GROUP 1

Atig, Ronald
Balili, Rummel
Becite, Ellen
Caroro, Mae Ann

MEDICOLEGAL ASPECTS OF DEATH

Coverage:
I. Importance of Death Determination
II. Definition of Death
III. Criterion Used in Death Determination
IV. Kinds of Death
V. Signs of Death
VI. Changes in the Body Following Death
VII. Duration of Death
VIII. Presumption of Death
IX. Presumption of Survivorship

Importance of Death Determination

1) The civil personality of a natural person is extinguished by death: (Art. 42, Civil Code)
2) The property of a person is transmitted to his heirs at the time of death: (Art. 774, Civil
Code).
3) The death of a partner is one of the causes of dissolution of partnership agreement:
(Art. 1830, Civil Code).
4) The death of either the principal or agent is a mode of extinguishment of agency:
(Art.1919, Civil Code).
5) The criminal liability of a person is extinguished by death: (Art. 89, Revised Penal
Code).
By death of the convict, as to the personal penalties; and as
to pecuniary penalties, liability therefore is extinguished only when the death of the
offender occurs before judgment. (Art. 89, Revised Penal Code).

Definition of Death
Death is the termination of life. It is the complete cessation of all the vital functions without
possibility of resuscitation It is an irreversible loss of the properties of living matter. Dying is a
continuing process while death is an event that takes place at a precise time. The
ascertainment of death is a clinical and not a legal problem.

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Criterion Used in Death Determination

1) Brain Death
Death occurs when there is deep-Irreversible coma, absence of electrical brain activity
and complete cessation of all the vital functions without possibility of resuscitation.

a. Unreceptivity and unresponsibility — There is a total unawareness to

externally applied stimuli and inner need and complete unresponsiveness —
our definition of irreversible coma. Even the most intense painful stimuli evoke
no vocal or other response, not even a groan, withdrawal of his limb, or
quickening of respiration.

b. No movements or breathing — Observations covering a period of at least 1

hour by physicians is adequate to satisfy the criteria of no spontaneous
muscular movements or spontaneous respiration or response to stimuli such
as pain, touch, sound, or light. After the patient is on a mechanical respirator,
the total absence of spontaneous breathing may be established by turning off
the respirator for three minutes and observing whether there is any effort on
the part of the subject to breath spontaneously. (The respirator may be turned
off for this time provided that at the start of the trial period the patient's carbon
dioxide tension is within the normal range, and provided also that the patient
had been breathing room air for at least 10 minutes prior to the trial).

c. No reflexes — Irreversible coma with abolition of central nervous system

activity is evidenced in part by the absence of elicitable reflexes. The pupil will
be fixed and dilated and will not respond to a direct source of bright light. . .
Ocular movement (to head turning and to irrigation of the ears with ice water)
and blinking are absent. There is no evidence of postural activity (decerebrate
or other). Swallowing, yawning, vocalization are in abeyance. Corneal and
pharyngeal reflexes are absent. As a rule the stretch or tendon reflexes cannot
be elicited, i.e. tapping the tendons of the biceps, triceps and pronator muscles,
quadriceps and gastrocnemius muscles with the reflex hammer elicits no
contraction of the respective muscles. Plantar or noxious stimulation gives no
response.

d. Flat electro-encephalogram — Of great confirmatory value is the flat or iso-

electric E.E.G. We must assume that the electrodes have been properly
applied, that the apparatus is functioning normally, and that the personnel in
charge are competent.

All of these tests shall be repeated at least 24 hours later with no change. It is emphasized
that the patient be declared dead before any effort is made to take him off the respirator, if he
is then on a respirator.

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 2) Cardio-Respiratory Death
Death occurs when there is a continuous and persistent cessation of heart action and
respiration. Cardio-respiratory death is a condition in which the physician and the
members of the family pronounced a person to be dead based on the common sense
or intuition.

In 1969, the Ad Hoc Committee of Human Transplantation convened under the

auspices of the Institute of Forensic Sciences, Duquesne University School of Law
adopted the proposed criteria for the determination of death otherwise known as
Philadelphia Protocol, and the following were considered:

a. Lack of responsiveness to internal and external environment.

b. Absence of spontaneous breathing movements for 3 minutes, in the absence of
hypocarbia and while breathing room air.
c. No muscular movements with generalized flaccidity and no evidence of postural
activity or shivering.
d. Reflexes and response:
 Pupils fixed and dilated, non-reactive to strong stimuli.
 Corneal reflexes absent.
 Supra-orbital or other pressure response absent (both pain response and
decerebrate posturing).
 Absence of snouting or sucking response.
 No reflex response to upper airway stimulation.
 No reflex response to lower airway stimulation.
 No ocular response to ice water stimulation of the inner ear.
 No deep tendon reflexes.
 No superficial reflexes.
 No plantar responses.
e. Falling arterial pressure without support by drugs or other means.
f. Iso-electric electro-encephalogram (in absences of hypothermia, anesthetic agents
and drugs intoxication) recorded spontaneously and during auditory and tactile
stimulation.

Kinds of Death

1) Somatic Death or Clinical Death

This is the state of the body in which there is complete, persistent and continuous
cessation of the vital functions of the brain, heart and lungs which maintain life and
health^ It occurs the moment a physician or the other members of the family declare a
person has expired, and some of the early signs of death are present. It is hardly
possible to determine the exact time of death.

