FORENSIC MEDICINE

DR. WALTER RANDOLPH C. JALGALADO, MD, MHA

MEDICO-LEGAL ASPECTS
OF DEATH
 DEATH
o is the termination of life.
o it is the complete cessation of all the vital functions
without possibility of resuscitation.
o it is an irreversible loss of the properties of living
matter.
o an event that takes place at a precise time.
o the ascertainment of death is a clinical and not a
legal problem.
 Based on the Criterion Used in its
Determination, death may be:
1. Brain Death
Death occurs when there is deep irreversible coma, absence of
electrical brain activity and complete cessation of all the vital
functions without possibility of resuscitation.
(refer to Solis notes pages 15-16)
2. Cardio-Respiratory Death
Death occurs when there is a continuous and persistent cessation of
heart action and respiration.
3. Brain and Cardio-respiratory Death
 BRAIN DEATH (Harvard Report 1968)

1. Unreceptivity and Unresponsibility

2. No movements or breathing
3. No reflexes
o Pupils are fixed and dilated; no response to light
o Stretch and tendon reflexes cannot be elicited
o Plantar or noxious stimulation gives no response

4. Flat Electro-encephalogram (EEG)

 IMPORTANCE

1. The civil personality of a natural person is

extinguished by death.
2. The property of a person is transmitted to
his heirs at the time of death.
3. The death of a partner is one of the causes of
dissolution of partnership agreement.
 IMPORTANCE
4. The death of either the principal or agent is
mode of extinguishments of agency.
5. The criminal liability of a person is
extinguished by death.
6. The civil case for claims, which does not
survive, is dismisses upon death of the
defendant.
 What are the so called medico-legal cases

1. Injuries of deaths involving persons who have no

means of being identified
2. Persons pronounced as “Dead on Arrival” classified
as being dead on arrival (DOA) at the emergency
room of a hospital is liberally construed to mean also
dying within a short period of time from arrival which
may within 1 hour or as long as 24 hours depending
on the circumstances of the cases.
 What are the so called medico-legal cases

3. They also involve death under the following

circumstances:
a. Death occurring within 24 hours of admission, when the
clinical course of death is unknown or undetermined
b. Unexpected sudden death especially when the deceased
was apparently in good health
c. Death due to natural disease but associated with physical
evidence suspicious of foul play
 What are the so called medico-legal cases

4. They also involve death under the following

circumstances:
a. Death as a result of violence, accident, suicide or
poisoning
b. Death due to improper or negligent act of another
person

They also involve victims of physical injuries caused by ,

physical violence, vehicular accident, asphyxia or
electrocution, chemical or thermal insult.
 What are the so called medico-legal cases

5. Cases of child abuse, domestic violence, sexual

abuse, alcoholism and drug abuse
6. Cases involving mental competency of the patient
7. Iatrogenic causes brought about by negligent acts or
omission of the hospital staff resulting in violation
of rights of patients or leading to his physical injury
or death
 KINDS OF DEATH:

1. Somatic or Clinical Death

2. Molecular Death
3. Apparent Death or State of
Suspended Animation
 SOMATIC DEATH
 state of the body in which there is complete,
persistent and continuous cessation of the vital
functions of the brain, heart and lungs which
maintain life and death;
 hardly impossible to determine the exact time
of death;
 SOMATIC DEATH
IMMEDIATELY AFTER DEATH:
othe face and lips become pale
othe muscles become flaccid
othe sphincters are relax
othe lower jaw tends to drop
othe eyelids remain open
 SOMATIC DEATH
IMMEDIATELY AFTER DEATH:
opupils dilate
oskin loses its elasticity
obody fluids tend to gravitate to the most
dependent portions of the body
obody heat gradually assumes the temperature of
the surroundings
 MOLECULAR DEATH
o After cessation of the vital functions, there is still
animal life among individual cells.
o About 3-6 hours later, there is death of individual
cells known as molecular or cellular death
o Exact occurrence cannot be definitely determined
due to several factors
 APPARENT DEATH or STATE OF
SUSPENDED ANIMATION

