CDI Reviewer
CDI Reviewer
CDI Reviewer
What is Crime?
Crime is an act or the commission of an act that is forbidden or the omission of a duty that is commanded
by a public law and that makes the offender liable to punishment by that law.
Gaban states that "crime is a violation of societal rules of behavior as interpreted and expressed by a
criminal legal code created by people holding social and political power. Individuals who violate these
rules are subject to sanctions by state authority, social stigtna, and lose status (p. 5). It can take place at
anytime, anywhere and in any for it affects all of us. It affects our way of life and ways of living
High crime rate affects public safety and the country An example is when heavy traffic results from a
shootout street; another example is when the price of rice jacks economy. a nearby due to artificial rice
shortage because of rice hoarding by some unse apulous rice traders.
Article 3 of omissions punisha Moreover, felonies Revised Penal Code (RPC) states that acts and by law
are felonies (delitos); Crimes are felonies. committed not only by means of deceit (dolo) but also by
means of ult (culpa), Crimes are either informed actions or passive actions. Cria is an informed action if
the perpetrator has a deliberate intent to pearn the act, for example is when a burglar needs money to pay
the spital bill of his son, and thus he robbed a retail store. Crime as a passive action is when perpetrators
do not have a deliberate intent to perform the act and it is a result of negligence, imprudence and lack of
foresight or skill. An example for crime as a passive action is when a person bought a phone from a
friend without knowing that the phone that he bought was a stolen phone.
There are three types of crimes; namely crimes against the person, crimes against
property and crime against society.
● Crimes against the person are crimes that are directed to an individual person's body,
honor and life. It refers to a broad array of criminal offenses which usually involve bodily harm,
the threat of bodily harm, or other actions committed against the will of an individual; murder.
assault/ battery and harassment are classic examples of crime against person.
● Crimes against property are crimes that are directed to a person's belongings, intellectual
properties and money. It includes many common crimes relating to theft or destruction of
someone else's property. The object of crimes against property, such as, robbery, bribery, and
burglary, is to obtain money, property, or some other benefit from a victim (NIBRIS, 2011) or
destruction of someone else's property as in the crime of arson.
● Crimes against society are directed to the community's moral code and values. Crimes
againsts society, e.g.. gambling, prostitution, and drug violations, represent society's prohibition
against engaging in certain types of activity (NIBRIS, 2011). These are crimes that negatively
affect society, rather than individuals or property.
Revised Penal Code of the Philippines
Act No. 3815 or the Revised Penal Code of the Philippines is considered as one of the
Philippines most enduring pieces of legislation. It is the basic law that defines criminal offenses
and provides the penalties for the commission of those offenses.
Before it was enacted, the Filipinos were following the Spanish Código Penal of 1870. This has
been in force from 1886 to 1930. This served as the basis of the Revised Penal Code of the
Philippines. Although the RPC was enacted on December 8, 1930 it took effect on January 1,
1932. The Revised Penal Code is divided in two books. The first book contains general
provisions regarding criminal offenses, the persons liable and the imposition of penalties. On the
other hand, the second book describes the acts that constitute criminal offenses and the penalties
for the commission thereof.
According to the explanatory note of Hon. Niel C. Tupas of the 5th district of Iloilo, on House
Bill No. 2300; the Revised Penal Code of the Philippines contains antiquated provisions and it
has largely been ineffective in addressing organized crime, transnational crime, cybercrime and
such other emergent criminal activities that proliferate today. Since there are inadequacies on the
Revised Penal Code, the Legislative branch created several penal laws. These Special Penal Laws
are legislative provisions on how to deal with special crimes that is not covered by the Revised
Penal Code such as carnapping, cybercrimes, drug trafficking, gunrunning, intellectual property
theft, kidnapping for ransom, smuggling, trafficking in persons, and money laundering, just to
name a few.
The crimes that are penalized in the Revised Penal Code are generally "Mala in se" crimes that
are considered wrong in and of themselves. The phrase literally means wrong in itself. The
criminal liability would only arise when there is criminal intent or negligence in the commission
of the punishable act. The distinguishing factor of crimes mala in se is not their severity, but that
the public feels they are morally wrong in and of themselves, and require no outside reasons to
prove or justify their wrongness.
Example: murder, theft and fraud.
While crimes that are "Mala prohibita" is a term applied to any action that is criminalized
strictly by state and statutory law. The phrase translates as wrong because it is prohibited. They
are acts criminalized by state in an effort to regulate the general behaviors of society. The moral
trait of the offender is not considered; it is enough that the prohibited act was voluntarily done.
Example: smuggling, drug trafficking and cybercrime.
The crimes that are penalized in Special Penal Laws are generally "Mala prohibita no criminal
intent is needed in order to find a person liable for crimes punished under Special Penal Laws. As
long as the act is committed, then it is punishable as a crime under law.
In this book we will be discussing some prominent Special Penal Laws that describe and penalize
the seven (7) most prevalent special crimes in the country today, namely:
1. Carnapping 2.Cybercrimes
3. Drug trafficking
4. Gunrunning
5. Smuggling
6. Trafficking in Persons
7. Money laundering
CHAPTER 2
The two most basic functions of police work are: the Protection of Life and Property and the
Maintenance of Peace and Order. When either or both of these fundamental functions fail, the third
basic task, Investigation, must be undertaken.
Criminal investigation is designed to bring the criminal to justice through the identification and location of
suspect/s, providing of proofs through the collection of evidences and analysis of information which all
consist of reliable persons and things. It is the criminal investigator who performs these critical tasks in the
modern police department.
The criminal investigator must develop several skills and qualities to become an effective investigator
and solve cases. He must be thorough, methodical and calm under pressure. He must be logically
persuasive, analytical not only of the crime, but also of the potential subjects. He must be keen in
identifying key witnesses and their contributions to the investigation as this will lead to the solution of the
case and bringing the guilty party to the bar of justice (PNP, 2011).
Criminal Investigation is the coffun of facts in order to accomplish the three fold aim: a) touly the
guilty party, b) to locate the guilty party, and ejto pre evidence to the suspect's guilt (PNP,
2011). It is a process of construction of an event, which incorporates logical process of deductive
reasoning that leads to a conclusion based on specific facts. Thus, a criminal investigation is the lawful,
objective, logical search for people and things useful in reconstructing the circumstances surrounding the
commission of a crime. Moreover, criminal investigation seeks all facts associated with a crime to
determine the truth relating to what happened and who is responsible.
Careful gathering of information and the thorough evaluation of this information are the two essential
processes in criminal investigation. These will lead to a full understanding of the connection between the
crime, its victim and perpetrator, and the pieces of evidence."
The investigative process must be thought of in terms of gathering information, instead of gathering
evidence. Information is essential in order to understand the relationship between the crime and the items
of evidence. There are two sources of information: People and Things,
Information is derived from people and may not always be admissible in a court of law. Information
consisting of rumors, tips, and hearsay can often place an investigator on the right track to solve a crime,
but will probably never appear in the testimony. The collection of this information requires the unique
skill and ability to elicit facts that can be used to help uncover the truth, whether it comes from the
victim, an eyewitness, or a suspect in the crime.
Each source must be dealt with in a unique and skillful manner in order to obtain the information desired.
A good investigator must be well-versed in conversational skills and be able to successfully draw out
information that may not be readily forthcoming.
Physical evidence often provides invaluable information to the investigator. However, this information
cannot be used if the investigator does not understand and recognize the strict rules for collecting,
preserving and presenting this evidence once it is discovered. Physical evidence consists of inanimate
objects that cannot lie or flee (Hess, K., and Orthmann, C.H, 2009). The investigator must develop a keen
sense of detail when concerning potential items of evidence. Frequently, key items of evidence may be
microscopic in size, but monumental in helping to prove a crime that has been comunitted.
For example, hairs, fibers, or minute specimens of blood may be the one item of physical evidence that
helps convict a criminal in the absence of eyewitness identification. Familiarity with forensic science is
essential to becoming a successful investigator. Physical evidence annot generally speak for itself. It
needs someone to identify it. interpret it, and then present it for final evaluation by a court.
Relative Weight of Information
Courts throughout the world have consistently given higher relative evidentiary value to information
obtained from things, as compared to information obtained from persons. The reason for this is firmly
established in the fact that things cannot lie and are not affected by emotion or motive. Direct testimony
from persons may be subject to any of these defects. Therefore, courts have always given more weight to
physical evidence when trying a case (UNODC, 2006).
Verbal testimony must strike a balance with physical evidence before a criminal investigation is
considered complete. A case heavily weighted in one direction or the other exclusively can result in a
questionable outcome (UNODC, 2006).
Unanswered Questions
After obtaining all of the information and evidence related to the case, the investigator may still not be
able to answer all of the questions surrounding the crime. Quite frequently, cases are closed and
forwarded to the prosecutor for trial with some unanswered questions.
This is not always the fault of the investigator, but many times a reflection of the various individuals
involved in the case, as well as the evidence discovered. An investigator may fail to answer all of his
questions for a variety of reason. Some of these are as follows:
1. Incomplete information or confusion on the part of the victim due to trauma or stress related to the
offense
2. Missing or destroyed evidence due to accidental actions or in purpose on the part of the victim and/or
suspect. The victim of a rape may feel the need to wash before calling the police; thereby, innocently
destroying valuable evidence. A suspect may permanently dispose of a murder weapon; thereby,
climinating it as a key piece of evidence.
3. The suspect may confess to the crime, but leave out pieces of key information in an attempt to
downplay his/her premeditation or to lessen the role they played in the crime, particularly if there are
accomplices.
4. Eyewitnesses to the crime may provide inaccurate information due to personal bias,
confusion, or fear of retribution by the suspect(s).
Eyewitnesses to the crime may have left the area before the arrival of the police and may never have come
forward to offer their information.
Six Cardinal Points of Criminal Investigation
The goal of a criminal investigation is to determine the truth of the matter, as far as it can be found, in a
post facto inquiry (after the fact), so that a perpetrator can be brought to justice or an innocent party be
cleared.
A good investigation has been conducted when all the investigative leads have been followed to their
logical conclusion for filing of a case and subsequent arrest. Sometimes, there is an instance that evidence
is not enough to support an arrest.
Thus an investigator must seek to establish the six cardinal points of criminal investigation (PNP,
2011).
There are three interdependent factors in which the six cardinal points of investigation is rooted; the
motive (the reason that pushes the perpetrator to commit an act with a definite result in mind), the
opportunity (refers to the chance or the occasion to commit the act) and the means (the capability of
the perpetrator to commit the act using the available tools at hand).
These three factors are so interdependent, that in the absence of one would not result into a crime.
If an arrest is made in a case, it does not always mean that a good criminal investigation has been
conducted.
If the investigator does not develop all leads to a logical conclusion in any major case, the defense
(accused) will most assuredly point this out at trial or the dismissal of the case and subsequent acquittal of
the respondent of the charges.
The justification for making an arrest usually requires a degree of proof than the deliberate, meticulous
process required to convict and to commit a suspect to prison. In the United States, the standard for
conviction in a criminal case is "proof beyond reasonable doubt." Here in the Philippines conviction is
rooted on proving an accused as "guilty beyond reasonable doubt.
The Objectives of Criminal Investigation
Perpetrators can make mistake/s during the crime and may leave some evidences that will identify who
they are; this may be due to carelessness, emotional and mental stress, underestimation of law enforcers'
capabilities and influence of illegal drugs or alcohol. For example, a burglar because of panic he left his
thumb marks on the furniture inside the house while escaping, or a murderer who forgot to wash the
sleeves of his shirt and there's a blood stain on it. Thus, the objectives of criminal investigation by
using the information derived from these evidences are:
Trace evidences are tangible evidences like blood stained clothes, empty bullet shells, finger prints or
other visible and less. visible evidences. This can positively affect the success rate of an investigation,
however not all crimes has tangible evidences or trace evidences that can be used to pinpoint the
perpetrators of the crime, There are cases that there is no hard evidence found in the crime scene. For
example; a burglar who wears gloves so there will be no finger prints left on the things that he'll be
touching or a murderer who burned his victim so there will be no trace of it. Such cases can be
recognized as unsolvable, but only after all leads are exhausted. A successful investigation is therefore
one in which (Hess, K., Orthmann, C.H., and Cho, H.L. 2016);
6. All details of the case are accurately and completely recorded and reported
THE INVESTIGATIVE PROCESS
A typical criminal investigation covers an extensive scope of duties, methods, and objectives. In order to
attain a successful resolution to the crime, the investigator must possess and utilize some type of
methodical process. Frequently, an investigator will begin an investigation and will immediately be faced
with a myriad of information, much which will seem unrelated at the time.
