TYPES OF DEATH
ALCOHOL-RELATED:
Ethanol is the most commonly abused drug in the United States. Deaths from acute ethanol
intoxication are due to severe respiratory and central nervous system depression. Deaths
usually occur with ethanol levels of 0.35% or higher, but this level depends on the individual.
Lower levels of ethanol can cause death if there is associated positional asphyxia with the death
or when it is combined with any other drug that causes respiratory depression. An investigator
should always look around to determine if any such drugs are around the body or at the scene.
Documenting the position of the decedent is crucial as is documentation of the items around the
body such as illicit or prescription drugs or drug containers.
Document the drug prescription date, number prescribed, how often pills are to be taken, and the
number left in the container.
Completed prescription drug information sheet.
If a cup, glass, or other drinking container is found near the body, then it should be processed
as evidence to analyze the contents as well as for latent fingerprints.
Alcoholics may turn to non-beverage alcohols to satisfy their need for alcohol, including
mouthwash, hairspray, aftershave, and rubbing alcohol. Investigators need to look for these
items, which may be empty at the scene, to retain as evidence.
CAARBON MONOXIDE DEATHS
Carbon monoxide is formed by incomplete combustion of hydrocarbons during a fire. As a
result of being exposed to carbon monoxide, individuals often develop headaches and nausea.
With increased exposure, the symptoms progress to lethargy and eventually death if the level is
high enough. Carbon monoxide toxicity causes lividity of the blood, organs, and skin, resulting
in a bright cherry-red coloration.
Death from carbon monoxide is caused by an insufficient level of oxygen in the air (chemical
asphyxia) and is determined by testing the postmortem blood for carboxyhemoglobin levels.
Those who die of carbon monoxide toxicity usually have levels of carboxyhemoglobin saturation
between 50% and 80%.
High levels of carboxyhemoglobin (70 to 80%) are seen in people who are in an enclosed
environment and breathe fumes from car exhaust in a closed garage or smoke from a house
fire. The fumes from the car exhaust are hot, and, as a result, people who commit suicide by
inhaling these fumes may have skin slippage due to the heat and accelerated decompositional
changes—even though the person has only been dead for a short period of time.
Low levels of carboxyhemoglobin (approximately 20%) may cause death in older individuals
with medical problems such as cardiovascular disease or chronic obstructive pulmonary
disease. Note that smokers normally have carboxyhemoglobin levels of 10 to 15% at any given
time.
The manner of death for carbon monoxide toxicity can be accidental, suicidal, and even
homicidal. Accidental causes for carbon monoxide toxicity are usually from a house fire or other
type of fire. Accidental deaths from carbon monoxide toxicity can also be caused when a
generator or other such device, which gives off carbon monoxide gas when used, is being used
inside a residence as a power source (e.g. during extreme weather conditions or prolonged
power outages). A person will often commit suicide by inhaling exhaust fumes from a car in a
closed garage.
The manner of death in carbon monoxide deaths may be difficult to determine via autopsy
alone. The investigator needs to not only examine the scene but the life of the decedent (work,
family, health, and finance).
When you come to a scene with two or more people found dead in a residence without an
obvious cause of death, you should be suspicious of death due to carbon monoxide. Such a
death scene could entail certain risks.
Document how the body is found and everything that is around the body, including the
following:
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Pipes or hoses directing exhaust fumes towards the decedent
Generators or other such devices that might give off carbon monoxide gases. Document
with field notes and photography the make, model, serial number, on/off position, and
whether the gas tank is full or empty
Fire, and whether it is in an open or closed environment
Paraphenalia or equipment used/involved in the death
Collect any evidence (hoses, pipes, generators, and/or heating type devices) that may be
around the body/bodies.
There are no special considerations to take into account when transporting a body in carbon
monoxide deaths; however, standard precautions should be maintained in all cases.
DROWNING
Drowning is the fourth leading cause of death by accidental means in the United States.
Drowning is death due to lack of oxygen in the blood (asphyxia) after being submersed in water.
Drowning can be accidental, suicidal, and even homicidal; however, drowning deaths are
usually accidental.
Drowning can occur in many different types of water such as in a lake, a pond, the ocean, a
pool, the bathtub, and even a large bucket filled with water.