o This condition is not really death but merely a

transient loss of the vital functions of the body
on account of disease, external stimulus or
other forms of influence.
o It may arise especially hysteria, uremia,
catalepsy and electric shock
 SIGNS OF DEATH
1. Cessation of Heart action and circulation
a. Palpation of pulse, auscultation of heart sound,
electrocardiogram
b. Examination of peripheral circulation
2. Cessation of Respiration
3. Changes in the Skin
4. Changes in and about the Eye
5. Cooling of the Body (Algor Mortis)
6. Changes in the Muscle
7. Changes in the Blood
Methods of Detecting the Cessation of Heart
Action and Circulation
Examination of the Heart
o Auscultation for the heart sound at the precordial
Area. Heart sound can be audible during life even
without the aid of a stethoscope by placing the ear at
the precordial area. Difficulties in Auscultation may
be encountered in:
 Stout person
 Fatty degeneration of the heart.
 Pericardial effusion.
Methods of Detecting the Cessation of Heart Action
and Circulation
Examination of the Heart
o Palpation of the Pulse- may be made at the
region of the wrist or at the neck
o Fluoroscopic Examination- will reveal the
shadow of the heart in its rhythmic contraction
and relaxation. The shadow may be enlarged and
the excursion made less visible due to pericardial
effusion.
o By the Use of Electrocardiograph
Methods of Detecting the Cessation of Heart Action
and Circulation
Examination of the Peripheral Circulation:
o Magnus’ Test:
 A ligature is applied around the base of a finger
with moderate tightness.
 In a living person there appears a bloodless zone
at the site of the application of the ligature and a
livid area distal to the ligature.
 If the ligature is applied to the finger of a dead
man, there is no such change in color.
Methods of Detecting the Cessation of Heart Action
and Circulation
Examination of the Peripheral Circulation:
o Opening of Small Artery:
Living: the blood escapes in jerk and at a
distance.
Dead: the blood vessel is white and there is no
jerking escape of blood but may only ooze
towards the nearby skin.
When bigger arteries are cut, blood may flow
without pressure continuously.
Methods of Detecting the Cessation of Heart Action
and Circulation
Examination of the Peripheral Circulation:
o Icard's Test
 This consists of the injection of a solution of
fluorescein subcutaneously.
 If circulation is still present, the dye will spread all
over the body and the whole skin will have a
greenish-yellow discoloration due to flourescein.
 This test should be applied only with the use of the
daylight as the color is difficult to be appreciated with
the use of artificial light.
Methods of Detecting the Cessation of Heart Action
and Circulation

Examination of the Peripheral Circulation:

o Pressure on the Fingernails:
 lf pressure is applied on the fingernails
intermittently, there will be a zone of paleness
at the site of the application of pressure which
become livid on release.
 There will be no such change of color if the test
is applied to a dead man.
Methods of Detecting the Cessation of Heart Action
and Circulation

Examination of the Peripheral Circulation:

o Diaphanous Test
The fingers are spread wide and the
finger webs are viewed through a strong
light.
Living: the finger webs appear red while
Dead appear yellow
Methods of Detecting the Cessation of Heart Action
and Circulation

Examination of the Peripheral Circulation:

o Application of Heat on the Skin: If heated material
is applied on the skin
Living: blister formation, congestion, and other
vital reactions of the injured area will be
observed.
Dead: will not produce true blister, no sign of
congestion, or other vital reactions.
 Methods of Detecting the Cessation of Heart Action
and Circulation

Examination of the Peripheral Circulation:

o Palpation of the Radial Pulse With Fingers

Living: will feel the rhythmic pulsation

of the vessel due to the flow of
blood.
Dead: No such pulsation will be
observed
 Methods of Detecting the Cessation of Heart Action
and Circulation

Examination of the Peripheral Circulation:

o Dropping of Melted Wax
 Melted sealing wax is dropped on the breast of a
person.
 Dead: there will be no inflammatory edema at
the neighbouring cells of the dropped melted
wax.
 2. CESSATION OF RESPIRATION
o must be continuous and persistent.

