlight / daylight lamp / ice blue
fluorescent electric tube lights

Running water

Exhausts (03 at floor level)

25. Autopsy
EQUIPMENTS

Mortuary Refrigeration Units – 02, 04, 06
body units with hydraulic lift trolley (custom
built freezer room)

Autopsy tables

X-Ray machine + Mobile X-Ray unit

Suction unit

Dissection / Autopsy instruments

26. Autopsy
AUTOPSY INSTRUMENTS
Probes (general operators and straight)
 Scissors (large blunt-ended, small pointed-ended, medium
blunt and pointed-ended and a pair with one blade having a
hook extension for opening of the gut)
 Forceps (blunt end 4 , 6 )
 Knives
◦ Fixed blade 5
◦ Knife handles for detachable blades
◦ Operating amputating, cartilage cutting, and long knives
(from 12 to 24 blade for cutting of brain)


27. Autopsy

Urethral sound (curved and van burin)

Proctoscope (different sizes)

Saw electric and manual

Shears, different types (to cut ribs etc)

Hand and band saws

Chisels (small and large)

Hammers (small and large)

Post mortem needles (half curved and cutting
edged)

Sutures (different types)

30. Autopsy
EQUIPMENTS

Mortuary Refrigeration Units – 02, 04, 06
body units with hydraulic lift trolley (custom
built freezer room)

Autopsy tables

X-Ray machine + Mobile X-Ray unit

Suction unit

Dissection / Autopsy instruments

31. Autopsy
AUTOPSY INSTRUMENTS
Probes (general operators and straight)
 Scissors (large blunt-ended, small pointed-ended, medium
blunt and pointed-ended and a pair with one blade having a
hook extension for opening of the gut)
 Forceps (blunt end 4 , 6 )
 Knives
◦ Fixed blade 5
◦ Knife handles for detachable blades
◦ Operating amputating, cartilage cutting, and long knives
(from 12 to 24 blade for cutting of brain)


32. Autopsy

Urethral sound (curved and van burin)

Proctoscope (different sizes)

Saw electric and manual

Shears, different types (to cut ribs etc)

Hand and band saws

Chisels (small and large)

Hammers (small and large)

Post mortem needles (half curved and cutting
edged)

Sutures (different types)

36. External Examination
Steps of an external examination.
1. Photographed.
2. Physical evidence collected off body.
3. Samples of hair, nails, etc. are
collected.
4. Undressed, examined for wounds.
1. Lacerations, abrasions, bruises.
5.
Measured, weighed, cleaned.

37. Removal and Dissection of the
Organs
 One
organ at a time
 All body organs at once - ”Rokitansky
Method”
 Upon removal each organ is:
◦ Weighed & measured
◦ Examined
◦ Sliced in cross sections
◦ Sampled for microscopic & chemical
analysis
bsapp.com

38. Signs of death
algor mortis ;Cooling of the body
 Liver mortis ;color of death
 Rigor mortis; stiffness of death
 Pallor mortis; pallor of death

39. MLA
Time after death t b/w death &pm
exam is called pm interval
 death is immediate or instantaneous,
or hospitalized
 A diagrammatic representation o f all
imp injuries is sketched,
 e autopsy #
 .date ,place,
 signed by MLO.


40. Columns of General Register

Entry in the daily and autopsy register

Serial number

Date and time of receipt of corpse

Name and identity of deceased

Name and number of the constable and his police station

Date and time of delivery of corpse

Yearly number

Autopsy number

Date and time of autopsy

Details about specimens collected and laboratory where sent

Provisional / final conclusions regarding cause of death
The trained mortician fills all theses columns, except the last three entries that are made by the medical
examiner personally
Contd.

41. Autopsy

Personal identity of the corpse to be verified
by two relatives with their names and relation

In absence of relatives subjective
identification – may include photography and
finger prints

42. STAGES OF AUTOPSY
EXAMINATION

Physical examination of clothes and collection of evidence in
them

Physical examination of body surfaces and collection of any
evidence

Opening of the body cavities

Scrutiny of internal contents of cavities and vital systems

Collection of specimens

Closure of the body / reconstruction

Disposal of dead body – relatives/ police /contractor

43. Physical examination of the clothes

Preliminary inspection

Description of holes, cuts, tears

Removal of clothes from the body

Drying of wet clothes and preservation

Collection of any foreign material – shot
charge, glass pieces, hair, foreign fibers -not
matching the clothes of the deceased