Breathing is an unconscious act that occurs when air is inhaled into the mouth or nose and
flows into the respiratory system. Air follows a pathway that goes down the trachea and then
divides into the right and left bronchi. Air continues down the bronchi which break into
branches called bronchioles.
Within the bronchioles, there are millions of microscopic circular sacs, called alveoli, where gas
exchange occurs. The interior of the alveoli are coated with a fluid that reduces surface tension
and helps keep the sacs open (surfactant). When a person tries to breathe while their head is
submersed in water, the person will inhale water into the airways (aspirate), which causes
decreased oxygenation in the blood (hypoxemia) followed by brain injury (hypoxic brain injury)
and then death.
There are often visible physical signs in a drowning death. The body is most often found in or
near water and may be visible or submerged in the water. The skin will begin to soften
(maceration) resulting in a “washerwoman” appearance due to prolonged immersion in water.
Foam will often be coming from the mouth and nasal passages and will have the appearance of
whipped egg whites.
The foam is a result of the mixture of inhaled water and mucus, which is secreted when
swallowed liquid irritates the bronchi linings.
Foam may be a pinkish-red color if the alveoli are damaged and/or if blood from the pulmonary
capillaries is pulled into the alveoli. Make sure to properly document foam, as time and
transport may have an effect on this type of evidence.
The investigator or pathologist needs to try to determine why the person was in the water and
why the person could not get out of the water. Determine if the conditions were favorable for
swimming or hazardous. It is important to document:
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If it is believed the person knew how to swim
If the person has any underlying medical problems, such as seizure disorder, heart disease,
and/or severe pulmonary disease
If there is a history of drug or alcohol abuse
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The temperature of the water and the environment, which will affect postmortem
processes such as rigor mortis
Always look for any evidence that foul play may be a factor in the death, as bodies can be
placed in water to make it appear as though the person died as a result of drowning.
Thoroughly document the scene with photographs and/or drawings. Process medications or
other items around or near the body as evidence.
An autopsy needs to be performed on all drowning deaths to attempt to rule out any
underlying disease that may have played a role in the death, as well as other causes of death,
including homicidal violence. In an actual drowning death, the autopsy will reveal hyperinflated
lungs, which often extend across the heart as the lungs essentially fill the thoracic cavities.
The sphenoid sinus, when opened up or aspirated with a small needle, may contain fluid and
may reveal hemorrhages of the petrous portions of the temporal bones, or middle ear.
Hemorrhages may also be seen in the frontal and sphenoid sinuses that may be related to the
changes in hydrostatic pressures or postmortem injury from animals or items in the water, such
as tree stumps in a lake.
The brain will be swollen showing cerebral edema and water and/or other material from the
water source causing the drowning may be present in the stomach.
ELECTROCUTION
In an electrocution death, the body will often show no signs of injury, so the scene findings are
very crucial in determining the cause and manner of death. The cause of death is most often
related to an abnormality in the rate, regularity, or sequence of the heartbeat (cardiac
arrhythmia), such as an uncontrolled twitching in the lower chambers of the heart causing the
heart to fail to eject blood efficiently (ventricular fibrillation). Determining how and why the
person was electrocuted should be your mission.
Upon arriving at the scene, the investigator should make sure that the scene is safe before
entering and that any electrical sources have been turned off.
When an electrocution death is suspected, examine the hands, arms, legs, and feet for
electrical burns and/or injuries.
Make sure to thoroughly document the scene with photographs of the body and any energy
sources and/or wires that may have been involved. Make sure to take detailed photographs of
the environment, since examination of the body may not reveal any injuries or burns on the
body. Any tools, instruments, or machinery that may have been involved should be retained as
evidence and evaluated by an electrician (where possible).
High-voltage electrocutions (600 to 1,000 volts or greater) are usually caused by high-voltage
power lines. In these cases, examination of the scene is critical. Entry (point of contact with
electrical source) and exit (point of contact with the ground) burns on the body will often be
seen in such cases.
Evaluate the clothing, including gloves and shoes, for burns that correspond to the wounds on
the body.
Photograph and collect clothing and shoes, concentrating on burns and/or tears.
