How important is it to recognise artefacts that can present themselves in medico-legal postmortem examinations and differentiation them from specific lesions/pehenomenon for example bruises, scavenging and would resusicitation artefacts concern the coroner more than the forensic pathologist
Answers:
Certain artifacts are specific to death and resuscitation efforts and should be easily recognized by forensic pathologists. I have only ever worked in places where the coroners *were* physicians, unlike the respondent above - they weren't pathologists, but would be aware of general medical issues, so they should recognize these too - but in general (e.g. if you're writing a novel) it would be fair to say that coroners might be more concerned.Also, the role of the coroner is often to decide whether or not a case gets a forensic autopsy, and so they are going more on circumstances of death. For instance, if one of my patients dies, there is a list of certain "flags" that mean the coroner has to be called - e.g. patient recently had surgery; patient lived in an old-age care home; patient died within 24 hours of hospital admission; patient died of complications relating to pregnancy/childbirth; patient died unexpectedly. The coroner will ask questions about what is thought to be the cause of death, recent health, etc., and decide whether to order an autopsy or to let the physician sign off on the death certificate.Specific artefacts include: darkening of the skin over the dependent part of the body (usually the back of the shoulders and trunk, if the body is lying on its back) due to pooling of blood after death; cracked sternum or ribs broken over the front of the chest from CPR efforts (usually with some associated bruising); possible red marks/patches from the defibrillator pads. Depending on what was done during resuscitation there may also be mouth or nasal injuries from rapid insertion of endotracheal tubes (not usually, but for instance teeth could be chipped) and bruising from insertion of intravenous access. If things got really crazy there could be puncture marks in the left upper quadrant from an attempt to stick a large needle into the heart sac (to drain possible cardiac tamponade = fluid around heart) or chest tubes inserted.Most of these are pretty evident. If, however, you have someone who had a crushing blow to the chest, it obviously would be important to recognize this as cause of death and not write off bruising/rib fractures as related to resuscitation.There are other, internal findings that can be incidental but may be relevant. Kids get a skeletal survey, which checks all the bones for evidence of old fractures (possible indicator of past abuse.) Hope this is the kind of info you were looking for.
sorry, this is too hard for me.
in forensic autopsy, u usually check the possibilities of things that went in the body and the things that went out of the body before and after death.. You have to check the air passages and the possible entry points, both natural and artificial. natural entry points are the mouth, nostrils, ears etc. Unnatural are the wounds.. but u still got o classify the wounds as before death or post-mortem.
These are importand because they can verify the cause of death which is important o those concerned. Artifacts should concern both pathologist and the coroner..watch CSI once in awhile but separate the facts from the fiction though. i forgot, be sure to classify artifacts as before death or post-mortem too.
The coroner is often someone without any medical training, so a lot of things can get by a coroner--especially in a small town.Usually, traumatic death is not subtle, and the lesions are predictable. It's a very rare case when the diagnosis hinges on one mark on the person's body. However, lawyers are very good at twisting someone's words and creating bizarre scenario's to create "reasonable doubt"(Isn't it possible he stabbed himself in the back 10 times, and then tied himself up?), so if you can see that a case will be high profile, it pays to pay extra attention to detail and documentation.
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