CHAPTER V

MEDICO-LEGAL
INVESTIGATION OF
DEATH
BY: NOEL B. LAPAZ, RN,RCrim
INQUEST OFFICER – an official of the state charged
with the duty of inquiring into certain matters. In a
medico-legal investigation, an inquest officer is the
one charged with the duty of investigating the
manner and cause of death of a person. He is
authorized to summon witnesses and direct any
person to perform or assist in the investigation with
necessary.

The following officials of the government are authorized

to make death investigations:
The Provincial and City Fiscals.
The district health officer, upon request of any
provincial fiscal of a province within his district or
of any judge of a Court of the First Instance, or of
any justice of the peace, shall conduct in person,
investigations in cases of death where there is
suspicion of death was caused by the unlawful act or
omission of any person, and shall make such other
investigations as may be required in the proper
administration of justice.
2. Judges of the Courts of
the First Instance (now
Regional Trial Courts).
3. Justice of the Peace
(now Municipal Trial
Court)
4. The Director of the
National Bureau of
Investigation – Rep. Act.
157 (An act creating the
National Bureau of
Investigation)
5. The Chief of Police of the City of Manila – Sec. 34, Rep. Act 409
(Revised Charter of the City of Manila) as amended by Sec. 1, Rep.
Act 1934:
“There shall be a chief of police …..(who) shall cause medico-legal
examination by the medical examiner of the Manila Police
Department of victims of violence or foul play, sex crimes, accidents,
sudden death when the cause thereof is not known………..”
6. Solicitor General: Sec. 96 (b) P.D. 856 (Code Sanitation of the
Philippines)
Autopsies shall be performed in the following cases:
3…..
4. Whenever the Solicitor General, provincial or city fiscal as
authorized by existing laws, shall deem fit necessary to disinter and
take possession of remains for examination to determine the cause of
death.
STAGES OF MEDICO-LEGAL INVESTIGATION
1.Crime Scene Investigation (investigation of the place of
commission of the crime).
2.Autopsy (investigation of the body of the victim)

1.CRIME SCENE INVESTIGATION

Crime Scene – it is the place where the essential
ingredients of the criminal act took place. It include the setting
of the crime and also the adjoining places of entry and exit of
both offender and victim.

Crime scene investigation includes appreciation of its

condition and drawing an inference from it. It also includes the
collection of the physical evidences that may lead to the identity
of the perpetrator, the manner the criminal act was executed, and
such other things that may be useful in the prosecution of the
case.
IMPORTANCE OF CRIME SCENE
INVESTIGATION:
A great amount of physical evidence may be lost or
unrecovered if the investigation merely starts at the
autopsy table or in the medical examining room. Blood,
semen and other stains, latent finger and footprints, and
articles of value that may lead to the identification of the
offender and victim may be beyond the comprehension of
the investigator if the crime scene is not investigated.

Persons to Compose the Search Team:

a. A physician who has had previous knowledge and
training in medico-legal investigation must direct the
search and assume responsibility for an effective search.
b. A photographer whop will take pictures of the scene and the
pieces of evidence recovered. He may also act as sketcher and
measurer.
c. An assistant who will act as the note taker, evidence collector
and helper.

Equipment Needed in Crime Scene Investigation:

a.Searching for physical evidence – flashlight and magnifying
lens.
b.Collection of evidence – forceps, knife, screw driver, scalpel,
cutting instruments like plier, pair of scissors and fingerprint kit.
c.Preservation and transportation of evidence - bottles,
envelopes, test tubes, pins, thumb tacks, labelling tag and pencil.
d.Documentation – camera, sketching kit, measuring tape,
compass, chalk or any writing instrument.
Methods in Conducting a Search:
a.Strip Method – area is blocked out in the form of a
rectangle.
b.Double Strip or Grid Method – searchers will traverse
first parallel to the base and then parallel to the side.
c.Spiral Method – searchers will follow each other in the
path in the spiral manner beginning from the center
towards the outside or vice versa.
d.Wheel Method – searchers gather at the center and
proceed outwards along radii or spokes.
e.Zone Method – whole area is divided into subdivisions or
quadrants and search is made in the individual quadrants.
Disposal of the Collected Evidence:
-All evidences collected must be protected, identified and
preserved. Reasonable degree of care must be exercised to
preserve shape, minimize alterations due to contamination,
chemical changes, addition of extreneous substances.

