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Summon

Summon


SUBPOENA (SUMMONS)

  • Sub- under; Poena- penalty)
  • Also known as  Duces tecum

Section

  • Section 61 – 69 CrPC deal with summons

DEFINITION

  • Subpoena is defined as a legal document compelling the attendance of a witness on a particular day and time in the court of law under penalty.
  • It can be served also to produce any official document or any paper before the court of law.
  • However, summons is a milder form of process.

PROCEDURE OF SERVING THE SUMMONS

  • Usually, it is issued by presiding officer of the court, delivered by a court official or a police constable.
  • Person receiving should sign on the original and keep the duplicate with him.
  • If person summoned to is not available, it may be served to:
  • The other major member of the family/ relatives, but not to a servant.
  •  If the person is a government servant, it may be served through the head of the office in which he or she is employed.
  • It may be even affixed on some conspicuous part of the house in which the person summoned ordinarily resides.
  •  Summons by post: It can even be sent by registered post.
  • However, on these occasions, court may not consider this as being served. If the postal authority returns the cover stating he or she is refusing to receive the same, court considers that it has been served in spite of not receiving it.

Conduct of Money

  • Conduct money refers to the travelling and daily expenses to reach the court.
  • In civil cases, it is paid by the party calling him), at the time of serving the summon. judge decides the conduct money in the civil case.
  • The summon in civil case can be ignored if conduct money is not sanctioned or if the amount is less, and the witness can bring the fact to notice of judge.
  • In criminal cases, no money is paid along with summon
  • The witness can ask for it, after giving evidence, but he should not insist if the court is not willing to sanction, since otherwise he can be charged for contempt of court.
  • To an independent doctor, it is always paid (known as bhatta), while the doctor in government service, can claim from his office.

RULES OF SUMMONS

If a medical officer is summoned to attend two courts on a particular time and day, following rules may be opted:

  • Criminal cases should be given preference over civil cases.
  • If both are criminal cases, higher courts should be given first preference. However, the medical officer should inform the other court which he or she is not attending.
  • If both cases are of the same ranking courts, summons received earlier should be attended first.

If witness fails to attend the court :

In civil cases : 

  • He will be liable to pay damages.

In criminal cases: 

  • the court may issue notice under section 350 CrPC  and may sentence him to fine or imprisonment or may issue bailable or non-bailable warrant to secure the presence of the witness
Exam Question
 

SUBPOENA (SUMMONS)

  • Sub- under; Poena- penalty)
  • Also known as  Duces tecum

Section

  • Section 61 – 69 CrPC deal with summons

DEFINITION 

  • Subpoena is defined as a legal document compelling the attendance of a witness on a particular day and time in the court of law under penalty.
  • No conduct money is paid to the doctor in criminal cases
  • Conduct money is paid to expert witness with summons from civil court
Don’t Forget to Solve all the previous Year Question asked on Summon

Module Below Start Quiz

Summon

Summon

Q. 1

Conduct money is paid to expert witness with summons from :

 A

Civil court

 B

Criminal court

 C

High court

 D

Sub magistrate

Q. 1

Conduct money is paid to expert witness with summons from :

 A

Civil court

 B

Criminal court

 C

High court

 D

Sub magistrate

Ans. A

Explanation:

A i.e. Civil court


Q. 2

Subpoena is also called:  

MAHE 06

 A

Summons

 B

Panchnama

 C

Requisition

 D

Inquest papers

Q. 2

Subpoena is also called:  

MAHE 06

 A

Summons

 B

Panchnama

 C

Requisition

 D

Inquest papers

Ans. A

Explanation:

Ans. Summons


Q. 3

Duces tecum is: 

WB 08

 A

Summon

 B

Panchnama

 C

Conduct money

 D

Hostile witness

Q. 3

Duces tecum is: 

WB 08

 A

Summon

 B

Panchnama

 C

Conduct money

 D

Hostile witness

Ans. A

Explanation:

Ans./ Summon


Q. 4

Following is not true regarding summons ‑

 A

It is a legal document

 B

No conduct money is paid to the doctor in criminal cases

 C

Section 61 – 69 CrPC deal with summons

 D

None of the above

Q. 4

Following is not true regarding summons ‑

 A

It is a legal document

 B

No conduct money is paid to the doctor in criminal cases

 C

Section 61 – 69 CrPC deal with summons

 D

None of the above

Ans. D

Explanation:

Ans. is ‘d’ i.e., None of the above

All are true.

Summon

  • Summon is a legal document compelling attendance of a witness in a court of law under penalty, on a particular day, time and place, for the purpose of giving evidence. It is issued by the Court in writting, in duplicate, signed by presiding officer of court and bears the seal of the court.
  • Conduct money refers to the travelling and daily expences to reach the court. In civil cases, it is paid by the party calling him, at the time of serving the summon. Judge decides the conduct money in civil case. The summon in civil case can be ignored if conduct money is not sanctioned or if the amount is less, and the witness can bring the fact to notice of judge. In criminal cases, no money is paid along with summon. The witness can ask for it, after giving evidence, but he should not insist if the court is not willing to sanction, since otherwise he can be charged for contempt of court. To an independent doctor it is always paid (known as bhatta), while the doctor in government service, can claim from his office.
  • In case, two or more summons are received for the same date and time, the principles for preference of summon are:
  1. Criminal case is preferred over civil case.
  2. If both cases are criminal/civil, summon from higher court is preferred.
  3. If both cases are criminal/civil and from court of same status, summon received earlier is preferred.

However, in each situation other court is informed accordingly.

Quiz In Between



Rigor mortis

Rigor mortis


Rigor mortis (Cadaveric Rigidity or Death Stiffening)

  • It is defined as contraction, stiffening, shortening and opacity of muscles after death. 
  • It occurs after molecular (cellular) death.

Rigor mortis

Time of Onset :

  • Temperate climates – 3-6 hours
  • Tropical climates – 1-2 hours
Duration

Temperate climate –

  •  lasts for 2-3 days.

Tropical climate – 

  • 24 – 48 hours in winter
  • 18 – 36 hours in summer

In general – 

  • 1-2 hours sets on
  • for , 12 hours develop
  • for  – 12 hours maintains
  • and after 12 hours passes off
Pattern
  • Rigor mortis generally occurs when body is cold.
  • Not related to nerves action
  • Develops in paralysed limbs also
  • First appear in involuntary muscles
  • However, it does not start in all muscles simultaneously (nysten’s rule).
  •  Involuntary muscles (heart) are involved first than voluntary muscles.
  •  Sequence of muscles involvement is as follows : Heart> upper eyelid> neck >jaw > face > chest > upper limb > abdomen > lower limb > finger and toes.
  • It passes off in the same order in which it has appeared.

 Factors affecting rigor mortis

  • Rigor mortis is not seen :
  •   Fetus < 7 months
  •  Septicemic conditions.

Appears early and passes off quickly :

  • Chronic diseases (TB, cancer, typhoid, cholera)
  • Convulsive disorders (strychnine poisoning )
  • Violent deaths (cut throat, electrocution, lightening).

Early onset and last longer :

  • Drowning and strychnine poisoning

Early onset :

  • Organophosphate poisoning, cholera, heat stroke and fatigue/exhaustion before death

Delayed onset :

  • Asphyxia, apoplexy, severe haemorrhage, pneumonia and paralysis of muscles.

Lasts longer or delayed disappearance :

  • CO poisoning
  • Arsenic poisoning

Early disappearance : 

  • Widespread bacterial infection, e.g., gas gangrene.
Cadaveric spasm (instantaneous rigor)
  • Is defined as the condition wherein a group of muscles, which were in contraction or spasm at the time of death, continue to be in spasm even after death, without the stage of primary relaxation.
Exam Question
 

Rigor mortis (Cadaveric Rigidity or Death Stiffening)

  • It is defined as contraction, stiffening, shortening and opacity of muscles after death.  

