Medico Legal Autopsy

MEDICO LEGAL AUTOPSY

MEDICO LEGAL AUTOPSYAN OVERVIEWWHAT IS AN AUTOPSY?Autopsia (Greek) Auto Self, Opsia seeingOther 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 AUTOPSYMedico legal autopsyClinical/Hospital autopsy.Difference between medico legal & clinical autopsy:TraitMedico legalClinicalObjectiveHelp in investigationAcademic purposeAuthorityInvestigating authorityTreating doctorConsentNot necessaryMustDoctorForensic pathologist/ RMPPathologist along with treating doctorDissectionAlways completeCan be partialWho 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 cant 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. continueHistory: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:Cause of deathHow the injuries occurredManner of deathTime since deathIdentityCollect physical evidence

Benefits:Physician & health care organizationFamily of the deceasedPublic healthMedical discovery & applied clinical researchBasic biomedical researchMedical educationLaw enforcement. Where to be conducted?Morgue /Mortuary:

Instruments required -

Instruments required -

Ideal time:Natural Vs Artificial lightIndia Rules regarding night post mortem examination.

Which cases are send for medico legal autopsy?Un natural deathsNatural deaths Cause of death not knownSuspicious deaths.Procedure:1. Death reported to police.

Procedure:2. Preparation of inquest panchnama

Procedure:3. Body send to mortuary:

Procedure:Prerequisites:Inquest panchnamaRequisition from investigating authority or Magistrate.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 clothesStains: Blood stains Injury. Saliva stains Hanging Mud stains Site of death Vomit Poisoning cases Oil, grease stains RTA Dry or wet? Drowning.Damages Tears, cut marksIdentification Laundry mark, Tailor/ company label etc.

b) Identification marksTattoo marksOld scarsAny malformationAny peculiarity 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 InjuriesDescription of Injury:Nature of InjurySituation over bodySizeAny peculiarityAge

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 mortemHaemorrhageSigns of inflammationSigns of healingSigns of infection.

F) Ante mortem or post mortem

INTERNAL EXAMINATION:Incisions:To open cranial cavityTo 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:Stomach & loop of intestine with their contents1/3rd of liver, of spleen, of each kidneys.

Preservative:OpinionSufficient in ordinary course of nature to cause death.Negative or Obscure Autopsy:Other Types of Autopsies:

1. Virtual Autopsy2. Verbal Autopsy3. Psychological Autopsy