Deaths due to lightning are also high- voltage electrocutions (up to 100,000 volts) and always
have entry and exit wounds. The exit site is generally a foot and if the individual was wearing a
shoe, it is often blown away from the foot. The ear drums (tympanic membranes) will typically
rupture due to the high voltage.
Examine the body for singed hairs or burn marks under articles such as watches, bracelets, or
necklaces. Look at the clothing for evidence of damage from the lightning by looking for burns,
tears, areas dispersed away from the body, or areas melted away.
The scene examination is even more crucial in low-voltage electrocutions since the body of a
low-voltage electrocution (such as at a home with 120 volts) usually does not show any
electrical burns. In about 50% of electrocutions due to low voltage, there are no electrical burns
or other findings at autopsy that suggest electrocution as the cause of death. If the death
occurs, for example, in a bathtub or pool, electrical burns will not usually be visible on the body
because the water decreases the skin’s resistance to the electrical current. The electrical wiring
of the building or location where the possible electrocution occurred should be inspected by an
electrician.
Always make sure that the source of the electricity is turned off before approaching and
removing the body from the scene.
EXPLOSION-RELATED
Explosions can be mechanical, chemical, or nuclear and will be classified as either low-explosive
or high-explosive. Explosion-related deaths are due to blunt force injury from physical objects
and/or shockwaves that come across the body. The explosive agent may be the physical object
and/or other objects that may have moved during the explosion, causing injury to the body.
Blast injuries are categorized according to T.K. Marshall as:
...(1) complete disruption, (2) explosive injury with mangling of body parts, small discrete
bruises, abrasions, puncture wounds and dust tattooing, (3) fragmentation and shrapnel
wounds, (4) blast effects on ear drums, lungs and gastrointestinal tract, traumatic
emphysema, (5) blunt force injuries from structural collapse, (6)burns and inhalation of
toxic substances, and (7) sharp force injuries from metal and glass.
When a bomb results in a fire, the clothing may be burned and the body may have thermal
burns.
Explosions in residences are usually due to the ignition of natural gas. Some explosions at
residences may be caused by chemical explosions related to the manufacturing of drugs such as
methamphetamine.
Clothing may be torn off or blown away from the body and should be examined for chemicals
and/or other materials from the bomb. When clothing is still on the body, x-rays should be
taken to look for pieces of the bomb before clothing is removed.
Investigation of explosion-related deaths should include preservation of volatiles, residues, and
other trace evidence. Residues should be collected with methanol or ethanol swabs and
preserved in vials. You should also collect any embedded shrapnel and thoroughly investigate
the scene for any evidence of the exploding device.
Although there are no special body transport considerations, make sure that all body parts and
clothing are collected and transported.
FALL-RELATED
The severity of a fall is related to the distance the person falls. Some people can fall from a
normal standing position but the fall usually involved drinking, assault, or an underlying medical
condition, such as a seizure disorder. Fall-related deaths can be accidental, homicidal, or
suicidal. Falls from a height, such as a building, may be homicidal, but are more often related to
suicides and accidents, especially if a child is involved.
When young adults and children fall, they will usually fracture the skull, often resulting in
subdural hemorrhage. When the elderly fall, they usually fracture the femur, ribs, arms, and/or
pelvis. When an elderly person dies from a fall, it may be due to a blockage in a blood vessel in
the lungs (pulmonary thromboemboli) or a form of pneumonia in the bronchial passages
(bronchopneumonia) related to the fracture of the ribs, arms, femur and/or pelvis.
Alcoholics may die of injuries from a fall and often have had several falls in the past. Chronic
ethanol abusers may die of a fall due to a subdural hemorrhage or hematoma since their
balance is poor because of brain atrophy.
A fall from a height can cause the tibias to be driven through the bottoms of the feet or a
fracture of the base of the skull (occipital bone). Striking the ground from a height often causes
the aorta to be torn and possibly the carotid arteries. When an individual jumps or falls from a
height, the heart may be markedly torn from bursting or detached from the chest and found in
the abdominal cavity.
Evidence Collection - when investigating a fall:
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Obtain information about any underlying medical conditions.
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Ask if there is a history of alcohol and/or drug abuse and look for any medications present
at the scene.