Time of Onset :

  • Temperate climates – 3-6 hours
  • Tropical climates – 1-2 hours
Duration
  • Temperate climate – lasts for 2-3 days.
  • Tropical climate – 24 – 48 hours in winter,18 – 36 hours in summer

Pattern

  • First appear in involuntary muscles
  • However, it does not start in all muscles simultaneously (nysten’s rule).
  •  Involuntary muscles (heart) are involved first than voluntary muscles.
  •  Sequence of muscles involvement is as follows : Heart> upper eyelid> neck >jaw > face > chest > upper limb > abdomen > lower limb > finger and toes.
  • It passes off in the same order in which it has appeared. 

Factors affecting rigor mortis

  • Rigor mortis is not seen :  Fetus < 7 months
  • Appears early and passes off quickly :   Chronic diseases (TB, cancer, typhoid, cholera), Convulsive disorders (strychnine poisoning ),Violent deaths (cut throat, electrocution, lightening).
  • Early onset and last longer : Drowning and strychnine poisoning
  • Early onset : Organophosphate poisoning, cholera, heat stroke and fatigue/exhaustion before death
  • Delayed onset :Asphyxia, apoplexy, severe haemorrhage, pneumonia and paralysis of muscles.
  • Lasts longer or delayed disappearance : CO poisoning and Arsenic poisoning
  • Early disappearance : Widespread bacterial infection, e.g., gas gangrene.
Don’t Forget to Solve all the previous Year Question asked on Rigor mortis

Module Below Start Quiz

Rigor mortis

Rigor mortis

Q. 1

Which among the following is the correct order of onset of rigor mortis in a deadbody?

 A

Lower limb —> thorax —> eyelids

 B

Eyelids —> thorax —> lower limb

 C

Thorax —> lower limb —> eyelids

 D

Eyelids —> lower limb —> thorax

Q. 1

Which among the following is the correct order of onset of rigor mortis in a deadbody?

 A

Lower limb —> thorax —> eyelids

 B

Eyelids —> thorax —> lower limb

 C

Thorax —> lower limb —> eyelids

 D

Eyelids —> lower limb —> thorax

Ans. B

Explanation:

According to Nysten’s rule, rigor mortis does not start in all muscles simultaneously.
It appears in involuntary muscles; the myocardium becomes rigid in an hour. It begins in the eyelids, neck and lower jaw and passes upwards to the muscles of the face, and downwards to the muscles of the chest, upper limbs, abdomen and lower limbs and lastly in the fingers and toes.
 
Ref: Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 27th edition, Page 141.

Q. 2

Rigor mortis is also known as, EXCEPT:

 A

Death stiffening

 B

Cadaveric rigidity

 C

Cadaveric lividity

 D

None of the above

Q. 2

Rigor mortis is also known as, EXCEPT:

 A

Death stiffening

 B

Cadaveric rigidity

 C

Cadaveric lividity

 D

None of the above

Ans. C

Explanation:

Rigor mortis also known as death stiffening or cadaveric rigidity, is a state of stiffening of muscles, sometimes with slight shortening of fibres. Individual cell death takes place in this stage due to lack of oxygen.
 
Cadaveric lividity is the term used for post-mortem hypostasis. It is also called postmortem staining, subcutaneous hypostasis, livor mortis, suggilations, vibices, or darkening of death.
 
Ref: Essentials of Forensic Medicine and Toxicology by Narayan Reddy, 27th edition, Page 140.

Q. 3

Rigor mortis in India in summer sets in :

 A

2-3 hrs

 B

18-36 hrs

 C

2-5 days

 D

1 week

Q. 3

Rigor mortis in India in summer sets in :

 A

2-3 hrs

 B

18-36 hrs

 C

2-5 days

 D

1 week

Ans. A

Explanation:

A i.e. 2 – 3 hours

Quiz In Between


Q. 4

Rigor mortis in winter season in Northern India lasts for:

 A

24-48 hr

 B

>24 hr

 C

2-3 days

 D

>3 days

Q. 4

Rigor mortis in winter season in Northern India lasts for:

 A

24-48 hr

 B

>24 hr

 C

2-3 days

 D

>3 days

Ans. A

Explanation:

A i.e. 24 – 48 hours


Q. 5

In rigor mortis muscle :

 A

Stiffens

 B

Shortens

 C

Stiffens and shortens

 D

Stiffens and lengthens

Q. 5

In rigor mortis muscle :

 A

Stiffens

 B

Shortens

 C

Stiffens and shortens

 D

Stiffens and lengthens

Ans. C

Explanation:

C i.e. Stiffens & shorten

In rigor mortis, muscle shorten (contracted) & stiffensQ, and the reaction changes from alkaline to distinctly acidic d/t local formation of lactic acid.


Q. 6

Which of the following simulates Rigor mortis:

 A

Heat stiffening

 B

Cold stiffening

 C

Strychnine

 D

a and b

Q. 6

Which of the following simulates Rigor mortis:

 A

Heat stiffening

 B

Cold stiffening

 C

Strychnine

 D

a and b

Ans. D

Explanation:

A i.e. Heat stiffness; B i.e. Cold stiffness

Quiz In Between


Q. 7

Rigor mortis can be simulated by

 A

Cadaveric spasm

 B

Algor mortis

 C

Adipocere

 D

Livor mortis

Q. 7

Rigor mortis can be simulated by

 A

Cadaveric spasm

 B

Algor mortis

 C

Adipocere

 D

Livor mortis

Ans. A

Explanation:

A i.e. Cadaveric spasm


Q. 8

Delayed rigor mortis occurs with which poisoning:

 A

Mercury

 B

Lead

 C

Arsenic

 D

Strychnine

Q. 8

Delayed rigor mortis occurs with which poisoning:

 A

Mercury

 B

Lead

 C

Arsenic

 D

Strychnine

Ans. C

Explanation:

C i.e. Arsenic


Q. 9

Rigor mortis appears last in:             

March 2012

 A

Eyelids

 B

Neck

 C

Lower limb

 D

Toes

Q. 9

Rigor mortis appears last in:             

March 2012

 A

Eyelids

 B

Neck

 C

Lower limb

 D

Toes

Ans. D

Explanation:

Ans: D i.e. Toes

Rigor mortis first appears in the involuntary muscles; the myocardium.

It begins in eyelids, neck and lower jaw and passes upwards to the muscle of the face, and downwards to the muscles of the chest, upper limbs, abdomen and lower limbs and lastly in the finger and toes

Quiz In Between


Q. 10

Rigor mortis occurs due to:               

September 2008

 A

Muscle of the body began to relax

 B

Capillo-venous distension in the most dependent body parts

 C

Muscle of the body began to stiffen

 D

Mummification of the body tissues

Q. 10

Rigor mortis occurs due to:               

September 2008

 A

Muscle of the body began to relax

 B

Capillo-venous distension in the most dependent body parts

 C

Muscle of the body began to stiffen

 D

Mummification of the body tissues

Ans. C

Explanation:

Ans. C: Muscle of the body began to stiffen

A few hours after the death, the joints of the body stiffen and become locked in place. This stiffening is called rigor mortis. Depending on temperature and other conditions, rigor mortis lasts approximately 24- 48 hours in winter and 18-36 hours in summer.

The phenomenon is caused by the skeletal muscles partially contracting. The muscles are unable to relax, so the joints become fixed in place Rigor mortis can be used to help estimate time of death.

The onset of rigor mortis may range from 1-2 hours, depending on factors including temperature (rapid cooling of a body can inhibit rigor mortis, but it occurs upon thawing). Maximum stiffness is reached around 12-24 hours post mortem. It first starts in involuntary muscles (myocardium)

Eyelids, neck and jaw muscles are affected first, with the rigor then spreading to other parts of the body.

