FORENSIC PATHOLOGY/ MEDICINE
COURSE FILE
1. Course title: FORENSIC PATHOLOGY/ MEDICINE FOR BMS
2. Course code: MFT410
3. Hours taught: 4 units or 100 hours
4. Pre-requisite: Having passed in the multi-professional training program and Bio medicals
DURATION: OCTOBER 2024– APRIL 2025.
LECTURER: DR AHMED MAKATA
Purpose of the course: Is to impart the student knowledge, skills and attitude to enable them to explain and manage the medico-legal matters including court procedures, report writing, death certification, scene management, chain in custody procedure and evidence presentation to the court of law . The postmortem findings in cases of deaths of different medico-legal cases will also be explained. Legal toxicology, gender based violence, DNA studies related to forensic and traumatology will be detailed. It also addressees the role of the doctor in court of law as an expert witness presenting forensic evidence and the relevant acts via moot court..
Expected learning outcome: At the end of the sub unit, the students will to be able to know the following: ·
1. Outline the relationship between forensic and other sciences
2. Discuss the format and demonstrate how to write medico-legal reports for the court and forensic examination of both clinical and pathology including death certification in medico-legal cases
3. Apply the rules regulations and ethics governing court procedures and outline the
rights and expected behavior of a doctor giving evidence in court as an expert witness.
4. Explain the principles of toxicology and discuss the management of patients
5. suffering from toxic effects of certain agents
6. Describe the conduct of medico legal autopsy and explain the importance of finding relevant to the case and could give his/her opinion
7. Medical and laboratory practice in forensic medicine
8. Describe the physician’s medico legal obligations in the various situations he / she
involved in during his / her daily duties as a medical practitioner.
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Course content and delivery timeline
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Week
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Topic
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Mode of Delivery
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1
21st – 29th Oct
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· Introduction to forensic medicine and branches, a short history, Describe concepts and principles of forensic medicine
· A short history of forensic medicine Tanzania
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Power point/ lecturing
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2
1st – 5th Nov
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· Introduction Sources of Law in East Africa countries (The Constitution. Legislation (Act of Parliament), Subsidiary Legislation, Common law, the Doctrines of Equity and Statutes of General Application in England, Customary Law, Religious Law, Precedents
· What is Constitution?
· Type of Courts in Tanzania.
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Power point/ lecturing
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3
8th – 12th Nov
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Define blunt force Injuries/sharp injuries, Mechanical, thermal, • electrical, •chemical; • ballistics, •gunshot, •explosives. •Identify common causes of these injuries
•Explain clinical features of these injuries
• Injuries in general
•Refer of these blunt injuries
• Type of asphyxia
· hanging
· immersion deaths
· strangulation
· choking
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Power point/ lecturing
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SEMINAR/TUTORIAL (on injuries, photograph projections, including photos of various injuries, ballistics and introduction to crime scene and evidence collection in injuries and asphyxia/drowning, diatoms,
Autopsy techniques
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SEMINAR GROUPS PRESENTATIONS
PRACTICLES
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4
15th – 19th Nov
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What is death certification?
· Definitions of death and manner
· Stages of early and late decomposition
· The time of death
· Important to document death? Description of Death Notification Form AND its contents, Time interval of the onset to death.
· Definition of Important Terminologies on the Death Notification Form and Practices to fill the form. Causes of death (WHO)
· Immediate cause of death
· Underlying Cause of death is of importance to policy makers (prevention)
· Contributory Causes of Deaths
•Describe types of autopsy
•Describe general forensic investigations
· •Describe embalming and preservation of human remains
· Forensic Anthropology (can often answer many questions):
-Are the remains human?
-Are the remains single individual or mixed remains of several individuals?
-When did the death occur?
-What are the gender, age, and race of the individual?
· The manner of death: Definitions
Accidental,
Suicide,
Homicide,
Infanticide,
Sudden death
Unexpected natural death/undetermined.
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Power point/ lecturing
Mortuary illustrations
Assegments
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5
22nd – 26th Nov
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· Various human crimes; To know the definition and outline of various common human crimes in the society
· What is a crime?-an action or omission which constitutes an offence and is punishable by law.
· What are crimes against of Humanity? crime (murder, torture, enslavement, rape, forced abortion and other sexual violence, persecution on political, religious, racial and gender grounds, the forcible transfer of populations, enforced disappearance of persons and inhumane act knowingly
· Definitions of GBV and VAC
· rape,
· child abuse,
· incest,
· homosexual offences,
· Bestiality.