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 2) Molecular or Cellular Death
After cessation of the vital functions of the body there is still animal life among
individual cells. This is evidence by the presence of excitability of muscles and ciliary
movements and other functions of individual cells. About three to six hours later, there
is death of individual cells. This is known as molecular or cellular death. Its exact
occurrence cannot be definitely ascertained because its time of appearance is
influenced by several factors. Previous state of health, infection, climatic condition,
cellular nutrition, etc. influence its occurrence.

3) Apparent Death or “State of Suspended Animation”

This condition is not really death but merely a transient loss of consciousness or
temporary cessation of the vital functions of the body on account of disease, external
stimulus or other forms of influence. It may arise especially in hysteria, uremia,
catalepsy and electric shock. It may be induced voluntarily as has been cited by foreign
authors (Col. Townshend who could be able to pass into a state of pulselessness for
half an hour). Involuntary suspension is shown in still-birth. A newly born child may
remain at the state of suspended animation and may die unless prompt action is taken.
A person who has been rescued from drowning may appear dead but life is maintained
after continuous resuscitation.

It is important to determine the condition of suspended animation to prevent premature

burial. There are records of cases wherein a person was pronounced dead, placed in
a coffin and later angrily rise from it and walk unaided. The relative has sent death
notice and placed wreaths near his coffin.

Signs of Death

1) Cessation of Heart Action and Circulation

There must be an entire and continuous cessation of the heart action and flow of blood
in the whole vascular system. A temporary suspension of the heart action is still
compatible with life. The length of time the heart may cease to function and life is still
maintained depends upon the length of time it is readily reestablished and upon the
oxygenation of blood at the time of the suspension. 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.
Usually the auricle of the heart contracts after somatic death for a longer period than
the ventricle. And the auricle is the last to stop, hence called ultimen mariens.

In judicial hanging, the heart continues to beat for twenty minutes or half an hour after
the individual has been executed although its beating is irregular and feeble. In
decapitation of criminals, heart beating is present for an hour after decapitation has
taken place.

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Methods of Detecting the Cessation of Heart Action and Circulation

A. Examination of the Heart

1) Palpation of the Pulse

Pulsation of the peripheral blood vessels may be made at the region of the wrist
or at the neck. The pulsation of the vessels is synchronous with the heartbeat.
Occasionally the pulsation is very imperceptible and irregular that the examiner
experience much difficulty.

2) Auscultation for the Heart Sound at the Precordial Area

The rhythmic contraction and relaxation of the heart is audible through the
stethoscope. Heart sound can be audible during life even without the aid of a
stethoscope by placing the ear at the precordial area.

3) Flouroscopic Examination

Fluoroscopic examination of the chest will reveal the shadow of the heart in its
rhythmic contraction and relaxation. The shadow may be enlarged and the
excursion made less visible due to pericardial effusion.

4) By the Use of Electrocardiograph

The heart beat is accompanied by the passage of electrical charge through the
impulse conducting system of the heart which may be recorded in an
electrocardiograph machine. The electrocardiograph will record the heart beat
even if it is too weak to be heard by auscultation. This is the best method of
determining heart action but quite impractical.

B. Examination of the Peripheral Circulation

1) Magnus' Test

A ligature is applied around the base of a finger with moderate tightness. In a

living person there appears a bloodless zone at the site of the application of
the ligature and a livid area distal to the ligature. If such ligature is applied to
the finger of a dead man, there is no such change in color. The color of the
area where the ligature is applied will be the same as that one distal to it. There
may be no appreciable change of color if a living person is markedly anemic.

2) Opening of Small Artery

In the living, the blood escapes in jerk and at a distance. In a dead man, the
blood vessel is white and there is no jerking escape of blood but may only ooze
towards the nearby skin. When bigger arteries are cut, blood may flow without
pressure continuously.

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 3) Icard's Test

This consists of the injection of a solution of fluorescein subcutaneously. If

circulation is still present, the dye will spread all over the body and the whole
skin will have a greenish-yellow discoloration due to flourescein. In a dead man,
the solution will just remain at the site of the injection. This test should be
applied only with the use of the daylight as the color is difficult to be appreciated
with the use of artificial light.

4) Pressure on the Fingernails

If pressure is applied on the fingernails intermittently, there will be a zone of

paleness at the site of the application of pressure which become livid on
release. There will be no such change of color if the test is applied to a dead
man.

5) Diaphanous Test

The fingers are spread wide and the finger webs are viewed through a strong
light. In the living, the finger webs appear red but yellow in the dead. The finger
webs may appear yellow in a strong light even if living in cases of anemia or
carbon monoxide poisoning.

6) Application of Heat on the Skin

If heated material is applied on the skin of a dead man, it will not produce true
blister. There is no sign of congestion, or other vital reactions. But if applied to
a living person, blister formation, congestion, and other vital reactions of the
injured area will be observed.

7) Palpation of the Radial Pulse

Palpation of the radial artery with the fingers, one will feel the rhythmic pulsation
of the vessel due to the flow of blood. No such pulsation will be observed in a
dead man.

