November 8, 2018
This is useful if you are the counsel for the
TOPIC: Physical Injuries
Legal definition - Serious, Less Serious and Slight Physicial
Injuries.
Q: What would determine which is which? How will you
know? What is the qualifying element?
1.) Medical attendance
2.) Incapacity to do labor
3.) Demarcation – how many days? (more than 30, 30, less
than 10)
Except: Permanent marks on the face, impairment of
senses (hearing, vision)
- Pag tinamaan yan, these are serious physical injuries
already. Kahit bukas magaling na agad yung mata mo.
- Of course, consider the intention. Intention matters.
Intention must not be to kill otherwise, no longer physical
injuries.
Knowing the number of days of incapacity and medical
attendance is important, diyan papasok yung Medico-Legal
Certificate.
Q: Medicolegal certificate and medical certificate – are
they the same?
Basically the same although the other one is more expensive.
Both are legally binding to be used as pieces of evidence.
Q: Who should execute a medicolegal certificate?
Any physician is authorized to do so (government or not.)
Although a lot of doctors are afraid to sign medicolegal cert
because they know that if they sign, they will be required to
attend court hearings and be presented as witness to give their
testimonial evidence. And document will be part of
documentary evidence.
Q: Why are doctors afraid to go to court?
Sisirain pagkatao mo, credibility. Tapos palalabasin na
nagkamali ka and all of these. That’s why doctors are hesitant
to issue medico legal certificate.
Q: In practice, if a person becomes injured – vehicular
accidents
They normally ask if you will require a medicolegal certificate.
Q: How about those apprehended by police officers? Ex: It
was Pedro who stabbed the victim, tapos nahuli ng pulis.
What will the police officers require from the victim?
Medical certificate will do.
Q: Ano ba kadalasan tinitignan ng police officers even the
fiscal?
The number of days wherein the victim will become
incapacitated or required to go under medical attendance. It is
the most important part of the certification. As lawyers, you
know that it is important because that will be determinative of
the crime committed by the assailant whether serious, less
serious or slight.
o It will now depend on the certification given by the
physicians.
Problem is some physicians don’t even understand this until
now. Yung iba iniissue yung number of days by way of
accomodation. Ginagawang 10 days kasi gusto daw
magpahinga ng patients.
Doctors will be asked in court – why 10 days? If for
accomodation, mahuhuli yan. Your credibility will be
PASION 3AA
questioned.
accused. Because there are times when the certificate is no
longer questioned.
When? Parties may agree to stipulate to the admissibility of
the medical certification. (Wont be discussed in trial, already
admitted in evidence)
Ex: This is the medicolegal certificate issued by Dr. Juan. Do
you stipulate? Yes.
- It means that this is no longer in issue. The contents of
the certificate are already admitted in evidence. Pag
ganyan, sumuko ka kaagad sa karapatan mo. So that is
the idea there.
- If you are a diligent lawyer, you will not be stipulating
immediately. Ang dami mong pwedeng question diyan e.
Such as “who’s the signatory there?” for all you know, it
is the clerk who signed that certificiation which actually
happens in the hospital. These clerks are the lowest
form of animals in the hierarchy. Sila yung gumagawa ng
dirty works. They are the ones left awake in the ER.
- Of course if it is signed by the clerk, you cannot have
that admitted in evidence. Unlicensed physician yun eh
like an intern.
- But if it is signed by a resident surgeons, can you
question it now?
Q: If you are left by a medico legal certification signed by a
surgeon in training, is there an issue there?
Of course. He is in training. That is still questionable. When
you talk of an expert witness, yung requirement diyan, there
should be sufficient skill, knowledge, experience and training.
Most of the time in the ER, it is the lowest who stays in there.
The clerk, intern and even the first year residents. With that,
you can easily question the credibility. It is very easy to destroy
their credibility. Tanungin mo lang, how long have you been
practicing surgery? You can already damage their credibility.
This is for when you are the counsel for the accused.
- Pag ikaw yung counsel ng victim, you will push for the
admission of the document. Pa-admit mo agad na expert
yung doctor mo.
