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September 15, 2017
PHYSICAL INJURIES
Atty. Malaya Capulong, MD, DFM, LLB 4
Department of Bioethics and Legal Medicine)

TOPIC OUTLINE Description of Injuries

I. Medico-legal Cases Use of body diagrams
a. Conduction of medico-legal examination
b. Description of injuries
c. Classification of physical injuries
d. Special types of wounds
e. Medical classification of wounds
II. Legal Classification of Physical Injuries
III. Gunshot Wounds
a. Identification of firearm wounds

*Previous Trans+ Docs ppt

*Discussed by Doc
MEDICO-LEGAL CASES
A medico-legal case is a case of injury/ illness where the
attending doctor, after eliciting history and examining the
patient, thinks that some investigation by law enforcement
agencies is essential to establish and fix responsibility for
the case in accordance with the law
A case of injury or ailment, etc., in which investigations by
the law-enforcing agencies are essential to fix the
responsibility regarding the causation of the said injury or
ailment.
It is a medical case with legal implications or a legal case
requiring medical expertise.
Accordingly, a MEDICO-LEGAL REPORT is one, which is
prepared for the purpose of litigation - imminent or Location of Injury
prospective. Use standard anatomical terms
Anterior, Posterior, Dorsal , Volar, Ulnar etc.
Examples o Distal extent of the skin wound was situated along the
1. Assault and battery, domestic violence and child abuse ulnar border of the mid-forearm at a distance of 9cm
2. Accidents like Road Traffic Accidents, industrial accidents from the proximal palm
etc. o Laceration, 6cm, volar aspect, D/3, Forearm, Left
3. Cases of trauma with suspicion of foul play Associated Functional Damage
4. Electrical injuries Ability to bear weight, move fingers or limbs
5. Poisoning, Alcohol Intoxication will affect estimated recuperation period
6. Undiagnosed coma Examine wounds (esp. stab/slash wounds) look for
7. Chemical injuries tendon, nerve or vessel injury
8. Burns and Scalds Classification of Physical Injuries
9. Sexual Offences
1. Depth
10. Criminal abortions
o Superficial
11. Attempted suicide
o Deep
12. Cases of asphyxia (hanging, strangulation, drowning,
o Penetrating
suffocation)
o Perforating
13. Custodial deaths
2. Severity
14. Death in the operation theatre
o Deadly/Mortal
15. Unnatural deaths
o Non-deadly/Non-mortal
16. Fire Arm injuries
3. Instruments used/Cause
17. Drug overdose/Drug abuse
o Sharp instruments
18. Dead brought to the ER and deaths occurring within 24 hrs
o Blunt instruments
of hospitalization without establishment of a diagnosis
o Tearing force
Conduction of Medico-legal Examination o Change in atmospheric pressure
Type and nature of injury describe injuries as they appear o Heat or cold
Location of injury use standard anatomical terms o Explosion
Associated Functional Damage 4. Consequential Injury
o Coup
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o Contre coup
o Coup contre coup
o Locus minoris resistencia
o Extensive Injury
5. Integrity of skin
6. Legal Revised Penal Code
Special Types of Wounds
Defense Wounds
Patterned Wounds nature and shape of the instrument INCISED WOUND - produced by a
used to inflict the injury sharp-edged
Self-Inflicted Wounds instrument
Medical Classification of Wounds - Knife
CLOSED WOUNDS - Razor
TYPES CHARACTERISTICS - Bolo
CONTUSION - Extravasation of blood into - Edge of metal sheet
the tissues underneath the - Glass
skin because of rupture of
the blood vessels STAB WOUND - Produced by the
- Initially red or purple penetration of a
- 4-5 days turns green sharp-pointed
- 7 10 days turns yellow instrument
- 14-15th day disappears - Knife
HEMATOMA -Is a collection of blood in a - Saber
newly formed cavity - Dagger
underneath the skin - Scissors

LACERATED WOUND - usually caused by

INcise forcible contact of
the skin with a
blunt instrument

MUSKULO-SKELETAL Sprain Disruption in the

INJURIES continuity of a muscular or
ligamentous support of a
joint.

Dislocation Displacement
of the articular surface of
bones entering into the
formation of a joint

Fracture
Incised Wound Lacerated Wound
- Closed/Simple
Edges clean cut, regular, well- Edges roughly cute, irregular,
- Open/Compound
defined ill-defined
- Comminuted
- Linear No swelling, contusion With swelling or contusion
- Spiral Extremities of wound sharp or Extremities ill-defined and
- Greenstick round irregular
Hair bulbs are cut Hair bulbs are intact
OPEN WOUNDS Scar is linear or spindle- Scar is irregular
TYPES CHARACTERISTICS shaped
Healing is faster Healing is delayed
ABRASION - caused by friction
against a hard or Sharp-edged instrument Blunt instrument
rough surface
- usually involves the LEGAL CLASSIFICATION OF PHYSICAL INJURIES
superficial layer of Revised penal code
the skin Art. 263. Serious Physical Injuries
- consists of parallel Any person who shall wound, beat, or assault another:
linear injuries

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1. The penalty of prision mayor, if in consequence of the volcano, destructive cyclone, epidemic or other public
physical injuries inflicted, the injured person shall become calamity.
insane, imbecile, impotent, or blind; 5. With evident premeditation.
2. The penalty of prision correccional in its medium and 6. With cruelty, by deliberately and inhumanly augmenting the
maximum periods, suffering of the victim, or outraging or scoffing at his person
o lost the use of speech or corpse.
o the power to hear or to smell
o lost an eye, a hand, a foot, an arm, or a leg or lost the use GUNSHOT WOUNDS
of said member Firearms
o incapacitated for the work in which he was habitually
Hand weapon, hand guns or rifles, used for the propulsion of
engaged
a projectile
3. The penalty of prision correcional in its minimum and medium
Includes rifles, muskets, shotguns, revolvers, pistols, etc
periods
from which a bullet, ball, shot, shell or other missile may be
o the person injured becomes deformed
discharged by means of gunpowder
o lose any other part of his body or lose the use thereof
Types of Firearms
o become ill or incapacitated for the performance of the
work in which he as habitually engaged >90 days HAND GUNS
4. The penalty of arresto mayor in its maximum period to
prision correcional in its minimum period, if the physical
injuries inflicted shall have caused the illness or incapacity
for labor of the injured person for >30 days.

