Name(s): ______HASPI Medical Anatomy & Physiology 02c Lab Activity Period: ______Date: ______

The following outlines the standard procedure and protocol for an autopsy performed by a medical examiner or coroner.

Step 1. Preliminary Procedures Details are crucial to an autopsy! Anyone who will be reading the autopsy report will need to be able to follow these details step-by-step. This starts with identification of the victim (if known), case number, as well as the location, date, time, and reason for the autopsy. Any other special considerations also need to be recorded.

Step 2. Summary of Known Circumstances http://www.pathguy.com/lectures/autopsy_6_11_07_1.jpg This is a short summary of the known facts about the victim. This most often includes the victim’s sex, race, and age. If known, it will also include a description of the circumstances in which the body was found. Any additional information on the victim’s plans or activities before or after death will also be included.

Step 3. Review Documents and Examine Evidence Any reports created during the police investigation should be reviewed before autopsy. This allows for the medical examiner to have an idea of what he or she may be looking to find. In some cases, the type and shape of a weapon are crucial details in determining if any of the injuries found on the victim may be connected to any weapons found at the scene.

Step 4. External Examination of the Body It is important to note any and all external details before disturbing the victim. Simple notes like the condition, state, or position of an item of clothing may be the detail needed by investigators to piece together a crime scene. Photographs are normally taken of the victim during this phase of the autopsy. In general, an autopsy report will want the following details for the external examination: • Body height, weight, and hair color • Any clothing, valuables, or jewelry located on the body • Presence of rigor, livor, or algor mortis (rigor mortis is the stiffening of muscles post-mortem, livor mortis is any discoloration caused by blood settling due to gravity, and algor mortis is heat loss from the body post-mortem) • General body condition • External body details, scars, incisions, or punctures

Step 5. Victim Identification In some cases, the victim’s identity is unknown and steps must be taken to find their identity. Identification is also necessary if a victim’s identity is probable but not certain due to facial distortion. This may include the following: • Identifying clothing • Dental exam • Fingerprints • X-rays • Identification of any external markings (tattoos, scars, piercings, etc.)

85 Step 6. Internal Examination of the Body A Y-shaped incision is made on the thoracic and abdominal region of the victim. If necessary, the skull is also opened, and the brain is removed. An evaluation and description of all body organs is made with any injuries or abnormalities noted. In addition, every solid organ is removed and weighed for comparison. The autopsy report contains a list of organs that are evaluated.

Step 7. General Description of the Body Organs It is just as important to describe normal condition of the body organs as it is to describe abnormal. For this reason, a comparison of the victim’s organs to normal conditions is important. This can be dependent on average height and weight of the victim. Any abnormal organ conditions may require tissue collection, and possibly microscopic examination.

Step 8. Specific Description of Wounds or Injuries Any abnormal conditions, injuries, or wounds found either externally or internally need to be evaluated and detailed. A connection between the type of injury or wound to a weapon or cause of death is also hypothesized at this step. Common causes of death that are determined during autopsy include: • Blunt force trauma (car accident, bat, hit with fist, etc.) • Rifle or handgun (often a single entry wound) • Shotgun (many small entry wounds) • Penetrating or cutting trauma (knife, axe, etc.) • Asphyxiation (hanging, strangling, or drowning) • Burning (fire, electrocution, or lightning) • Child abuse (infant death or Sudden Infant Death Syndrome)

Step 9. Establish Evidential Chain-of-Custody If it is possible that the victim’s death was caused by another person, the autopsy report and any evidence discovered will need to be turned over to the police. If it is determined that the cause of death was accidental or caused by a suicide, the autopsy report is handed over to a coroner. In either case, a chain of custody for the autopsy evidence between the medical examiner’s office and either the police or coroner must be established.

Step 10. Record of Specimens Retained and Examinations Performed Following the physical autopsy examination, it may be necessary to submit evidence specimens, tissue, or body fluid samples for examination. These may require microscopic or toxicological examination by an additional agency. The medical examiner or coroner will compare the results to the findings of the physical autopsy examination. This will allow for further confirmation or to identify possible issues with the hypothesized cause of death.

Note on Negative Findings It is common for an autopsy report to contain more negative findings of conditions that are not present, than abnormal conditions that are present. These statements within the autopsy report are just as important as any abnormal findings reported, so it is important not to overlook these within the autopsy report.