Q: Contents – What will you find in the medicolegal
certificate?
1.) Findings – but as to the findings of the doctors, you
will end up in a dead end. You cannot question the
findings of the physicians. You will never succeed
because this involves his personal knowledge,
personal assesment or evaluation of the patient.
- You cannot destroy the credibility of the doctor as to the
contents of the certificate. It’s very hard.
- When the doctor starts to say “in my expert opinion, in
my personal knowledge, personal examination,
assesment of the patient etc, this is what happened..”
wala na.
- If you are the counsel for the victim, turuan mo yung
doctor na sabihin yun agad.
In traumatic cases, the hospital will always ask (in the ER):
a.) Nature Of The Incident (NOI)
- What is the accident about? Can either be a stabbing
incident, mauling, vehicular accident, dog bite. (Dog bite is
a medico legal case)
b.) Place (POI)
c.) Date (DOI)
d.) Time (TOI)
Next meeting: Main body of the certificate
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November 15, 2018
TOPIC: Rape
People vs Basite
Q: Was there a stabbing incident? Who was stabbed?
What weapon was used?
• What was the issue in the medical certificate?
• Was there a finding of guilt beyond reasonable doubt
even though the medico-legal certificate states that
there is no laceration of the hymen? It was noted that
the hymen was intact. How was that resolved?
• Who was the expert witness presented?
• How about the discrepancy in the findings of the SC?
There are instances when there are no admissions but the
physician still has to be presented in court, such as in this
case.
1. Private physician
2. NBI – as expert witness
Q: The medico-legal certificate states that there is no
laceration of the hymen? It was noted that the hymen was
intact. How was that resolved?
- As to the findings, the intact hymen does not negate the
presence of rape.
Researches will say that even though there is repeated coitus,
(sexual intercourse) it is still possible that there is no hymenal
laceration since the hymen may be elastic in some instances.
- Since there are different types of hymen.
- Presence of hymen not a conclusive proof of viriginity.
- When you talk of rape, hymenal laceration is not a
requirement.
Q: What is required in rape cases?
- It is not penetration that is needed. Inter-labial
penetration is sufficient. No need for actual coitus. Sa
inter-labia, sumagi ka lang dun sa labia majora niya,
that’s rape already.
- Even if there is an intact hymen, it will not follow that
there was no rape.
There are also hymens in which their actual appearance is kala
mo may laceration na when in fact it is the natural appearance
of the hymen.
Q: One of the finding is “admits one finger”
In the examination of the female genetalia, in assault cases,
look for defense wounds. Usually in the thigh area and also
look at the pubic hair.
- There may be findings that there may be 2 or 3 specimens of
pubic hair. 2 of which does not belong to the victim. There may
also be scrapings of pubic hair. It may be corroborative
evidence that someone touched.
Sa ari ng babae, after visual examination, tignan mo yung
tightness of the vagina of the female.
Q: How do you measure tightness?
- Admits one finger.
- In the other Colorado case, admits one and a half
finger with resistance
Q: How is it measured?
Hindi naman pinapasok yung daliri. Testubes are used and it
will approximate the size of the finger. Will be used to
determine tightness of the vagina.
Hymenal lacerations there are 2 criterias –
PASION 3AA
1.) Extent of laceration (napunit or kalahati lang)
- What is the extent of the hymenal alceration? Does it
include the full extent of hymen or beyond the hymen
itself? (napunit yung hymen including the ceramic
structures)
2.) Position of laceration
- In determining the position, use the face of the clock.
Colorado case: 6 o’clock position (bandang baba yung
punit ng hymen)
3.) Bleeding
- In this case no bleeding. Only discharge.
- That’s why sabi ng NBI walang rape kasi intact
hymen.
o But again, court is not bound to the
statements of expert witnesses.
You need not produce a medical cert or medico legal cert
to affirm the conviction of accused in rape cases. It is not a
requirement in rape cases. Because the statement of the
complainant would be sufficient enough.
