Archive for the 'Comment Responses' Category

27
Jan
07

“Manner of Death”

I’m embarrassed to admit how long ago the following question was asked. I remember setting it aside because it was a good topic and I wanted to give it a well developed answer. Thanks for your patience, Terri.

I do understand that sometimes other investigative agencies other than the coroner are relied upon to determine manner of death, but let’s say someone has a gun shot wound. All agencies know who shot this person. The question is “was it justifiable or not?” Doesn’t the coroner list the manner as homicide regardless of the justifiability?–Terri

Terri:

It depends on the particular agency or in some cases the individual that is certifying the death. Some agencies have policies on how they rule certain deaths based on a literal interpretation of the circumstances or on the charges that are likely to be filed. In some situations, the element of “intent” may help determine the manner of death.

Let’s say someone breaks into my house and I shoot them before they shoot me. I admit to the police that I’m the one who shot the intruder. Upon examination, the victim is found to have a distant range gunshot wound to the chest. When it comes to certifying, the Medical Examiner/Coroner (ME/C) is primarily focused on how the decedent died and not the issue of justifiability. That’s an issue for the law enforcement agency and the district attorney’s office to sort out when they decide whether or not to press charges.

Additionally, U.S. death certificates typically only have six options for classifying the death with no provision for justifiability. These are as follows:

–Natural
–Accident
–Suicide
–Homicide
–Pending Investigation (or Pending Further Studies)
–Could not be determined (or Undetermined)

In my shooting scenario, there’s a gunshot wound involved so Natural is out. I intentionally discharged the weapon, so Accident is out. The victim didn’t pull the trigger, so Suicide is out. The certifier may elect to classify the death as Pending Investigation/Further Studies, but at some point they have to place the death into one of the other categories when the investigation is officially completed. “Could not be determined” doesn’t apply because we know what happened.

Let’s say the above victim was actually found dead in his front yard with the same distant range gunshot wound to the chest. Without knowing the particular circumstances of the shooting, we can infer that someone else pulled the trigger and the death should therefore be classified as a Homicide.

Now, let’s say I was out hunting with some friends of mine, my shotgun accidentally discharged, and one of my friends was fatally shot. Two separate investigations would then follow. Law enforcement would investigate the shooting incident and the ME/C would investigate the resulting death. Regardless of my intent, our policy would have been to classify the death as a Homicide because we use the literal definition of Homicide—the killing of one person by another.

Even though the manner of death is listed as Homicide, law enforcement may conclude that the shooting was indeed accidental and the prosecutor may decline to press charges. The end result is that the ME/C has taken law enforcement’s investigation into consideration but ruled differently. Conversely, the ME/C may classify a motor vehicle fatality as accidental, but the agency and prosecutor may elect to pursue manslaughter charges because the surviving driver was intoxicated.

The reliance of the ME/C on other investigative agencies to accurately classify the manner of death is really quite common. The postmortem examination can verify that someone died from a hard contact gunshot wound to the head, but—in the absence of obvious physical evidence—such an examination will not indicate unequivocally that the wound was self-inflicted. It is typically law enforcement’s investigation that provides the information necessary to distinguish between a suicide and a homicide. Details such as recent personal loss, severe depression, or suicidal ideation are common indicators of suicidal intent.

I should also point out that there’s a reciprocal element to this reliance. Many times the law enforcement agency may treat a death as a natural event pending any information to the contrary from the ME/C.

11
Aug
06

“Autopsy vs. Investigation”

Dianna writes:

My sister recently was discovered by her husband , hanging in the barn. She lived in a rural setting and was isolated. There was a 2 year history of spousal abuse and in fact her husband had been charged and was convicted of assult against by sister. He served 6 weeks in jail, was on probation and required to receive treatment for anger management. I recently returned from a meeting to speak with the law enforcement who dealt with the case. They informed me that they were aware of a 2 year history of spousal abuse. They stated that they were wary when they were called to the scene because of the history. They said they could find no evidence that there was foul play involved and that it was a simple suicide by hanging. There was table at the scene with a large plastic drum on top. They said they saw a footprint in the dust and oil on the drum but did not check to see that it matched her shoe size (which was small for an adult – size 5) They also said that one of her shoes lay approx 20 feet from the body. They assumed that she had kicked off the shoe in her struggle. They also stated that there was no rigor mortis of the body.