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If the person is elderly, ask about any previous falls or frequent falling.
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Collect evidence noted at the scene and thoroughly document the area around the site of
the fall.
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Look at the body for any pattern-type injuries and try to find corresponding objects, noting
any inconsistencies, especially when foul play is suspected. Bring object(s) that may have a
corresponding imprint on the body with the body for comparison.
Document the scene if it looks like it has been cleaned up, changed, or staged.
Retain trace evidence.
Take fingernail scrapings and clippings if the scene is suspicious.
Record and photograph the height from which the decedent fell.
The findings at autopsy for an accidental, suicidal, or homicidal fall may all be the same, so
investigation and documentation of the scene is crucial. There may be very few external
findings, but multiple internal findings at autopsy may include fractures and injuries to
organs.
FIRES
Fire-related deaths are usually accidents, but can also be due to suicides and homicides. It is
important for you to look for evidence regarding why the person or persons could not escape
from the fire.
Whether the manner of death is ruled an accident, suicide, or homicide, relies heavily on the
arson investigator’s report but must also correlate with the autopsy findings.
Death may have occurred before the fire if the body does not have soot in the airways or an
increased level of carboxyhemoglobin (50% or greater) in postmortem blood.
The body may exhibit a pugilistic (fighting or boxing) stance with an extreme elevation of the
arms and the arms flexed at the elbows and wrists due to the effect of the heat on the muscles.
The organs may be well preserved even with extreme charring of the outside of the body.
Epidural hemorrhage or hematoma and brain shrinkage are due to the heat from the fire.
A person can pour gasoline or other accelerant on himself/herself or set a house or other
building on fire while inside resulting in death by fire by means of suicide. When gasoline is
poured on the body, the body will have patches of charring depending on where the gasoline or
other accelerant was placed. The clothing or materials around the body
should be analyzed for accelerants. Testing for accelerants can even be done on dry, leatherlike burned skin.
Retain glass that was broken at the scene and submit it to be analyzed for fingerprints and to
determine whether it was broken before or after the fire. Burned cans or metal containers can
also be processed for fingerprints.
If collecting items such as carpet or soil, collect the items in a metal can so that the fumes
cannot escape.
Take pictures of the body documenting exactly how it was found, the area immediately around
the body, and other areas of the location of the fire. Document anything out of the ordinary
that causes suspicion of foul play. Document drugs or alcohol found at the scene. Obtain the
medical history of the individual(s) found and ask family members or friends about any
surgeries that can be helpful in making positive identification.
Investigators typically compare DNA from tissue, bone, and teeth to identify victims. Bone and
tissue evidence most often comes from victims during the autopsy. While teeth may also be
collected during autopsy, this evidence may be discovered at primary crime scenes or
secondary crime scenes, such as dumping sites. Teeth are very resistant to trauma, incineration,
and decomposition. As a result, they are an excellent source for DNA material.
It is important to note that most dental prosthetics (crowns, fixed partial dental work, and
dentures) will have identification markings of some type. With this as a possibility, collect not
only human teeth but dental prosthetics as well. Package tissue samples in a clean, airtight
plastic container without formalin or formaldehyde. Place teeth and bone samples in clean
paper or an envelope with sealed corners. Freeze the evidence, and ship with dry ice.
Be very careful in handling charred remains. Total body x-rays should be performed prior to
beginning an autopsy of a charred body to help rule out the possibility of any projectiles or
other foreign objects.
Make sure to transport all body parts with the body. Additional body parts discovered later
should be taken to a forensic pathologist for examination.
FIREARMS
Gunshot wounds are the most common cause of death due to homicides in major cities of the
United States. Handguns, shotguns, and rifles are the most common types of firearms used in
firearm-related deaths.
Gunshot wounds can be homicidal, suicidal, and occasionally accidental. Most often selfinflicted gunshot wounds are to the head but can occur to the chest and abdomen.
Graze wounds, which are not typically seen in suicides, are superficial wounds made by the
grazing of a bullet across the surface of the skin/body. The skin tags of a graze wound point in
the opposite direction than the bullet traveled.
Intermediary targets can change the way the entrance gunshot wound appears. Examples of
intermediary targets include clothing, jewelry, furniture, doors, windows, walls, vehicles, or any
other object that is between the end of the firearm and the victim.
