Post on 02-Jun-2018
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DEATH
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DEATH
Death complete cessation of all
vital functions without possibility
of resuscitation; Irreversible loss
of the properties of living matter
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DEATH
"Organ Donation Act of
1991." Sec. 2 (j) "Death".- the
irreversible cessation of
circulatoryand respiratoryfunctions or the irreversible
cessation of all functions of the
entire brain, including the brainstem.
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DEATH
A person shall be medically andlegally dead if either:
(1) In the opinion of the attending
physician, based on the acceptable
standards of medical practice, there is
an absence of natural respiratory and
cardiac function and, attempts
resuscitation would not be successfulin restoring those functions. In this
case, death shall be deemed to have
occurred at the time these function
ceased ; or
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DEATH
(2) In the opinion of the consultingphysician, concurred in by the attending
physician, that on the basis of acceptable
standards of medical practice, there is an
irreversible cessation of all brain functions;
and considering the absence of suchfunctions, furthers attempts at resuscitation
or continued supportive maintenance would
not be successful in restoring such natural
functions. In this case, death shall be deemedto have occurred at the time when these
conditions first appeared.
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DEATH
The death of the person shall bedetermined in accordance with the
acceptable standards of medical
practice and shall be diagnosed
separately by the attending physicianand another consulting physician, both
of whom must be appropriately
qualified and suitably experienced in
the care of such patients. The deathshall be recorded in the patient's
medical record.
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DEATH
Absence of cardiac function
Absence of respiratory function
Absence of brain activity
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DEATH
Brain death absence of
electrical brain activity no
reflexes, circulation, respiration,
dilated non-reactive pupils, flatElectroencephalogram Two
Physicians Rule
Cardio-respiratory death
continuous and persistent
cessation of heart action and
respiration
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2 Physicians -must not be:
(a) A member of the team ofmedical practitioners who will
effect the removal of the organ
from the body; nor(b) The physician attending to
recipient of the organ to be
removed; nor
(c) The head of hospital or the
designated officer authorizing the
removal of the organ.
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Legal Implications of
Death
Civil personality extinguished
Succession
Contracts
partnership, agency,insurance
Criminal liability
Organ transplantation
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Death Investigation
If death is sudden, unexplained,violent, under suspicious
circumstance Investigate
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Types of Death
Natural
death may be made to look asthough it resulted from natural causes
Accidental death may not be
accidental but a result of suicide or
crime
Suicide death may be caused by
crime
Homicide, Murder, as a result of Crime
Unexplained
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Duties: Medical Examiner
1. Establish Fact of Death2. Identification of Deceased
3. Determination of Time of Death
4. Determination of cause and manner ofdeath
5. Obtain evidence in the body
- Evidence relevant to circumstances
of death
weapons, tools, blood
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FACT OF DEATH
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Signs of Death
Cessation of cardiac activity and
circulationno heartbeat and no
pulse, blood settles in dependent
portion due to gravity (livormortis)
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Signs of Death
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Signs of Death
Cessation of respiration person
stops breathing
- barbiturate overdose shallow
breathing
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Signs of Death
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Signs of Death
Cooling of body (algor mortis),
Skin becomes pale
Stiffening (rigor mortis) and
Decomposition
Eyes become non-reactive and
would later start to cloud
Action of heat
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Signs of Death
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IDENTIFICATION
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Identification
Visual Recognition, Personal effects orornaments
Fingerprints, DNA, also palm prints,
foot print
Medical history: Blood type to rule
out, Dental Records
Forensic anthropologist gender,
height, race and age; Forensicodontologist age range
Forensic entomologist location,
approximate time of death
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Identification
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Identification
Important:1. Legal certification of death
2. Succession
3. Insurance4. Criminal Law
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Time of Death
Postmortem interval time of
death and discovery of the body
Death within 4 days estimated to
within 4 hours
People vs. Seranilla, 348 SCRA
227, December 15, 2000
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TIME OF DEATH
1. Changes in Muscle
2. Cooling of Body
3. Lividity4. Putrefaction
5. Consider Digestive Process
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Time of Death
At death, body is limp until rigor
mortis sets in
Rigor mortis stiffening of joints
(low in babies and aged)
- Face then larger muscles
- Lasts 1-3 days, then muscles
decompose
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Time of Death
Changes in Muscle following Death
1. Stage of Primary Flaccidity
muscles relaxed, incontinence,
pupils dilated (when warm, only
1:51 minutes, may last up to 6
