Archive Page 3

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

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27
Mar
06

“Whatever Happened To…�

My apologies to anyone who may have been expecting, “The Girl of My Dreams—Part III.� I’m afraid there isn’t one. Part of the reason I ended “Part II� so abruptly with numerous questions left unanswered was to illustrate the fairly routine lack of closure associated with this job. Additional apologies for the delay in completing this post, as I hadn’t meant to delay the explanation this long.

I’ve long since become accustomed to this particular aspect of the job, so I suppose it affects the people I know even more. For every “remarkable� or unusual case I work, I may mention the particulars to a few people. If these few people are curious enough, they naturally ask me about the outcome of the case down the road.

I always feel like I’m somehow disappointing friends, family, and police officers when they ask questions like:

“What was the little girl’s cause of death?�

“Whatever happened to the parents?�

“Isn’t it a homicide if she died because of neglect?�

It’s at that point I’m forced to admit that I have no idea what the ultimate outcome was on a case.

Here’s why:

Once I’ve done the scene investigation and prepared the paperwork, my role in the investigation is for the most part completed. Unless the case requires some immediate follow up work at the time of the autopsy, I’m pretty much done with the case as soon as I inform the respective agency as to what our findings were. The dynamics are a little different on a homicide case, requiring more work to collect evidence and more conversations with the respective agency about the particulars of the case.

So beyond the day after the autopsy, there’s a very good chance that I’ll never have any involvement with a particular case again. Many of our cases require further investigation such as toxicology and histology. These additional tests mean that it could be months before the pathologist determines a cause of death. During this span of time, I will likely have brought in several dozen more cases.

When a case is finally closed, it’s basically a clerical matter that is handled in the front office and nothing that I ever see again unless I go and check. Unless I’ve remained in contact with the investigating agency or seen an update on the news, I may never know the final determination on a case.

I’m not sure if I ever knew what the little girl’s cause of death was. I don’t remember her name, but I recall enough of the details that with a little effort I could pull her case and find out. But then I think, in the grand scheme of things, “What difference would that make?�

Of course, that only explains why I don’t know the cause of death. As for what happened to the parents and whether she died from neglect—I can’t explain those at all. I can only assume that the case workers from child welfare arrived shortly after I left. Whether or not anything positive came from their visit is a separate issue. Neglect isn’t a pathological finding discovered at autopsy and is generally an issue for the judge, jury, and attorneys to sort out. To a certain degree, I’d rather remain blissfully ignorant on both issues.

So how do I answer those questions from friends and family? I typically don’t. I’ll offer something along the lines of, “I forgot all about that one,â€? and politely pretend to be as curious as they are as to what the answer might be. Depending on the case, that may or may not be a true statement, but it’s a lot easier that explaining all I’ve written here. I’m pretty sure no one wants to hear the sad truth–that for every case that sticks out in my mind, there are a hundred that I forget completely.

20
Feb
06

Click here for “The Girl of My Dreams—Part I�

I’ve walked into scenes spattered with blood before and not been shocked—reason being that when someone has been beaten to death with a hatchet it’s natural to walk in expecting to see some blood. But this scene was nothing like that. Not a drop of blood, and yet I was shocked nonetheless.

The bedroom itself appeared as though a laundromat had exploded. There were clothes scattered everywhere with the exception of two places. The first was an area on the full size bed that had been cleared just enough for an adult to sleep. The second was an area of floor in the corner of the room with one of the large round cushions that are available at any pet supply store. The fact that it was made for a large animal to sleep on didn’t discourage the girl’s caregivers from concluding it was an appropriate spot to place a child needing special care.

I understand that not everyone in this world can afford a crib or a bed and that some people have to make do or improvise. If that were the only issue, it could have easily been overlooked.

But it wasn’t.

The girl was lying face up in the center of the cushion. Scattered around the perimeter of the cushion and the room were dozens of empty cans of Pediasure that—when used with the tiny funnel and syringe that was present—were apparently administered through the girl’s feeding tube.

