Revised Penal Code: Killing of a Person by Means of Fire Is Considered As Murder

/ St. Luke’s College of Medicine-William H. Quasha Memorial
Batch 2012 / Book Notes
LEGAL MED / Block 5 / CHAPTERS 15-19 / Rebosa brothers
2009-2010
Kimpi, Doms, Oui, Gracie, David, Big J, Ivy, Len, Kaye / LEGAL MED: Chapters 15-19
page 10 of 11
/ St. Luke’s College of Medicine-William H. Quasha Memorial
Batch 2012 / Book Notes

Chapter XIV continuation…

Revised Penal Code: killing of a person by means of fire is considered as murder

Spontaneous combustibility:

·  A claim that the human body can ignite itself spontaneously and burn itself to death

·  Utilized as a defense in cases of homicidal burns

·  Con: high percentage of water in human makes spontaneous combustion hardly possible

Preternatural combustibility:

·  A claim that the human body is inflammable on account of the presence of gases which easily ignite; the gases are by-products of microorganisms in the body

3. Chemical burns (Corrosive Burns):

·  Action of strong acid, alkalies and other irritant chemicals

Characteristics of Lesions:

a.  Absence of vesication

b.  Staining of the skin or clothing by the chemical

c.  Presence of the chemical substance

d.  Ulcerative patches of the skin

e.  Inflammatory redness of the skin surface

f.  Healing is quite delayed on account of the action of the chemicals to the underlying tissue

Distinction between thermal and chemical burns:

Thermal burns / Chemical burns
Blister / May be present / absent
Stain on skin and clothing / absent / May be present
corrosion / Absent / present
Lesion / Diffuse / Distinct borders

Characteristic Lesions by Different Chemicals:

a.  Sulphuric Acid (oil of Vitriol)

·  Most intense action

·  blackish-brown sloughs; the face or other part will show splash marks

·  lines of ulceration seen where the acid run down the surface of the body

·  Clothing is destroyed where acid has spilled

b.  Nitric Acid

·  yellow or yellowish-brown slough; spot of yellow seen on the skin

·  Clothing is destroyed; color becomes brown

c.  Hydrochloric Acid

·  Not so destructive as sulphuric or nitric acid

·  intense irritation and localized ulceration of a red or reddish-gray color

d.  Caustic soda and potash

·  bleached appearance and greasy feeling to the skin

·  Skin becomes brown and parchment-like

Treatment

a.  Neutralization of the corrosive substances

b.  Protection of the eye

c.  Prevention of infection

d.  Other supportive/symptomatic treatments

4. Electrical burns

3 kinds

a.  Contact burn

·  due to close contact with an electrically live object

·  from small and superficial lesion to charring of skin

b.  Spark burn

·  Due to poor contact and resistance of dry skin

·  Shows a pricked appearance with a central white zone (parchment) and surrounding hyperemia

c.  Flash burn

·  Arborescent pattern of lightning burns to the “crocodile skin” appearance of high voltage flash

5. Radiation Burns:

a.  burns from X-ray

·  slight exposure: reddening & inflammation of the skin à bronze color on the skin

·  overexposure: produces blister, atrophy of the superficial tissue & obliteration of the superficial blood vessels

·  severe cases: ulceration of the tissue à malignancy

b.  ultraviolet light burns

·  severe and persistent dermatitis àblister

Chapter 15

PHYSICAL INJURIES OR DEATH BY LIGHTNING AND ELECTRICITY

DEATH OR PHYSICAL INJURY BY LIGHTNING:

·  lightning – an electrical charge in the atmosphere

Elements of Lightning that Produce Injury:

1.  Direct effect from the electrical charge

·  electrocution of the body

·  Nerves of the body are good conductor of electrical current

2.  Surface “flash” burns from the discharge

·  Electrical energy in lightning à Superheated air à burning of the skin à typical arborescent marking

3.  Mechanical effect

·  Superheated air à mechanical injury (laceration, severe tearing of the clothings and displacement of parts of the body)

4.  Compression effect

·  Compressed air pushed before the current with superheated atmosphere may produce a backward wave

·  Causes “sledge hammerblow” on the body producing concussion, shock, or unconsciousness

Points to be considered in making a diagnosis of death from Lightning:

1.  History of a thunderstorm

2.  Evidences of effects of lightning found in the vicinity; death of other person/animals nearby

3.  Metallic articles are fused & magnetized

4.  Fusion of glass materials due to severe heat

5.  Absence of wound & other injuries indicating suicidal or homicidal death

6.  Skin showing arborescent markings

7.  Burns may be present

Classes of Burns due to Lightning:

1.  Surface burns – superficial burns under metallic objects worn or carried by the victim

2.  Linear burns – found in areas of the skin with less resistance (moist creases, folds of the skin), 1-12 inches in length

3.  Arborescent or filigree burns – radiating burns

Effects of Lightning in the Human Body:

·  Death due to immediate involvement of the CNS

·  Shock produced by instantaneous anemia of the brain

·  May cause immediate loss of consciousness; clothings may be removed from the body or severely torn due to intense disturbance of air

·  Range from neurologic disturbances to death

1.  Symptoms of Mild attack (pp 415 -416)

2.  Delayed effects (p 416)

Treatment:

1.  Artificial respiration

2.  Air passage must be kept free

3.  Lumbar puncture to release the tension in the CSF

4.  Rectal hypnotic to combat delirium

5.  Treatment to combat shock

6.  Treatment to build resistance of the victim

Post-mortem findings (p 417)

1.  External

2.  Internal

Medico-legal aspect of death due to lightning:

·  Not of medico-legal interest in itself; an accidental death

·  Useful to eliminate death due to felonious act of another person

DEATH OR PHYSICAL INJURIES FROM ELECTRICITY

·  The main cause of death in electricity is shock.

·  Domestic line (100-250 volts) is sufficient to produce death; ≥300 volts is similar to a lightning stroke

·  Amperage or intensity of the electrical current – principal factor causing injury

·  inc conductivity (more injury): moist skin, wet floor, barefoot, proximity of metals

·  Inc resistance: dryness of the skin, presence of rubber boots or shoes, dryness of the floor, better insulation

Factors which influence the Effect of Electrical Shock:

1.  Personal idiosyncrasy

2.  Disease: cardiac dse à inc risk of death due to electrical shock

3.  Anticipation of a shock

4.  Sleep – inc resistance

5.  Electrical voltage or tension

6.  Amperage or intensity of electric current

·  principal factor

·  amperage = voltage/resistance

·  dangerous to man: 70-80 amperage in AC; 250 in DC

7.  Density of the current

8.  Resistance of the body

9.  Nature of the current – AC is more dangerous than DC

10.  Earthing – promotes continuous flow of electric current à inc development of shock

11.  Duration of contact

12.  Kind of electrodes

13.  Point of entry – left side is more dangerous than the right

Mechanism of Death in Electrical Shock:

1.  Ventricular fibrillation à rupture of muscle fibers and focal haemorrhages in low voltage

2.  Respiratory failure due to bulbar paralysis in high voltage

3.  Mechanical asphyxia due to violent and prolonged convulsion

Nature of Electrical Burns:

·  “electrical necrosis”, “electric marks”, “current markings

·  Skin is puckered with gray color and traversed by deep impressions at the right angle

·  Painless; show no vital reaction

·  Hair is intact in the absence of burns

·  Repaired through the process of aseptic necrosis ff by luxuriant granulation and healing à smooth, thin, pink scar

·  Absence of mark does not exclude electrocution

Microscopically:

·  Compression of the stratum corneum

·  Superficial carbonization

·  Papillae of the corium are flattened with vascular contraction, esp at the center of the mark

Symptoms:

·  Surface of the body is cold and moistened

·  Breath is stertorous

·  Pulse is rapid, filiform and may be irregular

·  Pupils are dilated and insensitive

·  Pale face

Metallization:

·  Specific feature of electrical injury

·  Metal of the conductor is volatilized and driven into the dermis; areas of the body may be darkened by metallization

·  If the metal is iron à yellow-brown mark

·  Copper: copper salts à blue mark

Delayed Effects of Electrical Injuries:

·  Necrosis à gangrene (more extensive due to arterial damage)

·  Damaged arterial arteries become brittle and friable à rupture à severe hemorrhage

·  Late nervous injuries: retrograde amnesia, changes in personality, hemiplegia, aphasea, and postconcussional syndrome

·  Entry in the head may cause cataract

Post-mortem findings: nothing specific, or may show no lesion at all

DOMS

…p. 429

XVII. Death by Asphyxia

A. Asphyxia by Hanging

Mechanism of Death:

ligature around the neck with a knot, or with a sliding nood; other end fastened to an elevated object (e.g. peg, nail, window casing, door knob, tree, etc.)

