Principles of Forensic Pathology 1st Edition by James Gill,Susan Ely 9780323986397 0323986390

Chapter 1. Forensic pathology: overview

Introduction: who we are and our unique role as physicians

Historical perspective

Coroner versus medical examiner systems in the United States and abroad

What constitutes “medical examiner/coroner jurisdiction”?

The forensic autopsy (see also Chapter 5)

Death certification (see also Chapter 3)

Planning for a career in forensic pathology: advice to future trainees

Chapter 2. Thinking forensically: planning, anticipating, observing, documenting, inquiring, synthesizing, opining, and communicating, in that order

The importance of context

The role of inference: releasing the grip on exclusively anatomic findings

Objectivity, neutrality, and observational acumen: being autoptic

Anticipating, planning, observing, documenting, inquiring, synthesizing, opining, and communicating, in that order

Preautopsy analysis and planning

Anticipating questions and future issues

Postautopsy analysis and planning

Observing and documenting

Inquiring

Interpreting and synthesizing

Opining

Communicating

Chapter 3. The pathophysiology of death and death certification

The pathophysiology of death

Death certification

Other death certificate fields and miscellaneous issues

Key death certification tips

Chapter 4. The scene investigation, postmortem changes, and time of death

The written narrative

Postmortem changes and establishing the basis for postmortem interval estimates

Time of death versus time of pronouncement: reports and testimony

The trauma scene

Crime scenes and deaths in public view

Field challenges in the recognition and identification of human skeletal remains

Attempts at postmortem concealment of bodies in homicides (dismemberment, incineration, and burial)

Mass fatality incidents (MFI)

Avoiding the top 10 investigative oversights

Chapter 5. The forensic autopsy

The big picture

The forensic autopsy: general tips

Photography

Radiography

Radiologic tasks and tips

Evidence

The standard external autopsy examination

The standard internal autopsy examination

Cardiovascular pathology

Neuropathology

Forensic anthropology

Toxicological sampling

Histology

Microbiology

Approach to the trauma autopsy

Special techniques and examinations

The negative autopsy: the importance of what we exclude

Organ and tissue donation

Dissections and the funeral home

Religious objections to autopsy

The forensic team: investigators, technicians, clerical staff

Quality assurance

Safety in the autopsy environment

Chapter 6. Approach to forensic perinatal and pediatric pathology

Initial investigation

Primary scene

Reenactment

Medical history

Radiology

Photography

The pediatric autopsy

External examination

Postmortem changes and artifacts

Evidence of therapeutic intervention

Clothing

Injuries

Internal examination

Histology

Neuropathology

Toxicology

Metabolic studies

Microbiologic studies

Molecular genetics

Forensic odontology

Forensic biology

Forensic anthropology

Pediatric trauma

Fatal child abuse syndrome (aka, battered child syndrome) and abusive head trauma

Patterns of inflicted injury: infants versus toddlers/preschoolers

Asphyxia

Bathtub drownings

Thermal injuries

Neglect

Consultations

Child fatality review boards

Mandatory reporting

Home births: stillbirth versus live birth

Approach to the live born versus stillborn infant/fetus and possible neonaticide

What is SUID, SIDS, SUDC, and SUDP?

Conclusion

Chapter 7. Approach to natural deaths (adult)

The sudden and unexpected death

Specific forensic issues in sudden cardiac death

Pulmonary thromboembolism

Seizure-related deaths and epilepsy

Anaphylaxis

Alcohol use disorder (formerly known as chronic alcoholism) and chronic substance use disorder

Pancreatitis

Gastrointestinal hemorrhage (GIH)

Bronchial asthma

Dementia and old age

Diabetes mellitus

Obesity as a cause of death

Bronchopneumonia

Sudden death and chronic renal disease

Sudden death from endocrine disorders

Sudden death and psychiatric disease

Sickle cell disease and trait

Human immunodeficiency virus

Chapter 8. Approach to medical intervention-related deaths

Therapeutic complications

Deaths related to cosmetic, weight loss, and dental procedures

Accidents and homicides in medical settings

Chapter 9. Approach to firearms deaths

Deaths due to trauma

Firearm injury

Conclusion

Chapter 10. Approach to blunt, sharp, and transportation deaths

Blunt injury

Sharp injury

Chop injury

Transportation injury

Chapter 11. Approach to asphyxial deaths

Asphyxia

Chapter 12. Approach to burns, blast, and radiation injury

Thermal and inhalational injury

Blast/radiation injury

Animal attacks, domestic and in the wild

Chapter 13. Approach to environmental deaths

Drowning

Electricity

Environmental exposure: hyperthermia

Environmental exposure: hypothermia

Chapter 14. Approach to toxicological deaths

History and scene investigation

Autopsy examination

Toxicology testing

Death certification

Examples of drug intoxications

Natural disease in the presence of intoxicants

Toxicology testing and trauma deaths

Toxicology testing following hospitalization

Interpreting toxicology test results in the decomposed body

Drug packers (“Mules”)

Suicide versus accident

The apparent drug intoxication death with negative toxicology and no anatomic cause

Legal implications of mixed drug intoxications and other special toxicologic considerations

Miscellaneous toxicological issues

Toxicological considerations in pediatric deaths

Chapter 15. Special topics: in-custody deaths, physical altercations, neglect (adult), approach to unexpected hemorrhage, and delayed and concealed homicides

Deaths in detention centers/correctional facilities/police custody

Deaths in the setting of police restraint

Hyperactive delirium (so-called “excited delirium”)

Suicidal behavior in law enforcement encounters

The investigation

Police investigations and the medical examiner/coroner

Physical struggles: contact, altercations, and the death certificate

Abuse and/or neglect in the debilitated adult or teen

Approach to hemorrhage of unclear origin (unexpected hemorrhage found at autopsy)

Delayed deaths due to remote injury: issues and concepts

Approach to dismembered remains and other forms of postmortem concealment

Chapter 16. Communication

Overview

Verbal: one-on-one communication

Testifying in legal forums

High-profile deaths, media inquiries, and press offices

Public speaking: case presentations, lectures, and teaching

Written communication

Chapter 17. The forensic pathologist’s public health role

Introduction

Passive surveillance

Active surveillance

Death review teams

Identification of missing and unidentified persons

Detection and characterization of infectious disease

Conclusion

Chapter 18. Developments in postmortem imaging

Introduction

Approach to PMCT interpretation

CT reporting

Radiologic identification

Postmortem CT angiography

Image-guided procedures

Postmortem and decomposition changes on imaging

Mummification, skeletonization, predation, and charred remains

Natural disease

SARS-CoV-2 relating findings

Blunt chest trauma

Penetrating injury

Drug intoxication

Pediatric imaging

Foreign bodies

Pro tips/pearls

Forensic pathology postmortem imaging training curriculum: the New Mexico experience

Future directions

Chapter 19. Recent and ongoing technological advancements in forensic pathology practice

The role of molecular genetics in sudden and unexpected deaths

Rapid DNA

Digital fingerprinting

3D printing and anthropology

Facial reconstruction and recognition