8) Dropping of Melted Wax

Melted sealing wax is dropped on the breast of a person. If the person is dead,
there will be no inflammatory edema at the neighborhood of the dropped melted
wax.

2) Cessation of Respiration
Like heart action, cessation of respiration in order to be considered as a sign of death
must be continuous and persistent. A person can hold his breath for a period not longer
than 3-1/2 minutes. In case of electrical shock, respiration may cease for some time
but may be restored by continuous artificial respiration.

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Methods of Detecting Cessation of Respiration:

A. Expose the chest and abdomen and observe the movement during
inspiration and expiration.

B. Examine the person with the aid of a stethoscope which is placed at the
base of the anterior aspect of the neck and hear sound of the current of
air passing through the trachea during each phase of respiration.

C. Examination with a Mirror

The surface of a cold-looking glass is held in front of the mouth and nostrils. If
there is dimming of the mirror after a time, there is still respiration. The dimming
of the cold mirror is due to the condensation of the warm moist air exhaled from
the lungs if respiration is still going on. However, it must not be forgotten that
the dimming of the mirror may be due to the expulsion of the air from the lungs
due to the contraction of the diaphragm in rigor mortis. Ordinarily there is no
dimming of the mirror when the subject is dead.

D. Examination with a Feather or Cotton Fibers

Place a fine feather or a strip of cotton in front of the lips and nostrils. If there
is movement of the feather or cotton not due to external air, respiration is
present. The feather or cotton fibers will be blown away during expiration and
towards the nose and mouth during inspiration. This is not a reliable test as the
slightest movement of outside air or nervousness of the observer will move the
feather or cotton fibers.

E. Examination with a Glass of Water

Place a glass half full of water at the region of the chest. If the surface of the
water is smooth and stable, there is no respiration taking place, but if it waves
or water movement is observed, then respiration is taking place. This is not a
good test because of the difficulty of preventing movement of the place where
the body lies.

F. Winslow's Test

There is no movement of the image formed by reflecting artificial or sun light

on the water or mercury contained in a saucer and placed on the chest or
abdomen if respiration is not taking place. The reflection is utilized to magnify
the movement of the surface of mercury or water.

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3) Cooling of the Body (Algor Mortis):
After death the metabolic process inside the body ceases. No more heat is produced
but the body loses slowly its temperature by evaporation or by conduction to the
surrounding atmosphere. The progressive fall of the body temperature is one of the
most prominent signs of death. The rate of cooling of the body is not uniform. It is rapid
during the first two hours after death and as the temperature of the body gradually
approaches the temperature of the surroundings, the rate becomes slower. It is difficult
to tell exactly the length of time the body will assume the temperature of the
surroundings. Several factors influence the rate of fall of the body temperature.

The progressive fall of the body temperature is one of the most prominent signs of
death. The rate of cooling of the body is not uniform. It is rapid during the first two hours
after death and as the temperature of the body gradually approaches the temperature
of the surroundings, the rate becomes slower. It is difficult to tell exactly the length of
time the body will assume the temperature of the surroundings. Several factors
influence the rate of fall of the body temperature.

The fall of temperature may occur before death in the following conditions:
a. Cancer
b. Phthisis
c. Collapse

The fall of temperature of 15 to 20 degrees fahrenheit is considered as a certain sign

of death.

Post-mortem Caloricity is the rise of temperature of the body after death due to rapid
and early putrefactive changes or some internal changes. It is usually observed in the
first two hours after death.

Post-mortem caloricity may occur in the following conditions:

a. Cholera
b. Yellow fever
c. Liver abscess
d. Peritonitis
e. Cerebro-spinal fever
f. Rheumatic fever
g. Tetanus
h. Smallpox
i. Strychnine poisoning

Factors Influencing the Rate of Cooling of the Body

A. Conditions that are connected with the body

1. Factors Delaying Cooling
a. Acute pyrexia! diseases
b. Sudden death in good health
c. Obesity of person

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 d. Death from asphyxia
e. Death of the middle age
2. Factors Accelerating Cooling
a. Leanness of the body
b. Extreme age
c. Long-standing or lingering illness
d. Chronic pyrexial disease associated with wasting.
B. Conditions that are connected with the surroundings
A. Factors Delaying Cooling
a. Clothings
b. Want of access of air to the body
c. Small room
d. Warm surroundings
B. Factors Accelerating Cooling
a. Unclothed body
b. Conditions allowing the access of air
c. Large room permitting the dissipation of heat
d. Cooling more rapid in water than in air

Methods of Estimating How Long a Person Has Been Dead From the Cooling of
the Body:

A. When the body temperature is normal at the time of death, the average rate
of fall of the temperature during the first two hours is one-half of the
difference of the body temperature and that of the air.

During the next two hours, the temperature fall is one-half of the previous rate, and
during the succeeding two hours, it is one-half of the last mentioned rate.

As a general rule the body attains the temperature of the surrounding air from 12
to 15 hours after death in tropical countries (Medical Jurisprudence and Toxicology
by Modi, 12th ed.,p. 121).

B. To make an approximate estimate of the duration of death from the body

temperature, the following formula has been suggested:

(Normal Temperature) 98.4°F — (Rectal Temperature)

Approximate number of hours after death

This formula is only applicable to cases where the rectal temperature has not yet
assumed the temperature of the surroundings, otherwise, the result will be
constant.