The investigator should have knowledge of blood spatter patterns in order to examine, analyze,
and properly record the blood spatter at the scene. Impact spatter patterns, which include a
majority of bloodstains that measure 1 mm or less in size, may result from gunshot wounds,
explosions of hand grenades, high speed machinery, or an aircraft propeller. Extremely small
droplets of blood are seen from wounding mechanisms with explosive force; the grater the
energy source (as seen with a firearm), the smaller the resulting bloodstains.
Impact spatter resulting from gunshot wounds or great forces of energy may have a mist-like
appearance. It should be remembered that blood drops this minute in size will not travel very
far due to their mass and the effects of gravity and air resistance. Blood impact spatter that
measures 1 mm or less in size will not travel much further than 3 feet.
Upon arriving at the scene, an investigator should examine the wound and attempt to
determine if it could have been self-inflicted. In examining wounds resulting from a handgun,
examine the barrel of the gun for bloodstains that are 1 mm or less in size, the presence of
blood in the barrel of the gun, or hair on the tip of the gun barrel.
Examine the hands of the victim for bloodstains measuring 1 mm or less in size on the web of
the hand.
In addition, blood may be present on the interior of the forearm as well as the bicep.
However there will be a clean area (void) in the bend of the elbow.
If the wound resulted from a rifle or shotgun, verify that the person was capable of firing the
weapon by measuring the length of the weapon from the trigger to the tip of the barrel,
comparing the measurement with the length of the arm or leg. Document the person’s
wingspan, measuring from the shoulder to the tip of the longest finger.
The clothing of the victim should be evaluated to help determine the range of fire of the
firearm. Take pictures of the scene around the body, of the body, and in other areas of the
shooting—especially those containing blood evidence.
Gunshot residue can often be found on the hands of the shooter. But it is essential that this
type of evidence is protected from loss and collected as soon as possible as it easily rubs off.
The hands need to be covered in paper bags before moving the decedent.
At the scene, make sure to document the bullet strikes using the rectangular coordinates
survey method. Record the bullet strike data (x,y coordinates) and the location of gunshot
wound(s) on the decedent. If the projectile exits the decedent, make sure to note the location
where the projectile struck. By accurately recording gunshot wounds, the position of the
decedent can be reconstructed, as well as the trajectory of the striking bullet.
Due to the blood-letting nature of firearm-related deaths, it is imperative that standard
precautions be used in every case. Before starting an autopsy, all gunshot wounds should be xrayed to search for projectile(s) and to help determine the path of the bullet(s).
HANGING
Hanging is most often an asphyxial death due to pressure on the outside of the neck causing
compression of the airway and/or the vessels supplying and draining blood to the brain. In
hangings, a ligature is placed around the neck, and the neck structures are compressed with the
aid of all or part of the body weight. Minute, round, non- raised hemorrhages of pinpoint size
(petechiae) on the face or the clear mucous membrane covering the white part of the eye and
eyelid (conjunctivae) can be seen with hangings but are more often related to strangulations.
Different types of materials can be used as ligatures in hanging deaths, including but not limited
to:
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Ropes
Electrical cords
Belts
Chains
Sheets
Scarves
Whips
Straps
The body does not have to be fully suspended with the feet off of the ground for the hanging to
happen—the person can be found in a sitting or standing position. Death usually occurs within
3 to 5 minutes after compression of the neck by the ligature.
Hangings are most often suicidal and typically no suicide notes are discovered. Hangings can be
homicidal, although these are very rare and there will usually be signs of a struggle, defensive
type injuries on the body, or some other inconsistency for a suicidal hanging. It is imperative to
determine if the victim’s death could have been self-inflicted without assistance.
Hangings can also be accidental in the case of autoeroticism.
Documentation of how the person is found is the top priority, especially if the person has not
been moved. Photograph the ligature while it is still around the neck, and if possible, still in the
hanging position without the scene being altered. The ligature should be cut away from the
knot and only removed from the body during the autopsy, not at the scene. The integrity of the
knot needs to be maintained for evaluation.
The hands need to be covered with paper bags prior to transport if fingernail scrapings and
clippings are to be done at autopsy.
