Atlas of Forensic Pathology

CHAPTER 3 Basics of Death Scene Investigation 17

DOCUMENTATION OF DISCOVERY HISTORY AND TERMINAL EVENTS The history regarding the terminal events is important especially if the cause of death is a condition that may produce no, minimal, or non-specific autopsy findings and require additional testing that is not normally obtained (eg, a fatal allergic reaction, and possible mast cell tryptase testing). In addition, the history regarding the terminal events may help guide the autopsy procedure. For example, if the decedent was witnessed to suddenly collapse, with little or no previous symptoms having been voiced, a cardiac condition or a pulmonary thromboembolus is a likely source and can determine how the organs are removed at autopsy and the thoroughness of the cardiac examination, such as choosing to include dissection of the sinoatrial and atrioventricular nodes. The discovery history is an important component of infant death investigation, with the determination of who placed the infant to sleep, who last knew the infant was alive, and who found the infant dead being important pieces of information; however, the discovery history can provide utility to adult death investigations as well. For example, if a boyfriend says that his girlfriend was acting fine when he left the room but that he found her dead after he returned from smoking a cigarette, suspicions of a subtle traumatic event such as a strangulation could be considered. PEARLS & PITFALLS If a liquid substance, such as soda pop or beer, is found adjacent to the decedent, especially if in an open container, or in a container that has had the seal broken and partially consumed, it is prudent to consider taking a sample of the liquid for potential future toxicologic testing. If the decedent is found to have died related to consumption of a drug or toxin, the family may allege that they were given the substance in the drink. Without a sample of the substance to test, this allegation could not be adequately confirmed or refuted. PEARLS & PITFALLS If more than one individual or pet is dead at the scene, an environmental cause (eg, carbon monoxide poisoning) or similar circumstance should be considered. If one individual and one or more pets are dead at the scene, determining whether the pets died at the same time as the decedent is important. If there is evidence the pets were alive following the individual’s death (eg, scratched doors, presence of feces or urine), the likelihood of an environmental type death is less (Figure 3.3).

Figure 3.3. Environmental-related deaths. When there are two or more decedents and no obvious injuries that would have caused the death are apparent, an environmental hazard should be considered. If pets are found dead at the scene along with the decedent, an environmental hazard should also be considered. Determining whether the animal has been alive since the death of the individual can assist. In the photo (Figure 3.3), numerous piles of dog feces would be evidence that that dog was alive for some period of time after the decedent’s death, unless the animal was known to urinate/defecate in the house. Copyright © Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 2023