C. Chemical Method

Schourup's formula for the determination of the time of death of any cadaver whose
cerebro-spinal fluid is examined for the concentrations of lactic acid (L.A.), non-

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 protein nitrogen (N.P.N.) and amino acid (A.A.) and whose axillary temperature
has been taken at the time the cerebro-spinal fluid has been removed.

The lactic acid content of the cerebro-spinal fluid rises from 15 mg. to over 200 mg.
per 100 cc. The rise is rapid during the first 5 hours following death.

The non-protein nitrogen (N.P.N.) increases from 15 to 40 mg. per 100 cc. during
the first 15 hours. This test is modified by ante-mortem anemia and rapid cooling
of the body.

Amino-acids (A.A.) increases from 1 mg. to 12 mg. percent during the first 15
hours, but the result is modified by rapid cooling of the body.

Limitations of the Schourup's Formula:

a. The method is only applicable to adults, as the rate of biochemical change

in a child is far more rapid than in adult. It is the value to person over the
age of 15 years.
b. The cerebrospinal fluid must be free of blood, the presence of which raises
the lactic concentration.
c. Injuries must not have allowed the escape of cerebrospinal.
d. Death must have occurred' within a period 15 hours prior to the withdrawal
of the sample of cerebrospinal fluid, as after that time the changes in the
concentration per time unit become irregular (Modern Trend in Forensic
Medicine by Keith. Simpson, 1953, pp. 83-84).

4) Insensibility of the Body and Loss of Power to Move

After death the whole body is insensible. No kind of stimulus is capable of letting the,
body have voluntary movement.

This condition must be observed in conjunction with cessation of heart beat and
circulation and cessation of respiration.

The insensibility and loss of power to move may be present although living, in the
following conditions:
a. Apoplexy
b. Epilepsy
c. Trance
d. Catalepsy
e. Cerebral concussion
f. Hysteria

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5) Changes in the Skin
The following are the changes undergone by the skin after death:

A. The skin may be observed to be-pale and waxy-looking due to the absence
of circulation. Areas of the skin specially the most dependent portions will
develop livid discoloration on account of the gravitation of blood.

B. Loss of Elasticity of the Skin

Normally when the body surface is compressed, it readily returns to normal

shape. After death, application of pressure to the skin surface will make the
surface flattened. Application of pressure with the fingertip will produce fitting
impression like one observed in edema.

Post-mortem Contact Flattening — On account of the loss of elasticity of the

skin and of the post-mortem flaccidity of muscles, the body becomes flattened
over areas which are in contact with the surface it rests. This is observed at the
region of the shoulder blades, buttocks and calves if death occurs while lying
on his back. Certain degree of pressure may be applied on the face
immediately after death and may be mistaken for traumatic deformity.

C. Opacity of the Skin

Exposure of the hand of a living person to translucent light will allow the red
color of circulation to be seen underneath the skin. The skin of a dead person
is opaque due to the absence of circulation.

D. Effect of the Application of Heat

Application of melted sealing wax on the breast of a dead person will not
produce blister or inflammatory reaction on the skin. In the living, an
inflammatory edema will develop about the wax.

6) Changes in and about the Eye

A. Loss of Corneal Reflex:

The cornea is not capable of making any reaction to whatever intensity of light
stimulus. However, absence of corneal reflex may also be found in a living
person the following conditions:
a. General anesthesia
b. Apoplexy
c. Uremia
d. Epilepsy
e. Narcotic Poisoning
f. Local Anesthesia

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 B. Clouding of the Cornea

The normal clear and transparent nature of the cornea is lost. The cornea becomes
slightly cloudy or opaque after death. If the cornea is kept moist by the application
of saline solution after death, it will remain transparent. Opacity of the cornea may
be found in certain diseases, like cholera, and therefore is not a reliable sign of
death.

C. Flaccidity of the Eyeball

After death, the orbital muscles lose their tone making the intra-orbital tension
rapidly fall. The eyeball sinks into the orbital fossa. Intra-orbital tension is low.

D. The Pupil is in the Position of Rest

The muscle of the iris loses its tone. The pupil can’t react to light. The size of the
pupil varies at the time of death, however, if contracted, it may infer poisoning by
narcotic drugs. A relaxed iris may be found in life in the following conditions:
1. Action of drugs like atropine
2. Uremia
3. Tabes dorsalis
4. Apoplexy

E. Ophthalmoscopic Findings

1. The optic disc is pale and has the appearance of optic atrophy.
2. The remaining portion of the fundus may have a yellow tinge which later
changes to a brownish-gray or slate color.
3. The retina becomes pale like the optic disc.
4. The retinal vessels become segmented, no evidence of blood
The retinal veins and arteries are indistinguishable:

F. “Tache noir de la sclerotique"

After death a spot may be found in the sclera. The spot which may be oval or round
or may be triangular with the base towards the cornea and may appear in the sclera
a few hours after death. At the beginning it is yellowish but later it becomes brown
or black. This is believed to be due to the thinning of the sclera thereby making the
pigmented choroid visible.

7) Action of Heat on the Skin

This test is useful to determine whether death occurred before or after the application
of heat.

