Artefacts

Artefact " An Artificial Product "- Any structure or change introduced into the body after death, that is likely to lead misinterpretation of medico-legally significant ante-mortem findings is considered to be an artefact.
OR
Artefact is a fact which is not a fact but misinterpreted as a fact.
It may lead to wrong conclusion about cause/manner of death or may result in non-deduction or undue suspicions of crime and unnecessary spending of time/effort because of misleading findings.
Artefacts can be divided into 2 groups:

1- Those introduced during the period between death and autopsy.
2- Those introduced during Autopsy.

1- Artefacts introduced during death and autopsy:
For understanding, they are further subdivided into:
a- Angonal Artefacts.
b- Resuscitation Artefacts.
c- Embalming Artefacts.
d- Exhumation Artefacts.
e- Artefacts due to handling of the body.
f-  Artifacts related to rigor & lividity.
g- Decomposition Artefacts.
h- Toxicological Artefacts.
i- Miscellaneous Artefacts.

a- Angonal Artefacts: Regurgitation & Aspiration of Gastric contents.

b- Resuscitation Artefacts:
Injection Marks: In cardiac region/extremities. Intra-cardiac injection associated with bruising of heart and collection of blood in the pericardium.
Cardiac massage: Fracture of ribs, fat and bone marrow embolism during cardiac massage.
Defibrillator application: Ring shaped bruise over the chest due to defibrillation.
Positive pressure breathing apparatus: Acute emphysema and air in mediastinum during application of positive pressure breathing.

c- Artefacts due to Handling of the Body:
Fractures of the cervical spine.
Bruising in occiput.

d- Embalming Artefacts: 2 methods of embalming,
Arterial: at a site of approachable arteries.
With Trocar introduced through abdominal wall.
When embalming is done through the injuries, their number, shape and dimension gets altered.

e- Artefacts related to Rigor & Postmortem Lividity :
Rigor: 1- Breaking of rigor during handling.
               Misjudgment of rigor of heart as hypertrophy.
Lividity: 1- Misjudgment for bruise and of colour in refrigerator and bodies exposed to cold                  environment.

f- Artefacts & Exhumation:
1-Ballotment as obesity.
2-Presence of fluid blood in mouth and nose as haemorrhage.
3-Decomposition blebs, skin slip condition as burns.
4-Buttoned shirt groove (contact flattening) simulates ligature mark.
5-Decomposing blood staining in brain, lungs, heart etc.- for asphyxia.
6-Rupture of stomach due to rapid post-mortem acid digestion.
7-Bluish colouration of intestine due to decomposition as infarcted bowel.
8-Post-mortem gas formation in blood especially in large veins and right heart as embolism.
9-Collection of blood in body cavities due to post-mortem injuries.
10-Post-mortem separation of sutures of the skull.
11-Decomposing pancreas may simulate Haemorrhagic Pancreatitis.

g- Miscellaneous Artefacts:
1-Animal bites under water especially by crabs maybe mistaken as stab wounds.
2-Tissue damages by boats.
3-Dependent area flattening of cerebral hemisphere convolutions as oedema of brain.
4-Discolouration of liver at a place of contact with large bowel- (a post-mortem change) taken as an injury.

2- Artefacts introduced during autopsy:
a-Introduction of air bubbles: into the vessels,
Head (while dura is pulled in saggital line).
Neck (during reflection of skin).

b-Extension of skull fracture during sawing of skull or forceful pulling of skull cap.
c-Post-mortem tear of mid-brain.
d-Extravasation of blood in soft tissues especially cervical tissue during post-mortem examination/handling.

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Artefacts in Gunshot Wounds

These Artefacts may add to the difficulty of interpretation. In Gunshot injuries they maybe divided as,
1-During Treatment: The external injuries maybe modified by therapeutic procedures. Excision of wound margins and closure of wound by sutures may make it difficult to identify correctly an entrance and exit wound. The marks of sutures may appear as gunpowder tattooing. During hospitalization, victim may sustain "Pseudo gunshot wounds". The trocar marks and drainage incision in chest & abdomen. A classical example of this is Kennedy phenomenon. It is surgical alteration of the gunshot wounds on the neck of President John F.Kennedy which lead to difficulty in evaluation of that wound and the subsequent controversy raised whether it was an entrance or an exit wound.
2-Decomposition Artefacts: With the skin slippage there maybe loss of hair and loss of gunpowder from skin around the entrance wound. The margins of the entry wound may become ragged due to disintegration of the tissues at the margins. The size and shape of a gunshot wound may also be considerably altered by decomposition.
3-Embalming Artefacts: The embalming of bodies maybe arterial through incisions at the sites of approachable arteries or with a trocar which is introduced through abdominal wall. The embalmer may enlarge a gunshot wound or he may introduce trocar through a gunshot wound and modify its dimensions. Since the skin and subcutaneous tissues are rendered bloodless and are fixed by embalming, the gunshot wounds sustained during life may resemble trocar holes. The trocar may disturb the track of bullet within the body and may even create false tracks. The gunpowder around an entrance maybe washed or scrubbed.
4-Artifects on X-Rays: There maybe loose bullets fired and unfired in the clothings. Pockets should be examined for unspent ammunition. If there are any loose cartridges on clothes and body is X-rayed with clothes on, there maybe misinterpretation. X-rays may also depict other metallic objects such as buttons, which resemble a bullet or stem of zipper giving the impression of a mushroom bullet and a dislodged crown from tooth may resemble a flattened bullet.
5-Autopsy Artifects: a- Careless cutting of tissues may obliterate the bullet tracks and the evaluation of angle of fire maybe difficult.
a-Displacement of bullet from one area to the other in the body during an autopsy may effect conclusions about directions of fire.
b-While sawing off the vault of skull during autopsy, sometimes leads to the fractures of skull while an antemortem fracture maybe created.
6-Miscellaneous Artefacts: In the investigations of gunshot cases the findings of unexpected bullets in the body is always a puzzle and may lead to a false conclusion.
Example of an old bullet: In case of a severely burned body, x-rays showed a bullet in the posterior wall of chest. This x-ray finding immediately raised suspicion of murder. However when the bullet was located and removed, it was found to be well wrapped by dense fibrous tissue.

Example of a new bullet: A man shot him in right temple and the bullet was recovered from the brain. There was,however,another bullet in the stomach. The investigation showed a row of beer cans in his house’s backyard, used as a target. Part of the beer in the cans that had bullet holes had been consumed. The man drank beer from each can and drank a bullet with the beer.
Injuries such as puncture wounds and lacerations may resemble exit & entrance wound.

Importance of Identifying an Artefact:
The misinterpretation due to artefacts may lead to:
1-Wrong cause of death.
2-Wrong manner of death.
3-Undue suspicion of criminal offense.
4-A break in the investigations of a homicide or non-detection of a murder.
5-Wasting of time.
6-Miscarriage of justice.

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