Forensic Pathology (aka Medicolegal Pathology). What is Pathology? Pathology: The scientific study of the nature of disease, its causes and consequences

Forensic Pathology Forensic Pathology (aka Medicolegal Pathology)(aka Medicolegal Pathology)

What is Pathology?What is Pathology?

Pathology: Pathology: The scientific study of the The scientific study of the nature of disease, its causes and nature of disease, its causes and consequences.consequences.– Subdisciplines are Clinical, Anatomical and Subdisciplines are Clinical, Anatomical and

Forensic Forensic PathologyPathology..

Forensic PathologyForensic Pathology A branch of medicine that A branch of medicine that

applies the principles and applies the principles and knowledge of the medical knowledge of the medical sciences to problems in the sciences to problems in the field of forensics field of forensics (medicolegal).(medicolegal).

Investigates and Investigates and determines cause and determines cause and manner of death.manner of death.

ForensicsForensics: The scientific : The scientific application of methods, application of methods, techniques and procedures techniques and procedures to the resolution of problems to the resolution of problems pertaining to the law.pertaining to the law.

History of Death InvestigationsHistory of Death Investigations Death investigation techniques used in Death investigation techniques used in

the U.S. today originated in England.the U.S. today originated in England. A Death Investigator was given the A Death Investigator was given the

title of Coroner (crown)title of Coroner (crown)– Elected to protect the crownElected to protect the crown’’s interests s interests

from corrupt sherifffrom corrupt sheriff’’s.s. A Coroner could arrest suspects A Coroner could arrest suspects

including the sheriff. including the sheriff. – This is still the case in Missouri.This is still the case in Missouri.

The InquestThe Inquest

The coroner was The coroner was required to required to assemble a group assemble a group of peers to judge a of peers to judge a suspectsuspect’’s guilt or s guilt or innocence.innocence.

The group also The group also considered the considered the necessity of a necessity of a postmortem (after postmortem (after death) examination death) examination or autopsy.or autopsy.– Antemortem (prior Antemortem (prior

to death)to death)

History of the Medical ExaminerHistory of the Medical Examiner

New York city established the 1New York city established the 1stst city city wide death investigations division.wide death investigations division.

In 1939, Maryland developed the 1In 1939, Maryland developed the 1stst statewide death investigations statewide death investigations division.division.

Today death investigations are Today death investigations are performed differently from state to performed differently from state to state and county to county.state and county to county.

Coroner/ME JurisdictionCoroner/ME Jurisdiction

Sudden or Unexpected DeathSudden or Unexpected Death Violent Deaths, e.g. homicide, Violent Deaths, e.g. homicide,

suicidessuicides Unattended DeathsUnattended Deaths

– The person had not seen a physician for The person had not seen a physician for more than 20 days prior to deathmore than 20 days prior to death

Contagious Diseases, e.g., AIDSContagious Diseases, e.g., AIDS Occupational Diseases, e.g. COPDOccupational Diseases, e.g. COPD

Coroner/ME SystemCoroner/ME System

California has Coroner/ME System California has Coroner/ME System separated by county. separated by county. – We have more Coroner than ME We have more Coroner than ME

systems.systems. Some States have either a CO or ME Some States have either a CO or ME

system or it is split by Region.system or it is split by Region.

Coroner/ME SystemCoroner/ME System

Across the U.S., there are Across the U.S., there are MOREMORE Coroner Systems; these are generally Coroner Systems; these are generally represented under the setting of the represented under the setting of the SheriffSheriff’’s Office. s Office. – Some CoronerSome Coroner’’s offices are also the local s offices are also the local

Funeral Homes.Funeral Homes. U.S. (Federal) Government has their U.S. (Federal) Government has their

own system.own system.

CoronerCoroner

Usually an elected officialUsually an elected official May be appointed by the SheriffMay be appointed by the Sheriff’’s s

departmentdepartment May be a physicianMay be a physician

– May be a medical examinerMay be a medical examiner It all depends on the county/stateIt all depends on the county/state

Medical ExaminerMedical Examiner (also known as (also known as a Forensic Pathologist)a Forensic Pathologist)

Must be a Pathologist who is a M.D. or Must be a Pathologist who is a M.D. or D.O.D.O.

A doctor must have advanced training to A doctor must have advanced training to become a ME or Forensic Pathologist.become a ME or Forensic Pathologist.

