William The Coroner’s Forensic Files

Friday, 28, October, 2011

Graduate School–Deaths in Custody

Filed under: Forensics,Teaching — williamthecoroner @ 12:21

I. Situations
A. Arrest
B. Jail/Prison
C. Hospital/nursing home
D. Controversy
1. Lawsuit
2. Documentation
3. Consulting another agency
4. Keep your mouth shut
a. Forbes
b. Attica
5. Toxicology

II. Arrest
A. Occur after a violent struggle
1. After the arrest, combination of stress and drugs
2. Struggle, subdued, quiet, not breathing
3. Minor, if any injuries
4. Drugs
a. alcohol
b. P.C.P.
c. cocaine
5. Handcuff injuries

B. Mechanism
1. Catecholamine release
2. Increase heart rate, contractility, O2 demand
3. Overdrive heart, cause arrhythmia
4. After arrest
5. People complain of retribution

C. Physiologic effects
1. Cardiac arrhythmia
2. Lucky, enlarged heart
3. Really lucky, toxicology

III. Hogtie/chokehold/tazer
A. Hogtie
1. Wrists tied/cuffed to ankles
2. Rope around neck
3. Positional asphyxia
a. Ruled out

B. Chokehold
1. Bar-arm
a. Forearm to compress windpipe
b. Dangerous, not taught
c. Sudden death
2. Carotid sleeper hold
a. Moderately safer
C. Tazer
1. Shoot barbs electric charge
2. Cardiac arrythmias

IV. Police shootings
A. Tremendous controversy
B. Lawsuits

V. Jail/Prison
A. Jail vs. Prison
1. Jail, short term confinement
a. Minor offenses
b. Awaiting trial
c. Farmed out for space
d. Less professional staff
e. Lake County Cases
i. Smuggled drugs and jewelry
ii. Hanged

2. Prison long term
a. Worse folks
b. Tougher crowd
c. Interpersonal violence

B. Initial stages of confinement
1. Adjustment difficult

C. Prison violence
1. People don’t know how to behave
2. Poor impulse control

D. Disease
1. Ageing population
2. TB, Hepatitis, HIV
3. Confining authority responsible
a. Guard “slow code”

VI. Hospital/nursing home
A. Psychiatric hospitals
1. Suicide is a risk
2. Determined people can find a way
3. Choking on toilet paper

B. Dementia
1. Escape
2. Poor quality of care
C. Restraints

VII. Techniques
A. Photography
B. Incise wrists and ankles
C. Filet back
D. Analogue of child abuse

Wednesday, 26, October, 2011

Graduate School–Rape and Sex Homicides

Filed under: Forensics,Teaching — williamthecoroner @ 12:21

I. Introduction
A. Types of rape
B. Defenses to rape
C. Date rape etc.
D. Rape kit

II Types of rape
A. Rape is a crime of power and control
B. Rapists not “oversexed”
1. Many have regular partners
2. “Power rush when rapists realize they have total physical control over someone weaker; that joy at degrading and terrorizing another human being for the sexually expressed thrill of it.”—Alice Vachss
C. Types of rape
1. Power-assertive
a. 40%
b. Values
i. Machismo
ii. Aggression
iii. Traditional sex roles
iv. Cop wanna-bes
c. Random victims
d. Humiliation, trauma
e. Ejaculation on victims/urination on victims

2. Power-reassurance
a. 28% of perps
b. “Gentleman rapist”
c. Characteristics
i. of average intelligence
ii. not physically aggressive
iii. insecure about his masculinity
iv. socially-deficient
v. unable to develop relationships
d. Knows the victim
i. stalking
ii. erotomanic component
e. “Relationship
i. emulate foreplay
ii. give victim phone number
iii. set up second date
vi. fantasize about relationships

3. Anger-retalitatory
a. 28% of perps
b. Substance abuse
i. impulsive
ii. anger towards victim
iii. dumb
c. Anger related
d. spontaneous attacks to hurt
e. Leave evidence

4. Amger-excitiation
a. 5% of rapes
b. Charming, intelligent and elusive
c. Enjoys inflicting pain and humiliation
i. Anal eroticism
ii. Oral-genital contact after ano-genital contact
iii. Urinate upon victim
d. Murder for the thrill of it.

III Defenses to rape
A. Three defenses
1. It never happened
2. It was consensual
3. It wasn’t the defendant
a. “SODDI” Some Other Dude Did It

B. It never happened
1. Cast aspersions on the mental status of the victim
2. Vulnerable victims
a. Mental illness
b. Retardation
c. Incarceration
3. “Reasons to lie”
a. Misattributed paternity 5-14%
b. Pregnancy
4. Put victim on trial
a. Jokes about rape
b. Burden of proof

C. It was consensual
1. Drugs and alcohol
2. People will lie.

D. It wasn’t the defendant
1. “SODDI” Some Other Dude Did It

IV. Date rape etc.
A. Date rape
1. Use of alcohol or drugs to lower inhibitions

B. Statuatory rape
1. Intercourse below age of consent (16)
2. Intercourse between persons >4 years apart

C. Abuse of power
1. Quid pro quo—tit for tat
2. Power differentials
a. Student-teacher
b. Prisoner-guard
c. Doctor-patient

