LEGAL MEDICINE

Hand out #2 (Finals)

CAUSES OF DEATH
 Injury, disease or the combination of both injury and disease responsible from initiating the trend or
physiological disturbance, brief or prolonged, which produce the vital determination.
IMMEDIATE (PRIMARY CAUSE OF DEATH)
 Causes when trauma or disease kill quickly that there is no opportunity for sequelae or complications to
develop
 example: extensive brain laceration as a result of vehicular accident
PROXIMATE (SECONDARY CAUSE OF DEATH)
 injury or disease was survived for a sufficiently prolonged interval which permitted the development of
serious sequelae which actually caused the death
 stab wound in the abdomen later caused general peritonitis
MECHANISMS OF DEATH
 is a physiological derangement or biochemical disturbance incompatible with life which initiated the
cause of death
MANNER OF DEATH
 Death is an explanation as to how the cause of death came into being or how the cause of death arose
 Natural Death
 Fatality is caused solely by disease (lobar pneumonia, ruptured tubal pregnancy, cancerous growth,
cerebral hemorrhage etc)
 Violent or Unnatural Death
 Death due to injury of any sort (gunshot, stab, fracture, traumatic shock etc)
MEDICO- LEGAL MASQUERADE
 violent deaths, may be accompanied by minimal or no external injury or natural death where signs of
violence maybe present; in cases of homicide, medical findings may tend to favor suicide or accidental
death
INSTANTANEOUS PHYSIOLOGIC DEATH
 Death from Inhibition, Death from Primary Shock, Syncope with (Instantaneous Exitus)
 is sudden death occurring in seconds or minutes after a minor trauma or peripheral stimulation of
relatively simple and ordinarily innocuous nature
 Sudden Infant Death Syndrome (SIDS)- Crib Death
 unexpected death with no apparent cause in infants less than 6 months apparently in good health
 Sudden Unexplained Nocturnal Death (SUND)
 known as “pok-kuri” disease in Japan and “bangungut” in the Philippines; sudden death
of healthy men of young age seen in East Asian Countries
 Violent Death
 Those injuries inflicted in the body by some forms of outside force
MEDICO- LEGAL CLASSIFICATION CAUSES OF DEATH
 Death is presumed natural consequence of the physical injuries inflicted, when the following facts are
established:
 victims at time the physical injuries were inflicted was in normal health
 Death may be expected from the physical injuries
 Death ensued within a reasonable time
CLASSIFICATION OF TRAUMA OR INJURIES
 Physical Injury- use of physical force
 Thermal Injury- heat or cold
 Electrical Injury- electrical energy
 Atmospheric Injury- change in atmospheric pressure
 Chemical Injury- chemicals
 Radiation Injury- radiation
 Infection- macrobiotic invasion
PENAL CLASSIFICATION OF DEATH
 Accidental Death
 due to misadventure or accident (something that happens outside the sway of our will, and although
it comes about through some act of will, lies beyond bounds of human foreseeable consequences
 Article 12, No. 4 Revised Penal Code
 Exempting Circumstances:
e The following are exempt from criminal liability:
 Any person who performing a lawful act with due care, causes an injury by mere accident without fault
or intention causing it.
 Negligent Death
 Due to reckless imprudence, negligence, lack of skill or foresight
 Infanticidal Death
 Killing of a child less than three (3) days old
 Article 255, Revised Penal Code
 Same penalty in articles 246 and 248
 If the crime penalized in this article be committed by the mother of the child for the
purpose of concealing for dishonor- prison mayor in its medium-maximum period
 If maternal grandparents or either of them- reclusion temporal
 Requisites of the Crime:
 A person was killed
 Person killed was less than 3 years old
 If killer is father, mother or any legitimate ascendants- parricide
 If killer is any other person- murder
 Parricidal Death
 killing of one’s relative
 Article 246, Revised Penal Code
 Any person shall kill his father, mother or child whether legitimate or illegitimate, or any of his
ascendants or descendants, or his spouse, shall be guilty of parricide and be punished by
reclusion perpetual to death
 Requisites
 A person was killed by the offender
 The person killed was the father, mother or child, legitimate or illegitimate in relation to the
offender or other legitimate ascendants or descendants or his spouse of the offender.
