This blog will discuss anything related to the practice of forensic pathology. Topics will including recent articles in the medical literature, interesting cases in the news, TV forensics, and the general day to day things I have to deal with as a forensic pathologist. If there is something you want to know or have an idea for a topic, drop me a line. I am going to try and spend some time on histopathology with the hope of getting fellows ready for the boards!
Friday, April 29, 2011
What's the Diagnosis April 29, 2011
This is a very typical board-type question: What's the manner of death?
I recognize these changes from a case I once had, and a great book I have read recently. I will let someone else think up the answer as to what these changes represent. Depending on the background information and the autopsy findings the manner of death could theoretically be any of the four manners, really.
Many specimens in "regular" pathology have similar artifacts from electrodissecting devices used during operations, so my guess is an electric shock/electrocution.
I had to google the 4 manners of death according to forensics, but as acekpinnarm said it could probably be all of those 4: natural (lightning strike), accidental, homicide or suicide. Any affirmative conclusion cannot be made on histomorphologic grounds alone.
Lightning strike would be an accidental death (unless you're really careless). Natural death refers to death from a disease, although what you write makes sense. I was just being purposefully obnoxious, i.e. a person could die from a disease and have these changes as an incidental finding. Most electrocutions are accidental, follow by suicidal and homicidal. Which brings up a question: How is capital punishment certified? As a homicide?
Not only capital punishment, how do you certify death due to gunshot by police/other authority let say during an ambush? My prof once suggest to put as "judicial death"....well, we do not certify death here so not a big problem anyway....
Great comments everyone!! Like I said, I had this exact question on my forensic boards. All manners were options. This is in fact electrocution. I answered the question as accident; It was the most likely answer. Most electricutions that I have seen have been accidents. I've seen a few suicides where people have made contact with the third rail. Lightening strikes are accidental. I see a few every summer. I still am amazed by that. I can't imagine nothing more natural than being struck down by a bolt of lightening! Under most circumstances, environmental deaths are accidents. Judicial executions are homicides as are police shootings. The death of an individual at the hands of another is a homicide. With police shootings, it's typically justified and no charges are filed. It's up to the DA or whoever to file charges, and that's true regardless of how I sign a case out. I like this manner discussion! Maybe this weeks blog will continue with this theme!
I recognize these changes from a case I once had, and a great book I have read recently. I will let someone else think up the answer as to what these changes represent. Depending on the background information and the autopsy findings the manner of death could theoretically be any of the four manners, really.
ReplyDeleteHA! You said it! I actually had this question on my FP boards with all manners as options. I guess pick the most common!
ReplyDeleteMany specimens in "regular" pathology have similar artifacts from electrodissecting devices used during operations, so my guess is an electric shock/electrocution.
ReplyDeleteOk, but how about manner? The boards are full of questions like this. Annoying.
ReplyDeleteI had to google the 4 manners of death according to forensics, but as acekpinnarm said it could probably be all of those 4: natural (lightning strike), accidental, homicide or suicide. Any affirmative conclusion cannot be made on histomorphologic grounds alone.
ReplyDeleteLightning strike would be an accidental death (unless you're really careless). Natural death refers to death from a disease, although what you write makes sense. I was just being purposefully obnoxious, i.e. a person could die from a disease and have these changes as an incidental finding. Most electrocutions are accidental, follow by suicidal and homicidal. Which brings up a question: How is capital punishment certified? As a homicide?
ReplyDeleteNot only capital punishment, how do you certify death due to gunshot by police/other authority let say during an ambush? My prof once suggest to put as "judicial death"....well, we do not certify death here so not a big problem anyway....
ReplyDeleteThis comment has been removed by the author.
ReplyDeleteGreat comments everyone!! Like I said, I had this exact question on my forensic boards. All manners were options. This is in fact electrocution. I answered the question as accident; It was the most likely answer. Most electricutions that I have seen have been accidents. I've seen a few suicides where people have made contact with the third rail.
ReplyDeleteLightening strikes are accidental. I see a few every summer. I still am amazed by that. I can't imagine nothing more natural than being struck down by a bolt of lightening! Under most circumstances, environmental deaths are accidents.
Judicial executions are homicides as are police shootings. The death of an individual at the hands of another is a homicide. With police shootings, it's typically justified and no charges are filed. It's up to the DA or whoever to file charges, and that's true regardless of how I sign a case out.
I like this manner discussion! Maybe this weeks blog will continue with this theme!