Art. 265. Less Serious Physical Injuries

Any person who shall inflict upon another physical injuries
which shall incapacitate the offended party for labor for 10
days or more, or shall require medical assistance for the
same period.
Art. 266. Slight Serious Physical Injuries
The crime of slight physical injuries shall be punished:

1. By arresto menor when the offender has inflicted physical RIFLES - With longer barrels,
injuries which shall incapacitate the offended party for labor spirally grooved
from 1 to 9 days, or shall require medical attendance during - May be single shot
the same period.
2. By arresto menor or a fine and censure when the offender Military rifles semi-automatic
has caused physical injuries which do not prevent the or automatic
offended party from engaging in his habitual work nor
require medical assistance.
3. By arresto menor in its minimum period or a fine when the
offender shall ill-treat another by deed without causing any
injury SHOTGUN - usually sporting guns
Title 8, Chapter 1 Destruction of Life with long smooth bore
Art. 246. Parricide barrels
Any person who shall kill his father, mother, or child, whether - effective within a range
legitimate or illegitimate, or any of his ascendants, or of 30 to 50 meters
descendants, or his spouse, shall be guilty of parricide and shall - fires large numbers of
be punished by the penalty of reclusion perpetua to death small spherical lead
Art. 248. Murder shot
Any person whoshall kill another if committed with any
of the following attendant circumstances:

1. With treachery, taking advantage of superior strength, with

the aid of armed men, or employing means to weaken the
defense or of means or persons to insure or afford impunity. Identification of Firearm Wounds
2. In consideration of a price, reward, or promise. 1. Serial Number
3. By means of inundation, fire, poison, explosion, shipwreck, 2. Manufacturer
stranding of a vessel, derailment or assault upon a street car 3. Caliber the diameter of the barrel between two
or locomotive, fall of an airship, by means of motor vehicles, lands, in inches.
or with the use of any other means involving great waste and 4. Fingerprints
ruin. 5. Fouling of the Barrel
4. On occasion of any of the calamities enumerated in the 6. Cartridge Complete unfired unit consisting of the bullet,
preceding paragraph, or of an earthquake, eruption of a primer, cartridge case and gunpowder.

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Ballistics science dealing with the trajectories of Mortality 20-30%

projectiles, firing characteristics of firearms, bullets & Injury due to Cold
cartridges, usually for identification. Degree of damage depends upon
Forensic Ballistics science of firearm identification. o Severity
Medical Ballistics - studies the penetration/effects of the o Duration of exposure
missile or bullet to the human body, with emphasis on the o Area of body involved
appearance and severity of wounds. o Sex
Firm Contact Fire Gunshot Wound o Humidity
Firm Contact Fire Gunshot Wound Death may result
o Entrance wound large, star-shaped when bone is Effects may be local or systemic
located superficially Injury due to Heat
o Edges are everted Burns
o Smudging, burning & tattooing prominent o Thermal
o Muzzle imprint present o Chemical
o Singeing of the hair o Electrical & lightning
o Blood & tissue are pink due to carbon monoxide o Radiation
Close Contact Gunshot Wound Thermal burns
Close Contact Gunshot Wound - illustrating a patterned Due to dry heat
abrasion around the wound in the shape of the gun muzzle. May be due to fire, radiant heat, friction, solid substances
o Entrance wound round or oval and electricity
o Abrasion Collar distinct Usually accidental
o Smudging, burning & tattooing prominent Singeing of hair present
o Muzzle imprint may be present
o Blackening of bullet tract
o Carboxyhemoglobin present
Short Range Fire (1-15 cm) Gunshot Wound
Entrance wound inverted
There may be area of burning (3-6 inches)
Smudging is present
Powder tattooing present
Abrasion ring present
Medium Range Fire (15-60 cm) Gunshot Wound
Entrance wound inverted Chemical Burns
Smudging may be present (<30 cm) May be due to strong acids or alkali
Powder tattooing of lesser density Blisters are not present
Burning effect absent Staining of skin and clothing
Contact ring present Borders are distinct
Usually accidental
Powder Tattooing
Radiation Burns
May be due to x-ray, ultraviolet light or radioactive
substances
Injury ranges from reddening of the skin to blister formation
to atrophy of superficial tissue
Ultraviolet light causes severe & persistent dermatitis

Electrical Injury/ Electrocution

Short range Factors affecting injury and outcome
Medium Range Amperage
Long Range Fire (>60 cm) Gunshot Wound Voltage
Entrance wound circular or oval Type of current (AC vs DC)
No burning, smudging or tatttooing Duration of contact
Contact ring present Tissue resistance
Exit Wound Pathway of current
Slit-like exit wound
No powder or soot
Could be mixed up with a stab wound
Lightning Injuries
One of the most frequent injuries caused by natural
phenomenon

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