In the following conditions there may be suspension of respiration

without death ensuing:
a. In a purely voluntary act, as in divers, swimmers, etc. but it
cannot be longer than two minutes;
b. In some peculiar condition of respiration, like Cheyne-Stokes
respiration, but the apneic interval cannot be longer than fifteen
to twenty seconds;
c. In cases of apparent drowning;
d. Newly-born infants may not breathe for a time after birth and
may commence only after stimulation or spontaneously later.
 4. CHANGES IN THE EYES

NORMAL CLOUDED
LIVING EYES EYES
5. COOLING OF THE BODY (ALGOR MORTIS)

Factors Delaying Cooling

o Acute Pyrexial diseases
o Obesity of person
o Clothing
o Warm surrounding
Factors Accelerating Cooling
o Extreme age
o Long standing or lingering illness
o Unclothed body
o Conditions allowing the access of air
 6. CHANGES IN THE MUSCLE

Stage of primary flaccidity

(post mortem muscular irritability)
Stage of post-mortem rigidity
(Cadaveric rigidity or Rigor Mortis)
Stage of secondary flaccidity
(decay of muscles)
 Conditions Simulating Rigor Mortis
a. Heat stiffening if the body is exposed to temperature
above 75 degree C, it will coagulate the muscle proteins
and cause the muscle to be rigid. The body assumes the
pugilistic attitude.
b. Cold Stiffening is due to the solidification of fat when the
body is exposed to freezing temperature.
c. Cadaveric Spasm or Instantaneous Rigor is due to
extreme nervous tension, exhaustion, and injury to the
nervous system or injury to the chest.
ADDITIONAL SLIDE
 7. CHANGES IN THE BLOOD

Blood may remain fluid inside the blood vessels after

death for 6 to 8 hours.

Post- mortem Lividity is the stoppage of the heart

action and loss of tone of blood vessels that cause the
blood to be under the influence of gravity.
ADDITIONAL SLIDE
 DURATION OF DEATH
1. Rigor Mortis
- sets in 3-6 hours after death
- fully develops after 12 hours
- last until 18-36 hours.
2. Post- Mortem Lividity
- develops 3-6 hours after death.
3. Onset of Decompositions
- early as 24-48 hours manifested by presence of watery, foul
smelling froth coming out of the nostrils and mouth.
 Rigor Mortis

Post Mortem Lividity

 DURATION OF
DEATH
4. Stage of Decomposition
5. Entomology of the Cadaver
6. Stage of Digestion of Food- it normally takes 3-4
hours for the stomach to evacuate its contents
after a meal; this is determined by the size of the
meal, kind of meal and personal variation.

* Solis notes page 18-19

 Presumption of Death
1. A person on board a vessel lost during a sea voyage or an
airplane, which is missing, who has not been heard of for
four years since the loss of the vessel or airplane.
2. A person in the armed forces who has taken part in war,
and has been missing for four years.
3. A person who has been in danger of death under other
circumstances and his existence has not been known for
four years.
 Presumption of Death
4. If both were under the age of fifteen years, the
older is presumed to have survived.
5. If both were above age 60, the younger is
presumed to have survived.
6. If one is under 15 and the other is above 60, the
former is presumed to have survived.
 Presumption of Death

7. If both be over 15 and under 60, and sexes be

different, the male is presumed to have survived,;
if the sexes are the same, then the older has
preference.
8. If one be under 15 or over 60, and the other
between those ages, the latter is presumed to have
survived
 MEDICO-LEGAL
CLASSIFICATION OF DEATH
1. Natural Death
2. Violent Death
a. Accidental death
b. Negligent death
c. Infanticide death
d. Parricidal death
e. Homicidal and Murder
 MEDICO-LEGAL
CLASSIFICATION OF DEATH
3. SPECIAL DEATH
a. Judicial death
b. Euthanasia
c. Suicide
d. Starvation
 JUDICIAL DEATH

