INTRODUCTION PHYSICIAN AS A WITNESS

Legal Medicine Witness

• Branch of medicine which deals with • Section 20 Rule 130 Rules of Court
the application of medical (and o Witnesses; their
paramedical) sciences as demanded qualifications. — Except as
by law and to aid the administration provided in the next
of justice. succeeding section, all
persons who can perceive,
Medical Jurisprudence and perceiving, can make
• Comprises of all laws, rules, their known perception to
doctrines and principles, legal others, may be witnesses.
opinions and decisions of competent Religious or political belief,
authority regarding the governance interest in the outcome of the
and regulation of the practice of case, or conviction of a crime
medicine. unless otherwise provided by
• Hallmark: Negligence law, shall not be ground for
disqualification. (18a)
Legal Medicine Medical • Section 36 Rule 130 Rules of Court
Jurisprudence o Testimony generally confined
Branch of Medicine Branch of Law to personal
Medicine applied to Law applied to knowledge; hearsay
law and justice practice of health excluded. — A witness can
professionals testify only to those facts
Based on the Based on the which he knows of his
principle of principle of personal knowledge; that is,
coordination (of subordination which are derived from his
medical sciences and -Health practitioner own perception, except as
law) should obey the law otherwise provided in these
an should practice rules. (30a)
within the premise of
law Subpoena
-Study of rights, • Section 1 Rule 21 Rules of Court
duties and obligation o process directed to a person
of a practitioner requiring him to attend and to
testify at the hearing or the
trial of an action, or at any
investigation conducted by
competent authority, or for
the taking of his deposition.
• Subpoena duces tecum
o Person is required to produce
books, documents, or other
things under his control or
possession that are pertinent
to the case

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 • Subpoena ad testificantum both, if it be a lower court.
o Person is required to appear (1a)
before a trial or investigation
• Indirect (Section 3 Rule 71)
Contempt o Indirect contempt to be
• Section 9 Rule 21 punished after charge and
o Failure by any person without hearing. — After a charge in
adequate cause to obey a writing has been filed, and an
subpoena served upon him opportunity given to the
shall be deemed in contempt respondent to comment
of the court from which the thereon within such period as
subpoena is issued. If the may be fixed by the court and
subpoena was not issued by a to be heard by himself or
court, the disobedience counsel, a person guilty of
thereto shall be punished in any of the following acts may
accordance with the be punished for indirect
applicable law or Rule. contempt;

• Direct (Section 1 Rule 71) (a) Misbehavior of an officer

o Direct contempt punished of a court in the performance
summarily. — A person of his official duties or in his
guilty of misbehavior in the official transactions;
presence of or so near a court
as to obstruct or interrupt the (b) Disobedience of or
proceedings before the same, resistance to a lawful writ,
including disrespect toward process, order, or judgment
the court, offensive of a court, including the act
personalities toward others, of a person who, after being
or refusal to be sworn or to dispossessed or ejected from
answer as a witness, or to any real property by the
subscribe an affidavit or judgment or process of any
deposition when lawfully court of competent
required to do so, may be jurisdiction, enters or
summarily adjudged in attempts or induces another
contempt by such court and to enter into or upon such real
punished by a fine not property, for the purpose of
exceeding two thousand executing acts of ownership
pesos or imprisonment not or possession, or in any
exceeding ten (10) days, or manner disturbs the
both, if it be a Regional Trial possession given to the
Court or a court of equivalent person adjudged to be
or higher rank, or by a fine entitled thereto;
not exceeding two hundred
pesos or imprisonment not (c) Any abuse of or any
exceeding one (1) day, or unlawful interference with
the processes or proceedings