To Become a Forensic PathologistTo Become a Forensic Pathologist– Four years of undergraduate schoolFour years of undergraduate school– Four years of medical schoolFour years of medical school– Internship and residency in pathologyInternship and residency in pathology– Residency in Forensic pathologyResidency in Forensic pathology

Less than 1,000 board certified Less than 1,000 board certified forensic pathologists in the U.S.forensic pathologists in the U.S.

Medical ExaminerMedical Examiner’’s Dutiess Duties

Visits death scene on requestVisits death scene on request– responds or has an investigator respond to responds or has an investigator respond to

all homicide related deathsall homicide related deaths Reviews field investigative informationReviews field investigative information Performs autopsy (aka Performs autopsy (aka ““postsposts””))

– Autopsy means to Autopsy means to ““see for yourselfsee for yourself”” Orders all ancillary tests & examsOrders all ancillary tests & exams Provides consultation to DAProvides consultation to DA Provides conclusions as to cause and Provides conclusions as to cause and

manner of deathmanner of death

What types of death need What types of death need investigating?investigating?

Violent Deaths (homicide, accidents, Violent Deaths (homicide, accidents, suicide)suicide)

Suspicious DeathsSuspicious Deaths Sudden and unexpectedSudden and unexpected Deaths without a physician in Deaths without a physician in

attendanceattendance Death in custodyDeath in custody Deaths during or after a medical or Deaths during or after a medical or

surgical proceduresurgical procedure

Death InvestigatorDeath Investigator Works for Coroner/ME OfficeWorks for Coroner/ME Office Reports to the medical examiner or Reports to the medical examiner or

pathologist performing the autopsy.pathologist performing the autopsy. Goes to the death scene and make an Goes to the death scene and make an

evaluation.evaluation. Gathers relevant medical history as well Gathers relevant medical history as well

as talks to witnesses and relatives about as talks to witnesses and relatives about the decedentthe decedent’’s last whereabouts.s last whereabouts.

Reports death to the next of kin.Reports death to the next of kin.

Death InvestigatorDeath Investigator

Usually an individual with law Usually an individual with law enforcement training or a:enforcement training or a:– Licensed registered nurse orLicensed registered nurse or– Trained mortician Trained mortician

Must attend the Must attend the PC 832 PC 832 course.course.Must attend the Must attend the coronercoroner’’s investigations s investigations

academy academy after being hired by the coronerafter being hired by the coroner’’s s office.office.

Crime Scene TechnicianCrime Scene Technician

Usually a member of local law Usually a member of local law enforcement.enforcement.– Typically civilian personnelTypically civilian personnel

The technicianThe technician’’s expertise includes:s expertise includes:– Photographing and diagramming the death Photographing and diagramming the death

scene.scene.– Collecting all potentially important Collecting all potentially important

evidence.evidence.– Recovering fingerprintsRecovering fingerprints– Recovering other prints such as shoes and Recovering other prints such as shoes and

tirestires

CriminalistCriminalist

The expert who works The expert who works in the forensic lab.in the forensic lab.– Has a MasterHas a Master’’s degree in s degree in

criminalistics/forensic criminalistics/forensic sciencescience

– Most criminalists work Most criminalists work with one particular type with one particular type of evidence, such as:of evidence, such as:

BloodBlood BulletsBullets AmmunitionsAmmunitions FibersFibers HairHair ImpressionsImpressions

Other Types of Forensic Other Types of Forensic Investigators Investigators

Other specialists include:Other specialists include:– SerologistsSerologists– Questioned Document ExaminerQuestioned Document Examiner– ToxicologistToxicologist– AnthropologistAnthropologist– OdontologistOdontologist– RadiologistRadiologist– EntomologistEntomologist– BotanistBotanist– MeteorologistMeteorologist

Forensic PathologistForensic Pathologist– At scene of death controls bodyAt scene of death controls body– Performs autopsiesPerforms autopsies– Determines cause of deathDetermines cause of death

Death InvestigatorDeath Investigator– Works for the CO/ME officeWorks for the CO/ME office– Investigates cause of deathInvestigates cause of death

Crime Scene InvestigatorCrime Scene Investigator– Works for law enforcementWorks for law enforcement– Collects evidenceCollects evidence– Takes photographsTakes photographs

Criminalistic SpecialistCriminalistic Specialist– Processes evidence in the laboratoryProcesses evidence in the laboratory

Forensic medicine Forensic medicine is the application of is the application of various medical specialties to legal issues.various medical specialties to legal issues.

