6-23-07: Cleaning
the Crime Scene
Q: In
my story, a serial killer murders young women in their apartments/homes. Since
these are violent deaths, and the victims fight back, there
is ample chance for DNA to be left at the scene. My question
is what substance, or combination of substances, easily accessible
by the general public (perhaps bought on-line) could be used
to "clean up" the crime scene and make the job difficult
or impossible for the police, in regards to the DNA evidence?
Sherri Painter, Georgia
A: If
either blood or semen is left at the scene then bleach would
work. Any chlorine-bleach-containing cleaning substance can
destroy DNA or at least damage it to the point of being unusable
for identification. And these a readily available at your local
supermarket. Criminals are using this more and more as they
learn about it from CSI and Court TV.
But—there’s
always a but---blood is a liquid and seeps into all sorts of places. It can
soak beneath floorboards and baseboards, between tiles and into grout, and
deep into carpet pads. Here, simply lifting the floorboards or removing the
baseboards or unseating the tiles or peeling back the carpet might reveal undamaged
blood.
Blood can
also spatter on to walls and furniture and other objects. A careful search
of the scene can often reveal tiny blood droplets that escaped the killer’s
cleaning efforts. Blood can be unknowingly tracked or dripped from a small
wound by the killer to areas that aren’t cleaned. The best place to find
this type of evidence is near the corpse and along the killer’s escape
route.
And blood
and semen can be found on the victim or her clothing or on the bed sheets or
floor. These might also escape the killer’s view, particularly in nighttime
attacks.
6-21-07: Versed Effects
Q: I
am working on a novel in which my main character is injected
with Versed, then wakes up a few hours later with no memory
of what happened. She goes to the hospital shortly afterwards.
Would the hospital be able to detect Versed in her system?
What would the side effects of the drug be once she woke up?
Would she be drowsy, or would she feel normal? Does Versed
cause permanent amnesia, or would it be possible for her to
remember what happened after a few days?
Cynthia Lynn Combs, Chula Vista, CA
A: Versed
(which is commonly used is pre-op and pre-procedure anesthesia)
and several of the date rape drugs—GHB, Ecstasy, Ketamine,
and Rohypnol share the effect of interfering with memory formation.
While under the influence of these drugs the victim may seem
awake and alert, or slightly giddy or sleepy—it varies
from person to person, and will talk appropriately and answer
questions and to observes appear more or less normal. That’s
what makes these drugs so dangerous in a date rape situation.
The victim will have absolutely no memory—or if any a
very spotty memory---for events while under the drug’s
influence. This loss of memory is permanent.
The person
is not sleepy or groggy or confused as with narcotics and sedatives, and they
will suddenly return to real time but remember nothing for the previous few
hours. It’s as if the drug turns off the movie and then it restarts suddenly
when the drug’s effects dissipate. The victim would feel normal with
little if any residual effects of the drug.
When she
went to the ER and told her story, drugs and particularly sedatives or one
of the date rape drugs would be suspected and a toxicology evaluation would
be done. The Versed would be found.
6-18-07: Corpse in
Wood Chipper
Q: I
have a situation where the victim's body has been put through
a wood chipper, and the remains are found in a plastic container.
How would a medical examiner proceed to examine these remains,
and what language would s/he use to describe them to an investigating
officer? How would the process differ from a more conventional
autopsy?
CM, Hinesburg, VT
A: There
is no particular terminology to define the mass that would
remain. The ME would simply say the corpse was ground into
pulp. There would be no limbs or organs, or much of anything.
There would be no real autopsy since there is nothing to dissect.
The ME would of course be able to determine blood type, DNA
profile, and could do toxicological testing on the tissues,
which might reveal any toxins present. He would also look for
intact teeth in the hopes that these might help identify the
remains if the identity wasn’t already known.
Lastly he
would search for any bullet fragments or perhaps the tip of a knife as finding
either of these might point to the cause of death. If neither these nor toxins
were found, the ME would be hard pressed to state what the cause of death was
in this situation.
6-5-07: GSW to Abdomen
Q: I'm
writing a story about a character who is recovering from being
shot twice in the abdomen. If it's realistic recovery-wise,
I'd like for one bullet to hit her spleen and the other to
not damage any major organs, but to tear through some abdominal
muscles. And my primary question has to do with advice for
the medical timeline. How long would be medically accurate
or advisable for the following:
1--Time between being shot and arriving at the hospital
2--Time in surgery
3--Symptoms in various stages - about how long would she be
in severe pain and sedated vs. moderate pain and lessening
gradually to no pain whatsoever?
4--Days before she's released from hospital, assuming she has
a minor post-surgery infection.
5--How long before she could lift an eight-month-old infant?
6--Would this type of injury require physical therapy and if
so, what type of exercises?
7--And regarding the minor infection, what would be the symptoms
- fever, nausea, and listlessness?
Keri, Red Deer, Alberta, Canada
A: The
sooner the victim gets to the hospital the better but people
survive abdominal gunshot wounds (GSWs) for many hours and
even days. How rapidly the victim gets to the ER depends upon
the location of the incident. If in a populated area of a big
city the medics could have her in the ER in a matter of minutes.
If in a rural or remote area, it could take hours.
The surgery
would be to remove the spleen (these are almost always removed when damaged
and only rarely repaired since we get along fine without a spleen and this
organ is difficult to repair) and to repair the damaged muscles and to clean
any blood from the abdomen. It could take anywhere from an hour to 3 hours
depending upon the surgeon and the exact nature of the injuries.
The initial
GSW would be very painful as would the trip to the hospital. The victim would
of course be asleep during surgery and afterwards would have fairly typical
post-operative pain. The pain would be significant the first 2 or 3 days and
then gradually decline. By a week, she would be much better, but still uncomfortable.
It would take about 3 or 4 weeks for the pain to resolve completely.
Also, she
would continually lose blood during the time between the GSW and the operation.
As she lost blood her blood pressure 9BP) would gradually decline and she would
slip into shock. During this time period she could also experience and combination
and severity of these symptoms: nausea, shortness of breath, chills, dizziness,
confusion, disorientation, sleepiness, and finally coma and if not treated
death.
A post-op
infection is a serious problem and would prolong her hospitalization. It is
impossible to say exactly how long since these infections come in a thousand
flavors. With no infection and with all going well, she could be out of the
hospital in as little as 4 or 5 days. With an infection, depending upon its
severity and response to treatment, her hospitalization could be anywhere from
a week to several months. It’s up to you.
If all went
well, she should be able to lift the child after a couple of weeks. Maybe with
a bit of discomfort, but she could do it.
She would
really have physical therapy for this. Only get out f bed as soon as possible
after surgery and gradually become wore mobile with progressive walking.
6-2-07: Skeletal Remains
and Cause of Death
Q: In
my novel the body of a six-year-old boy is found entombed in
a brick wall. The body has been there for 25 years and is mummified.
These are my questions: How would the coroner go about establishing
the cause of death? Could an autopsy be done on a body in that
condition and would it be useful? Would there be a coroner's
inquest in this case and, if so, who would attend?
M. Heath, Birmingham, AL
Q: Skeletal
remains present difficult problems for the ME. With no tissues
to work with, the analysis of things such as gunshot wounds
(GSWs), knife wounds, most illnesses, and any reliable toxicological
testing is essentially impossible. But, not always. A bullet
might punch a hole in the skull, fracture a rib, or damage
another boney structure in a manner that the ME could deduce
that a bullet must have cause the skeletal defect. Also, the
bullet or some of its fragments might be found in or near the
burial site or even imbedded in a bone. Same can be said for
a knife blade. Certain boney cuts and scrapes might suggest
that a blade was involved. And the tip or a small piece of
the knife blade or an ice pick might be knocked loose during
the attack and be found with the skeletal bones.