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 of a court not constituting
direct contempt under section
1 of this Rule;
(d) Any improper conduct
tending, directly or
indirectly, to impede,
obstruct, or degrade the
administration of justice;
(e) Assuming to be an
attorney or an officer of a
court, and acting as such
without authority;
(f) Failure to obey
subpoena duly served;
(g) The rescue, or attempted
rescue, of a person or
property in the custody of an
officer by virtue of an order
or process of a court held by
him.
Physician may be asked to be an ordinary
witness, expert witness, or both.
*note: always offer your witness before
presenting.
Ordinary Witness Expert Witness
Only allowed to state Allowed to give his
the facts which come inference, deduction,
to his own conclusion
perception (based on opinion based from
five senses) the facts presented to
him
Enlightens the court
on matters of his
expertise
Example: Example:
Q: Doctor, what Q: Doctor, what can
procedures did you you say about the
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do during the possible cause of the
patient’s hospital injury?
stay?
A: After stabilizing A: Your honor, this
the patient, I can be caused by a
proceeded to bullet that failed to
perform exploratory exit the patient’s
laparotomy to body possibly a 45
remove the metal caliber pistol
fragments from the depending on the
patient’s abdomen. I height and relative
observed that there distance of the
was a 3x5cm assailant.
perforation
traversing the **The witness was
a Ileocecal valve. not present when
the injury happened
**Note that this is but can give an
still ordinary even if opinion on how the
couched in medical victim sustained it
terms
***2 Important
Questions to
discredit the witness
1.Were you present
when the injury was
sustained?
2. Is it possible that
accident or a self-
inflicted wound
could cause the
injury?
Witness need not be Witness must be
skilled on the line he skilled on the art,
or is testifying because science, or trade he
it is based on his is testifying
perception
Who are disqualified to be a witness
• Section 21 Rule 130 Rules of Court
Disqualification by reason of mental
incapacity or immaturity. — The
following persons cannot be
witnesses:
 o (a) Those whose mental
condition, at the time of their
production for examination,
is such that they are
incapable of intelligently
making known their
perception to others;
o (b) Children whose mental
maturity is such as to render
them incapable of perceiving
the facts respecting which
they are examined and of
relating them truthfully. (19a)
• Children of tender age (can be
discredited by opinions of experts
such as child psychologist or
psychiatrist
• Senile
• Insane
• Those previously convicted of
perjury
How to qualify physician as expert
• Present credentials
o 4-5 years of undergraduate
o 4 years of medicine proper
o 1 year of post graduate
internship training in hospital
or institution of choice
o Medical Board Passer
o 3-5 years of Residency
training (ex. Surgery,
Pediatrics, Internal Medicine,
OB etc)
o Fellowship/Diplomate
§ 2-3 years
subspecialty training
§ A doctor who finished
residency training and
passed the exam and
would want to further
subspecialize
§ Ex. Cardiology fellow
finished internal
medicine for 3 years,
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Plastic surgeon
finished general
surgery for 5 years
§ *** note that there is
no law prohibiting a
non specialist to
practice technical
fields of medicine but
highly unethical.
***GP can still be
qualified as an expert
witness but you can
discredit by
presenting a specialist.
o Consultant
• Other qualifications
o Teaching appointments
o Author of books
o Previously called to be an
expert by the court
o Professional affiliation
§ Must be recognized
by PMA or PRC as a
specialty society
§ Members of affiliate
societies are not
recognized as
specialists
PHYSICAL INJURIES
Physical injury
• Effect of some form of stimulus on
the body
o Effect of the application of
stimulus may be immediate
of (ex. Stab) or delayed (ex.
Bruises)
Wound
• The effect of application of physical
violence on a person
• Dissolution or break in the natural
continuity of any tissue of a living
body
Legal Classification of Physical Injuries • Stab wound (saksak)
(RPC) o caused by a sharp pointed
• Mutilation (Art. 262) instrument followed by a
• Serious physical injuries (Art. 263) sharp edge.
• Less serious physical injuries (Art. o Ex. Knife, saber, dagger,
265) scisors, samurai, balisong
• Slight physical injuries (Art. 266)
• Administering injurious substances • Hacking wound (taga)
and beverages (Art. 264) o Large incise wounds
• Physical injuries inflicted in a o Ex. Bolo, axe, machete, blade
tumultuous affray (Art. 252) of propeller

