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Category Archives: Cause & Manner of Death

Crime and Science Radio: Dealing With the Dead: A Life in the Morgue: In Conversation with Dr. Cyril Wecht

Join DP Lyle and Jan Burke as they welcome Dr. Cyril Wecht, internationally renowned forensics pathologist Dr. Cyril Wecht as we discuss his life in criminal justice and the numerous famous cases he has been involved with over his stellar career.

BIO: Dr. Cyril Wecht holds degrees in both medicine and law, receiving his MD degree from the University of Pittsburgh and his law degree from the University of Maryland. He holds professorships at the University of Pittsburgh and Duquesne University School of Law. He has published nearly 600 scientific articles, is on the editorial board of more that 20 medical-legal and forensic scientific publications, and had published several books on forensic science. His list of famous cases is a who’s who in medical-legal investigation.

 

CYRIL-WECHT

LISTEN: http://www.blogtalkradio.com/suspensemagazine/2014/03/07/crime-and-science-radio-with-special-guest-cyril-wecht-md

LINKS:

Dr. Wecht’s Website: http://www.cyrilwecht.com

Dr. Wecht’s books and videos: http://www.cyrilwecht.com/books.php

50 Years Later, Wecht Continues To Poke Holes in Report on JFK Assassination: http://triblive.com/news/allegheny/5017529-74/wecht-commission-specter#axzz2tuBTchS1

Dr. Cyril Wecht Believes Killers of JFK, RFK, MLK Had Help: http://www.vindy.com/news/2013/may/01/renowned-pathologist-makes-a-case-for-co/

Dr. Cyril Wecht Lectures on the JFK Assassination: https://www.youtube.com/watch?v=-muQL-QPKeM

Dr. Cyril Wecht on JFK Assassination: Let’s Uncover the Truth: https://www.youtube.com/watch?v=YtUL-BpZAu8

Crime Library: JonBenet: From Impressions To Book by Dr. Katherine Ramsland: http://www.crimelibrary.com/criminal_mind/forensics/cyril_wecht/6.html

Dr. Cyril Wecht Discusses Forensic Challenges of Cold Cases: http://www.wtae.com/news/local/allegheny/Dr-Cyril-Wecht-discusses-forensic-challenges-of-cold-cases/19648550

Dr. Cyril Wecht: The Benefits of Forensic Credentialing: http://www.pbs.org/wgbh/pages/frontline/criminal-justice/real-csi/dr-cyril-wecht-the-benefits-of-forensic-credentialing/

Cyril H. Wecht: What I Know: http://www.pittsburghquarterly.com/index.php/What-Do-I-Know/what-do-i-know-with-cyril-h-wecht.html

Dr. Cyril H. Wecht: Pittsburgh’s Polymath: http://www.popularpittsburgh.com/pittsburgh-info/pittsburgh-history/famous-pittsburghers/dr-cyril-wecht.aspx

 

Final-Exams

 

 

 

 

 

Nip, Tuck, Jump: An Anesthetic Death?

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Beverly Hills is famous for plastic surgery. And famous plastic surgeons. Like Dr. Brian Novak, one the surgeons to the stars. But recently, things didn’t go so well with one of his patients. Like something from the TV series Nip/Tuck, where odd happenings were common, the recent suicide of a 53 year old woman was bizarre and unexpected. Seems she and undergone a face lift, after which she recuperated at the North Camden Drive clinic. At some point she became agitated, confused, ripped off her gown, and now naked climbed to the 10th floor roof where she threatened to jump. Ultimately she did, despite the efforts of a crisis negotiation team.

 

BH Clinic

 

How and why did this happen? I would suspect her tragic behavior had to do with drugs. Not those kind. The medical kind. Anesthetics and pain meds, drugs that work on the brain, the former to induce deep sleep and the latter to reduce the perception of pain. But these drugs can also cause confusion, disorientation, and bizarre behavior. Even delusions and hallucinations. These reactions can be part of the drug’s effects or a reaction to withdrawal or “coming down” from the drugs’ effects. These reactions are often unpredictable and come on quickly, as seems to be the case here. Sad.