44. Physical examination of body surfaces
-
Physical examination of body surfaces

Inspection (naked eye and with
magnifying glass) and palpation of body
surfaces
◦ Abnormal coloration of skin
◦ Presence of injuries
◦ Location and extent of hypostasis
◦ Examination of the natural orifices – oral,
auricular, nasal, ocular, anal, vulvar / groin /
axila / natal cleft

45. Autopsy

Palpation of the body surface
◦ Detection of rigor mortis
◦ Detection of lump or foreign body – bullet, pallet

Examination of the external injuries
◦ Shape, size, site (in relation to fixed anatomical
landmark), number and pattern of distribution
◦ Correlation of holes, cuts, extent of blood soaking with
injuries
◦ Defense wounds / hesitational cuts / cadaveric spasm

46. Autopsy

Opening of body cavities
◦ All the three cavities to be opened
◦ Abdomen and thorax opened together

Autopsy incisions
◦ Straight incision extending from chin to pubis avoiding the
umbilicus
◦ Y – shaped incision – extending from the base of each ear
to meet in the midline at suprasternal notch and continued
as straight incision (better exposure of neck structures –
may be modified)
◦ Incisions for cranial cavity opening

47. Autopsy

Exposure of the thorax
◦ Reflect skin along with muscles from chest wall
◦ Cut costal cartilages medial to costo-chondral junction with large cartilage
knife
◦ Cut the first rib with rib shear
◦ Dissect to free the diaphragm from the last rib
◦ Remove the sternum – exposes heart, superior media sternum and pleural
cavities
◦ Test for presence of air in the plural / pericardial cavities
◦ Examine the pleural cavities for presence or absence of any fluid / adhesions
◦ Examine the pericardial cavity & note the amount of fluid and condition of
surface and adhesions if any
◦ Haemo pericardium if any be collected and measured
◦ Locate the source of bleed

52. Autopsy
PERICARDIAL CAVITY

Open with care

Note amount of fluid
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Condition of surfaces

Presence or absence of adhesions

Hemo-pericardium – amount of blood – source of
bleed

53. Autopsy

Heart may be removed unopened or right side
opened before removal – make incision in the right
atrium continue through tricuspid valve along the
inferior part of right ventricle then through interior
wall of right ventricle close to septum and into the
pulmonary artery

Scrutinize atrium, ventricle, pulmonary artery for
thrombus / embolism.

55. Autopsy

Exposure of the Neck Structures
◦ Elevation of skin and subcutaneous tissues as
far as the arch of the mandible – layer wise
dissection of neck muscles

57. Autopsy

Examination of the abdominal cavity
◦ Peritoneum incised using two fingers of left
hand to elevate to avoid injury to internal
viscera
◦ Inspect all the organs and the blood vessels
including those in the pelvis

60. Autopsy
OPENING OF CRANIAL CAVITY
 Neck extended by a wooden block under the
neck and upper chest
 Incision – intermastoid extending on the
vertex
 Reflect the scalp anteriorly (1.5 cm above
supra orbital ridge) and posteriorly
 Clean and examine the skull
 Give circular saw cut 4 cm above the supra
orbital margin anteriorly and over the occipital
bone posteriorly

69. Autopsy
Examination of Vertebral Column and Spinal
Cord

Anterior approach
◦ Removing all the structures of thorax and
abdomen and vertebral column exposed and
spinal cord exposed by cutting the vertebral
bodies

70. Autopsy

Posterior approach
◦ Midline incision from base of head to the
sacrum, tissues on each side separated,
examine the vertebrae. cut through the lemina,
spinus processes and laminae removed and
spinal dura exposed.
◦ To examine the spinal cord- separate dura from
the anterior surface of vertebral bodies
◦ incise the dura
along posterior and anterior

72. Autopsy
ADOPT SPECIAL PROCEDURES FOR

Pneumothorax

Pulmonary embolism

Location of thrombus in atrium / ventricle

73. Autopsy
Collection of Samples
1.
For chemistry – blood, urine, CSF
2.
For toxicological examination – organs, fluids
3.
Histological examination