Type and Nature of Injury (Wounds) • Abrasion (gasgas)

o contact with a rough surface /
Open Wounds friction or scratching
• Lacerated wound / tear (putok) o superficial portion of the skin
o open wound caued by a blunt is removed due to rubbing or
object or instrument. friction against a hard, rough
o Tear of the skin or underlying surface
tissues due to forcible contact o ex. Skinned knees, graze,
with a blunt object scratch.
o ex: baseball bat, fist blow to o Note: could be indicative of
face, bump of the car, lead struggle or a chase
pipe. o Types:
o note: rape injuries are usually § Linear (scratch)
lacerations • Long but not wide
• Caused by a sharp
• Punctured wound (tusok) or pointed object,
o caused by a sharp pointed not sharp enough
instrument or object. to incise, but
o ex: Syringe, needle, pen, ice pointed enough to
pick, nail, tip of the knife scratch
(</=.5cm.) • Caused by
fingernails across
• Incised wound (hiwa/cut) the skin
o caused by a sharp edged § Multilenear
(cutting) or sharp linear edge § Multiple
of the instrument. § Confluent (tapyas)
o ex: blade of the knife, razor, • “Road rash”
scalpel • Usually in motor
o surgical scars are usually vehicular
incised wounds accidents when
§ ex. Post caesarian skin is grazed by
section, pavement
appendectomy scar)

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 Incised wound Lacerated o Size of contusion is usually
wound bigger than the size of the
Edges Clean cut, Roughly cut, object causing it.
regular, well irregular, ill-
defined defined • Hematoma (bukol)
Swelling None Yes o Blood cyst or tumor
Contusion None Yes o Extravasation or effusion of
Healing Faster Delayed blood in a newly formed
Scar Linear Irregular cavity
Caused Sharp edged Blunt o caused by a blunt object/
by instrument instrument trauma or a break in the wall
of a blood vessel
Closed Wounds
Contusion (pasa) Hematoma (bukol)
• Scalding Effused blood are Blood accumulates
o Caused by boiling liquid accumulated in the in a newly formed
tissues underneath cavity under the skin
• Burns Slight to no Skin is always
o Caused by flame elevation elevated

• Contusion (bruise, pasa) Special types of wounds

o Effusion of blood into the
tissues underneath the skin • Patterned wounds
due to rupture of blood o Injury in which a pattern or
vessels as a result of blunt imprint is transferred from
force or violence the impacting object
o Ex: bumps, hitting, black eye o Nature and shape of wound
(periorbital contusion) transfers to injured area
o Color progression: o Can be used to identify
§ Red-purple – soon weapon used
after its complete o Present in domestic violence
development cases
§ Blue o Ex. Cigarette burns, paddle
§ Brown marks on arms or thighs, belt
§ Green – 4-5 days post marks on buttocks
injury
§ Yellow – 7-10 days • Defense/Defensive wounds
§ Gradual o Instinctive reaction for self-
disappearance after preservation to minimize
more or less 2 weeks impact or injury
o Note: bruises do not appear o Ex. When assailant is about
immediately after injury but to hack you, natural reaction
area may be tender or painful is to cover self with forearm
to touch, or warm. or catch blade with hands.
Resulting injury would be
hacking wounds to such parts.

