Tag Archives: Pathology

FORENSIC ENTOMOLOGY – HOW INSECTS SOLVE CRIME

This special guest post is from Professor Gail Anderson of Simon Fraser University in Vancouver, British Columbia, Canada. I was fortunate to work with Gail in death investigations. She’s a world leader in her field of forensic entomology.

FE1Forensic entomology is the study of insects for medico-legal purposes. There are many ways insects can be used to help solve a crime, but the primary purpose of forensic entomology is estimating time since death.

Once a person dies his or her body starts to decompose. The decomposition of a dead body starts with the action of microorganisms such as fungi and bacteria, followed by the action of a series of insects (arthropods).

Bodies decompose slowly or fast depending on weather conditions, if they have been buried or are exposed to the elements, if there is presence of insects, or if they have a substance in their bodies that prevents their fast decomposition such as body size and weight, clothing,

FE2The dead body goes through constant changes allowing investigators to estimate how long that person has been dead. Generally speaking, there are 5 basic stages of decomposition: Fresh, putrefaction, fermentation, dry decay and skeletonization. Every stage attracts different kinds of organisms that will feed off the body and recycle the matter. These stages may take days or years (even thousands of years!)

It is by collecting and studying the insects that are feeding on a body that a forensic entomologist can estimate the time elapsed since the person died.

Flies have great powers of dispersal and they rapidly discover bodies, usually ahead of beetles. Although they can feed on fluid that exudes from a fresh body, the acidic tissues of a fresh corpse cannot be digested by flies. 

FE3Blow flies are the most common insects associated with a dead body. However many other species of flies, beetles, and arthropods may also be found at a death scene. Because blow flies arrive earlier in the decomposition process, they provide the most accurate estimation of time of death.

Some of the blow fly species found in Canada include Calliphora vicina, Calliphora vomitoria, and Cynomya cadaverina. The scientific names are used because the common names are not always consistent.

FE4Beetles in both their immature and adult form can also be found on dead bodies. These usually occur at later stages of decomposition. As the corpse dries, it becomes less suitable for the blowflies, flesh flies and house flies that like a semi-liquid environment.

Different fly families, the cheese flies and coffin flies, are abundant as the corpse dries. Eventually, the corpse becomes too dry for the mouth hooks of maggots to operate effectively.

FE5The hide beetles, ham beetles and carcass beetles, with their chewing mouthparts, devour the dry flesh, skin and ligaments. A few of these include Silphidae (Carrion beetles), Dermestidae (Dermestid beetles) and Staphlynidae (Rove beetles). Other insects that may be found include Piophilidae (Skipper flies), Sphaeroceridae (Dung flies), and Phoridae (Humpback flies). Finally, moth larvae and mites consume the hair, leaving only the bones to slowly disintegrate.

Estimating time elapsed since death or Post Mortem Interval is the main function of forensic entomology.

There are two methods to estimate time since death: 1) using successional waves of insects and 2) maggot age and development. Insect succession is used if the individual has been dead for a month or longer. Maggot development is used when death occurred less than a month prior to discovery.

Insect succession uses the fact that a body (human or otherwise) supports a rapidly changing ecosystem as it decomposes. As they decay, the remains go through physical, biological and chemical changes, and different stages attract different species of insects.

FE6Calliphoridae (blow flies) and Sarcophagidae (flesh flies) may arrive within 24 h of death if the season is suitable or within minutes if blood or other body fluids are present. Other species, like Piophilidae (cheese skippers), are not interested in the fresh corpse, but are attracted to the body at a later stage of decomposition. Some insects do not seek the body directly, but arrive to feed on other insects at the scene.

Many species are involved at each decomposition stage and groups of insects may overlap with each other. Knowing the regional insect fauna and times of colonization, a forensic entomologist can determine a period of time in which death took place. They may also be able to establish the season of death (e.g. summer) according to the presence of absence of certain insects that are only seasonally active.

Maggot age and development is used in the first few weeks after death and can be accurate to a few days or less. Maggots are immature flies and Calliphoridae (blow flies) are the most common insects used.

Blow flies are attracted to a corpse very soon after death and lay their eggs in natural openings or in a wound, if present. Eggs are laid in batches and hatch after a period of time into first instar (or stage) larvae. The larva feeds on the corpse and moults into a second, and then third instar larva.