The heat is applied to a portion of the leg or arm. If death is real, only a dry blister is
produced. The epidermis is raised but on pricking the blister, no fluid is present. There

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 is no redness of the surrounding skin. In the living, the blister contains abundant serum
and area of vital reaction (congestion) on the skin around is present.

The Following Combinations of Signs Show Death has Occurred

a. Loss of animal heat to a point not compatible with life.
b. Absence of response of muscle to stimulus.
c. Onset of rigor mortis.

Changes in the Body Following Death

1) Changes in the Muscles

After death, there is complete relaxation of the whole muscular system. The entire
muscular system is contractile for three to six hours after death, and later rigidity sets in.
Secondary relaxation of the muscles will appear just when decomposition has set in.

The Entire Muscular Tissue Passes Three Stages After Death:

A. Stage of primary flaccidity (post-mortem muscular irritability):

The muscles are relaxed and capable of contracting when stimulated. The
pupils are dilated, the sphincters are relaxed, and there is incontinence of
urination and defecation.

Immediately after death, there is complete relaxation and softening of all the
muscles of the body. The extremities may be flexed, the lower jaw falls, the
eyeball loses its tension, and there may be incontinence of urination and
defecation.

To determine whether the muscles are still irritable, apply electric current and
note whether there is still irritability of the muscles. Normally during the stage
of primary flaccidity, the muscles are still contractile and react to external
stimuli, mechanical or electrical owing to the presence of molecular life after
somatic death.

This stage usually lasts about three to six hours after death. In warm places,
the average duration is only one hour and fifty-one minutes (Mackenzie cited
by Modi, p. 122).

Chemically, the reaction of the muscle is alkaline and the normal constituents
of the individual muscle proteins are the same as in life.

B. Stage of post-mortem rigidity (Cadaveric rigidity, or Death struggle of

muscles or Rigor Mortis):

The whole body becomes rigid due to the contraction of the muscles. This
develops three to six hours after death and may last from twenty-four to thirty-
six hours.

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Three to six hours after death the muscles gradually stiffen.

It usually starts at the muscles of the neck and lower jaw and spreads
downwards to the chest, arms, and lower limbs. Usually the whole body
becomes stiff after twelve hours. All the muscles are involved — both voluntary
and involuntary. In the heart, rigor mortis may be mistaken for cardiac
hypertrophy. Chemically, there is an increase of lactic acid and phosphoric
content of the muscle. The reaction becomes acidic. There is no definite
explanation as to how such contraction of muscles occurs although it has been
proven that there is coagulation of the plasma protein.

In the medico-legal view point, post-mortem rigidity may be utilized to

approximate the length of time the body has been dead. In temperate countries
it usually appears three to six hours after death, but in warmer countries it may
develop earlier.

In temperate countries, rigor mortis may last for two or three days but in tropical
countries the usual duration is twenty-four to forty-eight hours during cold
weather and eighteen to thirty-six hours during summer. When rigor mortis sets
in early, it passes off quickly and vice versa.

Factors Influencing the Time of Onset of Rigor Mortis

1. Internal Factors:
a. State of the Muscles:
Rigor mortis appears late and the duration is longer in cases
where the muscles have been healthy and at rest before death.
It has been observed that in the following deaths, the onset of
rigor mortis is hastened:
 Animal having been hunted to death.
 Prolonged convulsion and lingering illness.
 Death from typhoid fever, typhus, cholera and phthisis.
b. Age
Rigor mortis has early onset in the aged and new-born. The
onset is delayed in good health and good muscular
development.
c. Integrity of the Nerves:
Section of the nerve will delay onset of rigor mortis as shown in
paralyzed muscles.
2. External Factors:
a. Temperature:
The development of rigor mortis is accelerated by high
temperature but a temperature above 75°C will produce heat
stiffening.
b. Moisture:
Rigor mortis commences rapidly but the duration is short in
moist air.

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Conditions Simulating Rigor Mortis:

1. Heat Stiffening

If the dead body is exposed to temperatures above 75°C it will coagulate

the muscle proteins and cause the muscles to be rigid. The stiffening is
more or less permanent and may not be easily affected by putrefaction. The
body assumes the "pugilistic attitude" with the lower and upper extremities
flexed and the hands clenched because the flexor muscles are stronger
than the extensors.

Heat stiffening is commonly observed when the body of a person is placed

in boiling fluid or when the body is burned to death.

2. Cold Stiffening

The stiffening of the body may be manifested when the body is frozen, but
exposure to warm condition will make such stiffening disappear. The cold
stiffening is due to the solidification of fat when the body is exposed to
freezing temperature. Forcible stretching of the flexed extremities will
produce a sound due to the frozen synovial fluid.

3. Cadaveric Spasm or Instantaneous Rigor

This is the instantaneous rigidity of the muscles which occurs at the

moment of death due to extreme nervous tension, exhaustion and injury to
the nervous system or injury to the chest. It is principally due to the fact that
the last voluntary contraction of muscle during life does not stop after death
but is continuous with the act of cadaveric rigidity. In case of cadaveric
spasm, a weapon may be held in the hand before death and can only be
removed with difficulty. For practical purposes it cannot be possible for the
murderer or assailant to imitate the condition. In cadaveric spasm, only
group of muscles are involved and they are usually not symmetrical.