1. Death by Electrocution
2. Death by Hanging
3. Death by Musketry
4. Death by Gas Chamber
5. Lethal injection
6. Others (e.g. beheading, crucifixion,
stoning)
 Lethal Injection
Conventional lethal injection protocol.
Typically, three drugs are used in lethal
injection. Sodium thiopental is used to induce
unconsciousness, pancuronium bromide
(Pavulon) to cause muscle paralysis and
respiratory arrest, and potassium chloride to
stop the heart.
 EUTHANASIA
Mercy Killing is a deliberate and painless acceleration of
death of a person usually suffering from an incurable and
distressing disease
TYPES:
1.Active Euthanasia
2.Passive Euthanasia
a. Orthothanasia sometimes used to denote the
deliberate stopping of artificial or heroic means of
maintaining life
b. Dysthanasia occurs when a person who is dying has
their biological life extended through technological
means without regard to the person's quality of life.
 SUICIDE
Evidence that will infer death is suicidal:
1.History of depression, unresolved personal
problem, mental disease
2.Previous attempt of self- destruction
3.If committed by infliction of physical injuries, the
wounds are located in areas accessible to the hand,
vital parts of the body and usually solitary.
 DEFINITION OF TERMS*
1. Parricide- killing of one’s relative
2. Infanticide- killing of a child less than three days
(72 hours) of age.
3. Murder (criminal homicide) – is the killing of one
by another sometimes with evident premeditation
or cruelty except when it is either parricide or
infanticide.
4. Homicide- is the killing of one by another person
not attended by any of the qualifying
circumstances of murder, parricide or infanticide.
A felony is CONSUMMATED when all the elements necessary
for its execution and accomplishment are present;

FRUSTRATED when the offender performs all the acts of

execution which would produce the felony as a consequence
but which, nevertheless, do not produce it by reason of
causes independent of the will of the perpetrator.
 
There is an ATTEMPT when the offender commences the
commission of a felony directly or over acts, and does not
perform all the acts of execution which should produce the
felony by reason of some cause or accident other than this
own spontaneous desistance.
 JUSTIFYING CIRCUMSTANCES*
1. Anyone who acts in defense of his person
or rights, provided that the following
circumstances concur;
a. Unlawful aggression.
b. Reasonable necessity of the means employed
to prevent or repel it.
c. Lack of sufficient provocation on the part of
the person defending himself.

http://www.un.org/depts/los/LEGISLATIONANDTREATIES/PDFFILES/PHL_revised_penal_code.pdf
 JUSTIFYING CIRCUMSTANCES*
2. Anyone who acts in defense of the person or rights of his
spouse, ascendants, descendants, or legitimate, natural
or adopted brothers or sisters, or his relatives by affinity
in the same degrees and those consanguinity within the
fourth civil degree, provided that the first and second
requisites prescribed in the next preceding circumstance
are present, and the further requisite, in case the
revocation was given by the person attacked, that the
one making defense had no part therein.

http://www.un.org/depts/los/LEGISLATIONANDTREATIES/PDFFILES/PHL_revised_penal_code.pdf
 JUSTIFYING CIRCUMSTANCES*
3. Anyone who acts in defense of the person or
rights of a stranger, provided that the first and
second requisites mentioned in the first
circumstance of this Art. are present and that
the person defending be not induced by
revenge, resentment, or other evil motive.
4. Any person who acts in the fulfillment of a duty
or in the lawful exercise of a right or office.

http://www.un.org/depts/los/LEGISLATIONANDTREATIES/PDFFILES/PHL_revised_penal_code.pdf
 CIRCUMSTANCES WHICH EXEMPT FROM
CRIMINCAL LIABILITY*
1. An imbecile or an insane person, unless the latter has acted
during a lucid interval.
2. A person under nine years of age.
3. A person over nine years of age and under fifteen, unless
he has acted with discernment, in which case, such minor
shall be proceeded against in accordance with the
provisions of Art. 80 of this Code.
4. Any person who, while performing a lawful act with due
care, causes an injury by mere accident without fault or
intention of causing it.

