Sorsogon College of Criminology Inc,.

3928 Rizal St.Piot Sorsogon City

LEGAL MEDICINE

(MEDICO LEGAL ASPECT

OF DEATH)

Prepared By:
Debbie Lascota & John Lewis Quisto
III - B
MEDICO-LEGAL ASPECT OF DEATH

Importance of Death determination:

1. The civil personality of a natural person is extinguished by
death.
2. The property of a person is transmitted to his heirs at the time of
death.
3. The death of a partner is one of the causes of dissolution
partnership agreement.
4. The death of either the principal or agent is mode of
extinguishment of agency.
5. The criminal liability is extinguish by death.
6. The civil case fro claims which does not survive is dismissed
upon death of the defendant.

 Death – is the termination of life

Kinds of Death:
1. Somatic or clinical death – persistence of vital functions
2. Molecular or cellular death – 3 to six hours after cessation of life
3. Apparent death or state of suspended animation – transient loss
of consciousness is hysteria, uremia, electric shock

Signs of death:
Cessation of Heart Action and Circulation:
There must be an entire and continuous cessation of the heart
action and flow of the blood in the whole vascular system. A
temporary suspension of the heart action is still compatible with life.
As a general rule, if there is no heart action for a period of five
minutes death is regarded as certain.
 Respiration ceases frequently before the stoppage of heart
contraction and circulation.

Method of detecting the Cessation of Heart Action and Circulation:

Examination of hearth:
1.) Palpation of the pulse:
Pulsation of the peripheral blood vessels may be made at
the region of the wrist or at the neck.
2.) Auscultation for the heart sound at the precordial area:
The rhythmic contraction and relaxation of the heart is
audible through the stethoscope.
3. Cooling of the body ( ALGOR MORTIS)

- After death the metabolic process inside the body ceases.

- The progressive fall of the body temp. is one of the most
prominent signs.
- First two hours after death the cooling is rapid.
- Fall of temp. of 15 to 20 degrees Fahrenheit is considered as a
certain sign of death

POST – MORTEM CALORICITY - is the rise of temp. of the body

after death due to rapid and early putrefactive changes. Usually in the
first 2 hours.
= seen in cholera, liver abscess, tetanus, RF, strynine
poisoning, peritonitis

A. Conditions connected with the body:

Factors delaying the rate of cooling of the body:
1. Acute pyrexial disease
2. Sudden death in good health
3. Obesity of person
4. Death from asphyxia
5. Death of the middle age
Factors accelerating cooling:
1. Leaness of the body
2. Extreme age
3. Long – standing illness
4. Chronic pyrexial disease with wasting
B. Conditions that are connected with the surroundings
Factors delaying cooling:
1. Clothings
2. Want to access of air to the body
3. Small room
4. Warm surroundings

Factors accelerating cooling:

1. Unclothed body
2. Conditions allowing the access of air
3. Large room permitting the dissipation of heat
4. Cooling more rapid in water than in air

c) Stage of secondary flaccidity or commencement of putrefaction

(DECAY OF MUSCLE)
= Muscle are flaccid, not respond to stimuli, reaction is alkaline

= Due to dissolution of muscle proteins

FACTORS INFLUENCE THE TIME OF ONSET OF RIGOR MORTIS
(1) Internal Factors
a) State of the muscle
= healthy – appears late
= onset is hastened in:
a. 1 hunted animal
a. 2 prolonged convulsion/lingering illness
a.3 death from – TY, cholera, phthisis, typhus
b) Age
= early onset – aged and newborn
= delayed – good health, good muscular development
c) Integrity of nerves
= section of the nerve will delay onset, paralyzed muscle

(2) External factors

a) Temperature
= Hastened by high temperature
= > 75 degrees will produce heat stiffening
 b) Moisture
= rapidly but with short duration in moist air

Conditions simulating RIGOR MORTIS:

1. Heat stiffening - > 75 degrees coagulates muscle proteins resulting
to rigidity.
= “Pugilistic attitude” flexed upper and lower limb
= hands clenched, flexor stronger than extensors, burned
to death
2. Cold stiffening
= due to solidification of fats when exposed to cold temp.
3. Cadaveric spasm or Instantaneous Rigor
= instantaneous rigidity due to extreme nervous tension,
exhaustion, injury to the nervous system.
= weapon in hand, weeds

Distinctions between Rigor Mortis and Cadaveric Spasm

1. Time of Appearance
- Rigor mortis appears three to six hours after death, while
cadaveric spasm appears immediately after death.
2. Muscle Involved:
- Rigor mortis involves all the muscles of the body whether
voluntary or involuntary, while cadaveric spasm involves only a
certain muscle or group of muscles and are asymmetrical.
3. Occurrence:
- Rigor mortis is a natural phenomena which occurs after
death, while cadaveric spasm may or may not appear on a person at
the time of death.

