Department of

Forensic Medicine and Medicolegal

Faculty of Medicine
Hasanuddin University

Gatot S Lawrence

Chairperson of the Department

2013
Lecturers
Prof. dr. Solihin Wirasugena, SpPA(K), SpF, DFM
Dr. Gunawan Arsyadi, SpPA(K), SpF

Dr. Djumadi Achmad, SpPA(K), SpF

Dr. Berti Nelwan, SpPA, MSi, DFM, SpF
Dr. Muh Husni, DFM, PhD

Prof. dr. Randanan Bandaso, SpPA(K), MSc, SpF, DFM

Prof. dr. Syarifuddin Wahid, PhD, SpPA(K), DFM, SpF
Prof. dr. Johanna Kandouw, SpPA(K), DFM, SpF
Drg. Peter Sahelangi, DFM
Dr. Cahyono Kaelan, PhD, SpPA(K), DFM, SpS
Dr. Truly D Dasril, SpPA(K), SpF
Dr. Rina Masadah, MSc, SpPA, DFM
Tutors
Dr. Muh Mauluddin, SH, SpF, MSi
Dr. Jerni Dase, SH, SpF, MSi
Dr. Muh. Basri (+)
Dr. Denny Mathius, SpF
Dr. Anisa Anwar Muthaher, SpF
Dr. Arkipus Pamuttu, SpF
Dr. Zainal Abidin
Dr. Ulfa Camelia Indiasari
Dr. Nola Timor Sangirta Mallo
Dr. Costantinus William Sialana
Definition

Forensic Medicine & Medicolegal: a branch of

medicine that applies the principles and knowledge of
medical science to solve the problems in the legal
field.

Main objective: revealing

The cause and manner of death of death (COD)
The cause of insult/ damage
The identity of diseased if unknown
The truth in medicolegal cases
The major duties:

1. To determine the cause of damage (for living victims)

2. To determine the cause and manner of death
3. To identify the deceased if unknown
4. To determine the proximity time of death and injury
5. To collect evidence from the body that can be used to
prove or disprove a case
6. To document any natural disease present
7. To determine or exclude other contributory or causative
factors to the damage or death
8. To provide expert testimony if the case goes to trial
9. To provide expert testimony for medicolegal cases
 Visum et Repertum (VeR)
Postmortem (Dead Victim) Report

Gatot S Lawrence

Department of Forensic Medicine and Medicolegal

Faculty of Medicine, Hasanuddin University
Makassar
A Tale of Origin

VISUM ET REPERTUM
(seen and discovered)
Modern Day Forensic Sciences

CSI Effects
 Criminal Investigation

Investigator

Dokter Ahli Kedokteran Kehakiman

(Kedokteran Forensik dan Medikolegal)

Visum et Repertum

- To determine the cause and manner of death

- To identify the decease if unknown, etc
 PEJABAT PEMINTA VISUM ET REPERTUM
Pasal 133 KUHAP :
(1)Dalam hal penyidik untuk kepentingan peradilan menangani
seorang korban baik luka, keracunan ataupun mati yang
diduga karena peristiwa yang merupakan tindak pidana, ia
berwenang mengajukan permintaan keterangan ahli kepada
ahli kedokteran kehakiman atau dokter dan atau ahli
lainnya.

(2)Permintaan keterangan ahli sebagaimana dimaksud dalam

ayat (1) dilakukan secara tertulis, yang dalam surat itu
disebutkan dengan tegas untuk pemeriksaan luka atau
pemeriksaan mayat dan atau pemeriksaan bedah mayat.

(3)Mayat yang dikirim kepada ahli kedokteran kehakiman atau

dokter pada rumah sakit harus diperlakukan secara baik
dengan penuh penghormatan terhadap mayat tersebut dan
diberi label yang memuat identitas mayat, dilak dengan
diberi cap jabatan yang dilekatkan pada ibu jari kaki atau
bagian lain badan mayat.
Authorities that have the right to request the
expertise of Forensic & Medicolegal

1. Judges

2. Investigators
Format Generik

I. Pembukaan
II. Pendahuluan
III. Pemberitaan
1. Pemeriksaan Dalam
2. Pemeriksaan Luar
3. Pemeriksaan Penunjang
IV. Ringkasan
V. Kesimpulan
Format of Visum et Repertum
(Generic)

1. Pembukaan:
The phrase Pro justitia
for the sake of justice
Highly confidential
2. Bagian Pendahuluan (Introduction)
- The identity of requesting parties
- The identity and qualification of the
physician conducted the examination
- The registration number, date, time of
place of the examination
- The decease identity as stated by the
formal postmortal letter of request.

