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Challenges in Identification of Unknown Deceased

Oct 13 | 1:30 PM

Trying to determine the identity of unknown dead bodies is probably the most challenging task for the attending physician. In a country the size of India, there are many unclaimed bodies, and identifying them is one of the obstacles we face. There are numerous other reasons why identification is difficult. Join Dr. Pathak as he addresses these issues and how we can overcome them in our practise.

[Music] um good evening everyone and welcome to netflix i'm dr naveed na and on behalf of team netflix i welcome you all to today's session which i'm sure is going to be really interesting uh we have with us this evening uh dr akilesh patak he is um professor and head of forensic medicine and toxicology at ames pattenda during a work tenure of more than 20 years sir has conducted over 3 500 postmortem of numerous kinds inclusive of the human rights commission and apart from this he has numerous publications in both national and international journals and he's also published a book titled a practical record book of forensic medicine and toxicology thank you yes i are audible uh would you like me to run the polls now yeah please okay uh so sir has a few polls to run by uh so let's start with the first one there you go [Music] uh y'all can scroll uh to see all the four options uh [Music] okay so i think you can see the whole results let's run the second poll [Music] [Music] okay and we have one last ball [Music] there you go [Music] all right [Music] so those are the poles and uh over to you nasa so good evening everyone and uh can we start from the first poll and its results ah good evening everyone as i asked one of the question in this and just to start the discussion in this area that what challenges we are facing for the identification of the unknown disease so we are receiving so many dead bodies and here their bodies are unknown or unidentified right so what kind of challenges we are having that is my topic of the today's talk and first poll as i asked you that uh what is the most common method which is police is using for the identification of unknown so in this case my experience is that the police formerly using the identification of the unknown by the close and pocket examination am i right uh doctor this was the first one or yes sir this was the first one okay um so most commonly the police and the investigating officers they are calling the relatives to the scene and they try to identify the victim by their close different pocket contents the mobile and other things second question what was the second question so it was uh which sample is best among the following for dna profiling so uh maximum both have gone to blood in etda vial that's 41 then we have a molar tooth 25 blood on fda card 20 and blood on gauze is 12 yes so as for the literature we can see that blood on the fda card so blood on the fd card is the [Music] during autopsy in india with sample is most commonly preserved for dna profiling so maximum uh votes have again gone for blood and etta vial with 35 then you have molar tooth 24 uh blood on fda card 22 and blood on gauze is 17 so again in this uh because of the constraints and non-availability of the fda card the most common simple whatever we are preserving during the autopsy examination that is the dried blood or blood on a gauze piece so blood we are using the gauze piece as an alternative to the fda card and that is dried in here and then it is transported to the forensic science laboratory so the process of identifying a diseased person it begins when an unknown dead body is recovered so whenever the police is receiving any information that there is a dead body is there somewhere and after the receiving of the dead victim or after receiving that information commonly what happens in india that they reach to the scene of crime and they find out the unknown so what is the most important thing in history the identity of the deceased person it is having a vital importance to start the investigation in right direction and to find out the accused so the most important thing for the police person is to start the investigation but how they can start the investigation when the victim or whatever the disease is there it is undefined they don't know who is that person what happened with him or whether it is a case of homicide suicide or accident so to start the investigation in a proper direction they have to first identify the disease then only these things can be started that was in the context of the disease person or where the diseased person was going or whatever the other conflicts were there previously before the death so we have conducted lots of autopsy and yearly we were receiving around more than 2000 autopsies when i was working in one of the center in india and during my experience we have received so many dead bodies in which the person was unidentified and the most common reason of the unidentification for the non-identification of the disease that there was no history available with that or the body was decomposed or the face was crushed badly or one of the reason maybe that body was mutilated or it can be a burn case so badly one case also there [Music] so here i would like to discuss the different case scenario uh what uh whatever i have observed during my practice of forensic medicine [Music] so you can see that this scenario are very common in india especially where the brush of the traffic is there and this is one case where the police got a call that uh that person met with an accident and lying down the publicity is to the scene of the crime these kind of the cases are very common police reach to the scene of the crime and they found that the person is lying down and [Music] immediately what are the duties in this case what are the challenges in this particular case for peoples so first thing is they have to shift immediately they have to shift the vacuum to the nearest hospital preferably government hospital where the life of this victim can be saved or if the person if there are chances then the person may survive if he is getting the treatment in any hospital so immediately shifting of the victim in the nearest hospital and offering him the proper treatment during this emergency that can only be the um only the benefit that we can offer to the patient in this emergency scenario the second challenge with the police is there that who is this person so if they are able to identify this person they can call his relative they can call some near ones