postmortem artefacts, forensic medicine.

1. Dr Sujeet Kumar Samadder
RMO 1st year

2. POINTS TO BE COVERED
 Literature regarding “ARTEFACT”
 Definition
 Classification
 Description
 Medico-legal Importance
 Take home message

3.  British variant of ‘artifact’.
 First used in 1821.
 Origin – Latin.
 Meaning by dissection of word ‘artefact’-
 ‘arte’ – skill
 ‘fact’ from ‘factum’ from ‘facere’ – something made.
Cont.

4.  2 meanings:
 A simple object created by humans, from a particular period in
past for any practical purpose which have cultural or historical
interest, so usually used by historians. (a favorite word among
them)
 A product of artificial characters, usually due to extraneous
agency.
or
Something observed or evident that is not naturally present
but occurs as a result of outside source or procedure.
(a non-favorite word among doctors)

5. Definition
 Artefacts means anything which is not real but something
artificial.
 It is a change or feature which was not physiologically or
even pathologically present in the body tissues before
death in natural course of events, but which have been
caused or introduced into the body after death, often
leading to much confusion about its nature and causative
effect and often resulting in misinterpretation of medico-
legally significant findings.

6. Classification
 Four types
1. Due to resuscitative or therapeutic measures
2. Between death and autopsy
3. Due to injuries or lesions of organs before death
4. During post-mortem examination

7. Due to resuscitative or therapeutic
measures
1. From the very outset, I want to state that HISTORY OF
PATIENT is of utmost importance in every branch of medical
science, either clinical or non-clinical, so is applied to
Forensic Medicine.
2. Marks of injection & defibrillator on chest
3. CPR – fracture of ribs & sternum
a) Can cause haemothorax & haemopneumothorax
b) Fat embolism from fractured ribs or sternum
c) Laceration of spleen, liver and diaphragm
4. Positive pressure ventilation – emphysema, sub-pleural air
blebs, tension pneumothorax.
Cont.

8. DEFIBRILATOR MARKS SIMULATING ANTEMORTEM ABRASION
OVER CHEST

9. 5. Counter irritation Chinese style on neck – extravasation
of blood under skin – suspicion of throttling.
6. Endo-tracheal intubation – inexperienced hands – injury
to larynx and adjacent tissue – suspicion of foul play.
7. Carotid Angiography – neck muscle bruise – suspicion
of throttling.
8. Antemortem surgeon’s intervention on wounds may
mislead autopsy findings.

10. Between death and autopsy
1. Agonal artefact – ‘agonal’ the struggle that precedes
death.
a. Common agonal artefact is REGURGITATION &
ASPIRATION
b. Vascular collapse or shock before death
May prevent any significant bleeding
Crux: Accidental Deaths Can Also Have Congested Viscera.
Ante mortem Agonal Reaction Post mortem Agonal Artefact
Stomach contents aspirated and
goes to lower respiratory tract
mixed with fluid and mucus
choking effect death
Never reaches to lower
respiratory tract.

11. • Embalming : chemical treatment
of dead body to protect from
decay.
• Trochar insertion for arterial
access from
• Existing wound – may change
size shape direction , can create
false tracks
• Freshly created wound – may
simulate stab or gunshot wound
2.
Embalming
Artefact:

12. TROCHAR INSERTION FROM NECK AND
ABDOMEN

13. • Embalming fluid may extravasate blood from
veins & arteries, may mistaken as bruise;
Or
small bruise large bruise
• Embalming fluid interferes in toxicological
analysis.

14. 3. Internment & Exhumation Artefacts
Fungus on
injuries &
natural orifices
Area underlying
simulate bruise
Digging may
produce fracture
of bones

15. Exhumed body

16. 4. Artefacts due to handling of cadavers
• From transportation
• Abrasion, laceration, blood spots on clothes and body
which was absent in original.
• From careless handling
• Bruise in occipital area due to head bumping on hard
surface, differentiated by wiping off the bruise.
• Fracture ribs and vertebras.
• Weak, osteoporotic bones may get fractured due to
counteract the Rigor Mortis.
• Brush abrasions on back by dragging.

