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Authors: D P Lyle

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Does the M.E. Use Tattoos and Body Marks for Corpse Identification?

Q: Does the coroner use distinctive body marks and tattoos to help identify unknown corpses? Would such marks be used if the hands and face of the victim had been destroyed or removed?

A: The coroner would use any and all means to ID a "John Doe."

Body marks such as tattoos or birthmarks are often helpful in suspect and corpse identification. They are often sketched or photographed as part of the booking process, although this is far from universal. If your suspect or corpse had body marks and if

photos existed from a previous arrest, they could obviously be compared even if the photo was sent from another jurisdiction via e-mail or fax.

At autopsy the pathologist routinely photographs these as well as surgical and injury scars, particularly if a homicide is suspected.

Many tattoos and birthmarks are so distinctive as to be fairly strong ID evidence. In the case of a corpse, a previous cell mate or corrections officer or family member or previous arresting officer might be able to supply the presumptive ID.

Birthmarks come in many varieties. One distinctive type is called a port-wine stain
(nevus flammeus).
It is a reddish or purplish discoloration, and it may be small or cover a large area such as an entire shoulder or half of someone's face. Former Soviet President Mikhail Gorbachev had one on his forehead. They are typically very irregular, like an amoeba, and thus have a shape or pattern that is distinctive since no two are exactly alike. So if your suspect or corpse had such a mark, an old photo revealing the mark could be used to make a fairly positive ID.

As you know, many tattoos can be traced to the artist, especially today, since many are considered body art and some tattoo artists have distinctive techniques and loyal followings. Many tattooists use black pigments that contain carbon, reds that contain mercuric chloride, and greens that contain potassium dichromate. Others use aniline-based dyes. It is possible to extract some of the pigment from the corpse's skin and possibly exclude or confirm that a specific artist did the work.

Certain gangs boast their own tattoos. In California the CAL-GANG database stores such data, and often a query will result in a hit. This type of lead may result in the ultimate identification of the victim.

Can the Age of Surgical Scars Aid in Victim Identification?

Q: My protagonist is a detective who is confronted with a female corpse whose hands and head have been removed to hinder identification. She has a scar on her abdomen, which he believes is about three months old. This is important because a woman of about the same age and size was reported missing, and she had had her gallbladder removed three months before her disappearance. Can the age of scars be determined this accurately?

A: Yes and no. Any wound, whether surgical or from a knife fight, will follow the same healing pattern if it is closed properly with sutures and doesn't get infected. Lack of proper treatment or an infection of the wound would lead to delayed healing and more prominent scarring. Also, some people develop keloids when such wounds heal. A keloid is a raised thick scar that can be a half inch wide and rise a quarter inch above the surrounding tissue—sometimes more.

With normal healing the wound becomes mechanically strong after about two weeks. For several weeks the scar will be slightly pink to brownish red due to the microscopic blood vessels that invade the area to aid with the healing process. Over the next few months, as the body repairs the damage by laying down collagen (thick fibrous strands of connective tissue), the color gradually fades, and the scar shrinks considerably. With further maturing of the scar it finally becomes a faint white line by four to six months. The collagen continues to shrink until about one year. Thereafter, the scar remains unchanged for life. This means that the age of a scar can be approximated in the first four to six months, but after that all bets are off.

Your astute detective could see a 6-inch diagonally directed wound in the right upper quadrant of the corpse's abdomen and construe that it was from a cholecystectomy (gallbladder removal). He could further see that it appeared well healed but still possessed a pinkish hue and deduce that the wound was likely between six weeks and four months old. This would at least leave open the possibility that the missing woman and the corpse were one and the same. However, dental records, DNA evidence, or some other form of identification would be necessary to determine the true identity of the victim.

Will Stomach Contents Reveal When and What the Victim Ingested?

Q: My murder victim is found in the middle of the night. I have two questions. First, for a high-profile case, would the autopsy be done early the next morning? Second, can the autopsy tell very specifically what the victim ate? For example, if the victim ate chicken, vegetables, and bread five to six hours before death, would the contents still be visible at the time of the autopsy? Also, can the autopsy determine specific fluids and drugs, such as Coca-Cola versus tea or aspirin versus Alka-Seltzer? Would it be logical for a medical examiner to find traces of bicarbonate of soda and aspirin if the victim took Alka-Seltzer shortly before death?

A: Yes, the autopsy could be done the next morning. The M.E. could simply juggle the day's schedule and handle the high-profile case first. Also, in many jurisdictions the M.E.'s office has a "special cases room" where "special case" postmortem examinations can be videotaped.

Stomach and intestinal contents found at autopsy depend on

several factors such as the type and amount of foods consumed and the time lapse between ingestion and death. Digestive processes cease at death. Various foods remain in the stomach for different amounts of time. In general the stomach empties by four to six hours and the small intestines by twelve hours. If
food
material is found in the stomach, it would be reasonable for the M.E. to determine that death likely occurred within four hours of the meal. If the stomach is empty, he might conclude that the victim ate more than six hours before death.

Partially digested food, either in the stomach or in the small intestine, might reveal what that last meal was. This would be particularly true for high-cellulose foods such as corn since the body cannot digest cellulose. The vegetables in your scenario may still be identifiable, especially if you shorten the time between eating and death to less than four hours.

The stomach contents, blood, and urine would be tested for drugs. Unless death occurred shordy after ingestion, finding Coke or tea and distinguishing aspirin from Alka-Seltzer would be difficult.