At autopsy, the ligature will be removed and should be compared with the ligature abrasion
mark to make sure that it is consistent with the ligature. The strap muscles of the neck will be
dissected layer by layer looking for areas of hemorrhage. The hyoid bone, cricoids cartilage, and
the thyroid cartilage will be examined for any type of injuries, including fractures. The ligature
will be saved and used as evidence after thorough examination by the investigator and the
pathologist. There may be petechiae on the legs and feet known as Tardieu spots. Tardieu spots
are a postmortem phenomenon and occur because of the distention and rupture of blood
vessels resulting from the pronounced lividity.
The decedent’s blood will need to be tested for alcohol and/or other drugs.
OVERDOSE
Overdoses can occur almost anywhere—at a person’s residence, at another residence, at a
place of business, in a person’s car, or at a hotel. Drug overdoses can be accidental, suicidal, or
even homicidal. In suicides, more often than not, a note that the person took his/her own life is
not found at the scene; however, look for a suicide note near the body or in other locations in
the house or car, on tablets, cell phones, or social media sites. When foul play is suspected, look
for abrasions, contusions, and/or injuries to the frenulum in the mouth. Obtain a medical
history and previous suicide attempts from family, friends, or a physician.
Obtain pictures of the body, as the body was found, around the body, and in other areas
depending upon where the scene is. Clues that indicate that the death is due to an overdose
are foam coming from the mouth and nares, and discoloration of the lips, tongue, oral cavity,
and/or stomach. There may also be frothy fluid and foam coming out of the airways, such as
the bronchi and trachea.
It is important for the investigator to have a log of all the pills and pill bottles found at the
scene.
It is important to also document over- the-counter medications since some people may
intentionally or unintentionally overdose on those medications. If pills are found without labels,
attempt to identify the pills via the Physician’s Desk Reference (PDR) on-line, or through a
pharmacy or Poison Control.
(Use Web MD pill identifier,)
Evidence Consideration:
Search for any patches that reduce chronic pain (such as Duragesic/Fentanyl), on the body, in
drawers, or cabinets. Drug paraphernalia may also be found at the scene, such as needles
and/or syringes, and should be recorded, photographed, and taken as evidence.
Ask family members or friends if the person has tried to overdose before. If they have, ask if the
person went to a hospital or rehabilitation center so that medical records can be obtained for
review by the pathologist.
At autopsy, undigested pills (whole or portions) may be in the stomach, as well as pasty or
chalky material. The lungs might be heavy, usually greater than 500 to 600 grams each, and
have evidence of pulmonary edema and congestion. The urinary bladder may be full with more
than 200 milliliters of urine because of alcohol or another liquid used to take all the pills.
Standard precautions need to be taken when transporting the body. If liquids in glasses or cups
are near the body, collect a sample of the liquid for further analysis by a toxicologist. Also,
collect the glasses or cups and process for fingerprint evidence.
POISONINGS
Often, poisonings are not thought of as a cause of death until after the autopsy has been
performed and usually not until after the body has been buried. At the scene, the investigator
should look for any evidence that indicates that poisons could have possibly been used.
During the toxicology analysis, a general panel will usually be performed. A thorough
investigation will help determine the testing required for specific poisons. Poisons such as
arsenic, cyanide, and heavy metals should be ruled out first, and specific testing for these
substances must be requested. Most laboratories require that the blood or fluid/tissue sample
be placed in a specific type of container for analysis. Hair and fingernails need to be saved in
suspected poisonings since the presence of poisons in them is associated with long-term
exposure.
When considering poisonings as a cause of death, be sure to ask family members what the
deceased did for a living, as some occupations are more likely to be exposed to poisons,
including:
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Carpenter
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Landfill worker
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Firefighters
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Coal miners
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Pesticide/insecticide applicator
A thorough investigation of the scene is required. Thoroughly document the scene with pictures
and collect
drug(s) that may be a potential candidate for poisoning as evidence.
A family member may approach law enforcement after a person has died stating that they
believe someone poisoned their family member. The body has to be examined for any needle
marks to rule out the possibility that someone injected the person to cause the death.