In order to filter out the important from the unimportant, a scientific process must be employed. This
process consists of five simple steps that can lend order and direction to the investigation of the crime.
The five steps of this process are (Gardner, R. 2004):
2. Form a Hypothesis
5. Draw a Conclusion
In this example, solving the problem would seem to be very simple identify, locate, and arrest the rapist
and recover the stolen property. However, upon careful consideration, it becomes clear that the steps of
identifying, locating, and arresting the rapist, along with recovering the stolen jewelry, are not all that
must be considered. The investigator must recognize and appreciate that his/her actions have a major
bearing on the success or failure of justice.
2. Form A Hypothesis
Apply Reasoning
This will create more problems for investigators more than any other. In order to form a
hypothesis, an investigator must be able to apply some type of reasoning to formulate an idea about how
the crime was committed, a subject's involvement, or some other aspect of the crime. An investigator must
be careful not to draw too narrow a hypothesis, or one that is so broad that nothing meaningful can be
derived from it (Gardner, R. 2004). Care must also be exercised to avoid allowing one's personal bias to
influence this process.
For example, nearly anyone could walk into a convenience store and snatch cash from the hand of the
clerk. The taking of the cash in and of itself is not arl as important an element as the others.
The hypothesis is put to further scrutiny by the search. of this suspect's fingerprints, hairs, or other
biological fluids among the items of evidence recovered from the crime scene. The investigator
constantly re-evaluates the hypothesis by examining any and all information that is obtained during the
course of the investigation.
Each of these examinations will help test the strength of the investigator's hypothesis. Additionally, the
investigator's hypothesis will also be tested for accuracy by other investigators, supervisors, and eventually
the prosecutor should an arrest be made.
4. Interpret Data
This step is self-explanatory. However, the investigator must be careful to ensure that his/her personal bias
does not unduly influence the data. Interpreting data means that the investigator must evaluate all the
evidence, statements, and personal observations in order to reach a conclusion (Gardner, R. 2004).
5. Draw Conclusions
The investigator must employ not only deductive reasoning, but more importantly inductive reasoning to
help reach final conclusions concerning the witnesses, evidence, and motivations in the case (Gardner,
R. 2004). By using proven truth (facts), the investigator should hopefully be able to draw some
meaningful conclusions concerning certain aspects of the case.
Through this final step in the investigative process, the investigator should reach the conclusion that the
accused is the person who committed the crime being investigated, to the exclusion of all others. This
conclusion should be supported by as many other facts as have been uncovered during the investigation,
such as victim/witness statements, physical evidence, and/or a confession.
Here are the Standard Methods of Recording Investigative Data as per PNP's 2011 Revised Criminal
Investigation Manual:
a. Photographs;
f. Plaster cast;
● Identify suspect
● Locate suspect
● Arrest suspect
2. Form a Hypothesis
● Motive
● Opportunity
● Means
● Evaluate hypothesis
● Modify/Reject hypothesis
5. Draw Conclusions
● Has every facet of the investigation been conducted within the law?
Once a crime has been committed, the crime may or may not come to the attention of the police. In order
for the police to conduct an investigation, they must be aware that a crime has occurred. A crime may
come to the attention of the police in a number of ways. The primary manner is generally through
someone who reported the crime directly to the police.
1. By A Victim- The crime may be reported by the victim, such as robbery or assault. By
bringing the crime to the attention of the police, the victim has initiated the first step in the
investigation notifying the police.
2. By An Eyewitness- An eyewitness or another person may have knowledge of a crime that has
been committed and notifies the police, or someone else, who brings it to the attention of the
authorities.
3. By An Accomplice- An accomplice in a crime may confess his/her involvement in the crime. For
example, a person who is arrested for a minor offense may tell the police information about the crime
that has been committed by someone else.
4. By An Anonymous Tip- An anonymous tip may be provided by an unknown person with the hope
of having the police arrest the perpetrator, or simply enact revenge on an enemy or competitor, such as a
rival drug dealer.
● An example might be where the police are at home investigating a complaint of domestic
violence or assault, and happen to notice illegal drugs, firearms or stolen property in the home.
● Another example is where the suspect was lawfully arrested for a theft or robbery and while on
the process of frisking the suspect, a concealed firearm was found on the waist of the suspect.
In crime investigation, the first 72 hours of a murder or kidnapping/ abduction investigation is referred to
the "The Golden Hour" (PNP, 2011). This is the most crucial time for the investigator to collect vital
evidence and information on the crime. In this time frame, the initial response to a crime scene and the
initial investigation such as interview of witness and profiling is being held. This is also the time where
most investigative process is prone to error mostly in the response in terms of crime scene and evidence
protection and evidence collection (Galero-Müftüoğlu, 2015, pp. 13-14).
In order to have a successful investigation, according to the PNP Criminal Investigation Manual these are
the phases in gathering all facts (PNP, 2011).
2. Eyewitness- made by several objective persons who are familiar with the appearance of the suspect
who personally witnessed the commission of the offense and who have personal knowledge of what had
happened.
The crime perpetrator may not operate near his residence hence his flight from the scene is merely a
return home, unless he is recognized during the commission of the offense.
Phase III: Gather and provide evidence to establish the guilt of the accused.
The investigator must be competent in finding relevant evidence. In criminal cases, physical
evidence can be found at the crime scene, with the victim and from the perpetrator and their
environment. Appreciation of forensic science is vital.
In proving the guilt of the accused in court, the fact of the existence of the crime must be established; the
accused must be identified and associated with the crime scene; competent and credible witnesses must
be available; and the physical evidence must be appropriately identified and the investigator must know
by heart the elements of a specific crime
(Galero-Müftüoğlu, 2015, p. 13).
A follow-up investigation is conducted when the preliminary investigation does not result in the
immediate apprehension of a criminal. A follow-up investigation is usually performed by a criminal
investigator, who preferably has the following:
2. Detailed experience in investigating the specific crime, such as robbery, homicide, or sex crimes
3. A particular familiarity with the type of crime committed and the specialized equipment or particular
Modus Operandi (MO) used, such as computer crimes involving unauthorized access to financial or
personal electronic accounts
It is the responsibility of the investigator to address every step of the investigation in a manner that the
existing legal system will support. Once the investigator receives a case for investigation, he/she is
personally responsible for the following:
1. Becoming thoroughly familiar with the initial report and determining what leads have been
identified and what activities might produce additional leads:
2. Viewing all evidence in the case and determining what should be submitted to a crime
laboratory for analysis, and exactly what analysis should be performed;
3. Coordinating with the preliminary investigator to determine if there is any additional information that
may not be reflected in the initial report and help clarify information contained in the initial report;
5. Identifying the Modus Operandi (MO) and attempting to associate it with other reported cases in
hopes of identifying a suspect;
6. Evaluating the legal significance of any victim or witness statements and determining which
individuals need to be re-interviewed;
7. Collecting any additional evidence that may have been overlooked during the preliminary
investigation; and
8. Attempting to identify and arrest a suspect based on a review of all of the facts,
circumstances, statements and evidence connected with the case.
Cases in criminal investigations are normally assigned by a criminal investigation chief or supervisor, or
through rotation in shifting basis. These assignments are usually based on investigative expertise, case
load, and/or area of responsibility (Galero-Müftüoğlu, 2015, p. 14).
To be an effective criminal investigator, other than being adequately prepared he/she must develop this
qualities and skills (PNP. 2011):
1. Team Player
2. Communication skills
3. Street knowledge
4. Observation skills
5. Self-discipline
6. Reasoning Ability
8. Organizational abilities
9. Persistence
Tools of Investigation
1. Information this refers to the data gathered by an investigator from either regular or cultivated
sources including the victim themselves; and from public and private records; Modus Operandi Files,
Arrest Records and Rogue Gallery,
2. Interview this refers to the skillful questioning of suspects and witnesses believed to possess
knowledge that is of official interest to the investigator. It includes so called interrogations which
are actually interviews that elicit information from witnesses and volunteers, paid or confidential
informants.
3. Instrumentation this refers to the use of forensic technology as a tool in the examination of
physical evidence using established methods.
The Police Station, which has territorial jurisdiction of the area where the crime incident was committed,
shall immediately undertake the necessary investigation and processing of the crime scene, unless
otherwise directed by higher authorities for a certain case to be investigated by other units/agency (PNP,
2011).
A Police Blotter is an 18" x 12" logbook with hard-bound cover that contains the daily register of all
crime incident reports, official summary of arrests, and other significant events reported in a police
station. All crime incidents must be recorded in the official police blotter (PNP, 2011).
However, a separate Police Blotter, shall be maintained for offenses requiring confidentiality like violence
against women and children and those cases involving a child in conflict with the law to protect their
privacy pursuant to R.A. 9262 (Anti- Violence Against Women and Children Act of 2004) and R.A. 9344
(Juvenile Justice and Welfare Act of 2006).
The duty police officer shall record the nature of the incident in the police blotter containing the five
"W"s (who, what, where, when and why) and one "H" (how) of the information and inform his superior
officer or the duty officer regarding the occurrence of such incident. In answering the above 5 Ws and 1
H and the Case Disposition, all such material details about the incident, including the nature of the
action or offense; the Date, Time, and Place of Occurrence; the names of the suspect/s, the victim/s, the
witness/es, if any; facts of the case; significant circumstances that aggravate or mitigate the event or the
crime should be entered along with the identity of the officer to whom the case is assigned (Officer-on-
case); and, the status of the case (PNP,2011).
3. Investigation team and equipment
All investigators in any police unit must be a graduate of prescribed investigation course with a rank of at
least PO2 (pre- requisite to assignment) (PNP, 2011).
1. Team Leader;
2. Investigator/recorder;
3. Photographer;
4. Evidence custodian; and
5. Composite Illustrator/Artist
1. Police line
2. Video camera
3. Voice recorder
4. Camera
5. Measuring device
6. Gloves
7. Flashlight
8. Fingerprint kit
9. Evidence bag
10. Evidence tag
11. Evidence bottles/vials; and
12. Investigator's tickler (contains the following)
a) Investigator's checklist
c) Evidence checklist
d) Turn-over receipt
FIRST RESPONDERS-are members of the police, military, fire, medical teams, and other volunteer
organizations who are expected to be the first to respond to calls for assistance in cases of incidents
involving explosives (PNP,2011). These are their duties according to the 2011 PNP Criminal
Investigation Manual.
c. Cordon off the area and secure the crime scene with a police line or whatever available material
like ropes, straws or human as barricade to preserve its integrity;
d. Check whether the situation still poses imminent danger and call for back up if necessary;
e. Identify possible witnesses and conduct preliminary interview and ensure their availability for the
incoming investigator-on-case;
f. Arrest the suspect/s if around or in instances wherein the suspect/s is fleeing, make
appropriate notification for dragnet operations;
g. Prepare to take the "Dying Declaration" of severely injured persons with the following
requisites:
ii. That the declaration refers to the cause and surrounding circumstances of such death;
iii. That the declaration relates to facts which the victim is competent to testify to; and
iv. That the declaration is offered in a case where in the declarant's death is the subject of the inquiry.
(Section 37, Rule 130 of the Rules of Court).
i. Account for the killed, wounded and arrested persons for proper disposition;
k. Brief the investigator-on-case upon arrival and turn over the crime scene.
1. Conduct inventory on the evidence taken at the crime scene; Inventory receipt should be properly signed
by the first responder, SOCO and the investigator.
6. Investigation of subjects
SUSPECT OR SUSPECTS Individual(s) who is/are pointed to be by the victim(s) and witness (es)
to have had committed the crime in issue. Subject person is not considered as a criminal unless
otherwise his/her conviction is pronounced in the court (PNP, 2011).
2. Inform the arrested person on the cause of his arrest and his rights as provided for in the
Constitution;
3. Conduct thorough search for weapons and other illegal materials against the suspect/s;
The execution of a suspect's "WAIVER" as stipulated in Article 125 of the RPC shall always be done in
the presence of his chosen counsel or any independent counsel (PNP, 2011)
Sworn Statement or Affidavit of complainant/s and witness/es must be taken immediately by the
investigator- on-case. Affidavit of Arrest of arresting officers must be taken immediately not later than
24 hours. In Inquest cases, the investigator-on-case and the arresting officer/s shall observe Art. 125 of
the RPC (PNP, 2011).
9. Preparation of reports and filling of charges
b. Progress Report;
d. Final Report after the case is filed before the prosecutor's office/court; and
e. Accomplishment Report.