I snapped a few distant photos and as I stood counting the empty cans, one of the technicians asked, “What’s with all the baby powder?�

He was referring to the white powder that had been scattered all over the girl and the pad as though she had been dusted with powdered sugar like a pastry. As I knelt down in the garbage next to the pad I noticed a small canister that was different from the Pediasure cans. Examining the canister I realized the baby powder was actually lice powder and a closer look at the girls head confirmed the presence of insect activity on her scalp.

During the entire external exam, it felt like there were bugs crawling all over my forearms. Thankfully, it was just my imagination. Part of me wanted to find some sign of trauma so I could at least go home knowing that the little girl’s parents would spend the night in jail. I borrowed the cleanest baby blanket I could find and spread it out on top of the cans, diapers, and clothing and wrapped the little girl inside.

I exited the house with the lieutenant, gave the funeral home the go ahead to remove the body, and asked the lieutenant to introduce me to the family. At this point I was simply going through the same routine I always did with families: introduce myself, let them know what I’m doing there and where their loved one is going, and answer any questions they have at that time. If I hadn’t just been going through the motions, God only knows what I would have said to them.

After giving them one of my cards, the lieutenant walked with me back to my car.

“Do you think we ought to call Homicide out?� he asked.

“No. But if you’re not going to call Child Welfare, I damn sure am.�

“They’re on their way,� he assured me.

I got in the car and headed home, scratching my forearms from time to time.

13
Feb
06

Late one night I was called out to a house in one of the lower economic regions of the city. It was actually my first trip to this particular area. I’d driven past it numerous times on the expressway and never even knew it was there. There are several of these types of areas in this and every other city I suppose. Thousands drive past them on the interstates and main roads and never actually go through them. These are areas of the city I would never drive through if it weren’t for the fact that there were police officers waiting for me.

This particular part of the city was certainly known to law enforcement. The fact that one of the major thoroughfares for rail traffic in the city was only two blocks to the west would have made one think that I was now on the wrong side of the tracks. One look down the street to the neighborhood on the other side of the tracks, and I was immediately aware that neither side was particularly enviable.

As I parked across the street from the address, a police lieutenant appeared from nowhere as I opened the door. He spoke quietly so that only I could hear, “We’ll talk inside.�

He then ushered me past a large group of people that had accumulated in the driveway and we made our way to the front porch. An officer on the porch nodded at me with a look as though he recognized me from some previous scene and opened the screen door. I nodded back politely, though in truth I didn’t specifically recall him. It’s fairly easy for thousands of officers to remember a dozen or so death investigators. It’s not so easy the other way around.

My first clue that the inside of this house was going to be an absolute pit was the circuitous route that the lieutenant and I made to the front porch as we navigated our way through car parts, appliances, and broken toys. People who give little regard to the impression their front yard makes seem to care even less when it comes to the part of their property that is not in the public eye. I have yet to walk across such a yard and enter a house where I would consider sitting down or touching anything without gloves on.

As I entered the house I couldn’t help notice the pie-shaped “snow angel� pattern that the front door had carved in the debris that covered the living room floor. Beyond that, a small path had been trampled in the garbage that forked at the other end of the room and led to other parts of the house. It was along this path that the lieutenant and I now stood along with another officer and two crime scene technicians, each of us seemingly afraid to step off the main path into the surrounding area.

I got the rest of the information I needed from the officer inside the house. A mother had gone to check on her two and a half year old girl and called 911 when the little girl didn’t respond. The officer had arrived at the scene shortly after the paramedics who were in the process of checking for vital signs. The lack of vital signs and the obvious presence of rigor mortis was enough for the paramedics to pronounce the girl dead at the scene. The little girl was also known to have some sort of debilitating disease because paramedics noticed that she had a gastric feeding tube in place.