4. Medico-legal Significance:
- Rigor mortis may be utilized by a medical jurist to approximate
the time of death, while cadaveric spasm may be useful to determine
the nature of the crime.

Distinction between Muscular contraction and rigor mortis

Muscular Contraction:
 1. Contracted Muscle is more or less transparent, or rather
translucent
Rigor Mortis:
1. Muscle in rigor mortis losses this translucency, and becomes
apaque.

Muscular Contraction
2. It is very elastic, i.e., Capable of restoration to its original form
as soon as the distorting force has ceased to act.
Rigor Mortis:
2. It has lost this elasticit and readily maintains a distorted
position.
Muscular Contraction:
3. In reaction to litmus, it is either neutral or slightly alkaline, and
a / reduction in this alkalinity is very speedily removed.
Rigor Mortis:
3. It is distinctly and constantly acid ( until decomposition is
advanced ) owing to the development of sarcolastic and other acid
metabolites.

Muscle Contraction:
4. If the contraction be overcome by mechanical force, the
muscles though they may remain for a time uncontracted, posses still
their inherent power of contraction; they may then keep the limb fixed
in a new position or allow a return to the old position.
Rigor Mortis:
4. If rigor mortis be overcome by mechanical force, absolute
flaccidity corresponding in degree with the amount of mechanical
movement, at once ensues, and there is no power to resume the old
position nor any new one, except so far as gravity may cause a new
position. The flaccidity is permanent till decomposition destroys the
muscles

Stage of Secondary Flaccidity or Secondary Relaxation:

After the disappearance of rigor mortis, the muscle becomes
soft and flaccid.
It does not respond to mechanical or electrical stimulus. This due to
the dissolution of the muscle proteins which have previously been
coagulated during the period rigor mortis.
 This body while at the stage of rigor mortis, if stretched or flexed
to become soft, will no longer be rigid. This condition of the muscles
is not secondary flaccidity.

2. Changes in the blood

a. Coagulation of the Blood:
- The stasis of the blood due to the cessation of circulation
enhances the coagulation of the blood inside the blood vessels.
- Blood clotting is accelerated in cases of death by
infectious fevers and delayed in cases of asphyxia, poisoning by
opium, hydrocyanic acid or carbon monoxide poisoning.

- The clotting of blood is a very slow process that there is a

tendency for the blood to separate forming a red clot at the lower
level and above it is a white clot known as chicken-fat clot.
- Blood may remain fluid inside the blood vessels after death for
6 to 8 hours.

Distinction Between Ante – mortem from Post – mortem Clot:

1. Ante-mortem Clot – Firm in consistency.
2. Post-mortem Clot - Soft in consistency.
1. Ante-mortem Clot – Surface of the blood vessel raw after the
clots are removed
2. Post-mortem Clot – Surface of the blood vessels smooth and
healthy after the clots are removed.
3. Ante-mortem Clot – Clots homogenous in construction so it
cannot be stripped into layers.
3. Post-mortem Clot – Clots can be stripped off in layers.
4. Ante-mortem Clot – Clot with uniform color.
4. Post-mortem Clot - Clot with distinct layer.

- if the position of the body is moved during the early stage of its
formation, it may disappear and develop again in the most dependent
area in the new position assumed.
- but if the position of the body has been changed after clotting
or the blood has set in or when blood has already diffused into the
tissues of the body, a change of position of the body will not alter the
location of the post-mortem lividity.
 - ordinarily, the color of post-mortem lividity is dull-red or pink
or purplish in color, but in death due to carbon monoxide poisoning,
it is bright pink.
- Exposure of the dead body to cold or hot may cause post-
mortem lividity to be bright-red color.
- the lividity usually appears three to six hours after death and
the condition increases until the blood coagulates.

Physical Characteristics of Post-mortem Lividity:

1. It occurs in the most extensive areas of the most dependent
portions of the body.
2. It only involves the superficial layer of the skin.
3. It does not appear elevated from the rest of the skin.
4. The color is uniform but the color may become greenish at the
start of decomposition.
5. There is no injury of the skin.

Kinds of Post-mortem ( Cadaveric ) Lividity:

1. Hypostatic Lividity:
- The blood merely gravitates into the most dependent
portions of the body but still inside the blood vessels and still in fluid
form.
2. Diffusion Lividity:
- This appears during the later stage of its formation when
the blood has coagulated inside the blood vessels or has diffused
into the tissues of the body.

