Manner of Death Can Be a Matter of Timing

09 Jan

There are five matters of death: natural, accidental, suicidal, homicidal, and undetermined. Natural deaths are not usually within the domain of the medical examiner and accidental and suicidal deaths are rarely addressed by his office. But if a death is determined to be homicidal, the full force of the medical examiner and police investigators are brought into play.

This is why, along with cause of death and time of death, the manner of death is one of the most important things the medical examiner must determine. His official statement as to the manner of death will determine what happens next. Will the police be involved or not?

An interesting but sad case in Santa Ana, California underscores this point. In 2006, just before his 16th birthday, Robert Flores was shot numerous times in what is believed to be a gang related shooting. Robert survived the shooting but was left quadriplegic.

Quadriplegia is a difficult and complex medical condition and people who suffer from this are plagued with many complications including pneumonia, urinary tract infections, bed sores, muscle wasting, and a host of other problems. Many of these can progress and become deadly. This is what happened with Robert. Four years after his shooting Robert died.

So what was Robert’s manner of death? I don’t know whether he died from pneumonia or a urinary tract infection or one of the other complications of quadriplegia but he did die from some medical problem related to his paralysis. Since his death was due to a medical problem would his manner of death be listed as natural? The answer is no. His manner of death would be homicidal. He was shot five times and this act started the cascade of events that led to his death. In other words, had he not been shot he would not be quadriplegic and would not have been subjected to the medical complications of this condition. It was not an automobile accident or a fall or some other injury that might cause quadriplegia but rather the criminal act of his being shot that began his decline to death and that is what makes his death a homicide rather than some natural or accidental event.

As of right now there are no suspects in Robert’s shooting but if suspects are ever identified they will likely be charged with homicide.


For more on the Cause, Time, and Manner of death take a look at my books Howdunnit: Forensics or Forensics For Dummies.




2 responses to “Manner of Death Can Be a Matter of Timing

  1. Pat Brown

    January 9, 2011 at 2:43 pm

    What would the classification be if a person suffered a heart attack, say while they were being robbed? They must have had a weak heart to start with, but if they hadn’t been held up what are the chances they would have died at that time?

    How would that sort of death be ruled?


    • D.P. Lyle, MD

      January 10, 2011 at 9:20 am

      Actually cases such as this have occurred in the past. How such a case would be classified would be up the the particular coroner/ME involved and whether it would go to trial would depend on the prosecutor and the judge. It could go either way. One side would say it was a natural event and the other would say that were it not for the stress of the assault the victim would not have had the heart attack.



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