or his friends so he can be helpful in that area he can bring some medicine he can manage the operations or he can if he want then he can shift that patient to a proper hospital where the treatment is required suppose if the surgery is required of the head then the patient can be shifted to the other hospital where the neurosurgeons are available or the ct scan is available and the investigation can be done so these are the challenges for the police [Music] have observed one more challenge here for the police that police has to transfer this network this person so commonly the police is not having such kind of the facility that whether this victim can be shifted to the nearest hospital by giving him the initial treatment of oxygen or a proper position so they are not trained in that kind of things so in some of the area i was working in that kind of state where the 101 facility was available when you will dive 101 immediately ambulance format impedance will reach to the scene and immediately the person will be shifted to the nearest hospital but unfortunately it is not available in majority of the areas of the india and transportation of such victim to the nearest hospital of the government hospital again is a big challenge for the police because police is having either they are having the bikes or they are having the some kind of uh jeep like vehicles in which the victim cannot be transported immediately so whatever usually they do they immediately stop whatever the vehicle is coming [Music] nearest hospital so these are the challenges the second and biggest challenge to the police is to identify this person that who is he so that can be done either by uh if there are some id cards are available in this pocket or some mobile phone is there or if any identity proof is available with him then the person can identify otherwise they have to again it will be a challenge for the district so this was the current scenario which is very common in india [Music] so it is identification of this victim it is easy if it is a case a fresh case but that i have also observed in my autopsy practices that sometimes the case is so severe severely decomposed or severely sometimes the only the remains of the human being are recovered and in that kind of the case the identification is almost impossible for the police person so this was the another case scenario you can see here that this red body was recovered from a river the whole body was completely decomposed the face was swollen and the whole body was stronger totally disfigured the discharge and foul smelling was coming out from the red one so again it is a one more children to the police that recovering of that dead person so after getting the information that somebody somebody's uh that body is floating in the river so after that kind of getting the information this placement is to be [Music] it is very difficult so nobody or you can say nobody will be ready to touch or even to go nearby such kind of dead body which is badly published so that kind of cases are again a big challenge in the police that how the dead body should be recovered from the liver or from and after recovering of these dead cases the body is shifted to the nearest hospital for autopsy examination so during the autopsy examination also uh we face so many challenges because the end whatever the antimodal findings are present in such kind of the cases they are commonly obliterated and they are mixed with the decomposition changes or we can say that whatever the decomposition changes occurred in the dead body they will destroy whatever the antimodal findings are so in such kind of the cases it is very difficult to identify a person you can see in this photograph that even a near one or even the relative of this individual they will not be able to identify that whether he belongs to his family or not so this was the case scenario [Music] so in this case this dead body was recovered from a terrace so the person was living alone in his house and went to uh went on the terrace for sleeping few after uh unnoticing of the few days when there was a bad smell was coming out in that area and somebody informed the police that the very bad man is coming out from this house then police started the investigation they broke the door of that house and they found that the body was lying [Music] you can see in this case the dead body was decomposed and because of the dry heat it was also partly mummified so again there was a challenge of identification in such kind of cases [Music] now i move towards the next scenario that is the burn scale so these kind of cases are very common in hospital when a patient or when a female make at one while cooking or all working kitchen it may be accidental one sometimes it is suicidal one or very rarely it may be homicidal so in such kind of cases the patient is having deep bones over body at different places and everybody for the treatment so this case was there when the victim died during the treatment after the hospital administration after after the hospital admission [Music] so here also you can see the whole face is burned the body is disregard there are changes of septicemia present over the body and foul smell is coming out in and when such kind of the victim [Music] is transported by the investigating agency or by the police or by the hospital stop for the autopsy then the whole uh body is wrapped into the bandage so when we receive such kind of the body uh we commonly observe that the body is wrapped from all side with the hospital vendors for the treatment purpose so in such kind of the case is very difficult to identify by the relatives even if the some more similar kind of bodies are lying there in god of zero so sometimes [Music] the mishappening of the exchange of dead bodies has also been noticed during the um during the practice so all such kind of things can be there because of the non-identification [Music] because of the non-identification of the cases so this is the case scenarios in which you can see in first case the whole face was completely burnt and you can see that identification of this individual or this victim is very difficult for anyone and second case which is cvl you can see the dead body is completely checked so it has converted almost into a code so in that case forget about the identification even detection that whether this dead body belongs to a male or a female that is also difficult for a investigator agencies or whatever the so such foreign of the cases we are receiving regularly for the autopsy examination and there is a big challenge