CRIME SCENE A venue or place where the alleged crime/ incident/event has been committed (PNP,
2011). A crime scene may include a home, a vehicle, an open space, a park, a playground, a remote
location in the bushes and woods or any private and public place or establishment. In order to remove the
cordon and release the crime scene these needs to be followed:
b. Release is accomplished only after completion of the final survey and proper documentation of
evidence, witness/es, victim/s and suspect/s; and
c. If the crime scene is within a private property, the same must be released to the lawful owner
witnessed by any barangay official. In case of government facility, it should be released to the
administrator
a. Freedom
b. Money
c. Reputation
d. Protection
Maintaining Self-Control
If the investigator becomes upset or morally offended because someone is lying to him or her, the
investigator loses effectiveness. The investigator must always maintain a high level of professionalism
and never lose their self-control. Once the investigator shows their own emotional vulnerability, the
suspect gains the upper hand. If an investigator loses control when someone lies, the next time he will
talk to this suspect, he will lost some degree of rapport (Galero-Muftuoglu, 2015).
This can be interpreted by the suspect as a weakness on the part of the investigator. It can also affect
whatever rapport the investigator and suspect may have developed. The loss of this rapport can seriously
impede the investigator's efforts to obtain additional information, or even a confession. A good
investigator simply realizes that "being lied to" is an inevitable part of doing business in law enforcement.
This is a very important characteristic of human behavior for investigators. The use of Modus
Operandi (MO) is based on this principle. MO is the way a criminal commits the crime,
step-by-step. It is the outward behavior, not the mental processes (Galero-Muftuoglu, 2015). For
example: Several rapes were committed in a similar manner, but no suspect has been identified.
Investigator X speaks with another police officer, Investigator Y from a neighboring town who
handle the same kind of case with the same MO and has a suspect. Now, Investigator X may ALSO have
the same suspect.
C. Personal Emotions
There is no typical criminal or typical criminal personality. A criminal's occupation, upbringing, and/or
personality can run the entire gamut of humanity (Galero-Muftuoglu, 2015). Lawyers, doctors, and
ministers can all be a potential suspect.
If the investigator is morally offended by the crime committed and reveals this fact, the lines of
communication may shut down. Regardless of how heinous the crime is, the investigator must always
act in a professional manner and not allow their emotions to be exposed to the suspect.
Example: An investigator must be faced with interviewing a suspected child molester or pedophile.
Although the investigator will probably find this act to be repulsive and disgusting, he cannot reveal his
true feelings to the suspect, particularly if they expect to engage him in incriminating dialogue.
Even if an investigator has an intense dislike of the suspect, because he has committed an indecent act with
a child or has committed some other terrible crime, the investigator must still treat the person with respect
and dignity.
To do anything less would be a poor reflection on all investigators, and will surely eliminate the
possibility for any meaningful questioning since the suspect will probably form an instant dislike for the
investigator. By failing to project a professional image, the investigator can quickly become ineffective
when dealing with the suspect.
Personal Biases or Prejudice is a factor that all investigators must take into account as they go about
their work. Everyone has their own personal biases which influence them in their everyday lives. Often,
we are unaware of the influence that our biases have on our actions and decisions. Frequently, this
influence occurs without us being aware of it (Galero-Muftuoglu, 2015). Personal bias simply means
that you probably do not like the same things that the person sitting next to you like (as well). Many
times, it is simply an opinion, not necessarily based on a scientific fact or a study. In other words,
sometimes you simply like or dislike something without being able to articulate why. However, the most
common bias is one based on personal preference, for whatever reason.
Victims and witnesses can often transfer their own biases or preference into an investigation, sometimes
inadvertently. A person may unconsciously slant his/her account of what happened, without even
recognizing that their own personal bias is influencing their perception. Everyone is biased in some
manner, and a good investigator sbald not be surprised when a person gives an account which is
bstantially different from the other witnesses. The person may not be trying to
directly lie to the investigator. It is simply a fact of life that some individuals see things slightly different
than others. Bias is one reason this occurs.
In an identical manner, an investigator's personal preference or bias-type feelings can also be transferred to
a criminal investigation. Care must always be exercised by the investigator to ensure that opinions,
decisions, and observations are never tainted by the investigator's own personal bias.
Group Perception
Personal biases shape the way people view things by having them focus on certain elements while
screening out others. To this same end, one can most likely draw the logical conclusion that groups of
people with like backgrounds tend to see things the same. As discussed above, certain individuals will
notice or experience events based on their personal interests and backgrounds.
In a similar fashion, persons who have similar experiences and backgrounds tend to develop common
beliefs and attitudes. These attitudes cause them to filter out certain types of information and become
highly sensitive to other types information. This is due to common experiences, age, professional
backgrounds, education, or socialization (Galero-Muftuoglu, 2015),
The following are different types of crime scene according to time of commission, location and source of
evidence.
According to Location
1. Indoor crime scenes- Affords the crime scene protection from weather and allows
investigators to take time and process the scene in a slow and methodical manner, without concern
for weather influences
2. Outdoor crime scenes most vulnerable to weather condition and present more problems
3. Continuing/ mixed crime scenes- from indoor to outdoor and/or vice versa
4. Special Location- the most difficult to handle because of its nature, it need special support
resources to process; examples includes vehicle, air plane, drum, septic tank, etc.
1. Primary Crime Scene Investigation usually begins where the body is originally found.
Crime Scene Investigation refers to the post-incident police operational procedures undertaken at
the crime scene when a crime has been committed. Crimes can't be solved by a single individual no
matter how good he/she is. Criminal Investigation needs to be solved by a team of experts in order to be
successful and be shrouded by a veil of stringent accountability (Galero-Müftüoğlu, 2015, p.26). Thus
there are three components of crime investigation according to the 2011 PNP's Manual on Investigation
of Crimes of Violence and other Crimes; namely:
1. First Responder
2. Investigator-on-Case
First Responder
First Responders are members of the police, military, fire, medical teams, and other volunteer
organizations who are expected to be the first to respond to calls for assistance in cases of incidents
involving explosives (PNP.2011).
The four main tasks of the first officer on the scene are (PNP, 2011):
Investigator-on-case
Investigator-on-Case refers to the duty investigator duly assigned or designated to conduct the inquiry of
the crime by following a systematic set of procedure and methodologies for the purpose of identifying
witnesses, recovering evidence, arresting and prosecuting perpetrators (PNP, 2011).
The Scene of the Crime Operative refers to the functional capability of the PNP Crime Laboratory
performed by its trained personnel through the recognition, methodical search, proper documentation/
recording and collection of physical evidence at the crime scene. (PNP Crime Laboratory Revised SOCO
Manual 2014).
See on the next page the Crime Scene Investigation's Flow Chart as depicted on the 2011 PNP's Field
Manual of Investigation of Crime of Violence and other Crimes.
The purpose of these procedures is to adapt to the current trends in modern investigation, in line with the
PNP Integrated Transformation Program which seeks to improve and integrate the different manuals used
by the PNP to serve as guide in all aspects of police investigation. It also aims to come up with a definite
investigative procedure on specific cases from the time the incident happened, until the case is filed,
which will be adopted by the PNP investigators in pursuing their mandated tasks.
Here is the General Investigative Procedure as defined in the 2011 PNP's Revised Criminal Investigation
Manual.
G. Direct the nearest mobile car/beat patrollers or the nearest police precinct to act as first
responder equipped with "police line" to secure the place of incident a camera; and
The First responder shall perform his duty and in addition, check the condition of the victim while the
other members of the first responders shall simultaneously secure the area by putting a police line or any
material (like rope, straw and etc).
A. If in serious condition
a) Bring the victim immediately to the nearest hospital using emergency services;
b) Photograph and make a sketch of the victim (if the victim is dead);
1. What is your name and address? (What is your name and address?)
ii. Do you know who did this to you? (Who did this to you?)
iii. Do you feel that you will die from the wound you received? (Do you think the wounds you
received are fatal?)
However, if there is still a chance to ask more questions, then follow-up should be done. The statement,
once reduced into writing. shall be duly signed by or with the thumb mark of the victim.
a) Bring the victim immediately to the nearest hospital using emergency services;
Note: The other member/s of the first responders shall remain at the crime scene to secure the premises.
C. If the suspect is arrested at the scene
a) Get the names of the persons who turned-over or arrested the suspect.
b) Isolate the arrested suspect/s and separate them from any probable witness of the incident.
e) If the suspect volunteers any statement, take note of the time, location and circumstances of the
statements.
2. Record time/date of arrival at the crime scene, location of the scene, condition of the weather,
condition and type of lighting, direction of wind and visibility.
4. Before entering the crime scene, all investigators must put on surgical gloves.
5. Before touching or moving any object at the crime scene in a homicide or murder case, determine first
the status of the victim, whether he is still alive or already dead. If the victim is alive, the investigator
should exert effort to gather information from the victim himself regarding the circumstances of the
crime, while a member of the team or someone must call an ambulance from the nearest hospital. Before
removing the victim, mark, sketch and photograph his/her relative position. Only a coroner or a medical
examiner shall remove the dead body unless unusual circumstances justify its immediate removal.
6. Designate a member of the team or ask other policemen or responsible persons to stand watch
and secure the scene, and permit only authorized persons to enter the same.
7. Identify and retain for questioning the person who first notified the police, and other possible
witnesses.
8. Determine the assailant through inquiry or observe him if his identity is immediately apparent. Arrest
him if he is still in the vicinity.
9. Separate witnesses in order to get independent statements.
B. Recording
The investigator hegins the process of recording pertinent facts and details of the investigation the
moment he arrives at the crime scene. (He should record the time when he was initially notified prior to
his arrival). He also writes down the identification of persons involved and what he initially saw. He alno
draws a basic sketch of the crime scene and takes the initial photograph (if a photographer is available,
avail his services). This is to ensure that an image of the crime scene is recorded before any occurrence
that disturbs the scene. As a rule, do not touch, alter or remove anything at the crime scene until the
evidence has been processed through notes, sketches and photograph, with proper measurements.
● Each crime is different, according to the physical nature of the scene and the crime or offense
involved. Consequently, the scene is processed in accordance with the prevailing physical
characteristics of the scene and with the need to develop essential evidentiary facts peculiar to
the offense. A general survey of the scene is always made, however, to note the locations of
obvious traces of action, the probable entry and exit points used by the offender(s) and the size
and shape of the area involved.
● In rooms, buildings, and small outdoor areas, a systematic search of evidence is initiated (In the
interest of uniformity, it is recommended that the clockwise movement be used.) The investigator
examines each item encountered on the floor, walls, and ceiling to locate anything that may be of
evidentiary value.
● You should give particular attention to fragile evidence that may be destroyed or
contaminated if it is not collected when discovered.
● If any doubt exists as to the value of an item, treat it as evidence until proven otherwise.
● Ensure that the item or area where latent fingerprints may be present is closely
examined and that action is taken to develop the prints.
● Carefully protect any impression of evidentiary value in surfaces conducive to making casts
or molds. If possible, photograph the impression and make a cast or mold.
● Note stains, spots and pools of liquid within the scene and treat them as evidence
● Treat as evidence all other items, such as hairs, fibers, and earth particles foreign to the area in
which they are found; for example, matter found under the victim's fingerprints.
● Proceed systematically and uninterruptedly to the conclusion of the processing of the
scene. The search for evidence is initially completed when, after a thorough examination
of the scene, the rough sketch, necessary photograph and investigative notes have been
completed and the investigator has returned to the point from which the search began.
● Further search may be necessary after the evidence and the statements obtained have
been evaluated.
● In large outdoor areas, it is advisable to divide the area into strips about four (4) feet
wide. The policeman may first search the strip on his left as he faces the scene and then
the adjoining strips.
● It may be advisable to make a search beyond the area considered to be the immediate
scene of the incident or crime. For example, evidence may indicate that a weapon or
tool used in the crime was discarded or hidden by the offender somewhere within a
square-mile area near the scene.
● After completing the search of the scene, the investigator examines the object or person
actually attacked by the offender. For example, a ripped safe, a desk drawer that has
been pried open or a room from which items has been stolen, would be processed after
the remainder of the scene has been examined for traces of the offender.
● In a homicide case, the position of the victim should be outlined with a chalk or any
other suitable material before the body is removed from the scene. If the victim has been
pronounced dead by a doctor or is obviously dead, it is usually advisable to examine the
body, the clothing and the area under the body after the remainder of the scene has been
searched. This is to enable the policeman/investigator to evaluate all objects of special
interest in the light of all other evidence found at the scene.
D. Collection of Evidence
This is accomplished after the search is completed, the rough sketch finished and photographs
taken. Fragile evidence should be collected as they are found. All firearms (FAs) found to have
tampered serial numbers (SNs) shall be automatically subjected to macro etching at the Philippine
National Police Crime Laboratory (PNP-CL). A corresponding request to the Firearms and
Explosive Office (FEO) must be made for verification purposes.
