CHAPTER 6:

CAUSES OF
DEATH

Primary purpose of a medico

legal autopsy:
*Determination of the cause of
death.
*Death is the direct and the
proximate consequence of the
criminal or negligent act.

Defense wounds on the victim:

Qualify the crime to homicide.

*Series of cuts in the borders of

the wound:
Multiple thrust- intent to kill.

Cause of death
*is the injury or disease or both which
initiates the physiological disturbance
resulting to a fatal termination.

1. Immediate or Primary cause of death

> when injury or disease kills quickly
the victim and no opportunity for
complications to develop.
Ex: extensive brain injury

2. Proximate causeor
Secondary cause
> the injury or disease was
survived for a longer period.

MANNER OF DEATH
> is the explanation as to how the
cause of death arose.
1. Natural death
fatality is cause solely by
disease.
Ex: pneumonia, cancer

2. Violent or unnatural death

due to injury

MEDICO LEGAL MASQUERADE

violent deaths may be

accompanied by minimal or no
external evidence of injury or
natural death where signs of
violence may be present.

DEGREE OF CERTAINTY TO THE

CAUSE OF DEATH:
1. Structural abnormalities
established beyond doubt of the
cause of death.
Ex. Stab Wound with Hemorrhage

2. Degree of probability
amounting to the cause of
death.
Ex: Electrical shock
3. History establishes cause of
death and confirmed by
anatomic or chemical
findings.

4. When neither history,

laboratory and anatomic
findings, taken individually or
in combination is sufficient to
determine the cause of death
but merely speculate as to the
cause of death.
Ex. Crib death among infants.

STEPS IN THE INTELLECTUAL PROCESS

IN THE DETERMINATION OF THE CAUSE
OF DEATH:

1. Recognition of the structural

organic changes or chemical

abnormalities responsible for
the cessation of vital
functions.

2. Understanding and
exposition of the mechanism
by which the anatomic and
other deviations from normal
caused the death.

3.Instantaneous physiologic
death or Death from
inhibition, death from primary
shock,syncope with
instantaneous exits.

4. This is sudden death which

is cause within seconds or
minute or two after a minor
trauma or peripheral
stimulation of relatively
simple nature.

5. The peripheral stimulation

initiates the cardio-vascular
inhibitory reflex.
Ex: Vagocardiac slowing or
stoppage of the heart.

6. Blow to the larynx, solar

plexus, scrotum,pressure to the
carotid sinus.

DISEASES WITH NO SPECIFIC

FINDINGS OF A DISEASE:

1. Sudden infant death syndrome

(SIDS) or crib death

2. Sudden unexplained nocturnal

death (SUND)

DOA (DEAD ON ARRIVAL)

means actually dead or dying,

provided the physician had not
been given ample opportunity to
arrive at a working diagnosis as to
the cause of death.

Undetermined
if the physician cannot determine
the cause of death.

MEDICOLEGAL
CLASSIFICATION OF THE
CAUSES OF DEATH
a.

Natural death
cause by natural disease
condition in the body.

b. Violent death
1.Accidental death
2.Negligent death
3.Infanticidal death
4.Parricidal death
5.Murder
6.Homicidal death

If signs of violence are associated

with the natural cause of death:

* Did the person die of a natural

cause and were the physical
injuries inflicted immediately after
death?
- violence applied in a dead person
: Impossible crime

* Was the victim suffering from a

natural disease and the violence

only accelerate the death?
= Offender responsible of the death
of the victim.
= Criminal liability shall be incurred
by any person committing a felony
although the wrongful act done
be different from which he intended.
(Art.4 no.1 RPC)

* Did the victim die of a natural

cause independent of the
violence inflicted?
- accused will not be
responsible for the death but
merely for the physical injuries he
had inflicted.
Ex. Slapping a person with heart
problem, only slight physical
injury.

* To make the offender liable

for the death of the victim, it
must be proven that the death
is the natural consequence of
the physical injuries inflicted.