Blunt trauma
might also leave behind skeletal evidence. Hammers, crowbars, baseball bats,
and other unusual implements can also leave behind boney defects that can be
matched to one of these instruments and the ME might be able to guess that
the weapon was one of these. For example, a circular defect in the skull would
suggest a hammer while a wide, linear defect might suggest a baseball bat.
An axe or hatchet could make deep cuts into the bones and even cut some in
half.
But finding
such skeletal damage doesn’t necessarily mean that the injury was the
cause of death. What if the person had broken a arm or suffered a skull fracture
and survived it and was then killed or died from some other cause? Fractured
bones heal in time. This healing is by way of callus (scar) formation at the
area of injury and this process takes months to complete. And of course, no
healing occurs after death. So, a fracture with a robust callus must have occurred
months before death. On the other hand, peri-mortem (around the time of death)
fractures show no signs of healing and thus no callus formation. Thus, a skull
fracture that showed no signs of healing could have occurred around the time
of death and may indeed be related to the cause of death. This means that a
blow to the head or a fall could have led to the individual’s death.
Conversely, well-healed fractures could not be directly related to the cause
of death.
But, what
of fractures that occur years after death, after the skeleton has been exposed
to nature for a considerable time period? Bones left in nature tend to undergo
trauma from natural forces and from predators. Can the examiner determine when
the fractures occurred? Often, he can.
Living bones
possess moisture, living protein, and fat, which makes them less brittle. Fractures
tend to be spiral or “greenstick” in nature. Bones that have dessicated
(dried out) are very brittle and tend to crumble more readily and fracture
cleanly, usually parallel or at a cross-section to the long axis of the bone.
By examining the nature of any fractures the forensic anthropologist may be
able to distinguish pre-mortem from distant post-mortem fractures.
So, based
on the timing and nature of skeletal injuries, the forensic anthropologist
and the ME might be able to determine the cause of death and whether it was
self-inflicted, accidental, or homicidal in nature. Determining the manner
of death is not always easy or accurate. What if the findings suggest that
the individual died as a result of a skull fracture? Was this from a blow to
the head (homicidal), a fall (accidental), or a fall after a heart attack or
stroke (natural)?
It’s not always easy.
This skeletal examination by the ME and the forensic anthropologist
would be the autopsy.
The coroner could call for an inquest or not. It’s
up to him and the courts. If so, the ME and any other scientist he designated,
the DA, and the investigating officers would attend. It could be open to the
public or closed at the coroner’s and the court’s discretion. If
an arrest has been made, the suspect might also attend with his attorney. You
might check with local law enforcement or with a local ju8deg to see how things
are done in Birmingham to be sure.
5-26-07: GSW Infection
Q: My
character has been shot in the shoulder and two days after
the surgery has developed an infection and high fever. Would
he be taken back to the ICU for treatment (which I assume would
be IV antibiotics)? Or would he be treated in his regular,
private room? Also, is this infection scenario credible, and
if so how quickly could he recover from it?
M.H., Maryland
A: Wound
infections are common complications of all types of wounds
including gunshot wounds (GSWs). Treatment is indeed with IV
antibiotics and keeping the wound clean and freshly dressed.
The wound would be cleaned with Betadine—an antiseptic
solution that is rusty red in color and with a very astringent
odor—and a fresh dressing would be placed twice each
day. It is also possible that the victim would have to return
to surgery to debride the wound---this is the surgical removal
of dead and infected tissue. At that time a drain might be
placed to allow tissue fluids and blood (good media for bacterial
growth) to drain away. This is simply a soft rubber tube that
is placed within the wound to serve as a conduit to remove
these fluids. It is usually left in pace for 2 or 3 days and
then as the wound begins to heal it is simply tugged out.
The victim
might or might not be placed in the ICU, depending upon how ill he was. Most
often these kinds of things can be handled on the surgical ward, but if he
became very ill with high fevers and unstable blood pressures, he would go
to the ICU until he stabilized.
He could
recover form the infection in a few days though it would take several weeks
for the wound to heal properly. This is highly variable and depends upon the
nature of the wound, the severity of the infection, the adequacy of the treatment,
the healing ability of the victim, and luck. In general, if all went we might
be in the hospital for the first week and then treated as an outpatient with
antibiotics orally for the next couple of weeks.
5-25-07: Bruise Patterns
Q: In
a new book, my heroine is framed for murder, which involves
a beating through martial arts technique and then a fatal push.
Are there specifics that help authorities determine from (I
assume) fatal injuries that can determine whether someone was
pushed versus they fell?
A mildly
clever notion I had for clearing my heroine is for her to voluntarily have
casts done of her knuckles. Having trained in karate in the past myself, I
know that over time, your knuckles somewhat morph from hitting equipment, etc.
So it occurs to me that bruising by knuckles on a body could be compared, or
am I way off and the notion ludicrous? I.e. size of bruising from say a foot
compared to a suspect's foot or hand?
Jeff Pearce, Toronto, ON, Canada
A: Pushing
almost never leaves any bruises in and of itself so distinguishing
a push from and accidental fall is virtually impossible. The
ME might be able to determine whether the bruises and injuries
on the victim resulted from a fall or a series of blows with
hands or other objects. Rocks and other objects can leave bruises
just as hands and bats do and the ME might be able to discern
a distinctive pattern that would distinguish exactly what made
the bruises. Or not. It can go either way.
Bruises
do often reveal the pattern of the object that made the bruise. For example,
a rope of a chain used for strangulation can leave behind neck bruises that
reveal the braid or link pattern. A blow from a baseball bat or a flat board
would leave different bruising patterns---the bat a narrower bruise with diffuse
edges and the board a wider bruise with sharper edges. Bite marks often leave
bruises that reflect the teeth pattern of the biter and these can sometimes
be used to match to a dental impression made from a suspect.
And knuckle
bruises can sometimes be matched. Knuckles could leave a row of 2 to 4 more
or less round bruises. The size and spacing could be used to rule out certain
hands as having delivered the blow while leaving those of a similar size and
spacing in the suspect list. The same could be true for the edge of the hand
or foot. Either could leave a linear bruise that reflected the thickness of
the side of the hand or foot. This would be less clear than would be the knuckles.
Also, if
the attacker wore a ring with an initial or other distinctive pattern, this
pattern could be left as a bruise on the flesh of the victim and it is possible
that it could be matched to the ring.
So,
the size and spacing of the knuckle bruises on the victim could eliminate or
not eliminate your character as a suspect. It’s up to you. Whatever fits
your plot needs will work.
5-17-07: Dwarfism
and Giganticism in the Same Family
Q: Could
a family with a history of occasional dwarfism in its male
children also have an occasional "giant" male child?
My story takes place circa 1890. Am I correct in assuming
that treatments based on sheep pituitary glands would not have
been 100 percent effective at reversing dwarfism at that time?
John Mullen, Poway, CA
A: There
are many causes of short stature---over 200 different varieties.
True dwarfism is a genetic disorder. By far the most common
is termed Achondroplastic Dwarfism, which is caused by a spontaneous
mutation. This means that it isn’t necessarily passed
on from parent to child and the parent doesn’t have to
have the dwarf gene for the child to be a dwarf. Rather the
defect occurs spontaneously and unpredictably. Any conception
can have this mutation so that normal parents can have a dwarf
child. The mutation is more likely to occur if one or both
parents are dwarfs but it isn’t the passing of the abnormal
gene, which occurs in most genetic disorders, that is the mechanism.
Complicated genetics but the bottom line is that dwarf parents
can have a normal child and normal parents can have a dwarf
child.