FE7The size and the number of spiracles (breathing holes) determine the stage. When in the third instar, the larva stops feeding and leaves the corpse to find a safe place to pupate. This is the prepupal stage. The larva’s skin hardens into an outer shell, or pupal case, to protect it as it metamorphoses into an adult. Freshly formed pupae are pale in colour, but darken to a deep brown in a few hours. After a number of days, an adult fly emerges, leaving an empty pupal case behind as evidence.

Each developmental stage takes a known amount of time, depending on the temperature and availability of food. Temperature is especially important since insects are ‘cold-blooded’ – meaning their metabolic rate increases (and the duration of development decreases) as the temperature rises, and vice-versa.

Looking at the oldest stage of insect and the temperature of the region, a forensic entomologist can estimate the day or range of days in which the first insects laid eggs and provide an estimate of time of death.

This method applies until the first adults emerge. After this, it is impossible to determine which generation is present and time since death must be estimated from insect succession.

Collecting, preserving, and packaging specimens are the vital steps in processing evidence. 

FE8Forensic investigations rely on evidence and material found at a crime scene, which must be recorded and collected carefully. This is especially true for insect material, which can be hard to find.

When approaching a scene with insect evidence, a forensic entomologist first considers the surroundings. If the scene is outdoors, they note the landscape, plants and soil types, as well as the weather. Temperature is especially important and if possible, a portable recording device is left to record long term changes.

A soil sample is often taken, since larvae may wander away from the body to pupate. If the scene is indoors, an investigator looks for access points where insects could get in. Once at the body, the forensic entomologist takes several samples from different areas of the body. If there are maggots, some are collected, placed in boiling water and preserved in alcohol. This stops development and allows the insect to be aged. 

Other maggots are collected alive so that they can be kept until they reach adulthood.

FE9At this stage, the species can be determined. Normally, eggs are only collected if there are no later stages associated with the body. Again, some are taken and preserved in alcohol while others are watched until they hatch. Empty pupal casings are also collected.

Adult flies are useful only if the wings are crumpled. This suggests they have recently emerged and can be linked to the body. Otherwise, they are not collected since they may have just arrived to the scene.

The careful and accurate collection of insect evidence at the scene is essential. Ideally, an entomologist collects a range of insect stages from different areas of the body and the surroundings (e.g. clothing or soil). Different species, or insects collected from different areas, are kept separately.

Human bodies attract two main groups of insects: flies (Diptera) and beetles (Coleoptera).

FLIES are found as eggs, larvae or maggots, pupae, empty pupal cases or as adults.

FE10EGGS are tiny, but usually laid in clumps. They are often found in a wound or natural opening, but may be in clothing, etc. Eggs are collected with a damp paint brush or forceps. Half are preserved in alcohol and half are collected alive. Eggs are especially important when maggots or later insect stages are absent. The time of hatching is vital and the eggs must be monitored every few hours.

FE11MAGGOTS are found on or near the remains and may be in large masses. The masses generate heat, which speeds up development. The site of the maggot mass, the temperature (and size) of each mass are important. Large maggots are usually older, but small maggots may belong to a different species so a range of sizes are collected.

Since third instar larvae leave the body to pupate, the soil around the body is carefully sifted. The soil below the corpse is also checked to a depth of several centimetres. Half the sample is kept alive and half preserved immediately. Preservation allows the entomologist to see what stage the maggots were in when collected. Preserved specimens may also be used as evidence in court.

FE12PUPAE and EMPTY PUPAL CASES are very important but easy to miss. Pupae like dry, secure areas away from the wet food source so clothing pockets, seams and cuffs are likely hiding places. If the remains are found indoors, they may be under clothing or rugs etc. Pupae are dark brown, oval, and range in size from 2-20 mm.  Empty pupal cases look similar, but one end is open where the adult fly has emerged. Pupae are not preserved. They won’t grow and the species and exact age cannot be determined until the adult emerges.

ADULT BLOW FLIES are not as important as eggs, maggots or pupae. They are only used to determine the species of insect. However, if an adult fly has crumpled wings, it may have just emerged and can be linked directly to the body. These are collected and kept separately. Flies smaller than blow flies are important at all stages as they are used when analyzing the succession of insects on the remains

FE13BEETLES (Coleoptera) are found as adults, larvae, pupae and as cast skins. All beetle stages are important. They move fast and are often found under the body, or in and under clothing. They should be placed in alcohol in preserve them.