Examination of the Dead Body in the Crime Scene:

Special Consideration:
a.Evidences which will tend to prove identity.

b.Position of the victim.

c.Condition of the apparel worn.

d.Approximate time of death.

e. Presence of wounding instrument and its approximate
distance from the body.
f. Potential cause of death.

In a death caused by gunshot, the clothing must be left

undisturbed at the crime scene.
a.Bullet might have produced an exit on the skin but failed
to cause mark or tear on the clothings which through
improper handling may not be recovered.
b.Examination “in situ” may be useful in the determination
of the site of entrance and exit of the bullet and also the
trajectory of the shot.
AUTOPSIES
An autopsy is a comprehensive study of a dead body,
performed by a trained physician employing recognized
dissection procedure and techniques. It includes removal of
tissues for further examination.

Post-mortem examination – refers to an external

examination of a dead body without incision being made,
although blood and other body fluids may be collected for
examination.

Autopsy – indicates that, in addition to an external

examination, the body is opened and an internal
examination is conducted.
POST-MORTEM EXAMINATION
POST MORTEM
Kinds of Autopsies:
a. Hospital or Non-official Autopsy
b. Medico-legal or Official Autopsy
 
a. Hospital or Non-official Autopsy:
This is an autopsy done on a human body with the consent
of of the deceased persons' relatives for the purpose of:
determining the cause of death;
providing correlation of clinical diagnosis and clinical
symptoms;
determining the effectiveness of therapy;
studying the natural course of disease process
educating students and physicians.
b. Medico-legal or Official Autopsy:
This is an examination performed on a dead
body for the purposes of:
determining the cause, manner (mode), and
time of death;
recovering, identifying and preserving
evidentiary materials;
providing interpretation and correlation of
facts and circumstances related to death;
providing factual, objective medical report
for law enforcement, prosecution, and
defense agnecies;
separating death due to disease from death
due to external cause for protection of the
innocent.
 
 When shall an autopsy be performed on a dead body:
 Sec. 95 (b), P.D. 856, Code of Sanitation:
 a. Whenever required by special laws;
 b. upon order of a competent court, a mayor and a provincial or city fiscal;
 c. upon written request from police authorities;
 d. whenever the Solicitor General, Provincial or city fiscal as authorized by
existing laws.
 e. whenever the nearest kin shall request in writing the authorities
concerned in order to ascertain the cause of death.
  
 Persons who are Authorized to Perform Autopsies and Dissections:
 a. health officers;
 b. Medical officers of law enforcement agencies and
 members of the medical staff of accredited hospitals.
a. Health Officers
The health officers referred to by the Sanitation Code are
the district health officer and local health officer (rural
health officer).
District Health Officer
Local Health Officer
b. Medical Officers of Law enforcement agencies:
1. Medical examiner of the City of Manila
2. Medical staff of the National Bureau of Investigation
3. Medico-legal officers of the Philippine Constabulary
assigned in the Philippine Constabulary Crime
Laboratory.
Members of the medical staff of accredited hospital.
 Pathological Autopsy Medico-legal Autopsy

a. Requirement Must have the consent of the next of kin It is the law that gives the consent.
Consent of relatives are not needed.

b. Purpose Confirmation of clinical findings of Correlation of tissue changes to the

research criminal act.

c. Emphasis Notation of all abnormal findings Emphasis laid on effect of wrongful act
on the body. Other findings may only be
noted in mitigation of the criminal
responsibility.

d. Conclusion Summation of all abnormal findings Must be specific for the purpose of
irrespective of its correlation with determining whether it is in relation to the
clinical findings criminal act.