The findings of weapon, hair, pieces of clothing, weeds on the palms of the
hands and firmly grasped is a very important medico-legal point in the
determination whether it is a case of suicide, murder or homicide. The
presence of weeds held by the hands of a person found in water shows that
the victim was alive before disposal.

Instantaneous rigor may also be found following ingestion of cyanide but

usually it is generalized and symmetrical. Strychnine may produce the
same but rigidity appears sometime after ingestion.

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 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. Muscles 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.

Distinctions Between Muscular Contraction and Rigor Mortis

Muscular Contraction Rigor Mortis

Contracted muscle is more or less Muscle in rigor mortis losses this translucency,
transparent, or rather translucent. and becomes opague.

It is very elastic, i.e., capable of restoration to

It has lost this elasticity and readily maintains
its original form as soon as the distorting force
a distorted position.
has ceased to act.

It is distinctly and constantly acid (until

In reaction to litmus, it is either neutral or
decomposition is advanced) owing to the
slightly alkaline, and any reduction in this
development of sarcolatic and other acid
alkalinity is very speedily removed.
metabolites.

If rigor mortis be overcome by mechanical

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

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 C. 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 is due to the
dissolution of the muscle proteins which have previously been coagulated
during the period of 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 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.

Distinctions Between Ante-mortem from Post-mortem Clot

Ante-mortem Clot Post-mortem Clot

Firm in consistency Soft in consistency

Surface of the blood vessel are raw after the Surface of the blood vessels smooth and
clots are removed healthy after the clots are removed.

Clots homogenous in construction so it can’t

Clots can be stripped off in layers
be stripped into layers.

Clot with uniform color. Clot with distinct layer.

B. Post-mortem Lividity or Cadaveric Lividity, or Post-mortem Suggillation

or Post-mortem Hypostasis or Livor Mortis

The stoppage of the heart action and the loss of tone of blood vessels cause
the blood to be under the influence of gravity. Blood begins to accumulate in
the most dependent portions of the body. The capillaries may be distended with
blood. The distended capillaries coalesce with one another until the whole area
becomes dull-red or purplish in color known as post-mortem lividity. If the body
is lying on his back, the lividity will develop on the back. Areas of bone
prominence may not show lividity on account of the pressure. If the position of

17
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 in
color.

The lividity usually appears three to six hours after death and the condition
increases until the blood coagulates. The time of its formation is accelerated in
cases of death due to cholera, uremia and typhus fever. Twelve hours after
death, the post-mortem lividity is already fully developed. It also involved
internal organs.

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 fluid in form. Any change
of position of the body leads to the formation of the lividity in another
place. This occurs during the early stage of its formation.

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. Any change of position will not change the location of the
lividity.

Importance of Cadaveric Lividity

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 the lividity may indicate the cause of death.
Example:
a. In asphyxia, the lividity is dark.
b. In carbon monoxide poisoning, the lividity is bright pink.
Hemorrhage, anemia — less marked.

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 Hydrocyanic acid — bright red.
Phosphorus — dark brown.
Potassium chlorate, Potassium bichromate — chocolate or
coffee brown.
c. If the body is found for considerable time in snow or ice the
lividity is bright red.
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 the position 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. This condition may occur and is of value if
the state and position of the body was not moved before rigidity and lividity took
place.
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.
c. Cadaveric Spasm:
In violent death, the attitude of parts of the body may infer position on account of
the spasm of the muscles.
Example:
1. In drowning, the victim may be holding the sea weeds.
2. In suicide, the wounding weapon may be grasped tightly by the hands.

Distinctions Between Contusion (Bruise) and Post-mortem Hypostasis

Contusion (Bruise) Post-mortem Hypostasis

a. Below the epidermis in the true skin in small

a. In the epidermis or in the cutis, as a simple
bruises or extravasations, below this in
stain or a showing through the epidermis of
epilarger ones, and often much deeper still.
underlying engorged capillaries
The reason is obvious, viz., that the epidermis
has no blood-vessels to be ruptured.

b.Cuticle was probably abraded by the same

b.Cuticle unabraded, because the hypostasis
violence that produced the bruise. In small
is a mere sinking of the blood; there is no
punctures, such as flea bites, this is not
trauma.
observed.

c. A bruise appears at the seat of and c. Always in a part which for the time of
surrounding the injury. This may or may not be formation is dependent, i.e., at a place where
a dependent part gravity ordains it.

d. Often elevated, because the extravasated d.Not elevated, because either the blood is
blood and subsequent inflammation swell the still in the vessels or, at most, has simply
tissues. soaked into and stained the tissues.

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e. Incision shows blood outside the vessels. e.Incision shows the blood is still in its
This is the most certain test of difference, and vessels; and if any oozing occurs drops can
can be observed even in very small bruises. be seen issuing from the cut
mouths of the vessels.

f. Colour uniform. The well known change in

f. Colour variegated. This is only true of bruises
colour (green, yellow, etc.) produced in blood
that are some days old; it is due to the
extravasted
changes in the haemoglobin produced during
into living tissues does not occur in dead
life.
tissues with the same regularity.

g. In a place which would otherwise be the

seat of a hypostasis pressure of any kind,
even simple support (the wrinkling of a shirt or
g. If the body happens to be constricted at, or
necktie, garters, etc.) is sufficient to obliterate
supported on, a bruised place, the
the lumen of venules and capillaries, and so
actual surface of contact may be a little lighter
to prevent their filling with blood. White lines
than the rest of the bruise, but
or patches of pressure bordered by, the dark
will not be white.
color of a hypostasis are produced and marks
of floggings, strangulation, etc., are thus
sometimes
simulated.