 

 

Crime & Science Radio: The Body Tells the Tale: DP Lyle and Jan Burke Interview Dr. Bill Bass and Jon Jefferson

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The Body Tells the Tale: DP Lyle and Jan Burke Interview Dr. Bill Bass and Jon Jefferson

Join DP Lyle and Jan Burke as they explore the world of death, corpses, and decay with Dr. Bill Bass and Jon Jefferson. Dr. Bass is the founder of the University of Tennessee Anthropological Research Facility, the so called Body Farm. Jon Jefferson is a journalist, writer, and documentary film maker. Together they write fiction as Jefferson Bass. This will be a lively, or is it deadly, interview.

LISTENhttp://www.blogtalkradio.com/suspensemagazine/2013/11/20/crime-and-science-radio–jon-jefferson-and-bill-bass

LINKS:

The Body Farm-Wikipedia: http://en.wikipedia.org/wiki/Body_farm

Tour The Body Farm: http://www.jeffersonbass.com/videos.html

Video Tour of The Body Farm: http://www.youtube.com/watch?v=GSDCiOW81mk

WBIR Interview: http://www.wbir.com/news/article/139066/190/Your-Stories-Dr-Bill

JeffersonBass Website: http://www.jeffersonbass.com/index.php

Death’s Acre: Inside the Legendary Forensic Lab the Body Farm Where the Dead Do Tell Tales: http://www.amazon.com/Deaths-Acre-Inside-Legendary-Forensic/dp/0425198324

Metro Pulse: The Cult of Forensics Expert Dr. Bill Bass: http://www.metropulse.com/news/2009/feb/25/cult-forensics-expert-dr-bill-bass/

Peter Breslow’s 2004 NPR Profile of The Body Farm: http://www.npr.org/templates/story/story.php?storyId=1906569

Taphonomy-Wikipedia: http://en.wikipedia.org/wiki/Taphonomy

 

Life Imitating Art? Murder or Accident?

It’s been said that art imitates life and that often life imitates art? Is the death of “spy” Gareth Williams a murder or a tragic case of autoerotic asphyxia? Is it a true mystery anticipated by an author’s question?

 

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The Story:

http://bigstory.ap.org/article/police-spy-bag-probably-died-accident

The Question:

http://writersforensicsblog.wordpress.com/2011/09/18/q-and-a-can-a-murder-be-staged-to-look-like-an-accidental-death-from-autoerotic-asphyxia/

Two other posts on autoerotic asphyxia:

http://writersforensicsblog.wordpress.com/2009/06/02/autoerotic-asphyxia-a-very-bizarre-case/

http://writersforensicsblog.wordpress.com/2009/06/05/autoerotic-asphyxia-redux-david-carradine/

 

 

Q and A: Can My Villain “Force Feed” Pills To a Dead Woman?

Q: My hero, an investigative journalist, is looking into the death of a woman at an acid house/rave party in the early 1990′s. The novel is set in the present day and so the hero has no access to the body, just autopsy reports, coroners reports, the transcript of the inquest, etc. The woman was a light user of Ecstasy but the autopsy discovered that she had 70 ecstasy pills in her stomach. The scenario I want to create is that the hero discovers that while the woman took some of the pills willingly, she was then force fed others, and then after she died she was force fed yet more. In order for this scenario to work I’m wondering the following:

1) For how long after death does stomach acid continue to operate?

2) For how long after death would the digestive system continue to break down the ecstasy and would the ecstasy continue to be absorbed into the bloodstream?

3) Is it likely/possible that a sizeable amount of pills would remain undigested in her stomach, bearing in mind that the body was not found for a number of hours?

4) What injuries/signs on the body would there be of someone force feeding her the pills?