Substances such as insulin, morphine, heroin, cocaine, and other drugs can be injected.
If the body has to be exhumed to look for the possibility of a poisoning death, take soil samples
around the casket to test for arsenic and other chemical agents that are normally found in
some soils. When the soil is found to contain these substances, compare them to any poisons
found in the body to ensure that they did not come from the soil.
It is very important to have an idea about what kind of poison may have caused the death,
otherwise it would be like looking for “a needle in a hay stack” when going back to look for
poisons in the postmortem blood or other bodily fluids and/or tissues.
There are no special body transport considerations but standard precautions should be
followed in all cases.
IN-CUSTODY DEATHS
Police in-custody deaths occur while a person is a prisoner and require careful and thorough
investigation and appropriate handling. The media will usually get involved and the public will
usually become very concerned about any death that occurs while a person is in custody of law
enforcement.
Deaths occurring in custody are usually due to a combination of factors and may result from
various causes, such as traumatic asphyxia due to arm or neck holds by police officers, “hog
tying,” positional asphyxia, blunt trauma, drug and/or alcohol related, suicide by hanging or
self-inflicted gunshot, police-involved shooting, and natural causes. A meticulous and very
thorough autopsy is required, especially involving police in-custody death.
The investigator must do the following:
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Take multiple detailed photographs of the scene of police in-custody death. (An
investigator cannot take too many photographs.)
Take and review statements from all persons involved with the death.
Create a timeline documenting all action(s) of the individual prior to his/her death.
Obtain a core body temperature as soon as possible when arriving on scene.
Look for any evidence of sexual assault.
The autopsy is performed to find answers as to why the person in police custody died. The
autopsy has to be performed knowing information about the circumstances of the death.
Autopsy findings must be correlated with the information given concerning what happened
during the events prior to death.
The following photographs are necessary:
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Front and the back of the body
Close-ups of the face
Mucosa of the upper and lower lips
Eyes showing any petechiae
Front, sides, and back of the neck
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Front and backs of the hands and forearms
Chest plate and abdomen opened up
External genitalia
Anus
Fronts and backs of feet
Wrists and ankles
Reflected scalp
Brain
Chest cavity before and after removal of parietal pleura
Testes and other reproductive organs
The body should always be transported sealed in a body bag and with the hands bagged, in case
they contain any trace evidence.
AUTOMOBILE vs. PEDESTRIAN
In an auto-pedestrian death, the decedent is typically struck by the front of the vehicle. The
initial impact occurs when the bumper strikes the decedent’s leg, typically causing a fracture of
the tibia and/or fibula, femur, contusions of the muscles of the legs, and abrasions and/or
lacerations along the legs. The primary impact point is the best indicator of the decedent’s
position at the time of the impact.
No primary impact on the legs of the decedent may indicate an unusual position when struck by
the vehicle, such as lying down in the roadway. This is significant because the investigation
should then focus on why the decedent was in that position, such as intoxication, an altercation
in which the decedent was knocked down, or a suicide attempt.
A secondary impact occurs when the decedent is thrown up on the hood and strikes the
windshield. This can cause blunt force trauma to the head and the upper body and sometimes
can be the fatal blow rather than the initial impact from the bumper. When larger vehicles are
involved, such as trucks and SUVs, the decedent may be pushed under the vehicle instead of
over the hood.
The primary focus should be on identification of the decedent and establishing the cause of the
incident as either driver or pedestrian error. Document weather conditions at the time of the
incident such as rain causing the pavement to be wet, fog, snow, and/or high winds.
Examine the vehicle that struck the decedent and measure the distance of the front bumper to
the ground. This should be consistent with the height of the impact on the legs of the decedent.
Bumper injuries to the leg typically involve fractures of the tibia, fibula, and femur, contusions
of muscles of the leg, and abrasions and/or lacerations on the legs. As a result of the impact, a
hemorrhage deep in the muscle may not be visible on the legs. Cutting into the back of the legs
to document the site of the impact is often necessary. Place a measuring tool (ruler) in the
photograph when measuring the height of the bumper injuries for documentation purposes.
(If the impact area measures slightly lower than the height of the bumper, this indicates that
the vehicle was braking at the time of impact, causing the front bumper to dip.)