 Suicidal Death
 Destruction of oneself
 Law does not punish the person committing suicide
 Article 253 Revised Penal Code: Giving Assistance to Suicide
 Assist- prision mayor
 If extent of doing the killing himself- reclusion temporal
 If suicide not consummated- arresto mayor, medium-maximum periods
 Acts Punishable in Giving Assistance to Suicide
 The offender assisted in the commission of suicide of another which was consummated
 The offender gave assistance in the commission of suicide to the extent of doing the
killing himself which is consummated
 The offender assisted another in the commission of suicide which is not consummated.
 Murder
 Article 248, Revised Penal Code
 Any person, who, not falling within the provisions of article 246 shall kill another, shall guilty of
murder and shall be punished by reclusion temporal in its maximum period of death if committed
with any of the following:
 Article 248, Revised Penal Code
o With treachery, taking advantage of superior strength, with aid of armed men, or
employing means to weaken the defense or of means of persons to insure of afford
impunity
o In consideration of a price, reward or price
o By means of inundation, fire, poison, explosion, shipwreck, stranding of a vessel,
derailment or assault upon a street car or locomotive, fall of an airship, by means of
motor vehicles, or with the use of any other means involving great waste and ruin
o On occasion of any calamities enumerated in the preceding paragraph, or of an
earthquake, eruption of a volcano, destructive cyclone, epidemic, or any other public
calamity
o With evident premeditation
o With cruelty, by deliberately inhumanly augmenting the suffering of the victim, or
outraging or scoffing at his person or corpse
 Requisites of the Crime of Murder
o The offender killed the victim
o The killing is attended by any of the qualifying circumstance mentioned
o There was intent of the offender to kill the victim
o The killing is not parricide or infanticide
 Homicidal Death
 Article 249, Revised Penal Code
 o Any persons not falling in provision 246 shall kill another without the attendance of any
other circumstances enumerated in the next preceding article, shall be deemed guilty of
homicide and be punished with reclusion temporal
 Requisites of Homicide
o The victim of the criminal assault was killed
o The offender killed the victim without justifications
o There is an intention on the part of the offender to kill the victim and such presumption
can be inferred from the death of the victim
o The killing those not fall under the definition of the crime of murder, parricide or
infanticide
 Death caused in a Tumultuous Affray
 Article 251, Revised Penal Code
 When while several persons, not comprising groups organized for the common purpose of
assaulting and attacking each other reciprocally, quarrel and assault each other in a confused a
tumultuous manner, and in the course of affray someone is killed, and it cannot be ascertained
who actually killed the deceased, but the person or persons who inflicted the serious physical
injuries can be identified, such person or persons shall be punished by prison mayor
 Requisites of Crime
o The person that was killed in confused or tumultuous affray
o That the actual killer is not known
o That the person or persons who inflicted the serious physical injuries or violence are
known
 Death or Physical Injuries under Exceptional Circumstances
 Article 247, Revised Penal Code
o Any legally married person who, having surprised his spouse in the act of committing
sexual intercourse with another person, shall kill any of them, or shall inflict upon them
any serious physical injury, shall suffer the penalty distierro
o If any other physical injuries inflicted, he shall be exempted from punishment
o Apply to parents with respect to their daughters under 18 years of age, and their seducers,
while the daughters are living with their parents
o Any legally married person who, having surprised his spouse in the act of committing
sexual intercourse with another person, shall kill any of them, or shall inflict upon them
any serious physical injury, shall suffer the penalty distierro
o If any other physical injuries inflicted, he shall be exempted from punishment
o Apply to parents with respect to their daughters under 18 years of age, and their seducers,
while the daughters are living with their parents
o Surprise of Spouse
 there must be valid marriage
 guilty spouse caught by surprise in the act of committing sexual intercourse with
another person
 killing or injury was inflicted to either or both at the very act or immediately
thereafter
PATHOLOGICAL CLASSIFICATION/ CAUSES OF DEATH
 Death due to Syncope
 Due to sudden and fatal cessation of the action of the heart with circulation included
 Causes of death: Coronary Disease (embolism or thrombolism), Myocardial Infarction,
Valvular Diseases, Aneurysm, Congenital Heart Diseases etc
 Symptoms: Person falls, becomes motionless, paleface, pulse disappears or becomes filiform,
respiration ceases
 Symptoms in none fatal cases: Cold sweats, dimness of vision, pulse rapid or filiform, vomiting
and involuntary movement of the limbs, persons may past in a delirium state
 Death from Asphyxia
 Supply of oxygen to the blood or to tissues or both has been reduced below normal working level
 Causes of death: Diseases of the Respiratory System, Compaction of Foreign Body and
Compression of the Larynx, Tumor or Intracranial Hemorrhage, Strangulation, Suffocation,
Hanging, Drowning, Inhalation of Irritant Gases, etc.
