iv.

DEATH

1. Definition
Termination of life. Death is the complete cessation of the all the vital
functions of the body without possibility of resuscitation. The
ascertainment of death is a medical and not a legal problem
Complete and persistent cessation of heart action and respiration
(cardio respiratory) is the standard criteria in the determination of
death
2. Medico-legal aspects of death
1.
2.
3.
4.
5.

Civil personality is extinguished by death

Properties of a person is transferred to his heirs at the time of his death
Death of a partner is one of the causes of the dissolution of partnership
The death of either the principal or agent extinguishes agency
Death totally extinguish criminal liability

Death may be:

1. BRAIN DEATH occurs when there is deeply irreversible coma and absence
electrical brain activity
2. CARDIO-RESPIRATORY DEATH occurs when there is continuous and
persistent cessation of heart action and respiration
4 kinds of death
1. Clinical or somatic death when in the judgement of the clinical eyes of the
physician, the bodys vital signs of life ceases to exist continuously and
permanently
2. Brain death This kind of death follows clinical death, almost immediately unless
rescitative procedure is started promptly, because human brain, under
normal condition, cannot survive loss of oxygen for more than 6-10
minutes.
Brain death may occur:
1. stage 1- CEREB CORTEX- CC is the highest center of the brain which is most
sensitive to the change in the supply of the blood and oxygen to the brain.
When the CC dies, the patient is in Cortical death
2. stage 2- Cerebellum- follows the death of the Cereb Cortex. It DEALS WITH
THE FUNCTION OF equilibrium.
3. stage 3- brainstem and vital centers These centers controlling the
heart rate, respiration and blood pressure ultimately die. When it does, the
patient is BRAINSTEM DEAD.

If the brainstem is damaged, vital centers in the medulla maybe

destroyed causing respiratory center to fail.
OCCURRENCE OF BRAIN STEM DEATH IS EQUIEVALENT TO LEGAL
DEATH SO THAT doctors may already issue death certificate, even
though the heart is still beating. And make arrangements to harvest
donor organs and tissues at this stage.
In the presence of BSD, artificial respirators only achieve the
maintenance of an oxygenated circulation thru a corpse or cadaver.

Criteria for diagnosing BSD:

Exists when the the irreversible damage to the cortex occurs without damage
to the vital centers, and there a re permanent eyes, open state of
unconsciousness, but cardio respiratory functions continue sometimes
without respiratory assistance but most often with respiratory support.
Do not match the clinical criteria of brain death in as much as they have elicit
reflexes, spontaneous respirations, and reactions to external stimuli.

HARVARD CRITERIA OF BRAIN STEM D EATH

1.
2.
3.
4.

UNRECEPTIVITY AND UNRESPONSIVITY

NO SPONTANEOUS MOVEMENT OR BREATHING
NO REFLEXES
FLAT EEG OF CONFIRMATORY VALUE

WHOLE BRAIN DEAD- When the brain CEASED ALL FUNCTIONS although the heart
still continues to breath. As a rule a doctor can legally declare Whole brain death 12
hours after they have made all the corrections 2 to medical problems, but still
BRAIN does not respond even to induced pain, the eyes did not react to light and
does not breath without respirator.
3. Biological death all components of the brain are dead
permanent extinction of the bodily life
It is cardiorespiratory and brain death altogether with permanent
cessation of all anatomic and physiological functions of the body
organs.

4. CELLULAR DEATH.
DEATH of different parts of thebody occurs at different time and
stages that is why some organs kidney and corneas can be removed
immediately after biological death and transplanted successfully.
signs of death