Note: The decease identity should be

double checked with label attached to
the part of the decease
3. Bagian pemberitaan
(Examination Part: External and Internal)

Written down all what we have seen and discovered,

using the simplest language possible for the layman
(for those who have no medical background).
The description should be written as clear as
possible (anatomical location, body coordinate, and
measurement).
 For the death victims
External examination
Internal examination
Laboratory (toxicologi, molecular biology, etc.)

For the living vitims

Physical examination, laboratory and other additional
examination.
Management/ medication that has been
conducted previously and its medical indication
The last medical condition of the victim.
(4a) Ringkasan (Summary)
Arrange the findings that have been seen and
discovered in a pathobiologic and mechanistic order.

Use the simplest langguage possible

Summary is a scientific subjectivity of the physician

who conduct the examination
EVIDENCE FOUND
 PRO JUSTITIA

I. PEMERIKSAAN LUAR

I.1.a . . .

I.2.a . . .
PEMERIKSAAN LUAR

I.3.a . . .

I.4.a . . .

I.5.a . . .

I.11.a . . .

I.11.b . . .
I.11.c . . .

I.11.d . . .
II. PEMERIKSAAN DALAM

II.13.a . .

II.14.a . .

II.15.a . .

II.16.a . . .

II.16.b . . .
II.16.c . . .

II.16.d . . .
 RINGKASAN

I. 4.a . . .

I.11.b . .

II.14.a . .

II.16.b . .

I.11.d . .

II.16.d . .
 IV. KESIMPULAN

II

I-d
I-a I-b I-c

The mechanism written as the cause

of death should be selected from the
current established understanding in
the medical field.
(Proximus Mortis Approach)
V. PENUTUP
Contoh

Respiratory Failure
Massiv
 G.Law 18: PROXIMUS MORTIS
Lahir 10-10-2010
SPV
Minutes - hours

Incidence

Minutes - hours
SPV

SPV
Hours - Days
Damage-1
A

Months - Years
Danage-2

B Damage-3

C Death
 Cause of Death (COD)

The internationally accepted format is that adopted by

the World Health Organization (WHO), which originated
from devised by the Registrar-General of Birth and
Deaths (Registrasi Kelahiran dan Kematian).

It is divided into two main parts (part I and II), the first of
which is further subdivided into three sub-sections (I-a, I-
b, I-c).
Multiple Cause Of Death (WHO)
I-a : Disease or condition directly leading to death (due to or
as a consequence of b)
I-b : Antecedent causes. (due to or as a consequence of c)
I-c : Antecedent causes. (due to or as a consequence of d)
I-d : Morbid condition that cause the above condition
(the major underlying cause / condition)

II : Other pathobiologically significant conditions, contributing

to the death, but not directly related to the disease or
condition causing it (I).
4. Bagian Kesimpulan (Conclusion)

To determine the cause and manner of death

To identify the deceased if unknown
To determine the time of death and injury
To collect evidence from the body that can be used to
prove or disprove a case
To document any natural disease present
To determine or exclude other contributory or causative
factors to the death
The mechanism written as the cause of death (COD)
should be selected from the current established
understanding in the medical field (Proximus Mortis
Approach=PMA).
5. Bagian Penutup (Closure)

- Stating that the postmortem report was written with

the best knowledge, remembering the oath declared
at the time of taking office (according to KUHAP).

