Final report says `Cause of Death is undetermined`

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IMPHAL, May 17: Even as people from all over the country have been expecting much from the final Forensic Science examination report of Loitam Richard, it has failed to live up to the expectations.

The report had ended with a “CAUSE OF DEATH IS UNDETERMINED”. “However, based on expert opinion furnished by Prof and Head of Department, Department of Pathology, further examination of the heart may throw more light regarding disease of the heart due to hereditary factors or other natural causes”, the report ended.

The full report of the Department of forensic medicine Victoria Hospital, Bangalore is produced as it is for the perusal of the general public.

Summary

I. Forensic Science Laboratory examination report no FSL/TS/605/£Q12 dated 2-5-2012 reveals

1) Thin layer chromatographic and high performance thin layer chromatographic methods have responded for the presence of Paracetamol (analgesic drug) in the sent exhibits no 1, 2, 3.

1) Stomach and its contents, portion of small intestine and its contents

2) Portion of liver and kidney

3. Blood

The quantum of paracetamol found was 27.17mg/l of blood. It is within therapeutic limits.

2) The above tests responded negative in sent exhibit no 4

4. Preservative used – saturated solution of sodium chloride

II. Histopathology examination report MLC No.80/12 Dated 14-5-2012 reveals

Microscopy:

1. Lungs : Multiple sections studied show autolytic changes. Atveolar septacare widened with edema. Rest of the parenchyma is within normal limits.

2. Kidneys: Multiple sections studied show autolytic changes and appears to be within normal limits

3. Liver: Multiple sections studied show autolytic changes and appears to be within normal limits.

4. Spleen: Multiple sections studied show autolytic changes and appears to be within normal limits.

5. Skin: Multiple sections studied from the skin labelled as “right forearm skin” shows epidermis, dermis and subcutaneous fat showing autolytic changes.

Multiple sections studied from the skin labelled as “right side of chin skin” shows epidermis dermis and subcutaneous fat showing autolytic changes, Dermis shows numerous congested blood vessels and multiple foci of extravasated RBC`s, suggestive of ante mortem change.

6. Half of brain: Multiple sections studied show autolytic changes. Subarachnoid space shows small focal aggregates of mononuclear cells and congestion.

7. Heart: Left coronary artery shows atheroma with no significant narrowing of lumen. Right coronary artery, left anterior descending artery, and left circumflex artery are within normal limits. Pulmonary artery is within normal limits. Aorta shows fatty streaks. Both atria and ventricles show autolytic changes and appear within normal limits

8. Testis: Sections studied from testis appear within normal limits IMPRESSION:

Skin: Features are suggestive of ante mortem change.

Further opinion given by Prof and Head of Department, Department of Pathology letter no. nil dated 15-5-2012.

The clarification for the points mentioned in the report is as follows:

1. The lungs appear edematous grossly with microscopy showing interstitial edema, which is the usual course of findings in any death. No significance is attached to this finding, regarding the cause of death.

2. Coronary artery shows atheroma with no evidence of narrowing of lumen, indicate that atherosclerosis has started well before the usual age, probably due to hereditary cause. This finding cannot be taken as a cause of death, since occlusion/ narrowing of lumen, does not cause death directly.

Once again, fatty streaks in aorta is just an indicator of initiation of atherosclerosis and cannot be taken as cause of death.

3. In the brain, focal aggregates of mononuclear inflammatory cells in subarachnoid space and congestion is not a cause of death of immediate nature. The infiltrate is more of chronic inflammatory in origin, maybe due to subclinical insult.

Thus the cause may not be due to above reasons. A complete evaluation of the back ground of death scene is necessary to come to a conclusion.

OPINION: On perusal of Post mortem examination report, Chemical analysis report, Pathology examination report and opinion given by Prof and Head of Department, Department of Pathology, Bangalore Medical College and Research Institute, we are of the opinion that, at the time of conducting post mortem examination, the decomposition process had already set in and was progressing. The visible injuries which were noted at the time of post mortem examination, (both external and internal injuries) are either individually or collectively not sufficient to cause death.

Chemical examiner`s report reveals presence of prescription drug PARACETAMOL of 27.17mg/L of blood which is not sufficient to cause death,

Prof and Head of Department, Department of Pathology, in his expert opinion reveals that there is pathology in the heart, which has started well before the usual age, probably due to hereditary cause.

Based on the available facts we are of the opinion that, opinion as to the cause of death cannot be arrived at scientifically. Hence we conclude that the opinion as to “CAUSE OF DEATH (S UNDETERMINED”.

However, based on expert opinion furnished by Prof and Head of Department, Department of Pathology, further examination of the heart may throw more light regarding disease of the heart due to hereditary factors or other natural causes.

Place: BANGALORE Date: 16-5-2012

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