5) Is it possible to force feed somebody pills after death, how would they get the corpse to “swallow” and what injuries might be caused to the body as a result?

James, St Albans, UK.

 

PIlls

 

 

A: At death, all metabolic processes cease immediately since there is no longer blood flow to keep these processes going or even to keep the tissues and cells responsible for these activities alive. This includes the digestive processes. Sure there could still be a small amount of acid effect but this would only be from the acid in the stomach at the time of death and this would be quickly neutralized by the materials the acid was combining with. The bottom line is that all digestive processes cease immediately on death, more or less freezing the stomach contents in time. This is also true for the level of most toxins in the blood and urine, which offers the medical examiner a tool for determining the cause and time of death.

At death, the stomach would no longer move or churn or secrete acids and digestive enzymes so the ecstasy would remain intact as it was at the time of death. Yes there could conceivably be residual whole pills and in fact this is not uncommon in overdoses of all kinds. Some dissolve and are absorbed prior to death and others do not and these remnants can then be tested to determine what they are. All the stomach contents would remain intact until the decay process destroyed them, so if the body was found in a reasonable period of time, the stomach contents could be analyzed for their chemical characteristics, which would include the presence of any drugs or alcohol.

It is very difficult to force-feed a living person pills and so doing could lead to trauma around the mouth and face as the pills were shoved into the victim’s mouth and his mouth and nose held close until he swallowed. Or there could be no trauma and in which case there would be no way of knowing this. But evidence of trauma might suggest a force-feeding. It would be a best guess but an experienced medical examiner can usually make this determination. Since all processes and movement by the deceased stop at death, swallowing cannot occur and force-feeding a corpse is impossible. The pills would simply collect in the mouth and throat.

In your victim there could easily be undigested pills and toxicological testing of these, and of course blood and urine, would reveal what chemicals were in the victim’s stomach and system. Since your body is found several hours later there would be essentially no decay and therefore everything in the bloodstream and in the stomach would remain intact more or less as it was at the time of death. With facial trauma the ME might consider that the OD was forced, and in the absence of such evidence might simply think it was an intentional or accidental OD.

Also this ARTICLE on my website might help.

 

Q and A: Can My ME Uncover Drugs in a Charred Corpse?

Q: I have two characters who are found dead in their house, having been at the center of a fire that turned into a wildfire. Before the fire, a hitman gave them some type of medication that he believed would not be detected in an autopsy to cause them to go unconscious or unable to move while he set the fire around them and escaped. The idea is that I want it to look — on the outside, at least — as though they accidentally caused the wildfire, starting in their home in the forest. Then, it’s discovered that they were, technically, murdered by someone giving them a strong sedative (or something) and they were burned in the fire.

When the medical examiner does the autopsy, what is he likely to be able to notice? I read that bodies are usually not burned completely in a fire, but what would the ME find? What kinds of things would he notice and talk about in the report?

Is there a drug that would have a sedative effect on the characters that would NOT show up in an autopsy? Or something that might show up with a particular test and what reasons could an ME have to run that test?

Kari Wolfe, Colorado Springs, CO

 

Iraqi Convoy Bombed During Persian Gulf War

 

A: You are correct that fires rarely destroy a body completely. The fire simply does not burn hot enough or long enough to completely destroy the body in most structure and automobile fires. The same would hold for wildfires. The body would likely be charged severely on the outside and for several inches down but deep inside most tissues would remain intact. This would allow the medical examiner to test the muscles, brain tissue, liver, blood, bone marrow, urine, and the vitreous humor inside the eyes for various drugs.

Almost any narcotic or sedative would work for your purposes but most of these are easily found with even simple toxicological screening and for sure by more sophisticated toxicological testing using gas chromatography and mass spectroscopy.

More sophisticated drugs are not revealed by a routine drug screen and therefore more difficult to find. Add to this the fact that the medical examiner might have no reason to go to the time and expense of looking for more esoteric toxins if all evidence pointed to the victim having died in the fire.