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 • Self-inflicted wounds functions of the brain, heart,
o Wounds caused by self to and lungs
cause death or to aggravate o It occurs the moment a
injury physician declares that the
o Note handedness of victim person has expired
§ Ex. A right handed
person will likely • Molecular
have cuts on the left o Cellular death
side of the body o After the cessation of the
vital functions of the body,
• Suicide wounds cells are still “alive”
o Mortal wounds causing death o Death of cells occurs usually
§ Usually inflicted on 3-6hours after a person dies
vital organs
o Hesitation cuts/wounds • Stage of suspended animation /
§ Superficial cuts, Apparent death
usually multiple o Merely a transient loss of
§ Shows intent but consciousness or temporary
abandoned or was cessation of vital functions
prevented from o “Freezing” or cryogenics
proceeding o those in a state of catatonia
o Note handedness of victim
§ Can possibly rule out Muscular changes following death
suicide if victim is left • Legal importance – determination of
handed and GSW time of death
entry is on the right
side of the temple • Stages
1. Stage of Primary Flaccidity
DEATH • Post mortem irritability
• Occurs immediately after
Death (Organ Donation Act of 1991) death
• Irreversible cessation of circulatory • Lasts about 3-6 hours or
and respiratory functions less
• Irreversible cessation of all functions • Body is warm and flaccid
of the entire brain, including the • Muscles are relaxed and
brainstem. capable of contracting
• Complete, persistent, permanent, when stimulated
irreversible cessation of all
cardiopulmonary functions and/or 2. Stage of Post Mortem Rigidity
brain activity • Rigor Mortis or Cadaveric
rigidity
Kinds • The whole body becomes
• Somatic rigid due to the contraction
o Clinically dead of the muscles.
o Complete, persistent and • Starts in 3-6 hours and is
continuous cessation of vital completed in 6 to 24 hrs

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 (to 36 depending
climate)
3. Stage of Secondary Flaccidity
/ Onset of Decomposition:
• Commencement of
putrefaction
• After disappearance of
rigor mortis
• Muscles become relaxed,
flaccid and soft but with
foul odor
• Does not respond to
mechanical or electrical
stimulus
• Beyond 24-36 hrs
Changes in blood following death
Post-mortem lividity
• Extravasation of blood on dependent
portion of body
• Livid = purple on dependent part
• Blood accumulates in the most
dependent portions of the body with
superior area pale or while the
dependent portions are dull red or
purplish
• Importance
o One of the signs of death
o Relative position of the
victim when killed, or when
body was moved
o Color of lividity may indicate
cause of death
§ Asphyxia or
suffocation lividity
may be dark colored
§ Carbon monoxide
poisoning lividity
may be dark pink
o May determine how long the
person has been dead
on • Kinds
o Hypostatic –blood is still
fluid and accumulating inside
the blood vessels
o Diffusion – blood has started
to coagulate inside the blood
vessels
AUTOPSY
Autopsy
• A comprehensive study of a dead
body, performed by a trained
physician employing recognized
dissection procedure and techniques
• Includes removal of tissues for
further examinations
• Most comprehensive method of
examination of the dead
• Objective is to determine the cause
of death
• Negative Autopsy
o If after an autopsy was done
cause of death still not
determined
• Negligent Autopsy
o Cause of death still
undetermined because of
errors in procedure or
handling of autopsy
Autopsy Post-Mortem
Examination
Indicates that, in Refers to the
addition to an external
external examination of a
examination, the dead body without
body is opened and incision being made,
an internal although blood and
examination of the other body fluids
organs are conducted may be collected for
examination

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Kinds of Autopsy o The State gives the consent
• Hospital / Non-official / Elective for the autopsy. Consent of
Autopsy relatives not needed
o Autopsy done on a human o Medicolegal deaths
body with the consent of the § Trauma, stab, and the
deceased person’s relatives like
o Purpose: determining the § Industrial accidents
cause of death, clinical § Domestic abuse cases
diagnosis, effectiveness of § Child abuse cases
therapy, studying the natural § Unknown cause of
cause of the disease, death
educating students and § Dead on arrival or
physicians death within 24 hours
o Done in hospitals by of admission
pathologists on patients who § Suspected medical
died of natural causes like negligence
disease § Burns
o If done without the consent § Drowning
of the next of kin, may be § Suspected toxic
charged with poisoning
§ Theft (of internal
organs) Who are authorized by law to perform
§ Desecration of the autopsies (PD856 Code on Sanitation)
dead (Art. 309 NCC) • Health officers;
• Any person who o Ex. Municipal health officers
shows disrespect to • Medical officers of law enforcement
the dead, or agencies; and
wrongfully o Ex. NBI or PNP Crime lab
interferes with a • Members of the medical staff of
funeral shall be accredited hospitals.
liable to the family o Ex. Hospitals in partnership
of the deceased for with NBI or Crime lab
damages, material • Note: PAO not accredited to do
and moral. autopsies

