The presence of blood at a scene doesn’t always indicate a traumatic death. Many times when a person dies face down, their body “purges�? a small amount of watery, bloody discharge. Other times, an even larger amount can be present. Unfortunately for death scene investigators, first responders—be they police, paramedics, or family members—perceive blood to be a sure sign of foul play. In these cases, a scene investigation is required to determine the source of the blood.

When I first started, one of the smaller police departments in the area discovered a bloody scene while conducting a welfare check on an older gentleman. Being a smaller department, they were going to have to call in the state police to conduct their scene investigation. I was already in the area, so I offered to stop by and see what I thought before they made the call. Even with my limited experience at that time, I knew my impression of “a lot of blood�? differed from an officer’s impression. My plan was to go in and have a look around without altering the scene. If I saw anything alarming, I would back out and wait for the scene investigators to arrive.

Upon my arrival, I was informed that the gentleman was on the floor of the master bath in front of his vanity. According to the officers, there was blood everywhere—on the body, on the walls, on the sink, on the mirror, on the floor—everywhere. I walked through the house and into the bathroom expecting to find a little blood here and there. As the bathroom came into view I saw how inaccurate the officers had been.

There was twice as much blood as they had described. Not even the muting effect of the wallpaper pattern could hide the blood that covered it. I did my best to shake of my astonishment and focus on the matter at hand. A common pitfall for any scene investigator is to focus on the obvious and consequently overlook the less obvious.

The face, shirt, and hands of the gentleman were covered with blood but I couldn’t see any obvious signs of injury to any of those areas. The mirror appeared to be covered with high velocity blood spatter similar to that resulting from high velocity firearm injuries. I discounted the possibility that such a firearm had been used because the mirror was intact and the damage to the body would have been much more devastating. I also knew that expectorated (coughed up) blood was often similar in appearance to high velocity blood spatter.

The bowl of the sink seemed to be covered in blood as well, forcing me to consider that the gentleman had severed a neck vein. Judging from the apparent absence of any razors and the presence of the electric razor on the sink, I discounted that possibility as well. There was also blood in the adjoining room where the toilet and tub were located. The significance of that observation was that the gentleman had lost blood in two areas signifying that he was alive long enough to move from point A to point B.

I felt pretty certain at that point that the death hadn’t resulted from foul play, so I decided to examine the body more closely. When I lifted the shirt, I saw markings on his chest that outlined the treatment field for his radiation therapy. As it turned out, the gentleman’s cancer caused a sudden onset of hemorrhage into his airway causing him to cough up large amounts of blood. The experience served as a good example of how a natural death can initially give the appearance of a violent death.