Indiana Government Services. 2012. Part 5 Autopsy Procedure. http://www.in.gov/ctb/files/section501.pdf, Section 502, pp. 140-151.

86 Fetal pig Scalpel Paper towels Dissecting tray Forceps Gloves Ruler Scale Sutures Weighing dish

Scenario Your team is part of the HASPI Medical Examiner’s office. A body has been found in the small town of Uli City. The body was found in suspicious circumstances and has been brought to you for autopsy. The following police report came in with the body.

POLICE REPORT

Responding Officer Jermaine Shepherd Date/Time 1/2/13, 3:54 am

Case # 451-22-0142 Victim Piper Piglet Location Babe Pond, Uli City

Date of Birth 1/2/12 Date of Death 1/2/13 Species: Pig

Narrative: At 3:31 am on Wednesday, January 2, 2013 a body was found in Babe Pond. The body was later identified as Piper Piglet by the victim’s mother, Paula Piglet. The mother stated that Piper had disappeared from their backyard at 6:30 pm on Tuesday, January 1. The victim’s house is located approximately 0.4 km south of Babe Pond and the backyard is unfenced.

The body was found enclosed in a green plastic trash bag tied closed with twine. The front legs of the victim had pierced http://screamingsushi.com/blog3/wp-content/uploads/2007/06/dead_pig.JPG the bag (see crime scene photos). Kat Kitten was at the pond late catching frogs and noticed the legs protruding from the bag. Kat immediately called the police.

After further interview of the mother, she did not report her child as missing because Piper had the tendency to wander off. She only noticed he was missing when he did not show up for dinner. No witnesses observed Piper in the backyard or near Babe Pond.

An autopsy has been requested due to the suspicious nature that the body was found.

Evidence Collected: Green plastic bag Black twine Two cigarettes Water from pond

87 ✔when complete Part 1. Preliminary Procedures Step 1 Read the scenario and police report. Step 2 Complete Part 1 of the Autopsy Report with information from the police report. Part 2. Summary of Known Circumstances Step 1 Read the scenario and police report. Complete Part 2 of the Autopsy Report with information from the police report. Step 2 You will need to check the body to determine the sex. Part 3. Review Documents & Examine Evidence Step 1 Complete Part 3 of the Autopsy Report with information from the police report. Step 2 Note any evidence that may help determine the cause of death. Part 4. External Examination of the Body Put on gloves and use a scale to weigh the body. Record the weight in grams in Step 1 Part 4 of the Autopsy Report. Step 2 Use the ruler to measure in cm the length from the tip of the tail to the snout. Step 3 Use the ruler to measure in cm the circumference of the abdomen. Step 4 Describe and record the color of the skin and hair. Step 5 Describe and record any identifying features, such as spots, hair location, etc. Make note of any other abnormal features on the external anatomy of the body. Step 6 This may include scars, incisions, puncture wounds, discoloration, marks, etc. Part 5. Victim Identification Step 1 The victim has already been identified and therefore this is not required. Part 6. Internal Examination of the Body Place the body on its back with the ventral surface Step 1 facing up in the dissecting tray. Using the scalpel, make a Y-shaped incision from the shoulders down to the umbilical cord. The Step 2 incision will need to go around the umbilical cord and down the sides to expose the abdomen. See the diagram for an example. Use the scalpel or scissors to remove the rib cage Step 3 and expose the lungs and heart. Use the “Fetal Pig” diagram and/or website on the Step 4 next page to identify the major organs that will need to be removed for examination. Start by removing the lungs and place them in the Step 5 weighing dish. Weigh and measure the length of the lungs. Record in Part 6 of the Autopsy Report. Place the lungs on a paper towel. It may help to http://www.biologycorner.com/resources/pig_incision2.gif Step 6 label the paper towel so you can keep track of each organ. Step 7 Remove, weigh, and measure the heart. Place it on the paper towel. Step 8 Remove, weigh, and measure the liver. Place it on the paper towel. Step 9 Remove, weigh, and measure the gall bladder. Place it on the paper towel. Step 10 Remove, weigh, and measure the stomach. Place it on the paper towel. Step 11 Remove, weigh, and measure the pancreas. Place it on the paper towel. Step 12 Remove, weigh, and measure the spleen. Place it on the paper towel. Step 13 Remove, weigh, and measure the small intestine. Place it on the paper towel. Step 14 Remove, weigh, and measure the large intestine. Place it on the paper towel. Step 15 Remove, weigh, and measure the kidneys. Place them on the paper towel. 88 Fetal Pig Diagram Go to the following website for a virtual fetal pig dissection with labeled images that can be used to assist during your autopsy procedure, if needed. Also consult the “Organ Description and Location” list on the next page.