Other information is also important. For the site, this includes:

  1. the habitat (woods, beach, a house)
  2. the site (shady or exposed to sunlight)
  3. the vegetation (trees, grass, bush, shrubs)
  4. the soil type (rocky, sandy, muddy)
  5. the weather at the time of collection (sunny, cloudy)
  6. the temperature and humidity
  7. the elevation and map coordinates of the scene
  8. unusual details (like whether the body was submerged)

For the remains, it is helpful to know:

  1. the presence, extent and type of clothing on the body
  2. if the body was covered or buried (and with what)
  3. if there is an obvious cause of death
  4. if there are wounds on the body or body fluids (blood etc) at the scene
  5. if drugs were involved (drugs can affect decomposition rates)
  6. the position of the body
  7. what direction the body faced
  8. the state of decomposition
  9. if other carrion was found in the area that might also attract insects
  10. if the body was moved or disturbed

Analysis of the evidence is the next step in an entomology investigation.

FE14At the laboratory, entomologists measure and examine immature specimens, placing them in a jar with sawdust and food. The insects are checked frequently and when they pupate they are removed. The date of pupation and emergence is noted for each specimen.

When the adults emerge, they are killed and stored. This process is important because adult flies are much easier to identify to species than larvae. Also, pupation and emergence times are used to calculate the age at the time of collection.

There are other uses for forensic entomology.

Forensic entomology is used most commonly to determine time since death. However, insects can provide other important information about a crime or victim.

FE15For example, insects can provide details about a person’s life before they died. Because development is predictable, depending on specific factors, the use of drugs can change the lifecycle timing of an insect. One such drug is cocaine, which causes the maggots feeding on affected tissues to develop much faster than they normally would.

Insect behavior can also offer clues about what happened around the time of death. Flies tend to lay their eggs first in moist places in the body like the eyes and mouth. If eggs or maggots are found on normally dry skin, like the forearms, before these other areas, it suggests that the skin was damaged in some way. This may be because the individual injured themselves in a fall or because they were trying to protect themselves from a weapon. In either case, an important piece of evidence has been discovered.

Finally, the species of insect can point to events that occurred after death.

FE16For instance, some insects are found only in some areas. If a species that is normally found only in the countryside is found at a scene in the city, it suggests the body has been moved at some point after death. Again, this provides an essential piece of evidence that could help solve a crime.

These are some entomology clues for homicide scenes.

  1. The presence of insects on the body that are not found in the area suggests the body was moved, and may indicate the type of area where the murder took place.
  2. If the insect cycle is disturbed, it may suggest that the killer returned to the scene of the crime. The entomologist may be able to estimate the date of death and possibly the date of the return of the killer.
  3. If maggot activity occurs away from a natural opening, this may indicate a wound. For example, maggots on the palm of the hands suggest defence wounds.
  4. If maggots feed on a body with drugs in its system, those chemicals accumulate and may be detected.
  5. If an insect is found from a specific site, it may place a suspect at the scene of a crime.
  6. If insects are found on a living individual (often young children or seniors), it may indicate neglect or abuse.

These are the limitations of forensic entomology.

  1. Time of death estimates depend on accurate temperature information, but local weather patterns can be variable and data may come from stations quite distant from the crime scene.
  2. Forensic entomology relies on insect abundance. In winter, there are fewer insects and entomology’s use is limited.
  3. Since it takes time to rear insects, forensic entomology cannot produce immediate results.
  4. Treatments (like freezing, burial or wrapping) that exclude insects can affect estimates.
  5. Since chemicals can slow or accelerate growth, insect evidence may be affected by the presence of drugs in a corpse’s system.

The last duty in a forensic entomology investigation is report writing.

FE17A report is a formal description of an event or investigation. A forensic report explains what an investigator did, how they did it, and what they think the evidence shows.  

A forensic investigator’s report is especially important because it must be able to explain the results of the investigation to a judge and possibly a jury who would not be able to attend a crime scene and observe an investigation first-hand.