Read: Colorado Case
November 22, 2018
TOPIC: Wounda
1.) Punctured wounds vs Stab Wounds
• Punctured wounds – from a pointed instrument.
(ice pick, screw driver, bbq stick etc)
• Stab wounds
2.) Lacerated Wound vs Incised Wound
• Incised– instrument used has a sharp edge
(scissors, knife, cutter)
• Lacerated – due to blood instrument such as metal
pipes, walls, sinuntok etc.
- In practice it’s very hard to discern whether the
wound is lacerated or incised wound since there are
instances wherein yung wound diretso. Akala mo
hiniwa. When it fact it was due to a sharp-edged
instrument.
- One way on how to verify is to use a magnifying
glass to look closely the edges of the wound.
• If the hair on the skin is cut, it is due to a sharp-
edged instrument (incise)
o Even the hair root, napuputol.
• If the hair stays on one side of the wound, it is
due to a blood instrument (lacerated)
o Pag sinuntok ka tapos pumutok, it can
give rise to a lacerated wound.
It’s important to know the difference:
1. Healing time – important to know especially for
lawyers. Especially for physical injuries
• Incise wounds – heals very quickly
compared to lacerated
• Lacerated wounds – prolonged healing
- prone to scar formation
2. Scar formation
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 - Important especially if you’re talking about
injuries on the face.
- If you have a permanent scar on the face, days
of medical attendance becomes immaterial.
Q: What crime is committed? Permanent scar on the
face.
- Serious physical injury.
I had one case, nagkalmutan yung 2 babae. Yung isa sa
face nakalmot. So nagkarooon siya ng peklat. What’s
the difference? So yung isa serious physical injuries
yung charge tapos the other, slight lang.
Kalmot refers to abrasion.
Q: Ano yung instrument mo pag abrasion?
Rough surface, sahig, pader.
Sometimes, these are called friction marks. When you
read cases you’ll see “friction marks located at blah”
- So parehas lang silang may kalmot but the charges are
different. Yung isa slight lang yung isa serious. Kasi sa
mukha nahagip. Nagkapeklat.
The victim suffered stab wounds, 2cm, in the right upper
quadrant. Sometimes you write it this way, “2cm SW
RUQ”
- So you have the measurement, nature and
location, size of the injury
Contents of medicolegal certificate:
1.) Name of patient
2.) Other circumstances like address
3.) Nature of incident - NOI
4.) Time of incident - TOI
5.) Place of incident – POI
6.) Date of incident – NOI
7.) Findings
8.) Signature of doctor
“2cm stab wounds right upper quadrant”
- The basic components there we have the size,
nature of the injury, the location.
3.) Contusion and Hematoma
• Contusion - Sa tagalog pasa. Discoloration of the
skin. Whether red, green. As long as there is
discoloration due to trauma. (sinampal, sinuntok,
hinampas etc.)
- It’s a flat injury. Patag.
Q: What leads to discoloration?
- Due to blood diffused in the tissues./skin.
- Flat discoloration on the surface of the skin
versus hematoma
• Hematoma
- Elevated. Bukol. Usually found in boney
surfaces. Madalas sa ulo.
PASION 3AA
Q: What causes hematoma?
- Inflation of blood under the skin
Q: Bakit nagbubukol?
- No room for blood kahit saan kaya makikita mo
to madalas sa boney surfaces.
- Unlike contusion, sa muscular area. Mga hinahampas
ng paddle contusion yun because there’s room for
expansion.
- Subukan mo hampasin ka sa ulo, there’s no room for
expansion there since boney surface. Instead, blood
becomes collected underneath the skin.
Difference there is, you get a syringe put it there, it will
not be able to extract blood in contusion. But in
hematoma, when you try to put a syringe, tusukin mo
yan may lalabas na dugo diyan.
That’ s why sometimes sa hematoma, yung bukol, cyst
na yung laman sa loob dugo. Madalas makikita yan sa
ulo, legs sa shin, thigh.
Q: Sometimes it’s a combination of the 2. Elevated
and discolored. Paano pag ganun?
- Contusion hematoma
“2x2 cm abrasion left anterior fore arm”
- Size, nature (abrasion due to rough surface),
location.