Giganticism
is not a genetic disorder but rather an endocrine disease. It is most often
caused by a pituitary tumor, which produces excess growth hormone (GH). This
excess GH causes the victim to grow very tall. If the tumor appears before
the bone growth plates close. If the tumor appears afterward, the person cannot
grow taller but rather will develop Acromegaly---a condition where the bones
thicken—particularly over the eyes and the jaw, as well as the hands
and feet. If the tumor appears early and is not treated for many years after
the growth plates close, the victim will suffer a combination of Giganticism
and Acromegaly. He will be both tall and thick boned. Like the wrestler Andre
The Giant. But this is not a genetic disorder so the probability that a family
with dwarfism would also have a Giant is no more likely than anyone else having
a child with Giganticism.
So,
yes, your family could have both a dwarf and a giant child but the probability
of this occurring would be extremely small statistically.
The use
of pituitary extracts for short stature is to supply excess GH to the victim.
If his short stature is caused by a GH deficiency then the extract will help.
But it will not help someone with achondroplastic dwarfism.
5-16-07: Gas As Tool
for Murder
Q: In
my scenario the villain has some wine with the heroine and
slips her a drug to make her very, very sleepy – incapacitated
but still breathing. There are lots of candles burning in the
room, or perhaps an oil lamp, as the heroine likes soft light.
When she has fallen asleep, the villain opens the tap of the
gas cylinder behind the gas fireplace so that gas starts to
leak into the room. The heroine does not wake up as she is
in too deep a sleep. What exactly would kill the heroine: would
it be gas inhalation/oxygen starvation or would it be more
likely that there would be an explosion and/or fire caused
by the gas and the candles or oil lamp?
Diane Korber, Cape Town, South Africa.
A: Definitely
an explosion. Any open flame, including pilot lights on ovens,
water heaters, or central heating units would ignite the gas
once it accumulated to any degree. So could flipping on a light
switch or striking a match. So, under the circumstances you
describe, the room would explode long before enough gas accumulated
to render the victim unconscious.
Natural
gas is classified as a suffocating gas. It is not a toxic gas as is cyanide
or chlorine since it doesn’t react with the blood or the cells of the
body. It causes problems when it accumulates in a sufficient quantity to reduce
the amount of oxygen (O2) in the air, thus suffocating anyone who breathes
the gas-laden air. Normal room air contains 21% O2. If the O2 level falls to
15 to 18% the victim would become short of breath, sleepy, and develop headaches.
If lower, the victim would become confused and lethargic and as the level of
O2 continued to fall, he would lapse into a coma and die from asphyxia. To
render the victim unconscious, enough gas would have to accumulate to cause
the concentration of O2 within the room to fall below 10-15% or so. For example,
if enough gas entered the room to replace half the room air, the air in the
room would then be half air and half gas. In this situation, the O2 content
of the air in the room would also fall by 50%. This means that the O2 percentage
would fall from 21% to about 10.5%. This would be a deadly situation.
For the
gas to accumulate, the room would need to be sealed or at least be poorly ventilated.
The rate of accumulation would depend upon the size of the room, the rate at
which the gas entered, and the degree of ventilation. It’s highly variable.
But, an open flame and a room full of gas are not compatible. The room would
explode long before the level of O2 fell enough to do the victim in. So, if
you want the victim to die from asphyxia rather than an explosion, dump the
candles and the oil lamp.
5-15-07: GSW to the
Aorta
Q: I'm
a fan of the classic British crime drama THE PROFESSIONALS.
In the show a main character is shot once through the back
and once through the chest with the bullet lodging in the aorta.
Luckily, it is 1970s TV, and he recovers within twenty minutes
with no adverse affects. My question(s): Is it likely he would
survive these injuries? If he did survive, what would recovery
time be like--and what would the residual lasting effects be
of such an injury? Would a return to active duty be likely?
Diana Killian
Author of The Poetic Death series & The Corpse Pose series
http://www.girl-detective.net
A: A
gunshot wound (GSW) to the aorta is almost uniformly fatal.
The aorta is the major artery in the chest that sits above
the heart. All the blood must pass through it on its journey
from the heart to the far reaches of the body. Any defect in
the aorta, whether from a GSW, a knife, an auto accident, or
any other significant trauma, allows blood to escape. And since
the blood in the aorta and the other arteries is under pressure,
it does so rapidly. Add to this the fact that blood that escapes
the thoracic aorta (the chest portion of this vessel that extends
from the heart to the legs) will fill the chest and compress
the lungs or the pericardium (sac that surrounds the heart)
and compress the heart. In this situation, death comes very
quickly.
Can people
survive a GSW to the aorta? Sure. I’ve seen it. It’s just not the
most likely outcome. And, as in the story you mention, there is no way the
victim would “recover in 20 minutes.” If he is to survive he would
need emergent surgery to repair the aorta. And this would mean he would have
to survive long enough to get the hospital and into surgery. This is extremely
unlikely and that’s why we rarely see it. In 35 years I’ve seen
it twice---once a GSW and once an ice pick.
If he did
survive to get to and get out of surgery and if all went well, he would remain
in the hospital for a week or so, recover at home for many weeks, and after
a few months could return to normal and go on with life. Of course there are
all sorts of complications that can rise up along the way and these would kill
him or render him disabled for many months if not forever.
5-14-07: Using DNA
to Determine Who Shed Blood at a Crime Scene
Q: If
the police found blood at a crime scene, but no bodies, and
the police can't find the woman who lives there or her ex-husband--how
much could they tell by testing her son's DNA? Could they tell
that the blood belonged to one parent (as opposed to a sibling
with similar DNA)? And could they tell if it was the mother's
or father's side?
Donna Andrews
http://donnaandrews.com
A: DNA
from the blood found at the scene could be used to determine
that the blood came from the missing mother in several ways.
The most straightforward method would be to obtain DNA that
was known to be that of the mother from another source. Maybe
from her toothbrush or from an envelope or stamp that she had
licked. A match would prove that the blood came form the missing
mother. In addition, DNA can in some cases be obtained from
a simple fingerprint. As the print is laid down, oil and cells
from the skin are deposited. DNA can be gleaned from the cells
in the print and used for matching. This way, if both the print
and the DNA matched that of the missing woman, there would
be no doubt as to who left the blood at the scene.
Also, the
ME could use the missing woman’s hair obtained from her hairbrush. Hair
is often removed with the bulb intact during brushing. Nuclear DNA obtained
from the cells of the bulbs could be matched to the blood and if they were
identical, the hair and the blood came from the same person. But, if no bulbs
were present, all is not lost. Mitochondrial DNA (mtDNA) can be obtained from
the hair shaft and if this matched the mtDNA from the blood, it would be strong
evidence that the blood was that of the same person that left the hair on the
brush. Not absolute proof, but strongly suggestive.
The DNA
used for standard DNA testing is nuclear DNA and it can be extracted from any
nucleated cell. But, cells also contain non-nuclear DNA. This DNA is found
within the mitochondria, which are small organelles that reside within the
cytoplasm of the cell and serve as the cell’s energy production center.
A small amount of DNA is found within the mitochondria, but each cell has many
mitochondria.
Mitochondrial
DNA has several characteristics that make it unique. It is passed from generation
to generation by the maternal linage, mutates rarely, is found in places where
nuclear DNA doesn’t exist, and is exceptionally hardy.
Your mtDNA
is inherited unchanged from your mother and only from your mother. And she
received hers from her mother, and her mother from her mother, and so on. Why
is this? At fertilization, the egg supplies the cell and half the DNA while
the sperm supplies only half the DNA. The sperm cell itself breaks down and
disappears after passing its genetic material into the nucleus of the egg cell.
This means that the actual cell and all the cell components (including the
mitochondria) of the developing zygote come from the mother. As the cell divides
and multiplies, these mitochondria are copied and passed on, generation after
generation. This means that all the cells of the body contain identical mtDNA.