There are no agreed-upon protocols or standards for writing forensic reports in Canada, but most forensic scientists use a scientific format that includes the following:

  • Report summary
  • Background (how the author became involved in the case)
  • Qualifications of the author (what makes the author an authority on the subject)
  • Materials, methods and limitations (what work was done, how and why it was conducted, and any barriers to further investigation/analysis)
  • Results (what the evidence found)
  • Interpretation of results (what the evidence means, within the area of expertise)
  • Conclusions (another short summary of the case, the findings and their importance)
  • Bibliography (what sources of information – professional literature, interviews etc – were used).

FE19

FE18Many thanks to Professor Gail Anderson of Simon Fraser University in Vancouver for sharing her expertise with DyingWords followers. Not only is Gail a world leader in her field of forensic entomology, she’s a great lady to pull maggots from a decomposing corpse with. Here’s a bio on her.

SFU’s pure research is raising the bar on solving crime. Professor Gail Anderson and her forensic entomology team have made discoveries in many pure disciplines, and law enforcement agencies all over the world are currently using them to solve crimes.

Gail Anderson’s lab exclusively examines the ways insect biology can be applied to criminal investigations. She was the first full-time forensic entomologist in Canada, and is one of just 15 certified by the American Board of Forensic Entomology. Her research has helped to identify victims and suspects; to determine how victims died; and to solve arson and poaching cases.

Recently, Anderson’s research was used to help convict Robert Pickton for the murder of dozens of Vancouver women. She has also advised on the mysterious human feet that have washed ashore in the Pacific Northwest in recent years.

One discovery at a time, Anderson and her team are helping debunk the common misconception that pure research has no practical application. They know that engaging research means mobilizing discoveries and enriching communities at the same time.

Also, thanks to Barb Winter of Simon Fraser University’s museum who runs this really cool site called Investigating Forensics where you can be a coroner for a day through interactively investigating a case of found human remains by using all the modern forensic disciplines. Here’s the link:

 http://www.sfu.museum/forensics/eng/

 

7 CSI FAILS

Working Stiff is a new release and New York Times BestSeller by Forensic Pathologist Dr. Judy Melinek and co-authored by her husband T.J. Mitchell. If you want to know what it’s really like behind the morgue door, this is a fascinating read. I’m thrilled to death to have Dr. Melinek do this guest post on Dyingwords.

Melinek11The CSI effect is a term coined by attorneys for the unrealistic expectations created by television crime shows on the public. It’s a real thing.  As an expert witness in forensic pathology I see the CSI effect when I’m faced with questions like, “Why can’t you tell us the precise time of death down to the minute, like on TV?”

Potential jurors are now being asked if they watch NCIS, CSI, Bones, Law & Order: Criminal Intent, and a plethora of other shows that depict police and other forensic professionals doing their jobs. So how close are these shows to reality? I’m here to tell you. Here are 7 things these shows consistently get wrong:

1. Somebody Turn on the Lights! 

Melenik1The first thing the police do when they secure a crime scene outdoors is set up Klieg lights to illuminate the scene while we do our work there. When I get to an indoor death scene and the lights are off? Well, we turn on the lights. Television shows striving to effect an atmosphere of suspense portray the crime scene investigators looking around a death scene with flashlights. Back at the lab, it’s gloomy and dim. The scientist is wearing a headlamp while he pokes at something bloody but indistinct. Seriously? Forensic science is done in a clean and bright lab. My autopsy suite in the morgue has the same overhead lighting as a surgery suite, with good reason: I need to see what I’m cutting. You can’t find the evidence if you can’t see the evidence, and without evidence there is no forensic case.

2. Where Do You Shop? 

Melenik2Low cut blouses and high-hemmed skirts are not appropriate attire at a crime scene. Neither are stiletto heels, platform heels—any heels. You don’t want to wobble or trip when you’re negotiating your way around a corpse on the sidewalk, believe me. Police departments and sheriff-coroners have strict dress codes and grooming rules with restrictions on hairstyles and visible tattoos. You can lose your credibility as a forensic professional if you are not wearing business attire. And one more thing: No Louboutinson a government salary.