The investigator places his initials, the date and time of discovery on each item of evidence for
proper identification. Items that could not be marked should be placed in a suitable container and
sealed.
E. Markings of Evidence
Any physical evidence obtained must be marked or tagged before its submission to the evidence
custodian. These are information to ensure that the items can be identified by the collector at any
time in the future. This precaution will help immeasurably to establish the credibility of the
collector's report or testimony and will effectively avoid any suggestions that the item has been
misidentified.
F. Evaluation of Evidence
Each item of evidence must be evaluated in relation to all the evidence, individually and
collectively. If necessary, these pieces of evidence must be subjected to crime laboratory
examination. Example: firearms for ballistic examination, hair strands etc.
G. Preservation of Evidence
H. Releasing of Evidence
All collected evidence can only be released upon order of the court or prosecutor, as the case
maybe.
1. Chain of Custody
A list of all persons who came into possession of an item of evidence, continuity of possession,
or the chain of custody, must be established whenever evidence is presented in court as an
exhibit. Adherence to standard procedures in recording the location of evidence, marking it for
identification, and properly completing evidence submission forms for laboratory analysis is
critical to chain of custody.
Every person who handled or examined the evidence and where it is at all times must be accounted
for. As a rule, all seized evidence must be in the custody of the evidence custodian and deposited
in the evidence room or designated place for safekeeping.
Proper handling of physical evidence is necessary to obtain the maximum possible information
upon which scientific examination shall be based, and to prevent exclusion as evidence in court.
Specimens which truly represent the material found at the scene, unaltered, unspoiled or
otherwise unchanged in handling will provide more and better information upon examination.
Legal requirements make it necessary to account for all physical pieces of evidence from the time
it is collected until it is presented in court. With these in mind, the following principles should be
observed in handling all types of evidence (PNP, 2011):
1. The evidence should reach the laboratory in same condition as when it was found, as much as
possible.
2. The quantity of specimen should be adequate. Even with the best equipment
available, good results. cannot be obtained from insufficient specimens.
4. Keep each specimen separate from others so there will be no intermingling or mixing of
known and unknown material. Wrap and seal in individual packages when necessary.
5. Mark or label each of evidence for positive identification as the evidence taken from a
particular location in connection with the crime under investigation.
6. The chain of custody of evidence must be maintained. Account for evidence from the time it
is collected until it is produced in court. Any break in this chain of custody may make the
material inadmissible as evidence in court.
Forensic Science
Forensic science deals with the application of scientific facts to legal problems and the judicial process.
Forensic means the analysis of information suitable for use in a court of law; it comes from the Latin
word "forensis," which means forum (Brenner, 2000). Issues used to be debated in public in the forum,
but now occur in civil and criminal courts where conflicting evidence is presented to determine the truth.
Special areas of forensic sciences can be applied to the documentation of evidence and to the solution of
various criminal and civil problems, thereby providing enormous value to law enforcement and justice.
Every aspect of forensic science involves (1) the careful and proper collection, documentation and
evaluation of evidence; (2) the chain of custody or the written documentation of all the stages of transfer
of evidence from the crime scene to the laboratory and the court; (3) the admissibility of tests, evidence
and testimony, based on legal standards; and (4) the opinion of an expert witness regarding issues that
relate to specific forensic science fields such as forensic ballistics, questioned document examination,
fingerprint examination, polygraphy, and legal medicine (Prahlow & Byard, 2012).
The Field of Forensic Medicine
Legal medicine, forensic medicine, and medical jurisprudence are the principles and knowledge of the
medical sciences in the field of law. terms used interchangeably to refer to branches of medicine that
apply the terms will also be used interchangeably in this book.
The field of legal medicine is typically associated with death and autopsies, but it also applies in other
legal processes, such as accident, determining whether a violent crime is a homicide, suicide, or a or
whether they constitute negligence, sexual assault, physical abuse or domestic violence. Practitioners are
sometimes referred to as forensic pathologists or forensic physicians.
Forensic medicine is a branch of medicine that covers both the fields of forensic pathology and clinical
forensic medicine. Forensic pathology involves the investigation of unnatural, unexpected, or violent
death, whereas clinical forensic medicine involves an interaction between the living person, medicine,
and legal processes. In broad terms, the forensic pathologist deals with the deceased while the forensic
physician deals with living individuals. However, the clinical and pathological aspects of forensic
medicine tend to overlap, and different countries have medical doctors who are involved in both the
clinical and the pathological aspects of legal medicine.
Each practitioner should be aware responsibilities, not only to their patient or the deceased, but to the of
their respective society as whole; they should also be able to utilize their medical expertise in the pursuit
of fairness and justice within the framework of legal requirements and ethical values.
Forensic Pathology
The word pathology' literally means "the study of disease." A pathologist is a physician who
determines a patient's diagnosis from an examination of a tissue sample or cells under the microscope.
Forensic pathology is a subspecialty that deals with the investigation of sudden, unexpected, and/or
violent deaths. The main role of most forensic pathologists is to undertake forensic death investigations
and perform medico-legal autopsies. These activities will be discussed in further detail in corresponding
chapters in this book.
Executing accurate and complete documentation of findings is crucial to the work of the forensic
pathologist. The forensic pathologist also undertakes the death certification or the completion of an
official
death certificate- which includes some personal information of the deceased, as well as the cause of
death (the disease or injury that was responsible for death) and the manner of death (the means or
circumstances by which the cause of death occurred). They are also often required to provide official
testimony in court regarding the deaths they have investigated (Prahlow & Byard, 2012).
Most hospital autopsies involve natural deaths; hence, hospital pathologists primarily attempt to
explain the signs and symptoms of natural disease through autopsies focused on internal organs; they are
generally not as concerned about information that can be crucial in civil and criminal actions. Forensic
pathologists are concerned with the reason behind the occurrence of death; thus, they must investigate
the context of surrounding events before and after the death of the deceased, especially in homicidal,
accidental, and suicidal cases. Forensic pathologists are more alert to unnatural deaths. Their
investigation can begin with the determination of the following (Wecht, 1997):
1. Who is the victim? (identification based on sex, race, age, and distinguishing characteristics)
2. When did the death and related injuries occur?
3. Where did the death and related injuries occur?
4. What injuries are present? (identification based on type, distribution, pattern, path, and direction)
Pathologists deal with death and tragedy every day; they can serve important functions by helping to
convict the guilty or exonerate the innocent, by helping families deal with the death of a loved one (once
they know the exact cause and manner of death), by preventing future deaths and injuries from dangers
that have proven to be deadly, and also by alerting and educating the public and the government in an
effort to prevent these hazards from being repeated (Adelman, 2007). The forensic physician is tasked to
undertake a variety of functions. The following illustrates the variety of functions a forensic physician
may be asked to undertake (Payne-James, History and Development of Clinical Forensic Medicine,
2005).
Clinical forensic medicine involves the examination of living patients who have certain rights (e.g.,
right of confidentiality) and capabilities (e.g., capacity to give consent). The medical doctor examining
prisoners or victims of abuse must, therefore, consider the boundaries among the conflicting rights of the
person examined, the processes of investigation, and the interests of justice. A forensic physician has a
dual responsibility to the patient and the general public that might come in conflict, such as when a rape
victim requests for confidentiality at the expense of the perpetrator becoming free of criminal charges.
In clinical forensic medicine, most examinations have both therapeutic and forensic aspects. The doctor
has the primary responsibility of providing care and actual treatment (or giving a referral for further
treatment). However, the examination will most likely involve the interpretation of evidential content,
such as major or minor injuries that could later be the subject of detailed cross- examination in court.
While the doctor has a duty of confidentiality to the person examined, the forensic physician also has an
obligation to provide necessary and appropriate information to the police to facilitate the investigation of
a crime.
Forensic Toxicology
Forensic toxicology is a forensic science discipline that deals with the identification and quantification
drugs, poisons, and other toxic substances in body tissues and fluids. Victims who are suspected to have
been accidentally or purposely poisoned are examined by the toxicologist to detect toxic substances in
the blood, urine, spinal fluid, A discussion of poisons and their relevance in medico-legal
gastric contents, bile, and tissues (Brenner, 2000).
Forensic Anthropology
The scientific field of physical anthropology is concerned with subspecialty of forensic anthropology is
concerned with the examination the study of humans in relation to their physical characteristics. The of
bones and skeletal remains in order to provide information about sex, race, age, and time of death.
Forensic anthropologists can differentiate between post-mortem changes to help in identifying
mysterious remains and to determine whether the death was caused by foul play race,
(Brenner, 2000).
Forensic anthropology is discussed in more detail in a latter chapter.
CHAPTER 4 MEDICO-LEGAL INVESTIGATION
MEDICO-LEGAL CASES
The term "medico-legal cases generally refers to something related to both medicine and law.
Medico-legal cases refer, on the one hand, to those that involve injuries or ailments, in which
investigations are essential to determine the cause and the responsible party. On the other
hand, it could also refer to legal cases or police investigations that may require the expertise of
a medical practitioner
The items below are examples of cases that usually have medico- legal implications, some of
which shall be discussed in further detail in other chapters.
Medico-legal considerations, decisions, definitions, and policies provide the framework for
informed consent, professional liability, and many other aspects of current practice in the health
care field. They are significant in the process of making many patient care decisions and
determining definitions and policies for the treatment of mentally incompetent people and
minors, the performance of sterilization or therapeutic abortion, and the care of terminally ill
patients (Mosby's Medical Dictionary, 2009).
Careful documentation of every step in the investigation process is critical to forensic problem
solving. The forensic pathologist or forensic physician must ensure that their interpretations and
conclusions are based on sound medical principles. Errors and mistakes could result in wrongful
convictions that could result in serious liabilities for the medico-legal practitioner. Throughout
history, innocent people have suffered arrest and incarceration due to negligence. This is why
medico-legal practitioners must be careful with their work.
Definition of Death
Simply put, death is the cessation of life. In the medical and legal sense, human death has been
traditionally defined as the complete and irreversible cessation of heart and lung activity.
However, controversies arise when religious and ethical concerns come into play. For example,
a person who has been dead for several hours can still have functional sperms that can fertilize
an egg. A dead person's cells can also be cultured in a laboratory to be kept "alive" for decades.
To clarify this distinction, the medical profession considers separately the death of a single cell
(or cellular death) and the cessation of the integrated functioning of an individual (somatic
death). Somatic death, therefore, refers to the death of the person, while cellular death refers to
the death of the cells within the person (Adelman, 2007).
Cellular death is defined as "the cessation of respiration (the utilization of oxygen) and the
normal metabolic activity in the body tissues and cells, and is "soon followed by autolysis and
decay, which, if it affects the whole body, is indisputable evidence of true death" (Shepherd,
2003, p. 27). The cells can still be cultured days after if the skin and bones remain metabolically
active. However, the complete process may take hours because the body dies cell by cell.
Meanwhile, somatic death occurs when "the individual is irreversibly unconscious and unaware
of both the world and his own existence" (Shepherd, 2003, p. 28). Unlike during deep sleep or
under anesthesia or temporary coma, unconsciousness in somatic death is "irreversible.”
1. Coma -Death results primarily from the failures of the vital centers of the brain; the person
becomes unconscious and loses all reflexes, after which the heart and lungs slowly cease to
function.
2. Syncope -Death occurs primarily as a result of heart failure, possibly due to blood loss,
power loss of the heart muscle, or neurogenic shock.
3. Asphyxia -Death occurs primarily when the respiratory function of lungs stops as a result of
lack of oxygen, resulting in failure of the heart and brain
If a person dies within 24 hours without suffering from a recognizable cause, such death would
be called a sudden death.
Death Investigation
One of the most important duties of the forensic pathologist is to investigate the death of an
individual by examining all the medical, scientific, and evidentiary information. Death
investigations usually involve sudden, unexpected or violent deaths, even those that may be
related to natural deaths. Depending on jurisdiction, a death investigation may include an initial
investigation and the examination of the body, followed by further investigations.
The following are the goals and purpose of death investigation (Adelman, 2007):
2. To seek the truth objectively, intellectually and without bias or emotional coloration;
From a legal perspective, one of the most critical tasks of the forensic pathologist is to establish
the cause and manner of death. Based on the objectives enumerated above, the forensic
pathologist must also estimate the time of death, infer the type of weapon used, determine
additive effect of trauma or pre-existing conditions, as well as establish the identity of deceased.
By understanding the role of the pathologist and the natural changes that occur in the body after
death, the criminal investigator can gather information that is deemed useful to everyone
involved in the investigation.