PathologyPathology refers to the study of disease. refers to the study of disease. Forensic Pathologist Forensic Pathologist is a medical doctor who is a medical doctor who

studies injuries and disease to determine the studies injuries and disease to determine the causecause and and mannermanner of death. (in suspicious of death. (in suspicious deaths)deaths)

Medical Examiner Medical Examiner isis a forensic pathologist a forensic pathologist

who conducts autopsies to determine the who conducts autopsies to determine the cause, mannercause, manner, and , and modemode of death by of death by examining the internal organs of the corpse.examining the internal organs of the corpse.

Coroner Coroner isis a public officer whose primary a public officer whose primary function is to investigate by inquest any death function is to investigate by inquest any death thought to be of other than natural causes.thought to be of other than natural causes.

Is a coroner the same as a medical Is a coroner the same as a medical examiner?examiner?

Each state has a law requiring that either a Each state has a law requiring that either a coroner or a medical examiner oversee the coroner or a medical examiner oversee the investigation of unexpected deaths. investigation of unexpected deaths.

Click here to watch video-clipClick here to watch video-clip

Medical Examiners vs CoronersMedical Examiners vs Coroners

As you watch the video record the differences As you watch the video record the differences and similarities between medical examiners and and similarities between medical examiners and coronerscoroners

Forensic EvidenceForensic Evidence

Evidence: Evidence: Anything that can be Anything that can be used to determine whether a crime used to determine whether a crime has been committed.has been committed.– May exonerate the innocent May exonerate the innocent – Corroborate or refute an alibi or Corroborate or refute an alibi or

statement of a witnessstatement of a witness– Identify a perpetrator or victimIdentify a perpetrator or victim– Induce a confessionInduce a confession

Forensic EvidenceForensic Evidence Direct Evidence: Direct Evidence: Establishes a factEstablishes a fact

– Eyewitness testimonyEyewitness testimony– ConfessionConfession

Circumstantial Evidence: Circumstantial Evidence: Requires that Requires that a judge and/or jury make an indirect a judge and/or jury make an indirect judgment or inference about what judgment or inference about what happened. No absolute proof; provides a happened. No absolute proof; provides a general idea of what happened. Often general idea of what happened. Often much more reliable than Direct Evidence.much more reliable than Direct Evidence.– Fingerprints Fingerprints – HairHair– FibersFibers

Forensic EvidenceForensic Evidence Forensic evidence canForensic evidence can’’t t

find and convict the find and convict the criminal unaided.criminal unaided.

It provides an additional It provides an additional weapon in the weapon in the detectivedetective’’s armory.s armory.– It can offer clues to help It can offer clues to help

the detectives track down the detectives track down the criminal andthe criminal and

– It can help detectives It can help detectives prove a suspect was prove a suspect was present at the crime present at the crime scene or committed a scene or committed a particular act of violence.particular act of violence.

Medicolegal InvestigationsMedicolegal Investigations

Duties of the medicolegal systemDuties of the medicolegal system– Determine cause, manner, mechanism and Determine cause, manner, mechanism and

time of deathtime of death Four important medicolegal elements of death Four important medicolegal elements of death

investigation. investigation.

– Identify the deceased if unknownIdentify the deceased if unknown– Collect evidence from bodyCollect evidence from body– Document injuries or lack thereofDocument injuries or lack thereof– Deduce how injuries occurredDeduce how injuries occurred– Provide expert testimony if case goes to trialProvide expert testimony if case goes to trial

Definition of DeathDefinition of Death

In 1968 BlackIn 1968 Black’’s Law Dictionary s Law Dictionary defined Death as: defined Death as: the cessation of the cessation of life; the ceasing to exist; defined by life; the ceasing to exist; defined by physicians as the total stoppage of physicians as the total stoppage of the circulation of the blood, and the circulation of the blood, and cessation of vital functions cessation of vital functions consequent thereon, such as consequent thereon, such as respiration, pulsation, etc.respiration, pulsation, etc.

What is Death?What is Death?

Cellular DeathCellular Death– The tissues and their constituent cells The tissues and their constituent cells

are dead.are dead.No longer function or have metabolic No longer function or have metabolic

activity, primarily aerobic respirationactivity, primarily aerobic respirationFrom cardiorespiratory failureFrom cardiorespiratory failureDifferent tissues die at different ratesDifferent tissues die at different rates


Clinical DeathClinical Death– The cessation of respiration and The cessation of respiration and

circulation functioning. Resuscitation circulation functioning. Resuscitation may or may not be possible.may or may not be possible.Anoxia and hypothermiaAnoxia and hypothermia

– May live for more than 5 minutes after cessation May live for more than 5 minutes after cessation of respiration and circulation.of respiration and circulation.