THE FOLLOWING ARE DEATHS

DUE TO NATURAL CAUSES:
1.

Infection of the CNS

a. Cerebral apoplexy
sudden loss of consciousness followed
by paralysis or death due to
hemorrhage from thrombosis or
embolism in the cerebral vessels.
b. Abscess of the brain
c. Meningitis of fulminant type

2. Infection of the circulatory system

a.Occlusion of the coronary vessels :
=most common cause of sudden death
due to natural causes.
b. Fatty or myocardial degeneration of
the heart.
c. Rupture of the aneurysm of the aorta
d. Valvular heart disease
e. Rupture of the heart

3. Infections of the Respiratory system

a. Acute edema of the larynx
b. Tumor of the larynx
c. Diphtheria
d. Edema of the lungs
e. Pulmonary embolism
f. Lobar pneumonia
g. Pulmonary hemorrhage

4. Infections of the GIT

a. Ruptured PUD
b. Acute intestinal obstruction

5. Infections of the GUT

a. Acute strangulated hernia
b. Ruptured tubal pregnancy
c. Ovarian cyst with twisted
pedicle

6. Infection of the glands

a. Status thymico-lymphaticus
b. Acute hemorrhagic pancreatitis

7. Sudden death in young children

a. Bronchitis
b. Congestions of the lungs
c. Acute bronchopneumonia
d. Acute gastroenteritis
e. Convulsion
f. Spasm of the larynx

B. VIOLENT DEATH
*are due to injuries inflicted in the body
by some forms of outside force.
= the physical injury must be the
proximate cause of death.
= That the victim at the time the
physical injuries were inflicted was in
normal health.
= That the death may be expected from
the physical injuries inflicted.
= That the death ensued within a
reasonable time.

CLASSIFICATION OF TRAUMA OR INJURIES

1. Physical injury trauma sustained

through the use of physical force.
2. Thermal injury injury by heat or cold
3. Electrical injury electrical energy.
4. Atmospheric injury due to change
of atmospheric pressure.
5. Chemical injury chemicals
6. Radiation injury radiation
7. Infection microbic invasion

PENAL CLASSIFICATION OF VIOLENT

DEATHS

1. Accidental deaths due to

misadventure or accident.
Art. 12 no. 4 RPC
Any person who while performing a
lawful act with due care, causes an
injury by mere accident without fault
or intention of causing it.
Ex. Patient died of ATS injection
after proper skin test.

2. Negligent death
felonies may be committed when
the wrongful act is due to
reckless imprudence, negligence,
lack of skill or foresight.
Ex. Surgeon left a pack
Homicide through reckless
imprudence

3. Suicidal death ,destruction of

ones self
- not punished, unfortunate
being.
- Art 253 RPC Giving
assistance to suicide. Punishable
because he has no right to
destroy or assist in the
destruction of life of another.

4. Parricidal deaths
Art. 246 father, mother, child,
(leg/illeg) ascendant,
descendant, spouse (leg.)

5. Infanticidal deaths Art. 255

killing of a child less than 3 days

6. Murder Art. 248

treachery, consideration, means
of inundation, occasion of
calamities, evident
premeditation, cruelty
7. Homicidal deaths Art 249

DEATHS UNDER SPECIAL

CIRCUMSTANCES

1. Death caused in a tumultuous

affray Art 251.

2. Deaths or physical injuries

inflicted under exceptional
circumstances. Art 247

2. PATHOLOGICAL CLASSIFICATION
OF THE CAUSES OF DEATH

a. Death due to syncope

fatal and sudden cessation of
the action of the heart.

b. Death from asphyxia

condition in which the supply of
oxygen to the blood or to the tissues
or to both has been reduced below
normal working level.
Stage of increasing dyspnea 1 min
Stage of Expiratory convulsion
Stage of exhaustion 3 min

c. Death from coma

END...