Death investigators initially determine which locality has jurisdiction over a reported case, after
which they will obtain identification information about the deceased, such as the name, birth
date, gender, address, and legal next-of-kin. The investigator will also gather other significant
information such as time of death, where the person died, whether or not there are injuries, the
position and condition of the body, evidence of post-mortem changes, environmental
information, when and where the person was last known to be alive, medical history,
employment status, recent activities, relationship issues, and recent state of mind (Prahlow &
Byard, 2012).
The death scene must be well documented so that the pathologist and criminal investigator can
perform a thorough investigation. The following are the main functions of the forensic medical
examiner in the death scene (Crane, 2009):
● To observe the scene and take detailed contemporaneous notes:
● To ensure that trace evidence is not removed or destroyed from the body or its
surroundings;
● To assist and supervise the removal of the body from the scene where necessary.
A visit at the death scene (or where the fatal incident began) will also provide information to the
forensic medical examiner about the final events preceding death, along with critical information
about the circumstances of death. It is also through a scene investigation that the medical
examiner can determine the best approach with which to conduct the autopsy, especially when
investigating unusual or suspicious deaths.
A death scene is usually secured by the police for the safety of all crime scene officers. The
area is cordoned by police barrier tapes in order to control access to the crime scene. Police
detectives, fire department personnel, and utility workers may also be involved in the
investigation process; thus, it is important to make sure that the death scene is not
contaminated or disturbed.
The following are among the details to be noted by the death scene investigators (Prahlow &
Byard, 2012):
● General conditions of the scene (indoors versus outdoors, temperature, wet versus dry,
etc.);
● The presence or absence of rigor mortis, livor mortis and body cooling:
Witnesses, police detectives, and other authorities involved in the scene, such as fire
department personnel and emergency medical services, may also provide vital information.
Follow-up investigations may also be necessary when additional information arise even after the
autopsy and upon review of all available information.
While investigating the death scene, forensic pathologists and other law enforcement officers
must work cooperatively as a team in order to "solve the medical mystery of why that particular
person died at that particular time, under those particular circumstances" (Lew & Matshes,
Death Scene Investigation, 2005, p. 9). It is important to note that while law enforcement has
jurisdiction over the entire scene, it is the forensic medical examiner who has jurisdiction over
the deceased body.
To effectively conduct the autopsy, the medical examiner will need to determine the nature
and extent of injuries of the body, especially in a homicide case. This can be very helpful for
police officers to focus their efforts in finding the assailant. For example, if the medical
examiner has ascertained that the injuries are gunshot wounds but there are no casings on the
scene, the police can immediately search for a possible suspect with a revolver. Determining
the extent of injuries can also help in prescribing other necessary laboratory tests.
Death Certification
Death certification refers to the completion of the medical death certificate, which includes
personal information of the deceased (name, birthdate, etc.), as well as the cause and manner
of death (to be discussed further in the next section). If the cause of death is natural, with no
unusual or suspicious features, the doctor who last attended the deceased for the administrator
of the hospital or clinic where the person died) can immediately issue the death certificate and
certify the cause of death. The death certificate is then forwarded to the local health officer and
then to the Office of Civil Registrar for registration.
The World Health Organization (WHO) has issued instructions to assist physicians and
surgeons in the completion of medical certificates of cause of death in keeping with a
recommended international standard (World Health Organization, 1979). This format of
indicating the primary pathological condition is used in most countries. The format also allows
for the inclusion of predisposing conditions and multiple pathologies (most often used for the
elderly) that have contributed to death.
CAUSE OF DEATH
Gunshot Wounds
● Peritonitis
● Septicemia
● Hemorrhage
Mechanisms of death
The cause of death helps to answer the question of why death occurred. It refers to the disease,
injury, or a combination of these that produces a physiological derangement in the body and can
be considered responsible for the death. It is the physician's best opinion (with or without an
autopsy) on the specific medical diagnosis denoting a disease or injury. Examples include
strangulation, gunshot wound, or myocardial infarction.
The underlying or proximate cause of death refers to the condition or the initial incident or act
that triggered the chain of events leading to death. In a natural and continuous sequence that is
unbroken by any efficient intervening cause, the underlying cause of death produces the end
result, without which the end result would not have occurred. Meanwhile, the antecedent cause
of death refers to the intervening or intermediate disease or injury that occurred as a result of
the underlying cause of death.
The immediate cause of death refers to the final complication resulting from the underlying
cause of death, occurring closest to the time of death and directly causing death. An immediate
or antecedent cause of death may not be identifiable in all cases. Therefore, an underlying
cause of death can stand alone. For example, consider a man who is burned extensively in a
house fire and dies two weeks later due to sepais. In this case, the proximate cause of death is
burns, and the immediate cause of death is sepsis.
Another example is a pedestrian who is accidentally hit by a car, remains in and out of coma for
several months in the hospital, and eventually dies of bronchopneumonia, which is a natural
complication of his coma and confinement to bed. The immediate medical cause of death is
bronchopneumonia, but the underlying cause of death would be the injuries resulting from being
hit by a car.
MECHANISM OF DEATH
Massive Hemorrhage
● Gunshot Wound
● Stab wound
● Blunt Force
Causes of death
The mechanism of death refers to the physiological derangement set in motion by the causes of
death, which leads to the cessation of cellular electrical activity. These are alterations of
physiology and biochemistry whereby the causes exert their lethal effects. The mechanism of
death is more closely linked to the immediate cause of death (if any) than to the underlying
cause of death. For purposes of death certification, immediate causes and mechanisms are
interchangeable.
Manner of Death
The manner of death refers to the means or circumstances by which the cause of death
occurred. The manner of death could be natural, accident, suicide, homicide, therapeutic
complication, or undetermined. It is usually the lawyers and police investigators who determine
the manner of death, but physicians can also make such conclusion based on the information
about the decedent's (a legal term referring to a person who died) activity just before death,
recent symptoms, and previous medical records.
Natural deaths are caused exclusively by some type of organ failure due to old age or disease.
An example in a man with an inherited weakness in the aorta who suffers a heart attack,
causing enough blood loss into the chest to compress the heart and prevent it from beating.
A homicide refers to the intentional killing of one person by another person. At the very least,
someone else did something wrong that set in motion a process resulting in the person's death.
For example a robber who shoots a sales clerk surely intends to cause harm, and a drunk driver
who runs a red light and hits someone is guilty of criminal negligence.
A suicide refers to the intentional taking of one's own life. At the very least, the person did
something that resulted in his or her own death, in accordance with what he/she has intended to
happen.
An accident is the result of an unexpected, unforeseen, and unintended fatal event. These refer
to deaths in which trauma causes. or contributes to the cause of death, and the harm inflicted is
not intentional.
The manner of death is considered undetermined when the circumstances surrounding the
death cannot be explained, when the findings leave considerable doubt about the classification
of the manner of death, or when there is insufficient information about the circumstances
surrounding the death.
As previously mentioned, the manner of death is considered natural if the cause is some type of
organ failure due to old age or disease. Natural disease is considered as "an inherent pathologic
process resulting from the body's natural, usually long-term, response to a combination of
genetic (internal) and environmental (external) factors" (Prahlow & Byard, 2012, p. 243). This
definition includes contracting and dying from infectious diseases as well as certain external
lifestyle factors, such as poor diet, a sedentary lifestyle and chronic substance abuse, as
influences within the realm of natural disease. Hence, when an elderly with a long history of
heart disease is found dead at home, and the police finds no evidence of foul play, the doctor of
the deceased can issue a death certificate based upon the medical history and indicate that the
manner of death is natural.
Instances where there is a well-documented history of potentially lethal natural disease allows
for a straightforward cause of death determination. However, in cases where death has
occurred suddenly, unexpectedly, or without obvious explanation as to why the individual died,
a forensic medical examiner is called in to investigate the case. For example, a movie
personality may suddenly collapse in front of numerous fans; a mother recovering in the hospital
suddenly gasps and falls back into her bed; a father doing simple carpentry work at home
suddenly collapses on the floor and dies on the spot. Many of these deaths occur by natural
causes, but the forensic medical examiner will certify it as natural only until other causes like
trauma, poisoning or assault have been ruled out.
Many forensic practitioners define "sudden death" as death that occurs within 24 hours without
suffering from a recognizable cause. However, it would be practical to divide sudden death into
two categories to prevent confusion regarding time intervals from collapse to resuscitation and
pronouncement of death (Di Maio & Dana, 2007, p. 40).
● True sudden death or instantaneous death - this refers to death that occurs within
seconds of the onset symptoms or infliction of trauma, or absolutely no warning
● Non-instantaneous sudden death -this refers to death that occurs within minutes of the
onset symptoms or infliction of trauma
Instantaneous deaths almost invariably involve diseases of the cardiovascular system, whereas
broader definitions (those occurring within 24 hours) can involve virtually any organ system or
disease.
The natural causes of death as defined in Sharma (2011, pp. 40- 41), are listed below:
2. Diseases of the Respiratory System -these are diseases that produce asphyxia, such as
acute edema of glottis, membrane deposit in larynx or tumor pressing on trachea, spasm of
vocal cords, etc.; these also include other respiratory reasons, such as air embolism, rupture of
emphysematous bullae or tubular cavity, hemothorax, pneumothorax, hydrothorax, lung
carcinoma, asthma, pneumonia, acute bronchitis, and acute regurgitation of stomach content
into lungs in comatose conditions, etc.
3. Diseases of the Alimentary System these include hematemesis due to esophageal varices,
peptic ulcer, carcinoma of stomach or esophagus, perforation of peptic ulcer, peritonitis, acute
gastroenteritis, acute pancreatitis, bursting of liver abscess, rupture of enlarged spleen,
strangulated hernia, obstructive cholecystitis, drinking of a large quantity of water in heated
condition, etc.
6. Systemic Diseases these include bleeding disorders, diabetes mellitus, Addison disease,
cerebral malaria, convulsions, etc.
8. Some diagnostic or therapeutic procedures that may induce syncope, which may lead to
death; common procedures are lumbar puncture, vaginal examination, catheterization of
distended bladder, drainage of fluids from pleural or pericardial cavities, etc.
9. Reflex inhibition of vagus that may occur due to sudden impaction of a foreign body in the
larynx.
It should be noted that medico-legal documents must be prepared in duplicate, with utmost care
in giving all necessary details that must be written with a ball-point pen without errors and
overwriting. Should there be corrections made on the document, then the document should be
authenticated with the full signature and stamp of the doctor. Furthermore, no abbreviation
should be used.
In addition, the next-of-kin must be informed of the death. In fact, during an evaluation, the
attending doctor is also legally bound to inform the police unit concerned (by telephone) about
the arrival of a medico-legal case. In this case, the informal verbal communication should be
followed by more formal communication done in writing.
CHAPTER 5
In the forensic medical context, physical injury refers to the damage inflicted on "any part of
the body due to the deliberate or accidental application of mechanical or other traumatic agent"
(Payne- James, Crane, & Hinchliffe, 2005, p. 127). A wound is a disruption of the continuity of
tissues and lining epithelium (layer of the skin) produced by external mechanical force. The term
injury is used synonymously with wound, but the former can have a wider meaning, which
encompasses not only damage produced by physical force, but also damage produced by other
means such as heat, cold, chemicals, electricity, and radiation.
When an attending doctor conducts a clinical examination of a patient with injuries and wounds
and thinks that law enforcement investigation is essential to ascertain responsibility regarding
the case, the doctor should immediately register it as a medico-legal case. It is also not up to
the patient nor other concerned parties to decide whether the case should be registered as
medico-legal. Further, the doctor should focus on recording observations correctly and not on
acting as a detective.
Cases that should be labeled as medico-legal may include any of the following (Sharma, 2011):
1. Roadside accidents, factory accidents or any other
unnatural mishaps
2. Suspected or evident homicides or suicides (including attempted ones)
3. Suspected or evident poisoning
4. Burn injuries due to any cause
5. Injury cases where foul play is suspected, i.e., if a doctor thinks that the patient is an accused
or a victim in a criminal case
6. Injury cases where there is a likelihood of death in the near future
7. Suspected or evident sexual offenses
8. Suspected or evident criminal abortions
9. Unconsciousness, when the cause is not clear
10. Cases brought dead with improper history
11. Cases referred by courts
It is important for forensic physicians and forensic pathologists to appropriately assess and
document injuries to provide effective assistance in establishing the cause, which may later
become an issue in courts or other legal processes. Documentation should be provided
unambiguously and in detail so that it will be comprehensible not only to other doctors but also
to law enforcement officers, legal advisers, and the courts. The documentation may include
hand-drawn notes, photographs, and annotated pro forma diagrams or body charts.
