TOM MCMAHON, Staff Writer 08/07/2006
Under Iowa law, state and county medical examiners investigate deaths affecting the public interest, including homicides, suicides, accidents, those related to disease that could pose a public health risk, inmate deaths, deaths where the body is not identifiable and unnatural deaths. The latter includes any child under 2 if the cause of death is unknown or if the circumstances surrounding the death indicate it may have been caused by sudden infant death syndrome.
John Kraemer, director of the state medical examiner's forensic operation, said the forensic investigation and autopsy's ultimate goal is to develop logical, scientific and unbiased information necessary to determine the cause and manner of death for proper and accurate completion of the death certificate. The autopsy report, evidence collected and court testimony provided are often critical to both civil court proceedings and murder trials.
Pottawattamie County Attorney Matt Wilber said an examiner's testimony is usually very important at trial, but there are exceptions.
"In the Michael Gunther case, the cause of death was not an issue," Wilber said. "She was stabbed 22 times."
Gunther was convicted of second-degree murder for stabbing Sally Kennedy in May 2004.
Generally, Wilber said, autopsy reports are not seriously questioned. But, he said, in Harris Hedges' 2004 death there was a question as to whether he died from a beating or a fall down the stairs that followed.
"Were the skull fractures from the fall or from the beatings?" Wilber asked. The medical examiner's report indicated Harris died as the result of blunt force trauma to the head from both. The suspects in the case eventually pleaded guilty.
In cases where the cause of death seems obvious, such as when someone is shot, the autopsy examination can help determine details regarding the manner of death and provide information that may be necessary in legal proceedings. Details may include determining the bullet's direction, extent of injury, number of wounds and distance from muzzle to victim.
In Dixie Duty's trial, State Medical Examiner Dr. Julia Goodin testified that Duty's first husband, Scott Shanahan, was shot in the back of the head from a distance of 10 feet or less.
That testimony was deemed critical to Duty's conviction as she testified she shot Shanahan in self-defense.
Kraemer said each case determines what procedures are included in its autopsy investigation. He said the body is examined externally for trauma or other obvious pathology.
"We also collect evidence such as hair, fibers or paint chips in clothing. Their personal effects are examined, too," he said.
X-rays may be taken and internal organs are looked at for signs of trauma or disease. The pathologist will draw blood and bodily fluids/tissues and send those to consulting forensic labs to test for the presence of chemicals, which could include alcohol, legal or illegal drugs or poison. Microscopic examination of organs is also done if nothing unusual can be determined by the naked eye, Kraemer said. Depending on the results, other experts might be called in, like pathologists specializing in neurology or cardiology, he said.
While murder and high-profile accidental deaths put his office in the headlines, Kraemer said about 70 percent of the autopsies his office performs are related to natural disease.
"An example would be a young person who collapses and dies playing basketball," he said.
Kraemer said 18 percent of the autopsies are related to accidental deaths, including motor vehicle accidents; 8 percent are suicides and 2 percent homicides.
"From TV, people think all that we do is homicides. That is obviously not the case," he said.
About 2 percent of deaths remain in the undetermined category.
"Those are cases when we either don't know the cause or have narrowed it down to a couple but can't make a definitive decision," he said.
Kraemer said while homicide autopsies are infrequent, they become a priority if needed
"The first 48 to 72 hours is critical for evidence," he said. Kraemer said law enforcement officials are usually present during examinations when a homicide is suspected.
In addition to the legal systems' interest in autopsy results, Dr. Robert Fryzek said insurance companies also have a stake in some cases.
The Mills County medical examiner said he handled a case where a man had recently been released from the hospital after coronary bypass surgery. While attempting to exit his garage he tripped and was struck in the back of the neck by the garage door that was automatically closing. The man died and the insurance company questioned whether he had a heart attack. If so, the death benefit would have been less.
Fryzek said the autopsy revealed the deceased's arteries were fine and that a fractured vertebrae caused his death.
Kraemer said autopsy results are also used in public health issues. He said when AIDS/HIV was first discovered, autopsies confirmed the virus' presence and contributed to the public health discussion.
Note: The state's three forensic pathologists do not work under Kraemer, as stated in the first article. They all work in the State Medical Examiner's Office.
http://www.zwire.com/site/news.cfm?newsid=17022985&BRD=2703&PAG=461&dept_id=555106&rfi=6
|