What is Death?What is Death?

Somatic DeathSomatic Death– Irreversible loss of personality, being Irreversible loss of personality, being

unconscious, unable to be aware of or unconscious, unable to be aware of or communicate with onecommunicate with one’’s environment, unable to s environment, unable to appreciate any sensory stimuli or to initiate any appreciate any sensory stimuli or to initiate any voluntary movement.voluntary movement.

– Reflex nervous activity may persist and Reflex nervous activity may persist and circulatory and respiratory functions continue circulatory and respiratory functions continue either spontaneously or with artificial support so either spontaneously or with artificial support so that the tissues and cells of the body, other than that the tissues and cells of the body, other than those already damaged in the central nervous those already damaged in the central nervous system, are alive and functioning.system, are alive and functioning.


Brain Death Brain Death – An irreversible An irreversible

process.process.– Irreversible cessation Irreversible cessation

of all brain functions, of all brain functions, including brain stem.including brain stem.

– PVSPVS – Persistent – Persistent Vegetative State = Vegetative State = permanent damage to permanent damage to frontal lobe function frontal lobe function and not brain stem.and not brain stem.


Brain Death Brain Death is determined by:is determined by:– Coma and cerebral responsivenessComa and cerebral responsiveness– ApneaApnea– Fixed and Dilated PupilsFixed and Dilated Pupils– Absence of Cephalic Reflexes (brainstem)Absence of Cephalic Reflexes (brainstem)– Absence of Electrical Impulses in the Absence of Electrical Impulses in the

Cerebrum(no EEG pattern)Cerebrum(no EEG pattern) Two physicians required to pronounce brain death; Two physicians required to pronounce brain death;

one must be a neurologist in California.one must be a neurologist in California.

Death CertificateDeath Certificate

Medicolegal requirement of the Medicolegal requirement of the death certificatedeath certificate– Cause and Cause and – Manner of DeathManner of Death


The death certificate has two major The death certificate has two major groupings for the cause of death:groupings for the cause of death:– Primary or immediate cause of deathPrimary or immediate cause of death– Secondary cause of deathSecondary cause of death

Primary Cause of DeathPrimary Cause of Death

The Primary cause of death is The Primary cause of death is subdivided into a three-link subdivided into a three-link sequential chainsequential chain– Primary cause of death:Primary cause of death:

Hypoxemic necrosis of brain (brain death) Hypoxemic necrosis of brain (brain death) due todue to

ExsanguinationExsanguinationdue todue to

Gunshot wound (GSW) of abdomenGunshot wound (GSW) of abdomen

Secondary Cause of DeathSecondary Cause of Death

Includes conditions which are not Includes conditions which are not related to the primary cause of death related to the primary cause of death but are substantially contributory to but are substantially contributory to the individual’s demisethe individual’s demise– Emphysema of the lungsEmphysema of the lungs– Arteriosclerotic cardiovascular diseaseArteriosclerotic cardiovascular disease

Cause of DeathCause of Death The reason someone dies is the cause of The reason someone dies is the cause of

deathdeath Proximate cause Proximate cause of death refers to an of death refers to an

underlying cause of death as opposed to the underlying cause of death as opposed to the final cause.final cause.– The The ““originaloriginal”” underlying medical condition which underlying medical condition which

initiates a lethal chain of events culminating in initiates a lethal chain of events culminating in death.death.

i.e.. a shotgun blast to the head, stab wound to the chest i.e.. a shotgun blast to the head, stab wound to the chest or coronary atherosclerosis.or coronary atherosclerosis.

Immediate cause of deathImmediate cause of death– What kills a person now, but was originally What kills a person now, but was originally

precipitated by something else (proximate)precipitated by something else (proximate)

Mechanism or Mode of DeathMechanism or Mode of Death

An abnormal physiological state that An abnormal physiological state that pertained at the time of deathpertained at the time of death– i.e. coma, congestive heart failure, cardiac i.e. coma, congestive heart failure, cardiac

arrest, pulmonary edema, septicemia and arrest, pulmonary edema, septicemia and hemorrhagehemorrhage

Mechanism of death Mechanism of death describe the describe the specific change in the body that specific change in the body that brought about the cessation of life.brought about the cessation of life.– **usually only **usually only ““CauseCause”” and and ““MechanismMechanism”” are are

listed on the dead certificate**listed on the dead certificate**

Manner of DeathManner of Death

The circumstances surrounding a The circumstances surrounding a death or how the cause of death death or how the cause of death came about. came about.