But what if the victim didn’t die in the fire? What if the victim was already dead before the fire started? This would change everything since in that case the medical examiner could not say that the cause of death was asphyxia from the fire but rather that something else must have killed the victim. In the absence of overt trauma or another obvious cause of death, the ME would likely do more complete toxicological testing.

 

How would the ME determine that the victim was dead before the fire? One clue would be the carbon monoxide level in the blood. If this is low, the victim was not breathing while the fire was consuming him. If the carbon monoxide level was high it would indicate that he was breathing and had inhaled carbon monoxide, which comes from the burning of wood and almost any other product. The normal carbon monoxide level is less than 5% but in victims of fire it can be 60 to 90%.

Also, if the victim was still breathing during the fire he would inhale soot and heat. The heat would damage the throat and airways and soot and other fire debris would be inhaled deeply into the lungs. Finding these would indicate the victim was alive while the fire burned and not finding them would suggest a prior death. This latter situation could launch a more complete toxicological analysis of the remains and ultimately lead to the lethal drug. Such testing could take many weeks, even months, so that you can delay the discovery of the true cause of death for almost as long as you need for story purposes.

Rare toxins you might consider would be succinylcholine, PSP (paralytic shellfish poisons), Rohypnol, GHB, and a few others.

 

Q and A: Can My ME Determine If a Child Died From Exposure As Opposed To Being Locked in a Heated Vehicle?

Q: In my story, a police officer is on the scene where the body of a 3 year old child was found among the rocks and weeds of a dried up riverbed in Southern California. It is early summer. Can the CSI techs or the ME determine if the child died from being locked up in a heated car rather than from exposure to the elements where the body was found?

Jack Dietz, Production Coordinator, Las Vegas, NV

A: The simple answer is that this is not very likely however there might be a way. Much depends on the condition of the body. If it is severely decayed or has become skeletal, the ME would have little to work with and there would be no way to determine exactly where the death occurred. In either case the death would be from that catchall term “exposure.” What that means is that the victim died from lack of water or food, with water of course being the most important. Exposure deaths are almost always due to severe dehydration.

However, if the child is found within a day or two of death, the body would be more or less intact and the ME might be able to estimate where the death had occurred, given the two choices you outlined. One difference would be insect activity. If the child died in the trunk as opposed to being exposed outdoors there would be less insect activity for the amount of time since death than would be expected from an exposed corpse. If the ME determined that the child had been dead for 2 or 3 days yet there was essentially no insect activity, it would mean that she had been in a protected environment, such as an enclosed car or car trunk, for those 2 or 3 days and only exposed for maybe a few hours. On the other hand, if he found insect activity that matched his estimate of the time since death, this would favor her being in an exposed environment for those 2 to 3 days. It’s not that flies can’t get into car trunks, it’s just that most trunks are so well sealed, fly access would be very limited, if at all.

On a similar note, predatory animals would not be able to attack the body while it was in the car but if exposed predator feeding on an exposed body is fairly common. Coyotes are everywhere. Predator activity would suggest a longer period of environmental exposure.

fiberanalysis2

 

One circumstance that might be interesting for you would be if the child died in either the trunk or on the floorboard of the car. As she died from hyperthermia and dehydration, she would increasingly gasp for breath toward the end of her life and could inhale carpet fibers from the trunk lining or floor carpets. This would not happen if death occurred while exposed outside. This would of course require that the body be in fairly good condition. I think as long as you have the body found within a few days, the decay process would not have progressed far enough for the lungs to be destroyed and the medical examiner might see these fibers during his microscopic examination of lung tissue. Once he found these fibers, he would know that the victim had inhaled them and therefore was alive while in the car. So finding the fibers would at least allow the medical examiner to guess that she had been in the car near or shortly before her death.

fiberanalysis

 

Another interesting thing about this scenario is that the ME could then analyze these fibers physically, optically, and chemically and determine the manufacturer of the carpet and this in turn could lead to the car manufacturer and even the make and model year–or at least a narrow range of years since car manufacturers change their products quite frequently. This would greatly help your police officer develop suspects.