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Power point/ lecturing
Mortuary illustration
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6
29th – 3rd Dec
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· Collection of evidence; what is forensic evidence? To know how to collect, filling the forms and maintain chain in custody
· List types of forensic evidences
· Identify forensic evidences for common situations
· Identify tools/instruments for evidence collection
· Identify tools/instruments for storage of forensic evidence
· Explain principles for collecting evidences for forensic analysis
· Describe procedures for collecting evidences Basic tools for practical (how to fill the forms)
· Police Form 3 (PF 3)
· Police Form 99 (PF 99)
· Postmortem form
· Chain of custody
· Right and assurance form – as a sampling officer processing
· Definition of crime scene
· Forensic Evidence begins at the crime scene and it involves sample management from proper collection, packaging, storage, transportation and analysis.
· It is also important to maintain the chain of custody in order to:
· Preserve sample integrity
· avoid contamination
· avoid tempering with the sample
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Power point/ lecturing
SEMINARS, PRESENTATIONS AND PRACTICALS
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6th – 10thDec
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CAT I
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Dr. A. Makata
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7
13th – 17th Dec
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SEMINAR/TUTORIAL (practices, demonstrations and filling the forms, packaging and chain in custody of evidence)Practical Activity/Seminar
Quality assurance & documentation
The respective documents have to be properly filled with clear hand writing and language to be simple and understood.
-Understand the information to be collected.
-Formal writing style has to be used.
-The same terminology should be used throughout the document to avoid confusing the reader.
-For this purpose, PF 3 and Postmortem form shall be filled by a Medical Practitioner
•Each evidence which is well packed and properly labeled should state:
-Type of evidence
-Where was it collected
-Who collected
-Date and time it was collected
Activity (Practice)/Seminar then demonstrate on the filling of basic tools for documentation of forensic evidence and/sample
•Police form 3 (PF3)
•Police form 99 (PF99)
•Post-mortem report form
Activity/Seminar: Procedures for Preservation and Transportation of Forensic Evidences Important things to consider in processing Forensic evidences are;
•Have PPEs e.g. clinical coat, masks, goggles, sterile gloves, shoe cover, head cover
•Have sample collection materials e.g. sterile swabs, EDTA bottle, filter papers
•Have packaging materials e.g. brown paper envelops and/or plastic containers
•Storage facilities e.g. shelves/metal cabinets for dry samples, refrigerator/freezer for wet samples
•Transportation materials e.g. large boxes/brown envelops for DRY samples and cold boxes for WET samples
· Have a SEAL for securing a forensic evidence
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SEMINAR AND GROUPS PRESENTATIONS
PRACTICLES
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8
3rd – 7th Jan 2024
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Labeling of the Forensic Sample and/or Evidences Appropriately; This is process of marking the evidence collected either at crime scene or received during crime scene i.e. investigation is inventoried.
• Labeling of forensic evidence is very crucial for identification and easy tracing
• Labeling starts right at the crime scene or during sample collection and packaging
• Marking/labeling of sample and/or evidence include the following information:
· Registration number /file number
· Name of the patient/victim
· Date of birth (age)
· Sex
· Date of collection
· Time of collection
· Description of sample and/or evidence
· Name of location of collection (geographical)
· Name of collecting officer
• Marking should not be direct on the item as it may interfere with forensic analysis
Labeling need to be clear and defined
LABELING → PACKAGING → SEALING
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Power point/ lecturing
Crime scene and collections of specimen
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9
10th – 14th Jan
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· Preservation of Forensic Sample and/or Evidences;
• Personnel involved in managing biological evidence often face challenges because of the:
• Size of the sample/evidence
· Location of the storage facility
· Supplies available for packaging
· Adequacy of tracking systems and resources.
Principles of chain of custody
In order to maintain chain of custody when collecting forensic sample/evidence for forensic analysis the following principles should be strictly adhered to:
· Avoid contamination
· Collect sample/evidence only
· Handle appropriately (ensure well preservation etc)
· Label accurately
· Ensure security (no one to tamper with sample/evidence)
· Maintain continuity (ensure sample reach the required authority/custody)
· Document collection
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Power point/ lecturing
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10
17th – 21st Jan
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Laboratory methods used Special histological status. (mention the tests)
· Cytological staining.
· Bacteriological methods.
· Biochemical examination of body fluids and tissues.
· Blood grouping.
· DNA profiling.
· Semen analysis.
· Pregnancy tests.
· Examination of hair, faecal material, saliva and other specimens.
Tests used to:
· Establish drowning,
· identify metallic deposits in electrical mark,
· Gunshot and explosive injuries.