3. Don’t You Have Anything Else to Do?

Melinek3Most forensic science jobs, whether in an office or the lab, are nine-to-five. As we say in the morgue at quitting time, “They’ll still be dead tomorrow.” There is no need to come in at two in the morning to run a lab test because you just can’t sleep until you do, or to perform an entire autopsy, alone, in the middle of the night. In fact, most offices have restrictions on entering after hours, and any technician or employee who is poking around in the lab without supervision will encounter serious scrutiny. It’s true that police officers work unorthodox hours, but they do so on a shift schedule and overtime is monitored. When the shift ends they pass the case to another investigator, go home to their families, or to bed to sleep, or off to do ordinary things like normal human beings. Unlike their television avatars, they do not single-handedly conduct an investigation around the clock.

4. You’re Dating Who?

Melinek4Why are TV forensic scientists always flirting or sleeping with cops and co-workers? Dating someone you met on the job is taboo in most professions, and even more so in a field where your work is subject to legal scrutiny. If you are caught canoodling with a co-worker you could find yourself under investigation from—no pun intended—internal affairs, and if IA finds either of you has been influenced or biased by your fraternization you could both lose your jobs. Yes, television series need steamy subplots, but do they all have to involve intramural romance?

5. Lab Results!

Melinek5DNA results in crime shows come back while the body is still warm, and the toxicology report is ready before the bone saw is even fired up. Someone please tell me where these labs with five minute turn-around-times are, because I want to send my specimens there! Tox results take a minimum of two weeks in the best labs, and DNA can take months to come back. Meanwhile, the autopsy paperwork gets filed and we wait for the results to come back before we conclude anything.

6. Where Are Your PPEs?

Left - Television   Right - Real Autopsy Gear

Left – Television Right – Real Autopsy Gear

PPE is personal protective equipment: gloves, face shields, masks and Tyvek suits, gear worn by forensic professionals while performing autopsies to keep themselves safe from blood-borne pathogens and potentially transmissible emerging infectious diseases. But PPE is notably absent on most shows, probably because directors want to see the actors’ faces. Showing emotion with your eyes, body language and tone of voice is not sufficient? If I am pissed off at someone in the morgue that’s what I do, and it seems to work just fine. OSHA would shut down these imaginary TV labs in a New York minute over these high-risk and needless violations. Nobody eats in the lab anymore either. That was something they did back in the days of Quincy ME, but it can get you fired nowadays.

And, finally…

7. Where Can I Get Me One of These?

Melinek7Most crime labs and autopsy facilities in the United States are underfunded. We are lucky to be working with basic equipment, like an X-ray machine that works reliably, and we don’t have access to the highfalutin gadgets these lucky TV scientists enjoy. Things like 3-D holographic reconstructions exist in digital-simulation labs at academic institutions, and may be used to publish papers on virtual autopsies in foreign countries, but such doodads are not available to the forensic civil servants who are doing the actual, daily work in the real world. In my autopsy suite I handle tools you will recognize from your kitchen. It’s the ultimate in hands-on investigation. I love my job. And I’d love to see it portrayed in fiction with more accuracy—because the reality of forensic death investigation is even more riveting than the fantasy as seen on TV.

Melinek11For more about real death investigation don’t miss “Working Stiff: Two Years, 262 bodies and the Making of a Medical Examiner” by Judy Melinek, M.D. and T.J. Mitchell. It’s been available on-line and in stores since August 12, 2014. For updates check in with Facebook/DrWorkingStiff or at www.drworkingstiff.com. Follow @drjudymelinek and@tjmitchellws on Twitter.

Get Working Stiff at http://www.pathologyexpert.com/working-stiff-book/

AMAZON LINK for Print, eBook & Audiobook at http://www.amazon.com/Working-Stiff-Bodies-Medical-Examiner-ebook/dp/B00GEEB8GQ

Here’s an excerpt from Working Stiff –

Chapter One – This Can Only End Badly

“Remember: This can only end badly.” That’s what my husband says anytime I start a story. He’s right.

So. This carpenter is sitting on a sidewalk in Midtown Manhattan with his buddies, half a dozen subcontractors in hard hats sipping their coffees before the morning shift gets started. The remains of a hurricane blew over the city the day before, halting construction, but now it’s back to business on the office tower they’ve been building for eight months.