and there is a big challenge to us in such kind of the cases regarding the identification so now i want to move that what are the challenges of identification in case scenario six so we also receive such kind of dead bodies where the fetus or a newborn baby brought to us for the autopsy exhibition from roadside wrapped in a newspaper for some time wrapped in so such kind of cases are also quite common so it has been observed that after the abortion of the hospital the fetus is handed over to the relatives for its disposal but they are not doing the proper disposal of these cases and they throw [Music] it somewhere at unusual places uh at that place when it is noticed by uh any person in that area then the information is sent to the police dead fetus or a one babies lying deadline here so after receiving the information that kind of the cases are referred to us again it is very difficult to find out that to whom this baby is and identification of such kind of the case is very difficult so this is again a case scenario sometimes we are receiving the dismembered body parts so in different cases i can remember in one case the body were cut into pieces and packed in different bags and bags were thrown at different places but the investigative agencies and police was very smart and they collected the all bags and their bags were transported us for the autopsy examination in that case we had was there so we received the legs in one way trunk in another way and the both upper limbs in third wave so this such kind of heinous crime cases involving the heinous crime are also registered in our center so this is the case where a limb was recovered by the police and it was brought to us for the autopsy examination and identification of this person by examination of this limb [Music] whether it belongs to a male whether it be a female what was the height of that individual or how we can identify that individual that what happened with him it is very difficult so identification is again important in this case [Music] this was a case scenario 8 where i the investigative agencies they found a box and when they opened the box the skull completely skeletonized the skull with some of the soft tissues attached on the right side that was recovered in that box so again the identification of this victim is important that who was that person what happened with him so to start the investigation it is important for the police process it is the one of the biggest challenge [Music] this is the next case you can see here that often we receive the skeletal remains [Music] this chemical remains in this form or in next slide you can see we received many times a bundle of bonds enthalpy bonds in so these kind of the cases they create a emergency for the police to identify this the victim and to create the case so what is the role of attraction in this or how actually identification is the role of police or it is of police police i have to identify the person but autopsy surgeon can help them in identification of the individual so how autopsy person can help in identification of this victim policy is even not aware that these bundle of bones belongs to human being or not they are not aware that it belongs to one individual or more than one so how many people this is skeleton under the bones belong to how many there may be two there may be three it may be lost so that is again then what was the cause of death in this case so that kind of cases we are regularly receiving and as a autopsy surgeon we can help them to find out yes yes these bonds belongs to a human individual human being [Music] these bones belongs to one individual or two individuals these bonds belongs to male or female you can also determine the gender of the this skeleton we can also determine the age is of this individual so approximate range of a particular range we can decide so we can also determine the age of this individual then we can also determine the stage or the height of that individual so if so by examining all these things we can narrow down the range for the identification that yes it was a male of 25 years of age and the height was approximately five feet and six inch suppose so that kind of information we can give to the police after examination of these cases so that may be very helpful investigating agencies to find out such kind of person who was missing in that area and and definitely by the dna fingerprinting or dna profiling [Music] recently we have all observed that there were the cases of the over 19 days and the dead bodies piled up in the hospitals as well as in the work areas and you can see uh in this photograph that the dead body are lying on the stretcher in a body bag so there was a plastic body in which the many dead bodies are lying here so identification that which individuals in which their body belongs to whom it is again a difficult translator case [Music] identification in mass disasters in bomb blast in collapse of buildings in tsunami or drowning of a boat so in which [Music] hundreds of the people are dying at simultaneous in one incidence in that case the identification of the 15 individual victims [Music] so here i've asked some of the question before starting my discussion that what is the common methods of identification so how the police identify the victim or what common methods they are [Music] immediately after getting the information of a disease policies to the scene of crime they shift the person to the nearest hospital and once they are confirmed that the person has stacked that then the dead body shifted to the and after shifting the autopsy assumption the important part of the identification is commonly done by the two methods one initially they take the fingerprints of the victim and they also take the photographs so fingerprints they can check it with their fingerprint records and the individual can be identified if the records are available previously which is not commonly available in india so we are not having a large database or uh sustainable database except the criminals but for civilians the database is commonly not available for such kind of cross matching that is again a disadvantage second thing iu takes the photographs of the individual and that photographs they are publishing in the media for the identification so the near one they can come if they are identifying their relatives in the media or in great media that they can come to the end again it can be identical [Music] so recovery of unwanted body they are publishing the picture in newspapers and similarly they also try to clear the reports