Lesson : After the discussion the student will be able to:

1. Explain the what is death and the different signs of death

2. Explain the medicolegal aspect of death
3. Differentiate the different kinds of death and the signs of death
4. Explain the different changes in the body after death
5. Differentiate the stages of death
6. Explain the different types of putrefaction
7. Explain the different basis of estimating the time of death
8. Apply and explain the presumption of death and survivorship

Medico legal aspect of death

Death- absence of life in living matter

Termination of life and complete loss of vital function
Organism return to stable equilibrium both physical and chemical

legal definition of death :

in Common law :
irreversible cessation of circulatory and respiratory function

After Cardio-Pulmonary support and organ transplant created a reason for alternative definition
 Irreversible cessation of all functions of the entire brain including the brain stem
 Uniform Determination of death Act 0f 1980-81
Sign of life in human being
Locomotion
Respiration
Circulation
Brain activity
Presence of faculty of senses
In medico-legal death
Death which involve crime to prove or dis approve that foul play has been done
Importance of determination of death
1. personality is extinguished by death
2. criminal liability is extinguished
3. property of a person is transmitted to the heirs or nearest of kin
4. basis for immediate removal of organ for transplant
5.Civil cases for claim is dismiss

Kinds of death
1. Somatic or clinical death
types of clinical death

A. Sociological death
 Sociological death
 Withdrawal from the society
 isolation

B. Psychic death
 Individual accepts their fate and regress , a very severe and personal form of withdrawal
 The sense of being dead
 Giving up fighting for life
 Rejecting life

C. Biologic death or molecular –

 The individual cell and other biomolecules dies
 D. Physiologic death
 Vital organ ceases functioning
 Organ cannot function independently ( ventilator machine ) ( cardio pulmonary machine )
 Cessation of brain waves
 No consciousness no awareness

2. Molecular death or cellular death

3. Apparent death or state of suspended animation

 All the conditions in which all signs of life or vitality are seemed to be absent although the individual still
remains alive
 The person appears to be dead because a very feeble or minimum function of his body system
 The function of the circulatory respiratory and nervous system may not be perceived by conventional
method the person is still alive
 The function of the system may return sometimes by proper resuscitation
 Such death like state is also known as suspended animation
The circulation do not stop but maintain at a minimum

Causes of suspended Animation/ apparent death / death trance

Voluntary
 Yoga
Involuntary
 Newborn infant
 Drowning
 Electrocution
 Thunder injury
 Severe diarrhea/ cholera
 Poisoning
 Anesthesia
 Shock
 Sun stroke
 snake bite
 epilepsy
 head injury
 severe narcosis

Medicolegal importance of ssupended animation

1. it can lead to error if precaution is not taken
2. confussion may lead into issues like death certificate for alive person
3. a live person may be sent to the mortuary
4. premature burial or funeral
5. may create professinal problems for doctors
6. may creat social /public agitation/problem
Signs of death

Answer the question

1. Is the body dead?
2. How long has the body been dead?
3. What is the cause of death

External sign of death

Immediate
 loss of vital functions of the brain ( cerebral brain cortex and brain stem
 Flat electroencephalogram (EEG)
 Cessation of circulation through the retina
 Lack of responsiveness to internal and external environment
 No muscular movement with generalizes flaccidity
 Absence of brain stem reflex

1. Loss of power
2. Stoppage of respiration –
normal person can hold breathing for 3.5 mins
a. upward movement of chest and abdomen
b. palpation of respiratory movement
c. examination with the aid of a stethoscope
d. mirror test
e. placing a feather of cotton fiber in the nosetrils and mouth
f. place a glass water in the chest region
g. Winslow test
3. stoppage of heart action & circulation 5-10 mins
Decapitation – heart beat persist 15 mins-1 hr
Methods of detection
a. Heart action
1. Palpation
2. Auscultation
3. Fluoroscopic examination
 4. Electrocardiogram

B. examination of peripheral circulation

1. magnus test
 one most of the most realiable test consisting of tying a ligature tightly around the base of the finger
sufficient to cut off the venous channels without occluding the artery
 the finger reamins white – if the circulation has ceasesd entirely
 other wise the seat of the ligature is mark by a bloodless zone
 and the point beyond becomes gradually blue and swollen

2.palpation of pulse
 3. Icard test- flourescein test
Hypodermic injection of the solution flourosceine
 Doesn’t produce discoloration if the circulation stop
 But renders the neighboring skin yellowish green if the circulation is still going on
 The substance may be detected in the blood by pricking a distant area
Use a thread ( silk) immerse in blood then boil in a test ube with distilled water the thread will become
greenish in colour

4. diaphanous test-reddish color of the web of fingers place against a sharp light
 web of the fingers scarlet red or very red and translucent
 yellow and opaque after death
 Carbon monoxide poisoning – red
 Anemic, syncope - yellow

4. Loss of body heat or algor mortis

1st 4 hours most rapid fall
12 ours- reach the temp of the sorroundings fall of 15 0 to 200F