· DNA techniques and toxicology techniques.
The serology section of a forensic laboratory
Blood typing
· Characterization of unknown stains
· Blood spatter or pattern analysis for crime reconstruction
· Paternity testing
· Semen identification in sexual assault cases
· DNA typing for identification of victims and suspects
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Power point/ lecturing
Laboratory practice
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11
7th – 11th Feb
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CAT II
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Dr. A. Makata
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12
14th – 18th Feb
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Presentation of evidence in court of law and court procedures;
· Define & their role
· Expert witnessing
· Summon
· Public Prosecutor
· Judge/Magistrate
· Law enforcer
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Power point/ lecturing
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16
21st – 25th Feb
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· Evidence Examination in-chief:-
· Cross examination: -
· Re-examination:-
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Power point/ lecturing
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13
28th – 4th Mar
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Present Forensic Evidence
Forensic evidence is any material or object collected from the victim, suspect or crime scene for the purpose of the law (eg stained clothes especially underwear)
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Power point/ lecturing
SEMINARS, PRACTICLES AND PRESENTATIONS
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14
7th – 11th Mar
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Importance of forensic evidence
· Analysis of forensic evidence is used in the investigation and prosecution of civil and criminal proceedings
· Help to establish the guilt or innocence of possible suspects
· Needed to confirm the occurrence of sexual assault and to prove or disprove a link between the alleged perpetrator and the assault
· Forensic examination, specimen collection, analysis and documentation provide the vital link between the health and criminal justice systems
In establishing an identity of the person connected to the crime, it can exonerate the innocent or collaborate the victim testimony
Medico-legal report writing (important input in your report to be mentioned)
What are the components of forensic medical report? Forensic reporting is the presentation of detailed report in forensic medicine resulting from forensic analysis
Forensic report writing guidelines, M.G.L.c.123, s.15 (a)
Role Play (Moot Court)-when there is enough time
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Power point/ lecturing
SEMINARS, PRESENTATIONS AND PRACTICALS
MOOT COURT PRACTICES
REPORT WRITTING
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15
14th – 18th Mar
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END OF SEMESTER EXAM
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Reading list
1.Simpson's Forensic Medicine: by Richard Shepherd, 12th Edition, and Hodder Arnold, USA
2.Text book of Forensic Medicine and Toxicology by V.V. Pillay, 15th Edition, ParasMedical Publishing, Hyderabad.
3. Fundamentals of Forensic Medicine and Toxicology by R. Basu, Publishers-Books and Allied (P) Ltd, Kolkata.
4. Guharaj Forensic Medicine, 2nd Edition by P.V. Guharaj, Edited by M.R.Chandran, Orient Longman, Hyderabad.
5. Ahmed M.(2001). Forensic Medicine, Medical Law and Ethics in East Africa, Section C Pathology of injuries, Pg 217-271
6.http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/clinical+resources/health+notifications/firearm+notifications
7. Pekka S, BenardK(2004).Knight Forensic Pathology ,third edition. Part of Hachette Livre UK
8. A practical guide to Istanbul protocol -for Medical doctors by Stine Amris, MargrietBlaauw,LisDanielsen, Ole Vedel Rasmussen
9. Forensic Pathology by Second Edition by VincetDiMaio&DominickDiMaio
10. Ely SF and Hirsch CS, Asphyxial deaths and petechiae: a review. J ForensSci2000; 45(6):1274-1277
11. www.who.int.guidelines-chap4 ; Assessment and Examination of a Adult Victims of Sexual Assault (18/12/2017)
12. www.who.int.>leg>violence, Guidelines for medico-legal care of victims of sexual violence (18/12/2017)
13. Linda L. Klepinger, (2006), Fundamentals of forensic anthropology, John Wiley & Sons, Inc.
14. Hoboken, New Jersey Saxena S, Sharma P, Gupta N. Experimental studies of forensic odontology to aid in the identification process. J Forensic Dent Sci. 2010;2:69-76.
15. www.sjsu.edu/people/mary.juno/courses/1066/s7/ForensicSerology.pdf Forensic Serology, 21st December 2017
16. Guideline for Gender Based Violence and Violence Against Children Evidence Management-MoHCDGEC, April 2015
Assessment methods
Continuous assessment (40%);
End of Semester (50%) which shall comprise of the following MCQs, short answer types and essay questions.
Practical Report (10%)
Total (100%); the pass mark is 50% of the total mark.
Contact the Lecturer in case of anything.
Dr Ahmed Makata: 0755573601/0713444647