The joints are stiff but after some time general tissue decay and leaking of lysosomal intracellular digestive enzymes will cause the muscles to relax.


Q. 11

True about rigor mortis are all, except:          

FMGE 08

 A

Seen immediately after death

 B

It last 18-36 h in summer

 C

It disappears in the sequence as it appears

 D

It last 24-48 h in winter

Q. 11

True about rigor mortis are all, except:          

FMGE 08

 A

Seen immediately after death

 B

It last 18-36 h in summer

 C

It disappears in the sequence as it appears

 D

It last 24-48 h in winter

Ans. A

Explanation:

Ans. Seen immediately after death


Q. 12

Rigor mortis completely develops in:          

Bihar 10

 A

1-2 h

 B

3-6 h

 C

6-8 h

 D

10-12 h

Q. 12

Rigor mortis completely develops in:          

Bihar 10

 A

1-2 h

 B

3-6 h

 C

6-8 h

 D

10-12 h

Ans. D

Explanation:

Ans. 10-12 h

Quiz In Between


Q. 13

Rigor mortis starts in:     

UP 08

 A

Eyelids

 B

Heart

 C

Voluntary muscle

 D

Limbs

Q. 13

Rigor mortis starts in:     

UP 08

 A

Eyelids

 B

Heart

 C

Voluntary muscle

 D

Limbs

Ans. B

Explanation:

Ans. Heart


Q. 14

Rigor mortis occurs first in which voluntary muscle:

Delhi 06, 07; COMEDK 08; SGPGI 11

 A

Muscles of eyelids

 B

Small muscles of hands

 C

Neck muscles

 D

Face muscles

Q. 14

Rigor mortis occurs first in which voluntary muscle:

Delhi 06, 07; COMEDK 08; SGPGI 11

 A

Muscles of eyelids

 B

Small muscles of hands

 C

Neck muscles

 D

Face muscles

Ans. A

Explanation:

Ans. Muscles of eyelids


Q. 15

Rigor mortis come early in all, except:             

PGI 14

 A

Cholera

 B

Heat stroke

 C

OPC poisoning

 D

Pneumonia

Q. 15

Rigor mortis come early in all, except:             

PGI 14

 A

Cholera

 B

Heat stroke

 C

OPC poisoning

 D

Pneumonia

Ans. D

Explanation:

Ans. Pneumonia

Quiz In Between


Q. 16

Rigor mortis not seen in:  

AIIMS 13

 A

Fetus < 7 months of age

 B

Full term fetus

 C

Elderly

 D

Anemic person

Q. 16

Rigor mortis not seen in:  

AIIMS 13

 A

Fetus < 7 months of age

 B

Full term fetus

 C

Elderly

 D

Anemic person

Ans. A

Explanation:

Ans. Fetus < 7 months of age


Q. 17

Rigor mortis is simulated by all, except:         

PGI 06

 A

Cold stiffness

 B

Heat stiffness

 C

Tetanus

 D

Putrefaction

Q. 17

Rigor mortis is simulated by all, except:         

PGI 06

 A

Cold stiffness

 B

Heat stiffness

 C

Tetanus

 D

Putrefaction

Ans. C

Explanation:

Ans. Tetanus


Q. 18

When group of muscles of dead body were in state of strong contration immediately prior to death and remain so even after death, this is termed as ‑

 A

Gas stiffening

 B

Rigor mortis

 C

Cadaveric spasm

 D

Cold stiffening

Q. 18

When group of muscles of dead body were in state of strong contration immediately prior to death and remain so even after death, this is termed as ‑

 A

Gas stiffening

 B

Rigor mortis

 C

Cadaveric spasm

 D

Cold stiffening

Ans. C

Explanation:

Ans. is ‘c’ i.e., Cadaveric spasm

Cadaveric spasm (instantaneous rigor) is defined as the condition wherein a group of muscles, which were in contraction or spasm at the time of death, continue to be in spasm even after death, without the stage of primary relaxation.

Quiz In Between


Q. 19

Rigor mortis in fetus at birth can be seen in ‑

 A

Dead born

 B

Still born

 C

Superfoetation

 D

Superfecundation

Q. 19

Rigor mortis in fetus at birth can be seen in ‑

 A

Dead born

 B

Still born

 C

Superfoetation

 D

Superfecundation

Ans. A

Explanation:

Ans. is ‘a’ i.e., Dead born

Signs of dead born (intrauterine death : IUD) are (i) Rigor mortis at birth, (ii) Maceration, (iii)Putrefaction, and (iv) Mummification.


Q. 20

Elderlyindividual living alone in a temperate zone is found dead one morning & electric heater is found to be damaged. The rigor mortis will set in‑

 A

Earlier than expected

 B

Later than expected

 C

Will not set in

 D

No change

Q. 20

Elderlyindividual living alone in a temperate zone is found dead one morning & electric heater is found to be damaged. The rigor mortis will set in‑

 A

Earlier than expected

 B

Later than expected

 C

Will not set in

 D

No change

Ans. B

Explanation:

Ans. is ‘b’ i.e., Later than expected

  • In temperate climate, rigor mortis begins late and lasts longer than in tropical countries.

Rigor mortis (Cadaveric Rigidity or Death Stiffening)

  • It is defined as contraction, stiffening, shortenig and opacity of muscles after death. It occurs after molecular (cellular) death.
  • In tropical countries (e.g. india), it begins 1-2 hours after death, takes further 2 hours to develop, and lasts for 18-36 hours in summer and 24-48 hours in winter. In temperate countries, it begins in 3-6 hours, takes further 2­3 hours to develop and lasts for 2-3 days.
  • All muscles of body are involved, i.e. voluntary or involuntary.
  • However, it does not start in all muscles simultaneously (nysten’s rule). Involuntary muscles (heart) are involved first than voluntary muscles. Sequence of muscles involvement is as follows : Heart> upper eyelid> neck >jaw > face > chest > upper limb > abdomen > lower limb > finger and toes.
  • It passes off in the same order in which it has appeared.
  • Factors affecting rigor mortis
  1. Rigor mortis is not seen : (1) Fetus < 7 months, (ii) Septiccemic conditions.
  2. Appears early and passes off quickly : (i) Chronic diseases (TB, cancer, typhoid, cholera), (ii) Convulsive disorders (strychnine poisoning ), (iii) Violent deaths (cut throat, electrocution, lightening).
  3. Early onset and last longer : Drowning and strychnine poisoning
  4. Early onset : Organophosphate poisoning and fatigue/exhaustion before death
  5. Delayed onset : Asphyxia, apoplexy, severe hemorrhage, pneumonia and paralysis of muscles.
  6. Lasts longer or delayed disappearance : (i) CO poisoning, (ii) Arsenic poisoning
  7. Early disappearance : Widespread bacterial infection, e.g., gas gangrene.