If mtDNA
from the blood and from the son matched, this would prove that the blood came
from a sibling or a maternal relative of the boy. It could be his mother, his
sister or brother, his maternal grandmother, or his maternal aunt, since each
of these individuals shares the same maternal lineage and thus the same mtDNA.
This is not as strong a match as standard DNA, but in your scenario, it would
be adequate to identify who shed the blood at the scene.
Lastly,
the son and the mother would share much DNA in common, but this would not be
absolute evidence that the blood at the scene was from the boy’s mother.
Only that it was likely from a close relative. In paternity testing, the ME
must have blood from both parents and from the offspring to prove or disprove
paternity. The child receives his DNA from both of his parents, half from each,
so his DNA is a mixture of his parents DNA. For this reason, DNA from both
parents are needed to prove paternity. The same holds true for your scenario.
If the ME had blood from the boy, from the scene, and from the boy’s
father, then a paternity-like analysis would prove that the blood at the scene
came from the boy’s mother. In your scenario, since the boy’s father
is also missing, the ME would need to locate DNA from the father in a similar
fashion as described above. If he then had DNA from a hairbrush, toothbrush,
stamp, etc. that was known to be from the father, he could prove the blood
at the scene came from the mother.
5-9-07: Car Versus
Pedestrian Accident
Q: In
my book, a fifteen-year-old male football player was hit by
a drunk driver. He lands on the hood, slides up the windshield,
and then the driver slams on the brakes and the boy slides
back down off the car onto the ground. What type of injuries
would he sustain? Are broken legs and/or broken ribs (with
a possible punctured lung) plausible?
Anne M.
http://www.allanne.com
A: Yes,
this could easily happen and indeed often does. The boy could
suffer all types of injuries in any combination and in any
degree of severity. Or he could suffer only a few minor scrapes
and contusions. There is an adage in medicine that says: whatever
happens, happens. It’s all possible.
Head: He could suffer a concussion (loss of consciousness
with no real brain injury), a brain contusion (brain bruise),
a skull fracture, severe brain trauma and death, bleeding into
or around the brain, or a severe neck injury that could also
be lethal. And any combination of these.
Chest: Rib fractures with or without a pneumothorax (punctured
lung), a lung or cardiac contusion (bruise), a sternal (breastbone)
fracture, or only minor chest bruises and scrapes.
Abdomen: Superficial contusions and scrapes, rupture of the
liver, spleen, kidneys, bladder, or bowels, or rupture of a
major blood vessel with fairly quick death.
Extremities: fractures of almost any
type, severity, and combination. A common fracture in car
versus pedestrian accidents are fractures of the leg bones
in and around the knees. This is where the bumper usually
strikes the legs. There could be fractures of the upper leg
(femur), knee )patella), or lower leg (tibia—larger
bone or fibula—smaller bone), or any combination of these.
5-4-07: GSW versus
Stiletto Heel Wound
Q. My
male victim was found bound, wearing only a pair of pantyhose
in a field of wheat stubble with two holes in his chest. The
immediate assumption is to be that they are GSW's. I want the
weapon to actually be something more unusual like a stiletto
heel. Would the ME of a city the size of Topeka (approx. 50K)
be likely to mistake the wounds during the primary examination
in the field?
Tony H, Topeka, KS
A: Yes,
this could happen. In the field, he would see two round wounds
in the victim’s chest and could only speculate as to
what caused them. Since GSWs are common and the old medical
adage says “Common Things Occur Commonly,” he would
likely think these were either GSWs or perhaps some other round
stabbing device. He would never think of spike heels---unless
a bloody one was lying nearby. Also, the coroner wouldn’t
likely visit the scene. He could, but more likely one of the
coroner’s techs would. And they would be even more likely
to make the assumption you outline.
Once the
coroner got the corpse to the morgue and began his autopsy he would figure
it out very quickly. Maybe not the exact weapon used, but he would know it
wasn’t a GSW. The X-rays that are taken as part of the autopsy would
show no bullets or bullet fragments, and since there would be no exit wounds,
he would know that a GSW was not the cause of the injury.
How could
he figure out that it was a stiletto heel? Perhaps some of the leather or whatever
material the shoe was made of chipped off during the attack and he found the
small fragment in the wound. Analysis if this might lead him the conclusion
that the weapon was a shoe heel. And if the shoe was an uncommon type, the
material and color and chemical analysis of the chip might even reveal the
shoe’s manufacturer.
4-27-07: Poison That
Mimics a Natural Death
Q: I
am working on a short story in which a person is poisoned.
However, I'm not sure what type of poison I should use. The
requirements are: 1. A fast acting poison. 2. The cause of
death should appear natural (i.e. heart failure, or some other
illness) 3. Symptoms of death would seem natural under a normal
Medical Examination
Is
there such a substance? Would it be readily available to the general public
(without prescription or having to sign a form that would leave a trail to
the killer)?
Vaughn C. Hardacker
A: I
get this question a lot. Seems to be a common plot. The problem
is that most drugs don’t kill quickly and on demand.
And those that cause a dramatic death like a heart attack are
usually easily found at autopsy. In fact, there is no substance
that can't be found if the ME looks for it or does an aggressive
toxicological evaluation. The combination of gas chromatography
and mass spectroscopy (GC/MS) will give the exact and individual "fingerprint" of
virtually any and all chemicals.
The trick
is to make the death look like a heart attack or some other medical condition
so the ME will not perform an autopsy. These could happen if your character
is older and has a history of heart disease. Here the victim's private MD might
sign the death certificate with the cause of death as a heart attack (myocardial
infarction or MI) and the ME might accept that as the true cause of death and
not get involved. He can or cannot get involved solely at his discretion. Here
you could use cyanide, which causes a sudden and dramatic death, or any other
poison since if no autopsy were done it wouldn’t be discovered.
Other reasons
the ME might not get involved are such things as he could be lazy or corrupt
or in on the murder or gets paid off. Also if your story takes place in a small
town where there is no ME but rather a locally elected coroner who could be
the local mortician or dog catcher, he wouldn't be as likely to do an autopsy
and for sure all the toxicological stuff. He simply might not know how to handle
a poisoning death and also these tests cost a good deal and his budget might
be small. He wouldn’t be inclined to bust his budget on one case.
On the other
hand, there are several drugs that can actually cause a MI. Not with any degree
of certainty—they may or may not do the victim in---but it’s possible.
Large doses of cocaine and amphetamines can cause a rapid rise in blood pressure
and a spasm (narrowing) of the coronary arteries (these are the ones that supply
blood to the heart muscle) and this can lead to a MI or a deadly change in
the heart’s rhythm---either of which could lead to a sudden death. But,
whether this works in a particular person or not, is unpredictable. If your
character is older or has known heart disease and if you your villain slipped
some cocaine or amphetamines into his drink, he could collapse and die and
the ME might just right it off as an MI and never do an autopsy. I wouldn’t
use cocaine here since it has such a bitter taste and would numb the victim’s
mouth and throat and he would know something was wrong. But if the ME did do
an autopsy, the normal drug screen that is done as part of this procedure would
easily detect both amphetamines and cocaine.
Another
choice, as I mentioned above, would be cyanide. It is a “metabolic poison” that
basically shuts down the ability of cells to use oxygen. The red blood cells
cannot carry oxygen to the tissues and the tissue cells of the body can’t
use the oxygen anyway. It is as if all the oxygen were removed from the body
instantly. This process is immediate and profound and leads to death in 1 to
10 minutes, depending on the dosage.