After the briefing in the living room, I carefully followed the two crime scene technicians into the back bedroom of the house. To say that I was shocked by what I saw is an understatement. The significance of first exposure to that scene was evidenced by the way that both crime scene technicians were looking at me to see my reaction.

Stay tuned for Part II…

19
Jan
06

“Room to Breathe�

I’ve spent the better part of the holidays and the first part of January catching up on e-mails. They seem to take up a lot more time than I’d ever anticipated. I apologize to those that have been waiting for me to get back to writing actual “stories.” Based on my recent posts, a more accurate title for this site would be “AsktheCoroner.com.” I hope to have a real story written very soon. In the meantime, here’s a posted comment I received recently along with my response.

Hi, I’m having a terrible time with residual odor in my apartment after a death in neighboring apartment in mid-December. The body went undiscovered for between 10-14 days. The apartment was below mine on the ground floor sharing a wall with a deli. Now the deli, my apartment and another apartment adjoining mine, all have a terrible odor.

The neighbors had been reporting an odor since December 16th and were told a rat/mouse had died in the wall. The smell of decay was awful by the 23rd, it had invaded the lobby and hallways. The body was removed on December 26th. According to the apartment owner, the police came into the apartment and placed some type of “pellets” there that were supposed to absorb the decomposition odor around New Year’s Day. While the owner was advised the pellets may have an odor of their own, they nor the advanced decompostion, were supposed to have a negative impact on the neighbors affected by the odor.

I had been away for the holidays at the time the body was discovered and arrived home on the 29th to find my apartment unlivable. The smell is so overwhelming the deli resorted to burning wood fires to cover the odor (of course the fire department was called and they were cited appropriately). The smell is acrid and almost ammonia-like…not like the odor of decay reported before Christmas.

The odor is causing my eyes, throat and nose to burn as well as causing nausea, fatigue and headaches. I spoke with several air quality experts who suggested I move out until the source apartment is cleaned and that I try ventilation (as much as possible when the apartment is vacant) and possibly an air purifier designed to handle gaseous odor removal. I also have tttropical fish and my fish tanks have become unmanageable…the gas fumes are driving the ph levels off the charts and seem to be putting bacteria in the water.

I’ve moved in with my parents in NJ, purchased a $1000 IQ multi-gas air-purifier (running on max 24 hours a day) but my apartment is still toxic. The odor is coming up through the hardwood floors, under the kitchen sink, and is also quite strong in the bathroom. The odor increases dramatically when the heat comes on. I have been driving into the City every toher day to check on my apartment and things are not improving.

The The Co-op board and building management haven’t accepted any responsibility for clean-up and the unit owner is grieving and trying to clean the unit a bit at a time herself with family/friends. She has not employed professionals and has not taken any precautions or chemically neutralized any surfaces. For that matter, the deceased’s mattress is standing in the building courtyard…when I complained about possible contamination, they cut the larger stains off and left it there. They now plan to paint th walls with sealer as a remedy.

I have tried contacting the Board of Health and gotten no response, tried the Public Advocate only to find that he can’t help a Co-op building. I don’t know where to turn, but I need to get rid of the odor and move home.

Do you have any suggestions for odor removal? Could you tell me what the “pellets” were that the police put in the apartment?

Also, do you have any suggestions on who I might contact for help at this point…I don’t have a lot of money to hire a lawyer to fight this and I don’t want it to drag on forever. I just want to breathe decent quality air in my own home.

Any help or suggestions would be greatly appreciated!

Best,

C

C,

The only effective remedies I’ve ever known are ventilation and time. Of course it’s harder to ventilate a house in the winter when one has to worry about pipes freezing. While the odor is extremely repugnant, I personally have never experienced respiratory burning, eye irritation, or headaches—even after hours of exposure to the smell in a confined space.

I’ll admit that when I first started there were some nauseating effects, but in retrospect it seems to have been more of a psychosomatic effect of knowing the origin of the stench. Now I find that the longer I’m around the odor, the more my olfactory senses become “acclimated.� Sort of like walking into a public restroom after someone has fouled up the atmosphere—multiplied by 100 of course. The smell doesn’t go away, the nose just gets used to it.