http://www.un.org/depts/los/LEGISLATIONANDTREATIES/PDFFILES/PHL_revised_penal_code.pdf
 MITIGATING CIRCUMSTANCES
AGGRAVATING CIRCUMSTANCES

http://www.un.org/depts/los/
LEGISLATIONANDTREATIES/PDFFILES/
PHL_revised_penal_code.pdf
 SUICIDE
Evidence that will infer death is suicidal:
1.Effects of act of self-destruction found in the body
of the victim
2.Presence of suicide note
3.Suicide scene in place not susceptible to public
view
4.Evidence which will rule out homicide, murder,
parricide, and other manner of violent death.
 DEATH CERTIFICATE
Who is responsible for the issuance of a
death certificate?
a.Death that occurred in the hospital
b.Death in emergency room
c.Death in the ambulance
d.Death that occurred outside the hosp.
e.Special cases/Mass deaths
 DEATH CERTIFICATE
Different types of causes of death in the death
certificate:
a. Immediate- most recent condition that directly
leads to death
b. Antecedent- other intervening cause/s
occurring between immediate and underlying
causes
c. Underlying-the disease or injury which initiated
the train of morbid events leading to death.
 DEATH CERTIFICATE
A 32 year old man dies from hypovolemic shock
after sustaining multiple fractures when he was
hit by a truck.

a.Immediate - HYPOVOLEMIC SHOCK

b.Antecedent- MULTIPLE FRACTURE
c.Underlying – PEDESTRIAN HIT BY A TRUCK
 DEATH CERTIFICATE
A 56 year old man dies from acute Myocardial
Infarction after 3 hours from being admitted to
the ICU. He was hypertensive.
a.Immediate – Myocardial Infarct
b.Antecedent- Hypertension
c.Underlying –
 METHODS OF DISPOSING
DEAD BODY
1. Embalming
2. Burial or inhumation
Death certificate may be issued by attending
physician, local health officer, municipal mayor,
municipal secretary, any councilor
3. Cremation
Use of the body for scientific purpose
 METHODS OF DISPOSAL OF THE DEAD
BODY
1. EMBALMING
Artificial way of preserving body be injecting formalin and
perchloride of mercury or arsenic in the common arteries
and the femoral arteries.
2. BURIAL or INHUMATION
Body must be buried within 48 hours after death except when
required for legal investigation or authorized by local
health authorities or when embalmed (impliedly allowed).
After 48 hours, new permit is needed. If with
communicable disease, within 12 hours after death unless
directed otherwise by local board of health.
 METHODS OF DISPOSAL OF THE DEAD
BODY
In Philippines, body needs to be buried within 24 hours because of
the climatic condition.
Death Certificate necessary before burial except in
cases of emergency. Primary duty of physician to furnish if
available. If not, local health officer, mayor, the secretary or of a
councilor. Order is successive and exclusive.

It must be forwarded within 48 hours after death. Permission from

the provincial fiscal or mayor is necessary if death due to violence
or crime.
 DISPOSAL OF DEAD BODIES
Persons Charged with Duty of Burial:
1.If married: surviving spouse if possesses means to pay the
necessary expenses.
2.Unmarried or child: nearest kin if they be adults and
within the Philippines and in possession of means to pay the
necessary expenses.
3.Unmarried or no kin left with means: municipal authorities

*Shall perform such duty within 48 hours after death, if able

to do so.
 BURIAL AND TRANSFER PERMIT

a. Municipal secretaries, in the capacity of secretaries

of municipal boards of health or as clerks to
municipal councils as the case may be, shall issue
burial or transfer permits upon the presentation of
the death certificate.
b. Copy of death certificate shall accompany transfer
permit if body will be transferred from one
municipality to another.
 BURIAL AND TRANSFER PERMIT

