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Death Investigations

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Death Investigations
Summarize algor mortis and livor mortis.

Algor Mortis
Algor mortis, the cooling of the body postmortem, is the result of a cessation in
thermoregulation. As body temperature is controlled by the hypothalamus, this homeostatic
feature can no longer be maintained after death. Thus the body temperature will begin to change
toward the ambient temperature of the room or surroundings in which the remains are found.
This occurs through radiation, convection, conduction, and, if the subject is wet, evaporation.
Most commonly, the body temperature decreases, although in more extreme climates an increase
in cadaver temperature may result. Consequently, temperature change can play a particularly
important role in establishing the PMI, which in turn helps to reconstruct the chronology and
circumstances surrounding death (Guharaj, 2003).

Although a generally accepted principle is that body temperature decreases by an average of 1°C
per hour, research findings suggest that this process can be delayed by up to 3 h in the initial
postmortem period (Al-Alousi et al., 2002). Newton’s Law of Cooling states that the larger the
temperature difference between an object and its surrounding, the quicker it will cool. However,
it has been well accepted that this pattern should not be adapted for cadavers with Rainy (1868)
first recording that cadaveric cooling did not occur in this fashion. This was later attributed to the
continuation of metabolic processes and the complexities of interior and surface cooling,
resulting in nonuniform changes across the body being recorded (Joseph and Schickele, 1970).
Numerous formulae have been suggested over the last century taking this into account, each with
varying degrees of accuracy noted but all of which faced problems in their application to field
work due to differences predicted by body position, location or temperature reading, or the
presence of clothing (Glaister, 1942; Marshall and Hoare, 1962). It has also been noted that such
standardized curves may not take into account other factors such as natural differences in body
temperature at the time of death, wind speed, and surface area-to-volume ratio. For example,
thinner individuals tend to cool much more quickly. Individual variations such as these have led
to suggestions that this PMI estimation approach holds little value when applied to human
remains in real criminal investigations (Sutherland et al., 2013).

One of the most renowned tools for PMI estimations from body temperature is the nomogram
method. The approach adopts separate graphs that are provided for ambient temperatures above
and below 23 °C and considerations such as clothing and water can be taken into account with
the lag phase also corrected for (Henssge, 1988). To militate against the numerous environmental
uncertainties, a more sophisticated formula was subsequently designed to factor in multiple
crime scene variables into the “Henssge equation.” This formula facilitates more objective
calculations as it does not focus on an exact time of death but rather a PMI range of 5.3 h.
Although less precise, this novel technique, which is now available through smartphone
application technology, has increased accuracy and functionality at crime scenes (Madea, 2015).

Concerns over the use of algor mortis as a feasible method for PMI estimation remain
particularly for death scenes where significant abdominal trauma or potential sexual assault has
occurred. This is because the methods for measuring postmortem body temperature rely on the
penetration of internal organs or rectal thermometer readings, which can be either impossible or
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unsuitable depending on the nature of the crime. Additionally, depending on the amount of
microbial and entomological activity, accurate body temperatures cannot always be established
as maggot masses and bacteria activity may generate heat. Therefore the use of body temperature
as a method for determining PMI should be restricted to fresh remains

Decomposition and postmortem soft tissue changes

The soft tissues of the body are the first to become modified after death. Early visible
postmortem changes to the soft tissues include algor mortis, and livor mortis stages that are
typically assessed by investigators and the medical examiner at autopsy. Algor mortis is the
cooling of the body after death. During life, the body maintains a temperature of approximately
98.6°F (37°C), which is an optimum operating temperature for many of the body’s chemical
reactions. After death, the body no longer maintains this temperature, so it begins to cool and
equilibrate to the ambient temperature. The rate at which this cooling occurs depends on the
temperature differential between the body and the environment since elevated body
temperatures and cool ambient temperatures will increase this rate, but as a general rule, the
body cools at a rate of about 1.5°F (0.8°C) per hour during the first 12 hours.