The following are potentially relevant factors to be determined when the doctor notes the history
of the injured person (Payne-James, Crane, & Hinchliffe, 2005, p. 129):
How was the injury sustained? Are weapons involved and are they still available?
What time was the injury sustained? The assault may have been reported days or weeks
after the incident, or there may be several injuries from different incidents. Specific times
should be documented.
Has the injury been treated?
Are there pre-existing illnesses? (e.g., skin disease)
What are the patient's regular physical activities? (e.g., contact sports)
Does the patient take regular medication? (e.g., anticoagulants, steroids)
Is the victim right- or left-handed? How about the suspect? This may affect the
interpretation of injury causation.
Is the patient under the influence of drugs and alcohol?
What is the clothing worn by the patient?
The attending doctor should also assess potentially relevant information regarding the
injury by looking at specific characteristics, such as the type, location, pain, tenderness,
stiffness, causation, handedness, size, shape, color, orientation, age, time, and transient nature
of injury. Injuries can be classified according to cause, namely, blunt force injuries, sharp force
injuries, gunshot injuries, burns, and head injuries. These and other medico-legal terms
discussed in this chapter are critical in documenting injuries.
In the medical sense, the abdomen of the human body is subdivided into smaller
regions. The two most common schemes divide it either into four (4) quadrants or nine (9)
divisions. This is an essential in documenting the location of the injuries and wounds.
The Four Abdominopelvic Quadrants
The Right Upper Quadrant (RUQ) contains the following: the right portion of the liver,
right kidney, a small portion of the stomach, portion of the ascending and traverse colon, as well
as parts of the small intestine; while the Left Upper Quadrant (LUQ) is where the left portion of
the liver, the larger portion of the stomach, the pancreas, left kidney, spleen, portions of the
transverse and descending colon, and parts of the small intestine are located. For its part, the
Right Lower Quadrant (RLQ) is the location of the cecum, appendix, part of the small intestines,
the right reproductive organs, and the right ureter; while the Left Lower Quadrant (LLQ) serves
as the location of most of the small intestine, some of the large intestine, the left reproductive
organs and the left ureter (O'Connell Smeltzer, et al. 2010).
The Nine Abdominopelvic Divisions
The nine abdominopelvic divisions are as follows: right hypochondriac, right lumbar,
right inguinal (or the right iliac), epigastric, umbilical, hypogastric (or the pubic), left
hypochondriac, left lumbar, and the left inguinal (or left iliac). The outer and uppermost
segments are the right and left hypochondriac regions, respectively. The epigastric division lies
in between these two. The right and left lumbar divisions are the outer middle sections, while the
umbilical region is between these two. The lowest divisions are the right and left iliac region with
the hypogastric between them (Nath, 2006).
Blunt Force Injuries
Blunt force injuries are those resulting from forceful contact with a blunt object, such as
fists, hammers, baseball bats, furniture, floors, walls, roads, trees, or the interior surfaces of
vehicles. They are among the most common types of trauma encountered by forensic
pathologists.
The injury can be caused by either a moving object that strikes the body. (such as the blow from
a baseball bat) or a moving body that strikes an unyielding object (such as a fall that involves
forces associated with sudden deceleration). It can also occur when the physical force is applied
more slowly by the pressure of crushing, squeezing, or pinching.
The three main types of blunt force injuries include (1) abrasions, which are produced by the
crushing or scraping of the skin; (2) contusions or bruises, which occur when the elastic limit of
subcutaneous blood vessels is exceeded so that they tear and bleed; and (3) lacerations,
which involves a greater force to tear the skin. These blunt force injuries may occur singly or
together in any combination, all at one time or inflicted one after the other at different times.
Abrasions
Abrasions are also known as scrapes, scratches, or grazes. They refer to superficial injuries
involving only the outer layers of the skin; they do not penetrate the full thickness the epidermis.
When a blunt object impacts the of surface of the skin, it results in the disruption and loss of
superficial layers, or the crushing or loss of skin or mucous membrane. Abrasions may bleed
only slightly, heal quickly and oftentimes, leave no scar. Brush abrasions are broad patches, the
frictional element of which gave rise to the term brush burns (e.g., carpet burns). Brush burns
are commonly seen in their most florid form as road rash following a motor/ vehicular accident in
which the victim slides along the road surface. A scratch is a linear abrasion produced by
drawing a sharp point over the surface of the skin or mucous membrane. Common examples of
such sharp points include plant thorns, barbed wire, human fingernails, and animal claws. The
scratch marks may be distinguished as coming from an adult or child by looking at the spacing
and convergence of the scratches. Skin be scrapings may recovered from beneath the
fingernails used for scratching, and likewise be linked to the person who was scratched through
serology or DNA techniques. Abrasions Are sometimes considered superficial or trivial and are,
therefore, therefore, easily overlooked by regular attending physicians.
Contusions
A contusion, also known as bruise or ecchymosis (plural: ecchymoses), refers to a
discoloration resulting from hemorrhage beneath the skin, tissue, or mucosa, without any
associated breach in the surface. It is generally produced when a blunt force has caused
disruption of blood vessels with escape of red blood cells into the surrounding tissues, such as a
blow or a fall, but can also result from crushing, squeezing, or pinching. The blood vessels
most commonly ruptured are the capillaries and small veins, rather than arteries.
Any tissue may bruise, but bruises confined to deeper tissues, as in the skeletal muscle,
are not visible on the skin surface. Bruises of the deep tissues, even when fatal, may not be
evidenced by any injury to the skin surface. For example, a fatal head injury where there is a
subdural hematoma may be encountered without recognizable superficial bruising (also known
as internal hemorrhage). A fatal strangulation with extensive bruising of the muscles of the neck
may be accomplished without obvious bruising of the skin. Blows to the abdomen produce
bruising and ruptures of internal organs, but such blows may not produce any abdominal wall
bruising.
Contusions tend not to accurately reflect the shape of the object that produced them, and they
change shape with time. In other cases, the surface detail of the striking object or wounding
weapon may be imprinted as a patterned bruise on the skin and may be seen during physical
examination which can be documented by photography.
The patterned injury or imprint bruises usually occurs following a heavy impact, like from a shod
or motor vehicle foot or from the muzzle or foresight of a gun in a contact gunshot wound.
With death Soon occurring after inflicting injury, the diffusion of blood is limited and thus
obscuring the imprinted pattern. There are cases where bruises give a more general impression
of the wounding weapon or object, such as a belt used to hit a child. Finger-pad bruising can
also be seen on the neck in throttling, on the upper arms in restraint, on the thighs in rape, and
on the chest and face in cases of child abuse.
The size of a bruise is not a reliable indicator of the degree of force that caused it. There
are several other factors that could influence bruise size, such as anatomical site, gender, age,
or the presence of natural disease. Females commonly bruise easily, and patients with blood
dyscrasia or blood disorder bruise easily. Blood thinning medications, such as warfarin, may
also accentuate hemorrhages.
Elderly individuals bruise more easily because of the degenerative changes in the blood
vessels and the supportive tissues of the skin and subcutaneous fat. In the very old and frail, a
finding of senile purpura can be seen. This is characterized by sharply defined geographic areas
of "spontaneous" bruising to the backs of the hands and forearms. Meanwhile, there are
individuals, such as children, who may have been victims of significant violence and have
significant internal injury but show little to no external evidence of injury.
Contusions may change color as they age before finally fading away. A fresh bruise is
typically dark red (the color of venous blood) and soon turns to a dusky purple. Thereafter, the
color changes progressively from the periphery of the bruise towards the center. It can be
brown, green, yellow, and a pale straw color before finally disappearing. These color changes
reflect the breakdown of hemoglobin into colored products as part of the inflammatory process.
The time frame of the color change is extremely variable depending upon the size, depth and
location of the bruise and the general health of the individual.
Most contusions normally disappear within one to four weeks (complete healing)
barring any medical complications. In general, contusions having green or yellow margins are
three or more days old and those with dark red or dusky purple color are fresh, having been
inflicted within a day or so. The accurate estimation of the age of a single bruise is notoriously
difficult but fresh bruises are easily distinguishable from bruises that are several days old.
Establishing that bruises are of different ages, and therefore inflicted. at different times, is
important in the assessment of allegations of repeated assaults, such as in child abuse and
spousal abuse.
The color of bruises does not change after death, but they may become more evident against
the now pale skin, or may alternatively be obscured by the post-mortem skin color changes of
lividity and decomposition. It may be difficult to distinguish a bruise sustained at the time of
death from one
that occurred ante mortem (before death), and such bruises are best described as having
occurred approximately "at or about the time of death."
Contusions to the deep tissues can be present without any evident skin surface injury,
particularly if the force applied is by a smooth object over a wide area. Such deep bruises may
spread under the influence of gravity and body movement, following the path of least resistance
along natural or traumatic planes of cleavage of the tissues, making them visible only after
dissection and otherwise not visible on the skin surface.
The shifting of deep bruises explains their delayed appearance at the skin surface
some days after infliction, often located at sites distant from the points of impact. For example,
the delayed appearance of bruising around the eyes follows a blow to the forehead, bruising
behind the knee follows a blow to the lateral thigh or a fractured neck of femur, and bruising to
the neck follows a fractured jaw.
A second examination of the alleged victim of an assault after an interval of a few days
may show visible bruising where previously there had been only swelling or tenderness of deep
bruising. Such second examinations are recommended as best practice.
Skin and mucosal bruises may be accompanied by abrasions and lacerations, but they are
not usually associated with cuts and stabs, where there is a free flow of blood from the cut
vessels rather than infiltration of blood into the tissues.
Bruising is essentially a vital phenomenon, in which the infiltration of blood into the tissues
occurs under the pressure of the circulating blood. Therefore, after death, the lack of blood
pressure means that a considerable force is required to produce a bruise on the cadaver. Such
post-mortem bruises are disproportionately small relative to the force applied, which may be
evident from associated fractures, and the resultant bruises are usually only a few centimeters
in diameter.
In assessing whether the contusion is ante-mortem or post- mortem, the findings and
circumstances as a whole should be considered as these can cause confusion. However, finger-
pad bruises to the insides of the upper arms may be produced by simply lifting the cadaver,
particularly in those elderly women who have abundant loose upper-arm fat, which is often
congested due to post-mortem lividity. Any livid dependent area of a corpse bruises more
readily post-mortem as a result of the vascular congestion.
Post-mortem lividity, which is the gravitational pooling of blood within the blood vessels after
death, may be confused with bruising. However, the pattern and distribution of lividity usually
makes the distinction straightforward.
Various terms exist to describe the gross appearance of a contusion. These include petechiae,
ecchymosis, and hematoma. Petechiae or petechial hemorrhages are small punctate
hemorrhages or very small contusions. They are minute reddish purplish spots or containing
blood that appears in the skin and mucous membranes as a result of localized hemorrhage.
Sizes range from pinpoint to pinhead.
Ecchymoses are the so-called "love bites" (also called hickeys in American slang or chikinini in
Filipino). These are superficial contusions produced by the negative pressure of mouth suction.
They are usually located at the side of the neck, on breasts or inner thighs, especially in victims
of alleged sexual abuse or sexual assault.
If the extravasated blood collects as a discreet tumor-like pool, the lesion is referred to as a
hematoma, which is defined as a focal space- occupying collection of blood that expands
and/or distorts the tissue configuration. In most cases, the sac of blood or hematoma eventually
dissolves. In some cases, however, it may continue to grow or show no change. If the sac of
blood does not disappear, then it may need to be surgically removed.
Lacerations
A laceration refers the splitting of tissues and the forceful tearing of the skin when an object
impacts the skin with a force that exceeds its elastic capacity. Lacerations result from blunt
force or acceleration/ deceleration injuries and are different from incised wounds resulting from
sharp objects.
Direct crushing, typically between an unyielding object on the one side and underlying bone on
the other, will result in split-like lacerations of the skin. Such skin splits occur most commonly
where the skin lies close to the underlying bones, such as on the scalp, eyebrows, cheeks,
elbows, knuckles, knees, and shins.
Lacerations have the following characteristic features (Crane, 2009, pp. 104-105).