V. “Rape kit”
A. External examination
1. Look for abrasions, contusions, lacerations
B. Forensic evidence
1. Pubic hair, DNA, Spermatazoa
2. Sperm lasts days
3. DNA Male inside, female inside

VI. Sex homicides
A. Asphyxial games
1. Choking

B. Homosexual homicides
1. Overkill
2. Multiple stabbings

Tuesday, 25, October, 2011

Bad Blogger

Filed under: Teaching — williamthecoroner @ 14:33

I’ve been stuck in grading Hell for the past couple of days, haven’t been able to do much of anything but sort papers and try to meet deadlines. For one thing, evaluating folks on 15 Lykert scales and trying to give meaningful feedback is just hard to do properly. It takes a lot of observation and thought, and it’s impossible to do quickly. Oh, you could just dash some BS off, but there’s too much of that in education.

Secondly, there was a schedule change that I wasn’t made aware of, and for the next two weeks, I’m double booked for the exact same time. Yep. Two places at once. I have to disappoint one group or the other, and so I did, but I really feel bad that I didn’t catch it sooner.

Histology

Filed under: Teaching — williamthecoroner @ 13:11

Esophagus and stomach. A re-review of the entire GI track.

Monday, 24, October, 2011

Graduate School–Environmental Issues

Filed under: Forensics,Teaching — williamthecoroner @ 12:28

What Environmental things cam lead to cancer?

I. Introduction
Chemical and environmental hazards
Environments
Heat
Cold.

II. Heat
A. Summer
Heat and Humidity
Compromised individuals
1. Children
2. Elderly
a. Don’t drink
3. Breathing disorders
4. Maine nursing homes
5. W. Jones, Atlanta GA, 115.7 F. Endothelal damage, DIC, shock

B. Microenvironment
1. Automobiles

C. Bodies attain temperature of the environment
Be careful with a body in a 120 deg. car.

III. Cold
A. Conditions
1. Not confined to outdoors
2. Aged, infirm, young
3. 50’s, draughts, damp clothing,
4. Depression, hypothyroidism

B Temperatures
1. 37-32 feeling cold
2. 32-24 LOC, bradycardia, hypotension
3. record 60.8F

C. Frostbite
1. First degree—cold erythema
2. Second degree—blisters
3. Third degree—freeezing gangrene

C. Autopsy findings
1. Pinkness of livor
2. Gastric ulcers
3. Pancreatitis
4. Strips of hemorrhageing in iliopsoas
5. Acetonemia

D. Paradoxical undressing
1. Hide and die

IV. Starvation
A. Elderly, Infirm, Young
1. People who can’t take care of themselves
2. Dependency is bad
3. Children aren’t small adults
a. They have different nutritional needs.
b. No one-size fits all diet
i. Vegan cat
ii. Elderly tea-and-toast
iii. Headache in 8-year-old

B. Bottom line
1. 1500-2000 calories to maintain weight
2. 40% weight loss life threatening
3. 50-60 days no food BUT with water
4. 10 days without water

C. Conditions
1. “Failure to thrive”
a. Poor feeding
b. Depression (adults)
c. Dementia
2. Situation
a. At home vs. in institution

D. R/o Natural disease

Thursday, 20, October, 2011

Histology –The Small Intestine

Filed under: Teaching — williamthecoroner @ 18:00

Not much of a lecture today. Not much of a day today. Overslept, got lost on the way to work, left my lecture notes…somewhere. When I got to class, noticed that my pants were falling down. All in all, I’ve had better days.

It is interesting that I now get questions that aren’t just about histology or medical school applications, but more about life in general. To day is was “Do you think I should study abroad?” I forebore the obvious straight line, but I said I have rarely regretted trying something, that not everything works, but most things are worth a shot.

Monday, 17, October, 2011

Vascular Pathology I and II

Filed under: Teaching — williamthecoroner @ 21:21

Vascular Pathology IVascular Pathology II

So There I Was

Filed under: Teaching — williamthecoroner @ 21:11

Sitting quietly in my office trying to catch up on papers now that IQ group is finished, in a pleasant,warm haze, when I get a phone call.

“Doctor Bligh-Glover,did you remember you were supposed to teach the dental students this week?” I check my Google calender. “No, that was NEXT week.”

“Oh, they must not have told you when they changed it.”

“When am I supposed to do this?”

“Fifteen minutes ago.”

Words cannot express the rush of adrenaline that went through me as I went down four flights of stairs, across the parking lot, and into the lecture hall. Then I learned what my lecture topic was to be. Two hours on atherosclerosis and vessel pathology. THAT lecture, was in my Google Docs, thank goodness, so I was able to do the bloody thing, but this arrangement was frankly, sub-optimal.