â

Suspension of body

â

Weight causes noose to tighten

= pressure at neck region

â

Air passage constrict,

larynx pushed backwards, closed opening due to contact of anterior and posterior laryngeal wall

=asphyxia

Ligatures may also compress superior laryngeal nerve, carotid arteries and jugular veins

=cerebral anoxia

·  Form of furrow that develops in the neck depends on:

o  Type of ligature

o  Number of loops around the neck

o  Point of suspension

·  Protrusion of tongue depends of how pressure is applied around the neck

o  Above the larynx and upward direction à tongue pushed outward = protrusion

o  Below the larynx à NO protrusion

Ligature in Hanging:

1.  Materials used in ligature:

o  Thinner and tougher material à more pronounced the mark on the skin of the neck

o  Special quality material = suggest premeditation (i.e. in suicide)

o  Often used: rolled beddings, leather belts joined together, rope (commonly used; easily available and strong), electric wire and vines

2.  Noose:

o  There may be no sliding noose are the end of the ligature

o  May be tightened after it has been encircled around the neck

o  pressure on airways, blood vessels and nerves on the neck established upon suspension of body

o  Metal buckle, ring or sliding noose may be attached to the end to make it slide

3.  Mode of application of the ligature:

o  May have single, two or more loops placed around the neck àdistinguished on the nature of ligature marks

§  Single à one ligature furrow

§  Several loops à several ligature marks, intervening redness between furrows

*tendency to have more pressure in a single loop ligature considering concentration of force at the weight compared to 2 or more loops

4.  Position of the knot (joint):

o  Usually located on either side of the neck

o  Head is flexed opposite the location of the know

o  Level of ligature around the neck à differentiate hanging vs. strangulation

§  Hanging – ligature usually above the thyroid cartilage; upward pull of constricting force

§  Strangulation – ligature below throid cartilage

o  Not easy to retain knot beneath the chin

5.  Course of the ligature around the neck:

o  Usual appearance: groove or ligature mark deepest opposite the location of the knot

o  EXCEPTION: knot underneath the chin à course = inverted V-shape, vertex at the location of the knot

§  Groove on the back of the neck is not deep on account of firmer skin and muscular tissue

Symptoms:

1.  Gradual loss of sensibilities

2.  Sensation of constriction of the neck

3.  Loss of consciousness and muscular power

4.  Numbness of the legs and clonic convulsion

5.  Sensation of ringing inside the ear

6.  Sensation of flash of light before the eyes

7.  Face becomes red, with eyes prominent and feeling of heat in the head

If the victim is timely rescued and revived after artificial respiration, he will suffer the following symptoms:

1.  Whistling sensation inside the ear

2.  Watering of eyes

3.  Difficulty of breathing and swallowing

4.  Sensation of numbness of both legs

Amount of tension in the ligature sufficient to occlude the vital structures of the neck:

·  Jugular veins – 2kg (4.4lbs)

·  Carotid artery – 5kg (11.0 lbs)

·  Trachea – 15 kg (33.0 lbs)

·  Vertebral artery – 30 kg (66.0 lbs)

Causes of Death in Hanging:

1.  Simple asphyxia by blocking the air passage

2.  Congestion of venous blood vessel in the brain

3.  Lack of arterial blood in the brain due to pressure of the carotids

4.  Syncope due to pressure on the vagus and carotid sinus which leads to reflex irritation and paralysis of te medullary automonomic centers

5.  Injury on the spinal column and spinal cord

6.  Combination of the above-mentioned causes

Time Required in the Process of Death:

Factors Influencing

1.  Severity of constricting force

o  Sufficient only to occlude windpipe à death may be delayed

o  Sufficient to occlude carotids, jugular vein and vagus nerve à immediate unconsciousness, death accelerated

2.  Point of application of ligature:

o  Below larynx à death almost instantaneous

o  Above the larynx à death not occur for 3-5 minutes

o  Knot on one side à delay death: closure of cerebral vessel cannot be completely maintained.

o  Knot just below jaw àdelay death: maximum pressure at the back of the neck = occlusion of windpipe and blood vessels only partial

3.  Other factors:

a.  Physical condition of the subject

b.  Rate of O2 consumption in blood and tissues

* pressure of the ligature on the blood vessels à disturbance in cerebral circulation à loss of sensibility

-- respiratory movement may persist 1-2 mins, heart action for 15-30 mins à artificial respiration may successfully revive the victim

Treatment:

1.  Induce the natural acts of respiration:

a.  Ligature must be loosened, mouth wiped à remove all obstacles to free air

b.  Tongue pulled forwards, body laid on back rest

c.  Patient placed where there is free current of fresh air

d.  Electrical stimulation of the phrenic nerve

e.  Administration of respiratory stimulant (i.e. ammonia)