• Medicolegal / Official Autopsy

o Mandatory autopsy done on
medicolegal deaths
o Purpose: to determine the
cause, manner, and time of
death; recovering, identifying
and preserving evidence;
providing factual, objective
medical report; separating
death due to disease from
death due to external causes

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GUN SHOT WOUNDS (GSW)
Gun shot wound
• Injury sustained from firearm
Kinds of Firearm
o Short – revolver, pistol
o Long – rifle, shotgun
Parts of Firearm
o Barrel (DNA of gun)
o Handle
o Trigger
o Percussion cap
o Firing Pin
o Muzzle
Parts of Ammunition (bala)
o Shell / cartridge case
o Gun powder – inside the shell
o Primer – made up of lead,
antimony, barium which
functions to transform the
mechanical energy by the hit
of the firing pin on the
percussion cap to chemical
energy by rapid combustion
o Projectile (tingga)
Firearm Identification Ballistics
o When the bullet or the shell
or both has been recovered
and a suspected firearm has
been found in the possession
of a suspect, the procedure is
to fire the suspected firearm
and compare the bullet or
shell from that which was
recovered
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Kinds of Ballistics
1. Internal – from the time you pull the
trigger or before the bullet is
airborne
2. External – from the time it leaves the
barrel of the gun
3. Terminal – effect of the bullet on an
object when hit
4. Medical – when a bullet hits human
body.
Products of Combustion
• Smudging smoke or soot
o Temporary marks left on the
skin of the victim
o Distance of shooter is <12 in
• Singeing of hair
o Hair got burned
• Tattooing, stippling
o Blackish deposits on skin of
victim
o Distance of shooter is <24 in
• Contusion/Abraision collar
o Pressure of the bullet on skin
as it enters the body
o Used determine the relative
position between the assailant
or the victim and or the
trajectory of the bullet.
Paraffin testing
• Done to determine gun powder
residue on hands of suspected
shooters
• Dorsum of the hand is used
• Results only presumptive
• Obsolete in most countries because
may lead to false positive and false
negative results
o False positive
§ Recently shot a gun
(in a firing range) but
not the shooter
§ Chronic smoker will
most likely have
 nicotine and tar SEXUAL CRIMES
(carbon containing)
stains on the hands Virginity
§ Farmers who use • Female who has not experienced
carbon based sexual intercourse and whose genital
fertilizers organs have not been altered by
o False negative carnal connection
§ Paraffin test done • Hymen – thin fold of mucus
after 3 days membrane in the external orifice of
§ Shooter wore gloves the vagina
§ Incessant washing
with soap and water Types of Virgins
or vinegar
• Moral Virgin
Entry wound v. Exit wound
o State of not knowing the
Entrance Exit nature of sexual life and not
Size in Smaller Always having experienced sexual
comparison bigger relations
with the o Applies only to CHILDREN
bullet below age of puberty and
*Edges Inverted Everted whose sexual organs have not
Shape Usually oval Does not yet fully developed
or round manifest • Physical Virgin
depending definite o A woman who is conscious
on the angle shape of the nature of sexual life
or approach but has not experience sexual
*Contusion Positive, None intercourse
collar Contact ring o Applies to women who have
may also be reached physical sexual
present maturity
*Tattooing Positive Always o No conclusive medical
or smudging when shooter absent findings t show that a woman
is near is physically virgin
o Types:
Underlying Do not May seen
o True Physical virgin
tissues protrude protruding
§ Hymen is intact and
from the
opening is small to
wound
barely admit the tip of
Presence Always May be
the smallest finger of
after fire present absent if
the examiner
bullet is
o False Physical Virgin
lodged in the
§ The hymen is intact
body
but the orifice is wide
*Paraffin test May be Always
and elastic to admit 2
positive negative
or more fingers
**Significance: position of the assailant and
the victim, if attended by treachery etc.
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 • Demi-Virgin
o Hymen is intact but permits
any form of sexual liberalities
except actual intercourse
• Virgo Intacta
o A truly virtuous woman
o No structural changes in
organ to infer previous sexual
intercourse
Defloration
• Laceration or rupture of the hymen
as a result of sexual intercourse.
• All other lacerations of the hymen
which are not caused by sexual act
are not considered as defloration.
Other causes of Hymenal Laceration:
1. Passage of clotted blood during
menstruation (not all the time)
2. Ulceration due to disease like
diphtheria
3. Jumping or Running ; Aerobics /
biking / gymnastics
4. Trauma to the genitalia or falling on
hard sharp object
5. Medical instrumentation
6. Self-scratching or irritation
7. Masturbation
8. Insertion of foreign bodies
9. Previous operation
10. Horseback riding
Carnal knowledge
• Act of a man having sexual bodily
connection with a woman
• Present if there is the slightest touch
or penetration of the penis in labia
Sexual Intercourse
• Actual sexual contact
Rape
• Rape is commited by having carnal
knowledge of a woman under the ff
circumstances
o Use of force or intimidation
o When woman is deprived of
reason or otherwise
unconscious
o Woman is under 12 yo
o Foreign object is inserted in
genetalia
o Genitals inserted in the
mouth
Significant changes in new rape law (not in lecture)
• Rape is no longer a private crime –
can be prosecuted de officio
• Rape now transcends genders – man
v man, woman v woman
• Now includes rape through sexual
assault
o now includes insertion of any
object or instrument in the
genitals of a woman or in the
anal orifice of any person
o by a man who would insert
his penis n the mouth of any
person, or in the anal orifice
of any person
• now includes rape through fraudulent
machination or abuse of authority
• effect of pardon extended by the
offended party to the offender would
no longer result to the extinction of
the criminal action
o only a subsequent valid
marriage between offender
and offended extinguishes
not only the criminal action
but remits the penalty as well