• They are ragged wounds with irregular division of the tissue planes
They tend to gape because of the pull of elastic and muscular tissues
Their margins are often bruised and abraded; these are important diagnostic features
that must be looked for with a hand-lens if necessary
Blood vessels, nerves, and delicate tissue bridges may be exposed in the depth of the
wound soiled by, for instance, grit, dirt or particles of glass
Occasionally, the margins are shelved, or flaps of skin are produced by a shearing blow,
the direction of which can then be deduced
Laceration of skin overlying bone may split the skin so cleanly simulates to an incision; this is
particularly so on the scalp, face, or shin, but close examination of the wound together with the
history of how the injury came to be sustained should clarify the situation. Lacerations do not
generally reflect the shape or size of the object that produced them. They may be smaller than
the impact area or may extend beyond the impact area. However, like contusions and
abrasions, lacerations may have forensic value in death certification and in courtroom
testimony, such as when the degree of violence and suffering are discussed.
Sharp Force Injuries
Sharp force injuries refer to damage to tissues or organs by objects or weapons with sharp
edges or pointed ends. They are generally classified into three, namely, incised, stab, and chop
wounds.
Lacerations are to be distinguished from sharp force injuries. On the one hand, lacerations are
caused by crushing of tissues by the application of a blunt force, while a sharp force wound is a
cut. For example, when an orange fruit is crushed with the blunt force of a hammer, the result is
similar to a laceration with abraded, torn, and irregular edges. On the other hand, when the
orange is sliced with a sharp knife, the result is like a clean incised wound (Prahlow & Byard,
2012).
Straight wounds can be referred to as linear, while rounded wounds can be described as
curvilinear; the ends are called the angles, while the sides are called margins. Tool, marks found
in the wound should be documented for later comparison against the striations of a suspect's
weapon.
Incised Wounds
Incisions or incised wounds refer to cuts or slices caused by a sharp-edged object that has
impacted the body in an approximately parallel or tangential direction. Most often, the object that
caused the injury was moving in a slashing motion, with the angles at either end having a sharp
appearance.
Incised injuries usually have clean edges, minimum bruising, and no bridging of nerves
or vessels. Wounds tend to be straight and longer than their depth, with no contusions and
abrasions. Blood vessels and nerves are cleanly divided, and bleeding is often profuse. When
caused by a blade slash, the incision will appear deeper at their origin and shallower at the end
from which the blade is withdrawn.
In general, however, it would be impossible to determine the direction at which an incised
wound was inflicted (for example from right to left across the neck). Penetration of at least the
full thickness of the skin is usual, but shallow and partial thickness skin cuts can also occur,
such as the common "paper cut."
In clinical practice some medical practitioners might label both incised wounds and
lacerations as "lacerations." This may create confusion when clinical medical records are
used in legal proceedings, such as when implicating certain sharp-edged weapons as the
causative object. To ensure clear forensic value of medical records, documentation should
ensure the clear distinction between an incised wound, which implies contact with a sharp-
edged weapon and a laceration, which implies contact with a blunt object or weapon.
The key features of incised wounds reflect the fact that they are produced by keen-edged
objects rather than blunt objects. Incised wounds typically have well defined margins with no
associated abrasion or bruising of the adjacent skin. There is always complete severance of all
tissues within the depth of the wound, so that there are never any of the tissue bridges that
characterize lacerations.
Most incised wounds are knife wounds. However, forensic physicians and forensic pathologists
cannot safely make this conclusion by examining the wound alone. This is because knife
wounds look similar to incised wounds caused by razors, shards of glass, sharp edges of
machinery, and other sharp tools. There are also marked differences in knife blades. Cuts
produced by a serrated knife blade may give an indication of the nature of the blade if the cut is
tangential to the skin surface, such that the serrations leave shark-fin skin tags at the wound
edge, or parallel scratch abrasions on the adjacent skin.
Occasionally, incised wounds have irregular or ragged margins because either the causative
object had an irregular edge, such as broken glass, or the cut was made across skin folds, such
as on the neck or palm, so that the wound assumes a different shape when the folds flatten out.
Cleanly severed blood vessels within an incised wound bleed profusely, and if large vessels are
cut then the hemorrhage may be sufficient to kill. Such extensive hemorrhage commonly results
in blood soaking of clothing, together with blood staining and spattering of surroundings, thus
opening the possibility of reconstructing the events through blood spatter analysis. When large
veins are severed, particularly in the neck, air may be drawn into the circulation, obstructing the
flow of blood through the heart, and killing the victim by air embolism. Stab Wounds A stab
wound is the result of a pointed or sharp and pointed object forced inward. A stab wound is
also sometimes puncture, called perforating, or penetrating wounds. The direction of force is
usually perpendicular to the skin surface. It is often caused by a weapon being thrust at, or into
a victim. However, a stab wound may also be the result of a moving body against a relatively
stationary pointed object (Prahlow & Byard, 2012).
The typical feature of stab wounds is a depth greater than their width or length. They
often have little or no external blood but present danger to vital organs. Stabbing can cause
serious penetrating injuries that, in turn, can lead to hemorrhage (or occasionally air embolism)
and result in rapid death. The victim may also die later from infection, pulmonary embolism, or
other complications.
Causative objects include knives, daggers, scissors, screwdrivers, and pokers. On the one
hand, a dagger with a sharp point and double- edged blade tends to produce an elliptical wound
with sharp edges and clean-cut ends. The single-edged blade of the kitchen knife, on the other
hand, may cause squaring or fish-tailing of one extremity of the wound caused by the non-
cutting back of the blade. When a pair of scissors is used for stabbing, the wound looks more
rounded with bruising surrounding the margins.
Although the above instances show that the appearance of the wound in the skin can point to a
possible weapon, the wound could also have a jagged appearance when the weapon is
withdrawn at a different angle from the way it entered the body. Further, the skin's elasticity
enables it to close tightly around the stabbing object and close again if the object is removed.
Hence, the length of the wound could shorten, and the width could increase (Crane, 2009).
Both incised wounds and stab wounds typically retain no trace evidence from the weapon,
but they are associated with blood staining of the weapon, clothing, and crime scene. A
commonly asked question in the courts is the amount of force required to produce a specific
stab wound. This is usually a difficult, if not impossible, question to answer. The sharpness of
the point of the weapon is the most important factor in determining the degree of force required
to produce a stab wound.
Chop Wounds
Chop wounds are caused by objects with relatively sharp edges (e.g., hatchet, axe, tom-
ahawk, boat propeller, or lawn mower blade) possessing a reason- able weight resulting in a
combination of sharp and blunt force injuries at the point of impact.
Chop wounds tend to have an incised appearance on the skin surface, with associated
bruises, abrasions, and significant underlying blunt trauma (Prahlow & Byard, 2012).
Defensive Wounds
Defensive wounds refer to injuries sustained by victims attempting to defend themselves from
attack. The wounds are often found on the victim's fingers, hands, forearms, and upper arms.
Defensive injuries may include not only sharp force injuries, but also blunt force injuries and
gunshot wounds. They are highly suggestive of homicide.
When attacked with blunt objects, the instinctive reaction of the victims is to raise their arms and
cover their head in an attempt to protect their eyes, head, and neck. The arms, therefore,
become exposed surfaces for impacts against blows. When the victim curls into a ball in a fetal
position, the outer and posterior aspects of the lower limbs and back may be injured (Payne-
James, Crane, & Hinchliffe, 2005).
In sharp-blade attacks, the victim will often try to disarm the assailant and seize the weapon,
sustaining injuries in the process. Cuts to the palms and fingers result from attempts to grab or
deflect the weapon, whereas slash and stab wounds to the backs of the hands and the forearms
result from shielding movements. By contrast with the pattern seen in defensive wounds, if the
knife slips within the hand of the assailant, then the blade typically cuts either the base of the
little finger or the web of the thumb of the assailant.
Gunshot wounds sustained through the arms could be from raising arms in front in a defensive
posture. Defensive wounds may also be present in the legs of victims attacked on the ground
kicking away an assailant.
If an individual claiming to be a victim of assault lacks such defensive injuries, it is possible that
he or she has been incapacitated through alcohol, drugs, or other injuries. Another possibility is
that the wounds may have been self-inflicted.
Self-Inflicted Wounds
Self-infliction of shallow cuts as a form of self-harm, which falls short of attempted suicide, are
parallel, shallowly incised wounds that heal and leave multiple, fine, horizontal, linear white
scars. They are often located in reasonably accessible areas, such as the forearms, upper
thighs, abdomen, and the front of the chest; they are most prominent on the non-dominant arm.
They usually do not to involve sensitive areas, such as the eyelids, nipples, and genitalia.
When seen in clinical practice, the scars raise the possibility of a personality or psychiatric
disorder, with an attendant risk of suicide in custody. If seen at autopsy, they raise the index of
suspicion for suicide, alcohol and drug abuse, or high-risk behavior leading to accidental death.
Occasionally, individuals self-inflict incised wounds in order to falsely allege that they have been
assaulted. These injuries have a pattern that reflects handedness, easy accessibility of the
injured parts, infliction by pressing the sharp edge against the skin and then running it across
the skin surface rather than slashing movements, and the avoidance of sensitive or critical
areas such as nipples, lips, and eyes.
There are also individuals known as "cutters" who engage in self- injury and deliberately cut
their skin, usually on the arms. In some instances, there may be associated psychiatric disorder
(such as a borderline personality disorder or depressive illness). However, there are also
instances among pre-teens, teenagers, and young adults where there is no suicidal intent or
definite psychiatric diagnosis (Prahlow & Byard, 2012).
Due to the risk of suicide, it is important to carefully assess injuries that may indicate deliberate
self-harm. The items listed below are possible indicators that may assist in the recognition or
suspicion that injuries are self-inflicted. These are not diagnostic, but some may give an
indication of self-infliction (Payne-James, Crane, & Hinchliffe, 2005, p. 143).
Firearm Injuries
Firearm injuries refer to those caused by projectiles (missiles or bullets) fired from guns. When
a bullet or projectile has entered but not exited the body, it is termed as penetrating; if the
projectile has passed completely through the body, it is termed as perforating. Wound
characteristics are influenced by the caliber of the weapon and the distance from the gun to the
victim (Prahlow & Byard, 2012).
In cases of non-fatal injuries, the forensic physician or the hospital clinician has to ensure that
the initial appearance of the wound is accurately documented because surgical treatment may
distort the wound characteristics. Fragments, bullets, and pellets found and removed from the
body must be handed over to the appropriate authorities (Payne-James, Crane, & Hinchliffe,
2005).
In cases of fatal injuries, the autopsy examination should include the retrieval of the bullet for
examination of a ballistics expert who will determine the type of firearm used and match the
specific bullet to a specific gun. The forensic pathologist can also assist in reconstructing the
positions of the shooter and the deceased relative to each other by determining the entrance
and exit wounds as well as the trajectory of the bullet within the body (Adelman, 2007).
Weapons and Ammunitions
Knowledge of the construction and mechanism of guns and the ammunition from which they
were fired is also important. The basic structure of a firearm consists of the following parts
(Prahlow & Byard, 2012):
.
The grip - the appendage designed to be held in order to use the gun. It is that portion of the
mechanism that is held by the hand and orients the hand in a forward, vertical orientation,
similar to the position one would take with a conventional pistol. Grip serves multiple functions
such as magazine housing or bipod
The barrel- the tube through which a bullet travels when a gun is fired
The trigger - the lever that activates the firing mechanism of a gun
The internal mechanisms that transfer the trigger pull into the firing of the bullet (usually
including a "firing pin")
The firing chamber or the part that holds the cartridge containing the bullet or projectiles to be
fired
A mechanism that allows for quickly supplying another round (bullet) to be fired.
The three basic types of firearms are handguns, rifles, and shotguns. Handguns are
weapons with short barrels that can generally be held and controlled with one hand. The usual
handgun barrel is rifled. Handguns include (a) revolvers, which contain a cylinder within which
multiple bullets are placed; and (b) semiautomatic pistols, which have a self-loading aspect
that can fire continuously so long as the trigger is depressed.
Rifles are long-barreled firearms that are available in different models with a variety of
ammunition. The two general categories are the (a) rim fire or low-velocity rifle, which is used
in hunting small game and is commonly of .22 caliber; and the (b) center fire or high- velocity
rifle, which is used in hunting and in war and has a higher muzzle velocity, typically in the 2000
to 3500 feet/second range.
Hunting ammunition is generally designed to break apart on impact so that the projectile is
less likely to completely perforate the target and harm something behind the target, whereas
military ammunition is designed to completely perforate the target. High- powered rifles produce
devastating wounds when fired both at close and distant ranges.
Shotguns are long guns with smooth (non-rifled) barrels; these are designed to fire a shell
containing a single large lead slug or lead pellets that, on exiting the barrel, spread out in a
cone-like distribution to cover a large surface area. Ammunitions include tiny lead pellets called
"birdshot," large pellets called "buckshot," and a single large lead projectile called "slug."