That said, the odor you describe (“acrid and almost ammonia-like�) and its persistence long after the death makes me think you are actually smelling someone’s failed attempt to clean or cover up the smell. It sounds like the symptoms and situation you describe are more likely to result from exposure to a meth lab than to a dead body. I’m not suggesting that as a possibility—it just sounds awfully familiar.

Smells are like smoke—where there’s smoke, there’s a source. If the smell doesn’t go away, then there is likely biological contamination in the carpet, padding, or ventilation that will have to be removed before the smell will go away. My money is on the ventilation system as the intensity increases when the heat comes on.

I myself wouldn’t worry about exposure related issues unless I came into physical, unprotected contact with biological fluids. I suppose airborne pathogens are a remote possibility, but not after this amount of time.

Keep in mind that the persons most at risk are those that handled the body within close proximity to the time of death. People moved him, examined him, transported him, and prepared him for disposition and most likely managed to do so without any short-term or long-term consequences. If there are long-term hidden effects of dealing with dead people, I’m screwed.

Please don’t think I’m making light of your concerns. I’m only trying to emphasize that people have been dying for centuries without adversely affecting the living—excluding the Black Plague of course. Unless you have a problem with biting rodents, I wouldn’t worry about health effects.

I’m curious as to what pellets the police used myself. I’m not aware of any sort of product. I know many fire departments have a solution that they apply to contaminated sections of pavement after motor vehicle fatalities, but I doubt that would benefit you since your problem seems to be smell.

I’m most curious that the police would’ve been concerned about the smell at all. Ordinarily, the clean up of any mess created by the deceased has always been the responsibility of the property owner. The logic being that the taxpayers shouldn’t be held responsible for the expense or effort required to clean up a scene.

My only knowledge of co-op boards was gleaned from watching reruns of Frasier. As for legal issues apart from criminal or civil cases involving death, I know even less. I’m afraid I haven’t been much help, but I hope some of what I’ve written proves to be of use. I plan to use your comment as the subject of a post in hopes that someone else might be able to offer you some useful advice. The only comfort I can offer is that there are thousands of residences across the country that have contained decomposing bodies that are inhabited today, and I’m sure yours will be too.

Good luck to you.

A Douglas

17
Dec
05

“Autopsy Reports�

Apologies for the delay since my last post. I’ve spent the last couple of weeks trying to catch up on emails and responding to comments. I’ve included one comment in particular (along with my response) that dealt with some issues I haven’t discussed before that may be of interest.

I found this article very interesting. I am looking into the death of my son, who died of an accidental overdose of morphine 2% ug/ml and codeine ug/ml. The corners’ report states he died between 0500 of 9/6 and 1320 9/7.

Liver mortis as positioned fixed; rigor mortis full body. There is as a statement of skin slippage. Dark gray discoloration around his neck.

He checked into a hotel, but had no identification.

There is more information if this would help assist in determining just what happened. You see he died in 1995 with no one in his family being notified. He was not married. And had left my home on 9/1/95 over 1200 miles from where he died.

Thank you for you response.

J

J:

Based on what you included in your email, there are a few basic observations I can make. I’m reluctant to speak with too much authority on the circumstances since obviously I wasn’t involved in the entire investigation. If I did, it would be a gross misrepresentation of my abilities, if not downright fraudulent.

Most coroners rely heavily on the particular amount of a substance in someone’s system when it comes to classifying the manner of death. A level that is classified as accidental is typically a range that is considered by the toxicological professional community as a level that is just above a recreational/therapeutic level. These levels are typically seen in those individuals with an extended history of substance abuse.