 Death from Asphyxia
 Supply of oxygen to the blood or to tissues or both has been reduced below normal working level
 Causes of death: Diseases of the Respiratory System, Compaction of Foreign Body and
Compression of the Larynx, Tumor or Intracranial Hemorrhage, Strangulation, Suffocation,
Hanging, Drowning, Inhalation of Irritant Gases, etc.
 Symptoms:
  Stage of Decreasing Dyspnea - Lasting for ½ to 1 minute, increased rate and depth of
respiration leading to dsypnea, exaggerated movement of the respiratory muscles, rise BP
and heart rate becomes quicker and forcible, person becomes bluish and unconscious
pupils contracted
 Stage of Expiratory Convulsion - Lasts about a minute, marked expiratory effort,
convulsion of limbs, BP lowers
 Stage of Exhaustion - Lasts for 3 minutes, person lies still except for occasional deep
inspirations, BP falls, pupils dilated
 Death from Coma
 State of unconsciousness with insensibility of the pupil and conjunctivae, and inability to
swallow, resulting from the arrest of the functions of the brain
 Death from Coma
 Causes of Coma - Lesions of the brain such as abscess, tumor, embolus, apoplexy, Poisons such
as ingested alcohol, uremia, ingested morphine etc
 Symptoms of Coma: unconscious, stertorous breathing, full and intermittent pulses, cold and
clammy perspiration, imperfect sensory perception, delirium. Relaxation of the sphincter
muscles, accumulation of mucous in the respiratory passages
DURATION OF THE DIVISIBLE PENALTIES AND THE TIME INCLUDED IN EACH OF THE
PERIODS
PENALTIES Time included in Time included in Time included in Time included in
the penalty and its its minimum its medium period its maximum
entirely period period
Reclusion 12 years and 1 day 12 years to 1 day to 14 years and 4 17 years and 4
Temporal to 20 years 14 years and 8 months and 1 day to months and 1 day ;
months 17 years to 4 to 20 years
months
6 years and 1 day to 6 years and 1 day to 8 years and 1 day to 10 years and 1 day
Prison Mayor 12 years 8 years 10 years to 12 years
Absolute
Disqualifications
and Temporary
Disqualifications
Prison 6 mouths and I 6 months 2 years, 4 4 months and 2
Correctional day to 6 years and 1 day to 2 months and 1 months and 1
Suspension and years and 4 day to 4 years day to 12 years
Distierro months and 2 months

1 month and 1 1 month to 2 2 months to 1 4 months and 1

Arresto day to 6 months months day to 4 months day to 6 months
Mayor
1 day to 30 1 to 10 days 11 to 20 days 21 to 30
Aresto Menor days days

PHYSICAL INJURY
 Impairment of the body structure or functions caused by outside force.
 It is the effect of some form of stimulus to the body
 The effect of the application of force is the production of wound.
WOUND
 Is the break in the continuity of the skin or tissues of the living body
VITAL REACTION
 Is the sum total of all reactions of tissues or organs to physical injury or trauma
CLASSIFICATION OF WOUNDS
 I. AS TO SEVERITY
 Mortal or fatal wounds
 which when inflicted is capable of causing death
 Ex. Injuries to the brain, spinal cord, big blood vessels, internal abdominal organs.
 Non- Mortal or fatal wounds
 wound when inflicted will not endangers one’s life
 II. AS TO MANNER OF INFLICTIONS
  Hit
 By the stroke of bolo. Axe and other blunt instruments
 II. AS TO MANNER OF INFLICTIONS
 Thrusts or Stab
 By the stroke of a knife, dagger, ice pick, bayonet and spears.
 Sliding or Rubbing
 Gun- powder explosion by projectile or shrapnel
 Tearing or stretching
 III. AS TO KIND OF INSTRUMENT USED
 Lacerated wound
 Produced by blunt instruments eg. Pipe, piece of wood
 Incised Wound
 Wound produced by sharp edged instruments
 Stabbed Wound
 Wound produced by sharp edged and sharp pointed instruments e.g. kitchen knife, balisong,
dagger
 Punctured Wound
 Wound produced by sharp pointed instruments e.g. ice pick, screw driver, barbecue stick
 Wound produced by tearing force
 IV. AS TO DEPTH OF WOUND
 Superficial Wound
 wound which involves the outer layer of the skin e.g. scratch or abrasions
 Deep Wound
 Wound which involves the outer as well as the inner structure of the body.