After phoning the coroner, I was told that I could not ask for a full autopsy and in fact they did only a superficial or external autopsy. They did say that there was no tissue under the finger nails and no scratches or marks on her neck other than the ligature mark.. My question is … if she struggled as she died enough to kick off her shoe would she not have had some sign of grabbing the rope or trying to loosen it from her neck. I understand that in a short drop hanging, regardless of how committed the individual is to taking their life there is an automatic response to preserving her airway. The only toxicology study they did was for blood alchohol level. Nothing else. My second question is why would they not do a complete autopsy when there was a history of spousal abuse, she was isolated and found by her husband. Why did they not do a full toxicology screen? They also did not estimate the time of death. I would really appreciate any answer you could provide me with especially in what they look for in a short drop hanging. Thank you so much.

Dianna:

Not having worked the scene myself or having access to all the information, I don’t feel comfortable commenting on the particular circumstances of the death. I can however shed a little light on your questions about how the case was handled based on the general procedures of most coroner and medical examiner offices.

The reason you were likely told that you couldn’t ask for a full autopsy is that the general public doesn’t have the legal authority to request an autopsy. In many cases where there is an obvious cause of death like a gunshot wound, a crushed chest, or in your sister’s case a ligature around the neck, an autopsy isn’t deemed necessary to determine why the death occurred. Reason being is that all an autopsy is going to accomplish is to verify that someone died as a result of their trauma. That is why the extent of the coroner/M.E. investigation may only involve an external examination.

The best comparison is to think of a vehicle in a car crash. A mechanic doesn’t need to tear down the motor to figure out why the car doesn’t run when the engine has been pushed into the cab of the vehicle.

If I were in your position, I’m sure I too would be shocked that no one felt a full autopsy was warranted when taking into account the spousal abuse and isolation that were involved. However in my position, I understand that forensic pathology is limited in its application. In cases with no sign of trauma or foul play, the coroner/M.E. determines both the cause and the manner of death. In traumatic or suspicious cases, they only determine the cause of death and rely primarily on the law enforcement agency’s investigation when classifying the manner of death.

In other the words the coroner speaks for why the person died and law enforcement speaks for how the person came to be injured in the first place. The point here is that the coroner can only account for the cause of death. Neither an external exam nor an autopsy are going to tell how a person came to be injured or whether they were “helped along‿ with the circumstances leading to their death. Many law enforcement agencies have felt your frustration when their request for a full autopsy on an individual with a ligature or a hard contact gunshot wound to the head is denied. They are told what many families are told—an autopsy is only going to confirm that which is already known. Beyond that, any involvement on the part of anyone else is a criminal matter and by law falls under the jurisdiction of law enforcement.

The coroner/M.E. could have interviewed the husband on issues related to the how your sister was found, but does not have the legal authority to treat him as a suspect. Typically the end result is that in traumatic cases, the coroner/M.E. isn’t likely to officially classify a death as suspicious when it conflicts with the investigation of law enforcement. That’s not to suggest a conspiracy though. It’s just that the coroner has no evidence to prove otherwise. They may have a different opinion or a gut feeling, that something is amiss, but they can’t (or at the very least shouldn’t) base their conclusion on speculation. On the other hand, law enforcement tends to rely heavily on the impression of the coroner—if the coroner isn’t comfortable then law enforcement generally isn’t either.

As for the toxicology study, in cases where there is an obvious external cause of death a full tox screen is rarely done—the reason being that positive test results won’t do anything to change the manner of death. If someone puts a gun in their mouth and pulls the trigger, a likely cause of death is “Intraoral Gunshot‿ with a manner of “Suicide.‿ There may in fact have been drug or alcohol involvement that affected the person’s sense of reason, but the bottom line is that the person took their own life and the death is therefore ruled a suicide. Using the mechanic analogy again, the wrecked car may have had faulty brakes which played a major role in the crash, but the reason the car no longer runs isn’t damage to the brakes, it’s the damage to the car.

