Medico Legal Autopsy

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Medico-legal autopsy and related rules in India. Prerequisites and procedure for conducting autopsy.

Text of 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