Q. 21

All are true regarding muscular changes after death except ‑

 A

Rigor mortis occurs 1-2 hours after the death

 B

Cadaveric spasm involves involuntary muscles

 C

Rigor mortis involves voluntary muscles

 D

Rigor mortis involves involuntary muscles

Q. 21

All are true regarding muscular changes after death except ‑

 A

Rigor mortis occurs 1-2 hours after the death

 B

Cadaveric spasm involves involuntary muscles

 C

Rigor mortis involves voluntary muscles

 D

Rigor mortis involves involuntary muscles

Ans. B

Explanation:

Ans. is ‘b’ i.e., Cadaveric spasm involves involuntary muscles

Quiz In Between



Postmortem changes – Early

Postmortem changes – Early


Early changes
  1. Changes in the eye
  2. Changes in the skin
  3. Cooling of the body/Algor mortis
  4. Post-mortem lividity/Hypostasis
  5. Rigor mortis/Cadaveric rigidity
Changes In Eye
  • Corneal Changes;
  • Loss of Clear Glistening
  • Dry, Cloudy and opaque
  • Loss of reflexes
  • Light reflex abolished
  • Intra Ocular tension falls, eyeballs become flaccid and sink in the orbit
  • Blood flow in the retina became dotted and segmented look.
  • Optic disc looks pale.
  • Pupils fully dilated in the early stage and constict later due rigor mortis.
  • Brownish discolouration of the sclera due to cellular debris and dust-Tache noire

Changes in Skin

  • Loss of its translucency
  • Pale and Ashy white appearance
  • Loss of Elasticity
  • Wounds will not gape if it is inflicted after death
  • Wounds caused during life will retain their characteristic features

Cooling Of Body/Algor Mortis

  • Imbalance between heat production and heat loss.
  • Loss of heat of body by means of conduction convection and radiation, till it balances with the temperature of surroundings.
  • Rate of cooling is fast during first few hours and later slows.
  • Temperature is recorded by Chemical thermometer- Thanotometer 25 cms.

Recording of temperature :

  • Normal temp. – Rectal temp.
  • Rate of temp. fall/hour
  • Variation of body temperature
  • Conditions in which heat may be retained or increased.
  • Sunstroke and pontine haemorrhage, disturbed heat-regulating mechanism.
  • Tetanus and strychnine poisoning, due to increase in heat production in the muscle.
  • Acute bacterial or viral infection, lobar pneumonia, typhoid fever, encephalitis, etc.
  • Intense asphyxial conditions- rise of temp by 2-3 c at death“ Postmortem Caloricity”

The rate of cooling of the body is modified by the following conditions;

  • Age
  • Condition of the body
  • Mode of death
  • Surroundings
  • Environmental temperature

Postmortem Lividity

  • It means discolouration or staining of the skin and organs after death due to accumulation of fluid blood in the dependent parts of the body. 
  • Post mortem staining/Hypostasis/Suggilation/ Vibices/ Livour mortis.
  • 1- 3 hr. Starts
  •   6-8 hr. Fixes.
  • Is the fourth stage and one of the signs of death.
  • Purple coloration of dependent parts, except in areas of contact pressure, appearing within 30 minutes to 2 hours after death, as a result of gravitational movement of deoxygenated blood within the vessels. 
  • If the body is lying in moving water, due to constant movement of the body postmortem lividity may not develop.

Colour of post mortem lividity (hypostasis)

  1. Normal – Bluish pink which later turns into bluish purple
  2. Hypothermic- Bright Pink
  3. Carbon monoxide – Bright cherry red
  4. Cyanide – Pink
  5. Phosphorous – Dark brown
  6. Nitrates – Reddish brown
  7. Chlorates – Chocolate brown
  8. Hydrogen sulphide – Bluish Green
  9. Aniline – Deep blue
  10. Opiates – Black
Medicolegal Importance of Postmortem Lividity
  • It is a reliable sign of death
  • It gives the information about the position of the body at the time of death
  • Time since death can be estimated
  • Colour suggest the cause of death
  • Distribution of lividity may give the information about the manner of death
Changes in Muscle
  • Primary relaxation/ Flaccidity
  • Rigor mortis/Cadaveric rigidity
  • Secondary relaxation

Starts immediately after death with generalised relaxation of muscle tone:

  • Drop of lower Jaw
  • Eye balls lose their tension
  • Pupils are dilated
  • Joints are flabby
  • Smooth relaxation- incontinence of Urine and Faeces.
Exam Question
 
Early changes
  1. Changes in the eye
  2. Changes in the skin
  3. Cooling of the body/Algor mortis
  4. Post-mortem lividity/Hypostasis
  5. Rigor mortis/Cadaveric rigidity
Changes In Eye
  • Brownish discolouration of the sclera due to cellular debris and dust-Tache noire

Changes in Skin

  • Wounds caused during life will retain their characteristic features
Cooling Of Body/Algor Mortis
  • Imbalance between heat production and heat loss.
  • Tetanus and strychnine poisoning, due to increase in heat production in the muscle.
  • Acute bacterial or viral infection, lobar pneumonia, typhoid fever, encephalitis, etc.

Postmortem Lividity

  • Post mortem staining/Hypostasis/Suggilation/ Vibices/ Livour mortis.-  1- 3 hr. Starts
  • Purple coloration of dependent parts, except in areas of contact pressure, appearing within 30 minutes to 2 hours after death, as a result of gravitational movement of deoxygenated blood within the vessels. 
  • If the body is lying in moving water, due to constant movement of the body postmortem lividity may not develop.

Colour of post mortem lividity (hypostasis)

  1. Normal – Bluish pink which later turns into bluish purple
  2. Hypothermic- Bright Pink
  3. Carbon monoxide – Bright cherry red
  4. Cyanide – Pink
  5. Phosphorous – Dark brown
  6. Nitrates – Reddish brown
  7. Chlorates – Chocolate brown
  8. Hydrogen sulphide – Bluish Green
  9. Aniline – Deep blue
  10. Opiates – Black
Medicolegal Importance of Postmortem Lividity
  • It gives the information about the position of the body at the time of death
  • Time since death can be estimated
Don’t Forget to Solve all the previous Year Question asked on Postmortem changes – Early

Module Below Start Quiz

Medical Evidence

Medical Evidence


It means :

  • All statements which the court permits or requires to be made before it by witnesses,  in relation to matter of fact under inquiry.

It includes:

  • All documents produced for the inspection of court.
Types of Medical Evidence

Documentary

  • Medical certificate
  • Medico-legal reports
  • Dying declaration

Oral-

  • Direct
  • Indirect or Circumstantial
  • Hearsay

Medical Certificates:

  • Documentary evidence
  • They refer to ill health, insanity, age, death etc.
  • The medical practitioner is bound to issue death certificate, stating the cause of death, without charging the fees.
  • Issuing false medical certificate is punishable under section 197IPC.

Medical reports:

  • They are the medical reports prepared by a doctor on request of the investigating officer, usually in the criminal cases.
  • The report consists of two parts:
  • Facts observed on examination
  • Opinion  drawn from the facts

Dying declaration:

  • It is a written or oral statement of a person, who is dying as a result of some unlawful act, relating to the material facts of cause of his death.
  • Magistrate should be called to record the declaration (if there is time).
  • Doctor should certify his mental state and consciousness before recording(compos mentis).
  • If there is no time to call the magistrate, the doctor should take the declaration in the presence of two witnesses.
  • It can also be recorded by village headman, police officer, but its value is less.
  • Oath is not necessary.
  • It must be signed by the declarant, doctor and the witnesses.
  • If the declarant dies, it is accepted as the evidence in court.
  • If the declarant survives, it is not valid,  but it has the corroborative value.
  • The declarant should not be influenced.
Dying Deposition
  • It is the statement of a person on oath, recorded by the magistrate in the presence of the accused or his lawyer, who is allowed to cross-examine the witness.
  • More importance in court then dying declaration
Exam Question
 
Types of Medical Evidence

Documentary

  1. Medical certificate
  2. Medico-legal reports
  3. Dying declaration

Medical Certificates:

  • Documentary evidence
  • Issuing false medical certificate is punishable under section 197IPC.