from various police station whether at that kind of particular person a male of 25 years of age of 5 feet 6 inch is missing in that area suppose if some person on some relative of any person is missing definitely he will [Music] so definitely there will be a report will be registered in the any police area in that particular area of the missing person of similar kind of age and height so these relationships can be asked to identify if the cosmetic examination findings are matching with that individual then the relatives are called for confirming the identity and definitely the clothes may have pocket sometimes the ornaments are available sometimes the wrist watch that helps in identification and sometimes the keys keys of the house that may help in identification of the that individual [Music] what happens if the completed documentation shows that it remains is that of a named individual or an individual of a great group and that all reasonable doubts of the identity has been resolved means the identification is confirmed then there is final disposition is deposit disposition is made of the remains if the identification is not confirmed then the case is continuous and it remains as an active case so i've already told you that water is the role of autopsy surgeon in such kind of cases so as a forensic pathologist we can help the investigating officers and identify the disease by examination of body during autopsy we can also preserve the various samples by which the identity can be confirmed and most common sample in such of the cases is the sample for dna profiling if the information is available from the witness if we that can be documented by the policy [Music] by which that can be identified suppose some kind of deformity is having i can remember one case in which we received the skeleton but one forearm bones the left side of the forearm was foreign bones were comparatively shorter as compared to the right are right foreign [Music] individual was having cold fracture in his left forearm and because of the non-union or improper union of the forearm bones his left side of the forearm was shorter as compared to the right qra so that was a typical deformity in that particular case and on behalf of that that case was identified so such kind of dependence that can also be there [Music] the examination of the close examination of the ornaments sometimes it is watched and the other pocket contains that will also help in identification [Music] but here i would like to highlight one of the important issue which i also observed that we are using or if the investigative agencies they are using unscientific methods because these methods are not central methods the identity has to be confirmed by the dna profiling of that but when we are using such kind of the unscientific methods for misidentification of the dead or sometimes the exchange of dead bodies can happen that kind of cases also i have seen during my efforts so this was the one case in which [Music] a man believed to be chair to death walks back home so it was the case in which family member of a 35 year old farmer who was presumed to be chaired to death in his car wherein for a shock when he turned up at his house on monday so what happened in this case actually the uh burn car was powered near the roadside and when the police was informed they found that there was a completely burnt dead body was there inside the school where and when the details were investigated by the police then they found that this van belongs to the individual and he was the driver of that van and the dead body is belonging to him only after the effect of sales was handed over to the electrics and relatives did his last friends and when they were in the shop then after two days they saw that that person or was coming back to the earth and immediately they went into the shop [Music] that how he can uh definitely they were happy also that he's alive but yeah that how it can happen we have already done the last night of this that person so that kind of the case was there and you can see here the local has the ishtivas is there the locals had found body of a man in a maruti when in the early hours near road on sunday even belongs to nayak who had left his house saying that he was going for work however he is not returned till late night for whatever remain of his clothes the family identified the body as that of nine so this dead body was identified by the clothes and as it was found inside the school band of that individual so after claiming the dead body the family members performed its last rights and then offense of murder was also resisted by his brother because there was blood on the ground near the burnt car so near the burnt car some of the blood was also there next day when nyack walked into the village he shot many including his own family members a group gathered to see him he was wearing only trunk and a vest and had burn injuries the delayed serpents was informed who in turn called the police knack was taken in an ambulance to the civil hospital the police interrogated him on two days after and it came to light that mike suspected that his wife had an affair with a villager mr raynes and to kill mr x he took him along under the pretext of going on a drive he brought mr x back to the place and then smashed his head with a spanner [Music] just when he got down froggy when neither then put mr x who may have been unconscious or dead in the van and then procured five liter of petrol [Music] he doused mr x with the fuel after taking him inside the van and set it please so this was the holy story the whole story in which the individual was misidentified because of the unscientific method and this was the dead body which was collected from that school so this was a another case in which identification was done in a dead body which was recovered from a river the dead body of a well-known advocate of a city was recovered from a river in decomposed condition and identified by the relative by close and appearance the autopsy was conducted and the family performed the last rites of disease on third day of the incident another recording from the same river from some distant area was recovered with similar appearance and some pocket complaints including the keys the investigating officer sent these keys to the home of that advocate or home of this disease to find out whether it is belonging to him or not and he was shocked that it was it opened the log at his home means the keys we are working to open the blocks at his home and finally [Music] the identity was confirmed by the