Aspirin is acetylsalicylic acid (ASA), which is also in Alka-Seltzer (which also contains sodium bicarbonate and citric acid). Once ASA is in the bloodstream, it would be impossible to tell what ASA-containing product it came from unless undigested pills were present in the stomach. This is unlikely with Alka-Seltzer and aspirin since both dissolve readily.

Coke is simply sugar syrup, colorings and flavorings, caffeine, and carbonated water, all of which are digested and absorbed into the bloodstream fairly quickly. Most teas also contain caffeine.

Bicarbonate is a normal electrolyte in blood, so unless a large amount of Alka-Seltzer was ingested, it would be difficult to trace after digestion.

The M.E. could easily detect ASA, which is invariably part of a routine drug screen, and caffeine. Finding abnormal levels of bicarbonate would be more difficult and much less specific.

A complete examination of the crime scene could help the M.E.

here. If food was still on the table or in the refrigerator, it would help him analyze the stomach contents by narrowing his focus. The same would be true if aspirin and Alka-Seltzer bottles were found. The M.E. uses all the evidence he can accumulate, not just the autopsy, drug screen, and so forth, in making his assessment of cause and manner of death.

Can the Type of Alcohol Found in Stomach Contents Be Determined?

Q: In my story an old woman with a fondness for wine is found shortly after death in the tub of her stiflingly hot trailer. Would chemical analysis during an autopsy show what kind of alcohol the woman was drinking? Although she is known to drink only wine, a glass with a small amount of whiskey in it is found on the edge of the tub. Also, if distinctions between whiskey and wine can be detected, could an analysis also determine the brand of the whiskey? Would an autopsy show that the woman was actually drunk or only that she did indeed have alcohol in her system?

A: The M.E. might be able to determine the type of alcohol consumed if the victim expired shortly after drinking it. Since digestive processes cease at death, the stomach contents stay more or less intact. Decay and bacterial-mediated putrefaction would alter them over time, and these processes are accelerated in a warm environment. But this process might take a couple of days or more in most circumstances. If the stomach contents were well preserved, it might be possible to determine the type and even the brand of the alcohol.

If the alcohol was consumed a couple of hours or more before death, the digestive process would be fairly complete, since alcohol

is basically a type of sugar and digests readily. The stomach contents probably would not be helpful, and once alcohol is in the bloodstream, it is alcohol. Blood analysis could distinguish ethanol (ethyl alcohol, the type in alcoholic beverages) from methanol (methyl alcohol, which is denatured alcohol, a poison) from iso-propanol (isopropyl alcohol, which is rubbing alcohol), but if ethanol is found, it is generic ethanol; that is, in the bloodstream, wine is like vodka is like a good sour mash whiskey.

The blood alcohol level can be readily determined, and it is this level that dictates legal intoxication. In California the legal limit is 0.08 milligrams of alcohol per 100 milliliters of blood. This varies from state to state. Some people—and this seems more prevalent in women than in men—can become impaired at lower levels. Everyone is different. The M.E. could determine the blood alcohol level, and even if it was below the legal limit, he might be able to make a good guess as to the victim's level of impairment.

Can an Autopsy Reveal a History of Pregnancy or Childbirth?

Q: If a female corpse is autopsied soon after death, can the pathologist tell if she has had children or been pregnant? What if the body is partially decomposed from several months' exposure to cold weather?

A: After pregnancy there are permanent changes in the microscopic architecture of the breast and uterine tissues, which the M.E. would see. Also after pregnancy, pale striations often appear over the surface of the breasts and abdomen. These are similar in appearance to stretch marks and may have a faint pinkish, bluish, or silvery hue. Whether these tissue clues would help in your scenario depends on how well preserved the body is. The cold weather may help in this regard by delaying corpse putrefaction and decomposition.

Even in skeletonized remains, evidence of the trauma caused by previous childbirth is often present. Multiple pregnancies and deliveries make this evidence more profound. The M.E. would look for scars on the pubic bone that result from tears of the periosteum (the layer of tissue that covers the bones) and at the insertion sites of the various tendons that attach to the pelvic bones. It wouldn't be possible to determine how many children she had delivered, only that she had had at least one.

Can the Coroner Determine the Caliber of a Bullet by Simple Inspection?

Q: If an M.E. recovers a bullet during an autopsy, can he determine the millimeter gauge of the bullet, or would ballistics determine that?

A: Both. The M.E. could make a guess as to the type of bullet, but confirmation would require a true ballistics exam. Depending on how much damage the bullet suffered, an experienced M.E. could tell a .38 slug from a .45 from a 30.06, and some are very good at it. A complete ballistics evaluation would follow to confirm this and to make the information more acceptable in court.

In Slashing Wounds, Can the M.E. Determine What Weapon Was Used?

Q: I have a victim of a slashing being autopsied. How would I describe the wound if it is from a sharp claw versus a sharp instrument? How would the medical examiner know that the wound was caused by something other than a knife?

A: In general, slashing or cutting wounds are extremely difficult to analyze. Determining the type of weapon is virtually impossible. With stab wounds you have depth, width, thickness, angle of attack, shape of the blade, and sometimes serrations that help determine what type of weapon was used. These same characteristics make comparison with a suspected weapon easier.

With slashing wounds these characteristics don't exist. A Bowie knife and a dagger make very different stab wounds but similar slash wounds simply because the nature of the slashing motion produces a long wound with ragged edges that bleeds considerably.

A claw or talon could make a similar wound. The pathologist might be able to determine the width and at least a minimum length of the object by the depth and width of the wound, but little else unless trace evidence (fur, talon fragments, tissue, attacker's blood) was left behind.

Can the Coroner Distinguish Between Freshwater and Saltwater Drowning?

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