Dying declaration:

  • It is a written or oral statement of a person, who is dying as a result of some unlawful act, relating to the material facts of cause of his death.
  • Magistrate should be called to record the declaration (if there is time).
  • Doctor should certify his mental state and consciousness before recording(compos mentis).
Dying Deposition
  • It is the statement of a person on oath, recorded by the magistrate in the presence of the accused or his lawyer, who is allowed to cross-examine the witness.
  • More importance in court then dying declaration
Don’t Forget to Solve all the previous Year Question asked on Medical Evidence

Module Below Start Quiz

Medical Evidence

Medical Evidence

Q. 1

All is exempted from oral testimony EXCEPT

 A

Dying declaration

 B

Medical evidence of injury as witness

 C

Chemical examination report

 D

Evidence of medical expert in lower court

Q. 1

All is exempted from oral testimony EXCEPT

 A

Dying declaration

 B

Medical evidence of injury as witness

 C

Chemical examination report

 D

Evidence of medical expert in lower court

Ans. B

Explanation:

B i.e. Medical evidence of injury as witness


Q. 2

Dying deposition is recorded by :

 A

Doctor

 B

Magistrate

 C

Police officer

 D

Lawyer

Q. 2

Dying deposition is recorded by :

 A

Doctor

 B

Magistrate

 C

Police officer

 D

Lawyer

Ans. B

Explanation:

B i.e. Magistrate


Q. 3

Dying deposition is more important than dying declaration becase it is :

 A

Made to a magistrate

 B

Oath is taken

 C

Made in presence of accused

 D

Cross examination is permitted

Q. 3

Dying deposition is more important than dying declaration becase it is :

 A

Made to a magistrate

 B

Oath is taken

 C

Made in presence of accused

 D

Cross examination is permitted

Ans. A

Explanation:

A i.e. Made to magistrate

Quiz In Between


Q. 4

Which carries more weight in a court of law :

 A

Dying declaration

 B

Dying deposition

 C

Both carry the same weight

 D

Both are not significant

Q. 4

Which carries more weight in a court of law :

 A

Dying declaration

 B

Dying deposition

 C

Both carry the same weight

 D

Both are not significant

Ans. B

Explanation:

B i.e. Dying deposition


Q. 5

Medical certificate is :

 A

Documentary evidence

 B

Oral evidence

 C

Hearsay evidence

 D

Parole

Q. 5

Medical certificate is :

 A

Documentary evidence

 B

Oral evidence

 C

Hearsay evidence

 D

Parole

Ans. A

Explanation:

A i.e. Documentary evidence

Medical certificate is simplest form of documentary evidence. In case of death certificate doctor

Must issue certificate & cannot charge any fees for itQ

Can not delay it even if his professional charges are not paid

Must mention the exact cause of death instead of vague terms.


Q. 6

When a doctor issues a false medical certificate, then he is liable under:        

AIIMS 11; Bihar 11; NEET 15

 A

Sec. 197 IPC

 B

Sec. 87 IPC

 C

Sec. 304A IPC

 D

Sec. 338 IPC

Q. 6

When a doctor issues a false medical certificate, then he is liable under:        

AIIMS 11; Bihar 11; NEET 15

 A

Sec. 197 IPC

 B

Sec. 87 IPC

 C

Sec. 304A IPC

 D

Sec. 338 IPC

Ans. A

Explanation:

Ans. Sec. 197 IPC

Quiz In Between


Q. 7

Dying declaration can be taken by:

PGI 12; NIMHANS 14

 A

Village headman

 B

Doctor

 C

Magistrate

 D

Any one

Q. 7

Dying declaration can be taken by:

PGI 12; NIMHANS 14

 A

Village headman

 B

Doctor

 C

Magistrate

 D

Any one

Ans. D

Explanation:

Ans. Any one


Q. 8

Dying declaration is a:     

MAHE 10

 A

Circumstantial evidence

 B

Oral evidence

 C

Documentary evidence

 D

Hearsay evidence

Q. 8

Dying declaration is a:     

MAHE 10

 A

Circumstantial evidence

 B

Oral evidence

 C

Documentary evidence

 D

Hearsay evidence

Ans. C

Explanation:

Ans. Documentary evidence


Q. 9

Documentary evidence along with oral evidence is required:  

PGI 12

 A

Dying declaration

 B

Postmortem report

 C

DNA fingerprinting

 D

Chemical examiner report

Q. 9

Documentary evidence along with oral evidence is required:  

PGI 12

 A

Dying declaration

 B

Postmortem report

 C

DNA fingerprinting

 D

Chemical examiner report

Ans. B

Explanation:

Ans. Postmortem report


Q. 10

Doctors role in noting dying declaration is to ‑

 A

Ascertain compos mentis

 B

Call the magistrate

 C

Elicit information by leading questions

 D

Ask the investiating medial officer to be there

Q. 10

Doctors role in noting dying declaration is to ‑

 A

Ascertain compos mentis

 B

Call the magistrate

 C

Elicit information by leading questions

 D

Ask the investiating medial officer to be there

Ans. A

Explanation:

Ans. is ‘a’ i.e., Ascertain compos mentis

Dying declaration

  • It is the written or verbal statement made by a person likely to die because of some unnatural act done on his body, narating the circumstances or the conditions responsible for his present state of health or the cause and manner of likely unnatural death.
  • Ideally dying declaration should be recorded by executive or honorary magistrate, but can also be recorded by doctor, village head man, police or any other person, if there is no time to call a magistrate. Doctor has to certify the patient to be compos mentis (sound mind). It is recorded in presence of two disinterested witnesses. Relatives and police officers are not allowed to be present. No oath is administered.
  • It carries less weight than dying deposition as no cross-examination is possible. If the patient does not die after the recording of declaration, the dying declaration loses its importance sice now he can be called to the court and his evidence can be recorded after cross-examination.

Quiz In Between



Postmortem changes – Early

Postmortem changes – Early

Q. 1

In which of the following conditions postmortem lividity is unlikely to develop?

 A

Drowning in well

 B

Postmortem submersion

 C

Drowning in a fast flowing river

 D

Drowning in chlorinated swimming pool.

Q. 1

In which of the following conditions postmortem lividity is unlikely to develop?

 A

Drowning in well

 B

Postmortem submersion

 C

Drowning in a fast flowing river

 D

Drowning in chlorinated swimming pool.

Ans. C

Explanation:

If the body is lying in moving water, due to constant movement of the body postmortem lividity may not develop.
 
Ref: The Essentials of Forensic Medicine and Toxicology By Dr K S Narayan Reddy, 27th Edition, Pages 137-9

Q. 2

Which among the following is not known to cause delay in algor mortis?

 A

Pontine hemorrhage

 B

Asphyxial death

 C

Septicemia

 D

Burns

Q. 2

Which among the following is not known to cause delay in algor mortis?

 A

Pontine hemorrhage

 B

Asphyxial death

 C

Septicemia

 D

Burns

Ans. D

Explanation:

Algor mortis is the cooling of body after death.

Pontine hemorrhage, tetanus, asphyxial death, septicemia, sunstroke etc are causes for post mortem caloricity.

In case of burns, there is a loss of heat due to evaporation of fluids from the raw surface and hence causes ↑ algor mortis.

Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 23, Page – 124


Q. 3

Which of the following is TRUE about cadaveric lividity?

 A

It occurs only in the dependent parts

 B

It occurs only upto 3-4 hours after death

 C

It occurs due to dilatation of arterioles

 D

All these

Q. 3

Which of the following is TRUE about cadaveric lividity?

 A

It occurs only in the dependent parts

 B

It occurs only upto 3-4 hours after death

 C

It occurs due to dilatation of arterioles

 D

All these

Ans. A

Explanation:

Cadaveric lividity is the bluish-purple or purplish-red discolouration which appears under the skin in the most superficial layers of the dermis (rete mucosum) of the dependent parts of the body after death, due to capillo-venous distention.
It is well developed within four hours and reaches a maximum between 6 to 12 hours and persists until putrefaction sets in.
 
Ref: Essentials of Forensic Medicine and Toxicology by Narayan Reddy, 27th edition, Page 136-137.