74. Autopsy
Specimens for a suspected case of poisoning (for toxicological analysis)
Specimen / Organ
Quantity
Hair
10 gm
Brain
500 gm
Liver
500 gm
Kidney
One whole / ½ of each
Lung
One whole
Stomach
Whole with contents
Small intestine
Initial two feet with contents
Blood
50 – 100 cc
Urine
All available

75. Autopsy
Choice of Specimens
Nature of Poison
Specimen
Alcohol, chloroform, ether, alkaloids,
barbiturate, benzene
Brain
Metals, barbiturates, fluoride, oxalate
Liver
Heavy metal especially mercury
Kidney
Lead, arsenic, radium (chronic poisoning)
Bone
All gaseous poisons
Blood
Barbiturate, sulfonal, heavy metals
Urine

76. Autopsy
Preservatives

Toxicology:
◦ Saturated solution of sodium chloride 33%
◦ Rectified spirit – not to be used in alcohol,
phosphorus, acetic acid, carbolic acid
◦ For gaseous poisoning – no preservative
(blood, urine in test tube with a layer of liquid
paraffin, refrigerate and examine quickly)

77. Autopsy
Preservatives

Histology:
◦ 10% formalin in normal saline
◦ Ethyl alcohol – 90%

78. Autopsy
Reconstruction and Disposal of dead body:

Replace organs in their places

Reconstruct the body – to make it
presentable for the relatives

Disposal – hand over to relatives through
police – if unclaimed keep in refrigerator and
arrange to inform the official burial contractor
/ may be handed over to anatomy department

79. Autopsy
Post mortem artifacts
 Artifact – artificial product or feature which is
not real but added to original by processing /
handling
 Artifacts added to dead body during post
mortem period – post mortem artifacts lack
vital reactions
Causes:
 Post mortem phenomenon
 Physical handling
 Interference by scavengers / insects /
animals

80. Autopsy Hazards

Mechanical

Biological

chemical
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Electrical

Radiological

81. Autopsy / Hazards
Mechanical
 Injuries to limbs
◦ Fractures of lower limbs by fall on wet slippery
floor

Injuries to hands
◦ Cut by sharp instruments during dissection
◦ Needle prick during closure of dead body
◦ Burns from boiling water and hot instruments

Injuries to back
◦ Muscles sprains from carrying of heavy corpse

Injuries to eyes
◦ Corneal ulcers by bone dust from sawing of bone

82. Autopsy Hazards

Biological hazards
◦ Bacterial
◦ Viral
◦ fungal

83. Autopsy / Hazards
Biological

Bacterial infections
◦ From septicemic and pyemic dead body
◦ From purulent fluids in cavity, abscess or from pus
from organs and viscera
◦ From specific infections
 Typhoid and paratyphoid
 Tuberculosis
 Leprosy
 Anthrax

84. Autopsy / Hazards

Viral infections
◦ Hepatitis
◦ HIV / AIDS

Fungal

85. Autopsy / Hazards
Chemical

Antiseptics and disinfectants
◦ Iodine
◦ Phenols fluid
◦ Dettol

Fixatives
◦ Formalin

86. Autopsy / Hazards
Electrical

Electric burns due to faulty appliances,
metallic autopsy table and wet floors
Radiation

Electromagnetic radiation

Ionizing radiation from therapeutic radioactive
isotopes

87. Autopsy Hazards

Measures to prevent hazards :
◦
◦
◦
◦
◦
◦
Autopsy protective dress including shoes
Thick rubber gloves ( kitchen gloves)
Protective eye glasses
Keep surfaces dry
Insulate all electrical appliances
In case of needle pricks---remove gloves –
allow to bleed wash thoroughly and apply
antiseptic dressing
◦ Get all the workers vaccinated against
infectious diseases

88. Exhumation

It is lawful digging out of the dead body from the
grave for postmortem examination or reexamination.
 Objectives of Exhumation:
a- When suspicion of foul play has been raised after
burial.
b- When cause of death is disputed and further
medical evidence is required.
c- When identity of the dead body is to be
established.
 Authorization:
In Pakistan............... By Session Judge.(Magistrate)
Time Limit:
In Pakistan............... No time limit.