Symptoms
are rapid breathing, shortness of breath, dizziness, flushing, nausea, vomiting,
and loss of consciousness, maybe seizure activity, and finally death. The victim
would develop sudden, severe shortness of breath, a flushed face, perhaps clutch
at his chest, collapse to the floor, and die, with or without having a seizure
in the process. It would look like a heart attack.
The problem
is that cyanide combines with the hemoglobin of the blood’s Red Blood
Cells (RBCs) to form cyanohemoglobin, which imparts a bright cherry red color
to the blood and tissues. If the victim cut or scraped himself as he fell,
his blood would be noticeably red. And at autopsy, the ME would see that the
blood and the tissues were reddish and any lividity that had developed in the
corpse would be pinkish rather than the usual bluish-purple and he would likely
suspect cyanide. Testing would then follow.
Another
situation would be if your victim had heart disease and was taking certain
cardiac medications. An over dose or adverse reaction or a deadly combination
of these could be written off as accidental. Even if the ME found the drugs
in excess levels at autopsy he might simple assume the victim got his meds
mixed up or miss used them. Happens all the time. Some examples would be:
Digitalis: If he were taking digitalis for heart failure or
a cardiac arrhythmia he would likely be taking one 0.25 milligram
(mg) pill each day. If someone slipped an extra pill or two
into his food each day for a week or two, the level of digitalis
in the blood would rise and could reach levels where he suffered
a deadly cardiac arrhythmia (change in the normal beating of
the heart, and collapse and die. This is a common effect of
digitalis excess and unfortunately this happens from time to
time in people taking this medication. The ME would assume
he had simply gotten mixed up and took too much of his digitalis.
You would be surprised how many people believe that if one
pill of their medication is good two must be better. Or your
killer could crush up 8 or 10 Digitalis tablets and put them
into some food and feed it to the victim. This would cause
an acute elevation of the digitalis level and all the things
described above.
Or your
character could have coronary artery disease with angina and could be using
a long-acting nitrate such as Imdur (a pill) or one of the many nitroglycerine
patches---Minitran and Transderm Nitro are two common ones. The taking of one
of the Erectile Dysfunction (ED) drugs—Viagra, Cialis, or Levitra—while
using a long acting nitrate can be treacherous. Both nitrates and Viagra and
its friends dilate (open up) blood vessels throughput the body. That’s
how they work. But too much of either class of drug or the two classes of drugs
taken in combination can cause excess dilatation and this can result in a profound
drop of the person’s blood pressure (BP). This in turn can cause a MI
or a cardiac arrest. With Viagra, this would most likely happen about 45 minutes
to an hour after ingestion and with the other two you could stretch that out
to 3 or 4 hours or so. This reaction is unpredictable but does happen and can
lead to the type of death you want for your story.
Here the
ME would assume the victim used Viagra in the face of the long-acting nitrates
and had a bad reaction. Again, happens all the time.
Another
option is that your character could be depressed and could be taking a class
of antidepressant medications known as Monoamine Oxidase Inhibitors or MAOIs
for short. If so, he would be vulnerable to the action of some other drugs
and foods.
MAOIs alter
the chemistry of the brain by blocking the enzyme monoamine oxidase, which
normally breaks down norepinephrine and other neurotransmitters in the brain.
Complex biochemistry and it’s not necessary to explain it. Just that
a person on a MAOI must not take some other meds and must avoid certain foods.
If not a Hypertensive Crises could ensue. In this situation the BP abruptly
shoots up and the person can suffer a stroke, heart attack, and death. This
reaction can happen anywhere from 30 minutes to 3 or 4 hours after ingestion
of the conflicting medication. Again, this reaction is unpredictable and might
or might not happen in any given individual. But it can and does happen, so
it will work in your story.
Common MAOIs
are: Nardil, Pamate, and Marplan.
Drugs that
can cause a Hypertensive Reaction when taken in conjunction with one if these
MAOIs are:
Amphetamines
Diet Pills of all types
Many High Blood Pressure meds
Flexeril (Cyclobenzaprine)
Prozac (Fluoxetine)
Paxil (Paroxetine)
Zoloft (Sertraline)
Demerol (Meperidine)
Any Tricyclate Antidepressant. These include: Elavil (amitriptyline),
Sinequan (doxepin), and Tofranil (imipramine)—and many
others.
The list is very long but the above are a few common ones.
Foods
to avoid are those that are high in the amino acid tyramine
such as: certain cheeses, fava beans, smoked or pickled meats,
fermented sausages (bologna, pepperoni, salami, and summer
sausage), alcohol, and caffeinated drinks such as coffee, tea,
colas, and chocolate. The list is much longer but this gives
you the idea and some choices.
If your
character was secretly given or was taking one of the MAOIs for some mild depression,
your villain could then slip him a few amphetamines or diet pills or a couple
of Paxils and wait. In a few minutes to several hours his BP would shoot up,
he would develop a severe headache, blurred vision, shortness of breath, and
then collapse. He could or could not have a seizure with this. The elevated
BP damages the brain and might even cause bleeding into the brain. This would
be called a hypertensive hemorrhagic stroke. That means that the stroke resulted
from bleeding (hemorrhagic) into the brain due to an elevated BP (hypertensive).
As you can
see, using a drug to mimic a heart attack and getting away with it takes a
bit of clever slight of hand. But that’s what storytelling is.
4-25-07: Identifying
Skeletal Remains
Q: In
my story, a murderer kills multiple people, dumps them (but
does not bury them) in a somewhat dilapidated abandoned barn
in Iowa, and sets fire to the bodies and the barn using accelerants.
The site is allowed to burn down, and left unexamined for five
years. Considering the climate and wild animals, what could
investigators expect to find if they examined the site now?
Would there still be anything recognizable? Anything useful
for identification? The fire burns the bodies VERY badly.
DKF, Indiana
A: The
odds are that only skeletal remains would be found. What the
fire didn’t destroy, putrefaction would. So, there would
be no tissues left and thus no fingerprints or tissue DNA.
This would make identification of the remains difficult and
perhaps impossible. And if predators entered the picture and
hauled away many of the bones, he might have only a few left
to analyze. But, the ME does have a few tricks.
He would
call in a forensic anthropologist to determine the height and stature, the
sex, approximate age, and perhaps the race of each of the victims. He could
then compare this to any missing persons list he had and perhaps come up with
the IDs. Also, clothing or jewelry at the scene might have survived the fire
and these too could help.
The same
goes for any teeth found. Even if only a few are found, they could be compared
to the dental records of any suspect missing persons and the IDs might come
from that. At least some of them. Or none of them.
The anthropologist
might also be able to determine the approximate time of death and the cause
of death. Skull and bone fractures from blunt trauma or chipped and shattered
bones from knife blades or bullets might help in this regard. And blade or
bullet fragments might be found. If the bullet could be matched to a particular
gun, this could lead to the killer and in turn to the victim’s ID.
DNA would
not likely survive such an intense fire, but drilling into the pulp of the
teeth might yield usable DNA. Or not. It could go wither way. Of course, the
ME would need DNA from a known missing person to compare it with or the DNA
would be worthless. This could be from a suspect missing person’s tooth
or hair brush or from licked letters and stamps from the suspected person.
The identification
of skeletal remains is a difficult and complex art. This is a brief sketch
of some of the things that the ME and the anthropologist would do. And it might
be all you need for your story. If not or if you want to know more, my book Forensics
For Dummies covers this subject in greater detail.
4-20-07: DNA in Half-siblings
Q: A
woman is murdered. At the scene of the crime, the police find
a blood sample of the killer. We know the killer and the woman
are half-siblings. Is this something the police would automatically
and inevitably discover?
Private Ellgee, Portland, ME
A: Not
likely, but maybe. The victim and the killer could have two
different blood types and their DNA could be very different,
since they only share one parent in common. And if so, the
ME would never consider that they were related. Unless good
police work turned up that possibility.
