SEMINAR

INTERPRETING REPORTS OF CHEMICAL ANALYSIS AND

HISTOPATHOLOGY WITH POSTMORTEM REPORT

PRESENTED BY –
ASHEESH B. PATEL
PG RESIDENT 2ND YEAR
DEPT. OF FORENSIC MEDICINE AND
TOXICOLOGY, LATE B R K M G M C
JAGDALPUR, C.G.
contents
• Introduction
• Chemical analysis
• Interpretation of results
• Interpretation of chemical analysis report with relation to other factors
• Causes of false negative report
• Causes of false positive report
• histopathology
• Histopathology in natural diseases
• Histopathology in Medicolegal cause of death
Introduction
Medicolegal postmortem examination is done to know the cause, manner, time
since death, collection of trace evidence etc. chemical analysis and histopathology
may serve to find out the cause of death even if there is no gross pathological
changes, or to support the gross findings, or to rule out poisoning and suspected
tissue lesion. Histopathological examination can give more accurate estimate
regarding age of injury. A toxicological report should be straight forward in a simple
non-scientific language. The report of toxicologist usually states those substances
which have been found and sometimes their concentration.
 Chemical analysis

Interpretation of results
• Sufficient to cause death or is this a fatal level
• Sufficient to have affected the actions of the deceased so as to
cause the death
• Insufficient to have any involvement in the cause of death
• Insufficient to protect the individual from an underlying
mechanism of death, such as epileptic seizure (therapeutic drugs)
Interpretation of chemical analysis report with relation to
other factors-
• Route of administration
• Synergistic effect of drugs
• Age, sex, body weight, genetic factors, tolerance, environmental exposure
and general health state of individual
• Level – therapeutic, chronic high level or acute overdose
• Highly toxic substance even in trace amount, cause of death may be
justified as poisoning
• In case of poisoning by ingestion, whether remaining quantity in stomach is
after vomiting or absorption
• Site of blood sampling
• Postmortem drug redistribution
• Other factors- scene report, autopsy report, history, other circumstantial
findings
Causes of false negative report-
• Treatment received
• Insufficient biological material
• Postmortem decomposition
• Faulty preservation
• Poison might have been vomited out, excreted, neutralized, metabolized, detoxified
• vegetable alkaloids
• Routine toxicological screening procedures may not detect carboxyhaemoglobin, sulfa-
methemoglobin and methemoglobin, diuretics, solvents, radioactive compounds,
antibiotics, NSAIDS except except aspirin, paracetamol, calcium channel blockers and
beta blockers
• Rapid metabolizing drugs – haloperidol, oxycolone,
• Biological toxin and snake venom. Immunoassay method may detect these poisons
• Decomposition of poison due to improper preservation- clonazepam, cocaine, isoniazid,
methadone, morphine and nitrazepam. alkaloids, phenothiazines, like LSD and psilocybin
are photolabile. Catecholamines are easily oxidized if container is not airtight
• Small amount of drugs and need considerable amount of viscera and
sensitive analysis procedures- amphetamine, clonidine, ergot alkaloids,
dioxin, digoxin, THC
• Heroin, primidone, diazepam, anesthetics gets rapidly hydrolyzed or
altered, in such case their metabolites are detected in chemical analysis
• Polar molecules- phosphorous
• Structural dissimilarity from prototype- fentanyl
• Tampering of viscera during preservation. Addition of strong chemicals like
soap, bleach powder or glutaraldehyde alters the result in immunoassay.
• Personal variation in therapeutic and lethal dose.
Causes of false positive report
• Decomposition
• Wrong preservative
• Cross reactivity and structural similarity. Opiate.
• Faulty instrument
• Faulty figures
• Tampering of viscera during preservation
Histopathology
The two main disease process that may be encountered in the
tissues are- • Inflammation
• neoplasia

Common causes of inflammation

microorganisms Bacteria, viruses, fungi, parasite
Physical agents Mechanical trauma
Extremes of temperature
Chemicals
radiation
Histopathology in natural diseases-
• To establish natural cause of death
• Local ischemia of heart
• Myocarditis
• Myocardial Infarction
• Cardiomyopathy
• Pulmonary thromboembolism
• Encephalitis
• Pneumonia
• Acute Asthma
• Emphysema
• esophageal varices
• Fatty liver, Cirrhosis of liver, renal disease.
• Histopathology in Medicolegal cause of death-
• Chronic iv drug abuse- foreign body in bloodstream- can trapped in lungs and
cause fibrous scarring
• Brain injury
• Detection of fat emboli
• Gunshot wound
• Inhaled foreign body and vital reactions in asphyxia
• Burn injury- thermal, electrical burn
• Still birth vs live born lung histology
• Fat embolism
• Air embolism
• Product of conception
• abortion
burn
• Morphological changes in burnt skin
• Blister
• Pus
• Healing
• Red line of demarcation
• Histopathological changes in burnt skin
• Separation of epidermis and dermis
• Vacuolisation
• Petechial haemorrhage
• Flattened and elongated epithelial cells
• Histopathological changes in junctional skin
• Capillary dilatation
• Oedema
• Congestion
• Leucocytic infiltration
bone
• Age estimation – size and number increases with age.
Regression equation for estimation of age, Age = number of
osteons + 8.3
• Antemortem fracture, stages of healing.
Mechanical injuries
• Antemortem injuries vs postmortem artefacts and injuries
• Vital signs vs postmortem phenomenon
• Antemortem vs postmortem contusion
• Contusion vs postmortem lividity
• Contusion vs congestion
• Firearm injury
• Rarely needed
• Entrance vs exit wounds in unclear cases
bibliography
• Jaiswal A K, Millo T; Handbook of forensic Analytical Toxicology; 1st
edition January 2014.
• Allen D C, Cameron R L; Histopathology Specimens Clinical,
Pathological and Laboratory Aspects; 3rd edition 2017.
• Orchard G, Nation B; Histopathology(Fundamentals of Biomedical
Science); 2nd edition November 2017.