Circumstantial events or manner of Circumstantial events or manner of death may be: death may be: – Natural due to disease or Natural due to disease or – Unnatural due to: Accident, Suicide, Unnatural due to: Accident, Suicide,

Homicide, Questionable/Undetermined.Homicide, Questionable/Undetermined.NASH/QNASH/Q

Certification of DeathCertification of Death

Five Classifications of Death (Five Classifications of Death (NASH/QNASH/Q)) Referred to Manner of DeathReferred to Manner of Death

– NaturalNatural: pathology; death caused by disease.: pathology; death caused by disease.– AccidentAccident: not intentional or by a criminal act.: not intentional or by a criminal act.– SuicideSuicide: death by one: death by one’’s own hand.s own hand.– HomicideHomicide: death by another.: death by another.– QuestionableQuestionable: cause and/or motive is not : cause and/or motive is not

known; generally when other classifications are known; generally when other classifications are not used. Also not used. Also ““UndeterminedUndetermined”” death is used. death is used. ““EquivocalEquivocal”” has also been used as well. has also been used as well.

Examples:Examples:

Manner of deathManner of death: - : - homicidehomicide

Cause of death:Cause of death: -- smothering smothering

Mechanism of deathMechanism of death: - : - asphyxiaasphyxia


Cause of death:Cause of death: - - stabbingstabbing

Mechanism of death: Mechanism of death: - - loss of loss of bloodblood

Man shot during robbery. Man Man shot during robbery. Man stabilizes. Develops pneumonia. stabilizes. Develops pneumonia. Followed by kidney failure, liver failure, Followed by kidney failure, liver failure, heart failure, death. Had prior lung and heart failure, death. Had prior lung and heart disease, and probably would have heart disease, and probably would have survived if not for these diseases.survived if not for these diseases.


Cause of death:Cause of death: -- gunshot gunshot

Mechanism of death: Mechanism of death: - - heart heart failurefailure

REVIEW CAUSES AND REVIEW CAUSES AND MECHANISMS OF DEATHMECHANISMS OF DEATH

Examples of causes of death: Examples of causes of death: heart attack, gunshot wound, skull fracture, diseases heart attack, gunshot wound, skull fracture, diseases

or injuries, stroke, burning, drowning, strangulation, or injuries, stroke, burning, drowning, strangulation, hanging, suffocation, massive trauma, bludgeoninghanging, suffocation, massive trauma, bludgeoning

Examples of mechanisms of death: Examples of mechanisms of death: Exsanguination (bleeding to death)Exsanguination (bleeding to death)Sepsis (infection in blood stream)Sepsis (infection in blood stream)Brain trauma (cerebral contusion)Brain trauma (cerebral contusion)Brain bleeding (intra-cerebral bleed)Brain bleeding (intra-cerebral bleed)Stop breathing (asphyxia)Stop breathing (asphyxia)Pulmonary arrest Pulmonary arrest Cardiac arrestCardiac arrest

Whitney Houston death certificate:Whitney Houston death certificate:No cause of death listedNo cause of death listed

Click here

←← to read the news article.

The manner, cause and mechanism of death The manner, cause and mechanism of death of:of:

•Jon Bennet RamseyJon Bennet Ramsey–Manner – Manner – homicidehomicide–Cause – Cause – strangulationstrangulation–Mechanism – Mechanism – asphyxiation asphyxiation - - respiratory respiratory arrestarrest

•Whitney Houston Whitney Houston –Manner – Manner – accidentalaccidental–Cause – Cause – drowningdrowning–Mechanism – Mechanism – Pulmonary arrestPulmonary arrest

• Michael JacksonMichael Jackson– Manner – Manner – homicidehomicide– Cause – Cause – acuteacute propofol intoxicationpropofol intoxication– Mechanism – Mechanism – cardiac arrestcardiac arrest

• Hugo ChavezHugo Chavez– Manner – Manner – naturalnatural– Cause – Cause – heart attackheart attack– Mechanism – Mechanism – Pulmonary arrestPulmonary arrest

You tryYou try

Write a short scenario that includes Write a short scenario that includes information about cause, manner and information about cause, manner and mechanism of death, without labeling mechanism of death, without labeling them as such.them as such.

Exchange your scenario with other Exchange your scenario with other students and try to classify theirs.students and try to classify theirs.