There are generally two types of ammunition utilized in shotguns. They can fire "shots," which
are spherical metal (lead or steel) pellets that are available in a variety of sizes, ranging from
small "birdshot" (diameter of 0.05-0.22 in) to large "buckshot" (diameter of 0.24-0.36 in). The
shot pellets are contained within a shot-shell cartridge, where the collection of pellets overlie
various forms of "wadding," which separates the pellets from the underlying gunpowder.
Different ammunition manufacturers utilize different types of wadding.
A second type of ammunition used in shotguns is the shotgun "slug." A slug is a single, large
piece of metal (usually lead) that is fired from the weapon. Generally, shotguns wounds are
highly destructive when fired at close range but loses its destructive nature at increasingly
distant ranges (Lew, Dolinak, & Matshes, 2005; and Prahlow & Byard, 2012).
The barrel of a gun is an important factor in firearms identification. It varies depending on the
manufacturer of the guns. The rifling consists of spiral grooves that cut the length of the interior
or bore of the barrel. When a rifled weapon is discharged, the rifling causes the bullet to spin
around its long axis like that of a spinning-top. This lends gyroscopic stability to the bullet in
flight, increasing the accuracy of the weapon.
As a gun is fired, it expels not just the bullet but also a host of other things, such as flame; the
heated, compressed and expanded gas; and the residue. The residues include the bullet
(jacket, lead), the powder particles (grains, soot, graphite), the primer (lead, barium, antimony),
the barrel (lubricant, rust, dust, scraping), and the cartridge case (copper, zinc).
A bullet is a projectile that is fired from a gun. It came from the French word boulette ("a small
ball"), reflecting the fact that original projectiles were small lead spheres, or the so-called
musket ball. The ammunition or cartridges for rifled weapons consists of a cartridge case. On its
base is a chemical primer with a chemical propellant above and the bullet clamped on top.
Wound Ballistics
Basic knowledge of ballistics (the science of the motion of projectiles) is essential for an
examiner to have a proper understanding of wounds caused by firearms. Wound ballistics refers
to the study of the effects of penetrating projectiles on the body.
The morphology, pathway, and exit of a gunshot wound from the body are dependent on several
factors, such as the weapon used and the bullet's shape, size, and weight. The nature of the
wound can also be affected by the angle of impact, the depth of penetration, and the character
of the target tissue (i.e., bone or fat). Wounding potential could also depend on the placement,
penetration, yaw, and fragmentation of the projectile.
X-rays of gunshot victims, both living and dead, provide valuable information. This should
always be performed in autopsies on gunshot fatalities if the facilities are available. X-rays may
identify any projectiles present, along with their locations, or may identify projectile fragments if
the bullet has exited. From such information, the path of the projectile through the body and the
type of ammunition or weapon used can be determined.
Gunshot Entry Wound
A typical entrance wound has a round or oval-shaped skin defect, surrounded by a rim of
abrasion called the abrasion collar or circumferential marginal abrasion. It is a result of the
forward motion of the bullet indenting the skin and grazing it at the time of its entry. The abrasion
ring appears reddish-brown but can darken to almost black with post-mortem drying. It is
typically absent from exit wounds. Bullet caliber cannot be determined by looking at the wound
because the skin stretches on impact. The abrasion ring, and a very clear muzzle imprint, is
seen in this contact range gunshot wound.
When a bullet enters the skull, it produces a sharp-edged "punched-out" hole in the outer table,
with a larger corresponding "beveled-out" hole in the inner table.
Gunshot entry wounds vary in their overall appearance based on the range of fire or how far
the muzzle of the weapon is from the target. Distance ranges are categorized as contact, close
contact, intermediate, or distant. Determining the range of fire from the wound appearance is of
forensic importance.
Entry wounds have several inherent characteristics depending on the range of fire (Prahlow &
Byard, 2012, p. 488).
. Contact wounds have associated charring of the skin, with soot deposited within the depths
of the wound. Some contact wounds also have muzzle imprint abrasions.
. In close-range entrance wounds, wherein the muzzle is close to, but not in contact with the
skin), soot and gunpowder will be evident around the entrance skin defect. Gunpowder stipple
marks or gunpowder tattooing are embedded in the skin as gunpowder particles that strike and
injure the skin and cannot be washed away. With most handguns, soot combined with
gunpowder stippling around gunshot entrance wounds can occur when the muzzle of the
weapon is up to about 12 inches from the skin.
Close gunshot wounds often have a dense pattern of gunshot residue around the wound
The surface of the skull demonstrates the heavy soot in this contact range entrance wound, as
well as radiating fracture lines. The direction of the fire was thus toward the back of this picture.
Intermediate range gunshot entrance wounds, wherein the weapon is greater than 12 inches
but less than about 3 feet from the skin, will have gunpowder stippling, but no soot surrounding
the entrance defect. If the range of fire is more than 3 feet from the target surface, gunpowder
particles do not typically have enough energy to produce stipple injuries.
Intermediate gunshots will have a pattern of burned and unburned gunpowder around the
wound
Distant gunshot entrance wounds with a range of fire over 3 feet have no associated soot or
gunpowder stippling. However, many forensic pathologists prefer to consider entry wounds
without soot or stippling as indeterminate in terms of range of fire because this is also possible
in closer range shots where the soot and gunpowder is totally blocked by clothing or some
intervening material or interposed target.
The terms gunpowder stippling and gunpowder tattooing are often used interchangeably but
are actually two different things. Stippling refers to small bruises or punctate wounds on the
skin, whereas tattooing occurs when particles of burned or unburned gunpowder are embedded
into the skin.
In distant range gunshot wound entry, the firearm is too far away to deposit residues on
target and the bullet wound is usually round. If a bullet enters at an angle, there may be an
elliptical abrasion around the hole.
When looking at gunshot residues, it is important to remember that it is not possible to
accurately determine distances without conducting tests using the suspected firearm and similar
ammunition. Clothing can help determine entrance and exit by looking at how fabric threads
protrude from cloth.
Blowback and blood spatter, sometimes including tissue, can be found on or in the muzzle of
the firearm.
Gunshot wounds to the head may cause eye orbits to fracture and fill soft tissue with blood,
giving appearance of beating referred to as raccoon eyes.
Burns
A burn is an injury caused by the application of heat or by a chemical or physical agent having
an effect similar to heat. Most burns are produced by dry heat, and result from contact with
flame or a heated solid object, or from exposure to radiant heat. Burns caused by moist heat are
described as scalds. Chemical burns are produced by acids and alkalis, or by vesicants
developed for chemical warfare. Microwaves and electricity also produce burns.
In the medico-legal field, injuries caused by friction, electricity, lightning, corrosive substances
and radiation are also classified as burns. Tissue damage results from several mechanisms that
are initiated when a tissue's ability to cool itself fails to compensate for externally applied heat.
The nature of burns is affected by certain conditions, such as the intensity of heat, the duration
of exposure, the extent of area involved, the site of injury in the body, the age and even the sex
classification of the victim. Burns would be more severe if the intensity of heat applied is high
and the exposure is for a greater duration. Burns on the trunk, especially over the abdomen and
the genital area, carry high fatality compared to burns in limbs.
Old people are more prone to death compared to adults, while children are generally better
able to stand burns. However, burns of 10% in children or 15% in adults (or greater) are
potentially life- threatening injuries. Men also tolerate burns better than women. The "rule of
nines" as shown below is also a useful way to estimate the total body surface area affected by
burns (Sharma, 2011).
Area Percentage
1. Head and neck 9%
2. Right upper limb 9%
3. Left upper limb 9%
4. Right lower limb 18%
5. Left lower limb 18%
6. Anterior trunk 18%
7. Posterior trunk 18%
8. Genitalia Total 1%
100%
Chemical fires may reach temperatures of several thousand degrees. House fires seldom
exceed 649° C (1200° F). At this temperature, it is unlikely for an adult body to burn completely.
Postmortem forensic procedures for identification can be used. Even though the external body
is charred and unrecognizable, some internal organs and viable tissues may still be intact and
samples for DNA analysis can be obtained. DNA can also be extracted from the center of a
tooth or from the bone marrow and even the blood. The other procedure is through dental
identification. Teeth will usually be in excellent condition for identification purposes. This is one
of the most powerful methods when dealing with burnt victims. Toxicology and carbon monoxide
testing can also be done.
Burns resulting from burning clothing may have a pattern that reflects both the nature of the
clothing and the position and of the movements victim. Clothed body burns more completely
than unclothed one, and the body of an obese person will burn more completely than a thinner
person because fat acts as an accelerant.
When the body is exposed to a very high temperature, the muscles contract and draw the arms
and legs into a bent position due to the coagulation of proteins. This burned position or fencing
posture has been compared to the stance of a pugilist or a boxer and is referred to as the
"pugilistic attitude."
Classification of Burns
Burns can be classified in various ways. Clinically, they may be classified as superficial or
deep. Superficial burns refer to those affecting only the epidermis or the outer layer of the skin;
deep burns involve the dermis (the deep vascular inner layer of the skin), tissues and bones
(Sharma, 2011).
Burns in the skin can also be classified in degrees, depending on the depth of injury or the
severity of tissue destruction.
• Bright pink-red discoloration of tissues that indicate elevated levels of carbon monoxide;
• Soot within the airways, including the nose, mouth, larynx, trachea and main stem
bronchi indicating that smoke had been inhaled); and
• Elevated level of carbon monoxide in the blood shown on the toxicology report.
Radiant Burns
Radiant burns are caused by a heat source close to the victim or electromagnetic energy
radiating out from an energy source. They may produce skin blisters and erythema, and
charring may result from prolonged exposure. Sources of electromagnetic energy include
ultraviolet and ionizing radiation. In contrast to dry burns where direct contact with the heat
source is required, radiant heat burns do not require direct contact with a heat source.
Alternating currents (AC) are more dangerous than direct currents (DC), because the former
produce contraction of muscles by which a person is not able to release the grip on the wire
through which the current is flowing. High voltage currents of up to 7,000 volts are very
dangerous; in fact, even low voltage currents (110 to 220 volts) of high amperes are dangerous.
The human body's resistance to electricity is decreased when wet or wearing wet clothes, or
when carrying a metallic article touching the ground. Greater duration of current also means
more damage; in fact, even low voltage current for a long duration can cause spasm of muscles
and the person may not be able to release himself and die (Sharma, 2011).
When a person first touches an electric source, he will feel some tingling, shocks, and severe
muscular contraction or spasm. Burns may be found at the point of entrance or exit of electricity.
Skin may also split due to burns. Headache and loss of memory is also possible
in later stages. Investigators who are removing the victim immediately from the source of
electrocution should adopt safety techniques, such as wearing gloves. The victim should be
immediately resuscitated and checked for possible ventricular fibrillation.
Low voltage currents of up to 220 volts can cause death by ventricular fibrillation, mid-voltage
currents of up to 1000 volts can cause ventricular fibrillation and respiratory failure, and high
voltage current of above 1000 volts can cause direct respiratory failure. Delayed death may also
occur due to infection, paralysis, etc.
A person can also die from electrical shock and show no outward signs. In most cases,
however, electrical shocks leave marks on the body and internal burns may be discovered
during an autopsy.
Lightning Injuries
A dead body found in an open space should raise the possibility that it was hit by a lightning
strike. When there are injuries, the clothing may be torn or damaged and the hair may be
seared. A patterned skin burns as a result of the metal object being hit by the lightning such as
buckle of a belt, which may be left magnetized or even melted. Typical findings include severe
burns with skin blisters, charring of the specific body part, ruptured tympanic membranes,
fractures, and lacerations.
Head Injuries
The effects of an injury may vary depending on the exact area of the body that sustained such
injury. For example, a blow in the head will be more catastrophic than a similar blow to the
chest. Injuries to the head are particularly important because of the brain's vital role in
sustaining the life of the individual.
When a person suffers from a head injury, it may result to loss of consciousness. These are
often associated with the acceleration. or deceleration of the head where the brain moves within
the skull. Cerebral concussion (sometimes called stunning) following a head injury is
characterized by temporary loss of consciousness due to a disturbance of brain function without
any identifiable pathological changes in the brain.
After suffering from concussion, the person may have retrograde amnesia, which is loss of
memory extending backwards in time from the moment of impact. The longer the period of
unconsciousness and the deeper the coma, then the more likely it is that irreversible brain
damage has occurred.
Brain injuries may be: (a) focal, which occurs just deep to the area of head impact; or (b)
diffuse, which is a consequence of the acceleration/ deceleration forces applied linearly or
rotationally. Focal brain injuries are comprised of contusions in the area of impact, in association
with fracture lines and in a stereotypical distribution resulting from impact with bony irregularities
of the skull present in the anterior and middle cranial fossae.