medico legal autopsy
DESCRIPTION
Medico-legal autopsy and related rules in India. Prerequisites and procedure for conducting autopsy.TRANSCRIPT
MEDICO LEGAL AUTOPSY
AN OVERVIEW
WHAT IS AN AUTOPSY?
Autopsia (Greek) –
Auto – Self, Opsia – seeing
Other names: Post mortem examination
Necropsy (Animals)
Definition:
-thorough examination of a dead body
- to determine the cause and manner of death and
- to evaluate any disease or injury that may be present.
TYPES OF AUTOPSY
1. Medico legal autopsy
2. Clinical/Hospital autopsy.
Difference between medico legal & clinical autopsy:
Trait Medico legal Clinical
Objective Help in investigation Academic purpose
Authority Investigating authority Treating doctor
Consent Not necessary Must
Doctor Forensic pathologist/ RMP
Pathologist along with treating doctor
Dissection Always complete Can be partial
Who can conduct medico legal autopsy?
• Forensic pathologist: To help in investigation of death.
• Any R.M.P. can conduct medico legal autopsy.
• Usually limited to Govt. Hospitals.• Medico legal work can’t be denied,
delayed or referred.• Can take help of post mortem assistant /
diener.
History:
• Egypt – Mummification (3000 B.C.E.)• India – Shushruta (600 B.C.E.)• China – 16 C.E.• Japan – 456 C.E.• Arabian countries – Condemned.• Europe –
Greece – Herophilos, Erasistratus (335 – 250 B.C.E.)
Romans – 1st official autopsy – Julius Caesar
(44 B.C.E.)
- Frederic II(1194 -1250 C.E.) – 1st law
authorizing autopsies.
continue…
History:
• Europe:
Romans – Varignana (1302 C.E.) – 1st medico legal autopsy.
Leonardo da Vinci (1452 -1519)
France – Andraes Vesalius (1514 -1564) students
Italy – Morgagni (1682 -1771)• America –
1st autopsy – 1525 , on conjoined twins.
19th & 20th Centuries: Rokitansky, Bichat, Osler, Virchow.
Objectives:
1. Cause of death
2. How the injuries occurred
3. Manner of death
4. Time since death
5. Identity
6. Collect physical evidence
Benefits:
1. Physician & health care organization
2. Family of the deceased
3. Public health
4. Medical discovery & applied clinical research
5. Basic biomedical research
6. Medical education
7. Law enforcement.
Where to be conducted?Morgue /Mortuary:
Instruments required -
Instruments required -
Ideal time:
• Natural Vs Artificial light• India – Rules regarding night post mortem
examination.
Which cases are send for medico legal autopsy?
• Un natural deaths• Natural deaths – Cause of death not
known• Suspicious deaths.
Procedure:1. Death reported to police.
Procedure:2. Preparation of inquest panchnama
Procedure:3. Body send to mortuary:
Procedure:Prerequisites:
1. Inquest panchnama
2. Requisition from investigating authority or Magistrate.
3. Identification by accompanying police.
Autopsy report:
A} General particulars:
1. Name, address.
2. By whom was the corpse sent?
3. Name of place from which sent?
4. By whom identified?
5. Date & time of autopsy
6. Substance of accompanying police
report, supposed cause of death.
Autopsy report:
B} External Examination:
a) Examination of clothes
b) Identification marks, dental status
c) Post mortem changes
d) Condition of the skin
e) Natural orifices
e) Surface Injuries
f) Fractures
g) Injuries: Ante mortem or Post mortem?
a) Examination of clothes
1. Stains: Blood stains – Injury.
Saliva stains – Hanging
Mud stains – Site of death
Vomit – Poisoning cases
Oil, grease stains – RTA
2. Dry or wet? – Drowning.
3. Damages – Tears, cut marks
4. Identification – Laundry mark, Tailor/ company label etc.
b) Identification marks
1. Tattoo marks
2. Old scars
3. Any malformation
4. Any peculiarity
5. Dental status
c) Post mortem changes:1. Rigor Mortis:
c) Post mortem changes:2. Post mortem lividity
c) Post mortem changes:2. Post mortem lividity
c) Post mortem changes: 3. Cooling of the body
C) Post mortem changes4. Changes in the eyes
C) Post mortem changes4. Changes in the eyes
C) Post mortem changes:5. Signs of decomposition
C) Post mortem changes:5. Signs of decomposition
C) Post mortem changes:5. Signs of decomposition
C) Post mortem changes:5. Signs of decomposition
D) Condition of natural orifices
E) Surface Injuries
Description of Injury:
1. Nature of Injury
2. Situation over body
3. Size
4. Any peculiarity
5. Age
E.g. An incised wound present over back of left forearm middle 1/3rd, 6cm below back of elbow, of size 3cm X 0.5cm X Muscle deep, fresh.
F) Ante mortem or post mortem
1. Haemorrhage
2. Signs of inflammation
3. Signs of healing
4. Signs of infection.
F) Ante mortem or post mortem
INTERNAL EXAMINATION:
Incisions:
1. To open cranial cavity
2. To open thoracic & abdominal cavity.
Cranial cavity:
Extending from one mastoid process to other, passing through vertex.
Cranial cavity:
Under scalp haematoma:
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
Skull fractures
Skull fractures
Skull fractures
Opening thoracic & abdominal cavity:
Opening thoracic & abdominal cavity:
Opening thoracic & abdominal cavity:
Opening thoracic & abdominal cavity:
Opening thoracic & abdominal cavity:
Opening of spine & spinal cord:
Opening of spine & spinal cord:
Dissection of individual organs:1. Brain:
Dissection of individual organs:1. Brain:
Dissection of individual organs:1. Brain:
Dissection of individual organs:2. Heart:
Dissection of individual organs:2. Heart:
Dissection of individual organs:2. Heart:
Dissection of individual organsLungs
Dissection of individual organsKidneys:
Dissection of individual organs:Liver
Dissection of individual organs:Spleen
Preservation of viscera:
1. Stomach & loop of intestine with their contents
2. 1/3rd of liver, ½ of spleen, ½ of each kidneys.
Preservative:
Opinion
Sufficient in ordinary course of nature to cause death.
Negative or Obscure Autopsy:
Other Types of Autopsies:
1. Virtual Autopsy2. Verbal Autopsy3. Psychological Autopsy