Suicidal or homicidal levels are generally considered to be those levels that are much higher than accidental levels. In those cases, the person dispensing the amount of the substance necessary to precipitate death wants to be sure they administer enough to “get the job done.�

As far as the “time of death� is concerned, it’s not uncommon for there to be a very large window of time in which the death is stated to have occurred. I would assume that your son was found at 1320 on 9/7 and last known alive around 0500 on 9/6 when he was last seen by another person or possibly that was the time he checked in. As such, the coroner is only able to state positively that the death occurred within that time frame.

Television dramas tend to give the impression that coroners are able to pinpoint time of death with great accuracy and in reality that simply isn’t the case. The most accurate “time of death� is when a doctor or nurse is present at the exact moment death is pronounced or when someone dies instantly in a witnessed event like a car crash or a shooting. Beyond that, most estimations of time of death are based on observations and experience and become more speculative the longer the person has been deceased. For more on the difficulty of establishing an exact time of death, please refer to my post “Postmortem Interval�.

The notations of rigor and livor may help narrow this window somewhat, but their value depends on when they were observed. If they are observed at the scene, they are very relevant. If they aren’t observed until the body is seen at the morgue by the coroner, they are of very little value considering it may be the next day or the body may have spent time in the cooler before the coroner sees it. As such, the time lapse and the cooler temperature can affect the relevance of postmortem changes.

I’m afraid I haven’t been much help or added anything worthwhile, but I at least wanted to provide you with some insight. As you continue your search for answers, please keep in mind that autopsy reports are very effective for determining the cause of death but are very ineffective when it comes to answering the “why� and “how� questions that the living desperately seek answers to when coping with the loss of a loved one.

Personally, I haven’t been in the very unfortunate position that you have been placed in. I have however had the opportunity to work with countless family members in your position with questions that are difficult—and in some cases impossible—to answer. Good luck to you.

A Douglas

25
Nov
05

“What’s That Smell?”

Shannon writes:

Recently, a man died in the apartment above mine. He was dead for several days – at first we thought his refrigerator died, and contacted our landlord. But, the next day, when blood and bodily fluids started dripping from our bathroom and kitchen ceiling – we telephoned the police.

A Hazmat team is currently working on removing the contaminated bits of the house, while we stay in a hotel.

Once they are finished, how concerned should we be that that awful smell will return – say, when the heat is cranked, or on a hot summer day?

Shannon:

Thanks for sharing your unique experience. I may have stood in pools of body fluids and have been dripped on by the same on numerous occasions, but I can’t imagine how revolting it would be if it happened in my own home.

I’ve always been amazed at how often it happens that someone isn’t discovered dead until the person in the adjoining apartment notices a foul smell. I’m equally amazed at how long that person can tolerate the smell before notifying anyone. I’ve worked scenes where the neighbor had put up with the smell for weeks. From my point of view, it seems to happen all the time. I suppose it’s so common because there are so many single people who live in apartments. It’s been my experience that there are many of these single folk living in relative isolation from the rest of the world. Virtually no one calls them or visits, so no one discovers them until they’ve been dead for quite some time. Ordinarily it’s the apartment manager who discovers them when the neighbors begin to complain.

“Crime Scene� clean up services and the like will generally remove all of the biohazardous material that is present. Pools of blood and other bodily fluids will be cleaned up. Bloodstains will be washed off of surfaces like walls and floors and those that are soaked into surfaces like carpet, padding, bedding, and furniture will simply be removed from the premises entirely and disposed of.

Of course, not every contaminated article can be removed from the scene. In your case, floor joists and such are likely stained but cannot be removed without great effort and expense. The stains on those will likely just be chemically neutralized so that there is no immediate contact threat.

As for the smell, I wouldn’t expect there to be any down the road unless some of the fluid made it’s way into your heating and air system and went undiscovered during the clean up. The smell might linger even after the offending by-products of human decomposition have been removed, but the only truly effective way to remove smell is time. Exposure to air circulation and scented candles can certainly speed up the process though.

Thanks again for the comment. I hope that answers your question.

A Douglas