 

 

Deadly Screwdriver

Screwdrivers can be dangerous. Not only the ones used to tighten and remove screws, which can be lethal weapons, but the ones you get at your local bar. OJ and Vodka. Nice way to get hammered and up your vitamin C intake. Multitasking.

top_screwdriver1

But Ramineh Behbehanian apparently has her own recipe. OJ and alcohol. Not vodka or even ethyl alcohol (ethanol–the kind you drink), but isopropyl alcohol (isopropanol–rubbing alcohol). It seems she whipped up a couple pf bottles of this concoction and placed them in the refrigerated section of her local Starbucks. Fortunately, someone observed her doing it and called the police.

Maybe this was simply a prank. Maybe she innocently thought isopropyl alcohol and ethyl alcohol were interchangeable. No harm, no foul. Maybe. Except she’s a pharmacist. She knows the difference.

So what is isopropyl alcohol and why is it dangerous?

From HOWDUNNIT: FORENSICS

Isopropanol

Isopropanol is also an intoxicant and a CNS depressant whose effects usually appear within ten to thirty minutes after ingestion, depending upon the amount consumed and whether food or other beverages are taken as well. Fifteen to 20 percent of ingested isopropanol is converted to acetone, which produces acidosis (excess acid in the body). This greatly complicates things. The victim appears drowsy and off balance, and possesses a staggering gait, slurred speech, and poor coordination. Nausea, vomiting (sometimes bloody), abdominal pain, sweating, stupor, coma, and death from respiratory depression may follow. Hemorrhage into the bronchial tubes (breathing tubes or airways) and chest cavity may occur.

Isopropanol also absorbs through the lungs and the skin. Not infrequently, infants experience isopropanol toxicity from alcohol-and-water sponge baths used to treat childhood fevers.

As they say: Don’t try this at home.

Howdunnit 200X267

 

Carbon Monoxide: A Deadly Gas

From HOWDUNNIT: FORENSICSWhen more than one person is found dead in a house or a car and there is no evidence of trauma, carbon monoxide toxicity is considered. The odds of two or more people dying from natural causes at the same time and the same place are extremely remote.

Such is the case of “Buckwild” star Shane Gandee who was found dead, along with two other men, in a vehicle partially submerged in mud. The supposition is that mud clogged the vehicle’s tail pipe and this allowed carbon monoxide (CO) to accumulate inside the passenger compartment, resulting is death from asphyxia.

When I first read the circumstances surrounding this tragedy, my first thought was CO. With no signs of trauma, little else made sense. Apparently the authorities have agreed that this was the cause of death.

 

Howdunnit 200X267

 

Also from HOWDUNNIT: FORENSICS: CHAPTER 8: ASPHYXIA

CARBON MONOXIDE

Deaths from carbon monoxide poisoning are usually suicidal or accidental. It is an uncommon method for homicide, but it has been reported. Carbon monoxide is stealthy, treacherous, deadly, and common. A family is found dead and the cause is a faulty heater or fireplace. A suicide victim is found in his garage with the car engine running. Campers are found dead in a tent, a kerosene lantern burning in one corner. Each of these is due to carbon monoxide poisoning.

Carbon monoxide is a tasteless, odorless, colorless gas that is completely undetectable by humans. It results from the incomplete combustion of carbon-containing fuels—paper, wood, gasoline, and many other combustible products. Complete combustion of one of these fuels yields carbon dioxide (CO2). If there is a deficiency of oxygen or if the fi re is smoldering and doesn’t produce enough heat to drive the reaction to completion, incomplete combustion occurs and the result is the production of carbon monoxide.