1. Cessation of heart action and circulation

2. Cessation of respiration
3. Cooling of the body( Algor Mortis)- 15-20 degrees F is considered as certain
sign of death
4. Loss of motor power
5. Loss of sensory power
6. Change in the skin
7. Changes in and about the eye- loss of corneal reflex
CHANGES IN BODY FOLLOWING DEATH
1. MUSCLE CHANGES
1. Stages of primary fallacity
2. Cadaveric rigidity or rigor mortis
Cadaveric spasm appears immediately after death while rigor
mortis appears 3-6 hours after death. \
Medico-Legal significance of cadaveric spasm and rigor mortis
Rigor mortis may be used to approximate the time of death. Generalized muscular
contraction occurs from 3-6 hours until 36 hours
cadaveric spasm may be useful in determining the nature of the crime and
ascertain the circumstances of death.
Cadaveric spasm- is the immediate or instantaneous spasm or rigidity of the
skeletal muscles occurring at the moment of death due to exhaustion, etc.
2. BLOOD CHANGES
a. Coagulation of the blood
b. Postmortem lividity
3. Autolytic or auto digestive changes
4. Putrefaction of the body ( kinds: mummification, saponification and
maceration)
Factors to be considered in approximating the duration of death in the
cadaver
1. Maggots- the presence of maggots in the cadaver indicates death for
more than 24 hours
2. The presence of live fleas in clothing. In death by drowning, a flea can
survive sub merged in the water for 24 hours, after 24 hours, the flea dies.
3. Blood vessels clots- blood clotting occurs in 6-8 hours after death
4. Rigor mortis begins to develop in 3-6 hours after death and may last for
24-36 hours after death
5. Onset of decomposition- decomposition takes place withing
6. 24-48 hours after death
7. Food in stomach
8. Skeletal soft tissues soft tissues may disappear from 1.5 years to 2 years
after burial

Position of the body at the time of death

1. Postmortem lividity
2. Cadaver spasm
3. Medico-legal investigation of death

Deaths which are NOT DUE TO NATURAL CAUSES but which are due to criminal,
accidental, suspicious, suicidal, murderous, homicidal , unexpected or
unexplained death need medico-legal investigation
Stages of medico0legal investigation fo death are:
1. Crime Scene investigation( investigation of the place of the commission of
the crime
2. Autopsies ( investigation of the body of the victim )Comprehensive study of
the dead body, performed by a trained physician employing recognized
dissection procedure and techniques
Post mortem examination is an external examination of the body although blood
and other flluids may be collected while autopsy refers to both the internal and
external examination of the dead body.
4. Provisions of law on death

5. Legal presumption of death

If absent without explanation from his or her last place of residence for a long
continuous period.
Circumstantial proof of death
Ex. A passenger of an airplane that crashed is considered to have died even if no
remains have been recovered.
In common law the presumption of death does not arise until the expiration of 7
years of continuous absence.
.

1. Defintion and types of trauma

TRAUMA is the leading cause of detah in the first four decades of life and 3 rd
cause of death of all age groups today
Penetrating trauma particularly headguns
2. Medico legal aspects of injuries
3. Legal classification of injuries
1. Mutilation
- Any person who shall intentionally mutilate another by depriving him,
either totally or partially, of some essential organ of reproduction(RPC
art. 262)
2. Serious physical injuries
- beat wound or assault another guilty of Physical injuries ( 263)
3. Administering injurious substances or beverages
4. Less serious physical injurie
- inflict Physical injuries which shall incapacitate a person for labor for 10
days or more or shall require medical attendance for medical period
5. Slight physical injuries and maltreatment
- Incapacitate the injured to labor from 1-9 days or shall require medical
attendance for the same period
4. Medico-legal classification of Trauma
5. Classification of wounds
1. As to severity
1.Mortal wound death results immediately after infliction
2. Non mortal wound does not result into death immediately
2. As to kind of instruments used (BST CHIC)
1. Blunt instruments(ex. Block of woodor iron produces contusion,
hematoma abrasions,lacerated wounds when used with strike
2. Sharp instruments (ex. Incised wound, punctured wound ,stab
wound,dagger or kitchen knife.
3. Tearing force
4. Change of atmospheric pressure (ex. Barotrauma)
5. Heat or cold( frostbites, burns,scalds)
6. Infection