17.  Abrasion
 Laceration
Antemortem Postmortem
Looks brownish or reddish Brown or parchment like
Scab is noticed if gets older Scab is never noticed
Bleeding surface present if fresh No bleeding surface is evident
Healing is evident No such thing can ever happen
Can be found on any part of body Usually on bony prominences
Surface is moist Surface is dry
Antemortem Postmortem
Vital reactions will be seen No vital reaction will be seen
Margin is bruised No bruising is seen on margin

18. Post mortem abrasion

19.  Bruise – it is essentially a vital phenomena
Antemortem Postmortem
Swelling Cannot be similar as antemortem
Evidence of extravasation of blood Can be produced like antemortem to
some extent with in 2 minutes to
maximum of 2-3hrs, that to on the
tissue which can be forcibly
compressed against the bone.
Extravasated blood will impart
colouring to the affected area
But disproportionate to effect of force,
bruise will always be less
Colour changes denote resolution of
bruise
Occipital postmortem bruise simulate
antemortem bruise , difference is
absence of vital reaction apart from
microscopy.
Detection of enzyme ascertain
antemortem origin eg. – esterase,
aminopeptidases, acid phosphatase,
alkaline phosphatase

20. False simulated artificial bruise
• Irritant substances can do so
• Done to substantiate a false charge of assault
• By plumbago zeylanica, rolsea, semicarpus anacardium
• Margins contain tiny vesicles containing acrid serous
fluid
• Surrounding skin shows inflammatory reaction
• Diagnosis is made by incision, clot cannot be wiped off

21.  Clotted blood
 Postmortem blood clot is of 2 types:
 Red current jelly: forms rapidly, soft, lump, slippery,
uniformly dark red.
 Chicken fat: forms when clotting occurs slowly, consist of
2 layers:
 Reddish moist lower layer: consist of red cells, soft, lumpy.
 Bright yellow upper layer: of fibrin and serum, jelly like.
Antemortem Postmortem
It cannot be wiped off as it
fibrin.
It can be wiped off easily
because it does not have
fibrin.

22. 5. Artefacts due to Rigor Mortis
• To move the body, breaking is done, resulting in
asymmetrical Rigor Mortis
• May cause misinterpretation of Time Since Death.
• Heat/Cold stiffening may pose as an artefact against Rigor
Mortis.
• How to differentiate heat/cold stiffening to Rigor Mortis:

24.  Gas stiffening may simulate Rigor Mortis, but with the
following features one can easily differentiate it from Rigor
Mortis:
 Putrefactive changes will be seen, as it is due to inflation of
tissue spaces by gases of putrefaction, which is not seen in
heat or cold stiffening.
 No particular order of appearance or disappearance as in
Rigor Mortis
 Joints are not tight, so can be moved easily.
 No muscle shortening as in heat stiffening.
 Stiffening will pass if gas is allowed to escape by incisions over
the areas.

25. Rigor Mortis

26. Heat Stiffening

27. Gas Stiffening

28. 6. Artefacts due to hypostasis
• Localised hypostasis may be mistaken as bruise
• Hypostasis in dependent part of –
• Heart - Resemble Myocardial Infarction.
• Lung - Pneumonic or broncho-pneumonic consolidation.
• Intestine – suggest corrosion or strangulation.
• Stomach – looks like poisoning.
• Hypostasis in nails sometime confuses with cyanosis.
• Hypostasis artefact colors in –
• Refrigeration – pink.
• Carbon Monoxide poisoning– cherry red.
• Hydrogen Cyanide poisoning – bright red.
• Potassium Chromate / Bichromate – chocolate brown.
• Phosphorus poisoning – dark brown.

29. Hypostasis like bruise

30. Hypostasis of lung

31. hypostasis in refrigerated body: pink
colour

32. Decomposition
artefacts:
• It brings lots of significant
changes which can be mistaken
as artefact on naked eye
examination. Some of the
following are:

33. Sl. No. Artefact Misinterpretation Remark
1 Swollen oedematous
corpulent in early stage
Antemortem obesity
2 Blood stained froth
from mouth and nostrils
Pulmonary oedema,
head injury etc
History can tell about
head injury or drowning
3 Postmortem blisters Antemortem blisters
due to burn or scald
Difference shown in other
slide.
4 Post mortem bleeding
from severed blood
vessels
Antemortem bleeding Antemortem bleeding
cannot be wiped off
5 False groove over neck
due to tight collar, neck
tie
Strangulation Close observation,
history, ecchymosis if
evident.
6 Separation of head
sutures or burst of
abdomen due to gas
Trauma Close observation and
history
7 Gas in heart and blood
vessels
Embolism Alkaline Pyrogallol gas
treatment - gas will turn
brown due to O2 in
antemortem embolism

