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Category Archives: Cause & Manner of Death

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.

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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.

 

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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.

 

 

Can Amyl Nitrite Cause Death And If So Would It Appear To Be Natural?

Q: Under what circumstances can poppers (Amyl nitrite) kill a victim so it looks like natural death? If this is not possible in reality, could you provide a pseudo-medical explanation?

L. Mitana, Slovakia

A: Amyl Nitrite is what we call a vasodilator–meaning it opens up all the blood vessels in the body. Too much can lead to an immediate and profound drop in blood pressure (BP) and this can cause death directly from shock or indirectly by generating a cardiac arrhythmia due to poor blood flow to the coronary arteries. If the victim has coronary artery disease (CAD), this drop in BP can cause a heart attack (myocardial Infarction or MI). So, too much Amyl can definitely be lethal and do so in several ways.

At autopsy the coroner would see nothing unless the victim had CAD. Either way he might write the death off as a cardiac arrhythmia. If he did test for amyl nitrite he might find it or not–it is destroyed very quickly by the body’s enzyme systems but some might remain after death–or not. But he would not test for this unless he had some evidence that Amyl Nitrite might be involved in the death.

This same vasodilatory effect is why Viagra should not be taken with long-acting nitrates. Some people who suffer from CAD are prescribed long-acting nitrates to help relieve angina—chest pain due to poor blood supply to the heart muscle. Like Amyl, these nitrates and Viagra are vasodilators and when taken in combination can cause a dramatic decline in BP and death can follow.

 

 

Q and A: Could My Investigator Determine If the Knife Used in a Murder was Made of Obsidian Rather Than Some Other Material?

Q: I am a lawyer in Tacoma, WA with a hobby of writing detective novels, all unpublished but fun for me. My question is would a knife wound from an obsidian knife be identifiable as from an obsidian knife as opposed to a knife made from another material?

John C. Cain, Tacoma, WA

A: Not likely, unless the knife had an unusual shape or curve or both. Wound analysis will only give the width, thickness, and general shape of the blade as well as its minimum length. The depth of the wound would tell the ME what length of the blade entered the victim. The blade could be longer but not shorter–thus the minimum length. If the ME then had the suspected murder weapon he could measure it and say that this blade was or was not consistent with the victim’s wound. That’s as far as he could go. He could completely exclude the knife as the murder weapon if the wound didn’t match but he could not say that this blade, and no other, made the wound. Only that this blade or one similar to it did the deed. The more unique the blade is the better this would narrow the possibilities.

 
But there are a couple of ways he could make a more conclusive judgement. If the victim’s blood was found on the weapon, say in the groove between the handle and the blade where the killer would overlook it and where even washing the knife might not remove it all, he could then DNA match this to the victim and say that this knife held the victim’s blood and was very likely the murder weapon. Why else would the blood be there?

 
Even better, if the point of the knife broke off in the victim and this was found at autopsy, then the ME would know the knife was made of obsidian. A comparison of this tip with the suspect weapon could prove very conclusive. If the tip fit the suspect blade in an exact jigsaw fashion this is very conclusive and individualizing evidence. That is, the ME could confidently say that this tip came from this knife to the exclusion of all others. The science behind this is that no two things fracture exactly the same way.

 

Q and A: What Poison Could Be Placed on an Envelope and Cause a Quick Death?

Q: I have a character who needs to die after licking an envelope. I would prefer a fairly quick demise. What sort of poison could the murderer use? It would need to be something that doesn’t taste too awful or she’ll stop licking it!

A: There are very few poisons that work instantly in small doses, but cyanide would fit your needs and can be acquired fairly easily.

Cyanide is quick and even if someone attempted to save the victim, it is next to impossible because treatment with a Cyanide Antidote Kit or a Cyanokit must begin immediately if any chance of survival is to be realized and people don’t usually carry these kits around. Simple CPR won’t do it. This is because cyanide is a “metabolic poison.” It basically shuts down the ability of cells to use oxygen. The red blood cells cannot carry oxygen to the tissues and the tissue cells of the body can’t use the oxygen anyway. It is as if all the oxygen were removed from the body instantly. This process is immediate and profound and leads to death in 1 to 20 minutes, depending on the dosage and a few other things. Even of CPR were begun immediately, it would be ineffective since the cells couldn’t use the oxygen supplied by this process.

Symptoms would begin very quickly in the delivery method you have chosen since the cyanide would absorb rapidly through the membranes of the mouth. The symptoms are rapid breathing, shortness of breath, dizziness, flushing, nausea, vomiting, and loss of consciousness. Maybe seizure activity. Then death. This could happen in a matter of minutes. Your victim might develop sudden, severe shortness of breath, a flushed face, perhaps clutch at his chest, collapse to the floor, and die, with or without having a seizure in the process. This would look very much like a heart attack. His skin might appear pinkish and if he hit his head or scraped an elbow in his fall and bled, the blood is a noticeably bright cherry red due to a chemical reaction between the cyanide and the hemoglobin molecules in the red blood cells.

Potassium Cyanide (KCN) and Sodium Cyanide (NaCN) are your best bets. They are white powders with a faint bitter almond smell, which most people do not notice. Both dissolve readily in water and saline. One caveat. Your killer must be careful in handling the KCN or NaCN as both readily absorb through the skin and could do in your killer. Rubber gloves or a complete avoidance of direct contact with the powder would be wise.

KCN and NaCN are used commercially in metal recovery such as extracting gold or silver from their ores and in electroplating such metals as gold, silver, copper, and platinum. They could be pilfered from a jewelry or metal plating company or could be purchased from a chemical supply firm.

In your story, the powder could be dissolved in water, applied to the envelope glue, and allowed to dry. When your victim licked the glue, he would develop the above symptoms within a very few minutes and would then collapse and die. This could take as little as two or three minutes.

 
 
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