Coroner Stories

The following link is to an article by Jeremy Hudson of The Clarion Ledger:

“Death of Union girl, 9, found hanged under investigation.”

It was sent to me by a reader (range314) who questioned the likelihood of a 9 year-old girl committing suicide. I responded that the occurrence is rare, but it does happen. The youngest asphyxial death I have ever worked was ten years old.

I liked the article and thought it was worth commenting on because of how accurately it reflects a key element of death investigation. The subtitle says it all—“Police to determine whether child victim of accident or crime.�?

The role of a medical examiner or a coroner is to determine the cause and manner of death. An autopsy is essentially a diagnostic examination allowing the pathologist to determine the cause of death. Manner of death is simply how the death is classified. In this case, the cause of death is the hanging itself and the manner of death could ultimately be ruled as a homicide, accident, or suicide.

The individual certifying the death will ordinarily postpone determining the manner until the law enforcement agency has concluded their investigation—as the coroner does in this case. An autopsy provides information that is vital to the pathologist, but it is not intended to provide a manner of death. In most cases it is actually the investigative work of other agencies that the pathologist relies on.

I am always amused at detectives that act as though an autopsy is going to tell them whether or not a person with an intraoral gunshot wound committed suicide. An autopsy is going to tell them that the person died as a result of a gunshot wound inside the mouth. Unless there is physical evidence on the hands of the deceased, an autopsy won’t tell them who pulled the trigger. Whether the death was a suicide or a homicide will depend on their investigation.

The amount of foresight that some people demonstrate prior to committing suicide has always been of interest to me. Many people seem to have considered the ramifications of committing suicide—especially when they opt for a particularly devastating means such as a firearm. Of course, the preceding statement is just a gentler way of saying that they considered the mess they were about to make.

On numerous occasions I have worked firearm suicides that have been committed in a bathtub or a shower. The presumed reason for this choice is that these areas are easily cleaned. Others may put down plastic or wrap a blanket around their head to limit the resulting mess. At any rate there can still be property damage involved. Exiting rounds sometimes shatter lights, glass shower enclosures, and tiles. Even still, foresight can play a role. I recall one instance in which a person stacked several books onto the tile floor, laid their head sideways on top of the stack, and fired a round through their head that penetrated well into the stack of books.

Leaving the house altogether is really the only sure way of preventing extensive cleaning or property damage. It is really quite common for the person planning to commit suicide to simply go into the backyard or to a separate location altogether. Examples include local parks, back roads, and wooded areas. Oftentimes, the deceased is found not too far from a vehicle containing a suicide note or a copy of a will.

Some people even take measures to ensure they are found by someone other than a loved one. Perhaps the most common means is for the person to call 911 and state their intent or simply to hang up on the dispatcher. Either method will elicit a response from an officer. Typically the gunshot is heard over the phone or as the police arrive at the scene. I’m not a police officer, but I’ve been told that unexplained gunfire tends to be a little unsettling to those who are. Understandable.

Another measure is when the person has scheduled a meeting in advance. Inviting a family friend over while the kids are still at school or having a repairman come by the house at a set time are good examples. In a few cases, I have even seen notes placed upon entry into the house requesting that the reader notify police and avoid going in any further.

One of the most interesting trends in tracking this sort of behavior is apparent when considering how men and women tend to differ in this area. In a large percentage of the violent suicides I have worked, men have a greater tendency to follow the above behaviors than do women. However, it should also be pointed out that men are more likely than women to select a firearm as their preferred means for suicide.

Perhaps the most consistent behavior listed above that men exhibit is leaving the house altogether. The predominant theory is that men are concerned with unnecessarily tainting the house as the place they committed suicide—thereby further burdening the family with having to change residence.

Women seem to follow a different trend. Most stay within the house—retreating to a personal area such as a bedroom, bathroom, or closet almost as if attempting to hide their act. This behavior is seen in other means of suicide as well. With regard to firearms, however, women for the most part appear to exhibit more of a concern for “viewability.�? That is to say, the person is concerned with whether or not they are still presentable for friends and family to view after the act. This desire is generally presumed when the entrance wound is located over the heart or in the hairline away from the face.