I understand that the presence of foreign substances in a person’s system may be of key interest to a family member who is trying to come to terms with what their loved one’s state of mind may have been when committing suicide, but for medicolegal investigative purposes it is essentially irrelevant. Specimens are typically held by a tox lab for a certain period before they are destroyed. If the family wishes to obtain samples for private testing, they can usually do so with a court order.

For information on the time of death issue, here’s a paragraph from “Agencies, Answers, and Assumptions.‿

Among the countless ways that crime scene dramas misinform the general public, “time of death‿ is perhaps the most misleading. In most cases there simply aren’t enough solid physiological markers to establish an accurate time of death, and the longer someone has been dead, the more difficult it is to be as accurate as Hollywood portrays. As such, it is not uncommon for a person’s “time of death‿ to be listed as the time that they were found. The time of the original call to 911 is usually the first documented time and serves as a solid “found‿ time. Please refer to my post on “Postmortem Interval‿ for more information on the subject.

Hopefully this information helps you in some way.

A Douglas

07
Aug
06

“Three Skulls in a Ballroom”

Jayne wrote:

I think it’s creepier going under the house than finding the bones. I’m very claustrophobic. I have a question for you: Back in 1991 (in Hermann, MO) my dad bought this old general store that also had a ballroom and small stage. My brothers and I were exploring the ballroom which was filled with all sorts of neat things left behind years ago. I got the fright of my life when I found a box, opened it, and three skulls on top of a pile of costumes were staring up at me. Although we called the police, they sent over the coroner who just picked up the bones and left. We did find out that they were human, but that was it. It seemed odd that we never heard anything more and there seemed to be no investigation. Neither was there any mention in the news. I know you don’t have the answer, but would just like your point of view on this. Was this handled normally? Or was it small town indifference toward old bones? How would such a discovery be handled (such as the bones under the house) if bones were human?

Jayne:

I hate to make assumptions without knowing all the particulars of the case, but since you asked for my point of view it sounds fairly normal to me. In many cases, about the only thing a coroner/medical examiner can do with certain skeletal remains is determine the sex, race, gender, and age of the deceased based on certain skeletal traits and measurements. A dental comparison or DNA extraction might be possible, but unless there are dental records or an existing DNA profile from a suspected individual to compare with, then all the dental restorations or genetic material in the world is of little value.

Unless there was an apparent traumatic injury to one of the skulls, chances are there was very little the coroner/medical examiner could do to determine the cause and manner of death when the rest of the remains are absent. As such, the investigation—which is really just a partial examination—may not yield anything worth reporting and give the impression that no investigation was conducted. I would guess that the skulls were sealed up and stored at the morgue until a positive I.D. could be made.

Unless the media knew specifically that the skulls were discovered, they wouldn’t have had a reason to call the morgue and ask for information regarding them, so it’s likely there was nothing ever reported in the news.

When it comes to the scene detailed in “Them Bones‿, if I had determined that the bones were human, I would have backed out of the scene immediately and contacted the police department’s crime scene unit to see if they wanted to document the scene before I proceeded. From there, we would work the scene as thoroughly as we would any other suspicious death. Believe it or not, bones are found quite frequently. Fortunately they are almost always determined to be non-human.

A Douglas

02
Aug
06

“General Scene Photography”

I just found several comments that were somehow diverted into my “spam‿ folder. I’ve now posted all of them with the exception of a few that I’ll be responding to in “post‿ form here on the main page as soon as I can.

Kate asked:

Do you generally take photos from all angles when picking up a body, or just a few? I’ve often found them to be very useful, though they don’t always seem so right at first.

Kate:

We generally take quite a few photos of the decedent, the scene, and any obvious or suspected mechanism of death. Oftentimes the law enforcement agency working the death takes photos of the scene, but we still take our own photos because what we find to be of interest may differ from what they elect to photograph. If we rely on other agencies’ photos, then we risk not getting the photographic documentation we may need later on in our investigation. Plus, when working with some of the smaller agencies, our camera may be the only camera at the scene.

As for the body, we generally take distant photos that show the body in relationship to the overall scene. We then take a couple of photos of the body itself in full frame and an i.d. photo of the face.