Quiz In Between


Q. 4

Post mortem lividity persists till :

 A

24 hours

 B

18 hours

 C

2-3 days

 D

Merges with putrefactive changes

Q. 4

Post mortem lividity persists till :

 A

24 hours

 B

18 hours

 C

2-3 days

 D

Merges with putrefactive changes

Ans. D

Explanation:

D i.e. Merges with putrefactive changes

–  Postmortem lividity also k/a suggilation, vabices, hypostasis, staining, darkening of death is an early sign of death & commences within an hour of death.Q

–  Fixed in about 4 – 6 hoursQ; reaches maximum between 6-12 hoursQ and persists until putrefaction sets in.Q Lividity does not develop in drowning in running water & areas of contact flattening.Q

When lividity first develops (i.e. before fixing), on applying firm pressure it disappears & releasing pressure it reappears (Difference from bruise).


Q. 5

A dead body is having cadaveric lividity of bluish green colour. The most likely cause of death is by poisoning due to

 A

Hydrocyanic acid

 B

Hydrogen sulphide

 C

Oleander

 D

Sodium nitrite

Q. 5

A dead body is having cadaveric lividity of bluish green colour. The most likely cause of death is by poisoning due to

 A

Hydrocyanic acid

 B

Hydrogen sulphide

 C

Oleander

 D

Sodium nitrite

Ans. B

Explanation:

B i.e. Hydrogen sulphide


Q. 6

Dark brown P.M. lividity is seen in:

 A

Aniline

 B

CO

 C

Phosphorous

 D

Hydrocyanide

Q. 6

Dark brown P.M. lividity is seen in:

 A

Aniline

 B

CO

 C

Phosphorous

 D

Hydrocyanide

Ans. C

Explanation:

c i.e. Phosphrous

Quiz In Between


Q. 7

Which of the following is not a postmortem change:

NEET 15

 A

Algor mortis

 B

Rigor mortis

 C

Atria mortis

 D

Livor mortis

Q. 7

Which of the following is not a postmortem change:

NEET 15

 A

Algor mortis

 B

Rigor mortis

 C

Atria mortis

 D

Livor mortis

Ans. C

Explanation:

Ans. Atria mortis


Q. 8

Postmortem lividity is useful to access:      

TN 06

 A

Time since death

 B

To know the weapon used

 C

Position of the body after death

 D

A and C

Q. 8

Postmortem lividity is useful to access:      

TN 06

 A

Time since death

 B

To know the weapon used

 C

Position of the body after death

 D

A and C

Ans. D

Explanation:

Ans. A and C


Q. 9

Best medium to estimate time since death:

Maharashtra 09

 A

Blood

 B

Vitreous humor

 C

CSF

 D

Pericardial fluid

Q. 9

Best medium to estimate time since death:

Maharashtra 09

 A

Blood

 B

Vitreous humor

 C

CSF

 D

Pericardial fluid

Ans. B

Explanation:

Ans. Vitreous humor

Quiz In Between


Q. 10

Color of postmortem lividity in hypothermic deaths:

NEET 13

 A

Purple

 B

Deep red

 C

Cherry red

 D

Bright pink

Q. 10

Color of postmortem lividity in hypothermic deaths:

NEET 13

 A

Purple

 B

Deep red

 C

Cherry red

 D

Bright pink

Ans. D

Explanation:

Ans. Bright pink


Q. 11

A dead body is having cadaveric lividity of bluish green color. The most likely cause of death is by poisoning due to:   

AIIMS 06; DNB 10; NEET 13

 A

Hydrocyanic acid

 B

Hydrogen sulfide

 C

Oleander

 D

Sodium nitrite

Q. 11

A dead body is having cadaveric lividity of bluish green color. The most likely cause of death is by poisoning due to:   

AIIMS 06; DNB 10; NEET 13

 A

Hydrocyanic acid

 B

Hydrogen sulfide

 C

Oleander

 D

Sodium nitrite

Ans. B

Explanation:

Ans. Hydrogen sulfide


Q. 12

What is the proof of eyes being open for few hours after death ‑

 A

Kevokian sign

 B

Tache noir

 C

Both of the above

 D

None of the above

Q. 12

What is the proof of eyes being open for few hours after death ‑

 A

Kevokian sign

 B

Tache noir

 C

Both of the above

 D

None of the above

Ans. B

Explanation:

Ans. is ‘b’ i.e., Tache noir

If the eye lids are open for a few hours after death, a film of cell debris and mucous forms two yellow triangles on the sclera on either side of the iris , which become brown and then black called tache noir withing 3 – 4 hours.

Quiz In Between


Q. 13

Algor mortis is ‑

 A

Rise of body temperature after death

 B

Cooling of body

 C

Persistent body spasm

 D

None

Q. 13

Algor mortis is ‑

 A

Rise of body temperature after death

 B

Cooling of body

 C

Persistent body spasm

 D

None

Ans. B

Explanation:

Ans. is ‘b’ i.e., Cooling of body

ALGOR MORTIS

After death, dead body behaves like an inert substance and therefore, if atmospheric temperature is low, body loses its heat by conduction, covection, radiation and evoporation, so as to attain the atmospheric temperature, i.e. the body cools. No cooling of dead body occurs if atmospheric temperature is higher than that of body.

Cooling of body starts 1/2 to 1 hour after death. There are varying opinions about rate of cooling of dead body:

i) Most widely accepted view is that the rate of cooling in india (tropical countries) is 0.5-0.7° C/hour, so that body attains atmospheric temperature in 16-20 hours after death. In temperate climate, the rate of fall is about 1.5° C/hour.

ii) As per another view, cooling is faster in initial period, when the temprature difference between body and atmosphere is maximum ‑

  1. First 30-45 minutes —> No temperature fall (isothermic phase).
  2. First 1-6 hours —4 1.5-2° C/hour.
  3. 6-12 hours       0.9-1.2° C/hour.
  4. After 12 hours —> 0.4-0.6° C/hour.

iii) Rate of cooling is related to difference in temperature and its surroundings (environment). In the first 2 hours average rate fall of temperature is roughly half this difference. In next 2 hours the temperature fall is at half this rate and in subsequent 2 hours, at quarter this rate.

iv) Most common site for recording temperature is the rectum. Thermameter is inserted in rectum around 8-10 cm for 2 minutes. Other sites for recording temperture are nose, ear (external auditory meatus), vagina and under liver.

Medicolegal importance of algor mortis –

i) It is a sign of death.

ii) Time since death may be determined and and algor mortis is the most important indicator to determine the time since death during first 24 hours.


Q. 14

Post mortem lividity in a case of poisoning caused by inhalation of fumes for a few minutes in a person working in gold mining is represented in the picture below .It is seen in a case of ? 

 A

CO poisoning.

 B

HCN poisoning.

 C

H2S poisoning.

 D

Phosphorus poisoning.

Q. 14

Post mortem lividity in a case of poisoning caused by inhalation of fumes for a few minutes in a person working in gold mining is represented in the picture below .It is seen in a case of ? 

 A

CO poisoning.

 B

HCN poisoning.

 C

H2S poisoning.

 D

Phosphorus poisoning.

Ans. B

Explanation:

Ans:B.)HCN poisoning.

The poisoning case shown in the picture above represents HCN poisoning as lividity shown is bright red(pinkish red) staining.

