Another misunderstanding about forensic pathologists, Andrew says, concerns reporting of the cause of death. Clinical physicians focus on the immediate cause, such as a heart attack. But a forensic pathologist reports the underlying cause of death. In the case of a heart attack, that would be the chronic heart disease that led to the heart attack.
This distinction, he says, is important and affects crime reports. For example, "let's say a taxi driver is shot, and he becomes a quadriplegic," Andrew says. "Years later, he dies of the effects of his quadriplegia. The autopsy would list the cause of death as the gunshot wound, and the death would be regarded as a homicide."
The Importance of the Autopsy
Forensic pathologists deal with dead bodies in all sorts of conditions. Whereas medical students probe cadavers that are basically in good condition, forensic pathologists deal with bodies that have been submerged in water, charred in fires, hacked apart, or riddled with larvae.
These bodies are not only difficult to see, smell, and touch, but their decomposition makes it harder to find clues.
Autopsies are ordered when deaths are unusual, unnatural, or suspicious in nature, but in many cases, the autopsy shows no evidence of crime.
The autopsy room is basically like a surgeon's operating room. The doctor wears surgical scrubs, gloves and a protective mask. However, the autopsy room is not sterile and, to help preserve the body, it is cooler than an operating room.
If the autopsy is not done very carefully, the doctor may arrive at the wrong conclusion about the cause of death. Such circumstances occurred in a crime case that involved Judy Melinek, MD, a forensic pathologist who is CEO of Pathology Expert Inc., an independent consultancy in Los Angeles that is called in to solve difficult cases.
In this case, a woman killed her boyfriend in a San Francisco hotel room. He was a methamphetamine user and had been beating her. He attacked her, and she defended herself with a knife. She told police that he impaled himself on the knife when lunging at her.
The man died after going to the emergency department. A forensic pathologist at the ME's office examined the body. Melinek says this doctor found four sharp-force injuries to the body, indicating that the woman had taken a more active role in killing the man than she had let on.
The woman was indicted for the killing, and her defense attorney hired Melinek to do a second autopsy. In her autopsy, Melinek says she found that three of the supposed sharp-force injuries had nothing to do with the man's death.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Leigh Page. Clues to Mysterious Deaths: Doctors Who Help - Medscape - Nov 06, 2019.