5.Change in the eyes

A. loss of corneal reflex and light reflex

B. Haziness or clouding of the cornea

C. fixation of the Pupil
D. Flaccidity of the eyeball
E. Tache noir Sclerotique
6. Change in the skin
a. Change in color
b. Loss of elasticity
C. absence of reaction to injury

Changes in the body after death

In time of death or few mins or hour is important

Stages of muscular changes

1. stage of primary flaccidity-
upon death relaxation of the muscles loss of natural tone
upon stimulation using mechanical or electrical means muscle will contract
lasting 3-4 hours
2. stage of post mortem rigidity or rigor mortis

the whole body becomes rigid 3-4 hour after death lasting for 18-36 hours

Condition stimulating rigor mortis

1. heat stiffening
2. cold stiffening
3. cadaveric spasm spontaneous rigidity

3.stage of secondary Flaccidity

 Softness and flaccidity of muscle which no longer respond to electric stimulation due to dissolution of
protein beginning of putrefaction

Putrefaction –process of dissolution of tissues by digestive action of its enzyme and bacteria resulting into softening
and liquifaction of tissue,
 accompanied by foul smelling gas
 change in color of tissue
 flies are attracted to the dead tissue egg will hatch w/in 24 hours and forming maggots

Sequence of events in putrefaction of a dead body in a tropical country

1-2 days
72 hours 3 days
1 week

2 weeks
1 month
Special form of putrefaction
1. mummification – removal of body fluid before decomposition sets in result to sinking & preservation of the body
natural- dead buried or expose to dry or hot sandy soil with air movement
artificial- or embalming preserving the dead body using formalin or alcohol phenol mercury and arsenic and
covering the skin with the plaster of paris
2. saponification – formation of soft friable, brownish white greasy substance –adipocere
formed by post mortem hydrolysis and dehydrogenation of fat,

3. maceration –dead body usually fetus ,

- softening and discoloration of tissue
- blister formation due to autolytic & proteolytic enzyme in the absence of putrefactive bacteria
Changes in the blood after death
 stoppage of circulation – stasis draining of blood from vein and capillaries to the most dependent part of
the body producing discoloration
-Post mortem lividity Livor mortis- discoloration of the body after death due to the pooling of blood to the
dependent area
20-30mins after death completed 12 hours
 uasually dull red or reddish purple w/ bluish black petechiae due to rapture of small capilliary

 Importance of livor mortis


1. One sign of death
2. Determines the position maintain by the body after death
Basis in estimating the time of death
1. General physical changes

2. Post mortem lividity

 3. Post mortem rigidity

4. Onset and state of decomposition

5. Life cycle of flies
6. Change in body temp
7. Changes in blood- blood is fluid in the body until 6-9 hours after death
8. Changes in the stomach-empty after 3-4 hour after meal
9. Change in the hair 0.4-0.5mm/day
10. Change in the urinary bladder
11. State of clothing
12. Presence or absence of fleas in the clothing of the dead person in water

Presumption of death
Disputable Presumption – rules of court Sec 96 rule 123, that a person not heard seen or absent for 7 years is dead

- A person on a vessel who was lost during the voyage or airplane which is missing and not been heard for 4 years
- A person in the military or armed forces who has taken a part in the war and was missing for 4 years
- A person who is in danger of death under other circumstances and his existence has not been known for 4
years

Presumption of survivorship
- As to who died first can be interred from the strength , Age, sex of the person concern
1. If both are under 15 y/o the elder is presumed to have survived
2. If both are over 60 y/o the younger is presumed to have survived
3. If one is under 15 y/o and the other is above 6o y/0 the older is presumed to have survive
4. If both are over 15 y/o under 16 y/o from different sex the male is presumed to have survived
If both sex are the same the older is presumed to have survived
5. If one is under 15 y/o or over 60 y/o and the other is in between the ages the later is presumed to
have survived
Activity:
Watch you tube and answer the question
https://youtu.be/intBEYKlaGY Rigor Mortis, Livor Mortis, Pallor Mortis, Algor Mortis: Forensic Science Explains Stages of
Death
what are the signs of death ? How to estimate the sign of death ? (5Pts)
https://youtu.be/jJVqQrrAHlg The Dead tell stories - Medicolegal Death Investigations

https://youtu.be/BZQs89RsggQ Confirmation of Death – Simulation

external sign of death

https://youtu.be/euKtX4XNlgE Clinical Death vs Biological Death: WHEN can Organ Donations commence?
What is the difference of clinical death and Biological death
https://youtu.be/cFVL4AQO2hM Is A Brain Dead Person Actually Dead?
What is brain death ? what is the difference of coma and brain death

https://youtu.be/TW_112HDxW0 Researchers have placed humans in suspended animation

what is suspended animation?

https://youtu.be/9Zblg9esUGM Science of Death: What happens to your body after you die?
What changes in the body if the body dies?