Minor or non-pathological Need not be mentioned in the report If the investigator thinks it will be useful
in the administration of justice, it must be
included.
Other Salient Features Peculiar to Medico-Legal Autopsies:
Clinical history of the deceased in most instances absent, sketchy or doubtful.
The identity of the deceased is the responsibility of the forensic pathologist.
The time of death and the timing of the tissue injuries must be answered by the
forensic pathologist.
Forensic pathologist must alert himself of the possible inconsistencies.
 
The following manner of death should be autopsied:
a. Death by violence
b. Accidental death
c. Suicides
d. sudden death of persons who are apparently in good health.
e. Death unattended by physicians.
f. death in hospitals or clinics wherein a physician was not able to arrive at a clinical
diagnosis as the cause of death.
g. death occurring in an unnatural manner.
  
Guidelines in the Performance of Autopsies:
1. Be it an official (medico-legal) or non-official autopsy, the pathologist must
be properly guided by the purposes for which autopsy is to be performed.
 
2. The autopsy must be comprehensive and must not leave some parts of the
body unexamined.
3. Bodies which are severely mutilated, decomposing or damaged by fire, are
still suitable for autopsy.
4. All autopsies must be performed in a manner which show respect of the
dead body. Unnecessary dissection must be avoided.
5. Proper identity of the deceased autopsied must be established in non-
official autopsy. An autopsy on a wrong body may be a ground for
damages.
6. A dead body must not be embalmed before the autopsy.
The body must be autopsied in the same condition when found at the crime
scene.
 
Precautions to be Observed in Making Medico-legal Post-mortem
Examination:
The physician must have all the necessary permit or authorization to
perform such an examination which must be issued by the inquest officer.
The physician must have a detailed history of the previous symptoms and
condition of deceased to be used as his guide in the post-mortem
examination.
The true identity of the deceased must be ascertained.
Examination must be made in a well-lighted place and it is advisable that no
unauthorized person should be present.
All external findings must be properly described and if possible a sketch
must be made or photograph must be taken to preserve the evidence.
All steps and findings in the examination must be recorded.
 
Rules in the Examination:
Look before you cut.
Never cut unless you know exactly what you are cutting.
Weigh and measure everything that can be weighed or measured.
 
Stages in the Post-mortem Examination of the Dead Body:
1. Preliminary Examination
a. Examination of the Surroundings (Crime Scene)
b. Examination of the Clothings
c. Identity of the Body
2. External Examination
a. Examination of the Body Surfaces
b. Determination of the Position and Approximate Time of Death
 
Internal Examination
 ABDOMINAL CHEST WALL:

Fat Amount, color, moisture, fibrosis

Musculature Development, color, thickness, atrophic changes

PERITONEAL CAVITY

Fluid Amount, character, color, consistency, purulent or bloody material

Omentum Amount of fat,extent, adhesions, blood distribution, color

Liver Level of anterior border, adhesions, blood distribution, color, fatty or atrophic
changes.

CHEST CAVITY

Fluid Amount, color, character, consistency, purulent or bloody materials

Adhesions Kind, extent, concommitant disease, distribution

Pleura Luster, hemorrhage, disease

Mistakes in Autopsies:
Error or omission in the collection of evidence for
identification.
a. failure to make frontal, oblique and profile photographs of
the face.
B. Failure to have fingerprints made
c. failure to have a complete dental examination performeed
2. Errors or ommision in the collection of evidence required for
establishing the time of death.
3. Errors or omission in the collection of evidence required for
other medico-legal examination.
4. Error or omission result in the production of undesirable
artifacts or in the destruction of valid evidence.
Negligent Autopsy – an autopsy wherein no cause of death is
found on account of imprudence, negligence, lack of skill or
lack of foresight of the examiner. The act of omission which
may be inadvertent or deliberate may be:
Failure to have an adequate history or facts and circumstances
surrounding the death.
Failure to make a thorough external examination.
Inadequate or improper internal examination.
Improper histological examination.
Lack of toxicological or other laboratory aids.
Pathologist incompetence.