GROUP 1

Medico Legal Aspect of Death

TIPAY, EMELIE L.
SANCHEZ, LEONARD C
QUIPED, SHYRA S.
HALOG GERALD
MENSALVAS EMERSON
MACAYAN ANGELO
TOPICS:
l. Medico Legal Aspect of Death 
    2. Kinds of Death
       a. Somatic Death
       b.Molecular Death
       c. Apparent Death/State of Suspended Animation
2. Signs of Death
A. Cessation of heart action and Circulation
- Methods of Detecting the Cessation of Heart Action and  Circulation
1.Examination of the Heart
2.Examination of the Peripheral Circulation
B. Cessation of Respiration
              - Methods of Detecting Cessation of Respiration
Medico Legal Aspect of Death
Importance of Death Determination

1. The civil personality of a natural person is extinguished by death: 

 -The civil personality is extinguished by death. The effect of death upon the rights and
obligations of the deceased is determined by law, by contract and by will (Art. 42,
Civil Code).
2. The property of a person is transmitted to his heirs at the time of death: 
-Dissolution (of a partnership) is caused. . . (5) by the death of any partner; (Art. 1830,
Civil Code).
3. The death of either the principal or agent is a mode of extinguishment of
agency: 
-Agency is extinguished. . . (3) By death, civil interdiction, insanity or insolvency of
the principal or of the agent. . . (Art. 1919, Civil Code).
4. The criminal liability of a person is extinguished by death: 
    - Criminal liability is totally extinguished: 
   A. 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).
 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.
 Kinds of Death

1. Somatic Death (Clinical Death)

- Somatic death, also known as 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. 

     
 Kinds of Death

       2. Molecular Death (Cellular death) 

- After cessation of the vital functions of the body there is still animal
life among individual cells.  About three to six hours later after the
somatic death, 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. Such as, previous state of health, infection, climatic condition,
cellular nutrition, etc. influence its occurrence. 
 Kinds of Death

3. Apparent Death/ 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. Apparent
Death is a condition in which all the signs of life or vitality are seemed to
be absent although the individual still remains alive. It is a condition,
wherein the vital functions of body (heart beat and respiration) are
maintained at a low pitch reduced to a minimum for some time, that they
could not be detected by routine methods of clinical examination.
 ll. Signs of Death

A. Cessation of heart action and circulation 

There is 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
 Methods of detecting the cessation of heart action and circulation

1. Examination of the Heart 

a. 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 heart beat. Occasionally
the pulsation is very imperceptible and irregular that the examiner experience much
difficulty.
b. 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.
 Methods of detecting the cessation of heart action and circulation

1. Examination of the Heart 

c. Fluoroscopic 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.
d. 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. 
2. Examination of the Peripheral Circulation:
a. 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.
b. 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.
2. Examination of the Peripheral Circulation:
c. 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 fluorescein.
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.
d. 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.
2. Examination of the Peripheral Circulation:
e. 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.
f. 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.
2. Examination of the Peripheral Circulation:

g. 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.
h. 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.
II. Signs of Death

B. 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.
 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. 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.  
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. 
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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