- Because we don’t have a general standard here
in the PH on how to write. Basta important hindi
mawawala yan.
There are some that are more detailed such as the
indication of “anteror” (side)
In one case, pinagtatalunan yung injury because the
medical certicate indicates that the victim suffered stab
wounds but the instrument they secured is a screw
driver. So ginisa yung expert witness. The first question
was what is the difference between a stab wound and a
punctured wound? The doctor does not know. The
credibility of the expert witness was already tarnished.
- Because how can a screw driver produce a stab
wound, taking into consideration the
measurement of the alleged instrument that was
recovered.
- That’s why you have to know this. Especially the
size, when we talk of stab wounds. Why? It has
to correspond with the width of the
instrument.
- In this case, when you try to look at the details of
the medico legal cert, iba yung sukat ng blade
and width ng injury.
If you try to look at the details of the medico legal
certificate, iba yung sukat nung blade, iba yung width ng
injury. But definitely, if the width of the weapon is 2
inches, can you have an injury that is less than 2
inches?
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 - Pwede rin kung mababaw lang yung pagsaksak.
lang. Yung weapon may width na 2 inches.
Lahat yun hindi nabaon ng maayos? Ano yun
partial na nasaksak lang lahat?
- Pag criminal case, ang kailangan mo lang diyan
reasonable doubt. Diyan pa lang you can get
away.
Q: If the width of the knife is 2cm, can the wound be
greater than 2 cm?
- Yes depends on the approach. Yung angle
- Will also depend on whether the instrument is
double edged or single. Kasi if the instrument is
double edged, expect that the size would be
greater kasi pagpasok and paglabas
So these are the things that you have to notice when
you handle a medico legal certificate:
- Size, nature and location.
4.) Burns (thermal injury)
Q: How do doctors document burns?
- Documented based on debris.
Debris – how deep the skin is burned.
Q: How do you know if it’s first degree burn, second,
third?
- The thickness or what is the extent of the burn.
- Pag sunburn, first degree lang yan.
- Pag nag blister na, nagkaroon na ng tubig,
second degree na.
o Mga markers yan.
- Also try to determine the surface area that is
affected. The extent of the burnt area.
Q: How is it measured?
- So in addition, try the rule of nines in burn injury.
Rule on nines - the body is divided into several surfaces
with particular measurements.
ex: It is safe that this part is 9% of the body surface,
abdomen.
o If this (abdomen) is burned, body surface is 9%
burned.
rd
This is to approximate. Para pag sinabing 3 degree
burn 30% of the body area.
The problem with burns is:
First, it is painful. But if the skin that got burned is very
th th
deep, umabot ng 4 -5 degree burn, it really is not
painful anymore kasi tinannggal na yung balat.
- But the main issue with burns is deliberation (?),
infection,
This one is penetrable to disease-causing agenst.
- Pag tinanggal mo yan tapos nasunog, exposed na sa
agents na nagkalat kahit saan. That’s why burned
patients are placed in an isolated room.
Another purpose of the skin is that it prevents water from
evaporating. Kaya di umiihi yung mga nasusunog kasi
yung tubig nila lalabas dito. So this can really kill,
PASION 3AA
eventually the victims will die especially if large surface
area was burned.
In medicolegal certifications of patients that has burns,
there will be an indication of how big is the affected
surface area, gaano kalalim etc
5.) Gunshot wounds
Q: How do you document gunshot wounds?
Other then the bullet, what else comes out of the
trigger of the gun?
- Flame, smoke, unburned powder, gases
Of course our concern is the bullet but for medicolegal
purposes, if these touches the skin of the victim, this will
produce certin marks.
• Singeing -if the flame touches the skin of the victim,
masusunog lang yung hair not the skin. Flash burn
lang. Mabilis lang. This is called
• Smudge - If the smoke touches the skin of the
victim, it will produce a mark.