If there is an obvious or suspected mechanism of death (firearm, ligature, pill bottles, aerosol cans, etc.) or other pertinent evidence present, then we photograph those as well. At minimum, we like to get a shot of the mechanism or evidence in relation to the body, an overall photo of the item, and a close up of any evidence on the article itself (such as blowback on a gun or vomitus containing macerated pills).

If there are any fatally traumatic injuries to the body, then we get a close up shot of the injury with an anatomical landmark for reference. Of course these injuries are photographed at the morgue as well, but taking photos of them at the scene ensures that they are documented prior to being disturbed during transport.

Thanks to digital photography, we’re able to take as many scene photos as we like without the added expense of developing and we are able to see the photographed image as we take them. When digital photos were first used at crime scenes, there were grumblings about their technical susceptibility to being altered, but we’ve found them to be just as admissible in court as the old 35mm photos. When it comes down to it, it is the testimony of the expert on the witness stand that “vouches‿ for the photos as an accurate representation of the actual scene.

These of course are just the broad strokes of how we document scenes photographically and should only be perceived as a thumbnail sketch of forensic photography.

A Douglas

08
May
06

“Diagnosis Drowning”

The following comment/question was posted by TCat .

I was wondering if you could tell me what a body of a child looks like after being in the water(drowned)for 2 weeks to 1 month. The weight 110lbs. Drowned or Murdered/ Sexually Assaulted? is the question. Fully clothed. Any criminal knows that water will wash evidence away, all you have to do is watch TV. What if the examiner does not do an accurate examination and the cause of death is ruled “AN ACCIDENTAL DROWNING” just because they can tell the body has been emerged into water for a long period of time when other evidence points to foul play? Would ligature marks show up? What about strangulation marks? Are they even looked for? I figure that it is easier to speculate drowning in a case like this and move on to the next case. 20 ft and icy?

Please reply

TCat,

Ideally, every case is treated as suspicious until evidence supporting such a suspicion is ruled out. Still, any death involving a child or a drowning is placed under even more scrutiny–if such a thing is possible (i.e., giving a case 120% instead of just 100%). That said, any recognizable signs of ligature marks and strangulation that remain visible–internal or external–should be recognized during the course of a standard postmortem examination.

The temperature of the water and the physiology of the individual dictate the extent and rate of progression of postmortem changes. From the two weeks to one month range you presented, I would expect to find extremely wrinkled skin on the hands and feet, bloating, skin slippage, and discoloration–but these characteristics are likely to progress more slowly in icy waters. Depending on the length of submersion and the condition of the body when found, there should be findings like edematous airways and enlarged lungs at autopsy that confirm a drowning took place rather than simply a disposal.

Even if a body was submerged for an extended period of time, assuming it was an accidental drowning would be as inaccurate as calling it a homicide without specific signs of evidence on which to base the classification. The possibility that exposure of the body to the elements may have “disguised” potential evidence is exactly the reason the death would be classified as unknown because a possibility exists that it could be either. In other words, an accident isn’t a “default diagnosis.” It should take as much evidence for a pathologist to rule a death as an accident as it does for them to rule a death as a homicide.

Water may wash away external trace evidence deposited on the body, but it doesn’t wash away trauma inflicted on the body or preserved within the body. As far as criminals and television are concerned, if criminals are watching television, it isn’t making them any smarter. Fortunately, most homicidal acts are committed on the spur of the moment with little effective premeditation on the part of the perpetrator. I say fortunately because it tends to make the crime easier for police to solve. Based on the resolution rate of television cases, you’d think criminals would learn to give up their profession altogether, but apparently they haven’t learned that either.

Soapbox Warning

On a personal note, I feel that any medical examiner who would find it “easier to speculate drowning in a case like this and move on to the next case” should move on to their next career.

A Douglas

03
May
06

“Agencies, Answers, and Assumptions”

With Sherry’s permission, here are three emails she sent to me after I responded to her original question in the post “Violent and Unnatural.? I’ve also included my responses.

Thanks for the clarification. Makes sense. First reasonable explanation I have received in 15 years since his passing. Yes, the puzzling part is that it was classified an accidental death yet the police report remain sealed and classified a suspicious death. Took me 7 years to get the police report and when I did most information was blacked out including a suspects name. Yet police never resolved the case.

