Transcript Coroner Presentation - El Paso County, Colorado

INTRODUCTION TO
FORENSIC MEDICINE
Robert C. Bux, MD
Coroner/Medical Examiner
El Paso County
DUTIES OF THE MEDICAL
EXAMINER
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Determine the cause and manner of death
Positively identify the deceased
Determine the time of death
Collect evidence from the body
Document injuries and natural diseases
Provide expert testimony in court
CASES REQUIRING
INVESTIGATION
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Sudden, unexpected deaths
Suspicious deaths
Trauma related deaths
Deaths in custody
Deaths in the work place
Deaths in less than 24 hours after
admission to an institution
CAUSE OF DEATH
Any injury or disease that is
responsible for initiating a train of
events, brief or prolonged, that
result in the individual dying.
MECHANISM OF DEATH
The physiological derangement
produced by the cause of death
which results in death.
MANNER OF DEATH
An opinion based on known facts
concerning the circumstances
leading up to and surrounding the
death in conjunction with the
findings at autopsy and the
laboratory tests.
NATURAL DEATH
Death resulting from a natural
disease process.
SUDDEN DEATH
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Cardiac arrhythmia (25% of all A.M.I.’s
present with a sudden death)
Pulmonary embolus
Seizure disorder
Berry aneurysm or CVA (rarely sudden)
Drug overdose (cocaine or heroin)
ACCIDENTAL DEATH
An unexpected death which results
from a lawful act performed under a
reasonable belief that no harm is
possible.
“GOOD JUDGMENT COMES FROM
EXPERIENCE; AND EXPERIENCE – WELL,
THAT COMES FROM POOR JUDGMENT.”
Anonymous Surgeon, Vietnam
Toxicology
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Blood:
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Alcohols - 0.111 g/dl Ethanol
Acid & neutral screen - None detected
Alkaline screen - None detected
Cannabinoids None Detected
Volatiles - 0.23 mg/l Toluene
Vitreous:
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Alcohols -
0.205 g/dl Ethanol
SUICIDE
The deliberate termination of one’s
existence.
HOMICIDE
The killing of one human being by the act or
omission of another.
UNDETERMINED
Autopsy and investigation fail to provide
sufficient information to establish a
manner of death.