FORENSIC EVIDENCE COLLECTION:
A Medical Examiner's View

Up Schedule Objectives Faculty

SCHEDULE

7:15 - 7:45 Registration
7:45 - 9:30 "Slovenly Sleuthing in the ED and the ICU"

Cause and Manner of Death

Importance of Certain Specimens and Preservation of Evidence

Importance of “original blood” specimen and critical nature of proper labeling

Gastric washings or vomited material 

• Hematomas and large blood clots
Head and facial hair (gunshot residue for range of fire?) • Head hair (repeated drug abuse?)

Blood for carbon monoxide • Paint chips and headlight glass (which vehicle?)
Substance allegedly abused (what was it?)

Chain of Custody

Proper Handling of Clothing in Violent or Suspicious Death Cases

Postmortem Care and Documentation in Special Cases

How to handle the body to make it possible to determine:

Chest tube hole vs. chest tube placed through bullet wound? • Hospital needle puncture vs. one that was self-inflicted? • Surgical incision vs. an incision made through a wound? • Airway in the esophagus, deliberately or inadvertently? • No urine vs. catheterized without documentation? • No internal bleeding vs. blood previously drained?

 

9:30 - 9:45 Break

 

9:45 - 11:30 Forensic Potpourri

Asphyxia: Strangulation, Choking, Auto-erotic deaths
Burns, Fire, and Arson • Forensic Toxicology • Sudden Infant Death Syndrome

 

11:30 - 12:30 Lunch (on your own)

 

12:30

 

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1:30

 

Motor Vehicle Deaths

Questions To Be Answered:
Who was driving? Was it accidental, homicide, or suicide? 
Did natural disease cause the crash?

Wound patterns and medicolegal evidence

Importance of documentation in the ED

 

1:30 - 1:45 Break

 

1:45 - 2:15 Expert Witness Testimony

Practical advice on how to communicate with the jury
…and be careful of lawyers (from an MD with thousands of hours of courtroom experience)

 

2:15

 

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3:30

 

Medical Photography and Documentation

Photography has been widely used for decades in cosmetic, maxillofacial, and other specialties. With impending changes in reimbursement for complications of medical care and hospitalization (e.g. decubiti), it will be increasingly important to document conditions at the time of admission.

Topics include: perspective, scale, lighting, “walk-up” sequences, and thinking ahead


 

 

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