Wood, coal, and gas are common carbon-containing fuels. Faulty stoves,heaters, and fireplaces, as well as the exhaust from a car engine, can fill the air with carbon monoxide. Carbon monoxide poisoning is a more common cause of death in fires than is the fire itself. Charcoal briquettes are particularly dangerous as they are designed to smolder rather than burst into flame and are also good sources for carbon monoxide. Using a charcoal grill in an enclosed space such as a garage or tent can lead to carbon monoxide buildup very quickly. Faulty butane and propane camp stoves and heaters can also be deadly.

Carbon monoxide’s treachery lies in its great affinity for hemoglobin, the oxygen-carrying molecule within our red blood cells (RBCs). When inhaled, CO binds to hemoglobin producing carboxyhemoglobin. It does so three hundred times more readily than does oxygen, and thus it displaces oxygen. The result is that the blood that leaves the lungs and heads toward the body is rich in carbon monoxide (carboxyhemoglobin) and poor in oxygen (oxyhemaglobin).

This strong affinity of hemoglobin for carbon monoxide means that very high blood levels can occur by breathing air that contains only small amounts of carbon monoxide. For example, breathing air that contains a carbon monoxide level as low as 0.2 percent may lead to blood carbon monoxide saturations greater than 60 percent after only thirty to forty-five minutes. So, a faulty heater or smoldering fi re that produces only a small amount of carbon monoxide becomes increasingly deadly with each passing minute.

This powerful attraction for hemoglobin explains how certain individuals succumb to carbon monoxide poisoning in open areas. Most people believe that carbon monoxide is only toxic if it is in an enclosed area, but this is not true. There have been cases of individuals dying while working on their cars in an open area, such as a driveway. Typically the victim is found lying near the car’s exhaust. Similarly, the newly recognized problem of carbon monoxide poisoning in swimmers and water skiers who loiter near a dive platform on the back of a powerboat with an idling engine.

The degree of exposure to carbon monoxide is typically measured by determining the percent of the hemoglobin that is carboxyhemoglobin. The signs and symptoms of carbon monoxide toxicity correlate with these levels. The normal level is 1 to 3 percent, but may be as high as 7 to 10 percent in smokers. At levels of 10 to 20 percent, headache and a poor ability to concentrate on complex tasks occur. Between 30 and 40 percent, headaches become severe and throbbing, and nausea, vomiting, faintness, and lethargy appear. Pulse and breathing rates increase noticeably. Between 40 and 60 percent the victim becomes confused, disoriented, and weak, and displays extremely poor coordination. Above 60 percent, coma and death are likely. These are general ranges since the actual effect of rising carbon monoxide levels varies from person to person. In the elderly and those with heart or lung disease, levels as low as 20 percent may be lethal. Victims of car exhaust suicide or those who die from fire in an enclosed room may reach 90 percent.

A running car engine in an enclosed garage is a common method for suicide, but it could also be used for homicide. If the killer subdues the victim by force or by way of intoxication, he could place the victim in his car and let the carbon monoxide actually do him in. When determining the manner of death, the ME looks for evidence of trauma to the victim as well as performs a toxicology screen. Finding trauma, such as evidence of a blow to the head, might change the manner of death from suicide to homicide, but finding drugs may not. Some people use multiple suicide methods to assure success and a drug overdose combined with carbon monoxide inhalation is not rare.

When more than one person is found dead in a house or a car and there is no evidence of trauma, carbon monoxide toxicity is considered. The odds of two or more people dying from natural causes at the same time and the same place are extremely remote.

Carboxyhemoglobin is bright red in color and imparts this hue to the blood. When the ME performs an autopsy and sees bright cherry-red blood, he suspects carbon monoxide poisoning as the cause of death. This finding is not absolutely conclusive since cyanide inhalation or ingestion can also result in bright cherry-red blood and tissues. Also, individuals dying from cold exposure or corpses exposed to very low temperatures may show bright red blood.