As the sun comes up and the traffic din grows, a new noise punctures the hum of taxis and buses: a metallic creak, not immediately menacing. The creak turns into a groan, and somebody yells. The workers can’t hear too well over the diesel noise and gusting wind, but they can tell the voice is directed at them. The groan sharpens to a screech. The men look up—then jump to their feet and sprint off, their coffee flying everywhere. The carpenter chooses the wrong direction.

With an earthshaking crash, the derrick of a 383-foot-tall construction crane slams down on James Friarson’s head.

I arrived at this gruesome scene two hours later with a team of MLIs, medicolegal investigators from the New York City Office of Chief Medical Examiner. The crane had fallen directly across a busy intersection at rush hour and the police had shut it down, snarling traffic in all directions. The MLI driving the morgue van cursed like a sailor as he inched us the last few blocks to the cordon line. Medicolegal investigators are the medical examiner’s first responders, going to the site of an untimely death, examining and documenting everything there, and transporting the body back to the city morgue for autopsy. I was starting a monthlong program designed to introduce young doctors to the world of forensic death investigation and had never worked outside a hospital. “Doc,” the MLI behind the wheel said to me at one hopelessly gridlocked corner, “I hope you don’t turn out to be a black cloud. Yesterday all we had to do was scoop up one little old lady from Beth Israel ER. Today, we get this clusterfuck.”

“Watch your step,” a police officer warned when I got out of the van. The steel boom had punched a foot-deep hole in the sidewalk when it came down on Friarson. A hard hat was still there, lying on its side in a pool of blood and brains, coffee and doughnuts. I had spent the previous four years training as a hospital pathologist in a fluorescent-lit world of sterile labs and blue scrubs. Now I found myself at a windy crime scene in the middle of Manhattan rush hour, gore on the sidewalk, blue lights and yellow tape, a crowd of gawkers, grim cops, and coworkers who kept using the word “clusterfuck.”

I was hooked.

See more at: http://books.simonandschuster.com/Working-Stiff/Judy-Melinek-MD/9781476727257/excerpt#sthash.ToVVB0WO.dpuf

About the Authors

Melinek8Judy Melinek, M.D. is a graduate of Harvard University. She trained at UCLA in medicine and pathology, graduating in 1996. Her training at the Office of the Chief Medical Examiner in New York is the subject of her memoir, Working Stiff, which she co-wrote with her husband. Currently, Dr. Melinek is an Assistant Clinical Professor at UCSF, and works as a forensic pathologist in San Francisco. She also travels nationally and internationally to lecture on anatomic and forensic pathology and she has been consulted as a forensic expert in many high-profile legal cases, as well as for the television shows E.R. and Mythbusters.

Melinek9T.J. Mitchell, her husband, graduated with an English degree from Harvard and has worked as a screenwriter’s assistant and script editor since 1991. He is a writer and stay-at-home Dad raising their three children in San Francisco. His consult practice, T.J. Mitchell Consulting, offers advice to aspiring screenwriters. Working Stiff is his first book.

Dr. Melinek is a American Board of Pathology board-certified forensic pathologist practicing forensic medicine in San Francisco, California as well as an Assistant Clinical Professor of Pathology at the UCSF Medical Center.

Dr. Melinek trained in Pathology at University of California, Los Angeles and then as a forensic pathologist at the New York City Medical Examiner’s Office from 2001-2003. She has consulted and testified in criminal and civil cases in Alaska, Arizona, California, Florida, Illinois, Louisiana, Maryland, Mississippi, New Mexico, New York, Oregon, Pennsylvania, Texas and Washington.

Dr. Melinek has been qualified as an expert witness in forensic pathology, neuropathology and wound interpretation. She has had subspecialty training in surgery and has published and consulted on cases of medical malpractice and therapeutic complications. She trains doctors and attorneys on forensic pathology, proper death reporting and certification. She has been invited to lecture at professional conferences on the subjects of death certification, complications of therapy, forensic toxicology and in-custody deaths. She has also published extensively in the peer-reviewed literature on subjects of surgical complications, death following gastric bypass, forensic toxicology, opioid overdose deaths, immunology, neuropathology and transplant surgery.

