The Medical Examiner/
A doctor who performs
an autopsy when
someone dies an
accidental or violent
A medical examiner
can be a coroner,
however not all
coroners are medical
Investigate how, when,
and where someone
Schooling/Credentials to Become a
Four years of medical school,
A five year residency in anatomic and clinical
A one year fellowship in forensic pathology.
Pass a Medical Boards in Anatomic Pathology
following the fellowship you need to pass
Boards in Forensic Pathology
A medical doctor is also required to take a
minimum of 20 hours of approved medical
education every year to maintain their medical
Medical Examiner vs. Coroner
A medical examiner is always a medical
doctor whereas it is not necessary for a
coroner to be a medical doctor.
A medical examiner is appointed while a
coroner is usually elected.
A medical examiner gives objective
opinions on the circumstances of a
victim’s death. A coroner must give
subjective opinions based on evidence
found surrounding a victim and their
death. Coroners usually have legal
powers such as subpoena powers.
is a subgroup
which focuses on
the medical and
of sudden or
A forensic pathologist is a physician who
has received special training in pathology
and forensic pathology. Their training
takes approximately six years after
graduating from medical school.
Physicians can take the examinations
offered by the American Board of
Pathology. If they pass this examination,
the pathologist is considered Board
Forensic Pathologist vs. General
A medical doctor who has completed training
in anatomical pathology and who has then sub-
specialized in forensic pathology.
Performs autopsies/post mortem examinations
to determine the cause of death
Analyzes blood, fluid, and tissue samples
Looks at tumors and other abnormal growths
removed from the human body
Determining Cause of Death
Using the external and
a medical examiner
can determine the
cause of death of a
victim. Usual causes
of death are
Determining Location of Death
Many factors used to
determine location of
death. Some examples
Fluid in lungs show
death by drowning
Testing the fluid can
lead to a definite
conclusion as to where
the body had drowned.
Insects that are
indigenous to an area
can show location of
death. However, bodies
found with insects are
usually sent to a
Determining Time of Death
contents in the
stomach of the victim
and the amount of
Examining the amount
of vitreous humor
fluid in the eyes.
stages of death:
Determining Natural/Unnatural Deaths
Natural Death- According to pathologists, "A natural death is
a death that results from a natural disease process, distinct
from a death that results from accident or violence."
Unnatural Death- According to pathologists an unnatural
death is constituted by any of the following events:
Being attacked by insects, reptiles, fishes, lions, tigers, bears,
stingrays, or other wild animals
Adverse outcome of surgery
Work Besides Performing Autopsies
Review medical records and investigator reports.
Examine glass slides of tissue samples under a
microscope to identify diseases.
Review toxicology reports for evidence of
chemical abnormalities or drug use or abuse.
Report findings as to the cause and manner of
Meet with law enforcement officers, attorneys and
family members to explain their findings.
Appear in court to testify as an expert witness.
Objections to Performing Autopsies
From the moment a death is reported, the
coroner/medical examiner is in charge of the body
until it is released for the funeral. The coroner is
responsible for finding the specific cause of death.
They decide whether an autopsy is needed. The
relative’s of the deceased can make a formal
objection to an autopsy.
The state coroner will seriously consider any
objections. Objections can be made on religious,
cultural, or personal grounds.
Testifying in Court
A Medical Examiner cannot leave
doubt in the minds of the jury
with either their methodology or
When testifying in court, the
State Medical Examiner must be
able to explain scientific and
medical findings in clear precise
language understandable to a
The testimony of the State
Medical Examiner is crucial in
establishing the cause and
manner of death.
This is most important in
cases of fatal child abuse,
where the defense will
almost always claim that the
The findings and testimony of the
State Medical Examiner can lead
to the acquittal of an innocent
What is an Autopsy?
A surgical procedure after death which
involves the examination of body tissues,
often to determine cause of death.
Medical Examiner Autopsy vs. Hospital
Hospital autopsies are different from
coronial autopsies. Permission is
needed from the family of the deceased
prior to performing a hospital autopsy.
Families have the right to say no and
hospital staff will always have to
respect the families wishes. A family
may request a doctor to arrange for a
hospital autopsy to help determine why
the person died.
After the Medical Examiner is notified of a death, in
order to conduct an investigation, they are in charge of
what happens to the body of the deceased.
The Medical Examiner Investigator determines whether
to release the body from the crime scene to the
morgue or whether they will go to the crime scene.
The investigation to determine cause of death may
include interviewing witnesses, friends, relatives, and
health care providers.
An examination of the crime scene and the surroundings
may also be included in the investigation to collect and
preserve evidence. The investigation may also require a
physical examination of the body or autopsy, and may
require laboratory tests of tissue or bodily fluids.
Circumstances for an Autopsy
determine the cause of
Reduce the family’s
what they could have
done to prevent the
genetic diseases that
may be problems for
them in the future
Circumstances for an Autopsy (cont.)
Practice of medicine
and research leading
to improved health
Community at large
diseases and health
hazards that can
awareness of the
Steps Taken in an Autopsy
The pathologist records the results of the external
examination and lists all physical characteristics.
First cut- 'Y' incision
The arms of the Y extend from the front of each
shoulder to the bottom end of the breastbone. The
tail of the Y extends from the sternum to the pubic
The ribs are sawn off in order to remove the
organs so that they can be examined/tested.
The brain is removed using a transverse incision.
It is then either cut fresh for examination or is
placed in a 20% solution of formalin to preserve it
for future analysis.
Steps Taken in an Autopsy (cont.)
All removed organs are weighed and
studied individually. Most organs are cut
up in sections by a scalpel.
Intestines are drained in a sink to remove
undigested food and feces that remains.
The stomach is cut open and the contents
Microscopic samples of most organs are
taken for further analysis.
Finally, all major blood vessels are cut
open lengthwise and examined.
Steps Taken in an Autopsy (cont.)
The organs are placed back in the body, and the
body will be filled with a filler material. The head
and body are then sewn up. The brain is returned
to the body, except in the cases where the brain
has been retained for further tests.
Once the Y incision is sewn up, the autopsy
(without brain and tissue analysis) is complete.
The body must be measured
and weighed and placed on an
autopsy table prior to making
the Y-cut. A general description
of the body is made before any
further examinations are done.
All identifying features are
Hair color and length
Any identifying features (scars,
tattoos, birthmarks, etc.)
Any wounds inflicted on the
outside of the body (burns,
ligature marks, stab wounds,
The Y-cut is made so that organs can be removed from
All organs are removed and samples are taken in order
to examine them.
The brain is removed in order to examine the skull.
Internal examinations are conducted in order to check
for internal wounds to determine cause of death.