Cause of death written on the death Cause of death written on the death certificate:certificate:– Primary or ImmediatePrimary or Immediate– SecondarySecondary


Primary cause of deathPrimary cause of death– Subdivided into a three-link sequential Subdivided into a three-link sequential

chain, eg.chain, eg.Hypoxemic necrosis of brain (brain death)Hypoxemic necrosis of brain (brain death)

– Due toDue toExsanguinationExsanguination

– Due toDue toGunshot woundGunshot wound


Secondary cause of deathSecondary cause of death– Includes conditions which are not Includes conditions which are not

related to the primary cause of death related to the primary cause of death but are substantially contributory to the but are substantially contributory to the individualindividual’’s demises demiseEmphysema of lungs,Emphysema of lungs,HypothermiaHypothermiaArteriosclerotic cardiovascular diseaseArteriosclerotic cardiovascular disease

Autopsy ReportsAutopsy Reports

Cause of death: Cause of death: Heart Heart failure with cardiac failure with cardiac arrhythmia due to a arrhythmia due to a pulmonary emboli.pulmonary emboli.

Contributing cause: Contributing cause: Intestinal dismobility, on Intestinal dismobility, on chronic pain chronic pain management.management.

Manner of Death - Manner of Death - Undetermined.Undetermined.

Autopsy ReportAutopsy Report

A A Psychological AutopsyPsychological Autopsy may have to may have to be done if manner of death is thought to be done if manner of death is thought to be suicide.be suicide.– An investigation of a decedentAn investigation of a decedent’’s mental state s mental state

prior to death.prior to death.

AutopsyAutopsy

Final photo of the Final photo of the King.King.

AutopsyAutopsy

Autopsy Photo of Autopsy Photo of Marilyn MonroeMarilyn Monroe

Identification of the DeceasedIdentification of the Deceased

Physical DescriptionPhysical Description– HeightHeight– WeightWeight– Color of eyes, hair and skinColor of eyes, hair and skin

Scars and MarksScars and Marks– Birthmarks, scars, etc.Birthmarks, scars, etc.– TattoosTattoos

FingerprintsFingerprints

Identification of DeceasedIdentification of Deceased



PhotographsPhotographs– The entire body should be The entire body should be

photographed.photographed. Radiological FeaturesRadiological Features

– X-rays should be taken of the body.X-rays should be taken of the body.


Age DeterminationAge Determination– Age may be roughly estimated by the Age may be roughly estimated by the

teethteeth– Joining of the bones (epiphysis)Joining of the bones (epiphysis)– Ossification centerOssification center

Dental FeaturesDental Features– The pattern of dental work may be The pattern of dental work may be

determined by an Odontologist.determined by an Odontologist.– Eruption of TeethEruption of Teeth


Blood FactorsBlood Factors– ABO groupings, Rh factors, DNA testing.ABO groupings, Rh factors, DNA testing.

Medical IndicationsMedical Indications– Postmortem may reveal preexisting Postmortem may reveal preexisting

diseases.diseases. Any Other Means AvailableAny Other Means Available

– Clues may be found at the scene or in Clues may be found at the scene or in the personal effects.the personal effects.

Definition of MurderDefinition of Murder

P.C. 187P.C. 187: Unlawful killing of human : Unlawful killing of human being, or fetus, with malice aforethought.being, or fetus, with malice aforethought.– 11stst Degree: by any of the destructive devices Degree: by any of the destructive devices

or explosive, use of ammo designed primarily or explosive, use of ammo designed primarily to penetrate metal or armor, poison, lying in to penetrate metal or armor, poison, lying in wait, torture, other willful, deliberate, wait, torture, other willful, deliberate, premeditated killing, committed or attempted premeditated killing, committed or attempted during a burglary, arson, rape, robbery, during a burglary, arson, rape, robbery, mayhem, carjacking, kidnapping, train mayhem, carjacking, kidnapping, train wrecking or a drive-by shooting with intent to wrecking or a drive-by shooting with intent to kill. kill.

First-Degree Murder in California Law First-Degree Murder in California Law

California law, there are three ways to be California law, there are three ways to be convicted of first-degree murder:convicted of first-degree murder:– By committing the murder using:By committing the murder using:

a destructive device or explosive, weapon of mass a destructive device or explosive, weapon of mass destruction, ammunition primarily designed to destruction, ammunition primarily designed to penetrate metal or armor or poison, or penetrate metal or armor or poison, or

by lying in wait or by inflicting torture, by lying in wait or by inflicting torture,

– By killing in a way that is willful, deliberate and By killing in a way that is willful, deliberate and premeditated, ORpremeditated, OR

– By way of the felony-murder rule (that is committing By way of the felony-murder rule (that is committing a specifically enumerated felony that automatically a specifically enumerated felony that automatically turns any logically relate death into first-degree turns any logically relate death into first-degree murder).murder).