Internal Hypostasis in Visceral Organs

Post-mortem lividity also occurs in the internal organs. The principal organs affected
are the lungs, loops of the intestine and brain. It may in some instances be mistaken
for disease.

Post-mortem hypostasis in the organs may have the pathological appearance in the
visceral organs. In the heart, it may simulate coronary occlusion while in the lungs it
may appear like pneumonic changes. The intestine may be reddened to appear like
strangulation.

Differences between Post-mortem Lividity of Organs and Simple Congestion:

a. Post-mortem staining in organs is irregular and occurs in the most dependent parts,
while congestion is generally uniform and found all over the organs.
b. The mucous membrane in post-mortem staining (lividity) is dull and lusterless, but
not so in congestion.
c. In post-mortem staining (lividity) inflammatory exudate is not seen, and areas of
redness alternating with pale areas will be found if a hollow viscus is stretched out
and held in front of light. This is not seen in cases of simple congestion.

3) Auto Lytic or Autodigestive Changes after Death

Autolytic action is seen in the maceration of the dead fetus inside the uterus. The stomach
may be perforated, glandular tissues become soft after death due to autodigestion and
the action of autolytic enzymes.

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4) Putrefaction of the Body
Putrefaction is the breaking down of the 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
2. Evolution of Gases in the Tissues
a. Effects of the Pressure of Gases of Putrefaction
 Displacement of the Blood
 Bloating of the Body
 Fluid Coming Out of Both Nostrils and Mouth
 Extrusion of the Fetus in a Gravid Uterus
 Floating of the Body
3. Liquefaction of the Soft Tissues

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 the 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. This is also true when the diseased condition is
accompanied with anasarca. Bodies whose sudden death is not due to
microorganism decompose late.
2. External Factors
a. Free Air
 Air — The accessibility of the body to free air will hasten
decomposition.
 Moderate Moisture — Moderate amount of moisture will accelerate
decomposition, but excessive amount will prevent the access of air to
the body thereby delaying decomposition. Moisture is necessary for
the growth and multiplication of bacteria, however, if the evaporation
of fluid is marked, there will be mummification of the tissues and
putrefaction will be retarded.
 Condition of the Air — If the air is loaded with septic bacteria,
decomposition will be hastened.
 Temperature of the Air — The optimum temperature for specific
decomposition is 70°F to 100°F. Decomposition does not occur at
temperatures below 32°F or about 212°F.
 Light — The organism responsible for the putrefaction prefers more
the absence of light.
b. Earth – Dry absorbent soil retards decomposition while moist fertile soil
accelerates decomposition.

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 c. Water – Decomposition in running water is more rapid than in still water.
Bacteria-laden pools will accelerate decomposition.
d. Clothings – Clothings initially hasten putrefaction by maintaining body
temperature but in the later stage, clothings delay decomposition by protecting
the body from the ravages of flies and other insects. Tight clothings delay
putrefaction due to the diminution of blood in the area on account of pressure.

Physical Changes of the Body during Putrefaction in Chronological Order

External Changes
1. Greenish discoloration over the iliac fossa appearing after one to three days.
2. Extension of the greenish discoloration over the whole abdomen and other parts
of the body.
3. Marked discoloration and swelling of the face with bloody froth coming out of the
nostrils and mouth.
4. Swelling and discoloration of the scrotum, or of the vulva.
5. Distention of the abdomen with gases.
6. Development of bullae in the face of varying sizes.
7. Bursting of the bullae and denudation of large irregular surfaces due t the
shedding of the epidermis.
8. Escape of blood-stained fluid from the mouth and nostrils.
9. Brownish discoloration of the surface veins giving an arborescent pattern on the
skin.
10. Liquefaction of the eyeballs.
11. Increased discoloration of the body generally and progressive increase of
abdominal distention.
12. Presence of maggots.
13. Shedding of the nails and loosening of the hairs.
14. Conversion of the tissue into semi-fluid mass.
15. Facial feature unrecognizable.
16. Bursting of the abdomen and thoracic cavities.
17. Progressive dissolution of the body.

Internal Changes
1. Those which Putrefy Early:
a. Brain
b. Lining of the trachea and larynx
c. Stomach and intestines
d. Spleen
e. Liver
f. Uterus (if pregnant or in puerperal stage)
2. Those which Putrefy Late:
a. Esophagus
b. Diaphragm
c. Heart
d. Lungs
e. Kidneys
f. Urinary bladder

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 g. Uterus (if not gravid)
h. Prostate gland

Duration of Death

1) Presence of Rigor Mortis

In warm countries like the Philippines, rigor mortis sets in from 2 to 3 hours after the death.
It is fully developed in the body after 12 hours. It may last from 18 hours to 36 hours and
its disappearance is concomitant with the onset of putrefaction.