 A. Penetrating wound
 Wound wherein the instruments pierces a solid organ or tissues.
 E.g. stab wound, piercing the liver, kidney , spleen
 B. Perforating wound
 Wound where there is communication between the outer and inner portions of the
hollow organs
 V. As to the relation of site of application or force and the location of injury
 Croup injury
 Injury which is found at the site of application of the force
 Coup Contre coup injury
 Injury which is found at the site and also opposite of the application of force
 Extensive injury
 It is the physical injury involving greater areas beyond the site of application of force. E.g.
fall from height, vehicular accident
 VI. SPECIAL TYPES OF WOUNDS
 Patterned wound
 Wound produced by the shape of the instrument or object reflected in the body, e.g. imprint
of the radiator on the chest, tire marks on the body.
 Defense wound
 produced by person’s instinctive reaction for self protection. E.g. contusion in the forearm
produced by incised wound
 Mutilation
o The intuitional act of cutting or looping any part of the living body
 Slight Physical Injury
o It is the physical injury wherein the victim is incapacitated for work or requires medical
attendance for a period of 1- 9 days
 Less serious Physical Injury
o A physical injury wherein the offended party is incapacitated for work or require medical
attendance for 10 days or more but not more than 30 days.
 Serious Physical Injury
o A physical injury wherein the victims becomes ill or incapacitated for the performance of his
usual work for more than 90 days, the injury caused deformity, loss of any member of his body
and loss of use thereof
 DEFORMITY
o Permanent disfigurement of the body producing physical ugliness, e.g. loss of an ear, scars in
the face.
 INCAPACITY
o The inability of the injured person to perform his works where he is habitually engaged
 VII AS TO THE TYPE OF WOUNDS
o 1. Closed wound
 Wherein there is no break in the continuity of the skin and mucous membranes
 PETECHAI
 Minute pin-point circumscribed extravasations blood underneath the skin or
mucous membrane
e.g. subpleural hemorrhage, insect bites
 CONTUSIONS OR BRUISE
 Wound in the skin and subcutaneous tissue characterized by swelling and
discoloration of tissues because of extravasations of blood.
 HEMATOMA
o Large extravasations in newly formed cavity secondary to trauma characterized by
swelling, discoloration of tissues, and effusion of blood underneath the tissues
 MUSCULOSKETAL INJURIES
 E,g. sprain, discoloration, strain, fracture.
 INTERNAL HEMORRHAGE
 Rupture of blood vessels causing hemorrhage. May be due to the following
 1. traumatic intracranial hemorrhage
 2. Rupture of parenchymatous organs
 CEREBRAL CONCUSSIONS
 Jarring or stunning of the brain follows a blow in the head.
 2. Open wound
 There is break in the continuity of the skin. E.g. abrasions, incised wound, stab wound,
punctured wound, lacerated wound and shrapnel wound.
 A. ABRASIONS (“ gasgas, scrat graze, Friction mark
 Characterized by superficial layer of the skin brought about by friction against a
hard rough object.
 B.SRATCHES Abrasions brought about by the stroke of sharp pointed instrument over
the skin
 C. GRAZES- Due to forcible contact with a rough hard object resulting to irregular
removal of skin surface
TYPES OF ABRASIONS
A.IMPACT OR IMPRINT ABRASIONS- An abrasions due to contact with a rough, hard object in
which he structural form of the object is reflected over the skin
 PRESSURE OR FRICTION ABRASION- an abrasions due to pressure applied and with
accompany movement over the skin
 B. INCISED WOUNDS ( Cut, slash, “ Hiwa”)
 An open wound produced by forcible contact with sharp edged instruments characterized by
gaping of the wound with smooth edges and causing profuse bleeding
 e.g. knife, razor, broken glasses, metal sheet.
 C. LACERATED WOUNDS ( Tear, “ putok, punit”)
 An open wound produced by blunt instruments characterized by ill- defined or irregular edges
 E.g. blow by piece of woods, lead pipe, stone, fist blow
 D.PUNCTURED WOUNDS ( “tusok”)
 An open wound produced by round bodied and pointed instruments characterized by small
openings
 E.g. ice picks, nails, thorns, hook, screws drivers, and barbeque sticks
STABBED WOUNDS ( “saksak”)
 Wound produced by pointed and sharp edged instrument. The edge of the wound are clean- cut,
smooth and distinct
 Penetrating stab wound- involves solid internal organs
 Perforating stab wound- involves hollow internal organs