Forensic Pathology for Police - Brainshare Public Online Library

Homicide by Heart Attack 555
identity of the decedent or other persons involved in the death. Examples of cases
that should be considered “high-profile” include in-custody deaths, police-involved
deaths, deaths involving well-known persons (politicians, professional athletes and
entertainers, and other public figures), and deaths involving unusual, bizarre, highly
public, or politically charged circumstances. An example of the latter would be a
death resulting from a “hate crime,” which is a crime in which the perpetrator’s conduct
is motivated by hatred, bias, or prejudice, based on the actual or perceived race,
color, ethnicity, national origin, religion, sexual orientation, gender, gender identity,
or disability of another individual or group. Mass fatality incidents and in-custody
deaths are two subtypes of high-profile cases that have specific sections within this
chapter. The comments that follow apply to these, as well as to other high-profile
cases.
When a high-profile case is encountered, all those involved in the investigation
of the case should anticipate intense scrutiny. As such, an attempt should
be made to predict and address all issues that might become important in such a
case. Obviously, this is not necessarily an easy task. As has been advocated elsewhere
in this text, detailed and complete investigation and documentation should
be part of every death investigation. It is an extremely good idea to perform an
autopsy on these cases, even if one might only perform an external examination in
a similar case that is not considered high-profile. In high-profile cases, as well as
certain other cases, and depending on the specifics of the case at hand, a variety of
ancillary autopsy procedures should be considered. These include taking additional
photographs, photographically documenting “negative” findings (lack of injuries),
collecting and retaining clothing and trace evidence, collecting a sexual activity
kit, performing radiologic examination, performing anterior and posterior neck dissections,
performing additional skin incisions looking for subcutaneous trauma,
performing additional specialized dissections (eyes, spinal cord, etc.), performing
additional special studies (microbiology, chemistry, etc.), documenting presence or
absence of genital trauma, performing extensive toxicology testing, collecting and
saving extra blood and tissue samples, performing histologic examination, retaining
important organs/tissues for further dissection/examination, inviting impartial
witness to observe autopsy, videotaping autopsy, delaying death certification until
additional follow-up information is obtained, deciding to delay releasing the body
so that additional examination can be performed in subsequent days, keeping family
members updated regarding results and progress, and being careful and truthful
when dealing with the media. Certainly, some of these suggestions should be implemented
in every case; however, in high-profile cases, deliberate attention should be
paid to these issues.
Homicide by Heart Attack
The term “homicide by heart attack” is used by some forensic pathologists to
describe a situation where the final mechanism of death is related to underlying
heart disease via an arrhythmia which is induced by the physical and/or emotional