Importance of Cadaveric Lividty:

1. It is one of the signs of death.
2. It may determine whether the position of the body has been
changed after its appearance in the body.
3. The color of lividity may indicate the cause of death.
For example:
In hemorrhage, anemia – less marked

4. It may determine how long the person has been dead.

5. It gives us an idea as to the time of death
Points to be considered which may infer of the body at the time of
death

a. Posture of the body when found:

- The body may become rigid in the position in which he
died. Post-mortem lividity may develop in the assumed position.
b. Post-mortem Hypostasis (Lividity):
- Hypostatic lividity will be found in areas of the body
which comes in contact with the surface where the body lies. If there
is already coagulation of blood or if blood has already diffused into
the tissues of the body, a change of position will not alter the location
of the post-mortem lividity.

Other changes in the blood

1. Hydrogenion concentration
2. Breakdown of liver glycogen leads to accumulation of dextrose
in the IVC and the right side of the heart
3. There is a rise of non – protein nitrogen and Free amino-acid.

4. Chemical – The chloride in the plasma and red blood cells falls due
to the extravascular diffusion so that after 72 hours it is only ½ of its
content.
Magnesium content increases as a result of diffusion from
without.

3. AUTOLYTIC OR AUTODIGESTIVE CHANGES AFTER DEATH:

After death, proteolytic, glycolytic and lipolytic ferments of
glandular tissues continue to act which lead to the autodigestion of
organs.
This action is facilitated by weak acid and higher temperature.
It is delayed by the alkaline reaction of the tissues of the body
and low temperature.
Autolyctic action is seen in the maceration of the dead fetus
inside the uterus.

4. PUTREFACTION OF THE BODY

- is the breaking down of complex proteins into simpler
components associated with the evolution of foul smelling gasses
and accompanied by the change of color of the body.
Tissue changes in putrefaction:
1. Changes in the color of the tissue
A few hours after death, there is hemolysis of the blood
within the blood vessels and as a result of which hemoglobin is
liberated. The hemoglobin diffuses through the walls of the blood
vessels and stains the surrounding tissues thereby imparting a red or
reddish-brown color
MARBOLIZATION
- Prominence of the superficial veins with reddish discoloration
which develops on both flanks of the abdomen, neck, and
shoulder
- = look like “marbled” reticule of branching veins.

2. Evolution of gasses in the tissues

One of the products of putrefaction is the evolution of gases.
Carbon dioxide, ammonia, hydrogen, sulphurated hydrogen,
phosphoretted hydrogen, and methane gases are formed.
effects of pressure of gasses of putrefaction:
a) displacement of the blood – bleeding in open wounds
b) bloating of the body
c) fluid coming out from nostrils, mouth
d) extrusion of the fetus in a gravid uterus
e) floating of the body

3. Liquefaction of the soft tissues

As decomposition progresses, the soft tissues of the body
undergo softening and liquefaction.
The eye balls, brain, stomach, intestines, liver and spleen
putrefy rapidly, while highly muscular organs and tissues relatively
putrefy late.

Factors modifying the RATE of putrefaction:

1. INTERNAL FACTORS
a) age:
Healthy adults decompose later than infants. It may be late
in a newborn infant who have not yet been fed. Markedly emaciated
person has the tendency to mummify.
b) condition of body
 Those of the full – grown and highly obese persons
decompose more rapidly than skinny ones. Bodies of still-born are
usually sterile so decomposition is retarded.
c) cause of death
Bodies of persons whose cause of death is due to infection
decompose rapidly.

2. EXTERNAL FACTORS
a) free air
a. 1 air: free air hastens decomposition
a. 2 moderate moisture – accelerates
a. 3 loaded with septic bacteria – early aerobes, later
anaerobic
– clostridium welchii = decomposition
b) Earth
b. 1 dry absorbent soil – retards
b. 2 moist fertile soil – accelerates
c) running water – more rapid than still water
d) clothings – early it hastens but delays in the later stage.
– tight clothings – delay

Factors influencing the changes in the body after burial:

1. state of the body before death – thin slower, mummify
2. time elapsed between death and burial and environment of the
body
3. effect of coffin – later
4. clothings and other coverings on the body when buried –
pressure, insects
5. depth at which the body was buried – greater the later
6. condition and type of soil
7. inclusion of something in the grave which will hasten
decomposition – food
8. access of air to the body after burial
9. mass grave – rapid
10. trauma to the body – violent death - slow

CHRONOLOGICAL SEQUENCE OF PUTREFACTIVE CHANGES

OCCURING IN TEMPERATE REGIONS
1-3 DAYS AFTER DEATH – greenish discoloration over iliac fossa,
soft eyeballs
3-5 DAYS – frothy blood from mouth, nostrils
8-10 DAYS – abdominal distention, nails firm
14-20 DAYS – blisters all over the body, maggots
2-5 MONTHS – skull exposed, orbits empty