Livor mortis (also called hypostasis) is the pooling of the blood in the body due to gravity and
the lack of blood circulation as a result of the cessation of cardiac activity. These factors cause
the blood to pool in the lowest points of the body, giving the skin a purplish-red discoloration.
Livor mortis typically begins around 30 minutes to 4 hours after death, and is most pronounced
approximately 12 hours after death. There are two recognized stages of livor mortis, which are a
function of whether the blood has begun to coagulate. Prior to blood coagulation, livor is
“unfixed”; if the body is moved, the blood will repool in whichever part of the body is closest to
the ground in the new position. Livor becomes fixed when the blood coagulates, preventing the
blood from repooling if the body is moved into another position.

What is livor mortis?

Livor mortis, also known as post-mortem lividity or post-mortem hypostasis, refers to the
pooling of blood in the lower portion, or dependent parts, of the body after death. This results in
a dark purple discoloration of the skin. Livor mortis is one of the four post-mortem signs of death
and occurs as a result of the heart no longer pumping and moving blood through parts of the
body. Consequently, gravity causes the red blood cells to sink and pool in the dependent parts of
the body.

When does livor mortis set in?

Livor mortis begins appearing as dull red patches after 20 to 30 minutes from the time of death.
Over the next 2 to 4 hours, the patches come together to form larger areas of bluish-purple
discoloration. At this point, the skin is blanchable, meaning that it can take on a whitish
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appearance when pressure is applied due to the diversion of blood flow from that region.
Blanching can last for up to 8 to12 hours after death. Once pressure is removed, the blood will
usually return to the pooled location, appearing bluish-purple in color again. After 12 hours, the
skin typically becomes non-blanchable or fixed, meaning applying pressure on the skin during
this period will no longer lead to a whitish discoloration.

Forensic investigators often use these signs to determine the estimated time of death in crime
scenes. Assessing livor mortis can also be useful in determining the cause of death, particularly
in cases such as hypothermia, carbon monoxide poisoning, and cyanide intoxication, as such
factors can lead to livor mortis taking on a variety of distinguishing colors.
What is the difference between livor mortis and rigor mortis?
Rigor mortis is another post-mortem sign of death and refers to the stiffening of the muscles.
Unlike livor mortis, which develops less than an hour from the time of death, rigor mortis begins
2 to 4 hours after death and develops fully by 6 to 12 hours. Stiffening occurs as cells in the body
are broken down by digestive enzymes and intracellular calcium is released. This results in
continuous muscle contraction since calcium is a necessary component in initiating contraction.
Another cause of rigor mortis is the lack of adenosine triphosphate (ATP), or the energy
molecules in the muscle cells. After death, oxygen is unable to reach muscle fibers and ATP is
no longer produced. This, along with the build-up of lactate and phosphate in muscle tissue,
results in an acidic environment that promotes the binding of actin and myosin fibers of the
muscle. The muscle remains contracted as long as the actin and myosin fibers of the muscle are
bound. Rigor mortis can last anywhere from one to four days, after which the muscles become
limp again. Lower temperatures speed up the onset of rigor mortis and prolong its duration,
whereas warmer temperatures will slow the onset and shorten its duration.

The remaining two post-mortem signs of death include pallor mortis and algor mortis which both
occur shortly after the heart stops beating. Prior to both livor mortis and rigor mortis, the body
goes through pallor mortis, or the development of pale skin, and algor mortis, the cooling of the
body after the body is no longer producing heat.
What are the most important facts to know about livor mortis?
Livor mortis is the gravitational settling of blood which is no longer being pumped through the
body after death, causing a bluish-purple discoloration of the skin. It is one of the post-mortem
signs of death, along with pallor mortis, algor mortis, and rigor mortis. Livor mortis usually sets
in 20 to 30 minutes after death and increases in intensity until it becomes fixed at about 12 hours.
Assessment of livor mortis can be useful in determining the approximate time of death or cause
of death, based on the approximate stage of lividity and the specific coloration

Explain postmortem artifact and postmortem lividity.

Postmortem artifact is defined as “any change caused or afeature introduced into abody after
death, that is likely to lead to misinterpretation of medically significant antemortem findings”. In
the context of Forensic Pathology an artifact can be defined as a spurious postmortem
presentation which stimulates a finding which would be significant in the course of antemortem
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events1. Artifacts can be broadly divided into two groups i.e., those introduced in the period
between Death and Autopsy2 and those introduced during autopsy.