I can only suppose the reason people take these sorts of measures prior to committing suicide is that they are trying to limit the impact of their death on the family. It doesn’t seem to occur to them that the devastating effect of their death will cancel out any efforts to “soften the blow.�? One would think that if they truly cared about the family’s best interest they wouldn’t go through with it at all.

When a body is found after a fire has been extinguished, the extent of the damage to the individual can make positively identifying them difficult. The severity of the fire and the location of the body in proximity to its origin determines just how difficult. For example, someone found in a remote part of the house may have died from smoke inhalation with little or no thermal injuries and still be identifiable at a glance. At the other end of the spectrum, someone close to the origin of the fire may be burnt beyond recognition.

Identifying a body typically follows the same process. Viewing someone is the quickest and easiest method, but in the case of someone burnt beyond recognition other means must be used. Fingerprints are the next avenue provided the fingertips weren’t too damaged by the fire. Extremities are often the first parts of the body to be “cremated” if the fire burns hot enough and long enough.

If fingerprinting isn’t possible, then the remains can be x-rayed while at the morgue. Comparison of dental x-rays and charting is the most efficient considering most people have had dental work fairly recently. The success of using old fractures, surgical fixtures, and bone characteristics found in body x-rays ultimately depends on the extent of fire damage and the existence of antemortem x-rays to compare them with.

DNA comparison is typically only used when the previous approaches are insufficient. The process relies on the availability and successful extraction of genetic material to begin with. There must also be a sufficient number of living, immediate blood relatives to compare with. While this method is very precise, the process of collecting specimens, submitting specimens to a DNA lab, and awaiting the results of the analysis extends the amount of time that family and friends must wait for a positive identification.

Many times fire personnel and family members may have little doubt as to the identity of the person who died. However, the responsibility of confirming identity ultimately falls on the shoulders of the coroner or medical examiner because they are the ones who are legally accountable for accurately certifying a death.

As a general rule, I avoid watching Hollywood’s dramatic interpretations of death investigation. I can only assume that physicians have similar issues if or when they watch hospital dramas. The exception to this rule is when I stumble on a crime drama while channel surfing or I’m simply looking for something amusing to watch. To say that writers and directors take liberties with reality is putting it mildly.

These inaccuracies must be the Hollywood equivalent of “anticipated casualties” when the sole intention of any program is to attract and retain viewers. Fortunately for me, these inaccuracies serve as a seemingly unlimited source of writing material for this site.

I plan to use these inaccuracies—and my subsequent issues—in what I anticipate to be a series of segments. I admit this series may be perceived as an extended rant filled with various soapbox issues, but the goal here is to deliver some insight. I certainly don’t expect anything I write here to change the face of television. I fully expect the modern-day crime drama to continue to be successful for years to come. After all, fiction has historically been easier to sell than non-fiction. I prefer the History Channel, but at last check it has yet to eclipse the networks in the prime time ratings.

Q: Is it true that a person spontaneously urinates or defecates when they die?

A: The short answer is no. The longer answer is that it does happen but not in every death. On average, only about one person in ten has urinated or defecated prior to death. Urination can occur simply because there is enough time for the body to relax enough to urinate before it shuts down. This elimination isn’t necessarily indicative of a full bladder. Someone who has drank heavily and has been passed out for several hours prior to death may in fact have several hundred cubic centimeters of urine built up in their bladder (this amount is often documented at autopsy).

Defecation may not occur until after the death has occurred—although the process of elimination isn’t a voluntary movement on the part of the deceased. Moving a body around while examining it or attempting to remove it from a scene can cause fecal matter to exude from the individual. In this respect, the human body acts similarly to a tube of toothpaste as the bowels are compressed.

As a side note, gas that has built up in the bowels is also eliminated as the body is moved or examined. This elimination typically occurs without an audible sound, but I have heard some with this expected accompaniment. For description sake, the degree of smell ranges from “dirty diaper�? to “you should see a doctor about your ass�? to “who would do that in a public restroom.�?