c. Those bodies with dangerous communicable disease

shall not be carried from place to place except for
burial or cremation. It is the duty of the local health
authorities to cause such body to be thoroughly
disinfected before being prepared for burial. Only
adult members of the family may be permitted to
attend the burial.
d. Burial permit (death certificate) must be presented
before burial.
 Burial Grounds Requirements
(PD 856, Code of Sanitation)
a. It shall be unlawful for any person to bury remains in
places other than those legally authorized in conformity
with the provisions of this Chapter.
b. A burial ground shall at least be 25 meters distant from
any dwelling house and no house shall be constructed
within the same distance from any burial ground.
c. No burial ground shall be located within 50 meters from
either side of a river or within 50 meters from any source
of water supply.
 Burial Grounds Requirements
(PD 856, Code of Sanitation)
a. It shall be unlawful for any person to bury remains in
places other than those legally authorized in conformity
with the provisions of this Chapter.
b. A burial ground shall at least be 25 meters distant from
any dwelling house and no house shall be constructed
within the same distance from any burial ground.
c. No burial ground shall be located within 50 meters from
either side of a river or within 50 meters from any source
of water supply.
 Burial Grounds Requirements
(PD 856, Code of Sanitation)
The burial remain is subject to the following requirements:
a.Shipment of remains abroad shall be governed by the rules and
regulations of the Bureau of Quarantine.
b.The burial of remains in city or municipal burial grounds shall
not be prohibited on account of race, nationality, religion or
political persuasion.
c.Except when required by legal investigation or when permitted
by the local health authority, no unembalmed remains shall
remain unburied longer than 48 hours after death.
 Restrictions as to funeral in cases of deaths
due to communicable disease

When the cause of death is a dangerous

communicable disease, the remains shall be
buried within 12 hours after death. They shall
not be taken to any place of public assembly.
Only the adult members of the family of the
deceased may be permitted to attend the funeral.
 RA 349 as amended by RA 1056 (Donations of
Human Body Parts)

a. The donation shall be authorized in writing by the donor

specifying the recipient, the organ or part of his body to be
donated and the specific purpose for which it will be
utilized.
b. A married person may make such donation without the
consent of his spouse.
c. After the death of a person the next of kin may authorize
the donation of an organ or any part of the body of the
deceased for similar purposes in accordance with the
prescribed procedure.
 RA 349 as amended by RA 1056
(Donations of Human Body Parts)
d. If the deceased has no next of kin and his remains are in the
custody of an accredited hospital, the Director of the hospital
may donate an organ or any part of the body of the deceased in
accordance with the requirement prescribed in this Section.
e. A simple written authorization signed by the donor in the
presence of two witnesses shall be deemed sufficient for the
donation of organs or parts of the human body required in this
Section
f. Any authorization granted in accordance with the requirements
of this Section is binding to the executors, administrators, and
members of the family of the deceased.
 Persons who can grants permission to used body parts
of deceased:
BEFORE DEATH:
1.Deceased during his lifetime
2.If minor, guardian with the approval of the court or by
the legitimate father or mother. Married woman can
give consent without husbands consent.
AFTER DEATH:
1.Nearest relative
2.Head of hospital or institution having custody in the
absence of relatives
 Persons permitted to detach body parts:

1. License physician or surgeon

2. Known scientist
3. Medical or scientific institutions
including eye banks.
 EXHUMATION

The deceased buried may be raised or disinterred upon

lawful order from fiscals, court and any entity vested
with authority to investigate. It must be identified by
relatives, friends or by marks on the body. Physician
must describe the coffin, clothing and degree of
decomposition before stating the actual disease or
violence in his report. Even members of NBI are
required to get permit from the Director of Health for
exhumation.
 EXHUMATION

Person died with for a cause other than

dangerous communicable disease may be
disinterred after 3 years of being buried or in
special cases, shorter time when in the opinion
of Director of Health, the public health will not
be endangered. It will be immediately
disinfected and inclosed in a coffin, case or box.
 Disinterment of remains is subject to the
following requirements:
a. Permission to disinter remains of persons who
died of non-dangerous communicable diseases
may be granted after a burial period of three
years.
b. Permission to disinter remains of person who
died of dangerous communicable diseases may
be granted after a burial period of five years.
 Disinterment of remains is subject to the following
requirements:
c. Disinterment of remains covered in paragraphs "a"
and "b" of this Section may be permitted within a
shorter time than that prescribed in special cases,
subject to the approval of the Regional Director
concerned or his duly authorized representative.
d. In all cases of disinterment, the remains shall be
disinfected and places in a durable and sealed
container prior to their final disposal.
e. If dead body is a subject matter of criminal
investigation, it may be exhumed anytime.
 assignment
1. STUDY MUMMIFICATION (p20)
2. DEATH BY ASPHYXIA (p56-63)
3. AUTOPSY (handouts from Maligaya)
 ASPHYXIA
TWO MAIN CLASSES
1.Due to respiratory obstruction
2.Circulatory arrest