However,
the DNA profile of the two samples could be somewhat similar and this could
lead the ME to investigate further. DNA inheritance is a bit like roulette—you
never know exactly what you’ll get from each parent. But even if the
two DNA samples were somewhat similar, the ME could not prove their sibling
relationship with nuclear DNA alone. He could only suggest the possibility.
But, if
the ME were suspicious, he has another tool in his arsenal. If the common parent
were the mother, then the two would share the same mitochondrial DNA (mtDNA).
This DNA is passed down through the maternal line exclusively. So if the two
samples had the same mtDNA, the ME would know that the victim and the killer
were maternally related. They could be brother and sister (same mother), or
cousins (same grandmother through the maternal side). But he would not do this
expensive and time-consuming testing unless he was suspicious in the first
place. If the common parent were the father, then mtDNA would be of no value
since they would have had different mothers and thus different mtDNA.
If you want
to pursue thus line of investigation in your story, you can find a full discussion
of DNA technology, including mtDNA, in my book Forensics For Dummies.
4-19-07: Insulin to
Sedate
Q: I
have a character in my story who is a Type 1 insulin dependent
diabetic and I wish to know if a certain scenario is possible
or plausible.
The
bad guy forces this character to inject all of the insulin left in her pen
into her body, which will hopefully render her unconscious long enough for
him to take her to his hideout. Is it possible that the hero could reach her
before serious, irreversible damage has occurred?
What
effects, both visible and invisible, would occur after this large dose of insulin
was administered? How long would it take for her to lose consciousness? How
should the hero treat this character when he first arrives on the scene? Another
point is that the bad guy doesn't want her to die, so is there something that
he could do to stop the damage? And finally, would the victim require hospitalization,
and if so, for how long?
M McGoldrick, Scotland
A: Insulin
will not work for your scenario.
The brain
requires a continuous supply of blood and nutrients, predominantly in the form
of sugar. Excess insulin causes a profound and rapid drop in blood sugar levels.
This causes the brain to malfunction. First the victim will become sleepy,
then slip into a coma, and finally die from brain damage. The rapidity with
which the victim goes through the stages will depend upon the amount of insulin
given and the route by which it is administered. The brain does not live long
without the steady sugar supply. So, your victim would indeed lose consciousness
very quickly. In less than a minute if the insulin is given intravenously (IV),
in 2 to 5 minutes if given intramuscularly (IM), and in 10 to 15 minutes if
given subcutaneously (Sub-Q), which is an injection just beneath the skin.
But, the
loss of consciousness signals the onset of brain damage and every minute that
passes, the damage worsens. How long does it take for the damage to be severe
and permanent? It is highly variable and depends upon the amount of insulin
given and the degree to which the blood sugar level is depressed. It could
be permanent in as little as 5 minutes or could take up to an hour. So, this
is not a safe way to sedate someone. I’d suggest using a narcotic such
as morphine or heroin, or a sedative such as Valium or Xanax along with a little
alcohol, or Chloral Hydrate with alcohol (the original Mickey Finn), or one
of the date rape drugs. There is an article on these latter drugs on this site
under Articles. One of these should work well for your needs since they not
only sedate, they prevent the victim from remembering.
4-19-07: GSW to Leg and Shoulder
Q: My
protagonist is a healthy male in his mid-thirties who is shot
in the shoulder and leg from behind with a 9 mm handgun. Will
he feel impact and pain simultaneously or sequentially, e.g.,
jolt, then searing pain? If the bullet goes through the shoulder
and exits, will bleeding be light, heavy, or something in between?
If the femoral artery in the leg is hit, how quickly could
he bleed to death if no tourniquet is applied (he'll be thinking
he has only so much time to stanch the bleeding).
S.A. Clarke, Silver Spring, MD
4-17-07: Carotid Artery
Compression
Q: Just
a quick question: How long does it take for someone to die
if their carotid artery is compressed?
Carola Dunn, Author of Gunpowder Plot and Fall
of a Philanderer
A: The
two carotid arteries lie in the front of the neck on either
side of the trachea (windpipe) and carry blood from the heart
to the brain. They supply 90% or so of the brain's blood, with
the rest coming form two small vertebral arteries that travel
along the spine and over the back-most portion of the brain.
The carotids are interconnected in the brain so that in a normal
individual compressing a single carotid artery will have little
effect. Compressing both can cause a loss of consciousness
in 15 to 20 seconds and death in 2 to 4 minutes.
One general rule in medicine is that if the heart stops,
the victim will lose consciousness in about 4 seconds if standing, 8 if sitting,
and 12 if lying down. This simply reflects the effects of gravity on blood
flow. These numbers would also mostly hold true if both carotids were suddenly
pressed shut---not easy to do---see below. But, to the brain, the complete
interruption of blood flow through carotids would look the same as it would
if the heart had stopped. Either way, the brain would receive no blood supply.
And the brain needs a continuous supply of blood to function and survive.
Another medical truism is that dizziness, loss of consciousness,
and sudden death are simply gradations along the same scale. That is, what
makes you dizzy can make you lose consciousness, and what makes you lose consciousness
can cause death. One of the things that can do this is compression of the carotid
arteries. Brief compression, can cause dizziness, longer compression can cause
loss of consciousness, and even a longer period of compression can cause death.
Another variable is how severely the arteries are compressed.
If only partially collapsed, the victim might have no problems. Severe and
almost complete compression can cause loss of consciousness and death in short
order. And anywhere in between. Significant and potentially deadly compression
can result from strangulation--either manual or ligature, hanging, or an aggressively
applied choke hold.
So, depending upon the nature, force, and duration of the
compression, your victim could have no symptoms, become dizzy, lose consciousness,
or die. Or could progressively move form one of these to the next. The time
require for death could be a couple of minutes or many minutes if the compression
is less severe or intermittent. As the victim struggled, he could intermittently
release the choke hold and this would prolong the ordeal.
All these variable means that you can have it almost anyway
you want. The killer could overpower the victim, render him unconscious in
20 seconds, and kill him in 2 minutes. Or the struggle could go on for many,
many minutes. It's up to you.
4-16-07: Determining
Bullet Caliber
Q: I
have a mystery in progress and, in the interest of accuracy,
would appreciate answers to a few questions. The victim died
of a gunshot wound, and the projectile was still in the body.
Is it possible to determine from the projectile the type of
firearm used, e.g., shotgun or handgun? In my story, the weapon
used is a 9 mm handgun. Is it also possible to tell, from the
projectile, that it was a 9 mm? Finally, the city in which
the crime occurs has its own crime lab. Can you give me an
idea of a reasonable time frame for making these determinations?
S. L. Smith, St. Paul, MN
A: If
the bullet is fairly well intact, determining the caliber is
usually easy and can be done shortly after it is removed at
autopsy. Measuring and weighing will give the caliber. If the
bullet is severely deformed, measuring is difficult and weighing
alone might not give the exact caliber. But here the difference
between a .22 and .45 is easy but distinguishing a .38 from
a 9 mm might not be possible, since bullets of this caliber
are fairly close in size. If the bullet is fragmented and only
parts of it are available, the determination of caliber becomes
more difficult and sometimes can’t be done at all.
A shotgun
fires a mass of small pellets so it is easily distinguishable from a handgun,
which fires a single projectile.
4-12-07: GSW Treatment
Q: Question:
for my sequel to Chasin’ the Wind, my character
receives a gunshot wound to his left side. It is not life threatening
and treated at the ER. He is kept overnight and released. Would
the wound be stitched or stapled, or is there something else
the ER would use to seal it?