“Found on the victim are signs of smudging”
• Tempering (?) - If unburned powder lands on the
skin of the victim, it will produce small marks
If there are signs of singeing on the victim, expect the
blow to be around 6 inches away. Otherwise, if more
than 6 inches away, you do not expect to find singeing or
burning of the hair.
- If there is smudging or smoke, the barrel of the
gun would be around 12 inches away. Beyond
that wala na.
- Pag tempering, around 18 inches away.
NOTE: General rule to, cause now, marami na factors to
consider like type of weapon used, the bullet used. May
smokeless bullets din. The type of powder used.
- If nakita mo to, this will tell you that the assailant
is close to the victim. That’s why there are able
to determine kung approx ilang inches away with
the presence of singeing etc.
How about gases? Wala naman injury diyan.
Gunshot wound - If it lands on the skin of the victim
2 yan. Pinasukan and nilabasan. Point of entry and point
of exit.
Q: What’s the difference?
The point of entry – shows the shape of the bullet.
Either oval or round. Sometimes, star shape. Kailan
magkakaganun? Pag star yung bullet. HUHU !
- But this happens actually pag may press fire or
contact fire. Instead na bilog lang yung bullet
yung point of entry, pupunitin niya yung skin,
causing now the star shape of the appearance of
the entrance wound.
- It is actually due tp the gases. Imagine, bullet
enters, other than that, gases would also enter.
Pagpasok, it will ruptre and tear the skin.
Puputok. Will not create the star shape
appearance.
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 - Mga malapitan na gunshot, napupunit din kasi
yung balat.
The point of exit – no particular shape but definitely not
round or oval. Most of the time, it would appear as a
lacerated wound. Other doctors, mapagkakamalan na
stab wounds. Binaril mo na, bakit mo pa lalapitan para
saksakin. Also look at the history.
Q: What else are the differences?
Singeing, tempering, smudging, - you will all find these in
the entrance wounds.
Why is entrance wound oval and why is the exit
wound not round?
- As the bullet penetrates the skin, there are
supporting structures underneath the skin, na
preserve yung circular entrance unlike paglabas
na yung bala, pupunitin niyan from inside to
outside causing now that non-oval shape.
If you will look at the edges of the entrance wound, it is
inverted, papasok yung edges.
In exit wound, the edges are palabas, everted.
- There are instances wherein the tissues are
directed outside. Everted eh. Palabas yung bala.
Lalabas din yung laman ng tissues.
Abrasion Collar or Concussion Collar– also found in
the entrance wound.
- As the bullet approaches the target, it will rub
itself first before it penetrates the skin of the
victim.
- Due to the rubbing of the bullet before
penetrating the skin.
Ex: This is the skin and the bullet is here, trajectory is
here, it will rub itself first before finally penetrating the
skin, causing now the entrance wound.
Why is this imporant?
- The general rule is the abrassion collar points
towards the location of assailant.
- Kaya pag may gunshot wound, laging hinahanap
kung may abrassion collar and where is it
pointed.
Read the case of Custodio vs Sandiganbayan
- If there is no abrassion collar or it is evenly
located, direct yung approach nung bullet. Not
angulated.
In rape, for example this is the hymen and the opening,
when we talk of documenting hymenal lacerations, does
it go beyond 50% or beyond 50% of thw width of the
hymen or destorys the entire width of the hymen or
destorys together with the surrounding tissues?
- If the hymenal laceration does not go beyond
50%, the laceration is called superficial
laceration.
o Case assigned.
- If it goes beyond 50%, it is called deep
laceration
PASION 3AA
- If destorys entire width, complete hymenal
laceration
- If destorys entire width and surrounding tissues,
compound lacerations.
o This is true especially in cases of raped
children.
December 6, 2018
TOPIC: Death
Changes in the body
Q: What happens in the body when a person dies?
There are several changes.
Q: What do you mean by death?
- Cessation of vital functions. But actually, a lot of authors
characterize death as either clinical death or molecular death
- What we use in the hospital in pronouncing a person dead is
clinical death aka somatic death
Q: What is the basis on declaring a person dead?
Clinically or somatic death?
- Permanent cessation of vital signs.