Past clients include the Santa Clara County District Attorney, Office of the County Counsel County of Contra Costa, Marin County Public Defender, the Court Appointed Attorney Program of the Alameda County Bar Association, the Attorney General of the State of California, the United States Military, and many private civil plaintiff’s and defense attorneys. Dr. Melinek travels locally in Northern California to testify in and around the Bay Area including San Mateo, Santa Clara, Marin, Monterey, Napa, Lake, Shasta, Solano, Sonoma and Stanislaus Counties. She has also been called to Southern California to review cases in Los Angeles, San Bernadino, Riverside, Ventura and San Diego Counties.

Melinek11

 Available in Print, eBook, and Audiobook at http://www.amazon.com/Working-Stiff-Bodies-Medical-Examiner-ebook/dp/B00GEEBGQ8

ALL ABOUT AUTOPSIES

Ever been to the morgue?

Morgue DoorNo?

Well, like most people, you probably never think of the morgue except during shows like CSI, Bones or Hawaii 5-0.

But the popularity of forensic TV series is social proof that you’re interested in finding out just what goes on behind the autopsy suite’s closed door.

The word autopsy means ‘to examine for yourself’. It’s a medical procedure that sounds simple in principle – taking a look at the outside and inside of a cadaver to establish the cause of death. In practice, a post mortem examination can be highly complicated and time consuming; employing leading-edge scientific expertise.

morgue imageThere’s three types of PM’s. A hospital autopsy is a non-legal process where the cause of death is known, but the caring physician wants to confirm a specific issue – such as a cancer tumor. A routine autopsy is conducted when the cause of death is not known, but foul play is not suspected. Then there’s a forensic autopsy – the one that’s going to be torn apart in a murder trial.

All autopsies follow a standard protocol. It’s the nature of the investigation that determines just how in-depth the procedure gets. The deceased arrives at the morgue and is cataloged with personal details and a registration number. Yes, they really do use toe-tags. The body is then placed in a refrigeration unit and waits its turn for examination. In a busy morgue this can take several days.

Usually two people conduct the autopsy. The pathologist, or medical doctor who is trained in the study of death and disease, is assisted by the Deiner (German word for helper). Often there’s observers present; police officers, students, or technicians who come and go. The length of time quite varies – fifteen minutes to confirm a tumor, two hours routinely, and up to eight for a complicated forensic ordeal.

Autopsy SuiteExternal observation can take a good portion of time. The body is removed from its shipping shroud, stripped, photographed, X-Rayed, weighed, measured, and identifiers such as race, age, hair and eye color, markings, abnormalities, as well as evidence of trauma or medical intervention is recorded. In homicide cases, the bulk of the evidence can be recovered in the external exam – clothing perforations, gunshot residue, lacerations, abrasions, hair, fibre, DNA, chemical contamination, or foreign objects. The observations are recorded on notes, diagrams, photos, and verbal dictations.

The corpse is placed supine, on its back, on the examining table which is an angled stainless steel tray draining fluids to a disposal sink. A plastic block is placed under the back to elevate the chest and recline the head and arms, making internal operations practical. A Y-incision is sliced from the tip of each shoulder, horizontally to the center of the chest, then vertically down to the pubic area. The skin is scalpeled back in a butterfly pattern accessing the thorax and abdomen, then the ribcage is snipped loose, exposing the upper and lower organs.

Autopsy toolsThe major ones are removed, weighed, and cross-sectioned – lungs, heart, liver, kidneys, spleen, stomach, and intestines. Tissue sections are exscinded and fluids are extracted – blood, urine, vitreous humor, and digestive contents. These can be of immediate visual interest, or may tell later tales in toxicology and microscopic processing.

Cranial examination is the part that most newbies find difficult. The neck is now propped to elevate the head and the scalp is cut from ear to ear, peeled over the face and down the neck, then the skull cap is severed with a vibrating saw. The brain extracts easily and is often preserved in formalin to gel for later sectioning.

Tox labCompletion involves returning the organs to the central cavity and sewing-up the incisions before releasing the body to a funeral home. Tissue and liquids are retained for histology and toxicology. In forensic cases, exhibits such as bullets, trace evidence, DNA standards, and clothing are transferred to the crime lab.

Often the cause of death is conclusive at autopsy. Occasionally nothing is known until the lab results come in. And sometimes… it’s never determined just why the subject died.

Our scientific understanding of life and death is extensive, but it’s far from perfect.