Second Degree MurderSecond Degree Murder

Willful murder but is not deliberate Willful murder but is not deliberate and premeditated. and premeditated. – Second-degree murder is any murder Second-degree murder is any murder

that isn't defined as first-degree murder. that isn't defined as first-degree murder. Shooting a gun into a crowded room and Shooting a gun into a crowded room and

killing someone, even if that wasn't your killing someone, even if that wasn't your intention intention

Vehicular Manslaughter; intoxicated driver.Vehicular Manslaughter; intoxicated driver.

Degrees of MurderDegrees of Murder

– Manslaughter: Unlawful killing of a human Manslaughter: Unlawful killing of a human being, without malice.being, without malice.Voluntary: A sudden quarrel or in the heat of Voluntary: A sudden quarrel or in the heat of

passion.passion. Involuntary: While committing an unlawful act, Involuntary: While committing an unlawful act,

not a felony; or while committing a lawful act that not a felony; or while committing a lawful act that might produce death, done in an unlawful manner; might produce death, done in an unlawful manner; or without due caution and circumspection; or without due caution and circumspection; provided that this subdivision shall not apply to provided that this subdivision shall not apply to acts committed in driving of a vehicle.acts committed in driving of a vehicle.

Vehicular: Drives in an unlawful way that produces Vehicular: Drives in an unlawful way that produces deathdeath

HomicideHomicide

Justifiable HomicideJustifiable Homicide::– Public Officer: Homicide justifiable when Public Officer: Homicide justifiable when

committed by public officer, and those acting by committed by public officer, and those acting by their command in their aid and assistance.their command in their aid and assistance.

– Other Persons: (Including Peace Officers): Other Persons: (Including Peace Officers): When committed by a person in the following When committed by a person in the following cases.cases.

Resisting an attempted murder or felony.Resisting an attempted murder or felony. In defense of habitation, property or person.In defense of habitation, property or person. In lawful defense of persons such as wife, husband, In lawful defense of persons such as wife, husband,

child or parent.child or parent. In attempt to apprehend a person for committing a In attempt to apprehend a person for committing a

felony, lawfully suppressing a riot or lawfully keeping felony, lawfully suppressing a riot or lawfully keeping or preserving the peace.or preserving the peace.

Case 1Case 1

A 25 year old man was shot in the abdomen A 25 year old man was shot in the abdomen with a handgun. He was taken to the with a handgun. He was taken to the hospital where he underwent an emergency hospital where he underwent an emergency exploratory laparotomy. All life-threatening exploratory laparotomy. All life-threatening injuries were repaired. His postoperative injuries were repaired. His postoperative course, however, was complicated by course, however, was complicated by peritonitis which led to sepsis and eventually peritonitis which led to sepsis and eventually death two weeks after surgery. An autopsy death two weeks after surgery. An autopsy revealed an extensive abdominal infection. revealed an extensive abdominal infection. The medical examiner ruled the cause of The medical examiner ruled the cause of death as a gunshot wound to the abdomen death as a gunshot wound to the abdomen and the manner of death as a homicide.and the manner of death as a homicide.

Case 1 Case 1

During the trial, the pathologist was During the trial, the pathologist was questioned about the cause of death. questioned about the cause of death. The pathologist reiterated his opinion The pathologist reiterated his opinion that the decedent died from a gunshot that the decedent died from a gunshot wound. A fierce cross-examination wound. A fierce cross-examination followed. The defense attorney followed. The defense attorney contended the man died as a result of contended the man died as a result of an abdominal infection. Consequently, an abdominal infection. Consequently, it was the physician, not his client, who it was the physician, not his client, who was to blame for the death. was to blame for the death.

Case 1Case 1

Who should the jury believe?Who should the jury believe?

Would the victim have died if the Would the victim have died if the infection had been discovered infection had been discovered sooner?sooner?

Should the physician be responsible for Should the physician be responsible for the manthe man’’s death?s death?

