medical forensics

The bags of cocaine seen here in the stomach were swallowed by the victim as a form of concealment. This method is also used by persons smuggling drugs. A latex condom is typically used as a container. Occasionally, the container ruptures or leaks, and a drug overdose ensues, as happened here.

An acute cocaine overdose presents with a number of symptoms. Body temperature will dramatically increase and a person will typically experience a drug induced psychosis. Vasoconstriction is one of the main effects of cocaine, and this results in a dramatically increased blood pressure. The most common cause of death in these cases is a heart attack, but a person can also die from a stroke or seizures. 

A Basic Overview of the Many Different Types of Death

When talking about death forensically, or medically, there are many different categories of death, and types of deaths to consider. Here, I will walk you through some of the basics.

Basic definitions

Thanatology: is the scientific study of death. It investigates the mechanisms and forensic aspects of death, such as bodily changes that accompany death and the post-mortem period, as well as wider social aspects related to death. the types of deaths investigated in a forensic context include:

  • Violent deaths (accidents, homicides, suicides)
  • Suspicious deaths
  • Sudden and unexpected deaths
  • Deaths without a physician in attendance 
  • Deaths in an institution (such as a prison)

Death: Cessation of life. In lower multicellular organisms, death is a gradual process at the cellular level, because tissues vary in their ability to withstand deprivation of oxygen. In higher organisms, death is a cessation of integrated tissues and organ functions. In humans, death is manifested by the loss of heart beat, the cessation of breathing, and cerebral death.

Cerebral Death: Permanent loss of cerebral and brainstem function, manifested by the absence of responsiveness to external stimuli, absence of cephalic reflexes (reflexes associated with the cranial nerves) and apnea (absence of breathing). 

Delayed Deaths: Long delay between injury and death, as long as the death was a result of the injuries. An example of this would be a person being shot, living through the experience, but dying years later from health complications arising from being shot. In such as case as someone being shot, the death may be ruled a homicide, although the death happened years after the initial gunshot, and legal ramifications may be dealt out.

Cause, Mechanism, and Manner of Death

Cause of death: Any injury or disease that produces a physiological derangement in the body that results in the death if the individual.

Mechanism of Death: The physiological derangement produced by the cause of death that results in death.

Manner of Death: Explains how the cause of death came about. They can generally be categorized as:

  • Natural
  • Homicide
  • Suicide
  • Undetermined

So basically, the cause of death is the initial injury or disease that was inflicted upon a person. The mechanism of death is the body’s resulting reaction to the disease or injury; a biochemical or physiological abnormality is produced. The manner of death is simply used by medical examiners in order to categorize cause and mechanism of death. For example, a person can be shot (the cause of death, the initial injury), and die of a massive hemorrhage (the mechanism of death, the physiological abnormality), and the death is ruled a homicide (the manner of death). 

Forensic pathologists evaluate the evidence of a case, as well as the results of the autopsy (if one is performed) in order to determine the manner of death. It is the job of the forensic pathologist to compare the accounts of what happened to the victim, and the forensic evidence and determine if those two things match up or not. For example, a person is found dead due to a fatal gunshot wound. A witness says that the person committed suicide, but the forensic evidence reveals a gunshot wound to the back of the head, inflicted from a distance. The forensic evidence and the account of what happened do not match in this case, which might lead the forensic investigator to determine the manner of death to be homicide instead of suicide.

Subcategories Within Natural Death: Sudden and Unexpected Deaths

Sudden deaths and unexpected deaths are the two most common types of natural deaths. Sudden deaths can be instantaneous, sudden but not instantaneous, or a case where the person was found dead, and it is unclear if it was instantaneous or not.

Sudden, Instantaneous Death

A sudden, instantaneous death can occur in many different forms, but the most common one is someone walking along, and suddenly they collapse, and they are dead upon hitting the ground. The most common cause of this type of death is ventricular arrhythmia due to coronary artery disease. A person who died a sudden, instantaneous death will often show impact abrasions on the bony ridges of their body and face (check bone, forehead, chin, elbows, knees, etc.) The impact abrasions are caused by the individual’s inability to brace their fall; the person is usually dead before they hit the ground, therefore they cannot brace their fall. Impact abrasions are a good way to distinguish an instantaneous death from a sudden, but not instantaneous death.

Sudden, But Not Instantaneous Death

The sudden, but not instantaneous death is simply slower than instantaneous death. The person usually has time to complain of chest pain, difficultly breathing, weakness, sweating, or nausea (or any other symptoms) before they collapse and die. Depending on how long it takes the person to die, the death may not be considered sudden. Most medical examiners consider a death within a hour of the onset of symptoms a sudden death. Usually people who die sudden, but not instantaneous deaths die on the way to the hospital, or in their homes. In their homes, the individuals are usually found in their bed, or in some type of intentional position, as opposed to instantaneous deaths, where the individuals are usually found sprawled on the floor, or in a position indicative of a fall. Individuals who die sudden, but not instantaneous deaths usually do not have impact abrasions, but in some cases, they may.

Unexpected Deaths

There are two types of unexpected deaths, really. There are unexpected deaths that come about because of a car crash, or train derailment, building collapse, a fatal fall, etc. These are unexpected deaths, but the manner of death is usually classified as accidental. In this section, we will talk about unexpected natural deaths. Unexpected natural deaths are usually individuals who are found dead (of some natural cause) and it cannot be determined whether the death was instantaneous or not. The classification of unexpected death is mainly used when the medical examiner cannot determine the type of sudden death that occurred.

Mechanical asphyxia, including strangulation, can be marked by the appearance of petechial haemorrhages on the conjunctiva, as shown here. However, such a finding is not specific for this injury and can be seen with other conditions. Of course, finding ligature marks on the neck, hyoid bone fracture, and/or soft tissue haemorrhages in neck and larynx may help to determine the mechanism of injury.

Saponification is the process of the human body partly or completely turning to soap. The fatty tissue and the liquid from putrefaction gradually form into adipocere, which is also known as grave wax. This process can happen to emabalmed and non-embalmed bodies. It is most common with those who are overweight. The photograph above is of “The Soap Lady” who is housed at the Mutter Museum. She is entirely composed of grave wax.

Solve A Case

- Deduction Practise

A police officer, his wife and their six year old daughter have been found dead in a shared hotel room.

The family had been on their way to Cardiff and decided to spend a night in the historical holiday cottage and to enjoy this years traditional horserace before visiting relatives in the city. There were no visible marks found on their bodies, except for reddish discolored nail beds and some purple-red spots on the extremities and torso. The child and the mother also had small cuts on their wrist, hands and forearms from playing with the cats of the cottage owner.

The father of the family had complained about a headache to his colleague during a call the evening before and complained that he would have done better to choose a room that was above ground floor with a better view and better lightning.

However, rumor has it, that the family of the police officer had preferred the protectiveness of the room without big windows as they had been attacked by a stalker in their home in Oban. It is to be assumed that this attack might also have been the reason for their spontaneous holiday.

Authorities are continuing the search for the stalker who has been officially declared a suspect. The man has been described as 1.7m tall, tanned, with a muscular physique (approximately 90kg) who speaks with a Scottish accent and has short brown hair and is wearing a black and yellow uniform. If you have any information on this man call your local police by dialling 101 or call the Crimestoppers on 0800 555 111 anonymously.

The police investigation will continue and we will keep you updated as soon as the pathological report is released.


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Post scriptum: This riddle is designed to be comparably simple and to include some facts. However, keep in mind that any resemblance to actual persons, living or dead, or actual events is purely coincidental.