POSTMORTEM LIVIDITY (LIVOR MORTIS)

DEFINITION
Postmortem lividity is the purplish or reddish purple areas of discolouration of skin and organs
after death due to accumulation of blood in dependent parts of the body and seen through the
skin.
It is also known as Postmortem Stains, Postmortem Hypostasis, Postmortem Suggilation,
Postmortem Vibices.
MECHANISM
After death, blood in its fluid state gravitates into the toneless capillaries and venules of the ‘rete
mucosum’ in the dependent parts of body and causes capillovenous distension, which through
the skin imparts a discolouration to the area involved.
SITE
It can involve skin, all tissues and viscera.
In body which was supine at death, it is seen on the back, ears and posterior aspect of the body
except the pressure areas (contact areas) like bony prominences, buttocks, the neck area with a
tight collar, neck tie, etc.
TIME OF ONSET
The lividity appears by 1 to 3 hours of death. Initially it will be in the form of a series of mottled
patches, which gradually increases in size and then coalesce by 3 to 6 hours, and becomes fully
developed and fixed in 6 to 8 hours of death.
FIXATION
Generally, it is said that if pressure applied by a thumb blanches the area, the lividity is not fixed
and time since death is less than 8 hours. If the area does not blanch, lividity is fixed and the time
since death is more than 8 hours.
Fixation is due to the diffusion of haemoglobin through capillary walls and staining of the
tissues, permanently.
According to Knight B, fixation of lividity is untrue as there can be ‘secondary gravitation’ and
if left in new position for further few hours, some or all hypostasis may slip down to the most
dependent areas then.
COLOUR OF POSTMORTEM LIVIDITY
Usually the colour of lividity is purplish. However, it will change depending on the cause of
death.
HYPOSTASIS OF THE VISCERAL ORGANS/INTERNAL ORGANS
Postmortem hypostasis is also seen in the dependent parts of visceral organs, depending upon
position of the body.
In a dead body lying on the back, it will be evident in the posterior portion of the cerebral lobes,
cerebellum, in pial vessels in the posterior fossa, posterior surface of heart, lungs, liver, kidneys,
spleen, larynx, stomach and intestines.
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Hypostasis in heart may be mistaken for myocardial infarction, hypostasis in lung may resemble
pneumonic consolidation, and hypostasis of the dependent portion of intestinal coils may
resemble strangulated coils.
Hypostatic engorgement of gastric mucosa may simulate irritant poisoning like changes.
MEDICOLEGAL IMPORTANCE OF POSTMORTEM LIVIDITY
Can assess time since death.
Can decide the position of the deceased at the time of death.
Can establish the cause of death.
It may be mistaken for a contusion.

Describe rigor mortis.

Rigor mortis is occasionally helpful in determining whether a body has been moved after death.
If a body is found in an unusual position – for example, one that could not have been maintained
under the influence of gravity during primary relaxation of the muscles after death – this position
implies that the body has been moved after the development of rigor mortis.

Rigor mortis may make examination of the palms and inner aspects of the fingers difficult, so
that current marks or defense injuries located here may be overlooked.

Marked anal dilatation may be observed postmortem, particularly in children. As previously

mentioned, when death occurs and preceding the onset of rigor mortis, the whole body
musculature loses its tone. In children, rigor mortis may fix a dilated anal orifice, and this finding
may persist after rigor mortis has faded. Anal dilatation is not, therefore, a sufficient marker of
penetrative anal abuse.

Muscle relaxation immediately after death with opening of the eyes and mouth and subsequent
fixation in rigor mortis often occurs after death, giving the face the appearance of grimacing.
However, despite common beliefs, the face of a decedent does not reflect whether the
individual's last moments were of fear or fright.