IN TROPICAL REGION
12 HOURS rigor mortis all over, hypostasis, greenish – discoloration
caecum
24 HOURS rigor mortis absent all over, abdominal distention
48 HOURS ova of flies, trunk bloated, face discolored
72 HOURS whole body grossly swollen, hairs and nails loose
ONE WEEK soft viscera putrefied
TWO WEEKS soft tissues largely gone
ONE MONTH body skeletonized

BEEN SUBMERGED IN WATER

FIRST 4 OR 5 DAYS cold water little change, in rigor mortis
FROM 5-7 DAYS skin on hands, feet is bleached, face faded white
1-2 WEEKS face swollen and red, skin of hands and feet wrinkled
4 WEEKS skin wrinkled, nail intact
6-8 WEEKS abdomen distended, skin of hands/feet come off with
nails

Factors influencing the floating of the body in water:

1. Age – fully developed, well nourished – rapid
2. Sex – females floats sooner
3. Conditions of the body – obese float quicker
4. Season of the year – moist hot air – putrefaction – floats due to
gas
5. Water – shallow and stagnant water of creeks, higher specific
gravity – sea water floats sooner than fresh water,
higher specific gravity
6. External influence – heavy – wearing apparel – slower
Only teeth, bones and hair remain for an indefinite time.
Flat bones disintegrates faster than round bones.
SPECIAL MODIFICATION OF PUTREFACTION
1. Mummification
= is the dehydration of the whole body which results in the
shivering and preservation of the body.
= usually occurs when buries in a hot, dry with free access of
hot air
2. Saponification or adipocere fromation
= a condition where the fatty tissues of the body are transformed
to soft brownish – white substance known as ADIPOCERE at SQ level.
3. Maceration
= softening of the tissues when in fluid medium in the absence
of putrefactive mircro-org, seen in death in utero
- reddish or greenish color, skin peeling off and arms flaccid and
frail.

HOW LONG A PERSON HAS BEEN DEAD? DURATION OF DEATH

1. Presence of rigor mortis:
= 2-3 hours after death
= 12 hours fully developed
= 18-36 hours disappears concomitant with putrefaction
2. Presence of post-mortem lividity
= 3-6 hours after death
= appears as small petechial-like red spots
3. Onset of decomposition
= 24-48 hours after death
= manifested water, foul smelling froth, mouth, nostrils

4. Stage of decomposition
5. Entomology of the cadaver
= 24 hours before eggs are hatched, maggots
6. Stage of digestion
= 3-4 hours gastric empty
= 6-8 distal ileum, cecum
7. Presence of live flies in the clothing in the drowning victim
= less than 24 hours
8. State of clothings
= pajama, night

9. Changes in CSF
 10. Blood clots inside the b.v. in 6-8 hours after death
11. Soft tissues of the body may disappear 1 to 2 years after
burial.
Post-mortem conditions simulating disease, poisoning or inury:
1. Post mortem hypostasis – contusion, inflammation, poisoning
2. Blister of the cuticle – scald and burns
3. Swelling, detachment or splitting - injury

PRESUMPTION OF DEATH
Rule 131, Sec. 5, Rules of court:
Disputable Presumption.
- That a person not heard from for seven years, is dead.

Art. 390, civil code and Sec. 5, Rule 131, Rules of court:
- After an absence of seven years, it being unknown whether or
not the absentee still lives, he shall be presumed dead for all purpose
except for those succession.

Art. 391, Civil Code and Sec. 5, Rule 131, Rules of court
The following shall be presumed dead for all purposes,
including the division of the state among the heirs:
1.) A person on board a vessel lost during a sea voyage, or an
aeroplane which is missing, who has not been heard of for four years
since the lost of the vessel or aeroplane.
2.) A person in the armed forces who has taken part in war, and
has been missing for four years.
3.) A person who has been in danger of death under other
circumstances and his existence has not been known for four years.

Presumption of survivorship
Sec. 5 (jj), Rule 131, Rules of court:
When two persons perish in the same calamity, such as
wreck, battle, or conflaguration, and it is not shown who died first,
there are no particular circumstances from which it can be inferred,
the survivorship is presumed from the probabilities resulting from the
strength and age of the sexes, according to the following:

1. If both were under the age of fifteen years, the older is

presumed to have survived;
 2. If both were above the age of sixty, the former is presumed to
have survived;
3. If one is under fifteen and the other above sixty, the former is
presumed to have survived;

4. If both be over fifteen and under sixty, and the sexes be

different, the male is presumed to have survived; if the sexes be the
same, then the older;
5. If one be under fifteen or over sixty, and the other between
those ages, the latter is presumed to have survived.