dna examination so this was again a case where the misidentification of the body was done so these are these kind of the cases we are regularly [Music] facing where the problem in identification is there so what kind of samples we are preserving in such kind of cases so best sample i have already told you that is a blood on fda card so blood on fda card is simple but why we are not preserving it because it is not available to the most of the auto system in india so non availability of the fda card that's why we are preserving the sample of blood on the glass piece and we dry it in air and press up in a container for dna profile when they become body severely decomposed then the best and preferred sample is the molar tools so molar tooth is extracted out and that it can be preserved in a water for dna in some of the centers the external bone when we are receiving the dismembered body or when we are receiving the mutilated body then whatever the soft tissue is available that can be sent for the dna profiles like we can send the muscle tissues around 100 gram in saturated solution of salt that can be issued in cases of skeletonized remains portion of the remains whatever we are receiving that portion of the remains that can be said for the dna profiling [Music] in completely chat body the molar tool is the preferred choice for the dna properly as there is no need for any to add any preservative and it can be transported to the fsi so whenever we are receiving the fetus then again the dry color on gauze piece can be preserved or disarticulated bones that also can be is up for the dna in sexual offense cases whenever we are having the autopsy cases where the history of sexual assault is there then we preserve the swept from the vagina and from the parts where the suspected sexual assault history is there and we can collect this web and then prepare these slides and that strap can be preserved for the dna blood and edta is also a choice for the dna but the basic problem is that it has to be transported immediately to the fsa in a cold chain and again there is a non-availability of the clear code chain to the police personnel so they are commonly not able to transport the sample properly [Music] shipping as i already told you that resulted in ship that should be done simple can be stored at room temperature it delays there and blood samples should be stored at 4 degree celsius now i would like to conclude my session so there are different challenges in identification is there as we have seen by different case scenario and what can happen when anyone is using unscientific method a holistic approach that must be used for the identification purpose close examination by a general physical examination of the that then the dna profiling all things should be taken into the consideration for confirmation of the identity dna sampling and cross matching should be done to confirm the identity and the forensic pathologist should have the knowledge proper sampling and transportation of the sample for dna with a fsm so this was all about representation [Music] thank you so much asap for the lovely presentation [Music] uh comments the questions so we have dr hitesh karana was asked why is the choice of shifting accident victims is preferably to a government hospital because in private hospital if you will shift a unknown person then who will pay for the treatment because as we all are aware that uh the private hospital they would not allow any person who is not paying them so the preferred choice is to shift that individual to the government so these kind of uh we can say the indirect type of instructions are there to be police personnel so they always go for the formatives uh dr mahesh you've asked about autopsy during overt period but i think sir's already covered that during the session so if you want to just briefly explain about that that'll be uh yeah yeah actually the autopsy should be avoided uh for the if it is a positive case of covet that it should be above autopsy but if it is a medical legal case an autopsy can be done in that kind of case because as far as i know till now there is no kind of case in which the infection has spread from a dead person because infection spreading of the carbon infection is through the droplets while in case of autopsy there are very less chance of spreading of the inflation from the division so if you are taking the proper care if you are using the proper pp kids using the disinfectants putting the body in body bag cleaning the instruments all other surfaces with the one percent sodium hypochlorite solution then it can be done easily and at many centers it has been observed that the so many autopsies of the covert has been done but there is no incidence that the infection has been spread [Music] uh can we use any bone for identification or only sternum and females used yeah any bond can be used for the identification what is the best thing if we are preserving any bone that there is no need to add any preservative it can be easily transported to the fsn there is no need to maintain any cold chain so it can be stored for many days even an autopsy center even at the center of the investigative agencies [Music] so that is the advantage of the preserving of the bone so whatever bones we are having that can be sent for the examination but just try to keep in mind that there should be a probability of the presence of dna [Music] i hope that answers your question um what is the importance of molar tooth in forensics actually molar tooth is commonly preserved because it is having the high amount of the bone marrow as well as it is commonly preserved during the incidences because it is a placed inner side at a inner side it is placed so even in severely burnt cases it is commonly preserved there is no effect of the bonds over the molar tooth as it is situated behind as well as there are the more amount of the bone marrow in that and that that's why it is the choice for the reservation [Music] you think um that's it i think there are no more questions as of now um but thank you so much sir for this awesome session that we had today and we hope to see you again on our thank you

BEING ATTENDED BY

Dr. Darius Justus & 453 others

SPEAKERS

dr. Akhilesh Pathak

Dr. Akhilesh Pathak

Professor & Head Forensic Medicine and Toxicology at All India Institute of Medical Sciences (AIIMS) - Bhatinda

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dr. Akhilesh Pathak

Dr. Akhilesh Pathak

Professor & Head Forensic Medicine and Toxico...

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