HCN poisoning

  • Acute hydrogen cyanide poisoning can result from inhalation of fumes from burning polymer products that use nitrile in their production, such as polyurethane, or vinyl.
    • Cyanides are used in many industries and thus are available to potential poisoners.
      • The main industries that use cyanides are:Mining of gold and Silver,Electroplating industry,pesticide industry
  • Cyanide poisoning is a form of histotoxic hypoxia because the cells of an organism are unable to create ATP, primarily through the inhibition of the mitochondrial enzyme cytochrome c oxidase.
  • Autopsy Findings
    • Hypostasis is said to be brick-red, due to excess oxyhaemoglobin (because the tissue are prevented from using oxygen) and to the presence of cyanmethaemoglobin.
    • There may be a smell of cyanide about the body, and a distinct odor of bitter almonds about the viscera especially in the skull cavity and the brain.
    • Internally the tissues may also be bright pink caused by the oxyhaemoglobin that cannot be utilized by the tissues – which is probably more common than the presence of cyanmethaemoglobin.
    • The stomach lining may be badly damaged and can present a blackened, eroded surface, by altered blood staining the stripped mucosa.The oesophagus may be damage, especially the mucosa of the lower third.
  CO poisoning Cyanide poisoning
Effect on ability of RBCs to transfer Oxygen Yes,it impairs No
Effect on mitochondria Effect not as much as Cyanide poisoning Complete and sustained blockade of cellular respiration inducing severe lactic acidosis
Type of Hypoxia Hypemic hypoxia is caused by the reduction of the oxygen carrying capacity of the blood.  

Histotoxic hypoxia because the cells of an organism are unable to create ATP, primarily through the inhibition of the mitochondrial enzyme cytochrome c oxidase.

Amount of exposure required Requires hours of exposure  Occurs within seconds or minutes of exposure
Post-mortem lividity Colour Cherry red Pinkish red
Treatment Oxygen Oxygen with Antidote like amyl nitrite,intravenous sodium nitrite, intravenous sodium thiosulfate and Hydroxocobalamin

Q. 15

Measurement of which electrolyte in this fluid as marked by an arrow shown in the  photograph below to evaluate time since death ? 

 A

Sodium.

 B

Potassium.

 C

Chloride.

 D

Proteins.

Q. 15

Measurement of which electrolyte in this fluid as marked by an arrow shown in the  photograph below to evaluate time since death ? 

 A

Sodium.

 B

Potassium.

 C

Chloride.

 D

Proteins.

Ans. B

Explanation:

Ans:B.)Potassium

The fluid shown in the picture above represents Vitreous humor.

Vitreous humour

  • It is a transparent, colorless, gelatinous mass that fills the space in the eye between the lens and the retina.
  • Produced by cells in the non-pigmented portion of the ciliary body.
  • Biochemical Properties:
    • It is composed mostly of phagocytes, which remove unwanted cellular debris in the visual field, and hyalocytes.
    • The vitreous humour contains no blood vessels, and 98–99% of its volume is water .
    • In addition to water, the vitreous consists of salts, sugars, vitrosin (a type of collagen), a network of collagen type II fibrils with glycosaminoglycan, hyaluronan, opticin, and a wide array of proteins.
    • It has a refractive index of 1.336.
  • Clinical Significance:
    • Unlike the fluid in the frontal parts of the eye (aqueous humour) which is continuously replenished, the gel in the vitreous chamber is stagnant. Therefore, if blood, cells or other byproducts of inflammation get into the vitreous, they will remain there unless removed surgically.These are known as floaters.
    • The metabolic exchange and equilibration between systemic circulation and vitreous humour is so slow that vitreous humour is sometimes the fluid of choice for postmortem analysis of glucose levels or substances which would be more rapidly diffused, degraded, excreted or metabolized from the general circulation.
      • Vitreous humor is strongly recommended as a body fluid for determination of ethanol in postmortem toxicology to help establish whether the deceased had consumed ethanol before death.
  • Forensic Significance:
    • After death, the vitreous resists putrifaction longer than other body fluids. The vitreous potassium concentration rises so predictably within the hours, days and weeks after death, that vitreous potassium levels are frequently used to estimate the time-of-death


Quiz In Between


Q. 16

Post mortem lividity as shown in the photograph below is due to which poisoning ? 

 A

Carbon monoxide.

 B

Hydrogen sulphide.

 C

Nitrites.

 D

Phosphorus.

Q. 16

Post mortem lividity as shown in the photograph below is due to which poisoning ? 

 A

Carbon monoxide.

 B

Hydrogen sulphide.

 C

Nitrites.

 D

Phosphorus.

Ans. A

Explanation:

Ans:A.)Carbon Monoxide

Post mortem lividity shows Bright red cherry discolouration of Skin.

Postmortem lividity

  • Livor mortis (postmortem lividity / hypostasis / suggillation)is the fourth stage and one of the signs of death.
  • Purple coloration of dependent parts, except in areas of contact pressure, appearing within 30 minutes to 2 hours after death, as a result of gravitational movement of deoxygenated blood within the vessels.

Colour of post mortem lividity (hypostasis)

  • Normal – Bluish pink which later turns into bluish purple
  • Carbon monoxide – Bright cherry red
  • Cyanide – Pink
  • Phosphorous – Dark brown
  • Nitrates – Reddish brown
  • Chlorates – Chocolate brown
  • Hydrogen sulphide – Bluish Green
  • Aniline – Deep blue
  • Opiates – Black

Postmortem findings of CO-poisoning

  • Fine froth at mouth and nose.
  • Bright cherry red discolouration of skin, mucous membranes, nail-beds, blood, tissues and internal organs as shown in the picture aboveCyanide poisoning and exposure to cold causes similar redness.
  • Blood is fluidish thin, hyperemia (congestion) is general, and serous effusion are common.
  • Skin blisters or red patches due to hypoxia in areas that contact the ground or appositional skin e.g. axilla, inner thigh, buttock, calves, knee.
  • Lungs show congestion with pink fluid blood, followed by pulmonary edema and bronchopulmonary consolidation.
    Pleural and pericardial anoxic haemorrhage, tiny focal necroses in myocardium are late changes (5 days).
  • Bilateral symmetrical necrosis and cavitation of basal ganglia (esp globus pallidus and putamen)
  • Spectroscopic examination, Hoppe – Seyler’s test (10% NaOH), kunkel’s (tannic acid) test and adding water (15 ml) in 2 drops of blood can detect CO.

Q. 17

Tache noire de salenortica is a postmortem finding is related to 

 A

Eye

 B

Muscle 

 C

Hair

 D

Semen

Q. 17

Tache noire de salenortica is a postmortem finding is related to 

 A

Eye

 B

Muscle 

 C

Hair

 D

Semen

Ans. A

Explanation:

  • Brownish discolouration of the sclera due to cellular debris and dust-Tache noire

Q. 18

Which of the following shows Kevorkian sign?

 A

Retina

 B

Sclera

 C

Vitreous

 D
Q. 18

Which of the following shows Kevorkian sign?

 A

Retina

 B

Sclera

 C

Vitreous

 D
Ans. A

Explanation:

Fragmentation or segmentation (trucking or shunting) of the blood columns (Kevorkian sign) appears in the retinal blood vessels within minutes after death and persists for about an hour.

Quiz In Between



Witnesses and Recording Of Evidence

Witnesses and Recording Of Evidence


Witnesses
  • A person who gives evidences regarding facts.
Types
  1. Common witness
  2. Expert witness

Common witness:

  • A person who gives evidence about the facts observed or perceived by him.
  • Principle is known as “first-hand knowledge rule”

Expert witness:

  • A person who has been trained or is skilled or has knowledge in technical or scientific subject, and is capable of drawing the opinion and conclusions from the facts observed by himself or noticed by others.
  • Eg: doctor, fingerprint expert, ballistic expert.