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Acts of Lasciviousness
• acts which tend to excite lust;
conduct which is wanton or with
lewd designs
• ex: mashing of the breasts (not
always), placing of penis over
woman’s genitals even if clothed
Seduction – with consented sexual
intercourse
Qualified Seduction
• seduction of a virgin over 12 under
18
• committed with abuse of trust or by a
person in authority, priests, domestic,
guardian or any person entrusted
with the custody of the woman
seduced (teacher-student)
Simple Seduction
• seduction of a woman who is single
or widow of good repute
• committed by means of deceit
Incestuous Seduction
• woman seduced need not be a virgin
or may be over 18 years
o there is sexual act bet
offender and offended
o ascendant who seduces his
descendant
Adultery (Art. 333 RPC)
• Committed by any married woman
who shall have sexual intercourse
with a man not her husband and by
the man who has carnal knowledge
of her knowing her to be married,
even if the marriage be subsequently
declared void.
• Elements
o Woman is married
o Has sexual intercourse with a
man not her hurband
o Man knows her to be married
Concubinage (Art. 334)
• Any husband who shall keep a
mistress
o in the conjugal dwelling, or
o shall have sexual intercourse,
under scandalous
circumstances, with a woman
who is not his wife, or
o shall cohabit with her in any
other place

Abduction
• woman is taken away by the
abductor with lewd designs
Forcible Abduction
• victim is a woman
• abduction is against her will
• abduction is with lewd designs
Consented Abduction
• offended party must be a virgin
• over 12 under 18
• carrying away is with her consent
• with lewd designs

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