- Vital signs may include blood pressure, respiratory rate,
pulse rate, heart rate, temperature (all signs that a person
is still alive)
Blood Pressure:
" A pressure that is low means that there is a problem in
the movement of the blood. Hence, delivery of oxygen
will be compromised.
" We also cannot have pressure that is too high. It will
affect the movement of the heart. The heart will be
burdened. It will also damage the blood vessels causing
it to burst leading to heart attack or stroke.
" So we don’t want a blood pressure that is too high or too
low.
" If the bp is 0, mo more movement. There would be no
pressure that is pushing the blood.
Respiratory rate
– Respiration of the invidiual if he is still respiring, it is a sign of
the heart rate and pulse rate. Dapat same.
NOTE: Any alteration in the vital signs would compromise body
function.
In documenting the death of the person – 0 respiratory rate,
heart rate and a temperature that is abnormal (goes down) ,
you call this Clinically Dead or Somatic Death – that’s the
basis on pronouncing that a person is dead already in the
hospital.
Q: What is the documentary proof that a person is already
dead? If a patient died at 6pm, what is your proof that he
died at 6pm?
" In the hospital setting, to document the time of death,
what we will do is to measure the activity of the heart
through ECG.
" If still moving, then there is still electric current causing
the heart to beat.
" So kung flat line na, wala na. No more electric current
because the heart is no longer moving.
" Have this printed (flat line), write the name of the patient,
time of death and now you have documentary proof that
is now attached to the records of the patient.
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 o There are instances that this is very crucial but there
are also instances wherein you just get the death
certificate and declare that the patient is dead.
o But there are instances na kailangan saktong oras
namatay – so look for ECG tracing which is signed
by the doctor who pronounced the person dead. The
same doctor will also be the one to sign the death
certificate. Cant be that another doctor pronounced
him dead then another will execute the death
certificate.
Cellular Death or Molecular Death - Death of the individual
cells
" If a person is declared dead already, it does not follow
that the individual cells or tissues are also dead. (Cells –
basic unit of life.)
" It will take time for these cells to die. And while the cells
are still alive, the tissues, the cells, are still capable of
being stimulated.
o So even if the person is dead already, no longer
moving, if you apply electric current, gagalaw pa
rin yan. Gagalaw pa rin yung muscles niyan.
o It’s because the individual cells or tisses are still
alive. Can still be stimulated.
" But after some time, the cells will die eventually. If the
individual cells are dead already, even if you apply
electric current, hindi na gagalaw yan.
Q: What is important is how long will the indivual cells
start to die?
" Around 3 hours. The reckoning point is always from time
of clinical or somatic death.
" If you are pronounced dead now, it will take around 3
hours for the cells to die and that’s also important
because you call that period the Cooling of the Body
" Sometimes, it’s also called Algor Mortis (Cooling Of
The Body)
Algor Mortis or Cooling of the Body
" It will take around 3 hours for the cells to die and as the
cells die, the temperature of the dead body will go down.
(lalamig na ung bangkay)
" When cooling is completed, malamig na yan.
• When you hold a dead body tapos mainit pa, it means
that it’s still within the 3 hour period. Buhay pa yung
mga cells niyan. Hindi pa molecular death.
• Pero pag malamig na, 3 hours have lapsed already
Other changes observed is the changes in the muscles.
Different Stages:
1.) Stage Of Primary Flaccidity (muscles are flacid or
lupaypay ang muscles)
" When a peron dies, initially, the muscles are relaxed.
Even the sphinters guarding the organs will open up.
Yung bantog, bubukas yan tapos lalabas yung ihi. Even
the anal area will open up. Since it is also guarded by
muscles. Lalabas din yung dumi.
" Kaya sa ospital, pag naamoy mong mabaho na, dead
already. The muscles are already relaxed.
" Immediately at the time of death
2.) Rigor Mortis or Post Mortem Rigidity
" Stage wherein the muscles would become stiff.
" What is important is you know the time of death. Usually
starts at 3 hours from time of death and completed in 12
hours then the last 24 to 36 hours.
o After 3 hours, the body will become stiff. Then by or
after 12 hours, the entire body is stiff already.