Dad had a 2-1/2″ by 3/4″ hole in the back of his head on the left side. I raised many questions during that period of time. Coroner told me he didn’t know what the weapon was except it was a hammer. I thought the same as you about the gun. It was no accident I am positive of that.

What do you make of this one?

Again, thank you.

Sincerely,

Sherry

I’m sure that if I were in your shoes, I would find it alarming that one agency determined the manner as accidental while another agency maintained the death was suspicious. It seems incomprehensible that two separate agencies with two distinct groups of professionals specifically trained in their roles couldn’t come to some agreement.

It’s been my experience that medicolegal agencies and law enforcement agencies almost always reach the same conclusion at the end of the case. To a certain extent there is a symbiotic relationship between the two agencies. The medicolegal agency needs the investigative work of law enforcement and law enforcement needs the pathological diagnosis of the medicolegal agency.

That’s not to say there can’t be disagreement between the two. Law enforcement may suspect foul play in a child death, but if there is no evidence to confirm their suspicion, no self-respecting forensic pathologist is going to manufacture findings just to help law enforcement build a case.

Different agencies also have different departmental policies. A medical examiner system may classify alcohol related fatalities as accidents while a law enforcement agency or district attorney’s office may classify them as homicides.

I can’t offer any insight into the police report you received. Where I work, all of the details contained in our report are public record and available to anyone who requests a copy.

God bless you for taking your precious time to help me understand that miserable medical examiner’s report. I am blessed to have your comments. I have sent you an additional e-mail. Maybe some day you can answer that as well. Not one day in 15 years have I stopped that about that day my sweet Dad died and all the un-answered questions no one would provide. I’m no medical examiner or coroner but only an idiot would have believed the BS version they handed me.

Additionally, I had the foresight to collect and preserve evidence at the scene and have submitted it for forensic testing. Thank God for scientists and decent, honest professionals like you. In 1990 I had one sample tested and all I could get was that the DNA at that time belonged to only 9% of the population. Wasn’t my father’s as he belonged to 37.5% of the population. New age, new technology today, and my finger’s are crossed. Makes me want to get into forensics and pathology field.

Thanks again, my friend.

God Bless You Always.

Sincerely,

Sherry

I can’t imagine it serves as any consolation, but even in cases where the suspected events and motives are very cut and dried, family and friends are often still faced with numerous unanswered questions that can haunt them for the rest of their lives. I’ve dealt with a lot of family members (both satisfied and dissatisfied) and it appears to me that the best anyone can do is continue living their life with a strong belief that they are right no matter what anyone else says. That’s not to say that such a belief should consume your life, but hopefully will allow you to move on past the point that you feel everyone else must agree with you in order for you to have closure.

As for DNA, here is all I know about the subject, and all I ever plan to know—I know it exists, and I know there exists people that understand it so that I don’t have to. As such, I can’t shed a lot of light on any DNA issues other than G to C and A to T. That’s about the only detail I’ve retained from the seemingly numerous presentations on the subject I’ve endured.

My mind is racing from your comments and I thank you. The head injury I described to you is that consistent with a gunshot wound to the head? There are so many unanswered questions. Cops didn’t care, medical examiner didn’t care, and there wasn’t even an accurate time of death. Time of death was when they put him on the gurney and took him to the morgue. How ridiculous.

My dad deserved so much respect. He was a good, kind, decent, respectable businessman in our community. And, the best father in the world. Everyone always wanted my parents for their own. I could go on and on but I know you are very busy. Thanks for your help.

God Bless.

Sherry

As a general rule, I’ve long since avoided commenting on trauma that I didn’t examine first hand. Reason #1 is that I feel I’d be grossly misrepresenting my abilities if I were to do so. Reason #2 is that I feel anyone who doesn’t abide by Reason #1 has just ventured onto the path of becoming a medicolegal prostitute, also known as a “paid whore.? This is the kind of forensic “expert? who either blatantly manufactures findings or simply sees things a certain way for monetary or professional gain.