89. Procedure of Exhumation

:
a- Necessary preparations with the help of
graveyard authorities
b- Identification of the grave by:
Care taker of graveyard
Grave digger.
Relatives or friends present at the time of
burial.
c- Removal of the dead body from the grave.
d- Collection of the samples of the earth in
cases of suspected poisoning from :
Above the dead body
Below the dead body
On the sides of the body
Control sample from distant place

90. 
Autopsy Examination:
No difference in the procedure of Autopsy
between a fresh body and body buried in a
grave.
a- Identification
b- External examination
c- Internal examination: Special attention to
any bony injury.
d- Collection of viscera for chemical
examination,
If not available------- shapeless, homogenous
mass of different organs in abdominal &
thoracic cavities.
Hair, nail, teeth, skin if present.

91. Autopsy / Exhumation
Exhumation
 Removal (interment) of corpse from the grave to determine
the cause of death
Procedure of Exhumation:

Exhumation order by District Magistrate

Nomination of a magistrate by District Magistrate

Team consist of duty magistrate, investigating officer with
police and medical examiner

The team reaches the graveyard in the early morning hours

Area cordoned by the police

92. Autopsy / Exhumation

Grave identified by relatives

Interment of body ordered

Autopsy performed – if feasible body may be shifted to mortuary

Skeleton may reveal useful information

Specimens from the sites of organs may be collected for
toxicological analysis if required

The investigating officer must consult the medical officer about
the usefulness of the procedure especially if more than 3 weeks
have passed since burial

94. 
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
First Information Report (FIR) is a
written document prepared by the police when they
receive information
about the commission of a cognizable offence.
It is a report of information that reaches the police
first in point of time and that is why it is called the First
Information Report.
It is generally a complaint lodged
with the police by the victim of a
cognizable offence or by someone -on his/her behalf.
Anyone can report the commission
of a cognizable offence either orally
or in writing to the police. Even a
telephonic message can be treated
as an FIR.

95. Cognizable Offence

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
A cognizable offence is one in which the
police may arrest a person without warrant.
They are authorized to start investigation
into a cognizable case on their own and do not
require any orders from the court to do so.
Non-cognizable Offence
A non-cognizable offence is an offence in
which a police officer has no authority to arrest
without
warrant.
The police cannot investigate such an offence
without the court's permission.

96. An FIR is a very important

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
document as it sets the process of
criminal justice in motion. It is only
after the FIR is registered in the
police station that the police takes
up investigation of the case.
Who can lodge an FIR?
Anyone who knows about the
commission of a cognizable offence
can file an FIR. It is not necessary
that only the victim of the crime
should file an FIR. A police officer
who comes to know about a
cognizable offence can file an FIR
himself/herself.

97. The police may not investigate a
complaint even if you file ,
a when:
 FIR
(i) The case is not serious in nature;
(ii) The police feel that there is not
enough ground to
 investigate.
 However, the police must record
 the reasons for not conducting an
 investigation and in the latter
 case must also inform you.
 —[Section 157, Criminal Procedure
 Code, 1973]



98. filing an FIR?

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









The procedure of filing an FIR is
prescribed in Section 154 of the Criminal Procedure
Code, 1973.
* When information about the commission of a
cognizable
offence is given orally, the police must write it down.
* It is your right as a person giving
information or making a
complaint to demand that the
information recorded by the
police is read over to you.
* Once the information has been
recorded by the police, it must
be signed by the person giving the information.

99. 







You should sign the report only
after verifying that the information recorded
by the
police is as per the details given by you.
* People who cannot read or write
must put their left thumb impression on the
document
after being satisfied that it is a correct record.
* Always ask for a copy of the FIR, if the
police do not give it to you. It is your right to
get it free of
cost.

100. What should you mention in
the FIR?
* Your name and address;
 * Date, time and location of the
 incident you are reporting;
 * The true facts of the incident as
 they occurred;
 * Names and descriptions of the
 persons involved in the incident;


101. Things you should NOT do:










* Never file a false complaint or
give wrong information to the
police. You can be prosecuted
under law for giving wrong
information or for misleading the
police.
—[Section 203, Penal
Code 1860]
* Never exaggerate or distort facts.
* Never make vague or unclear
statements.

102. What can you do if your FIR
is not registered?











* You can meet the S u p e r i n -tendent of
Police or other higher officers like
Deputy Inspector General ofPolice & Inspector General
of
Police and bring your complaint to their notice.
* You can send your complaint in writing and by post to
the
Superintendent of Police concerned. If the
Superintendent of Police is
satisfied with your complaint, he
shall either investigate the case
himself or order an investigation
to be made.