In both of these, there is a reduction of the oxygen

content of the blood (hypoxia) as well as the
elevation of carbon dioxide content (hypercapnea)
 CLASSIFICATION OF ASPHYXIA
1. Asphyxia by hanging
2. Asphyxia by strangulation
3. Asphyxia by suffocation
4. Asphyxia by drowning
5. Asphyxia by compression on the chest
(traumatic crush asphyxia)
6. Asphyxia by breathing irrespirable gases
7. Asphyxia by hanging
 ASPHYXIA BY STRANGULATION
DIFFERENCE BETWEEN HANGING AND STRANGULATION BY LIGATURE
HANGING
Ligature mark is inverted V
shape with the apex at the
site of the know
Ligature mark is usually
above the thyroid cartilage
Hyoid bone and thyroid
cartilage is frequently injured
Vertebral injury is common
STRANGULATION
Ligature mark is either across
or below the thyroid cartilage
Ligature mark is either across
or below the thyroid cartilage
Fracture of the hyoid bone
and thyroid cartilage seldom
occurs
Vertebral injury is not
observed
 SPECIAL FORMS OF STRANGULATION
1. PALMAR STRANGULATION- the palms of the hand
will be used in applying pressure over the neck
2. GARROTING- form of judicial killing wherein a ligature,
metal strap or bowstring is placed around the neck and
tightened to the point of compressing the neck
3. MUGGING- assailant uses the arm or forearm, legs or
thigh in compressing the neck of the victim
4. COMPRESSION OF THE NECK WITH A STICK-
a piece of stick or pipe is used in applying pressure over
the neck and the assailant is either in front or the back of
the victim
 ASPHYXIA BY DROWNING OR SUBMERSION
Drowning or submersion is a condition of asphyxia due to
submersion in water or other fluid in such a manner that
there is hindrance in the free passage of air. The average
time for death to occur in drowning is 2-5 mins.
1.PRIMARY DROWNING- victim dies a few minutes after
placing or submersion in water
2.SECONDARY DROWNING- occurs when the victim shows
an initial apparent recovery from drowning but later on dies hours
or days after the incident

TETE DE NEGRI- bronze color of the head and neck due to

drowning
POST MORTEM FINDINGS - EXTERNAL
1. Hypostatic lividity on the head, neck and chest. In
putrefaction of the dead body assumes a greenish-
bronze or dark brown color
2. Pale face with foreign bodies clinging on the cloth
or body of the victim
3. “Champignon d ocreme” – a whitish foam at the
mouth or nostrils due to mucous secretions of the
respiratory tract and which by respiratory
movement whips by the substance into a foam
and goes to upper respiratory tract to the mouth
and nose
POST MORTEM FINDINGS - EXTERNAL
4. “Cutis Anserina” or goose- skin or gooseflesh. A
condition of the skin usually due to the contractor
of erector pili muscles during the process of rigor
mortis
5. “Washerwoman”- changes in the skin of the hand
and feet when immersed in water characterized
by bleaching, corrugation and sudden appearance
6. Clenched fist which holds foreign material like
weeds and sand indicative that the person was
alive when placed in water as well as an indication
of struggle of the victim for life.
POINTS TO REMEMBER
1. Classification of death
2. Kinds of death
3. Signs of death
4. How to approximate time of death and conditions
surrounding the death?
5. Different types and signs of death via asphyxia.
6. Did the injury/injuries occur ante or post mortem
7. Regulations pertaining to organ donation
8. Regulations pertaining to autopsy, burial and
exhumation of dead bodies.
THANK YOU VERY MUCH!