PASION 3AA
Gradual stiffening of the body. The muscles will
become stiff.
3.) Secondary Flaccidity
" After 12 hours, the muscles will now start to relax again.
" This one is important since you have a time frame there.
If you discovered a dead body that is entirely rigid, now
you have a landmark. He died 12 hours ago or below 12
hours.
o Just look for other signs or landmarks like if
mainit pa ba? If mainit pa (within 3 hours) if
malamig na or lupaypay na, that’s 3 hours
already or way beyond stage or rigor mortis.
" This is also important in terms of handling the dead
body.
o In the business of handling dead body (funeral
parlor), nagmamadaali kunin ang bantay, stand
by yan kasi pag inabutan ka ng rigor mortis,
paano mo pa bibihisan yan. Kaya usually
ginagawa pinapatong na lang. Ginugupit yung
damit.
" Due to muscles stiffening. Entire body becomes rigid.
Other Conditions Which May Stimulate Rigidity:
1.) When you burn a dead body or person
- Maninigas yun but that’s not rigor mortis
2.) When you freeze a dead body
3.) Cadevaric Spasm
- Also stiffening of muscles but this time, only a localized group
of muscles becomes stiff at the time of death. Unlike rigor
mortis, wherein the entire body becomes stiff.
Ex: The person decides to commit suicide. Gets a gun and
pulled the trigger. At the time of death, the muscles hodling the
weapon will become stiff. The localized group of muscles
holding the weapon. And you call that stiffness or localized
rigidity as cadaveric spasms.
" That’s why when there’s alleged suicide, titignan muna
kung may cadaveric spasm.
" Mamaya planted lang pala. Malalaman mo kung fake
kasi bakit malambot yung kamay. If stiff, suicide talaga.
• That’s actually the use of this. It will give us an idea if the
death of an alleged suicide is suicidal or homicidal.
Presence or absence of cadaveric spasm must be noted.
• This is different from rigor mortis cause this will happen in
3 hours. In cadaveric spasm, at time of death. Instantly.
• This is also observed in cases of drowning. If the person
does not know how to swim, he will try to grasp something
until he dies or drowns. Immediately if the body is
recovered, makikita na closed yung fists/hands are tightly
clenched.
o Hands are tightly clenched and the other muscle
groups lupaypay.
That’s helpful kasi nagagamit to determine whether homicidal
or suicidal. In cases of drowning, will determine how person
died. Did he drown or was he killed or thrown in the water?
• But you cannot tell time of death. Unlike Rigor Mortis.
• Simulates Rigor Mortis or Post Mortem Rigidity but it is not
RM. The chemical mechanism is very different.
Changes in the blood
Q: What are the changes in the blood of a person when he
dies?
" When a person dies, the heart stops. Blood will stop
circulating. And if it stops, naturally, the fluid/blood will
settle on the most dependent portion. Babagsak sa
pinakamababang lugar.
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 " If dead body is lying on his back and the heart stops
pumping, then blood will settle to the most dependent
part which is the back.
Hypostatic Lividity
" Settling of blood to the most dependent part of the body.
If you will shift the dead body, dinapa mo, gagalaw ulit, iikot na
naman yung dugo. It will now cool down to the anterior (front)
of the body. Pag ginilid mo naman, babagsak na naman yun.
That’s hypostatic lividity. Pag hiniga mo ulit, magpupull down
na naman sa likod. Basically because the heart is no longer
pumping. Wala na pressure eh. Walang tutulak.
If blood is already pulled to the most dependent parts, it will
now start to leave the blood vessels. Will start to escape the
blood vessels and will go now to the tissues and you call that
process now as, diffusion lividity.
Diffusion Lividity
" Blood starts to diffuse on the tissues of the dead body
parts of the dead body.
Q: What would be the difference?
If blood already diffused in the tissue, it stays there. Galaw
galawin mo yung bangkay, it will no longer move since it’s
already outside of the blood vessels.
Q: What is the importance of this lividity?