Michael Haskins, Key West, Fl
Author of Chasin’ the Wind
www.michaelhaskins.net
A: Gunshot
wounds (GSWs) are not usually sutured as are clean cuts. GSWs
tend to be more ragged. If the bullet merely grazed the victim’s
side, creating a furrow of skin and tissue loss, the wound
would be cleaned and dressed and the victim would be placed
on antibiotics. The wound would be cleaned and re-dressed once
or twice a day. It would heal in a couple of weeks unless and
secondary infection set in.
The same
is true if the bullet enters the skin and tissue and the exits out a separate
wound. This is called a through and through GSW. The treatment is as above
expect that a drain—basically a rubber tube---might be placed into the
wound to drain away any oozing blood and tissue fluid as these can serve as
a good broth for infection. The tube would be left in place for 3 or 4 days
and then removed and the healing process would progress from there.
4-9-07: Treatment
of Lung and Leg Injuries in a Remote Area
Q: My
story takes place in a small mountain town. A doctor is asked
to ride in the copter in place of an absent paramedic to attend
car wreck. Patient has a punctured lung from a broken rib.
I need to know the procedure Dr. would go through on arrival
and the jargon used. In same accident, child has severely crushed
leg. I need to know procedure taken in the field and jargon
used.
Bobby J. Shoemaker, Banner Elk, NC
A: In
the field, and particularly when helicopter transport is involved,
there are only a handful of things he could do. For the punctured
lung he would place the victim on an oxygen mask and start
an IV and transport him to the ER. In virtually all cases a
punctured lung with collapse (called a pneumothorax or pneumo
for short) is not life-threatening. We have two lungs, but
only need one to live. The only real complication that could
endanger his life would be the development of what is called
a Tension Pneumothorax. The physiology is complicated but the
net effect is that pressure begins to build inside the chest
and this can collapse the other lung and the heart and cause
shock and death. The signs that this is occurring would be
increasing shortness of breath, a fall in blood pressure, and
a movement of the trachea away from the side of the injury.
The trachea—wind pipe---is in the front of the neck and
is easily felt. It normally sits dead center. If the injured
lung is on the right side and if a tension pneumo develops,
the trachea would be shifted to the left.
Here he
would insert a large-bore needle into the chest on the side of the injury.
This could relieve the pressure and the victim would be fine. At the ER a thoracostomy
tube (called a chest tube) would be placed to re-inflate the lung. This is
a plastic tube that is passed through the chest wall and into the chest but
outside the lung. It is attached to a suction device and this causes the lung
to re-expand. It may take a few days for the lung to heal and then the tube
is removed.
The injured
leg would be placed in an air-filled cast, strapped to a board, and the child
would be flown to the ER, where surgery would be needed. Any bleeding would
be controlled with applying pressure and this victim would also have an IV
placed and be given oxygen via a mask. He would apply a tourniquet to the leg
only if the bleeding couldn’t be controlled with direct pressure.
The IV would
be something like D5 RL—stands for 5% Dextrose in Lactated Ringer’s
solution—and the oxygen would be given at 10 liters per minute.
4-4-07: Rape Report
Q: I
have a scene where my protagonist prosecutor is reading an
autopsy of a woman who had been raped. What are some phrases
that would be in that report?
Linda Bell Harrell, Cedar Key, FL
A: First
of all the term rape would not appear in the report since rape
is a legal term and not a medical term. Only and judge or jury
can determine if a rape has occurred. What the ME will do at
autopsy is to look for signs of force, or penetration, and
of sexual intercourse.
Force could
be in the form of drugs or restraints. The forensic toxicologist would test
for drugs in the victim and then determine if the drugs present and the amounts
found would be enough to make the patient complaint or unconscious. Not always
easy and is often a judgment call. Restraint could be in the form of ropes
or the attackers hands. The ME would look for bruises of the arms, wrist, and
throat that might indicate that the victim was strangled and/or held down.
Rope abrasions around the wrists and ankles could indicate that the victim
had been tied.
The problem
here is that some people practice rough sex with B&D and other sex games
involved. All the ME could say is that the victim was likely held down or tied
up. It would be up to the jury to determine is this was consented to or not.
Cuts from knives or bruises from punches would favor non-consent, but not always.
The next
thing he would look for are signs of vaginal or anal penetration. He would
look for contusions and abrasions. Again, these could be for forcible penetration
or from consensual rough sex. A judgment call that would be ultimately decided
by the judge and jury.
Lastly,
he would look for signs of sexual intercourse. Basically, this is finding semen
in the vagina, anus, or on the corpse. If semen is found, it proves that ejaculation
has occurred. But rapes can occur with ejaculation and in this case, no semen
would be found. But, if it is, it can also help the ME estimate the time since
intercourse and this can help clear some suspects and point the finger at others.
In living
victims, the duration of sperm motility is from 4 to 6 hours. If motile sperm
are found in vaginal swabs, the sexual act likely occurred less than 6 hours
earlier. After that, the sperm die and begin to breakdown and fragment, and
timing becomes a guessing game. First the tails are lost, leaving behind sperm
heads, and then the heads and tails undergo fragmentation and destruction.
The survival of sperm heads and sperm remnants in various body orifices is
extremely variable so that no truly accurate timeline can be established. In
general, these remnants may remain in the vagina for up to 6 or 7 days, the
rectum for 2 to 3 days, and the mouth less than 24 hours.
In cases
of rape-homicide, sperm may remain in the vagina of the corpse for up to 2
weeks. So, if the ME found sperm or sperm remnants in the corpse he could say
that the rape/intercourse occurred within the past two weeks. Again, this is
a best guess situation.
In his report
and court testimony, your ME would simply describe the bruises and abrasions
he saw on the victim’s arms, wrists, neck, etc., any injuries to the
vagina or anus, and whether any semen was found or not. Based on these he might
conclude that the victim was restrained, was penetrated, and that intercourse
had taken place. The jury would then decide what this meant in terms of rape
versus consensual sex.
4-4-07: Poisons in Five-Year-Old Skeleton
Q: I
use your Dummies book---incredibly helpful---but I have a couple
of questions, if you have time to answer them. Can poisons
be detected in bones of a 17-year old male that were buried
in the sandy desert for five years before discovery? Or should
I make the skeleton be buried longer since I want only the
bones to be found, no flesh.
You
say that bones contain moisture, fat and protein how long does it take for
these elements have disappeared from the bones, if at all? Would there be any
dried blood clinging to the bones, or in the sand and if so, could that be
used to test for poison?
J. Amadio
http://www.ghostwritingpro.com
A: A
corpse buried in a desert can either putrefy (decay) or mummify.
The key is the average temperature and the moisture content
of the area. In hot and dry climates, mummification is more
likely. In warm and damp areas or if the body is buried during
the rainy season that many deserts experience, then the corpse
would more likely decay. The bacteria that cause putrefaction
thrive in warm, moist environments.
The rate
of tissue destruction also increases the warmer and damper the climate. A corpse
in a swamp in Louisiana could be completely skeletonized in a 3 or 4 weeks,
while one in a snow bank in Minnesota wouldn’t decay until spring and
might take years to be reduced to a skeleton. It is extremely variable but
after five years most corpses would be skeletonized under average temperate
conditions. So, within the above parameters of environmental conditions, your
corpse could easily be only a skeleton or could be a mummy. Either way would
work.
If the corpse
in your story were to mummify, the ME and toxicologist would have tissues to
work with and a much better chance of finding any toxins that might be present.
If the corpse is reduced to only bones, then there would be no tissues. And
if there were no tissues there would not likely be any blood remnants, since
blood is considered a tissue and is subject to putrefaction just as are muscles,
skin, and organs. The same is true for the bone marrow, which is where the
fats and moisture of the bones predominantly reside. Very few toxins can be
found in bones, but there are several that can be found in hair. Often skeletonized
remains will have hair nearby as hair is sturdier than tissues. Heavy metals
such as arsenic, lead, and mercury can usually be uncovered in hair.