I may be missing something in the details you provided, but I’m curious as to what would lead the coroner to state “he didn’t know what the weapon was except it was a hammer.? I can only assume that the hole you described was the only hole in the head and that no projectile was discovered within. I can also only assume that there were no deposits from the weapon such as gunshot residue, powder burns, or stippling around the wound or signs of stellate tearing that would suggest that a weapon was involved. As you can see, there is a lot of room for assumption—another reason I don’t like to comment on things I haven’t witnessed myself or listen to anyone who does.

Among the countless ways that crime scene dramas misinform the general public, “time of death? is perhaps the most misleading. In most cases there simply aren’t enough solid physiological markers to establish an accurate time of death, and the longer someone has been dead, the more difficult it is to be as accurate as Hollywood portrays. As such, it is not uncommon for a person’s “time of death? to be listed as the time that they were found. The time of the original call to 911 is usually the first documented time and serves as a solid “found? time. Please refer to my post on “Postmortem Interval? for more information on the subject.

Good luck to you…

A Douglas

20
Apr
06

“Violent and Unnatural?

On my dads autopsy report it stated violent, unatural
death, means/weapon. What does this mean? It was
classified an accidential death. However, the above
description does not make me feel that way. Please
comment.

Thank you.

Sherry

Sherry:

Autopsy reports generally contain the same “matter of fact” terminology that is commonly found on death certificates–very literal terms that refer to broad classifications. In your father’s case, “violent” and “unnatural” are the literal but broad terms (and fairly redundant as “violent” essentially implies the death was “unnatural.” The primary reason these terms are used is that they need to be “codeable” or placed into broad categories for the purpose of generating statistical data at a later date. As such, these terms are helpful to the poor soul who enters death info all day, but they can be very confusing to family members.

For families, it is usually best to focus on the pathologist’s conclusion at the end of the autopsy report (may be titled differently, but serves the same purpose). It is in this summation that the pathologist gives their reason for determining the cause and manner of death and consequently selecting the categories used when certifying the death.

Keep in mind, the “cause of death” is the precipitating factor that leads to the death and the “manner of death” is how the cause is classified. For example, a common cause of death is “Gunshot Wound to the Head.” Based on the circumstances of how the shooting occurred, the manner of death could be homicide, suicide, accident, or unknown.

Based on what you’ve written, the words “violent, unnatural death” says to me that the death wasn’t natural. Such a statement requires a certain degree of specification–in this case a weapon is listed as the means. If your father had died in a car crash, the report would likely have read “violent, unnatural death, means/vehicle” classified as an accidental death. At any rate, neither of these abbreviated explanations offers much detail as to how the individual became injured. That’s why I encourage you–as I have others–to focus on the pathologist’s conclusion when trying to understand the logic they used in classifying the death.

Upon reading “violent, unnatural death, means/weapon” I assume that the weapon was a firearm. That’s understandable and fairly common. The only curious thing that jumps out at me is that the death was classified “accidental.” Please note I said “curious” and not “inaccurate”–I certainly don’t know enough to argue one way or the other. It’s just that (in my experience) accidental firearm deaths are fairly rare. That said, I am forced to assume there was some fairly concrete evidence that the shooting was truly accidental (such as statements from more than one witness).

Also keep in mind that the logic of the pathologist or jurisdictional policy may play a role in any manner of death determination. Here’s a somewhat timely example:

Let’s say Vice President Dick Cheney actually had shot and killed his hunting partner. In some jurisdictions, the death of the hunting partner would be classified as an accident by the coroner/medical examiner. That seems reasonable enough as the Vice President didn’t intentionally shoot and kill the man. The District Attorney’s office could still prosecute the case as a negligent homicide if they so chose.

In other jurisdictions, the death could be classified as a homicide by the certifying office. Some jurisdictions don’t get involved in the argument of “intent” when one person kills another. When one person takes the life of another, they call that a homicide regardless of whether the assailant intentionally killed the deceased. The District Attorney’s office could elect not to prosecute such an act based on the circumstances even though a death resulted.

It’s a little tricky to explain that words appearing to be so exact are in actuality fairly vague to those seeking answers or closure. I hope I’ve answered your question instead of confusing you more.

A Douglas