Lividity

Livor mortis in these situations may also be red or pink rather than the usual blue-gray color (see Chapter Five: Time of Death, “Livor Mortis”).

Lividity, CO

At autopsy, the internal organs in victims of carbon monoxide intoxication are also bright red. Interestingly, this color does not fade with embalming or when samples taken by the ME are fixed in formaldehyde as part of the preparation of microscopic slides. At times the presence of carbon monoxide can be found in the blood as long as six months after death.

Individuals who survive carbon monoxide intoxication may have serious long-term health problems. The brain is particularly vulnerable since it is extremely sensitive to lack of oxygen. Symptoms and signs of brain injury can begin immediately or be delayed for several days or weeks. The most common aftereffects include chronic headaches, memory loss, blindness, confusion, disorientation, poor coordination, and hallucinations. The ME may be asked to evaluate a living victim in this situation if the exposure was due to a criminal act or if a civil lawsuit is involved.

 

Q and A: Can My Killer Hack the Victim’s Implanted Defibrillator and Cause His Death?

Q: How could a failing ICD kill someone? My idea is for the victim to be an older individual who has this kind of device implanted in him. The killer hacks the wireless device in a similar manner to this: www.secure-medicine.org/icd-study/icd-study.pdf. According to this paper, the two attacks that seem most dangerous are to turn off therapy or to administer a V-fib shock intended for test purposes during the implantation procedure. How long would these take to kill someone? How healthy would someone be that had a pacemaker? How would this change if the victim had a mechanical cardiac pump?

Adam High, Marysville, CA

A: An AICD (Automatic Implantable Cardioverter Defibrillator) is a fancy pacemaker that has a defibrillator built in to it. It is used in people who have very severe and dangerous cardiac arrhythmias such as ventricular tachycardia and ventricular fibrillation, both of which are typically immediately deadly. These rhythms can occur in anyone. but are very problematic in those with severe coronary artery disease and/or severely damaged heart muscles, which we call a cardiomyopathy. These people are highly prone to death from these dangerous arrhythmias, so these are the types of patients who receive these devices. These are also the types of patients that are candidates for cardiac transplants and artificial hearts, or what are called left ventricular assist devices (LVADs). Since people who receive these assist devices have extremely damaged heart muscles and are at a very high risk of dangerous arrhythmias, they will also often receive an AICD at the same time.

 

 

An AICD basically monitors the cardiac rhythm, and when a dangerous rhythm occurs, they fire an electrical impulse which shocks the heart back to a normal rhythm. Sometimes it stops the heart and if so the pacemaker portion of the device will kick in. Some people have these devices implanted as a precautionary measure and never use them, while others have significant problems with arrhythmias and the device discharges more frequently. What this means is that turning off the defibrillator portion of the device will leave the victim a jeopardy but will not in of itself cause death. If he is one of those individuals that never uses the device, or only rarely, then your killer would have to wait a long time, and maybe forever, before the victim had a lethal change in heart rhythm. And since these devices are frequently checked, typically every 1 to 3 months, it would be noted during the check that this portion of the device had been turned off. So that leaves a narrow window for something serendipitously to happen. Most killers want more assurance that their method will work.

 

 

A better method is to trick the device into firing an impulse in the hopes that it would start a dangerous arrhythmia. Again this is not assured. In the cardiac catheterization lab, after the device is implanted, it is tested by inducing one of these arrhythmias. But the heart doesn’t always cooperate. Sometimes the rhythm cannot be induced. That would be the same situation with your victim. That is hacking the device and causing it to deliver a shock that was an appropriate might or might not cause the desired effect––a deadly cardiac arrhythmia.

Neither of these methods are assured of working, but of the two, I would go with hacking the device and delivering an inappropriate jolt of electricity. This would have the greatest probability of causing the result your killer wants. If so, death would be immediate.

 

 
 
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