hours), may pass electric current
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Time of Death
2. Rigor Mortis usually develops
after 3-6 hours, body become rigid
(may last from 24-36 hours), faster
development if warmNote: if holding something that is
difficult to remove, may be something
held in hand just before death - due tocadaveric spasm
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Cadaveric Spasm
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Time of Death
Cadaveric Spasm - instantaneousmuscle rigidity at time of death;
only certain muscles and no
whole body, does not disappear,cannot be induced
3. Decay of muscles
musclesbecome flaccid, no more reaction
to stimulus (3 days, shorter if
warm)
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Change in Muscles
Flaccid - up to 6 hours
Stiff (rigor mortis) up to 2 days
Flaccid (decaying)
after 2 days
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Time of Death
Algor mortis - Cooling of the body
- fastest during first two hours
-Tropical countries 12 -15 hours,
same as environment
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Algor Mortis
Delay
fever, sudden death ingood health, obesity, death from
asphyxia, death of middle age
Accelerate
leanness of body,extreme age, long-standing
disease, chronic fever with
wasting
Air in large room, in water
speeds up cooling
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Time of Death
POSTMORTEM LIVIDITY- effect of gravity once circulation
ceases , Blood may remain fluid
after death for 6-8 hours- Dark blue discoloration (livor
mortis) but may be cherry red if
death is due to carbon monoxidepoisoning
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Time of Death
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Time of Death
POSTMORTEM LIVIDITY- develops up to 10-12 hours after
death
- this means, after 10-12 hours,lividity is fixed
- If body moved after 12 hours,
pattern of lividity may indicateposition at death
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Time of Death
POSTMORTEM LIVIDITY
- Lividity on dependent portions
(back legs) if face down (face,
chest, stomach, legs)
- If pressing directly on hard
surface, no lividity
- If blood released from large
wounds little lividity
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Signs of Death
Dead
blood collects usually
dependent portion
if dead, vessels remain healthy,
clot can be stripped
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Time of Death
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Putrefaction
Tropical region
12 hours rigor mortis
24 hours rigor mortis , greenish
discoloration of abdomen
48 hours trunk bloated, face
discolored, there may be maggots
72 hours whole body swollen,
disfigured
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Putrefaction
1 week
internal organs putrefied
2 weeks almost all soft tissues
gone, cannot be distinguished
1 month skeletonized
* Temperate areas slower process
2-5 months after death soft parts
change into thick, semi-fluid black
mass
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Putrefaction
Insects will help
- ties suspect to victim
- insect parts in car, clothes
- whether body was moved
- time of death based on life cycle
of insect
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Submerged in Water
Usually body remains immersedfor 8-10 days in warm water (up to
3 weeks in cold water)
Fleas
if still alive, then body hasbeen in water for less than 24
hours
DROWNING
victims curl up in
semifetal position
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Submerged in Water
If submerged in water, there isvery little change after 4-5 days
especially if water is cold
From 5-7 days - face swollen andred, wrinkled hands and feet,
outer skin loosen (5-6 days),
upper surface of brain greenish
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Submerged in Water
2-3 weeks
nails separate 4 weeks scrotum and penis
distended with gas
6-8 weeks
abdomen distended
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Time of Death
STAGES OF DIGESTION
Stomach:
Light meal empty within 11/2 2
hours after being eaten
Medium sized 3-4 hours
Heavy 4-6 hours*Stomach empties 4-6 hours after a
meal
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Time of Death
STAGES OF DIGESTION
Small Intestines
After 6-8 hours from eating
reaches distal ileum
Small intestine 12 hours to be
empty
*Must find out when victim last ate,
or if there is vomit near body
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Suicide
People vs. Operaa, Jr., 343 SCRA43, October 13, 2000
Investigating a suicide1. Obtain information
any condition that deceased may
have
disease, psychiatric current medications
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Suicide
2. Obtain evidence oncircumstances surrounding death
frame of mind, behavior near time
of death, history Look for:
suicide note
History of previous attempts Self-mutilation
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Suicide
Jokes, communications, writingabout suicide
Giving away possessions
Depression or anxiety
Increased risk-taking behaviour
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Suicide
3. Clues in crime scene weapons near body
crime scene movement of body,
lividity
*For death investigation, a timeline
must be established
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Cause of Death
Not a guaranty of accuracy,
depends on the examiner, based
on available information
Manner of Death
circumstance,condition of body, medical
findings
Natural, suicide, homicide,accident, undetermined
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Cause of Death
External Examination and Internal
Examination: Examination of
injury, determination of possible
weapon used, identifying marks Microscopy, Xrays, Samples for
toxicology
Evidence obtained in bodyimportant
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DEATH CERTIFICATE
A death certificate is conclusive
evidence only as to the fact of
death of the deceased.
The cause of death may beestabished by other evidence.
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THANK YOU.