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Why blameless autopsies are important in a justice system
What you need to know:
- Photography during a post-mortem examination is very important, especially in forensic post-mortem examinations. It is very vital when such cases are reviewed.
- The pathologist, who carried out the post-mortem examination, did not carry out subcutaneous dissections of the upper and lower limbs to establish injuries attributed to attempts of the deceased to defend herself or any sign of struggle.
The safety of the criminal justice system relies, in part, on accurate and objective forensic evidence.
It is now increasingly apparent that when significant error creeps into the scientific or forensic medical aspects of a criminal case, the prosecution case may be unsafe. That there are some challenges encountered during post-mortem examinations is not in doubt. The worst outcome of some of these challenges is when it leads to a miscarriage of justice.
In some jurisdictions, there are post-conviction remedies that may detect and remedy such cases. The use of modern scientific methods such as DNA has exonerated convicted persons.
In some cases, it has been found that there are errors of interpretation of forensic evidence as presented at trial and these have led to wrongful convictions.
In the wee hours of December 24, 1997, a housewife died in her home. Her husband claimed that malaria was the cause of death. The deceased was reported to have been healthy and performing household chores the previous day.
Eyewitness account
During the night in question, neighbours of the deceased told court that they heard a female voice crying “mummy, mummy” and this went on for a long time.
Two post-mortem examinations were carried out on the body of the housewife and samples were also removed for toxicology. Injuries were found on the arms of the deceased. One doctor described the injuries as “multiple ecchymotic bruises, surrounding black deep burns.”
Ecchymosis is a medical term that means a little blood has seeped out of the blood vessels into the surrounding tissues. The second doctor documented the injuries as punched-out abrasions accompanied by multiple ecchymoses.
An abrasion is a superficial injury caused by a mechanical force. Both doctors attributed the death of the housewife to electrocution as manifested by electrical burns. It was alleged that the husband of the deceased and another relative tortured her with an electrical implement. The two were convicted of her murder and sentenced to death by hanging.
Toxicology report
The toxicology report of the samples revealed that a poison, an acaricide, was detected in the exhibits submitted for analysis. The government analyst told court that the acaricide found in the body of the deceased was very toxic and could cause death.
The court, however, rejected the evidence of the analyst as he did not quantify the amount of the poison found in the body of the deceased, and did not state in no uncertain terms whether the poison must have caused the death of the deceased.
These findings were presented during one of the meetings of the African Society of Forensic Medicine. The specialist doctors were appalled at these findings. The doctors were more than certain that the injuries described on the body of the deceased could not have been caused by electric current.
On the morning of September 10, 2017, another housewife died shortly after being taken to hospital. She had been found unresponsive in her marital bed that morning after she had prepared breakfast for her family. A post-mortem examination carried out on her body by a pathologist concluded that she had been strangled. The husband of the woman, a retired military officer, was convicted of her murder and handed a life sentence.
Husband protests
The husband of the deceased, however, contested the post-mortem report and appealed against the conviction and the sentence. Two forensic pathologists were independently asked to review the initial post-mortem report.
The first forensic pathologist to review the post-mortem report noted that the technique used in this particular case was below the accepted standards. The standard technique of bloodless neck dissection in cases of trauma to the neck was not carried out during this post-mortem examination and failure to use this method has been shown, time and again, to cause artefacts of blood in the neck that have erroneously been attributed to trauma such as strangulation.
To the expert, the hyoid bone and thyroid cartilage were not dissected out. These tissues usually get fractured due to the violent nature of manual strangulation. Furthermore, the deceased was resuscitated in hospital and the injuries that she got during the resuscitation could have led to misinterpretation of the neck injuries.
Photography during a post-mortem examination is very important, especially in forensic post-mortem examinations. It is vital when such cases are reviewed.
The pathologist who carried out the post-mortem examination, did not carry out subcutaneous dissections of the upper and lower limbs to establish injuries attributed to attempts of the deceased to defend herself or any sign of struggle.
Her fingernails were noted to be long and intact, suggesting that there were no features of a struggle or violence in this case, facts not in keeping with cases of strangulation. Further, her clothes o were intact, an indication that there was no struggle. In typical cases of strangulation, there is usually a struggle, hence tearing of clothes.
Finger nail clippings of the deceased should have been taken for DNA analysis, and often yield the DNA of the offender. It is apparent that this was not done in this case.
Histology is the microscopic examination of tissues and is important in determining the interval of injuries. It is also important in establishing any pre-existing medical conditions that would have led to the death of the deceased.
The post-mortem report made no mention of the results of any histology carried out. Histology often demonstrates the cause of death in people who die suddenly.
There is a report of a case that was thought to have been a homicide by strangulation but a histology examination of the tissues found a totally different and unrelated cause of death.
It is standard practice that during a post-mortem examination, the various organs in the body are dissected out and their weights taken. The weights of the organs indicate whether they are normal or are diseased.
This was not documented in the post-mortem report. The post-mortem report states that there was accumulation of bloody fluid in the abdomen and around the heart and lungs, findings which point to a disease process rather than strangulation.
Causes of death
In the post-mortem report, the causes of death were mentioned as asphyxia (lack of oxygen) and cardiac arrest. The mechanisms of death were listed as airway obstruction, obstruction of the arteries and veins, heart failure in remotely stimulated cardiac dysfunction and brain concussion. In the post-mortem report, the heart was noted to be normal. The mechanism of death of heart failure in a remotely stimulated cardiac dysfunction is, therefore, at best a non-specific finding and at worst a contradiction.
The forensic pathologist noted that concussion of the brain is a clinical diagnosis and cannot be seen at a post-mortem examination and is, therefore, not a pathological finding.
It is a disorder of brain dysfunction after head trauma and is pathophysiological and not anatomical. The expert also concluded that the skull fracture and swellings mentioned in the post-mortem report were artefacts as they were not accompanied by bleeding, as would have been in blunt force trauma in the living.
To the forensic pathologist, there was no evidence in the post-mortem report to support the conclusion that the cause of death was manual strangulation. Could this, once again, be a case of a miscarriage of justice?
To be continued