There may be superficial parallel linear and irregularly linear stretch type tears/lacerations in
the groin (inguinal) regions. These tears are often seen when a pedestrian is struck directly or
obliquely from the back.
It is important to save the pedestrian’s clothes especially in the case of a hit and run accident. A
good practice is to wrap the body in a white sheet for transport so that any evidence on the
clothing could fall on the sheet upon removal of the clothing.
The vehicle should be inspected for damages to see the correlation of the damages with the
injuries on the body. If bumper injuries are absent, then the pedestrian was most likely struck
by the vehicle’s side.
In cases with bumper injuries, the apex of the triangular portion of bone that has been
fractured points in the direction that the vehicle was traveling. Physical evidence on the vehicle
can include:
• Fingerprints
• Blood evidence
• Pattern transfer from clothing/footwear
• Hair found in a broken windshield
It is very important to evaluate witness statements, scene findings, and the vehicle in motor
vehicle accidents, whether involving a pedestrian or not.
Important questions to ask at an auto-pedestrian scene are:
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Was the pedestrian walking, standing, or lying on the road?
What direction was the vehicle traveling?
Did the driver apply the brakes at the time of impact?
Did the driver see the pedestrian before the collision?
Was there any evidence of the vehicle on the body?
What was the speed of the vehicle at the time of the impact?
TRAFFIC FATALITIES
The basic mechanics of a traffic fatality include a moving vehicle striking a stationary object,
which causes the vehicle to abruptly stop. The driver/passenger, who is still moving forward,
then strikes the stationary vehicle. There are four types of collisions:
- Head-on collision. Injuries arise from the face hitting the windshield, impact to the steering
wheel, and knees striking the dashboard. Vehicles are constructed to withstand this type of
impact.
- Side impact (T-bone). Involves injuries caused by direct impact, or being thrown against the
opposite side of the vehicle. This type of impact can have fatal consequences even at low
speeds because the impact usually causes the head to strike the pillar.
- Rear impact. Injuries arise from being thrown into the front of the vehicle when the
passenger/driver is unrestrained. Vehicle seats are designed to absorb the impact of this type of
crash.
- Vehicle rollover. Collapse of the vehicle roof can cause various types of injuries such as skull
fractures, spinal fractures, and chest and abdominal injuries. Unrestrained occupants may be
ejected from the vehicle.
Motor vehicle accidents are most often accidental but they can be classified as homicidal or
suicidal depending upon the information obtained at the scene and scene reconstruction.
People who die in motor vehicle accidents usually die of multiple blunt force injuries. The
injuries noted often can be patterned. To determine if the person was the driver or the
passenger, and if the person was wearing a seat belt, certain patterns may help determine their
position. Adequate scene information is needed in order to help determine the cause of death,
and obtaining witness statements may help clarify autopsy findings.
Find out if the driver has some underlying medical condition, as some motor vehicle accidents
may be caused by the person’s medical condition, or, if there is little damage to the vehicle, the
medical condition may be the cause of the person’s demise rather than the vehicle accident.
Look carefully in the vehicle or in the driver’s belongings for medications and indications that
the driver and/or passengers had been drinking. Most often the reason for motor vehicle
accidents is that the driver is under the influence of some drug, most commonly alcohol by
itself or with other drugs (medications).
Examine the soles of the shoes to help to determine who the driver of the motor vehicle was,
as the soles may show the transfer pattern of the pedal. The pattern of the gas pedal and not
the brake pedal shows acceleration, which could be evidence of suicide when a person has
driven into a fixed object without turning or stopping to avoid the accident.
Toxicological analysis of blood and vitreous fluid of the driver is necessary in motor vehicle
accidents to determine if driver impairment due to any drugs (including alcohol) caused the
accident. Testing the passenger(s) is also important, especially in case the passenger turns out
to be the driver of the vehicle.
For motor vehicle accidents, thorough evaluation of the scene is important, along with
reconstruction and evaluation of the vehicle. Take numerous photographs, including
photographs of how the person(s) was/were found in the vehicle in case the cause of death is
not related to trauma but possibly to positional asphyxial or another cause.
The body should be transported secured in a body bag with clothing still on the body. Standard
precautions have to be followed.