Hostile witness:

  • One who is supposed to have some interest or motive for concealing part of the truth, or for giving completely false evidence.
  • IPC -191
Perjury
  • Willful false evidence
  • Whoever, being legally bound by an oath or by an express provision of law to state the truth , or being bound by law to make a declaration upon any subject , makes any statement which is false , and which he either knows or believe to be false ,is said to give false evidence(sections 191 ,192 IPC and 344 CrPC).
  • Punishment of up to 7 years(section 193 IPC)
Record of Evidence
  • Oath
  • Oath is declaration required by law, which is compulsory and hold the witness responsible for the consequences of his evidence.
Examination-in-chief  (Direct Examination)
  • This is the first examination of a witness.
  • Question are put to him by the lawyer for the side which has summoned him.
  • In criminal cases burden to prove is always on the prosecution, and accused is presumed to be innocent till the contrary is proved against him.
  • No leading question is allowed.
The objects are:
  • To elicit all relevant, convincing medical facts.
  • To elicit the conclusion which the doctor has drawn from the facts
Cross-Examination
  • Witness is questioned by the lawyer for the opposite party.
  • The defense witness is cross examined by the public prosecutor.
  • Leading questions are allowed.
The main objects are: 
  • To  elicit facts favourable to his case.
  • To test the accuracy of statement made by witness.
  • To modify or explain what has been said.
  • To develop new or odd facts.
  • To discredit the witness.
  • To remove any undue emphasis which may have been given to any of them.
Reexamination(Re-Direct – Examination)
  • This is conducted by the lawyer for the side which has called the witness.
The objective is:
  • To correct any mistake or to clarify or to add the details to the statement made by witness in cross-examination.
  • Leading questions are not allowed.
  • The opposing lawyer has right to re-cross-examination on the new point raised.
Conduct money
  • It is money paid in some legal systems to a person under the compulsion of a summons to witness/ subpoena to pay for their expenses to attend in court.
  • It generally incorporates a daily rate for each day the witness must attend in court (with a one-day minimum), plus a travel allowance to allow the witness to get to the place of the hearing.
  • Generally, conduct money must be delivered with the summons for it to have legal effect.
  • Witnesses are generally entitled to additional conduct money if their attendance is required on more days than anticipated.
  • Moreover, witnesses who are required to make an overnight stay to attend in court on more than one day are generally entitled to an allowance for accommodation and meals.
  • The rates for travel, daily attendance, accommodation and meals are generally set under a court tariff, and are fixed for all witnesses.
  • A witness may not refuse to appear merely because they believe the conduct money is insufficient to make up for their lost wages or actual travel expenses.
  • Witnesses may be paid more, but the additional cost cannot be claimed against the losing party – only the tariff amount can be recovered.
  • Occasionally, special witnesses, such as experts, may be entitled to receive conduct money under a higher tariff.
Exam Question
 
Witnesses
  • A person who gives evidences regarding facts.
Types
  1. Common witness
  2. Expert witness

Expert witness:

  • doctor, fingerprint expert, ballistic expert.
  • Volunteering a statement can be done by doctor

Hostile witness:

  • One who is supposed to have some interest or motive for concealing part of the truth, or for giving completely false evidence.
  • IPC -191
Perjury
  • Willful false evidence
  • Whoever, being legally bound by an oath or by an express provision of law to state the truth , or being bound by law to make a declaration upon any subject , makes any statement which is false , and which he either knows or believe to be false ,is said to give false evidence(sections 191 ,192 IPC and 344 CrPC).
  • Punishment of up to 7 years(section 193 IPC)
Record of Evidence
  • Oath is declaration required by law, which is compulsory and hold the witness responsible for the consequences of his evidence.
Cross-Examination
  • Witness is questioned by the lawyer for the opposite party.
  • The defense witness is cross examined by the public prosecutor.
  • Leading questions are allowed.
Conduct money
  • It is money paid in some legal systems to a person under the compulsion of a summons to witness/ subpoena to pay for their expenses to attend in court.
  • Conduct money is paid to expert witness with summons from civil court
  • In civil cases, conduct money is decided by judge
Don’t Forget to Solve all the previous Year Question asked on Witnesses and Recording Of Evidence

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Postmortem changes -Immediate

Postmortem changes -Immediate


Postmortem changes after death

  1. Immediate Changes
  2. Early Changes
  3. Late Changes

Immediate changes

  1. Permanent cessation of Brain function
  2. Complete Cessation of Circulatory function
  3. Entire and permanent cessation of Respiratory function

Permanent Cessation of Brain Function: 

  • Loss of Sensations; viz, 
  • touch, pain and temperature
  • Loss of reflexes
  • Unresponsiveness
  • Flat E.E.G.Rhythem
  • Confirmation of Brain- stem death

Brain –stem death: 

  • Brainstem death is defined by the absence of all brainstem mediated cranial nerve reflexes.

Criteria for Brain Death/Brainstem death 

  • The patient must be comatose state at least six hours.
  • No Abnormal Decorticate or decerebrate postures should be present
  • Absent Pupillary Light reflex (CN II, III)
  • Dilated fixed pupil not responding to light surest sign of brain stem death
  • Pupils are usually midsized but may be enlarged but they should not be small
  • Absent Corneal Reflex (CN V, VII)
  • Absent Vestibulocochlear Reflex (CN III, IV, VI, VIII) (No eye movement in response to caloric irrigation of ears)
  • Absent Oculocephalic Reflex
  • Absent Doll’s eye reflex
  •  Eyes will move with the head
  • No occular movements on rapid turning of head.
  • Absent Gag Reflex (CN IX, X)
  • Absent Tracheal Cough Reflex (CNX)
  • Absent Central Motor Response to Pain (CN V, VII) (No response to deep somatic stimulation).
  • A positive apnea test(apnea despite induced hypercapnia)

After disconnection of ventilator.

  • Complete Cessation of Circulatory Function 
  1. Magnus’s test:Fingers fail to show congestion and swelling to a ligature applied at their base.
  2. Finger nail test:blanching and filling of blood on applying pressure and release of pressure.
  3. Diaphanous test(transilluminationtest):Fallure to show redness in finger web spaces on transillumination from behind.
  4. Icard’s Fluorescein test:Failure to produce yellowish green discoloration of skin on injection of fluorescrin dye.
  5. Heat test
  6. Artery incision test
  7. A flat E.C.G. for a continuous period of five minutes

 Entire and permanent cessation of respiratory function 

  1. Mirror test:Mirror held in front of nose does not show vapors and blurring
  2. Feather test:No movement of feather if held in front of nose.
  3. Winslow’s glass water test.
Suspended Animation
  • It is a condition in which the vital functions of the body are at such a low level that they cannot be appreciated by clinical examination 

Apparent death 

  • This may last few seconds to minutes.

Voluntary- 

  • by yogis 

Involuntary –

  •  drowning, electrocution, heat stroke, typhoid fever etc. 
Exam Question
 

Criteria for Brain Death/Brainstem death  

  • Absent Pupillary Light reflex (CN II, III)
  • Dilated fixed pupil not responding to light surest sign of brain stem death
  • Absent Central Motor Response to Pain (CN V, VII) (No response to deep somatic stimulation).
  • A positive apnea test

After disconnection of ventilator.

  • Complete Cessation of Circulatory Function 
  • Magnus’s test:Fingers fail to show congestion and swelling to a ligature applied at their base.
  • Finger nail test:blanching and filling of blood on applying pressure and release of pressure.
  • Diaphanous test(transilluminationtest):Fallure to show redness in finger web spaces on transillumination from behind.
  • Icard’s Fluorescein test:Failure to produce yellowish green discoloration of skin on injection of fluorescrin dye.

 Entire and permanent cessation of respiratory function 

  • Mirror test:Mirror held in front of nose does not show vapors and blurring
Suspended Animation
  • It is a condition in which the vital functions of the body are at such a low level that they cannot be appreciated by clinical examination 

Apparent death 

  • This may last few seconds to minutes.
  • Voluntary- by yogis 
  • Involuntary – drowning, electrocution, heat stroke, typhoid fever etc. 
Don’t Forget to Solve all the previous Year Question asked on Postmortem changes -Immediate

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