- Should be signed and stated the name of doctor

who conduct examination (may be co-signed by
related physician)
 Visum et Repertum (VeR)
Living Victim

Gatot S Lawrence

Department of Forensic Medicine and Medicolegal

Faculty of Medicine, Hasanuddin University
Makassar
 Gatot S Lawrence 2011
Birth
VeR Report (Living victim)

SPV-1

Dr. UGD
Medical Record Damage-1

Incidence
Disease
Treatment
Complication
Damage
 Gatot S Lawrence 2011
Birth

VeR Report (Living victim)

Dr. UGD
Medical Record SPV-2

Dr. SpB
Medical Record
Damage-2

Incidence
Disease
Treatment
Complication
Damage
 Gatot S Lawrence 2011
Birth

Dr. UGD
Medical Record

Dr. SpB
VeR Report (Living Victim)
Medical Record
SPV-3

Dr. SpB, SpB Plastik

Medical Record
Damage-3
Incidence
Disease
Treatment
Complication
Damage
 Gatot S Lawrence 2011
Birth
VeR Report (Living victim)

SPV-1

VeR Report (Living victim)

Dr. UGD
Medical Record Damage-1 SPV-2

Dr. SpB
VeR Report (Living Victim)
Medical Record
Damage-2 SPV-3

VeR Report (Dead Victim)

SPV-4
Dr. SpB, SpB Plastik

Medical Record
Damage-3
Incidence
Disease
Treatment
Complication
Damage
 Format Surat Keterangan Visum et Repertum
I. Surat Permintaan VeR
a) Nomor Surat Keterangan VeR 1
b) Tanggal dan Waktu SPV
2
c) Pihak yang membuat SPV (penyidik)
3
II. Laporan Visum et Repertum
a)Tanggal dan Waktu Pembuatan VeR 4
b)Identitas pasien / korban : KTP / Pasport/ SPV
1. Nama Korban
5
2. Tanggal Lahir/ Umur
6
3. Alamat
7
4. Bukti Identitfa
8
5. No Bukti Identitas
c)Hasil Pemeriksaan: 9

1. Anamnesis, Pemeriksaan Fisik

10
2. Pemeriksaan Penunjang:
11
3. Diagnosis Kerja (ICD Coding)
12
4. Pengobatan dan Tindakan
13
5. Prognosis dari penyakit / damage
14
6. Odontogram (kasus gigi)
15
 Format Surat Keterangan Visum et Repertum

III. Kompetensi Dr/ Drg/ Tenaga Kesehatan

a) Tanda tangan dr/ drg/ tenaga kesehatan yg diberi 16
wewenang pelayanan kesehatan

17
b) Jabatan dan kompetensi dari (a)

IV. Lampiran Pemeriksaan

18
a) Lampiran Hasil Pemeriksaan Klinis
b) Lampiran Hasil Pemeriksaan Toksikologi
c) Lampiran Hasil Pemeriksaan Histopatologi
d) Lampiran Foto
e) Lampiran Video
 Multiple Cause Of Damage(MCOD)
A-1. Damage / Morbid condition directly related to the current Insult
(current condition)
A-2. Antecedent causes A1 (due to or as a consequence of A-3)
A-3. Antecedent causes A2 (due to or as a consequence of A-4)
A-4. Antecedent causes A3 (due to or as a consequence of A-5)
A-n. Underlying cause of the initial insult that cause the damage

B-1. Morbid Condition not directly related to the cause of the current
damage, yet contribute to the current damage.
B-2. Other morbid condition
B-3. Other morbid condition
B-n. Others
 ACKNOWLEDGEMENTS
Prof. dr. Solihin Wirasugena, SpPA(K), SpF, DFM
Prof. Dr. John MF Adam, SpPD-KEMD
Prof. dr. A. Husni Tanra, PhD
Prof. dr. Syarifuddin Wahid, PhD
Prof. Prof. Dr. Nur Nasry Noor, MPH
dr. Gunawan Arsyadi, SpPA(K), SpF
Prof. dr. Irawan Y usuf, PhD
Prof. Dr. dr. Suryani Asad, MSc
Drs. Andi Wijaya, PhD
Prof. dr. Peter Kabo, MD, PhD, SpJP
Dr. dr. Anwar Santoso, SpJP, FIHA
Colleagues in European Society of Cardiology (ESC)
Colleagues in European Association for Cardiovascular Prevention
and Rehabilitation (EACPR)
Colleagues in Vascular Biology Working Group (VBWG)
Walaupun keindahan alam ini tidak terdapat di Indonesia
Namun, kita bertanggung jawab menjaga dan merawatnya
Sebab, kita semua adalah bagian dari dunia ini
TERIMA KASIH