2) Presence of Post-mortem Lividity

Post-mortem lividity usually develops 3 to 6 hours after death. It first appears as a small
petechia-like red spots which later coalesce with each other to involve bigger areas in the
most dependent portions of the body depending upon the position assumed at the time of
death.

3) Onset of Decomposition
In the Philippines like other tropical countries, decomposition is early and the average time
is 24 to 48 hours after death. It is manifested by the presence of watery, foul-smelling froth
coming out of the nostrils and mouth, softness of the body and presence of crepitation
when pressure is applied on the skin.

4) Stage of Decomposition
The approximate time of death may be inferred from the degree of decomposition,
although it must be made with extreme caution. There are several factors which modify
putrefaction of the body. For the stage of decomposition and the approximate time after
death, see tabulations (supra p. 143)

5) Entomology of the Cadaver

In order to approximate the time of death by the use of the flies present in the cadaver, it
is necessary to know the life cycle of the flies. The common flies undergo larval, pupal and
adult stages. The usual time for the egg to be hatched into larva is 24 hours so that by the.
mere fact that there are maggots in the cadaver, one can conclude that death has occurred
more than 24 hours.

6) Stage of Digestion of Food in the Stomach

It takes normally 3 to 4 hours for the stomach to evacuate its contents after a meal. The
approximate time of death may be deduced from the amount of food in the stomach in
relation to his last meal. This determination is dependent upon the amount of food taken
and the degree of tonicity of the stomach.

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7) Presence of Live Fleas in the Clothings in Drowning Cases
A flea can survive for approximately 24 hours submerged in water. It can no longer be
revived if submerged more than that period. In temperate countries, people use to wear
woolen clothes. If the body is found in water, the fleas may be found in the woolen
clothings. The fleas recovered must be placed in a watch glass and observed if it is still
living. If the fleas still could move, then the body has been in water for a period less than
24 hours. Revival of the life of the fleas is not possible if they are in water for more than
24 hours.

8) Amount of Urine in the Bladder

The amount of urine in the urinary bladder may indicate the time of death when taken into
consideration, he was last seen voiding his urine. There are several factors which may
modify urination so it must be utilized with caution.

9) State of the Clothings

A circumstantial proof of the time of death is the apparel
of the deceased. If the victim is wearing street clothes, there is more likehood that death
took place at daytime, but if in night gown or pajama, it is more probable that death
occurred at night time.

10) Chemical Changes in the Cerebrospinal Fluid (15 Hours Following Death)
a. Lactic acid increases from 15 mg. to 200 mg. per 100 cc.
b. Non-protein nitrogen increases from 15 to 40 mg.
c. Amino-acid concentration rises from 1 to 12% following death.

11) Post-mortem Clotting and Decoagulation of Blood

Blood clots inside the blood vessels in 6 to 8 hours after death. Decoagulation of blood
occurs at the early stage of decom- position. The presence of any of these conditions may
infer the approximate duration of death.

12) Presence or Absence of Soft Tissues in Skeletal Remains

Under ordinary condition, the soft tissues of the body may disappear 1 to 2 years’ time
after burial. The disappearance of the soft tissues varies and are influenced by several
factors. When the body is found on the surface of the ground, aside from the natural forces
of nature responsible for the destruction of the soft tissues, external elements and animals
may accelerate
its destruction.

13) Condition of the Bones

If all of the soft tissues have already disappeared from the skeletal remains, the degree of
erosion of the epiphyseal ends of long bones, pulverization of flat bones and the diminution
of weight due to the loss of animal matter may be the basis of the approximation.

24
 Post-mortem Conditions Simulating Disease, Poisoning or Injury
a. Post-mortem hypostasis simulating contusion or inflammation or poisoning.
b. Blister of the cuticle simulating scalds or burns.
c. Swelling, detachment or splitting of the skin simulating injury.

Presumption of Death
Rule 131, Sec. 5(x), Rules of Court:
Disputable Presumption
That a person not heard from for seven years, is dead.

Presumption of Death
Art. 390, Civil Code and Sec. 5(x), 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
purposes, except for those of succession.

The absentee shall not be presumed dead for the purpose of opening his succession till after
an absence of ten years. If he dis- appeared after the age of seventy-five years, an absence
of five years shall be sufficient in order that his succession may be opened.

Art. 391, Civil Code and Sec. 5(x), Rule 131, Rules of Court:
The following shall be presumed dead for all purposes, including the division of the estate
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 loss 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 circum- stances and his
existence has not been known for four years.

Art. 392, Civil Code:

If the absentee appears, or without appearing his existence is proved, he shall recover his
property in the condition in which it may be found, and the price of any property that may have
been alienated or the property acquired therewith; but he cannot claim

Presumption of Survivorship

Sec. 5(jj), Rule 131, Rules of Court:

When two persons perish in the same calamity, such as wreck,

battle, or conflagration, 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 younger is presumed to have survived
3. If one is under fifteen and other under sixty, the former is presumed to have survived;

25
 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.

Art. 43, Civil Code

If there is a doubt, as between two or more persons who are called to succeed each other, as
to which of them died first, whoever alleges the death of one prior to the other, shall prove the
same; in the absence of proof, it is presumed that they died at the same time and there shall
be no transmission of rights from one to the other.

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