Case DiscussionCase DiscussionCase 1Case 1

This man died as a result of a gunshot This man died as a result of a gunshot wound to the abdomen and the manner of wound to the abdomen and the manner of death was homicide. It was a life-death was homicide. It was a life-threatening injury which would have threatening injury which would have caused his death within hours if he had not caused his death within hours if he had not been treated. A well-recognized risk of been treated. A well-recognized risk of abdominal surgery is peritonitis. If he had abdominal surgery is peritonitis. If he had been admitted with a non-lethal injury, been admitted with a non-lethal injury, and the physician made an error in and the physician made an error in judgment which caused his death, then judgment which caused his death, then the manner of death would have been an the manner of death would have been an accident, not homicide. accident, not homicide.


In this case, however, the pathologist In this case, however, the pathologist correctly stated that the sequence of correctly stated that the sequence of events was continuous from the time events was continuous from the time the man was shot until he died.the man was shot until he died.

In the state of California the statute of In the state of California the statute of limitations for this type of crime limitations for this type of crime leading to the personleading to the person’’s death is one s death is one yearyear

Case 2Case 2

A woman in her seventies was walking to a A woman in her seventies was walking to a grocery store. An assailant pushed her grocery store. An assailant pushed her onto the sidewalk as he grabbed her onto the sidewalk as he grabbed her purse. She was apparently unharmed but purse. She was apparently unharmed but obviously shaken by the experience. obviously shaken by the experience. Within 10 to 15 minutes she developed Within 10 to 15 minutes she developed shortness of breath, increased chest pain shortness of breath, increased chest pain and was taken to a nearby emergency and was taken to a nearby emergency room. During her evaluation she room. During her evaluation she developed an arrhythmia and died.developed an arrhythmia and died.

Case 2Case 2

An autopsy revealed severe An autopsy revealed severe atherosclerotic disease in all atherosclerotic disease in all coronary arteries and numerous coronary arteries and numerous infarcts of the left ventricle. There infarcts of the left ventricle. There were no signs of injury from the fall. were no signs of injury from the fall. The medical examiner ruled the The medical examiner ruled the cause and manner of her death as cause and manner of her death as heart disease and homicide, heart disease and homicide, respectively.respectively.

Case 2Case 2

During the trial, the defense attorney During the trial, the defense attorney disagreed with the cause and manner of disagreed with the cause and manner of death. He stated this was not a homicide death. He stated this was not a homicide because the woman died of heart disease, because the woman died of heart disease, and the fall to the sidewalk caused by his and the fall to the sidewalk caused by his client was not a contributing factor. Was client was not a contributing factor. Was the pathologist correct? Should he have the pathologist correct? Should he have called the death a homicide? Did the man called the death a homicide? Did the man who took her purse actually cause her who took her purse actually cause her death?death?


This case is more complex than Case This case is more complex than Case 1. The manner, not the cause, of this 1. The manner, not the cause, of this womanwoman’’s death is in dispute. Since s death is in dispute. Since there was no significant trauma, the there was no significant trauma, the cause of death had to be the heart cause of death had to be the heart disease. He was more concerned disease. He was more concerned with the sequence of events and how with the sequence of events and how the pathologist believed the robbery the pathologist believed the robbery was directly related to the death.was directly related to the death.


There was only a 10-15 minute interval from There was only a 10-15 minute interval from the time the woman was knocked to the the time the woman was knocked to the ground to when she experienced signs and ground to when she experienced signs and symptoms of a heart attack or angina. symptoms of a heart attack or angina. Since the time period was short, the Since the time period was short, the pathologist believed that the woman was pathologist believed that the woman was still under stress and correctly interpreted still under stress and correctly interpreted the manner of her death as a homicide. the manner of her death as a homicide. The longer the time frame, however, The longer the time frame, however, between the incident and heart attack, the between the incident and heart attack, the more difficult it would be to make this more difficult it would be to make this interpretation.interpretation.


If, for example, the woman had gone If, for example, the woman had gone home, had not been seen for a few home, had not been seen for a few hours, and then complained of chest hours, and then complained of chest pain, the same interpretation could pain, the same interpretation could not have been made. She would not have been made. She would have been unwitnessed during that have been unwitnessed during that time and some other incident could time and some other incident could have triggered a fatal arrhythmia. have triggered a fatal arrhythmia. Consequently, in such a situation, her Consequently, in such a situation, her death could not be ruled a homicide.death could not be ruled a homicide.

Documents

Forensic Pathology (aka Medicolegal Pathology). What is Pathology? Pathology: The scientific study of the nature of disease, its causes and consequences