3. As
1.
2.
3.
4.
4. As
1.
2.
a.
b.

7. Chemical explosion ( gunshot or shrapnel wound

to manner of infliction(GHST)
Gunshot wound
Hit
Sliding or rubbing abrasion
Thrusts or stab
regards depth of wound
Superficial- wound involves only the layer of the skin
Deep- wound involves the inner structure beyond the layer of the skin
Penetrating wounding agent enters the body but did not come out.
Perforating theres point of entry and exit traversing completely a
particular part of the body

5. as regards site of application of force and the location of injury

1. Coup injury- injury located at the site of the application of the force
2. Countre- Coup Injury- injury is opposite the site where force was
applied
3. Countre coup coup injury located at both the site and opposite the
site of application of force
4. Locus Minoris Resistencia physical injury located not at the site
where force was applied nor opposite it but in some areas offering the
least resistance to the force applied.
5. Extensive injury involving greater area of the body with wide area of
injury and varied types of injury
6. as to regions or organs of the body involved
SPECIAL TYPE OF WOUNDS ( MEDICAL CLASSIFICATION)
A. Closed wounds- there is no breach of the continuity of the skin. Only outward
manifestation of injury internally .
1. Superficial when the wound is just underneath the layers of the skin or the
mucous membrane
1. Petechiae a circumscribe extravasation of blood in the subcutaneous
tissue
2. Contusion -effusion of blood into the tissue underneath the skin as a result
of blunt force. Ex. Black eye
3. Hematoma is the extravasation or effusion of the blood in a newly-formed
cavity underneath the skin. Unlike contusion, here the skin is always
elevated
Ex. Abscess is the potential complication of hematoma
2. Deep
Close wound

1. SPRAIN partial or complete disruption in the continuity of the muscular

or ligamentous support of a joint. Usually caused by a blow, kick or a
torsion force
2. DISLOCATION displacement of the articular surface of bones entering
into the formation of a joint
3. SUBLAXATION incomplete or partial dislocation
4. FRACTURE solution of continuity of bones resulting from violence or
some existing pathology
5. STRAIN the over-stretching instead of the actual tearing or rupture of the
muscle or ligament which may not be associated with the joint
OPEN WOUND there is a break in the continuity of the skin
1. ABRASION scratch, friction mark, graze or impression mark
Injury characterized by the removal of the epithelial layer of the skin caused
by a rub or friction against a hard rough surface
2. INCISED wound (cut, slice,slash)
Produced by a sharp-edge (cutting) instrument like knife, bolo, metal sheets.
It may be an impact cut when there is forcible contact of the cutting
instrument with the body surface , when cutting injury is due to the pressure
accompanied with movement of the instrument.
Incised wounds may be accidental, suicidal, or homicidal
1. Suicidal located in the peculiar part of the body like neck,wrist or the
accessible to the hand in inflicting the injury
2. Homicidal- incised wounds are deep, multiple and involve both the
accessible and non-accessible part of the body to the hands of the victim
3. Accidental- multiple on the passen2gers or drivers of the vehicular
accidents
3. STAB WOUND produced by the penetration of the sharp-pointed and sharpedged instrument, like a knife ,dagger,scissors.
Stab wound is suicidal if the stab wound is accessible to the hands of the
victim
4. PUNCTURED
5. LACERATED
Medico legal investigations of wound
1. General investigation of the surrounding during or after life or after death
2. Points to be considered in the determination as to w/ the wound is homicidal
suicidal or accidental
Under cadaveric spasm- the finding of weapons, hair, pieces of clothing,
weeds on the palms of the hands and firmly grasped is a very important
medico-legal point in the determination of whether it is a case of homicide,
murder or suicide.

3.
4.
5.
6.
7.

Possible instruments used by the assailants in inflicting inuries

Factors showing which of the wounds are inflicted first
Effect of medical and surgical intervention on the death
Gunshot wounds
Medical evidence showing that the victim was shot at close range (firmcontact firm or at a distance loose contact firm
8. Distinction between entry and gunshot wounds
9. Test for presence of powder residues
10.