34. Sl. No. Artefact Misinterpretation Remark
8 Rupture of oesophagus
& stomach due to
gastric juices
corrosive acid
poisoning
Absence of vital signs
9 Hypostatic
discolouration of
intestine
strangulated or
infarcted bowel
History of hospitalization,
histopathology.
10 Stains on face due to
regurgitation
chemical burns chemical analysis
11 Vaginal introitus will
be loose, lax and flaccid
with blood stained
discharge with bluish
discolouration of
mucosa
sexual assault History, vaginal swab,
uterus examination and
histopathology will bring
the truth.
12 Decomposing pancreas acute pancreatitis Signs of inflamation and fat
necrosis willn be seen in
antemortem cases
13 Fissure or split in skin lacerated or incised
wound

35. Heat cracks resemble lacerations

36. Postmortem and
antemortem blisters

37. 8. Artefacts due to post mortem
corrosion
Gasoline exposure to skin in
accidents causes soiling
After drying –
abrasion or thermal
burn

38. 9. Artefacts associated with accidental deaths
– Railway electrician on electric poles
• Get electrocuted die fall on track
run over by train
• Accidental run over antemortem
post mortem run over
Identification is difficult difficult to tell about
ante / post mortem

39. 10.Artefacts due to animals or insect bites
– Rats & rodents – nibbled pale white
– Dogs & jackals – deeper teeth impression
Superficial Stab Injury
– Cat bite – small & rounded
– In drowned bodies – lips cheek eyelids, genitalia,
tips of genitalia, finger toes, muscles of limbs
Homicidal inflictions by fish, crab etc

40. Animal bite resembling
stab wounds

41. Gnawing Effect

42. Postmortem vulture eating,
appearing gun shot

43. – Ants, cockroaches bites in moist area (eyes, lips,
axila, etc), brown parchmentised area
antemortem abrasion
– Maggots – in antemortem injuries
changes stab or gun-shot wounds

44. Ant Bite

45. Gun shot appearing wound, made by
maggots

46. 11. Toxicological artefacts :
Erroneous results of tests.
• Faulty collection & faulty preservation of samples
• Blood sampling for alcohol estimation – from peripheral
veins
• Preservative used is NaF (Sodium Fluoride).
• Introduction of contaminants in body fluid may lead to
erroneous results of tests.
• Decomposed and embalmed bodies can have ethanol &
methanol respectively.

47. • Blood came out from
torn or cut vessels
• Post mortem clot can be
wiped off
• Ante mortem clot
cannot be wiped off
12.
Artefacts
due to
post
mortem
bleeding

48. Due to lesions of organs before
death
1. Artefacts in respect to gun-shot wounds
• Surgical/Medical tending – cleaning debridement
etc, removes gun powder, and changes the all over
character, as in J F Kennedy murder case
• Decomposition causes peeling of epidermis,
disintegration of tissue
• Trochar insertion in embalming – track distortion,
false track, detection of direction of fire may
become difficult

49. 2. X-ray Artefact
• In a dead body x-ray for gun-shot bullet, false
missile shadow can be found due to, bullet in
shirt pocket, bullet not fired, bullet between shirt
fold etc.
3. Artefacts induced by criminals
• Dismemberment of body part, mutilation
• Post mortem injuries

50. Artefacts during Post Mortem
Examination
1. Injury to visceral organs – ante mortem injuries
2. Fracture of skull bones, may continue with antemortem
fracture, misinterpretation of whole fracture
3. Hyoid and thyroid fracture during forceful extraction the
heart and lungs
4. Bleeding in neck; anti/post mortem ?
Can be told only after enzyme study.
So, take out heart, lung, brain before neck.4

51. Medico Legal Importance
Wrong conclusion as to
• Cause of death
• Mode of death
• Nature of death
• Antemortem or Postmortem
Unjustified suspicion of foul play
Misguided direction to investigating officer
Miscarriage of justice

52. Take home message
ARTEFACT MAY
LEAD
IMPRISONMENT
OF INNOCENT
AND FREEDOM
OF THE GUILTY.

53. THANK YOU