Asphyxia

Filed under: Forensics,Teaching — williamthecoroner @ 12:00

I know, you were waiting breathlessly for this one…

Asphyxia

I. Introduction
A. Anoxia vs. ischemia
B. Neck compression
1. Hanging
2. Ligature strangulation
3. Manual
C. Smothering
1. Burking
2. Pillow
3. Grain elevators
D. Choking
1. Bolus of food
2. Young or incapacitated
E. Positional (mechanical asphyxia)
1. Unable to make respiratory movements
2. Crushing of chest
3. Crucifixion
F. Poisonous environments
1. Manure pits, coal mines, gas ovens
2. Near dry ice
3. Freezers
H. Chemical asphyxia
1. CO
2. CN

II. Anoxia vs. ischemia
A. Anoxia lack of oxygen
B. Ischemia lack of blood flow
C. Ischemia worse
1. Re-perfusion injury
2. Lack of metabolic substrates
3. “Starve and strangle”

III. Cervical Compression
A. Hanging
1. Pressures
a. Venous 5#
b. Carotids 12#
c. Airway 40#
d. Vertebrals 65#
e. “Vascular hanging” impede outflow
f. Tardieu spots

Asphyxia p. 2

2. Suspension is not necessary
a. Complete noose
b. U-shaped
c. Chair or bet

3. “hangman’s fracture”
a. Short drop
b. Long drop
c. Cruel ones (piano wire)

IV. Strangulation
A. Ligature
1. below larynx
2. Homicidal, accidental suicidal
3. Spanish windlass
4. Belt as control

B. Manual
1. Pattern injuries, ♀ by ♂

V. Smothering
A. Block off air with soft object
1. Pillow over face
2. Final exit suicide.
3. Avalanche

B. Torn frenulum
Broken teeth

VI. Choking
A. Café coronary
B. Victims
1. Impaired. Alcohol.
2. Young
3. No teeth.

VII. Positional asphyxia
A. Pressure on chest
B. Industrial accidents
C. Crucifixion

Asphyxia p. 3

VIII. Exclusion of oxygen
A. Gases
1. Manure pit
2. Hiding in ice cream truck
3. CO2 heavier than air
4. Canary in coal mine

B. Dangerous environments
1. Refrigerators

IX. Chemical asphyxia
A. CN
1. Poison electron transport chain.
2. Cyanide is natural.

B. CO
1. Irrevocably bind to hemoglobin
2. Smoke, auto exhaust, smoker
a. Smoke inhalation 90% in healthy
b. Fatal 40-90 depending on disease
c. Car 40-60%
d. Smokers 10%
e. Non-smokers 1-5%
f. Don’t put gurney behind the ambulance

X. Drowning
A. Sweet water

B. Salt water

C. Retardation of decomposition

D. Diatoms

Friday, 14, October, 2011

Burns and Electrocutions

Filed under: Forensics,Teaching — williamthecoroner @ 12:03

Shocking that this is so late…
Burns, Explosions, Electrocutions
I. Thermal injuries
A. Classification of burns
1. First degree—sunburn, superficial
2. Second degree—blistering
3. Third degree—full thickness burns
No pain, scar
Contractutres and keloids
4. Fourth degree burns—charring
5. Severity—
a. Intensity of heat
b. Duration of exposure
c. How hot object conducts heat/density
Cell injury 65 C 149 F protein denaturati0n, burn toxins.
Early death shock, late (week) uremia
B. Rule of nines
1. Head 9 %
2. Trunk 18%
3. Back 18%
4. Arms 9%
5. Legs 18%
6. Gentials 1%
7. Different for kids

C. Incineration of bodies
1. Cremation 1.5h at 1500 F $8.00 natural gas
2. House fire under 1300 F
3. Obesity adds fuel,
4. Clothes may protect or act as wicks
a. Mr. Roberts shirts
b. Polyester melts
5. Rayon “Mother-in-law silk”

D. Fire artifacts
1. Heat fixation
2. Heat desquamation
3. Pugilistic attitude
4. Skin splits
a. follow muscle fibers
b. perpendicular due to trauma
5. Epidural
a. blood boils in brain out of saggital sinus
6. Heat fractures
7. Decomposition delayed, cooking

E. CO
1. Flash fires
a. Granger road accident
b. Self-immolation
2. Can be quite high
3. Higher CO, better health of victim

F. Soot below larynx

G. Scalding
1. Liquids over 120F
2. Mouth more resistant than skin
3. Palm more resistant than face,
4. Duration 20 s 131 F, 1s @ 150 F
5. Clothing worsens damage

II. Bombs
A. Identification & reconstruction

B. Blast
1. “overpressure”
2. Burst eardrums, hollow viscera
3. Injury to lungs
4. Trauma

C. Fire
1. High order explosions
a. Liberate lot of energy
b. Conversion of chemical to thermal energy

2. Incendiary
3. Napalm
a. 1800 F
b. Jellied gasoline Napthitic and palmitic acids (detergent)
c. Sticks and burns
d. Asphyxia flash and inhalation
4. Magnesium, Phosphorus
a. Burn really hot
b. Burn on contact with water

D. Projectiles

E. Home made bombs
1. Molotov cocktails
2. Practice grenades
3. Smoke grenades
4. Pipe bombs
5. 1 pint of gasoline energy of 2 sticks of dynamite
6. Plastique

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