http://www.whitman.edu/content/virtualpig

http://voyager.dvc.edu/~nmiller/biosc139/fetal_pig/fetalpig_diag02a1.jpg

89 Organ Description and Location Heart – located between the folds of the lungs. Must be cut free from the aorta and vena cava. Lungs – located in the chest cavity surrounding the heart. There will be a few lobes that must be cut free from the trachea and heart. Liver – located at the top of the abdominal cavity. It will be the largest organ and attaches at the back of the abdominal cavity. Pancreas – located under the stomach between the liver and intestines. Spleen – small organ located behind the stomach. Kidneys – shaped like kidney beans and located under the intestines. Will be visible when the intestines are removed. Small Intestine – located in the lower abdomen and held together with a thin tissue called mesentery. Will need to be cut free from the stomach and the large intestine. Large Intestine – located in the lower abdomen. Much shorter and thicker than the small intestine. Will need to be cut free from the small intestine and rectum. Stomach – located in the left upper quadrant of the abdomen next to the liver. Will need to be cut from the esophagus and duodenum. Gallbladder – located directly under, and sometimes attached to, the liver. Very small organ that is often greenish in color.

Part 7. General Description of the Body Organs Look at each organ and describe how each organ looks in Part 7 of the Autopsy Step 1 Report. Use the scalpel or scissors to open the stomach, small intestine, large intestine, Step 2 and gallbladder. Describe the contents of each organ in Part 7. If needed, the brain would also be removed, weighed, and described. This step is Step 3 not required for this autopsy procedure. Return all organs to the chest and abdominal cavity. Organs do not have to be Step 4 returned to the correct locations. Step 5 Use the sutures to close the incisions and prepare the body for funeral and burial. Part 8. Specific Description of Wounds or Injuries Make a note of any wounds, injuries, or abnormal findings that were found during Step 1 the external and internal autopsy. Hypothesize how any abnormal findings (or lack of abnormal findings) could lead Step 2 to death. In other words, what could have caused the death of your victim? Explain your theory in Part 8 of the Autopsy Report. Part 9. Establish Evidential Chain-of-Custody According to your hypothesis on cause of death, do you think this was an Step 1 accidental death or a homicide? Explain your theory in Part 9 of the Autopsy Report. Part 10. Record of Specimens Retained and Examinations Performed Summarize the organs you examined and the procedures that were used in this Step 1 autopsy. Include any abnormal findings that would lead to a cause of death.

90 The Autopsy Report Complete the following report as you conduct the autopsy on your victim. All necessary information can be found in the scenario, police report, or from the victim’s body during autopsy.

Part 1. Background Information

Office of the Medical Examiner HASPI, District 1234 Healthcare County 4321 Dissection Road, Uli City, CA 12121

MEDICAL EXAMINER REPORT

Victim Name: ______Medical Examiner(s): ______

Case #: ______Date of Birth: ______Date of Death: ______Age: ______

Race/Species: ______Sex: ______Date/Time of Exam:______

Reason for Autopsy: ______

Part 2. Known Facts

How and where was the body found?

Additional information:

Part 3. Review of Police Report and Evidence

Information from police report:

Information from the evidence:

91 Part 4. External Characteristics

Body Weight: ______g Body Length: ______cm Circumference: ______cm

Color (skin, hair):______

Identifying features (spots, hair location, etc.): ______

______

Any additional external features of note:

Part 5. Victim Identification How was the identification of the victim confirmed?

Parts 6 and 7. Internal Examination and Description Organ Weight Length Description (g) (cm) Heart

Lungs

Liver

Pancreas

Spleen

Kidneys

Organ Weight Length Description Internal Contents (g) (cm) Small intestine

Large intestine

Stomach

Gall bladder

92 Part 8. Wounds or Injuries What wounds, injuries, or abnormal findings could lead to a cause of death?

Hypothesize the possible cause of death.

Part 9. Cause of Death Was this death accidental or a homicide? Explain your hypothesis.

Note: There is no right or wrong answer on this. It is only your best hypothesis with the evidence that you have observed and collected. Part 10. Specimens and Examination Summarize the organs you examined and the procedures used in this autopsy.

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