OR
Rigor mortis is muscle stiffening caused by the binding together of muscle fibers. Muscles
require a molecule called adenosine triphosphate (ATP) in order to release from a contracted
state; after death, the body’s ATP reserves are quickly exhausted and muscles remain contracted
until the muscle fibers themselves start to decompose. Rigor mortis is typically seen first in the
small muscles of the face and jaw. Rigor generally begins several hours after death, peaks around
12 hours after death, and then subsides over the next day or so with decomposition of the muscle
fibers. The timing of rigor mortis is dependent on environmental conditions such as temperature,
as well as the physical activity of the decedent around the time of death
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Explain how lgor mortis, livor mortis, postmortem artifact, postmortem lividity, and rigor
mortis provide information, details, facts, and inferences to investigators who are
investigating a death.

A body undergoes complex and intricate changes after death. These post mortem changes depend
on a diverse range of variables. Factors such as the ambient temperature, season, and
geographical location at which the body is found, the fat content of the body, sepsis/injuries,
intoxication, presence of clothes/insulation over the body, etc. determine the rate at which post-
mortem changes occur in a cadaver. Understanding the post mortem changes is imperative to
estimate the time since death (TSD) or the post mortem interval (PMI).

Clinical Significance
Immediate post mortem changes have clinical significance in diagnosing death. Loss of
voluntary movement and insensibility are seen in cases of narcosis, catalepsy, fainting attacks,
drowning, and electrocution. Cessation of respiration may be observable in cases of drowning,
electrocution, in newborn infants, and due to Cheyne-Stokes breathing. Doctors need to be wary
of these differential diagnoses while declaring an individual dead.

Suspended animation is the state in which the signs of life are absent, due to either cessation or
decrease in life-supporting functions. In cases of suspended animation, the rate of metabolism of
the individual declines to such an extent that the oxygen requirements are satisfied through the
use of dissolved oxygen of the biological fluids. Individuals who are in the state of suspended
animation can be resuscitated. Suspended animation can be voluntary, as in cases of ascetics who
pass into a trance through meditation, or involuntary as in cases of electrocution, drowning,
narcotic poisoning, shock, or hypothermia, etc. It is imperative for doctors to rightfully diagnose
the difference between systemic death and suspended animation as animated people have been
wrongly declared dead on multiple occasions.

Early and late post mortem changes are a sure indication that death has occurred. The post
mortem changes can be used to estimate the time since death (TSD) or post mortem interval
(PMI). PMI is a crucial aspect of medicolegal investigation as it helps in determining when a
crime has been committed. Based on this estimated time, alibis of suspected individuals may be
verified, and conviction or acquittal of a suspect may be determined. The medicolegal expert
needs to be extremely careful while opining about the PMI since a variety of factors affect the
post mortem changes. An estimate of ‘time since death’ should always be given, rather than a
specific ‘time of occurrence.’ Besides, PMI, specific postmortem changes can provide
information on the cause and manner of death, position/ change in position of the body,
identification, etc. Medicolegal experts can determine the existence and location of external
injuries, if any, on a cadaver in advanced stages of putrefaction.

The human body undergoes sequential changes after death due to a combination of internal and
external factors. These changes primarily serve in estimating the post mortem interval. Besides,
these provide other useful information relating to the cause and manner of death too. The post
mortem changes depend on multiple intrinsic and extrinsic factors. Thus, the experts should be
prudent while giving their opinion after taking into consideration the various factors modifying
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changes after death. This caution is especially necessary as the nature and direction of the
investigation may vary depending on the description of postmortem changes and its correct
interpretation

Create at least three recommendations on how investigators can become more effective and
efficient when investigating deaths

Estimating the time since death is among the pertinent challenges faced by forensic pathologists
and law enforcement agencies worldwide. While this is primarily the bailiwick of the forensic
pathologist or medical examiner in collaboration with law enforcement, as is demonstrated in the
preceding discussion, this requires collaborative efforts from an interprofessional team, including
bio-chemist, pathologists, anthropologists, in addition to the already mentioned forensic
pathologist and law enforcement personnel. Other health care practitioners, such as clinicians
and nursing, need to understand the processes to provide input when requested and be aware not
to damage any evidence accidentally.

Increasing the investment in personnel and facilities. Increases in medical examiner salaries and
incomes. Current salaries are substandard and need to be higher to attract qualified people.
Increasing the level of education, training, and qualifications of death investigators, and in
modernization of facilitie

References