- This is important because this will give us as an idea as to the
position of the body when it died.
If you try to look at a dead body, look at the back. Pulang pula.
The posterior portion. Full of blood. And sometimes relatives
would say puro pasa yung likod ng bangkay. Foul play daw but
in fact it’s natural. Nagpull down lang yung dugo.
Lividity – pulling of the blood
In one case, yung foregigner hindi lumalabs sa hotel. Gusto na
ipatawag ng police. So forced open na yung door. Pagpasok,
una nakita nakahiga na nakahubad. But one of the first
observation is humidity is in front of the body.
- The conclusion is, somebody touched this body and
tampered the crime scene. Kasi pag namatay yan tapos yung
lividity nasa harap, dapat nakadapa kasi nag diffuse sa harap
yung blood.
Rigor Mortis will give us an idea as to the the timing of the
death while Lividity will give us an idea on the position of the
dead body
• When a person dies, within the first 3 hours, Clinical
death or Somatic death tapos Algor Mortis (lumalamig
sa first 3 hours ) the temp going down tapos Lividity,
blood is also settling down (first 3 hours). Lividity is also
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found in the first 3 hours. Pagdating ng 3 hour, Rigor
Mortis already sets in until such time that it peaks the 12
hour completely, matigas na yung bangkay, tapos onti
onting lalambot until it reaches. Malambot na ulit after
24-36 hours. It will now enter stage of Secondary
flaccidity. At this stage, you now have a dead body that
is relaxed, malamig na yung bangkay and lividity has
already settled.
• In 24-36 hours after death, also simultaneous with
secondary flaciddity is also the start of Putrefaction
which is decay of the dead body. (dito nagsisimula
mabulok yung bangkay) So pag lupaypay na ulit yung
bangkay, diyan na papasok yung pagka bulok ng
bangkay, in 24 to 36 hours after death.
PASION 3AA
• With the decay of the dead body, may landmarks ulit
diyan such as:
o What happens when the body starts to decay?
# Gases will increase the pressure inside,
pushing fluids outside. Kaya yung bangkay
amoy bulok na itlog. Kaya din nilalagyan ng
cotton yung mga bangkay. Para di mangamoy
and yung fluids hindi lumabas.
" There can also be secondary explusion of fecal material.
Since puro gases sa loob, tutulak niyan yung mga may
dumi pang natitira tapos babaho na naman. Secondary
expulsion of fecal material in the anal area.
" If the woman is pregnant, it can expel a fetus. Yung 48
hours after death, biglang nag expel ng death fetus yung
mattress ng bangkay because of the force of the gases
inside of the dead body.
" Kaya pag tinignan mo bloated yung mga bangkay. Mga
after 24-36 hours after discovery. Bloated yan.,
namamaga. Already signifies, Purefraction.
" In drowning, also significant because that’s the time that
the body will start to float. Lulutang yan bukas. Magiging
parang salbabida na yan. Purefraction has already set
in.
These values (3, 12, 36 hours etc) can be viewed only as
reference because in actual practice, you still have to consider
a lot of factors.
Ex: Temperature ng surrounding, underlying sakit ng bangkay,
ano ginagawa bago namatay, what is the type of attire, ano
humidity.
- But as a guide, the values I mentioned, yung ang ginagamit.
Intial guide.
There are a lot of clues that will help us determine the type of
death of the person. Such as changes in muscles, blood and
also external factors like the food of the person last ate, anong
oras ba huling kumain yan? This can help determine the timing
of death of the person.
• Ex: If you were able to find food in the stomach (food
will take around 3-4 hours before it is expelled, kakain
ka ngayon, lalabas yan after 3-4 hours pa) so upon
autopsy, if found food in the stomach, it means
kumain pa yan within 3-4 hours ago bago namatay.
You can now cooperate in other findings.
We even examine the insects found. If there are maggots in
the dead body, the presumption is that he is dead for around
24 hours already. From egg to maggot, will take around 24
hours. Which you have to correlate with the fiindings. The
external examination of the dead body.
Coverage of exam: Cover to cover
Expect an objective type of questions
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