What happens
in your story depends upon the condition of the corpse and exactly which poison
is involved.
4-2-07: Anthrax Vaccine
and Treatment
Q: Your
article on Anthrax was very helpful, but my question is: If
someone has been inoculated, how much of a threat is being
around the powdered version? We've run across terrorists who
have lots of the stuff, but it's sealed in containers ready
to be smuggled. The bad guy, who has been inoculated, has a
small vial of anthrax powder and forces two of my characters
to inhale the stuff (a teaspoon full each) while he wears a
mask and gloves. The clock is ticking and the good guys have
24 hours to be treated if I understand the process correctly?
Philip Donlay, Author of Category 5 and Code
Black
http://www.philipdonlay.com
A: Anthrax
vaccine is a series of 6 doses. The first three are given at
2-week intervals, then at 6, 12, and 18 months. After this,
an annual booster is needed to maintain protection. Once completed,
it protects against both the cutaneous (skin) variety and the
inhaled type. If your guy was adequately vaccinated, he wouldn’t
need treatment. If not, treatment should be as soon as possible
with ciprofloxacin, doxycycline, or penicillin. Since inhalation
anthrax is rare there are no clinical studies on the effects
of treatment delay but every hour counts as the inhaled spores
invade the bloodstream and spread throughout the body. If you
need 24 hours, then it will work. In real life, sooner would
be better. But then again, you deal with what you have. Even
if treatment is delayed for 24 hours, your guy could recover
completely. Or not. It could go either way so make it come
out as you need.
4-2-07: Cyanide Poisoning Signs
Q: I
am one of 10 women who are writing a murder mystery. We would
like to know if our victim is poisoned by sodium cyanide in
sushi how long will the redness or ruddiness remain in his
skin after his demise and the body is found and the authorities
come? Also will the ME test him for this type of poisoning
ie: stomach contents. He may not be discovered for a couple
hours. Will his tongue be tested? Are there any other outward
signs from NaCn? There will be no signs of foul play. He is
found slumped over.
Mary Ann Kerns, Jackson, NJ
A: Cyanide
is a metabolic poison, which means that it poisons the cells
of the body. It reacts with the iron in cytochrome oxidase,
an enzyme necessary for the cell to use oxygen. This reaction
prevents the body’s cells from using oxygen and they
begin to die rapidly. It is as if all the oxygen was suddenly
removed from the body. It’s still present, it’s
just that the cells can’t use it.
Since the
cells no longer remove oxygen from the blood, the blood remains very well oxygenated
(rich in oxyhemoglobin) and thus bright red. Another contributor to this cherry-red
color is the reaction of cyanide with the blood’s hemoglobin to produce
cyanohemoglobin, a bright red compound. This means that the blood of victim’s
of cyanide exposure is bright red in color. As the blood settles and produces
lividity, the lividity reflects the red color of the blood.
At autopsy,
the ME would see the bright red blood, the reddish hue of the internal organs,
and pinkish lividity and would suspect the presence of cyanide (or Carbon Monoxide
which also turns the blood bright red). He would then test for both. He might
also detect the typical bitter almond odor of cyanide. That is, if he were
capable. Curiously, the ability to detect this odor is genetically determined
and about 50% of people cannot.
So, your
victim would have pinkish lividity instead of the usual bluish-purplish lividity
and bright red blood and organs. Since all bodily processes cease at death,
this colorization would remain until the body decayed. The ME would readily
see this and test for cyanide. There would be no need to test the victim’s
tongue. The blood, tissues, and stomach contents would each test positive for
cyanide and the ME would know the cause of death. He might then have the toxicologist
measure the cyanide level in the blood to confirm his suspicions.
4-2-07: Codeine OD
Q: My
heroine has been given Tylenol with codeine by the bad guy,
ingested unknowingly in a cup of coffee. She has an adverse
reaction to codeine. Would the ER doctors give her any drugs
to counteract this, and if so, which ones? Or would they
simply let her sleep it off and monitor her?
Ruth Carrillo, author of The Bard’s Circle Chronicles Series
A: Codeine
is a opiate narcotic, which means it is in the opium family.
In fact, it and morphine are the two principle substances obtained
from the opium poppy. As with all narcotics, it depresses many
bodily functions in the user. The symptoms of codeine ingestion
are giddiness, sleepiness, loss of balance and coordination,
coma, and death. The drug depresses the respiratory center
of the brain so that if too much is taken the victim lapses
into a coma, stops breathing, and dies from asphyxia.
However,
these effects would not be considered “adverse” reactions since
they are predictable and consistent. An adverse reaction would be such things
as an allergic reaction. And an allergy to codeine is not an uncommon occurrence.
So, I’m not exactly sure what you mean by “adverse” reaction.”
If you mean
an allergic reaction, the victim would develop hives, redness to the skin,
wheezing and difficulty breathing (like an asthmatic attack), low blood pressure,
and could slip into anaphylactic (allergic) shock and die. The treatment is
to give an intravenous (IV) or subcutaneous (Sub-Q) injection of Epinephrine,
IV steroids (such as Decadron or Solu-Medrol), and IV Benadryl. This should
rapidly reverse the allergic effects. Each of these drugs might have to be
given again, if the symptoms and signs of the allergic reaction reappear. The
reaction should subside and after about 12 to 24 hours would be unlikely to
recur.
If you mean
that the person reacts to the codeine in the more predictable manner, then
the treatment is directed toward breathing for the victim and reversing the
effect of the narcotic. Breathing for the victim could be done two ways. An
Ambu bag attached to a facemask would be easy and immediately available in
any hospital. The paramedics also carry them. An ambu bag is football-shaped,
made of rubber or some synthetic material, and works like a bellows. It is
attached to a facemask and each squeeze of the bag forces air through the mask,
which when held tightly against the victim’s face forces air into the
lungs. The second method is to place an endotracheal (ET) tube. This is a plastic
tube that is passed thought the victim’s mouth or nose and into the trachea
(wind pipe). Either an Ambu bag or a mechanical ventilator is then attached
to the ET tube and air is rhythmically forced into the lungs. This must continue
until the drug wears off.
To hasten
this process, Narcan is given IV. This is a drug that blocks the effect of
the Codeine. It works in about a minute. Again, the drug might have to be given
several times over the first hour or so if the victim begins to slide back
into a coma. Once the effects of the drugs wear off the victim would be essentially
normal. Unless brain damaged occurred during the time he wasn’t breathing,
that is.
4-2-07: Cardiac Arrest From Blunt Trauma
Q: I’ve
just finished a scene in which my good guy gets hit in the
chest by a bullet. He’s wearing his body armor. I’m
thinking that trauma to the heart could stop it and then I’ll
have the folks around him apply CPR to bring him back. Am I
within the base pads?
Norm Benson, Lower Lake, CA
http://www.normbenson.com
A blow to the chest can indeed cause
a deadly change in heart rhythm (cardiac arrhythmia), usually
in the form of what we call Ventricular tachycardia (a rapid
rhythm that is not very effective at pumping the blood) or
heart block (a block in the conduction of electricity from
the upper to the lower part of the heart), which is a very
slow and ineffective rhythm. Both can cause shock and death
if CPR isn’t instituted
very quickly and then either medication (for the former) and
a meds and pacemaker (for the latter). This is however an extremely
rare occurrence and would not likely happen under the conditions
you describe. Like virtually never. Of course anything is possible,
bit that doesn’t make it plausible. It simply takes a
more massive blow than could be provided buy something as small
as a bullet, regardless of its speed. A 2X4 or a car bumper
or a fall from a height or a concrete block, okay, but a bullet,
no. |
